For people living with fibromyalgia or ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome), energy can be a complex, elusive resource. It’s not just about feeling tired, it’s about the body’s fundamental ability to recover, repair, and function from day to day.
Many patients describe feeling as though their batteries don’t recharge. Others speak of a daily ration of energy that, once used, leads to hours or days of mental and physical payback. And while research continues into the root causes of both fibromyalgia and ME/CFS, many theories suggest that mitochondrial dysfunction, immune dysregulation, oxidative stress, and impaired methylation may all play a role.
It’s no surprise, then, that some people in these communities are exploring supplements like NMN and TMG. While these aren’t cures, several studies suggest that they may support the energy systems that tend to be under strain in chronic illness.
Let’s explore the conditions more deeply, what we know about mitochondrial support, and how NMN and TMG might fit in.
Understanding the Conditions
Fibromyalgia
Fibromyalgia is a chronic condition marked by widespread pain, fatigue, and cognitive issues often described as “fibro fog.” It affects around 2–4% of the global population and is more common in women. Symptoms vary, but often include:
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Muscle and joint pain without visible inflammation
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Unrefreshing sleep
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Difficulty concentrating or remembering words
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Sensitivity to light, sound, and touch
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Digestive symptoms (often overlapping with IBS)
The exact cause is unknown, but theories include central nervous system sensitisation, stress-related dysregulation, and abnormalities in neurotransmitters and pain processing.
ME/CFS
ME/CFS is often even more debilitating and misunderstood. Defined by post-exertional malaise, a worsening of symptoms after physical or cognitive exertion, ME/CFS affects energy production at a systemic level. Its symptoms include:
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Severe, persistent fatigue that is not improved by rest
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Cognitive impairment (“brain fog”)
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Orthostatic intolerance (symptoms worsen when standing)
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Immune abnormalities
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Sleep disturbances
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Gastrointestinal issues
Unlike general fatigue, ME/CFS is classified as a multisystem disease with metabolic and immune dysfunction. Recent research has pointed toward abnormalities in mitochondrial function and redox balance, but there is no single known biomarker.
Why the Energy Deficit?
Although fibromyalgia and ME/CFS are separate diagnoses, they share one crucial issue: a breakdown in cellular energy availability.
This can happen when:
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Mitochondria (which produce ATP, the cell’s energy currency) are inefficient or damaged
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The body has reduced access to NAD+ (a molecule required for mitochondrial energy production)
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The body is under continuous oxidative stress or inflammation
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Methylation cycles, which govern detoxification, neurotransmitter balance, and energy metabolism, are impaired
These issues aren’t limited to chronic fatigue conditions, they also appear in ageing and stress-related disorders. But in ME/CFS and fibromyalgia, they seem to occur earlier, more intensely, and with longer-lasting effects.
NMN and NAD+: A Role in Cellular Energy
NMN (nicotinamide mononucleotide) is a direct precursor to NAD+ (nicotinamide adenine dinucleotide), a molecule that plays a crucial role in:
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Converting food into energy (via the Krebs cycle and oxidative phosphorylation)
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Repairing DNA
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Regulating circadian rhythm
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Maintaining mitochondrial health
NAD+ levels naturally decline with age, and can also be depleted by chronic stress, inflammation, and illness, all common in people with ME/CFS and fibromyalgia.
What the Research Says
Recent research has begun to connect the dots between NAD+ metabolism and the energy collapse seen in ME/CFS. A comprehensive 2022 review proposed that hyperactivation of the kynurenine pathway, the main route through which tryptophan is broken down, may deplete NAD+ levels, increase neurotoxic compounds like quinolinic acid, and worsen symptoms such as fatigue, inflammation, and cognitive dysfunction. This pathway, triggered by chronic immune activation and gut microbiome imbalance, diverts tryptophan away from serotonin production and toward excessive kynurenine metabolism, limiting the body’s ability to maintain NAD+ balance.
The authors suggest that restoring NAD+ levels through supplementation with precursors like NMN or NR could support energy metabolism and reduce the downstream effects of inflammation and oxidative stress.
Another clinical study on older adults found that afternoon NMN supplementation significantly improved markers of fatigue and physical performance, especially lower limb function and drowsiness, compared to placebo. These findings, while not specific to ME/CFS or fibromyalgia, offer encouraging evidence that NAD+ support via NMN may improve daily energy resilience and physical recovery, two key challenges for people living with chronic fatigue conditions.
TMG: Support for Methylation and Balance
TMG (trimethylglycine) is a compound that donates methyl groups in the body, which are used in processes like:
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Neurotransmitter synthesis
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Detoxification (via the liver)
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Homocysteine regulation
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DNA methylation (gene regulation)
For people with chronic fatigue or fibromyalgia, methylation may be inefficient, due to stress, nutritional gaps, or genetic predisposition (e.g., MTHFR variants). Some people report improvements in mood, clarity, and energy when supporting methylation with cofactors like TMG, B12, and folate.
TMG is also often paired with NMN to balance methyl group usage, since NAD+ production places some demand on the body’s methylation system. Taking both together may support smoother energy support for those sensitive to single-ingredient NAD+ boosters.
A Great Option for Supporting Energy
At Simply Nootropics, we developed Ageless NMN and TMG + B Complex to support energy production and resilience at the cellular level.
While they’re not intended to treat or diagnose chronic conditions, they’re designed with simplicity, science, and purity in mind for people who need a gentler, daily foundation.
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Ageless NMN helps support NAD+ levels for mitochondrial energy and repair
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TMG + B Complex supports methylation, detoxification, and mood balance
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Both are stimulant-free, third-party tested, and formulated to support calm, steady energy over time
If you’re living with a condition that limits your energy, or simply feel like your reserves never quite refill, you’re not alone. And while these supplements won’t be the whole answer, they may be a small, steady step toward building it.
