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CGA (mainly 5- and 3-CQA) also affects glucose absorption through the reduction of α-amylase and α-glucosidase activities and α-amylase activity is also decreased in the presence of caffeine, resulting in reduced uptake of glucose (51) and suggesting a positive role in glycaemic control (52) (Figure 3), Further, CGA from coffee sources (coffee silverskin included) was able to significantly attenuate the postprandial release of glucose-dependent insulinotropic polypeptide (GIP), a gut hormone that potentiates insulin secretion, in the proximal part of the small intestine (53)

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Autonomic changes in ME/CFS are likely to cause an overall effect of vasoconstriction and resultant hypoperfusion (58), which is central to the pathology of ME/CFS (183) ( Figure 8 )