Metabolic Biomarkers for ME/CFS: A New Test?

Robert Naviaux et al. have published new evidence of metabolite abnormalities somewhat specific to ME/CFS, indicating that we may soon have a - to date, lacking, and much needed - diagnostic biomarker for the disease vs. the laborious existing objective diagnostic: VO2 max repeat exercise tests

Consistent with my own integrative pathophysiological research/guidance, their data suggest that the condition centres on a common (maladaptive) systemic response to trauma (of varying kinds), rather than differential presentation of an illness stemming from a particular stressor

The aberration profile itself is said to resemble hibernation activity, arguably tantamount to organismic survival behaviour i.e. autonomic responses to systemic physiological threats such as malnutrition, dehydration, and hypoxia. Again, this conception is consistent with my review of the contemporary literature

Related article: The Economist

ME/CFS and The Location Effect

ME/CFS is a neurological disorder that appears to have become increasingly prevalent in the West over recent generations and is associated with idiopathic neural sensitivity. Increasingly, patients report sensitivities to atmospheric pollutants vs. an improvement in their health when they move to certain (relatively remote, and damp/fungi free) coastal, arid, or high altitude locations: ‘The Location Effect'. Perrin Technique also suggests that ME/CFS often involves a degree of lymphatic drainage dysfunction, which has ramifications for effective toxin clearance from the body - a problem that can be addressed by way of manual lymphatic drainage

Such improvements likely do relate to mitigating exposure of sensitive areas of the central nervous system (CNS) to e.g. (possibly interacting) fungal biological/anthropogenic chemical neuroimmune stimulative (myco)toxins

New name/diagnostic for ME/CFS: SEID

New criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) were outlined earlier this year, when The Institute of Medicine (IOM) - an independent US health think tank - presented a comprehensive report on the condition, also recommending that it be renamed: Systemic Exertion Intolerance Disease (SEID)

Under the proposed criteria, at least 4 of the following 5 core symptoms (edited for brevity) must apply in order for one to receive a positive diagnosis:

◦ Fatigue + reduction in activity *
Post exertional malaise (PEM)**
Unrefreshing sleep

Cognitive impairment OR
Orthostatic intolerance (OI) ***

* Substantial and persisting for over 6 months, not the result of ongoing excessive exertion, and not substantially alleviated by rest
** A worsening of some symptoms e.g. typically including pain/fatigue, in the 12-48+ hours following exertion
*** Irregularities in blood pressure/heart rate regulation, associated with being upright and stationary, and in the context of low blood volume

This is an interesting, long overdue development in a sensitive/somewhat controversial area (diagnosis/nomenclature) relating to a sensitive/somewhat controversial topic (an ‘invisible illness' about which there has historically been much ‘confusion' in the media/medical profession)

The focus on the objectively demonstrated physiological dysfunction (PEM) that is essentially unique to this condition is welcome, insofar as it helps to underline the fact that it is a very real, and disruptive, disease, and to differentiate it from chronic fatigue more broadly, as well as other illnesses (e.g. depressive/sleep disorders), which may bear similarities to ME/CFS but ought not to be confused with it

Contrarily, it is perhaps unhelpful insofar as it does not explicitly incorporate the core pathology of the disease which is, fairly irrefutably, inflammation of the central nervous system

Link: ME Association Article