And the Cycle Continues
At some point in the middle to late twentieth century (possibly 1982) it was discovered that vitamin B12 injections could treat ME but it was not curative. Many doctors know that and use it clinically, but it is only recently that serious research has been conducted on this, a story we know well on Phoenix Rising. Vitamin B12 is only one of a range of nutrients that have been implicated in ME and CFS. It is interesting that most seem to tie into either antioxidant mechanisms or antioxidant support mechanisms.
Lerner has shown that CFS and ME patients with high viral load can be successfully treated with antivirals, though the treatment required is still considered experimental. Yet the success is an order of magnitude better than anything achieved by CBT or GET. The science behind this proceeds slowly and may one day give us definitive treatments, but its being ignored in some parts of the world by some who prefer a psychogenic explanation. History is repeating itself.
Research by Peckerman, Pacific Labs and Alan and Kathleen Light have shown that there are physiological abnormalities that make inappropriate exercise therapy somewhere between problematic and dangerous. Yet graded exercise is still a favourite therapy amongst some psychiatrists.
Current biomedical research is also focussed heavily on several types of immune dysfunction. While much of this is focussed on the innate immune system including Natural Killer cells, some of it is also looking at the adaptive immune system including B and T cells. I have hopes that major breakthroughs will be made soon. In particular the drug Rituximab is showing great promise though phase 3 trials have yet to be completed.
One thing that seems to be totally ignored by those promoting the Dysfunctional Belief model is that serum levels of lipopolysaccharide in CFS appear to correlate with illness severity. My guess is they are hoping that findings like this will just go away.
Karl Popper and others have called psychoanalysis non-science and pseudoscience for good reasons, although there is no universal agreement on those reasons. The modern variants are simply Freudian thinking with cognitive and behavioural issues emphasized instead of emotional ones, I point I hope to return to in a later blog.
Just in case there is any doubt, I am well aware that Popper's claims have been disputed, as have those of Kuhn. Kuhn himself refutes Popper's claim about pseudoscience and psychoanalysis, but notes they both came to the same conclusion. Detailed discussions of this I will leave for my book unless there is a lot of interest.
The idea that CFS is due to a Dysfunctional Belief System is far beyond the evidence supporting it, and in direct contradiction with the bulk of the biomedical evidence. When will the bulk of the medical profession recognize this? At some point I will be writing a series of blogs on this issue.
The book Skewed by Martin J Walker presents a similar view, but with application to so-called functional syndromes including MCS, GWS, CFS and ME. I may review this book soon, in a blog called Greenwashing.
Christie D. A., Tansey E. M. (eds) Peptic Ulcer: Rise and Fall, Wellcome
Witnesses to Twentieth Century Medicine, vol. 14. London: Wellcome Trust Centre
for the History of Medicine at UCL, 2002.
Fluge, Ø. & Mella, O., Clinical impact of B-cell depletion with the anti-CD20 antibody Rituximab in chronic fatigue syndrome: a preliminary case series.
Lerner, A., et. al., Subset-directed antiviral treatment of 142 herpesvirus patients with chronic fatigue syndrome, Virus Adaptation and Treatment, 24 May 2010
Light, A.R., et. al., Moderate Exercise Increases Expression for Sensory, Adrenergic, and Immune Genes in Chronic Fatigue Syndrome Patients But Not in Normal Subjects, The Journal of Pain, Volume 10, Issue 10 , Pages 1099-1112, October 2009
Pacific Fatigue Lab, Hope for the Weary.
Maes M., Mihaylova I., Leunis J.C., Increased serum IgA and IgM against LPS of
enterobacteria in chronic fatigue syndrome (CFS): indication for the involvement of gram-negative enterobacteria in the etiology of CFS and for the presence of an increased gut-intestinal permeability. J Affect Disord. 2007 Apr;99(1-3):237-40
http://www.ediver.be/ediver/latest news/Leaky Gut, CFS, Maes M.pdf
Maes, M. & Leunis, J.C., Normalization of leaky gut in chronic fatigue syndrome (CFS) is accompanied by a clinical improvement: effects of age, duration of illness and the translocation of LPS from gram-negative bacteria., Neuro Endocrinol Lett. 2008 Dec;29(6):902-10.
http://ediver.be/ediver/latest news/Leaky gut in CFS, treatment of leaky gut.pdf
Overton, S., Charcot's Bad Idea, www.simonoverton.co.uk, 2009
Peckerman, A., et. al., Abnormal Impedance Cardiography Predicts Symptom Severity in Chronic Fatigue Syndrome, Am J Med Sci 2003; 326(2): 55-60.
Walker, M.J., Skewed, Slingshot Publications, 2003.
Webster, R., Why Freud Was Wrong, Harper-Collins, 1995
White, P., Biopsychosocial Medicine, Oxford University Press, 2005
Other web links:
Here we go round the Merry-go-round. Part Two
Blog entry posted by alex3619, Aug 12, 2012.
About the Author
I am a long term ME patient with many complications. While I have pushed research advocacy since 1993, I become political around 2009. My current project is a book called "Embracing Uncertainty". Uncertainty in medical science seems anathema to too many doctors. "I do not know" is something more doctors should be honest about.