Rich with the greatest respect - please may I ask why psychological/emotional stress (not for me at the time) is still considered to have a place in the possible origins. Are we not looking at viral/bacterial stressors here, genetic predispositons too. In your experience is there evidence for psychological/emotional distress causing the whole chain of pathologies or is it just speculative ?
Hi, Enid.
I want to emphasize that I am not referring to anything psychiatric in this regard. What I am referring to is the variety of stressors to which the body's nonspecific stress response system responds. This system elevates the secretion of cortisol, epinephrine and norepinephrine, and these hormones produce biochemical and physiological effects. In ME/CFS onset, I have proposed that these stressors are responsible for the depletion of glutathione, which in turn leads to a functional B12 deficiency, which in turn causes a partial block in the methylation cycle and loss of folates from the cells.
The point is that the body's nonspecific stress response system responds to the entire collection of stressors added together. It does not distinguish among physical, chemical, biological, and psychological/emotional stressors, and all of these can contribute to depletion of glutathione.
Is there evidence for the involvement of psychological/emotional stressors in the onset of ME/CFS? Yes, there are several published studies that describe stressors that were present prior to onset in ME/CFS patients. I reviewed this literature in my AACFS poster paper on glutathione depletion in 2004, and it can be found in the General Wiki pages of this forum, or at
http://aboutmecfs.org.violet.arvixe.com/Rsrch/GluAACFS04.aspx
In my own interviews of many PWMEs/PWCs by questionnaire over the past 15 years I have also received a great deal of evidence of the importance of psychological/emotional stressors in many (but not all) cases. Often there is a "perfect storm" type of situation prior to onset, in which several of the various stressors are present simultaneously.
Over the years, I have occasionally been "jumped on" in ME/CFS forums for proposing this as part of the GD-MCB hypothesis, because some people have interpreted what I have written to mean that I think people who develop ME/CFS have mental or psychiatric problems as the cause of their illness. I assure you that this is not the case. It is true that many people who have ME/CFS do become depressed, but this is a secondary effect, not at all surprising to me, given that so much has been taken away from them by this disorder, and it is not always easy to find a basis for hope. The treatment I have suggested is a biochemical treatment, not a psychiatric treatment. It is helping many people, and I believe it is cause for hope for many more.
I would encourage you to view the video and/or PDF slides from the seminar I presented last month in Sweden if you want to get a more detailed understanding of my hypothesis. It can be found at
http://iaomt.media.fnf.nu/2/skovde_2011_me_kroniskt_trotthetssyndrom/$%7Bweburl%7D
Note that a genetic predisposition is also part of the model I have proposed, as are viral and bacterial pathogens.
Best regards,
Rich