TPN is Total Parenteral Nutrition; nil by mouth, intravenous feeding. It occurred to me that three people who recovered all had this as part of their treatment. I theorize that the act of eating can trigger an immune response that perpetuates ME/CFS. Take away this reaction and your body can fight off the primary infection and reboot, or something like that. Now bear in mind that LPS entering the bloodstream can produce Shoemaker's CIRS just as easily as mold toxins using the exact same innate immune mechanisms. Cheney said in his most recent talk that mold illness and ME/CFS are indistinguishable. It's too bad he didn't expound because I think the significance of this statement is lost on most. Mold/biotoxin illness can produce: orthostatic intolerance, chemical sensitivities, glutamate/GABA imbalances, PEM, etc, etc... Shoemaker bristles at the term fibromyalgia. He clearly believes this is biotoxin illness. And our 'cardinal' symptom of PEM, this is also present in many cases of mold illness. It usually resolves with sufficient avoidance and treatment. Since mold illness is pretty well understood, shouldn't we suspect the same mechanisms are at play in ME/CFS? Don't we understand through Shoemaker a lot more about our disease than we thought we did? C4a is the only real change in post-exertional testing amongst our population so far. This fits right into Shoemaker's science. How our community is not jumping all over this, I really don't understand.