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(Norwegian) Wyller: Kronisk utmattelsessyndrom/ME – sykdomsmekanismer, diagnostik...

Discussion in 'General ME/CFS Discussion' started by mango, Dec 1, 2015.

  1. mango

    mango Senior Member

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    (Not a recommendation.)

    Tidsskr Nor Legeforen - Publisert først på nett 1. desember 2015
    doi: 10.4045/tidsskr.15.1180

    Continue reading:
    http://tidsskriftet.no/article/3426100
     
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  2. Sidereal

    Sidereal Senior Member

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    From what I can make out using my Google Chrome translation, it's trash. There's a section talking about how ME/CFS is a sustained stress response and some handwaving is invoked to explain away the failure of his own clonidine trial.
     
  3. Sidereal

    Sidereal Senior Member

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    Scary:

     
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  4. Marky90

    Marky90 Science breeds knowledge, opinion breeds ignorance

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    That man is so full of C*** and contradictions. Doesn`t even spell Rituximab right.

    He demands evidence for everything else than his own theory. Bizarre.

    And of course he don`t mention the phase two-trial or the ongoing phase 3-trial. The agenda is sickening.
    When I get well I shall illuminate his nonsense for the public to see.
    For the time being I hope some Norwegian doctors step up for the task.

    Or maybe we could get James Coyne on the case?
     
  5. Marky90

    Marky90 Science breeds knowledge, opinion breeds ignorance

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    It really is. It*s so important that somebody replies to this article. I`ve already contacted a few. Iv`e also sent some e-mails to Wyller with questions, but he don`t answer, as he don`t have any answers..
     
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  6. Gijs

    Gijs Senior Member

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    He has disapproved his own theory
    http://www.consultant360.com/story/clonidine-doesnt-help-adolescents-chronic-fatigue

    That said i agree with Wyller that an abnormal stressrespons is a key problem in ME/CFS but not due to psychologial stress. There is something very wrong with our ANS/HPA or it is a compensation respons. Very dangerous to put this system down if you don't know the cause. Dr. Bansal has found glucocorticoïd resistance which could explain this problem very well!
     
    Last edited: Dec 1, 2015
  7. Cheshire

    Cheshire Senior Member

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    He tried twice to put his theory into practise, using clonidine with adolescents. He failed twice.




    http://archpedi.jamanetwork.com/article.aspx?articleid=1827799

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566847/pdf/12887_2015_Article_428.pdf
     
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  8. BurnA

    BurnA Senior Member

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    Is it abnormal to have a stress response to these articles ?
     
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  9. Marky90

    Marky90 Science breeds knowledge, opinion breeds ignorance

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    Hah! Maybe he will stop publishing articles if we convince him that he is contributing to our sustained stressresponse..
     
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  10. Snow Leopard

    Snow Leopard Hibernating

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    Glucocorticoid resistance has not been found in most ME/CFS patients, in fact there are suggestions of increased GC receptor affinity or expression, based on the evidence so far, though most studies had results more on the normal side.

    Most of the claims of 'stress' problems in ME/CFS are not credible based on the evidence.
     
    Last edited: Dec 2, 2015
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  11. A.B.

    A.B. Senior Member

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    Anecdotally, I reacted strongly to an ACTH stimulation test, suggesting sensitive receptors.

    A trend towards lower than average cortisol levels is also consistent with increased receptor sensitivity (less cortisol needed to acheive the same effect).

    Again anecdotally, in every day life it also seems to be that there is tendency to react strongly to stressful events, but there is no sustained stress response. Relapses produce symptoms that can't be explained by a stress response alone.

    In my case catecholamines in urine, in particular norepinephrine, were very low. I believe this contradicts Wyller's theory. Side note: does anyone know what very low norepinephrine in urine actually means?

    I think the body might be doing this on purpose to get us to avoid the stressors that can trigger relapses.
     
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  12. Snow Leopard

    Snow Leopard Hibernating

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    This may seem strange, but on a psychological level, many patients (non severe) actually have lower day to day stresses compared to someone working full time and this may explain the subtle shifts you have observed.
     
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  13. A.B.

    A.B. Senior Member

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    Or maybe it's really this simple. My life is very boring and uneventful for the most part.
     
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  14. biophile

    biophile Places I'd rather be.

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    There's plenty of room on the BPS Titanic for those who refuse to see the icebergs. There's no convincing safety data for severely affected patients, and the safety is disputable even for the moderately affected. There's also evidence from trials that CBT does not increase activity levels, so the idea that patients can safely increase activity levels is unsupported by evidence.
     
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  15. Gijs

    Gijs Senior Member

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    I believe that many patients have a wrong idea about stress. Wyller thinks psychological factors maintains a chronic stress response. This idea is outdated and objectively wrong. Nevertheless, in ME there is a sustained abnormal sympathetic activity, especially after physical and mental exertion This is a very important objective and measurable phenomenon with huge consequences. PEM is the distinguishing symptom of ME.
     
  16. Valentijn

    Valentijn WE ARE KINA

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    I tested low for norepinephrine in urine as well, and later tests in blood were even lower. And NRI (Strattera) and then Yohimbe have both helped with my OI problems, probably by boosting norepinephrine levels and/or making existing amounts more effective.
     
  17. mango

    mango Senior Member

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    i was just reading through some comments in the facebook group "Norges ME-forening - voksne" and it seems ME-foreningen (the norwegian ME association) and possibly their scientific council are on the case. i guess we'll just have to wait and see...
     
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  18. alex3619

    alex3619 Senior Member

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    The finding by Bansal is in fact an increase of a glucocorticoid receptor, if I recall correctly the beta receptor. This receptor inhibits the glucocorticoid response because it is an inactive receptor, presumably evolved as a control mechanism to prevent excessive glucocorticoid responses. However this research needs much more work and a decent article published. Until that happens we cannot be sure of its importance, or indeed if it can be replicated.
     
  19. Snow Leopard

    Snow Leopard Hibernating

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    That still contradicts some of the current evidence, which suggested either normal or slightly increased (not decreased) GR response to agonists.
     
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  20. mango

    mango Senior Member

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    I'm cross posting this here and in the thread for the English version of the same article.

    A comment by Saugstad has been published now :thumbsup:

    (See below for the Google translated version)

    Here's the Google Translate version:
    http://tidsskriftet.no/article/3431709#comments
     
    Last edited: Dec 22, 2015

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