Professor & patients' paper on the solvable biological challenge of ME/CFS: reader-friendly version
Simon McGrath provides a patient-friendly version of a peer-reviewed paper which highlights some of the most promising biomedical research on ME/CFS ...
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Physiopedia publishes an article on metabolism and ME/cfs

Discussion in 'General ME/CFS News' started by Kati, Feb 21, 2017.

  1. Kati

    Kati Patient in training

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    Physiopedia is seemingly a resource for physiotherapists. They have over 55,000 people liking their facebook page and over 33,000 followers on Twitter.

    Today they published the following on their webpage, on Facebook and on Twitter.
    http://www.physiospot.com/2017/02/20/metabolism-and-chronic-fatigue-syndrome/

    Yay!



    You can leave a comment at the bottom of the page
     
    Last edited: Feb 21, 2017
  2. shannah

    shannah Senior Member

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    Good article.

    One bone to pick in this statement which seems misleading.

    "An unfortunate by-product of this is a build up of lactate which is perceived as pain."

    It actually produces pain as any runner will tell you. When it clears, the pain does too. So it's not just a perception of pain which puts a different spin on it.
     
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  3. Daisymay

    Daisymay Senior Member

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    Quite, and physios should know that!
     
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  4. alex3619

    alex3619 Senior Member

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    It is an old myth that lactic acid produces pain. It can, under some unlikely conditions, as can any acid. The acid that is very high in exercise is carbonic acid, which could be causing pain by triggering acid sensors. That is the far more likely cause of pain. The risk with lactic acid is more to do with lactic acidosis, that is with issues arising out of oxygen regulation. This arises because of chronic lactic acid buildup. It is not clear that most of us with ME have that. Some might. Those that do need to be aware of possible lactic acidosis which can be fatal but can also be treated.

    There are also probably cytokine and other changes, as shown by the Lights, which might lead to pain.

    Lactic acid is a good thing in exercise. Along with carbonic acid it contributes to a local pH shift which causes more oxygen dumping to the tissues in the short term. Athletes benefit from lactic acid in their muscles.
     
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  5. alex3619

    alex3619 Senior Member

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    If lactic acid builds up a lot in a small area, then it can be an issue, and I would expect highly localized pain. Researchers have been trying to show this. The research does not appear to have succeeded ... yet.
     
  6. shannah

    shannah Senior Member

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    You know science and I don't question that @alex3619

    My point is that it's not perceived pain. It is actual pain.

    What is involved in causing the pain and where it stems from I don't pretend to know, although I suspect oxygen deprivation is involved. Wish I understood it all better. What I do know is the least amount of muscle provocation, even the act of sitting up, will bring on a sharp increase in burning pain. When I ingest baking soda, it brings a vast amount of relief.
     
  7. Daisymay

    Daisymay Senior Member

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    And in the physio article, if they had been talking about some other illness would they have said "perceived as pain" ?
     
  8. shannah

    shannah Senior Member

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    Exactly!
     
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  9. Helen

    Helen Senior Member

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    .Thanks @Kati for posting this article.

    @Daisymay and @shannah

    "An unfortunate by-product of this is a build up of lactate which is perceived as pain."
    I wouldn´t think this is an odd expression as the author might just have wanted to state how lactid acid is perceived. Without this comment a reader not being among these professionals could have thought of lactic acid being perceived mainly as decreased endurance or muscle fatigue or cramps or not causing any symptom at all.

    I think the author clearly stated her/his position as of ME/CFS being a physical disease earlier in the text:
    " Sufferers of CFS have often had to battle with the stigma of some healthcare professionals believing it a psychological condition more than a physical one and bets managed with CBT ".
     
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  10. Valentijn

    Valentijn Senior Member

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    My blood lactate is often mildly elevated in the evening, despite being fully rested at the time (little or no movement in the prior 3 hours). This seems to be associated with crashes, and/or certain types of headaches, and/or exhaustion.

    I also had a reaction to metformin, a common diabetes drug, which included the symptoms associated with lactic acidosis. It felt a lot like ME, aside from the pain & weakness hitting muscles which I hadn't been using. And the headache rapidly intensified, culminating in feeling like my brain had been dipped in acid.

    If I have MELAS as I suspect, there's a problem with lactic acid accumulating, especially in the spinal cord and brain. This might mean that even moderate amounts of lactic acid produced by the muscles are having an inordinate impact on the CNS.
     
  11. rosie26

    rosie26 Senior Member

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    How do they treat this @alex3619 ?
     
  12. alex3619

    alex3619 Senior Member

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    Divided into two things ... treating the cause, which they cannot do in ME, and treating the lactic acid by restoring the bicarbonate buffer. That is often by sodium bicarbonate.

    I have never heard of a case of lactic acidosis due to ME however. If it happens it might be due to some other cause.
     
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