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XMRV and gender ratio in CFS

Discussion in 'XMRV Testing, Treatment and Transmission' started by Nina, Jan 21, 2010.

  1. Nina

    Nina Senior Member

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    I'm sorry if this has been discussed before, but I can't use the search today so I'll post anyway.

    When I woke up this morning this thought just came to my mind:

    If XMRV was the cause of CFS, how would this fit in with the gender ratio in this disease? (Women:Men about 4:1 or something)

    I remember when Dr. Mikovits was asked for further details on patient selection in her study she said something like "Retroviridae don't discriminate in sex or age".

    Is there a theory that could explain this?

    Nina
  2. spit

    spit Senior Member

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    There are a number of issues here -- if we're talking about XMRV specifically, it's true that it would be unusual to see a vastly different rate of infection between men and women.

    So a major question there is whether diagnoses tend to be gendered. And I think the answer is a very likely yes, honestly. There are a lot of questions in that, things that I don't know the answers to but would think are likely candidates for exploration. Do men wait longer before seeking care than women, on average? Do men report their symptoms differently than women? Do doctors tend to respond to men's complaints differently? What is the effect on diagnosis that CFS is often thought of as a "women's disease" already? I could go on.

    At the same time, bear in mind that XMRV or no XMRV, sex differences in disease are not that uncommon, especially in diseases of the immune system. For whatever reason, women are far, far more likely to develop a whole host of autoimmune diseases, for example. Estrogen is, we're finding, highly involved in immune response, along with many other hormones. So another angle, if you still want to look at it in terms of possible XMRV, is that while the virus doesn't likely care about the sex of its host, the host immune response (and subjective symptoms that go with it) may have some statistical difference based on sex.

    All of this is total conjecture, to be clear -- but in terms of places to start looking for the "why" of those differences, these are a few that come to mind.
  3. spit

    spit Senior Member

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    Just to add a hopefully illustrative anecdote --

    I have a male relative with symptoms similar to mine (though his have developed over time to be more extreme). He was railroaded into a psych diagnosis for a long time by his doctors -- though to be fair, the shrink he wound up with disagreed that his problem was psychological in origin -- but never, to my knowledge, did the words "chronic fatigue" ever pass any of their lips.

    For me, with a similar set of symptoms to his early ones, it was one of the first things my current doctor mentioned. Not as a diagnosis, but his thoughts were already on that track before he ordered me a single blood test.

    That's one anecdote, and certainly it could just be a difference in the particular doctors. But if that sort of thing happens broadly when you're looking at medical approaches differing with men and women, you'd find a gender difference in the diagnoses even if there may not be one in the actual physiology.
  4. usedtobeperkytina

    usedtobeperkytina Senior Member

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    Remember, I have posted this before, but Mikovitz said the way the virus responds to, that is turned on by, androgens, particularly progesterone. This, she said, explains the difference in illness in women and men and also explains why women get sick during hormone transition periods, from late 30s to menopause and teenage years.

    The hypothesis is therefore that the illness from XMRV is more likely in women, but men are carriers, so to speak. Or maybe the virus causes other illnesses in the men, if it does cause illness, such as prostate cancer.

    Add to that the comments about different immune system in women, and XMRV still fits, very logically, to what has been seen clinically.

    As to actual infection of the virus, that is not gender specific. But I guess what happens as a result of the infection is affected by gender, as well as stress (cortisol), and other viruses, possible genetic weakness in the CNS, and vaccines, according to the hypothesis.

    Tina
  5. Hope123

    Hope123 Senior Member

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    Taking another tact, "CFS" may cover a bunch of different diseases not yet known. It's possible that XMRV could infect males/ females more-or-less 50/50 but that there are women who are classified as 'CFS' who have non-XMRV illnesses. This is not just due to the non-existence of good tests or non-performance of the tests that are out there but also health care staff bias as mentioned already.

    Also, keep in mind that a major difference between male and female immune systems is that females are able to modulate their immunity to carry a foreign organism for 9 months (babies). I sometimes wonder if this ability renders the female immune system less stable. (speculation here)
  6. Mark

    Mark Acting CEO

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    This has indeed been discussed before, and you may find me on autism threads repeating myself on the subject of autism, CFS and gender; autism has a 4:1 male-female bias, a huge overlap of symptomology, and an epidemic growth since the mid-80s. Loads of evidence for overlap once you start looking, I just found out the other day that they too are interested in abnormalities in the methylation cycle, there's a very believable and 'neat' picture beginning to emerge...
  7. usedtobeperkytina

    usedtobeperkytina Senior Member

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    So could it be that men have a weakness in their brain, which means if they have XMRV, they are likely to get autism. But women have a weakness in their immune system, which makes them more likely to get CFS?

    I still say the difference is due to the virus being turned on by hormones. This is what Dr. Mikovitz said.

    Tina
  8. Mark

    Mark Acting CEO

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    Yes absolutely, that is the theory. Specifically that women have more of the specific type of brain matter that is attacked by the neurotrophic XMRV, so in simple terms, they can afford to lose lots of it without obvious effect - perhaps just becoming slightly more 'geeky' and considering that a personality thing rather than an effect of illness. Didn't hear a full scientific explanation as to why it might affect women's immune systems more severely - other than hormones which makes the most sense to me - but note that people with autism do also have all the sorts of immune effects that people with ME/CFS do, so it's not yet clear to me whether the immune effects are actually worse in women; one would probably need a detailed bringing together of the autism and ME/CFS evidence in order to start thinking about that. But if immune effects are worse in women with autism than with men with autism, that would fit this part of the theory very well.

    But the idea that ME/CFS and autism are predominantly female and male versions of the same condition remains compelling to me.
  9. Another way to look at it, possibly, would be instead of seeing the same condition in a different 'sex', it's the same author. The author potentially being Monseiur/Madame XMRV.

    The two conditions are different . Having a Cousin with Autism he has none of my symptoms or disabilities at all. And importantly, all the people I have met with CFS in my country
    have only a handful of my symptoms. The people with ME have many of my symptoms, if not all.

    Again we should remember that CFS is a vague term and describes lots of different conditions.
    It would be true to say that Autism and people who complain of cognitive difficulties/sensitivity to light and sound 'share' symptoms.

    Yet people with Autism aren't bed bound/wheel chair bound and unable to stand or sit upright, sneezing with lymph glands like
    sausages, red eyes, and wasted muscles. This types of problems affect both males and females in ME (termed CFS recently).

    It could be plausible that XMRV pushes you down one path to Autism, and one path to ME (termed CFS), and one path to CFS, and FMS, etc etc.....
    That doesn't mean it's the same condition. There is difference in similarity and similarity in difference.
  10. Nina

    Nina Senior Member

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    Thanks for all the theories posted here.

    Personally I don't think that the solution lies in the diagnoses given. Hormone issues sound very plausible, and so do genetic differences of the immune system.

    So we would assume that infection with XMRV would probably be about 50/50 in men/women, but the diseases would be different? Very interesting. I hope we will get more clues soon.

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