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New prospective study finds fatigue associated with two inflammatory markers

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3,263
Association of C-reactive protein and interleukin-6 with new-onset fatigue in the Whitehall II prospective cohort study
Cho, H. J., Kivimäki, M., Bower, J. E., & Irwin, M. R. (2013).
Psychological medicine, 43(08), 1773-1783.

(Click on title for full text link)

Abstract said:
Background
Although basic research on neuroimmune interactions suggests that inflammatory processes may play a role in the development of fatigue, population-based evidence on this association is limited. This study examined whether plasma C-reactive protein (CRP) and interleukin-6 (IL-6), biomarkers of systemic inflammation, predict fatigue onset.

Methods
The Whitehall II study is a large-scale cohort study conducted in 20 civil service departments in London. Plasma CRP and IL-6 were measured in 4847 non-fatigued participants at Phase 3 (1991-1993, ages 39-63 years). Fatigue was assessed using the Vitality Subscale of the 36-item Short Form Health Survey (SF-36) at Phase 3 and Phase 4 (1995-1996).

Results
During a mean follow-up of 3.1 years, 957 new fatigue cases (19.7%) were identified using the pre-established cutoff score 50 or less on the Vitality Subscale. CRP values were dichotomized as low (<1.0 mg/L) or high (≥1.0 mg/L) using the Centers for Disease Control/American Heart Association recommendations. Similarly, IL-6 values were also dichotomized as low (<1.5 pg/mL) or high (≥1.5 pg/mL). After full adjustment for sociodemographic and biobehavioral covariates, the odds ratios for new-onset fatigue were 1.28 (95% confidence interval 1.09-1.49, P=0.003) for high CRP and 1.24 (1.06-1.45, P=0.008) for high IL-6. Similar results were found when CRP and IL-6 were treated as continuous variables.

Conclusions
Plasma CRP and IL-6 were prospectively associated with new-onset fatigue, supporting the hypothesis that low-grade inflammation has a role in the development of fatigue.

This is potentially important work. The absence of biomarkers associated with fatigue severity has been used to argue that it is a largely due to psychological factors. This is true in CFS, and also in other diseases that feature fatigue as a prominent symptom (e.g., MS, lupus). If we can find a biomarker that predicts fatigue at the group level - even if it can't fully predict how much fatigue any particular individual will experience - then that's a huge step forward.
 
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3,263
This suggests that although Plasma CRP and IL-6 can be associated with fatigue, these are neither specific, nor sensitive measures.
Yes, I did see that its only a group-level effect. Still, I think its a step forward, since people have used the absence of biological correlates of fatigue as evidence that it is entirely psychological.
 

halcyon

Senior Member
Messages
2,482
Have these markers ever been assessed in short duration vs long duration patients? Were they covered yet by Lipkin et al?
IL-6 was found low in long term patient's CSF and blood and elevated in short duration patient's blood. Not sure about CRP.
 

roller

wiggle jiggle
Messages
775
they are talking about some "onset".

i didnt see a doctor/go to a blood test, when feeling very bad.
in fact, i canceled appointments like verything else. frequently.

i would go there, when being halfway ok.

what is CPR? is it quite a constant, or can it change daily?

in contrary faik vitamin b12 (or other vitamins) are 'stored' in the body, and can therefore be measured once, to have a valid indication.
 
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15,786
My ESR was consistently elevated in the first few years of illness, and CRP was elevated on the one occasion when it was tested during that period.

I think some things get repeated ("ME patients have low CRP"), based on very little evidence. Then it gets repeated more, and people think it's established fact.
 

Seven7

Seven
Messages
3,444
Location
USA
My fatigue correspond with ANY inflammatory marker I can have high, like high IL10 and IL6 being normal. And I still feel that really bad fatigue.
 
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3,263
Not sure these results have anything specific to say about MECFS. They just support the idea that fatigue as a general symptom may have biological correlates - specifically, those related to inflammation.

So just a point against the purely psychogenic view of fatigue.
 

Effi

Senior Member
Messages
1,496
Location
Europe
Yeah, but who the hell takes those sorts of claims seriously?
When have they ever cared about anyone taking them seriously? :rolleyes:
Valentijn said:
"I'm sorry, but your thoughts are making your tissues swell. Think happy thoughts until the inflammation subsides." o_O
'I've tried this, but it didn't do anything for me.'
'But have you really tried it?' 'Yes I have, it didn't work.'
'I'm sure you didn't put in all the effort you could have' 'Yes I did, it just didn't work.'
'Get out! You just don't want to get better!'
That's how logic works in their world :cautious:
 

A.B.

Senior Member
Messages
3,780
Yeah, but who the hell takes those sorts of claims seriously?

"I'm sorry, but your thoughts are making your tissues swell. Think happy thoughts until the inflammation subsides." o_O

A large part of the game they are playing is keeping things vague. If they attempted to explain in detail how thoughts are supposedly causing inflammation in tissues it would quickly start to look ridiculous.

main-qimg-a3b19e99fad0ee2c1d663d4aa65d8dd1
 
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3,263
Lately in the psychogenic view they say things like: oh but depression has inflammation markers too! (turning things upside down as per usual)
Yea, you're absolutely right, @Effi, that new model of depression we discussed, can't remember the thread. Will see if I can find it.
 

roller

wiggle jiggle
Messages
775
couldnt they just measure the endotoxins and exotoxins in the body?
A large part of the game they are playing is keeping things vague. If they attempted to explain in detail how thoughts are supposedly causing inflammation in tissues it would quickly start to look ridiculous.

main-qimg-a3b19e99fad0ee2c1d663d4aa65d8dd1

they may make some brains scans, red, blue, green ...
this whole brain scan thing is occupational therapy for them idiots, imvho