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Mitochondrial myopathy presenting as fibromyalgia: a case report (sounds like ME/CFS)

Dolphin

Senior Member
Messages
17,567
Free full text: http://www.jmedicalcasereports.com/content/pdf/1752-1947-6-55.pdf

Case report

Mitochondrial myopathy presenting as fibromyalgia: a case report

Mishal Abdullah, Sahana Vishwanath, Amro Elbalkhi and Julian L. Ambrus

Journal of Medical Case Reports 2012, 6:55 doi:10.1186/1752-1947-6-55

Published: 10 February 2012

Abstract (provisional)*

Introduction

To the best of our knowledge, we describe for the first time the case of a woman who met the diagnostic criteria for fibromyalgia, did not respond to therapy for that disorder, and was subsequently diagnosed by biochemical and genetic studies with a mitochondrial myopathy.

Treatment of the mitochondrial myopathy resulted in resolution of symptoms.

This case demonstrates that mitochondrial myopathy may present in an adult with a symptom complex consistent with fibromyalgia.

Case presentation

Our patient was a 41-year-old Caucasian woman with symptoms of fatigue, exercise intolerance, headache, and multiple trigger points.

Treatment for fibromyalgia with a wide spectrum of medications including non-steroidal anti-inflammatory drugs, antidepressants, gabapentin and pregabalin had no impact on her symptoms.

A six-minute walk study demonstrated an elevated lactic acid level (5mmol/L; normal <2mmol/L).

Biochemical and genetic studies from a muscle biopsy revealed a mitochondrial myopathy.

Our patient was started on a compound of coenzyme Q10 (ubiquinone) 200mg, creatine 1000mg, carnitine 200mg and folic acid 1mg to be taken four times a day.

She gradually showed significant improvement in her symptoms over a course of several months.

Conclusions

This case demonstrates that adults diagnosed with fibromyalgia may have their symptom complex related to an adult onset mitochondrial myopathy.

This is an important finding since treatment of mitochondrial myopathy resulted in resolution of symptoms.

*I've given each sentence its own paragraph
 

Dolphin

Senior Member
Messages
17,567
The patient had more symptoms than those given in the abstract

The patient had more symptoms than those given in the abstract.

Abstract:

Our patient was a 41-year-old Caucasian woman with symptoms of fatigue, exercise intolerance, headache, and multiple trigger points.

Case presentation

Our patient was a 41-year-old Caucasian woman who presented to our Rheumatology
clinic for evaluation of progressive exercise intolerance, fatigue, diffuse myalgias,
arthralgias and difficulty sleeping. The pain primarily involved her entire back and arms,
and she reported multiple tender points all over her body. On the basis of her
symptoms, our patient had also been diagnosed with fibromyalgia, and was treated with
multiple different medications without any relief.

Her other medical history included hypothyroidism, cervical disc disease, hypertension
and Raynauds disease. Notable family history included breast carcinoma and
hypertension in her mother, and lymphoma in her father. Her medications at
presentation included lisinopril 5mg daily and levothyroxine 25?g daily. Other pertinent
medications she had previously used included pregabalin, amitriptyline and gabapentin.
Her physical examination results were normal except for mild tenderness to palpation
along her upper and lower back, and shoulders.

Patients perspective

I am pleased to contribute to this article as to help others with a similar problem. I am
truly grateful to Dr Julian Ambrus Jr and to those who referred me to his expert care.
I am a 44-year-old woman with mitochondrial myopathy confirmed by blood tests and
muscle biopsy. This disease grew worse as I aged and was exacerbated by pregnancy
and other stressors. Certain medications really made me feel ill (which I now know to be
mitochondrial killers). My main symptoms included muscle and joint pain, weakness,
fatigue, muscle twitching, pain, headaches, and visual disturbances.

I have been to several doctors and have had several tests to rule out certain diseases.
This process was slow and frustrating knowing I was sick and not having a clear
answer. I was diagnosed with fibromyalgia, but there were other symptoms as well. My
feet, hands and legs were weak to where I fell several times down stairs and in my
home. I was too weak to hold dishes and to wash them. Simple daily chores proved
difficult, and at times I could not get out of bed or a chair without help. The fibromyalgia
medicines did not help. As my symptoms waxed and waned, time and rest helped a bit.
I was concerned that in time I would get progressively worse.

I think she could have been given a diagnosis of ME, ME/CFS, or CFS along with, or instead of, Fibromyalgia by another doctor.
 

Dolphin

Senior Member
Messages
17,567
Anyone know the normal range for CK on tests in your country?

This person had:
"Significant laboratory results included creatine kinase (CK)=325U/L (normal range 0 to 150U/L)"
But Wikipedia gives a range of 60 to 400.

Would a value that was slightly high always be followed up?

I know I have benefited from L-Carnitine (3000mg/day) (from seeing the effect from stopping it).
I've never tried Creatine. I've taken CoQ10 but never at the level even close to 800mg/day.

Not sure I've ever heard of anyone having the mitochondrial tests mentioned.

----

Units seem to be universal for CK i.e.
http://en.wikipedia.org/wiki/Creatine_kinase

Normal values are usually between 60 and 400 IU/L,[6] where one unit is enzyme activity, more specifically the amount of enzyme that will catalyze 1 ?mol of substrate per minute under specified conditions (temperature, pH, substrate concentrations and activators.[7] This test is not specific for the type of CK that is elevated.

http://www.mdausa.org/publications/quest/q71ss-cktest.html

To measure CK levels, a blood sample is taken and separated into fractions that contain cells and a fraction that doesn't - the serum. The amount of CK in the serum is reported in units (U) of enzyme activity per liter (L) of serum. In a healthy adult, the serum CK level varies with a number of factors (gender, race and activity), but normal range is 22 to 198 U/L (units per liter).

------
I wonder if you were pacing yourself with ME, or being relatively inactive, would that leave one's CK level lower than it might otherwise be (and hence an abnormal result wouldn't show up)?
 

Dolphin

Senior Member
Messages
17,567
Somebody from the US has asked me (elsewhere):
.have often wondered if I have this, am being treated for FM/CFS...
no progress....am seeing 2 different neurolotists, have been to rhumatolotists...
what kind of dr. could check this in me???? and how might I go about getting referred???
If anyone has suggestions that I could send as a reply, feel free to PM me.
 

Dolphin

Senior Member
Messages
17,567
Can a metabolic myopathy = Mitochondrial myopathy (or vice versa)?

This study found a higher rate of lactate following exercise in a group of PVFS patients who had enterovirus RNA. Could they be like the patient in this study?

Free full text: http://jnnp.bmj.com/content/74/10/1382.full.pdf+html

Enterovirus related metabolic myopathy: a postviral fatigue syndrome.

J Neurol Neurosurg Psychiatry. 2003 Oct;74(10):1382-6.

Lane RJ, Soteriou BA, Zhang H, Archard LC.

Source
Division of Clinical Neurosciences and Psychological Medicine, Imperial College, London SW7, UK. r.lane@imperial.ac.uk

Abstract

OBJECTIVE:
To detect and characterise enterovirus RNA in skeletal muscle from patients with chronic fatigue syndrome (CFS) and to compare efficiency of muscle energy metabolism in enterovirus positive and negative CFS patients.

METHODS:
Quadriceps muscle biopsy samples from 48 patients with CFS were processed to detect enterovirus RNA by two stage, reverse transcription, nested polymerase chain reaction (RT-NPCR), using enterovirus group specific primer sets. Direct nucleotide sequencing of PCR products was used to characterise the enterovirus. Controls were 29 subjects with normal muscles. On the day of biopsy, each CFS patient undertook a subanaerobic threshold exercise test (SATET). Venous plasma lactate was measured immediately before and after exercise, and 30 minutes after testing. An abnormal lactate response to exercise (SATET+) was defined as an exercise test in which plasma lactate exceeded the upper 99% confidence limits for normal sedentary controls at two or more time points.

RESULTS:
Muscle biopsy samples from 20.8% of the CFS patients were positive for enterovirus sequences by RT-NPCR, while all the 29 control samples were negative; 58.3% of the CFS patients had a SATET+ response. Nine of the 10 enterovirus positive cases were among the 28 SATET+ patients (32.1%), compared with only one (5%) of the 20 SATET- patients. PCR products were most closely related to coxsackie B virus.

CONCLUSIONS:
There is an association between abnormal lactate response to exercise, reflecting impaired muscle energy metabolism, and the presence of enterovirus sequences in muscle in a proportion of CFS patients.
 

Valentijn

Senior Member
Messages
15,786
I think she could have been given a diagnosis of ME, ME/CFS, or CFS along with, or instead of, Fibromyalgia by another doctor.

Agreed ... I didn't think exercise intolerance was an aspect of FM, and that light exercise is usually recommended for them to help with pain. Maybe she and/or the doc went with the FM diagnosis because the US definition of CFS is so bad and ME doesn't really exist there. Might have been an insurance or disability related decision as well.
 

SOC

Senior Member
Messages
7,849
Agreed ... I didn't think exercise intolerance was an aspect of FM, and that light exercise is usually recommended for them to help with pain. Maybe she and/or the doc went with the FM diagnosis because the US definition of CFS is so bad and ME doesn't really exist there. Might have been an insurance or disability related decision as well.

I have to agree on this. My PCP really wanted to diagnose me with FM rather than CFS but I don't have the tenderpoints, so he wrote "FM, CFS, or other connective tissue disease that has not shown up". He told me it was CFS, though.

Plenty of US doctors "don't believe in CFS" and won't give the diagnosis, so FM is used as an "acceptable" substitute, especially if pain is a big issue.
 

Mark

Senior Member
Messages
5,238
Location
Sofa, UK
Very interesting: the successful treatment:

"a compound of coenzyme Q10 (ubiquinone) 200mg, creatine 1000mg, carnitine 200mg and folic acid 1mg to be taken four times a day."

...looks to me like a pretty standard cocktail in many physicians' approach to treating ME/CFS, and all of these were present in what I was prescribed by Dr Myhill's colleague (together with B12 and various vitamin supplements); that treatment got me back on my feet as well...
 

Firestormm

Senior Member
Messages
5,055
Location
Cornwall England
Interesting...Thanks to WD :cool:

Journal of Medical Case Reports

Mitochondrial myopathy presenting as fibromyalgia: a case report

Mishal Abdullah, Sahana Vishwanath, Amro Elbalkhi and Julian L Ambrus

Full paper open access: http://www.jmedicalcasereports.com/content/6/1/55

Received: 21 October 2011 Accepted: 10 February 2012 Published: 10 February 2012



Abstract

Introduction


To the best of our knowledge, we describe for the first time the case of a woman who met the diagnostic criteria for fibromyalgia, did not respond to therapy for that disorder, and was subsequently diagnosed by biochemical and genetic studies with a mitochondrial myopathy.

Treatment of the mitochondrial myopathy resulted in resolution of symptoms. This case demonstrates that mitochondrial myopathy may present in an adult with a symptom complex consistent with fibromyalgia.

Case presentation

Our patient was a 41-year-old Caucasian woman with symptoms of fatigue, exercise intolerance, headache, and multiple trigger points.

Treatment for fibromyalgia with a wide spectrum of medications including non-steroidal anti-inflammatory drugs, antidepressants, gabapentin and pregabalin had no impact on her symptoms.

A six-minute walk study demonstrated an elevated lactic acid level (5 mmol/L; normal < 2 mmol/L). Biochemical and genetic studies from a muscle biopsy revealed a mitochondrial myopathy.

Our patient was started on a compound of coenzyme Q10 (ubiquinone) 200 mg, creatine 1000 mg, carnitine 200 mg and folic acid 1 mg to be taken four times a day. She gradually showed significant improvement in her symptoms over a course of several months.

Conclusions

This case demonstrates that adults diagnosed with fibromyalgia may have their symptom complex related to an adult onset mitochondrial myopathy.

This is an important finding since treatment of mitochondrial myopathy resulted in resolution of symptoms.

[Have skipped a bit]

Discussion


Mitochondrial myopathies are disorders characterized by morphological abnormalities of muscle mitochondria. Accumulating evidence suggests that mitochondrial disorders are among the most common inherited metabolic diseases [10]. Similar to fibromyalgia, patients may present with muscle weakness, pain, fatigue and exercise intolerance that progressively worsens over time.

Several steps are involved in Adenosine-5'-triphosphate (ATP) generation in the mitochondria, and defects in any part of the cycle may impair energy production leading to symptoms [11]. These abnormalities in generation and utilization of ATP can be assessed by specific tests, which as in our patient pointed towards problems in energy metabolism [12].

Genetic testing with sequencing of the mitochondrial genome and chromosomal genes affecting mitochondrial function may also be pursued, as was performed in our patient. Mutations in POLG1 and several mitochondrial genome polymorphisms were noted.

Subsequently, our patient was started on a regimen of coenzyme Q10 (Co-Q10; ubiquinone), creatine, carnitine, folic acid and ?-lipoic acid. Co-Q10 transports electrons between complex I and complex III of the mitochondrial respiratory chain and has been shown to improve mitochondrial function in several studies [13].

Creatine generates additional ATP through the creatine phosphate shuttle. Carnitine enhances transport of fatty acids into the mitochondria. Folic acid is a cofactor for several mitochondrial enzymes, while ?-lipoic acid is a strong antioxidant [14].

Although this treatment regimen was started several years after symptom onset, within the first few months our patient showed tremendous improvement. With continued therapy, her complaints dissipated over several months, with a gradual but sustained resolution of all symptoms.

Conclusions

This case postulates the possible role of mitochondrial disease in the pathogenesis of the symptom complex known as fibromyalgia, whereby not only is the underlying defect identified at the molecular and genomic level, but with appropriate therapy, significant symptomatic improvement is also noted.

Underlying mitochondrial disease may not be the only explanation for such a symptom complex, but the exact role of mitochondrial myopathy in the development of fibromyalgia needs to be studied further for a better understanding of the disease, and to ensure adequate and effective patient care.

All patients with fibromyalgia should be evaluated for sleep disorders, endocrine disorders such as hypothyroidism and metabolic disorders before a diagnosis of primary fibromyalgia is given. The relative frequency of these medical problems in patients currently diagnosed with fibromyalgia is unclear, but would be worthy of future study.

Patient's perspective

I am pleased to contribute to this article as to help others with a similar problem. I am truly grateful to Dr Julian Ambrus Jr and to those who referred me to his expert care.

I am a 44-year-old woman with mitochondrial myopathy confirmed by blood tests and muscle biopsy. This disease grew worse as I aged and was exacerbated by pregnancy and other stressors. Certain medications really made me feel ill (which I now know to be mitochondrial killers). My main symptoms included muscle and joint pain, weakness, fatigue, muscle twitching, pain, headaches, and visual disturbances.

I have been to several doctors and have had several tests to rule out certain diseases. This process was slow and frustrating knowing I was sick and not having a clear answer. I was diagnosed with fibromyalgia, but there were other symptoms as well.

My feet, hands and legs were weak to where I fell several times down stairs and in my home. I was too weak to hold dishes and to wash them. Simple daily chores proved difficult, and at times I could not get out of bed or a chair without help. The fibromyalgia medicines did not help.

As my symptoms waxed and waned, time and rest helped a bit. I was concerned that in time I would get progressively worse.

Today however, I am happy to say that I am feeling much better and able to enjoy normal activities again and more. I take the prescribed treatments for mitochondrial myopathy and can tell you they do work and they have been every bit worth the price.
 

Enid

Senior Member
Messages
3,309
Location
UK
Thanks for this - Firestormm - I never thought of fibromyalgia in isolation as a diagnosis very helpful (too many other problems).
 

Firestormm

Senior Member
Messages
5,055
Location
Cornwall England
Apparently this had come up before on MEA FB. Sorry I didn't realise/wasn't part of that discussion. Doesn't prevent my being interested in this though.

20 February 2012 Dr Shepherd commented:

'The references in this case study suggest that the doctors involved are not aware of the fact that abnormalities in muscle energy metabolism and mitochondrial function have been demonstrated in ME/CFS.

This includes the early and excessive intracellular acidosis on exercise study I did with Professor George Radda at Oxford that first demonstrated an abnormality in skeletal muscle and the follow up work (MEA funded) done by Professor Julia Newton et al in Newcastle. And it may well be that the patient being described here has an ME/CFS- like illness with mitochondrial dysfunction.

The various muscle energy supplements that are referred to - carnitine, creatine, Co-enzyme Q10 - are all very speculative forms of treatment for mitochondrial myopathies. In the case of ME/CFS there is no sound evidence to show that they are of benefit. That is my personal and professional experience as well. And it is interesting to note that there is no information on what happened to various indicators of muscle structure and function following treatment.

The MEA has an information sheet that covers the pros and cons of all these muscle energy supplements, as well as doses that appear to be safe.

The MEA Ramsay Research Fund is co-funding Professor Anne McArdle at Liverpool University, who is a leading authority on mitochondrial disease, to carry out further work into the connection between ME/CFS and mitochondrial dysfunction.'
 

Glynis Steele

Senior Member
Messages
404
Location
Newcastle upon Tyne UK
Here is an old case study entitled "Mitochondrial encephalomyopathy with lactic acidosis and strokelike episodes ( MELAS): a mitochondrial disorder presents as fibromyalgia". As some of you may know, I look for all things d-lactic acid. In this case I searched for ME/CFS/Fibromyalgia and Lactic acidosis. If lactic acid levels are high in urine samples, this might suggest high d-lactic levels, and a further test for this should be carried out. In this case they looked at the blood, routine bloods would not show up a d-lactic acid level, as it is not part of a routine test.

http://www.solacenutrition.ca/pdfs/...-Encephalomyopathy-Lactic-Acidosis-Stroke.pdf

D-lactic acid as a bio-marker is being investigated in CFS patients, see below.

http://sacfs.asn.au/download/Lactic acid study 2008 - Ethics Application.pdf

I do have concerns about this study though, as they are using morning urine samples, and I have a paper in which it states that late afternoon/early evening samples are best at detecting d-lactate, and norming tests can actually test negative. I just hope it will still show up in bloods.
 

mellster

Marco
Messages
805
Location
San Francisco
Exercise intolerance does appear in FM as well, it's usually not as pronounced as in CFS/ME but no exercise makes FM (esp. the stiffness) worse as well - so FM patients are advised to exercise frequently but gently with specific exercises being superior to others.
How'd she get diagnosed with FM and not ME/CFS with exercise intolerance as a symptom?
 

Tom Kindlon

Senior Member
Messages
1,734
I tried highlighting a possible relevance to ME or CFS, but the journal hasn't posted my e-comment/letter unfortunately:


Findings may be relevant for some patients diagnosed with myalgic encephalomyelitis or chronic fatigue syndrome

Tom Kindlon (23 Feb 2012) Irish ME/CFS Association email

I would like to thank the authors for taking the time to write up this case report, as well as thanking the patient for giving permission for the use of her story.

I thought it was worth pointing out that the symptoms described by the authors and the patient would be quite similar to the symptoms patients with myalgic encephalomyelitis (ME) or chronic fatigue syndrome (CFS) would report (1-7). I don't believe patients with an ME or CFS diagnosis are often assessed for a mitochondrial myopathy using the tests mentioned although a novel test did find evidence for mitochondrial dysfunction (8). At least two studies have found carnitine supplementation to be of benefit in patients diagnosed with CFS (9,10).

Excessive acidosis on exercise has been found in patients (11,12). One study, looking for an association with enterovirus infection, found that 58% of CFS patients had an abnormal lactate response to subanaerobic threshold exercise test (13).

CFS is increasingly recoognized as being heterogeneous (14). Despite its name, more symptoms than fatigue are generally associated with it (15). Mitochondrial problems could relevant for some patients even if they may not be relevant for all patients.


References:

(1) Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A. The chronic fatigue syndrome: A comprehensive approach to its definition and study. Annals of Internal Medicine. 1994;121:953-959.

(2) Sharpe MC, Archard LC, Banatvala JE, et al. A report--chronic fatigue syndrome: guidelines for research. J R Soc Med. 1991 Feb;84(2):118-21.

(3) Carruthers B, Jain A, de Meirleir K, Peterson D, Klimas N, Lemer A, et al.: Myalgic encephalomyelitis/chronic fatigue syndrome: clinical working case definition, diagnostic and treatment protocols. J Chronic Fatigue Syndrome 2003;11(1):7-33

(4) Holmes GP, Kaplan JE, Gantz NM, et al. Chronic fatigue syndrome: a working case definition. Ann Intern Med. 1988 Mar;108(3):387-9.

(5) Jason LA, Evans M, Porter N, et al. The development of a revised Canadian Myalgic Encephalomyelitis-Chronic Fatigue Syndrome case definition. American Journal of Biochemistry and Biotechnology. 2010:6;120–135. Retrieved from
http://www.scipub.org/fulltext/ajbb/ajbb62120-135.pdf

(6) Carruthers BM, van de Sande MI, De Meirleir KL, et al. Myalgic Encephalomyelitis: International Consensus Criteria. J Intern Med. 2011 Jul 20. doi: 10.1111/j.1365-2796.2011.02428.x. [Epub ahead of print]

(7) Goudsmit EM, Shepherd C, Dancey CP, Howes S. ME: Chronic fatigue syndrome or a distinct clinical entity? Health Psychology Update, 2009, 18, 1, 26-33.

(8) Myhill S, Booth NE, McLaren-Howard J. Chronic fatigue syndrome and mitochondrial dysfunction. Int J Clin Exp Med. 2009;2(1):1-16. Epub 2009 Jan 15.

(9) Vermeulen RC, Scholte HR. Exploratory open label, randomized study of acetyl- and propionylcarnitine in chronic fatigue syndrome. Psychosom Med. 2004 Mar-Apr;66(2):276-82.

(10) Plioplys AV, Plioplys S. Amantadine and L-carnitine treatment of Chronic Fatigue Syndrome. Neuropsychobiology. 1997;35(1):16-23.

(11) Arnold DL, Bore PJ, Radda GK, Styles P, Taylor DJ. Excessive intracellular acidosis of skeletal muscle on exercise in a patient with a post-viral exhaustion/fatigue syndrome. A 31P nuclear magnetic resonance study. Lancet. 1984 Jun 23;1(8391):1367-9.

(12) Jones DE, Hollingsworth KG, Jakovljevic DG, Fattakhova G, Pairman J, Blamire AM, Trenell MI, Newton JL. Loss of capacity to recover from acidosis on repeat exercise in chronic fatigue syndrome: a case-control study. Eur J Clin Invest. 2012 Feb;42(2):186-94.

(13) Lane RJ, Soteriou BA, Zhang H, Archard LC. Enterovirus related metabolic myopathy: a postviral fatigue syndrome. J Neurol Neurosurg Psychiatry. 2003 Oct;74(10):1382-6.

(14) Jason, L.A., Corradi, K., Torres-Harding, S., Taylor, R.R., & King, C. (2005). Chronic fatigue syndrome: The need for subtypes. Neuropsychology Review, 15, 29-58. PMID: 15929497

(15) De Becker P, McGregor N, De Meirleir K. A definition-based analysis of symptoms in a large cohort of patients with chronic fatigue syndrome. J Intern Med. 2001 Sep;250(3):234-40.

Competing interests

I am the information officer of the Irish ME/CFS Association. All my work for the Irish ME/CFS Association is voluntary (i.e. unpaid)
 

Valentijn

Senior Member
Messages
15,786
I took a look at the mitochondrial DNA for the ME/CFS patient 23andMe data which I have access to. Purple = 1% or lower prevalence in the general population, red = 1 - 2.5%, orange = 2.5 - 5%, and yellow = 5 - 10%. A red font for the SNP indicates that it's a known missense mutation. Underlined alleles and SNPs are known to cause problems.

MT.gif


Overall, ME patients are looking pretty normal - more normal than the controls for many genes! But there are a few exceptions. One of those is rs3888511 on MT-RNR1, a pathogenic missense mutation which sometimes causes deafness on its own, but nearly always causes deafness when a certain type of antibiotics are taken. Apparently the mutation makes the protein look like something which the antibiotics are supposed to attack :rolleyes:

I've got a pathogenic missense mutation at i3002114 (rs28357970) which can cause "adult-onset dystonia, spasticity, and core-type myopathy". The gene, MT-DN1, is also known to be a cause of MELAS. Mutations in the gene cause problems with the transfer of electrons from NADH to ubiquitone,

rs28359178 is a very small increase in the odds of developing rheumatoid arthritis.

But the one that looks most interesting is rs3928306 on MT-RNR2. It's not known to be a missense mutation, but should be present in about 17% of the general population, or 25% of Europeans. Yet it's present in 58% of our small ME patient sample, and 0% of controls. Problems with MT-RNR2 can cause muscle and nerve issues, especially involving the eyes. The gene is also neuroprotective (when functioning), and suppresses apoptosis.

It also looks as though that SNP is used to determine if someone is of the H1 haplogroup (A = H1). So even if that SNP isn't causing problems itself, perhaps the H1 haplogroup has increased risk of ME/CFS due to some other common factor. Or it's just a random anomaly which is completely meaningless :D

Here's a text list of the 23andMe SNPs and minor alleles, for those who like to use a plugin to see what they've got:
i3003124 A
i3000806 A

i3001476 A
rs28623747 A
rs1970771 A
i3000604 A
i3000621 A
rs3021089 A
rs8896 A
rs9743 C

rs28357681 C
i3001522 A
rs3088309 A
rs28357372 G
i3001404 C
i3001525 G

i3002076 G
rs28358584 G
i3002114 G
i3001460 T
i3001461 G
rs1599988 C
rs28357976 G
rs28357977 A
i3002607 G
i3001469 C
i3002229 G
rs28358275 C
i3001502 A
rs3915952 G
rs28358285 C
i3001012 T
i3001505 A
rs2853493 G
rs28529320 C
rs28550734 T
rs28358280 G
i3000937 C
rs28617389 A
rs28397767 A
rs28359172 G
rs28359175 G
rs3899498 A
rs28359178 A
rs28630861 C
i3001513 G
i3001241 C
rs41535848 G
rs28357670 T
rs3915611 G
rs28357675 C
i3001518 G

rs3888511 G/C
rs3928305 A
rs28358576 G
rs28358577 A
i3001455 C
rs3928306 A

i3002264 A
rs41347846 C
rs2853498 G
i3001100 C
rs2853510 G
rs28357377 A
rs28358279 C
i3000624 T
 

bel canto

Senior Member
Messages
246
Thanks, Val!

As the plug-in doesn't work for the is #'s, I've added the list below. The first column is the last 4 digits of the is300xxxx.

3124 rs3135028 A
0806 rs28358270 A
1476 rs41474553 A
0604 rs28358875 A
0621 rs199474822 A
1522 rs41518645 A
1404 rs200975632 C
1525 rs41337244 G
2076 rs202123618 G
2114 rs28357970 G
1460 rs41402945 T
1461 rs41504646 G
2607 rs28357980 G
1469 rs41419549 C
2229 rs199794187 G
1502 rs41467651 A
1012 rs55714831 T
1505 rs201999217 A
0937 rs200487531 C
1513 rs41358152 G
1241 rs28359184 C
1518 rs41354845 G
1455 rs28358579 C
2269 rs201932824 A
1100 rs201754056 C
0624 rs201950015 T
 
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