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Physiopedia publishes an article on metabolism and ME/cfs

Kati

Kati

Patient in training
Messages
5,497
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/

Chronic Fatigue Syndrome (CFS) or myalgic encephalopathy (ME) is a debilitating condition which affects some 250,000 people in the UK or 1 million people in the U.S. The main symptoms include persistent mental and physical exhaustion that do not improve with sleep. There is often an unknown cause although it has been linked with post-viral illness. 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.

However research is now suggesting it may be to do with your body’s ability to utilise carbohydrate to generate energy as people with CFS may switch to using less effective forms of energy such as aminoacids. An unfortunate by-product of this is a build up of lactate which is perceived as pain.

The cause of this change may be in enzymes which are involved in a crucial metabolic pathway in the process of cellular respiration. The build up of these enzymes suppress a different enzyme called pyruvate dehydrogenase (PDH) which is part of the citric acid cycle. However it is important to not it isn’t just PDH which holds the key to CFS.

Other studies have shown there to be disruption to the immune system which attacks processes similar to the citric cycle and other amino acid changes which affects sugar metabolism in different ways. Overall it is much more likely that CFS isn’t a psychosomatic disorder and new treatments are needed to liberate those suffering with this disorder.
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Yay!

https://twitter.com/i/web/status/833807904922804224

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shannah

shannah

Senior Member
Messages
1,429
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.
 
Daisymay

Daisymay

Senior Member
Messages
754
shannah said:
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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Quite, and physios should know that!
 
alex3619

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
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.
 
shannah

shannah

Senior Member
Messages
1,429
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.
 
H

Helen

Senior Member
Messages
2,243
.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 ".
 
V

Valentijn

Senior Member
Messages
15,786
alex3619 said:
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.
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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.
 
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