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"A Boost for Chronic Fatigue Syndrome Research" - The Atlantic


ᴀɴɴɪᴇ ɢꜱᴀᴍᴩᴇʟ
The National Institutes of Health announced on Thursday that it will strengthen its efforts to find the roots of a mysterious disorder known as Chronic Fatigue Syndrome, or Myalgic Encephalomyelitis. Researchers from a number of the agency’s institutes will design a clinical study involving individuals who developed crippling fatigue and other symptoms after an acute infection. The agency may also increase the funding dedicated to the disorder from its current level of about $5 million annually, less than the amount devoted to hay fever.

“The effort aims to take advantage of the NIH Clinical Center, the largest research hospital in the world, to try to carry out every kind of imaginable analysis of the immune system, neurological system … metabolism … all of the things you'd want to know to try to get a handle on what is driving this very mysterious, puzzling disorder,” the NIH director Francis Collins said in an interview. “Given the seriousness of the condition, I don't think we have focused enough of our attention on this.” ...
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Senior Member
Midwest, USA
I can't keep up with all the press of the last few days, from atrocious - (I'm looking at you England) - to hopeful. But some of the comments to this one at their site (I think it was this one) deflated some of my hopefulness at the news. I REALLY wish we had an anti-defamation league that could protest ignorant, prejudicial, hurtful hate speech being spouted about this illness.


Senior Member
I would like to believe Dr. Collins means this.

One proof will be NIH willingness to find out what takes place when PEM/PENE causes anaerobic threshold and VO2Max to drop for 24 hours or more following exercise testing. Replicated research showing there really are patients with this characteristic has been out there for several years. Studying patients who do not have this characteristic may not even be studying the same disease.

If this is considered too expensive, perhaps the NIH might consider dealing with common hemodynamic problems reported by patients: Postural Orthostatic Tachycardia Syndrome and Neurally-Mediated Hypotension. These are not completely distinct. If a patient's heart rate climbs dramatically when they stand, yet pulse pressure (systolic - diastolic) scarcely rises, and/or if pulse pressure drops over a period of 20 minutes of standing, below the threshold normally used in diagnosing heart failure, you have found a physiological problem with direct impact on the patient's ability to perform many common activities and hold a job. Note to medical professionals: most places of employment do not provide facilities to lie down during the work day, and few automobiles can be driven while lying down. Testing for this can be done with equipment already in most medical facilities, (though you may have to replace standard medical personnel.)

I do not consider it necessary to diagnose neurally-mediated syncope. Patients will generally have learned ways to avoid syncope over a period of years when standard medical advice did not benefit them. If they did not, you would find them in much worse shape than many are. Repeated episodes of syncope are a recognized bad prognostic sign for a number of conditions. Telling patients who have become cautious of pushing to their limits they are "catastrophizing" when they have actually experienced multiple syncope episodes in the past should count as malpractice.