'At the moment, we're in a very optimistic place"
Dr. Julia Newton
Dr. Newton came to chronic fatigue syndrome by an unusual pathway but one which will resonate with any person with ME/CFS who's felt decades older than their chronicle age. A geriatrician focusing on fainting in elderly patients, Newton's interest was piqued by a strange set of younger people with similar issues.
Further study suggested that problems regulating blood pressure were highly associated, to her surprise, with the fatigue in both. She knew, of course, that fatigue was an enormous problem in ME/CFS but she was surprised at how much fatigue the elderly patients with blackouts were experiencing - long after they had experienced dizziness or blackouts.
That long-lasting fatigue suggested that the fainting problems were an indicator of a larger problem; Dr. Newton believed the fatigued and dizzy elderly patients were not just getting too little blood to the brain - causing dizziness and fainting - but were also probably not getting enough blood to the heart, the other organs and the muscles. Feel like 80 years old? Dr. Newton's research suggests in some ways you may be.
A Central Theme Revealed
She sees ME/CFS as a spectrum disorder; on the one end of the spectrum are patients with milder fatigue who don't experience fainting spells and blackouts and on the other patients with high rates of fainting who experience enormous fatigue...She believes that blood pressure/blood flow problems figure prominently in all these patients.
Blood Flow Problems - Her work backs this up. Recent studies have found impaired blood pressure regulation in ME/CFS and a study of patients showed something that could be caused by problems with blood flows; patients exercising in an MRI scanner showed a) elevated muscle acid buildup during exercise and b) and then slow removal of it afterwards.
Since blood washes away the acid produced during exercise reduced blood flows (ie impaired blood pressure regulation) could allow acids to build up. (Several studies are examining this possibility). Alternately the transporters that remove acids from the muscles be malfunctioning.
Muscle Problems - Dr. Newton also believe some problems are muscle based and has gone so far as to biopsy muscles in ME/CFS patients, grow the cells in culture, put nanosensors in them (using a technology she developed), and then measure the changes in pH that occurs as she 'exercises' them. The study will explore why ME/CFS patients energy production system shifts from aerobic to anaerobic functioning so quickly.
You can throw away the deconditioning theories if Dr. Newton's latest study proves out; if she finds abnormalities in cellular metabolic functioning they cannot be explained away by deconditioning, behavioral problems, etc.
If she's correct people with ME/CFS could have problems on both sides of the equation; a) their muscles aren't getting enough blood to wash away the acids that develop during 'exercise' and b) they have metabolic problems as well.
Fixing the problem
Here's where it gets exciting. In the Naked Scientist interview, Dr. Newton reported she has some 'very exciting' pilot data which suggests she can reverse the acid accumulations using various medications (unfortunately not named). Reporting that 'at the moment, we're in a very optimistic place", she hopes to be able to tease out the specific metabolic defects present (which could include autonomic nervous system factors since the ANS controls many aspects of muscle functioning) and then aim drugs at them. We're trying to get in touch with Dr. Newton to find out more about her work.
Kudo's to the Action for ME group for funding such intriguing work. Check out a description of the study.
- Dig Deeper - Check out the second article on Dr. Newton's work - The Wolf in ME/CFS: Newton on a System Stuck in Overdrive
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- Next Up: Dr. Newton on problems with blood pressure regulation