The thing that interests me a lot about the idea that a structural issue like brainstem compression is behind ME/CFS, is that while I think the metabolomics findings are robust in CFS, its still sort of unclear what the cause of the metabolic issues is and what makes them so hard to reverse. One would think that if its a matter of an impairment in cellular respiration via a given pathway or two, that someone experimenting with cofactors and substrates and things that upregulate various enzymes (thiamine, coq10, succinic acid,BCAAs, etc) would have cured themselves by now. However, what often seems to happen is that people have noted but transient relief from treatments like this,and often treatments that worked stop working. It often seems to me that I am throwing a bunch of fuel down a deep metabolic well, and that its almost a pointless endeavor to treat metabolism directly. I could imagine brainstem compression fitting into a scenario like this, because a structural problem that isn't resolved , like that, could cause profound metabolic and immune disturbances, and if you treat the metabolic and immune disturbances, you would only get transient relief, because the ultimate cause of the disturbances is so omnipresent and severe that its almost impossible to compensate for.
