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In honour of tomk - advocate extraordinairre


In on-going appreciation of tomk - advocate extraordinairre

Dr. Marc-Alexander Fluks posted this to co-cure Mar 20 2010

(if: in reading yet another of tomk's letters to the editor, I was struck, yet again, by how much Tom contributes to advocacy for ME/CFS. And how he has been consistently doing so for years. And now is expanding his horizons to include well-referenced, balanced letters to editors.

I have brain envy. And a deep respect for all that he does for us. I wish I could follow more closely in his footsteps. I believe that well-written articles/letters of the nature that he contributes do so much for us and the profile of ME/CFS in the medical world and general media.

And now that I'm sure I've embarrassed Tom :innocent1: - you can take a look at this latest addition to his oeuvre.)

Source: Psychological Medicine
Vol. 40, #2, page 352
Date: February 2010
URL: http://journals.cambridge.org/action/displayJournal?jid=PSM

Stratification using biological factors should be performed in more CFS studies.
Kindlon T.

Letter to the Editor:

The careful work of Roberts and colleagues (2009), in examining possible predictors in the response of Chronic Fatigue Syndrome (CFS) patients to Cognitive Behavioural Therapy (CBT), is to be welcomed. The results are consistent with findings reported by Jason et al. (2007). In a study of four non-pharmacological interventions (including CBT), they found that those with abnormal cortisol at the baseline did not improve over time, while those with normal baseline cortisol recorded positive outcomes on a number of immunologic and self-report measures [cortisol levels were considered abnormal if they continued to rise, were flat, or were at abnormally low over time].

More recently, Jason et al. (2008) reported that baseline measures including immune function, as well as activity levels, sleep status and past psychiatric diagnosis significantly differentiated those participants who demonstrated positive change over time from those who did not. Those with a dominance of the Type 2 over the Type 1 immune response, as indicated by the patterns of lymphocyte subset distributions among those with CFS, did not improve over time.

Roberts et al. (2009) state that "no studies have yet looked at whether there might be any biological factors that predict preferential response to CBT in CFS." However in 1991, Butler et al. found that there was a trend for patients positive for VP1 (a specific enteroviral antigen) to do worse, although this did not reach conventional statistical significance (Fisher's exact = 0.08). Lane et al. (2003) found 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, providing a possible reason for the disappointing results for some patients from CBT programmes which are focused on increasing activity.

It is generally acknowledged that CFS covers a heterogeneous population (Jason et al., 2005). More research is required to elucidate the factors underlying neuroendocrine dysregulation in CFS, and to ascertain what treatment modalities may improve outcomes in individuals with evidence of endocrine and immunological abnormalities.

Tom Kindlon


Butler S, Chalder T, Ron M, Wessely S (1991).
Cognitive behaviour therapy in chronic fatigue syndrome.
Journal of Neurology, Neurosurgery and Psychiatry 54, 153-158.

Jason LA, Corradi K, Torres-Harding S, Taylor RR, & King C (2005).
Chronic fatigue syndrome: The need for subtypes. Neuropsychology Review 15, 29-58.

Jason LA, Torres-Harding S, Maher K, Reynolds N, Brown M, Sorenson M, Donalek J, Corradi K, Fletcher MA, & Lu T (2007). Baseline cortisol levels predict treatment outcomes in chronic fatigue syndrome.
Journal of Chronic Fatigue Syndrome 14, 4, 39-59.

Jason LA, Torres-Harding S, Brown M, Sorenson M, Julie D, Corradi K, Maher K, Fletcher MA (2008).
Predictors of change following participation in non-pharmacologic interventions for CFS.
Tropical Medicine and Health 36, 23-32

Lane RJ, Soteriou BA, Zhang H, Archard LC (2003). Enterovirus
related metabolic myopathy: a postviral fatigue syndrome. Journal of Neurology, Neurosurgery and Psychiatry. 4(10):1382-6

Roberts AD, Charler ML, Papadopoulos A, Wessely S, Chalder T,
Cleare AJ (2009).
Does hypocortisolism predict a poor response to
cognitive behavioural therapy in chronic fatigue syndrome?
Psychological Medicine. Jul 17:1-8.

(c) 2010 Cambridge University Press


Senior Member
East Coast city, USA
Yes! Bravo, Tom!

This is just the latest of several letters written by Tom that have been published in medical journals.

Tom has several letters criticizing the Reeves "empiric" definition in print, as well.

Go, Tom! :victory:

I share IF's admiration.



Senior Member
Thanks Tom,

You do a great job. Your letters and contributions are always well written and jam-packed with relevant facts. Thank you!

Jerry S

Senior Member
:Sign Good Job:

Thank you, Tom, for the painstaking, effective work you have done. It is appreciated!


Dr. Yes

Shame on You
Good God, islandfinn, change the thread title!! When I saw it I thought it was an obituary!! :eek: :eek:

(I'm so glad you're still with us, Tom!)


I may have discovered another forum glitch. I changed the title, but it doesn't show up for me on the forum or today's posts pages, but only when I click on the thread. Hope I don't scare anyone else!


Senior Member
I agree. I've been noticing his name a lot when I read CFS stuff, always making sensible comments. Good work.


Senior Member
Thanks everyone

Thanks very much for the kind words and IF for the nice thought. :thumbsup:

I'm back from the dead now ... miracle cure X worked and it's available for only $59/week - just E-mail your credit card details and we'll sort it out. :Retro wink:

I'd like to thank my parents, siblings, aunts and uncles, my pet dog, the postman .... ;)

But seriously, always nice to get acknowledged. I should say that, although I have written some of the letters to medical journals all by myself, the wording for that one was tightened up a bit by Ellen Goudsmit, although I did not take all her suggestions. And I've learned from lots of people over the years.

Thanks to everyone who is doing their bit for the cause. :hug:


Senior Member
Tom, Tom, Tom... He has a fine mind, he cuts through the scat, he doesn't suffer fools, he is relentless, he is prolific... he is legend!

ETA: Always check to see if there is a page 2 before posting! Hi Tom! You are legend!


Senior Member
Tom, Tom, Tom... He has a fine mind, he cuts through the scat, he doesn't suffer fools, he is relentless, he is prolific... he is legend!

ETA: Always check to see if there is a page 2 before posting! Hi Tom! You are legend!
Thanks Koan. :Retro smile:
I don't aspire to "not suffer fools" but I suppose in recent times, I can be spreading myself thinly and not put as much thought/tact/time into some posts as I might like. No need to reply.


Senior Member
Asheville, NC
Thank you from me as well. Beautifully written for laymen or doctor. Keep advocating...you have a gift and thank you for using it


Well done Tom. I have noticed your advocacy work on co-cure. You do a great job.


Senior Member
Thank you, Tom! It's fantastic to have great minds like yours work so diligently for our cause.

I am rather new to the advocacy thing and there is a lot I can learn from your letters and posts.

:Sign Good Job: (Wishing there was one that said "great job")


Senior Member
Sheffield UK
Fine Advocate

Tom, Tom, Tom... He has a fine mind, he cuts through the scat, he doesn't suffer fools, he is relentless, he is prolific... he is legend!

ETA: Always check to see if there is a page 2 before posting! Hi Tom! You are legend!

Hear! Hear! More legends like TOM. Read a lot of your stuff elsewhere. A fine voice indeed.