Hi! Yes, we have some people in remission right now and a number of people at various stages of recovery. It’s an interesting journey.
What I did differently..
Probably starting from scratch with a completely blank slate and no expectations.
I didn’t set out to study CFS - I just had a cluster of people I was coaching with different goals, common symptoms and markers. While digging through the problems, I realised along the way it was CFS... and as I kept digging, it got even more interesting.
Another key factor - I initially worked with a handful of people and talked to them for at least 5 hours each day, over many months. Being “retired”, I had the time to do this. There were no billable hours or pressures, just days of poking and teasing out aspects of the puzzle. I enjoy puzzles and helping people, so this was rewarding enough.
From these ongoing experiences - reactions to variables and discussions - it all became clearer and clearer.
I think also looking at this as a “biological engineering problem” rather than with a mindset honed by classical medical training also helped a lot - my skill-set has been developed around pattern recognition, pathways and problem solving.
My background was once electronics engineering and later, IT. My daily work expectations were having to dive into highly complex environments with typically unquantifiable numbers of “unknown” variables and being required to quickly zero-in on problems by using inferences from tangible behaviour / pressures / flows from related pathways / processes / functions. It was like building 3D jigsaw puzzles, by seeing the inputs/outputs, flows/pressures and feedback loops for every system and function.
This was often in a high-stress situation where a fault condition would cost >$1M/day and you ALWAYS had to locate the root cause - placing bandaids on a faulty pathway would invariably lead to unexpected behaviour and future problems. This would be completely unacceptable.
So, armed with that mindset, time/opportunity and tools from perhaps a decade or so of studying biological sciences out of sheer curiosity (I’m thoroughly in love with this topic), without simultaneously having being taught how I “should” look at things, I appear to have found myself in a fairly unique position.
It’s possible that solving this needs someone who has ample time, has lovingly studied metabolism, clinical / sports endocrinology and exercise sciences, with the mindset of an engineer, while also having (quite remarkably) fully recovered from CFS, thereby having a very personal understanding of it and desire to stamp it out.
I’m trying my best.
Prusty - PDH. There are multiple causes for this, but the main one is hypoxia / HIF. Just as we’ve seen in cancer studies, the remodelling under hypoxic conditions (which happens when a-KGDH is impaired) alters PDHK.
Disable the HIF-1a transcription factors being activated and that problem usually stops quite quickly, providing the “autoimmune antibodies” for eg. the beta-adrenergic receptor (which may/may not be present depending on the infection) have been already resolved. This is quite easy to do - there are many ways to achieve this, however the best way is to resolve the root cause.
Anaplerosis via succinate (succinate, GABA, B12, etc) or fumarate (urea cycle, aspartate) does it quickly, but does nothing to fix the underlying problem - in fact, it adds to the ROS and continues the vicious cycle.
This is the same underlying issue with nutrition / hormones in cancer treatments and was the key realisation in the third paper.
We “had the important pieces”, however were looking at the whole puzzle “through a mirror.”
The more patches you put in place, by fixing individual legs / cascades, usually accelerates the progress of the disease, without simultaneously doing something to modify the viral behaviour itself.
In a nutshell - everything you put in gets turned into viral proteins, ROS and further metabolite depletion via urine. You can/will “move the pressures around” and create new pathway impairments by healing another.
So much easier just to turn the whole thing off, instead.