Following on from comments about alcohol above, I've had some thoughts about why I have a problem with it.
I feel okay sometimes drinking it but afterwards it gives me PEM, just like exercise, and with about the same time delay. Furthermore, the problems seemed to multiple: Alcohol+activity is especially bad for me, even with a day of rest in the middle. At one point I developed the following theory (which I wrote up at the time and have copied below):
Everything that made me get PEM was also a known cause of vasodilation: alcohol, stress and exercise. This also served to back-up my fear of hot water - I have a vivid memory of a relaxing onsen that, to my utter surprise, made me go straight to PEM town.
I began to believe what was happening was my veins were getting baggy and saggy from vasodilation, then, presumably, not springing back. In response, my immune system was calling in a full shut down in a desperate attempt to prevent me doing more exercise, and to maintain homeostasis. It was a simple theory but one that explained everything I was feeling.
In that context, I was excited to hear about Fluge and Mella's nitric oxide patent. But I came away disappointed. They patented something that *causes* vasodilation. That would be no good to me, I concluded.
Time passed. I tried eating different things. Saw various medical professionals. Added and subtracted supplements.
Eventually I came back to the topic and began doing yet more research on vasodilation and vasconstriction. There has been rather a large amount written about CFS and nitric oxide (NO).
What slowly became clear to me was that endothelial cells, in charge of regulating vasoconstriction and vasodilation, release nitric oxide in response to feeling stress in the blood vessel. As blood flow speeds up turbulence increases, and in response they release NO to relax the blood vessel.
Or at least they should.
I began to wonder: what would happen if in my body, the ability of these cells to react was for some reason broken? What if I was never getting actual vasodilation in response to these theoretically vasodilatory activities like exercise? What if my veins were never getting loose and relaxed at all?
How would the endothelium react if it tried to make and release NO in response to the stress, and still couldn't make the stress go away? The question may be important, because endothelial cells are a major part of the immune system, and play a role in regulating the metabolism.
If they feel constant stress that they can't alleviate, might they trigger an immune response? Could they even send signalling molecules that trigger a hypometabolic state? There is not yet evidence that they do... But no evidence that they couldn't, either... The body uses arginine to make NO. Naviaux found arginine levels were increased in the bodies of CFS patients compared to controls. Perhaps a compensatory mechanism? It was not clear.
--
Anyway, I tried taking arginine to see if I could make more NO and solve my problems. Didn't seem to do anything much. The above is speculation based on snippets of evidence really, so I'm not too surprised.
I'm interested in hearing whether other people experience 'problems with alcohol' in the same way, i.e. as a direct cause of PEM.
