Comments on the NYT article are now closed at a total of 581.
Dr Kaufman's early and valuable contribution was easy to overlook. In gratitude I repeat it here:
David Kaufman, MD California
"I will assume that the first two comments are by physicians. Let's begin with a suggestion: find a doc who treats these patients and spend one week in their office. You will be astounded at the degree of illness and misery (and I would hope a little shamed). You will hear patients describe how they cannot wash their hair, they cannot stand for more than 30 seconds, that writing an email leaves them exhausted, and on and on. I am talking about people that were PhDs, software engineers, venture capitalists, major real estate developers, entrepreneurs, you name it. These are not lazy people looking for a disability check. Several times a week I hear the same comment: I wish I had AIDS or Leukemia.
Regarding biomarkers of disease, it is correct that there is no single test comparable to an HIV pcr or an A1C for diabetes. But virtually every patient has profoundly low natural killer cell function, about 80 % have undetectable vasopressin levels, about 95% have mutations of the MTHFR gene (compared to 30% in the general population), and nearly every patient has documented abnormalities of the HPA axis. The real problem is our abysmal lack of understanding: why do these patients get sick, what is the cause, what starts the spiral? Perhaps research dollars might solve this problem.
But I would submit that not knowing the CAUSE of disease does not mean there is NO disease. We treat hypertension and don't know the cause. We treat MS and don't know the cause."