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Chronic fatigue syndrome may have a post-viral infection origin

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Re: Chronic fatigue syndrome may have a post-viral infection origin

#181
post #96

Earlier quoted context omitted.

Thanks for these - don't have an opinion on either but will look into. Broadly, I think immune dysfunction is a feature of most cfs so there is often a positive EBV test, or HSV test. I suspect this is more "downstream" than causative of CFS. However, it may be that there is a biomarker in the mitochondrial function, bone marrow etc...I hope one is found!

Why is the medical profession obsessed with biomarkers but not the next optimal step in patient treatment plans? Root cause analysis of dysfunction in complex dynamic systems is a waste of energy. Someone has the biomarker but they are a heroin addict which confers them a protective mechanism. What then? If you have 5 heroin addicts with similar symptoms you can just experiment with likely beneficial next treatment s…

Machine learning doesn't actually work very well for that. Attempts to apply it as you suggest in medical research have mostly not produced clinically useful results. More basic research into root causes is the only approach that is likely to lead to truly effective treatments.

Re: Chronic fatigue syndrome may have a post-viral infection origin

#182

Physician here. Imo CFS is best understood as the endpoint of an evolution within the nervous system that is increasingly called "central sensitization syndrome." (CSS) This syndrome is caused by a chronic dissociative or avoidant stress response, usually having it's origin in early childhood adversity. Prior to developing CFS, most individuals have other manifestations of CSS, such as IBS, chronic pain, TMD, etc. Ev…

What you're looking at is people with really bad gut microbiomes or other ongoing infections, not "CSS" - the behavior you're describing is called sickness behavior[1] and is produced by ongoing infections and blood infiltration by bacterial toxins like LPS (which coincidentally is used to induce mouse models of depression)

Rhetoric like yours is why most chronically ill people suffer for years and decades before getting any kind of diagnosis or treatment at all.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8960409/?report...

Re: Chronic fatigue syndrome may have a post-viral infection origin

#183

Earlier quoted context omitted.

In my case, the CFS like syndrome was all in my head in the worst fashion possible. After COVID, I developed a cross reactive species of antibody targeting my hippocampus and the opioid receptors in my brain. I have been bedridden since I was 17. I also manifested severe orthostatic intolerance and peripheral neuropathy that put me in the lowest 1 percent of neurite density. I was diagnosed at Mass General Hospital a…

Auto Immune Disorder (IBD in my case) sufferer here. I sometimes wonder why we're all not more annoyed that we get sent to specialists for the parts of our body (GI in my case) where the immune system is causing most damage at a given moment who will ask questions about other symptoms that we now have a good idea are likely the result of the same inflammation (depression, joint pain, peripheral neuropathy, CFS, etc.…

I'm curious about the small fiber neuropathy in your toes you mentioned. I was diagnosed with severe sarcoidosis a few years ago, and am currently taking azathioprine along with adalimumab. As far as I know the suppression is working regarding the sarcoidosis, although I've been having trouble with viral infections lingering a long time. Recently I've been noticing some burning and numbness in my toes, and your post made me realize it's most certainly nerve related.

Re: Chronic fatigue syndrome may have a post-viral infection origin

#184

Can chronic fatigue type syndrome that only effects you mentally, not physically? I have zero energy to do things that take mental energy unless I take ADD meds and even then it is a struggle. But doing things physically I have no problems. Like to the point I would rather walk a mile somewhere than figure out how to buy a bus ticket in an unfamiliar city.

That just sounds like ADHD

Re: Chronic fatigue syndrome may have a post-viral infection origin

#185
post #156

Earlier quoted context omitted.

Auto Immune Disorder (IBD in my case) sufferer here. I sometimes wonder why we're all not more annoyed that we get sent to specialists for the parts of our body (GI in my case) where the immune system is causing most damage at a given moment who will ask questions about other symptoms that we now have a good idea are likely the result of the same inflammation (depression, joint pain, peripheral neuropathy, CFS, etc.…

>I sometimes wonder why we're all not more annoyed that we get sent to specialists for the parts of our body . . . . at no point, is there a department of immunology that takes over or even contributes. As a person with Multiple Sclerosis seeing a neurologist I have been wondering this very thing since my diagnosis. I am on a B-cell depleting drug. It feels silly talking to my neurologist about my B cells. Lots of te…

Ocrevus? How's it treating you?

I've been on Fingolimod Accord (generic Gilenya) for a year, Gilenya for 8-9 years, and before that Rebif for like 13 years? Medicated at 18, ill since 12. Never felt better really. Symptom free and side-effect free.

The Rebif was kicking my ass with its side effect, I attribute my constant intrusive suicidal thoughts during that time to the medicine, but other than a lower-than-normal heart rhythm I am a very happy user of my current medication.

Re: Chronic fatigue syndrome may have a post-viral infection origin

#186
post #29

Earlier quoted context omitted.

What is meant by TMD? If it’s “Temporomandibular disorders” do you consider those a manifestation of “css”?

Yes Temporomandibular disorders are included in the group of Central Sensitivity disorders.

Hi Lindsay, please contact me. I have been dealing with health issues since 2019 and what you say about dissassociatiom, tmj, and fatigue/inflammation seems extremely relevant to me. My symptoms seem caused/exacerbated to the extreme by pornography and computer games. I have a long history of dissasociation as do my parents. I would like to discuss this with you as nobody else believes or understands what I have noticed concerning the connection between my physical and psychological symptoms. My email is hydrok9@gmail.com. I tried to message you on hn but wasn't able to. Thanks.

Re: Chronic fatigue syndrome may have a post-viral infection origin

#187

Earlier quoted context omitted.

What of the fact that my father and I both get painless clicking when we open our jaws too wide? Unless I'm having an arthritis flare, it doesn't hurt at all, but every dentist I've ever seen has pointed it out with curiosity. That certainly seems like a mechanical issue. My immediate reaction here is that casting (my) TMJ pain as a matter of emotional avoidance feels a tad dismissive, tbh. Particularly when the pain…

Could it be that some TMJ pain has one cause and some TMJ pain has a different cause?

Probably, sure. Which if anything is all the more reason I think it's unhelpful to jump right to "my guess it's an emotional regulation problem" before you've ruled out physical causes like chronic enthesitis.

Re: Chronic fatigue syndrome may have a post-viral infection origin

#188

Earlier quoted context omitted.

Depression may not be psychosomatic. It may be somatopsychic. Some physical ailments have psychological and emotional side effects. Depression may be rooted in physical ailments negatively impacting mood and brain function.

I don't even understand the distinction you are trying to make. Your mind is part of your physical body. If you are depressed then it is constitutively a physical ailment. Are people just this bought into mind-body dualism like two centuries later?

Depression is physical ailment but it can have either an external cause (a death, loss of job) and an internal/physical ailment (a virus or other pathogen) which causes depression.

Re: Chronic fatigue syndrome may have a post-viral infection origin

#189

I did not get covid but did get the vaccines + 2 boosters. I have been feeling tired etc for the last 6+ months turns out because of the work at home etc and my lifestyle I was not getting enough sunlight and had very low vitamin D levels. I am not white so need to spend longer time in sunlight according to my doctor.

Unless you've been getting weekly tests you can't be sure that you haven't been infected with SARS-CoV-2. Many infections are asymptomatic. You might not have noticed at the time.

Re: Chronic fatigue syndrome may have a post-viral infection origin

#190
post #112

Physician here. Imo CFS is best understood as the endpoint of an evolution within the nervous system that is increasingly called "central sensitization syndrome." (CSS) This syndrome is caused by a chronic dissociative or avoidant stress response, usually having it's origin in early childhood adversity. Prior to developing CFS, most individuals have other manifestations of CSS, such as IBS, chronic pain, TMD, etc. Ev…

Hmm. The argument is that it lies within the nervous system (physically), but then you mention avoidance/dissociation (psychological)? This reminds me of a lot of physical/psychological/"it's all in your head" discussions with various sorts of CFS sufferer, most of whom have serious problems getting anyone to take seriously the possibility that it might not be all in your head. https://www.cfsselfhelp.org/pacing-tuto…

You're on the nose. Dismissing mystery symptoms like this is doctor 101. As it happens we do have research on ME/CFS causes and biomarkers such as gut dysbiosis toxins[1], deficient SCFA production[2], elevated rates of enterovirus[3] and herpesvirus[4](particularly EBV, HHV-6 and -7) infections. Coincidentally, every single of those things is associated with dementia in old age.

Absolutely everything points at the origin of CFS being down to ongoing infections causing immune response, mitochondrial dysfunction, and sickness behavior. OP's "central sensitisation syndrome" is akin to 19th century's "female hysteria".

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8960409/?report...

[2] https://www.medrxiv.org/content/10.1101/2021.10.27.21265575v...

[3] https://web.archive.org/web/20170809125253id_/http://enterov...

[4] https://linkinghub.elsevier.com/retrieve/pii/S13866532067000...

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