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Biomarker for chronic fatigue syndrome identified

med.stanford.edu

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Re: Biomarker for chronic fatigue syndrome identified

#11

Post by benatkin »

hliyan wrote: post #6
DiseasedBadger wrote: post #4

But which is the cause? Perhaps someone convinced they're ill, weakens their own immune system - either through some psychosomatic mechanism, or through associated behaviors.

It's somewhat irresponsible to suggest that this is psychosomatic, even in the face of a highly reliable biomarker. CFS sufferers have had insult added to injury for decades due to physicians dismissing them as hypochondriacs. This is a complex, debilitating syndrome that requires a lot of study. The type of fatigue these individuals experience is a lot more severe than "I'm tired and I don't know why"

For many of them it could be that they expect to feel better than they do, buy how they feel is closer to normal than they realize, given their body fat %, blood pressure, cholesterol, triglycerides, atherosclerosis, breathing problems, prediabetes, acid reflux, etc. They are feeling bad compared to their parents and grandparents at their age, but not due to what people normally think of as a medical condition.

Re: Biomarker for chronic fatigue syndrome identified

#13

Post by ufo »

benatkin wrote: post #7
ufo wrote: post #5

Earlier quoted context omitted.

No one knows the cause yet, which is why studies like this are important. Please don't idly suggest that CFS is just something psychosomatic or behavioral. The disease is much more debilitating than that, and this very common psychological misdiagnosis most often leads to dangerous advice. For example, CFS patients are often told by doctors to excercise, which actually only makes the symptoms even worse.

This reminds me of this quote from an article about Phil Libin, former CEO of Evernote: > Eventually he (Phil Libin) pinpointed the source. "It was the carbs," he said. https://www.businessinsider.com/phil-libin-fasting-routine-2... I think bad eating habits, eating unhealthy food, too much, too often, and too erratically has something to do with the uptick in these conditions.

I think that this suggestion that CFS might be caused by bad diet is even more irresponsible than telling it is psychological. CFS patients would wish that it were that simple.

CFS onset is often abrupt, and can often happen to otherwise very healthy and active people. For example, a common story is that the patient becomes sick from a viral infection and then gets stuck with chronic fatigue syndrome even after the infection goes away.

Re: Biomarker for chronic fatigue syndrome identified

#14

Post by Smaug123 »

benatkin wrote: post #11
hliyan wrote: post #6

Earlier quoted context omitted.

It's somewhat irresponsible to suggest that this is psychosomatic, even in the face of a highly reliable biomarker. CFS sufferers have had insult added to injury for decades due to physicians dismissing them as hypochondriacs. This is a complex, debilitating syndrome that requires a lot of study. The type of fatigue these individuals experience is a lot more severe than "I'm tired and I don't know why"

For many of them it could be that they expect to feel better than they do, buy how they feel is closer to normal than they realize, given their body fat %, blood pressure, cholesterol, triglycerides, atherosclerosis, breathing problems, prediabetes, acid reflux, etc. They are feeling bad compared to their parents and grandparents at their age, but not due to what people normally think of as a medical condition.

I don't know whether you've experienced chronic fatigue, but from your comments on this thread it looks like you haven't. It is dramatically more debilitating than you seem to give it credit for. (I haven't personally suffered from CFS, but I know people who have. Additionally, I have experienced months of insomnia which resulted in my being unable to do pretty much anything - lack of sleep is truly crippling - and I can only presume that CFS makes you feel much worse in a wide variety of ways.)

Re: Biomarker for chronic fatigue syndrome identified

#15

Post by Vomzor »

benatkin wrote: post #11
hliyan wrote: post #6

Earlier quoted context omitted.

It's somewhat irresponsible to suggest that this is psychosomatic, even in the face of a highly reliable biomarker. CFS sufferers have had insult added to injury for decades due to physicians dismissing them as hypochondriacs. This is a complex, debilitating syndrome that requires a lot of study. The type of fatigue these individuals experience is a lot more severe than "I'm tired and I don't know why"

For many of them it could be that they expect to feel better than they do, buy how they feel is closer to normal than they realize, given their body fat %, blood pressure, cholesterol, triglycerides, atherosclerosis, breathing problems, prediabetes, acid reflux, etc. They are feeling bad compared to their parents and grandparents at their age, but not due to what people normally think of as a medical condition.

You clearly have a very wrong idea about cfs. Walking 100 meters and then you’re very sick for a couple of days, that’s cfs. Can’t get out of bed sick.

Re: Biomarker for chronic fatigue syndrome identified

#16

Post by gwern »

danieltillett wrote: post #3
Smaug123 wrote: post #2

Paper at https://www.pnas.org/content/pnas/early/2019/04/24/190127411... Pleasantly surprised to discover that it was legally available! The test appears to be ridiculously good. Perfect separation of 40 subjects into those who have been diagnosed with CFS and those who are known to be healthy, from blood samples. I want to see this replicated, by people who are not the original authors; but if this test is anything…

I have to agree with you here - the separation is too good. You just never get anything in the real world that works this well with complex diseases.

It is suspicious but look at the scatterplots: https://www.pnas.org/content/pnas/early/2019/04/24/190127411... It really is pretty much perfect separation on their metric. When the effect size is that large...

Re: Biomarker for chronic fatigue syndrome identified

#17

Post by Smaug123 »

DanBC wrote: post #10
Smaug123 wrote: post #9

Earlier quoted context omitted.

Did you read the paper? The authors don't know a cause, but they mention a previous hypothesis by Myhill and such people, that it's something to do with the metabolic system breaking somehow; and they have a brief discussion of whether their test could be detecting something in this area. (Myhill's suggested mechanism is better fleshed-out than that, but I have only a passing interest in this subject so I don't reall…

> Myhill Sarah Myhill is a crank who sells blood tests and weird megavitamin mixes to vulnerable people.

She is certainly a crank by most reasonable definitions, whether or not she is right, and in my blindness I had rather forgotten that not many people are aware of specific details like this. I've edited my comment to make it much more tentative.

Re: Biomarker for chronic fatigue syndrome identified

#18

Post by ufo »

benatkin wrote: post #11
hliyan wrote: post #6

Earlier quoted context omitted.

It's somewhat irresponsible to suggest that this is psychosomatic, even in the face of a highly reliable biomarker. CFS sufferers have had insult added to injury for decades due to physicians dismissing them as hypochondriacs. This is a complex, debilitating syndrome that requires a lot of study. The type of fatigue these individuals experience is a lot more severe than "I'm tired and I don't know why"

For many of them it could be that they expect to feel better than they do, buy how they feel is closer to normal than they realize, given their body fat %, blood pressure, cholesterol, triglycerides, atherosclerosis, breathing problems, prediabetes, acid reflux, etc. They are feeling bad compared to their parents and grandparents at their age, but not due to what people normally think of as a medical condition.

CFS is much more debilitating than you make it sound and it is not about "feeling bad". Some patients are effectively bedridden.

The disease is very poorly understood but one common symptom seems to be a low tolerance for excercise. CFS patients recover very poorly from exercise, and a day of even moderately increased physical ativity may cause them to "crash" and become debilitated for multiple days.

It is also worth mentioning that CFS patients often have normal results for cholesterol, blood pressure and so on. One reason why biomarker studies like this one are important is exactly because currently CFS patients often end up bouncing from doctor to doctor, and none of the diagnosis ever work.

Re: Biomarker for chronic fatigue syndrome identified

#19

Post by benatkin »

ufo wrote: post #13
benatkin wrote: post #7

Earlier quoted context omitted.

This reminds me of this quote from an article about Phil Libin, former CEO of Evernote: > Eventually he (Phil Libin) pinpointed the source. "It was the carbs," he said. https://www.businessinsider.com/phil-libin-fasting-routine-2... I think bad eating habits, eating unhealthy food, too much, too often, and too erratically has something to do with the uptick in these conditions.

I think that this suggestion that CFS might be caused by bad diet is even more irresponsible than telling it is psychological. CFS patients would wish that it were that simple. CFS onset is often abrupt, and can often happen to otherwise very healthy and active people. For example, a common story is that the patient becomes sick from a viral infection and then gets stuck with chronic fatigue syndrome even after the i…

> No one knows the cause yet

If we can determine for sure that it's happening a at a much higher rate than in the past, we have a pretty good idea that the cause is the conditions that we live in. Diet that is one thing in which the changes over the years have been similar across different regions. If it was air pollution, the increased rates would show up in some regions but not others. Ditto radiation.

I don't think this is like autism in that we were mostly oblivious to it in the past, but I could be wrong. Enlighten me.

Re: Biomarker for chronic fatigue syndrome identified

#20

Post by [deleted] »

danieltillett wrote: post #3
Smaug123 wrote: post #2

Paper at https://www.pnas.org/content/pnas/early/2019/04/24/190127411... Pleasantly surprised to discover that it was legally available! The test appears to be ridiculously good. Perfect separation of 40 subjects into those who have been diagnosed with CFS and those who are known to be healthy, from blood samples. I want to see this replicated, by people who are not the original authors; but if this test is anything…

I have to agree with you here - the separation is too good. You just never get anything in the real world that works this well with complex diseases.

[deleted]
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