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Biomarker for chronic fatigue syndrome identified

med.stanford.edu

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Re: Biomarker for chronic fatigue syndrome identified

#81

Post by cpncrunch »

erentz wrote: post #75
cpncrunch wrote: post #70

Earlier quoted context omitted.

Those are all well known to be significantly influenced by stress, and all the evidence is pointing towards the stress system being central to CFS.

I disagree with your conclusion that it’s “the stress system”, but even if so, that’s not a mental illness then. Whatever is going on in CFS isn’t causing behavior or mood etc. changes. It’s causing physical changes, such as the measurable dysautonomia, measurable response on the 2day CPET, measurably response in the invasive CPET that Systrom has been doing, so on. Sure CFS patients do often get comorbid mental illn…

If you look at the evidence, all the studies so far show that CFS is triggered by stress and/or viral infections, and that the HPA axis is dysrupted. So it isn't my "conclusion", it's just what the evidence is showing.

Also, mental health is intrinsically linked to the stress system. Mental stress causes depression.

https://link.springer.com/article/10.1007/s00213-016-4218-9

If you talk to patients who have severe CFS and depression, you'll see that it isn't comorbid depression. Instead it is a fundamental symptom related to PEM. (See for example, Whitney Dafoe's description of his attacks). I had the same experience. The depression is not psychological (caused by thinking about the illness). Rather it is PEM, and comes on suddenly after exertion. That is not "comorbid".

Re: Biomarker for chronic fatigue syndrome identified

#83

Post by cpncrunch »

jchw wrote: post #78
cpncrunch wrote: post #76

Earlier quoted context omitted.

(I'm fully recovered from CFS, although I still have occasional mild IBS). There is certainly an overlap between CFS, IBS, lymph nodes, pain, fatigue, sleep problems and tinnitus: they can all be caused by stress. The most likely explanation ("I can barely stay awake during meetings") is probably that you need a better job. Having said that, you do need to rule out other explanations, such as cancer. Talk to your doc…

Meetings were just an example; I can barely stay awake period. My job is great, and my work life balance is good. And of course, we are watching for cancer. It’s very unlikely at my age, but I definitely can’t rule it out.

Do you have exactly the same symptoms when you take 2 weeks off work to go on holiday (say, after the first week)?

Re: Biomarker for chronic fatigue syndrome identified

#84

Post by Malcx »

jdietrich wrote: post #74
erentz wrote: post #65

Earlier quoted context omitted.

> The leading hypothesis remains that chronic fatigue syndrome is a mental illness. According to who? At least in the USA I see no evidence of that. The research is all pointing towards dysautonomia, dysimmunity, and metabolic issues.

The literature published over the last decade or so gives a highly biased picture, because people keep threatening to kill psychiatrists who research CFS. Understandably, most psychiatrists have abandoned the field for their own safety. Lots of people are researching biomedical factors, but nobody has identified a plausible biomedical etiology. https://doi.org/10.1136/bmj.d3780

>people keep threatening to kill psychiatrists

No they don't. Several psychologists have made claims of harassment, all of which have been shown to be specious at best. In the UK at least the link between psychology and The Science Media Center has massively helped push the, dare I say it "fake news" of threats.

Re: Biomarker for chronic fatigue syndrome identified

#85

Post by jchw »

cpncrunch wrote: post #83
jchw wrote: post #78

Earlier quoted context omitted.

Meetings were just an example; I can barely stay awake period. My job is great, and my work life balance is good. And of course, we are watching for cancer. It’s very unlikely at my age, but I definitely can’t rule it out.

Do you have exactly the same symptoms when you take 2 weeks off work to go on holiday (say, after the first week)?

Yeah, last holiday I took I felt horrid the entire time. I actually had some fairly bad headaches and ended up getting tests done; they came back normal.

Re: Biomarker for chronic fatigue syndrome identified

#86

Post by Someone »

kurthr wrote: post #29
danieltillett wrote: post #3

Earlier quoted context omitted.

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.

AIDS was once considered a very complex disease, but it has a very accurate (HIV) test today. My big concern would be if, like cancer, there are really many diseases and Chronic Fatigue symptoms are common, not differentiating.

AIDS, like CFS, was never considered a disease in the medical sense. They both are called “syndrome”, which is medical short-hand for “interesting enough to study further, but frankly, we don’t know shit about what’s causing this”.

https://en.wikipedia.org/wiki/Syndrome: ”A syndrome is a set of medical signs and symptoms that are correlated with each other and, often, with a particular disease or disorder.”

That’s why AIDS became “HIV infection” when medical science discovered what caused AIDS.

If this research gets confirmed, and a mechanism is found, that will happen here, too.

However, as you say, if that happens, there’s a good chance there are people currently diagnosed with CFS who don’t show this biomarker.

If so, those people run the risk of getting stigmatized even more than current CFS sufferers do.

The real solution to that problem, I think, would be for the world to accept that, if you have a mental problem, a) that doesn’t imply you put it there, and b) it doesn’t imply you should be able to get it out without outside help.

Only a few centuries ago, people were being blamed of being “unfaithful to god” when they got sick, be it due to a bacterial infection or due to mental illness. I see blaming people for their mental problems as a remnant of that.

Re: Biomarker for chronic fatigue syndrome identified

#87

Post by tempguy9999 »

jdietrich wrote: post #48
whalabi wrote: post #31

I'm just astonished by this. Millions of people (in the US alone!) suffer from this illness and I think everyone has wondered, or heard it wondered, if it's imaginary. For all these people to know there's something actually physically wrong with them is massive. It'll shift the thinking of everyone in the profession, of their families and friends and colleagues, and of themselves. It's a huge, huge breakthrough.

>Millions of people (in the US alone!) suffer from this illness and I think everyone has wondered, or heard it wondered, if it's imaginary. For all these people to know there's something actually physically wrong with them is massive. IMO the broader issue is the stigma against mental illness. The leading hypothesis remains that chronic fatigue syndrome is a mental illness. Both your comment and the linked article im…

> IMO the broader issue is the stigma against mental illness

Yeah yeah that rubbish again. I have mental illness (see my posts for boring details) and I've always been open about it, except when it's so obvious that people pick up on it without my assistance.

I've never had a problem. Stop saying there is a stigma. Any stigma may be down much more to the individual's anticipation of stigma which might cause them to not admit stuff, but my experience is society (UK anyway) is very tolerant of it. You're really not helping.

There's no frigging stigma for mental illness alone. If it causes someone to reek or act unpredictably there might be, but it's a reaction to the sad manifestations, not the illness per se.

NB. I contacted a company I'd previously contracted for, explained the situation, met some of the guys, became evidently stressed in front of them (people + noise get overwhelming quickly), and now I'm working for them. It gives me summat to do and to get used to social situations again, and they get a DB guy. Win/win! No drama.

So I repeat, STOP claiming this crap. You're making it harder for people who have to deal with it.

(Edit: no argument with the rest of your post)

Re: Biomarker for chronic fatigue syndrome identified

#88

Post by daegloe »

Off topic, but does anyone know why this post didn’t match up with my submission from last week [0]? I know scheme and querystring can throw it off. But in this case the links appear to be the same? Not sore about it, genuinely curious what the matching rules look like!

[0] https://news.ycombinator.com/item?id=19783668

Re: Biomarker for chronic fatigue syndrome identified

#89

Post by GordonS »

DanBC wrote: post #38
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"

It's also irresponsible to suggest, as you do here, that "psychosomatic" means "they're making it up". Even if CFs is a somatoform disorder the sufferers aren't making it up, they genuinely feel fatigued.

That's a bit of an uncharitable reading of the parent's comment - they do specific call out some doctors as making patients feel this way, rather than assert that as their own opinion.

Re: Biomarker for chronic fatigue syndrome identified

#90

Post by cpncrunch »

jchw wrote: post #85
cpncrunch wrote: post #83

Earlier quoted context omitted.

Do you have exactly the same symptoms when you take 2 weeks off work to go on holiday (say, after the first week)?

Yeah, last holiday I took I felt horrid the entire time. I actually had some fairly bad headaches and ended up getting tests done; they came back normal.

Headaches and fatigue typically happen after the stress, so if you do have a stressful job then it can take a few days or longer to recover.

Even if you like your job and you think it's great, that doesn't mean it isn't stressful. IMHO if you have meetings then your job isn't great, but maybe you're a strange person who enjoys meetings :)

Anyway, all I'm saying is to think carefully about your job and decide whether or not it is right for you.

Also worth getting a sleep study done, in case it is sleep apnea.

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