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Has there been follow up on these people? It would also be interesting to test L-C's before and after the H1 and H" blocker protocols, which have helped some people. Problem of use of the term PEM vs exercise intolerance vs exertion intolerance. Sorry if others have already pointed this out.

Thanks

Reply: Muscle abnormalities in Long COVID | Nature Communications Apologies if already posted. Response to "it's all deconditioning" theorists. May even represent a correct use of the term "refute". FAO Dr O'Sullivan.

The first line in fluent Mancunian would be "Wha' i' is , is , is" - just for clarity

Her general thought world is is Start with no precise definition of chronic Lyme. Criticise the concept as having no precise definition but do not take up any challenges (e.g. does untreated Lyme become chronic and if it has become chronic does it exist or not?) A bit wry but not a trick...

Where it does matter is at the point of (differential) diagnosis and cohorting. Re Yann04

I agree. It offers some hope. A few on here with success from antifungals, modafinil has helped a few but not me. No one was bankrupted a few helped. Better appreciated if we approach pWME as a varied cohort. Glad to say a decade of calf pain away after a day on nystatin. Placebo? Mechanism...

I think we will not get far here esp as clinical matters are the subject.

Just redefine psycho in physical terms according to your philosophy. The problem will then be how to differentiate differentiate phenomena which we instinctivley feel are worthy of distinction esp on the clinical level.

You get stressed and your eczema gets worse. Cause, symptom, process, resolution. All occur in the physical world and may require different form of intervention - behavioural, biophysical, psychological, but work stress can be usefully distinguished from an obviously physical insult. The...

That psychosomatic symptoms exist and that they may be very serious. The assertion of this truth should however be shorn of insinuations that PS diagnoses are less harmful than physical ones, that over diagnosis is diagnosis which does not help (when?), that the interests of the so called...

OS is right to point out that PS is also a thing and it is vexing to hear people talk otherwise. But consistent with psychosomatic does not automatically mean psychosomatic and should there not be an onus on those who say sth is PS to demonstrate that? She says that there are no consistent...

A diagnosis which is not helpful now may prove helpful in time. OS has little nuance.

How does aphysician decide whether an L-C sufferer is PS or in need of muscle testing as in the Dutch study? Is it not entirely possible that PS phenomena would arise in the context of physiomatic symptoms worthy of investigation. Strong suspicion that for all the explanations re. All in the...

PS diagnoses create labels equally, of course, and the record of PS in achieving improvement is very patchy. Hence for many such diagnoses are by her own definition overdiagnosis.

I hope to hear her declare that the diagnosis of walkies for fear of walkies to be treated by CBT/GET was an overdiagnosis since so many have not improved. Diagnoses alone do not necessarily benefit. Treatment may be needed. Her contention is anyway more that certain diagnoses harm, but this may...

Brain remains biophysically compromised, physiosomatically functionally compromised and then finds it harder to deal with things so circumstance, emotions, stimuli mayl put more of a strain on it leading to psychosomatic phenomena, but its still a compromised brain. First comes wound, then comes...

Chronic but not acute sarcoidosis shows lowered oxphos, so interesting what you say. Sadly this area of sarc is not widely appreciated as a possible cause of fatigue and of inflammation which may cause further fatigue.

I certainly believe in persistence of borrelia in late stage Lyme and that the Germans sensibly call this "Borreliose mit chronischem Verlauf/course" whereas many English speakers throw a hissy fit at the thought and shout "woo" or invoke BPS according to taste. Some have more informed...

Have you excluded Pompe's disease?