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I'm not sure I understand what you mean here. What is close to that argument?

The perspective really was that from researching Metformin there are a lot of reported roles of Metformin and many touch on areas of research of ME/CFS that might be helpful but nothing stood out about Metformin to suggest this urgently needs to be trialled. If it were to have an impact it...

Yeah they do. POTS is a more common one. Absolutely, the goal is to try identify treatments of ME/CFS which would be a lot simpler if we knew what the mechanism was. Doesn't mean clinicians can't help now by trying to manage symptoms while identifying and treating comorbidities. At least some...

ME/CFS patients often have a number of comorbidities, treatments strategies are often taken to deal with these once recognised. I'm not talking about anything to do with Australian guidelines.

No not at this stage. We explored the potential through this review, detailing the mechanism of the drug and what studies have observed as occurring in ME/CFS. We think it could have potential but is not high on the list of targets. If doing a trial we'd trial a list of others first.

I can't discuss the guidelines AFAIK other than that I'm one voice among many and it's advisory to decision makers that will listen but may not action what we advise. This review was primarily put together by Dr David Fineberg with input and guidance from myself. It was an exploration of how...

We have an interest in cerebral blood flow and already have a project ongoing that doesn't require funding. We aren't sure if CBF is of value yet but I find it a good exercise to get our PhD students to put together a review paper of some form early on in their PhD. I think this systematic...

NIRS devices are difficult to use because a lot of data noise is generated from head movement. I don't know how they managed NIRS with maximum cycling, perhaps newer devices have resolved this problem.

Yeah the upright ASL is something we tried to find locally but none of the upright MRIs I could find had a strong enough magnet to conduct ASL. It's a real limitation in the field. We actually are doing a PET study using FDG tracer and getting ME/CFS patients to do a standing test while they...

Yes very little use of deconditioned controls in the literature. Also, I think it was noteworthy that there were better quality CBF measures and papers on OI than ME/CFS.

I think you've got a bias against our research group for reasons unknown to me but perhaps we can discuss it sometime? (Correct me if wrong) These sentences are all just mild even when you pull them out of context and dissect them as you have. The sentence you add at the end is a rewriting of...

Great to see it published. Some interesting hits. CA10 stands out to me

1. The confounders are relevant to steroid levels but have little relevance to relationships between steroids. 2. Yes the study shows something we did not expect in a cohort of 25, the loss of relationships between steroids. 3. This loss of relationship requires follow up investigation, if...

But we do think steroid dynamics are relevant to the pathophysiology. We think we did provide some evidence for that. We have published reviews on this topic, we think there is evidence. I think we disagree on the value of the work, which means the way we would word it differs.

Individuals have different levels of steroids at a particular point in time due to things like activity levels, oral contraceptive use, stage of the menstrual cycle and whether they are menopausal or not. Some steroids will change in ratio differently to other steroid during different times but...

In my experience, track record isn't a big factor in securing philanthropic grants. You're not out competing other ME/CFS researchers with quantity of publications. I think it helps to have at least a paper on ME/CFS that shows your understanding of the disease and a proven source of sample...

If one tree existed that made all fruit and the type of fruit created were separated by a few enzymes then that also works as an analogy for what I'm trying to describe.

I might try use an analogy to help. If one car in traffic breaks down then the cars behind it are also stopped in their progression. This outcome highlights a relationship in progression. This is relevant to OCP impact on controlling steroid production. Even in this instance you expect...

In a healthy cohort you'd expect correlations to exist yes. There are many potential reasons, we landed on the most likely but not to say you should rule out any reason for what we saw. Yes degradations and half-life do vary. Production will vary. You still expect a relationship across a...

Yes underpowered, we highlight the low sample size in the manuscript. I think our limitations section was quite lengthy from memory. We did a power analysis and I think it was 35-40 in each group that would have identified a significant decrease. Yeah, we haven't pinned down exactly what is...