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If fatigue is the decrease in physical and/or mental performance, then fatigue can be treated by improving physical and/or mental performance. For example with exercise.

I'm not sure if this is the right place but it's related.

@J.G do you have poor fasting tolerance?

FGF21 Source is Wikipedia

Funny and spot-on article by Brian Hughes, as usual.

SolveCFS appears to be misunderstanding what others have said. If I remember correctly, Nancy Klimas has said that MS was frequently misdiagnosed as psychiatric before MRIs.

Yes, I think there has been a misunderstanding. It's correct that MS is not viewed that way and I wrote my first post on this erroneously believing that SolveCFS had argued that before MRI, MS was often misdiagnosed as psychiatric illness (what they actually said was different). I doubt that my...

I suppose it's possible they were admitted for dementia rather than misdiagnosed conversion disorder which was really MS, but am not convinced. The patients my doctor mentioned must have survived a long time if they developed MS before the advent of MRIs. These patients were still alive at the...

My neurologist said he has older MS patients who were put into psychiatric wards, so it's definitely true. The exact misdiagnosis given to these patients probably varied. The point is that it was in practice often treated as psychiatric disorder, and I assume, seen as something arising from...

The biopsychosocial model of illness means that you can make up a psychosomatic cause of symptoms on the spot, whenever you want. He seems to be saying that they need this freedom, presumably because they aren't able communicate normally with patients and simply say that they don't understand...

Yes it's fair. Ideally it would list the comorbidities and better explain what pacing is.

I had a story to tell today at dinner with the family, about penis thefts. We all laughed. At least these stories are good for something. Maybe entertainment is why they're popular.

To illustrate his idea, he chose an example where (allegedly) a group of men in Africa started believing that someone had stolen their penises. In this story, the patients are portrayed as utterly dumb. Presumably he also thinks patients with long covid are utterly dumb - for failing to see the...

Ironically the decision to distance themselves from ME/CFS could quickly turn out be disastrous. The BPS brigades are waiting with open arms to welcome long covid patients for holistic multidisciplinary biopsychosocial flexible rehabilitation. Meanwhile ME/CFS patients are slowly making progress...

I suspect the long covid community is in a way, making the bet that they'll be able to figure out the disease quicker without the taint of ME/CFS. The similarities are obvious and undeniable. Clearly at some level the long covid community is making a deliberate choice to keep some distance from...

The strong beliefs in the treatment exhibited by CBT/GET proponents do not show that we can do without controlled clinical trials but that bias-proof clinical trials are especially important. Strong beliefs could be a result of the treatment being very effective, but they could also be what...

That's a good letter, as always. I would like if something about the historical context was added. Something about CBT and GET and the standards of evidence being a paradigm that failed, and how this has probably contributed to there being a lack of progress in ME/CFS. Without a way to discard...

Thanks to Anil sharing a copy, I have been able to read more than the initial part that's visible on the BMJ website. I couldn't quite muster the energy to write out a detailed critique but will just say: it is nothing more than a protest against the loss of undeserved privilege. She doesn't...

It appears that most people will get better regardless of what they do or don't do. A controlled study is needed to distinguish the effect of treatment from the effect of time passing.

Hey at least we're a threat now. That's better than being irrelevant and ignored. I hope I live long enough to see the functional disorder paradigm discredited entirely and exposed as mass delusion.