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It is a bit unclear if the data in 14 includes every test or just the tests that achieved some level of significance. I think that is something that would need to be asked because they certainly didn't report it.

Ah it would make sense that it is every test they ran with that particular method. In any case, I think we are pretty sure that at no point did they ever test for Cortisol in CSF itself. It seems like there are a few related compounds but I don't know to what extent they would indicate a...

I believe 17 has every CFS test they ran. About 1300 different tests and Cortisol is not one

Cortisone is mentioned in supplementary data 14 for the CSF metabolites. Adrenocorticotropic hormone is mentioned in supplementary data 17. CSF Cortisol is not mentioned anywhere as far as I can tell.

I think inevitability assumes that that the future and past are things that exist. It doesn't make sense to say that something that doesn't exist could have been different or is certain to happen. My view is that time only exists in so far as there is an indivisible experience. We have an...

The leadership at Grok has refused to limit the creation of AI generated explicit images including that of children. The algorithm has also been repeatedly changed to produce responses that better align with a conservative stance.

There seems to be much more discussion about the differences between controls and patients on each test rather than the change between the two CPETs. The basis for employing the 2nd test was claimed to be that patients and controls had different changes in VO2 max and workload at peak exertion...

I haven't looked through the paper yet, but I think mechanisms of orthostatic intolerance is going to be key to this disease. Looking for differences between what is happening when lying down and when standing is something that needs more study.

If all you are saying is that sometimes people with psych diagnoses get additional or are incorrectly diagnosed with other conditions which can cause harm, I don't think that is particularly controversial. But that doesn't negate the fact that psych diagnoses face similar issues when they go...

I think this is a dangerous position to take. You seem to be suggesting that you (or others) can tell which patients' GI symptoms have a physical basis and which are produced by the mind. I don't think that is a useful distinction but even if it was I have no confidence that doctors can...

Thanks for the discussion. I don't have any other ideas about why the glymphatic system would be relevant for removing waste. I didn't realize that there are about as many capillaries as neurons in the brain. I was imagining that on the scale of induvial cells, some would be closer or further...

Those are useful points, I think that is where the disagreement existed. I agree that if the role of the glymphatic system is solely to remove amyloid it seems relatively uninteresting. I know waste is an oversimplification. But for the sake of argument I am right in thinking the pathways to...

Thanks for spending some time going through it. I haven't been able to go through your proposal in more detail other than what you posted here, but I do see how that could be a competing explanation if waste removal isn't important. When I feel up to it, I'll have a closer look. Here a few...

If it was clear that PEM wasn't a factor I would just use the term OI. I think the POTS label does have some use but primarily in a research setting for grouping people with OI that have a certain HR/BP responses. Given the baggage with POTS and the uncertainly surrounding diagnostic criteria, I...

https://www.cell.com/neuron/fulltext/S0896-6273(25)00843-8 This review is more recent and much easier to read that the one in this thread. I think it answers your question to that last paragraph with: along with a number of other potential efflux routes. Under your proposal what is the...

After spending some time looking through the paper there is still a lot I don't understand but I thought I'd send some of the parts that seemed important. I also don't know if what I said in the second paragraph above is even somewhat accurate. The first thing the paper seems to suggest is that...

From what I can understand it seems like after moving from the periarterial space to the perivenous space it flows back into the subarachnoid space. From here CFS is being reabsorbed into the superior sagittal sinus through arachnoid granulations which takes some "waste" with it. Lymphatic...

https://www.nature.com/articles/s41573-022-00500-9 This is the reference for how the fluid flows across the ISF: https://pubmed.ncbi.nlm.nih.gov/22896675/

To me it seems like the idea of the stress response has been added in post hoc as an explanation because all of the objective ways to measure sleep issues were not correlated with fatigue. Like what the hell is a somatic arousal? You can't just throw together a questionnaire, give it a name and...

I think you are getting caught up on the labels. If we have "placebo response" as the category that includes all effects not directly tied to casual pathway of the drug then that is the level at which we can make conclusions. The "placebo effect" would be a subcategory that is hypothesized to...