Comparing acute sickness symptoms with ME/CFS

[bobbler]

Convalescence for TB was the norm back in the day;
see film 'Twice round the daffodils'

And no one is going to let you go into the workplace etc

 

[bobbler]

I think researchers may consider this kind of testing to be unethical. I'm guessing because the tested hypothesis would include increased risk of death from infection, among other things. From the Friman study a few posts up:


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Basically, it seems like the most obvious hypothesis is ME/CFS is long infection, and that PEM is viral load increasing due to exertion, and I'm astounded that I haven't seen this PEM idea mentioned even a single time in research. (Edit: Not that I've searched that deeply. If anyone has seen something like this, I'd love to know.)

The three main reasons I think so, which I wrote in another thread:


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The connection is that if exercise causes increased viral load during acute infection, and if it is found that ME/CFS is at least partly a "long" infection, the obvious question is if exercise also causes increased viral load during ME/CFS, which could explain PEM.




Yes, there are differences. I know they very well could be totally unrelated, and viruses be totally uninvolved. But I'm sure there could be ways of explaining the differences as well under this hypothesis. For example, maybe it's because during acute infection, everything is very uncontrolled. The virus enters through some random route with a variable initial viral load, and the body has very little "memory" of this pathogen. In contrast, in ME/CFS, maybe the virus is kept in a little highly controlled zone in a tissue, and the method and degree of "escape" or proliferation of the virus is very consistent after exercise. The adaptive immune system is constantly seeing it, so it can respond very predictably every time.

(Edit: I think I misunderstood what you were saying here and answered about the delay always taking the same amount of time in ME/CFS and not in acute infection. But in terms of symptoms flipping on like a light switch after a delay, see the next text and the edit added at the end.)

You already saw me say this, but for anyone else, I previously found two anecdotes of a symptoms "flipping on" like a light switch some time after a COVID infection, kind of like how some describe PEM. Yes, it's only two people, but still may point to more of a connection between the conditions.


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Yeah, that's one thing I'm hoping for, but if viruses are involved, it will require technology to detect them in the first place. It seems like they're gradually getting better at detecting the COVID virus persisting, so maybe eventually they'll test viral levels before and after exercise in long COVID ME/CFS, probably long before something similar is done in pre-COVID ME/CFS.

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Edit: I will say, for those whose symptoms just "switch on" after some time, it is harder to compare that to the gradual increase of viral load. I may be biased by my own symptoms, where it feels like a very gradual increase in symptoms over a couple days. I don't know exactly how or if a sudden symptom increase could be explained by viruses.

Maybe something like at first after exercise the virus increases in a "safe zone" of a tissue where it doesn't cause symptoms. But the moment it reaches levels where it escapes, one or two days later, maybe into the blood stream, the symptoms start.

But I agree it makes the hypothesis harder.

Funny isn’t it given the 2007 guideline was I assumed at the time a giant lab test of seeing what happens if they changed the culture around us so our only option was to never rest gif anything ever

until I realised no one was allowed to write down the results if you gif worse or didn’t improve

 

[bobbler]

I looked at the study to see what it says about this "mental stress" and it's just two people (participants 34 and 38) that took >250 mile drives during the preparalytic stage of polio. It's not totally clear, but it looks like one died, and it doesn't give details about the other. I think maybe he wrote the wrong participant number, because there is no data for No. 34 in the table. I don't think much can be concluded from this about mental stress.

But here's the main data for the physical activity causing worse outcomes:
View attachment 24496

Here are the degrees of physical activity:


All 5 that had a day during the preparalytic stage doing level 3 activity died. Out of the 10 that did bed rest every day, 6 had no paralysis, and all 10 survived.

You see reading the table of physical activity and having driven long distances id slot in 250 miles particularly in an older car as just under the 4 manual labour one. It involves mental concentration too of course but sitting driving that long isn’t not physical either

 

[poetinsf]

I think researchers may consider this kind of testing to be unethical. I'm guessing because the tested hypothesis would include increased risk of death from infection, among other things.

10-100w in 10 min is fairly modest for healthy people. They could study the effect of moderate exercise on cold/flu patients without too much issue, I'd think. Recruiting patients could be a bigger problem. Cold/flu only last a week and the infection would be over by the time they are recruited. Not too many would be interested either in something that is not much benefit to them.

You already saw me say this, but for anyone else, I previously found two anecdotes of a symptoms "flipping on" like a light switch some time after a COVID infection, kind of like how some describe PEM.

Yeah, I remember that. It's possible that those two cases may have already developed me/CFS while they are still infected with COVID. That's more plausible explanation to me since we don't have any report of PEM in cold or flu

 

[Yann04]

Not too many would be interested either in something that is not much benefit to them.

Compared to costs of running a study, it’s not that much to pay each participant 100 USD equivalent which is probably going to be a motivator.

 

[poetinsf]

I never tried to do a workout with influenza, influenza is just too horrible with the very high fever. Even purely existing feels terrible. Getting off the couch is a challenge.

Nope, certainly not while you have fever or first a few days of infection. But I was able to get back on the trail on the second week of COVID with the drained/exhausted feel and all. I was a little afraid of relapsing into MECFS, but hiking 8 miles up the mountain didn't cause PEM nor relapse

 

[forestglip]

10-100w in 10 min is fairly modest for healthy people. They could study the effect of moderate exercise on cold/flu patients without too much issue, I'd think. Recruiting patients could be a bigger problem. Cold/flu only last a week and the infection would be over by the time they are recruited. Not too many would be interested either in something that is not much benefit to them.

It would be interesting. Would have to keep in mind differences between infections. As the book above discussed, exercise only worsens health in some infections. E.g. it seems to be the case in polio, but not TB. So just recruiting based on a "cold" may cause too much variance to be useful.