Medical News Bulletin - The ME/CFS Myth

[Kalliope]

An article from December 15th which I don't think has been shared here yet.

Sympathetic and talks about the myths that ME/CFS is psychogenic and treatable with exercise.

Sadly it seems that the author doesn't understand how little it can take to initiate PEM, she seems to believe the debate is only about vigorous exercise..

The ME/CFS Myth

 

[SNT Gatchaman]

The references are odd also. Eg —

Moreover, several secondary analyses of these studies have found a failure to report the harms that individuals with ME/CFS endure because of exercising, particularly post-exertional malaise. 11-13 In response to exercise as a treatment for ME/CFS, an update by the UK National Institute for Health Care Excellence (NICE) in 2020 has stated that there is a "lack of evidence for the effectiveness of these interventions. "11

[11] is Updated NICE guidance on chronic fatigue syndrome (2020, BMJ editorial by Turner-Stokes and Wade)

The idea that vigorous exercise might help to "wake—up" people suffering with chronic fatigue or somehow keep them active gained popularity because:

1. In the past, when scientists compared muscle biopsies from individuals with ME/CFS to healthy individuals, they found no structural variations or differences in enzymes that produce energy.9 Exercising could be an appropriate treatment because scientists observed no issues within the muscle.
2. Some doctors feared muscle wasting would occur in people with ME/CFS as their daily activities decrease so much. They speculated that this muscle wasting could lead to further ME/CFS.

[9] is Chronic Fatigue Syndrome (1992, Clinical Infectious Diseases) which I haven't yet reviewed the historical references used to support these paragraphs —

Patients with CFS have demonstrated normal strength both during [100] and after [101] maximal isometric exercise and during repetitive submaximal exercise [102]. Weakness in patients with CFS is apparently due to submaximal effort rather than intrinsic muscle weakness because maximally exercised patients with CFS usually [100, 103], but not always [104], demonstrate a subnormal maximal heart rate during graded exercise as well as incrementally increased contractil-ity with electrostimulation [100].

Light and electron microscopic studies of muscle from patients with CFS have demonstrated no significant histologic abnormalities [25]. Glycolytic enzyme activities in patients with CFS have been normal (105). 3'P nuclear magnetic resonance studies have demonstrated excessive intracellular acidosis in exercised skeletal muscle from three patients with CFS [106, 107]; however, this abnormality could have merely reflected deconditioning. Findings of electromyography in CFS may be normal [100] or abnormal [108], although the reported abnormality can occur with muscle disuse [108] and should not account for fatigue [102].

In CFS, no significant discernable myopathy is present. Patients with CFS, compared to controls, estimate their exertion during exercise to be equal [102] or greater [104]. The fatigue in this syndrome could be due to this abnormal perception of muscle force [102].

 

[wabi-sabi]

[9] is Chronic Fatigue Syndrome (1992, Clinical Infectious Diseases) which I haven't yet reviewed the historical references used to support these paragraphs —

And why do people keep using such out of date references? In the very same journal there is an article on the WASF3 protein (just presented at NIH!) that's doing something bad to muscle mitos. And yet this author is using a paper from nearly 30 years ago to say there's nothing wrong in the muscle!?

 

[Mithriel]

The problem with papers from 30 years ago was that the subjects were not required to have PEM. We can have no idea how many had problems with exertion so the research tells us nothing.