@AgnesWold
It is not doctors who have poor knowledge, it is the ME concept that is diffuse and lacks defined criteria
@StenHelmfrid
The ME concept has emerged from the observation that many patients, after undergoing certain infections, develop a chronic state of fatigue that is not relieved by sleep, post exertional malaise, autonomic and central nervous system disorders, and sleep disorders.
@AgnesWold
What are the disorders of the autonomic nervous system? Do you mean to become dizzy when you stand up (postural hypotension), which is a completely normal phenomenon
@StenHelmfrid
Orthostatic intolerance, dizziness, palpitations, agitated bladder, extreme paleness, shortness of breath after exertion, IBS, NMH and POTS are usually counted as the autonomic symptoms.
@AgnesWold
"Orthostatic intolerance"
@AgnesWold
Being dizzy in the head when you get up after lying down is physiology, not something pathological
@StenHelmfrid
Orthostatic intolerance means that patients develop symptoms if they stand up for an extended period of time. It's not the same as getting dizzy after standing up.
@AgnesWold
Why should you stand up for a longer period?
@StenHelmfrid
Yes, Agnes, why do people stand up? They could, for example, stand in a queue or stand in a crowd with little opportunity to move.
@AgnesWold
But what does this have to do with ME? Feeling dizzy if forced to stand up is extremely normal (for example, I am, I never stand if I can avoid it).
@StenHelmfrid
Some ME/CFS symptoms also occur in other people. I do not agree that it is any kind of normal to be dizzy when standing up. A number of years ago we had half-hour long presentations at work, and nobody had a problem with that.