The problem is that that very desire to have the illness seen as biological plays right into the hands of the BPS crowd. To the extent that EDS has now been adopted by gastroenterologists as an especially 'functional' disorder - in other words entirely imaginary but we must say it is real, or whatever double think they prefer.
MCAS may sound 'biological' but to a physician it just sounds pseudoscience. And people with ME/CFS are deliberately being excluded from a physician led service because they keep insisting they have these pseudo-diseases. As soon as a mouth is opened and MCAS and EDS are mentioned you are in the functional pigeonhole where feeding support is not good management.
If we think someone has food intolerance we can just call it food intolerance. Adding a special syndrome is where the make-believe comes in. And if it is part of ME/CFS it doesn't need another syndrome because it is already part of one with a meaningful definition. It is vanishingly unlikely that there are so many people with four unrelated syndromes together (MCAS/POTS/EDS/ME/CFS) when as far as we know there is no biological or epidemiological evidence for a link. Yet so many people have been told they have all these diagnoses.
I may be misguided but it seems that in the UK it is me that has the job of trying to persuade physicians to begin taking ME/CFS seriously again. I have managed to get lab researchers interested - that was remarkably easy. There was no hesitation. But persuading physicians is going to need a very persistent and well organised campaign. As long as advocacy groups keep talking in pseudo-biology terms I think I am probably scuppered.
ME/CFS is a real biological problem.
Food intolerance is a real problem. It probably involves mast cells somewhere along the line but then pretty much any tissue reaction does so calling it a mast cell problem just muddles things.
EDS is a real biological problem but hEDS is not - it has no useful meaning.
The patient community needs to dig itself out of this hole if we are to get any clinical service. To some degree it has, but judging by what I have heard in terms of responses to our Fact Sheet 3 there are still a lot of people out there who cannot see the wood for the trees.