Sympathetic nervous system?

It seems that she is selective. Have you looked at the raw data, or @mecfsscience.org 's blog post about it?

But there were no significant differences between groups. (Her paper doesn't give that info, so you need to look at the data itself).

No, I was hopeful that cpet would pan out, and offered to part fund a trial. I'm recovered and try to help other patients. What do you do other than shitpost?

I think after Keller's recent study showing no significant difference between patients and sedentary controls, it isn't really that surprising.

They use the 2015 IOM criteria, so definitely ME/CFS and not just chronic fatigue. clinicaltrials.gov/study/NCT047...

1) Unfortunately, it looks like Benjamin Natelson's group failed to replicate the 2-day exercise testing results in ME/CFS.

"The data do not support using the 2 day CPET protocol to define PEM or disability."

1) Researchers from Leeds University tested a "Personalised Dysautonomia Management Protocol" involving 3 liters of daily fluid intake, 10 g salt, pacing and calf exercises.

There were some improvements in OI symptoms, but the authors caution that these were quite limited.

Systematic Review of the Evidence of a Relationship Between Chronic Psychosocial Stress and C-Reactive Protein - Molecular Diagnosis & Therapy Introduction C-reactive protein (CRP) is an acute-phase reactant with an increasing number of clinical functions. Studies in recent years have identified several social, economic, demographic, and psy...

CRP is significantly increased from psychosocial stress, which seems to be a major factor in ME/CFS. link.springer.com/article/10.1...

Tagging @cgatist.bsky.social.

Even though the title of that study was "replicated", those results haven't actually been replicated yet. And there are of course physical changes in blood due to factors such as psychological stress: adrenaline, cortisol, NK cytotoxicity, etc. all change, as well as mitochondria.

And of course that isn't "deliberate" either.

Even though the title of that study was "replicated", those results haven't actually been replicated yet. And there are of course physical changes in blood due to factors such as psychological stress: adrenaline, cortisol, NK cytotoxicity, etc. all change, as well as mitochondria.

1) 🇩🇪 The university hospital of Regensburg looked at the effect of general analgesia in 15 ME/CFS patients and matched controls.

No severe hypotension or perioperative adverse events were found although ME/CFS patients had a higher increase in pain afterwards.

Narratives of recovery from persistent fatigue: a stepwise learning process - PubMed <span><b>Background:</b> Persistent fatigue is a transdiagnostic symptom that is present in many different medical conditions and diagnoses and is a common reason for seeking health care. Despite a lack of consensus on how to understand and treat persistent fatigue, a subset of patients recover. The exper</span> …

Recovery from CFS is possible.
#mecfsrecovery

pubmed.ncbi.nlm.nih.gov/41762695/

1) 🇨🇦 This study tested near-infrared light therapy in 43 Long Covid patients. The primary outcome was a collection of cognitive tests. Although the intervention group did slightly better, the difference was not statistically significant.

A brief summary.

1) 🇩🇪 A small randomized trial tested vagus nerve stimulation in 45 Long Covid patients but found that it didn't have more effect than a sham device.

A brief summary.

Recovery from chronic fatigue syndrome: a reflexive thematic analysis of experiences of people before, during and after treatment Chronic fatigue syndrome (CFS) is a chronic illness marked by severe, medically unexplained fatigue. Cognitive behavioural therapy (CBT) moderately improves fatigue and functioning. However, there is debate about recovery and how this should be ...

Recovery from chronic fatigue syndrome: a reflexive thematic analysis of experiences of people before, during and after treatment pmc.ncbi.nlm.nih.gov/articles/PMC...

Transcutaneous Auricular Vagal Nerve Stimulation Against Fatigue Syndrome in Patients with Long COVID: Results of the Randomized, Placebo-Controlled Clinical Pilot Trial COVIVA - Neurology and Therapy Introduction Fatigue is the most prevalent symptom in “long COVID”, affecting 6–7% of patients after COVID-19 infection. Its pathophysiology remains unclear, with viral persistence, immune dysregulati...

Transcutaneous Auricular Vagal Nerve Stimulation Against Fatigue Syndrome in Patients with Long COVID: Results of the Randomized, Placebo-Controlled Clinical Pilot Trial COVIVA link.springer.com/article/10.1...

Seems to be "Muscle building, breathing exercises, trauma processing". www.thermewienmed.at/rehabilitati...

Screenshot of the RECOVER-VITAL trial registration

1) RECOVER-VITAL results are in.

The trial tested long-term Paxlovid to treat viral persistence. It included more than 900 Long Covid patients, tested multiple outcomes for PEM, cognitive and autonomic dysfunction, but none showed significant improvement.

A brief summary...

1) 🇦🇹 A Post-COVID Rehabilitation clinic in Vienna found that 15 out of 216 (7%) Long Covid patients met the Canadian criteria for ME/CFS.

ME/CFS patients were younger, more often female, more fatigued and had a worse trajectory than those without ME/CFS.

What specifically was the rehab? If it was just exercise, this isn't really surprising.

Only 7% of LC cases met ME/CFS criteria in this study, this is 50% in some other studies. ME/CFS cases also responded less well to rehabilitation.

1) 🇧🇷 A big trial from Brazil reports that the antidepressant fluvoxamine improved fatigue in Long Covid patients while the diabetes drug Metformin had no effect.

The effect of fluvoxamine unfortunately looks quite small and it's unclear if it is clinically significant.

1) fluvoxamine is a serotonin reuptake Inhibitor but it's a bit different than other antidepressants because of its high affinity for sigma-1 receptors.

Would be interesting to have a replication study that not only compares fluvoxamine to placebo but another SSRI as well.

The Effect of Fluvoxamine and Metformin for Fatigue in Patients With Long COVID: An Adaptive Randomized Trial www.acpjournals.org/doi/10.7326/...

expert reaction to study looking at fluvoxamine (an antidepressant), metformin, and long COVID fatigue
www.sciencemediacentre.org/expert-react...

1) Results from the RECOVER trial of Ivabradine for patients with Long Covid and POTS have been shared.

While Ivabradine did produce a significant reduction in heart rate compared to placebo, it reportedly did not improve POTS symptom.

1) Looking at a large dataset (n = 4,244 participants) from the Visible app paper.

Seems that crashes and symptoms are mostly predicted by symptoms the day before and that biometrics such as heart rate variability add relatively little info to that.