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I have not met Dr Montoya or Dr Davis. I think you raise reasonable concerns about false claims. There have been far too many of these in the 'non-BPS' camp over recent years unfortunately. Judging by the media piece on Bullimore you linked to he is grossly oversimplifying, yes. Unfortunately...

I have speculations but nothing concrete enough to offer publicly. It is possible to 'cut corners' if you know what direction you are heading, like knowing there is a retrovirus to get rid of. But if you have no real idea which way to head then it makes no sense. Much of the problem with ME...

Because I think he is oversimplifying, or simply wrong, I am afraid. I spent my entire career working on inflammatory effector mechanisms. To say something is inflammatory you need some evidence of actual inflammation and in ME there is none. Moreover, the standard cytokine mediators of...

I think this is normal. I certainly experience it. It tends to be more in low light levels I think - maybe something to do with the depth of field in vision being less at low light levels. I suspect the after images are more apparent superimposed on out of focus areas of vision.

An interesting thought. TLR4, as you probably know, is part of a receptor complex that confused us for about twenty years before it was finally worked out which bits did what. If ME/CFS involved some sort of 'decoy' signal that managed to make people feel ill as if they were making TNF and IL-6...

I think it is unlikely that any potential benefit of naltrexone has anything to do with these cytokines since they are not raised in ME/CFS. (Nor is the body's own 'bioassay' for them in the form of CRP.) We have pretty extensive evidence that ME/CFS is not 'inflammatory' in that sense.

I don't think we will ever be able to know what happened here. However, I would caution against emotive language like 'powerful black box drug'. As you know I spent ten years studying the use of this drug in my patients. It has very few side effects in comparison to a lot of very standard drugs...

The wording seems wrong for that interpretation, although it is an interesting one. Perhaps all will become clear.

Agreed. Or there are more public responses. I suspect the author of the letter does not quite realise what she has got herself into here. Whichever way you read it the letter is totally unprofessional.

Um!

I wonder if this is the only evidence. The abstract is not very well written. They do not actually tell us the answer to the questions they pose. It says blood volume was low in CFS but give no figures or statistical analysis. They then tell us how low it was in the ones in which it was low -...

It seems that this idea became popular, particularly in relation to the claim that NK function was abnormal. The name CFIDS was coined. This all seems to have started with a suggestion that ME was somehow like AIDS. But the evidence for immune dysfunction has not really held up. So while it may...

I wonder if there is actually any good evidence for this? So many myths surround ME physiology.

Palpitation from tachycardia has lots of causes other than incipient reduction in cardiac output.

That confirms my suspicion. My guess is that this symptom has nothing to do with blood flow or pressure.

You are right, he seems to be measuring cerebral blood flow by internal carotid doppler, which can be done in any position. However, I am doubtful that this is a reliable method of measuring flow. It is highly subjective so would need to be done without knowing whether or not the person was...

Maybe the physicians should take heed of this - that PWME find they feel lightheaded after prolonged standing. A tilt table test would clearly be useless if it is done over a short period. It would be interesting to know if blood pressure actually falls when this symptom occurs. It makes me...

Yes, but that would not be orthostatic intolerance. The term refers to a cardiovascular shift on standing - or orthostasis. I am pretty sure that hypoperfusion reported on fMRI is with patients lying flat - Most MRI scanners only work that way.

What you are describing does not sound like orthostatic intolerance in the sense it is used medically. Orthostatic intolerance refers to a problem with regulating blood pressure on standing which will either present as faintness or rapid heart beats (palpitation) or both. I have always had the...

Dear Justy, There are various possible explanations. Titres do go up and down so the results may be real. More likely the labs are using different methods or thresholds. Until recently I would have said that standardisation in the NHS is as good as any and probably better than in a commercially...