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I see little chance of an actually well designed clinical trial. The risk of a reliable study producing evidence of lack of efficacy will make other people uncomfortable.

Perhaps the researchers want confirmation for their ideas from patients. They want to be feel useful and make a difference. Perhaps they don't realize, being immersed in their academic culture, that their ideas are often ugly prejudice, easily shown to be wrong, and not insightful and brilliant...

The authors seem to have poor knowledge of ME/CFS. Looking at the abstract, they fail to propose the obvious explanation: patients have exertion intolerance and orthostatic intolerance and so they don't leave home much. The internet is a way to connect to the outside world. The other...

I'm in my 30's, my neighbor in her 60's. We sometimes walk together. The last time I observed that initially I'm the one with apparently better cardiovascular fitness and strength, as seen by her breathing heavily while walking uphill and being a little slower. But she can keep going, while my...

Psychosomatic medicine seems to be a continuation of the ancient belief that illness is a punishment from God for sinning and moral weakness. At some point God and the punishment was removed from the explanatory model. What we consider sins (undesirable behaviour) and moral weakness also...

I suspect that Garner is also confused by the unpredictability of his illness. It's difficult to predict PEM precisely. He predicted PEM, exercised and it didn't happen so he thought that his mental attitude allowed him to prevent PEM. I also see in myself that as the illness fluctuates, during...

Garner seems to be cognitively impaired in some way. His ideas contradict each other and he doesn't seem to realize it. He says we should take people's lived experience into account, but he also thinks patients are wrong to reject "the mind-body connection" and "exercise therapy" and that he...

I'm hungry most of the time. I have no idea why.

Fantastic letter.

I'm pretty sure that the illness had already been present for a while when I first noticed the "onset" event. I'm curious what the NIH intramural study will find. They have very strict entry criteria requiring a documented infection. That means their findings might not extend to patients where...

The BPS stuff sometimes comes across as a system that is primarily concerned with acting as moral police when in reality medicine has nothing to do with policing people to be good diligent citizens. The explanations they give for illness tend to involve moral failure, and the solutions they...

Q fever fatigue syndrome appears to be an instance of a postviral syndrome that wasn't lumped in with ME/CFS and this doesn't appear to have helped them make any scientific progress.

She appears to believe that ME sufferers believe in a postviral disease, while in her eyes long covid is viral and not postviral. Also, the reason there has been lumping in ME is not for the lack of trying to split, but due to an inability to do so in a meaningful way.

So just like in ME/CFS.

No, I think these people are lying to themselves or having some transient placebo responses, which by the way are entirely consistent with a purely physical illness. A person can also experience genuine improvement of the illness for reasons that are not clear, but attribute it to their favorite...

I wouldn't consider it a strawman argument. We're being asked to believe in a psychological cause of illness for political reasons and there's simply no good reason to believe in this idea. Since there is no magical mind-stuff that is not physical that makes diseases happen, and nobody...

Sudden severe chronic illness, disability is a shock. In response, a person may cling to unrealistic hopes. I know I did.

Summary: A new theory of memory visualizes the brain as an organic super-computer that runs complex binary code with neurons acting like mechanical computers. The theory is based on the discovery of the protein molecule, talin, which contains switch-like domains that change shape in response to...

The lowest GRADE certainty rating is "very low", described as "The true effect is probably markedly different from the estimated effect". Does that really accurately describe the worst possible scenario? It's as if only positive results are possible with this system, a bit like a questionnaire...