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It very specifically means, in medical terms, that pathology occurs in multiple systems. Talk of systems is talk of mechanism and as you say, no mechanism is known. It very definitely is not meant to mean lots of different symptoms, it wants to claim more. The use of the term is designed to...

DwME clearly want to speak with authority. They need to if they are to be taken seriously. But simple things like the credits for this psychiatry piece make the process look amateur: Psychiatry and Psychology Working Group Dr Crowder BSc (hons) MB ChB FRANZCP, Associate, DwME Yochai Re’em...

It should justify the statements made. The NICE advice on diagnosis is just a rough and ready approximation to what is really needed - an understanding of why a label is being used. Rather than say that ME is a disease and PEM is the most important symptom I would say something more like...

And really this sort of account is not alright for lay people. ME is not a nultisystem disease in any meaningful sense of the word and calling it that is likely to generate misunderstandings in patients and carers that may do significant harm. I find myself very much in the middle here. I think...

It is OK as a take home message for lay people but it commits so many of the mistakes the psychiatrists make and it plays into the MUS narrative through having a complete lack of supportive evidence.

This isn't going to persuade a single psychiatrist of anything other than 'Just what we thought, a group of people with MUS and unhelpful beliefs'. To counter the psychiatric story there needs to be a well-argued case and an evidence base. The case exists but it is not made use of.

Agreed.

I think Keith's gripes are a reflection of reasonable frustrations even if a bit rough edged. I personally think there is every reason to fund people who have done something useful rather than for what they might claim they might do next. Keith has made a major contribution and is worth funding...

He doesn't get it though, does he. GET is not appropriate for anyone with a post-viral illness. There is no evidence base and no scientific rationale. When people are well they can exercise if they want to. There is no reason to think that even someone who is deconditioned from illness needs an...

Both my wife and I now have hand problems these days and we have moved over to a 3 component system: 1. Very light small thin bladed, very sharp Victorinex veg knives. These cut almost anything without much effort when an ordinary knife is hard work. 2. An Any Sharp knife sharpener with a...

This simply a symptom of how much biomedical research has collapsed in the last twenty years. The situation is the same at UCL now. Nobody has a clue what they are doing. Paper after paper is produced based on gibberish. This is a real change. It was noted by James Le Fanu in his Rise and Fall...

That looks garbage to me. I worked out that the way to produce remission in RA was to target B cell clones rather than T cells despite the mockery of the immunology community and proved right. I made that decision because I had reached an understanding of how autoantibody production occurs. No...

Yes, this is basic medical student immunology.

Yes, we have known from the outset that autoantibodies occur in normal healthy people but less frequently. The stuff about them being useful is speculation. We just know they are there. We probably know why they are too but that gets complicated. They are almost certainly noise rather than...

Perhaps it should be like the great bake off. You have two psychologists CBT-ing each other and the one that alters the most unhelpful beliefs in the other wins. It could get quite vicious.

Yes, we probably ought to keep the lid on!!

Yes but what is the point of providing 'activity guidelines' when the government you work for has no interest in reducing sales of high sugar foods, has encouraged schools to sell off recreation areas, has eaten in to physical activity time with curricular regulations, made life so...

So maybe the answer to the original question is that what matters is whether or not there is a problem with bone density. Bone density is obviously a concern for those who are housebound and not very active anyway. A DEXA-type bone density scan would indicate whether or not there was a problem -...

Yes, looking at various sources the figures are confusing. I was assuming that the original quote was talking about soluble phase magnesium in cellular or extracellular fluids. It looks as if there is a large store in bone matrix which is presumably solid phase so concentration does not really...

But if that were the case there would be a well known syndrome of magnesium deficiency due to poor absorption - like pernicious anaemia. There isn't as far as I know.