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Same, I only maintained one when I went to Uni as it made a huge difference then (my Uni was built on the side of a hill).

It means it depends on what you are doing. The heart rate at which the anerobic threshold occurs for riding a bike is different to that of jogging on a treadmill, is different to that of lifting things quickly, is different to that of standing up for a long time. Measuring what heart rate it...

Heart rate variation is *extremely* non specific, this method would pick up **many** people who do not have ME/CFS. It also doesn't imply the sympathetic nervous system aspects the authors are trying to imply - it is a poor marker for parasympathetic/sympathetic balance as well.

The Anaerobic Threshold is task specific, so yes patients can go past it depending on the task, independent of the heart rate - the threshold is not fixed to any particular heart rate can can also vary with PEM.

Yes, I'm trying to re-think things from a different perspective.

I think there are different phenomena going on, malaise isn't just fluey symptoms but I maily attribute those fluey symptoms to histamine related symptoms (sore throat, sinusitis etc)

What are people's experiences with NDRIs, eg Methylphenidate and Burpropion I tried the latter and it was great mentally, but led to bad/painful whole body muscle cramping and excessive muscular PEM.

That's not my experience at all, when suffering from acute Guillain Barre Syndrome, I felt severe fatigue/weakness/paralysis and had autonomic symptoms (OI) but I wouldn't say I had that fluey/feeling sick feeling at all. I think "sickness behaviour" is too nonspecific to be a useful construct...

Cause or effect? Maybe they were experiencing mental distress because their symptoms were worsening.

It has been researched, we know the burning sensation and sensation of fatigue alone is not simply due to lactate. https://pubmed.ncbi.nlm.nih.gov/24142455/ Less efficient metabolism (excessive glycolysis) leading to excess lactate, can be due to multiple reasons (besides mitochondrial disease)...

I'm not convinced using carbohydrates rather than fat is "inefficient". This is another study that the authors don't understand why they should do a 2-day CPET and what they are supposed to be looking for.

Yeah, he should choose a cute animal avatar to be taken more seriously.

This is why for decades, medicine has demanded genuinely controlled trials. If that evidence doesn't exist - without known scientific mechanisms, it becomes pure speculation.

Science based treatment maybe, but evidence for those scientific mechanisms is lacking here.

Yes, a person who has been bedbound for a long time will have different cortisol responses as a result, this can simply be an adaptation rather than a cause of disease. Also it could be a consequence of medications tried, I have bad reactions to a lot of medications (such as all classes of...

ME/CFS missing again.

This is a really bad attempt and I am quite upset. Why do researchers skip the most important steps - the qualitative talking to patients steps? They're trying to shoehorn multifaceted experience into a stupid questionnaire and I am quite disappointed at how bad it is.

There have been many 2 day CPET findings and most have not found abnormal VE/VCO2 so there might be something unusual about this study. The authors also don't seem to understand that feedback from muscle afferents alter ventilation patterns, they explanation they put forth may be backwards and...

70% vs 30% in controls is really poor sensitivity/specificity, this doesn't really suggest much at all. This is a case-control study so that could entirely be biases in selection between healthy and patient participants.

https://physoc.onlinelibrary.wiley.com/doi/abs/10.1113/JP282564 This is the scientific basis for the sensation and brain response to peripheral fatigue.