Do ME symptoms fit with the faulty energy metabolism hypothesis?

Utsikt said:
It’s not that easy. When you’re holding your arm straight out from the body you’re not moving at all but your muscle cells are still consuming energy and will fail eventually. Or do a plank.

Doing an action rapidly might engage the muscle cells in a different way that has a different energy to power output ratio compared to doing an action slowly.

Try doing a squat very slowly compared to doing it quickly. I remember the slow ones as being far more straining.
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Yes, I do acknowledge what I say is very simplistic. I don't doubt that in human physiology if you hold something out straight as in your example and not moving, there is no doubt things going on inside that are still consuming energy. But not something I have understanding of. And I also agree human physiology makes these things very complex. I'd guess - and it's only a guess - that longer duration of having to apply a force will take its toll, as well as during a squat where the mechanical (dis)advantage aspects no doubt come into play for muscle stress etc.
 
Barry said:
Potential energy. But yes, no energy being used. Though as @Utsikt points out, there is likely something going on in human physiology that I do not understand, that maybe energy is still being used in some way.
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There is definitively something going on that uses energy when not moving. You can just look at the calories a bedbound person needs to maintain their weight. I think I need about 70 % of what I did when I was healthy but not exercising regularly. So a fair chunk of the energy expenditure of a person is not related to movement.
 
Utsikt said:
There is definitively something going on that uses energy when not moving. You can just look at the calories a bedbound person needs to maintain their weight. I think I need about 70 % of what I did when I was healthy but not exercising regularly. So a fair chunk of the energy expenditure of a person is not related to movement.
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I find that easier to understand. The human body is actually doing a lot when we are apparently doing nothing, just keeping its basic life support systems going, heart, lungs, brain, digestion, and much more I don't understand. When very severe ME sufferers are completely bed bound, it must essentially mean they are only capable of providing the power needed to keep them alive and little else. Like an engine ticking over, the engine itself still consumes energy to keep it going.
 
Barry said:
I find that easier to understand. The human body is actually doing a lot when we are apparently doing nothing, just keeping its basic life support systems going, heart, lungs, brain, digestion, and much more I don't understand.
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Yes. And when not moving but holding your arm out, the muscles are actively working to stay in a contracted state. Maintaining that state requires energy. An analogy could be an electrical magnet. If you don’t supply continuous power it won’t attract things.
Barry said:
When very severe ME sufferers are completely bed bound, it must essentially mean they are only capable of providing the power needed to keep them alive and little else.
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I’m not sure this is right because that assumes an energy shortage is the issue. And there is no central power source for a human body like in a combustion engine in a car. Each cell produces it’s own power. So why would there be a selective power shortage in only the cells required for bodily movement, but not all of the other ones that are needed to keep us alive regardless of what the muscles do?
Barry said:
Like an engine ticking over, the engine itself still consumes energy to keep it going.
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Yes, that’s kind of right. Your car will consume gas/electricity when turned on but not moving. But a car only has one engine. You have billions that are fuelling lots of different things.
 
A couple more analogies:

When on holiday my phone may say that I have used up my access to mobile data for the month. That is not an energy issue. It is an issue of limited processing capacity someone or costing thereof. It may be what makes us want to go to sleep.

I had a lawn mower that would run for ten minutes and then stop working because the cooling system was choked up. There was no energy problem. The problem was the cylinder was too hot for the ignition to be controlled. It was fine after being left for half an hour but not because it had more fuel.

Maybe people with ME/CFS should stay away completely from attempts to explain PEM until we actually have a valid story for what is going on.
 
Jonathan Edwards said:
Doing things slowly
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It's not just doing things slowly. More than once I have described it being like someone turning up gravity so that everything requires so much more effort and other pwME often say this is exactly what they feel. This is not fatigue or fatiguability there is some kind of on/off or faulty switch or blockage. People have tried to explain it as build up in lactic acid in muscles etc which I think has been disproved, but I think there is some evidence for PEM being caused by something cumulative.
 
Sly Saint said:
It's not just doing things slowly. More than once I have described it being like someone turning up gravity so that everything requires so much more effort and other pwME often say this is exactly what they feel. This is not fatigue or fatiguability there is some kind of on/off or faulty switch or blockage. People have tried to explain it as build up in lactic acid in muscles etc which I think has been disproved, but I think there is some evidence for PEM being caused by something cumulative.
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I agree it's not just doing things slowly. Being upright and doing things slowly does not help at all. In fact it maybe makes things worse because being upright is a variable in its own right. I can do all sorts of things while reclined but not when upright. I brush my teeth when reclined, very thoroughly, which I couldn't attempt when upright, even slowly. I take meds when reclined, cleanse my face reclined etc.

It's hard to stay away from explaining ME using PEM because it is so critical to the illness.
 
Barry said:
Are we sure this is not a partial problem for those bed bound with very severe ME?
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Yes, they do not go into nitrogen retention or pulmonary oedema, which would be the effect of renal failure.

As far as I am aware we have never had any direct evidence of problems with energy supply for any biological function in moderate or very severe ME/CFS. It has just been part of the folklore put about by people spinning stories about mitochondria and such like.
 
I was pondering the comments here, especially @Jonathan Edwards' hypothesis regarding the body's signalling. Thinking about my wife's illness, there is nothing I can see in my observations that would discount that idea.

The notion of bodily distress signals provoking vital corrective action must, in evolutionary terms, be a very ancient development; very many species seem to have this sort of protection mechanism. So I'm guessing it must be a pretty low level mechanism within our biology.

So I think from what Jonathan is saying (apologies if I've misunderstood), it could conceivably be - nothing proven, just a possibility - that for a person with ME their energy processing system itself could be absolutely fine, energy in, energy out, all working as it should. But what if the body's signalling mechanism has got screwed up, and is signalling the body has reached exhaustion point long before it really has. The person's very real and inescapable perception will then be that their body has reached its limit, and they must slow down or stop. Just like if they touched something a bit warm, but their body erroneously signalled back that they were touching something red hot. The overall effect would be just the same as if their body really experiencing the extreme trauma being signalled, the body would have no way to discriminate between real signal levels versus grossly amplified ones, the perception would be the same so the body's natural responses also would be. Our perceptions of these things are, in a very real sense, what our body is telling us about these things, truthful or otherwise. A bit like if we set our boiler to come on at 20 degrees, but somewhere between the thermostat and the boiler controller the signal gets corrupted to 50 degrees even if the room temperature is really 10 degrees, then the boiler will stay off - it can only believe what it is being told.

It might be argued: But what about how GET really does harm some people, and that pushing through these artificially high signals can and does sometimes make people much worse? Surely that could only be the case if there really was something wrong with the energy handling system itself? But that would not necessarily follow. If the fundamental problem for people with ME is their signalling system grossly amplifying its warning signals, and the person unable to distinguish between real and fake signals, then it is also a strong possibility that something like GET simply increases the damage to the signalling system itself, so it might then deliver even more corrupted signals than before. And this would all be purely at the physical level, even if it included some of the physical signalling apparatus within the brain itself.

Could this also be why people with ME also experience pain a lot? I imagine that the body's signalling mechanisms for exhaustion and pain, being they are all trauma warning signals, maybe share a fair bit of common biology. What if the same signalling fault also exists for some of the pains signalling, and that gets inflated levels also?

Edit: A thought @Jonathan Edwards. I don't know if this would be ethically feasible or even practicable. But would there be any milage for proving/disproving this, by somehow safely temporarily disabling such signalling mechanisms to see how the body reacted? I'm guessing not, because if the problem turns out to not be a signalling issue, then such study might end up committing the same kind of damage as GET. But just a thought.
 
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wallfish said:
Since we're on the topic of carefully choosing our words: "sickness behaviour" doesn't sit well with me either. Makes it sound like our chosen behaviour is the issue, not our symptoms.
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I got the impression the meaning did include behaviours when I read about it years ago—withdrawal from social spaces to solitary ones, limiting movement, eating less, etc. They would limit the spread of infectious disease as well as aiding recovery, but were driven by symptoms rather than altruism.

It might all have been made up, of course!
 
Jonathan Edwards said:
It has just been part of the folklore put about by people spinning stories about mitochondria and such like.
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like this?
Sly Saint

Thread 'Perspective: Cell Danger Response Biology—The New Science that Connects Environmental Health with Mitochondria and the Rising Tide of Chronic Illness'

Perspective: Cell Danger Response Biology—The New Science that Connects Environmental Health with Mitochondria and the Rising Tide of Chronic Illness

Robert K Naviaux Dec 2019

Highlights
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Mitochondria have been shown to be fundamental regulators of the cell danger response (CDR) that controls innate immunity, inflammation, healing, and aging.

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The setpoint of the CDR is adjusted by exposure to chemical, physical, and microbial stressors in the environment.

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Chemical pollution in waterways, air, soil, and the food chain interferes with the biology...
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  • Like
 
Barry said:
Edit: A thought @Jonathan Edwards. I don't know if this would be ethically feasible or even practicable. But would there be any milage for proving/disproving this, by somehow safely temporarily disabling such signalling mechanisms to see how the body reacted? I'm guessing not, because if the problem turns out to not be a signalling issue, then such study might end up committing the same kind of damage as GET. But just a thought.
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I think it is a very realistic thing to aim for, with care. The weak point is that it must be some subtle signal pathway that is not disabled by some known drugs like morphine or steroids or whatever.
 
wallfish said:
Since we're on the topic of carefully choosing our words: "sickness behaviour" doesn't sit well with me either. Makes it sound like our chosen behaviour is the issue, not our symptoms.

I have seen it used multiple times on this forum; I underrstand it is an established medical term. From wikipedia:

Reduction in grooming is the only behaviour I see in that list. The others all describe some internal state of the subject that an observer can only guess at. For example 'eating less' is a behaviour that could imply 'loss of appetite', but 'loss of appetite' is not a behaviour in my dictionary.

Would sickness response or symptoms be better? Why is the term sickness behaviour used?
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Sickness behavior is just the biological term for what a creature does, how it acts (acts are observable data and observable data is called behavior--even mollusks have behavior).
It's the connotation.
As in elementary school, the teacher would say, to the effect of, "you must control your behavior."

Different context. The same word can have several meanings. In the dictionary the context is noted. An example might be a word that in legal terminology has a separate meaning from the common use of the word.
 
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