Evaluating Routine Blood Tests According to Clinical Symptoms and Diagnostic Criteria in Individuals with [ME/CFS], 2021, Baklund et al

Abstract

There is a lack of research regarding blood tests within individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and between patients and healthy controls. We aimed to compare results of routine tests between patients and healthy controls. Data from 149 patients diagnosed with ME/CFS based on clinical and psychiatric evaluation as well as on the DePaul Symptom Questionnaire, and data from 264 healthy controls recruited from blood donors were compared. One-way ANCOVA was conducted to examine differences between ME/CFS patients and healthy controls, adjusting for age and gender.

Patients had higher sedimentation rate (mean difference: 1.38, 95% CI: 0.045 to 2.714), leukocytes (mean difference: 0.59, 95% CI: 0.248 to 0.932), lymphocytes (mean difference: 0.27, 95% CI: 0.145 to 0.395), neutrophils (mean difference: 0.34, 95% CI: 0.0 89 to 0.591), monocytes (mean difference: 0.34, 95% CI: 0.309 to 0.371), ferritin (mean difference: 28.13 95% CI: −1.41 to 57.672), vitamin B12 (mean difference: 83.43, 95% CI: 62.89 to 124.211), calcium (mean difference: 0.02, 95% CI: −0.02 to 0.06), alanine transaminase (ALAT) (mean difference: 3.30, 95% CI: −1.37 to -7.971), low-density lipoproteins (mean difference: 0.45, 95% CI: 0.104 to 0.796), and total proteins (mean difference: 1.53, 95% CI: −0.945 to 4.005) than control subjects. The patients had lower potassium levels (mean difference: 0.11, 95% CI: 0.056 to 0.164), creatinine (mean difference: 2.60; 95% CI: 0.126 to 5.074) and creatine kinase (CK) (mean difference: 37.57 95% CI: −0.282 to 75.422) compared to the healthy controls. Lower CK and creatinine levels may suggest muscle damage and metabolic abnormalities in ME/CFS patients.

Open access, https://www.mdpi.com/2077-0383/10/14/3105

 

so many drs read the results of test and if they are just within range just shrug of any difference as unimportant .i think all the ranges of multiple routine test are in need of a complete overhaul since they where mostly done on the results of military volunteers in the fifties if i remember correctly very fit teenage males .

 

I mean if these tests gave us any good clues we would have known it by now...

In the paper they report the means but fail to put boxplots side by side, which is definitely not very cash money.

 

It actually suggests the opposite - CK spills over into circulation when muscles are damaged. What it really means is patients are less active than controls.

 

Our gp was slightly amused when I gave her a copy of blood tests over 4 years. ' we don't use bloods like that '
Visible were clear shifts in glucose, ferritin , electrolytes and TSH


Apart from creatinine and urea, these never fell outwith normal ranges .

As my daughter was still growing some of these are doubtless expected .

The glucose may reflect metabolic issues as diet is lower carb than normal.

GP could perhaps see value in potential long term monitoring for chronic illnesses but won't happen anytime soon.

 

It's reasonable to assume the dropouts were the most severe and, although the study still had 43 out of 149 (c. 29%) participants rated as severe, this may or may not have skewed the results somewhat.

Though the findings aren't really dramatic anyway so probably not too much should be read into them. At least I hope so because if they're right then they're not studying my type of ME.

Looking at my own blood test values for the things they found differences in, only three of my results match the direction found in the study: high B12 (without supplementation), highish LDL and lowish creatinine.

But most go the opposite way.

The study found higher levels of leukocytes, lymphocytes, neutrophils and monocytes as well as increased
calcium, protein, ALAT and ASAT (severe patients) - mine are all low or low-normal. Plus the study found lower levels of potassium. Mine is normal.

(I don't have any CK or sedimentation rate values and my ferritin levels are a function of my haemochromatosis treatment so can't be compared.)

Meh.

 

Low, not high, ESR has in the past been cited as a potential marker/finding of ME/CFS. I don't think these sorts of studies will lead us anywhere.

 

It would be interesting to compare those with a modern sampling of typical underexercised poor diet subjects.

 

Has anyone ever done a study like this into hormone tests for the same number of ME patients and controls I wonder? Looking at thyroid hormones as well as sex hormones and gdh/ifg-1?

 

Seems that there is a small type in table 2. I think the mean difference for monocytes should be 0.039 rather than 0.39

 

The standard deviation for CK in the control group seems unusually large. It's reported as 282.88 while the mean is only 121.90. The standard deviation in the control group is only 34.43. It also doesn't fit with the relatively small confidence interval for the mean:

 

My blood tests always come back fabulous. I'm a very lucky chap.

 

"Patient looks well", too. Doubly lucky.

 

"You appear to be my healthiest patient."