In Search of Effective Treatments for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, 2019, Theoharides

[Andy]

Short article, looks to be some kind of foreword to an ME focused edition of the journal.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is characterized primarily by severe, unexplained fatigue1 accompanied by dysfunctional homeostasis with possible focal inflammation in the hypothalamus.2Scientists have struggled to identify the pathogenesis of ME/CFS. In the April issue of Clinical Therapeutics, experts report their findings on the diagnosis and possible causes of ME/CFS.3–10 However, effective treatments remain elusive,11,12 and the presence of comorbidities13 further complicates the search for a cure.

Open access at https://www.clinicaltherapeutics.com/article/S0149-2918(19)30175-4/fulltext

 

[Trish]

It looks like this is introducing the second collection of articles, following the ones he introduced with this article:
A Timely Multidisciplinary Update on ME/CFS (link to thread).

I am puzzled by his definitions of ME/CFS.
In the first article he says:

Chronic fatigue syndrome (CFS), later named myalgic encephalomyelitis (ME), is characterized primarily by severe, long-lasting fatigue along with dysfunctional homeostasis, especially temperature dysregulation.

And now in this article he says:

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is characterized primarily by severe, unexplained fatigue1 accompanied by dysfunctional homeostasis with possible focal inflammation in the hypothalamus

 

[Wonko]

My exhaustion is easily explained by the following;

I am alive,
I have ME.

I would imagine, but as I'm not an 'expert' I cannot be totally sure, that resolving either one would resolve my exhaustion.

Possibly a subject for research.

 

[Mithriel]

"characterized primarily by severe, unexplained fatigue"

I am in a bit of a relapse so I am feeling bored and grumpy but I am getting angrier and angrier about people who should know better describing our disease this way.

It is an ABNORMAL RESPONSE TO EXERCISE which characterises ME. This can lead to experiencing fatigue most of the time because every bit of exertion causes payback but GET IT RIGHT!

 

[Wonko]

Grumpiness would definitely appear to be a symptom of ME, unfortunately it's specificity seems low, with at least one other condition having the same symptom (VMS - Victor Meldrew Syndrome - risk factors for this appear to be being male and above a certain age - not things that typically define PwME well).

So the diagnostic and predictive characteristics of grumpiness lead me to believe that it would probably be unsuitable as a primary sign.