Well remembered, details in the tweets in this post, https://s4me.info/threads/updates-from-the-uk-me-cfs-biobank.2401/page-3#post-109236
@Hutan Very interesting. So we could speculate that we probably don't have much problems with ischaemia as this lack of oxygen would also result in problems with fat metabolism. Quite a few people with CFS/POTS do ok on fats but bad on carbs. So what would be causing the NO that then results in poor PDH function? Could it be some sort of pathogen or something in the gut? The body produces peroxynitrite to deal with pathogens, right?
Ischaemia - an inadequate blood supply to an organ or part of the body The work on blood cell deformability suggests that there is an inadequate supply of blood to some tissues due to problems with blood flow in the small capillaries. I don't know. It would take me a long time to work out if/how this might fit with what we suspect about ME. But maybe someone who knows more can do it.
@Hutan I do think there is a problem with blood getting places based on red cell deformity and my symptoms of pounding heart, feeling like it has to work harder to get the blood where it needs to be. Having said this though, fat needs more oxygen to burn than carbs. So if we where experiencing a lot of ischaemia then I would think people would do a lot worse on fat but this doesn't seem to be the case generally. This sort of implies that if PDH malfunction is caused by NO then it is not generated by ischaemia but something else. Obviously just wildly speculating here.
@sb4 : Of course, there is a subset of us ME/CFS patients who do have a lot of problems with fats (I know @Sid on the other forum has talked about her problems with fats also). I would think the patients with comorbid gastroparesis would be having difficulties with fats too as they slow down digestion. Interesting study in light of some of the research going on, including Fluge and Mella's PDH paper a couple of years ago.
@Michelle You are right about the gastropareses. In fact that is the reason I dont tolerate fats well. However the mechanism is differen't. As far as I am aware that actual metabolism of fat isn't a problem in as many people with CFS as is carb metabolism.