Professor Anthony Komaroff, articles and videos, 2018 onwards

Activation of “hunkering-down” systems. Animals, including humans, have systems to protect them during times of major threats. For example, worms and bears that are faced with a shortage of food “hunker down”: they activate systems that focus the energy they are able to make on the processes necessary to stay alive. Nonessential, energy-requiring activities are minimized. Humans who are seriously injured or sick also activate various hunkering-down systems. Some evidence suggests that in ME/CFS the hunkering-down systems may have been turned on, and remain inappropriately stuck. Research teams are trying to figure out how to turn off the hunkering-down systems.

Which systems does he refer to here? Is this a reference to Naviaux' findings and ideas?
 
Which systems does he refer to here? Is this a reference to Naviaux' findings and ideas?
Seems to refer to the general malaise, brain fog, weakness and aches that accompany the flu and is caused by the body's response, not the pathogen. It doesn't seem to be a well-defined concept. Sometimes called the sickness response but I'm not sure why he chose that hunker down label.

It would definitely help to clarify that concept. It's something everyone is familiar with and would go a long towards explaining what ME feels like, because malaise doesn't really cut it that much better than fatigue does. No one who's been sick with the flu for a week will say they were "fatigued" or "malaised" for a week. Everyone will say they were sick. That's the only word that fits, but we're somehow not allowed to use it.

I guess it's just not considered that important since it's believed to only exist as a temporary thing, that when it becomes chronic, like with us, it's something else and some people have taken to call it fatigue for arbitrary reasons, mostly having to do with being necessary for their alternative explanation.

Medicine would enormously benefit from a "back to basics" approach to basic vocabulary. Too much slang with too many meanings has creeped in and the meaning of some words has been stripped of all meaning. That so many words have multiple meanings is embarrassingly bad for a field of science.
 
Activation of “hunkering-down” systems. Animals, including humans, have systems to protect them during times of major threats. For example, worms and bears that are faced with a shortage of food “hunker down”: they activate systems that focus the energy they are able to make on the processes necessary to stay alive. Nonessential, energy-requiring activities are minimized. Humans who are seriously injured or sick also activate various hunkering-down systems. Some evidence suggests that in ME/CFS the hunkering-down systems may have been turned on, and remain inappropriately stuck. Research teams are trying to figure out how to turn off the hunkering-down systems.

I suspect that we are in a basic survival mode most of the time because our bodies do not have enough ATP because of the broken aerobic respiration system. The Workwell studies show that we rely on anaerobic respiration for our basic needs like using a credit card for everyday food.

We do not have an inappropriately stuck system we have a system that is doing its job properly by helping us survive with very broken bodies.
 
The problem (apart from not mentioning my favourite exercise physiology findings) is the fact that there really have been very few original insights and still a lack of research capacity going forward. The amount of articles seems to go up by 1000 (we're now over 9000!) everytime someone quotes a similar figure. But 9000 is a drop in the bucket, given most of them are low-budget studies studying the same old things and getting the same old null or non-specific results) (oh and the old '$17 to $24 billion annually' is way out of date, given inflation)
Also there haven’t been 9000 studies finding abnormalities: these sorts of figures tend to refer to the number of PubMed search results which cover all sorts of publications. Not sure how many studies there have been finding abnormalities, maybe 1000-1500?
 
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Also there hasn’t been 9000 studies finding abnormalities: these sorts of figures tend to refer to the number of PubMed search results which cover all sorts of publications. Not sure how many studies there have been finding abnormalities, maybe 1000-1500?

I would be surprised if Dr. Komaroff were not right about the number. He has been tracking these publications since the early ’90s at the latest and the number has gone up slowly. His own paper in the ‘90s was a game changer; he was the first to show brain scans that distinguished our brains from depression and other conditions.

This is a complete aside, but when that paper came out, a good friend was at an appointment with one of our “experts” who held up the paper and said, “This paper says that your brain is deteriorating and will stop functioning.” My friend went home, took out a hunting knife, and contemplated suicide. I happened to call and literally screamed “That’s not what it says! Read it”

My friend stuck around until he died many years later of a heart attack. (The same “expert” advised him not to stop smoking.) I haven’t forgiven the “expert” yet.
 
I would be surprised if Dr. Komaroff were not right about the number. He has been tracking these publications since the early ’90s at the latest and the number has gone up slowly. His own paper in the ‘90s was a game changer; he was the first to show brain scans that distinguished our brains from depression and other conditions.
https://www.ncbi.nlm.nih.gov/pubmed/?term="Chronic+fatigue+syndrome"
Items: 1 to 20 of 6756

This sample shows an example of how most papers are not individual biological studies with their own results:

Items: 1 to 20 of 6756
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Select item 317374911.
Implementing guided ICBT for chronic pain and fatigue: A qualitative evaluation among therapists and managers.

van der Vaart R, Worm-Smeitink M, Bos Y, Wensing M, Evers A, Knoop H.

Internet Interv. 2019 Oct 31;18:100290. doi: 10.1016/j.invent.2019.100290. eCollection 2019 Dec.

PMID:

31737491
Similar articles

Select item 317369662.
Naltrexone Restores Impaired Transient Receptor Potential Melastatin 3 Ion Channel Function in Natural Killer Cells From Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients.

Cabanas H, Muraki K, Staines D, Marshall-Gradisnik S.

Front Immunol. 2019 Oct 31;10:2545. doi: 10.3389/fimmu.2019.02545. eCollection 2019.

PMID:

31736966
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Select item 317316063.
An Association of Serotonin with Pain Disorders and Its Modulation by Estrogens.

Paredes S, Cantillo S, Candido KD, Knezevic NN.

Int J Mol Sci. 2019 Nov 15;20(22). pii: E5729. doi: 10.3390/ijms20225729. Review.

PMID:

31731606
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Select item 317271604.
A systematic review of natural killer cells profile and cytotoxic function in myalgic encephalomyelitis/chronic fatigue syndrome.

Eaton-Fitch N, du Preez S, Cabanas H, Staines D, Marshall-Gradisnik S.

Syst Rev. 2019 Nov 14;8(1):279. doi: 10.1186/s13643-019-1202-6. Review.

PMID:

31727160
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Select item 317201645.
Cannabis-induced Acute Coronary Syndrome: A Coincidence or Not?

Landa E, Vigandt E, Andreev A, Malyshev Y, Sahni S.

Cureus. 2019 Sep 19;11(9):e5696. doi: 10.7759/cureus.5696.

PMID:

31720164

Free PMC Article
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Select item 317123516.
Correction: unidentified chronic Fatigue Syndrome/myalgic encephalomyelitis (CFS/ME) is a major cause of school absence: surveillance outcomes from school-based clinics.

[No authors listed]

BMJ Open. 2019 Nov 10;9(11):e000252corr1. doi: 10.1136/bmjopen-2011-000252corr1. No abstract available.

PMID:

31712351

Free Article
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Select item 317090067.
The longitudinal effects of seated isometric yoga on blood biomarkers, autonomic functions, and psychological parameters of patients with chronic fatigue syndrome: a pilot study.

Oka T, Tanahashi T, Lkhagvasuren B, Yamada Y.

Biopsychosoc Med. 2019 Nov 5;13:28. doi: 10.1186/s13030-019-0168-x. eCollection 2019.

PMID:

31709006

Free PMC Article
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Select item 317076358.
Developing and pretesting a new patient reported outcome measure for paediatric Chronic Fatigue Syndrome/ Myalgic Encephalopathy (CFS/ME): cognitive interviews with children.

Parslow RM, Shaw A, Haywood KL, Crawley E.

J Patient Rep Outcomes. 2019 Nov 9;3(1):67. doi: 10.1186/s41687-019-0156-8.

PMID:

31707635
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Select item 317064559.
Autonomic markers, chronic fatigue syndrome, and post-exertion states.

Friedberg F.

J Psychosom Res. 2019 Oct 30:109845. doi: 10.1016/j.jpsychores.2019.109845. [Epub ahead of print] No abstract available.

PMID:

31706455
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Select item 3169905110.
A logistic regression analysis of risk factors in ME/CFS pathogenesis.

Lacerda EM, Geraghty K, Kingdon CC, Palla L, Nacul L.

BMC Neurol. 2019 Nov 7;19(1):275. doi: 10.1186/s12883-019-1468-2.

PMID:

31699051

Free PMC Article
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Select item 3167132111.
Intra brainstem connectivity is impaired in chronic fatigue syndrome.

Barnden LR, Shan ZY, Staines DR, Marshall-Gradisnik S, Finegan K, Ireland T, Bhuta S.

Neuroimage Clin. 2019 Oct 19;24:102045. doi: 10.1016/j.nicl.2019.102045. [Epub ahead of print]

PMID:

31671321

Free PMC Article
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Select item 3166985812.
News and views in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): The role of co-morbidity and novel treatments.

Comhaire F, Deslypere JP.

Med Hypotheses. 2019 Oct 22;134:109444. doi: 10.1016/j.mehy.2019.109444. [Epub ahead of print]

PMID:

31669858

Free Article
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Select item 3165186813.
Evidence of altered cardiac autonomic regulation in myalgic encephalomyelitis/chronic fatigue syndrome: A systematic review and meta-analysis.

Nelson MJ, Bahl JS, Buckley JD, Thomson RL, Davison K.

Medicine (Baltimore). 2019 Oct;98(43):e17600. doi: 10.1097/MD.0000000000017600.

PMID:

31651868

Free Article
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Select item 3164779914.
The motivations behind science denial.

McLintic A.

N Z Med J. 2019 Oct 25;132(1504):88-94.

PMID:

31647799
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Select item 3164234515.
The effect of comorbid medical and psychiatric diagnoses on chronic fatigue syndrome.

Natelson BH, Lin JS, Lange G, Khan S, Stegner A, Unger ER.

Ann Med. 2019 Nov 7:1-8. doi: 10.1080/07853890.2019.1683601. [Epub ahead of print]

PMID:

31642345
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Select item 3164063216.
Persistent physical symptoms reduction intervention: a system change and evaluation in secondary care (PRINCE secondary) - a CBT-based transdiagnostic approach: study protocol for a randomised controlled trial.

Chalder T, Patel M, James K, Hotopf M, Frank P, Watts K, McCrone P, David A, Ashworth M, Husain M, Garrood T, Moss-Morris R, Landau S.

BMC Psychiatry. 2019 Oct 22;19(1):307. doi: 10.1186/s12888-019-2297-y.

PMID:

31640632

Free PMC Article
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Select item 3163765017.
Rethinking the Standard of Care for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Friedberg F, Sunnquist M, Nacul L.

J Gen Intern Med. 2019 Oct 21. doi: 10.1007/s11606-019-05375-y. [Epub ahead of print] No abstract available.

PMID:

31637650
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Select item 3163521818.
Neuroimmunology: What Role for Autoimmunity, Neuroinflammation, and Small Fiber Neuropathy in Fibromyalgia, Chronic Fatigue Syndrome, and Adverse Events after Human Papillomavirus Vaccination?

Ryabkova VA, Churilov LP, Shoenfeld Y.

Int J Mol Sci. 2019 Oct 18;20(20). pii: E5164. doi: 10.3390/ijms20205164. Review.

PMID:

31635218

Free Article
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Select item 3163411619.
Paroxysmal Kinesigenic Dyskinesia Symptoms Markedly Reduced with Parenteral Vitamins and Minerals: A Case Report.

Bruton A, Fuller L.

Perm J. 2019;23. doi: 10.7812/TPP/19.036. Epub 2019 Oct 3.

PMID:

31634116
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Select item 3163075820.
Recent insights into innate and adaptive immune responses to Giardia.

Singer SM, Fink MY, Angelova VV.

Adv Parasitol. 2019;106:171-208. doi: 10.1016/bs.apar.2019.07.004. Epub 2019 Aug 1.

PMID:

31630758
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I think I recall him using the 4000+ number when they were 4000+ "chronic fatigue syndrome" entries in PubMed.
 
I would be surprised if Dr. Komaroff were not right about the number
I think Dolphin is right. Pubmed gives hits if keywords are used in abstract information. If you used all synonyms of ME/CFS you probably get a figure of around 6000 to 9000 hits. Not all scienitific papers ard indexed on Pubmed but most of them are.

Many of those hits will have little to do with ME/CFS, they just mention it somewhere. And of those about ME/CFS only a minority will report on biomedical abnormalities (there are letters, editorials, treatment trials systematic reviews, all the questionnaire studies etc.). So it doesn't seem likely that there are 9000 studies showing biological abnormalities in ME/CFS. What he probably means is there have been a lot of papers on ME/CFS (around 9000) and many of these have reported biological abnormalities or something like that.
 
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Poem based on Anthony Komaroff ME/CFS article is a finalist in US poetry contest

No, really:

@Veronica Ashenhurst is a poet with severe ME. Her poem “Redefining Her” was chosen as a finalist in Health Affairs’ poetry contest. It’s a “found poem,” meaning that text from another source is used to create poetic meaning. Specifically, in writing the poem, Veronica restricted herself to only using words from Anthony L. Komaroff’s article Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: When Suffering is Multiplied. She selected specific words from Komaroff’s article and rearranged them to create the poem.

This might seem an unlikely route to poetry but, as you can see, it works:

…One cloud-high day, she cleared
for takeoff on a runway. Next, her hard,
sudden fall. Illness, a large exhausted lack.
“There is nothing wrong with you,” said doctors,
in decades multiplied like judgments …

View the shortlisted poems here (scroll down a bit to read or listen to the full version of Redefining Her).
here is a direct link to Veronic reading her own poem.

There is a separate thread with Veronica's other published poems.
 
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It is very challenging to write a "found' poem because the poet must not change verb tense, nor make a singular noun plural, nor add in a single word of her own. It's about creating your own meaning using another text, and all the vocabulary found therein. It is also about creating a dialogue with the original text. Maybe someone should send this to Komaroff??
 
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EP32: ME/CFS and Long COVID: Are They Connected?Hope and Help For Fatigue & Chronic Illness
    • Medicine




Read "ME/CFS and Long COVID share similar symptoms and biological abnormalities: road map to the literature" – co-authored by Dr. Anthony L. Komaroff & W. Ian Lipkin.

https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1187163/full


In this week's episode, Haylie Pomroy is joined by Dr. Anthony Komaroff to explore the complications of ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome) and long COVID, discussing their underlying causes, symptoms, and the latest research.

Dr. Komaroff shares his extensive experience in the field, discussing the evolution of ME/CFS research, the significance of recognizing these conditions, and the common challenges and misconceptions patients face.

Haylie and Dr. Komaroff provide valuable insights, practical advice, and a compassionate perspective on ME/CFS and long COVID diagnosis and management.


Sign up for the COVID-UPP Study:

https://redcap.nova.edu/redcap/surv...*1h830h7*_gcl_au*MTM2NDA0MTQyOS4xNzE1MDA0ODAy


Donate to ME/CFS Research:

https://givecampus.com/b3yrwb

If you are interested in joining a Gulf War Illness (GWI) trial, please complete the Recruitment Registry Form.

https://redcap.nova.edu/redcap/surveys/?s=Y9YF8JJWJRK8HEKL &_gl=1*1fipp18*_gcl_aw*R0NMLjE3MDc5MTgwMzIuRUFJYUlRb2JDaE1JeWNyUXVfcXFoQU1WU1pCYUJSM3AyQWRBRUFBWUFTQUFFZ0s1NWZEX0J3RQ..*_gcl_au*MTg2NjgwMDQ4Ni4xNzA3MTQwNzgx


Learn more about INIM’s Research Studies:

https://www.nova.edu/nim/research-studies/index.html


Dr. Anthony L. Komaroff is a distinguished Professor of Medicine at Harvard Medical School and a Senior Physician at Brigham and Women’s Hospital. He has held significant leadership roles, including Director of the Division of General Medicine and Primary Care at Brigham and Women’s Hospital. Dr. Komaroff is known for his research on myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and human herpesvirus infections. He has published over 270 research articles and book chapters and served on numerous advisory committees for major health organizations.


LinkedIn: https://www.linkedin.com/in/anthony-l-komaroff-64133346/

Facebook: https://web.facebook.com/anthonyl.komaroff


"ME/CFS and Long COVID share similar symptoms and biological abnormalities: road map to the literature" - co-authored by Dr. Anthony L. Komaroff & W. Ian Lipkin

https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1187163/full


Solve ME: https://solvecfs.org

Open Medicine Foundation: https://www.omf.ngo

National Institutes of Health (NIH): https://www.nih.gov/mecfs/about-mecfs

Centers for Disease Control and Prevention (CDC): https://www.cdc.gov/me-cfs/about/index.html


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#MECFS #ChronicFatigueSyndrome #MyalgicEncephalomyelitis #ChronicIllness #ChronicFatigue #ClinicalResearch #MedicalResearch #LongCOVID #PostCOVIDSyndrome #Health #HealthPodcast

 
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The Biology of Post-Infectious Chronic Illness​


Institute for Neuro-Immune Medicine
13.1K subscribers


1,080 views Feb 10, 2026 Clinical Research
Read "ME/CFS and Long COVID share similar symptoms and biological abnormalities: road map to the literature" – co-authored by Dr. Anthony L. Komaroff & W. Ian Lipkin.https://www.frontiersin.org/journals/... Fatigue is the body’s hard-wired response to a viral infection.In today’s episode, Haylie Pomroy shares insights with Dr. Anthony L. Komaroff to examine the history of ME/CFS research, the causes and triggers of ME/CFS and other post-infectious chronic illnesses, and the abnormalities observed in the brain and autonomic nervous system among patients with ME/CFS and long COVID.Dr. Komaroff also addresses how patients have often been dismissed within the healthcare system, explains the physical and psychological processes involved in these conditions, and discusses how he and other clinicians are now moving to the forefront of diagnosis and treatment.
Key points:
00:01 Introduction
02:06 Growing interest in ME/CFS research
04:42 Why patients are dismissed by clinicians
06:01 Why “Myalgic Encephalomyelitis” is the better term
07:24 The early stages of ME/CFS research
09:37 Abnormalities in the brain and autonomic nervous system
10:36 Educating and reeducating doctors and physicians
13:02 What causes ME/CFS
17:07 What triggers ME/CFS
19:29 A combination of genetic and environmental vulnerability
21:43 Why some viruses doesn’t go away after 14 days22:54 How ME/CFS and long COVID reactivate EBV
24:44 Honoring an illness’s complexity
26:40 Getting into the forefront of diagnostics and treatments.
29:01 Strengthening the body against symptoms
31:29 Exacerbation is an inflammatory response
35:23 Online resources and information

Register for the Integrative Medicine Luncheon featuring Dr. Payam Hakimi.https://nova.zoom.us/meeting/register...Dr. Anthony L. Komaroff is a distinguished Professor of Medicine at Harvard Medical School and a Senior Physician at Brigham and Women’s Hospital. He has held significant leadership roles, including Director of the Division of General Medicine and Primary Care at Brigham and Women’s Hospital. Dr. Komaroff is known for his research on myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and human herpesvirus infections. He has published over 270 research articles and book chapters and served on numerous advisory committees for major health organizations.LinkedIn: / anthony-l-komaroff-64133346 Facebook: / anthonyl.komaroff

 
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