MedicalResearch.com Interview with:
Begoña Ruiz Núñez
Begoña Ruiz Núñez PhD (c)
Laboratory Medicine UMC Groningen
Co-directora de Healthy Institute
President of the Asociación Española de Psico-Neuro-Inmunologí
MedicalResearch.com: What is the background for this study?
Response: The diagnosis of Chronic Fatigue Syndrome (CFS) is based on the Fukuda criteria, i.e. symptoms, disability, and exclusion of explanatory illnesses, and not by means of physical signs or abnormalities in laboratory test results. CFS has been described as a ´allostatic overload condition´, where the physiological mechanisms employed to deal with stress contribute to the perpetuation of the disorder. Chronic Fatigue Syndrome patients are 1.9 times more likely to have a high allostatic load index than healthy controls. Thyroid allostasis-adaptive responses, presenting as non-thyroidal-illness syndrome, have been found in many conditions, ranging from critical illness, uremia and starvation to tumors. Taken together, it is possible that, despite TSH and T4 levels within reference ranges, Chronic Fatigue Syndrome symptoms may be attributable in part to allostatic responses, i.e. lower thyroid hormone activity, secondary to chronic (low-grade) inflammation caused by e.g. a compromised gut microbiome and gut wall integrity.
MedicalResearch.com Interview with:
Roland Staud, M.D.
Professor of Medicine
University of Florida
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Fatigue after exertion or sleep loss is normal. However, fatigue at rest is not. Resting fatigue is reported by cancer, heart disease, RA, SLE patients and patients with chronic fatigue syndrome (CFS). CFS has been mostly associated with chronic infections but findings are inconsistent. We hypothesized that chronic fatigue is signaled by sensitized tissue receptors to the CNS where minute amounts of muscle metabolites can activate these receptors (metabo-receptors). Why the receptors are sensitized is unclear. To test our hypothesis we injected CFS patients with lidocaine or normal saline into muscles once. We saw a statistical improvement of overall fatigue (27%) with lidocaine compared to saline.
Conclusion: Chronic fatigue syndrome patients are using metabo-receptors for inappropriately signaling fatigue to the CNS.
MedicalResearch.com Interview with
Prof. Julia I. Newton:
Dean of Clinical Medicine & Professor of Ageing and Medicine
Clinical Academic Office
The Medical School
MedicalResearch: What are the main findings of the study?
Prof. Newton: In this study we have explored for the first time the characteristics of patients with Postural tachycardia in the UK
- Postural Tachycardia Syndrome patients are predominantly female, young, well educated and have significant and debilitating symptoms that impact significantly upon their quality of life.
- Despite this, there is no consistent treatment, high levels of disability and associated comorbidity.
- Although individuals presented with symptoms at the same age, those attending a specialist clinic received a diagnosis quicker.
- Symptom burden for those with Postural tachycardia is high and comparable to that seen in Chronic Fatigue Syndrome.
- Chronic Fatigue Syndrome is recognized by the WHO as a neurological disorder and by the Disability Discrimination Act 2005 as a disability. At the current time those with Postural Tachycardia Syndrome suffer to the same extent as those with Chronic Fatigue Syndrome but do not receive the same protection from the law.
- It is important that more work is done to understand the underlying autonomic abnormality in those with Postural Tachycardia Syndrome in order to allow us to develop targeted treatments that are effective and go beyond the currently available simply symptomatic management.