Wednesday, February 5, 2014

Poor oxygen uptake and Post-exertional malaise

Post-exertional malaise is the most perplexing problem in ME/CFS, but hope
may be on the way. A large study finding that the muscles are not getting
very much oxygen during exercise suggests researchers may be getting closer
to understanding why exercise is such a problem.

Similar findings in fibromyalgia and some autoimmune disorders suggest
people with ME/CFS may not be alone.

Find out how low oxygen uptake may hampering your health in

Tuesday, February 4, 2014

Low-dose clonidine is not clinically useful in CFS

Original Investigation | February 03, 2014

Disease Mechanisms and Clonidine Treatment in Adolescent Chronic
Fatigue Syndrome:  A Combined Cross-sectional and Randomized Clinical

Dag Sulheim, MD1,2; Even Fagermoen, MD3,4; Anette Winger, RN, MA3,5;
Anders Mikal Andersen, BSc6; Kristin Godang, BSc7; Fredrik Müller, MD,
PhD8; Peter C. Rowe, MD, PhD9; J. Philip Saul, MD10; Eva Skovlund,
PhD11,12; Merete Glenne Øie, PhD13,14; Vegard Bruun Wyller, MD,

JAMA Pediatr. Published online February 03, 2014.


Importance  Chronic fatigue syndrome (CFS) is a disabling condition
with unknown disease mechanisms and few treatment options.

Objective  To explore the pathophysiology of CFS and assess clonidine
hydrochloride pharmacotherapy in adolescents with CFS by using a
hypothesis that patients with CFS have enhanced sympathetic activity
and that sympatho-inhibition by clonidine would improve symptoms and

Design, Setting, and Participants  Participants were enrolled from a
single referral center recruiting nationwide in Norway. A referred
sample of 176 adolescents with CFS was assessed for eligibility; 120
were included (34 males and 86 females; mean age, 15.4 years). A
volunteer sample of 68 healthy adolescents serving as controls was
included (22 males and 46 females; mean age, 15.1 years). The CSF
patients and healthy controls were assessed cross-sectionally at
baseline. Thereafter, patients with CFS were randomized 1:1 to
treatment with low-dose clonidine or placebo for 9 weeks and monitored
for 30 weeks; double-blinding was provided. Data were collected from
March 2010 until October 2012 as part of the Norwegian Study of
Chronic Fatigue Syndrome in Adolescents: Pathophysiology and
Intervention Trial.

Interventions  Clonidine hydrochloride capsules (25 µg or 50 µg twice
daily for body weight <35 kg or >35 kg, respectively) vs placebo
capsules for 9 weeks.

Main Outcomes and Measures  Number of steps per day.

Results  At baseline, patients with CFS had a lower number of steps
per day (P < .001), digit span backward score (P = .002), and urinary
cortisol to creatinine ratio (P = .001), and a higher fatigue score (P
< .001), heart rate responsiveness (P = .02), plasma norepinephrine
level (P < .001), and serum C-reactive protein concentration (P = .04)
compared with healthy controls. There were no significant differences
regarding blood microbiology evaluation. During intervention, the
clonidine group had a lower number of steps per day (mean difference,
−637 steps; P = .07), lower plasma norepinephrine level (mean
difference, −42 pg/mL; P = .01), and lower serum C-reactive protein
concentration (mean ratio, 0.69; P = .02) compared with the CFS
placebo group.

Conclusions and Relevance  Adolescent CFS is associated with enhanced
sympathetic nervous activity, low-grade systemic inflammation,
attenuated hypothalamus-pituitary-adrenal axis function, cognitive
impairment, and large activity reduction, but not with common
microorganisms. Low-dose clonidine attenuates sympathetic outflow and
systemic inflammation in CFS but has a concomitant negative effect on
physical activity; thus, sympathetic and inflammatory enhancement may
be compensatory mechanisms. Low-dose clonidine is not clinically
useful in CFS.

Trial Registration Identifier: NCT01040429

Sunday, February 2, 2014

Who is Causing Facebook to Block Tuller’s Article?


On Monday, January 27, 2014, David Tuller published, on Buzzfeed, a well-researched and factual article"—How "Chronic Fatigue Syndrome" Obscures A Serious Illness"—on ME/CFS and the government's efforts to redefine the disease. As of right now, 78,331 people have viewed the article. Also, almost 8,000 people "liked" the article directly from the Buzzfeed site by using the Facebook like button.

Some time last night or this morning, the Facebook share button for this article was disabled by Facebook and Facebook blocked any direct sharing of the piece from the Buzzfeed site.

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Paste this link to your Facebook -- if they won't let us "share", we'll do it manually!