Will "THE" cause of ME/CFS ever be found?

Whenever I read someone writing that they are looking for "the" one cause of ME/CFS, or that even "the" one cause of ME/CFS might have been pinned down, I know that the person writing has no clue about ME/CFS.

If you take at random two persons with ME/CFS – regardless of how strict your diagnostic criteria are – chances are high that their similar diseases are caused by different things. One person's body might be tormented by an food-induced autoimmunity, the other person's body might fail to recuperate from an infection.

So I do not think that one single cause of ME/CFS will ever be found, but instead the many different causes of ME/CFS in different people will be found – one by one.

Maybe Lipkin has a fast-track to finding the most prevalent causes of ME/CFS, but he will not find a silver-bullet to solve ME/CFS, once and for all.

Giving idle talk about "THE" cause of ME/CFS (and presenting it like a silver bullet) is not giving hope, it is spreading BS.

Someone giving the impression that there might be one single cause of ME/CFS is a either a charlatan, a quack or a idiotic know-nothing bullshitter.

Is POTS / OI / NMH another form of Deyhdration?

Dr. Briffa on dehydration:

I read a review paper recently about the assessment of dehydration. The authors conclude that we don’t have very good standardised tests for dehydration, but a reasonable test is to measure heart rate when sitting, and then again immediately on standing. During dehydration the blood volume tends to be lower and blood pressure too.

On standing, there is a tendency for blood to ‘pool’ in the lower body, causing blood pressure to drop further, which may induce a reflex increase in heart rate. If the pulse rate increases by 20 beats per minute or more on standing, this is generally taken as a sign of dehydration. However, as the authors concede, this test is not a particularly reliable way of assessing dehydration, even when blood volume is significantly depleted.

Anecdote: Paleo Diet helps for Crohn's

Robb Wolf has the details:

…
A couple weeks later, at home, bored and on Youtube, a video about the Paleo diet popped up and after watching this I was fascinated; For the next week I was locked to my laptop finding out all I could about it. I immediately decided to give the auto-immune protocol a try, and after a few trials and errors to discover what I could and couldn’t tolerate, virtually ALL my symptoms of Crohn’s were gone!

Let me break that down for you,

Joint pain-100%gone

Psoriasis-100%gone

Diarrhea-100% gone

Intestinal pain-100% gone
…

I think the note about the auto-immune protocol is important. IIRC Robb Wolf's auto-immune protocol gets rid of eggs and nightshades, among others, as I think eggs might be involved in the pathogenesis of Crohn's.

Low-dose naltrexone: Better than nothing?

Low-dose naltrexone for the treatment of fibromyalgia: Findings of a small, randomized, double-blind, placebo-controlled, counterbalanced, crossover trial assessing daily pain levels.
Younger J, Noor N, McCue R, Mackey S.

Stanford University School of Medicine, Palo Alto, California.

Abstract

OBJECTIVE:
To determine whether low dosages (4.5 mg/day) of naltrexone reduce fibromyalgia severity as compared with the nonspecific effects of placebo.

In this replication and extension study of a previous clinical trial, we tested the impact of low-dose naltrexone on daily self-reported pain.

Secondary outcomes included general satisfaction with life, positive mood, sleep quality, and fatigue.

METHODS:
Thirty-one women with fibromyalgia participated in the randomized, double-blind, placebo-controlled, counterbalanced, crossover study.

During the active drug phase, participants received 4.5 mg of oral naltrexone daily.

An intensive longitudinal design was used to measure daily levels of pain.

RESULTS:
When contrasting the condition end points, we observed a significantly greater reduction of baseline pain in those taking low-dose naltrexone than in those taking placebo (28.8% reduction versus 18.0% reduction; P = 0.016).

Low-dose naltrexone was also associated with improved general satisfaction with life (P = 0.045) and with improved mood (P = 0.039), but not improved fatigue or sleep.

Thirty-two percent of participants met the criteria for response (defined as a significant reduction in pain plus a significant reduction in either fatigue or sleep problems) during low-dose naltrexone therapy, as contrasted with an 11% response rate during placebo therapy (P = 0.05).

Low-dose naltrexone was rated equally tolerable as placebo, and no serious side effects were reported.

CONCLUSION:
The preliminary evidence continues to show that low-dose naltrexone has a specific and clinically beneficial impact on fibromyalgia pain.

The medication is widely available, inexpensive, safe, and well-tolerated.

Parallel-group randomized controlled trials are needed to fully determine the efficacy of the medication.

Color me unconvinced.

The results may be "significant" in the statistical sense – and then even barely, just look at the p-values and the small sample size. To me however they don't look significant in the common sense of the word.

LDN may help some patients, a bit – so I won't blame you if you do give it a try. A cure or significant help, LDN is not.

If the (small) benefits of LDN outweigh the side-effects, that can this study not answer.

Feedback!

I was just wondering: Is there anything you find helpful in this blog? If so, please leave a comment! Short one, long one, thoughtful one, quickly written one – any comment will do, raise your voice.

At the moment I'm a bit out of energy, and non-Internet things (aka "The Real Life") keep me from blogging more.

Also, my quest for health takes me a bit away from ME/CFS, both in a more broader sense (as I will try to focus more on nutrition and health, and mainly the Paleo Diet) and a more narrower sense (as I might have Behçet's, which might have been caused by dairy and eggs).

Amazing

I would not have thought it possible: Now that Cort Johnson has left Phoenix Rising and is blogging on his own website, this has resulted in a lower quality of both his postings on his new website and lower quality postings on Phoenix Rising by the remaining fools tools bloggers.


Oh well, so much for our only hope – harhar.

Vegetable Oils, PUFAs, Omega-6? Don't eat it.

If you need any more evidence that seed oil (aka "vegetable oil") is bad for your health, here it is:

Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis
…
Advice to substitute polyunsaturated fats for saturated fats is a key component of worldwide dietary guidelines for coronary heart disease risk reduction.

However, clinical benefits of the most abundant polyunsaturated fatty acid, omega 6 linoleic acid, have not been established.

In this cohort, substituting dietary linoleic acid in place of saturated fats increased the rates of death from all causes, coronary heart disease, and cardiovascular disease.

An updated meta-analysis of linoleic acid intervention trials showed no evidence of cardiovascular benefit.

These findings could have important implications for worldwide dietary advice to substitute omega 6 linoleic acid, or polyunsaturated fats in general, for saturated fats. 

To sum it up: The advise of the past decades for a "heart healthy" not only has no health benefits, it actually creates the problem it perpetuates to fight.

Don't eat vegetable oils, because vegetable oils cause disease.

Eat saturated fat, because saturated fat does not cause disease.

I know this will make most doctors unhappy, but hey: go fuck yourselves. Handing out murderous advise for decades? If people find out, there'll be a shortage of pitch-forks, I hope – one can dream, right?

(via)

[Update] Stan the Heretic an his take on the matter:

…
This high multiple factor seems to be confirm by the data from Table 5 indicating that for every 5% PUFA increase (in absolute energy%) the All cause mortality, the Cardiovascular disease mortality and the Coronary heart disease mortality increased by 31%, 35% and 26% respectively (relative risk factor).

This implies a proportionality factor of about 5-7. That is, for every 1% added Poly-Unsaturated Fatty Acids ( PUFA) in absolute calories % of the total, cardiovascular mortality INCREASED by 5 to 7%. This is big news!
…

[Update] Chris Kresser on the same topic.