Evidence browser

What is called symptom?

Eriksen, Thor Eirik, Risør, Mette Bech·Medicine, health care, and philosophy·2014

This paper explores what we actually mean by the word 'symptom' in medicine. The authors argue that when doctors can't find a clear medical cause for illness—like ME/CFS—our usual way of thinking about symptoms breaks down. They suggest we need to understand symptoms in broader ways, including how patients' social lives, personal experiences, and individual circumstances shape how they experience illness.

E3 PreliminaryMechanismPEM unclearObservational

Chronic fatigue syndrome, fibromyalgia, and myalgic encephalomyelitis: a clinical perspective.

Teitelbaum, Jacob·Alternative therapies in health and medicine·2014

This article reviews how chronic fatigue syndrome (ME/CFS), fibromyalgia, and related conditions present in clinical practice. Dr. Teitelbaum, an experienced clinician, discusses the symptoms and practical aspects of these overlapping illnesses that affect energy, pain, and sleep. The piece offers a clinical perspective on recognizing and understanding these conditions from a doctor's viewpoint.

Clinical features in patients with long-lasting macrophagic myofasciitis.

Rigolet, Muriel, Aouizerate, Jessie, Couette, Maryline et al.·Frontiers in neurology·2014

This study describes macrophagic myofasciitis (MMF), a condition where aluminum from vaccines persists in muscle tissue and causes long-lasting symptoms similar to ME/CFS, including widespread pain, severe fatigue, and significant problems with thinking and memory. Patients show patterns of brain abnormalities on imaging scans, and their cognitive problems appear to be caused by brain dysfunction rather than just pain or depression. The researchers found that standard treatments don't work well for these patients, making their condition particularly disabling.

Neuroinflammation

E3 PreliminaryMechanismPEM not requiredMechanistic

Utilization of replication-competent XMRV reporter-viruses reveals severe viral restriction in primary human cells.

Stürzel, Christina Martina, Palesch, David, Khalid, Mohammad et al.·PloS one·2013

Researchers tested whether XMRV, a virus once thought to be linked to ME/CFS, could actually infect and spread in human immune cells. They found that while the virus could replicate in some laboratory cell lines, it could not effectively infect or spread in real human blood cells from patients. This supports the conclusion that XMRV is unlikely to be a genuine human pathogen responsible for ME/CFS.

E3 PreliminaryReviewPEM not requiredReview-Narrative

Chronic fatigue syndrome in the UK armed forces.

Le Blackadder-Coward, J C Q, Perry, S·Journal of the Royal Naval Medical Service·2013

This study examined how ME/CFS (also called CFS) affects people serving in the UK military, and how the condition should be recognized and managed in this specific setting. ME/CFS can significantly impact a service member's career and ability to work in challenging military environments. The article discusses how doctors can better identify and treat this condition in military personnel.

E3 PreliminaryMechanismPEM not requiredMechanistic

Modulation of the axon-reflex response to local heat by reactive oxygen species in subjects with chronic fatigue syndrome.

Medow, Marvin S, Aggarwal, Arun, Baugham, Ila et al.·Journal of applied physiology (Bethesda, Md. : 1985)·2013

When skin is heated, blood vessels normally dilate to increase blood flow. This study found that people with ME/CFS have lower baseline blood flow in their skin compared to healthy people. When researchers used drugs to reduce harmful molecules called reactive oxygen species (particularly hydrogen peroxide), blood flow improved and the initial blood vessel response to heat increased in ME/CFS patients but not in healthy controls.

Pain and SensitizationAutonomic Nervous System

[Distinguishing between depression and chronic fatigue syndrome].

Asberg, Marie, Nygren, Ake, Nager, Anna·Lakartidningen·2013

This study examines how depression and ME/CFS are different conditions, even though they can look similar on the surface. The researchers discuss why it's important for doctors to tell these conditions apart, since they require different treatment approaches. Understanding these differences helps ensure patients get the right care for their specific condition.

E3 PreliminaryCohortPEM unclearObservational

Targeting mitochondrial dysfunction in the treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) - a clinical audit.

Myhill, Sarah, Booth, Norman E, McLaren-Howard, John·International journal of clinical and experimental medicine·2013

This study looked at 138 ME/CFS patients and found that all of them had problems with their mitochondria—the parts of cells that produce energy. Patients received personalized treatment based on diet, sleep, supplements, and rest-activity balance, adjusted according to their specific mitochondrial problems. Those who followed the full treatment plan improved their mitochondrial function by about four times on average.

Sleep

E3 PreliminaryCohortPEM not requiredCase-Control

[A case of lyme disease requiring over 1 year to diagnose at an infectious-disease clinic].

Iwata, Kentaro, Shimada, Tomoe, Kawabata, Hiroki·Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases·2013

This case report describes a 42-year-old woman who had fever and vague symptoms for years but was initially diagnosed with chronic fatigue syndrome. After 14 months, she developed facial paralysis, which prompted testing that revealed she actually had Lyme disease—an infection spread by tick bites. A month of antibiotics improved her symptoms. The report highlights that Lyme disease is rare in Japan but may be underdiagnosed and should be considered in patients with unexplained fevers.

E3 PreliminaryDiagnosticPEM unclearMethods-Paper

Method Issues in Epidemiological Studies of Medically Unexplained Symptom-based Conditions in Veterans.

Coughlin, Steven S, McNeil, Rebecca B, Provenzale, Dawn T et al.·Journal of military and veterans' health·2013

This study examined how researchers diagnose ME/CFS and related conditions in veterans, particularly those who served in the 1990-1991 Gulf War. The researchers found that many veterans had other medical conditions that could complicate or mask ME/CFS diagnosis. The study highlights that how doctors define and diagnose these conditions matters a lot, and different approaches can lead to very different results.

E3 PreliminaryReviewPEM not requiredReview-Narrative

Molecular mechanisms underpinning laser printer and photocopier induced symptoms, including chronic fatigue syndrome and respiratory tract hyperresponsiveness: pharmacological treatment with cinnamon and hydrogen.

Lucas, Kurt, Maes, Michael·Neuro endocrinology letters·2013

This review examines how emissions from laser printers and photocopiers might trigger symptoms in sensitive people, including fatigue, breathing problems, and chronic fatigue syndrome (CFS). The study suggests that particles and chemicals released during printing can trigger inflammation and oxidative stress in the body. The authors propose that two substances—cinnamon and hydrogen—might help reduce these symptoms by reducing inflammation.

E3 PreliminaryReviewPEM not requiredReview-Narrative

Role of the Toll Like receptor (TLR) radical cycle in chronic inflammation: possible treatments targeting the TLR4 pathway.

Lucas, Kurt, Maes, Michael·Molecular neurobiology·2013

This review examines how a part of the immune system called TLR4 may trigger ongoing inflammation in several diseases, including ME/CFS. The authors discuss environmental factors (like air pollution and certain chemicals) that can activate TLR4, and they review several drugs and natural substances that might reduce this harmful inflammation by blocking TLR4 activation.

E3 PreliminaryCohortPEM not requiredCross-Sectional

Lumbar puncture, chronic fatigue syndrome and idiopathic intracranial hypertension: a cross-sectional study.

Higgins, Nicholas, Pickard, John, Lever, Andrew·JRSM short reports·2013

This study looked at whether some people with ME/CFS might actually have a condition called idiopathic intracranial hypertension (IIH), which involves increased pressure around the brain and spinal cord. The researchers performed lumbar punctures (spinal taps) on ME/CFS patients with headaches and measured the fluid pressure around their spinal cord. They found that some patients improved after the procedure, suggesting a possible link between the two conditions.

E3 PreliminaryMechanismPEM not requiredObservational

Acute psychosocial stress-mediated changes in the expression and methylation of perforin in chronic fatigue syndrome.

Falkenberg, Virginia R, Whistler, Toni, Murray, Janna R et al.·Genetics & epigenetics·2013

This study looked at how a stressful situation affects a type of immune cell protein called perforin in people with ME/CFS versus healthy people. Researchers gave both groups a stress test and measured changes in perforin levels and a chemical modification (methylation) that controls whether genes are turned on or off. They found that while both groups increased perforin during stress, people with ME/CFS had a lower peak response and differently regulated perforin levels afterward.

E3 PreliminaryCohortPEM not requiredCase-Control

α-1 antitrypsin and chronic fatigue syndrome: a case study from pathophysiology to clinical practice.

Alegre, José, Camprubí, Sandra, García-Quintana, Ana·Pain management·2013

Researchers tested whether a protein called alpha-1 antitrypsin (AAT), which naturally reduces inflammation in the body, could help a woman with ME/CFS. She received weekly intravenous infusions for 8 weeks. After treatment, she showed improvements in how much physical work she could do, her memory, and thinking skills, and her inflammatory markers normalized. She was eventually able to return to part-time work.

E3 PreliminaryCohortPEM not requiredCase-Control

The role of mitochondrial dysfunctions due to oxidative and nitrosative stress in the chronic pain or chronic fatigue syndromes and fibromyalgia patients: peripheral and central mechanisms as therapeutic targets?

Meeus, Mira, Nijs, Jo, Hermans, Linda et al.·Expert opinion on therapeutic targets·2013

This study explores how damage to the energy-producing parts of cells (mitochondria) might explain why ME/CFS and fibromyalgia patients experience persistent pain and fatigue. When the body experiences oxidative stress, it produces harmful molecules that can damage mitochondria and reduce the energy (ATP) available to muscles and the brain. The researchers suggest that boosting antioxidants and repairing mitochondria could be promising treatments worth testing.

Pain and Sensitization

Thiamine and fatigue in inflammatory bowel diseases: an open-label pilot study.

Costantini, Antonio, Pala, Maria Immacolata·Journal of alternative and complementary medicine (New York, N.Y.)·2013

This small study tested whether high-dose vitamin B1 (thiamine) could help fatigue in people with inflammatory bowel disease. Twelve patients took large amounts of thiamine for 20 days, and ten of them reported their fatigue almost completely went away. The researchers suggest that fatigue in these patients may come from cells not absorbing thiamine properly, rather than from actual vitamin deficiency in the blood.

E3 PreliminaryMechanismPEM not requiredMechanistic

Xenotropic MLV envelope proteins induce tumor cells to secrete factors that promote the formation of immature blood vessels.

Murgai, Meera, Thomas, James, Cherepanova, Olga et al.·Retrovirology·2013

This study examined how certain viruses found in cancer cell lines affect tumor blood vessel growth. Researchers discovered that when tumor cells were infected with specific retroviruses, they produced substances that prevented normal blood vessel maturation, which could make tumors more aggressive and likely to spread. However, the study makes clear that these viruses do not actually infect humans and are not responsible for ME/CFS.

E3 PreliminaryReviewPEM not requiredReview-Narrative

Re-writing the natural history of pain and related symptoms in the joint hypermobility syndrome/Ehlers-Danlos syndrome, hypermobility type.

Castori, Marco, Morlino, Silvia, Celletti, Claudia et al.·American journal of medical genetics. Part A·2013

This review examines joint hypermobility syndrome and a related condition called Ehlers-Danlos syndrome hypermobility type, which cause chronic pain, loose joints, and other symptoms like fatigue and headaches. The authors describe how these conditions develop over time and suggest that they may share similar underlying mechanisms with other chronic illnesses like ME/CFS and fibromyalgia. The goal is to help doctors better recognize and treat these conditions.

Pain and Sensitization