Paul Chrisp is being disingenuous when he says GPs can still prescribe medicines not recommended by @NICEComms. In practice most GPs won't prescribe 'off menu' because they depend solely on NICE for their knowledge of medicines, or supposedly are afraid of prosecution. #r4today
Another example: many ME patients and non-NHS specialists report that Low Dose Naltrexone has an anti-inflammatory + immunomodulatory effect yet patients rely on private prescription to obtain it. @NICEComms is too slow and inflexible to add LDN to its guidelines and...
... consequently many people with chronic illnesses like ME, MS, RA + FM are deprived of a valuable tool to manage their symptoms. Mention it to your average GP and you'll get a blank look or snort of derision for daring to suggest something not on the curriculum at med school.
In research circles, there's growing recognition that a 'personalised medicine' approach is the most effective way to treat serious/complex health conditions. Given how NICE has reacted to #MedicalCannabis, such an approach is unlikely to be available via the NHS any time soon.
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🧵 A selection of #MECFS and #LongCovid research papers published in 2024:
1/ 'Physical exertion worsens symptoms in patients with post-COVID condition : Post-exertional malaise in patients with post-COVID condition' scienceopen.com/hosted-documen…
3/ 'Dysregulation of extracellular vesicle protein cargo in female myalgic encephalomyelitis/chronic fatigue syndrome cases and sedentary controls in response to maximal exercise' isevjournals.onlinelibrary.wiley.com/doi/10.1002/je…
The medical community is failing #pwME badly right now. From GPs who deny patients medication for treatable symptoms to consultants who deny appropriate feeding arrangements for severely ill patients in hospital. 1/4 #MECFS #MyalgicEncephalomyelitis
Change is being blocked by bad faith actors who occupy positions of strategic importance in the medical hierarchy. The new NICE guidelines only seem to have reinforced their determination to retain the fallacious biopsychosocial model of #MECFS in the healthcare system. 2/4
This is undoubtedly a low point for the #MECFS patient community. Even somewhat better media coverage hasn't budged the dial. Ideally we would take visible direct action, but since that isn't possible, we must continue to speak out against the prejudice and maltreatment. 3/4
The long-awaited NIH Intramural Study of ME/CFS, led by Avindra Nath, has finally been published in full.
🧵 "Considering all the data together, Post-infectious ME/CFS (PI-ME/CFS) appears to be a centrally mediated disorder." 1/ nature.com/articles/s4146…
"We posit this hypothetical mechanism of how an infection can create a cascade of physiological alterations that lead to the PI-ME/CFS phenotype. Exposure to an infection leads to concomitant immune dysfunction and changes in microbial composition." 2/
"These immune and microbial alterations impact the central nervous system, leading to decreased concentrations of metabolites, including glutamate, tryptophan, spermidine, citrate, and the metabolites of dopamine (DOPAC) and norepinephrine (DHPG)." 3/
Nath's back, finding a chronically activated immune response causing neuronal injury in the brains of #pwLC. It explains why it's taken him forever to publish his big #MECFS study, but the good/bad news is he thinks the same thing's happening in #pwME. 1/4 healthrising.org/blog/2022/07/1…
This looks very similar to what Komaroff et al suggested was happening in #MECFS 30 years ago: "patients may have been experiencing a chronic, immunologically mediated inflammatory process of the central nervous system." 2/4 pubmed.ncbi.nlm.nih.gov/1309285/
Nath also found the same widespread punctate hyperintensities in the microvasculature of brains which first started showing up in MRI scans of #pwME in the 80s (see J. Goldstein) and were routinely dismissed by neurologists as insignificant. 3/4 healthrising.org/blog/2021/01/2…
🧵 With poliomyelitis emerging as another Brexit benefit, it's worth restating, for people who are new to the study of infectious diseases, that the history and aetiology of #MyalgicEncephalomyelitis (ME) are inextricably linked to polioviruses. 1/
The viruses which cause polio belong to the Enterovirus family of viruses. Enteroviruses typically infect the gastrointestinal tract, sometimes spreading to the central nervous system. 71 human EV serotypes have been identified but more than 100 are thought to exist. 2/
Polio was originally thought to be caused solely by three enteroviruses - polio 1, 2, and 3, included in the Salk (1955) + Sabin (1960) immunisations. Since then at least 25 EVs capable of causing paralytic polio have been identified. No vaccine has been developed for these. 3/
🧵Long Covid research is advancing at an incredible rate. It's taken LC researchers less than 2 years to reach a point it's taken #MECFS researchers decades to get to - a reminder how quickly progress can be made when enough money/resources are dedicated to solving a problem.1/10
Good news for pwLC but it's not clear how pwME will benefit from this progress. Despite growing recognition that the two conditions share many similarities, not all LC research acknowledges the relationship between LC and ME/CFS, or even references earlier ME/CFS research. 2/10
Some LC papers are reproducing earlier ME/CFS findings which weren't replicated (due to funding) + were ignored by the med profession. Other LC papers show findings which have been hypothesised by ME/CFS researchers but not validated, again due to insufficient funding. 3/10