Thread by @doctorasadkhan

To those intent on psychologising #LongCovid & #MECFS because ‘there is no biomarker’- let me tell you something as a senior Dr. Many diseases don’t have biomarkers & diagnosis is clinical. Take asthma for example. Symptoms vary between patients. 1/n

Many patients have abnormal exhaled nitric oxide (FeNO) & histamine challenge tests- some don’t. Yet if the patient’s symptoms & signs fit with asthma, we have no hesitation in making the diagnosis. 2/n

There is the well-known example of multiple sclerosis. Many deemed it psychogenic because there was no lab or radiology test that was diagnostic. Until of course the MR scan was invented. 3/n

Take motor neurone disease (ALS). There is no blood or radiology test. Diagnosis is made on the basis of a careful history & examination. 4/n

In #LongCovid & #MECFS, there are actually a plethora of abnormalities on investigation. Cerebral hypoperfusion on transcranial Doppler, reduced anaerobic threshold on CPET, microclotting & activated platelets. Yes studies are small but findings are consistent. 5/n

Even then, just as with asthma above, a lab abnormality doesn’t always have to be present in 100% of patients to make a diagnosis. That is not how medicine works. Sensible doctors know this. Not-so-good doctors & some journalists obviously don’t. 6/n

So this whole biomarker obsession is just stupid. Medicine is a science but at the same time, it will always be a skill too. We can’t test for everything. At least not yet. 7/n

#MedTwitter #MedEd #TeamGP #psychtwitter #fibromyalgia #FQtoxicity #vaccineinjuries #Lyme #EDS #HSD #POTS #MCAS #Dysautonomia #smallfibre #CCI