Thread by @tessfalor

#IIMEC15 Dr Jesper Mehlsen

TREATMENTS - Toward uniform treatment
regimen for ME/CFS

Listen to patients about what works and what doesn't work.

There isn't an approved medication for #MECFS

Symptomatic treatment can be applied to improve quality of life

neuroinflammation and human herpes virus

EBV reactivation causes inflammation -> microglial inflammation

Treat with antivirals + reduce Inflammation (Minocycline, Doxycycline, LDN, Low Dose Abilify, PEA, COX-2 inhibitors, AT1R blockers.

@remissionbiome

Mitochondrial dysfunction

Problem with pyruvate, use fatty acid instead and produce ROS

Treat with antioxidants, L carnitine, d-Ribose, ketogenic amino acids, Q10, NAD+

GI dysfunction

Constipation: dietary adjustments, prokinetics, Avoid opioids and anticholinergics

For diarrhea: dietary, bile acid binders, opioids

Dysbiosis: probiotics, FMT

cardiovascular control (sympathetic nervous system)

for POTS - pyridostigmine, beta-blockers, ivabradine

IV saline infusions help severely ill

All of those systems are involved in #MECFS and many with #LongCovid

Few of the possible treatments have been subjected to placebo-controlled RCT. We need those, but there is no interest. Those drugs are already on the market.