🧵 An absolutely fascinating talk by William Gunning @Dysautonomia conf - Innate Immune system Activation in PoTS. A complex topic made easy to understand by a Prof in pathology & it makes a lot of sense to me, it’s like seeing another puzzle piece! Here’s some interesting 2/points:
Platelets are very important in innate immunity & homeostasis (still being debated)
Platelets have over 400 biochemicals!
Serotonin is produced in the gut & pooled in platelets for delivery around the body (outside of CNS 99% of serotonin is in the platelets)

🧵 Great talk with @BendyBrain at the @Dysautonomia conf. Dr Eccles shared some information from their mechanisms of chronic pain & fatigue programme with people with ME/CFS, Fibro & EDS. 2/In their studies they have found hypermobility factors correlated with pain, fatigue & cognition. Baseline inflammatory markers were raised compared to controls & though not abnormal they were relevant - autonomic induced fatigue was mediated by levels of inflammation that

🧵 Long covid & autonomic dysfunction with Dr Mitchell Miglis & Charlie (has lived long covid experience) @Dysautonomia conf #DysConf2022

PoTS is the most common autonomic dysfunction associated with long covid
67% of the people surveyed in the US had a compass-31 score 2/ suggestive of moderate to severe autonomic dysfunction with no difference between those hospitalised & those not
SFN is common in long covid
Potential mechanisms include: tissue injury, immune mediated, micrclotting, viral persistence, MCAS, baroreflex impairment,

🧵 Neurovascular dysregulation during exercise in ME/CFS & long covid with David Systrom @Dysautonomia conf. Some key points:
Preload failure contributes to exercise intolerance
Inability to take up oxygen in periphery tends to be either left to right shunting or #DysConf2022 2/dysfunction
- Left to right shunting in periphery in some people with ME/CFS
- Some with have ME/CFS also have small fibre neuropathy
- Poor systemic O2 extraction may also be related to mitochondrial dysfunction in skeletal muscle in ME/CFS
Hyperventilation is common in

🧵 Brilliant talk by David Putrino @Dysautonomia Autonomic Rehab Approaches to Long Covid care
We need to:
- Measure subjective symptoms - use outcome measures alongside self reports
- Look for organ pathology, make sure red flags ruled out
#DysConf2022 2/Correct deviations from normative physiology - avoid common triggers

Common triggers include stress (it doesn’t cause PoTs or dysautonomia but makes it worse), dehydration, over doing things, weather changes, consuming large meals, premenstrual period, alcohol & caffeine.