Neurovascular Dysregulation During Exercise in #ME/CFS & #LongCOVID David M. Systrom, M.D. Pulmonary and Critical Care Medicine Brigham & Women’s Hospital CDC SEC Call Presentation www.cdc.gov/me-cfs/pdfs/...
Surviving MyalgicE & AAG to tell the story, patient & advocate w/ a JD. Into MEdical, Social & Climate Justice & Arts. Human neutrino/MEdical apolide/Gnarled pacer. MEssLand Worldwide https://www.tandfonline.com/doi/pdf/10.2217/fmb-2022-0031
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Neurovascular Dysregulation During Exercise in #ME/CFS & #LongCOVID David M. Systrom, M.D. Pulmonary and Critical Care Medicine Brigham & Women’s Hospital CDC SEC Call Presentation www.cdc.gov/me-cfs/pdfs/...
Neurovascular Dysregulation During Exercise in #ME/CFS & #LongCOVID David M. Systrom, M.D. Pulmonary and Critical Care Medicine Brigham & Women’s Hospital CDC SEC Call Presentation (2023) www.cdc.gov/me-cfs/pdfs/...
Heart Preload Failure in patients w/ #ME/CFS #pwME and some #pwLC Original ongoing research conducted by Dr. D. Systrom @openmedf.bsky.social www.openmedicinefoundation.ngo/heart-preloa...
www.openmedicinefoundation.ngo/heart-preloa...
Heart Preliad Failure in #ME/CFS #pwME Ongoing research conducted by Dr. David Systrom @openmedf.bsky.social www.openmedicinefoundation.ngo/heart-preloa...
capillaries in the muscles, bypassing the muscle cells where oxygen should be taken up. • Autonomic Dysregulation: The autonomic nervous system, which controls involuntary body functions like heart rate and blood pressure, may be dysregulated, impacting blood flow and venous volume. #ME/CFS
Besides preload failure, other factors can lead to poor oxygen extraction: • Mitochondrial Dysfunction: The mitochondria in the cells may not be able to utilize the oxygen delivered to them, even if enough oxygenated blood is reaching them. • Peripheral Shunting: Blood may be shunted past the
preload failure, where the heart doesn't receive enough blood to efficiently pump to the muscles, or it can stem from issues like mitochondrial dysfunction or peripheral blood shunting that prevent oxygen from reaching the cells.
Poor Oxygen Extraction is Contributing to Exercise Intolerance in #ME/CFS, "oxygen extraction failure" refers to the body's inability to effectively extract oxygen from the blood during activity, leading to reduced energy production and post-exertional malaise #PEM. This can be a consequence of
Normally hard science & objective findings like these would bring all hands on deck and serious research fundings, but when it’s in #pwME, it’s just a meh & barely get noticed #ME/CFS = medicine pariah • Oxygen extraction issues • Preload failure • Reduced V̇O2peak • Skeletal muscle O2 diffusion
Post-COVID exercise intolerance is associated with capillary alterations and immune dysregulations in skeletal muscles (2023) actaneurocomms.biomedcentral.com/articles/10.... @scheibenbogen.bsky.social among the authors
compartment and lower levels of anti-RBD IgG and IgA. This correlated with reduced neutralizing capacity against SARS-CoV-2. #LongCOVIDKids #PediatricLongCOVID 🏷️ @buonsenso.bsky.social
🇪🇸 Our findings indicate that pediatric long COVID is associated with a dysregulated immune response characterized by altered innate immunity and overactivated T-, B- and NK-cell responses. Furthermore, CYP with long COVID had an impaired humoral response to SARS-CoV-2 marked by a dysregulated B-cell
What is that thing that shall not be named that is still airborne, still circulating, still non seasonal, still mutating, still infecting, still killing and still disabling? PS One way masking KN95/N95 is still highly effective to prevent 🦠⬆️ the thing/s ⬆️ 🦠 pmc.ncbi.nlm.nih.gov/articles/PMC...
represent a therapeutic target. However, our findings are limited by small sample size. #iCPET #ME/CFS #LongCOVID
Correcting DM alone improved V̇O2 by 66% in PASC (p = 0.008) and 34.7% in CFS/ME (p = 0.06), suggesting a dominant role for peripheral O2 extraction in exercise limitation. Impaired skeletal muscle oxygen diffusion (DM ) is a shared mechanism of exercise intolerance in PASC and CFS/ME and may
To simulate targeted interventions, each variable was sequentially normalized to assess its impact on V̇O2peak. V̇O2peak was significantly reduced in both PASC and #ME/CFS compared to controls. ⚠️ Skeletal muscle O2 diffusion (DM ) was the most impaired parameter in both patient groups (p = 0.01). ⚠️
A follow-up report was sparked by the unwillingness of public health leaders - deeply mired in conflicts of interest, around their responsibility for downplaying the significance of COVID and allowing it to spread out of control - to educate the public about long COVID. science.gc.ca/site/science...
The Office of the Chief Science Advisor of Canada released a report in December 2022 highlighting that while COVID is transmitted via respiratory aerosols, that doesn't mean it's just a respiratory virus - it gets into (and damages) almost every tissue in the body. science.gc.ca/site/science...
The entire report is valuable,but in particular Chapter 3 provides an overview of just how widespread and devastating long COVID can be, including impacts throughout the body. nap.nationalacademies.org/read/27756/c....
The US National Academies of Science, Engineering and Medicine have released a comprehensive report on long COVID - this one is often particularly useful when faced with attempts by public health leaders to erase the damage their poor choices have caused. nap.nationalacademies.org/read/27756/c...
From populists on the right, but also from establishment figures desperate to bury their responsibility, there's an ongoing push to bury the harms of COVID. Long COVID alone costs 7M life-years (QALYs) and on the order of a trillion dollars a year in the OECD. www.oecd-ilibrary.org/social-issue...
The list is long: many diseases are transmitted through the air we breathe. Good indoor air renewal reduces the risk of contamination, particularly in hospitals, schools, and nursing homes. For more information, visit our website or read our 25-page guide: letsair.org#mediation
www.science.org/doi/full/10.... Mandating Indoor Air Quality in Public Buildings. Our paper in Science. 🧪 #healthpolicy
We have policies/laws/regulations to ensure that our food and water are clean and safe. Why not for air, too? Typical amounts taken in per day: food = 4 lb water = 3 lb air = 30 lb
A nasal spray reduced the risk of Covid infections in a double blind, placebo controlled randomized trial jamanetwork.com/journals/jam...
and in some cases, may progress to severe disease.7-12 Even patients with mild COVID-19 may experience worsening of preexisting chronic conditions.13-17
SARS-CoV-2 remains highly transmissible and up to half of people living with an infected individual may develop COVID-19.3,4 The virus is constantly evolving, with novel symptoms reported.5,6 COVID-19 continues to impact daily life and may lead to absence from school and work, may cause long COVID,
Surprise ME not!
International Declaration spearheaded by the #ME/CFS Research Foundation, stating the moral, medical, economic and scientific imperative to invest robustly in international and collaborative research into the pathophysiology… @mecfsresearch.bsky.social declaration.mecfs-research.org/en/declaration
Reminder that there are multiple vaccines already out there that reduce your kids' chances of multiple types of cancers (and some people want you to believe this is bad!) www.scientificdiscovery.dev/p/6-vaccines...
The long term data on hepatitis B vaccination shows it reduces the incidence of liver cancer by 84% and death from liver disease by 70%. This comes from a large cluster RCT in which entire towns were randomly selected to give the hepatitis B vaccine to all newborns.
Results so stunningly clear they inspired this classic xkcd (xkcd.com/2400/):
These vaccines are... good?
Heightened innate immunity may trigger chronic inflammation, fatigue and post-exertional malaise in #ME/CFS pmc.ncbi.nlm.nih.gov/articles/PMC...
Study Reveals Details of Overactive Immune System in Patients with Chronic Fatigue Syndrome (ME/CFS) Peer-Reviewed Publication COLUMBIA UNIVERSITY'S MAILMAN SCHOOL OF PUBLIC HEALTH I. Lipkin et al.
Exactly, it was lack of good will, empathy and equality.
Virginia Woolf: A Night’s Darkness, A Day’s Sail Documentary #VirginiaWoolf
Bealach an t-Suidhe // Bellochantuy #beach #coast #sea #blue #kintyre #argyll #landscape #seascape
1993!!! Just imagine if we had been listened to, believed and our disease properly researched! Instead we had decades of stigma, gaslighting, neglect, mistreatments and no specialized care, unlike all other major chronic diseases. Medical-made suffering on top of the illness. #ME/CFS #pwME
FYI ouraring.com/blog/oura-us... www.reddit.com/r/ouraring/c...
“The patients told them and that was the best they could do. That is still going to be the case." 19🤬93!!! They knew already from brain scans that #pwME have hypo-perfusion in the brain and yet here we are in 2025 still having to fight for research, care and proper support! @rfh1955.bsky.social 🙏🏻
treat the illness because there had been no proven medical test for diagnosing it and that, despite the latest breakthrough, that was unlikely to change. "The trouble is the GP has never been able to have or test or see anything that showed what was wrong, he said on BBC1 Breakfast News today.
infection, including vaccination, life trauma accident and possibly envi ronmental poisons - all of which are stresses to the immune system," he said. But Professor James Mowbray. consultant immunopathologist at St Mary's Hospital, London, said that in the past doctors have often been reluctant to
controls in terms of reduced blood flow to the brain." Consultant immunologist Dr Jonathan Brostofi, also of UCL, who has been working with 500 patients believes the illness need not be triggered only by a virus. "It is a clinical observation that there are many triggers for ME, apart from viral
action to draw attention to the plight of the 150,000 sufferers in Britain of ME - myalgic encephalomyelitis. Dr Durval Costa, a nuclear medicine physician at University College London, said: "Initial published results from brain scans found significant differences between ME patients and healthy
#ME/CFS 1993! WEDNESDAY, 1 SEPTEMBER, 1993 - Yuppie flu link to slower blood flow to the brain BRAIN scans have shown reduced blood flow in sufferers from the illness ME — once dismissed as yuppie flu. Results published today of the latest research into the illness come at the start of a month of
Nearly 29% of post-acute COVID-19 patients developed long COVID-19 in this Middle Eastern cohort. Female sex, diabetes, reinfection, and hospitalization predicted delayed recovery. Persistent symptoms and impaired HRQoL highlight the need for early risk stratification and structured post-COVID care.
From the # When you/we wake up aka Groundhog Day ME/CFS community on Reddit www.reddit.com/r/cfs/commen...
A colloquial Swedish word for giving a confident answer to something you know nothing about is killgissa, or “guy-guessing.” Conversely, the lesser-known word tjejveta (meaning “girl-knowing”) can describe elucidating (shelucidating?) on a topic you have expertise in.
Dreaming of the day when all clinicians, researchers, PTs/OTs/RNs, in every medical specialty will get what #PEM is. (Pun intended!) To get there we need properly educated medical students and compulsory CME to undo the damages of the dogmatic past. #ME/CFS #ICD-10G93.3 #ICD-10G93.32 #ICD-11-8E49
and KIR3DL2*010 (OR = 0.46, 95 %CI (0.30–0.71), p = 0.0005). Our data support an involvement of NK cells in ME/CFS. #ME/CFS #KIR #NKcells
in patients, i.e. KIR3DL3*002 (OR = 1.43, 95 %CI (1.09–1.86), p = 0.009), KIR3DL1*020 (OR = 2.20, 95 %CI (1.19–4.06), p = 0.01) and KIR3DL2*009 (OR = 1.56, 95 %CI (1.09–2.23), p = 0.01), while two alleles had a reduced patient frequency, i.e. KIR3DL3*013 (OR = 0.60, 95 %CI (0.42–0.86), p = 0.005)
We found no association between ME/CFS and KIR gene content or copy number variations. However, our data suggested that specific KIR alleles at loci encoding inhibitory receptors were associated with #ME/CFS, which was further supported by allelic haplotype analyses. Three alleles were more frequent
and so much you want and need to do, but have to pay dearly for everything you try to give. @HEALMECFS Mein Blog: healmecfs.wordpress.com
The deterioration often occurs with a time delay (12 - 72 hours after the overloading activity) and lasts for days, weeks or even months. So in summary any activity, no matter how nice it may be, can worsen the condition. This feature is absolutely cruel when you have so much to give to the world,
the central feature of myalgic encephalomyelitis (ME), the so-called Post-Exertional Malaise #P aka Post Exertional Neuroimmune Exhaustion (PENE). Having PENE means a significant worsening of the typical ME symptoms after physical, cognitive, emotional and sensory overload.
ME sufferers #pwME are like butterflies tied to a stone. The butterfly represents the beauty and potential of every single ME sufferer who had dreams, wishes and plans for their life, but who can no longer fully develop their own potential because of the illness. Responsible for this is
ME sufferers are like butterflies tied to a stone. The butterfly represents the beauty and potential of every single ME sufferer who had dreams, wishes and plans for their life, but who can no longer fully develop their own potential because of the illness.
They definitely represent freedom, lightness and transformation. None of which are present in pwME’s lives.
Oh interesting facts
Totally stuck - from my ME/CFS photo project glass.photo/andrewgiffor... ALT: colour photo of a beautiful black and silver butterfly, trapped inside a class paperweight, on a drab blue background #MECFS #pwME #LongCovid #Photography
diseases
Today’s Quotation is care of Bertolt Brecht. Listen in! Subscribe to Quotomania on quotomania.com or search for Quotomania on your favorite podcast app! Bertolt Brecht, orig. Eugen Berthold Friedrich Brecht, (born Feb. 10, 1898, Augsburg, Ger.—died Aug. 14, 1956, East Berlin, E.Ger.)
Imagine hearing Bob Dylan play an unreleased "Desolation Row" for the first time at the Forest Hills Music Festival in Queens, New York OTD in 1965. He only recorded it 24 days earlier, for Highway 61 Revisited, which would be released 2 days after this concert. UNREAL [📷 Ken Regan]
There is a before Highway 61 and an after HW61 and yes, it must have been 🤯 in so many amazing and good ways. #BlueSkyDylan
The Central Error of the Pandemic… Is that of running pandemic management by laissez-faire socioeconomic principles. If you grasp this, all the other errors fall into place as the inevitable consequence of following that line of thought. 🧵 1/x
✌️☮️ & 🚲🚴🚴♀️🚴♂️
Sending all my love & solidarity to you Sarah and a happy belated & posthumous birthday to our Maeve 💙💙💙🫂💙💙💙
The U.S.’s summer COVID-19 surge continues, with cases increasing across all regions through early August, driven by travel and gatherings as well as the variant XFG. This week's full COVID-19 trends by @betsyladyzhets.bsky.social: bit.ly/4mWEUk9
Remember the pastel-washing of the COV-19 levels’ map back in 2022/2023? Well now there isn’t even a pastel shaded map…
“Long COVID researchers have proven, to an irrefutable degree, the scale and urgency of this global public health crisis...we are beginning a new era of incredible advancement in the field." @betsyladyzhets.bsky.social and I reported on the Keystone Symposia. thesicktimes.org/2025/08/19/t...
YES! Boys should get HPV vaccine for at least 6 reasons, including to protect themselves from head & neck cancers & other HPV-related cancers 5 reasons are summarized here, and in the rest of the thread I'll discuss herd immunity www.mskcc.org/news/5-reaso... 1/n
Some reading on that if you’re curious. “‘The research shows that any mask is much better than no mask, and an N95 is significantly better than the other options. That’s the No. 1 message,’ says the study’s senior author, Donald Milton, a professor of environmental health.”
Thank you for reposting this @coolbikeart1.bsky.social. It’s so good to re discover mutuals or people that we used to follow on other soc media. Even if I am disabled and cannot ride my bike anymore, seeing this kind of realities and other people doing it, fills ME with joy.
I hope the COVID vaccines would at least be available through employee health for healthy HCWs this winter: 1. A vaccinated health workforce reduces nosocomial spread of respiratory viruses 2. No hospital wants Drs and nurses out sick with COVID during peak utilization healthcare months.
Medical students need them too! 🙏🏽
Thank you Dr. Crystal 🙏🏻
COVID VACCINE INFO: List of states requiring a prescription for a COVID vaccine at CVS or Walgreens t.co/ZqCZwxwa57 COVID vaccine availability at CVS buff.ly/JHG5vml 💉COVID vaccines are no longer available at CVS in Massachusetts, Nevada or New Mexico. Vaccines.gov is still down. #medsky 🛟😷🧪
The only difference between us pwME and butterflies being that they only live for a few days, while we can last and do survive rotting away for decades, with these horrible disease. Mind you that to a butterfly a few days may feel like an eternity…
during T-cell recruitment. From Dr. Selina R Shaw GP rapid response in the BMJ Research must consider Post Exertional Malaise #PEM as a neurological event underpinning fluctuating cognitive dysfunction in Long Covid/ #ME/CFS www.bmj.com/content/390/...
powerful immune stimulus, yet the link between peripheral tissue injury and delayed onset neurological deterioration remains unexplored. Similarly, the unexplained 48 hr lag between exertion and symptom onset invites parallels with type IV hypersensitivity, in which delayed immune responses arise
Recent work demonstrates that exercise exceeding the aerobic threshold causes skeletal muscle damage and necrosis in LC patients with #PEM (3). Since the aerobic threshold is pathologically lowered in this group, even minimal daily movements may induce metabolic tissue damage. Necrosis is a
Decode ME #GWAS Initial DNA results webinar 14 August, 2025 Prof. Chris Ponting PI @cgatist.bsky.social @decodemestudy.bsky.social @actionforme.bsky.social @ukbiobank.bsky.social youtube.com/watch?v=rsvr...
I'll make it easy to determine if you are at high risk from COVID. Are you alive? If you answer YES, then you are at high risk. If asked at a pharmacy if you have a high-risk condition, say yes. There's no need to tell them which condition you have.
Measles outbreaks throughout the United States in 2025 have reignited concerns over vaccination. The reporting series "Tragedy in Paradise" by AndyPierrotti, for @atlantanewsfirst.com, sheds light on the potential consequences of declining vaccination rates. 👉 bit.ly/4mE6D9d
This is a great time to watch this @pulitzercenter.org documentary on why “doctors and parents in Samoa blame influential vaccine skeptic Robert F. Kennedy Jr. and his associates for bolstering anti-vax sentiment” pulitzercenter.org/blog/explori...
Long COVID patients show immunological imprinting and impaired antibody class switching: fewer IgG/IgA antibodies against SARS-CoV-2 spike, but more against seasonal coronaviruses. Interesting finding by my PhD student Ashwin Mak in J Med Virol: onlinelibrary.wiley.com/doi/10.1002/... 1/6
Those 1920s - 1940s NYT headlines about Hitler is a sight to behold www.nytimes.com/search?dropm...
spirit is truly important. The ancient injunction to love thy neighbor as thyself is still the force that animates our faith—a faith that we are determined shall live and conquer in a world poisoned by hatred and ravaged by war.”
In a radio address for the Mobilization for Human Needs on October 13, 1940, then President FDR said: “Human kindness has never weakened the stamina or softened the fiber of a free people. A nation does not have to be cruel in order to be tough. The vigorous expression of our American community
This is something else you don't see in Japan because people believe in science. Japan has an effective (adjusted) COVID-19 rate for five years of only 5-6% of the USA, with death rates also that comparatively low. Parties from left-to-right accepted mRNA vaccines, masks, and social distance.
This what you get when you have a culture that prizes cooperation and mutual respect instead of individualism.
individuals exhibited broader cross-neutralizing responses than those w/hybrid immunity, suggesting that infection history may narrow antibody responses through immune imprinting. These findings highlight the ongoing challenge of maintaining vaccine effectiveness against evolving SARS-CoV-2 variants
In Brief SARS-CoV-2 continues to evolve, producing variants that escape vaccine-induced immunity. Abbad et al. show that KP.2 monovalent vaccination provides limited protection against antigenically distant FLiRT variants (LP.8.1, LF.7.1, NB.1.8.1, XFG) and BA.3.2. Surprisingly, vaccination-only
As always, if you're enjoying The Gauntlet, please consider becoming a paid subscriber for $7/month (or $70 annual!) I never paywall critical public health info, but paid subscribers do get access to additional personal essays. Thanks all for the support! www.thegauntlet.news/subscribe
Why is the public learning potentially life-altering information about a virus they’ve almost certainly contracted multiple times now from the Economics section of Bloomberg? (Or from The Gauntlet, for that matter?) Read my latest: www.thegauntlet.news/p/people-can...
We are literally living or shall we say, surviving, on a tight rope. 💙💙💙🫂💙💙💙
Sorry for eventually putting the MTAF bad ear worm and intruding in your Saturday plans.
More than a whiff, to the tune of More Than a Feeling…