13 Dysautonomia including Postural orthostatic tachycardia syndrome (POTS) may be present in many patients with CFS
Overview of the current understanding of the associations between ME/CFS and metabolic disease by Erifili Hatziagelaki, MD, PhD, Maria Adamaki, PhD, Irene Tsilioni, PhD, George Dimitriadis, MD, Theoharis C. Theoharides, MS, MPhil, PhD, MD
ANS dysfunction/Dysautonomia
1 Abnormalities in bioenergetic function
1 Irregularities in the Metabolism, Energy, Amino Acid, Nucleotide, nitrogen, hormone, nucleotide, oxidative stress metabolism
3 Alterations in normal energy metabolic processes and abnormalities in cellular bioenergetics
4 Insufficient metabolic adaptation to incremental exercise
5 Switch to anaerobic glycolysis, i.e. a reduction in oxidative metabolism, and an increase in lactate production
6 Increased lactate production possibly related to the reduction of post-exercise oxygen delivery
7 Decrease in oxygen delivery perhaps due to reduced blood flow
8 Elevated ventricular lactate
9 Hypometabolic state (as evident in plasma and serum metabolomics)
10 Metabolic Disease (what is the association with CFS)
11b Half of CFS patients (appear to) have a previously undiagnosed medical condition, most often diabetes, CVD and thyroid diseases
12 Abnormal Findings concerning the Cardiovascular System
14 reported deficiencies in the urea and the TCA cycles, (ornithine/citrulline and pyruvate/isocitrate ratios)
17 impaired fuelling of the TCA cycle by pyruvate
18 TCA cycle intermediates reduced in Urea and Plasma
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13 Dysautonomia including Postural orthostatic tachycardia syndrome (POTS) may be present in many patients with CFS