> Is there evidence of a well-defined physiological mechanism rather than merely being a symptom cluster that might be purely psychological?
Is there evidence of a well-defined psychological mechanism rather than merely a symptom cluster common to autoimmune diseases and various other immune system disorders?
There seems to be a lot more evidence supporting CFS as an autoimmunity than any other avenue for explanation. It appears to be comorbid with numerous kinds of poor immune function, and often occurs after viral infections, frequently Epstein-Barr (so much so that one of its possible incarnations was even called "Post-Viral Fatigue Syndrome"). And like most autoimmune diseases, it favors diagnosis in women.
As one paper puts it as clearly as possible: "The continuing debate as to whether myalgic encephalomyelitis
or postviral syndrome is predominandy organic
or psychological is unhelpful." And that was in 1990; we're even more clear that it has its roots in biology now. The medical community is at a consensus that there's an organic cause, they just don't have enough data collated or a good enough understanding of the immune system and its interaction with the disease process to know what it is. And that's not surprising - rheumatology in the context of autoimmunity is one of the youngest branches of medicine and our understanding of autoimmunity is very much in its infancy. Lupus was known about for centuries, but only conclusively proven to be an autoimmune disease in 1948-49.
Frankly, at this point, with all of the collected evidence, over 9000 different scientific papers and three world-recognized medical agencies (the CDC, the NIH and the Institute of Medicine) in agreement that it's biological, suggesting it's all in the hundreds of thousands of sufferer's heads is pretty insulting. Maybe go educate yourself on the topic before lobbing such accusations?
Actually, everything is biological, including depression. The CDC, NIH, etc. are in agreement that the illness is real, and not malingering or hypochondria. But they are open-minded to the etiology.
>suggesting it's all in the hundreds of thousands of sufferer's heads is pretty insulting
> Is there evidence of a well-defined psychological mechanism rather than merely a symptom cluster common to autoimmune diseases and various other immune system disorders?
Are you asking if all autoimmune diseases can be detected by a single test. That doesn't really seem relevant. To my knowledge, all of the diseases that are confidently attributed to an autoimmune disorder do indeed have corresponding physiological evidence, with higher degrees of confidence when there are independent pieces of direct evidence. (One can imagine a case where there was overwhelming circumstantial evidence instead, but I've never heard of it; maybe you have an example in mind?) Autoimmune diseases generally have multiple common physiological features like excess inflammation, responsiveness to steroids (which suppress the immume system), or antinuclear antibodies (ANA).
The rest of your comment was much more helpful. Thanks! (Except for the part where you said I made accusations. I didn't.)
> Lupus was known about for centuries, but only conclusively proven to be an autoimmune disease in 1948-49.
Right, there are obviously lots of physiological diseases whose underlying causes aren't understood for a long time. But Lupus had objective (non-self-report) symptoms, giving doctors confidence in it was physiological. They were correctly unsure it was autoimmune until later evidence became available.
> The medical community is at a consensus that there's an organic cause,
Could you link to a consensus statement? I looked around a lot and all the documents i could find that reflect a consensus of experts like the CDC (rather than the opinion of individual researchers) were careful to never endorse a physiological mechanism, even an unknown one.
> ...they just don't have enough data collated or a good enough understanding of the immune system and its interaction with the disease process to know what it is
Sorry, are you saying there is a consensus it's autoimmune, or just biological? There appear to be lots of non-autoimmune theories too.
Is there evidence of a well-defined psychological mechanism rather than merely a symptom cluster common to autoimmune diseases and various other immune system disorders?
There seems to be a lot more evidence supporting CFS as an autoimmunity than any other avenue for explanation. It appears to be comorbid with numerous kinds of poor immune function, and often occurs after viral infections, frequently Epstein-Barr (so much so that one of its possible incarnations was even called "Post-Viral Fatigue Syndrome"). And like most autoimmune diseases, it favors diagnosis in women.
As one paper puts it as clearly as possible: "The continuing debate as to whether myalgic encephalomyelitis or postviral syndrome is predominandy organic or psychological is unhelpful." And that was in 1990; we're even more clear that it has its roots in biology now. The medical community is at a consensus that there's an organic cause, they just don't have enough data collated or a good enough understanding of the immune system and its interaction with the disease process to know what it is. And that's not surprising - rheumatology in the context of autoimmunity is one of the youngest branches of medicine and our understanding of autoimmunity is very much in its infancy. Lupus was known about for centuries, but only conclusively proven to be an autoimmune disease in 1948-49.
Frankly, at this point, with all of the collected evidence, over 9000 different scientific papers and three world-recognized medical agencies (the CDC, the NIH and the Institute of Medicine) in agreement that it's biological, suggesting it's all in the hundreds of thousands of sufferer's heads is pretty insulting. Maybe go educate yourself on the topic before lobbing such accusations?