Monday, 27 June 2016

Indicator of chronic fatigue syndrome found in gut bacteria


(This study mentions CFS and ME/CFS.  I hope it also applies to those with more strictly defined ME, Myalgic Encephalomyelitis)

Indicator of chronic fatigue syndrome found in gut bacteria | Cornell Chronicle | 24 June 2016

From The Cornell Chronicle (Cornell University website) | 24 June 2016 | story by Krishna Ramanujan.

Physicians have been mystified by chronic fatigue syndrome, a condition where normal exertion leads to debilitating fatigue that isn’t alleviated by rest. There are no known triggers, and diagnosis requires lengthy tests administered by an expert.

Due to this lack of information, some people have even suggested the disease may be psychosomatic.

Now, for the first time, Cornell researchers report they have identified biological markers of the disease in gut bacteria and inflammatory microbial agents in the blood.

In a study published June 23 in the journal Microbiome, the team describes how they correctly diagnosed myalgic encephalomyeletis/chronic fatigue syndrome (ME/CFS) in 83 percent of patients through stool samples and blood work, offering a noninvasive diagnosis and a step toward understanding the cause of the disease.

“Our work demonstrates that the gut bacterial microbiome in ME/CFS patients isn’t normal, perhaps leading to gastrointestinal and inflammatory symptoms in victims of the disease,” said Maureen Hanson, the Liberty Hyde Bailey Professor in the Department of Molecular Biology and Genetics and the paper’s senior author. “Furthermore, our detection of a biological abnormality provides further evidence against the ridiculous concept that the disease is psychological in origin,”

Ruth Ley, associate professor in the Departments of Molecular Biology and Genetics and Microbiology, is a co-author.

“In the future, we could see this technique as a complement to other noninvasive diagnoses, but if we have a better idea of what is going on with these gut microbes and patients, maybe clinicians could consider changing diets, using prebiotics such as dietary fibers or probiotics to help treat the disease,” said Ludovic Giloteaux, a postdoctoral researcher in both Hanson’s and Ley’s labs and first author of the study.

Researchers have evidence that an overactive immune system plays a role in chronic fatigue. Symptoms include fatigue even after sleep, muscle and joint pain, migraines and gastrointestinal distress. One hallmark of the condition is post-exertional malaise, meaning patients may take weeks to recover from minor exertion. To test for ME/CFS, clinicians may give patients a cardio-pulmonary exercise test where they ride a bike until they become fatigued. If the test is repeated the following day, ME/CFS patients usually cannot reproduce their performance from the first day..

“That’s very typical and specific of people with ME/CFS, because healthy people, or even people who have heart disease, can reproduce the exercise on the second day, but these people cannot,” Giloteaux said.

In the study, Ithaca campus researchers collaborated with Dr. Susan Levine, an ME/CFS specialist in New York City, who recruited 48 people diagnosed with ME/CFS and 39 healthy controls to provide stool and blood samples.

The researchers sequenced regions of microbial DNA from the stool samples to identify different types of bacteria. Overall, the diversity of types of bacteria was greatly reduced and there were fewer bacterial species known to be anti-inflammatory in ME/CFS patients compared with healthy people, an observation also seen in people with Crohn’s disease and ulcerative colitis.

At the same time, the researchers discovered specific markers of inflammation in the blood, likely due to a leaky gut from intestinal problems that allow bacteria to enter the blood, Giloteaux said.

Bacteria in the blood will trigger an immune response, which could worsen symptoms.

The researchers have no evidence to distinguish whether the altered gut microbiome is a cause or a whether it is a consequence of disease, Giloteaux added.

In the future, the research team will look for evidence of viruses and fungi in the gut, to see whether one of these or an association of these along with bacteria may be causing or contributing to the illness.

Co-authors include Julia Goodrich, a doctoral student, and William Walters, a postdoctoral researcher, both in Ley’s lab.

The study was funded by the National Institutes of Health.

Wednesday, 15 June 2016

Wise Words from Prof Malcolm Hooper

The following picture of Prof Hooper speaking was taken (I don’t know who by) at the recent Chasing Competent Care conference in Belfast – and I couldn’t agree more!

Click on the photo to bring up a larger version.



For a write-up of the conference, go to



Friday, 10 June 2016

Chelsea and Kew

My brother and sister-in-law, Tim and Lois, recently had a trip to London to visit both the Chelsea Flower Show and Kew Gardens, which they enjoyed very much (Tim is a gardener!). I have posted a few of their photos below. The first six were taken at the Chelsea Flower Show, the bottom six at Kew.

NB Clicking on the photos will enlarge them and bring up a slideshow.













Saturday, 4 June 2016

David's Fainting Fit


(Although written for the New Year, this article undoubtedly applies to any time of year.)

And David said in his heart, I shall now one day perish by the hand of Saul: there is nothing better for me, etc. – 1 Samuel 27:1

We read that Saul, Israel’s first king, was “turned into another man” and that “God gave him another heart” (1 Samuel 10:6,9). This sounds like conversion. However, in conversion God promises, “A new heart also will I give you, and a new spirit will I put within you” (Ezekiel 26:26) – and this is not the same. “Another heart” is not “a new heart,” and “another man” is not “a gracious man.” With Saul, God only equipped him for kingship and to deliver Israel from their enemies. In both these, Saul did well while he was humble (1 Samuel 15:17).

However, it was only a matter of time before his true character emerged. Without the new birth there can be no new life. After just two years Saul twice disobeyed God’s command, and the Lord rejected him from being king. This reminds us that our discipleship is always proven by our obedience; as the Master said, “If ye continue in my word, then are ye my disciples indeed” (John 8:31).

REJECTION

Saul’s rejection was bitterly disappointing to Samuel, who found it hard to get over. The Lord, therefore, kindly said, “How long wilt thou mourn for Saul, seeing I have rejected him from reigning over Israel? fill thine horn with oil, and go, I will send thee to Jesse the Bethlehemite: for I have provided me a king among his sons” (1 Samuel 16:1). Such disappointments will come, but they should not dismay us too much. David would be Israel’s next king, and he would be a man after God’s own heart. The Lord has other work for us to do, and He wants us to move on. We never know what blessing is just around the corner.

David, though, cannot immediately ascend the throne of Israel – that must be when Saul dies. The interval between David’s anointing and his crowning became a severe trial. Saul grew jealous, saw him as pretender to the throne and tried to kill him. David became a fugitive with a price on his head. He faced the treachery of Israelites who tried to betray him. In addition to his own and his family’s safety, he had the care of six hundred loyal followers and their dependents.

STRANGE

What a strange path to the throne! But it is a picture of our experience. We too are the Lord’s anointed (1 John 2:20) and one day we will “inherit the throne of glory” (1 Samuel 2:8; Revelation 3:21). Meanwhile, our lot is sometimes trials and troubles: “we must through much tribulation enter into the kingdom of God” (Acts 14:22). This, if sanctified to us, does two things. Firstly, it enables us to serve the Lord more fruitfully because we have proved His love and faithfulness. Without David’s troubles, he would not have been the king he was, nor could he have composed the precious psalms of this period, e.g. Psalm 57.

The story is told of little girl walking in a garden who noticed a particularly beautiful flower. She admired its fragrance. “It is so pretty!” she exclaimed. Then her eyes followed the stem down to the soil in which it grew. “This flower is too pretty to be planted in such dirt!” she cried. So she pulled it up by its roots and ran to the tap to wash away the soil. It wasn’t long until the flower wilted and died. When the gardener saw what the little girl had done, he exclaimed, “You have destroyed my finest plant!” “I’m sorry,” she said, “but I didn’t like it in that dirt.” The gardener replied, “I chose that spot and mixed the soil because I knew that only there could it grow to be a beautiful flower.” And so it is in our God-appointed circumstances that, by God’s grace, produce the beauty of Christian character and the fragrance of Christ.

The second thing it does is to prepare us for heaven. Without the “light affliction,” how could David – or we – appreciate the eternal “weight of glory” that will ultimately replace it? (2 Corinthians 4:17). Heaven will make amends for all.

Let us also notice that these troubles came upon David when he was in the way of obedience, not out of it. We can be pleasing the Lord and yet everything can go wrong. We can be in the centre of His will, just like the disciples who went across the lake at the Master’s command, and a storm can blow up. Our struggles and sufferings do not necessarily mean the Lord is displeased with us, quite the opposite. That is our great comfort when things are at their worst – if we are with Him, He is with us, and is leading us safely through (Isaiah 43:2) to greater blessing than before.

HEIGHT

The opening of 1 Samuel 27 comes at the height of David’s troubles and danger. He loses heart, and in near despair took his own way out:

And David said in his heart, I shall now perish one day by the hand of Saul: there is nothing better for me than that I should speedily escape into the land of the Philistines; and Saul shall despair of me, to seek me any more in any coast of Israel: so shall I escape out of his hand.And David arose, and he passed over with the six hundred men that were with him unto Achish, the son of Maoch, king of Gath.And David dwelt with Achish at Gath, he and his men, every man with his household, even David with his two wives, Ahinoam the Jezreelitess, and Abigail the Carmelitess, Nabal’s wife.And it was told Saul that David was fled to Gath: and he sought no more again for him.

This reaction may astound us. But have we not found that sometimes faith and patience have seriously faltered? Spurgeon described Asaph in Psalm 73 in a way that fits David here – and perhaps us all too often,

Here you have the psalmist in a fainting fit. He has allowed the flesh to conquer the spirit. The observant eye of reason has for awhile rendered dim the clear vision of faith.

Gospel ministers can suffer this “fainting fit,” and sink into deep dejection. Some can hardly continue, and some even leave the pastorate. Many Christians have sunk terribly low or turned aside from the right way. It may be, dear reader, that as 2015 draws to its close you find yourself on the brink of this. Or maybe you have already come to where David was and are now snared in the consequences.

David’s “fainting fit” is on record here for our admonition and comfort. Let us follow the account of what happened and seek to apply it to ourselves. We can see that,

1. THERE WERE REASONS FOR THIS LAPSE

Verse 1 “And David said in his heart, I shall now perish one day by the hand of Saul, etc.”

1] The long, drawn-out trial.
David was in his teens when anointed, and thirty when crowned. The danger and pressure from his enemies lasted for perhaps thirteen years. By now he could take no more. Sometimes, the hardest part of God’s dealings is that they go on and on with no end in sight. This is worse than the trial itself. Then trust can weaken, we become “weary and faint in [our] minds” and finally take things into our own hands. It is a comfort to know that no less than David came this way.

2] It followed a personal victory.
Chapter 26 records David’s encounter with Saul from a safe distance. He had his enemy in his power and could have had him killed, but he spared his life (verse 23). Using this, he asked Saul to spare his life and cease pursuing him (verse 24). This melted Saul and he acknowledged David as the heir apparent (verse 21,25). Thus, David proved the truth of Romans 12:19,20

Vengeance is mine; I will repay, saith the Lord. Therefore, if thine enemy hunger, feed him; if he thirst, give him drink: for in so doing thou shalt heap coals of fire on his head.

Why, then, this sudden hopelessness? It was probably because he knew Saul had not fundamentally changed and would soon be pursuing him again. The king has promised similar before and then reverted to his murderous pursuit (1 Samuel 24:16-22). David realised it probably would happen again.

However, there might be another factor. David had great grace in sparing Saul. He “overcame evil with good” (Romans 12:21) – faith was in exercise and forgiveness triumphed. But the next minute it is as though it had not happened. Where is grace and faith now? It might be that pride rose up at David’s finest moment, and now, the Lord withdraws His grace. He falls, like his New Testament counterpart Peter with his self-confidence and denial of the Master. Beware of pride. The Lord hates it, and will not give any of His glory to a creature (Proverbs 29:23). Sometimes, to remind us it is only by grace we stand, He uses a controlled failure that teaches us dependence for the future. Even our sins are overruled to His glory! (Romans 8:28). As Thomas Watson says, “God makes the saints’ maladies their medicines.”

3] David received bad advice.
“David said in his heart, etc.” He reached this conclusion after considering the situation. It was certainly not the result of prayerfully seeking the Lord’s guidance. Let us beware of forgetting the Lord and resorting to human reason. Scripture warns us against this: “Trust in the LORD with all thine heart, and lean not to thine own understanding” (Proverbs 3:5 cf Jeremiah 17:9). David now sounds little different from an unbeliever: “I shall now perish one day … there is nothing better for me, etc.” This was neither true nor fair. A.W. Pink justly says,

Under the pressure of trials, relief is what the flesh most desires, and unless the mind be stayed upon God, there is grave danger of seeking to take things into our own hands. Such was the case with David: having leaned unto his own understanding, being occupied entirely with the things of sight and sense, he now sought relief in his own way, and followed a course which was the very opposite to that which the Lord had enjoined him (1 Samuel 22:5). There, God had told him to depart from the land of Moab and go into the land of Judah, and there He had marvellously preserved him. How this shows us what poor weak creatures the best of us are, and how low our graces sink when the Spirit does not renew them!

The fact that none other than the man after God’s own heart has been here gives us comfort – and hope.

2. THERE ARE LESSONS FROM THIS LAPSE

What can we learn more particularly from David’s “fainting fit”?

1] How this dishonours God.
David makes no mention of divine providence or protection. It is as if there is no God to whom he can look. It is the language of unbelief. He is different from how he was in Psalm 27, probably written during this period,

The LORD is my light and my salvation; whom shall I fear? the LORD is the strength of my life; of whom shall I be afraid?

When we lapse like this we virtually deny our Christian profession and seem like different people. Yet, the Lord maintains His work in us. Despite our sinful failure, the Lord remains faithful and can raise us up again. Asaph in Psalm 73 confessed in wonder, “Nevertheless I am continually with thee: thou hast holden me by my right hand” (verse 23). Preserving grace is as wonderful as saving grace. It is not our hold of Him, but His hold of us that counts!

2] This was ironic.
David was so near the end of the trial period now. Saul’s death was not long in coming and David could then ascend the throne in God’s time and way. Dear believer, the appointed time of your deliverance may be very soon – it may be it is to come early this New Year. Your times are in His hand. “Wait on the LORD, and keep his way, and he shall exalt thee” (Psalm 37:34).

3] Yet, great good came of David’s failure.
The Lord delivered him from the dangerous consequences of where he was. At first, his new master Achish determined to have David and his men on his side in the impending battle with the Israelites (1 Samuel 28:1,2). What horror for David – the prospect of fighting against Saul the Lord’s anointed whom he would not touch before! What can David do now? Into what impossible situations our impetuosity can bring us!

However, the Lord is over all. The Philistine commanders do not trust David and his men and demand that they be relieved of duty (29:1-7). This was how the Lord intervened for David’s deliverance, for He has the hearts of all men – even enemies – in His hand. We may stray from the right path but we do not stray from a faithful God. This was for David a tremendous token for good.

Moreover, we notice Achish’s language as he has to dismiss David and his men: “Surely as the LORD liveth, thou hast been upright, etc.” This phrase “as the LORD liveth” is found more than twenty times in the OT – always on the lips of Israelites, including Gideon, Boaz, David himself, Ittai, Elijah, Elisha, Micaiah and others. It is never on the lips of a heathen. Yet it is on the lips of Achish the Philistine here! Could it be that he has been converted, through the witness and influence of David – even in his distrust and disobedience? If so, it shows the wonderful overruling sovereignty of God. Who would imagine that David’s failure here could further the kingdom of God! Similar was accomplished through Elimelech’s mistake (Ruth 1:1 – Ruth’s conversion) and Jonah’s rebellion (Jonah 1 – the mariners’ conversion). It is on record here, not to justify David’s error but to comfort us over ours. God in mercy takes up our worst mistakes and foolishness and makes us a bringer of blessing to others. If He does this through us at our worst, then surely He will do this when we try to serve Him at our best!

And so David and his men were kept safe in “the land of the Philistines” while the terrible battle raged and Saul was killed (1 Samuel 31). The Lord even gave them a gracious token over the Amalekite sacking of their city Ziklag. He answered David’s prayer, enabled him to “recover all” because he “encouraged himself in the LORD his God” (1 Samuel 30:6). All was right again, his danger and troubles were over, and now he could ascend the throne of Israel.

Believe, dear reader, that the way of obedience may not be the easiest way – but it is the safest. The Lord is wonderfully with us in it (Exodus 3:12) and never fails us. Turning aside from that way is to invite worse trouble, as one false step leads to another and dangers multiply. However, all is never lost for a true child of God. Saul’s turning aside will prove ultimately fatal, but the Lord will recover His own like David. There is hope for you – do not conclude that despairing surrender is the only course. Or, if you have done that, that there is no hope now (2 Corinthians 4:8). In your fainting fit, look to David’s God, believe He is above the mess you have made, and call upon Him.

Seek ye the LORD while he may be found, call ye upon him while he is near:Let the wicked forsake his way, and the unrighteous man his thoughts: and let him return unto the LORD, and he will have mercy upon him; and to our God, for he will abundantly pardon.For my thoughts are not your thoughts, neither are your ways my ways, saith the LORD.For as the heavens are higher than the earth, so are my ways higher than your ways, and my thoughts than your thoughts. (Isaiah 55:6-9)

by Rev. John Thackway, Pastor of Holywell Evangelical Church

Used with kind permission of the author


Wednesday, 1 June 2016

Why we shouldn’t call it ‘chronic fatigue syndrome’


By RIVKA SOLOMON
May 24, 2016

It started with a bout of mononucleosis. Two college roommates and I got it at the same time. They felt better after a month. I didn’t. Decades later, I’m still living with bone-penetrating exhaustion and brain fog as thick as pea soup. I spent much of my 30s and 40s tethered to my bed, too weak to function. I’ve had to abandon both my career in international relations and my social life.

My mono had morphed into something more permanent, a neuroimmune disease the World Health Organization calls myalgic encephalomyelitis (ME). It affects between 1 million and 2.5million Americans and 17 million people worldwide.

It’s a disease that can force you to put your life on hold. According to the Institute of Medicine, it can reduce an individual’s ability to function more than heart failure, multiple sclerosis, or end-stage kidney disease. There’s no generally accepted diagnosis for ME. It can take up to five years to be accurately diagnosed, and up to 90 percent of people with it are never accurately diagnosed. Worse still, the FDA hasn’t given the green light to any treatments for it.

Those of us with ME have long hoped the government would come to our aid. Instead, in 1988 it gave the disease a new name, chronic fatigue syndrome, that stigmatizes people with this condition. And the National Institutes of Health has generally looked the other way. Year after year, the NIH has set aside a paltry $5 million to $7 million of its $30 billion annual budget for ME research. Compare that with the $100 million set aside for research on multiple sclerosis, which affects about 400,000 Americans.

Labelling ME as chronic fatigue syndrome gives doctors, the media, the public, and even family members permission to assume individuals are exaggerating, that we’re simply refusing to pull it together. With such a name, who could fault folks for thinking we just need to take a nap, some fish oil, and a vigorous walk? This type of thinking has led to individuals with ME, some too sick to care for themselves, being abandoned by both disbelieving families and physicians.

Last October, two things seemed poised to break the logjam of government neglect and stigmatizing research. First, investigative journalist and public health expert David Tuller successfully debunked the PACE study, a randomized trial that had cemented the widely held but erroneous belief that ME is a psychological disorder rather than a physical illness. Tuller’s work showed that the many flaws in the trial’s methodology seriously undermined the credibility of the treatments it supported — cognitive behavior therapy and graded exercise therapy. The investigation prompted 42 scientists and experts from Columbia, Harvard, Stanford, Berkeley, and elsewhere to release an open letter to the Lancet supporting Tuller’s analysis and demanding an independent analysis of the trial.

As any ME patient can tell you, behavior or talk therapy and pushing yourself physically won’t make you well. In fact, exercise often causes me to relapse, requiring weeks or months of home-bound bedrest. Telling an ME patient to exercise is dangerous, tantamount to prescribing sugar to a diabetic.

Also last October, the federal government promised to bolster research on what it now calls ME/CFS. Many of us thought this condition would finally get the type of government attention and funding offered to multiple sclerosis and Parkinson’s disease, two other neurological diseases also without a known cause or cure. Unfortunately, half a year later, the government falls short in making a serious commitment to ME. The NIH’s offering in the last six months includes one study of just 40 ME/CFS patients that will take at least two years to complete and some supplemental research money to expand grants already awarded.

In an effort to get on the US Department of Health and Human Services’s radar, ME patients and their caregivers will stage a protest, #MillionsMissing, at various cities around the country on May 25. What’s missing are millions of dollars of federal research funds into ME and millions of patients missing out on their own lives, from attending school to climbing the career ladder to simply spending time with family and friends.

Of course, many of us are too sick to attend the protests in person. We’ll be there in spirit — with empty pairs of our shoes symbolically standing in for us — as we advocate for our lives from our beds.

Rivka Solomon is a Massachusetts advocate for myalgic encephalomyelitis who is helping coordinate the #MillionsMissing protest. She is working on a book about her quarter century with the disease.