Q and A: about health and research

The history of medicine demonstrates that the identification of disease mechanisms can vary dramatically in duration and complexity. The discovery and confirmation of HIV required only approximately two years, after which the diagnosis became universally accepted. The pharmaceutical industry subsequently developed therapies capable of suppressing viral replication, although no definitive cure has yet succeeded in eliminating the virus entirely from the human body. In contrast, other diseases required decades before their underlying mechanisms were understood. One notable example is Creutzfeldt-Jakob disease . Although the disease was initially described between 1920 and 1921, its true cause, misfolded proteins known as prions, was not verified until 1982, more than sixty years later. Research into Kuru played a critical role in uncovering the biology of prion diseases. As described by Robert Sapolsky :  “It was studied by Carleton Gajdusek, who showed that the condition was trans...

Since being diagnosed with Tarlov cysts in 2007—primarily in the sacral region—I’ve been exploring the possibility that these fluid-filled sacs may play a more significant role in chronic pain syndromes and immune dysfunction than currently acknowledged. My ongoing focus has been the connection between Tarlov cysts and the dorsal root ganglia, particularly when a cyst is located directly on or near a nerve root. Tarlov cysts, also known as perineural cysts, form around the spinal nerve roots and are filled with cerebrospinal fluid (CSF). They are most commonly found in the sacral region near the base of the spine but can also occur higher up, including the cervical spine, where they may contribute to neck pain.  While often dismissed as incidental findings, some patients—myself included—experience debilitating symptoms that clearly correspond with the T 11 and 12 location and behavior of these cysts. This raises an important and largely unanswered question: Could Tarlov cysts be ...

Ed Yong is pointing several times to lactic acid. https://www.theatlantic.com/podcasts/archive/2023/08/fatigue-can-wreck-you/675030/ I wonder if the Cori cycle might be impaired or dysfunctional. Metabolic stress can arise when the Cori cycle is interrupted or not functioning properly. This cycle is a key metabolic pathway responsible for recycling lactic acid produced by muscles during intense activity or times of high energy demand. It plays a crucial role in maintaining blood glucose levels and in replenishing glycogen stores in the muscles. If glucose is not effectively returned to the muscles, it cannot be used for energy, leading to fatigue and an inability to restore glycogen—a critical component for sustained physical function. To date, I haven't found any research publications that specifically examine the Cori cycle as a potentially dysfunctional pathway in ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome). While lactic acid buildup and glucose metabolism ar...