No! Not lower core body temperature! That’s a mistake everyone involved keeps making.
Low basal metabolic rate. I.e. after you’ve been asleep for a long time. Which Barnes claimed was best measured by waking armpit temperature.
Lots of papers saying thyroid hormones correlate with basal metabolic rate in animals. But not with ‘field metabolic rate’. That’s probably controlled by other hormones or the nervous system.
And core temperature is likely well defended. But basal metabolic rate has to correlate well with skin temperature (in equilibrium in a constant temperature known humidity environment, etc), because physics.
The other option is to directly measure basal metabolic rate while sleeping. That might be easier to do as a home thing these days. Barnes had to get people to go to the testing centre and then be scared stiff by complicated apparatus. They got all panicky and screwed up the test.
But if there’s some way of measuring BMR while sleeping in your own bed and you can do it every day for a week until you stop getting nervous, that looks like it would be sound.
Agreed. Some sort of 24-hour continuous thermometer attached while you slept might be good. And ideally you want to measure skin temp and outside temp, since what we’re interested in is the amount of heat passing through your surface, not your temperature per se.
But Barnes reckoned axilliary waking temperature was the best test, and he was a proper endocrinologist with access to whatever tests he wanted, and he looked at lots. And everyone thinks he was a loony because he said hypothyroidism was really common and explained everything. And I did too until I realised I’d just predicted the same thing from the simplest explanation for my mystery.
Sarah Myhill has an excellent test for CFS, which can tell you not only whether you’ve got it but how strong it is.
I like her paper. She is lying, or she is right.
If we can correlate that with Barnes’ waking-armpit-temperature thingy then I think I just buy the whole thing.
If we can’t, I think I have to give up with the ‘occult hypothyroidism everywhere’ already and retreat to ‘something funny about those tests, a few cases missed, maybe’
That’s a pretty strong statement. What makes you believe that it can only by one of those two cases?
Apart from that I’m not even sure whether she believes that she has an excelent test given that she writes: There is no simple test currently available to diagnose CFS because, as I have said already, CFS is not a diagnosis – it is a symptom.
Because her evidence is very strong. She hasn’t got it by luck or a bit of innocent p-hacking. Her test score correlates very nicely with her assessment of severity of symptoms.
I think in the quote she’s saying ‘I wouldn’t diagnose someone with CFS, that’s what they present with, my test is for mitochondrial dysfunction and that can be a cause of those symptoms, but so can e.g. lack of sleep or bad diet or hypothyroidism’. But I don’t know. Of course I think that hypothyroidism can cause mitochondrial dysfunction.
Everyone involved is using words differently, and that’s obviously confusing, but I think we have to avoid getting hung up on it and try to look for the predictions we have in common and our ways of carving reality up.
Everyone involved is using words differently, and that’s obviously confusing, but I think we have to avoid getting hung up on it and try to look for the predictions we have in common and our ways of carving reality up.
But it is ever so important not to get into pointless bunfights about words.
Fights about words are not pointless. Finding the right words is important to understand unclear territory. Getting clear about words allows to make more precise statements.
It seems to me a lot of the problem is due to it not being a clear diagnosis. Especially one that can be easily and objectively measured.
If johnlawrenceaspden thesis of a lower core body temperature is true, that might advance the field by providing an easier way to test for CFS.
Maybe there should be a suppository that continously measures bodytemperature and acceleration.
No! Not lower core body temperature! That’s a mistake everyone involved keeps making.
Low basal metabolic rate. I.e. after you’ve been asleep for a long time. Which Barnes claimed was best measured by waking armpit temperature.
Lots of papers saying thyroid hormones correlate with basal metabolic rate in animals. But not with ‘field metabolic rate’. That’s probably controlled by other hormones or the nervous system.
And core temperature is likely well defended. But basal metabolic rate has to correlate well with skin temperature (in equilibrium in a constant temperature known humidity environment, etc), because physics.
I think you would likely get a better measurement with 24⁄7 temperature measurement than simply measuring waking temperature on one spot.
The other option is to directly measure basal metabolic rate while sleeping. That might be easier to do as a home thing these days. Barnes had to get people to go to the testing centre and then be scared stiff by complicated apparatus. They got all panicky and screwed up the test.
But if there’s some way of measuring BMR while sleeping in your own bed and you can do it every day for a week until you stop getting nervous, that looks like it would be sound.
Agreed. Some sort of 24-hour continuous thermometer attached while you slept might be good. And ideally you want to measure skin temp and outside temp, since what we’re interested in is the amount of heat passing through your surface, not your temperature per se.
But Barnes reckoned axilliary waking temperature was the best test, and he was a proper endocrinologist with access to whatever tests he wanted, and he looked at lots. And everyone thinks he was a loony because he said hypothyroidism was really common and explained everything. And I did too until I realised I’d just predicted the same thing from the simplest explanation for my mystery.
That’s interesting. There might be some smartwatch that can measure skin temperature on the arm.
Sarah Myhill has an excellent test for CFS, which can tell you not only whether you’ve got it but how strong it is.
I like her paper. She is lying, or she is right.
If we can correlate that with Barnes’ waking-armpit-temperature thingy then I think I just buy the whole thing.
If we can’t, I think I have to give up with the ‘occult hypothyroidism everywhere’ already and retreat to ‘something funny about those tests, a few cases missed, maybe’
That’s a pretty strong statement. What makes you believe that it can only by one of those two cases?
Apart from that I’m not even sure whether she believes that she has an excelent test given that she writes:
There is no simple test currently available to diagnose CFS because, as I have said already, CFS is not a diagnosis – it is a symptom.
Because her evidence is very strong. She hasn’t got it by luck or a bit of innocent p-hacking. Her test score correlates very nicely with her assessment of severity of symptoms.
I think in the quote she’s saying ‘I wouldn’t diagnose someone with CFS, that’s what they present with, my test is for mitochondrial dysfunction and that can be a cause of those symptoms, but so can e.g. lack of sleep or bad diet or hypothyroidism’. But I don’t know. Of course I think that hypothyroidism can cause mitochondrial dysfunction.
Everyone involved is using words differently, and that’s obviously confusing, but I think we have to avoid getting hung up on it and try to look for the predictions we have in common and our ways of carving reality up.
That reminds me of Jay A. Labinger: The language you use to talk about something influences the way you think about it. If the chemistry you’re talking about is truly something new, then a fight over terminology may be quite an important part of getting to understand that chemistry better.
Mitochondrial dysfunction might be a much better disease target than CFS.
Absolutely. We need to ‘carve reality at its joints’ (may his name be praised), and naming things is important, whatever St Feynman said.
But it is ever so important not to get into pointless bunfights about words.
Fights about words are not pointless. Finding the right words is important to understand unclear territory. Getting clear about words allows to make more precise statements.
Agreed, let us not get into a pointless meta-bunfight