41. Pediatric Network For CFS, FM, OI @ Www.ezboard.com other professionals can discuss chronic fatigue syndrome, fibromyalgia, neurallymediated hypotension, postural orthostatic tachycardia syndrome, and related http://pub96.ezboard.com/bpediatricnetwork.boardStatsLink

"); else document.write(""); // >   for Chronic Fatigue Syndrome, Fibromyalgia, and Orthostatic Intolerance Home News Forum Contribute ... Help Pediatric Network for CFS, FM, OI Invite Friends! Login Register Your Free Account (Required) Search Help ... Need help logging in? Forum Guidelines and Help Guidelines What Are Violations? Keep Kids Safe How to Register ... Meet Our Moderators Ideas for Increasing Awareness: We had a wonderful, stimulating discussion about ways to increase awareness in our most recent live chat. Please visit our Awareness Day Page and read the summary of success stories shared and ideas brainstormed during the chat. Upcoming Live Chats: Monday, April 14 at 9:00 PM Eastern Time (6:00 PM Pacific; 01:00 GMT/UTC): Parents' Chat Thursday, April 17 at 3:30 PM Eastern Time (12:00 PM Pacific; 19:30 GMT): Youth Chat Back to Pediatric Network for CFS, FM, OI Pediatric Network for CFS, FM, OI Profile Founded: June 12, 2002 Daily Posts: 29 Total Posts: 4632 Daily Visits: 812 Total Visits: 113484 A welcoming place where teenagers, parents, physicians, educators, and other professionals can discuss chronic fatigue syndrome, fibromyalgia, neurally mediated hypotension, postural orthostatic tachycardia syndrome, dysautonomia, and related conditions Administrators rmooreny (Founder) MaryZ annaok JRain KMMusician ... vikkilouise Newest Members luckygoat first post...

42. TENS Units For Pain - Www.ezboard.com hypotension (NMH it means low blood pressure and lightheadedness caused by a nervoussystem problem) and postural orthostatic tachycardia syndrome (POTS - it http://pub96.ezboard.com/fpediatricnetworkfrm16.showPrevMessage?topicID=46.topic

43. Chat - Fall 1997 Orthostatic Tachycardia Syndrome. postural orthostatic tachycardia syndrome.Hyperadrenergic Postural Hypotension. Sympathotonic Orthostatic Hypotension. http://www.ndrf.org/NDRFChat.htm

NDRF National Dysautonomia Research Foundation 1407 W Fourth Street, Suite 160, Red Wing, MN 55066-2108 Phone: (651) 267-0525 Fax: (651) 267-0524 Be sure to visit the NDRF Reference Page where you can learn more about the NDRF Patient Handbook, Videos and other reference materials. NDRF Chat Fall 1997 Table of Contents: Orthostatic Intolerance Syndromes: Dr. David Robertson, Vanderbilt University, Nashville, TN FAQ's : Dr. Phillip Low, Mayo Clinic, Rochester Health Tips: Dr. Kathryn Boehm NDRF Updates: Linda J. Smith 1407 W 4th St, Suite 160, Red Wing, MN 55066 NDRF Chat Orthostatic Intolerance Syndromes: Postural Tachycardia Syndrome (POTS), Mitral Valve Prolapse Dysautonomia (MVP), Idiopathic Hypovolemia Since our start in April of this year, NDRF has received calls, letters and e-mail daily. Due to the large number of calls we receive from those who suffer from Orthostatic Intolerance Conditions, NDRF felt that our first newsletter should focus on this area. We have asked some of the leading physicians who treat these disorders to help us by providing a summary of the conditions, answering some frequently asked questions, and giving some helpful health tips to assist in managing Orthostatic Intolerance. We hope that this newsletter will provide you with information that will help you better understand and manage your condition. Our website also may provide you with some information - be sure to visit us and drop us a note.

44. The Connecticut CFIDS & FM Association Links its Treatment Our FMCFS World NMH Orthostatic Intolerance Chronic Fatigue Syndromepostural orthostatic tachycardia syndrome, Patient's Report The Mitral http://www.ct-cfids-fm.org/links.htm

P.O. Box 3010 Milford, CT 06460 InfoLine: (800) 952-2037 Home Our Activities Latest News Web Links ... Contact Us Links Of Local Interest Cfids Insights - Chronic Fatigue Immune Dysfunction Syndrome New Britain General Hospital Sara Bass, Conn. CFIDS Assoc., Statement to CFS Coordinating Committee of DHHS State of Connecticut Department of Public Health Home Page ... Welcome to Dr. Z's website! Associations and Organizations Center for Complex Infectious Diseases CDC - Chronic Fatigue Syndrome CFS-Information International CFIDS and FMS Support Group of DFW ... Shasta CFIDS Support Group Directories of Resources BUBL Journals Journal of Chronic Fatigue Syndrome CFS-FMS-M.E. Home Pages(Framed) Doctor's Guide- Global Edition httphealth.yahoo.com-health-dc-001244-0.html ... Yahoo! Health Diseases and Conditions Chronic Fatigue Syndrome Sites With Diverse Information A Story of Recovery from Chronic Fatigue Syndrome - CFIDS - by Tom Oates Jr. Advanced Techniques For Overcoming CFS, FMS and GWS CFS - M.E. Information from CFS-NEWS CFS Radio Show Transcript Page ... WebMD - Fibromyalgia-CFIDS Clinics and Doctors Cancer, ALS, Chronic Fatigue, Immune Institute

45. Medizinische Klinik Translate this page ABSTRACT. postural orthostatic tachycardia syndrome (POTS) Pathogenesis,Diagnostic Evaluation, and Therapeutic Options. Background http://www.multimedica.de/public/html/uvogel/ZE/FUFZE104X/2000/08/06.html

Fachportal Innere Medizin Zeitschriften Medizinische Klinik BDI aktuell ... Englisch A-Z Medline Reisemedizin Rote Liste Leitlinien Patientenservice Kongresskalender Posturales orthostatisches Tachykardiesyndrom (POTS): Blair P. Grubb , Thomas Klingenheben Division of Cardiology, The Medical College of Ohio, Toledo, USA, Eingang des Manuskripts: 18. 10. 1999. Annahme des Manuskripts: 24. 3. 2000. Z USAMMENFASSUNG Hintergrund: Diagnostik und Therapie: Med Klin 2000;95:442–6. A BSTRACT Postural Orthostatic Tachycardia Syndrome (POTS): Pathogenesis, Diagnostic Evaluation, and Therapeutic Options Background: Since the renaissance of tilt table testing in clinical cardiology some 15 years ago, the syndromes of autonomic dysfunction with orthostatic intolerance underwent improved differentiation and classification. In the present review a variant of autonomic dysfunction with orthostatic intolerance – POTS (postural orthostatic tachycardia syndrome) – will be discussed. Diagnosis and Treatment: The affected patients present with orthostatic intolerance, postural tachycardia, exercise intolerance, fatigue, dizziness and in some cases with other dysautonomic symptoms such as gastrointestinal or sudomotor dysfunction. Together with the clinical history, tilt table testing is the cornerstone of diagnostic evaluation by which the syndrome can be distinguished from typical neurocardiogenic disorders. POTS is characterized by

46. Biological Terrain And Live Blood Analysis Courses An increase in heart rate of 28 beats per minute (bpm) OR a pulse of more than 110120bpm is known as postural orthostatic tachycardia syndrome (POTS) happens http://www.bioterrain.co.uk/BioTerrain/bp.html

Blood Pressure Monitoring The Orthostatic Blood Pressure Test shows us how well your body adapts to standing up after having been lying down for 10 minutes. When lying down your blood vessels are relaxed and dilated, when you get up they must contract as otherwise all your blood 'would sit around your ankles with nothing in your head'. Actually venous pooling concerns mainly the large abdominal vessels. Among the chemicals released by the Autonomic Nervous System to control the circulating blood volume are cortisol, dopamine, epinephrine (adrenaline), and norepinephrine (very similar to epinephrine but with somewhat less effect on the heart). The organ crucial to this happening is the adrenal gland and principal hormones produced by its adrenal cortex are cortisol (hydrocortisone), aldosterone, and dehydroepiandrosterone (DHEA). Adults secrete about 20 mg of cortisol, 2 mg of corticosterone (which has similar activity), and 0.2 mg of aldosterone daily. Although considerable quantities of androgens (primarily DHEA and androstenedione) are normally produced by the adrenal cortex, their chief physiologic activity occurs only after conversion to testosterone and dihydrotestosterone. The orthostatic blood pressure test (10 minutes supine and upto 30 minutes standing) thus gives an insight into the functionality of the patient's adrenal gland. In a healthy subject the BP may temporarily rise slightly or remain constant as will the pulse rate; in a patient with poor adrenal functioning the BP will drop. The Orthostatic Blood Pressure Test is correlated to the U1 / U2 resistance of Biological Terrain Analysis as well as to the Heart Rate Variability study which is another, ECG based orthostatic test, and laboratory tests. Some BP irregularities that can occur alone or as combinations:

47. HealthlinkUSA Postural Orthostatic Tachycardia Syndrome Links AhHa. Click here for page 1 of postural orthostatic tachycardia syndromeinformation from the HealthlinkUSA directory. Save on Drugs Here. http://beta.healthlinkusa.com/248ent.htm

48. Listings Of The World Health Conditions And Diseases Listings World Health Conditions and Diseases Neurological Disorders Dysautonomiapostural orthostatic tachycardia syndrome. http://listingsworld.com/Health/Conditions_and_Diseases/Neurological_Disorders/D

49. Listings Of The World Health Conditions And Diseases postural orthostatic tachycardia syndrome (5), ShyDrager Syndrome (4). POTS PlacePost Review Information on postural orthostatic tachycardia syndrome (POTS). http://listingsworld.com/Health/Conditions_and_Diseases/Neurological_Disorders/D

50. Advanced Search that are considered to be dysautonomic responses to upright posture, such as orthostatichypotension and postural orthostatic tachycardia syndrome (POTS). http://www.aafp.org/afp/20000401/tips/9.html

Advanced Search Tips from Other Journals Previous Next Vasovagal Syncope and Related Disorders The management of patients in whom a primary abnormality in blood pressure regulation results in hypotension and loss of consciousness presents clinical challenges. The hypotension may be primary, or it may be secondary to a condition such as tachyarrhythmia or bradyarrhythmia. Vasovagal syncope describes this condition, as well as other conditions that are considered to be dysautonomic responses to upright posture, such as orthostatic hypotension and postural orthostatic tachycardia syndrome (POTS). Bloomfield and associates reviewed the pathophysiology of these two causes of syncope and developed an algorithm to guide diagnosis and treatment. see the accompanying figure on page 2212 Vasovagal Syncope and Related Disorders FIGURE. Vasovagal syncope and related disorders: a suggested algorithm for the diagnosis and treatment of vasovagal syncope and related disorders. (POTS = postural orthostatic tachycardia syndrome; HR = heart rate; BP = blood pressure; OH = orthostatic hypotension; HTN = hypertension; SSRI = selective serotonin reuptake inhibitors) Adapted with permission from Professional Postgraduate Services, a division of Physicians World Communications Group.

51. Autonomic Differential Diagnosis Trimethylaminuria produces fish odor. Postural Orthostatic TachycardiaSyndrome (POTS). postural orthostatic tachycardia syndrome (POTS) 2. http://www.neuro.wustl.edu/neuromuscular/autonomic.html

Front Search Index Links ... Patient Info AUTONOMIC DISORDERS Diseases or syndromes Acute Amyloidosis Catecholamines ... Systemic diseases External link: Pupil disorders System disorders Cardiac Gastrointestinal ... Urinary AUTONOMIC DISEASE SYNDROMES Systemic diseases Amyloidosis Diabetes Mellitus Porphyria Infections Chagas' HIV Leprosy Rabies Chronic renal or hepatic disease: Usually subclinical Immune disorders Acute Dysautonomia Paraneoplastic : Especially Small cell lung cancer Sensory neuronopathy: anti-Hu Dysautonomia : IgG vs a 3 subunit of acetylcholine receptor Enteric neuropathy anti-Hu CV-2 LEMS ? Collagen Vascular Disorders System Degenerations Idiopathic Orthostatic Hypotension Shy-Drager (Multiple systems atrophy) Parkinsonism: DOPA responsive Mitochondrial - MNGIE M yopathy and external ophthalmoplegia; N europathy; G astro- I ntestinal; E ncephalopathy) Neuronal intranuclear inclusion disease (NIID) Hereditary autonomic disorders Congenital Anhidrotic ectodermal dysplasia Aniridia : Paired box gene 6; 11p13 Biemond congenital anaesthesia Dopamine b -Hydroxylase deficiency (HSAN 2) Hirschsprung's congenital megacolon Hypoventilation Lacrimation: Absence Other congenital dysautonomias ... Riley-Day (HSAN 3): 9q31 Sensory PN + anhidrosis (HSAN 4): TRKA/NGF receptor; 1q21-q22

52. Autoimmune Disease Links Postural Orthostatic Tachycardia postural orthostatic tachycardia syndrome.Rheumatoid Arthritis Arthritis Foundation. Sjogren's Syndrome http://www.healinglight.com/autoimmune/linksh.htm

Autoimmune Resource Links Home Pages Dictionary Support Groups Addison's ... Yeast Addison's Home Pages Cyndi's Home Page Cindi's Addison's Disease Chat Addison News E-mail: Joan Hoffman Dictionary Internet Dictionary Foundations and Support Groups NORD National Organization for Rare Disorders, Inc. NADF National Adrenal Diseases Foundation Addison's Support Group of the Northwest (Link Broken, Site no longer at this address) Australian Addison's Disease News American Autoimmune Related Diseases Association Dutch/International Addison's and Cushing Society The Canadian Addison Society E-mail: Joan Southam New Zealand Addison's Network More CAH Support Forums UK Addison’s Support Group Contact Deana Kenward BrainTalk Communities - Neurology Support Groups Addison's Addison's Owner Manual Addison's Disease Net Medicine Net/Addison's Addison's Disease after 40 years of study ... Addison's Disease and Type I Diabates Adrenal Disorders Normal Adrenal Functionl Home Page of the International Patients Organisations on Addison and Cushing Addison's, Schmidt's, Cushings and Other Related Autoimmune Disease Support Forum and Bulletin Board Adrenocortex Stress Profile - Great Article! ... Enzymatic pathways for Cortisol and Aldosterone Asthma and Allergies Comprehensive Antibody Assessment (Food Allergies) Arthritis Medline plus Arthritis Rheumatology Fact Sheets Blood Work CO2 Blood Work Normal Blood Ranges Managing Adrenal Insufficiency (How to Give Yourself a Shot) Blood Work FAQ ... Lab Test Online Celiac Disease

53. Pamela Nerheim, M.D.: Division Of Cardiovascular Diseases: Department Of Interna interests include Sympathetic nerve activity measured with microneurography in patientswith postural orthostatic tachycardia syndrome and Inappropriate Sinus http://www.int-med.uiowa.edu/Divisions/Cardiology/Directory/PamelaNerheim.html

Internal Medicine home Appointments Blue Sheet This Week's Next Week's Clinical services and referrals Clinical trials ... Virtual Hospital® - UI Health Care's digital library Send comments and questions to Lori Strommer Pace University of Iowa Department of Internal Medicine Cardiology Faculty Pamela Nerheim, M.D. Assistant Professor (Clinical) Dr. Nerheim's clinical interests include Sympathetic nerve activity measured with microneurography in patients with Postural Orthostatic Tachycardia Syndrome and Inappropriate Sinus Tachycardia (planning stages). Her Research interests include cytomegalovirus as a novel risk factor for atherosclerosis, autonomic function in postural orthostatic tachycardia syndrome, inappropriate sinus tachycardia, and stereotaxis in ablation and coronary sinus lead location. She is currently studying the Model for the study of cytomegalovirus in vascular tissue (near completion). Honors, Awards, and Organizations

54. Cardiac Arrhythmias sufficient. postural orthostatic tachycardia syndrome. Being femaleprotects us from early atherosclerotic heart disease. However http://www.womensheartfoundation.org/content/HeartDisease/cardiac_arrhythmias.as

Home About WHF Seminars Programs ... Ask the Nurse Cardiac Arrhythmia Management: Why Women are Different from Men Electrical Explanation For Gender Differences The fact that women's hearts are wired differently from men's should come as no surprise. The development of every part of the body is determined genetically, and modified by the sex hormones. The fact that we develop so similarly should really surprise us. This is also true of the electrical system of the heart in women. The way that the heart works isthrough an electrical system that we can measure on the surface with the electrocardiogram (ECG). This detects the electrical activity of the top chambers of the heart, the atria, manifest by a p wave, followed by a sharp deflection, the QRS, which represents the electrical activity of the ventricles of the heart. Following the QRS, there is a recovery interval, marked on the ECG by a hump, and the distance between the beginning of the QRS and the end of this hump, the T wave, is called the QT interval. The electrical activity we see on the surface is created by the sequential, and sometimes simultaneous, activity of a number of channels in the muscle membranes of heart tissue to allow certain ions, such a sodium, calcium, potassium, and some chemicals, such as acetylcholine, and ATP (an energy molecule) to cross into or out of the cell. The structure of these channels is determined genetically, and to some degree, their genetic expression varies with gender.

55. Indications For Autonomic Reflex Testing (ART) postural orthostatic tachycardia syndrome, orthostatic tachycardia, Da Costasyndrome, soldier’s heart, effort syndrome, mitral valve prolapse http://www-neuro.med.ohio-state.edu/autoweb/indications.html

56. Anesthesiology Volume 93 1 2 3 Orthostatic intolerance syndrome is most often observed in young womenand has also been described as postural orthostatic tachycardia syndrome, 1 http://www.headachepainfree.com/POTS.htm

HeadachePainfree.Com Anesthesiology Volume 93 • Number 2 • August 2000 CASE REPORTS Perioperative Considerations in a Patient with Orthostatic Intolerance Syndrome Ali Mchaourab M.D., Anthony J. Mazzeo M.D., Judith A. May M.D., Paul S. Pagel M.D., Ph.D. *Resident. Assistant Professor. Professor and Director of Cardiac Anesthesia. Individual article reprints may be purchased through the Journal Web site, www.anesthesiology.org Received from the Department of Anesthesiology, the Medical College of Wisconsin and the Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin. Submitted for publication December 16, 1999. Accepted for publication April 3, 2000. Address reprint requests to Dr. Pagel: Department of Anesthesiology, Medical College of Wisconsin, MEB-M4280, 8701 Watertown Plank Road, Milwaukee, Wisconsin 53226. Address electronic mail to: atredeau@mcw.edu Key words: Autonomic nervous system; blood pressure; blood volume; syncope; tachycardia. Introduction ORTHOSTATIC intolerance syndrome is an unusual autonomic nervous system disorder characterized by episodic or postural tachycardia that occurs independent of alterations in arterial blood pressure and is associated with symptoms that include palpitations, tremulousness, light-headedness, fatigue, and syncope.

57. GWS2000 POTS which is postural orthostatic tachycardia syndrome where the heart rateincreases 28 beats per minute. This is also called idiopathic hypovolemia. http://www.ncf-net.org/forum/restheory.html

DR. BELL'S NEW RESEARCH BASED THEORIES By Gail Kansky A slide was shown to an appreciative audience of a cartoon where a doctor is saying to the patient, You have a serious disease of undetermined nature. Although the cartoon has been used for many years, David S. Bell, M.D., world known pediatric and adult CFIDS specialist said, "This is what we're still dealing with." Although the symptoms all appear to be connected, they will "from week to week frequently change," said Dr. Bell. In his first 100 patients he saw, only 49% had fatigue as the dominant symptom yet a high 97% of the children and 92% of the adults had neurological symptoms. Doctors "invariably give the wrong first diagnosis. They think they're helping by being decisive but this has only caused heartache in this illness." Dr. Bell mentioned that he had "lot of problems with the criteria that the CDC put out in 1994. Indeed, the restriction degree is possible.

58. Autonomic Question April 1999 Any suggestions? Dr. Chelimsky postural orthostatic tachycardia syndrome(POTS) is quite common in and of itself. It usually occurs http://mediswww.meds.cwru.edu/dept/autonomic/ANSQUEST/ans0499.htm

Autonomic Laboratory Patient Questions, April 1999 This Web page is designed for the general education of patients and their families. Dr. Tom Chelimsky . No patient should make any changes in their care without first consulting their physician. Question 1: I have postural orthostatic tachycardia. What other disorders can this be associated with? I am taking Flurinef, which helps with the lightheadness but I am still extememly fatiuged and brain fogged. Any suggestions? Dr. Chelimsky: Postural orthostatic tachycardia syndrome (POTS) is quite common in and of itself. It usually occurs after a viral syndrome ("flu") but may occur without any heralding event, or may also be inherited (check to see if you have relatives with milder similar symptoms). If there is an autonomic laboratory near where you live, it is best if the diagnosis can be confirmed by this type of testing (usually a heart nerve check, and a sweat nerve check of some type), and damage to the nerves can be excluded. This diagnosis is a SYNDROME, not a disease, and there are probably many types of diseases that lead to this set of symptoms. Depending on the reasons that the symptoms are there, the treatment would vary. If the veins are not returning blood to the heart, you need more salt loading (you should eat lots and lots of salt each day, aiming for 15 g per day). If the arteries are not constricting properly, a drug called midodrine may be helpful. Walking in the water and thigh strengthening exercises may be quite helpful in reconditioning you regardless of the cause of the problem.

59. CWRU/UHC Neurology Autonomic Lab postural orthostatic tachycardia syndrome occurs when orthostatic symptomsare accompanied by unexplained tachycardia. The disorder http://mediswww.meds.cwru.edu/dept/autonomic/ANSTEST/BROCHUR.HTML

Information on the tests for patients Assessment of symptoms Specific diagnoses Testing ... Contacting us...we're here for you and your patients! The Autonomic Laboratory at University Hospitals of Cleveland is the only facility of its kind in Ohio and surrounding states. Using state-of-the-art equipment, the lab offers non-invasive testing that evaluates abnormalities in the control of blood pressure, heart rate, urination, digestion, sexual function, and sweating. Testing, intended for patients over the age of 1, helps to diagnose a wide variety of autonomic disorders, enabling the referring physician to provide appropriate and specific treatment. Assessment of symptoms Autonomic testing will accurately and reliably establish whether the autonomic nervous system is the cause of any of the symptoms below: Syncope is due to an abnormality of the autonomic nervous system in 75 percent of patients who do not have obvious heart disease or a seizure disorder. Radicular thoracic and abdominal pain are common in diabetics or may be caused by infectious (herpes zoster) or mechanical (intervertebral disk herniation) processes. The sweat test confirms the diagnosis of radiculopathy by revealing a failure to sweat in the involved dermatome. Sexual dysfunction may be the initial manifestation of disorders affecting much of the autonomic nervous system. Autonomic function tests can directly estimate the extent of involvement of the sympathetic and parasympathetic nervous systems. This is especially important in evaluating diabetics and other patients with erectile dysfunction who may have both organic and psychogenic etiologies.

60. Canadian Expert Consensus Panel Criteria For M.E. AUTONOMIC MANIFESTATIONS Orthostatic Intolerance eg, neurally mediated hypotension(NMH), postural orthostatic tachycardia syndrome (POTS), delayed postural http://www.cfids-cab.org/MESA/ccpc.html

Canadian Expert Consensus Panel Clinical Case Definition for ME/CFS References American M.E. Review ... Reprint Policy Journal of Chronic Fatigue Syndrome , Vol. 11 (1) 2003. For a 39-page excerpt of this document, which includes the diagnostic part of the ME/CFS case definition in PDF format, click here PDF files require the use of an Adobe Acrobat Reader. If you do not already have one, it is available as a free download here We also have an HTML excerpt containing comments on Cognitive Behavior Therapy (CBT) and Graded Exercise Therapy (GET) available here The complete 109-page article "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols," J of Chronic Fatigue Syndrome , Vol. 11 (1) 2003, pp. 7-116, from which the above linked excerpt was taken, is available for a fee from the Haworth Document Delivery Service 1-800-HAWORTH . The complete article contains additional information on treatment protocols and disability issues, as well as the full references. The article can also be ordered on-line here It is summarized as follows: POST-EXERTIONAL MALAISE AND FATIGUE: There is a loss of physical and mental stamina, rapid muscular and cognitive fatigability, post-exertional fatigue, malaise and/or pain, and a tendency for other symptoms to worsen. A pathologically slow recovery period (it takes more than 24 hours to recover). Symptoms exacerbated by stress of any kind. Patient must have a marked degree of new onset, unexplained, persistent, or recurrent physical and mental fatigue that substantially reduces activity level. [Editor’s note: The M.E. Society prefers to use “delayed recovery of muscle function,” weakness, and faintness rather than “fatigue.” Further, we disagree that the muscle dysfunction is “unexplained.” See our M.E. Definitional Framework and researchers’ medical explanations on this website.]

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