To whom it may concern               
 
Re:  Dr Sarah Myhill.
 
Myalgic encephalopathy/Chronic fatigue syndrome, (ME/CFS), is still an enigmatic disease. However, several lines of research strongly indicate it is a multifaceted disease involving immunological, endocrinological, gastroenterological, and neurological functions. The hallmark of the disease is fatigue and energy exhaustion. Etiopathogenetically, viruses and occasionally bacteria are under discussion. Varying evidence points to infections with EBV, BDV, recently XMRV and occasionally Borrelia.

After a clinical and laboratory diagnosis, the modern international approach is to restore basic metabolic functions, eliminate infections and inflammations and restore gastrointestinal andendocrinological functions. Antiviral treatment may also be considered. These treatments are given according to the specific defects detected in each patient and must be individualized. This requires an extensive diagnostic work–up.

Vitamins as B and C are also given. Hydroxycobalamin, given intramuscularly in high doses up to 2-3 times a week, is beneficial for many patients due to its effect on the NO – ONOO cycle. A proper diet and detoxification are necessary parts of a correct approach to these patients. A proper balance of sleep and activity is fundamental. Too rapid of an increase in activity should be avoided.

The outcome is quite unpredictable. Some patients may significantly benefit from therapy, while the majority may experience only minor relief and may, unfortunately, continue to be affected by ME/CFS for years.

After reading Dr. Myhill’s homepage and evaluating her treatment approach for ME/CFS sufferers, we conclude that she is covering all the fundamental principles for a correct and up-to-date treatment of these patients.
(http://www.drmyhill.co.uk/wiki/Summary_of_my_approach_for_CFS_/_ME_sufferers.)

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