Speaking matter-of-factly and calmly in the impeccably enunciated English (we only find in the English), Dr. Newton started off the muscle metabolism video stating:
“When we’ve asked people with ME to exercise while we’re measuring the accumulation of acid in their muscles, what we see suggests that patients with ME have about twenty times more acid in their muscles than we would expect.”
Twenty times — not two times, or four times, but twenty times more acid than expected. That’s jaw-droppingly high. That’s headline type data. Hopefully the news will get around – and her findings will be validated.
We Are Not Alone
Dr. Newton then said something I found quite encouraging: these findings are similar to those found in other disorders associated with severe fatigue. Any ME/CFS research that links up with other disorders is good news, because, honestly, we need all the help we can get. With researchers like Dr. Newton mostly relying on private foundation funding, we need researchers in other disorders to do as much of our work as possible.
What’s causing these extreme muscle acid accumulations? Dr. Newton chose her words carefully. She noted that the degree of acid accumulation found is ‘associated’ with the degree of autonomic nervous system dysfunction; i.e., the more dysfunctional the autonomic nervous system was, the more acid ME/CFS patients muscles were accumulating.
This suggests that in some way the ANS is modulating or regulating the accumulation of acid. It may be doing that by affecting the transporters that remove the acids from the cells, or it may be affecting the blood flow that should wash the acids away. (The ANS controls the blood flows in our body.)
Dr. Newton’s lab has also found deficiencies in the proteins or kinases found in the metabolic pathway associated with these acids. Dr. Newton didn’t say whether the breakdown is causing too many acids to be produced or whether it’s simply slowing the metabolism of these acids, but she appears to getting, in a way few researchers have, closer and closer to the cause of PEM.
What do we do for now with these acid accumulations? What about exercise? It’s good for the heart, reduces pain, improves sleep … in just about everyone except for people with Chronic Fatigue Syndrome. Does it ever help people with “ME/CFS”?
Both Dr. Newton’s MRI studies and her muscle cell experiments indicate at least two types of muscle cell abnormalities – what researchers call ‘phenotypes’ (“fee – no – types,” she repeated, pausing slightly after each syllable in her perfect English) are present in ME/CFS.
Dr. Newton on Muscle Metabolism in ME/CFS
One of these ‘phe-no-types’ looks like it may very well improve with exercise, but the other one will not. That’s a fascinating finding given the huge dichotomy between studies suggesting that graded exercise therapy can be helpful and the surveys indicating it’s often very harmful. Is a small exercise-responsive subset present in ME/CFS? Dr. Newton’s research suggests there may be.
Newton is using nanosensors that can cross the wall of the muscle cells to determine the pH of the muscle cells as they ‘exercise’. These nanosensors ‘light up’ when a certain pH is reached. Importantly, they’re confirming what the MRI studies suggested – that the muscle cells of people with ME/CFS quickly accumulate enormous amounts of acid.
By adding different substances to the muscle cell mixture Dr. Newton been able to determine that the acidosis is reversible in the lab. That suggests that drugs could moderate or even possibly eliminate this problem.
(The acidosis is not just effecting the muscles. One of Dr. Newton’s recent studies indicated that the high acid levels in the muscles were associated with poor blood flows to the brain. That suggests that reducing muscle acid levels might be able to help with orthostatic intolerance and cognitive issues.)
Autonomic Nervous System Issues
Getting back to the autonomic nervous system, Dr. Newton noted that 90% of ME/CFS patients have symptoms associated with autonomic nervous system (ANS) dysfunction. Why ANS dysfunction is so prominent in ME/CFS is uncertain, but clear suspects have emerged.
The brain centers that control the ANS in the brainstem could be damaged, or problems in the hypothalamus and HPA axis could play a role, or the ANS could be having trouble regulating the cardiovascular system.
- See The Big Picture Emerging for Dr. Bateman’s presentation describing how brain problems could be affecting the ANS, the HPA axis and other systems.)
Large acid accumulations, varied muscle phenotypes, reversing acid accumulations, and ANS problems … Dr. Newton packed a lot into this seven-minute video. Her research is rich with promise for ME/CFS and other fatiguing disorders.
Validation of Dr. Newton’s work will, of course, be critically important and the CDC may help out in this regard. Their lactate accumulation testing in their multisite exercise study could help validate, if I have my facts right, the acid accumulations Dr. Newton has found. The CDC’s gene expression analyses could also shed light on this area (and hopefully validate the Light’s gene expression findings.)
Kudos to Dr. Newton and the UK nonprofits supporting her work and for ME/cvs Vereniging for providing this intriguing video.
Dr. Newton is Clinical Professor of Ageing and Medicine and Dean of clinical medicine at the School of Clinical Medical Sciences of Newcastle University inNewcastle upon Tyne, England. She is Director of MD Studies in the Faculty of Medical Sciences at Newcastle, and a member of the Pharmacogenomics & Complex Disease Genetics Research Group.
Dr. Newton’s studies on the origin of fatigue, autonomic dysfunction, orthostatic intolerance, etc. in disease include Chronic Fatigue Syndrome (ME/CFS), primary biliary cirrhosis, Sjogren’s Syndrome and other disorders. Find a list of her studies here.