7 days ago
#17 PEM: measuring the threshold and understanding the cause with Dr. Rob Wüst
What is the threshold over which PEM is induced in chronic illness? This is a hugely important question for sufferers, and one for which Rob Wüst is trying to find an answer.
Assistant Professor in Musculoskeletal Health and Physiology at the Vrije Universiteit Amsterdam, Dr. Rob Wüst is able to see the physiological impact of Long Covid and ME/CFS in skeletal muscle abnormalities.
In his latest study (currently in preprint) he finds that “Skeletal muscle properties in long COVID and ME/CFS differ from those induced by bed rest”, and the abnormalities that he observes in the muscles of this cohort of patients correlate with the Post-Exertional Malaise (PEM), autonomic dysfunction and wearable data that he gathered in another recent study.
In this week’s episode Wüst explains to Emily Kate Stephens how he observed exercise-induced worsening of symptoms in almost half of Long Covid patients when they exceeded their ‘ventilatory threshold’ but the much of the time this is from everyday activities such as hanging the laundry or carrying the groceries. But they discus
He discusses the physiological clues emerging from exercise testing and muscle biopsies in patients when viewed alongside wearable data and expounds on the circulating theories on this, including mitochondrial dysfunction, local hypoxia, and ion channel abnormalities. And he explores the parallels and distinctions between Long Covid and ME/CFS and why interdisciplinary collaboration is vital to unlock these complex, multi-systemic diseases.
The Impact of Bedrest Study 2024
Skeletal muscle adaptations and PEM in LC 2024
4 days ago
Dear Mrs Stephens, dear Dr. Wüst, I‘m so happy that you discussed ethical questions in this episode! I am a medical doctor and clinical ethicist suffering from me/cfs and long covid. I‘ve been thinking about the problems that you mention quite a lot and I agree with you: it is harmful to push patients over their pem treshold and so we are not allowed to do it. Neither for research nor for diagnostics or insurance questions. Not everyone agrees and some studies bring people into crashes on purpose. Unfortunately even access to medial treatment brings people to go over their treshold. Therefore I think that this is a topic that should be discussed in depth and that needs ethical guidelines. I just wanted to thank you for considering these things in your podcast! And thank you both for your marvellous work- I really appreciate what you‘re doing! Kind regards Anna