Saturday, May 14, 2016

Chicken vs Egg vs House-on-Fire vs Other Analogies

A short post on the tangled knot of Fibromyalgia/MECFS etiology and sustained allostasis.

I'd like to start with a situation many of us will have encountered. A friend, family member, or doctor will say something like:
"You're complaining about a lot of symptoms. You can't possibly have so many things going wrong!" 
This is akin to a firefighter showing up to a burning building and saying:
"More than one or two rooms are on fire? How could the whole house be on fire?!"


A house on fire serves as a decent analogy. The fire may have started in one room, but if it was not put out promptly, it will have spread to the whole house. Now it doesn't matter much where it started, every room must be doused. The same is true with these nebulous neuroimmune conditions.

Unusual infections, unusually high numbers of infections, and unusual presentation/persistence of 'common' infections are frequent findings (or at least theories) in MECFS and fibromyalgia. Do they clear up but leave the immune system exhausted, or does a preexisting immune issue allow them entry? This is a Chicken-and-Egg question that doesn't really provide much solace to the suffering.

Many things can subtly weaken the immune system: genetic predisposition, nutritional deficiencies, toxin exposure, dysbiosis, and ANS dysregulation. This last one can be due to PTSD, chronic stress, or an extremely 'Type-A" personality. All these things can alter the functioning of the HPA-axis, subsequently knocking the nervous system and endocrine system out of line. This domino effect then hits the immune system. Unfortunately, these dominos are arranged on something like MC Escher's infinite stairs (Penrose Stairs). Problems with the immune system can interfere with the nervous system, endocrine system, detoxification, etc. As soon as one domino, one body system, tries to get on its feet it gets knocked back down by the the collapse of another.

A final analogy: imagine your body systems as a collection of friends marching forward together as you journey through life. If one or two of these friends get sick or injured they can lean on the others for support. But if most of them are sick, or hopping around on one leg, then when they turn to each other for support they're more likely to just knock each other over. In systems engineering, this is termed Cascading Failure:
https://en.wikipedia.org/wiki/Cascading_failure

The good news is that if you work on several body systems at once, some of them can become robust enough to start to pull the others back up too.


Thanks for reading. For science-based discussions of how different body systems interact, check out some of my older posts. Deeper discussion is forthcoming (there's a lot of medical literature to dig through!)

How nutritional deficiencies can make viruses worse:
http://lavenderdojo.blogspot.com/2016/04/mutant-viruses.html

How molecules of the immune system can make pain worse:
http://lavenderdojo.blogspot.com/2016/03/pain-and-inflammation-nociception-and.html

How molecules of the immune system can cause low energy and brain fog:
http://lavenderdojo.blogspot.com/2016/05/thyroid-immune-interactions-rt3-and-tgf.html



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Addenda
Some studies that look promising:

This can't be stressed enough: The contribution of select environmental toxicants to disruption of the stress circuitry and response.
Caudle M. This can’t be stressed enough: The contribution of select environmental toxicants to disruption of the stress circuitry and response. Physiol Behav. 2015

The role of the hypothalamic-pituitary-adrenal axis in neuroendocrine responses to stress
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181830/?report=reader
Smith SM, Vale WW. The role of the hypothalamic-pituitary-adrenal axis in neuroendocrine responses to stress. Dialogues in Clinical Neuroscience. 2006;8(4):383-395.

(for this last study, if you use the search function in the upper right-hand corner, you can find little nuggets by searching "immune")

The role of the hypothalamic-pituitary-adrenal axis in neuroendocrine responses to stress

The role of the hypothalamic-pituitary-adrenal axis in neuroendocrine responses to stress

The role of the hypothalamic-pituitary-adrenal axis in neuroendocrine responses to stress

The role of the hypothalamic-pituitary-adrenal axis in neuroendocrine responses to stress

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