They do not identify a particular toxin, metal or detoxification pathway by themselves, but the combination may justify evaluating toxic overload and depression together when the exposure history is credible
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A reliable plan for dealing with flares (e.g., prompt bladder instillations with local anesthetic) may be formulated in advance to decrease stress and improve QoL
Dysfunction of the vasculature, endothelium, and coagulation Since persistent inflammation and immune cell activation is present in ME/CFS (305), vascular changes and endothelial damage (306, 307) will coexist due to the interplay between inflammation and vascular alterations
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Furthermore, epigenetic memories have been shown to persist in human adipose tissue, denoting incomplete recovery of metabolic function, and may explain the accelerated rebound obesity in individuals with subsequent exposure to obesogenic lifestyles, after substantial weight loss [163]