Table 2 Mapping overlap between myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and d-lactic acidosis (d-la) symptoms
ME/CFS International Consensus Criteria [1] | d-la symptoms mapped to ME/CFS criteria | |
|---|---|---|
Matching | Ambiguous/other | |
A. Postexertional neuroimmune exhaustion (compulsory) | A. Lethargy/fatigue | Â |
B. Neurological impairments (at least one symptom from 3 of the 4 categories)  B1. Neurocognitive impairments  B2. Pain  B3. Sleep disturbances  B4a. Neurosensory and perceptual and  B4b. Motor disturbances | B1. Encephalopathy/Mental confusion/disorientation/dazed/Concentration difficulties/Slow processing and responding to questions/slow speech B2. Headaches/Muscle pain B3. Drowsiness/sleepiness/somnolence B4a. Blurred vision B4b. Weakness/hypotonic (lowered muscle tone)/flaccidity/impaired gait (staggering/wide/ataxic/unsteady/instability)/ataxia (movement and co-ordination difficulties)/impaired balance | B1. Altered mental state/cortical dysfunction (e.g., disoriented to date, time, place and space)/delirium/blunted judgment/abnormal EEG B4a. Hallucinations (visual and auditory)/delusions/paranoid ideation B4b. Slowed cerebellar function/movement/dysiadochokinesia (difficulty performing rapid movement)/impaired reflexes/Neuropathy (fine motor coordination difficulties)/unable to grasp objects/Ptosis (eye drooping)/Asterixis (hand ‘flapping’/tremor)/Spasms: nystagmus (eye spasms)/opisthotonos (muscle spasms leading to hyperextended posture)/Bruxism |
|  |  | Speech symptoms: Slurred and incoherent speech/dysarthria (speech pronunciation difficulties, weak muscles effecting speech)/thickened speech/ataxic speech (explosive—pauses between syllables) |
| Â | Â | Consciousness: Altered/fluctuating/comatose/intermittent coma/stupor/induced sleep/depressed level of consciousness/obtunded/fluctuating from unrousable to alert |
C. Immune, gastro-intestinal and genitourinary impairments (at least one symptom from 3 of the 5 categories)  C1. Flu-like symptoms  C2. Prone to viral infections  C3. Gastro-intestinal abnormalities: nausea, abdominal pain, irritable bowel syndrome, bloating  C4. Genitourinary symptoms  C5. Sensitivities to food, medication, odours or chemicals | C3. Gastrointestinal symptoms*: Increased diarrhea/bowel movements Nausea/vomiting Diffuse abdominal pain |  |
D. Energy production/transportation impairments (at least 1 symptom)  D1. Cardiovascular: orthostatic intolerance (inability to tolerate an upright position), postural orthostatic tachycardia syndrome, palpitations, arrhythmias, hypotension, dizziness, pallor  D2. Respiratory: labored breathing, air hunger, fatigue of chest wall muscles  D3. Thermostatic instability: lowered body temperature, cold extremities, marked diurnal fluctuations, sweating, episodic feverishness  D4. Intolerance to temperature extremes | D1. Inability to stand/sit upright/Tachycardia (rapid heart rate)/Respiratory arrhythmia/Hypotension/low blood pressure/Dizziness/Pallor D2. Breathing difficulties: hyperpnoea (deep breathing)/dyspnoea (shortness of breath)/tachypnea (rapid breathing)/Kussmaul (deep and laboured)/breathlessness/hyperventilation D3. Body temperature changes (high or low) | D1. Bradycardia (slowed heart rate) D2. Respiratory acidosis and hypercarbic respiratory failure |
Comorbid Mood and Behavioural Disturbances 1. Depressive symptoms 2. Anxiety symptoms | 1. Unhappy/agitation/irritability 2. Anxiety | Irrational/unusual/disturbed behavior/aggressive/hostile/abusive/combative/uncooperative behavior/euphoria/aloofness |
Uncategorized d-la symptoms | ||
| Â | Â | Metabolic acidosis |
| Â | Â | Other abnormalities: dehydration/cravings (water, cigarettes)/excessive thirst Acute renal failure/hyperchloremic acidosis/liver dysfunction |