Burnet Research in Australia

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CHRONIC FATIGUE SYNDROME – A REPORT ON

RESEARCH BY

DR RICHARD BURNET, SENIOR ENDOCRINOLOGIST

ROYAL ADELAIDE HOSPITAL

Studies into the underlying Patho-physiology,

effects and management of

Chronic Fatigue Syndrome have been proceeding

at the Royal Adelaide

Hospital for the last five years, in

collaboration with Professor G.

Scroop, professor of exercise physiology, at

the University of Adelaide

Medical School.

The present working hypothesis of the

underlying Patho-physiology of

Chronic Fatigue Syndrome is that it is a

condition of metabolic energy

lack, more specifically an abnormality in

Glucose utilisation within the

cell. This is a new concept in the thinking

about Chronic Fatigue Syndrome.

Any hypothesis has to take into account the

fluctuating nature of the

condition, their variability of symptoms and

its protean manifestations.

PRESENT EVIDENCE FOR SUCH A HYPOTHESIS

INCLUDES:

Preliminary exercise on patients with Chronic

Fatigue Syndrome shows an

increased output of lactate under controlled

conditions in some (but not

all).

Lactate in excess can cause tissue damage as

it is a highly acidic

substance. Excess exercise in Chronic Fatigue

Syndrome, if it produces too

much lactate can then become a

self-perpetuating condition. It would appear

that there is a " switch " mechanism to change

from the normal glucose

metabolism producing adequate energy to

increase lactate production and an

adequate energy for muscular contraction to

occur

Abnormalities in cellular potassium flux to

exercise. Further exercise

studies in Chronic Fatigue Syndrome, has shown

changes in potassium with

exercise. Potassium flux is essential for

normal muscle contraction and

nerve cell conduction. These processes are

energy dependent.

Observations by many groups of an abnormal

physical response to alcohol in

Chronic Fatigue Syndrome, suggests an

underlying metabolic defect in

alcohol’s metabolic breakdown.

Possible increased incidence of diabetes in

Chronic Fatigue Syndrome

(personal observations).

Increased incidence of " Reactive

Hypoglycaemia " in Chronic Fatigue

Syndrome.

All of these factors suggest an abnormal

metabolism of glucose within the

cells.

Some recent reporting inferred that there was

a new treatment, which

unfortunately we do not have at this time. The

actual data presented was a

change in the concepts of this disease. The

actual cause of Chronic Fatigue

Syndrome is still unknown.

TREATMENT

Various treatments can now be considered in

the light of the previously

described concepts.

If you would like to make contact in relation

to these findings please feel

free to email Dr Burnet on

eprzibil@... OR Mr

Walsh on dwalsh@...