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PACE chronic fatigue trial was properly conducted, says UK research watchdog

BMJ 2019; 364 doi: (Published 07 February 2019) Cite this as: BMJ 2019;364:l639

Mitochondrial dysfunction and ME/CFS Re: PACE chronic fatigue trial was properly conducted, says UK research watchdog

John McLaren-Howard, Sarah Myhill and Norman Booth have shown that myocardial dysfunction is an important diagnosable and potentially treatable cause of myalgic encephalitis or chronic fatigue syndrome. It is not sensible to expect patients with severe mitochondrial dysfunction to exercise before the underlying causes of mitochondrial dysfunction have been diagnosed and treated. These usually include important essential nutrient deficiencies and toxic metals like nickel, cadmium, or dental mercury amalgams.1-3

Mitochondrial dysfunction in ME/CFS needs testing and treating and four women are affected for every one man. In my experience, this is because most have taken progestogens and/or oestrogens for contraception or HRT. Hormone use lowers zinc, increases copper levels, lowers copper stores and increases toxic DNA adducts.4,5

Mitochondrial dysfunction and essential nutrient testing should become more widely available and must be more cost effective than the PACE trial which did not investigate abnormal or correct biochemistry.

1 Myhill S, Booth NE, McLaren-Howard J. Targeting mitochondrial dysfunction in the treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) - a clinical audit.
Int J Clin Exp Med. 2013;6(1):1-15. Epub 2012 Nov 20.
2 Booth NE, Myhill S, McLaren-Howard J. Mitochondrial dysfunction and the pathophysiology of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).Int J Clin Exp Med. 2012;5(3):208-20.
3 Myhill S, Booth NE, McLaren-Howard J. Chronic fatigue syndrome and mitochondrial dysfunction.Int J Clin Exp Med. 2009;2(1):1-16. Epub 2009 Jan 15.
4 Grant ECG. The pill, hormone replacement therapy, vascular and mood over-reactivity, and mineral imbalance. J Nutr Environ Med 1998;8:105-116.
5 Howard JM. The detection of DNA adducts (risk factors for DNA damage. A method for genomic DNA, the results and some effects of nutritional intervention, J Nutr Environ Med 2002;12:19-31.

Competing interests: No competing interests

10 February 2019
Ellen C G Grant
Physician and medical gynaecologist
Kingston-upon-Thames, Surrey, UK