News from Denmark is being forwarded on personal title by Rebecca Hansen. Also keep to her advice: if you do react on this, do it in a composed way, tho' it's difficult. Otherwise you may further harm the interests of our Danish friends...
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Physical Training as Treatment for ME
The Danish Health Authority (SST) released their new treatment recommendations for ME patients on June 18, 2018, as part of a guideline called “Physical Training as Treatment.” The chapter on ME is nothing short of medical abuse.
It defines ME as fatigue and states that since there is no perfect criteria or biomarker for ME, they categorize ME as a Funktionel Lidelse, which translate best to a Functional Somatic Syndrome.
It states that all forms of exercise are ok and that there is no evidence that any type of exercise can hurt ME patients. But because some patients worry about being harmed, it might be a good idea to give them some “psychological support.”
It uses the PACE study, and the Cochrane reviews from 2015 and 2017 which include PACE, as the main documentation for using exercise to treat ME.
The guidelines give 2 possible mechanisms for the cause of ME. One theory is that ME is caused by deconditioning and if a patient just exercises, they will stop being tired. The guidelines also say: ”Besides that, it is likely that the patient will achieve a psychological effect by discovering that physical activity does not necessarily lead to further fatigue.”
The second theory is that ME is caused by an oversensitive nervous system, and that exercise will help desensitize the nervous system, so the patient can tolerate stimulation, like exercise, better.
They also claim that exercise decreases inflammation, but uses a study about rheumatic diseases as a reference.
And what about all the great ME research that has come out lately about cytokines, inflammation and metabolic dysfunction? Well this guideline says that all of those things can be caused by deconditioning, obesity and insulin resistance, which of course can be solved by exercise.
They completely ignore the warnings from ME experts that GET can be harmful. They claim there are no contraindications in recommending GET for all ME patients.
This guideline is what all doctors will be referred to in treating ME in Denmark. And it will be the basis for treatment at the new Functional Somatic Syndromes clinics that the government is recommending. The recommendation is that the new centres be based on Per Finks clinic.
The Physical Training guidelines can be seen here in Danish. I will try to post an English version soon.
The publication of these recommendations came with a state-planned propaganda storm. Newspapers, TV and radio all had stories saying that 300.000 Danes had symptoms like tiredness and pain and that these symptoms were really called Funktional Lidelse. The health director in charge of this, Søren Brostrøm, wrote in an opinion piece, that ME is better understood as chronic tiredness. That it really is a somatoform illness.
He said it was better to forget about a diagnosis and just concentrate on symptoms. He explained how “experts” thought that CBT and GET were the best treatments and claimed that now patients were going to get the coordinated help they needed. GET and CBT for everyone:
Søren Brostrøm is on Twitter here: https://twitter.com/SSTbrostrom
This cannot go unchallenged. It is an unscientific approach that ignores the facts. So many more patients will be harmed. Please write about this everywhere you can, but in a calm, fact-filled way. Inform, don’t attack. Insulting those your write to, will only harm our case. Our goal is to open eyes, not close ears.
You can contact the Danish Health Authority (SST) here:
Tlf. +45 72 22 74 00, Fax: +45 44 88 95 99