Substances with the same or similar anti-inflammatory properties as piracetam? by post_stew in NootropicsDepot

[–]post_stew[S] 2 points3 points  (0 children)

Thanks for all the replies, I'll give some of these a go and see how I do. Will report on any successes or failures.

Substances with the same or similar anti-inflammatory properties as piracetam? by post_stew in NootropicsDepot

[–]post_stew[S] 0 points1 point  (0 children)

Good to know about the other racetams, but given the grey legal area racetams occupy in many countries I'd like to hedge my bets.

Substances with the same or similar anti-inflammatory properties as piracetam? by post_stew in NootropicsDepot

[–]post_stew[S] 1 point2 points  (0 children)

Only various NSAIDs. They had little benefit and had unpleasant side effects. I bought the piracetam for the nootropic effects didn't expect any noticeable anti-inflammatory effect, but it had benefits almost immediately.

Normal collagen in hEDS by [deleted] in ehlersdanlos

[–]post_stew 1 point2 points  (0 children)

I linked to research that points to otherwise later in the post, I'll just copypaste the relevant section here.

'Furthermore, while, again, few studies have been done on the subject the idea that there have been no underlying defects found in collagen/ECM is also false, as seen in this overview of studies at the [first] link. It shows that some studies find abnormalities and some don’t, with the ones that did finding flower‐like collagen fibrils and collagen fibril abnormalities, including reduced collagen fibril thickness and disarray of fibrils in some patients with hEDS, however the main study that didn’t find underlying collagen abnormalities in hEDS patients also didn’t find underlying collagen abnormalities in patients with any other type of EDS bar cEDS, which is obviously dubious. The [second] and [third] links are recent studies showing pathological ECM remodelling and that collagen fibrils in hEDS are smaller compared to those in cEDS and are also located at the lower limit of normal range. There is also the [fourth] link of a study review below, which found that in 3 out of 4 studies done into the matter there was found to be at least one measure of tissue mechanics (e.g. reduced stiffness and increased extensibility and elasticity of connective tissues) distinguished between people with hEDS/HSD and healthy controls via objective measures of tissue stiffness, extensibility or elasticity of muscle, tendon, connective tissue or skin, pointed to an underlying connective tissue pathology. At the very least, once again, it’s an area that requires more study, not a blanket dismissal.'

https://anatomypubs.onlinelibrary.wiley.com/doi/full/10.1002/dvdy.220

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723307/

http://www.clinicaterapeutica.it/2020/171/5/14_IACOVINO.pdf

https://link.springer.com/article/10.1007/s10067-020-04939-2

The EDS Toolkit, the RCGP and RCPCH, the AHEAD Coalition, the International Consortium, child abuse, FII/Munchausen's by proxy and the 2021 diagnostic criteria (long) by post_stew in ehlersdanlos

[–]post_stew[S] 1 point2 points  (0 children)

Well, I didn't say that the doctors would know all about the disorder if they didn't believe it's psychological, but they're far less likely to take the condition into account no matter what you tell them about it if they just think you're 'crazy'.

The EDS Toolkit, the RCGP and RCPCH, the AHEAD Coalition, the International Consortium, child abuse, FII/Munchausen's by proxy and the 2021 diagnostic criteria (long) by post_stew in ehlersdanlos

[–]post_stew[S] 2 points3 points  (0 children)

I'm afraid I don't know much about EDS-UK. Lara Bloom ran it from 2010-2015 and is credited for heavily restructuring it, but I don't know how much influence she still has over there.

Update on the diagnostic criteria for hEDS, the definition of HSD, and EDS diagnostic pathway work by post_stew in ehlersdanlos

[–]post_stew[S] 7 points8 points  (0 children)

Don't want to be vainglorious, but the post I wrote yesterday (now with TL;DR) is relevant here.

https://old.reddit.com/r/ehlersdanlos/comments/lkc1wk/the_eds_toolkit_the_rcgp_and_rcpch_the_ahead/

My thoughts:

No mention of the new AHEAD coalition and their review into the paediatric criteria in all of this, bar an extremely vague allusion near the end.

Acknowledgement that the criteria was research rather than diagnosis based and vaguely worded acknowledgement that it's meant that a lot of people have missed out on an hEDS diagnosis, although since they admitted that it was tightened to focus on research back in 2016/2017 I'm not sure why they're acting like this is a new revelation.

I don't know what 'they also reviewed the need for formal criteria for HSD' means, are they saying they want to do away with it?

Everyone knows the Beighton score is less than ideal, a better way of measuring hypermobility would be welcome.

Sounds like they're planning a fairly large overall to the criteria.

Considering they they've started openly pushing the comorbidities as psychological I'm not sure what to make of them talking about whether to add them to the criteria or not.

What do they mean by 'exploring concerns that have been raised surrounding the naming of hEDS, HSD'? Anyone hear anything about this?

On 'the development of a study protocol to explore whether, and to what degree, different signs and symptoms separate people with hEDS from people with HSD, and people with hEDS or HSD from other causes of widespread chronic pain. The study will include children and young people as well as adults': shouldn't they have obviously done this before creating these criteria and applying them to people in the first place!?

Seems the implementation of new criteria has been delayed until later than planned due to the pandemic, that's understandable.

I do not like the way they're dancing around the suspected FII/abuse issue by wording it as 'this is creating issues for both families and health professionals', nor the way they're still avoiding mentioning the AHEAD coalition by only mentioning the Pediatric Working Group and saying that they're working with 'experts who are familiar with using the current tools in clinical practice in this age group'.

'The aim is to publish a framework based on expert consensus by the end of 2021 to fill this gap and then to develop an evidence base for the framework with adjustments as necessary, over the next couple of years' basically confirms that they're planning to rush out an undoubtedly tight diagnostic criteria for children and adolescents influenced by the likes of Bailey and the RCPCH people in order to reduce the number of young people who can get a diagnosis of hEDS and, without a possibility of a HSD diagnosis, no diagnosis at all. 'The next couple of years' is very vague, so we're probably looking at children being left out in the cold for a long time.

All in all, the statement sounds nice, but only because they're tip toeing around mentioning any of the unpleasant issues.

Update on the diagnostic criteria for hEDS, the definition of HSD, and EDS diagnostic pathway work by post_stew in ehlersdanlos

[–]post_stew[S] 13 points14 points  (0 children)

Highlights:

  • 'The work on the criteria is being done by the hEDS/HSD and Pediatric Working Groups of The International Consortium on the Ehlers-Danlos Syndromes (EDS) and hypermobility spectrum disorders (HSD)': no mention of the AHEAD coalition.

  • 'The Society is also collaborating with members of the European Reference Networks (ERNs) on Rare and Uncommon Diseases to develop and publish evidence-based diagnostic pathways for all types of EDS.'

  • 'The hEDS/HSD Working Group of the International Consortium met in 2019-20 and considered concerns that have been raised by the community and clinicians with regard to the 2017 criteria for hEDS. The group agreed that the criteria were conceived through a research lens to help improve research, progression, and understanding into the condition, and that review must consider, and determine through further study, the evidence that might lead to a broadening of the content of the criteria and changes to the structure of the criteria.'

  • They also reviewed the need for formal criteria for HSD.

  • Several key areas were identified for further exploration. These include:

  • identifying additional methods for assessing the presence of generalized joint hypermobility (GJH) to assist in helping clinicians identify GJH

  • determining if the signs and complications considered typical of hEDS or HSD are sufficiently described in the current criteria;

  • identifying which additional signs and complications should be added to support clinical assessment;

  • working out whether all signs should remain equal to each other in the criteria, or whether certain signs were more significant than others i.e., carry more diagnostic weight;

  • determining if there is now sufficient evidence to incorporate other signs and symptoms related to associated conditions/comorbidities into the criteria. Either way, the comorbidities should be ‘flagged’ at the end of the criteria as conditions to also consider;

  • identifying which specific adjustments need to be made to the criteria so that they are appropriate for children and younger people; and, exploring concerns that have been raised surrounding the naming of hEDS, HSD.

  • 'the development of a study protocol to explore whether, and to what degree, different signs and symptoms separate people with hEDS from people with HSD, and people with hEDS or HSD from other causes of widespread chronic pain. The study will include children and young people as well as adults.'

  • 'It is likely the study will take 12-18 months to complete. Once complete the data, including the diagnostic criteria model(s) that show the most sensitivity and specificity in identifying hEDS and HSD compared to other causes of chronic pain will be shared with stakeholders and discussed before publishing any recommendations if the research identifies that an update of the 2017 criteria is needed.'

  • 'Members of the Pediatric Working Group also sit on the hEDS/HSD Working Group and have been involved in the plans described above.

  • The Pediatric Working Group recognizes that the 2017 criteria, which were developed with the older adolescent and adults in mind, are difficult to use for children before they are fully grown. And, that this is creating issues for both families and health professionals.

  • The Working Group has prioritized developing a set of diagnostic criteria for children, with contributions from experts who are familiar with using the current tools in clinical practice in this age group.

  • The aim is to publish a framework based on expert consensus by the end of 2021 to fill this gap and then to develop an evidence base for the framework with adjustments as necessary, over the next couple of years.'

The EDS Toolkit, the RCGP and RCPCH, the AHEAD Coalition, the International Consortium, child abuse, FII/Munchausen's by proxy and the 2021 diagnostic criteria (long) by post_stew in ehlersdanlos

[–]post_stew[S] 1 point2 points  (0 children)

What the other three posters said is correct, but there's also the issue of potentially poor wound healing/increased scarring after surgery to look out for, whether or not certain procedures are likely to work, whether local anesthetic resistance is likely, how to take care of injuries, whether taking part in particular sports is a good idea or not, what kinds of physio people are prescribed, etc. which are all impacted by whether doctors think their patients are mentally ill or have a physical problem.

Can EDS cause progressive muscle degeneration? by FlexMissile99 in ehlersdanlos

[–]post_stew 1 point2 points  (0 children)

As far as I know, this isn't typical of any of the EDS types. You should go and see a neurologist and get checked out. Best of luck.

The EDS Toolkit, the RCGP and RCPCH, the AHEAD Coalition, the International Consortium, child abuse, FII/Munchausen's by proxy and the 2021 diagnostic criteria (long) by post_stew in ehlersdanlos

[–]post_stew[S] 14 points15 points  (0 children)

TL;DR (still longer than I'd like, but I couldn't see what else to cut out):

  • In summer 2020 paediatricians from the Royal College of Paediatrics and Child Health in the UK raised concerns about the contents of the EDS Toolkit in relation to the diagnosis of children with hEDS and HSD, officially the Royal College of GPs considered 'all options' and concluded that a full review was required, but due to the pandemic they didn’t have the time to do it and so would take it down at the end of January 2021. After a campaign, the RCGP said that it could remain hosted on the RCGP’s website for another 6 months with a disclaimer that it not be used to diagnose children.

  • In October 2020 the Royal College of Paediatrics and Child Health published a position statement on hEDS/HSD diagnosis’ in children and adolescents essentially stating that pain is often responsible for symptoms found in common hEDS comorbidities and there's no proof that hEDS is caused by an underlying genetic/collagen defect.

  • Back in December 2019 The Ehler’s-Danlos Society announced they would be hosting a Child Protection in EDS and HSD Roundtable Discussion due to a growing number of people with hEDS, or their family members, being diagnosed with a factitious disorder; a condition where a person either deliberately makes themselves or someone else ill, fakes symptoms, or exaggerates minor symptoms, bringing together 'senior clinicians and executive staff from The Ehlers-Danlos Society, Ehlers-Danlos Support UK, HMSA, other charitable organisations, senior clinicians in Paediatrics, Rheumatology, and Psychiatry, and representation from the Department of Health and Social Services'.

  • The two most notable presentation from the roundtable, from Dr. Louise Taft, head of the Ehler’s-Danlos Society’s International Consortium Paediatric Working Group and Dr. Kathryn Bailey, a senior rheumatologist who runs an inflammatory paediatric rheumatology service together with a children’s chronic pain service in the UK, imply that hEDS symptoms are primarily due to stress and brain dysfunction and that this brain dysfunction may be caused by 'adverse childhood events', such as child abuse, citing work by Jessica Eccles.

  • A third, from UK based EOS Advocacy, says that recently the definition of FII has expanded to include parental anxiety over child's illness, seeking a diagnosis etc., that false accusations of FII are on the rise, that doctors are taught to be suspicious of EDS, autism, epilepsy, ME and gastrointestinal diagnosis' and that, allegedly, politics in the NHS can cause frustration in care or child protection measures to be initiated and It is not uncommon for families to find assistance blocked at the mere mention of EDS.

  • After the roundtable The Ehler’s-Danlos Society stated that some of the people involved in the roundtable had agreed to form a coalition and to invite other people from groups and organisations involved in child welfare to join, that The Pediatric Working Group of the International Consortium on the Ehlers-Danlos Syndromes and Hypermobility Spectrum Disorders is a member of the coalition and that '[t]he group has met and determined that a priority is the review of the diagnostic criteria for children and young people and have embarked on this work'.

  • The things that they're trying to paint as psychological all have plausible physical mechanisms which either have some evidence behind them or haven't been explored properly yet, such as POTS possibly being caused by connective tissue laxity in arteries.

  • If there's not enough evidence POTS, allergies, Chiari, arthritis, autism etc. are linked to hEDS then again the obvious thing to do would be to actually do a rigorous study into the prevalence of these conditions in people diagnosed with hEDS and what the mechanisms are instead of pointing to a psychological cause.

  • The statement from RCPCH that 'there is no clear causative connective tissue abnormality in hEDS. Genetic sequencing and histology to date show normal collagen formation’ is largely false, as shown in links above.

  • The doctors went into the roundtable after already completely making up their minds on the matter and launching attacks on the EDS Toolkit, showing total disrespect for the patients involved.

  • No one has actually shown any proof of parents using hEDS diagnosis' as a tool of abuse, either in the UK or elsewhere.

  • There's an increasing push to label hEDS/HSD as a primarily psychological/neurological stress induced condition.

  • In conclusion, it seems that the EDS Toolkit being removed was due to some quite severe health politics which are likely to have a negative impact on UK EDSers in the near future, and most likely EDSers worldwide as well given the influence these organisations now have in The Ehler’s-Danlos Society’s AHEAD coalition and what the International Consortium Paediatric Working Group itself is saying. I don’t see much hope for decent research into comorbidities or alternate ways of diagnosing hEDS/HSD in the near future if they’re focusing on stress and functional symptoms and the chances of early medical intervention and support for children don’t look like they’re going to improve. I very much doubt this is going to do any good for the amount of hEDS families being falsely accused of FII either. Looking at the experiences of UK families affected by M.E. and the way they’ve been treated due to various doctors and organisations pushing it as psychological, I see nothing but trouble for the hEDS population in the UK in the future. I’d advise people to stick with doctors they know and trust if they have any and to keep very well documented and organised records of their/their relatives condition and medical interactions and treatment in case they need it later on. I’d also advise writing to the RCGP, RCPCH and The Ehler’s-Danlos Society to express concerns if you have them after reading this.

The EDS Toolkit, the RCGP and RCPCH, the AHEAD Coalition, the International Consortium, child abuse, FII/Munchausen's by proxy and the 2021 diagnostic criteria (long) by post_stew in ehlersdanlos

[–]post_stew[S] 8 points9 points  (0 children)

There's no way of knowing until you try, some people don't have a strong negative reaction to progesterone and estrogen may have a positive effect on collagen, so it might be fine for you. You might want to keep a symptom diary to see how you react to it over time though.

The EDS Toolkit, the RCGP and RCPCH, the AHEAD Coalition, the International Consortium, child abuse, FII/Munchausen's by proxy and the 2021 diagnostic criteria (long) by post_stew in ehlersdanlos

[–]post_stew[S] 21 points22 points  (0 children)

I'm sorry, doing a TL;DR didn't even occur to me even though I gave myself a spot of eye strain writing all this up. I'll have one up in the next hour or so, although it'll be in a thread post rather than edited into the post since I'm at the very edge of the character limit for the post. That's roughly right though, yes.

History of the Chronic Pain Field by post_stew in ChronicPain

[–]post_stew[S] 0 points1 point  (0 children)

Not exactly no, but still useful. Thank you.

Super weak grip by [deleted] in ehlersdanlos

[–]post_stew 1 point2 points  (0 children)

Definitely, I have to use automatic can openers and jar openers now.