AHMF: 98 Conference: Martinovic

Essential Fatty Acid Metabolite (Efam) Model of CFS Management Validated by Successful Predictions: Future Directions

Martinovic A.M .(MBBS), Gray J.B. (CPEng, FIE Aust)

Telephone: 07 3274 2352
Email: SMTP:dieteasy@karma.brisnet.org.au

Our previous EFAM Hypothesis of CFS pathogenesis allowed for aetiological and pathogenetic heterogeneity predicting beneficial effect of :

Dietary EFAM manipulation
Graded Exercise independent of Cognitive Behaviour Therapy (CBT)
Independent benefits of Cognitive Therapy
Adjuvant interventions titrated according to changes in symptom subsets and objective monitoring

Open case series evaluation of adjuvant EFAM modulations showed dramatic short and long term response in long term incapacitated primary care patients

Randomized controlled trials support various individual components of EFAM model :
Oral EFA Supplementation benefits majority of post viral syndrome
Graded Exercise showed benefit in CFS population without concurrent psychiatric disorder

CBT evaluated in filtered CFS patient populations unrepresentative of general practice CFS populations; hence carte-blanche prescription of unmetered CBT in all CFS sub-populations unsound. However evidence that CFS subsets with higher depression scores show significant improvement with CBT corroborates our call to treat on titrated as needs basis

These studies together corroborate our EFAM management model and case series.

Voluminous basic science supports EFAM pathogenesis of symptoms, offering common objective framework for various contentious CFS case definitions and likely aetiological heterogeneity

If further hypothesis predictions are confirmed, this will further validate this emerging treatment model e.g. :

confirming increased EFA turnover
correlating EFAM pathogenesis with :
CFS symptom subsets
CFS genetic diathesis subsets
maladaptive host response including paradoxical inflammatory/immune
upregulation and hypo-function
post-activity exacerbation in CFS
anabolic/catabolic related pathogenesis
multi-system dysfunction

Future research indicated to refine biological markers for convenient titration of treatments via this EFAM model.