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Boudewijn Van Houdenhove
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====Too much stress? ==== Boudewijn Van Houdenhove's approach to ME/CFS has been questioned by researchers and patient advocates. A recurring criticism is that his emphasis on stress in the etiopathogenesis of ME/CFS is not supported by sufficient evidence. Harvard professor and renowned ME/CFS expert [[Anthony Komaroff]] for example commented: <blockquote> "Van Houdenhove and colleagues would have to concede, however, that many patients with chronic fatigue syndrome do not report unusual stressors in the months before the onset of their illness and do not have evidence of hypothalamic dysfunction. Available data do not support the hypothesis that stress leading to hypothalamic dysfunction explains all cases of chronic fatigue syndrome. It must be more complicated than that."<ref>Komaroff AL. [[pubmed:11126311|The biology of chronic fatigue syndrome]]. Am J Med. 2000 Feb;108(2):169-71.</ref> </blockquote> Neurologist [[Benjamin Natelson]] essentially made the same remark: <blockquote>"While we also occasionally find patients whose history of fatigue precedes their getting a flu-like illness from which they are unable to recover, our own careful approach certainly does find appreciable numbers of patients who were perfectly well until succumbing to a sudden flu-like illness."<ref name=":0">Natelson B. [https://muse.jhu.edu/article/46036 Reply to Dr. Van Houdenhove.] Hum Biol. 2003 Jun;75(3): 413.</ref></blockquote> Others pointed out that even if stress is a factor in the development of ME/CFS, this doesnโt necessary mean much, since stress plays a role in almost every disease. As the De Meirleir & De Becker wrote: <blockquote>"It is clear that stress can influence the course of disease adversely as in cancer for example but do we treat stress instead of the biological correlates in cancer patients?"<ref>Van Houdenhove B, Vanthuyne S, Neerinckx E. [[pubmed:11023437|Chronic fatigue syndrome.]] Am J Med. 2000 Aug 15;109(3):257-9.</ref></blockquote>
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