I think antibodies to adrenergic receptors is a very probable cause of POIS.
Wow.
Very strong statement!
I'm a layman, so take this with a huge grain of salt. I just think autoimmunity would explain why people find help with strategies that manipulate the gut (diet, probiotics, antibiotics, etc), various supplementa, etc. Alternatively, there could be many other explanations, but autoimmunity, HPA axis dysfunction is where it is, IMO. This is pure speculation on my part.
My POIS disappeared during the duration of being sick with the cold in the 2020 February despite not abstaining during that time and the moment it healed and I trigerred the POIS it came back full with symptoms but when I did not have it I had even less brain fog and symptoms in general and felt better than I feel even on many weeks of abstinence in terms of cognitive clarity and such however due to the cold itself I did not feel that well physically however cognitively I had almost zero brain fog and this weird mental processing speed slowdown I seem to always have even when on a long streak of abstinence had fully disappeared while I was sick with that cold in the 2020 February
One more argument for POIS being related to CFS, because this is not uncommon in CFS community to have symptoms improve or disappear when sick. I've also had this experience. Some say it's because immune system shifts the focus away from something that's causing symptoms (maybe pathogen or autoimmunity) and directs it where ir is most needed, fighting the virus.
I wonder what is the root cause of this immune engagement? John21 POIS disappeared for some months after taking antibiotics and then returned. That could mean perhaps there is some pathogen that is chronically in the organisms of those with those rare chronic multisymptoms disorders and they either are attacked directly and thus the inflammation formed affects other and nearby tissues as well or they mimick healthy tissue which then the immunity system interprets as the pathogen because of their similarities and therefore causes those symptoms. Therefore the question should be what is the root cause of those symptoms and what to do to permanently fix and cure it? If John21 had POIS disappear for some months after taking those antibiotics and probiotics and then it returned it could mean for some reason those potential possible pathogens tend to return therefore the question should be why they returned in John21 POIS case? And what to do to ensure the organism is permanently free from those underlying imbalances or pathogens that then cause those symptoms. It could besome other imbalance that makes it harder for the body to naturally fight against them or some foods or environmental factors might contain them and the POISers are more prone to having those pathogens accumulate or some genetical reasons could make it easier for those pathogens to accumulate
Seems like my reply to this post disappeared? Well, anyway, I think this is something that you want to look at if you want to dig deeper:
https://pubmed.ncbi.nlm.nih.gov/30021103/Re-framing the theory of autoimmunity in the era of the microbiome: persistent pathogens, autoantibodies, and molecular mimicryAmy D Proal 1 , Trevor G Marshall 1
Abstract
The theory of autoimmunity was developed at a time when the human body was regarded as largely sterile. Antibodies in patients with chronic inflammatory disease could consequently not be tied to persistent human pathogens. The concept of the "autoantibody" was created to reconcile this phenomenon. Today, however, the discovery of the human microbiome has revolutionized our understanding of human biology. Humans are superorganisms that harbor trillions of persistent microbial cells. Indeed, vast human microbiomes have been detected in human tissue and blood. These microbial ecosystems harbor thousands of newly identified bacteria, viruses, and other microorganisms -- most of which can act as pathogens under conditions of immunosuppression. The theory of autoimmunity must be revised to account for the human microbiome. Here, we propose a model in which "autoantibodies" are created in response to chronic, persistent microbiome pathogens. The structural homology (molecular mimicry) between pathogen and host proteins can result in "collateral damage" to surrounding human tissue. This calls for a paradigm shift in autoimmune disease treatment. Immunosuppressive medications palliate inflammatory symptoms at the expense of microbiome health and balance. In contrast, treatments that support the immune system in autoimmune disease could allow patients to target pathogens at the root of the disease process.