Four Peaks Healthcare Associates

Four Peaks Healthcare Associates Theresa Dowell, FNP, PT
Nat Metz, FNP
Chronic Fatigue, Fibromyalgia, POTS & Long COVID

At Four Peaks Healthcare Associates, our mission is simple; to provide compassionate, patient-guided care. We believe that through empathy, communication, trust and shared decision-making our patients will achieve optimal outcomes.

A new study "demonstrated impaired glymphatic function in ME/CFS which may lead to symptoms such as cognitive dysfunctio...
08/27/2026

A new study "demonstrated impaired glymphatic function in ME/CFS which may lead to symptoms such as cognitive dysfunction and sleep disturbance experienced by ME/CFS."
The article is detailed and scientific but for those that reading and comprehension are a problem reading the abstract will give you an idea of the scientific details.

The glymphatic system is a recently discovered brain waste clearance system that is mostly active during sleep and disengaged during wakefulness. Impaired gl...

08/16/2026

Posted by Sibylle Dahrendorf on X for

Quote from Dr. Paolo Bolognese at The Center for Neuro-EDS and Craniospinal Disorders FB Group: It is allowed to share widely:

"Please share this amazing news!

Have you ever felt unseen or not believed by a physician?

Overwhelmed by the challenge of coordinating care among multiple specialists?

The Center for Neuro-EDS and Craniospinal Disorders is working to change this model of disconnected care.

Led by Dr. Paolo Bolognese, Dr. Allison R. Bloom, Dr. Illene S. Ruhoy, Dr. Randall A. Dass, Dr. Amanda Lerner, and Dr. Petra M. Klinge, a groundbreaking research paper, “Defining Neuro-EDS: A Neuro-Predominant Phenotype in hEDS/HSD and Related Heritable Connective Tissue Disorders,” is currently under peer review.

This paper is the culmination of discussions involving nearly three dozen international experts from multiple fields who care for and study complex Neuro-EDS patients.

By formally defining a Neuro-EDS endotype—a subcategory characterized by distinct biological and functional pathways—the goal is to advance several important objectives:

1. Unifying the language of the disorder
Creating a clear description and framework can improve communication among patients, physicians, and researchers.

2. Validating an endotype
Recognizing that conditions such as CCI, occult tethered cord, intracranial hypertension, spontaneous intracranial hypotension, cerebral and abdominal venous compressions, MCAD, dysautonomia, and related disorders can co-occur and contribute to multisystem symptoms may help researchers identify the underlying biological mechanisms and neuroinflammatory pathways connecting them.

3. Increasing recognition and access to care
Establishing a recognized disorder can eventually support the development of ICD-10 coding, potentially helping patients navigate insurance approvals while creating pathways for increased research funding.

4. Bringing current research and expertise to patients and physicians
Look forward to a YouTube channel featuring discussions with experts and patients, helping make emerging research more accessible to the broader community.

This is only the beginning.

Following peer review and publication of the paper, additional research will be needed to better understand the underlying biological mechanisms and, ultimately, develop improved diagnostic tools and treatments.
The Mount Sinai Health System is committed to developing a “medical home” model in which the burden of coordinating complex care can shift from the patient back to a team of knowledgeable experts.

For patients who have spent years searching for answers, being dismissed, or struggling to coordinate care across numerous specialties, this represents an important step toward recognition, understanding, and hope.

*Please share this announcement widely.
Share it with patients who need hope.
Share it with physicians who want to learn.
Share it with researchers who can help advance the science.
Awareness creates opportunity. Research creates understanding. And understanding can lead to better care.

Read the paper and learn more about this important step forward:

https://preprints.org/manuscript/202608.0567/v1

For detailed research and more information, see
https://neuro-eds.com

'EDS

The Center for

More insights into fatigue from Cort Johnson at HealthRising.org. There are no solid answers as to what or where fatigue...
08/16/2026

More insights into fatigue from Cort Johnson at HealthRising.org. There are no solid answers as to what or where fatigue is coming from yet but research is highlighting various theories.

https://www.healthrising.org/blog/2026/08/12/fatigue-me-cfs-brain/

An NIH paper proposed that the fatigue in ME/CFS is caused by the brain. That might not be the end of the story, however.

This is an opinion piece by MaryAnne Kinney, former State Representative who has knowledge of ME/CFS and its history.  T...
08/08/2026

This is an opinion piece by MaryAnne Kinney, former State Representative who has knowledge of ME/CFS and its history. The National Institutes of Health (NIH) approved the ME/CFS Research Roadmap. The Roadmap lays out exactly what needs to happen in research and treatment.

Share Facebook Twitter LinkedIn Email I spent my time in Augusta fighting for Maine people — for our workers, our families, our rural communities, and our veterans. And I have learned one thing above all else: the issues that matter most to Mainers are rarely the ones that make national headlines....

Research coming out of the Fred Hutch Cancer Center points to genetics as a risk factor in fibromyalgia.  "The results p...
07/31/2026

Research coming out of the Fred Hutch Cancer Center points to genetics as a risk factor in fibromyalgia. "The results provide the strongest evidence yet that fibromyalgia is primarily a nervous system disorder rather than an autoimmune disease..."

In a landmark study published in Nature Medicine, an international team of researchers have identified new genetic risk factors associated with fibromyalgia syndrome.

Pub Med has reviewed literature, identified where knowledge is lacking and highlighted research needs in MCAS.
07/20/2026

Pub Med has reviewed literature, identified where knowledge is lacking and highlighted research needs in MCAS.

Mast cell activation syndrome (MCAS) is a term applied to several clinical entities that have gained increased attention from patients and medical providers. Although several descriptive publications about MCAS exist, there are many gaps in ...

A recent study by Japanese researchers explores the effectiveness of Donezepil in mitigating symptoms of fatigue and dep...
06/29/2026

A recent study by Japanese researchers explores the effectiveness of Donezepil in mitigating symptoms of fatigue and depression in individuals with Long Covid.

IntroductionThe pathogenesis of post-acute sequelae of SARS-CoV-2 infection (PASC) remains poorly understood, and no effective treatment has been established...

Cort Johnson of Health Rising summarizes the NIH's progress or lack of progress in funding ME/CFS, long COVID, POTS, and...
06/10/2026

Cort Johnson of Health Rising summarizes the NIH's progress or lack of progress in funding ME/CFS, long COVID, POTS, and post-infectious diseases.

How are ME/CFS, long COVID, POTS and infectious diseases faring at the mighty NIH. Read this blog and find out.

Do you have POTS symptoms but don't fit the POTS criteria?  This blog from the Bateman Horne Center may help make sense ...
06/10/2026

Do you have POTS symptoms but don't fit the POTS criteria? This blog from the Bateman Horne Center may help make sense of your symptoms. POTS fits under the Dysautonomia umbrella but other symptomology like Orthostatic Intolerance also fit under this umbrella. In this blog from the Bateman Horne Center Dysautonomia is described.

A new NIH/NIAID strategic vision signals increased attention to post-infectious conditions like ME/CFS and Long COVID.

A review and subsequent article by Paul Watton and  Bhupesh K. Prusty has concluded that ME/CFS is "reframed here as a d...
05/23/2026

A review and subsequent article by Paul Watton and Bhupesh K. Prusty has concluded that ME/CFS is "reframed here as a disorder of impaired adaptive capacity within post-infectious disease biology." The Journal of Translational Medicine has granted full access to this article, click on the link below.

https://link.springer.com/article/10.1186/s12967-026-08319-3?fbclid=IwY2xjawR--L1leHRuA2FlbQIxMABicmlkETFWNTd4b09vbnVKNm1uanNzc3J0YwZhcHBfaWQQMjIyMDM5MTc4ODIwMDg5MgABHu9EK3I_zOyQ2cKDXO3h3hPPJag0iPlpbMVCIGoSYrA3_jNR8JJE9kijf83c_aem_otShCCOEbQ7axHUVzl8oKQ

Background Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a severe multisystem illness marked by post-exertional malaise (PEM), cognitive dysfunction, autonomic disturbance, and impaired physiological resilience. Historically, the absence of validated biomarkers, heterogeneous defini...

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