We have found this test to be the most useful there is to ascertain the day to day progress of the CFS patient. As an aside regarding ever rising medical costs I could not help but notice the obviously expensive tilt table used by Johns Hopkins. The exact same results are obtained by simply having the patient stand up for the upright reading. We are in agreement with this view. The mechanism here is similar to that found in any machine.
All machines have their weak spots.
As long as they are not stressed, these weaknesses remain undisclosed but when placed under ever escalating stress one by one these weaknesses will manifest. That's a good question. If you go back to the history of CFS on our web page you will see that in the chart of Dr. Selye various infective agents are one of the main causes of stress to the General Adaptive Syndrome. Whenever we find such infections in our CFS patients we treat the infestation as well as the underlying condition. Even here, however, we are very careful in the agents we use to fight the organisms since CFS patients are usually made worse by most drug therapy.