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While Shungu is pointing at a different or at least an additional cause of the high lactate levels hes found, its important to note that the same endpoint has shown up again and again: With regards to the single syndrome hypothesis: could the general finding of increased lactate in the ventricles of ME/CFS and FM point to a similar neuroinflammatory state in ME/CFS and FM which is expressed slightly differently producing more fatigue in one disease and more pain in the other