Alison Bested

Alison Christine Bested, MD, FRCP(C): Haematological Pathologist; Environmental Health Clinic; Sunnybrook & Women’s College Health Sciences Centre, Toronto, Ontario, Canada.

Her medical specialty practice has been dedicated to patients with complex chronic medical conditions including: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, Fibromyalgia, Multiple Chemical Sensitivity and persistent Lyme disease. She is a Clinical Associate Professor in the Department of Medicine at the University of British Columbia. She is works in Toronto and Vancouver, Canada.

One of the authors of the 2003 Canadian Consensus Criteria for Myalgic Encephalomyelitis, published as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome:Clinical Working Case Definition,Diagnostic and Treatment Protocols

Open Letter to The Lancet
Two open letters to the editor of The Lancet urged the editor to commission a fully independent review of the PACE trial, which the journal had published in 2011. In 2016, Dr. Bested, along with 41 colleagues in the ME/CFS field, signed the second letter. Virology blog]
 * 10 February 2016, [http://www.virology.ws/2016/02/10/open-letter-lancet-again/ An open letter to The Lancet, again -

Dr Alison Bested Scholarship Fund
A scholarship was founded in Dr Bested's name to honor her dedication to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), Fibromyalgia (FM) and Multiple Chemical Sensitivity(MCS) patients. Canadian Students enrolled in the Environmental Medicine elective at University of Toronto are eligible.

Notable studies

 * 2015, Review of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: an evidence-based approach to diagnosis and management by clinicians
 * 2009, A randomized, double-blind, placebo-controlled pilot study of a probiotic in emotional symptoms of chronic fatigue syndrome FULL TEXT"'Abstract - Chronic fatigue syndrome (CFS) is complex illness of unknown etiology. Among the broad range of symptoms, many patients report disturbances in the emotional realm, the most frequent of which is anxiety. Research shows that patients with CFS and other so-called functional somatic disorders have alterations in the intestinal microbial flora. Emerging studies have suggested that pathogenic and non-pathogenic gut bacteria might influence mood-related symptoms and even behavior in animals and humans. In this pilot study, 39 CFS patients were randomized to receive either 24 billion colony forming units of Lactobacillus casei strain Shirota (LcS) or a placebo daily for two months. Patients provided stool samples and completed the Beck Depression and Beck Anxiety Inventories before and after the intervention. We found a significant rise in both Lactobacillus and Bifidobacteria in those taking the LcS, and there was also a significant decrease in anxiety symptoms among those taking the probiotic vs controls (p = 0.01). These results lend further support to the presence of a gut-brain interface, one that may be mediated by microbes that reside or pass through the intestinal tract.'"
 * 2003, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols"'Abstract - Recent years have brought growing recognition of the need for clinical criteria for myalgic encephalomyelitis (ME), which is also called chronic fatigue syndrome (CFS). An Expert Subcommittee of Health Canada established the Terms of Reference, and selected an Expert Medical Consensus Panel representing treating physicians, teaching faculty and researchers. A Consensus Workshop was held on March 30 to April 1,2001 to culminate the review process and establish consensus for a clinical working case definition, diagnostic protocols and treatment protocols. We present a systematic clinical working case definition that encourages a diagnosis based on characteristic patterns of symptom clusters, which reflect specific areas of pathogenesis. Diagnostic and treatment protocols, and a short overview of research are given to facilitate a comprehensive and integrated approach to this illness. Throughout this paper, “myalgic encephalomyelitis” and “chronic fatigue syndrome” are used interchangeably and this illness is referred to as “ME/CFS.”"
 * 2001, Chronic fatigue syndrome: neurological findings may be related to blood--brain barrier permeability."'Abstract - Despite volumes of international research, the etiology of chronic fatigue syndrome (CFS) remains elusive. There is, however, considerable evidence that CFS is a disorder involving the central nervous system (CNS). It is our hypothesis that altered permeability of the blood-brain barrier (BBB) may contribute to ongoing signs and symptoms found in CFS. To support this hypothesis we have examined agents that can increase the blood-brain barrier permeability (BBBP) and those that may be involved in CFS. The factors which can compromise the normal BBBP in CFS include viruses, cytokines, 5-hydroxytryptamine, peroxynitrite, nitric oxide, stress, glutathione depletion, essential fatty acid deficiency, and N-methyl-D-aspartate overactivity. It is possible that breakdown of normal BBBP leads to CNS cellular dysfunction and disruptions of neuronal transmission in CFS. Abnormal changes in BBBP have been linked to a number of disorders involving the CNS; based on review of the literature we conclude that the BBB integrity in CFS warrants investigation.'"

Physician Guideline

 * Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Make the Diagnosis, a step-by-step process for physicians in order to make a diagnosis of ME/CFS successfully and to rule out other diseases

Talks and Interview

 * 2016, 12th International IACFS/ME Biennial Clinical and Research Conference, Emerging Science and Clinical Care, Review of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, Fibromyalgia and Multiple Chemical Sensitivities/Environmental Sensitivities: Office Assessment and Management
 * 2016, "An Update on ME/CFS" presented at [[Institute for Neuro Immune Medicine] Research Seminar Series]
 * Oct 2016, Toronto M E October 2016 Protest: Message of Hope
 * 2011, "Tools to Stop Crashing, Start Pacing and Planning Your Health" - Allison Bested, MD at IACFSME Conference, Patient Agenda, 2011

Books

 * 2013, The Complete Fibromyalgia Health Diet Guide and Cookbook, ISBN-10: 0778804534
 * 2008, Hope and Help for Chronic Fatigue Syndrome and Fibromyalgia, ASIN: B00V1D68LU
 * 2002, The Fibromyalgia Cookbook: More Than 120 Easy and Delicious Recipes, ISBN-10: 1581822707

Online presence

 * Pubmed
 * Faculty page University of British Columbia