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Stephanie Grach M.D. M.S.

@grachstephanie.bsky.social
2.8K followers 335 following 45 posts

Physician specializing in ME/CFS, Long COVID, & associated complex disease | Assistant Professor of Medicine | She/Her/Hers | t.co/TkYm2MXvir

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Reposted by Stephanie Grach M.D. M.S.
Litsa Dremousis @litsadremousis.bsky.social · 25/06/2026
YES!🎉 Dr Stephanie Grach @grachstephanie.bsky.social at Mayo Clinic & ME Action @meactnet.bsky.social Scientific Director Jaime Seltzer @exceedhergrasp1.bsky.social have launched an initiative to improve ER care for people w/ #MyalgicEncephalomyelitis & #LongCovid www.meaction.net/post/meactio...
meaction.net
#MEAction and Mayo Clinic Researchers Launch Initiative to Transform Emergency Department Care for People with ME/CFS and Long COVID
Funded by the Whittemore Peterson Institute (WPI) and Mayo Clinic, the project will develop the first nationally applicable clinical guidelines for emergency department care of ME/CFS and Long COVID p...
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Stephanie Grach M.D. M.S. @grachstephanie.bsky.social · 02/06/2026
So exciting to see our study (#2) referenced in OpenEvidence queries on ME/CFS therapies! >650k U.S. clinicians use OE for guidance. Now, if any clinician searches about management strategies for ME/CFS, they'll see expert-recommended therapies and can feel empowered to help.
List of references on OpenEvidence website that includes the paper, "Underuse of Pharmacologic Therapies for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Before Specialist Evaluation" by Grach et al.
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Reposted by Stephanie Grach M.D. M.S.
Critically Speaking with Therese Markow @criticallyspeaking.bsky.social · 29/05/2026
For patients with post-exertional malaise, the advice - push through, exercise more - can make things significantly worse. Should doctors be required to understand long COVID before treating it? 🎧 podcasts.apple.com/us/podcast/criti… @grachstephanie.bsky.social
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Reposted by Stephanie Grach M.D. M.S.
Billy Hanlon @bhanlon15.bsky.social · 29/05/2026
Medscape: 'Physicians Are Undertreating Chronic Fatigue, They Could Change Course for Long COVID' “There are high numbers of people with long COVID who either have the full criteria with ME/CFS or symptoms of it,” said Stephanie Grach, MD www.medscape.com/viewarticle/...
medscape.com
Treat the Overlap Between Long COVID and Chronic Fatigue
As more patients seek help for myalgic encephalomyelitis/chronic fatigue syndrome and similar symptoms for long COVID, primary care clinicians play a bigger role in treatment.
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Stephanie Grach M.D. M.S. @grachstephanie.bsky.social · 26/05/2026
Thank you @criticallyspeaking.bsky.social for having me!
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Reposted by Stephanie Grach M.D. M.S.
Annals of Family Medicine @annfammed.bsky.social · 29/04/2026
A new study suggests potentially helpful medications used by myalgic encephalomyelitis/chronic fatigue syndrome specialists may be underutilized to treat ME/CFS in #PrimaryCare @grachstephanie.bsky.social @mayoclinic.org @mayoclinicgimfl.bsky.social @meactnet.bsky.social doi.org/10.1370/afm....
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Reposted by Stephanie Grach M.D. M.S.
Annals of Family Medicine @annfammed.bsky.social · 29/04/2026
🚨 Out now are three 𝙀𝙖𝙧𝙡𝙮 𝘼𝙘𝙘𝙚𝙨𝙨 articles from Annals of Family Medicine! These articles explore new insights on ME/CFS treatment gaps, the value of rural medical training, and navigating the invisible complexities in rural practice Read each article here: www.annfammed.org/content/earl...
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Reposted by Stephanie Grach M.D. M.S.
It's ME(Jaime) @exceedhergrasp1.bsky.social · 29/04/2026
Incredibly excited to announce a new coauthored publication in Annals of Family Medicine ( @annfammed.bsky.social ): ✨"Underutilization of Pharmacologic Therapies for #MECFS Prior to Evaluation at a Specialty Clinic✨ This study has been chosen as an early-access publication! 🧵🧪
Underuse of Pharmacologic Therapies for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Before Specialist Evaluation | Annals of Family Medicine

"Our retrospective cohort study of 371 patients with an ME/CFS diagnosis, without a co-diagnosis of fibromyalgia, suggests medications used by ME/CFS specialists are being underused by nonspecialists. Furthermore, it shows that this patient population commonly uses supplements.  Given the increasing frequency of ME/CFS diagnosis, especially after COVID-19 infection, efforts should focus on educating clinicians generally on medications that can be used to manage symptoms of the condition."

April 2026 Early Access Latest Research: Stephanie L. Grach, MD, MS et al.
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It's ME(Jaime) @exceedhergrasp1.bsky.social · 28/04/2026
Incredibly excited to announce that our proposal to create Emergency Department guidance for #MECFS & #LongCOVID has received a generous grant from the Whittemore Peterson Institute! I'm working with longtime colleague @grachstephanie.bsky.social, plus Dhairya Jarsania and Kimberly Rogers at Mayo.
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It's ME(Jaime) @exceedhergrasp1.bsky.social · 23/04/2026
In journal special editions, once all papers are submitted and finalized, the special edition is released. From me, Diana Orbello, and @grachstephanie.bsky.social: ✨A Signal for Voice and Speech Abnormalities in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome✨ 🧪🧵 www.mdpi.com/2077-0383/14...
doi.org
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Reposted by Stephanie Grach M.D. M.S.
It's ME(Jaime) @exceedhergrasp1.bsky.social · 03/04/2026
New paper published today! ❤️ Improving Diagnostic Accuracy of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Through a Point-of-Care Clinical Algorithm 🧪 🧵 www.mdpi.com/1660-4601/23...
mdpi.com
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valebodi.bsky.social @valebodi.bsky.social · 21/10/2025
21 October 2025 Low-dose rapamycin alleviates clinical symptoms of fatigue and PEM in ME/CFS patients via improvement of autophagy: a pilot study Brian T. Ruan, Sarojini Bulbule, Brooke Gile, Amy Reyes, Bela Chheda, Lucinda Bateman, Jennifer Bell, Brayden Yellman, @grachstephanie.bsky.social
translational-medicine.biomedcentral.com
Low-dose rapamycin alleviates clinical symptoms of fatigue and PEM in ME/CFS patients via improvement of autophagy: a pilot study - Journal of Translational Medicine
Background mTOR activation is associated with chronic inflammation in ME/CFS. Previous studies have shown that sustained mTOR activation may cause chronic muscle fatigue by inhibiting ATG13-mediated a...
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Stephanie Grach M.D. M.S. @grachstephanie.bsky.social · 07/10/2025
Truly honored to have lead the inaugural chapter on #MECFS management in the @elsevierconnect.bsky.social textbook Scientific Basis of Fatigue, "Management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A New Narrative." The greatest honor of all was co-authoring with my role models--
Dr. Stephanie Grach, a Caucasian woman with brown eyes and (currently) shoulder-length brown hair, holding a textbook open to the mentioned chapter's first page. Wearing a blue suit jacket, red/blue shirt, and blue KN95 mask, against a purple-gray background.
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#MEAction Network @meactnet.bsky.social · 01/10/2025
Stellar new work from @grachstephanie.bsky.social, @exceedhergrasp1.bsky.social, @batemanhornecenter.bsky.social's Bell and Yellman & @raviganeshmd.bsky.social in the Elsevier text 'The Scientific Basis of Fatigue'! The book has chapters on #MECFS, COVID, Parkinson’s, stroke, and multiple sclerosis.
Text-based graphic with one photo. Text: New publication. Managing myalgic encephalomyelitis/chronic fatigue syndrome: a new narrative. a chapter in a new Elsevier textbook written by coauthors from #MEAction, Mayo Clinic Rochester and the Bateman-Horne Center. “I was honored to co-author this chapter with colleagues from Mayo Clinic and the Bateman-Horne Center to give clinicians and researchers the tools they need to better recognize, study and treat ME/CFS.”
 Jaime Seltzer,
Scientific Director, #MEAction
Photo: Jaime Seltzer (white woman with long, dark hair) wearing glasses and cream blazer and red top slightly smiling.
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Reposted by Stephanie Grach M.D. M.S.
It's ME(Jaime) @exceedhergrasp1.bsky.social · 08/07/2025
The first paper that uses the Pacing Narrative Study data is now published! @grachstephanie.bsky.social is building a case for vocal differences to detect #PEM. She found many discussed such issues during a crash. Find the paper here: 🧪 www.mdpi.com/2077-0383/14... #MECFS
mdpi.com
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Stephanie Grach M.D. M.S. @grachstephanie.bsky.social · 10/05/2025
"Navigating uncertainty is not about waiting for perfect data—it is about using the best available knowledge, engaging in structured clinical reasoning, and remaining open to new insights..." (1/2)
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Stephanie Grach M.D. M.S. @grachstephanie.bsky.social · 03/04/2025
Had the honor of presenting the initial patient-reported outcomes of the collaborative rapamycin study led by Simmaron at ACP #IM2025 today! Had an amazing time talking with clinicians from all over the country about advancing the knowledge and care of #MECFS
A poster with blue border and white background describing initial results of our rapamycin study.
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Stephanie Grach M.D. M.S. @grachstephanie.bsky.social · 06/12/2024
Incredibly honored to have received the Mayo Model of Care Award tonight. I am so thankful to my friends and colleagues for their support of me and the patients we serve 💙
Dr. Grach, brown haired, Caucasian female smiling and holding an award.
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Tom Kindlon @tomkindlon.bsky.social · 01/12/2024
Double-blinded, controlled study of oxaloacetate for improving fatigue in ME/CFS www.frontiersin.org/journals/neu... Great to see this sort of trial being done. Results seem quite modest given it's so expensive #MyalgicEncephalomyelitis #ChronicFatigueSyndrome #MEcfs #CFS #PwME 1/
Background: The energy metabolite oxaloacetate is significantly lower in the blood plasma of ME/CFS subjects. A previous open-label trial with oxaloacetate supplementation demonstrated a significant reduction in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)-related fatigue.

Methods: In this follow-up trial, 82 ME/CFS subjects were enrolled in a 3-month randomized, double-blinded, controlled study, receiving either 2,000 mg of oxaloacetate or control per day. The primary endpoints were safety and reduction in fatigue from baseline. Secondary and exploratory endpoints included functional capacity and general health status.

Results: Anhydrous enol-oxaloacetate (oxaloacetate) was well tolerated at the tested doses. Oxaloacetate significantly reduced fatigue by more than 25% from baseline, while the control group showed a non-significant reduction of approximately 10%. Intergroup analysis showed a significant decrease in fatigue levels in the oxaloacetate group (p = 0.0039) with no notable change in the control group. A greater proportion of subjects in the oxaloacetate group achieved a reduction in fatigue greater than 25% compared to the control group (p < 0.05). Additionally, 40.5% of the oxaloacetate group were classified as “enhanced responders,” with an average fatigue reduction of 63%. Both physical and mental fatigue improved with oxaloacetate supplementation.

Conclusion: Oxaloacetate is well tolerated and effectively helps reduce fatigue in ME/CFS patients.
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Reposted by Stephanie Grach M.D. M.S.
#MEAction Network @meactnet.bsky.social · 18/11/2024
Great news! #MEAction & the Mayo Clinic have been awarded the Sigma 2024 American Nurses Credentialing Center Evidence-Based Practice Implementation Grant awarded by The STTI Honor Society of Nursing. Details: www.meaction.net/2024/11/18/m... #pwME #MECFS #MyalgicEncephalomyelitis
meaction.net
#MEAction & Mayo Clinic Projects Continue - New Grant Awarded
A new grant awarded by Sigma
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Reposted by Stephanie Grach M.D. M.S.
C.H. Romatowski @chromatowski.bsky.social · 11/10/2023
I have this link saved so I can watch @exceedhergrasp1.bsky.social @grachstephanie.bsky.social & coauthors’ excellent ME review continue to climb the Altmetric ranks, for a steady supply of good news :) www.altmetric.com/details/1549...
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It's ME(Jaime) @exceedhergrasp1.bsky.social · 07/10/2023
Overjoyed to announce my Concise Clinical Review of ME/CFS in Mayo Clinic Proceedings (with updated diagrams!) Very glad to have worked with Stephanie Grach, and Ravi Ganesh and Tony Chon on this! #MedEd #MedTwitter 🧵 www.mayoclinicproceedings.org/article/S002...
mayoclinicproceedings.org
Diagnosis and Management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic neurologic disease often preceded by infection. There has been increased interest in ME/CFS recently because of its significant...
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