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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 · 08/05/2026

More to come in a paper! I have not used any commercial tests, only the research labs, so unable to comment on those.

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Stephanie Grach M.D. M.S. @grachstephanie.bsky.social · 30/04/2026

trying different things. The difference is those usually have a specialist to refer to, but there isn't generally a dedicated specialty for ME/CFS and related conditions. So for now most patients don't have that specialty access. Hopefully that (and the system in general) can change some day.

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Stephanie Grach M.D. M.S. @grachstephanie.bsky.social · 30/04/2026

I see, thanks for clarifying. That's definitely a systems problem, affecting a lot of conditions. Like with asthma, migraine, blood pressure...things that are okay when the patient responds to the first couple of medications, but acknowledging that there are patients who have to keep escalating and

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Stephanie Grach M.D. M.S. @grachstephanie.bsky.social · 30/04/2026

better states mentally and physically (less risk of physical progression due to lack of support and incorrect activity management guidance). If tens of billions are lost annually now due to loss of productivity and insufficient management for ME/CFS alone, is doing nothing really better?

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Stephanie Grach M.D. M.S. @grachstephanie.bsky.social · 30/04/2026

"unethically intensive level of primary care resource allocation." I would have to argue based on seeing these and related patient groups on a daily basis as a referral center that patients who are supported by their PCPs and have trialed some of these initial therapies tend to be in noticeably

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Stephanie Grach M.D. M.S. @grachstephanie.bsky.social · 30/04/2026

Hi @harrisonk.bsky.social, thank you for your comment. Agree that ME/CFS deserves well-designed research, and multiple medications listed are currently undergoing higher level studies. However, I am not sure that it can be argued that these generally low cost, mostly highly accessible result in

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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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Reposted by Stephanie Grach M.D. M.S.

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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Reposted by Stephanie Grach M.D. M.S.

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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Stephanie Grach M.D. M.S. @grachstephanie.bsky.social · 07/10/2025

YESSSS, my knowledge of Lonely Island lyrics had intrigued/scared(?) my husband lol

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Stephanie Grach M.D. M.S. @grachstephanie.bsky.social · 07/10/2025

And thank you also to everyone in the community who took the time to send thank you messages!! Wow!! We received the eCard and are so overwhelmed (in the best way) by your support and are so so grateful. 🥹 @meactnet.bsky.social

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Stephanie Grach M.D. M.S. @grachstephanie.bsky.social · 07/10/2025

@exceedhergrasp1.bsky.social, Ravi Ganesh, and Jen Bell and Brayden Yellman from @batemanhornecenter.bsky.social have all been guides and inspiration for me since the start of my journey in ME/CFS care. I could not think of a better experience to have with my first textbook chapter. Thank you all 💙

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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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Reposted by Stephanie Grach M.D. M.S.

#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 · 20/06/2025

So funny, Jay and I were chatting with each other right as you posted this! 😁

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Stephanie Grach M.D. M.S. @grachstephanie.bsky.social · 10/05/2025

"This mindset shift not only benefits patients with post-infectious conditions but strengthens our ability to manage other complex, poorly understood illnesses across medicine." - beautiful statement by Dr. Zeest Khan (2/2)

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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 · 06/04/2025

Thank you! No placebo control group for this one (would have needed more funding for the first round) but the biomarkers (blinded) will be informative in the full report. I believe PolyBio is doing a placebo-controlled for LC but I don't know which labs they'll use.

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Stephanie Grach M.D. M.S. @grachstephanie.bsky.social · 05/04/2025

I don't have the exact numbers (will be seeing with the manuscript draft soon), but my understanding has been that adverse effects have been uncommon, with the notable one being mouth sores, consistent with other studies at this dose. Pts could stop and reintroduce at a lower dose if so.

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Stephanie Grach M.D. M.S. @grachstephanie.bsky.social · 04/04/2025

in the overall interpretation even in this non-placebo controlled group, to be discussed in the upcoming manuscript.

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Stephanie Grach M.D. M.S. @grachstephanie.bsky.social · 04/04/2025

I'll leave it to the study leads to share overall plans, but note that this is just aggregate data of one area assessed (patient-reported outcomes, which was what was available at the time of conference abstract submission) and so use of biomarkers and subtyping in the more full data will be helpful

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Stephanie Grach M.D. M.S. @grachstephanie.bsky.social · 04/04/2025

Great question! This will be addressed in the greater analysis in the manuscript, interesting what we may be finding in respect to infection history. :)

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Stephanie Grach M.D. M.S. @grachstephanie.bsky.social · 04/04/2025

Thank you so much! Definitely looking forward to the full results coming out.

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Stephanie Grach M.D. M.S. @grachstephanie.bsky.social · 04/04/2025

Thanks for the question - app participants for this study received rapamycin and were aware.

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Stephanie Grach M.D. M.S. @grachstephanie.bsky.social · 04/04/2025

Thank you! It was exciting to present 😁 I was limited to presenting the kind of data available at time of submission (December) so it'll be great to have the full data out in the future.

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Stephanie Grach M.D. M.S. @grachstephanie.bsky.social · 04/04/2025

And this was with everyone combined! Paper will get to into subsets :) Thanks for sharing!

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Stephanie Grach M.D. M.S. @grachstephanie.bsky.social · 03/04/2025

It was also my first time being a senior author on a clinical vignette poster - also on #MECFS. Also very popular during the poster session, and won finalist for its category back in the MN ACP! Love getting to do what we do both in the clinic and out.

A poster with blue borders and white background describing a case of ME/CFS being diagnosed in the hospital, leading to improved patient trajectory.

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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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