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After then spending four years working overseas, Black was invited by Garry to help set up the physiology department at the University of Glasgow

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To summarise some of the key findings, FMS features: Defective central pain processing characterised by enhanced pronociception and reduced antinociceptive mediators Glutamate excitotoxicity in the central nervous system Neuroinflammation initiated by microglial cells A subset of patients display signs of small fibre neuropathy likely involving hyperexcitability of neurons in the dorsal root ganglia Mitochondrial dysfunction in skin, muscle and white blood cells Structural mitochondrial abnormalities Elevated tissue concentrations of lactate and pyruvate Elevated systemic inflammatory markers Elevated markers of oxidative stress with depleted endogenous antioxidant systems So now that we have rough idea of how the system malfunctions in FMS, we can begin digging deeper into the ways in which thiamine can help to address the abnormalities listed above