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The pathogenesis of MTX-induced renal impairment is thought to be mediated by either MTX and its metabolites precipitating in the renal tubules or MTXs direct toxic impact on the renal tubules (Reference Widemann and Adamson6)

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ME/CFS is a remarkably misunderstood disease, and many patients have experienced judgement, prejudice, and disbelief from healthcare professionals ( Finally, it is imperative to provide increased support to the ME/CFS community, a necessity that is steadily growing alongside the establishment of research groups and charitable organisations dedicated to aiding ME/CFS patients