Recently I was asked by my medical professional (who is also an Instructor at Bastyr University if I was pulsing my artemisia. I said yes, my rule of thumb is to always pulse anti-viral and antibiotics. This came out of the grandfather of all CFS protocols, the Jadin / Rickettsia approach, which found that pulsing was far more effective in dealing with occult infections than continuous application.

My medical professional mentioned that artemisia, if taken more than 2 weeks, will result in the body adapting to it, reducing it’s effectiveness. Unfortunately, I have not been able to find any PubMed studies to confirm it for artemisia.  I did find one 2004 study where pulsing was clearly as effective as continuous dosage. An additional study found that it was more effective against less susceptible bacterial strains as as effective for susceptible strains, which appears to confirm the experience from the 1950’s Rickettsia approach.

A 2012 mathematical modeling study pulsing may be the preferred application of anti-pathogens: “We find that constant dosing is not the optimal method for disinfection. Rather, cycling between application and withdrawal of the antibiotic yields the fastest killing of the bacteria.”

It should be noted that in some cases, supplements use their effectiveness after a few months (there are studies showing this with NADH with CFS patients). So there is a legitimate concern for taking anything continuously — you will likely loose the benefit sooner than with pulsing.

Remission and the wisdom of pulsing

If you are loaded up with substances modifying cytokines, coagulation, etc, how can you tell if there is actual progress to true remission (or are you just addressing the symptoms?).

I find that pulsing almost everything that is intended to lead to remission and then having a 1-3 week washout to see how much benefit persisted. For example, I pulsed Mutaflor(E.Coli Nissle 1917). After the first pulse, the benefits persisted when I stopped. When I proceeded to take Amoxicillian, which kills E.Coli, I noticed that niacin flush returned, but is a very minor manner. Once I stop items that kill E.Coli, I will promptly do another pulse to restore E.Coli levels. The same applies to all probiotics, for example, re-establishing Lactobacillus Reuteri so the need to supplement B12 disappears.

My general impression from reading studies on antibiotics and restoration of gut bacteria after antibiotics, suggests that 2 weeks is the maximum duration needed.

There’s another significant benefit to pulsing, it reduces the costs of treatment without adversely impacting the outcome (in fact, it may improve the outcome).

So what should pulsed? IMHO

• Antibiotics
• Antivirals
• Anticoagulants
• Most herbs (because they often act in the above areas)

To rephrase this another way: If you intend to treat CFS mitochondrial dysfunction by supplementing the vitamins, amino acids and minerals that are deficient, then you likely need to keep on them continuously.  If you intend to treat CFS mitochondrial dysfunction by eliminating pathogens causing it (including gut bacteria), encouraging good bacteria, adding probiotics that is causing the dysfunction, then you should pulse and taper off once the correction is established.

Recently I start corresponding with a CFS patient that has been successfully using Chlorine Dioxide to suppress the infections/symptoms successfully. The problem she was encountering was that the moment that she stops, the infection/symptoms flares.

During my prior flare (11 years ago), I also used Chlorine Dioxide as an adjunct to antibiotics that I was taking. Chlorine dioxide tablets are a standard part of hiking kits to purify water from streams. It kills most bacteria and creatures in the water.

• US Orders [ 50 tablets, $13]
• UK Orders [ 20 tablets, £10]

It was interesting to read that with this alone, she had good success with symptom suppression  My use was as an adjunct to antibiotics.

One of her questions, was whether taking Lactobacillus Rhamnosus (GG)  would counter it. She found a UK source containing just GG. Her concern was whether GG would neutralize the Chlorine Dioxide because GG is an antioxidant. IMHO, it will not — however, the Chlorine Dioxide will likely kill the GG…. oops!  There are no reports of eating yogurt while hiking and using chlorine dioxide tablets results in the tablets not being effective.

Suppression versus Elimination

It was interesting to note that Chlorine Dioxide tablets alone, was an effective suppressor but did not eliminate. It also appear to support the model that CFS symptoms for many is originating in the gut bacteria. It suggests that there may have a prophylactic role for this with recovered CFS patients whenever they have a flu or other infection. It may reduce the odds of the CFS gut flora alteration becoming established.

So, how do you go for elimination? IMHO, there are three routes: via the use of antibiotics OR via herbs used in Ayurveda medicine that have been demonstrated by scientific studies to eliminate probable overgrowth, or doing both at the same time. I will quote from my favorite paper on the herbs (2009)

“Ethanol extracts of Terminalia chebula and Ocimum sanctum exhibited antibacterial activity against Klebsiella pneumoniae. Ethanol extract of Cinnamomum cassia showed maximum antibacterial activity against Pseudomonas aeruginosa while ethanol extract of Azadirachta indica and Ocimum sanctum exhibited antibacterial activity against Enterococcus faecalis.”

For each of these bacteria, the powder or pill is easily available in bulk on Amazon or elsewhere.

• Terminalia chebula: Haritaki
• Ocimum sanctum: Tulsi
• Cinnamomum cassia: Cinnamon
• Azadirachta indica: Neem

The question now becomes dosage and the herx.  I recently wrote to medical professional friend that is very interested in my explorations, “These herbs kick ass — oops,   kick-head. In therapeutic dosages, massive continuous headaches for the first week…”

The dosages that I was taking slowly increased to 3 gms of each a day that was maintained for 2 weeks, then stopping. I stopped probiotics when I started (since most of them would be killed off), and then resume when the pulse was over.  My own positives responses within the first week were stopping of hypersomnia (I was sleeping 10-11 hrs/day), significant improvement in ability to learn and think, and lastly, I started to feel like “my old self”. The negative responses were nasty headaches, stool changed significantly, and if I farted, everyone in the house suddenly decided to take a walk… REMEMBER, the above was what I did after it was reviewed by my (very) knowledgeable medical professional, as always, any change of supplements should be discussed with your medical professional.

Remember, alteration of gut bacteria will usually impact one set of symptoms. It seems that set of symptoms is connected to specific species of bacteria. There appear to be many different species and families involved.

First, I should declare that I am a Software Development Engineer for Amazon. I was using Amazon for supplements before I took that job.

The Problem

Many CFS people have a very limited budget and often mental fog that interferes with selecting the best price. Often, when a bottle is found to be emptied, there is a panic to buy some more ASAP (ignoring the cost)  My recommendation is very simple:

• Find the best buy (per oz/per day) on Amazon.com /Amazon.co.uk
• See if it is available for Subscribe and Save, for free shipping and an extra 5% off
• Look at bulk for herbs and make your own capsules.
  • You can get Organic (which prepared capsules may not be)
  • Much less costs

Illustration

I looked for Turmeric on Amazon.co.uk, and then restricted it to Swanson. You see the results below…

The first thing is that the identical same item(but different quantity) was 2.5 times as expensive per pill (look at the first two above)!!! You then see “premium” versions that may be “technically better” (which often means just 5% better!), going for a much higher price, up to SEVEN times more per oz.  So, if someone told you that Gasoline ABC will give you 5% more mileage, you are willing to pay $28/gallon instead of $4/gallon????

This can be a problem with many MDs — they will recommend a specific brand because they have been told (often without any peer-reviewed study being done) it is “better”. They will rarely look at the cost, just the “better”. Better should be proven if the cost is 10+% more. A formal study, not just personal observations (which are very inclined towards placebo effects).

So, we are now down to 1.35/oz.  Can we reduce it more? Turmeric is a kitchen spice, so if you are willing to make your own capsules… just buy the powder (toss in 1% black pepper is recommended for Turmeric).

If you are not needing organic, then we are down to 4.69 per kilo.  Ok, we have per oz above and per Kilo here… 1 Kilo is 35 oz. so 4.69/35 = 0.13 /oz….

Bottom line: You could be spending 9.45/oz OR 0.13/oz. A SEVENTY FOLD (70x) difference… Ouch!

A pill making machine may cost $24 with 500 capsules,

• US Orders [Capsule
  Filler Kit + 500 Gelatin Capsules – Capsule Machine Size ’00’ $24]
• US Orders [750 Gelatin Capsules Size ’00’ $15]
• UK Orders [Capsule
  Filler Kit + 500 Gelatin Capsules – Capsule Machine Size ’00’ £40]
• UK Orders [750 Gelatin Capsules Size ’00’ £6]

In effect, capsules are between 1 and 2 cents each. 100 capsules are about $1.50 at retail (likely less than $0.50 for a manufacturer).

Subscribe and Save!

Amazon offers “Subscribe and Save” on items that it ships. They will gather all of your items into a single shipment each month. Before they send it, they will email you — you can opt to skip or cancel the shipment of any item. Our usual practice is to check the supplies when the email arrives, and cancel the shipment on any item where we have enough on hand to survive until the next cycle.

What you get will make the budget go further: FREE SHIPPING and 5% more savings!

The advantage to the brain fogged is that you do not run out! Remember, you can subscribe for just one shipment (getting free shipment and 5% off) and then cancel it with no hassles!

Not everything is available as bulk…

Today,there are a lot more things, especially herbs that are available is bulk. My bulk bin has: piracetam, turmeric, tulsi, haritaki as well as items such as L-Glutamine.

For L-Glutamine, I can get Source Naturals, 16 oz for $27. Or I could buy Now Food 120 capsules 500 mg for $10. Comparing these may be a challenge to the brain fog… so I will show the steps:

• Multiple capsules x mg, 500 x 120 = 60000
  • Take off 3 zeros, 60000 -> 60 to get the grams
  • Divide the grams by the price to get the price per gram. $10/60 = $0.17
• 1 oz is 28 gm, so 16 oz is 450 gm.
  • Divide the grams by the price to get the price per gram. $27/450 = $0.06

By buying the powder, I cut my supplement costs by 66%

The unexpected …

Sometimes, you discover that healthy is cheaper. A single loaf of organic bread will often run $5-$7. When I looked at FOS to help gut bacteria, I found that the best source was from rye (which is not used in FOS pills). I remember that I could buy 100% Rye bread made in Germany at some health food and delis; no GMO grains in it. Most US “Rye bread” contain wheat (sometimes more wheat than rye — these are 0% wheat breads!) I decided to check on Amazon… Feldkamp Whole Rye Bread , 16.75-Ounce Vacuum Packs (Pack of 12), for $29.00. That is $2.40 for a 17 oz loaf (half the cost per loaf as local bread). The loafs are vacuum pack and have a long shelf life (months). With Subscribe and Save (or with Prime), it is free delivery! If I ordered “Source Naturals FOS Fructooligosaccharides 1000mg, 200 Tablets”, it is $20.00, and an inferior FOS.

Turmeric is very similar to ALA in it’s benefit. The active ingredient of this kitchen spice is curcumin. Turmeric appears to be more effective than curcumin, the extract according to studies. Curcumin has anti-inflammatory, anti-oxidant, pro-apoptotic, chemo preventive, chemotherapeutic, anti-proliferative, wound healing, anti-parasitic, anti-malarial and anti-bacterial activity. All of these characteristics are shared by Turmeric.

Turmeric is best made from bulk Organic Turmeric that has 1% black pepper added to it. The black pepper increases it bioactivity. It is also a lot cheaper buying in bulk and making your own (for example: $18 for 2000 gms in bulk, or $25 for 12 gms in capsules produced by some company).

It has been shown to benefits IBS, a condition co-morbid with a lot of CFS patients.

In terms of coagulation

• Increases fibrinolytic activity
• Inhibits platelet aggregation, increases coagulation. time
• Reduces high level of fibrinogen

In terms of inflammation, it reduces IL6, IL8, TNFalpha. It is a known neuroprotective.
It also has some features that ALA does not have:

• Inhibits EBV, and is an antiviral
• Inhibits H. pylori
• Inhibits inducible nitric oxide synthase (iNOS)

Like ALA, it also normalizes Choline, an amino acid. Choline is high in occipital cortex areas of the brain and abnormally high in most patients. Choline reduces with viral clearance. This reduction has been documented to produce significant improvements in verbal learning, memory, and visuo-spatial memory.

• US Orders [ Powder:1 lb(450 gm) $19 ] [ Capsules: 100 @ 720 mg (72 gm) $6]
• UK Orders [ Powder: 500 gm £ 10] [ Capsules:(172 gm) 240 @ 720 mg £ 10]