Alpha Lipoic Acid(ALA) is a frequently recommended supplements by CFS specialists. It is good to see why it may work so often to reduce symptoms.

First it reduces coagulation issues, and improves blood flow

• Decreases CD62P platelet expression
• Decreases fibrinogen, factor VII, vWF, and triglycerides
• Decreases plasma levels of free fatty acids, triglyceride, total cholesterol, low density lipoprotein-cholesterol, small dense LDL-cholesterol, oxidized LDL-cholesterol, very low density lipoprotein-cholesterol

Second it reduce inflammation levels

• Decreases C-Reactive Protiens levels by 19%
• Decreases cytokines such as TNF-alpha, IL-6

Third, it been documented to decreases symptoms of neuropathy and neuropathic deficit (which could be because of improved blood flow, reduced inflammation or both). It also improves nerve function.

The last aspect is interesting, 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 [ (36 gm) 60 @ 600 mg $10]
• UK Orders [ (36 gm) 60 @ 600 mg £ 8]

Many many drugs are developed from the knowledge of medicine men. One of the problems of these discoveries are the lack of availability of some herbs. Recently I came across this 2009 study, Antibacterial Activity of Medicinal Plants Against Pathogens causing Complicated Urinary Tract Infections, It is almost a exact match for some of my model. The source of the information was medicine men (and women) from rural india — a country very rich is herbs and spices.

Looking at the Australian and other studies, we see the following overgrowth:

• Klebsiella/Enterbacter
• Enterococcus
• Streptococcus

Reviewing this article we found the following are most effective for two of these:

• Klebsiella pneumoniae – ethanol extracts of Terminalia chebula and Ocimum sanctum
• Enterococcus faecalis – ethanol extract of Azadirachta indica and Ocimum sanctum

Of course, latin names are always fun.. with a little wikipeding, we have

• Azadirachta indica – or Neem
  • US Orders [100 capsules $7]
  • UK Orders [100 capsules £9]
• Ocimum sanctum– or Tulsi
  • US Orders [1 lb (450gm) $21]
  • UK Orders [500 gm £13]
• Terminalia chebula– or Haritaki
  • US Orders [8 oz (225gm) $12]
  • UK Orders [300 gm £10]

Checking a few other similar articles, the problem was often finding the bark, herb, spice available for sale.

Fibrin are deposits from coagulation. If you have ever looked at pipes under your bathroom or kitchen sink, you will often find them coated with a thick slimy substance.  If the amount gets too much, you may have those pipes backup. If you get too much fibrin, you may have a strokes. The typical situation for CFS is not a stroke, just choked pipes so the sinks drain slowly.

Compounds that dissolve fibrin are called fibrinolytics or thrombolytics. There are a number of prescription drugs. In the US there are several supplements available that are also fibrinolytics. One of these was only by prescription when I first used it (and I had to cross the border to Canada to purchase it). Fibrinolytics should not be used without active involvement of a knowledgeable medical professional. If you start to notice any bruising anywhere (for example, at the site of a blood draw), you should immediately stop them and  consult with your knowledgeable medical professional before starting them again.

My own usage tend to be in pulses of 5-15 days whenever there are symptoms of excessive fibrin or once every 6 months if there are not.  This approach has been approved by physicians past.

The four supplements documented on PubMed as fibrinolytics (often acting by different mechanisms) are:

• Bromelain
  • US Orders[2400GDU @ 120 capsules $17]
  • UK Orders[3000GDU @ 90 capsules £17]
• Lumbrokinease
  • US Orders[720K LU @ 60 capsules $41]
  • UK Orders[720K LU @ 60 capsules £32]
• Nattokinase
  • US Orders[2000 FU @ 90 capsules $12]
  • UK Orders[2000 FU @ 90 capsules £16]
• Serrapeptase
  • US Orders[120KSU @ 90 capsules $30]
  • UK Orders[120KSU @ 90 capsules £20]

Note that they are sold by units of dissolving ability, not by gm alone. For example Swanson sells 240 GDU tablets and someone else sells 2400 GDU capsules. So care need to be taken in comparing products.

Watchout for severe herx

All of the above have been reported to increase tissue concentrations of many antibiotics up to ten fold. This means that if you are taking 100 mg of minocycline, the effective dosage will equivalent to 1000 mg. This is to be expected from a fibrinolytics because past fibrin deposits block the penetration rate. Removing this blocking layer result in deeper and faster penetration into tissue.

Also, some are known to inhibit the production of biofilms or break down existing biofilms. Again a severe herx could happen as a result.

In following posts, I will look at each of these unique supplements.

Frankincense is also known as Boswellia. Gum-resin extracts of Boswellia have been traditionally used in folk medicine for centuries to treat various chronic inflammatory diseases. It has been found to have anti-bacterial, anti-arthritic,anti-edemateous, anti-oxidant, anti-platelet and anti-coagulant (equivalent to heparin). Positive effects of Boswellia in some chronic inflammatory diseases including rheumatoid arthritis, bronchial asthma, osteoarthritis, ulcerative Colitis and Crohn’s disease have been reported.

It impacts many forms of thick blood and has been referred to as the poor man’s heparin. Impact includes:

• Decreases clotting factors Xa and Xia
• Decreases ADP induced platelet aggregation
• Increase coagulation time
• Increases prothrombin time
• Increases activated partial thromboplastin time

In terms of inflammation, it reduces many cytokines, including: TNF-alpha, IL-1, IL-2, IL-4, IL-6 and IFN-gamma. It also reduces the classic inflammation measure, C-reactive protein.

It is also an anti-bacterial, Anti-viral (especially EBV which is often re-activated in CFS).

Lastly, it is an established neuroprotective.

• US Orders:[400 mg @ 100 capsules $7 ]
• UK Orders:[400 mg @ 100 capsules £7 ]

<a href=”http://en.wikipedia.org/wiki/Ashwagandha”>Ashwagandha</a&gt; is an ideal supplement for CFS. It improves depression, and improves handling of stress. Stress is a contributing factor for onset and is associated with as a trigger for flares. This should reduce the number of flares and shorten their duration.

In terms of inflammation cytokines,
<ul>
<li>Increases IL-2, IFN Gamma</li>
<li>Reduces TNF-alpha</li>
</ul>
In terms of thick blood, it increases coagulation time(good) and the effect continues for up to 7 days after taking.

Lastly, it protects the mind, a neuroprotective and anti-oxidant. SPECT scans shows inflammation in the brain of 70+% of CFS patients, this should reduce it and protect the brain (hopefully reduce the 1% loss/year of some brain matter seen in studies).
<ul>
<li>US Orders [<a href=”http://www.amazon.com/dp/B00068UBYQ/?tag=chrofatisyn02-20&#8243; target=”_blank”>450 mg @ 100 capsules, $8 </a> ]</li>
<li>UK Orders [<a href=”http://www.amazon.co.uk/dp/B002MT8R70/?tag=chrofatisyn02-20&#8243; target=”_blank”>450 mg @ 100 capsules, £7 </a> ]</li>
</ul>