In this post I will cover a subset of supplements that have been shown effective for some infections:
- Viral infections
- Bacterial infections in the blood
- Microbiome shift (effective infections in the gut)
I have selected those that appears best on reviewing the medical literature. In general, there have been no studies with supplements and CFS. There has been studies for prescription antibiotics and antivirals.
For antivirals, those effective against EBV or CMV tend to be the focus. Some herbs like Cat s Claw (Uncaria tomentosa), have been found to have no impact http://www.ncbi.nlm.nih.gov/pubmed/11884218 (2002).
For CFS patients with herpes virus (EBV, CMV, and HHV6) 10% -57% had multiple infections, with 13% having all three ( source ) . A 2012 study testing for just 3 active pathogens found 65% positive in CFS patients versus 13% of controls http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3426163/ (2012). EBV and CMV may not be the cause, but they appear to contribute.
- CMV :Cytomegalovirus or Cytomegalovirus (HHV6)
- EBV: Epstein-Barr virus (HHV4)
WARNING: Any of these can cause a Herx. Always start with a low dosage and work upwards. When a herx occurs, hold that dosage (or slightly reduce it) until the herx ebbs. As always, changes in medications and supplements should be done in consultation with your medical professional.
With the current trend against the use of antibiotics, especially long term use, the following may be difficult to get prescribed by MDs.
- Med Hypotheses. 2009 Jun;72(6):736-9. Epub 2009 Mar 6. On the question of infectious aetiologies for multiple sclerosis, schizophrenia and the chronic fatigue syndrome and their treatment with antibiotics http://www.ncbi.nlm.nih.gov/pubmed/19269110 (2009). Frykholm BO.
- Excellent results that persisted for at least a year after 60 days of antibiotics [2 patients]
- Chronic fatigue syndrome after Q fever http://www.ncbi.nlm.nih.gov/pubmed/17599032 (2007)
- Fluoroquinolones and Tetracyclines for 3-12 months, [2/3 recovered]
- Treatment of chronic fatigue syndrome with antibiotics: pilot study assessing the involvement of Coxiella burnetii infection http://www.ncbi.nlm.nih.gov/pubmed/16415546 (2005)
- minocycline or doxycycline for 3 months
- Prior Q-Fever CFS (54 patients) improved.
- No Q-Fever CFS (4 patients) no change.
- minocycline or doxycycline for 3 months
- Improvement of chronic nonspecific symptoms by long-term minocycline treatment in Japanese patients with Coxiella burnetii infection considered to have post-Q fever fatigue syndrome http://www.ncbi.nlm.nih.gov/pubmed/14964579 (2004).
- Minocycline (100mg/day) for 3 months, all patients improved.
- Mycoplasma blood infection in chronic fatigue and fibromyalgia syndromes http://www.ncbi.nlm.nih.gov/pubmed/12879275 (2003)
- Long term doxycycline – most patients go into remission.
- Benefits and harms of doxycycline treatment for Gulf War veterans’ illnesses: a randomized, double-blind, placebo-controlled trial http://www.ncbi.nlm.nih.gov/pubmed/15262663 (2004).
- Long-term treatment with doxycycline (200mg/day) did not improve outcomes of GWVIs at 1 year.
- Counterpoint: long-term antibiotic therapy improves persistent symptoms associated with lyme disease http://www.ncbi.nlm.nih.gov/pubmed/17578772 (2007)
- prolonged antibiotic therapy (duration, >4 weeks) may be beneficial for patients with persistent Lyme disease symptoms
- Controlled trials of antibiotic treatment in patients with post-treatment chronic Lyme disease
- Treatment using a single antibiotic have not been successful http://www.cdc.gov/lyme/diagnosistreatment/Treatment/prolonged/index.html(typically ceftriaxone, possibly with a repeat the antibiotic used for Lyme originally) http://www.ncbi.nlm.nih.gov/pubmed/12821734 (2003) http://www.ncbi.nlm.nih.gov/pubmed/12821733 (2003) http://www.ncbi.nlm.nih.gov/pubmed/11450676 (2001) http://www.ncbi.nlm.nih.gov/pubmed/12804167 (2002)
- Cecile Jadin (South African MD – surgeon: firstname.lastname@example.org ) official sites: http://cecilejadin.com/ http://chronicfatiguesyndrome.co.za/case-studies , http://drcjadin.com/, protocol
- Vibromycyn 100 or 200 depending on weight and tolerance
- Riostaine – f(oxytetracycline) 250 QID, 500 TDS, 500 QTD
- Minomycin 50mg plus 100mg bd or 100 bd plus Rulide (Macrolide 150mg.)
- Tetralisal (lymecycliine) – 300mg bd X 7 days plus flagy Metronidazole 200mg bd 400bd
- Dumoxin 100mg + 50mg daily 100mg bd plus Quinolene =Ciprobay 500mp bd or Maxs wuin BD
- remission rate > 70%
- Dalacin C 150mg or 2 X 4 7 days each treatment to be taken with inteflora (no milk products)
“Rifaximin is a nonsystemic antibiotic that has shown efficacy in IBS”
- http://www.ncbi.nlm.nih.gov/pubmed/22251066 Expert Opin Pharmacother. 2012 Feb;13(3):433-40. Epub 2012 Jan 18. Rifaximin for the treatment of irritable bowel syndrome. Cremonini F, Lembo A. Source Harvard Medical School
Active against most species of the herpes virus family.
- Improves EBV only infection http://www.ncbi.nlm.nih.gov/pubmed/12582420 (2002) http://www.ncbi.nlm.nih.gov/pubmed/18019402 (2007)
- No impact on EBV+CMV http://www.ncbi.nlm.nih.gov/pubmed/12582420 (2002)
- Potential application for the treatment of neuroinflammatory diseases.
- Effective against CMV http://www.ncbi.nlm.nih.gov/pubmed/21904628 (2011) http://www.ncbi.nlm.nih.gov/pubmed/21843554 (2011)
- Effective against EBV http://www.ncbi.nlm.nih.gov/pubmed/18699744 (2008)
- Effective against EBV and other virus, http://www.ncbi.nlm.nih.gov/pubmed/16557613 (2006), http://www.ncbi.nlm.nih.gov/pubmed/11054840 (2000), http://www.ncbi.nlm.nih.gov/pubmed/16946522 (2006)
- Anti-bacterial http://www.ncbi.nlm.nih.gov/pubmed/21108917 (2010)
- Inhibits virus http://www.ncbi.nlm.nih.gov/pubmed/19416738 (2009), including EBV http://www.ncbi.nlm.nih.gov/pubmed/12834859(2003) (unique mechanism), against rotavirushttp://www.ncbi.nlm.nih.gov/pubmed/22834653 (2012)
- Inhibits CMV http://www.ncbi.nlm.nih.gov/pubmed/10933257 (2000)
Olive Leaf Extract
- Olive Leaf (Oleuropein) has antioxidant, antihypertensive, antiatherogenic, anti-inflammatory, hypoglycemic, and hypocholesterolemic properties http://www.ncbi.nlm.nih.gov/pubmed/19906250 (2009)
- Anti-viral activity http://www.ncbi.nlm.nih.gov/pubmed/17537437 (2007) http://www.ncbi.nlm.nih.gov/pubmed/12878215 (2003) http://www.ncbi.nlm.nih.gov/pubmed/17275783 (2003)http://www.ncbi.nlm.nih.gov/pubmed/15869811 (2005)
- Interactions with viral envelope http://www.ncbi.nlm.nih.gov/pubmed/15869811 (2005)
- A review on antibacterial, antiviral, and antifungal activity of curcumin
- The effect of curcumin on human B-cell immortalization by Epstein-Barr virus. 
Other Antiviral Herbs
- Centella asiatica,
- Epimedium Sagittatum,
- Hibiscus mutabilis,
- Hosta plantaginea,
- Inula japonica,
- Mosla punctata,
- Patriniavillosa (Valerian family)
- Pinus massoniana,
- Prunella vulgaris,
- Pyrrosia lingua,
- Rhododendron simsii
- Rhus chinensis,
- Sargassum fusiforme
- Taraxacum mongolicum
Most of the above antivirals, also appears to be antibacterials. My two favorites are tulsi and neem (up to 6 “00” capsules per day)
From Phytochemical Screening and Antimicrobial Activity of Some Medicinal Plants Against Multi-drug Resistant Bacteria from Clinical Isolates . “tulsi, thyme, oregano and rosemary showed the most promising broad spectrum antibacterial properties against the reference as well as MDR bacteria in which the diameter of zone of growth inhibition varied between 6 and 20 mm”
- Anti-bacterial http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3035883/ (2010) http://www.ncbi.nlm.nih.gov/pubmed/21331189 (2010) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866360/ (2009) http://www.ncbi.nlm.nih.gov/pubmed/20161895 (2007) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3035883/ (2010) http://www.ncbi.nlm.nih.gov/pubmed/20645797 (2010)
- Anti-bacterial http://www.ncbi.nlm.nih.gov/pubmed/1500569 (1992)
- Effective against gastrointestinal infections http://www.ncbi.nlm.nih.gov/pubmed/22428888 (2012)
I also tend to favor traditional medicinal gums (especially when chewed as a gum): Mastic, Boswellia http://www.ncbi.nlm.nih.gov/pubmed/21406118 (2011)
I tend to favor a Jadin style protocol: with anti-infection supplements, start with just one for 2 weeks and then rotate to another. Later increase to 2 at a time but keep rotating. A simple explanation is that a longer course can result in resistance to the active chemicals in the supplement. Where practical, rotate suppliers because each supplier will have different sources and thus slightly different chemicals in it.