Continuous or Pulse Supplements?

A reader wrote ”

If you had some free time, would you mind informing me which herbs should be pulsed and which (if any) can be taken indefinitely. Such as Ashwagandha.
Or if there is a way to tell which can be taken indefinitely? I was thinking of taking Shilajit (Ayurveda) daily to see if that had any benefit but I can’t remember if there was any reason behind pulsing herbs other than the bacteria getting resistant. Do other herbs lose their effects if you take them too long?”
Anti-Infection Items
My first exposure to the concept was from Dr. Jadin, who learnt it from her father friends at the Pasteur Institute in the 50’s and 60’s. Many modern studies show that alternating (even just rotating between members of the same family) result in higher remission rates. The actual condition or anti-infection agent is likely immaterial.

There are problems with MDs adopting it, because it is more complex then using just one, and there are likely misconceptions that somehow by prescribing two or more, “you’ll increase antibiotic resistance” because you are using twice the number of antibiotics and thus doubling the odds of antibiotic resistance — totally wrong!

Supplements – Organic

The first part of supplements, supplements/herbs/spices with anti-infection characteristics are simple — the above applies because they are anti-infection. This includes Ashwagandha (Withania Somnifera). Herbs like ashwagandha mechanism of action appear often to be via impact on bacteria or virii.

Another adaptogen, Rhodiola rosea (commonly golden root, rose root, roseroot, western roseroot, Aaron’s rod, Arctic root, king’s crown,lignum rhodium, orpin rose), is similar

Hence, rotation of all herbs is my preferred recommendation. If one is an EBV antiviral, then get a list of other anti-EBV herbs (documented by pub med please!!) and rotate them every 1-2 weeks. 

Supplements – Vitamins, Chemicals and Minerals
This enters an area where there are no clean studies, so I will slip into that dangerous space of logical thinking.
Typically chemicals and minerals are taken because we are deficient. In many cases, supplementation have zero impact on being low, or on symptoms. I term these incidental lows. Thus what is the benefit of supplementing? Well, apart from draining the abundance pocket book that every CFSer has… zip.
There are supplements that are well documented to improve FM/CFS/IBS, see prior posts. My favorite is Vitamin D3 ( I usually take 15,000 – 20,000 IU and periodically get tested that I am not too high — I have never been there).
Yes, there may be placebo effects (if you believe that it will help you, then this drops stress and can result in actual improvement in the short term). It may well have helped the person who recommended it and claimed it was significant for them. I believe in the placebo effect… do you really really believe this supplement will help? If not…  let it pass.
For minerals, vitamins and other chemicals, I prefer to pulse — why? Our gut bacteria is responsible for obtain them, if there is a dysfunction then if helps to get them directly.  The risk that I see is this, if the body sees no need to encourage specific bacteria strains that extract X because levels are high due to supplements — then it’s feedback mechanism will shut down those strains. In once sense, I am suggesting a rehabilitation approach. Exercise those bacteria strains regularly.
  • Effects of rotation of topical vitamin D3 in chronic plaque-type psoriasis[2012]. ” Our study showed that switching one VD3 reagent to another VD3 reagent could improve the objective scores of the psoriasis symptoms. It was surprising that switching to calcipotriol or other reagents improved the eruption in a similar way.”
  • ” Because of the chronic course of the disease, appropriate choice of therapy in particular stage of the disease, so-called rotation therapy, is of paramount importance.”[2006]
  • ” children showed significant academic and behavioral improvements within a few weeks or months of open-label treatment with nutrient supplements. …. For those who discontinued, it took at least 1 year to begin to see the first indications of decline in academic performance, and another year for their grades to drop significantly.” [2000]
    • So effective supplements have quick response and very slow reversal, suggesting no loss from pulsing.

Bottom line:

“Unproven diet therapies for patients with CFS include megavitamin/mineral supplements; royal jelly and other dietary supplements; and elimination, avoidance, and rotation diets. Claims that these therapies relieve CFS symptoms and promote recovery are anecdotal and have not been substantiated by clinical research. The yeast-avoidance and sugar-free diets, both promoted to combat Candida albicans overgrowth, are of questionable value in treating patients with CFS. …. Diet strategies that call for the avoidance of food additives, preservatives, sweeteners, and other ingredients are not supported by available evidence and are not practical for patients with CFS.” [1993] – some 23 years later, these claims are still circulating in the CFS patient’s community. The absence of studies finding them effective should not be ignored. I recall in 2000, many people trying these with good initial (aka Placebo) response that disappeared quickly.