Monthly Archives: September 2015

Unknown's avatar lassesen 5:35 am on September 19, 2015  

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.

Unknown's avatar lassesen 11:05 am on September 9, 2015  

Anti infection Supplements for CFS

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.

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.

Prescription Studies

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.
  • 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[10]
  • Cecile Jadin (South African MD – surgeon: gerinjadin@icon.co.za ) 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

 Valacyclovir

Active against most species of the herpes virus family.

Supplements

Artemisinin (Wormwood)

Boswellia

Licorice (Glycyrrhiza)

Monolaurin

Olive Leaf Extract

Turmeric

Other Antiviral Herbs

From: http://www.ncbi.nlm.nih.gov/pubmed/2161714 (1990), http://www.ncbi.nlm.nih.gov/pubmed/2550706 (1989), these are usually more difficult to obtain.

  1. Aristolochiadebilis,
  2. Centella asiatica,
  3. Epimedium Sagittatum,
  4. Hibiscus mutabilis,
  5. Hosta plantaginea,
  6. Hypericumjaponicum,
  7. Inula japonica,
  8. Linderastrychnifolia,
  9. Mosla punctata,
  10. Patriniavillosa (Valerian family)
  11. Pinus massoniana,
  12. Prunella vulgaris,
  13. Pyrrosia lingua,
  14. Rhododendron simsii
  15. Rhus chinensis,
  16. Sargassum fusiforme
  17. Taraxacum mongolicum

Antibacterials

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 [2012]. “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”

Natural control of bacteria affecting meat quality by a neem (Azadirachta indica A. Juss) cake extract [2015]

Lantana camara (Spanish Flag)

Monolaurin

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)

Protocol

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.

Unknown's avatar lassesen 5:58 am on September 8, 2015  

Coagulation: Thick Blood Supplements for CFS and Long COVID

Some readers may ask what is this about thick blood AKA micro clotting in COVID?

When I had my 2nd episode of CFS/ME, several papers had just be published by Dave Berg. He was not a MD nor a researcher. He owned and ran a laboratory that specialized in blood testing for infertility. The cause of one type of infertility is Hughes Syndrome or to put it into simple terms, thick blood. The blood is just thick enough that oxygen to the fetus is insufficient and results in spontaneous abortion. The modern treatment is low dosage of heparin (the body’s natural blood thinner) resulting in the fetus surviving. Heparin is not a single chemical, rather a bunch of different chemicals.

Dave Berg while working with MDs started to hear “oh by the way, Mrs. X while on heparin reported that her FM / CFS went away”. After hearing enough reports, he conducted a study of CFS patients (using his own labs and at his own expense) and found that most CFS had a detectable hyper coagulated state often connected to DNA mutations (i.e. inherited). These needed some external influence to become significant (i.e. an infection). A significant percentage went into remission from low dosage heparin alone. Others required heparin and either anti-virals or antibiotics.

As a side note, my mother had 2 sons and something like 7 miscarriages… I suspect “thick blood” was the cause. She did not have CFS.

Model

Some infection which prefers low oxygen levels has become established in the body. The infection manufactures chemicals to trigger coagulation (and thus lower oxygen levels to make your body friendly to it). Because of a person’s DNA mutations, not all of the coagulation is cleaned up — resulting in thick blood. At my worst, it took 12 tries at various locations to get one blood sample out of me, things were that thick!

With heparin or other appropriate blood-thinners, the oxygen increases and with some infections, the increased oxygen is sufficient to suppress the infection (which likes low oxygen levels), thus stopping further coagulation. The “infection” may be in tissue, or a combination of bacteria in the gut (or microbiome), it may not be detected in the blood.

My Experience

On my 2nd episode with CFS, the MD sat on the wall about coagulation — doing a “I will think about it”. I decided to try a simple experiment: I got a bottle of aspirin and read what the maximum dosage  allowed was (and for how long) and then did it.  About 7 days later I was climbing the ways with energy and improved thinking (I crashed fast once I stopped). The MD saw the changed and ordered extensive coagulation panels from Berg’s lab (later the MD sent to a local lab and got similar results — just to make sure that Berg’s lab was not misreporting). I was put on low dosage heparin and once my DNA results came back, I found that my DNA defect could be treated with Piracetam and Turmeric.

At the start of my 3rd episode, I hit the anticoagulants increasingly to keep me working while my new MD was running the mountain of exclusionary tests required before a CFS diagnosis could be given (as well as having symptoms for 6 months).  I knew what was happening — the MD did not believe me until the SPECT scans came back. I stopped the anticoagulants as soon as easy bruising started to happen — and totally crashed 3 days later. Antibacterial/antivirals were needed.

Coagulation is complex with many steps in the process. It takes just one step to over-produce or under-produce to create a problem. The typical mistake that people make is to address only the step that aspirin impacts (platelets)– that is usually insufficient (and if you take too many substances that impacts that step, you have a major risk of serious bleeding). Always consult with your MD before starting any supplements.

With that said, I will give my list of supplements which are available (in the US without prescription) and what each does according to PubMed. I will not try to explain all of the complexities or terms (sorry — that’s another topic, use wikipedia)

Thick Blood Supplements

Alpha Lipoic Acid

Boswelia Gum

Gum-resin extracts of Boswellia serrata have been traditionally used in folk medicine for centuries to treat various chronic inflammatory diseaseshttp://www.ncbi.nlm.nih.gov/pubmed/22457547 (2011). It has been found to have antibacterial http://www.ncbi.nlm.nih.gov/pubmed/22422529 (2012),  anti-arthritic http://www.ncbi.nlm.nih.gov/pubmed/21479939 (2011), anti-edemateous http://www.ncbi.nlm.nih.gov/pubmed/21855244 (2011),  antioxidant, antiplatelet and anticoagulant(equivalent to heparin)http://www.ncbi.nlm.nih.gov/pubmed/21771654 (2011). positive effects of BEs in some chronic inflammatory diseases including rheumatoid arthritis, bronchial asthma, osteoarthritis, ulcerative colitis and Crohn’s disease have been reported http://www.ncbi.nlm.nih.gov/pubmed/20696559 (2010).

Bromelain

Coagulation-inhibiting effects http://www.ncbi.nlm.nih.gov/pubmed/2203073 (1990)

Centella Asiatica [Gotu kola]

This is used in Spain

  • “The anti-thrombotic active constituents from Centella asiatica. [2007]”
    • “Thus, C. asiatica was shown to promote blood circulation to remove blood stasis. Consequently, C. asiatica is a useful medicinal plant for the prevention of lifestyle-related diseases such as hypertension, cardiopathy and cerebral apoplexy caused by arteriosclerosis.”

Coenzyme Q10

 Ginseng

Acts similar to aspirin for coagulation

Grape Seed Extract

Grape seed extract is rich in proanthocyanidins. Proanthocyanidins are available from other supplements (cranberry juice, cider). It may or may not offer protection for glutamate excitotoxicity (depends on grapes being used) http://www.ncbi.nlm.nih.gov/pubmed/21283677 (2011).

Licorice

Spezzata (pure Licorice – Glycyrrhia).  http://www.ncbi.nlm.nih.gov/pubmed/9196073 (1997)

  • Increases plasma recalcification, thrombin and fibrinogen clotting times
  • Reduces thrombin-induced, but not collagen-, PAF- or convulxin-induced platelet aggregation.

Lumbrokinease

Nattokinase

Nattokinase is from a fermented-soya desert food in Japan called Natto.

Maximum dosage: 4000 Fibrin Units  http://www.pureprescriptions.com/expert_opinion/Nattokinase-Information.asp http://digitalnaturopath.com/treat/T447441.html

 Piracetam

For coagulation http://www.ncbi.nlm.nih.gov/pubmed/8457235 (1993), reduces

  • von Willebrand’s factor
  • inhibition of thromboxane synthetase
  • inhibition of anti-thromboxane A2
  • 30-40% reduction in plasma levels of fibrinogen
  • reduces cell membrane deformability (red cells, white cells and platelets)

 Turmeric

The active ingredient of this kitchen spice is curcumin. Turmeric appears to be more effective than curcumin, the extract[1].

NOT RECOMMENDED

Evening Primrose Oil

Depending on your DNA, it may help or make things worst.

1.1.1     Sunflower Oil

More readings on thick blood

  1. https://atomic-temporary-42474220.wpcomstaging.com/treatment/thick-blood-clots-dimension-of-cfs-etc/hemex-protocol-and-dave-berg/dave-berg-cfs-radio-program-1999-08-29/
  2. https://atomic-temporary-42474220.wpcomstaging.com/treatment/thick-blood-clots-dimension-of-cfs-etc/
  3. https://atomic-temporary-42474220.wpcomstaging.com/treatment/thick-blood-clots-dimension-of-cfs-etc/hemex-protocol-and-dave-berg/transcript-of-townhall-with-dave-berg-hemex-labs/comment-page-1/
  4. https://atomic-temporary-42474220.wpcomstaging.com/treatment/thick-blood-clots-dimension-of-cfs-etc/hemex-protocol-and-dave-berg/townhall-with-david-berg-3/
  5. https://atomic-temporary-42474220.wpcomstaging.com/treatment/thick-blood-clots-dimension-of-cfs-etc/hemex-protocol-and-dave-berg/dave-berg-talk-4/
  6. https://atomic-temporary-42474220.wpcomstaging.com/treatment/thick-blood-clots-dimension-of-cfs-etc/hemex-protocol-and-dave-berg/
Unknown's avatar lassesen 5:14 pm on September 7, 2015  

Core CFS Supplements

Supplements are a challenge for many CFSer. Often their criteria is the very subjective “if I don’t feel better, then they are not working”. If there is improvement and it takes 4 weeks, they may not be able to remember how they were, and thus perceive no improvement.

Supplements Shown to Improve CFS – Reported  by PubMed studies

I am filtering the studies to CFS, IBS and FM since they tend to be co-morbid. There are many supplements that were found to have no impact. I would recommend these supplements be used (and lab results increased to the desired level) before trying speculative supplements. Many supplements help other conditions but not CFS/FM/IBS – and in a few cases may make things worst. Be careful with items “that are good for you (general population)”, they may be contraindicted for CFS.

Very few things are reported to help all CFS patients — with the exception of Vitamin D.  To get to and keep at the recommended level, I find that I need to take 15,000 to 20,000 IU of Vitamin D3 per day. If you are low, it can take months even at that dosage to raise your level. Many things are reported low in CFS, and too frequently supplementation has no impact on symptoms.

In my next post I will look at items that help with “low level” hypercoagulation (which is reported in some 90% of CFSers). By low-level, I mean not sufficient to cause stroke or deep vein thrombosis (which a hematologist would deem to be “significant”), but sufficient to cause mental fog and fatigue.

Zinc

Vitamin-D

Comment: a level of 50+ ng/mL appears to be a critical threshold for improvement, this is the level where parathyroid hormone stimulation occurs.

B12

  • 40% are good responders, 60% are mild responders for B12 Injections [2015] – unbelievably, there appears to be only one study.

Coenzyme Q10

Ginseng

Glutamine

A non-essential amino acid.

Licorice

Spezzata (pure Licorice – Glycyrrhia).

L-carnitine

  • Improvement seen after 4 weeks [1997]
  • 60% response rate [2004]

Magnesium

Melatonin

NAC N-Acetyl-Cysteine (NAC) or acetylcysteine

 NADH

Nicotinamide adenine dinucleotide (NADH). This is precursor for niacin

Dehydroepiandrosterone (DHEA)

  Evening Primrose Oil

To Be Avoided

Glutamate

Monosodium glutamate (MSG) is often added to food to improve favor.

Unknown's avatar lassesen 7:51 pm on September 6, 2015  

So what do you do…

A reader asked for a “cook book” summary for the best items for probiotics and foods. Supplements are another issue which I have looked at on early posts. Again, a grain of salt should be taken because the studies are parse and few.

Probiotics

See https://atomic-temporary-42474220.wpcomstaging.com/2015/02/24/probiotics-with-demonstrated-health-benefits-and-other-gems/ for research links

Foods

From Wikipedia’s FODMAR list

“Vegetables: bamboo shoots, bell peppers, bok choy, cucumbers, carrots, corn, eggplant (aubergine), lettuce, leafy greens, pumpkin, potatoes, squash (butternut, winter), yams, tomatoes, zucchini (courgette)

Fruits: bananas, berries (not blackberries or boysenberries), cantaloupe, grapes, grapefruit, honeydew, kiwifruit, kumquat, lemon, lime, mandarin, orange, passion fruit, pawpaw, pineapple, rhubarb, tangerine, tomatoes

Protein: beef, chicken, canned tuna, eggs, egg whites, fish, lamb, pork, shellfish, turkey, cold cuts (all prepared without added FODMAP containing foods), nuts (not cashews or pistachios), nut butters, seeds

Dairy and non-dairy alternatives: lactose-free dairy, small amounts of: cream cheese, half and half, hard cheeses (cheddar, Colby, Parmesan, Swiss), mozzarella, sherbet, (almond milk, rice milk, rice-milk ice-cream)

Grains: wheat-free grains/wheat-free flours (including gluten-free grains, which are free of wheat, barley and rye) and products made with these (e.g. bagels, breads, crackers, noodles, pancakes, pastas, pretzels, waffles); corn flakes, cream of rice, grits, oats, quinoa, rice, tapioca, corn tortillas.

Beverage options: water, coffee and tea, low FODMAP fruit/vegetable juices (limit to ½ cup at a time)”

To the above I would add:

  • Peanuts
  • Any food taken from the ground that are not on the list, especially bitter foods. The reasons are:
    • A normal healthy gut bacteria profile is very close to that found around underground foods — reflecting where our ancestors got their food supply (and how their gut got populated by bacteria by eating unwashed root vegetables).
    • Some foods have been breed to be less bitter (sweeter) than the natural wild variety. There is considerable evidence that the “bitterness” reflects compounds that are actually healthy for us.
  • 100% Rye Bread if you are of northern european extraction. There is a “rye/wheat” line across northern Germany. North of this, traditional wheat would not grow hence rye bread has been a norm for milleniums.