Levels of Remissions

The following comes out of my own experience. There is no literature on remission for CFS. It takes time for the body to “calm down” (i.e. reduce inflammation and immune response), it takes times for the brain to rewire itself and for unused synopsis to start working again, it takes time to get accustom to doing things and being social again.

Walking slowly thru remission is strongly recommended. I felt my remission was fragile for two years and made decisions based on that assumption. Do not put the remission at risk.

Level 1: Technical Remission

This one is very easy to define — would you walking into a new MD’s office meet the criteria for CFS/ME (according to whatever definition you were using). If the answer is No, you are in technical remission. Yes, you may still have many symptoms — but you are technically not defined as CFS/ME. What you are is another question.

Level 2: Able to do Work Simulation for 2 hr/day consistently

This may be something as simple of preparing and cooking a nice meal, 2 hrs of gardening, 2 hrs of house cleaning — without a break or payback on the next day. My work was computer programming — and I volunteer for 2hr/day for 6 weeks before I increased my volunteer hours to 4 hrs/day.

Level 3: Able to do Work Simulation for 4-5 hr/day consistently

The same as above but for more hours, it may include a regular 2 hr walk/hike every day or other non-strenuous activity. Again, the key is no payback on the next day. My own experience was keeping at this level with no issues for 2 months. It is important NOT to push beyond your envelope. Control your impatience.  I would call this and the prior levels,  tentative remission.

Level 4: Able to do a part time job or volunteering

The prior levels are done in a quiet control environment. Stepping into people contact and socialization is a major step. Dealing with strangers, demands from others (source of stress and thus risk to relapse). Again, two+ months is recommended. I would call this level, reconditioning remission.

Level 5: Return to a low stress job

The job should be 30-40 hrs/week. With executive function being impaired, look for jobs that are being a worker and not a boss. This can often be hard for CFSers because they are often driven individuals. I would call this level, effective remission. You should be able to continue to full remission if nothing stupid happens.

Level 6: Able to take a normal (not high stress) job

Forget ever taking a high stress job again! If a change of manager results in it becoming high stress, do NOT stick it  out. Start planning on an exit strategy (quietly) and then do it. Be smart, not combative.

At this  point, I would call it full remission.

Know your symptoms for a possible relapse: my own are a dry stress cough showing up, re-appearance or increase of psoriasis, and lastly — my wife telling me that she sees stress in me.  With CFS/ME, you only get one warning shot! The second shot is likely going to hit you and may take you down.

This is one of three posts going out today. They are related but because of the length of each, a separate post is likely better for CFS readers. The posts are:

• Followup on a reader’s progress. You may see the prior post from December 2015 here. She got whooping cough not long after that report, which set her back. She has been using the model, adapting it by experiment and experience.
• A post on what Remission is. She feels that she is approaching at least partial remission and want some guidance from my experience
• A post trying to re-illustrate what it means to be a model and not a protocol. The reader used the model and evolved her own protocol.

Overview Summary

Right before I started following this protocol, I was sleeping 12 – 18 hours per day, and had been for more than a year. Right before I quit my job I took two business trips. I kept having to break from meetings in order to sleep and it was very embarrassing. I had previously been low energy at times but this was worse than anything I experienced before. It would take everything I had to concentrate for 1.5 hours and then I would have to sleep at least a little bit in order to be able to think clearly.

That pattern almost without change for a year. I had about 1.5 hours good time in the am and 1.5 hours good time in the p.m. and the rest of the time I was sleeping or resting. Occasionally when I had to get something done I would down a bunch of energy drinks or something and power through the day and be really productive but I couldn’t do it very often. Sometimes I just slept all day.

So I would describe that as being at about 15 – 20 percent of a normal energy level.

As soon as I started this protocol, my energy level began improving markedly. (Keep in mind I also started allergy shots and got a tooth filled). I would say I had two weeks at about 50 percent energy and then about two weeks at 85 or 90 percent energy. It was amazing.

Then things started to fade, maybe back to about 40%. I thought at the time it was just the effectiveness of the various herbs and probiotics wearing off but *maybe* it was that having been exposed to the whooping cough and was in my incubation period.

I got sick very suddenly over about a 5 hour period while on a long drive over Christmas with what seemed to be bronchitis and was flat out in bed for six days. We were on vacation visiting family. On the seventh day, I pulled it together to drive home, which was SO LUCKY because two days later the whooping started and I was having uncontrollable coughing paroxysms and vomiting up to about 20 times a day. I didn’t actually feel sick really but I couldn’t really do anything, and driving would have been very unsafe. That was right around January 3.

I slept as much as I could through January, with the coughing/vomiting fits diminishing to once or twice a day. Family events …and there was a lot of family responsibility and stress that came with that, and I had days when my energy level was great followed by days of zero energy.

My life stabilized a bit in early March and I’d say that since then I’ve gone from an energy level of about 40 percent a day to now where I’m at about 60 – 70 percent. Not high energy but enough to get by, and trending positive.

December 2015:

•  You said in your notes accompanying the post from me that I may have just happened to use the right herbs and probiotics for me right out of the gate. This is true, and it wasn’t an accident – it is because I had figured for a long time that histamine had something to do with my problems. About 10 years ago I tried the histamine-restricted diet and it worked immediately but it is very challenging to stick with and I just couldn’t do it after I had kids. I mean, I continued to avoid lots of stuff but I could no longer be a perfectionist about it. That’s why I started taking a daily antihistamine about 8 years ago and it did help with my symptoms. 
• So, when I read your post about histamine-related CFS I was like, Bingo, that is it, and that’s when I started this.

• Today, I re-read some of your posts on the subject, as well as the comment from someone who’d had initial success with treatment and then a gradual return of symptoms, which may have been a result of him shifting his pro-biotics. For myself, I was initially taking tumeric but stopped for about a month, and I just started it again. I also started taking the original form of B. infantis I was using – Babylife – which delivers more than Align (I got it at Natural Grocers for about 14 bucks in the refrigerator section. It has 3 billion living organisms per scoop and an adult dose is up to 6 scoops per day. Maybe that’s not the same as CFUs…perhaps you can enlighten me.) So I don’t know which it is but thought I would share that.  I think most of my B-infantis probably got knocked out before I was two because I had pneumonia twice when i was a baby.

• I tried the chocolate treatment last night. Even though I love chocolate it’s going to be hard to choke down that much of it for two weeks. Anyway, it was interesting. After an hour or more I bloated, very painfully, for the first time since I started this whole process. Probably consistent with a big histamine-producing bacteria die-off. I drank some golden milk (tumeric) to try to ease the symptoms, and then before I went to bed piled on with oregano, tulsi and neem. I realize this is probably not what you are supposed to do. But, anyway, I woke up feeling great, and I am attempting to down my second dose of chocolate, which I am going to follow with a mega-dose of B. infantis. I will let you know what happens. 

• I have been thinking about ways to just incorporate this stuff into my diet and I looked up a recipe for dark mole sauce, which seems to contain many of the recommended histamine-releasing herbs, for example clove and cinnamon, as well as chocolate. I have never had it but I think I am going to try some over chicken soon.

• Based on your experience, I have started eating rye (I too have Scandinavian heritage) in the form of cooked rye berries, which can be used like rice or pasta for stir fry, salad, rice pudding-type dishes, etc. It really agrees with me and I thought I would mention it to you because you have talked about rye bread but not berries, which I like even better than bread. 
•  We’ve introduced cumin at our dinner table to be used as a condiment like salt and pepper. It is basically delicious on everything. I realize it’s not one of the main helpful herbs but I think it is positive. 
• Another relatively trivial thought — what I have notices since starting this is that I haven’t lost weight at all but my stomach is much flatter and I don’t bloat, which is an improvement. 🙂

February 2016

“Last I wrote to you I think I said I was hanging in there but had just got whooping cough. I still have it and am about six weeks into it. On the bright side, I do think some of my overall improvements are still holding. On the down side, it’s a long illness, and probably like many illness is capable of messing up the microbiome on it’s own, plus it has some characteristics that probably enhance the microbiome mess-up for the person with CFS or a related syndrome. Namely, the frequent vomiting that goes with whooping cough makes it difficult both to eat healthy foods, especially veggies (at least for me), and it’s difficult physically to swallow supplements and when I do I frequently throw them up.  

So the challenge is keeping the CFS treatment going. In a way, though, it’s been a good opportunity to rotate off some stuff, which I have done, and now I am starting to be able to swallow pills again, so I am re-starting the Vitamin D, Magnesiam, B6, and am also taking olive leaf, Triphala, alpha lipoic acid, and Swansons Lactobacillus Gasseri. I’m waiting for Miyarisan to arrive – the delivery has been delayed for over a month. And I am thinking about where to go after a few weeks of Miyarisan. I’m thinking of ordering Mutaflor and also the stuff…Bifido Maximus? That’s aimed mostly at the histamine issue.

On the bright side, most of my previous symptoms have not come back (sore skin, bloodshot eyes, uncomfortable/painful feet, swollen lymph nodes, asthma symptoms) so I feel like I am still ahead of the game compared to where I was when I started this in early October.

April 2016:

“By the way, in case you don’t remember, I’m the person who had the “miraculous” healing in October-November who then got whooping cough.

Just to keep you updated,  I’m now 90% symptom free from the whooping cough, and I feel like my energy level, which took a dive when I got sick but not as much as one might expect, is now improving and stabilizing again. Last month, I was using Neem as an anti-microbial/anti-inflammatory, and I think it worked very well. I tried using Olive Leaf just before that, with less satisfying results (but maybe I had a bad bottle), and I also used Triphala (which contains Haritake) and that seemed actually counter productive. As an adaptogen, I used Ashwaganda, which I liked, and now I’m out of it.

But I seem to have gotten quite a bit better mostly in the past couple of weeks, and here is what I have been taking (and my reasoning)

• Tulsi (As an adaptogen. I can’t figure out if it’s anti-microbial or not)
• Ginseng (As an adaptogen)
• Magnesium 500 mg
• Vitamin D 15,000 – 2000 mg
• Vitamin C 1000 mg
• Alpha Lipoic Acid (2 per day)
• Bromelyn (2 per day)
• Culturelle (since it helps with Vitamin D absorption) (1 per day)
• Cardio Viva (since it helps with Vitamin B12 production) (2 per day) [Lactobacillus reuteri NCIMB 30242]
• Align (1 per day)
• Prescript Assist (1 pills per day)
• Yakult (occasional, as a mood lifter – I was taking it consistently before)

Also allergy shots, an antihistamine, Advair 2X per day and Flonase.

I was taking 6 pills of Miyarisan per day and liking it a lot – among for one thing it seemed to be flattening my stomach … I have more on order.

And I’m very excitedly awaiting the arrival of my Symbioflor II which I will NOT take with Miyarisan.

Also, I am starting to exercise a *tiny* bit and am trying to be very mindful of how my body responds. I think I am feeling a little fatigued a day after exercise (I did 45 minutes of easy yoga one time, and played a little bit of beginner tennis [mostly to get my son out of the house]) but then am rebounding quite a bit stronger a day or two after. I have done just a few pushups, (like 3) which are far, far easier than when I was in the depth of my fatigue this time last year when I couldn’t even do one.

And in further good news a few days ago it was as if the gears realigned in my head and I am feeling mentally and emotionally capable of taking on my job search.

I’ve also started reaching out to people more than I have in years – because I feel good enough to do it – and then that is having a positive spiral effect.

But I am going to continue to be careful to pace and so forth. I don’t consider myself to be actually “in remission” yet – it feels like all of this could disappear tomorrow. How does one tell if one is officially in “remission?”

Comments

• Neem and Tulsi are preferred over Haritaki. Haritaki also reduces E.Coli with other of the overgrowths. It’s more of a “Hail Mary” herb.
• I will look at Advair  and Flonase. in a future post, I am curious. The question of how different antihistamine acts has come up in some conversations recently.

I have been active with support groups for over 15 years, with CFS and without CFS.  I was the main moderator of CFSFMExperimental on Yahoo now, originally on eGroups.

I disabled the group (archives are still there, and very rich for experiences trying various things). The reason that I turned it off was that it drifted into a social support network and not Experimental treatments for CFS/FM.

During that time I observe many issues and problems. I want to share my observations:

• CFS patients are often desperate — and have brain fog.  This means that anyone promising the moon will often be believed based solely on their words or claims.
  • The people who read these claims will often have placebo effects and post glowing results — which feed the belief frenzy.
  • Overtime, the reality is exposed BUT the material stays on the internet and is believed by the next generation of CFS suffers…  None of the CFSers have the brain cells to research.
  • For me, the only practical solution is “show me the PubMed studies“
  • A few examples (some harmless except for the bank account, others that were disasters for some patients that have still not returned to their prior state) are the Blasi Protocol from Spain (Recuperation mineral supplement), Ampligen, Marshal Protocol.
• CFS patients are easy targets for con-artists . CFS patients are not rich targets but because of brain fog, they are easy targets. CFSer often suffer from no support or help — if a person appears pleading for help, they feel great empathy and try to help — often this results in money being sent to a con artist.
  • Never send money to a CFSer that you do not know physically and can verify they are what they claim.
  • There is greater community good by you spending that money on getting yourself better and back to work, then donate some of your surplus earnings appropriately (to organizations, or select individuals)
  • Be very aware that a lack of executive decision ability in CFS will often result in an expensive set of supplements that you send to someone sitting on the shelf, unused for years and years.
    • Supplying supplements is good, but go for the cheapest effective ones (for example 5000 IU capsules of Vitamin D3) and monitor if they are actually being used!
    • Ask for postage to be reimburse!! This simple, reasonable request will often separate the chaff from the wheat. Both are CFS patients, but one is exhibiting the ability to take your kindness and bootstrap their recovery.
  • CFS patients can often become very dependent on anyone that show kindness. They are desperate for help. Most CFS patients do not have the reserves to deal with a dependent person — they have severe needs themselves.
  • There are always local groups! My Seattle group help each other in providing information about dealing with government and the best local MDs to go to , etc. This is awesome and the right way to help — provide information. 
• CFS support groups often result in poorer outcome for patients (Yes, there are pub med studies finding that).  The reason is simple, shared misery results in greater acceptance/resignation to the condition. Also, it is a social community — often the only one left; people want to belong. If they recover, their relationship to this important community in their life will radically change.
• CFSers often get totally focused on one thing and do not have mental ability to think clearly. Never try to correct them, instead provide information gently and then step away — “I disagree” –> “Each to their own thoughts”

 Bottom Line

Your heart is in the right place, brain fog can impact your decision making badly, especially in the “look ahead at longer term consequences”. Care about others, accept your limitations and keep well within your limits. Deal with the illness in yourself (the splinter in your own eye), before getting actively involved with illness of others.

This post examines four conditions that can be co-morbid, which fits the microbiome model. The differences may  be a combination microbiome strains and DNA SNPs. I have already posted about SNPs associated with MCS in this page (which I just updated).

• MCS – Multiple Chemcial Sensitivity
• EHS – electro-hypersensitivity
• IEI – idiopathic environmental intolerances
• MDAS –  multiple-drug allergy syndrome
  • hyper sensitivity to drugs is common with CFS/IBS/FM
• NS – noise-hypersensitivity (hyperacusis)  – prevalence ~ 3.7% in general population [2016]
  • Associated to Lyme [2002]

“Diagnosis of MCS can be difficult because of the inability to assess the causal relationship between exposure and symptoms. No standardized objective measures for the identification of MCS and no precise definition of this disorder have been established.” [2016]

• MCS affects middle-aged women with comorbidities (chronic pain, fibromyalgia and chronic fatigue)[2016]
  • “relation between noise and odor sensitivity reflects a general environmental sensitivity.” [2013]
  • “The estimated prevalence of MCS was higher among allergic patients than non-allergic participants. People with experience of dwelling in a new house and atopic dermatitis were more at risk of being intolerant to chemicals” [2014]
    • “Chemical Sensitivity Factor was associated with allergies and alcohol use.” [2012]
• “Much of the controversy over the causes of electro-hypersensitivity (EHS) and multiple chemical sensitivity (MCS) lies in the absence of both recognized clinical criteria and objective biomarkers for widely accepted diagnosis…” [2015]
  • “Near 40% had a increase in histaminemia (especially when both conditions were present),”
  • “. Both disorders were associated with hypoperfusion in the capsulothalamic area, suggesting that the inflammatory process involve the limbic system and the thalamus. Our data strongly suggest that EHS and MCS can be objectively characterized and routinely diagnosed by commercially available simple tests”

• ” Positron emission tomography activation studies with several different odorants showed in patients with odor-associated symptoms an odorant-related increase in activation of the anterior cingulate cortex and cuneus-precuneus in comparison with a control group.” [2008]

• “confirming MCS altered (P < 0.05-0.0001) glutathione-(GSH), GSH-peroxidase/S-transferase, and catalase erythrocyte activities.. Severe depletion of erythrocyte membrane polyunsaturated fatty acids with increased ω 6/ ω 3 ratio was confirmed in MCS, but not in EHS…. identified significantly altered distribution-versus-control of the CYP2C19∗1/∗2 SNP variants in EHS, ” [2014] – i..e. this has a DNA component
  • ” high chemical sensitive individuals diagnosed by using Japanese criteria as MCS patients were more significantly associated with SOD2 polymorphisms.” [2013]
  • ” Interestingly, the NOS3 -786TT genotype was associated with increased nitrite/nitrate levels only in IEI patients… the (CCTTT)16 allele discriminates MCS..Here, we first demonstrate that NOS3 -786T>C variant affects nitrite/nitrate levels in IEI patients and that screening for NOS2A -2.5 kb (CCTTT) n polymorphism may be useful for differential diagnosis of various IEI. “[2015]
• ” We identified 183 substances whose levels were beyond the normal detection limit. The most prominent differences included significant increases in the levels of both hexanoic acid and pelargonic acid, and also a significant decrease in the level of acetylcarnitine in patients with MCS.” [2016]
  • “suggest that acetyl L-carnitine 1500 mg/day (500 mg t.i.d.) is also efficacious in improving depressive symptoms, pain, and the quality of life of FMS patients.” [2015]
  • ” these results indicate that LAC may be of benefit in patients with FMS, providing improvement in pain as well as the general and mental health of these patients.” [2007]
  • “. Our data show that administering ALC may reduce both physical and mental fatigue in elderly and improves both the cognitive status and physical functions.” [2008]
  • ” Preliminary evidence of a relation between post-infectious fatigue and mitochondrial dysfunction indicates a complex response involving acetylcarnitine”[2006]
  • “Significant differences in plasma acetylcarnitine [41,42] were reported in CFS, while others found no difference [43,44]. There are several explanations for this discrepancy. One explanation could be that the selection of CFS patients differed. The patients of Kuratsune et al. [41,42] were selected according to the CDC criteria, but Jones et al [43] used the Oxford and CDC criteria.” — bacteria determines symptoms, symptoms determine selection. [2006]
    • “Of the 99 [CFS] patients investigated, 58 reported a decrease in the symptoms by the use of azithromycin. These responding patients had lower levels of plasma acetylcarnitine.”  [2006]
• “Plasma levels of substance P, vasoactive intestinal peptide and nerve growth factor, but not histamine, were elevated in patients with self-reported multiple chemical sensitivity (sMCS). Exposure to volatile organic compounds (VOC) increased plasma levels of all parameters in these patients, while it had no effect in normal subjects or patients with atopic eczema/dermatitis syndrome (AEDS).” [2004]
• ” The phenomenon of electromagnetic hypersensitivity in the form of dermatological disease is associated with mastocytosis. The biopsies taken from skin lesions of patients with EHS indicated on infiltration of the skin layers of the epidermis with mastocytes and their degranulation, as well as on release anaphylactic reaction mediators such as histamine, chymase and tryptase.” [2015]
• “Our data show an increased prevalence of metal allergy and elevation of mercury levels in bio-indicators among patients with MCS.” [2013]
• ” the histamine-releasing activity of plasma from patients with MDAS was significantly increased and correlated with [Hyper coagulation] F(1+ 2) levels (r = 0.68; P = .04).” [2008]

Discussion

Some of the studies suggest (speculate) that the section of the brain that is over activated in a MCS/EHS reaction has become “hard-wired” to over react. This smells of “it’s all in your head and not real” view. Other areas of the brain alteration have been associated with microbiome shifts, so the hard wired aspect or psychological aspect is not probable.

My own experience is that I had mild MCS during one episode which disappeared afterwards. Not 100% disappear, I do notice some reaction to various chemicals in sufficient concentration — but I then remove myself quickly, and the reaction disappear quickly. From this experience, I infer that MCS/EHS may have a significant microbiome dimension. I prefer this view, because it gives hope for treatment and improvement.

I personally deal with two individuals that have MCS and hyperacusis; they also have severe problems with histamine. One of them had a full coagulation panel done just before a bad MCS exposure. Two weeks after the exposure, a second panel was done on this person and the indicator for active coagulation jumped extremely high (i.e. 6 Standard Deviation higher than it was before). Both went through the antibiotic rotations of Jadin without any change of THIS symptoms. Hence, those antibiotics are not good candidates for treating MCS.

Interesting Case

“Immediately after taking 2-3 bites of cooked salmon, a clerical worker developed oral burning, urticaria, and asthma. In the emergency department, she was diagnosed with “allergies”; scombrotoxinism was never considered. She then developed wide-ranging symptoms (e.g., chronic fatigue, asthma, anxiety, multiple chemical sensitivity, and paresthesiae) and saw many specialists (in pulmonology, otorhinolaryngology, allergy, toxicology, neurology, psychology, and immunology). During the next 500+ days, she had extensive testing (allergy screens, brain MRI, electroencephalogram, electromyogram, nerve conduction velocity, heavy metal screen, and blood chemistry) with essentially normal results. She filed a workers’ compensation claim since this injury occurred following a business meal. She was evaluated by a Qualified Medical Evaluator (GL) on day 504, who diagnosed scombrotoxinism.” [2015] [Full Text]

Normally, “Symptoms typically occur within 10–30 minutes of ingesting the fish and generally are self-limited. …. However, symptoms may show over two hours after consumption of a spoiled dish. They usually last for about 10 to 14 hours, and rarely exceed one to two days.”[Wikipedia] In this case, it persisted for over 500 days… with antihistamines being ineffectual.  Morganella morganii is one bacteria that is associated with this condition. ” some M. morganii strains are resistant to penicillin, ampicillin/sublactam, oxacillin, first-generation and second-generation cephalosporins, macrolides, lincosamides, fosfomycin, colistin, and polymyxin B” [Wikipedia]

“Others, especially the Enterobacteriaceae, are contaminants that are introduced post-harvest. It is this second group that is considered most important in the development of histamine.” [Food Safety Watch] Enterobacteriaceae are one family of bacteria that are reported as major overgrowth in CFS.

Treatment Speculations

If you have low acetylcarnitine, then the antibiotic azithromycin (a macrolide) and  acetyl L-carnitine 1500 mg/day (500 mg t.i.d.) may help. Rotation to different macrolides  see macrolide page for a list of them), with Telithromycin and Solithromycin being interesting because they are not widely used (and thus more unlikely to be resistant).

Enterobacteriaceae and M. morganii are suspects. With the high degree of antibiotic resistance, the benefits of doing rounds of (different) antibiotic resistance is questionable. There were no published studies on antibiotics and MCS that I could locate. I could not find any studies using fecal transplants for MCS or EHS — positive results of such studies would likely confirm a microbiome aspect.

Bottom Line

All of these conditions appear to be connected to excessive release of histamine into the body and possibly link back to Enterobacteriaceae overgrowth . This could be normal release coupled with an excessive background level of histamine due to overgrowth of some bacteria, or a mis-signalling for histamine release. Often the body has a Ying/Yang aspect. The signal to release is combined with a signal to constraint. If the signal to constrain is inhibited, excessive histamine may be released.

Hexanoic acid  and pelargonic acid being high may lead to identification of the bacteria because these chemicals  tend to be used as antibacterials against many species. This hints that the bacteria(s) causing this condition produces them against other bacteria.

• “some natural microorganisms have been screened and evolved to produce hexanoic acid,” [2014]

 
An experience
A reader wrote that after a bad MCS exposure,
  she took a full dosage of Mutaflor and Symbioflor-2. She slept hard and almost all of the symptoms were gone afterwards.

Lactobacillus sporogenes is a name that is often incorrectly used when discussing Bacillus coagulans. It is part of a long standing trend to hide the actual ingredients in products by using latin names, former names and other obtuse references. Often you need to get the help of a librarian to actually find out what something is.

• “B. coagulans SL5 produced the maximum amount of histamine” [2013] this a risk for the subset of CFS patients who have histamine issues.

IBS

• Bacillus coagulans significantly improved abdominal pain and bloating in patients with IBS. [2009]
• “There was a significant decrease in the clinical symptoms like bloating, vomiting, diarrhea, abdominal pain and stool frequency in a patient group receiving B. coagulans MTCC 5856 when compared to placebo group (p < 0.01). Similarly, disease severity also decreased and the quality of life increased in the patient group receiving B. coagulans MTCC 5856 when compared to placebo group.” [2016]
• “Bacillus Coagulans improves abdominal pain and diarrhea in IBS patients.” [2014]

Fibromyalgia and CFS – No studies

And nothing on coagulation

• Is killed by oregano [2009], turmeric [1999]

Bottom line

It provides symptom relief for IBS only and is easily killed by herbs and spices. It is unlikely to be a good use of limited funds.