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>

Studies has found a 24 fold (2400%) more enterococcus in CFS than in controls. There is evidence suggesting that this situation also occurs in chronic Lyme. This family is very difficult to treat and is prone to develop resistance to the few antibiotics that produce any resistance. There are a very small number of non-prescription items that also inhibits enterococcus. For a background on this species see this LiveStrong article.

Known inhibitors

• Antibiotics – significant resistance has been reported
  • penicillin, ampicillin
  • Vancomycin – increasing resistance seen. A 1996 Lyme Conference report found that it worked when other antibiotics for lyme failed.
  • Amoxicillin with Cefotaxime – 1995 article
• Supplements: A review of the effectiveness of various herbs is in this 2009 PubMed Article. Remember we wish to avoid items that decreases E.Coli (or pulse (2 weeks) followed by Mutaflor for 2 weeks).
  • Azadirachta indica
    • US Orders [100 capsules $7]
    • UK Orders [100 capsules £9]
  • Ocimum tenuiflorum
    • US Orders [1 lb (450gm) $21]
    • UK Orders [500 gm £13]
  • Monolaurin:
    • Some species of E. are resistant,
    • used with bovines — so resistance will be increasing
    • improves vancomycin performance
      • US Orders [60 capsules (500mg) $11 [30 gm]]
      • US Orders [8 oz (220gm) $30 ] — best buy
      • UK Orders [90 Capsules(300mg) £20 [27 gms]]

Evidence suggesting that enterococcus is a player in chronic Lyme

The 1996 Lyme Conference report had a group of patients that did not respond to a host of other antibiotics, responded to vancomycin. Since the difference is effectiveness against enterococcus species, it suggests that this should be carefully studied.