<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.

Below is a simple picture of the model that I use in understanding CFS. This model also leads me into certain direction for items to investigate.

How CFS happens and maintains itself

CFS starts by health gut bacteria incorporating foreign RNA when they reproduce. The RNA will often come from an acute virus. Stress increases the “willingness” of bacteria to incorporated RNA (trying to find something that addresses the stress), this may be stress-induced mutagenesis or adaptive mutation. The result is an alteration of microflora populations families. Bacteria have a friend-foe identification, so some species may flip to the dark side because of the new RNA.  Normally, the bacteria will eliminate these mutations over time and return to their prior state, however in some cases this will fail to happen (or take a very long time). In general, about 95% will return to normal in 6 months or less.  The remaining 5% will likely be diagnosed as CFS.

Once the bacteria population shifts, there may be dramatic changes of what the body gets, two examples:

• Decrease of E.Coli results in reduced NADH
• Decrease or L. Reuteri results in reduced B12

These changes allow past bacterial or viral infection to be come active in a similar manner to Chickenpox / Shingles — both are caused by the same virus. Chickenpox happens on initial exposure. Shingles is the reactivation. Most bacterial infections have resisters, sleeping cells of bacteria (antibiotics usually act by interfering with the reproduction – if some cells sleep through this, they can become active later given the right situation).

These reactivated pathogens contribute to the gut bacteria dysfunction. They also can increase coagulation (which interact with the inherited coagulation defects very often found in CFS patients) causing “fibrin-walled cities of pathogens” that cannot be reached by antibiotics or antivirals. Any bacterial reactivation can result in biofilms forming, creating additional protected cities of viruses and bacteria.

This is the model — there are many factors that may need to be addressed for effective treatment:

• Gut Bacteria dysfunction
• Fibrin Deposits / Coagulation
• Biofilms
• Reactivated virus
• Reactivated bacteria

Recently I found that the bacteria that produces/releases B12 was identified in 2003. There have been a half dozen articles confirming that this bacteria produces B12, as well as what encourages and discourages the amount produced.

This bacteria is part of a family that is known to be low in CFS patients… low population, low production seems obvious. The bacteria is Lactobacillus Reuteri. It is recognized as a seperate species in the Lactobacillus family. It is found in mother’s breast milk. It is the dominant Lactobacillus found in most species, so if the Lactobacillus population is low, L. Reuteri will be low.

There is a 2009 article that identifies what affects the production of B12 by this bacteria. The following are needed to a moderate degree (absence may result in a 20% reduction)

• alanine (Ala),
• aspartate (Asp),
• cysteine (Cys),
• glycine (Gly),
• lysine (Lys),
• proline (Pro)

However, isoleucine (Ile) appears to be essential. This amino acid is not produced by humans, but may be obtained from eggs, soy protein, seaweed, turkey, chicken, lamb, cheese, and fish. You can view a detailed list here.

Glycerol increases production by 5+ fold. See WebMD for information on supplementation.

• A Lactobacillus Reuteri and Lactobacillus Rhamnosus mixture is available
  • US Orders (mixture) [ 90 capsules $16]
  • UK Orders (mixture) [ 90 capsules £22]

Lactobacillus Rhamnosus has some significant benefits (I will cover it in a later post).