Author Archives: lassesen

Unknown's avatar lassesen 12:00 am on November 28, 2012  

A mind altering supplement: Piracetam

Piracetam tend to be the most under utilized supplement for CFS/FM. The modes of action of piracetam and most of its derivatives remain an enigma, but we known that it impacts glutamate receptors. Glutamate dysregulation plays a significant role in CFS and FM, as well as mental fatigue. A 2011 study found genetic mutations (SNPs) of GRIK2 and NPAS2 appear to be involved with CFS [study].

Piracetam have decreased the severity of depression and fatigue in CFS Patients in studies. In normal people, it lowers depression and anxiety. It improves cognitive deficits/disabilities and reduces brain fog. It also reduces or correct psycho-emotional disorders. It easily passes into the brain.

Red blood cell deformity has been reported for CFS. It is one of very few supplements that have been demonstrated to reduce this. It reduces the effects of hypoxia (low oxygen delivery to the brain), skin color will often return.

On the coagulation vector for CFS and Lyme, it has significant impact.

  • Reduces platelet aggregation
  • Inhibits thromboxane synthetase or anti-thromboxane A2
  • Reduces von Willebrand’s factor and fibrinogen

I have seen CFS patients that were unable to add a column of numbers without great difficulty change in just 15 minutes to become math wizard (not only add quickly but suddenly able to understand algebra!).

In terms of risk, it appears to be far safer than aspirin and most herbs.

In this house we have 1 kilo of powder piracetam sitting on the shelf (cheapest way). Before you go to such large stockpiles, you should try a short course. In some parts of Europe it is still prescription (and often the first drug of choice for stroke). For many years, I got my supply from a friend in the Czech Republic where it was over the counter(“Nootropil” and “Lucetam”).

As usual, buying in bulk and making your own capsules reduces the cost by 50% or more.

Headache Warning!

Headaches can occur if you are low on choline   see:

Unknown's avatar lassesen 12:00 am on November 26, 2012  

Licorice – Glycyrrhiza

Preamble

When I came down with CFS about 1999, Licorice was one of the items that assisted me to full remission by 2001.

Licorice comes in several forms, we are NOT talking about a confectionery candy. There is a pure Licorice candy called Spezzata which Cap’n Dave introduced me to in 1999 and which I continues to use. The active ingredient is Glycyrrhiza.

What does it do?

It does almost everything that you really want from a supplement: PubMed studies report that it alters microfloras, is anti-bacterial, Inhibits viruses(including EBV via a unique mechanism, and rota-virus). It reduces inflammation, depression and crosses the blood-brain-barrier.

In terms of the thyroid, it increases the biological half-life of cortisol and potentiates the action of hydrocortisone.

It has been documented in patient studies to reduce symptoms — in fact, there are published reports of remission. This report is very creditable if EBV is the primary pathogen.

Three ways of taking

The report of remission was by dissolving taking 2.5 grams of extract dissolved in a pint of milk. Taking 40 grams/day as capsules did not result in remission.

The last  approach is using Spezzata and dissolving it in the mouth (possibly with warm milk, hot chocolate or a latte). This is my usual method.

Licorice may cause adverse interactions with some drugs so you should review any use of it with your medical resources.

Unknown's avatar lassesen 12:00 am on November 25, 2012  

Honestly! Chocolate!!!

By chocolate I means dark/bitter chocolate (85%). The dosages need to be at least 50-100 g per day (~ 2 oz) to replicate studies where they resulted in improvement and some patients being able to return to work. Note 85% chocolate has as much sugar in it as an apple, so the sugar hit is low. You may find that after a day or two, it is no longer a “treat” but something that you have to work on consuming the required dosage.

What does chocolate do? According to pub med studies:

  • changes metabolism at 40g/day
  • after 2 weeks, microfloras(gut bacteria is changed
  • reduce inflammation cytokines such as TNF, IL-10, as well as IgE
  • improves blood flow in the brain
  • reduces coagulation
  • reduces nitric oxide(NO) release – which various researchers deem very important (Martin Pall and others)
  • alters lactate, citrate, succinate, trans-aconitate, urea, proline, adrenaline, DOPA, 3-methoxy-tyrosine, methylamines, p-cresol sulfate, hippurate, etc .

And last, in terms of it’s impact on CFS patients, it improves symptoms with 20% of the patients in the study being able to return to work! Read the study yourself:

Thozhukat Sathyapalan, Stephen Beckett, Alan S Rigby, Duane D Mellor, Stephen L Atkin High cocoa polyphenol rich chocolate may reduce the burden of the symptoms in chronic fatigue syndrome Nutrition Journal

Sources:

  • One source is Trader Joe’s grocery stores — they have their own brand selling at < $2 for 75 grams.
  • Or online: (I’ve identified single (cheapest) orders that is just right for a single course)
Unknown's avatar lassesen 12:00 am on November 25, 2012  

CoQ 10

Coenzyme Q10, also known as ubiquinone, ubidecarenone, coenzyme Q, and abbreviated at times to CoQ10. It has many usages in the bodies from ATP to impacting the transfer of electrons in the body.

Studies found that ~70% of CFS patients improved with taking this supplement, especially with a reduction in the number of headaches. This rate of improvement is interesting because studies found that only 45% of CFS patients have low levels of CoQ10 (so you would expect only 45% to improve). Low levels are seen in various fibromyalgia. There have been no studies with Lyme or Irritable Bowel Syndrome.

The low levels of CoQ10 measured in the body are associated with worst headaches.

The mechanism of action is unclear, it improves mitochondrial function (the usual attempt to explain its impact) but it also reduces blood clotting. In other words, it may be used as part of the body anti-coagulation mechanism. Coagulation and headaches are associated — so how it helps is actually fuzzy for CFS/FM patients.

Marketing Versions?

There are many versions of CoQ10 sold as being “better”. Unfortunately, there is no evidence to support this marketing claim (Check PubMed yourself!). Without evidence, it is hard to recommend premium versions that will impact your supplement budget negatively. Often the cost of these “designer” supplements is 2 to 5 times more per mg.

The following items were selected for the lowest cost per mg of CoQ10.

The pricing is often contra-intuitative: For example on the Amazon.UK site, the same brand (and description) CoQ10 are:

So they charge more if they have to make less capsules!  This also illustrates that a supplement budget can be stretched a lot further by careful shopping.

Unknown's avatar lassesen 12:00 am on November 24, 2012  

Changing Microflora by Rotating Antibiotics

In 1999, I can down with sudden onset CFS. Once the diagnosis was made the challenge of treatment arose. My family practice MD did not know how to treat beyond trying to give symptom relief. The MD challenge me to find a way to treat… I still had periods of reasonable intelligence on some days. I also had done a Masters in statistical analysis of medical treatments…

After researching everything that was published, I ended up saying that no-one knows what causes this condition — tons of theories. I ended up with two protocols that had a high rate of remission being reported:

  • David Berg’s  use of Heparin to address hyper-coagulation of CFS patients (this has been confirmed to apply to Lyme patients also in 2009).
  • Use of long term antibiotics.

Both had a remission rate of 70+%. So if I did both, then my odds would be 91% for remission. I liked those odds. There were many protocols being proposed so the question became one of which one to pick. I opted for the protocol with the shortest time to remission and the highest incidence of remission: Cecil Jadin’s protocol.

Her protocol was very appealing because it was a grandfathered protocol. It had been used long before CFS or Lyme became medical conditions. This means that the risk of unexpected side-effects was much less than a newly created protocol.

It worked!  By 2001, I was in full remission and stayed there for eleven years. I went out of remission as a result of flu (that sent me to hospital) while under stress.

Re-Evaluating Jadin’s Protocol in light of Microflora

Jadin’s protocol does work for a considerable percentage of patients. The typical medical reaction when doing something that cures or improves a condition is to try to explain why it worked. For the use of antibiotics, the logical first-pass explanation is that it is impacting an infection in the body or the blood. There is a problem here…

The problem is that short term antibiotics should be sufficient. There are a few infections like TB that require long term antibiotics — but with those infections, the infection can continue to be detected. This was not always the case with CFS. Conclusion: long term antibiotics are not warranted.

If we do a second-pass on why Jadin’s protocol worked better than other protocols, we may conclude that it worked better because it’s rotation through different families of antibiotics resulted in different gut-flora species being reduced progressively until a healthy balance is re-established. Any single antibiotic will not do this. It also explains why the length of CFS and the length of treatment required have no relationship.

To recover means destroying the dysfunctional microflora which have settled into a steady state within 6 months of onset. Experience now makes sense.

Example of Antibiotics against one Microflora Species

My favorite probiotic is Mutaflor (E. Coli Nissle 1917) because CFS patients often have only 25% of the normal level of E.Coli. Worst still, E.Coli is usually reduced by lactobacillus species found in many common probiotics. The mutaflor people have identified which antibiotics it is sensitive to (and which it is not).

Anti-biotics Guidance for Mutaflor
May be taken with Efficiency reduced by
  • Clindamycin
  • Erythromycin
  • Metronidazole
  • Penicillin G
  • Quinupristin / Dalfopristin
  • Rifampin
  • Teicoplanin
  • Vancomycin
  • Cefsulodin
  • Amikacin
  • Amoxicillin / clavulanic acid
  • Ampicillin
  • Azlocillin
  • Cefaclor
  • Cefazolin
  • Cefoperazone
  • Cefotaxime
  • Ceftriaxone
  • Cephalothin
  • Chloramphenicol
  • Ciprofloxacin
  • Doxycycline
  • Gentamicin
  • Imipenem
  • Latamoxef
  • Mezlocillin
  • Nitrofuratoin
  • Norfloxacin
  • Pipemidic
  • Piperacillin
  • Tetracycline
  • Ticarcillin
  • Tobramycin
  • Trimethoprim / sulfamethoxazole

Antibiotics do not kill ALL of your gut flora. They reduce some species (but within each species there are species that may be resistant).

Summary

If you are a patient or a MD and wish to alter microflora via probiotics then consider Cecile Jadin’s protocol. It is typically 7-10 days on antibiotics followed by 2-3 weeks off. The weeks off should include aggressive use of non-lactobacillus probiotics and pre-biotics.