2002 TG PDF (Web)

Transcription

2002 TG PDF (Web)

HEALTHwatch
Pro Health’s Newsletter on Chronic Fatigue Syndrome & Fibromyalgia
2002 Volume XI, No. 3 Special Edition Treatment Guide
Special
Edition
NEWSLETTER
Your CFS & Fibromyalgia
Health Resource
2040 Alameda Padre Serra, Suite 101
Santa Barbara, CA 93103
www.immunesupport.com
Annual CFS & FM Treatment Guide
Featuring Treatment Protocols from 6 Leading Doctors
Dear Reader,
Following our recent announcement
that Healthwatch would be available
only by subscription in the future,
we heard from many of our loyal
customers who were concerned about
losing this valuable resource due to
fi xed income limitations. In response
to this feedback, we sought out and
obtained new funding sources to help
cover our mailing costs, and have
taken steps to decrease these costs in
order to once again offer Healthwatch
to you free of charge.
In future issues you will see evidence
of these cost-cutting measures,
including reduced mailings (three
instead of four issues per year), format
changes and advertisements. Of
course, you can continue to count on
the informative, high quality articles
from leading CFS and FM experts
that you have come to expect from
Healthwatch over the years.
We thank you for your support
of Healthwatch, and are pleased
to be able to continue publishing
this resource for you. We remain
committed to our mission of being
the premier source for health-related
information, comprehensive
treatment solutions and patient
advocacy, which empowers people to
take control of their health.
We encourage you to share the
information you find in these
newsletters with your family, friends,
patients, and health professionals.
Wishing You the Best in Health,
e Pro Health & HEALTHwatch Team.
Effective Treatment of CFS & FM
Charles Lapp, M.D.
Charles Lapp, M.D., is nationally recognized and sought after as a medical consultant
regarding CFS and FM. He is Co-Chairman of the Clinical Affairs Committee for the
American Association for CFS, medical advisor to the CFIDS Association of America,
and a board member of the American FM Syndrome Association. Dr. Lapp is currently
Director of the Hunter-Hopkins Center, P.A., Medical Consultations, in Charlotte,
North Carolina, where he is a practicing physician, and is also Assistant Consulting
Professor at Duke University Medical Center in Durham, North Carolina.
ImmuneSupport.com: When did you first become aware of Chronic Fatigue Syndrome
(CFS) and fibromyalgia (FM) as valid illnesses with real symptoms (what were the circumstances)?
Dr. Lapp: I had never heard of CFS or FM until 1984, when the VP of a Fortune 500
company came to me and described a debilitating illness that was triggered by the flu, and
prevented him for working more than 1-2 days per week. Soon after I began researching
his case, a similar case presented to my office, then another, and another. Before long it
became clear that many of these cases were related, so I called the CDC to report a possible
epidemic. e CDC put me in touch with two other groups (Dan Peterson and Paul
Cheney in Lake Tahoe, and David Bell in Lyndonville, NY) who were experiencing similar
epidemics in their towns, and thus began my new career and ambition!
Continued on page 3
Daniel J. Clauw, M.D.
Daniel J. Clauw, M.D., is the Scientific Director of the Georgetown Chronic Pain
and Fatigue Research Center, and the Chief of the Division of Rheumatology,
Immunology, and Allergy at Georgetown University Medical Center. Dr. Clauw has
been involved in the clinical care of, and research into, overlapping conditions such as
fibromyalgia, Chronic Fatigue Syndrome, Gulf War Illness, and Multiple Chemical
Sensitivity, and is widely recognized as a leading authority on these illnesses.
ImmuneSupport.com: When did you first become aware of
fibromyalgia as a valid illness with real symptoms (what were the circumstances)?
Dr. Clauw: While in training as a rheumatology fellow. Most of my mentors believed that
fibromyalgia was a real illness and taught me that. I was lucky in that regard, because many
rheumatologists of that era (and some of the present era) did not believe that fibromyalgia
was a “real” problem, and certainly would not recommend that their junior faculty do
research on this condition.
Continued on page 11
R N B
Kenny De Meirleir, M.D., Ph.D., Joins Pro Health’s
Scientific Advisory Board
Promising New Treatment for Chronic Fatigue
Syndrome: Procrit
Pro Health, Inc., is proud to announce that Kenny De Meirleir,
M.D., Ph.D., a renowned CFS clinician, has joined our Scientific
Advisory Board. Dr. De Meirleir is professor of physiology and
medicine at Vrije Universiteit Brussel in Belgium, where he is
also director of the Human Performance Laboratory and Fatigue
Clinic. Since 1990, Dr. De Meirleir has seen thousands of patients
struggling with chronic fatigue at the university-based clinic in
Brussels. He is a member of the board of directors of the American
Association for Chronic Fatigue Syndrome, and is board certified
in internal medicine (since 1982) and cardiac rehabilitation (since
1986) in Belgium.
e Behavioral Medicine Research Center at the University of
Miami is conducting a study funded by the National Heart, Lung,
and Blood Institute of the National Institutes of Health. Dr. Barry
Hurwitz, Ph.D., and Dr. Nancy Klimas, M.D., are the principal
investigators. e study is investigating a very promising potential
treatment for Chronic Fatigue Syndrome (CFS). e study is a
placebo-controlled clinical trial in which Procrit is prescribed
to the participants for 13 weeks. Procrit is a drug that has been
used for over a decade to treat anemia, which is low red blood cell
volume. e drug increases the production of red blood cells, which
has been discovered to be low in many CFS patients. Because
the red blood cell delivers oxygen to the body, it is projected that
this treatment may reduce the debilitating fatigue experienced by
individuals with CFS. For more information about the study, visit
http://www.bmrc.miami.edu/research/niaid/procrit.aps.
Dr. De Meirleir serves as editor of the Journal of Chronic Fatigue
Syndrome (2002). He has authored or coauthored several hundred
journal articles and books on internal medicine, cardiology, exercise
physiology, and Chronic Fatigue Syndrome (CFS). Currently, Dr.
De Meirleir conducts rigorous research on the etiology, diagnosis
and treatment of CFS. In addition to his research and teaching,
he serves as president of a medical disciplinary committee and on
a provincial medical regulatory commission. He is co-editor of the
groundbreaking new book Chronic Fatigue Syndrome: A Biological
Approach (CRC Press, 2002) which presents his novel research
into the causes and pathogenesis of CFS. In his introduction to
the book, Daniel L. Peterson, M.D., writes, “Chronic Fatigue
Syndrome: A Biological Approach is a monumental and landmark
publication. It represents years of clinical and basic research and
will form the firm foundation for future research and understanding
of Chronic Fatigue Syndrome and related disorders.”
New Brain Scan Study Finds Proof of Fibromyalgia Pain
A new brain-scan study confirms scientifically what fibromyalgia
patients have been telling a skeptical medical community for years:
ey’re really in pain. e results, published in the June 2002 issue
of Arthritis & Rheumatism, the journal of the American College
of Rheumatology, may offer the proof of fibromyalgia’s physical
roots that many doubtful physicians have sought. Lead authors
Richard Gracely, Ph.D., and Daniel Clauw, M.D., did the study at
Georgetown University Medical Center and the National Institutes
of Health, but are now continuing the work at the University of
Michigan Health System. To correlate subjective pain sensation
with objective views of brain signals, the researchers used a superfast form of MRI brain imaging, called functional MRI or fMRI,
on 16 fibromyalgia patients and 16 people without the disease.
As a result, they say, the study offers the first objective method
for corroborating what fibromyalgia patients report they feel, and
what’s going on in their brains at the precise moment they feel it.
And, it gives researchers a road map of the areas of the brain that
are most - and least - active when patients feel pain.
Dr. De Meirleir joins other highly respected CFS and FM experts
on Pro Health’s Scientific Advisory Board, including Robert
Bennett, M.D., Ph.D., Daniel Peterson, M.D., Jacob Teitelbaum,
M.D., William Crook, M.D., Jay A. Goldstein, M.D., and
William Maguire, M.D., Ph.D.
Scientific Advisory Board
Robert Bennett, M.D., Ph.D.
Oregon Health Sciences University, Portland, Oregon
William Crook, M.D., President and Founder
International Health Foundation, Inc., Jackson, Tennessee
Jay A. Goldstein, M.D., Director
e Chronic Fatigue Syndrome Institute, Anaheim Hills, California
William Maguire, M.D., Ph.D.
Harvard Medical School, New York Medical College, M.D.
Kenny De Meirleir, M.D., Ph.D.
Vrije Universiteit, Brussel, Brussels, Belgium
Daniel Peterson, M.D.
Sierra Internal CFS Center, Incline, Nevada
Jacob Teitelbaum, M.D.
National Research Center, Annapolis, Maryland
HEALTHwatch is published by:
Pro Health, Inc.
2040 Alameda Padre Serra, #101
1-800-366-6056
Editor: Lee Ann Stiff
Graphic Designer: JD Reive
IV Lignocaine (Lidocaine) Promising in Fibromyalgia
Treatment
Patients with fibromyalgia who have not responded to standard
treatments may benefit from an intravenous infusion of the
anesthetic lignocaine (lidocaine), according to results of a pilot
study presented at the British Society for Rheumatology meeting
in May 2002. Although the results are preliminary and the therapy
is still considered to be relatively risky, researchers say they are
promising enough to warrant further investigation. Dr. J. H.
Raphael, of the Dudley Group of Hospitals in West Midlands, and
colleagues offered intravenous lignocaine to 55 patients who failed
to respond to physical, psychological, or traditional pharmacological
therapy and had no cardiac conduction abnormalities. After
treatment, they asked patients to recall how much pain they felt
before and after therapy. Among 50 patients who responded to
the questionnaire, the median pain score dropped from 9 before
treatment to 5 after (p < 0.001), based on an 11-point rating scale.
e effect of the therapy reduced depression from a median of 8
to 5, dependency from 8 to 5, and ability to cope from 9 to 5, all
statistically significant (p < 0.001), the investigators reported.
Disclaimer: HEALTHwatch is published for individuals, health professionals and others
interested in CFS and Fibromyalgia. Any nutritional supplements discussed in
HEALTHwatch are not intended to diagnose, treat, cure, or prevent a disease, but rather
are dietary supplements intended solely for nutritional support.
© 2002 HEALTHwatch
For permission to reproduce any of the information contained in this publication,
please contact the Editor at: [email protected].
Continued on page 15
HEALTHwatch
Special Edition Treatment Guide

www.ImmuneSupport.com
E T  CFS  FM: continued from page 1
where a whole family is exposed to the same illness, or several
people are involved in the same wreck, but only one has symptoms
that persist and go on to behave like CFS or FM. e questions
are, what is the change that takes place and who is susceptible.
I personally feel that genetics explains the susceptibility. Dr.
Klimas has shown that PWCs frequently have several HLA
types (i.e., genotypes) in common, while Dr. Buchwald’s twin
study is suggesting that many twins have common physiological
abnormalities, whereas only one may have been exposed to the
“trigger” that causes CFS or FM. At the current time, leading
contenders for “the change” include persistence of RNaseL, discreet
immune changes, abnormalities in the central nervous system
(perhaps low blood flow) or infection by persisting or intracellular
organisms. Unfortunately, none of these predictions so far can
explain all of the symptoms that we find in CFS/FM, so it is
possible that CFS/FM is multifactorial or that the real culprit is
unidentified yet.
[Charles Lapp, M.D.]
As you probably know, Paul, David and I collaborated together in
Charlotte, North Carolina, for several years, during which time we
pretty much set the foundation of our clinical knowledge today.
Most doctors who study both CFS and FM find the two disorders
so similar that we consider them “identical” for all intents and
purposes. ere are some subtle differences, however. CFS is
most likely triggered by an infectious or flu-like illness, whereas
a number of FM cases are triggered by minor injury or trauma.
CFS is characterized biochemically by elevated levels of RNaseL
(an anti-viral enzyme), whereas FM is unique in having excess
Substance P (which triggers pain in nerves) in the bodily fluids.
Profound exertional fatigue, post-exertional malaise, deep
myalgias, sleep disruption, cognitive dysfunction, and autonomic
abnormalities are common to both. FM tends to be a more
persistent ailment, whereas studies have shown more spontaneous
improvement in PWCs (Persons with CFS). Persons with “pure
FM” (that is, minimal cognitive dysfunction) tend to improve with
low level, slowly progressive exercise, whereas persons with CFS are
more likely to flare or relapse with even minimal activity.
Because we do not have an identifiable cause for CFS, I am hesitant
to change the name of this illness unless the new name addresses
symptoms and not pathophysiology. e descriptions “myalgic
encephalopathy” (meaning muscle soreness and neurocognitive
problems) and “fibromyalgia” (literally tendon-muscle pain), for
example, describe unchanging symptoms of these disorders. us,
when the pathophysiology of either is found, it will be unnecessary
to change their descriptors.
Paul Cheney and I always looked at the study of CFS/FM as if it
were a gigantic tapestry. If we could see the face, we thought, the
whole picture would become clear, but only the base of the tapestry
was available to us. As a result, we pictured ourselves finding “a
loose string” and following it along the backing of the tapestry
until it either ended or led to something interesting. Over the past
18 years, I have followed an awful lot of “loose strings,” many of
which led nowhere. However, some led us to marvelous things, like
Ampligen, RNaseL, autonomic dysfunction, exercise regimens,
stimulant medications, supplements, and pharmacological
treatments. Many of our pilot studies, such as low dose cortisol
therapy and IV gamma globulin, have been expanded by the NIH
and private researchers. Nevertheless, research is hampered by the
lack of a homogeneous population to study, relatively few funds,
and the perception that CFS and FM are “not real diseases.”
I am confident that there is a common biophysiological thread
between CFS and FM, but also with other disorders like Gulf
War Syndrome, Multiple Chemical Sensitivities, and the “shadow
syndromes” like Temperomandibular Dysfunction, mitral valve
prolapse, Irritable Bowel Syndrome, and Overactive Bladder that
are closely associated with CFS/FM. At this time, these could
all be satisfactorily explained by changes in the Central Nervous
System, which I suspect holds the key to CFS/FM.
ImmuneSupport.com: Do you have a standardized treatment
protocol for your CFS/FM patients?
Dr. Lapp: Yes – it is the “Stepwise Approach,” and it is available at:
http://www.immunesupport.com/library/showarticle.cfm?id=3714
I used to show a slide portraying CFS research in 1987. It was
a turtle riding an exercycle – he was going nowhere, slowly! In
1992, I revised the slide to show our progress. Now there were
several turtles riding exercycles! But at least there were others with
an interest. ese great researchers have ploughed along despite
lack of support and often ridicule from their fellow scientists, but
we have stuck together and are now seeing many fruits from these
labors. What is most exciting to me is that more and more scientists
are recognizing how much research could be accomplished in
these areas, and it is now almost impossible to keep up with all
of the studies being performed around the world! As science
demonstrates more and more biophysiological explanations for CFS
and FM, the old school of skeptics and the psychologically oriented
are finding their ranks growing thinner and thinner.
ImmuneSupport.com: What are your recommendations for the
following important issues for CFS/FM patients:
Dr. Lapp:
Sleep (unrestful sleep; insomnia): Start with over-the-counter
products like melatonin, valerian, Tylenol PM; pharmacologically,
the best combo is clonazepam 0.5-1mg (to initiate sleep) and
trazadone 25-50mg (to maintain sleep); otherwise, Ambien and the
benzodiazepines (Restoril, ProSom, Halcion) may be helpful but
patients tend to develop tolerance over time.
Pain: If you find minimal response to PUFAs (poly unsaturated
fatty acids, like flaxseed, EPO and fish oil); then NSAIDs like
Advil or Aleve; then Ultram; then narcotics. When narcotics are
used, long acting preparations (OxyContin, MS Contin, Kadian,
etc.) are recommended in order to provide long lasting, constant
relief. Ultram is preferred because of its low addiction potential,
good efficacy compared to codeine, and its secondary benefit of
raising serotonin levels.
ImmuneSupport.com: What are the most common factors for these
illnesses – why do you think so many CFS patients also have FM,
and vice-versa?
Dr. Lapp: e leading explanation for CFS/FM is that an illness
or injury triggers a physiological change in susceptible individuals.
is change is clearly persistent or even permanent. Why do I
specify “susceptible individuals”? Because there are many situations
HEALTHwatch
Low energy (combating fatigue): Start with high dose
(injectible) B12 and NADH. Next step, consider Wellbutrin

Dr. Lapp: I can never emphasize enough that taking periodic
(a dopamine agonist) or a non-sedating Selective Serotonin
Reuptake Inhibitor (SSRI, like Prozac, Zoloft, Celexa, Effexor).
But the best therapy is to use low doses of CNS stimulants like
methylphenidate (Ritalin), dexamphetamine (Dexedrine or
Adderall), and modafinil (Provigil). e latter has an excellent
safety profi le, minimal effect on the cardiovascular system, and
little abuse or habituation potential. Provigil not only improves
fatigue (alertness), but also somnolence, mental clarity, attention
deficits, and depression.
rest breaks, limiting activities, and maintaining low level aerobic
activities is the most important treatment for both CFS and FM.
Unfortunately, many sufferers are unwilling to accept these drastic
lifestyle changes. ere is no drug, no potion, no supplement, herb
or diet that even competes with lifestyle change for the treatment
of CFS or FM. e next most important step is to minimize
stress, optimize your support systems, and to maintain a positive
attitude despite adversity. I have never seen a study that proves
these points, but I can assure you from experience that pushing and
crashing, denial, depression, and a negative attitude are all formulas
for disaster, and I have never seen a patient who practiced them and
yet recovered. Drugs, supplements, and alternative therapies are only
supportive and symptomatic treatments that make the path toward
recovery more bearable. But they do make it more bearable for most.
Depression: Consider Wellbutrin (a dopamine agonist) or a non-
sedating Selective Serotonin Reuptake Inhibitor (SSRI, like Prozac,
Zoloft, Celexa, Effexor). When there are sleep problems as well,
consider Paxil, Serzone, Desyrel, and the tricyclic antidepressants
(TCAs) like doxepin and amitriptyline. e TCAs are likely to
stimulate appetite and weight gain. When there is a significant
sleep problem plus weight loss, my first choice in Remeron.
Remember to use LOW doses of antidepressants and any other
sedative medication when treating PWCs.
For patients, CFS and FM are “high maintenance disorders.”
I mean that sufferers spend most of their day taking care of
themselves, and there is very little left over for family or friends.
Nevertheless, it is absolutely necessary for sanity and a reasonable
quality of life that sufferers do something fun – something that
they want to do – each day. Especially in the early stages of CFS
and FM, I believe it is very difficult for sufferers to work full time
and/or maintain a household in addition to self care. Accordingly, I
am a big proponent of reduced work load or even total disability, as
long as the patient uses this time for self improvement.
Brain fog (inability to concentrate, memory problems, etc.):
Same as fatigue, above. Small studies have shown limited
improvement with naloxone, Eldepryl, and Reminyl, but these
drugs are very expensive and not likely to be helpful.
Diet (foods to eliminate, excitotoxins, etc.): ere is very
little study of this aspect, but empirically my patients do best on
a low fat diet with lots of fresh fruits and vegetables, complex
carbs (like rice and potato), and light meats (chicken, turkey, scaly
fishes). We have also found that PWCs do not tolerate several
items: Sugar, Caffeine, Alcohol, Tobacco, and excitotoxins like
MSG and aspartame (Nutrasweet, Equal). Saccharin (Sweet N’
Low) is satisfactory, however. ese items are remembered by the
mnemonic SCATE (pardon the spelling!). Many patients with
loose stools may find that reducing dairy and gluten (wheat, barley,
oats and rye) intake may help.
ImmuneSupport.com: Are you currently involved in any research
studies?
Dr. Lapp: Yes.
We continue to study the beneficial effects of
Ampligen, an anti-viral immune modulator that has provided
significant improvement for a majority of patients, in my
experience. It is not a cure, however. We recently completed a
national, multicenter study of modafinil (Provigil). We continue to
compile demographic data on our patients, and studying autonomic
dysfunction. We are exploring the use of an inexpensive Actimeter
(or pedometer) to measure improvement in our patients.
Supplementation (how to address any deficiencies): e
literature confirms several deficiencies in CFS/FM, including
intracellular magnesium and B12, whole body potassium,
intracellular ATP, glutathione, taurine, serine, and the short-chain
fatty acids such as valine, leucine, and isoleucine. While patients
may not feel any better by supplementing these, health can at
least be optimized. I frequently recommend supplementation
with a multivitamin (like Super Multiple II or Cellular Support),
magnesium, potassium, NADH (for ATP), glutathione, and an
amino acid capsule.
ImmuneSupport.com: What do you think are the most promising
recent developments in CFS and FM research?
Dr. Lapp: In my opinion, the largest share of clinical research is
being supported by private groups such as e CFIDS Association
of America, the American Fibromyalgia Syndrome Association,
and Pro Health. It is extremely frustrating to me that the
NIH/CDC has allocated so little money for research of CFS and
FM, while spending many times more on AIDS, RA, MS, and
other illnesses that are less prevalent than CFS/FM and even less
disabling!
ImmuneSupport.com: What is your recommendation regarding
exercise for FM and CFS patients?
Dr. Lapp: I recommend that patients do stretches, Yoga, or
Many people ask why I do not do more research. e answer is that
my day is already fi lled with taking care persons with CFS and FM.
Furthermore, patients are looking for treatment possibilities, not
demographics and data, which have been the mainstay of research
over the past decade. So I focus on office-based clinical studies and
treatment. One of my mentors, Dr. F. Mason Sones, was frequently
criticized for the paucity of his books and peer reviewed articles.
Yet Sones was the first man to catheterize the human heart; and
he developed numerous tools, catheters, and procedures for the
diagnosis and today’s incredible treatments of heart disease. He too
felt more obliged to the patient than to scientific publication, and
we are all better off for it.
Tai Chi daily. I strongly believe that this stretches the tender,
contracted muscles of FM, maintains flexibility, and minimizes
tendonitis and bursitis that are so common in FM. Using 1-2#
weights can maintain biceps, triceps, and deltoids. I strongly
encourage low level interval aerobic activity (that is, repetitions
consisting of 3-5 minutes of exertion followed by 5 minutes of
rest). Even the sickest patients can tolerate this low level of activity
without triggering a flare. Over time the exercise period may be
increased while the 5 minute rest period is maintained.
ImmuneSupport.com: In your experience, what have been the
most effective treatments for your CFS/FM patients?
HEALTHwatch

ImmuneSupport.com: What do you think the future looks like for
CFS and FM patients? Are we moving forward in dealing with
these diseases – as patients, practitioners, and as a society?
antibiotic protocols as required for bacterial infections are the
so-called oxidation treatments, which include blood ozone therapy,
UVB or photoluminescence, and intravenous hydrogen peroxide.
Dr. Lapp: I am truly hopeful that CFS and FM will achieve more
In addition, specific immune strengthening botanicals I have found
are of benefit, too. Sometimes prescription medicines, such as
Tagamet and/or the opiate-blocking drug, naltrexone, are a useful
adjunctive therapy in the treatment of cancer.
and more legitimacy as we learn more about these medical – as
opposed to psychological – disorders. Even now, we are bringing
more researchers into the field, as they see a wide open opportunity
for exploration. HW
ImmuneSupport.com: If a patient’s primary complaint is
devastating fatigue what test do you perform to try to determine
the cause?
e Hunter-Hopkins Center is one of the very few centers in the world
that specializes in the management of CFS, FM, and related disorders.
Founded in 1996, the center currently follows over 2000 patients from
almost 50 states and over 14 foreign countries.
Dr. Guyer: is is certainly a broad question and a common profile
as many patients fit this category. Unfortunately, there are no
simplistic answers. Almost always in these cases there are complex
interplay of many causative factors in terms of chronic infections
which could be fungal, bacterial, viral, even parasitic, toxin
exposure such as mercury, cadmium, aluminum, and lead, digestive
dysfunction and poor absorption, coagulation abnormalities,
metabolism abnormalities, immune system dysfunction, food
allergies, and significant endocrine or hormonal abnormalities
- especially for thyroid, adrenal, testosterone, DHEA, and growth
hormone. erefore, selectively from the patient history and past
medical record, I am able to take that information and determine
which types of tests would be most appropriate for the individual,
and then from those results determine an appropriate treatment
course.
Dale Guyer, M.D
M.D.
Dale Guyer, M.D., is a holistic family physician and
the Director of e Advanced Medical Center located
in Zionsville, Indiana, where patients are offered a
unique blend of traditional and alternative therapies
(incorporating a mind-body-spirit approach) for a
number of health-related issues, including CFS and
FM.
ImmuneSupport.com: Do you see many
patients with Chronic Fatigue Syndrome and Fibromyalgia?
Dr. Guyer: Yes, I have seen probably several hundred patients who
have been given this diagnostic category.
ImmuneSupport.com: What might a comprehensive treatment
program include for a patient whose main symptoms are those
typical of Chronic Fatigue Syndrome?
ImmuneSupport.com: How do you go about treating a patient
with a weakened immune system?
Dr. Guyer: In a general sense that would depend, of course, on the
Dr. Guyer: Generally, these individuals require a detailed
laboratory analysis though the physician, myself in this case, would
know specifically what types of problems we are dealing with. All
of these patients that I have seen always have immune dysfunction,
and so products such as Transfer Factor are generally very helpful.
In addition, most are nutritionally depleted, so we often utilize
intravenous vitamin therapies for replacement, adjunctively adding
in Vitamin B12 shots of which we use a special formulation with
high dose Hydroxycobalamin that includes ATP and Glutathione
to help with the body’s energy reserves. For more recalcitrant cases,
I will utilize a special version of vitamin B12 called kynosolen,
which includes trace minerals, selenium, and potassium magnesium
aspartate in injectable form.
laboratory evaluation. I prefer to use the laboratory company
Antibody Assay Labs which has a chronic fatigue immune
dysfunction serum analysis panel so that I can give the assessment
of the balance of the immune system, natural killer cell activity
and number, and of course that information, coupled with the
data acquired from the past medical record, historical responses to
treatment, and a detailed past medical history to get an assessment
of their symptomatic immunologic vulnerability, can often paint a
much more clear picture, from a foundational perspective at least, of
where that person’s immune system is on an initial basis.
ImmuneSupport.com: What are the most effective treatments you
have found for supporting and strengthening the immune system?
In addition, most of these people will have a sub-clinical low
thyroid function and adrenal problems, which need to be
addressed pharmaceutically and/or nutritionally. ey often have
detoxification impairments and often evidence of heavy metal
toxicity. ey almost always have chronic infections that I treat as
noted above, and especially for the fibromyalgia patients, chronic
pain and sleep issues must be dealt with. In that context, I use
special topical pharmaceutical preparations that utilize a special
gel, which penetrates into painful areas to relieve discomfort
and support healing. I also work on reestablishing normal sleep
patterns, which can be simple in terms of deficiencies of calcium,
magnesium, or hormonal such as deficiencies of Melatonin or
thyroid. Some patients respond to a simple therapeutic regimen
such as a combination of 5-HTP and tryptophan which we have
formulated for us by a compounding pharmacy.
Dr. Guyer: After the evaluation from a laboratory analysis, I can
determine what areas of weakness or imbalance lie within the
immune system, and an appropriate treatment regimen is then
detailed. In a general sense, almost all the patients have found
excellent results with the Transfer Factor specifically. Generally I
tend to use the Transfer Factor Basics product and then tailor the
dose according to the patient’s needs.
Two or three capsules a day [of Transfer Factor Basics] has been
standard treatment for most of my patients, but also those with
rather profound immune dysfunction syndromes are those prone
to periodic or cyclic viral symptom expression. I will often need to
increase the dose to a much higher level, often three to four capsules
three to four times a day as needed. In terms of removing offending
infections, the more effective therapies I have seen beyond the
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ImmuneSupport.com: How do you feel about treating a patient
with heavy metal toxicity?
have a positive serum analysis on a PCR screen for viruses, bacteria,
or fungal organisms. e selection of the antibiotics has to be
specifically tailored to the individual in terms of tolerance and the
nature of the organism being treated, and sometimes the dose needs
to be adjusted or varied over time and even changed to different
pharmaceutical regimes.
Dr. Guyer: In my experience, nine times out of ten patients with
FM and CFS will always have elevated toxic metals, as determined
by a provocative challenge test. Most commonly this is mercury,
but often other metals such as lead, cadmium, and arsenic can
be present as well. Some patients will have many types of metal
exposure depending on their functional detoxification efficiency, as
well as the historical component of exposure. In any event, it has
been my experience that it is absolutely important to work on the
detoxification of heavy metals, and of course, the detoxification of
the entire body. In addition, supportive detoxification therapy such
as massage therapy, counterpulsation, intravenous Glutathione,
high dose vitamin C, and infrared saunas all tend to be selectively
and additively helpful.
All in all, I have found these therapies [pharmacological] to be very
effective additively, not as a stand-alone therapy without appropriate
nutritional support and other efforts to normalize a complex
internal bio-chemical milieu, in order to be totally effective.
ImmuneSupport.com: What are the main mistakes you have
noticed among patients who self-treat with vitamins and
supplements?
Dr. Guyer: Generally, the frustrating challenges are that many
ImmuneSupport.com: How do you use Transfer Factor to treat
a patient and what kinds of patients benefit most from this
treatment?
of the supplements that are available over-the-counter are often
of poor quality and the wrong combination. So the patients who
have not had the luxury of the clinical training, background,
or experience often engage in a hit-or-miss proposition, and
sometimes feel a little better but often times feel worse. To make
the matter more of an insurmountable challenge, most doctors
are ill-equipped from an educational standpoint to be able to
specifically recommend avenues for the patient to navigate through
nutritional supplementation successfully.
Dr. Guyer: In a general sense all of my patients with CFS and FM
take Transfer Factor. I have found it selectively useful for just about
every broad category of human health in addition to those who are
generally healthy. I myself take the supplement [Transfer Factor
Basics] every day, and at times when I feel tired and rundown or
have had a viral exposure and start to feel flu-like symptoms, I
will take fairly generous doses and often the symptoms will resolve
within a matter of hours. I have even found that using Transfer
Factor in cases of autoimmune dysfunction tends to bring about a
stability of the immune system “cross talk” and reestablishment of
the immune system balance. So in a general sense, I have felt that
almost everybody seems to benefit from Transfer Factor in one way
or another, specifically those with CFS and especially in those that
have a co-existing chronic infection. e Transfer Factor tends to
help support their immunologic clearance of the offending agent.
ImmuneSupport.com: Do you have any theories about the causes
and development of Chronic Fatigue Syndrome?
Dr. Guyer: I generally feel that “Chronic Fatigue Syndrome” is
not particularly diagnostically helpful since it just tends to imply
that a person is fatigued for a period of several months, and it
erodes their ability to live their normal life. If these patients have
sleep disturbance and pain in addition to severe fatigue, they often
get lumped into the fibromyalgia camp. As a diagnostic label it
carries meaning, but in terms of describing what is really going
on physiologically, it is not of much help. In my experience, these
people who acquired these diagnoses have a complex interplay of
many different elements as alluded to above, relating to nutritional
dysfunction, environmental sensitivities, toxin accumulation,
chronic infections, normal human aging issues, excess stress,
depleted hormone levels, and of course, the basic genetic structure
with which they came into the world which may have areas of
weakness that have made them vulnerable, given the right set of
circumstances, to the emergence of these symptomatic patterns.
ImmuneSupport.com: Where do you think traditional
pharmacological interventions fail in patients with CFS and
FM? What do you think of antibiotic therapies for such patients?
Dr. Guyer: In general, conventional medicine often fails to
recognize CFS and FM. Unfortunately, those patients often
get relegated to a category suggesting that all of their problems
are purely psychological, which is far from the case. It does,
however, lead the patient to a frustrating position as few doctors
are well-versed in the appropriate treatment of these illnesses.
Unfortunately, the few therapies that are provided from a
pharmacological basis and conventional medicine are often no more
than symptomatic cover ups. In a general sense they are medicines
prescribed to ease pain, to improve sleep, and reduce depression; all
of which can be helpful, but none of which get to the core of the
problem.
ImmuneSupport.com: Any additional comments of advice
regarding the value of a holistic approach to help in healing?
Dr. Guyer: One particular element of advice would be the Latin
phrase ‘caveat emptor’ or “buyer beware.” ere seems to be a lot
of media hype regarding “fluff y information,” most of which is
not particularly helpful to patients. On the other hand, there are
enormous amounts of clinical data and very high quality products
available that truly do make a profound difference in one’s overall
health. So the value of the holistic approach is exceedingly high.
Unfortunately, modern medicine in its current state has not yet
learned to fully recognize that reality. However, the medicine of
the future will make a more integrated effort to bring into play
the entire body, mind, and spirit connection to facilitate a patient
achieving their optimal health potential. at will include elements
of psychological services, structural attention through adjustments
such as chiropractic and osteopathic techniques, as well as the
As for antidepressants specifically, many of my patients have stated
that when their other doctors have put them on antidepressants, it
only helps them to “feel better about feeling bad,” but never really
improved their functional status.
As for antibiotic therapies for such patients, I have seen those to
be dramatically helpful. ere are usually subtle clues to delineate
which patients are going to benefit most, such as those who tend
to have elevated viral antibodies, including the Epstein-Barr virus,
HHV6, and CMV. Other good candidates are those who obviously
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biochemistry of a nutritionally based doctor who can reestablish the
normal internal chemical balance for each individual patient. HW
We are aware, for instance, that a person involved in a car accident
may develop FMS, and some other trauma may provoke the
symptoms to a first time flare-up. With CFS, some patients are
quick onset with viral-like symptoms similar to the flu. Others
begin as a very slow onset that can take years to really develop to
their low plateau level. Diagnosing CFS requires a 6-month time
frame of fatigue and symptoms. ese symptoms should be of a
new nature, such as unremitting headaches, sore throat, fever-like
flu feeling, sleep disruption, muscle aches and pains and cognitive
difficulties. is illness is a very debilitating and complex disorder.
e Advanced Medical Center in Zionsville, Indiana, was founded
in 1997 by Dr. Guyer. New patients are always welcome. For more
information, visit www.daleguyermd.com, or call 317-733-5433.
Derek Enlander, M.D.
Derek Enlander, M.D., is originally from Belfast,
Ireland, and is Physician-in-Waiting to the British
Royal Family and to several members of the British
government during their visits to New York. He is
presently in private practice in New York where he
sees CFS and FM patients, is on the faculty of Mt.
Sinai Medical Center in New York City and serves as
President of the Israel Medical Research Foundation.
What I do believe, is that whatever initiates the beginning of the
illness then directly affects the immune system into an upregulated
or a deregulated condition. e body, trying to heal itself and
return to a natural balance, seems to constantly be adjusting to find
that balance. I believe that is why over time we begin to find small
changes, for example, in thyroid function, hormones, etc. We are
unsure why one person experiences the longevity of the viral flu
symptoms and others deal with it at only sporadic times. Some
patients face serious neuro-cognitive symptoms, while others fare
lighter in this symptom. Or better yet, why one patient one week
will have few signs of one symptom, but the following week will
experience the symptom significantly. One thing I am sure of with
this illness is that it has cycles to it. A key to managing this illness
is learning to recognize those cycle times and behave accordingly.
e cycles do not seem to follow any known physiological patterns.
However, symptoms do seem to worsen for women during their
menstrual cycles.
Chronic Fatigue Syndrome and fibromyalgia as valid illnesses
with real symptoms (what were the circumstances)?
Dr. Enlander: I am from Belfast, Ireland. I originally came to
the United States to accept a one-year fellowship at Stanford
University. My primary research subject was the relationship of
Epstein-Barr Virus to cancer. I had studied virology with Lannette
(the father figure of modern clinical virology) in his lab in Berkeley.
While there, I performed early scanning electron microscopy on
cell surface changes in herpes virus infection. I came to New York
as Assistant Professor at Columbia University and then Associate
Director of Nuclear Medicine at New York University. I now have
a private practice in both Manhattan and Long Island, and am on
the faculty of Mt. Sinai Medical Center. Patients fly from around
the world to my office regarding this illness. e magnitude of this
illness is far-reaching and worldwide.
Many patients will start out with CFS and later develop FMS.
Some just develop FMS, and diagnosis criteria for FMS is slightly
different. A tender point test is given by the physician, with 11 of 18
tender points a criteria factor for the diagnosis.
At this point in time, our medical knowledge does not provide us
with enough iron-clad evidence to decide whose body does what
and why. We keep finding small pieces to the puzzle, but are still
trying to see the whole picture. We try to recognize in each patient
some common symptoms (after eliminating all other possibilities
for illness) as set out in medical standards and treat accordingly.
During my fellowship at Stanford many years ago, I made a return
visit to Belfast. I was asked by a childhood friend to help him in
a then virtually unknown condition, Myalgic Encephalomyelitis
(ME). is is more commonly known in the United States as CFS
or Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS).
e more I researched this illness, the more interested I became. It
had a direct relationship with my field of interest in Herpes Virus.
I was completely intrigued by this illness due to its highly unusual
effects on patients; its lack of consistency and seemingly affecting
so many aspects of the body; and the lack of objective testing
evidence when clearly these patients were so very ill. I especially
was intrigued by the dismissal of this illness by other physicians as a
mental condition, when clearly these patients suffered from physical
illness. A large number of patients were affected, a number far
greater than I first realized.
protocol for your CFS/FM patients?
Dr. Enlander: I hate to say I have a standard treatment because
each patient is an individual with various symptoms and levels of
the illness. My first line of treatment is to LISTEN TO THE
PATIENT. I cannot express this strongly enough. Most patients
have gone through many doctors that knew little of the illness, and
in some ways have done harm to patients by their lack of belief,
knowledge and support. It is very important to me to establish a
trust with my patient.
ImmuneSupport.com: What are the most common factors for these
illnesses – why do you think so many CFS patients also have FM,
and vice-versa?
After a full examination, I treat according to each patient’s health
needs. However, yes, there is a common thread of treatment. Over
10 years approximately, I developed a formula given by injection
weekly to help alleviate symptoms over time. is formula method
is NOT a cure, but it does help significantly over time. Many of my
patients have been able to resume a significant portion of their lives,
including returning to work.
Dr. Enlander: I do believe that CFS and FMS (Fibromyalgia
Syndrome) are related illnesses. ere is commonality of symptoms
between them. However, I don’t think we as a society or medical
community are really sure enough yet what the common factors are.
So far, the illness appears to be provoked in a number of ways and
it is difficult to separate and assign specific symptoms to specific
causes, creating subgroups within the CFS/FMS community.
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e formula works very slowly, often taking 8-12 weeks before the
first signs of improvement begin. Other physicians use some

of the ingredients I use to help treat CFS/FMS, but I have found
that combining these ingredients into a single injection and
consistently using this protocol has given tremendous improvement
for most patients. My studies over the years have found a 70-80%
improvement rate with use of the formula compared to only about
30% using individual items from the formula list [Editor’s note: For
more information about Dr. Enlander’s formula, please visit his web site
at http://www.enlander.com].
muscle relaxation therapies, biofeedback and meditation. ese
methods often help manage chronic pain.
Low energy (combating fatigue): One of the ingredients in the
formula that I use for patients is glutathione. Many patients find
this helpful for increasing energy levels. Other drugs I use may
also have side benefits of increasing energy. Neurontin is such a
drug. is is an anti-seizure medication that currently has uses
in sleep issues, pain issues, as well as helping with energy levels.
Antidepressants are used for many reasons besides depression, and
these may often help elevate energy levels. If a patient does suffer
from depression issues, certain antidepressants may help alleviate
any fatigue issues related to the depression. Elavil is one older
antidepressant drug that is often helpful for low energy, as well as
sleeplessness.
Aside from the formula, there are many symptoms that need to
be addressed. First, we eliminate anything that is not related to
CFS/FMS and take care of that separately. en we begin to
treat the remaining symptoms, such as poor sleep, neuro-cognitive
difficulties and pain. Let me state clearly here, that while many
patients develop depression and anxiety symptoms, I am of a firm
mind that this is a secondary response to the illness. erefore, we
treat depression as needed, but in respect to this point of view.
I like to see very, very slow graded exercise as a means to increasing
energy levels. I also find that rising in the morning hours often
helps a patient’s energy levels more than awakening in the
afternoon. I also believe that sunshine helps the body to rejuvenate
somewhat.
following important issues for CFS/FM patients:
Dr. Enlander:
Depression (drugs prescribed, etc.): CFS/FMS patients
Sleep (unrestful sleep; insomnia): Good, deep, refreshing
are very sensitive to drugs that treat depression and anxiety, so I
carefully discuss with the patient the best possible choices and side
effects. e best treatment medication may take a few tries with
different choices. For instance, a patient may need a more sedativelike antidepressant (e.g., Serzone, Celexa) or perhaps one such as
Wellbutrin SR that creates the opposite effect of a more stimulant
reaction. Many CFS/FMS patients cannot tolerate high doses of
these particular medications and respond much better to low doses.
Most responses take 3-6 weeks to be realized, though.
sleep is a major key to helping other symptoms of CFS/FMS.
Most patients have sleep disturbances to their normal cycle.
is includes falling asleep, staying asleep, and quality of that
sleep. Sleep studies may be beneficial to determine sleep apnea,
etc. For instance, I treat patients with sleep apnea with extreme
caution regarding any type of sleep medication. If the patient’s
breathing became obstructed or disrupted, a sleep medication could
potentially worsen the condition.
I prescribe various medications and treatment plans to help improve
sleep. I start the sleep adjustment with the least provocative
substance that will not be habit-forming: diphenylhydramine.
If that is not effective, I may use an older drug like Trazodone
(deseryl) to help establish a more stabilized pattern of sleep. Or
I may use drugs such as Ambien, Sonata, Klonopin, Flexeril,
Zanaflex and others. I am cautious about long-term use of certain
drugs due to their addictive or dependent qualities, and will shortterm swap medication to lessen the habit forming effect.
Brain fog (inability to concentrate, memory problems, etc.):
Again, I feel strongly that my formula injection helps improve this
symptom over time. I may also have to use certain drugs to help
the brain better focus. Additionally, I have found a product called
Immunoprop (oral pill form) that contains glutathione, l-cystine
and Selenium. It is thought to be involved in the immune system
and seems to diminish “brain fog,” concentration loss and shortterm memory loss.
I often caution patients about using alternative methods or overthe-counter sleep aids. I am not opposed to all such substances, but
I feel strongly that as your doctor I need to know ALL medicines/
substances you are taking, as there can easily be a cross-reaction and
damage to the body can occur. Substances bought over the counter
for sleep and other symptoms can in fact provide the opposite
effects.
I also ask patients to perform memory-enhancing exercises to help
their mind focus and stay sharp. Examples are crossword puzzles,
free word games provided by online services that help memory, and
TV shows such as Jeopardy! I urge patients to continue to challenge
their minds, even though I realize it is often difficult at the various
levels many CFS/FMS patients succumb to.
I may also prescribe a muscle-relaxant to help relax the muscles to
promote better sleep. I try to help the patient establish a routine
that will aid in establishing a sleep goal.
do indeed appear to help themselves by eliminating certain foods.
Patients seem to come to these problem foods and substances by
either allergy testing or sample diet reactions. ere are many books
that can be used as a self-help method to follow. I like for patients
to maintain a healthy balanced diet low in animal fat and high in
fiber with abundant fresh fruits and vegetables. e treatment that I
use to help in this area is a product called Immunoprop. I believe it
helps patients in better nutrition for the body, as well as addressing
other symptoms.
Diet (foods to eliminate, excitotoxins, etc.): Many patients
Pain (drugs prescribed, etc.): I recognize the seriousness of the
pain CFS/FMS patients suffer and treat accordingly. I am very
consciously aware of the dependency that many pain medicines
can contribute to, so I follow this closely with each patient. Pain
meds often used are both short-term and long-term. Patients have
different pain levels, thus requiring different choices of medications.
Supplementation (how to address any deficiencies): e
Stress reduction is very helpful to CFS/FMS patients. I ask my
patients to consider therapies such as deep breathing exercises,
HEALTHwatch
formula injection that I use provides many amino acids along with
minerals and vitamins. With testing results, I may also include

additional substances such as potassium, calcium, etc. I find that
pills often are not absorbed well, so I prefer to use the injection for
better absorption. I am not opposed to discussing other substances
that might be of particular help. However, I want patients to
recognize that supplements and herbal medicines have many
potential side effects and toxic reactions as standard drug therapy.
In fact, the dangers increase due to the lack of standards, doses and
quality for ingredients. Vitamin E has been recommended in low
doses to enhance the fatty acids in the cell membrane, and promote
cell function.
begin walking perhaps a block or to the end of their driveway and
back if necessary. Walking can be done at their own pace, place
and distance, so as to not overtax their bodies. en, very slowly
progress to 2 minutes twice a day with exercise that is not of a
strenuous nature, but include something different.
ere are many methods of exercise available today and one must
choose something they enjoy doing. A stationery bicycle is a good
choice once a patient reaches this level. It allows you to work your
arms as well as your legs, but your balance is better served here as
you progress in pedaling at your own speed. It is often difficult for
some CFS patients to use a treadmill, as balance and continuous
speed of the treadmill will make them fall. e type of exercise
therefore depends on each individual patient and their physical
abilities. I also like for the patient to choose an exercise that they
prefer.
Other issues (immune dysfunction, cognitive difficulties, etc.):
First, let me say that I believe a positive attitude is a key factor
in those patients that improve the fastest. Patients must seek out
physicians who are willing to consider their problem as a medical
condition and not a psychiatric one.
I want patients to recognize that there are often other unusual
symptoms that may occur in CFS. ese might include abdominal
pain, alcohol intolerance (avoid alcohol with medication use at all
times), bloating, chest pains, chronic cough, diarrhea and other
gastrointestinal situations, dizziness and loss of balance, dry eyes
or mouth, irregular heartbeat, jaw pain, morning stiffness, nausea,
night sweats, shortness of breath, peculiar skin sensations, tingling
sensations, pins and needles, creeping sensation under the skin
(feels as if an ant is crawling under the skin). In some patients, the
inability to exercise may cause weight gain, as well as medication
causes. Other patients may experience significant weight loss.
I, however, do not want my patients in an aerobic class. I feel this
causes considerable damage to CFS patients. is is often difficult
for the patient to accept on a long-term basis, as I find that most
CFS patients were very active prior to falling ill with CFS. Once
you have very gradually worked yourself up to the proper levels, one
might find benefit in a very low-grade aerobic type class, although
yoga, tai chi and similar exercises might be best.
For FMS, the prominent symptom is pain. erefore, some exercise
can help relieve some of this pain, but only done in slow, graded
methods. I follow a similar exercise for FMS patients as I do in
CFS patients, as I believe the illnesses are related. ey share
similar symptoms, with either pain or fatigue being the leading
factor. However, with FMS I believe that a patient might benefit
better from stretching exercises, building up slowly. en progress
to mild exercise efforts like water aerobics. Temperature of the
water for water aerobics is essential as well. FMS patients usually
need water warmer than the average person. Again, to overdo will
bring very painful muscle cramping, so this exercise must be done
very gradually.
However, I want to seriously caution patients to not assume any
symptom is simply part of CFS/FMS. is would be a grave error
that could cost a patient their life. For instance, ALWAYS check
out chest pains with a physician immediately. While FMS trigger
points can be a cause for chest pain, it is just as likely you could
be experiencing heart trouble. Never assume – check with your
doctor!
exercise for FM and CFS patients?
With FMS patients I often find using some complimentary services
to be helpful when exercising. e right type of massage done on
a regular basis, along with drinking lots of water can help lessen
the pain of the muscle. Our bodies need water, but most especially
CFS and FMS bodies. FMS bodies tend to significantly tighten
up their muscles after exercise, and particularly during periods of
stress. Deep tissue or trigger point massage is the eventual goal for
an FMS patient, but most patients need to be started with a much
lighter touch in the beginning and work up to the desired goal.
Again, the key is balance in all therapies.
Dr. Enlander: I consider exercise from different points of view
with FM and CFS. CFS patients’ prominent symptom is fatigue.
is word is not truly descriptive of what these patients feel. When
we use the word fatigue, the average person typically thinks tired
from activities such as work, physical exertion, or lack of sleep.
CFS patients feel a different type of “fatigue.” At times, they feel
they cannot lift an arm or leg without significant effort. eir
energy base is depleted. erefore, I suggest my CFS patients do
only slow, very graded exercise. Exercise is a very slow and tedious
but necessary aspect of recovering to a more productive level of
functioning.
I will add that I am very open to new treatment discussions and
new courses of studies. I research this illness considerably and am
open to other possible treatments with safety of my patient being
the first criteria.
If CFS patients overdo exercise or any physical activity, immediate
repercussions typically occur. At times, CFS patients do have spurts
of energy and typically overdo because suddenly they can do things.
One of the hardest obstacles to learn with CFS is to find balance in
all things. Patients walk a fine line regarding exercise and physical
exertion. CFS patients have relapses that often last for several days
before they recover. I tell patients to follow this rule: “only do 50%
of what you think you can do.”
studies?
Dr. Enlander: I have participated in a number of research
studies over the years, and do some in-house with the assistance
of other professionals. Recently I have been following more and
more patients regarding the low blood volume issue. Low dose
Naltraxone LDN and cytokine evolution in these diseases are
current research topics that we are presently working on.
I prefer my CFS patients to begin with stretching exercises, then
HEALTHwatch
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Don L. Goldenberg, M.D.
I often assist other entities doing the research, but I prefer to
participate in a quiet manner rather than announcing a new
study. I often help patients participate in research projects with
pharmaceutical companies.
Don L. Goldenberg, M.D., is Chief of Rheumatology
at Newton-Wellesley Hospital in Massachusetts and
Professor of Medicine at Tufts University School of
Medicine. An international authority in the fields of
CFS and FM, he has published more than 150 papers
in scientific journals. He is author of Chronic Illness
and Uncertainty: A Personal and Professional Guide
to Poorly Understood Syndromes and Fibromyalgia:
A Leading Expert’s Guide to Understanding and Getting Relief from the Pain
at Won’t Go Away.
I often find funding for CFS/FMS research to be a carefully
controlled and cliquish doling out of money. It seems often research
grants cover the same old territory for years. I would like to see
some new names and new opportunities granted for furthering
research. How many more studies do we need on CBT, depression
and somatoform issues?
ImmuneSupport.com: What do you think are the most promising
recent developments in CFS and FM research?
e diagnosis of fibromyalgia no longer takes an average of six years
(as previous data has indicated), although there is no hard data on
this. Most primary care physicians are much more comfortable with
the concept of fibromyalgia and Chronic Fatigue Syndrome (CFS)
than they were 10 years ago.
Dr. Enlander: I am interested in following the De Meirleir CFS
test made known to the public recently. I am also interested in
furthering the research over the blood volume issue, as well as
cytokine secretion and their relationship to these conditions.
e overlapping features of fibromyalgia and Chronic Fatigue
Syndrome are outlined in a number of chapters in my new book.
ere is significant overlap in the clinical and demographic features
of these two illnesses, and much of this may be related to shared
etiologic factors, such as low levels of certain neurohormones
including serotonin, or how the body responds to various stressors.
I attempt to treat the pain and fatigue in a multidisciplinary
fashion and the medications that typically have been useful for one
symptom are often useful for another symptom.
ImmuneSupport.com: What do you think the future looks like for
CFS and FM patients? Are we moving forward in dealing with
these diseases – as patients, practitioners, and as a society?
Dr. Enlander: I am concerned about the lack of true medical
understanding by most doctors regarding CFS/FMS. Recently, I
have written several letters to the British Medical Journal and the
Cleveland Clinic Journal. My letters were published in response to
previous articles published, which in my opinion shifted medical
thinking away from the importance of CFS/FMS. In an ABC-TV
appearance, I emphasized the fact that patients are not imagining
their disease. In my lectures and my book, e CFS Handbook, I try
to communicate the facts. I still continue to hear horrific stories of
how patients are treated with this illness and the complete lack of
knowledge of physicians. e worst is that physicians shy away from
learning more about this illness.
Medications I will prescribe as needed include analgesic
medications, low doses of medicines to help sleep disturbances,
and in many patients, low doses of antidepressants, along with
physical therapy are beneficial. I will also recommend counseling
and cognitive behavioral therapy, meditation, and yoga, as well as
numerous other modalities.
For exercise, I use a combination of cardiovascular fitness
training and stretching initially, with later introduction of some
strengthening. e program must be carefully individualized
and we typically use low-impact cardiovascular activities such as
walking, stationary biking or water exercises.
I believe every few years there are shifts in opinions on CFS/FMS.
I see a growing trend, unfortunately, once again to try to attach
a more psychiatric viewpoint and treatment plan to patients with
the illness. e continued push to CBT therapy and psychiatry by
much of the medical establishment and the insurance companies
concerns me.
Regarding sleep, I believe it is best approached with a combination
of medications and also non-medicinal therapies. Low doses of
tricyclic medications such as amitriptyline or medicines such as
Klonopin have been useful. It is also important that we exclude
any primary sleep disturbances such as sleep apnea and restless legs
syndrome.
I feel that more and more individuals are becoming aware of
the illness, but the name of CFIDS is very undermining to
the true nature of the illness. I think positive recognition is
happening in the public, and patients are being cheered for their
accomplishments. Much of this was seen in the recent Olympics
with athletes suffering from CFIDS [like speed skater Amy
Peterson].
Over time, the majority of patients that I have treated have
improved and 50 to 60 percent of patients feel well or very
well. Approximately 10 to 20 percent of patients in most large
community survey follow-ups have noted a complete disappearance
of fibromyalgia symptoms over time. As with any of these illnesses,
the longer the symptoms have been present without a remission
occurring, the less likely that one will occur. At this time, I don’t
believe that there is any “cure” but a multidisciplinary approach,
with information and education being the most important, will help
patients on the road to optimal improvement.
My largest concern with the future of CFS/FMS is attracting the
funding needed to really get to the root of this illness. As a society,
we need to accept only the best and brightest research models and
push for solid, scientific studies that can be replicated. We definitely
need an attitude adjustment to the current approaches. HW
For further information, visit Dr. Enlander’s web site:
www.enlander.com. Dr. Enlander’s CFS handbook is available through
his office for $10.00. e handbook is periodically updated as new
information becomes available. Dr. Enlander’s online assistant may
be contacted by email at [email protected] regarding specific information
about the formula injection Dr. Enlander uses to treat his patients.
HEALTHwatch
Patients with fibromyalgia who do not respond to more simple
management techniques may often respond to a multidisciplinary
approach, which would include structured rehabilitation and

following important issues for FM patients (as applicable):
cognitive behavioral and stress reduction techniques. ese are
simply more intensive and focused ways to treat both the mind and
body aspects of fibromyalgia. e rehabilitation typically utilizes a
physical therapist and often also a doctor of physical medicine and
rehabilitation. As mentioned in my book, we have done a number
of different studies looking at various types of stress reduction
and cognitive behavioral techniques. ere are numerous studies
demonstrating their efficacy in both fibromyalgia and Chronic
Fatigue Syndrome.
Dr. Clauw:
Sleep (unrestful sleep; insomnia): Sleep hygiene (avoiding
caffeine/alcohol, exercising near bedtime, etc.), followed by tricyclic
medications (e.g., Flexeril, Elavil in very low doses given a few
hours before bedtime), or sedatives (e.g., zolpidem [Ambien]).
When using the tricyclic drugs or any medications, fibromyalgia
patients should “start low, go slow.” I usually begin at 5–10 mg of
Flexeril or Elavil taken two hours before bedtime, and increase the
dose by 5 – 10mgs per week.
e most exciting research that I’m personally involved in
is working with my collaborators to better understand the
neurohormonal aspects of fibromyalgia. ese studies are designed
to help us understand why the hypothalamic - pituitary - adrenal
system seems to be sluggish in responding to physiologic stresses.
We believe that this is important in the brain-body connection.
Our other major research involves studies to find better medications
in randomized placebo-controlled trials.
Pain: Tricyclics, tramadol (Ultram), venlafaxine (Effexor)
Low energy (combating fatigue): Buproprion (Wellbutrin),
venlafaxine
Depression (drugs prescribed, etc.): See above
recommendations, plus selective serotonin re-uptake inhibitors (e.g.,
Prozac, Zoloft, Paxil, Celexa).
I believe that information and education is the most important
way to empower patients to deal with these difficult illnesses.
Obviously, that is what I have attempted to do in detail in my
new book, providing both what I consider the most important
pieces of information, but at the same time, commenting on the
misinformation which confuses people who suffer with these
common illnesses. HW
Brain fog (inability to concentrate, memory problems, etc.): Same
as for low energy, plus occasional use of Central Nervous System
(CNS) stimulants.
Diet: I don’t think there is any diet than can be recommended
except a sensible, healthy diet.
For more information about Fibromyalgia: A Leading Expert’s Guide to
Understanding and Getting Relief from the Pain at Won’t Go Away
(Perigee/Penguin Putnam, 2002) by Dr. Goldenberg (and to purchase a
copy) please visit https://www.immunesupport.com/shop/books.cfm.
Supplementation (how to address any deficiencies): ere are
a few supplements that may be helpful for FM such as magnesium
supplements, or SAM-e, but patients should understand that these
are drugs when taken in this way. I am always somewhat amused
when a patient comes in to me taking eight different nutritional
supplements, and says that he/she doesn’t want to take any drugs.
A drug is anything that is ingested to change the body’s physiology
– nutritional supplements are drugs.
E T  CFS  FM: continued from page 1
[Daniel Clauw, M.D.]
protocol for your FM patients?
Dr. Clauw:
exercise for FM patients?
I use a combination of low-impact aerobic exercise,
symptom-based pharmacologic therapy, and cognitive behavioral
therapy. Not all patients need all three. I usually begin by
prescribing medications to target the two or three most prominent
symptoms that a patient has. In most cases pain is one, but poor
sleep, fatigue, memory problems, or other symptoms sometimes
interfere more with function than pain. I only use one treatment at
a time, and see if it works before deciding whether to continue with
the treatment, or discard it.
Dr. Clauw: Just as with medications, a “start low, go slow”
approach is most effective. Focus on low-impact exercises, begin
at a very low level (5 minutes 3–4 times per week) and slowly
increase by a minute or two per week. In some patients who are
very intolerant of exercise because it worsens their symptoms, warm
water aquatic therapy can be a good way of starting an exercise
program. I try to eventually get patients to do 20 minutes per day
of aerobic exercise, and tell them it will typically take 3–4 months
to reach this point.
One of the biggest problems I see in practice is that doctors and
patients try too many things at once, and then they have limited
ability to tell if something is working, or whether a new symptom
is a side effect of a treatment. After I find the correct one or two
medications to reasonably control many of the symptoms, then
I will add aerobic exercise, and sometimes cognitive behavioral
therapy (CBT). Both exercise and CBT can either be done simply
(with simple instructions for exercise or a workbook or Arthritis
Foundation course for CBT) or with more professional guidance
(e.g., with a physical therapist, personal trainer, social worker, or
psychologist). ese treatments take many months to work (in
contrast to medications which usually work within a month or so
if they are going to work at all), but the benefits are more durable
than the benefits obtained from medications. If this combination of
treatments doesn’t work, I will sometimes add complementary and
alternative therapies at this point.
HEALTHwatch
studies?
Dr. Clauw: Yes, many.
We [at Georgetown University Medical
Center] are doing research into both the mechanisms, and most
effective treatments, for fibromyalgia and related conditions. With
respect to mechanisms, our group is particularly interested in the
pain amplification mechanisms in fibromyalgia. We and others
have uncovered clear evidence that there is some process causing
normal pain signals to be amplified in fibromyalgia, almost like the
volume control is set too high in the nervous system. We also study
other components of the nervous system, such as the hypothalamus,
and autonomic nervous system.

With respect to treatment, we are very interested in whether and
how non-drug treatments work in FM. We have ongoing trials of
cognitive behavioral therapy, exercise, and acupuncture in FM. We
are also working on trials of drugs being developed especially for
FM. I feel that all of the above areas are very promising.
focus on their abilities. at is why I like the Latin word “habile,”
because it focuses on making able again, or abilities, focusing on the
positive. Too often, we tend to focus on the negative, or inabilities,
or things that we used to do. Remember habile!
Teaching a successful program to self-manage fibromyalgia. We live
with this condition every day so we should try to find out what works
and learn to do it ourselves. We can’t sling our doctors and therapists
over our backs, carry them with us throughout the day, and pull them
out when needed to treat our increased pain. We must manage our
pain as best we can by ourselves on a daily basis. I use a combination
treatment approach that is individualized for each patient.
ImmuneSupport.com: What do you think the future looks like
for FM patients? Are we moving forward in dealing with this
debilitating disease – as patients, practitioners, and as a society?
Dr. Clauw: Perhaps the most promising thing for patients is that
the pharmaceutical industry is getting much more interested in FM
than in the past. e pharmaceutical industry ultimately will be
responsible for putting fibromyalgia “on the map,” both with respect
to the “legitimization” of this illness, and to finding more effective
treatments. at is how validation has happened with other
illnesses like irritable bowel syndrome, and migraine headaches. HW
Education. is is half the battle. People with fibromyalgia must
understand that this condition is not life threatening, deforming
or paralyzing, and it is a valid medical condition. e more one
learns about fibromyalgia, the more it is understood and the less
frightening it becomes.
Mark J. Pellegrino, M.D.
Medicines. ere is no magical medicine to eliminate all the
symptoms of fibromyalgia, but many medicines can be helpful in
controlling various symptoms. I use sleep modifiers (e.g., Ambien,
Restoril), antidepressant medicines (i.e., tricyclics and serotonin
reuptake inhibitors), pain medicines and various other prescribed
medicines. Often, different medicines need to be tried to find the
best combination, and even when a good combination is found,
the medicines can “stop working” after a while. Rotating different
medicines over time can help.
Mark J. Pellegrino, M.D., is Board Certified
in Physical Medicine and Rehabilitation and
Electrodiagnostic Medicine, and is one of the nation’s
leading experts on fibromyalgia. Dr. Pellegrino is the
author of numerous books and articles on FM, and
despite having FM himself, he maintains an active
medical practice with over 10,000 patients cared for.
fibromyalgia (FM) as a valid illness with real symptoms?
Nutritional supplements. A variety of nutritional supplements can
be used to help the symptoms of fibromyalgia. Magnesium with
malic acid, 5-HTP, colostrum and others can be beneficial. Many
people who are too sensitive to prescribed medicines may better
tolerate nutritional supplements.
Dr. Pellegrino: I first became aware of fibromyalgia as a valid
illness in the mid-1980s during my residency in physical medicine
and rehabilitation at e Ohio State University. I learned about
this disorder as a common problem for which patients present to
a physiatrist (specialist in physical medicine and rehabilitation).
Also, during my third year of residency, I was diagnosed with
fibromyalgia after developing chronic pains all over, especially in
the right shoulder and back areas.
Pain management. I like to prescribe a program that may include
moist heat, bioelectric therapy, trigger point injections, ultrasound
and more with the goal of decreasing pain to a lower level. Once the
pain has decreased, one can try to progress to an exercise program.
Exercises. It is important to increase the flexibility and tone of the
muscles. is can be done by instructing a person on a combination
of postural stretches, light aerobic conditioning and strengthening
and toning exercises. Elastic bands such as erabands can be used.
ImmuneSupport.com: What are the most common factors for FM?
Dr. Pellegrino: e two most common factors for fibromyalgia
are hereditary factors and trauma factors. Individuals can inherit
fibromyalgia, or they can inherit a vulnerability that makes them
more predisposed to getting fibromyalgia following a specific
trigger. In my experience the most common cause or trigger of
fibromyalgia is trauma, especially neck trauma that can be seen
with a whiplash type injury. Other factors involved in developing
fibromyalgia include infections, underlying rheumatic diseases,
hormonal imbalances, and chemical exposures.
Manual therapy. is includes therapeutic massage, myofascial
release, soft tissue mobilization and adjustments.
Relaxation. Sometimes one of the best treatments to prescribe is
relaxation! Deep breathing exercises, guided imagery, biofeedback,
yoga, tai chi, and prayer are a few examples of relaxation techniques
that can be very helpful and effective.
protocol for your FM patients? What are your treatment goals?
Home program. Each individual needs to find whatever works best
and must follow through with a home program on a regular basis.
Dr. Pellegrino: Decreasing pain, as much as possible. It would
following important issues for FM patients (as applicable):
be great if everyone could go into remission and be pain-free,
but this rarely happens. What usually happens, however, is the
pain decreases, sometimes decreasing considerably from a higher
level to a much lower and more stable level. Some people achieve
remissions where they hardly feel any pain.
Dr. Pellegrino:
Sleep: For sleep problems, I frequently recommend sleep modifiers
such as Sonata, Ambien, 5-HTP, or medicines in the tricyclic
antidepressant families such as Amitriptyline or Trazodone. I
emphasize developing a sleep routine to optimize restful sleep.
Improving function. Even if a person is unable to do activities done
prior to developing fibromyalgia, one can still improve and learn to
HEALTHwatch

Pain: I prescribe different medications for pain including pain
fibromyalgia research involve the attempt to better understand and
characterize the dysfunctional neurobiology involved, particularly
with the brain, spinal cord and autonomic nerves. I am fascinated
with the cognitive retraining research as well.
medicines, non-steroidal anti-inflammatory drugs (NSAIDs),
muscle relaxers, anti-seizure medicines, and other medicines.
Fatigue: For fatigue, I often recommend supplements that
ImmuneSupport.com: What do you think the future looks like
for FM patients? Are we moving forward in dealing with this
debilitating disease – as patients, practitioners, and as a society?
include magnesium/malic acid, colostrum, NADH, and others.
I recommend specific dietary strategies for fatigue, namely a diet
higher in protein and lower in carbohydrates.
Dr. Pellegrino: I believe we are moving forward in a positive and
Depression: For depression I prescribe different medicines in the
hopeful direction in dealing with the debilitating fibromyalgia
condition. e medical society has increased its understanding of
this disorder and enhanced its knowledge and treatment strategies,
which I believe will continue to progress into the future. I look
forward to better understanding the causes and mechanisms
of fibromyalgia and attempting to prevent it from occurring in
vulnerable individuals. I look for further research to understanding
trauma and how it can lead to fibromyalgia, and I am hopeful that
cognitive retraining and prolotherapy, among other treatments, will
be found to be effective in treating fibromyalgia. HW
tricyclic antidepressant family and selective serotonin re-uptake
inhibitor family. Often I will use a combination such as a selective
serotonin inhibitor in the morning and a tricyclic antidepressant
in the evening. I also recommend counseling whenever depression
issues are present.
Brain fog: For brain fog, I focus on optimizing sleep and
optimizing dietary and supplement strategies. I have found
magnesium/malic acid supplements and colostrum are helpful
supplements. Medicines that increase serotonin levels or
norepinephrine levels can be prescribed. Achieving a regular
exercise program is also helpful to combat brain fog.
Dr. Pellegrino’s latest book, From Whiplash to Fibromyalgia describes the
whiplash injury in detail and sets forth how fibromyalgia evolves from
this type of traumatic injury. All monies raised from the sale of this book
are given back to FM support groups, research, and advocacy efforts. e
book is 130 pages (ORC Publishing, 2002) for $15.00 plus $3.00 S&H
(within the US). A copy can be obtained by sending a check or money
order payable to: ORC Publishing, 6651 Frank Ave. NW, N. Canton,
Ohio 44720, or by calling 1-888-508-6604 to order and pay by credit
card.
Diet: I often recommend a diet that is higher in protein and lower
in carbohydrates to help fibromyalgia.
Nutritional Supplementation: Various supplementation
strategies exist for fibromyalgia. e research supports that people
with fibromyalgia have low or below normal levels of magnesium,
thyroid, growth hormone, B-12 levels and serotonin, among others.
If low or below normal deficiencies are identified, I recommend
specific supplementation.
I also address other issues when treating fibromyalgia including
immune dysfunction, chronic yeast infection, cognitive difficulties,
work issues, stress management and more.
exercise for FM patients?
Dr. Pellegrino: I instruct my fibromyalgia patients to try to achieve
a regular exercise program that includes stretching and a form of
light conditioning. Stretching can be done as many times during
the day as desired. e light conditioning program can include
warm water aquatics, walking, bicycling or any other form of light
aerobic activity, and should be attempted at least three times a week
for 20-30 minutes at a time.
ImmuneSupport.com: In your experience, what have been the
most effective treatments for your FM patients?
Dr. Pellegrino: e most effective treatments I have found include
education, improving sleep disorders, finding a successful therapy
program that usually includes some form of manual work combined
with stretching and a light conditioning program, nutritional
supplement strategies including magnesium/malic acid along with
dietary approaches, and a successful home program.
studies?
Dr. Pellegrino: Currently I am performing a couple of research
studies involving prescription pain gel and the management of
fibromyalgia pain. e most promising research developments in
HEALTHwatch

Y S S D C:
Do You Need an Attorney to Win?
Scott E. Davis is a social
security and long-term
disability insurance
attorney located in
Phoenix, Arizona. Mr.
Davis represents clients
throughout the United
States. Although Mr.
Davis has experience
representing clients with a
broad spectrum of physical
and/or psychological
disorders, the majority of his disability practice is
devoted to representing individuals with chronic
pain and chronic fatigue disorders. In Social
Security disability cases, a fee is charged only if his
client obtains benefits.
would you? Congressional and SSA’s own
statistics show dramatic differences in the
outcomes of cases depending on whether an
attorney is involved.
Did you know you can increase your odds
of winning your Social Security (SSA)
Disability case by more than 50% if you are
represented by an attorney? Simply put,
that’s a dramatic difference and one that
every Social Security disability applicant
should heed.
However, the testimony of Congressmen
Matsui and Shaw confirms what SSA and
many disability attorneys have known for
years. With such a compelling statistic,
it is my hope this article is viewed as
educational, rather than self-serving.
Congressional and SSA’s own statistics
confirm this statement is true. e
statistic came to light in November
2001, during Congressional testimony
provided by Congressman Robert T.
Matsui of California. During the hearing
Congressman Matsui provided the
following testimony:
“Professional representation is a
valuable - and indeed vital - service.
e disability determination process is
complex. Claimants without professional
representation appear to be far less likely
to receive the benefits to which they are
entitled. For example, in 2000, 64% of
claimants represented by an attorney,
but only 40% of those without one, were
awarded benefits at the hearing level.”1
At the same hearing, Congressman E. Clay
Shaw, Jr. of Florida provided the following
testimony:
“As many of you know, fi ling for Social
Security benefits - especially disability
benefits - is so complicated that many
claimants must hire attorneys to guide them
through the process.” 2
Please understand I am not suggesting that
you must have an attorney in order to win
your disability case. People can and do win
their cases on their own. In fact, SSA does
not require you to have an attorney, you
can represent yourself; but why on earth
HEALTHwatch
I have debated for years on whether to
write an article on why one should hire
a disability attorney. I did not want the
article to be viewed as self-serving for either
myself or my profession. I am aware of the
unfortunate stature attorneys hold in our
society, some of which is deserved. I always
enjoy the look in a person’s eyes when they
learn I am an attorney; it is clear they are
searching their mind to share the latest
attorney joke…and most are very funny!
So you know the difference a disability
attorney can make in your case…what can
you do about it? For those of you who are
now considering hiring an attorney, let me
provide you with some basic information to
assist you in making your decision.
1. You only pay an attorney’s fee if
you win your case
e number one question on people’s minds
is, “How can I afford an attorney when I am
not working?” e answer is simple…you
only pay the attorney a fee if you win your
case. You do not pay an attorney upfront.
Generally, every disability attorney will
represent you on a contingency fee basis.
Simply put, this means you do not pay an
attorney’s fee unless you win your case.
us, everyone seeking disability benefits
can afford an attorney. e question you
should be asking yourself is “can I afford not
to be represented by an attorney?”
2. General information regarding
the attorney’s fees
e SSA and federal law set the attorney’s
fees in disability cases. e standard fee
agreement most attorneys use states the
attorney’s fee is contingent upon winning
your case. e fee is 25% of all past due
benefits for you and your family, up to a
maximum of $5,300, or whichever is less.
Some attorneys may use a fee agreement
which provides for a maximum fee of
$7,000.

It is worth noting that on February 1, 2002,
SSA increased the maximum standard fee
amount to $5,300 from $4,000. is is the
first time the fee has been increased since
1990 and simply represented a cost of living
adjustment.
us, the attorney’s fees are usually only
a fraction of the benefits you receive;
depending on the amount of your past due
benefits, it can be a very small fraction.
3. What is my case worth if I win?
e answer to this question depends on a
number of factors including how long you
have been disabled, when or if you will ever
return to work, the amount of your monthly
benefit and whether you have eligible
dependents.
For example, if you are 45 years old, your
monthly benefit amount is $1,000, and if
you do not return to work before age 65;
your case can easily be worth $250,000!
is amount does not include the value
of the Medicare or Medicaid insurance
you will be eligible for after being found
disabled. As many of you know, the price
of medical insurance in middle age, with
pre-existing medical conditions, can be
staggering and not affordable. is of course
assumes that an insurance company is
willing to insure you.
4. Why you increase your odds of
winning your case if you hire a
disability attorney
ere are many reasons hiring an attorney
can significantly increase the odds of
winning your case. One significant reason
is that disability attorneys understand the
complicated laws and regulations that
determine success or failure. Two questions
I always ask potential clients are, “Do you
know what you need to prove in order to
win your case?” and “If you do not know,
how are you going to go about proving it?”
You should hire an attorney who
specializes in Social Security disability
law. Furthermore, I believe it is important
to hire an attorney who has expertise in
representing people with your type of
diagnosis. It is important that your attorney
believes in your case and that they can
win it. I suggest you ask the attorney how
much experience they have with your type
of diagnosis and how often do they win?
Any disability attorney should be willing to
provide you with this information.
5. What an attorney should do to
increase the odds of winning your
case
From the beginning, the attorney should
set forth a strategy that both of you should
follow to win your case. It is critical to
understand what is necessary to prove your
case and how you will go about winning
it. e sooner you know this, the sooner
you can take steps to execute the strategy
and thereby increase your odds of winning.
us, you should consult with and hire an
attorney either when you fi le your claim or
as soon thereafter as possible.
Based on my experience in representing
clients nationwide (remember Social
Security is federal law and not state
specific), none of them had a strategy or
plan on how to win their case before they
hired me. is is important because most
of them were simply “doing whatever SSA
told them to do” while their claim was
being processed. is included seeing SSA’s
doctors for an examination that often results
in a denial of their claim.
It is important to understand that SSA is
only obligated to investigate your case and
is not charged with approving it. I am not
suggesting that SSA denies every claim;
I’m simply stating that my experience after
having successfully represented many clients
whose claims were previously denied by
SSA because evidence was not obtained, not
reviewed or SSA focused on what it wanted
to in order to support a denial.
In conclusion, if you are contemplating
fi ling a claim for SSA Disability benefits, I
encourage you to consult with an attorney
as soon as possible to help you understand
the process. e consultation should not
cost you anything except your time. By
understanding the process and having a
strategy, you will significantly increase your
odds of winning your case.
Congressional and Social Security’s
statistics do not lie – it is penny wise and
pound foolish not to hire a disability
attorney.
Best of luck to you and remember to keep
fighting for the benefits you deserve! HW
References:
1 November 16, 2001 CONGRESSIONAL
RECORD, Testimony of Honorable Robert T.
Matsui of California, regarding the Attorney Fee
Payment System Improvement Act 2001.
2 November 16, 2001 CONGRESSIONAL
RECORD, Testimony of Honorable E. Clay Shaw
of Florida, regarding the Attorney Fee Payment
System Improvement Act 2001.
© 2002, Scott E. Davis. Esq. All rights reserved.
R N B: continued from page 2
Probiotics May Prevent Antibiotic Associated
Diarrhea
sought. Lead authors Richard Gracely, Ph.D., and Daniel Clauw,
M.D., did the study at Georgetown University Medical Center
and the National Institutes of Health, but are now continuing the
work at the University of Michigan Health System. To correlate
subjective pain sensation with objective views of brain signals, the
researchers used a super-fast form of MRI brain imaging, called
functional MRI or fMRI, on 16 fibromyalgia patients and 16
people without the disease. As a result, they say, the study offers
the first objective method for corroborating what fibromyalgia
patients report they feel, and what’s going on in their brains at the
precise moment they feel it. And, it gives researchers a road map
of the areas of the brain that are most - and least - active when
patients feel pain.
Probiotics (microbes that protect their host and can prevent
disease) can prevent diarrhea associated with the use of
antibiotics, finds a study in the June 8, 2002 issue of the British
Medical Journal.
Promising New Treatment for Chronic Fatigue
Syndrome: Procrit
e Behavioral Medicine Research Center at the University
of Miami is conducting a study funded by the National Heart,
Lung, and Blood Institute of the National Institutes of Health.
Dr. Barry Hurwitz, Ph.D., and Dr. Nancy Klimas, M.D., are the
principal investigators. e study is investigating a very promising
potential treatment for Chronic Fatigue Syndrome (CFS). e
study is a placebo-controlled clinical trial in which Procrit is
prescribed to the participants for 13 weeks. Procrit is a drug that
has been used for over a decade to treat anemia, which is low
red blood cell volume. e drug increases the production of red
blood cells, which has been discovered to be low in many CFS
patients. Because the red blood cell delivers oxygen to the body, it
is projected that this treatment may reduce the debilitating fatigue
experienced by individuals with CFS. For more information about
the study, visit http://www.bmrc.miami.edu/research/niaid/
procrit.aps.
IV Lignocaine (Lidocaine) Promising in Fibromyalgia Treatment
Patients with fibromyalgia who have not responded to standard
treatments may benefit from an intravenous infusion of the
anesthetic lignocaine (lidocaine), according to results of a pilot
study presented at the British Society for Rheumatology meeting
in May 2002. Although the results are preliminary and the
therapy is still considered to be relatively risky, researchers say
they are promising enough to warrant further investigation. Dr. J.
H. Raphael, of the Dudley Group of Hospitals in West Midlands,
and colleagues offered intravenous lignocaine to 55 patients
who failed to respond to physical, psychological, or traditional
pharmacological therapy and had no cardiac conduction
abnormalities. After treatment, they asked patients to recall how
much pain they felt before and after therapy. Among 50 patients
who responded to the questionnaire, the median pain score
dropped from 9 before treatment to 5 after (p < 0.001), based
on an 11-point rating scale. e effect of the therapy reduced
depression from a median of 8 to 5, dependency from 8 to 5, and
ability to cope from 9 to 5, all statistically significant (p < 0.001),
the investigators reported.
New Brain Scan Study Finds Proof of Fibromyalgia Pain
A new brain-scan study confirms scientifically what fibromyalgia
patients have been telling a skeptical medical community
for years: ey’re really in pain. e results, published in the
June 2002 issue of Arthritis & Rheumatism, the journal of the
American College of Rheumatology, may offer the proof of
fibromyalgia’s physical roots that many doubtful physicians have
HEALTHwatch

B  V C-I  C F S P
Garth Nicolson, Ph.D., is
President, Chief Scientific
Officer and a Research
Professor at e Institute
for Molecular Medicine
in Huntington Beach,
California. He is engaged
in research on the role of
chronic infections in a
variety of illnesses, such as
Chronic Fatigue Syndrome,
Fibromyalgia, Rheumatoid Arthritis, Gulf War
Illness and various autoimmune diseases.
By Garth L. Nicolson, Ph.D. (e Institute for
Molecular Medicine, Huntington Beach), Marwan
Y. Nasralla, Ph.D. (International Molecular
Diagnostics, Inc., Huntington Beach, California
), Kenny De Meirleir, M.D., Ph.D. (Department
of Internal Medicine, Free University of Brussels,
Brussels, Belgium), and Jeorg Haier, M.D., Ph.D.
(Department of Surgery, Wilhelm University,
Munster, Germany).
In Chronic Fatigue Syndrome (CFS)
patients, we have found that chronic
infections are a rather common feature of
the illness. Previously, we studied American
and European CFS patients and found that
most had Mycoplasmal infections11,19,20.
Others studied CFS patients and also
found evidence of widespread Mycoplasmal
infections12-14. When we examined the
incidence of particular Mycoplasmal
infections in CFS, we found that most
patients had multiple infections (two or
more species of Mycoplasma), which were
for the most part combinations of M.
fermentans and other Mycoplasma species19.
For example, in studying the prevalence
of multiple Mycoplasmal co-infections
we found that double or triple infections
occurred only when one of the species was
M. pneumoniae and/or M. fermentans11,19.
In a study on European CFS patients
a slightly different picture was found11.
Examining 261 consecutive patients seen at
a CFS clinic in Belgium 68.6% of patients
were found to have one or more species of
Mycoplasma in their blood. In contrast to
North American patients, however, the most
common species found was M. hominis. is
could indicate differences in demography
and exposures between North American and
Belgian CFS patients. We also found that
more than 50% of North American patients
with rheumatoid arthritis had Mycoplasmal
infections, and in the majority of these
patients multiple infections with more than
one species was found18.
Mycoplasmas are found commonly in
HEALTHwatch
the oral cavity, urogenital tract and as
symbiotic gut flora, but some species can
cause acute and chronic illnesses when they
penetrate into the blood vascular system and
systemically colonize organs and tissues3, 24-26.
For example, M. penetrans, M. fermentans,
M. hominis and M. pirum can enter a
variety of tissues and cells and cause systemic
signs and symptoms. Mycoplasmas have also
been shown to have a complex relationship
with the immune system. ey are very
effective at evading host immune responses,
and synergism with other infectious agents
has been seen24.
In addition to CFS, Mycoplasmas are
thought to contribute to patients’ morbidity
in rheumatoid arthritis18, 27, systemic
lupus erythematosis28, demyelinating and
axonal neuropathies29, HIV-AIDS24, 26,
30
and chronic respiratory conditions31-33.
Mycoplasmal infections have been reported
as co-infections with other microorganisms 34, 35.
Certain types of non-Mycoplasmal infections
are also commonly found in CFS patients.
e most common viral infection found is
HHV-615-17. Although HHV-6 infections are
commonly found in children, in adults such
infections are considered latent but can be
reactivated in certain illness states. In CFS
patients HHV-6 is frequently reactivated and
appears in blood leukocytes, in contrast to
control subjects15-17. In at least one of these
studies peripheral blood mononuclear cells
were cultured and tested for two HHV-6
glycoproteins using specific monoclonal
antibodies and HHV-6 genes were probed
using nested PCR17. In 23 out of 35 patients
(65.7%) peripheral leukocytes showed active
infection by PCR.
species are capable of possible cross-reactions
with Mycoplasma-related organisms21, we
used only unique primers and conditions
that detect only specific species. Similar
to a previous study20, we examined the
reliability of the methods by performing
multiple assays (repeated 3-6 times), and
the results were completely reproducible.
e sensitivity of Mycoplasma detection
by the described method was assessed by
the detection of control Mycoplasma DNA
and by internal Southern blot hybridization
using Mycoplasma-specific probes. Using
serial dilutions of Mycoplasma DNA the
method was able to detect as low as a few fg
of DNA 20.
In other experiments, Mycoplasma
was added to control blood samples at
various concentrations. We were able
to detect specific products down to 10
ccu/ml blood. us with the use of specific
Southern hybridization the procedure
can result in specific test results of high
sensitivity, down to the presence of a few
microorganisms in a clinical sample19,20.
In our experience, conventional PCR
yields similar results to forensic PCR with
extracellular microorganisms, but not with
clinical samples that contain intracellular
microorganisms. Although the reason
for this is not known, it could be due to
inhibitors present in the clinical samples
or to loss of Mycoplasma DNA in the
conventional extraction procedures due
to protein complexing or degradation by
cellular nucleases20.
e use of PCR techniques for detection of
microorganism infections in patients has
been questioned in studies where different
methods were used in different laboratories
without validation. e PCR tests that we
e multiple co-infections in CFS probably
used to identify bacterial and viral infections play an important role in determining the
are very sensitive and highly specific.
severity of systemic signs and symptoms
found in CFS patients19,25. Since most CFS
ese tests are a dramatic improvement on
patients that previously tested positive for
the relatively insensitive serum antibody
Mycoplasmal infections have benefited
tests that are routinely used to assay for
from therapies directed at their chronic
systemic infections36. For example, in the
infections25,37, we consider it important that
determination of Mycoplasmal infections we such infections be carefully considered in any
used primer sets for various genes found in
treatment program for CFS patients37-39. HW
19-23
specific species .
Editor’s note: e preceding is an excerpt. To view
Since the universal primers GPO-1 and UNI the complete text and references for this article, please
that have been used to detect all Mycoplasma visit http://www.immunesupport.com/library/
showarticle.cfm/ID/3635/T/CFIDS_FM.

P H F CFS  FM R: D U 
In keeping with our mission to fund research into the causes, pathology and potential cures for Chronic Fatigue Syndrome (CFS) and
fibromyalgia (FM), Pro Health is currently funding several important CFS and FM research studies, as described below. We extend
our sincere thanks to our many loyal customers, whose purchases from our Pro Health catalogs and ImmuneSupport.com provide some
of the funds we donate to such important research and advocacy efforts in the CFS/FM community. We also encourage you to make
outright donations to the following research studies, and as a further incentive, Pro Health will match donations up to $5,000 made by
Healthwatch readers to each of the research studies described below.
FM Research Study: “Mechanisms of Chronic
Pain in Fibromyalgia Syndrome”
Pro Health’s
$20,000
Challenge
see below…
I. Jon Russell, M.D.,
Ph.D., and colleagues are
conducting a study of the
“Mechanisms of Chronic
Pain in Fibromyalgia
Syndrome” at the University
Clinical Research Center
and e Research Imaging
Center at the University of
Texas Health Science Center
at San Antonio, Texas. e
objective of this study is
to utilize MRI and fMRI
methodologies to examine
the structure-function
relationships of the brain
in fibromyalgia syndrome (FMS) patients to a graded pressure
stimulus at one of the typical tender points [TePs].
CFS Research Study: To Identify Genes
Differentially Regulated by the 37-kDa RNase L
in CFS by DNA Microarray Analysis
Kenny De Meirleir, M.D., Ph.D., Patrick
Englebienne, Ph.D., and Robert Suhadolnik,
Ph.D., are currently seeking funding to conduct a
preliminary study of gene expression in Chronic
Fatigue Syndrome. According to Dr. De
Meirleir, “the only study done so far to look at
gene expression in CFS was recently presented
at a conference in Sweden, which I attended,
and is not published yet. e CDC discovered
that there is upregulated gene expression (seven
genes) and these genes are all implicated in the
immune system (based on a study of 25 CFS
patients and 50 matched controls). We want to
know what this means, and how this relates to
our own findings. We are seeking to determine
whether this [gene expression] is acquired
and if so, what elicits this increased
genetic expression, and whether there
is a genetic predisposition.” Dr. De
Meirleir and colleagues intend to use
the results of their preliminary study to
convince the NIH and other institutions
to invest further in this project.
Functional MRI [fMRI] is an expansion of the MRI technology
with great potential to measure the active function of the brain in
health and disease. is method is completely non-invasive and
does not require any injection. With the MRI camera continuously
focused on the head of a test subject, a stimulus such as a sound, a
picture, or a touch on the skin can be introduced. e areas of the
brain activated by the stimulus will be recognized by a change in
the fMRI signal specifically resulting from the stimulus. Systematic
induction or withdrawal of the stimulus will turn on or off the
change in the relevant brain structures. Drs. Gracely, Clauw, and
colleagues have demonstrated the utility of this method in patients
with fibromyalgia with pressure induction at a non-tender point in
the hand. Among other things, this study will determine whether
examining the brain response to painful pressure at a FMS TeP will
activate the brain in the same general way as was seen with pressure
at a non-tender area of the hand as reported by Drs. Gracely,
Clauw, et al.
Pro Health’s $20,000 Challenge
Pro Health encourages donations to make this important research possible, and will match your donations dollar-for-dollar (up to $5,000 per study). We challenge our many Healthwatch readers to make even a small donation to the study that
you would like to support. If combined reader donations total $10,000 ($5,000 for each study), Pro Health will match those
donations, bringing our collective total to $20,000 for this important research. For Dr. Russell’s FM study, please make your
tax deductable checks payable to UT Health Science Center, and for Dr. De Meirleir’s CFS study, please make your tax deductable checks payable to VUB/MFYS. Mail your donation checks to Attn: Research Funding, 2040 Alameda Padre Serra
#101, Santa Barbara, CA 93103. We will forward donations to the respective parties. ank you for your support!
HEALTHwatch

For the past fourteen years, Healthwatch has delivered the latest research on the pharmacological and alternative treatments most
effective for helping to relieve the symptoms of Chronic Fatigue Syndrome and fibromylagia. Given the wide selection of nutritional
supplements available, we are continuing to produce this treatment guide, highlighting the most promising 18 natural supplements that
contribute positively to the goals of better health and overall well-being.
NATURAL & ALTERNATIVE TREATMENT GUIDE
NADH ................................................................................. 18
Transfer Factor...................................................................... 19
Olive Leaf Extract ................................................................ 20
Glucosamine & Chondroitin ................................................ 20
Cuddle Ewe........................................................................... 21
Coenzyme Q10 ..................................................................... 22
Methylcobalamin.................................................................. 22
Alpha Lipoic Acid................................................................. 23
Methionine ........................................................................... 24
Undenatured Whey Protein .................................................. 25
Natural Enzymes .................................................................. 26
5-HTP.................................................................................. 26
SAM-e.................................................................................. 27
CLA ..................................................................................... 28
Milk istle .......................................................................... 28
Relaxin ................................................................................. 29
Magnesium & Malic Acid..................................................... 30
L-Carnitine .......................................................................... 31
NADH: C P  E, R  R A
NADH triggers energy production
through ATP generation. A naturallyoccurring coenzyme found in all living
cells, NADH helps supply cells with
energy. Professor George Birkmayer,
M.D., Ph.D., the researcher who first
discovered the therapeutic application of
NADH in cellular development and energy
transmission, summarizes the function
of NADH as follows, “NADH is the
biological rocket fuel. It is the biological
form of hydrogen which reacts with the
oxygen present in our cells to produce
energy. e more NADH we have, the
more energy we can produce.”
“According to our experience, the first
observation CFS patients experience
is clearing of what they call ‘ brain
fog.’ en, it elevates mood and
cognitive ability, short-term memory,
visual perception and finally, it
increases physical energy.”
George Birkmayer, M.D., Ph.D.
Research Study Results
An FDA-approved study conducted at
Georgetown University Medical Center
indicated that NADH may be a valuable
adjunctive therapy. ese research findings
were published in the Annals of Allergy,
Asthma & Immunology
Immunology, a leading peerreviewed medical journal. In this study,
twenty-three patients with Chronic Fatigue
Syndrome (CFS) were randomly assigned
to received either 10mg of NADH or
placebo at week zero for a four-week period,
followed by a four week ‘wash-out’ period in
which subjects were crossed to an alternate
treatment regimen. e results showed
that the patients taking NADH were four
times more likely to show improvements
HEALTHwatch
compared to those taking placebos. 1
e results of a longer 18 month follow-up
study, reported in Newsweek Magazine,
confirmed the positive results of the
Georgetown study. In the open label
follow-up study of eleven patients, 73%
showed significant improvement in clinical
symptomology and energy levels. At 18
months of using NADH, 83% of study
participants reported positive improvements
in symptoms. 2
Researchers in the Sleep-Wake Disorder
Center at the New York Weill Cornell
Medical Center, tested the ability of oral
stabilized NADH to improve alertness,
mood, and performance on cognitive
tasks in 25 healthy middle-aged adults
after one night of total sleep deprivation.
In this double-blind crossover study,
subjects performed significantly better on
some measures of cognitive performance
following one night of total sleep
deprivation when they received NADH
compared to placebo. In particular, overall
performance efficiency measured one
hour after consuming 20mg of sublingual
NADH was significantly higher than
after placebo. In a second analysis, math
throughput and visual sequence comparison
speed and throughput were themselves
significantly better following NADH.
Dr. Margaret Moline, the lead researcher
and Director of the Sleep-Wake Disorders
Center at the Westchester Division of New
York-Presbyterian Hospital, states, “NADH
is the first non-stimulant, non-herbal
product to show signs of improved cognitive
performance, despite normally reported
increased sleepiness and fatigue following
sleep deprivation.3

Significant Benefits for Energy and More
Regarding the therapeutic use of NADH,
Dr. Birkmayer has found, “according to
our experience, the first observation CFS
patients experience is clearing of what they
call ‘brain fog.’ en, it elevates mood and
cognitive ability, short-term memory, visual
perception and finally, it increases physical
energy.”
Dr. Birkmayer elaborates, “What we have
learned since the Georgetown study was
that 10mg is obviously too low a dosage, in
spite of the fact that one third of the CFS
patients in that study improved after one
month, and 83% improved after 18 months.
However, I am convinced if CFS patients
start with four tablets [20mg NADH] per
day, they will experience a positive effect
sooner.”
“NADH is the first non-stimulant,
non-herbal product to show signs of
improved cognitive performance,
despite normally reported increased
sleepiness and fatigue following sleep
deprivation.”
Margaret Moline, M.D.
References:
1. L M Forsyth, MD; H G Preuss, MD; A L
MacDowell, MD; L Chiazze, JR, ScD; G D
Birkmayer, MD, PhD; and J A Bellanti, MD.
NADH: A New erapeutic Approach in Chronic
Fatigue Syndrome. ANNALS OF ALLERGY,
ASTHMA, IMMUNOLOGY, February 1999,
Volume 82, Number 2.
2. Newsweek Magazine. March 1, 1999 issue.
3. Kay GG, Viirre E, Clark J. Stabilized NADH
as a countermeasure for jet lag: Abstract presented
and published in the proceedings of the 48th
International Congress of Aviation and Space
Medicine, September 2000.
T F: R  I S
Transfer Factor – e Key to
Immune System Memory
Backed by over 50 years of medical research,
Transfer Factor represents one of the most
exciting advances in immune system health.
Transfer factors are tiny protein molecules
(‘immune memory molecules’), which are
produced by immune cells called T-cells.
Transfer factor is based on the knowledge
that key immune information can be
transferred from cell to cell. ese cells
then teach our immune system to recognize
specific viruses or bacteria that our bodies
may not currently recognize. is is
particularly exciting given the therapeutic
role transfer factors play in activating
and enhancing immunity in individuals
suffering from chronic illness.
ere are several million naturallyoccurring transfer factors circulating in
the human body. Many of these transfer
factors were introduced to us from our
mother’s colostrum. is ‘first milk’ is the
richest source of concentrated transfer
factors known to scientists. Transfer
factor in colostrum has the sole purpose of
transferring immunity from the mother to
the baby’s immature immune system. is
imparts the mother’s immunity to the baby
to help ensure survival while the baby’s
immune system matures.
“In a general sense, all of my patients
with CFS and FM take Transfer
Factor…I myself take the [Transfer
Factor Basics] supplement every
day…I have even found that
using Transfer Factor in cases of
autoimmune dysfunction tends to
bring about a stability of the immune
system ‘cross talk’ and reestablishment
of the immune system balance.”
-Dale Guyer, M.D.
Transfer Factor for Treatment of
Chronic Illness
Non-specific transfer factor formulas (like
Pro Health’s Transfer Factor Basics™)
are formulated to combat daily attacks by
environmental bacteria, pollutants, fungus,
viruses, and allergens – thereby providing
you with a powerful weapon to fight chronic
illness.
Targeted transfer factor formulas are
designed for individuals challenged by
specific pathogens. Supplementation with
the appropriate transfer factor molecule may
provide the ‘missing link,’ thereby allowing
HEALTHwatch
the immune system to target and destroy
the offending pathogen. Chronic Fatigue
Syndrome (CFS), fibromyalgia (FM),
chronic candidiasis, Burkitts Lymphoma,
post-lyme syndrome, HIV infection, and
multiple sclerosis patients may benefit from
transfer factors targeted for pathogens
that have been identified through testing.
Targeted transfer factor formulas include
Transfer Factor 4000, Transfer Factor
6000, ImmuneTransfer C, Formula 540 and
Formula 560. Consult with your physician
to discuss whether a specific, targeted
transfer factor formula would be right for
you.
What Doctors and Researchers are
Saying About Transfer Factor
Dale Guyer, M.D., is a holistic family
physician and Director of e Advanced
Medical Center located in Zionsville,
Indiana, where patients are offered a unique
blend of traditional and alternative therapies
for a number of health-related issues,
including CFS and FM. Regarding transfer
factor treatment, Dr. Guyer explained, “In
a general sense, all of my patients with CFS
and FM take Transfer Factor. I have found
it selectively useful for just about every
broad category of human health in addition
to those who are generally healthy. I myself
take the supplement every day, and at times
when I feel tired and rundown or have had
a viral exposure and start to feel flu-like
symptoms, I will take fairly generous doses
and often the symptoms will resolve within
a matter of hours.”
Regarding transfer factor treatment for
Chronic Fatigue Syndrome, Paul. H.
Levine, M.D., stated, “With some studies
suggesting that persistent viral activity
may play a role in perpetuation of CFS
symptoms, there appears to be a rationale
for the use of transfer factor in patients with
CFS, and recent reports have suggested that
transfer factor may play a beneficial role in
this disorder.”*
Dimitri Viza, M.D., Director of the
Immunobiology Laboratory at the
Faculte de Medecine des Saints-Peres in
Paris, reported at the 11th International
Conference on Transfer Factor, “Once
again, the reported clinical results were
important, and theoretically, should
warrant funding to further explore the
phenomenon [transfer factor] and exploit
its uses for patients’ benefit. Indeed, from
viral and fungal infections to malignant

disorders, from herpes to tuberculosis,
transfer factor has proven able to stimulate
immune defenses, preventing new infections
or relapses and shortening the course of
disease.”
Carol Ann Ryser, M.D., Medical Director
of the Health Centers of America, treats her
chronically ill patients (including those with
Chronic Fatigue Syndrome) with transfer
factor. She reports, “Transfer factor helps
with viral, bacterial, and fungal infections
as well as parasites, and supports the
immune system while treating the problems
a patient has.” Dr. Ryser also treats her
fibromyalgia patients with transfer factor,
stating, “I believe that fibromyalgia is most
commonly caused by infections, including
bacteria, yeast, and parasites.”
“Transfer Factor helps with viral,
bacterial, and fungal infections as
well as parasites, and supports the
immune system while treating the
problems a patient has.”
-Carol Ann Ryser, M.D.
How Transfer Factor is Produced for
Human Consumption
Due to practical consideration in the
manufacturing and processing of transfer
factor, chicken derived and bovine
colostrum are the preferred sources of
transfer factor.
Colostrum from healthy, organically fed
cows is fi ltered and purified to provide a
mixture of pure transfer factor molecules.
In the case of chicken sourced transfer
factor, specific transfer factors are derived
from healthy chickens and combined
with growth factors found in colostrum.
Numerous rigorous techniques, including
further purification and isolation, result
in pure transfer factor. Every lot produced
undergoes meticulous testing to ensure
that the appropriate and effective levels of
each transfer factor are present, before it is
encapsulated and bottled. Also, people who
are lactose intolerant or who have allergies
need not be concerned about a reaction,
since all traces of milk proteins and lactose
are removed during the extraction and
concentration process.
*Source: Abstracts of the Communications
Presented at the 10th International Symposium
on Transfer Factor, Held in Bologna, Italy, June
22-24, 1995.
O L E:
A P D 
V  B
MSNBC R: T S
G  C
S E A
e key component of olive leaf extract is known as oleuropein,
which is found in the fruit, leaves, bark and roots of the olive tree.
Within this substance is a chemical called elenolic acid, which has
strong antimicrobial effects. It works by interfering with the amino
acid pathways of invading pathogens such as bacteria and viruses,
and inhibits them from reproducing in the body by neutralizing
the production of transcriptase and protease. ese enzymes are
essential for many viruses and bacteria in that they enable them to
infect a healthy cell. When these enzymes are inhibited, infections
cannot penetrate a healthy cell, enabling the immune system to
easily dispose of the pathogen.
By Robert Bazell, NBC News Correspondent
Zenaida Perdomo’s osteoarthritis hurt her legs so much that many
days she could not get out of bed. “I had to walk on my tip toes.
at’s how bad it was,” she recalls. A nutritionist suggested she try
two supplements — glucosamine and chondroitin. A year later,
she can’t believe the difference — she’s now taking high-impact
aerobics.
For years, many doctors were skeptical about the supplements, but
recently they received a powerful endorsement. Consumer’s Union,
the independent testing group, said the supplements not only
relieve pain but can actually rebuild damaged joints.
“We know that actually, of the 31 different viruses that
this compound (OLE) has been studied [in vitro] against,
it was effective against 31 viruses, including many of the
herpes viruses, which may have a lot of significance for
chronic fatigue patients.”
- John Martin, Ph.D.
Some 21 million Americans suffer osteoarthritis, a disease that
often occurs with aging where the cartilage wears out, leaving
severe pain in the joints. It affects 30 percent of women 60 and
over and 17 percent of men.
Studies so far show the supplements help about one in four people,
but no one at Consumer’s Union guarantees results like Perdomo’s.
Study Shows Olive Leaf Fights Infection
In a study conducted at the University of Messina, Italy,*
researchers examined the antimicrobial and inhibitory properties
of oleuropein and its derivatives on the growth rate of bacteria and
fungi in humans. Researchers examined five standard bacterial
strains including Haemophilus influenzae, Moraxella catarrhalis,
Salmonella typhi, Vibrio parahaemolyticus and Staphylococcus
aureus, with 44 fresh clinical isolates (agents that cause intestinal
or respiratory tract infections) in vitro.
“e good thing about them [Glucosamine & Chondroitin]
is that they appear to actually build up the structure of the
joint, lubricate it, strengthen it, and so on, in a way more
so than a simple painkiller would do,” said Dr. Geoff rey
Martin of Consumer’s Union.
But the group points out that glucosamine — derived from
shellfish shells — and chondroitin — made from cow cartilage
— appear to be free of side effects. Aspirin and other antiinflammatory drugs used by millions to ease the pain of arthritis
can cause stomach problems, and some studies suggest newer drugs
called Cox-2 inhibitors might increase the risk of heart attack.
By calculating the minimum inhibitory concentration (MICs)
the researchers found strong evidence of oleuropein’s broad
antimicrobial activity, as well as potent inhibitory effects against
the bacteria. Despite a poor effectiveness against Haemophilus
influenzae and Moraxella catarrhalis strains, the researchers
concluded oleuropein is still a potential source of promising
antimicrobial agents for treatment of intestinal or respiratory tract
infections.
“So we’re excited that there is a dietary supplement that people
can take that might help,” said Consumer’s Union Health Editor
Ronni Sandroff.
“[Olive leaf extract]…is the missing link that functions as
an antiviral and antiretroviral agent by slowing down the
organism’s reproductive cycle. A slow down of the spread of
the organism allows the patient’s immune system to go on
the attack.”
- Lisa Weinrib, M.D.
In its labs, Consumer’s Union also found that most brands actually
contain the amounts of pure supplements claimed on the label. So the
group recommends people buy the least expensive products, which cost
about 45 cents a day.
What does the medical profession think of the supplements?
e National Institutes of Health is carrying out a definitive $14
million study to be finished in 2005. Meanwhile, many doctors are
suggesting their patients give them a try. In fact, last year’s sales of
glucosamine and chondroitin hit $640 million.
According to rheumatologist Lisa Weinrib, M.D., who
treats patients suffering from Chronic Fatigue Syndrome and
Fibromyalgia, “[olive leaf extract] … is the missing link that
functions as an antiviral and antiretroviral agent by slowing down
the organism’s reproductive cycle. A slowdown of the spread of the
organism allows the patient’s immune system to go on the attack.”
Source: www.msnbc.com, Health Section, December 2001 (http:
//www.msnbc.com/news/672388.asp)
Olive leaf extract is a powerful tool in the fight for wellness.
Widely recognized as a powerful health promoter, olive leaf extract
helps strengthen the immune system, support healthy blood
pressure and a strong cardiovascular system, all the while helping
to energize the body.
*Bisignano G, Tomaino A, Lo Cascio R, Crisafi G, Uccella N, Saija A. “On
the in-vitro antimicrobial activity of oleuropein and hydroxytyrosol.” J Pharm
Pharmacol 1999 Aug;51(8):971-4
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
R S  D. I. J R C:
C E P F P  R, R S
Customer Survey Results
I. Jon Russell, M.D., Ph.D., a widely acknowledged authority
on fibromyalgia (FM), conducted a study to determine whether
fibromyalgia patients would experience sleep benefits following
three months of sleeping on Cuddle Ewe™ underquilts versus other
products tested. Study results showed that 76.2% of the patients
preferred sleeping on Cuddle Ewe™ underquilts and experienced
significant improvement in sleep quality.
Dr. Russell’s findings about the sleep benefits of Cuddle Ewe™
underquilts corroborate the results of an earlier survey of Cuddle
Ewe™ customers. e survey showed that 78.5% of fibromyalgia
patients reported significant pain relief as well as substantially
more restful, restorative sleep, with their Cuddle Ewe™ underquilt.
What makes these results more remarkable is that the survey was
conducted on 643 clinically or physician diagnosed fibromyalgia
patients - not just from a healthy population.
“…e Cuddle Ewe™ underquilt is the first thing I’ve
slept on “ like a baby,” since the pain got really bad. No
more tossing and turning at night and no more Codeine!”
- Amethyst S.
Methods: Forty-two adult outpatients with primary fibromyalgia
participated in the study. e patients were randomized to one
of six crossover schedules. e “U” group slept on Cuddle Ewe™
underquilts. e “P” and “B” groups slept on placebo quilts. Each
intervention was used for three months before crossover - the
full course was nine months. e patients were not told which
intervention was focal, and the assessor was blinded to the codes.
e primary outcome variable was a validated Sleep Efficiency
Scale (SES). Ten relevant secondary measures included: the
Fibromyalgia Impact Questionnaire (FIQ ), a Pain Relief Rating
Scale (PRRS), and a Device Preference Scale (DPS).
Results: Significant benefit accrued in the primary outcome
SES. Patients reported greater sleep efficiency and quality during
U treatment [using the Cuddle Ewe™ underquilt], than during
P treatment [the first placebo], and borderline significant benefit
with U than with B treatment [the second placebo]. Significant and
beneficial effects were found within the FIQ and PRRS during U
treatment. A significant and consistent preference for U treatment
relative to the P or B treatments was found, with 76.2% preferring
U treatment [the Cuddle Ewe™ underquilt].
“…night after night I would experience sweating and
discomfort. ...to my surprise, the low back spasms finally
ceased, I was no longer damp in the morning, and my
muscles felt much more relaxed…the temperature of the bed
[due to the underquilt] adjusting to my body temperature
does make relaxing an easier task to accomplish. ank you.”
- Karen P., Wynne, AZ
“Once you have slept on one, you will never be without
one again! It is great lying down and feeling the softness
coming up around you. I love it!”
-Dave Fuller
Sleep Warmer
Sleep is uncomfortable and difficult when you feel too cold or
overheated. e Cuddle Ewe™ underquilt helps your body to
maintain a regular temperature, which in turn keeps you relaxed
and asleep. e fibers of sheep’s wool capture air that acts as a buffer
to changes in temperature. at’s why clothing made of wool keeps
us warm in winter and cool in summer. Wool breathes - it can
absorb moisture without feeling wet to the skin, and then lets it
evaporate into the air.
Customer studies show the following symptoms are relieved
by using a Cuddle Ewe™ underquilt:
•
•
•
•
•
•
Soft tissue muscle pain
Tender point muscle pain
Fatigue
Morning stiff ness
Lack of restful and restorative sleep
Not sleeping through the night
Sleep Cooler
In hot weather, body moisture condenses in the form of perspiration
at contact points with the mattress. Your sheets become damp, you
feel wet and sticky, and sleeping in this condition is fitful at best.
Sleep Sounder
Deep, restorative sleep is elusive for so many chronically ill people,
but it doesn’t have to be that way. Cuddle Ewe™ underquilts, placed
between your mattress and bottom sheet, provide gentle, effective
support and simultaneously distribute your body weight. Even with
tender and sore muscles or aching limbs, the layers of thick, natural
wool batting support and cocoon you like no other material, natural
or synthetic. e natural properties of wool also help you maintain
regular temperature and moisture control for a very comfortable
night’s sleep.
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watch
e Cuddle Ewe™ underquilt reduces humidity in your bed. e
wool is fi lled with countless air spaces. As that wool absorbs your
water vapor, air circulating through it continually disperses the
moisture by evaporation. So in hot weather, your skin and sheets
remain dry, you stay cooler, and sleep much better.


C Q: R P
B  F  M
M L
H  A C
Since Coenzyme Q10 (CoQ10) facilitates cellular respiration, and
because clinicians believe it is of therapeutic value, it has long been
prescribed to Chronic Fatigue Syndrome (CFS) patients.1,2 One
research effort presented a formal study of 20 female patients who
required bed rest following mild exercise. ey were compared
to 20 sedentary sex-, age-, and weight-matched normal controls.
Eighty percent were deficient in CoQ10, which further decreased
following mild exercise over the course of normal daytime activity.
ree months following supplementation with 100mg CoQ10 daily,
exercise tolerance (400 kg-meters of work) more than doubled;
all patients had improved. Ninety percent had reduction and/or
disappearance of clinical symptoms, and 85 percent had decreased
post-exercise fatigue. 3
Vitamin B-12 is a member of a group of essential biological
compounds known as cobalamins. e most common form of
vitamin B-12 is called cyanocobalamin; however, over the last ten
years, a number of central and peripheral neurological diseases have
been linked to a deficiency of a very specific form of cobalamin,
known as methylcobalamin.
Published studies show methylcobalamin helps to correct
neurological defects, maintain neuron cell health and support the
myelin sheath that protects peripheral nerves. In a 1997 study
published in the Scandinavian Journal of Rheumatology, researchers
concluded that methylcobalamin protects against neurotoxicity
by enhancing brain cell methylation. e researchers also
recommended that ongoing intake of methylcobalamin is necessary
to protect against neurotoxicity.
What is Coenzyme Q10 and What is its Role?
Coenzyme Q10 (CoQ10) is a natural energy-producing nutrient
involved in a wide range of body systems. CoQ10 is an electron/
proton carrier located in the mitochondria, tiny power plants found
in every cell in the body, and effectively supports their energyproducing pathways to help fuel the body’s daily activity. CoQ10 is
found in high amounts in the cells of the heart, liver, kidneys and
pancreas. A potent antioxidant, CoQ10 also defends cells against
free radical damage.
Vitamin B-12 Aids Cognition
Cognitive impairment can range in severity from mild memory
loss or “brain fog” to severely debilitating conditions such as
Alzheimer’s disease. In a study published in the American Journal of
Clinical Nutrition, (Vol. 75, No. 5, 908-913, 2002) lead researcher
Susan J. Duthie and colleagues investigated the associations
between cognitive impairment and plasma concentrations of
folate, vitamin B-12, and homocysteine in 331 older subjects.
Homocysteine is an amino acid, which in high concentrations, has a
neurotoxic effect that could lead to cell death. e researchers found
significant negative effects on cognition in the elderly subjects
who had deficiencies of folic acid or vitamin B-12 and elevated
homocysteine.
In addition to its energy-producing benefits, CoQ10 has been
the subject of intense research for its cardioprotective benefits.
Multiple studies have investigated the ability of CoQ10 to reduce
the lipids that characterize harmful cholesterol buildup. An article
in the journal Atherosclerosis, reported that treatment with CoQ10
reduced the amount of plaque deposits in the coronary arteries, and
also reduced the incidence of plaque rupture and thrombosis - key
events in heart attacks.4 A new study reported in the Annals of
the New York Academy of Sciences explored the cardioprotective
benefits of CoQ10 against stress. 5
And now, new research indicates yet another benefit of CoQ10: it
may prevent migraine headaches. e article in the April 2002 issue
of the Journal of the International Headache Society, Cephalalgia,
reports very encouraging results from an open label trial of CoQ10
as a migraine preventive.
e participants were survivors of the Scottish Mental Surveys
of 1932 and 1947, which conducted intelligence tests in Scottish
school children. From 1997-1999, participants in the two
groups–born in 1921 and now aged 76-78, and those born in 1936,
now aged 61-63–participated in the study. Cognitive status was
measured by standardized tests that assessed nonverbal intelligence,
speed of information processing, pattern recognition, and general
cognitive ability. Concentrations of plasma homocysteine, folate,
and vitamin B-12 were also determined.
“Coenzyme Q10 looks to be an excellent choice for initial
therapy for prevention of episodic migraine if confirmed by
controlled studies of efficacy. It can be given to almost any
age group without fear of significant side-effects.” 6
Lead researcher T.D. Rozen of the Jefferson Headache
Center and omas Jefferson University School of
Medicine, Philadelphia, PA.
e older group (born in 1921) had increased levels of
homocysteine, which correlated both with lower serum folate and
vitamin B-12 concentrations, and with lower cognitive test scores.
ose who had higher plasma concentrations of folate and B-12
scored higher on 4 of the 6 cognition tests. Among the group
born in 1936, higher folate concentrations correlated with higher
scores on one of the assessment tests, but otherwise no effects of B
vitamins or homocysteine were apparent. e researchers conclude
that administration of vitamin B-12, or folic acid may lower
homocysteine and prevent those with mild cognitive impairment
from further cognitive decline.
References:
1. Lapp CW. Chronic fatigue syndrome is a real disease. North Carolina Family
Physician 1992;43:6-11.
2. Goldberg A. No article title available. CFIDS Chronicle, Summer/Fall 1989.
3. Judy W. Southeastern Institute of Biomedical Research, Bradenton, Florida.
Presentation to the 37th Annual Meeting, American College of Nutrition,
October 13, 1996. Published in Altern Med Rev 2001 Feb;6(1):4-6.
4. Singh RB, Shinde SN, Chopra RK, Niaz MA, akur AS, Onouchi Z.
Effect of coenzyme Q10 on experimental atherosclerosis and chemical composition
and quality of atheroma in rabbits. Atherosclerosis. 2000 Feb;148(2):275-82
5. Rosenfeldt FL, Pepe S, Linnane A, Nagley P, Rowland M, Ou R, Marasco
S, Lyon W, Esmore D. Coenzyme Q10 protects the aging heart against stress:
studies in rats, human tissues, and patients. Ann N Y Acad Sci. 2002 Apr;959:
355-9; discussion 463-5.
6. Rozen, TD, Oshinsky, ML, Gebeline, CA, Bradley, KC, Young, WB,
Shechter, AL & Silberstein, SD. Open label trial of coenzyme Q10 as a migraine
preventive. Cephalalgia 22 (2), 137-141.
HEALTHwatch
It is important to note that methylcobalamin is the only form of
vitamin B-12 that can cross the blood-brain barrier to effectively
promote healthy brain cell functioning. is powerful nutrient
appears to lower homocysteine, combat neurotoxicity, and helps
maintain cognitive ability.

S S A L A M R
 A B  A M
Alpha Lipoic Acid (ALA) was first
discovered in 1951 and was recognized as
a coenzyme necessary for sugar breakdown
and energy production. en in 1988,
researchers found it to be an effective
antioxidant. Today, new research confirms
the antioxidant effects of Alpha Lipoic
Acid may be effective in preserving brain
function and memory.
In the first of three combined studies from
the University of California, Berkeley,
published in the Feb. 19 issue of the
Proceedings of the National Academy of
Sciences (PNAS 99, 4:2356-61, 2002), lead
researcher Bruce Ames, M.D., reported that
an accumulation of oxidative damage on the
brain’s mitochondria, protein and nucleic
acid may lead to neuronal and cognitive
dysfunction. Ames and his colleagues found
that ALA in combination with acetylL-carnitine (ALC), improved memory
function by reducing oxidative damage and
improving mitochondrial function.
In the study, scientists fed old rats alpha
lipoic acid and/or acetyl-L-carnitine and
assessed the animals’ spatial and temporal
memories. Based on these results, the
researchers found supplemented rats
experienced improved memory function
as both metabolites reduced oxidative
damage to nucleic acid, especially when
administered together. Additionally, in
microscopic studies of the hippocampus (a
region of the brain important for memory),
the supplements reversed age-associated
mitochondrial structural decay.
In the second PNAS article (99, 4:1876-81,
2002), Ames and researchers found feeding
old rats high levels of
acetyl-L-carnitine
and/or alpha
lipoic acid
ameliorated
destructive
cognitive
HEALTHwatch
events such as oxidative damage and
mitochondrial dysfunction.
In the third study, (99, 4:1870-5, 2002)
Ames and colleagues reported that feeding
the rats alpha lipoic acid with acetyl-Lcarnitine together increased mitochondrialsupported cellular metabolism, and
lowered oxidative stress more than either
compound alone. Because decreased cellular
metabolism and increased oxidative stress
are associated with getting older, this
finding may prove to be significant in the
fight to retain cognitive health.
“Alpha-lipoic acid...is unique among
natural antioxidants … making
it a potentially highly effective
therapeutic agent in a number
of conditions in which oxidative
damage has been implicated.” Lester
Packer M.D., Ph.D
As the rats performed better on memory
tests, Ames noted a significant increase in
the rats’ energy. “With the two supplements
together, these old rats’ got up and did the
Macarena,” Ames said. “e brain looks
better, they are full of energy--everything
we looked at looks more like a young
animal.”
According to the researchers, alpha lipoic
acid targets mitochondria and removes
destructive free radicals, while acetyl-Lcarnitine boosts the activity of a damaged
enzyme (carnitine acetyltransferase)
that plays a key role in burning fuel for
mitochondria. “Each chemical solves a
different problem--the two together are
better than either one alone,” Ames said.
What is Alpha Lipoic Acid?
Alpha Lipoic Acid (ALA) is a sulfur
containing fatty acid that converts food
sugars for cellular respiration, and acts
as a free radical scavenger that is both fat
and water soluble for complete antioxidant
cell protection. ALA neutralizes the
effects of free radicals by enhancing the
antioxidant functions of vitamin C,
vitamin E, and glutathione. ALA
also increases cysteine utilization
in the body’s manufacturing of
glutathione, and plays a critical
role in the Krebs cycle, stimulating
production of ATP (the body’s
cellular energy source).

Alpha Lipoic Acid Increases
Cellular Glutathione
Previous research has focused on alpha
lipoic acid’s universal antioxidant properties
and ability to influence glutathione
production. Glutathione is the body’s
essential antioxidant, which scavenges
hydroxyl radicals, the most dangerous type
of free radicals found in the body. When
added to various types of animal and human
cells in laboratory cultures, alpha lipoic acid
stimulated a 30-70% increase in cellular
glutathione. Glutathione levels have been
found to increase dramatically in the lungs,
liver, and kidney cells of mice injected daily
with varying doses of alpha lipoic acid for
11 days.
Lester Packer, M.D., Ph.D. head of the
membrane Bioenergetics Group and
Department of Molecular & Cell Biology
at Berkeley, presented a compelling case
for ALA in a review article titled, “AlphaLipoic Acid as a Biological Antioxidant.”
In the review Packer explained, “Alpha
lipoic acid is readily absorbed from the
diet. It is rapidly converted to DHLA
(dihydrolipoic acid) in many tissues, as
recent advances in assay technique have
made evident… Both DHLA and alpha
lipoic acid have metal chelating activity.
DHLA acts syngeristically with other
antioxidants, including that it is capable of
regenerating other antioxidants from their
radical or inactive forms. Finally, there is
evidence that [ALA] may have effects on
regulatory proteins and on genes involved in
normal growth and metabolism.”
Analysis of these studies led Dr. Packer to
conclude:
“It appears that alpha lipoic acid and
DHLA act as antioxidants not only directly,
through radical quenching and metal
chelation, but indirectly as well, through
recycling of other antioxidants and through
the induction of increased intracellular
levels of glutathione.”
In all the clinical studies to date with alpha
lipoic acid, there have been no reported
serious adverse side effects, even at high
doses up to 1,800mg.
M  M D
Studies have shown the protective effects of Methionine in
animal models against mercury, lead and atrazine (an herbicide).
Methionine is an essential sulfur amino acid and is listed on the
FDA’s “generally regarded as safe” list. It was once used in soy
based baby formulas to provide adequate Methionine nutrition for
infants.
Fatigue Syndrome. After a three week period in which patients
were not allowed to supplement with trace elements and vitamins,
blood samples were taken and analyzed for cellular levels of
mercury. Levels exceeding the detection limit (0.5 ug/g dry weight)
were found in 14 patients and in 5-15% of their red blood cells. For
the studied granulocytes (another blood cell) 20 of the 25 patients
displayed detectable mercury
“When increased levels of toxic compounds are present,
Methionine is a critical component
levels in 10-30% of the cells. e
of tissue development, growth and more methionine is converted to cysteine and glutathione researchers concluded that all
synthesis. Methionine and cysteine have a protective
tissue repair for all humans - no
of the patients had an elemental
effect on glutathione and prevent depletion during toxic profile suggesting a heavy metal
mater what the age. Methionine
overload (Ruffman R and Wendel A. GSH rescue by
functions as an antioxidant (free
burden that had influenced their
N-acetylcysteine Klin Wochenschr 69:857-62, 1991). is health.
radical deactivator) and helps
helps protect the liver from the damaging effects of toxic
neutralize toxins. It serves as a
principal source of sulfur that
Another study presented at the
compounds and promotes their elimination.”
the body needs to replenish
International Symposium on
-Michael T. Murray, N.D., from Chronic Fatigue
daily. Sulfur is used for mucous
Syndrome: Getting Well Naturally (Prima Publishing, Functional Medicine6 tested
production and detoxification.
sensitivity to metals such as
1994).
mercury and lead using a method
of testing known as MELISA (Memory Lymphocyte Immuno
Stimulation Assay). Of patients with Chronic Fatigue Syndrome,
Mercury is a shiny, silver-white, liquid metal, or if heated, a
45 percent showed mercury hypersensitivity and 49 percent showed
colorless, odorless gas. Unfortunately mercury is one of the primary
lead hypersensitivity. When the metal burden was removed from
pollutants in our environment. It enters the air during mining,
burning coal and waste, and from industrial manufacturing1. It then the body (in many cases by removing mercury-containing silver
dental fi llings), 77 percent of patients reported improved health.
falls from the atmosphere through precipitation and is deposited
into rivers and lakes where it is absorbed by fish. While pollution
spreads this metal throughout the environment, mercury can also
be found in our homes and in our teeth. Amalgam dental fi llings
Methionine supports mercury removal by promoting the body’s
contain mercury as do thermostats and thermometers, lighting, and natural detoxification processes. Methionine suppresses and
electrical equipment 2.
neutralizes toxic chemical activity, and functions as a chelator,
a binding agent that deactivates and removes toxic metallic
substances by altering their molecular structure. is process
If someone is exposed to large amounts of mercury it is possible that inhibits transport of mercury throughout the body, including the
brain and central nervous system, where mercury may have its most
they may develop mercury toxicity. Common symptoms of mercury
harmful effects.
toxicity include fatigue, sluggishness, and low energy. Other health
problems may include headache, neuromuscular pain and stiffness,
Methionine also promotes healthy levels of homocysteine, a toxic
poor concentration and memory, while affecting organs and body
byproduct of the methylation process that, if left unchecked, may
systems like the brain, lungs, kidneys and liver. Additionally,
cause serious health problems.
mercury may impair immune system and enzyme function, inhibit
3
inflammatory processes and alter metabolic pathways .
References:
Mercury, the Environment & Human Toxicity
How Methionine Works
Symptoms of Mercury Toxicity
1. Mercury CAS # 7439-97-6. ToxFAQs, Agency for Toxic Substances and
Disease Registry. Atlanta, Georgia 1999.
2. Mercury Fact Sheet. Indiana Department of Environmental Management.
Indianapolis, IN.
3. Schmidt Michael A. Tired of Being Tired: Overcoming Chronic Fatigue &
Low Energy Frog, Ltd., North Atlantic Books, Berkeley, California.
4. “Update: Mercury Poisoning Associated with Beauty Cream -- Arizona,
California, New Mexico, and Texas, 1996.” Morbidity and Mortality Weekly
Report. July 26, 1996 / 45(29);633-635
5. Danersund, A., Lindvall, A., Lindh, U. “Elemental profiles in 25 patients
with chronic disease. In Trace Elements in Human Health. Presentation
Abstracts. Amsterdam, Holland 1993.
6. Stejskal, V. “Immunological reactions to metals in patients with chronic
fatigue syndrome.” International Symposium on Functional Medicine.
Presentation abstracts. Palm Springs, California 1994.
According to a Center for Disease Control and Prevention (CDC)
report4, chronic exposure to mercury can result in “a variety
of manifestations of central nervous system toxicity,” that is,
high levels of mercury in your brain and spinal cord may cause
personality changes, nervousness, irritability, tremors, weakness,
memory loss, mental illness, and changes in or loss of hearing,
vision, or taste. e CDC states mercury toxicity should be
considered as a probable cause in cases where neurologic symptoms
like these are of an unclear etiology.
Mercury Toxicity Research
A study conducted at the Uppsala University Medical School in
Sweden5 reported that chronically ill patients contain abnormal
levels of mercury within their cells. Of the 25 chronically ill study
participants, the researchers determined that 12 had Chronic
HEALTHwatch

U W P:
F I H  M D
e Physician’s Desk Reference (PDR) states that
undenatured whey protein is an important contributor to
health in the following ways:
In his book Tired of Being Tired: Overcoming Chronic Fatigue
and Low Energy, Michael A. Schmidt stresses the importance
of glutathione in the detoxification process. He states, “In one
of your body’s detoxification pathways, toxic substances are
temporarily converted into more toxic intermediate substances
and then converted into mercapturic acids to be harmlessly
eliminated. However, if you are deficient in vitamin E, selenium,
glutathione, glycine, vitamin C, or other nutrients, the highly toxic
intermediates are not properly quenched and can wreak considerable
havoc with your cells.”
• Supports health of the gastrointestinal tract
• Promotes repair of RNA and DNA
• Promotes removal of toxic metals from the body
• Aids in wound healing
• Supports production of hemoglobin, enzymes, hormones, antibodies
• Helps with creation of new muscle mass
Undenatured Whey Protein is Key to Glutathione
Production
As a precursor to glutathione production, undenatured whey protein
plays an important role in strengthening the immune system and
detoxifying the body.
Undenatured whey protein is an excellent precursor to glutathione
production. True undenatured whey protein naturally contains
many proteins, peptides, and other important nutrients that
enhance immune function. Undenatured whey protein also contains
generous amounts of the cysteine and glutamine/glutamate amino
acids necessary for glutathione production.
Glutathione is Crucial to Immune Function
Glutathione is a molecule consisting of three amino acids: Lglutamate, L-cysteine, and L-glycine. is molecule serves a variety
of functions, perhaps the most important is its role as the body’s
master antioxidant. In fact, other antioxidants such as vitamins C
and E are dependent on glutathione for their effectiveness. When
glutathione is exhausted, the cell cannot rid itself of free radicals,
nor can it produce energy via normal pathways. Eventually, the cell
dies through a process called apoptosis.
e components of undenatured whey protein work in several ways
to support immune health. ey stimulate the production of red
blood cells, enzymes, hormones, and antibodies, while inhibiting
the growth of harmful bacteria and viruses in the gastrointestinal
tract. Glutathione’s other benefits include the manufacture of new
muscle mass, repair of RNA/DNA, speedier healing of wounds,
removal of toxic metals and the production of antioxidants critical
to cellular detoxification and repair.
Glutathione is essential to the immune system’s fight against
sickness. Research has shown that Chronic Fatigue Syndrome
(CFS) and fibromyalgia (FM) patients have abnormally low levels
of glutathione. Without glutathione, cells are left defenseless
against viruses and toxins that assault the body daily.
Accepted by the Medical Community
e medical community has formally recognized and accepted
the compelling benefits of whey protein for improving immune
function and promoting detoxification. Given that the medical
establishment is slow to accept change, the addition of undenatured
whey protein to the highly respected Physician’s Desk Reference
underscores the conclusive research supporting its significant
benefits for immune health.
“I believe that glutathione deficiency found in virtually
all [Chronic Fatigue Syndrome] patients is the key
problem, particularly over time… ere are two major
implications of glutathione deficiency: detox failure and
viral/microbial activation. Glutathione plays a major role
in the detoxification pathways of the body. A deficiency
impairs the body’s ability to get rid of toxins, whether
environmental or by-products of cellular metabolism. If
you raise the glutathione levels you can stop the replication of
most any intracellular pathogen. We have found a way to do
this [raise glutathione levels]: undenatured whey protein.”
-Paul Cheney, M.D., prominent CFS physician and
researcher
References:
1. Physician’s Desk Reference. Page 3274, 2002 (undenatured whey protein).
2. Bounous G, Molson J. Competition for glutathione precursors between the
immune system and the skeletal muscle: pathogenesis of chronic fatigue syndrome.
Med Hypotheses 1999 Oct;53(4):347-9.
3. Logan AC, Wong C. Chronic fatigue syndrome: oxidative stress and dietary
modifications. Altern Med Rev 2001 Oct;6(5):450-9.
4. Droge W, Holm E. Role of cysteine and glutathione in HIV infection and
other diseases associated with muscle wasting and immunological dysfunction.
FASEB J 1997 Nov;11(13):1077-89.
5. Paul Cheney, M.D. Basic Treatment Plan for Chronic Fatigue Syndrome.
www.ImmuneSupport.com. Oct 2001.
6. New Study Shows Supplement Raises Glutathione Levels and Balances
Immune System. www.ImmuneSupport.com. Nov 2000.
7. National Center for Infectious Disease: Chronic Fatigue Syndrome
Treatment. http://www.cdc.gov/ncidod/diseases/cfs/treat.htm. Feb 2002.
8. Micke P, Beeh KM, Buhl R. Effects of long-term supplementation with
whey proteins on plasma glutathione levels of HIV-infected patients. Eur J Nutr
2002 Feb;41(1):12-8
9. Schmidt, Michael A. Tired of Being Tired: Overcoming Chronic Fatigue
and Low Energy. Frog, Ltd., North Atlantic Books, Berkeley, California. ISBN
1-883319-16-1. is book can be purchased at www.northatlanticbooks.com
10. Health News: Volume 33, Issue IX, July 2000.
Paul Cheney, M.D., a leading CFS researcher and physician,
stresses the significance of glutathione in CFS etiology and
states, “Glutathione plays a major role in the body’s detoxification
pathways and in its viral repression mechanisms. It is also a very
potent antioxidant (counteracts free radical damage/oxidative
stress/reactive oxygen species). Most CFIDS patients show
significant glutathione deficiency.” Cheney reported that more than
two-thirds of patients experienced significant improvements with
supplementation of undenatured whey protein.
Glutathione is a Key Detoxifying Agent
Glutathione is concentrated in the liver where it performs its
important detoxifying role. Toxins, pollutants, and carcinogens are
eliminated from our bodies through glutathione enzymatic pathways.
HEALTHwatch

N E P  H I R
What Are Enzymes and What Do
ey Do?
Enzymes are various types of proteins
which act as catalysts to facilitate the body’s
biochemical processes. Enzymes control the
chemical reactions of all organisms, big and
small. More than 3,000 different enzymes
have been identified in the human body.
ese enzymes build new proteins, cells,
tissues, and organs. We all rely on optimal
enzyme activity throughout our lives to
enjoy peak health.
Enzymes such as bromelain and papain
are derived from pineapples and papayas.
Trypsin and pancreatin are derived from
healthy porcine pancreas. Enzymes are
found most active in raw or lightly cooked
foods - unfortunately, the moderate
temperatures at which most foods are
cooked destroy important enzymes. is
is why it is very difficult to obtain all the
enzymes we need through diet alone.
Additionally, medical experts have found
that as we age, our ability to manufacture
enzymes diminishes.
Natural enzymes are commonly used to
treat sports-related injuries – including
those experienced by professional athletes.
According to Rudolph Kunze, Ph.D.,
“Enzymes play an important role in
healing sports injuries by mediating the
inflammatory process, enhancing and
hastening the removal of fibrin and other
clotting factors.”
Albert Lind, M.D., agrees: “Having
thoroughly researched enzymes, including
publishing my doctoral dissertation on
enzymes, I highly recommend their use
for all types of traumas, including sports
injuries…enzymes enable [physicians] to
safely and effectively stimulate the healing
process in their patients while relieving
soreness and inflammation.”
“Having thoroughly researched
enzymes, including publishing my
doctoral dissertation on enzymes, I
highly recommend their use for all types
of traumas, including sports injuries.”
-Albert Lind, M.D., from e
Aspirin Alternative (Michael Loes,
M.D., M.D.(H.), David Steinman,
M.A.)
How Are Natural Enzymes
Different From NSAIDs?
Pain is often treated with non-steroidal
anti-inflammatory drugs (NSAIDs),
including aspirin, diclofenac, and ibuprofen.
Normally, these drugs are prescribed
for short-term use (typically 2-3 days).
When these drugs are used for longer
periods, virtually all patients suffer from
some complications which can range from
micro-bleeding in the gastrointestinal tract,
to liver or kidney toxicity. Additionally,
NSAIDs can cause adverse reactions when
combined with other prescription drugs
- especially cortisone-type medications.
Further, NSAIDs do not address the
underlying conditions of pain and may
even hasten the degeneration of tissues.
According to Raul Ahumada, M.D., “e
bottom line is that enzyme therapy is safe
and as effective as the use of NSAIDs, but
without the long-term side effects.”
Source: e Aspirin Alternative, Michael Loes,
M.D., M.D.(H.), David Steinman, M.A.
Enzyme Research
In a study conducted at the Department
of Natural Medicine, University Hospital,
in Zurich, Switzerland, “erapy with
proteolytic enzymes in rheumatic disorders”
(Drugs 2001;15(12):779-89), Leipner and
colleagues conclude, “e results of various
studies (placebo-controlled and comparisons
with nonsteroidal anti-inflammatory
drugs) in patients with rheumatic diseases
suggest that oral therapy with proteolytic
enzymes produces certain analgesic and
anti-inflammatory effects. However, the
results are often inconsistent. Nevertheless,
in the light of preclinical and experimental
data as well as therapeutic experience,
the application of enzyme therapy seems
plausible in carefully chosen patients with
rheumatic disorders.”
-HTP: P B  FM S
Several different studies
by leading fibromyalgia
researchers, such as I. Jon
Russell, M.D., Ph.D.,
Muhammed Yunus, M.D.,
and I. Caruso, M.D., among
others, have also demonstrated
a connection between
fibromyalgia and lowered
serotonin levels in the blood.
In one double-blind study led
by Dr. Caruso, Fibromyalgia
patients given 300mg of 5-HTP
daily reported a reduction of
pain symptoms. Performed at
the L. Sacco Hospital in Milan,
Italy, Caruso and colleagues
performed a 90 day trial on
the efficacy and tolerability
of 5-HTP in 50 fibromyalgia
patients. Clinical measurements
including number of tender
points, levels of anxiety, quality
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of sleep, and fatigue were
taken at baseline and at the
end of the 90 day treatment
phase. e results showed
the patients had a significant
improvement in symptoms.
According to the researchers,
the overall evaluation of the
patient condition, assessed by
the patient and the investigator,
indicated a ‘good’ or ‘fair’
clinical improvement in nearly
50% of the patients during the
treatment period.
the symptoms of primary
fibromyalgia as it remained
effective throughout the 90 day
treatment period.
5-HTP Improves Sleep
5-HTP (5-hydroxytryptophan)
is used by the human body
to maintain healthy serotonin
levels. Serotonin is a
neurotransmitter located within
the brain and central nervous
system that enhances mood and
well being and promotes healthy
sleep patterns.
During the trial 5-HTP
had a good level of safety
and tolerability. A total of
15 (30%) patients reported
side-effects but only one
patient was withdrawn from
the treatment for this reason.
e researchers concluded that
5-HTP is effective in improving
According to Zoltan P. Rona,
M.D., MSc., 5-HTP can be
used for sleep improvement in
place of the psychoactive drugs
that are commonly prescribed
for people with fibromyalgia.
5-HTP is derived from Ltryptophan, which can break

down into 5-HTP or another
compound called kynurenin.
ere is some evidence to
suggest that people with FM
may be deficient in serotonin
because the tryptophan
obtained from food metabolizes
into kynurenin rather than
5-HTP. For this reason,
supplementing with 5-HTP
is likely to be more efficient
than L-tryptophan in boosting
serotonin. 5-HTP also controls
carbohydrate cravings and
helps prevent suboptimal blood
glucose control.
References:
Puttini PS, Caruso. “Primary
fibromyalgia syndrome and
5-hydroxy-L-tryptophan: a
90-day open study.” I.Int Med Res
Apr;20(2):182-9, 1992.
SAM- R P  I
J  L H, M E
e therapeutic properties of SAM-e have
become widely known and celebrated
by pain sufferers everywhere. Short for
S-adenosyl-methionine, SAM-e is a natural
compound found in every human cell that
is involved in over 35 biochemical processes
in the body, and has been long touted for
its mood elevating benefits, joint and liver
support and overall good safety profi le.
Improved Joint Function & Pain
Reduction
Strong evidence suggests that SAM-e
may protect cartilage from arthritis
damage while stimulating new cartilage
growth. Animal studies indicate that
SAM-e increases the production of
cartilage-building cells called chondrocytes
in joints. Some scientists believe that the
greater the number of chondrocytes in the
body, the greater amount of cartilage it
can produce. Additionally, SAM-e helps
prevent the breakdown of proteoglycans,
the molecules in cartilage that hold onto
water and provide cartilage with lubrication
and flexibility. It is when a joint becomes
arthritic that the proteoglycans begin to
break down, resulting in a damaged joint
that is painful and difficult to move.
SAM-e, in combination with other popular
prescription antidepressant medications
such as Fluoxetine (Prozac), Paroxetine
(Paxil) or Setraline (Zoloft) among others,
will be effective for patients with partial
or no response to a standard course of
prescription drug treatments.
e study is lead by Jonathan Alpert,
M.D., Ph.D., associate director of the
Depression Clinical and Research Program
at the Massachusetts General Hospital
and assistant professor of psychiatry at
Harvard. It includes an eight week open
trial involving approximately 30 patients,
both men and women between the ages of
18 and 75 who meet specific study criteria
for depression.
“Since there are more than 40
clinical trials that suggest SAM-e’s
effectiveness for depression as a
stand alone therapy, we are eager
to study its effectiveness and safety
as a possible alternative for use in
combination with a prescription
antidepressant.”
-Jonathan Alpert M.D., Ph.D.
SAM-e supplementation can have positive
affects on the symptoms of depression.
Research indicates SAM-e’s mood
enhancing qualities result from its ability
to increase levels of the neurotransmitters
dopamine and serotonin, while improving
receptor responsiveness in the brain.
A new study underway at Harvard Medical
School seeks to determine whether
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In fact, according to Dr. Alpert, some
mental health professionals familiar
with the benefits of SAM-e are already
recommending their patients take it
in combination with their prescription
antidepressants. He stresses, however,
that the combination should be tried
only under medical supervision, as
more clinical research is needed in this
area. In addition, individuals who have
bipolar disorder (manic depression) can
experience worsening of their illness on any
antidepressants, including SAM-e.
SAM-e and Liver Health
SAM-e plays a central role in liver
biochemistry. e liver contains the third
highest amount of SAM-e in the body
after the adrenal and pineal glands, and
is considered an essential nutrient for the
organ. SAM-e’s importance lies in its key
role in the production of the antioxidant
glutathione. Glutathione helps detoxify the
liver, boost the immune system, and reduce
inflammation. Without SAM-e, the body
could not manufacture enough glutathione.
In recent a study conducted at the
University of Maryland School of Nursing,*
researchers assessed the efficacy of SAM-e
in comparison to placebo and non-steroidal
anti-inflammatory drugs (NSAIDs) in
the treatment of osteoarthritis (OA). In a
meta-analysis of 11 randomized controlled
trials, the researchers found when compared
with placebo, SAM-e is more effective
in reducing functional limitation in OA
patients. Additionally, SAM-e’s benefits
appeared to be comparable to NSAIDs
in reducing pain as well as functional
limitations. Patients receiving SAM-e
however, were less likely to report adverse
effects associated with NSAID therapies.
Can SAM-e and Prescription
Medications Relieve Depression?
“With so many treatment options today,
we’re certainly doing a better job of treating
depression than we ever did before,” said
Dr. Alpert. “However, we know that 50
percent of patients will have a less than
ideal response or experience intolerable side
effects the first time they try a traditional
agent, and many lose hope when prescribed
one prescriptive treatment after another.
is has really motivated our interests to
develop guidelines for better use of existing
treatments while pursuing promising leads
that may result in novel treatments for
depression.”
Due to side effects of some prescription
antidepressants, some patients are
apprehensive about trying them. at
fear may increase when prescribed two
antidepressant medications simultaneously.
Dr. Alpert believes SAM-e, which has
few known side effects might be a more
acceptable solution in combination therapy.

In a study published in the Scandinavian
Journal of Gastroenterology, [1989; 24:
407-14] sixteen patients with liver disease
(both alcoholic and non-alcoholic) were
given 1,200mg of oral SAM-e daily for six
months. Liver biopsies showed a significant
increase in glutathione, while reducing
levels of oxidized glutathione. In the nonalcoholic, liver-damaged subjects, alanine
aminotransferase (a liver enzyme indicating
damage) was reduced.
*J Fam Pract 2002 May; 51(5): 425-30
CLA: R S D W-L B
CLA for Antioxidant Protection
Conjugated linoleic acid (CLA) is a fatty acid related to the
omega-6 fatty acids - one of the two types of essential fatty acids.
Although CLA occurs naturally in meat and dairy products, most
people do not consume adequate amounts through diet alone.
CLA has gained much acclaim for its safe and effective weight-loss
benefits. In fact, several scientific studies have backed up CLA’s use
as a weight-loss agent. Not only does CLA help you lose fat, but it
also has the added benefit of helping you to maintain lean muscle
mass. In an October 2001 random double-blind placebo-controlled
study of 20 healthy humans of normal body weight and body mass
index less than 25.0 kg/m2, who did standardized physical exercise
in a gym for 90 minutes three times weekly, CLA reduced body fat.
Participants took either placebo (hydrogel) or CLA 0.6 mg three
times daily, as two capsules during meals, for 12 weeks. Body fat,
measured using near infrared light, was significantly reduced in the
CLA group during the study, but not in the placebo group.1
CLA is also a powerful antioxidant agent. In the body it is taken up
by phospholipids, a class of fats that serve as the principal structural
components of cell membranes. CLA enhances the cell membrane’s
defense mechanism against attack by free radicals. Free radicals can
dangerously alter the shape and form of a cell. Antioxidant activity
in a test-tube model has shown that in a mixture of one part CLA
to 1000 parts linoleic acid, peroxide formation on the linoleic acid
was reduced by more than 90%.
“We found an average reduction of six pounds of body fat
in the CLA group compared to placebo. is new scientific
evidence supports previous observations that CLA is quite
effective as a fat-fighting supplement.”
-- Ola Gudmundsen, Ph.D., chief executive officer,
Scandinavian Clinical Research, Kjeller, Norway
Further investigating (and confirming) CLA’s benefits, in a
four-week double-blind randomized controlled study, researchers
investigated the short-term effect of CLA on abdominal fat and
cardiovascular risk factors on 25 abdominally obese men ages 39
to 64. Fourteen men received 4.2 g/day CLA and 10 men received
placebo. After four weeks, there was a significant decrease in
Sagittal Abdominal Diameter (cm) in the CLA group compared
with placebo.2
In one study, antioxidant activity was observed with only 0.25%
CLA in the diet. Comparative studies have shown that CLA
is approximately two times more powerful an antioxidant than
beta carotene, and yet another study concluded that CLA “may
produce substances which protect cells from the detrimental effect
of peroxides (J Am Coll Nutr 2000 Apr;19(2 Suppl): 111S-118S).”
Peroxides are one type of free radical that can cause permanent cell
damage. Of further note, the antioxidant properties of CLA also
contribute to its immune strengthening activities.
In a 2000 study, people who took CLA had significant reduction
in body fat gain with no serious side effects. e findings published
in e Journal of Nutrition (December 2000, Volume 130 #12)
reported that people taking this supplement lost “statistically
significant amounts of weight” without otherwise changing their
diets.
References:
1. om E, Wadstein J, Gudmundsen O. Conjugated linoleic acid reduces body
fat in healthy exercising humans. J Int Med Res 2001 Sep-Oct;29(5):392-6.
2. Risérus U. Conjugated linoleic acid (CLA) reduced abdominal adipose tissue
in obese middle-aged men with signs of the metabolic syndrome: a randomized,
controlled trial. Int J Obes 2001 Aug 25(8):1129-35.)
S S S B  M T  D
Milk thistle is a natural liver
detoxifier that contains a
powerful compound called
silymarin, which has been
found to defend the liver from
many industrial toxins such as
carbon tetrachloride, and more
common agents like alcohol.
Heavy metals and drugs can
cause liver toxicity and damage
through the production of
free radicals. Silymarin has
been shown to help restore the
cells in damaged liver tissue,
promoting good liver health
and functioning.
e U.S. National Library of
Medicine has catalogued more
than 300 scientific studies
of milk thistle and its active
compounds. One study at a
liver pathology institute in
France discovered milk thistle’s
two main actions. First, it
helps decrease the conversion
HEALTHwatch
of the carbon tetrachloride
into more toxic substances, and
secondly, milk thistle acts as a
potent antioxidant that inhibits
these toxic compounds from
damaging healthy liver cells.
In the experiment, milk thistle
extract allowed only half of the
expected damage to occur to
liver cells.
sugar levels, and is essential
to virtually every aspect of the
metabolism. It has been called
the third most important organ
in the body, after the brain and
the heart.
Test results showing elevated
levels of liver enzymes indicate
people with chronic illnesses
such as Chronic Fatigue
Syndrome and Fibromyalgia
frequently suffer from impaired
liver function. Timothy
Tupper, L.Ac., a California
chiropractor, nutritionist,
and acupuncturist, who
holds postgraduate degrees
in Clinical Biochemistry and
Parasitology, and lectures
frequently throughout the
country on the importance of
nutrition in treating chronic
diseases, notes milk thistle is
most helpful to CFS patients
suffering from impaired liver
It’s hard to overstate the
importance of the liver to our
general health. e second
largest organ in the body
after the skin, it processes all
nutrients, toxins, drugs, and
any other substances entering
the body through the intestines,
lungs, or skin. e liver is
responsible for detoxifying
poisons, including the natural
toxins in food, as well as
synthetic chemical substances
in food, water, and the air. It
helps regulate blood fat and

function. According to Dr.
Tupper, milk thistle heals
liver damage and works as a
preventive measure. Among
other things, it possesses
powerful antihistamine and
detoxifying properties, and
acts as a stabilizer of cell
membranes, preventing them
from releasing immuneinducing inflammation.
Milk thistle’s wide range of
benefits also includes protection
of blood cells. Silymarin’s
strong antioxidative properties
inhibit oxidation of red blood
cell membranes and provide
protection in conditions where
the cells may otherwise be
destroyed. Milk thistle extract
can be helpful to those seeking
better liver health, supportive to
those with chronic illness and
useful to people with chemical
sensitivities.
R S  R T U
Research Study of Relaxin erapy
for FM Underway at the University
of Minnesota
e University of Minnesota School of
Dentistry, Division of Orofacial Pain and
TMD, is conducting a study to determine
the efficacy of the hormone relaxin for the
treatment of fibromyalgia (FM). Women
with fibromyalgia between the ages of
18-65 have been recruited to participate
in a randomized, 12-week clinical trial
of relaxin in reducing the symptoms of
fibromyalgia. e study is being conducted
by Dr. Francisco Alencar.
e remission of fibromyalgia (FM) symptoms
among patients during pregnancy led Samuel
Yue, M.D., Clinical Medical Director of
the HealthEast Pain Clinic in Minnesota,
to believe that relaxin hormone deficiency is
one probable cause of FM. When secreted,
relaxin enables women to give birth by helping
to dilate the cervix, expand and make
flexible the pelvis, and stretch the skin.
Many female patients with FM who became
pregnant experienced a lessening or absence of
symptoms during pregnancy. According to Dr.
Yue, “One other interesting observation I have
made was that many FM patients reported
remission of their symptoms when they were
pregnant, and the return of their symptoms
almost within one to two months after
delivery.”
“Chemical sensitivity in patients
with FM is directly related to relaxin
deficit…because relaxin does affect
the entire body, relaxin replacement
therapy may help patients who have
developed reactions to foods and
medication. e deficit of relaxin
associated with fibromyalgia also
compromises the regulatory functions
of the liver…Daily supplemental
replacement of relaxin in patients
will relieve all the symptoms of FM.”
-Samuel Yue, M.D., Clinical
Medical Director, HealthEast Pain
Clinic, Minnesota
Relaxin is a protein hormone that is
produced and secreted during pregnancy in
all mammalian species. e symptoms of
relaxin hormone deficiency are strikingly
similar to the symptoms of FM and Chronic
Fatigue Syndrome (CFS); myofascial
pain, muscle problems, irritable bowel and
bladder, digestive difficulties, dizziness,
shortness of breath, joint pain, fatigue,
HEALTHwatch
headaches and emotional distress are all
symptoms of relaxin hormone deficiency.
Physicians and Researchers Promote
Relaxin for FM and CFS Treatment
“I’ve been treating FM for several years
now, and with my body-mind-spirit
approach to wellness, I have tried
everything in the book looking for a
solution. One of my patients introduced me
to Vitalaxin™ [relaxin], which provided
her with significant improvement and
relief from her FM symptoms. I have
found that the best candidates for relaxin
replacement therapy are post-menopausal
FM patients and those who have undergone
hysterectomies. Using Vitalaxin™ [relaxin],
my patients usually experience significant
improvement from FM symptoms within
3-4 months.” -Dr. John Walck, M.D.
“I’ve been treating FM for several
years now, and with my body-mindspirit approach to wellness, I have
tried everything in the book looking
for a solution. One of my patients
introduced me to Vitalaxin™
[relaxin], which provided her with
significant improvement and relief
from her FM symptoms. I have
found that the best candidates for
relaxin replacement therapy are postmenopausal FM patients and those
who have undergone hysterectomies.
Using Vitalaxin™ [relaxin],
my patients usually experience
significant improvement from FM
symptoms within 3-4 months.”
- John Walck, M.D.
“Chemical sensitivity in patients with FM
is directly related to relaxin deficit…because
relaxin does affect the entire body, relaxin
replacement therapy may help patients
who have developed reactions to foods and
medication. e deficit of relaxin associated
with fibromyalgia also compromises the
regulatory functions of the liver…Daily
supplemental replacement of relaxin in
patients will relieve all the symptoms of
FM.” -Dr. Samuel Yue, M.D., Clinical
Medical Director, HealthEast Pain Clinic,
Minnesota.
e Lancet Reports: Researchers
Track Down the Relaxin Receptor
Relaxin - a hormone important for the
growth and remodeling of tissues during
pregnancy, was one of the first reproductive
hormones discovered, but its receptors have
remained elusive until now. is week
[January 2002], US researchers describe two
G-protein coupled receptors, LGR7 and
LGR8, that mediate the action of relaxin
through a cAMP dependent pathway.
“Finding these receptors has many
implications; for example, studies on
relaxin receptors could now allow the
design of agonistic or antagonistic relaxin
analogues to treat disorders of labor onset,”
comments senior author Aaron Hsueh
(Stanford University School of Medicine).
Hsueh and colleagues transfected cells
with known G-protein coupled receptors
with no known ligands, and screened for
those that responded to porcine relaxin
by increasing cAMP production in a
dose-dependent manner. LGR7 and LGR8
gave positive results, but were not affected
by treatment with insulin or insulin growth
factor 1, proteins that both have a domain
arrangement similar to prorelaxin, the
precursor of relaxin.
ey then examined the expression patterns
of the two receptors to see whether their
distribution was consistent with known
relaxin binding sites in the body. LGR7
was expressed in the brain, kidney, testis,
placenta, uterus, ovary, adrenal, prostate,
skin, and heart whereas LGR8 was found
mainly in the brain, kidney, muscle, testis,
thyroid, uterus, peripheral blood cells, and
bone marrow. “is implies that the two
relaxin receptors also have mental, renal,
and cardiovascular functions, as well as the
well-established reproductive role”, says
Hsueh.
e discovery at last of receptors for relaxin
means that we can finally begin to develop
a proper pharmacology for this important
hormone system,” adds Ivell.
Source: Researchers track down the
relaxin receptor at last. e Lancet,
Volume 359, Number 9303, Page 323,
26 January 2002.
After years of studies dating as far back as
1926, research continues to show “the actual
importance of relaxin in human physiology
as well as the…therapeutic use of relaxin or
relaxin-derived drugs in human disease.”
-Relaxin: a pleiotropic hormone. (Bani D;
Gen Pharmacol,28(1):13-22 1997 Jan.)

E R M  M A  CFS  FM
Leading healthcare professionals familiar
with Chronic Fatigue Syndrome (CFS)
and Fibromyalgia (FM) continue to
recommend magnesium and malic acid
for chronic muscle soreness and fatigue.
is combination of nutrients has helped
many patients improve muscle pain and
tiredness, and is used by leading CFS and
FM physicians like Jacob Teitelbaum M.D.,
Daniel Peterson, M.D., Paul Cheney, M.D.
and Jay Goldstein, M.D., to help relieve the
symptoms of these diseases.
Dr. Goldstein, director of the CFS
Institute, has found magnesium and malic
acid to be safe and inexpensive options
to relieve CFS and FM symptoms, and
suggests it be added to the current list of
therapeutic approaches. He prescribes malic
acid and magnesium to his patients with
CFS and FM and explains, “…it may have
a modest effect on fatigue and/or other
symptoms. Fibromyalgia pain may respond
within 48 hours, while fatigue may take
about two weeks to respond.”
Magnesium
Magnesium is an essential mineral
necessary for proper muscle, nerve and
enzyme function. It acts as a coenzyme,
and is utilized by the body to help convert
carbohydrates and protein into ATP (the
body’s energy source), blood clotting,
activating B vitamins and relaxing muscles.
It is used to maintain healthy heart rhythms
and works with calcium and vitamin D to
help keep bones strong.
Research has shown magnesium is needed
for more than 300 biochemical reactions
in the body and is fundamental to a
number of important physical processes.
Magnesium works intricately with several
enzyme systems needed for neurochemical
communication, and helps transport
electrolytes like potassium and sodium in
and out of cells.
A lack of magnesium in the body may
disrupt the flow of energy that causes
muscle relaxation. During a magnesium
deficiency, the body may draw from the
already low supply of magnesium in the
muscles; however, as the muscle loses
magnesium, calcium may move in to replace
it, causing muscles to grow tense and
cramped.
Magnesium is often found to be deficient
in people with fibromyalgia and Chronic
HEALTHwatch
Fatigue Syndrome (ME). In a small study
of 15 patients with fibromyalgia, each
subject was administered 300 to 600mg
of magnesium daily, and 1200 to 1400mg
per day of malic acid. Results showed
pain levels were greatly reduced, although
benefits took some time to develop over
days and weeks.
Malic Acid
Malic acid is a naturally occurring fruit
enzyme that supports the energy production
essential for proper muscle performance,
and allows the body to produce ATP
more efficiently, even under low oxygen
or hypoxic conditions. In hypoxic muscles
ATP production can be inhibited, causing
the body to breakdown muscle tissue in
order to synthesize the ATP it needs. Malic
acid supports the removal of compounds
that build up under hypoxic conditions
and inhibit ATP production. Additionally,
malic acid acts as a catalyst during the
Krebs cycle where fats and sugars are used
to generate energy. Malic acid is a potent
aluminum detoxifier, and is especially
effective at decreasing aluminum toxicity
in various organs and tissues including the
brain.
“Controlled studies from England
and Texas in peer-reviewed journals
have documented modest effects
of [magnesium and malic acid] in
muscle spasm, fatigue and pain in
Fibromyalgia… is combination
may work as a result of interactions
between magnesium and calcium
channels within muscles and the
generation of adenosine triphosphate
(ATP), our cellular fuel.”
--Lawrence J. Levanthal, M.D.
Annals of Internal Medicine Dec.
1999
In a report published in the December 1999
issue of the Annals of Internal Medicine,
the American College of Physicians and
American Society of Internal Medicine
listed malic acid among nutrients
recommended for fibromyalgia (FM).
erapeutic Use
ere is some evidence for the therapeutic
use of magnesium and malic acid in FM.
Red cell magnesium levels are often low in
FM and trial therapies with magnesium
sulfate or magnesium chloride injections
can be very effective. A magnesium

deficiency can cause many of the symptoms
of FM, including fatigue, sleep disorders,
mood disorders, and muscle dysfunction.
Jorge Flechas, M.D., M.Ph., a holistic
practitioner, has participated in two medical
studies that have tested the combination
of malic acid and magnesium for FM
patients. In each of these studies patients
reported a significant reduction in pain and
tenderness within 48 hours and without any
side effects. In his practice, Dr. Flechas has
recommended both of these nutrients for
six years to about 500 fibromyalgia patients.
“I have found the results are positive 90
percent of the time,” he said.
One of many people who have benefited
by taking malic acid and magnesium is
Ann Lessel of Westlake Village, CA. She
noticed improvements in her symptoms
almost immediately.
“After about four days I noticed my
energy level and stamina was beginning
to increase,” she reports. “After taking the
product for three weeks I had an incredible
amount of energy. For the first time in the
six years that I have been sick, I can say I
feel normal. I now have been on the product
for about two months, and am keeping up
a pace that would make a healthy person
tired.”
“e sooner malic acid and
magnesium are started, the faster
[CFS & FM] patients begin to
return to their normal lifestyles.”
--Billy Jay Sahley, Ph.D. Malic Acid
and Magnesium for Fibromyalgia
and Chronic Pain Syndrome
R S B  L-C  CFS
L-Carnitine is an amino acid used by the body to convert fat
into energy. Synthesized by the liver and kidneys, L-Carnitine is
required for fatty acids to be delivered into cells where the fat can
be burned as a source of fuel. Supplemental levels of L-Carnitine
have been shown to stimulate the ability of some tissues to
produce more energy, which has led to the use of L-Carnitine in
various chronic illnesses, as well as to promote weight loss and
cardiovascular health.
Using the acetyl-carnitine form of L-Carnitine, researchers at
the Osaka University Medical School compared blood levels of
38 patients with LNKS (Low Natural Killer Cell Syndrome, the
Japanese term for CFS) with 308 healthy patients. eir findings
indicated acetyl-carnitine levels were indeed lower in patients
suffering from CFS.
In another study, 14 patients fitting the U.S. Center for Disease
Control and Prevention criteria for CFS received one gram of
L-Carnitine three times a day. e majority of patients showed
improvement in mental fatigue and mood, muscle soreness, and
physical stamina during their eight-week course of supplementation.
Furthermore, none of the L-Carnitine patients suffered any
significant adverse reactions.
In a study published in the medical journal Neuropsychobiology,*
researchers performed a crossover trial examining the antiviral drug
amantadine and L-Carnitine for 48 Chronic Fatigue Syndrome
(CFS) patients. While participants who completed the amantadine
treatment did not show any difference in any of the clinical
parameters that were followed, significant improvements were seen
in 12 of the 18 patients receiving L-Carnitine.
“L-Carnitine is a very safe and well-tolerated naturally
occurring amino acid which improves the clinical status of
CFIDS patients.”
-Audrius V. Plioplys. M.D., Chronic Fatigue Syndrome
Center and Department of Research at Mercy Hospital
and Medical Center Chicago, Illinois.
“L-Carnitine was found to promote statistically significant clinical
improvement in 12 of 18 Chronic Fatigue Syndrome patients.
Along with helping to reduce physical fatigue, our study showed
that L-Carnitine also helped aspects related to depression as well
as mental fatigue. L-Carnitine is a very safe and well-tolerated
naturally occurring amino acid which improves the clinical status
of CFIDS [Chronic Fatigue & Immune Dysfunction Syndrome]
patients,” said Dr. Audrius V. Plioplys, M.D., Chronic Fatigue
Syndrome Center and Department of Research at Mercy Hospital
and Medical Center Chicago, Illinois.
L-Carnitine and Fat Loss
L-Carnitine aids fat loss by transferring fat into the mitochondria
of a cell to be burned for cellular energy. Optimal amounts of
L-Carnitine promote improved fat burning capacity, and according
to Robert Crayhon, author of e Carnitine Miracle, L-Carnitine
is “the most important nutrient for naturally supporting the
weight loss process.” Crayhon cites more than 60 published studies
indicating L-Carnitine’s usefulness for obesity, fatigue, athletic
performance, energy and general well-being.
A deficiency of L-Carnitine in the body may produce symptoms
such as muscle pain, extreme fatigue and depression. In fact,
Japanese researchers are looking at the possibility that low levels
of L-Carnitine are a factor in the symptoms of Chronic Fatigue
Syndrome.
Heart and Circulation Benefits
L-Carnitine has been shown to have positive
benefits upon the myocardium of the heart and
upon peripheral circulation. e effects upon
the heart include improvements in energy
production and fat reduction. Additionally,
supplemental L-Carnitine has been associated
with significantly higher concentrations
of pyruvate, ATP and creatine phosphate
in portions of the heart muscle during
conditions of extreme stress. Similarly, in tests
upon peripheral circulation, L-Carnitine was
found to be quite useful for improving blood flow.
An excellent nutritional addition
to any healthy diet, L-Carnitne is a natural way to effectively
promote relief of chronic fatigue while supporting good
cardiovascular health and weight management.
*Neurophsychobiology 1997;35:16-23.
HEALTHwatch

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2002 TG PDF (Web)

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