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From the Townsend Letter
November 2014

Update: Injection Therapies for Chronic Fatigue and Fibromyalgia
by Paul S. Anderson, NMD
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Glutathione
A favorite IV additive, glutathione is known by those who use it to have extremely positive effects in the treatment of a wide range of illnesses. In the FMS/CFS setting, it also is known to be a helpful addition to most IV protocols. Although much has been written about the potential benefits of glutathione augmentation in medicine, the FMS/CFS patient may have a greater need for glutathione augmentation due to higher oxidative stress loads as well as a greater need for appropriate cell regulation.37,38 In addition to these factors, a connection between FMS/CFS and MCS is clinically noted in many patients. Glutathione is one factor in aiding repair of cell metabolism in MCS as well as damaged redox states in FMS/CFS.45,51,52 These and other likely reasons for inclusion are why the author includes glutathione IV in all FMS/CFS patient protocols. General doses are between 1 and 3 grams and may be as high as 6 to 10 grams in some cases. Clinically, the use of glutathione IV appears to be more efficient when support nutrients (such as are found in the general nutrient IV formulas) are given before the glutathione infusion. As some patients will have sulfation SNP defects and other reasons not to tolerate glutathione, the author typically uses a lower test dose on the first IV infusion of glutathione ranging from 100 to 500 mg.

The Lipoic–Acid Based Thiols
Alpha-lipoic acid (ALA): ALA is a thiol and as such is known in basic science to support levels of glutathione in the liver and other tissues. In experimental models, ALA has been shown to be helpful in pushing the redox balance in a positive direction via modulation of inflammatory cytokines such as tumor necrosis factor and NF-kappaB.39,40 Like glutathione, the lipoic acid molecules bring a high level of respect for clinical efficacy from those who use them. Due to recent changes in pharmacologic compounds of ALA, it is recommended that practitioners discuss dosing and potential reactions based on the available form of ALA from their individual compounding pharmacies before administration.
   
Lipoic acid mineral complex (LAMC): Known in North America as the proprietary formula Poly MVA, LAMC has shown to be helpful in cell repair, mitochondrial repair, and radioprotection.41–44 The author has found that low IV doses (5–15 mL) combined with low oral doses (5–10 mL b.i.d.) improve energy and other quality of life measures in FMS/CFS patients. Like ALA, LAMC does take time to work, so most patients are advised that either therapy (like all others) may need to be continued for a number of months for a positive effect to be noted.

DMSO
The sulfur-containing molecules DMSO and MSM have been reported as potentially therapeutic in FMS/CFS as well as useful in pain syndromes for palliation.46,50 DMSO is also used to transport drugs and nutrients across membranes including the blood–brain barrier.47–49 Given these data, as well as a long clinical history with both substances, the author utilizes both in the therapy of those with FMS/CFS. IV MSM is water soluble and mixes with most any water-soluble IV formula. DMSO is fat and water soluble and mixes well with most water-soluble formulas as well. As DMSO is a solvent, special handling and administration guidelines as taught in standard IV training should be observed. The author favors DMSO for acute and neuropathic pain syndromes and MSM for long-term therapies in FMS/CFS.

Summary
It is clear that there are many potential therapies both oral and parenteral for the patient suffering from FMS/CFS. Both the data presented and the author's experience would speak to the utility and improvement in outcomes when the above, and many other, interventions are used in a well-planned comprehensive care plan for these patients. Basic training and understanding of the biochemistry and pharmacology of these agents allow for safe and effective use in the IV or IM setting.

Notes
1.      Yasser E et al. Hippocampus dysfunction may explain symptoms of fibromyalgia syndrome. a study with single-voxel magnetic resonance spectroscopy. J Rheumatol. 2008;35:1371–1377.
2.      Treatment of fibromyalgia syndrome with antidepressants: a meta-analysis. JAMA. 2009;301(2):198–209. PreMedline Identifier: 19141768
3.      Brooks M. Fibromyalgia symptoms eased by "lifestyle physical activity." Arthritis Res Ther. Epub March 29, 2010.
4.      Klein R, Berg PA. High incidence of antibodies to 5-hydroxytryptamine, gangliosides and phospholipids in patients with chronic fatigue and fibromyalgia syndrome and their relatives: evidence for a clinical entity of both disorders. Eur J Med Res. 1995 Oct 16;1(1):21–26. PMID: 9392689
5.      Nazıroğlu M, Akkuş S, Soyupek F, et al. Vitamins C and E treatment combined with exercise modulates oxidative stress markers in blood of patients with fibromyalgia: a controlled clinical pilot study. Stress. 2010 Nov;13(6):498–505. doi:10.3109/10253890.2010.486064. Epub 2010 Jul 28. PMID: 20666654.
6.      Anderson PS. Active comparator trial of addition of MTHFR specific support versus standard integrative naturopathic therapy for treating patients with diagnosed Fibromyalgia (FMS) and Chronic Fatigue Syndrome (CFS). Poster presented at: the American Association of Naturopathic Physicians annual convention; August 2012; Bellevue, WA.
7.      Nazıroğlu M, Akkuş S, Soyupek F, et al. Vitamins C and E treatment combined with exercise modulates oxidative stress markers in blood of patients with fibromyalgia: a controlled clinical pilot study. Stress. 2010 Nov;13(6):498–505. doi:10.3109/10253890.2010.486064. Epub 2010 Jul 28. PMID: 20666654.
8.      Terman M, Levine SM, Terman JS, Doherty S. Chronic fatigue syndrome and seasonal affective disorder: comorbidity, diagnostic overlap, and implications for treatment. Am J Med. 28 September 1998. 105(3; Supplement 1):115S–124S. Epub 16 August 2004.
9.      Myhill S, Booth NE, McLaren-Howard J. Chronic fatigue syndrome and mitochondrial dysfunction. Int J Clin Exp Med. 2009;2:1–16. www.ijcem.com/IJCEM812001.
10.    Bell DS. Cellular Hypoxia and Neuro-Immune Fatigue. Livermore: WingSpan Press; 2007.
11.    Pall ML. Elevated, sustained peroxynitrite levels as the cause of chronic fatigue syndrome. Med Hypotheses. 2000;54:115–125.
12.    Richards RS, Roberts TK, McGregor NR, Dunstan RH, Butt HL. Blood parameters indicative of oxidative stress are associated with symptom expression in chronic fatigue syndrome. Redox Report. 2000;5:35–41.
13.    Zeevalk GD, Bernard LP, Song C, Gluck M, Ehrhart J. Mitochondrial inhibition and oxidative stress: Reciprocating players in neurodegeneration. Antioxid Redox Signal. 2005;7:1117–1139.
14.    Kennedy G, Spence VA, McLaren M, Hill A, Underwood C, Belch JJF. Oxidative stress levels are raised in chronic fatigue syndrome and are associated with clinical symptoms. Free Radic Biol Med. 2005;39:584–589.
15.    Pall ML. Explaining "Unexplained Illnesses." New York: Harrington Park Press; 2007.
16.    Ross AJ, Medow MS, Rowe PC, Stewart JM. What is brain fog? An evaluation of the symptom in postural tachycardia syndrome. Clin Auton Res. 2013 Dec;23(6):305–311. doi:10.1007/s10286-013-0212-z. Epub 2013 Sep 3. PMID: 23999934.
17.    Begum MN, Johnson CS. A review of the literature on dehydration in the institutionalized elderly. E SPEN Eur E J Clin Nutr Metab. 2010;5:e47–e53.
18.    Ali A, Njike VY, Northrup V, et al. Intravenous micronutrient therapy (Myers' Cocktail) for fibromyalgia: a placebo-controlled pilot study. J Altern Complement Med. 2009 Mar;15(3):247–257. PMID: 19250003.
19.    Brinkman K, Vrouenraets S, Kauffmann R, Weigel H, Frissen J. Treatment of nucleoside reverse transcriptase inhibitor-induced lactic acidosis. AIDS. 2000;14(17):2801–2803. PMID: 11125906.
20.    Osborne V, White C. Fibromyalgia and chronic fatigue syndrome: benefits of IV micronutrient therapy. Naturopath Doctor News Rev. August 2007:3–8.
21.    Schencking M, Vollbracht C, et al, Intravenous Vitamin C in the treatment of shingles: Results of a multicenter prospective cohort study. Med Sci Monit. 2012 Apr 1;18(4):CR215–CR224.
22.    Suh et al. Intravenous Vitamin C administration reduces fatigue in office workers: a double-blind randomized controlled trial. Nutr J. 2012;11:7. http://www.nutritionj.com/content/11/1/7.
23.    Dubé L, Granry JC. The therapeutic use of magnesium in anesthesiology, intensive care and emergency medicine: a review. Can J Anaesth. 2003 Aug–Sep;50(7):732–746. PMID: 12944451.
24.    Soave PM, Conti G, Costa R. Arcangeli A. Magnesium and anaesthesia. Curr Drug Targets. 2009 Aug;10(8):734–743. PMID: 19702521.
25.    Nagai N1, Fukuhata T, Ito Y. Effect of magnesium deficiency on intracellular ATP levels in human lens epithelial cells. Biol Pharm Bull. 2007 Jan;30(1):6–10. PMID: 17202650.
26.    Barbagallo M et al. Effects of glutathione on red blood cell intracellular magnesium : relation to glucose metabolism. Hypertension. 1999;34:76–82. doi:10.1161/01.HYP.34.1.76.
27.    Silver BR. Development of cellular magnesium nano-analysis in treatment of clinical magnesium deficiency. J Am Coll Nutr. 2004;23(6):732S–737S. PMID: 15637223.
28.    Virmani A, Gaetani F, Binienda Z. Effects of metabolic modifiers such as carnitines, coenzyme Q10, and PUFAs against different forms of neurotoxic insults: metabolic inhibitors, MPTP, and methamphetamine. Ann N Y Acad Sci. 2005 Aug;1053:183–91. PMID: 16179522.
29.    Claessens YE, Cariou A, Chiche JD, Dauriat G, Dhainaut JF. L-Carnitine as a treatment of life-threatening lactic acidosis induced by nucleoside analogues. AIDS. 2000 Mar 10;14(4):472–473. PMID: 10770558.
30.    Lambert IH. Regulation of the cellular content of the organic osmolyte taurine in mammalian cells. Neurochem Res. 2004 Jan;29(1):27–63. PMID: 14992263.
31.    Stevens MJ, Lattimer SA, Kamijo M, Van Huysen C, Sima AA, Greene DA. Osmotically-induced nerve taurine depletion and the compatible osmolyte hypothesis in experimental diabetic neuropathy in the rat. Diabetologia. 1993 Jul;36(7):608–614. PMID: 8359577.
32.    Guenther BD, Sheppard CA, Tran P, Rozen R, Matthews RG, Ludwig ML. The structure and properties of methylenetetrahydrofolate reductase from Escherichia coli suggest how folate ameliorates human hyperhomcyseinmia. Nat Struct Biol. 1999;6:359–365.
33.    Rosenblatt DS. Inherited disorders of folate transport and metabolism. In: Scriver CR, Beaudet AL, Sly WS, Valle D, eds. The Metabolic Basis of Inherited Disease. New York: McGraw-Hill; 1989:2049–2063.
34.    Ogier de Baulny H, Gérard M, Saudubray JM, Zittoun J. Remethylation defects: guidelines for clinical diagnosis and treatment. Eur J Pediatr. 1998 Apr;157 Suppl 2:S77–S83.
35.    Buccianti G et al. 5-methyltetrahydrofolate restores endothelial function in uraemic patients on convective haemodyalisis. Nephrol Dial Transplant. 2002;17:857–864.
36.    Ortancil O, Sanli A, Eryuksel R, Basaran A, Ankarali H. Association between serum ferritin level and fibromyalgia syndrome. Eur J Clin Nutr. 2010 Mar;64(3):308–312. doi:10.1038/ejcn.2009.149. Epub 2010 Jan 20. PMID: 20087382.
37.    La Rubia M, Rus A, Molina F, Del Moral ML. Is fibromyalgia-related oxidative stress implicated in the decline of physical and mental health status? Clin Exp Rheumatol. 2013 Nov–Dec;31(6 Suppl 79):S121–7. Epub 2013 Dec 16. PMID: 24373370.
38.    Ashtiani HR et.al. Glutathione, cell proliferation and differentiation. Afr J Biotechnol. 11 July 2011;10(34):6348–6363. Available at http://www.academicjournals.org/AJB. doi:10.5897/AJB10.044.
39.    Maes M, Mihaylova I, Bosmans E. Not in the mind of neurasthenic lazybones but in the cell nucleus: patients with chronic fatigue syndrome have increased production of nuclear factor kappa beta. Neuro Endocrinol Lett. 2007 Aug;28(4):456–462. PMID: 17693979.
40.    Moore RM et al. Alpha-lipoic acid inhibits tumor necrosis factor-induced remodeling and weakening of human fetal membranes. Biol Reprod. Apr 2009;80(4):781–787. Epub Dec 23, 2008. doi:10.1095/biolreprod.108.073205. PMCID: PMC2673805.
41.    Menon A, Nair CKK. Poly MVA – a dietary supplement containing alpha-lipoic acid mineral complex, enhances cellular DNA repair. Int J Low Radiat. 2011.
42.    Ramachandran L, Krishnan CV, Nair CKK. Radioprotection by a-lipoic acid mineral complex formulation, (POLY-MVA) in mice. Cancer Biother Radiopharm. 2010;25(4):395–399.
43.    Menon A, Krishnan CV, Nair CKK. Protection from gamma-radiation insult to antioxidant defense and cellular DNA by POLY-MVA, a dietary supplement containing palladium lipoic acid formulation. Int J Low Radiat. 2009;6(3):248–262.
44.    Menon A, Krishnan CV, Nair CKK. Antioxidant and radioprotective activity of POLY-MVA against radiation induced damages. Amala Cancer Bull. 2008;28:167–173.
45.    De Luca C et al. Biological definition of multiple chemical sensitivity from redox state and cytokine profiling and not from polymorphisms of xenobiotic-metabolizing enzymes. Toxicol Appl Pharmacol. 2010;248:285–292.
46.    Hoang BX et al. Dimethyl sulfoxide–sodium bicarbonate infusion for palliative care and pain relief in patients with metastatic prostate cancer. J Pain Palliat Care Pharmacother. 2011;25:350–355. doi:10.3109/15360288.2011.606294.
47.    Brasnjevic I et al. Delivery of peptide and protein drugs over the blood–brain barrier. Prog Neurobiol. 2009;87:212–251. doi:10.1016
48.    Broadwell RD, Salcman M, Kaplan RS. Morphologic effect of dimethyl sulfoxide on the blood-brain barrier. Science. 9 July 1982;217(4555):164–166.
49.    Walker M. Profile of the holistic cancer therapist W. Douglas Brodie, MD, HMD. (Medical Journalist Report of Innovative Biologics). Townsend Lett. Feb. 1, 2002.
50.    Parcell S. Sulfur in human nutrition and applications in medicine. Altern Med Rev. 2002 Feb;7(1):22–44. PMID: 11896744.
51.    Myhill S, Booth NE, McLaren-Howard J. Chronic fatigue syndrome and mitochondrial dysfunction. Int J Clin Exp Med. 2009;2:1–16. www.ijcem.com/IJCEM812001.
52.    Blaylock R, Maroon J. Natural plant products and extracts that reduce immunoexcitotoxicity-associated neurodegeneration and promote repair within the central nervous system. Surg Neurol Int. 2012;3:19.

Paul AndersonPaul S. Anderson, NMD, is medical director of Anderson Medical Specialty Associates, a clinic focusing on the care of patients with cancer and chronic diseases. Former positions include professor of pharmacology and clinical medicine at Bastyr University and chief of IV services for Bastyr Oncology Research Center. Dr. Anderson is a graduate of NCNM and began instructing classes at naturopathic medical schools in the early 1990s. He continues to hold board review classes and CME courses for most of the US and Canadian ND programs including BU, NCNM, Boucher Institute, UB, SCNM, and CCNM. He also is a founding board member of the Academy of Parenteral Therapies specialty group and an instructor and author for the IIVNTP IV Therapy training group.

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