9/19/02 in Los Angeles

by Larry J. Sharp, D.O

The conference was cosponsored by: National Fibromyalgia Association; American Association for Chronic Fatigue Syndrome; Foundation for Care Management; and The Healthy Foundation.

I was fortunate in being able to attend the clinical and patient symposium for CFIDS and FM on 9/19/02 in Los Angeles. The conference was cosponsored by: National Fibromyalgia Association; American Association for Chronic Fatigue Syndrome; Foundation for Care Management; and The Healthy Foundation.

Over the course of the three days there were excellent lectures and workshops all directed to understanding the pathophysiology and treatment of these misunderstood illnesses. Each speaker was an outstanding researcher or practitioner in his or her field, and most had authored one or more books on the subject. The PR field was covered by moving discussions with actress A.J. Langer and Olympic speed skater Amy Peterson.

Most important of all, the mood was optimistic and hopeful. It is my pleasure to share my lecture notes and this brief synopsis in hopes that the knowledge shared can light a candle in all our windows. Although this is in no way complete, it is a composite of what I felt were the most important lectures.

Todd Ovokaitys, M.D., "Enhancing Biological Methylation to Mitigate the Symptoms of Fibromyalgia."
One of the bodies' detoxification pathways involves METHYLATION. This involves adding a methyl group (CH3) to other molecules. This process takes place in every cell of the body. An example of defective methylation is increased HOMOCYSTEINE levels. Homocysteine is a toxic amino acid. Your bodies' methylation cycle converts it into methionine (an essential amino acid). Methionine is then combined with an energy source in the body to form S-ADENOSYLMETHIONINE (SAMe), a natural antidepressant.

Patients with CFIDS and FM (as well as heart patients) have high levels of Homocysteine in their blood and spinal fluid. This is an indication of defective methylation. Low SAMe levels, due to this defect, are associated with reduced serotonin and melatonin production that explain depression and sleep cycle disorders.

There are numerous other serious consequences to high homocysteine; lymphocyte dysfunction, Teleomere shortening- "The new aging theory", vascular endothelial damage- heart disease, and destruction of DNA, to name a few.

The good news is that one can lower homocysteine and raise SAMe levels with an inexpensive supplement; TRIMETHYGLYCINE, also known as BETAINE. Trimethyglycine is an amino acid which is capable of donating three methyl groups. This compound crosses the Blood-Brain barrier better than SAMe and is less expensive (dose 2 grams per day). It is most effective when supplemented with B6, B12, Folic Acid and Choline. Dr. O. has further improved this with laser treated Betaine manufactured by his company Gematria Products, Inc.

Michael McNett, M.D. "The Role of Candida in FM."
The pesky yeast, Candida, has been implicated in causing FM by:

1. blocking thyroid receptor sites causing
2. poor conversion of sugars to energy (ATP)
3. raising fat production and causing fatigue, and finally
4. inhibiting the production of substance P, which makes one more sensitive to pain.

Jacob Teitelbaum, M.D. "Effective Treatment of Chronic Fatigue Syndrome and Fibromyalgia."
We listened to three lectures and workshops given by this dynamic speaker. He presented impressive data concluding that treating hypothalamic dysfunction which produces poor sleep, low hormone levels and impaired immunity results in dramatic improvement in terms of pain, and lifestyle complaints.

His treatment protocol includes:

1. Addressing poor sleep, utilizing herbal or pharmaceutical interventions;
2. Hypothalamic hormone dysfunction-low thyroid, adrenal, growth hormone, low ovarian and testicular function, low vasopressin - measure levels and replace all or portions of these hormones.
3. Effects of immune dysfunction-chronic infections, bowel infections, dysbiosis, viral infections.
4. Gut dysfunction-recommends Great Smokies Lab Comprehensive Digestive Stool Analysis (CDSA).
5. Mind/body/soul attention. I would recommend reading his book "From Fatigued to Fantastic" or website www.endfatigue.com. Dr. Teitelbaum concluded his workshop by describing his next book, tentatively titled "Three Steps to Happiness".
   1. Be honest with your feelings- feel everything without the need to understand why. Feel this as long as it feels good, then let it go by shifting attention to something else.
   2. Life is a no-blame system: No blame
      No fault
      No guilt
      No judgement
      No comparisons
      No expectations
      
   Follow your bliss - use feelings to guide you.

Michael Rosenbaum, M.D. "Nutritional Immune Modulation of CFS"
Michael Rosenbaum is the author of "Solving the Puzzle of Chronic Fatigue Syndrome" as well as numerous original research articles on CFS. His strategy is to:

1. Shift from Th-2 to Th-1 predominance
2. Enhance NK cell activity
3. Reduce pro-inflammatory cytokines
4. Reduce herpes reactivation.

His approach is multifactoral: vitamins A, B's, Zinc, antioxidants, raise Glutathioine with NAC, Whey extracts and alpha Lipoic acid. Other adjuvants include:

1. Thymic Protein A - a potent stimulant of Th-1 cells, lowers RNase -L and 2, 5 A synthetase levels, improves sleep, anxiety and short term memory.
2. Chlorella- binds heavy metals, increases NK cell function.
3. Therapeutic mushrooms- improves Th1/Th2 balance.
4. Arabinogalactans- increase NK activity, lowers TNF-alpha.
5. Probiotics- influence Th cytokines.
6. Colostrum- contain transfer factors.
7. Echinacea and Astragalus- immune stimulating herbs.
8. DHEA- reduces proinflammatory cytokines.
9. Omega-3 oils- reduces pro-inflammatory cytokines.

Nan Fuchs, Ph.D. "The Importance of Emphasizing Magnesium in the Treatment of CFIDS and FM".
High calcium and insufficient magnesium diets are making people ill. Our S.A.D.(Standard American Diet) is excessive in calcium and deficient in magnesium (among other deficiencies). Supplementing magnesium can reduce pain, cramping, heart disease, arthritis, hypertension, PMS and even osteoporosis.

Magnesium is important for the production of cellular energy (ATP), reduces insulin resistance, corrects hypertension (it is a vasodilator), improves arthritis - unabsorbed calcium can collect in the joints. Magnesium helps calcium get into the bone and other tissues and it can reduce PMS. Dr. Fuchs mentioned an interesting side story: Dr. Robert Heaney studied 48 women in Nebraska in 1978. He estimated their daily calcium intake was (670 mg per day). He doubled this number to conclude that women should consume 1,200 - 1,500 mg per day of calcium. The U.S. dairy industry then used this study to increase sales. Dr. Fuchs believes that high calcium does not increase bone density, and high amounts can result in bone fragility.

Dr.Fuchs recommends a dose of 600 - 1,000 mg magnesium glycinate or citrate with or without malic acid daily. If diarrhea occurs, reduce the dose. She has authored numerous booklets on the use of magnesium.

Hyla Cass, M.D. "Natural Highs: "Dealing with Mood Changes of CFS and FM Using Specific Botanical Treatments."
Based on her book "Natural Highs", Dr. Cass explained the rationale and properties of several natural substances.

St.Johns Wort is an uptake inhibitor of serotonin, norepinephrine and dopamine - thus is an antidepressant.

Ginko Biloba - one of the oldest plants on the planet is an antioxidant, blood thinner and improves memory and energy.

S- Adenosyl-Methionine (SAMe) is a methyl donor as described previously, enhancing production of neurotransmitters, fatty acids, phospholipids, proteins, nucleic acids and glutathione.

Other herbs discussed were Kava, Valerian, Hops, and passionflower as relaxants.

Finally, adaptogens were described.

Ashwaganda - stabilizes cortisol levels, enhances memory.

Ginseng - supports the adrenals, enhances the body's response to stress, gives immediate energy.

Licorice - prevents the breakdown of cortisol.

Astragalus - adrenal support and immune support, as well as anti-inflammatory.

Many of these adaptogens are available in combinations commercially.

Unfortunately, this article cannot provide the detail given in the lectures; the complete syllabus or individual audiotapes can be purchased from: