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One of the most common is Magnesium. When it's low it makes the pain worse. You can't take Manesium if you have kidney problems. As a result of adrenal suppression we tend to put out less Cortisol and less DHEA. Cortisol replacement makes patients worse. DHEA replacement has yielded up to a 10% better. Doses usually are 25-50mg women daily, 50-100mg daily for men, both taken in the morning. Side effects-- DHEA is converted to estrogen and a smaller amout of testosterone in women and men, which can build muscle and bone and increases blood flow. Since this is a steroid, you must be careful to monitor side effects.
NEW, UNCONVENTIONAL INVESTIGATIONAL THERAPIES: Kutapressin.-- An extract of pig liver, which works as an anit-viral and an immune modulator. Requires a shot in the hip which is costly. IV Gammaglobulin. -- Used on sickest patients, especially those whith multiple infections. It's given monthly. Amphetamines. -- Speeds up brain waves and can boost energy. Ritalin, is used for attention deficit problems in CFIDS patients, which include letter reversal, forgetfulness. It's a very safe drug that isn't habit forming. Cylert is another amphetamine that has shown some success. Long term antibiotic therapy. (Doxycycline, Erythromyecin) -- many patients who have taken antibiotics long-term have reported feeling better while on the medication and felt worse when stopped. There is a high incidence of micoplasma incognedus in CFIDS patients, and antibiotics are helful in treating this. Ampligen. -- doubled stranded RNA, drug has been around for 30 years in the vetinary medicine. Over 130 patients have been treated, with a reported 50% recovery rate. 80% have improved globally. (globally meaning all symptoms). FDA hasn't approved ampligen yet.
ALTERNATIVE THERAPIES: Have some merit, but studies are lacking. Some people will do well, but it probably won't be a cure-all. Acupuncture, Massage, Neuromuscular therapy, Chiropracty, can be helpful for symptom relief. No Scientific support, but not risky, -- Homeopathy, Magnetic therapy, Aromatherapy. The following have some scientific merit why they might be tried but are still lacking controlled studies: Acetyl-carnitine, Anti-candida medications, Guafenisin, Proanthocyanidin, Amino acids, Echinacca, Sylimarin, Valerian, Glucosamine, Shark-cartilage, Pyridoxal-5-phosphate, Glutathione, N-acetylcystine, Garlic. The following are unproven and unsafe. -- Peroxide infusions, Chelation therapy. Chinese herbs, Ephedra, ma huang, gotu kola, will all make you fell better, however they are caffeine derivitives. It's a false energy that gives you a boost so you will do more and end up crashing worse. Amphetamines speed up the brain and do not give false energy. Takes a sleeping brain and wakes it up. Mushroom or fungus tea, Geranium -- not recommended. Caffeine -- a false energy, that will make you worse. Enemas have no value. (deaths have been reported)
PERPETUATING FACTORS: If you don't deal with these factors it is very difficult to recover. Treat the psychological problems. (reactive depression, anxiety, somaticism.) Manage allergies.(can zap your energy) Avoidance of chemicals, odors, fumes and smoke. Treat yeast infections aggressively. (over-the-counter medications usually don't work) Address stressors (counseling for family dysfunction, financial pressures, lack of support structures, disability administration issues.)
PREVENTIVE CARE: Avoid hot baths and sunbathing (Heat can be draining). Flu vaccine? pro: may prevent a virus. con: relapse, poor seroconversion. (most CFIDS patients don't get the flu due to an upregulated immune system). Bone density studies (DEXA) -- inactivity causes bone loss. Annual exam and laboratory. -- document progression or regression, review medications (for drug interactions), cancer checks, routine lab work (CBC, chem, ESR, TFT, UA). Kidneys, Liver and Colesterol need to be checked often. Dental checkup -- CFIDS patients have dry eyes and mouths which can lead to serious dental problems.
Dr. Charles Lapp, MD
Hunter-Hopkins Center
10724 Park Road, Ste. 105
Charlotte, NC 28210
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