Wednesday, December 31, 2014

This time of year - and Severe ME/CFS


It is that time of year again. Holiday time and the New Year is the saddest season for ME/CFS patients. While the dance of life goes on for many people, ME/CFS patients feel the heightened sense of abandonment and despair.

We need to try to do more to relieve their suffering.

I have felt for a long time that the key to the illness – should there be a key – lies with the severely ill. These patients at ground zero of this illness need to be studied - and studied in depth.

This is more possible today than any time prior. There are commercially available tests that could uniformly be applied to this patient group. I could list some of them, but I will forgo this at this time. And then there are the research tests that would delve even deeper.

Please excuse the repetition as I quote a few items from my previous blog posts.  As Stravinsky said, some things need repeating.

“It is my belief that we, collectively, have to look more closely at the most severely ill ME patients. It is my belief that they harbor, in their severity, the keys to this illness. Most doctors do not see the most severely ill. Dr. Kenny De Meirleir, in his trips into Norwegian homes, treats the very ill. Dr. Paul Cheney and Dr. David Bell also have occasionally seen the severely ill. Perhaps others have - and hats off to them.

But, by and large, the severe patient is isolated from everyone. The severely ill ME patients cannot get to a doctor's office. They languish in darkened rooms, cut off from reality, isolated and often abandoned, and without medical care. It appears that no one cares a whit about them. It is these patients on whom we have to focus our attention - both for their sake and for ours. More effort has to be made to "get in close," although this, in itself, is difficult under even the best of circumstances.

I know of a number of these patients. They have the willingness to participate, through testing, in their own potential betterment - provided that the severity of their situation is taken into consideration. Many already have had testing for immune function, NK cell activity, cytokine disregulation, gut dysbiosis, brain scans and so forth. Consistent testing needs to be applied to these patients using existing parameters - if only to set the stage for future possibilities that will soon arise.

Most people do not want to take a look in this direction. Most people turn away - including doctors. It is time to toughen up - and to consider these patients, and what they are going through. Testing of the moderately ill has not brought clarity. We need to brace up, take a good look and then move in close. While it is difficult it is the only decent and humane thing to do.”

“Until those at the center of this illness - those in darkened rooms - are depicted, embraced and understood, nothing will happen at the government level.

In order to set the tone, videos of severely ill patients should be presented at the beginning of any government or private conference on ME/CFS. Voices from the Shadows, Josh Biggs' and Natalie Boulton's very fine film (or similar videos), should be mandatory - to set the stage and to get the participants in the right frame of mind.

There is clear evidence that the government has no interest in this. Multiple times they have been given the opportunity to present visual evidence of the severity of the illness, and they have said no.  The government is content to give a grieving altar to the moderately ill and leave it at that.

The very, very ill have big problems. Everything around them represents a threat to their health. They need to be protected at every level – protected from doctors, from roofers, from plumbers, from realtors, from neighbors, from movement, from noise and vibration, from friends, from family, from hospitals, from water, air, chemicals, mold – from everything.”

“And what about the others - what about the really sick ones?

There is really only one way to present this illness, and it needs to be done more often. The face of this illness lies in the presentation of the severely ill patients. This is one of the real values of Laurel's CFSAC video testimony in October 2009. She did us a very great favor to make this video, visually and audibly describing her condition. This courageous and heartrending video that has so much power and dignity. We need to see more of these kinds of videos - images and pictures of the severely disabled. This is where the visual information lies - down near the bottom.

"Walled up:

Imagine a patient who cannot stand, who has extreme fatigue and must live a horizontal life. Imagine a person who is functionally blind from light sensitivity and eye muscle fatigue and wears a blinder 24/7. Imagine how this blindness might further limit this person's ability to move. Imagine this person with sound sensitivity so bad that they cannot tolerate the phone ringing or dogs barking outside. Imagine a person whose skin is sore and sensitive to the touch. Imagine a person who cannot focus their thoughts, has short term memory deficit, or can't speak clearly because of neurological deficits ("brain fog"). Imagine a person who has seizures, spasms and twitches. Imagine a person who has lost their sense of smell - or has hypersensitivity to smells. Imagine a person who cannot speak, or cannot speak above a whisper. Imagine a person with a feeding tube, IV medication, and oxygen. Imagine living in a world where things coming in and things going out don't happen. Take a good look. This is ME/CFS at the core. My friends in the UK call it ME. It is worth noting that all ME/CFS patients are on a continuum, shifting whimsically up or down the scale over the years.”

Incidentally these severe patients have measurable abnormalities that characterize the illness.

I have written about the film Voices from the Shadows here. Allow me to quote one part of this review.

And yet the film does focus on "those who do not back away" - the caregivers. These caregivers are trying valiantly to save their loved ones, but the stress is in their eyes, in their movements. It is a very difficult position to be in, to chose to move in close and support the very ill patient. Moments of interchange between the caregiver and patient are excruciatingly poignant and painful. This illness is terrible for the patients. It robs them of much of life's normal activities and interaction, and yet the caregiver, in his or her giving, suffers terribly also - and this film delivers that message. A properly balanced interaction between caregiver and patient - something that is extremely difficult to get right - is depicted with extraordinary sensitivity by these filmmakers.’

"Natalie Boulton has also done us a great favor in writing and editing her fine book, Lost Voices, a gathering or set of stories and pictures of severely ill UK ME patients. The book was published by InvestinME in 2008. It gives the clearest picture currently available of this illness, and is the most valuable resource for coming to terms with its reality. Otherwise there are various videos on youtube made by patients, and by the providers of these very sick patients. Many of the older videos that I viewed years ago - ones that were quite frightening to me - have disappeared off the internet. Soon we will have additional contributions in this area, and they will be welcomed for what they are - clear documents of the core of this ME/CFS illness.

This, of course, is not an easy subject. It is a delicate issue - this severe private illness that takes place in darkened rooms - and from many points of view. But I think we have to have the courage to put pictures and videos - with clear explanations - out into the world in order to show the serious consequences of this illness. This illness needs a face, a real face.

I was in the conference hall in London several years back when Dr. Kenny de Meirleir showed videos of desperately ill, bed bound patients in Norway. The video was extreme, showing a patient lying in a bed in a darkened room, with a feeding tube, wearing a blinder and ear protectors. The sheets were suspended above the patient due to intolerance of the weight and pain of the sheets. It was a riveting, terrifying video, an image straight out of Dante. At the same time, Dr. de Meirleir had a young woman speak about her "walled up" sister, who she had not seen in four years - even though they lived in the same house. It was easy to sense that this presentation shocked the audience, an audience consisting of patients or those familiar with the illness. It was as if Dr. de Meirleir had done something inappropriate. But for me, it was a revelation, and that moment has percolated in my mind ever since.

How can this illness be presented to the uninformed - doctors, researchers, journalists, friends and families - in a profound way? I think you have to go "to the core". It is like going inside of the smashed nuclear reactor and viewing the exposed fuel rods.

Certainly, at the moment, the face of this illness has not registered with the public at large, and listing a long list of symptoms is not going to cut it. I want a video in my hand that depicts the "very bottom" - a video that I can hand to Dr. Harvey Alter and say : "Dr. Alter, take a look at this." - and hand it to any number of people with the same intention. There is a need to provoke people into the recognition of the true devastation that this illness inflicts on patients - and caregivers.”

Such were some of my comments from the past. If I ever had a conspicuous idea about this illness it is to study the severity of it. Hopefully things are about to change in this regard and I will write more about this soon.

In the meantime, I have five or six ME/CFS friends who have made substantial improvement in the last few years. Most had the illness at a moderate to serious level and were disabled in one way or another, suffering serious consequences to their lives. Each of them pursued various avenues to betterment and there was no commonality to what brought them to some betterment - and a couple to substantial betterment.  No commonality, and yet they have the same illness. Their diverse treatments included antibiotics, acupuncture, Valtrex, methylation supplements, uv light therapy, thyroid regulation, dietary changes, Chinese herbs, jin shin jyutsu, ozone therapy - and cannabis.  Each had to find their own path through trial and error. This is an important bit of information.

Yesterday I read this article, which I found of interest.


Thursday, October 16, 2014

Dr. Joseph Brewer at ILADS, 2014



ILADS is a professional scientific conference focusing on the education and treatment of Lyme disease and its co-infections. This year's conference in Washington DC was packed.

I was particularly pleased to see Dr. Neil Nathan from Gordon Medical Associates give several lectures, one on viral treatment for the Lyme patient and one on methylation. Dr. Nathan is a remarkable clinician, one who is open to suggestion regarding different treatment modalities. Dr. Nathan, Dr. Eric Gordon and Dr. Wayne Anderson form a unique group of physicians working on these complex illnesses out of one clinic, Gordon Medical Associates in Santa Rosa, CA. 

Dr. Nathan worked closely with Rich van Konynenburg. In 2009, they did an important study together on methylation.

I really went to ILADS to hear Dr. Joseph Brewer update us on his treatment for Mycotoxins in ME/CFS and Lyme. The bottom line of Dr. Brewer’s lecture was that this treatment is continuing to provide remarkable results. Over time Dr. Brewer has gained confidence that he is really onto something here. Many others are beginning also to understand and treat patients for mold and mycotoxin involvement.

A previous blog post from October 2013 covered Dr. Brewers previous Mycotoxins lecture at ILADS. It can be found here.

Once again Dr. Brewer gave a quick review of the overall picture of mycotoxins and chronic illness.  Dr. Brewer pointed out that mycotoxins suppress all aspects of the immune system. Certainly this is what Shoemaker and others have found. 

Dr. Brewer continues to use Ampho B in an atomized nasal application. Ampho B has caused serious nasal irritation in some patients. These patients either cut back their treatment or shift to another treatment drug.

Dr. Brewer presented a pilot study, done with his own patients. This is an open label observational study done by him and his patients. This pilot study covered treatment of 151 patients between May 2013 and May 2014. The treatment for all patients was two fold: nasal atomized Ampho B and nasal atomized PX chelating formula. Chelating PX is a combination of EDTA and a surfactant. Each patient did each agent once daily for at least six months. A few were every other day dosage.

56 patients dropped out, not able to tolerate Ampho B.

94 of 151 continued on the study. 

Of those 94, 88 showed improvement at the end of the study. This is a 93.7% improvement rate. Improvement was 25-50% or greater from baseline, and this was self-reported.

One third of the 88 are pretty much back to normal. These patients have had a complete resolution of symptoms. 

58% of the total 151 improved with this treatment. 

Die off was reported at 13%. Dr. Brewer believes the die off percentage was higher, perhaps in range of 30-40%.

22 patients continue to be followed. Some of these have stopped treatment while others were on maintenance doses. A number of patients have relapsed after stopping treatment.

A few patients, more recently, have stayed off treatment and have not regressed. It is believed that the treatment has to be continued for a certain unspecified duration for complete resolution.

Since April 2014, Dr. Brewer has begun using nasal Nystatin on a number of his newer patients. He has now treated 80 patients with Nystatin. Most of them were in the Ampho B intolerant group. ASL pharmacy has been unsuccessful in making a liquid formulation of Nystatin for atomization. Instead they fashioned it in a pill form. The pill is opened and the powdered Nystatin is mixed with distilled water prior to being atomized with the Nasa-Touch. The patients on Nystatin have no nasal symptoms. It seems to be very user friendly on the nose. Die off is about the same as with Ampho B cohort. Preliminary results indicate that these patients are improving on nasal Nystatin treatment.

There may be other agents that could be useful and they will be studied.

This report is for informational and educational purposes only. It is not to be seen as medical advice in any way.



Tuesday, July 29, 2014

Mitochondria


The following is an update on mitochondria and mitochondria testing in ME/CFS, a kind of overview as I see it. None of the following has to do with "Science", say, as practiced by Dr. Lipkin. Instead it fits more into the category of what Dr. Shoemaker would call "desperation medicine". I prefer myself to call it 19th century medicine, epitomized by this: "here, try this".

I do not pretend to be interested in science - especially relative to ME/CFS. However, real science activity in other areas - the immune system for instance, or gut ecology - is of great interest to me. I absolutely believe that something helpful will "slop over" into "my illness area" from other illnesses. This is my view and I work accordingly, trying to calculate the odds of any particular treatment, knowing that all treatments are experimental ("non-scientific") - and a potential threat. No one can convince me though that "my chronic illness" does not involve mitochondrial dysfunction.

Dr. John McLaren-Howard started Biolab in London many years ago. He has always been a real hero to me. When he retired, he formed the small lab Acumen lab in Cornwall UK. (I have always imagined Acumen to be in Dr. Howard's basement - or garage.) Dr. Howard has continued doing various tests that he began at Biolab. Principal among these is a mitochondrial profile test (examples are at the end of this post). Dr Sarah Myhill discusses the mitochondrial profile test here. Dr. McLaren-Howard offers other mitochondrial tests - translocator protein, DNA adducts, cell-free DNA, Cardiolipin studies in mitochondrial membrane, blood metallothionein studies, and toxic effects studies. All these tests give insight into the working of the mitochondria.

Dr. Howard has worked with Norman Booth and Sarah Myhill and published various papers on his mitochondrial testing, as it relates to ME/CFS patients. A 2009 paper can be found hereHere is another important paper from 2012.

I wrote about this mitochondrial test in 2011 in another post on this blog, and also here a year later.

For a fee, Dr. Myhill will write an analysis on the test result and suggest various treatments. The treatments that she suggests to increase mitochondrial function are well known and can be found here and roughly parallel what in the larger world of mitochondrial illness is known as the "mitochondria cocktail". This includes co-Q10, acetyl-l-carnitine, d-ribose, NAD, creatine, and magnesium. I think it is fair to say that great weight is put on magnesium.

Often magnesium is found to be low in ME/CFS patients and this is one element that Dr. Myhill says can be corrected through sub-Q magnesium injections. (I would appreciate hearing a conversation between Myhil and Cheney on this subject.) Tests at Quest or Biolab can be done on coQ-10. Status of blood levels of carnitine and NAD are part of the basic Acumen test. The basic test covers ATP profile, SOD, Cell free DNA, NAD blood levels, and Carnitine blood levels.

Anecdotally, various items can be altered with supplements. Blood levels of coQ10, carnitine and NAD can be improved. What this means clinically is another matter.

A third paper of the collaboration, emphasizing treatment, can be found here. It indicates that a majority of patients improve with supplemental treatment. I myself have found that the test can be normalized with aggressive treatment. In the third paper published by Myhill et al, patient betterment was achieved, indicating clearly, as in my case, that mitochondrial normalization (via this test) is helpful.

Dr. Paul Cheney might take a slightly different view of the matter of mitochondrial treatment. He might express that "front-door" treatment of the low measurements of carnitine and co-Q10 is ineffective, and indeed perhaps counterproductive. Dr. Cheney believes that mitochondrial dysfunction in ME/CSF is a self-protective down-regulation and has to be dealt with carefully. This is a fantastic idea and certainly possible. Dr. Robert Naviaux holds similar views with his "playing dead" thesis.

Dr. Cheney himself would perhaps treat mitochondria with high- dose hydroxocobalamin B12, frequent S/Q magnesium injections, transdermal creams or sprays. It is his belief that magnesium in these patients is constantly leaking out of the mitochondria and needs constant replacement. Dr. Cheney might also suggest Isoprinosine (Inosine) and Klonopin. Mitochondria have a klonopin receptor.

Dr. McClaren-Howard and Dr. Derrick Lonsdale, now retired, would suggest thiamine injections or supplementation with an active form of thiamine, as found at Our Kids. Dr. McLaren-Howard would suggest that thiamine is necessary to get magnesium into mitochondria. A transketolase test can be done at King James lab to determine active thiamine levels and the presence or not of a blocking enzyme. This is not an unimportant detail. (Actually King James lab has closed now. Life goes on.)

Dr Joseph Brewer tested PQQ on a number of his patients several years ago, looking to increase mitochondrial function. He also told me about Dr. Richard Boles, who is medical director at Courtagen Life Sciences, a mitochondrial research company. This is another level of mitochondrial research testing and perhaps the wave of the future. Current prices for testing put it far out of reach.

Terry Wahls

And then there is Terry Wahls. I first wrote about Terry Wahls in 2009 on this post. Dr. Wahls recently published a book on her mitochondrial diet, which is a great elaboration of her first book, Minding My Mitochondria. Various ME/CFS patients gain physical strength in taking on her diet, including daily bone broth, seaweed, and fermented foods. Again there is very little that one would call science here and the treatment improvement is only part of the larger picture.

LRT - lipid replacement therapy



The recent ME/CFS conference in SF featured a poster paper of Dr. Garth Nicholson on lipid therapy for mitochondria. Dr. Nicholson has been working in this area for some years. It was interesting to see Dr. Nicholson and Dr. Cheney discussing Dr. Nicholson's poster paper. Here is a recent article on Garth Nicholson's ideas about LRT - or lipid replacement therapy. Dr. Nicholson has made presentations at various conferences promoting his research and treatment into phosphytidyl lipids, especially NT factor. Dr. Nicholson was certainly telling Dr. Cheney how effective NT factor was - and that it really did get into the cell membrane for repair.

Differing with this and giving a second argument would be Patricia and Ed Kane, both of whom have long advocated a separate phosphytidyl lipid treatment, mostly involving IV infusion. This treatment involves their proprietary phosphytidylcholine (PC), sold at bodybio. More recently they have moved into liposomal or microsomal phosphytidylcholine treatment, which proves to be effective. Here is a video of Ed Kane speaking on phosphatidylcholine therapy. It is a winner.

All of the above are different approaches to "feeding the mitochondria" - and improving the function and the number of mitochondria.

Nicotinamide Riboside

Recently I received the heads-up from my friend Nancy Rouch about a mitochondrial lecture by Dr. Robert Rountree, chief medical officer of Thorne products. While this is one long advertisement for various mitochondrial supplements, it does present interesting information. (This lecture will be available for viewing until the end of July.) Dr Rountree suggests the "usual suspects" - or "foods" - for mitochondria - magnesium, co-Q10, acytel-l-carnitine, creatine. He also adds these items: sulforaphan, green tea polyphenals, berberine, quercetin, cucurmin, resveratrol, pterostilbene, melatonin, NAC, and ketogenic amino acids. He spends a significant amount of time on NR - nicotinamide riboside, a precusor to NAD. What he says about NR is quite impressive. NR can be purchased from Thorne as NiaCell and is a proprietary formula developed and marketed by Chromadex. It is not cheap.

Important research is being done on Nicotinamide by collaborating groups in Switzerland and at Weill Cornell. A significant study was published in 2012.

I would be remiss not to mention all the information and discussions on mitochondria function in ME/CFS on Phoenix Rising and Healthrising. Just search for mitochondria and start reading. The internet is an amazing resource - and these sites are just great.

All these suggestions have to be approached carefully and are entirely dictated by trial and error. To me, strictures and dogmas are not particularly welcome. It is well known that each ME/CFS patient responds individually to any particular treatment. So one must work carefully. Taking things slowly, over weeks and months as opposed to days, is often helpful, setting the goal of building a long term framework. This is a one on one game. Incidentally this is not medical advice. I am not a doctor and I certainly do not want to be one, never did.

Here are the first and second page results of this Mito Profile:



The following is commentary by Dr. Myhill of the above page. "The result is made up of three elements. First of all it measures the rate at which ATP is recycled in cells. Because production of ATP is highly dependent on magnesium status, the first part studies this aspect. The second part measures the efficiency with which ATP is made from ADP. If this is abnormal it could be the result of magnesium deficiency and/or low levels of co-Q10 and/or low levels of NAD, and/or low levels of acetyl L-carnitine. The third possibility is that the protein which transports ATP and ADP across the mitochondrial membranes is impaired and that too is measured."


Friday, April 25, 2014

More on Enteroviruses and ME/CFS


A few recent comments on the history of research into enteroviral involvement in ME/CFS are worth highlighting. These comments come from Dr. Charles Shepherd and from Hip, of the Phoenix Rising forums. Hip contributes multiple, important observations to the Phoenix Rising forum and his ideas are always insightful.

From Charles Shepherd:

"I have now met and listened to Dr. Chia on several occasions and I was at the IACFS/ME conference in San Francisco - where he again presented his findings relating to persisting enteroviral infection. I agree with Tony Komaroff that these findings cannot simply be dismissed and we do need another independent group of virologists to see if they can replicate these findings. I have made these points in my own detailed summary of the conference - which is now being prepared for publication. At present, the balance of evidence (much of which was done in the UK by Professor John Gow and colleagues in Glasgow) relating to persisting enteroviral infection in ME/CFS is against any such link. But I think we should adopt a position of 'the jury is still out' on persistent enteroviral infection in ME/CFS until someone has tried to replicate what is a very thorough and interesting piece of virology research."

From Hip:

"Hi Charles Shepherd,

I believe Professor John Gow primarily looked for enteroviruses in the muscles of ME/CFS patients. However, generally speaking, muscle symptoms such as muscle pain are not that common in ME/CFs, whereas gut and of course especially neurological symptoms (e.g. brain fog, sound sensitivity) are the norm. Thus unless you look for enteroviruses in the areas where the symptoms exist, i.e. gut and nervous system or brain, you may not find much evidence for these viruses. Dr. Chia looked in the gut, and found a strong association between ME/CFS and enterovirus infection; but ideally I think you would want to look in the brain and nervous system (in postmortem studies), because neurological symptoms are really the core of ME/CFS. It is known that when enteroviruses like coxsackie virus B enter the brain, they form a persistent infection of the astrocyte cells and the neural progenitor cells. So these perhaps are the areas where we should be looking for enteroviruses in ME/CFS. Two brain autopsies on deceased ME/CFS patients did indeed find enterovirus in the brain.
See:
Viral Isolation from Brain in Myalgic Encephalomyelitis (A Case Report) 2001 J. Richardson www.oocities.org/vitamvas/viralfm.html 
Enterovirus in the Chronic Fatigue Syndrome 1994. McGarry F, Gow J, Behan PQ. www.ncf-net.org/library/enterovirusincfs.htm

Also, it is now known that enteroviruses such as coxsackie virus B form two distinct types of infections in the body: first the normal lytic enterovirus infection, and second the noncytolytic enterovirus infection.  The latter resides purely within human cells, and is not easily detected. Nevertheless, Dr. Chia, and other researchers such as Dr. Nora Chapman, suggest these hard to detect noncytolytic enteroviruses may play a significant role in ME/CFS. Thus ME/CFS studies need to search for both lytic and noncytolytic enteroviruses in ME/CFS patients.

Hi Charles Shepherd,

Also, if you look at the list of enterovirus studies by British researchers from 1983 to 2001 (which includes Prof. Gow's studies), these all found a pretty strong association between ME/CFS and enteroviruses such as coxsackie virus B. This list of enterovirus studies can be found here.

As far as I can see, there seems to be solid and consistent evidence over several decades for the role of enteroviruses in ME/CFS."

Thanks again to Hip and Dr. Charles Shepherd

Tuesday, April 15, 2014

"ad astra per aspera" - Dr. John Chia's ideas taking hold


("ad astra per aspera" - "a rough road leads to the stars")

Several summaries have emerged of the IACFS/ME conference, for those who are interested in the details. The first is the transcription of Dr. Komaroff's summary at the end of the conference. We have Patricia Carter of ME/CFS forums to thank for this. Another summary is by Dr. Charles Lapp. It can be found here

Several paragraphs in each summary caught my interest and both deal with a favorite subject of mine: Dr. John Chia and his research into Enterovirus and ME/CFS.

From Patricia Carter's transcription of Dr. Komaroff:

"Dr Chia reported again at this meeting, as he has in the past, the expansion, the latest summary of data from a remarkable report and a remarkable amount of work, Enterovirus Antigen and nucleic acid found in biopsy samples from stomach in cases and control subjects. Finding very marked differences in the frequency of both antigen and nucleic acid in CFS patients compared with controls. He then also reported that when you took the biopsy specimens that these tests suggested contained enterovirus and injected them into mice that, in fact, you found when you sacrificed the mice, evidence of enteroviral infection, a virus in the mouse, indicating that this thing lit up looking like it might be an infectious agent of the biopsy tissue actually produced an infection in another animal. 

To me, these results are very impressive, but it's also depressing to see that, to my knowledge, no academic enterovirologists have sought to try to reproduce this, not even in bulk, to take the samples that already have been collected at enormous effort by Dr. Chia and test them themselves to see if they get the same results that Dr. Chia does. It's a great shame and I hope it changes." 

In fact two of the infected mice died over a weekend, one on a Friday, one on a Monday. "If they do not believe in death, then what do they believe in?" At least one enterovirologist, and perhaps two,  have worked with Dr. Chia's samples.

And then there is this from Dr. Lapp:

"Dr John Chia is an infectious disease specialist and pathologist from Lomita CA. He and his son contracted CFS/ME and were found to have enterovirus infections in their stomachs (see his article in the Journal of Clinical Pathology, Jan 2009. After treatment with a Chinese herbal called oxymatrine (there is no other known therapy for EV) both have recovered and stayed well. Dr. Chia reported to us on further EV studies from his lab. To demonstrate the infectiousness of EV, Chia injected the lysate (Osterized tissue or homogenate) from 24 EV-positive human stomach biopsies into immune deficient SCID mice. When the mice were later sacrificed, 13 out of 20 were positive for EV in their spleens, but only 1 of 10 control mice were positive. However, Chia could not culture the virus from any of the spleens suggesting that although the infections were transferred, incomplete viruses were formed in the receiving mice. In a second study, Chia obtained pathology specimens from 27 women with CFS/ME who had undergone total hysterectomy or salpingo-oophorectomy for chronic pelvic pain. 24 or 27 specimens stained positive for EV, whereas none of 15 healthy control specimens were positive. Three SCID mice were injected from EV-positive specimens and the mice were sacrificed at either 2 or 5 weeks. Spleens and fallopian tubes stained positive for EV at both 2 and 5 weeks, although spleen stain was less obvious at 5 weeks. Western blot studies of all mouse fallopian tubes demonstrated enteroviral proteins. (Ed. note (Lapp) Dr. Chia is making a strong case for enterovirus as a common trigger for CFS/ME, and these studies imply that the infection is transferable. I found it interesting that chronic pelvic pain was localized to the infected fallopian tube in his patients, and that surgery relieved the pain. Sadly, no one else has taken on the task of confirming Dr. Chia's studies. Also there is no known antiviral therapy for EV - just an ill tolerated herbal preparation. Hopefully someone with Chia's expertise will investigate this further and confirm these important findings!)"

It has been seven long years since Dr. Chia's important paper of potential enteroviral involvement in ME/CFS. No one has significantly picked up on his study. As the backbone of his work, Dr. Chia has studied and revisited the history of ME especially in the UK. He has personally re-ignited important and forgotten associations. Dr.Chia is not coming out of nowhere on this. 

"We need to declare EV as one of the causes of ME/CFS. It has been 30 years!"

"Enteroviruses need to be accepted as one of the causes of this illness this year, or else we will wait another ten or more years before a drug will be available for this disease. You need to ask the researchers at Stanford and at the meeting why they are not working on enteroviruses."

I personally have witnessed several virologists flatten Dr. Chia's work. A prominent virologist (regarding Dr. Chia's work, which I had sent him) gave this blunt assessment: "It's crap". There is evidence that this prominent virologist might have altered his views - and perhaps might be willing to help.

We need to move on beyond these attitudes and find out what Dr. Chia is finding. Dr. Chia himself says: "I have spent considerable time trying to convince that I am right. Now it is time for others to prove that I am wrong."

After this IACFS/ME conference it seems that things are turning in a more positive direction for Dr. Chia's stupendous efforts in trying to get at this nasty illness. For those interested, there is more information on Patrick W. Calvins' Quixotic blog. 

And then there is the recent very exciting news regarding new drugs for Hep C. One drug, Sovaldi, from Gilead was approved by the FDA and is both well tolerated and extremely successful in treating Hep C. Two more amazing Hep C drugs are in the pipeline, one from Abbot and another from Bristol-Myers. There is some hope that one of these drugs might be effective against enteroviruses. "If this proves true, it will make all the difference in the world".

So there is some urgency here, and some real hope - but only if Dr. Chia's work is followed up on.