INTRODUCTION Do not rely solely on this discussion of nutrients and strategies, but seek other medical consultation if you are sick.

Chronic fatigue syndrome (CFS or CFIDS) or "myalgic encephalomyelitis" (ME) is a disease characterized by several of the symptoms of impaired sleep, muscle twitching at night, extreme long lasting fatigue which gets much worse with exercise (the fatigue has been suggested to be from creation of proteins which interfere with and/or destroy thyroid hormone receptors by interferon [Englebienne] ), loss of memory [Marcel], reduction of gray matter in the brain, disruption of the circadian rhythm [Tomoda], sore throat, muscle and joint aches, headache, cough, photophobia, night sweats [Evengard], depression that has much lower ACTH and cortisol secretion (it has been proposed that low cortisol may actually be a marker for the risk of developing CFIDS rather than a sign of the syndrome itself) than typical depression [Demitrack], also a much lower secretion of growth hormone, which Cheney believes can be used to repair some of the damage to the hypothalamus of the brain (but growth hormone is degraded when eaten so can not be used by patients) and which failure is thought to be from over secretion of somatostatin in the hypothalamus [Paiva], a failure for a 383 amino acid cortisol binding protein to decline under stress as it usually does when not ill, lower secretion of DHEA (Dehydroepiandrosterone ), [Kuratsune] which is the most abundant circulating steroid [No authors], there is a less rise of DHEA under ACTH stimulation compared to cortisol than normal [Scott 2000] (It looks as if DHEA has only small advantageous affects on old men, but with either no or few side effects, but they include small increases in muscle. Main Symptoms 1. Impaired Cognitive Functions - inability to concentrate - calculation difficulties - memory disturbance - spatial disorientation - frequently saying the wrong word - being in a 'fog' 2. Chronic sore throat - often with recurrent flu-fike illness 3. Tender and swollen lymph nodes - especially neck and underarms 4. Muscle pain 5. Multi-joint pain 6. New headaches - often severe 7. Non-refreshing sleep Other symptoms may include: Nervous system problems Sleep disturbance - insomnia, hypersomnia - often with vivid dreams or nightmares Severe muscular weakness without muscle wasting Paralysis or Paresis - weakness or short lived paralysis Numb or tingling feelings Twitching muscles Changes in visual acuity and photophobia-intolerance to light Changes to hearing - sensitivity to noise Alteration of taste and smell Tinnitus - ringing in ears Disequilibrium - severe dizziness Feeling 'spaced out' or 'cloudy' Blackouts Depression Anxiety Emotional lability - mood swings, may be related to fatigue Other main symptoms may include: Nausea Abdominal pain 'Irritable Bowel Syndrome', wind, diarrhoea Weight change - usually gain - often 2 to 3 stone gain or loss Temperature disregulation with cold hands and feet Low-grade fevers, abnormally hot or cold Symptoms worsened by extremes of temperature Night sweats Heart palpitations Severe nasal and other allergies Multiple sensitivities or allergic reactions to medicines, food and other substances Severe premenstrual syndrome and exacerbation of all symptoms before and during periods in women Other symptoms may include: Rashes Dryness of mucous membranes eg throat, mouth and eyes Ulceration of mouth Uncomfortable or frequent urination Muscle spasms Chest pain Shortness of breath on exertion Disordered sensation in tongue - difficulty moving tongue Intolerance of alcohol Decreased libido and occasional impotence Personality changes (usually a worsening of a previous mild tendency) TMJ Syndrome - pain/tendemess on movement of jaw Carpal Tunnel Syndrome - pressure on nerves in hand with pain/tingling Food cravings - especially carbohydrates Finger/toe nails and hair stop growing Hair loss Slow healing process of cuts/scratches The affects on women are more advantageous) and claims for use of several catabolic hormones, lower blood volume (hypovolemia) [from a dead URL], lymph node pain, low blood pressure upon standing (othostatic intolerance, especially standing still), eye pain and fibromyalgia (muscle pain) [Bell DS], as well as white spots on MRI brain scans [Buchwald 1992] and single-photon emission computed tomography (SPECT) scans [Schwartz], brain scans using 18Fluorine-deoxygluxose (18FDG) positron emission tomography (PET) CFIDS patients showed a significant reduced metabolism in right medium frontal cortex (p = 0.010) and brain stem (p = 0.013), reduced blood flow to the part of the brain which controls the stomach muscles, a reduction of gray matter in the brain, loss of fingerprints in a third of the patients [Johnson H p345], increased sensitivity to glucocorticoid hormones [Zisser], alterations in some of the immune hormones including a marked depletion of their CD19+IgM+ mature B-lymphocyte population (also see a review of immune hormone interactions,) which are extremely complicated. There is evidence of high levels of a substance called nuclear factor kappa beta in the immune cells. It is the cell which regulates inflammation and oxidative stress. Larger amounts of IgA and IgM proteins in the blood are correlated with the severity of the CFIDS [Maes]. There is evidence of disruption to calcium ion transport in the muscle of ME/CFIDS patients (but not in fibromyalgia) possibly from modification of the sarcoplasmic reticulum membrane [Fullea] and a chronic low level activation of the immune system [Cannon] which last may be accounting for many of the non neurological symptoms. Most neurological symptoms are very variable, perhaps because different parts of the brain are attacked, perhaps because there is more than one species of virus involved, and perhaps because of strong affects from the large variety of secondary infections which have been identified or even all three [Richardson The most consistent laboratory abnormality in patients with CFIDS is an extremely low erythrocyte sedimentation rate (ESR), which approaches zero. Typically, patients with CFIDS have an ESR of 0-3 mm/h. If the ESR is elevated or even in the high-normal range, another diagnosis is suggested.

Another abnormality that is said to be almost 100% present in CFIDS, highly correlated to severity of symptoms, and unique to that disease is the cardiac output as measured by passing a current of electricity through the chest. In the electrocardiogram the corrected QT interval (QTc) averages lower in CFIDS patients. Many physiological parameters are altered. Another consistent abnormality is an increased excretion of citrate in the urine. It has been suggested that this binds with and causes an increased excretion of magnesium [from a dead URL]. It is conceivable that this is a mechanism for conserving chloride in order to keep the serum at the correct acidity in order to make immune enzymes more effective. This would seem to suggest that use of citrus food should be investigated and maybe other acid foods like vinegar as well. Alternately, since the body uses the interference of hydrogen ion with potassium excretion to prevent loss of potassium, citrate excretion may possibly be tied in to some kind of counter balance against hydrogen ion loss, by interfering with chloride loss.

Eight RNA genes derived from blood samples have been determined to be much different in CFIDS than in normal people [Vernon].

The current list of external symptoms that attempts to define the disease by the Canadian Expert Consensus Panel is at this site.

One positive circumstance in this series of miserable symptoms is that quite a few report that they never get colds. This could be because part of the immune system is chronically activated.

Women are much more often affected than men no doubt a tiny bit because they vocalize more often than men and/or are more likely to be afflicted with emotional trauma which is a triggering circumstance (but see endometriosis below). Childhood trauma is a risk factor for CFIDS [Heim 2009]. Women who have CFIDS have a significantly higher level of isopregnanolone (a metabolite of pregnanolone). Oddly it is inversely correlated with depression, which would seem to indicate that depression does not cause CFIDS [Murphy]. There is also the circumstance that women who have fibromyalgia generally do not inhibit undistracted pain, unlike men, especially normal men, who inhibit both types [Staud]. People who have fibromyalgia fail to release dopamine when subjected to pain, unlike normal people. This may be the mechanism that accounts for much of their pain [Wood, et al]. Electron microscope views of skin nerves show considerable alterations in appearance and this has been suggested as maybe involved with the pain [Kim]. Also the hippocampus in the brain is dysfunctional. The hippocampus is involved with pain perception. Some ME research indicates that pain in women is said to activate emotional centers while men tend to have cognitive centers activated. Doctors are more likely to treat women with less sympathy than men because of this perception of complaint. Perhaps it would be a good idea for women to use lady doctors. Sodium oxybate has been suggested to relieve the pain.

One third of a percent of women are affected for the more severe form of CFIDS, which is about the same rate as breast cancers [from a dead URL]. Approximately 2.5% of a Brazilian population have fibromyalgia (which in this study may include CFIDS).

There have been other names for the syndrome proposed. Chronic fatigue immune dysfunction syndrome (CFIDS) was proposed because the immune system was distorted and it was hoped that this name would gain the victims some support and research funds. After all, the magic letters "ID" had gained massive support for AIDS. It would be too bad if the early cavalier attitude toward CFIDS resulted in adopting such a cumbersome name. It may be necessary though, because the contempt and loathing by patients for the CFS acronym is intense, for it has resulted in some dangerous and expensive behavior by doctors. In the United Kingdom, 44% of physicians lack confidence in making the diagnosis and those that do make the diagnosis more readily usually have had a family member with the illness. Recently the U.S. Department of Health and Human Services CFIDS Coordinating Committee proposed the name neuroendocrineimmune dysfunction syndrome, or NDS. This name is hopelessly cumbersome. Yuppie flu was proposed because at first only higher income people had enough money saved to hire doctors or lobby officials. High income has been ruled out as a risk factor for fibromyalgia [White] and also CFIDS (actually less than 16 years of education is a risk factor [Clark], perhaps because better educated people tend to know more about good nutrition). The name "myalgic encephalomyelitis" (ME) was assigned to a similar disease by medical researchers in the British Commonwealth. The last two have also been combined into the acronym CFIDS/ME, an acronym preferred by patients. Post viral fatigue syndrome (PVFS) and post-infectious neuromyasthenia were also used. The majority of patients are said to prefer "ME" as a name, so in view of this , if so, maybe the medical profession should adopt this acronym. I prefer CFS because such an extensive literature already exists for this acronym, thus facilitating future searches, but only if all doctors can be educated to its horror. Another acronym that has come into existence is "PWC", which means "people with CFIDS". Fibromyalgia, which is widespread muscular pain, was proposed as a variant of CFIDS (80% 0f fibromyalgia victims have CFIDS) and probably is [Buchwald 1994] However cell wall electrolyte pumps appear to be fundamentally different between the two syndromes [Fulea]. The cortisol circadian rhythm is different in fibromyalgia than it is in CFIDS. (see this site for a personalized discussion of fibromyalgia symptoms). and you can see a comprehensive discussion from a medical doctor’s view point here. You can see a comprehensive discussion of symptoms and efficacy of medications here (requires registration). Psychological aspects of sexual function in women are affected adversely in women, but not physical aspects [Prins]. Many of the adverse side effect symptoms of the statin class drugs, which are cholesterol lowering drugs are the same as fibromyalgia symptoms [from a dead URL]. It seems logical that these drugs should not be taken during fibromyalgia. Indeed, it is conceivable that they cause fibromyalgia. Low molecular weight R Nase L increased activity correlates well with severity of CFIDS symptoms but is normal in fibromyalgia, rheumatoid arthritis, lupus erythmatosis, HIV, and depression [Levine - Copies of the complete article are available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address:mailto:getinfo@haworthpressinc.com.]. 74% of fibromyalgia patients had antibodies against serotonin and gangliosides, which are absent in rheumatoid arthritis and polymyalgia rheumatica [Klein]. 65% of patients with systemic lupus erythematosis (see CFS Reza’s article)have fibromyalgia symptoms [Neumann]. Some of the more striking abnormalities are those found in the 2-5 Synthetase/RNase L anti-viral pathway. These are not specific to CFIDS/ME though, and abnormalities can occur in other viral illnesses. This pathway works as follows: viruses activate the 2-5- synthetase enzyme. This in turn converts ATP into 2-5 oligoadenylate and activates the RNase L enzyme, which degrades viral and single stranded RNA. Various Protein kinase enzymes also becomes activated and elevated, which again inhibits both viral replication and protein synthesis. It has been suggested that environmental toxins in the presence of heat shock proteins can also activate this pathway.

No one has been able to assign a definitive cause to CFIDS with certainty until now (see XMRV below), although it has been proposed to be a hypochondria from misdiagnosis [Johnson H p 126] or mass hysteria from reading newspaper articles proposed by the Center for Disease Control in the USA [Johnson H p 135-138, 339, 342] (both extremely unlikely [White] ) or psychosis from childhood trauma by Simon Wessely (real nonsense). Incredibly, it was not until the 1950s that the Witchcraft Act was repealed in the UK. Let us hope that we do not have to wait that long to get rid of the above nonsense. A virus cause is highly probable. An Epstein-Barr virus [Holmes] was proposed (because that virus antigen is often found in it as an opportunistic infection, but refuted [Buchwald 1988] ) or other herpes type viruses, poor nutrition compounded by lack of exercise [Johnson H p685] (probably a factor prior to onset but not after), a poison [Racciatti] , or a retrovirus, which is a virus composed of RNA instead of DNA. Fragments were detected in some of CFIDS victims similar to retrovirus [DeFreitas]. The retrovirus work has ended because Elaine DeFreitas PhD at the Wistar Institute in Philadelphia at the University of Pennsylvania who ultimately found HTLV-II-like genes associated with CFIDS (1991)[vii] has become very sick and no one else has been competent to continue her work. She wanted CDC scientists to come up to Philadelphia to replicate her work side by side, but unfortunately they did not have the money for plane tickets nor would they allow her to replicate her work in their labs. Now, however, a consortium of researchers from the Whittemore Peterson Institute (WPI, located at the University of Nevada, Reno), the National Cancer Institute (part of the National Institutes of Health) and the Cleveland Clinic, Ohio, have found that DNA from a human gammaretrovirus, xenotropic murine leukemia virus-related virus (XMRV), could be detected in the peripheral blood mononuclear cells of 68 out of 101 ME/CFIDS patients (67%) compared with only 8 out of 218 healthy controls (3.7%). The virus forces the cells to produce DNA. Judy Mikovits, senior author of the study and Director of Research at the Whittemore Peterson Institute in Reno, Nevada, confirm that tests since (unpublished) detect XMRV in 95% of PWCs. She has given the disease a scientific new name: X-associated neuroimmune disease (XAND). Viruses related to XMRV can cause blood vessels around the body to leak, a common symptom of CFIDS. This virus has all the appearance of causing important symptoms in the USA (see the original publication). Antiretrovirals active against HIV may be effective in suppressing XMRV. If so this could possibly prove to be a valuable treatment for CFIDS. Only a couple Reverse Transcriptase inhibitors, and Raltegravir have shown early promising results. However Groom, et al failed to find a correlation with CFIDS in the United Kingdom [Groom]. XMRV has been questioned recently as possibly laboratory contamination [Knox], but something is causing CFIDS.

The Center for Complex Communicable Disease has proposed that a new type of virus called a stealth virus is responsible for CFIDS and fibromyalgia and are currently doing research and testing. The stealth virus is thought to be capable of taking genetic sequences from bacteria and other hosts. That CFIDS is caused by a virus or virus like pathogen that damages the immune system is highly probable since it comes on suddenly with flu like symptoms and shows up in clusters associated with social groups [Buchwald 1992]. Several cases of chronic fatigue syndrome brought on by parvovirus B19 was cured by intravenous injection of 400 milligrams per kilogram of imunoglobin per day for 5 days were cured [from a difficult URL]. Fragments of Mycoplasma pathogen species have been found in CFIDS [Nicolson] and fibromyalgia but they are probably opportunistic infections because when multiple species are found in the same patient it correlates with the length of time CFIDS was present [Nasralla]. Mycoplasma pathogens are common in the blood of Europeans [Nijs]. A high percentage of veterans with Gulf War syndrome are infected with Mycoplasmin fermentans, especially, and quite a few of their family members also become infected with symptoms of autism in their children. There is also a suspicion that boron supplements can mute the affects of autism and mercury poisoning is greatly involved in autism.

Grinde has suggested that perhaps one of the circoviruses, which are normally mild but become serious when one of them is able to cross the blood/brain barrier. A blood analysis for the virus would not be useful since a common virus would be involved. He says that analysis of spinal fluid would be necessary to establish this [Grinde].

Much of the advantage of magnesium may come from its need for enabling potassium absorption. In regard to resisting diseases, especially bacterial, there is probably another reason for keeping cell potassium normal with adequate nutrition. It seems that the white cell vacuole requires an alkaline medium in order to both kill and digest microbes. To achieve this it must pump potassium into the vacuole using a calcium activated (Bkca) pump. This is known because, when a chemical blocks this pump channel, microbes are not killed in spite of normal phagocytosis (engulfing of microbes) and oxidase activity [Ahluwalia]. So it seems plausible to me that, even when the pump is operating normally, a low cell potassium would make it more difficult to achieve the enhanced alkalinity. This may be the reason why potassium deficient kidneys are susceptible to infection [Woods]. It is conceivable that this is a problem with mycobacteria also and help explain why potassium supplements are so effective against rheumatoid arthritis (see this site for obtaining a very comprehensive book about potassium nutrition and supplementation). Mycobacteria as a factor in joint pain is plausible and maybe other pain as well because those bacteria may well be increasing secretion of glucosteroid response modifying factors, although I have no evidence. People low in interferon-gamma are susceptible to mycobacteria and benefit from interferon-gamma treatment [Casanova].

Platelets are proposed to have an immune function [Yeaman] and it has been suggested that CFIDS is from a defect in the platelet’s immune function [Gallagher, Co-Cure communication].

Cheney has proposed that the immune system is divided into two mutually exclusive modes, TH1 against viruses and TH2 against bacteria. He believes that CFIDS victims are stuck in the mode, TH2, which fights serum bacteria and as a result can not kill viruses and inside the cell pathogens such as mycobacteria. Instead, the body secretes Rnase L peptide protein for the time being which prevents the viruses and mycoplasmin bacteria (bacteria that have no cell walls which resemble viruses) from replicating but does not kill them [from a dead URL]. Some substances are said to restore this balance. A form of Rnase-L, the low molecular weight (37 kilo Dalton) RNase-L, has been found in CFIDS (CFIDS) patients. It can be six times as destructive as the typical RNase-L. If the virus-fighting system is working normally, the normal form of RNase-L prevents the virus from reproducing. The rest of the immune system goes to work and wipes out the virus, and then the entire immune system returns to normal levels, and the person recovers. In CFIDS, the RNase-L shifts to the more destructive form, and instead of de-activating, it stays active much longer, causing serious cellular metabolic dysfunction, which ultimately affects the liver. The cells can no longer produce essential enzymes, and without them, the liver can't do its job of detoxifying the body. This last contention is by Cheney, and is one of the best theoretical articles written on CFIDS I have seen [from a dead URL]. Glucocorticoids have a different affect on IL10 in CFIDS patients than in normal people while the affect on IL12 is the same. This may explain some of the reduction in antiviral activity [Visser, Grafferman].

has been proposed that there is a strong genetic factor in CFIDS.

Van Konynenburg has proposed that the shift to the above disrupted immune function has been enhanced by long term emotional stress and that a deficiency in glutathione and cysteine accentuates it. He suggests that glutathione is important part of CFIDS because he suspects that a glutathione deficiency inhibits the action of the sodium/hydrogen pump, which in turn causes the cell fluid to become more acid, which in turn allows dormant viruses to reactivate. If so, this would be an argument for eating enough potassium. Those viruses are thought to further deplete the cell of cysteine, which is the precursor for glutathione and which makes getting glutathione back up difficult. Low glutathione is thought to increase the activity of caspace-3 enzyme which he believes is part of the cleavage of R-Nase-L. Unfortunately, glutathione breaks down in the digestive tract, so that receiving it intravenously is probably the only quick, overwhelming way, although I am not certain it can cross the cell membrane in this form. Milk whey is said to have the amino acids that the body uses to synthesize it in large amounts. Vitamin B-6 is a cofactor to the enzyme that converts homocysteine to cysteine [Brouwer]. Two enzymes are involved in synthesizing glutathione, glutamate cysteine ligase and glutathione synthetase. The first one is said to be inhibited by mercury. It has also been found that taurine amino acid protects it. Several amino acids have been found to be low in CFIDS, especially meththionein, which is an essential precursor of other sulfur-containing amino acids, specifically cysteine and taurine. It is also a precursor for the synthesis of the tripeptide glutathione (L-glutamyl-L-cysteinyl-glycine) and other functions [Eaton]. See further discussion of taurine below. There is a herb called Schisandra chinesis that is thought to enhance glutathione production and to protect the liver among other affects [from a dead URL]. Please keep in mind that herbs are medicines, and taking medicines interminably can be very risky. A chief function of glutathione is said to be to scavenge destructive molecules like peroxides and free radicals and thus convert them to harmless compounds. In the liver, the enzyme glutathione S-transferase takes the sulfur from glutathione and attaches it to toxic molecules, making them more soluble and easier to eliminate, similarly to the oxygen added by cytochrome p450 enzymes. Glutathione also maintains our proteins in their proper form. Its sulfur atom reacts with unnatural sulfur-sulfur bonds in proteins, breaking them and allowing the proper pairings to form.

Another nutrient that may affect CFIDS is eicosapentaenoic acid (EPA), since increasing it caused a marked clinical improvement of a woman.

It has been proposed that an important part of CFIDS is a chronic disruption of the coagulation system (I am skeptical that the blood actually coagulates), a variant of Hughes syndrome or antiphospholipid syndrome (APS). It can be triggered by various infections such as epstein bar virus, chicken pox, lyme disease, leprosy, mycoplasma, tuberculosis, and ricketstia, but can be accentuated by some foods such as carrot, soybean, garlic, avocado, walnut, plum, fat, excessive exercise [Shephard], heat stroke, estrogen, adrenaline, as well as by some chemicals such as alcohol, fluorides, mercury, some perfumes, some drugs, etc.

Fluoride has been found to inhibit the immune system’s white blood cell’s ability to destroy pathogens [Weisman]. Coffee contains high amounts of fluoride from pesticides and tea leaves are very high in fluoride by picking up fluoride from the soil. Many city water supplies have fluoride added because of a mistaken concept that this significantly reduces tooth decay. If your city adds fluoride I would urge you to buy fluoride free bottled water or collect rain water.

I have written a review of fluoride toxicity.

The side effect that is the most obvious is a discoloration of the teeth called fluorosis [Pendrys]. This is inevitable if the dose of fluoride is only a little over optimum. This is very easy to happen to anyone who drinks a lot of water, say for kidney problems or for baby formula.

A more serious effect is irreversible bone deformation [Reddy] and increases of bone fractures [Orcel]. It has also been found to inhibit the immune system’s white blood cell’s ability to destroy pathogens [Weisman] and fluoride interferes with the hydroxylation of proline to hydroxyproline [Sharma]. Therefore fluoride exposure disrupts the synthesis of collagen and leads to the breakdown of collagen in bone, tendon, muscle, skin, cartilage, lungs, kidney, trachea and arteries. [Susheela and Mukerjee] - the type of damage you'd expect to see in connective tissue disorders. Fluoride has been proposed to inhibit the thyroid and damage the kidneys. It will also cause damage to ligaments resembling arthritis.

An even more serious effect is bone cancer in young boys but for some strange reason not in girls. During the growth spurt during 6 to 8 years the bone cancer rate is 8 times higher in boys living in fluoridated areas than in non poisoned water areas [Bassin]

Proteins are kept in their three dimensional structure by weak bonds between adjacent proteins called hydrogen bonds. Emsley, et al found that fluoride disrupts this hydrogen bonding within proteins by virtue of an unusually strong bond between fluoride ion and the NH group of amides [Emsley]. In other words, it changes some associated proteins and enzymes from the exact shape they’re suppose to be in.

The most serious effects of all are damages to the nervous system. Fluoride synergistically with aluminum, causes nerve degeneration similar to Alzheimer’s disease. It has been found that behaviors associated with lead neurotoxicity are more frequent in communities using silicofluorides than in comparable localities that do not use these chemicals [Masters]. Rats fed amounts of fluoride similar and also slightly higher to that found in artificially fluoridated drinking water, suffered from impaired central nervous system functioning and poorer memory. There was more malaise and fatigue and significant alteration of enzyme functioning. Some researchers have concluded that there is a mechanism by which fluoride can contribute to so many neurological problems in children. Thus, links of fluoridated water to decreased intelligence in children [Lu], increased incidence of ADD and ADHD, lower cognitive ability, poorer memory and other related problems, are probably correct. So there is a good chance that fluoride would exacerbate mental symptoms in CFIDS.

Varner et al found that when fluoride in water with just 1 part per million fluoride, (the amounts used for artificially fluoridated water), was used in the presence of aluminum sulfate (frequently used to improve the appearance of drinking water and present in some baking powder and from aluminum pots), the results were disastrous. Aside from brain and kidney damage, there was an eighty percent mortality rate in the animals fed doses of sodium fluoride and aluminum similar to those found in artificially fluoridated water. Animals fed the aluminum/fluoride laced water developed sparse hair and abnormal, copper-colored underlying skin which is related to premature aging. Mostly the researchers related these effects to chronic kidney failure. Further autopsy results showed serious kidney abnormalities in animals that drank water containing both sodium fluoride and aluminum fluoride. The Varner team said that “Striking parallels were seen between aluminum-induced alterations” in cerebral blood vessels that are associated with Alzheimer’s disease and other forms of pre-senile dementia. Aluminum has been found to be significantly higher in chronic fatgue syndrome than in normal people [Van Rensburg]. Aluminum in baking powder should not be eaten and aluminum pots and pans should not be used. Aluminum in vaccines have been significantly linked to a chronic fatigue syndrome like disease [Gherardi]. If you keep rodents for pets, be sure not to give them city water. Aluminum has been linked to bone degeneration in horses.

Many medications are proposed for CFIDS, but usually use medications sparsely, alone, and for short periods of time (except maybe sometimes medications known to be effective killing infections). Even these should not be used endlessly since a strong correlation has been found between long time use of antibiotics and eventual onset of CFIDS. It may be that a new medicine called olmesartan medoxomil will prove to be an exception to long term use and prove to activate an immune system. You will have to use a search feature to find the medicine in this long article.Lyme disease has many of the symptoms of CFIDS. Research has disclosed excellent improvement in 100% of people with lyme disease by saventaro (TOA free cat’s claw herb). Please keep in mind that herbs are medicines, and taking medicines interminably can be very risky. You may see an extensive discussion of possible lyme disease alternate therapies, etc. here.

The hypothesis that CFIDS is a psychosomatic illness has resulted in millions of ruined and destitute lives. There probably has not been so ruinous a result from a failed hypothesis since governor Phips ended the Salem witchcraft trials. Even the blood letting of the 18th century was fairly minor. After all, how much harm can you do removing a few drops of blood? The hypothesis by medical doctors that it was not necessary to wash hands for childbirth caused many deaths, but at least these mothers were given a fairly quick end. The CFIDS victims could not collect insurance support or disability and descended into poverty. That hypothesis was probably an important part of the chief cause of death, which is suicide. It is not only in the USA that the physical nature of this disease was denied. A young girl in Australia was taken away from her mother until the age of 18 because the mother dared to disagree with a doctor that the girl was faking her symptoms. It is true that sometimes children do fake symptoms, but it is desperately dangerous to assume any such diagnosis just to avoid some unnecessary medical attention on those other rare occasions. This would be something like a fire department refusing to answer a fire alarm until proof of a fire was mailed to them in order to avoid rare false alarms. Parents were better than physicians at judging their children’s pain, but neither parents nor physicians adequately assessed the children’s pain severity [Singer]. The matter is further complicated with children because they are usually more resilient than adults, so sometimes something wrong is not detected. If anyone attempts to molest your child in this way, it is probably in order to migrate to a more humane country temporarily if at all possible. We should be demanding, that when people are evaluated for social disability benefits and are tested with endurance tests, they should be given follow up tests on following days because the malaise that results can go on for days.

Indeed, this inane hypothesis seems to be pervasive worldwide. You may see an extensive discussion of symptoms, physical abnormalities, history, semantics, and legal implications in this site. The psychosomatic hypothesis was probably the main reason why funds were illegally diverted by the NIH from a USA congressional mandate. and apparently this continues at present (2004). Funding against this disease has been poor in the United Kingdom also. It is conceivable that lawsuits could arise from it in the future. It is probably a considerable part of the reason why people with CFIDS despise the acronym CFS.

POISON

A poison can not be ruled out as at least a contributing factor [Bell IR 1998], and may have been involved, by virtue of protective chemicals, in the gulf war syndrome. Also the symptoms similar to the gulf war syndrome afflicted many Iraqi civilians, so these are a suspicious coincidence and hint at release of poison gas by bombardment of a depot. Supportive of this is that 45% of Kansas Gulf War veterans who were in forward positions came down with the syndrome compared to 12% in not deployed troops [Steele]. Anthrax vaccine has been proposed as triggering gulf war syndrome with some convincing statistical evidence. However, I believe there may have been other medical procedures at the same time, such as carbamate pyridostigmine bromide to protect against potential nerve agent exposure. Also large amounts of aspartame laced soft drinks were provided. It is conceivable that these factors were synergistic with each other (accentuate each other). Close to two hundred thousand were sickened and over seven thousand have died, most probably from this disease. These brave men were denied support at first also, but CFIDS and fibromyalgia are now recognized for compensation [from a dead URL]. One reason the Pentagon denied that poison was involved was that they asked the soldiers who captured the arsenal rather than the soldiers who blew it up. Gulf war syndrome is still unrecognized in the United Kingdom. Gulf war syndrome is not the same as CFIDS, however, because CFIDS patients respond much differently to acetylcholine on vascular tissue than do Gulf War syndrome, insecticide poisoned, or normal patients [from a dead URL] Gulf war syndrome has a much different disruption of immune cells and hormones than CFIDS patients.

There has been proposed a hypothesis that heavy exposure to microwave radiation as is produced by cell phone towers can produce symptoms similar to CFIDS. Doctors in Germany have become convinced that severe adverse symptoms arise this way, as are convinced these Spanish researchers. So it is possible that such radiation may accentuate CFIDS. There is currently enough evidence and technology available to warrant taking immediate steps to reduce exposure of consumers to cell-phone-related electromagnetic radiation because of increase of brain tumors after 10 years. Most of the dramatic rise of cell phone use to 3 billion people has taken place in the last ten years, so it may be a time bomb ready to go off.

MEDICINE and POISON CAUSES

Women who have taken the medicine Lupron for endometriosis, a fibrous growth of vagina liner growing outside the vagina which afflicts almost 10% of women before menopause, suspect that it makes fibromyalgia worse. It was found that almost 7% of women with endometriosis had chronic fatigue syndrome or fibromyalgia and CFIDS was 100 times as common as in the female population and fibromyalgia was twice as common. Half of women with endometriosis had allergies and even a greater per cent of those with allergies also had CFIDS (see this site). Some of these ratios may have been affected by medications like Lupron they had taken and some due to some extent to much higher rates of low thyroid secretion than in other women. That there is an intimate connection and not due to any generalized decline in health seems likely because fibromyalgia and rheumatoid arthritis was correlated much less and diabetes not at all [Sinaii]. According to this study there must be a relation between CFIDS and multiple sclerosis, lupus erythematosis, or Sjogren’s syndrome as well [Sinaii]. A recent study has shown a correlation with dioxin from living near an incinerator or a diet high in fish and endometriosis [Rier].

There is anecdotal evidence that Isotretinoin (Accutane, Roaccutane), which are medicines used for acne, can bring on CFIDS.

Half of people who have fibromyalgia are sensitive to pollution/exhaust, cigarette smoke, gas/paint/solvent fumes, and perfumes [Bell IR 2001]. Poisons like DEET and permythrin when combined with stress or synergism with other poisons causes brain damage in animals [Abou-Donia]. This may be the reason why poisons seem to be causal. Chemical sensitivity may be operating through a nitric oxide/peroxynitrite mechanism [Pall 2002] [Pall & Satterlee]. It could be that viruses can trigger this problem This may be acting through four known mechanisms, nitric oxide-mediated stimulation of neural transmitter release; peroxynitrite-mediated stimulation of post-synaptic NMDA sensitization; peroxynitrite-mediated blood brain barrier permeabilization and nitric oxide inhibition of cytochrome P450 metabolism, all of them acting synergistically to create an extreme sensitization and much misery. NMDA (N-methyl-D-aspartate) is (part of?) a neuroreceptor in the brain and spinal cord for the neurotransmitter glutamate (the most important excitatory transmitter in the brain) and is said to be involved in the toxic effects of excessive glutamate. NMDA is said to be not only a neuroreceptor but is also an ion channel and is involved in chronic pain [Pall, 2003]. Nitric oxide is generated from the amino acid arginine, which arginine stimulates natural killer white cells in normal people, but not in chronic fatigue syndrome patients. These hypotheses do not immediately suggest to me a course of action (but see Konopin below). However there is one circumstance that does. Those with multiple chemical sensitivity are often reported to have low magnesium pools, and Pall says that magnesium is known to lower NMDA sensitivity (see further discussion of magnesium below). Also cobalamin (vitamin B-12) has been proposed as a nitric oxide scavenger [Pall 2001]. Some people have enzymes missing capable of degrading poisons and insecticides and are extremely susceptible to even minute amounts of poisons. As a result insecticide residues and many pharmaceuticals are ruinous for them.

It has been proposed that aspartame, an artificial sweetener, will damage the hypothalamus, which part of the brain controls steroids and seems to be defective in CFIDS. Aspartame degrades to the very poisonous methyl alcohol (methanol), poisonous because it can become formaldehyde. Aspartame is suspected to cause blindness, systemic lupus, maybe heart disease, and cancer among other things, and mimics multiple sclerosis in some people. One of my respondents proposes that the chemical structure mimics 'real' phenylalanine, and is selectively/preferentially able to cross the blood-brain barrier into the brain, where it locks into place, preventing the 'real' chemical from getting to where it's supposed to go. See this site for Dr. Christine Lydon’s discussion of some of its affects and history of the politics of getting it declared safe. If you would like to write a letter to your state or federal legislator, you can see an elaborate letter for that here.

The following abstract was obtained from Gateway: Malcolm Randall Veterans Affairs Medical Center, Gainesville, FL, USA; "CASE SUMMARY: Four patients diagnosed with fibromyalgia syndrome for two to 17 years are described. All had undergone multiple treatment modalities with limited success. All had complete, or nearly complete, resolution of their symptoms within months after eliminating monosodium glutamate (MSG) or MSG plus aspartame from their diet. All patients were women with multiple comorbidities prior to elimination of MSG. All have had recurrence of symptoms whenever MSG is ingested. His discussion in the above; "Excitotoxins are molecules, such as MSG and aspartate, which act as excitatory neurotransmitters, and can lead to toxicity of nerves when used in excess. We propose that these four patients may represent a subset of fibromyalgia syndrome that is induced or exacerbated by excitotoxins or, alternatively, may comprise an excitotoxin syndrome that is similar to fibromyalgia. We suggest that identification of similar patients and research with larger numbers of patients must be performed before definitive conclusions can be made. The elimination of MSG and other excitotoxins from the diets of patients with fibromyalgia offers a benign treatment option that has the potential for dramatic results in a subset of patients." [Smith]. I propose that eating nothing but unprocessed food free of chemicals and poisons should be always the way to go.

There is good evidence that capillary blood flow to the muscles is reduced in fibromyalgia [Maekawa]. This is plausible, but I do not know what causes it.

S-adenosylmetionine (SAMe) is a substance synthesized by the body. It has been found to have beneficial effects without any bad side effects on osteoarthritis, fibromyalgia, and rheumatoid arthritis. Supplements of it seems to be especially advantageous for osteoarthritis.

See this site for some inexpensive, non prescription medicine protocols and a site that describes a prescription medicine called naltrexone, which is said to increase endorphins in the body by temporarily blocking endorphin receptors without serious side affects and thus activate the antiviral part of the immune system.. Perhaps it will prove to be synergistic with retrovirus medications.

It is rare that any medicine should be taken interminably, and doing so is risky. In particular, many people believe that herbs are safe because they are a natural material. However, cyanide in cherry leaves and peach pits, belladonna, opium in poppies, and liver poisons in wormwood, cloves or black walnut are all natural. It is especially important to be cautious and use small amounts at first when combining medications and/or herbs because there are many synergistic (reinforcing each other) affects. It is almost impossible to know them all.

A powder absorbent that operates in the intestines to absorb poisons that are excreted only by the liver and then reabsorbed into the body, called cholestyramine (Questran), has been suggested to help get rid of toxins, including toxins that have been generated by infections such as lyme disease. It used to be used to absorb cholesterol. It can take up to a month or more to get rid of past toxic loads. The main problem with it is that it can absorb supplements and medications taken at the same time.

In any case, it seems to me that it would be good common sense to eat, drink, breathe or smoke no poisons if you are afflicted with CFIDS or fibromyalgia, or for that matter, anytime. Imidazolidinyl, a preservative in cosmetics, has been shown to cause a disequilibrium of potassium, sodium, and calcium channels in sea urchin eggs [Amouroux]. Until researchers figure out the affect of chemicals on CFIDS/ME it might be prudent to eat or apply no chemicals of any kind, even in small amounts. Sodium stearate soap is safe though, more than likely. It is chemically no different than fat.

CIGUATERA TOXIN

Ciguatera poisons picked up by oceanic fish in the tropics have been linked to CFIDS, especially in Japan. This is a poison of many carbon rings generated by algae, which toxin can not be degraded by heat and which is thought to bind to sodium cell wall pumps. It remains in the body for a long time. It has been shown to cause too low a blood pressure, probably because of interference with the heart nerves’ sodium channel. Vitamin B-12 has been proposed as an antidote. Mannitol has been proposed as a treatment [Karlin] but clinical trials fail to show it. Since fish migrate and in addition are transported all over the world, eating oceanic fish (especially large reef fish) or pigs or chickens (it is said that chickens receive only 2% fishmeal) fed such fish may not be worth (Tyson Inc. claims no use of fish) the risk even for healthy people. Even farm raised salmon can have ciguatera and other poisons, presumably from poisoned food for the fish (click on its forward link). I suspect that cod-liver oil is safe since it is a northern fish. The link to CFIDS has been suggested as misdiagnosis [Ting]. It is more likely that the reagent used tests positive for both ciguatera and the poison found in CFIDS give the same result and thus produce what is then called an epitope, since amounts in CFIDS patients and hepatitis B seem to be enormously higher than the general population. Research and patents by Martin propose that a stealth virus is able to produce a toxin similar to ciguatera and thus create CFIDS. It is conceivable that a virus actually produces ciguatera it self, although that seems unlikey to me. It seems obvious that ciguatera poisoning must surely accentuate CFIDS at least, and should be avoided by everyone. A recurrence of neurological symptoms caused by the ocean ciguatera may be brought on by consumption of alcohol (probably not the alcohol itself, but poisons associated with it) or certain foods such as other fish, fish-flavored food products, meat such as chicken and pork , and peanut butter or nut oils. A researcher in New Caledonia has investigated extracts of plants used by native islanders as an antidote, and has found that many of these extracts reverse the affects of ciguatera on the voltage sensitive sodium channel with minimal cell toxicity in test tube experiments [from a dead URL]. They are encouraged to suspect that if the active chemical can be separated out, the small toxicity may be eliminated. Kava-kava extract is one of the above plant extracts, but is thought to be toxic from some sources [from a dead URL] and is a tranquilizer. These extracts may yet prove to have some advantage to CFIDS patients even if the epitope itself proves to be unaffected by these extracts.

MERCURY

There is a discussion of a case history of a patient who believes that mercury poisoning caused a CFIDS like affliction. and a controlled experiment found corroboration to this concept [Sterzl]. However, an epidemiological study found very little association between mercury and CFIDS, but some association with multiple sclerosis. However, even if mercury proves to be not associated directly, avoiding mercury is obviously a good idea. If a test shows high mercury, removing it by chelation is imperative because mercury is extremely poisonous. Calcium sodium EDTA is said to be the best form of EDTA intravenously. Chelation is said to be much less effective while suffering from a chronic disease. Mercury is especially important in children, because it has been shown that thimerosol (ethyl mercury, a close relative of methyl mercury present in many vaccines) causes autism. See this site and this one. Having this known poison removed from teeth may be a good idea on balance when it exists and it should never be injected. From an anecdotal experiment, one can sometimes expect a surge of four times of mercury in the blood immediately after removal from teeth so removal must be one very carefully. For information on protective measures when having mercury removed as well as other information see this site. Receiving an injection of glutathione might be a good idea also, or building it up some other way, since glutathione is thought to be involved in detoxification. But for a contrary opinion see this site. Their argument that mercury from fillings is minute seems persuasive. However there are side affects from fillings, discussed at this site. In any case, mercury is about to be banned in Europe. It is possible that coating the filling with epoxy resin would solve the problem. I have done this, but I was in good health, so it was impossible to see a change from this one coating. There is also a possible slight risk of damage to the intestines if the coating ever came off.

Some fish contain unacceptable amounts of mercury, especially large fish high in the food chain. The mercury in fish is the mercury methyl compound, which is the most dangerous form. So probably salt water fish should be eaten in small amounts, perhaps even by healthy people. Fish oils are safe, since they contain only minute amounts of mercury [Foran]. For a calculator of amount of mercury absorbed from fish see this site and for fish mercury content, see this site for fish which have lowest amounts of mercury. or this site for a discussion of fish eating compromises There is also a way of determining mercury now using x-ray fluorescence, which is not invasive [from a dead URL]. It is said that the amino acid cysteine and phytic acid in bran act as chelaters (removal agent) of heavy metal. It is also said that N-Acetylcysteine (NAC) will remove methyl mercury from the body.

There is some circumstantial evidence that strong electromagnetic fields can create some of the symptoms of chronic fatigue syndrome [Levallois]. See numerous links here. I don’t believe this has been established beyond a doubt, but you should know of the suspicion just in case. There is some research that indicates that magnetic fields cause melatonin secretion to decrease, thus affecting sleep. This could be a factor if you use electric blankets or heating pads, although I am very skeptical. There is evidence that cell phone use damages brain neurons and that blood flow to parts of the brain is inhibited and that it takes half an hour to come back in even one third of PWCs.

There is a suspicion that carbon monoxide from gas oven pilot lights can make the symptoms of CFIDS a little worse. This is conceivable, but incomplete burning of the odor chemicals are a possibility also if it does occur.

WHAT TO DO

So some causes are suspected but unproven. This leaves us with the problem of what to do about the disease currently while we wait for researchers to find the cure.

It has been proposed that poor nutrition and lack of exercise are contributing factors [Johnson H p 685]. It certainly is plausible that a poorly nourished body would be more at risk as is probably the case with most diseases. A vegetarian diet using lots of raw vegetables has significantly improved the symptoms of fibromyalgia with 19 out of 30 subjects reporting considerable improvement of all symptoms after a few weeks [Donaldson]. A Finnish study found raw vegetables devoid of meat, but with vitamin B-12 supplement, reduced the pain, slept better, reduced weight, and reduced cholesterol at the end of three months, but did not improve exercise ability by the end of three months. Despite its benefits, none of the patients chose to adhere to the diet beyond the study period. They did report, however, that their pain gradually returned as they drifted back to their previous omnivorous and, probably more likely the main factor, junk food diet [from a dead URL]. Instincts to eat what we were taught to eat when young and to eat sweet foods are overridden with great difficulty. It would be a good idea to find out what in raw vegetables was responsible, especially since it has been found that cooking some food increases the growth rate of animals, probably because interfering materials are destroyed in some of the vegetables by the cooking, something that would be especially important for children. It can not be by keeping enzymes intact because digestive enzymes break down all proteins, including enzymes, into amino acids. It is possible that increased vitamin C implied in not cooking food may have had an affect, since a pervasive vitamin C deficiency probably exists in our society. and it has been shown that vitamin C cures viral infections. However I suspect that the main advantage of such a diet is increased potassium and magnesium, which were inadvertently increased, and, if so, cooking without throwing away the boil water should work almost as well (vitamin C is easily supplemented). Donaldson's diet gave five to six thousand milligrams of potassium per day and 460 milligrams of magnesium. It has been discovered that magnesium injections mute the symptoms significantly [Takahasha][Cox] and in particular the taurate is proposed as the best magnesium supplement (this is probably because taurine itself is advantageous, although I can’t rule out augmentation of magnesium pumps).

Taurine, or 2-aminoethanesulfonic acid, is an acidic chemical substance sulfonated rather than carboxylated found in high abundance in the tissues of many animals (metazoa), especially sea animals. Taurine is also found in plants, fungi, and some bacterial species, but in far less abundance. It is an amine with a sulfonic acid functional group, but it is not an amino acid in the biological sense, not being one of the twenty protein-forming compounds encoded by the universal genetic code. Small polypeptides have been identified as containing taurine, but to date there has been no report of a transfer RNA that is specifically charged with taurine [from Wikipedia]. It is essential to babies. It has been found that supplements of the amino acid, taurine, will restore the abnormal electrocardiogram present during a potassium deficiency by an unknown mechanism. This information has been used in several case histories by George Eby to control a long standing type of cardiac arrhythmia called pre atrial contractions (PACs), a benign but irritating and nerve racking heart problem, with 2.5 grams of taurine with each meal. Taurine is said to be low in the diets of vegetarians. The 2,500 milligrams recommended by the American Heart Association causes diarrhea in some people and should probably be reduced in those people. As much as 6000 miligrams per day are said to be harmless [McCarty 2006, p67]. Taurine may make a copper deficiency worse, based on a single case history [Brien Quirk, private communication]. This may be because taurine may be mobilizing copper and zinc into the plasma [Li]. So if you should decide to take taurine, make sure your copper intake is at least adequate, as well as your zinc. Taurine has been used for high blood pressure (it lowers borderline hypertension by decreasing epinephrine, but has no affect on normal tension) [Fujita], migraine headache (I suspect that less than 1000 milligrams can remove the headache caused by allergy to peanuts from personal experience), high cholesterol, epilepsy, macular degeneration, Alzheimer’s disease, liver disorders, alcoholism, and cystic fibrosis, and depression. Keep in mind that some people may have a genetic defect that limits the amount of taurine tolerated and that adequate molybdenum may desirable. It is usually obtainable in health food stores.

MAGNESIUM DEFICIENCY

Magnesium deficiency causes or accentuates a large number of diseases. It is often deficient in processed food diets and can not be supplemented via vitamin tablets because it is too bulky. A deficiency must be causing migraine headaches because supplements orally and intravenously remove such a headache very rapidly.

One person reports getting red cell magnesium up to normal with magnesium orotate and Epsom sulfate foot baths every other day, along with choline citrate supplement in the hope the last helps with absorption. Magnesium as the orotate (Pyrimidinecarboxylic acid, also known as orotic acid or vitamin B13, Animal Galactose Factor, Oro, Orodin, Oropur, Orotonin, Oroturic, Orotyl, or whey factor) has been shown to be more readily absorbed than the carbonate [Schlebusch]. Orotate is not really recognized as a vitamin. It is manufactured in the body by intestinal flora. Atheletes had their swimming, cycling and running times decreased in the magnesium-orotate group compared with the controls and their insulin system markedly affected [Golf]. This was probably due to the orotate itself, because orotate is incorporated into RNA, enabled by biotin. Orotic acid is not necessarily always good in excess since it is said to bind zinc to a non-biologically active state and can damage the liver, but I would think that the 50 to 100 milligrams that has been recommended should be safe. Sources of oratate are whey, yogurt, beetroot, carrots, and jerusalem artichoke, but not human milk.

BEST MAGNESIUM COMPOUNDS

Mg-glycinate is best absorbed , famous for sedation , sweet taste
Mg-malate is easily absorbed , famous for energy and fibromyalgia pain, cheap , tolerable, but has bad taste
Mg-gluconate is easily absorbed.
Mg-salicylate is in Doan's pills.
Mg-citrate is famous for vulvodynia and kidney/gall stones, is a very mild laxative
Mg-sulfate or Epsom salt , mild laxative. Sulfate is an excretion product of amino acid degradation. Magnesium sulfate should have an acid reaction the same as adding sulfuric acid to a normal diet. Since sulfate is an excretion product, it is probably disadvantageous and can be dangerous in large amounts. It is possible to receive a lethal dose of magnesium just from gargling with Epsom salt [Gerard].
Mg-hydroxide or milk of magnesia , antacid , mild laxative
Mg-chloride is used in Europe and Russia. It should have the same acid reaction as adding hydrochloric acid to a normal diet, whatever that is, but should be easiest for the body to adjust pH.
Mg-oxide has been thought to be poorly absorbed. However research has shown this as probably not so. It is a laxative, cheapest (should be physiologically the same as Mg-hydroxide), and is found in drug .stores.

Anytime something acts as a laxative (loose stools), it probably causes loss of water soluble vitamins and minerals. So magnesium supplements may be in order for CFIDS and fibromyalgia people who eat junk food and maybe for everyone with CFIDS and fibromyalgia. Processing removes 75% of the magnesium, which, combined with sugar, phosphates, alcohol, stress and high fat diets that increase magnesium deficiency, is said to cause a deficiency in 80% of the population [Rogers]. Calcium interferes with magnesium absorption. This may be the reason why large calcium supplements, especially during a vitamin D deficiency, causes significant increase in cardiovascular death.Since milk contains ten times as much calcium as magnesium, excessive milk consumption should contribute to a magnesium deficiency. This large ratio must be because of the calf’s need for calcium to form bones. Also too high a dose of magnesium sulfate (50 grams) during labor can damage or even kill babies. Since this is so, this would be another argument for getting as much nourishment from food as possible and perhaps for not using excessive supplements of any nutrient interminably once body content is normal. Magnesium chloride could conceivably be too acid, although it has been used very advantageously since 1914 in France for a very wide variety of conditions [from a denied URL], and is very popular in Russia who are amazed that it has not caught on in western medicine. There is anecdotal evidence from a single case history that the chloride can solve a problem of low stomach acid. Magnesium aspartate for heart disease and the glycinate have been recommended in the past, especially in Europe. I suspect that its efficacy in heart disease is primarily because magnesium is required to enable potassium absorption. Magnesium hydroxide (milk of magnesia) I would think should be acceptable in reasonable amounts. Perhaps when the last word has been spoken about magnesium supplements, the correct mixture of most of the above associated anions will prove the way to go. In any case, so far as aspartate is concerned, healthy people are probably best advised to get amino acids for endurance from food [Williams]. This site shows how to increase magnesium in the diet.

Also it has been said that the following medicines can help create a deficiency; benzthiazide, bumetanide, chlorothiazide, chlorotrianisene, chlortetracycline, cholestyramine resin, conjugated estrogens, corticosteroids, demeclocycline, diethylstilbestrol, digoxin, doxycycline, esterified estrogens, ethacrynic acid, furosemide, hydrochlorothiazide, hydroflumethiazide, indapamide, methyclothiazide, indapamide, methyclothiazide, metolazone, minocycline, oral contraceptives, oxytetracycline, penicillamine, polythiazide, quinethazone, tetracyclines, torsemide and trichlormethiazide. [from a dead URL] as well as diabetes, use of diuretics and digitalis, excessive stress, exercise, malabsorption, poor diet, alcoholism, and heavy metal poisoning [from a dead URL]. So under these circumstances (those necessary), supplements may be in order. See this reference for a review of safe procedures for magnesium in clinics [Besunder]. Magnesium is said to be excreted in greater amounts during respiratory acidosis, so it may be desirable to sleep with the windows open at night or to install a carbon dioxide absorber in the bedroom. This suspicion is reinforced by the fact that the steroid hormone which stimulates acid excretion, 18hydroxy deoxycorticosterone, is secreted poorly during CFIDS, possibly a mechanism to allow an acid serum to activate immune enzymes. However, the logical way to handle magnesium is to make sure it is adequate in the diet in the first place, at least to permit no processing losses. See this site for abstracts of many magnesium affects.

Magnesium was found to be normal in the red cells in CFIDS patients [Hinds] and magnesium is normal in blood cells during a magnesium deficiency as well, so red cell content can not be used in diagnosis. Most of the magnesium is inside the cells, so probably plasma can not be used for diagnosis of marginal status either (but see below). A high level of C-reactive protean is said to be a definitive symptom of a magnesium deficiency. There also has been developed a method that uses electron bombardment of a single mouth mucous cell by electrons in order to generate distinctive x-rays. It is said to cost $175 and determines other electrolytes inside the cell at the same time. I do not know how reliable it is. You may see an excellent article by Seelig which proposes magnesium as of central importance in CFIDS and fibromyalgia and discusses clinical aspects of magnesium with extensive references. and also see this site for magnesium in fibromyalgia and migraine headaches. There is also an extensive article about the use of magnesium for depression. See abstracts of research into magnesium related to migraines. and this one for a general discussion. Potassium can not be absorbed efficiently in the presence of a magnesium deficiency [Ryan] and magnesium in food tends to be correlated with potassium intake. Total body magnesium does not predict a deficiency, but blood serum must be low for prediction. If blood serum magnesium is 25% low, the enzymes depending on magnesium fail to operate adequately, including those responsible for its own absorption [from a dead URL]. If magnesium is too low, it may be necessary to make possible magnesium absorption at first by injection of magnesium.

A test for magnesium deficiency is to inject 2.4 milligrams of magnesium per kilogram of body weight over 4 hours and urine collected for 24 hours. If 25% of the magnesium is retained a deficiency is probable. If 50% of the magnesium is retained a deficiency is certain [Rude]. This last reference has information about safe use of magnesium clinically.

Chlorella pyrenoidos (an alga plant) supplements have also been found to improve fibromyalgia in a three month study [Merchant]. The amounts of chlorella per day were 10 grams of dry chlorella which furnished 83 mg of potassium and 33 mg of magnesium [Merchant, private communication]. This is not nearly enough of these electrolytes to account for any affect. However people eating a vegan diet who included nori and chlorella algae had double the vitamin B-12 in their blood [Rauma]. Chlorella contains vitamin B-12 [Davis]. However there is a suspicion that this vitamin B-12 is only a useless (or worse), analog. Red Star T-6635+ yeast is said to be rich in vitamin B-12 derived from bacteria. (but do not add Zinc as they suggest, or copper will be deficient) Chlorella also contains inositol [Pratt] which is essential for some of the electrolyte pumps [Bian] and could be responsible for the effects. All vitamin B-12 comes initially from micro-organisms and is said to be not harmful in excess.

POTASSIUM

It is possible that the fact that Donaldson’s diet tripled the usual intake of potassium was a considerable advantage of the diet (see this site for a case history of successful use of potassium supplements for fibromyalgia). A whole body (cell content) analysis of potassium has found that potassium averaged a little lower in CFIDS than the general population [Burnet] which general population is low in potassium in our society to start with. The CFIDS average was about two thirds of the highest values of healthy people. This is ominous because the highest of these values is the normalcy which the body attempts to attain, since there is no storage of potassium in the body other than the tolerable range of the soluble potassium in the cell fluid. The low cell potassium may be the reason why the resting energy output is somewhat greater in CFIDS than normal [Watson], since most of the resting energy is used for electrolyte transport. Chaudhuri, et al suggest that this rise in resting energy is due to abnormal ion channel function similar to that in syndrome X (sic) [Chaudhuri]. However red blood cells are not the same as other cells, and show no correlation with plasma potassium [Ladefoged]. It could be that potassium supplements are in order [Lawson 1996], especially if the diet consists of processed food. However, if potassium supplements are given during the wet heart disease of beriberi (thiamin deficiency) the heart disease is made much worse [Mineno][Gould]. Wet heart disease is impossible if potassium is also deficient [Folis] (see further discussion below).

Magnesium should be part of the experiment since potassium requires adequate magnesium in order to be absorbed effectively [Petersen][MacIntyre]. If a person is suffering from a potassium deficiency and a magnesium deficiency at the same time, say from diuretics, supplementing with potassium alone will make that person more susceptible to arrhythmias and heart attack [Dyckner]. It is possible that inositol [Charalampous] [Bian] is necessary also. Inositol (vitamin B-8) may be similar to magnesium in its affect [Bian] [Allard].

While excessive salt intakes are detrimental to potassium retention, it is necessary to receive moderate amounts of sodium salt because extremely low intakes of sodium (or chloride?) also increase potassium excretion. Experiments must be performed with caution, however, because when a patient thought to be exhibiting symptoms of fibromyalgia was brought to 5.0 mEq/l in her blood (which is close to normal) she contracted paralysis [Gotze]. This may be because experiments have shown that people who have CFIDS with muscle pain have normal serum potassium [*] and so fibromyalgia must be a different variation of CFIDS. It is possible that the greater incidence of fibromyalgia among women who do not drink alcoholic beverages [Schochat] is related to the poison (in this case medicine?) in wine that interferes with potassium excretion [McDonald]. I have no information as to whether this poison has been identified and ethanol itself is said to increase excretion [McDonald]. In monkeys the electrocardiogram in magnesium deficiency resembles that of high serum potassium (hyperkalemia) in spite of low serum potassium (hypokalemia) [Manitius p39]. So it is possible that lower cell potassium requires lower serum potassium for adequate nerve transmission, but the serum potassium does not drop correspondingly [Manitius p38] during a magnesium deficiency. This may be part of the pain in fibromyalgia, analogous to the pain from cold fingers [Benjamin], which probably arises from potassium [Ghosh] released from the cells by cold [Ulrich 1959] below 4 degrees C [Hendricks]. Another possibility is that the low secretion of ACTH by the pituitary gland causes a lower secretion of 18 hydroxy deoxycorticosterone (18OH DOC) steroid. This in turn interferes with excretion of acid since the body probably uses that steroid to stimulate excretion of hydrogen ion. As a result aldosterone is decreased in order to prevent loss of potassium and the serum potassium rises. The cell fluid becomes more alkaline [Strobel]. The cell fluid pH (alkalinity and acidity) is the most reliable indicator of the intensity of muscle spasms [Krapf]. When muscle spasms are associated with chronic fatigue syndrome, it is possible that a low cell calcium exists in that disease even though serum calcium is normal [Magaldi] could be the reason. If a magnesium deficiency does develop, half a year of magnesium supplements can be required for complete normalization of magnesium and potassium - sodium pumps [Anonymous] [http://www.lef.org/prod_hp/abstracts/potassiumabs.html#26 ]. Not all the phenomena associated with a magnesium deficiency take so long. Magnesium supplements reduced leg cramps during a pregnancy in three weeks without any change in serum [Dahle]. Interleukin-1, interleuken-6, and tumor necrosis factor increase dramatically in the serum after 3 weeks of magnesium restriction in rats as well as the neuropeptide substance P [Weglicki 1992], which last causes histamine and PGE2 to rise [Weglicki 1994] in only 5 days, so it is possible that these would recede just as fast after repletion. It is obvious that the changes in the immune system (such as any change in IgE antigen [Wei] or rise in white blood cells [Gaudin-Harding] ), during CFIDS that might occur could easily be augmented by a magnesium deficiency. There is a suspicion that malic acid is helpful in the CFIDS diseases, so perhaps magnesium should enter as the malate. It is said to be not very effective for fibromyalgia by some [Russell]. Aspartate has been used with magnesium during heart disease therapy in the past, so the aspartate may prove advantageous as well. Of course it is probable that the chief advantage of the aspartate amino acid was to furnish nitrogen to ammonium in order to interfere with potassium excretion. Agar seaweed is a rich source of magnesium and contains 770 milligrams per hundred grams of dry weight, but I have no information as to its availability or toxicity. Also the greater ease with which potassium enters the body as the chloride [Classen] suggests that perhaps this anion should be tried as well for magnesium. It is also possible that associating magnesium with the chloride might prove disadvantageous since 18 hydroxy deoxycorticosterone (18 OH DOC) may be low during CFIDS and that is probably the steroid the body uses to stimulate acid excretion. This may be related to the use of increased amounts of sodium and potassium bicarbonates in solutions sometimes recommended to rehydrate people dehydrated by diarrhea who have CFIDS. Also acidifying the diets of cats suffering from a potassium deficiency with ammonium chloride causes a depletion of the amino acid, taurine, in cats resulting in lethal heart disease [Dow]. Using the potassium chloride would have the same net affect as supplementing an unprocessed diet with hydrochloric acid, whatever that is. If so, eating vinegar may be not a good idea either. Experience of mine with damage from toluene in automobile enamel reducer and pain it caused from gout makes me suspect so since vinegar and potassium chloride supplements seemed to augment the pain. I do not know which steroids stimulate or inhibit chloride excretion and it may not be known. This then would be an additional reason for being cautious about potassium as the chloride. An additional reason is that potassium as the chloride raises blood pressure (in rats) rather than lowering it. So presumably potassium chloride should not be used as supplements if your blood pressure is high (hypertension) or you are in pain, and maybe not magnesium chloride either. You may see an additional discussion of potassium supplements in a book I have written about potassium nutrition.

There is the table of contents for this book and the introduction at the end of this article. The book contains tables expressing potassium in weight of potassium per Calorie. Considerable increases in potassium are possible without the necessity of eating food raw and there is less danger of imbalances with other nutrients using food rather than supplements. For instance the magnesium problem should be adequate that way, at least for maintenance amounts. For CFIDS patients magnesium injections may be necessary at first. This strikes me as a possibly dangerous procedure though and small amounts over time would probably be the safest way.

Use of potassium supplements should keep in mind a new discovery that diabetics excrete vitamin B-1 at a much higher rate than other people, which leads to a vitamin B-1 deficiency. If potassium supplements are given during the wet heart disease of beriberi (thiamin or vitamin B-1 deficiency) the heart disease is made much worse [Mineno][Gould]. Wet heart disease is impossible if potassium is also deficient [Folis]. Instead a muscular atrophy similar to that from vitamin E deficiency appears [Hove][Blahd]. During a vitamin B-1 deficiency the heart loses potassium [Mineno]. This may be why heart damage in beriberi resembles that in a potassium deficiency. If you have heart disease it would be a good idea to try hard to find out which kind it is. If potassium is supplemented it would seem wise to supplement with vitamin B-1 as well or use foods high in it and the reverse. I assume this would be especially pertinent if you drink wine because wine has a poison in it that interferes with potassium excretion [McDonald]. The reverse is probably also the case, maybe even during diabetes. The vitamin B-1 deficiency would be much worse if refined, unfortified food is eaten or food that has sulfites added. This last is because sulfites destroy vitamin B-1 in the intestines [Amerine] [Fitzhugh]. Such foods poisoned with sulfites are wine, vinegar, pickles, olives, salad dressing, canned clams, fresh, frozen, canned, or dried shrimp, frozen lobster, scallops, dried cod, gelatin, pectin jelling agents, cornstarch, modified food starch, spinach pasta, gravies, hominy, breadings, batters, noodle/rice mixes, shredded coconut, vegetable juice, canned vegetables (including potatoes), pickled vegetables (including sauerkraut), dried vegetables, instant mashed potatoes, frozen potatoes, potato salad, corn syrup, maple syrup, fruit toppings, and high-fructose syrups such as corn syrup and pancake syrup, instant tea, liquid tea concentrates, beer, bottled lemon juice, some baked goods, and some dried fruits. Even if you are eating foods adequate in vitamin B-1 you could still possibly have a problem with vitamin B-1 deficiency if you are using diuretics. I believe that diuretics are seldom in order. They certainly should not be used to lose weight. That would be as logical as draining the radiator to make a truck weigh less. There is something in tea leaves that antagonizes vitamin B-1. Also, the symptoms of a vitamin B-1 deficiency can materialize even if vitamin B-1 is adequate if magnesium is deficient, say from Crohn’s disease [Dyckner, Nyhlin, Wester]. The diet can vary widely as to vitamin B-1 [Dept. of Health]. Also the use of benfotiamine, as is sometimes used during fibromyalgia, may be dangerous during potassium supplementation, since it is said to deplete the body of vitamin B-1. Vitamin B-1 deficiency may be suspected in refugee immigrants, critically ill patients, and alcoholics. Vitamin B-1 deficiency can result in cardiac failure, neuropathy, or Wernicke-Korsakoff syndrome (from alcoholic beverage over use), which last can not be cured with oral supplements even though classic thiamine deficiency symptoms do not show. [Thompson] Diabetics should keep in mind a new discovery that type 1 diabetics excrete vitamin B-1 four times normal people and type 2 diabetes three times, which leads to a vitamin B-1 content in plasma one fourth as high in diabetics. This is due to a malfunction of thiamine reabsorption in the proximal kidney tubules. Erythrocyte vitamin B-1 was normal in diabetics, probably because there were increased thiamine transporters THTR-1 RFC-1 in the cell wall. Therefore erythrocyte thiamine can not be used to determine thiamine status [Thornalley]. If you decide to use potassium supplements instead of food, I recommend that you read my book first.

I would suggest that a partial solution to the problem of poor potassium and magnesium nutrition would be to place a tax on all food that has had potassium or magnesium removed by food processors and completely fund all Medicare and workman’s compensation for injuries and disease that relate to rheumatoid arthritis, heart disease, high blood pressure, fibromyalgia, and chronic fatigue syndrome. This would also take the onerous Medicare tax burden now incurred for them and place it on the shoulders of those who cause the problem. And this tax burden is not the only burden. Half the bankruptcies in the USA are caused by medical bills. Achieving this would be much more likely possible if the money was removed from politics and there were runoff elections.

VITAMIN D

Vitamin D is proposed as necessary for reabsorption of magnesium in the kidneys [Ritchie]. Half of fibromyalgia patients have vitamin D levels less than the amount which starts to stimulate parathyroid hormone [Huisman] and fibromyalgia patients are much more often showing low vitamin D in their blood than normal women [Al-Allaf]. Indeed, people with a vitamin D deficiency causing muscle pain are often misdiagnosed as with fibromyalgia [Plotnikoff]. It is likely that the affect on magnesium is involved, at least to a considerable extent, and thus indirectly powers the potassium pumps [Grace] and more directly, the calcium pumps. The optimal values in the blood are proposed as 45-50 ng/ml or 115-128 nmol/liter of vitamin D. Studies in the past establishing normal levels were based on the general population who are marginally deficient. They should have been based on levels in life guards. Recent studies reveal that current dietary recommendations for adults are not sufficient to maintain circulating 25(OH)D levels at or above 80 nmol or 32 µg/L, especially in pregnancy and lactation. It is possible that CFIDS victims may have net bone resorption, which would be an additional reason for keeping vitamin D more than adequate. People getting no sunlight should supplement with at least 1,000 IU of vitamin D, which is 5 times the usually recommended amount [Glerup]. Children in an experiment were found to have an 80% reduction in onset of diabetes taking 2,000 IU per day, so I assume that 10 times or so that amount would be safe for adults. Almost 100% of CFIDS patients were deficient in vitamin D and 1,000 to 2,000 IU per day has been recommended for CFIDS patients with considerable advantages to immunity and cessation of fatigue. The majority of normal people are too low in vitamin D also. Recommended blood contents and intake are discussed here. Since naked Africans receive 10,000 IU, Vieth suggests that concerns of toxicity are inappropriate [Vieth]. There has been established a wide margin of safety above current intakes. Masterjohn proposes that vitamin D toxicity, when much too much is taken, is from a concurrent vitamin K and a vitamin A deficit [Masterjohn]. It is the menaquinone form of vitamin K that is involved, not the phylloquinone form [Beulens]. It has been suggested that boron is synergistic with vitamin D and enhances its affects. A number of other diseases are either caused or significantly increased by vitamin D deficiency, such as 17 varieties of cancer, stroke, hypertension, autoimmune diseases, heart disease, diabetes, depression, chronic pain, osteoarthritis, osteoporosis, muscle weakness, muscle wasting, birth defects and periodontal disease. It is also conceivable that vitamin D could be involved if fibromyalgia is caused by an intracellular pathogen, for it has been discovered that vitamin D activates a cell receptor that activates antimicrobial peptide (cathelicidin), which is involved in killing of intracellular bacteria such as tuberculosis bacteria [Liu]. Apparently epidemiological studies and circumstantial evidence show lower rates of multiple sclerosis, hypertension, osteoarthritis, and colorectal, prostate [Chan], inflammation, influenza, tuberculosis, breast, and ovarian cancer when vitamin D is adequate [Tavera-Mendoza]. We are now able to better identify sufficient circulating 25(OH)D levels through the use of specific biomarkers that appropriately increase or decrease with changes in 25(OH)D levels; these include intact parathyroid hormone, calcium absorption, and bone mineral density. Using these functional indicators, several studies have more accurately defined vitamin D deficiency as less than circulating levels of 25(OH)D 80 nmol or 32 µg/L. Recent studies reveal that current dietary recommendations for adults are not sufficient to maintain circulating 25(OH)D levels at or above this level, especially in pregnancy and lactation.

However, It has been proposed that vitamin D accentuates the symptoms of sarcoidosis (thought to be a bacterial infection), and supplements or sunlight probably should not be used then.

A double blind experiment was performed testing the efficacy of a complete spectrum of nutrient supplements and no significant improvement was found [Brouwers]. However only 20 mg extra per day of magnesium was added which is hopelessly inadequate. Also there was only 750 mg extra of potassium which in most people would probably be only a maintenance amount added to the usual 1500 to 2000 most people receive these days. In addition, the potassium was probably as the chloride, which might not be the best form for these diseases, at least initially.

In any case, it would seem to be desirable to know what are the optimum ratios of the electrolytes in the diet to make their correct regulation the easiest. It would seem that the determination should be made differently for fibromyalgia than for CFIDS because the changes in cell pH (acidity) are similar to controls during CFIDS [Wong].

It may be that meals should be more than three times per day in smaller increments. I suggest this because secretions from the adrenal glands are important in handling nutrient disposition in the body, especially potassium. Since the adrenal glands in CFIDS patients average smaller than other people [Scott & Dinan 1999] and the patient's depression has much lower ACTH (and therefore cortisol and 18 hydroxy deoxycorticosterone secretion) [Demitrack], which lower cortisol may be partly from the smaller glands, it is possible that any disruption in secretion mediators would be making it more difficult to handle food surges. Probably sodium is especially important not to be too low for people with small adrenal glands (symptoms here also). There is a good chance damage to the part of the brain which controls the pituitary is a more important part of that low cortisol than gland size, by virtue of disruption of the brain-pituitary axis [Scott, Svec & Dinan] and therefore ultimately of ACTH secretion, which ACTH stimulates cortisol secretion and is absolutely essential for 18 OH DOC (the acid secreting hormone). Determination of salivary cortisol upon awakening has been found to be a good noninvasive test for lack of normalcy [Roberts]. However only women have low cortisol upon awakening, which may be one reason why women are more afflicted with CFIDS than men [Nater]. Crude tests have been proposed to diagnose "adrenal fatigue", which consist of lower blood pressure on standing, slow dilation of the eye’s iris (in a darkened room you take a flashlight and shine it into your eyes from the side while looking into a mirror. If your pupils dilate and then contract and then dilate again, this is said to be an indication that your cortisol is low), and so called Sergent’s white line [Wilson]. Licorice herb (not licorice candy) can inhibit loss of cortisol from the body as can grape fruit. If this is used to increase cortisol, I assume it is important to decrease sodium and increase potassium intake because aldosterone turnover is also decreased. I suspect that there could be some negative feedback from using those materials.

Some long-term negative feedback from cortisol operating on the viability of the cells themselves could conceivably be accentuated by nutrient surges. Also smaller meals more often would help prevent surges of potassium too high for those with weakened kidneys to handle efficiently as well as possibly increasing the useful cell retention by virtue of preventing the correction of high plasma potassium which otherwise takes place by excretion in the urine and lower colon. Richard Burnet recommends small solid food meals. His rationale is that such a strategy helps prevent the bacterial overgrowth resulting from delayed emptying of the stomach. Since liquids have an even greater delay, he suggests drinking liquids 20 minutes later. I know of no additional experiments to further verify his explanation. However there is epidemiological evidence for the desirability of more small meals during the day.

Choline dihydrogen citrate along with vitamin C has given considerable improvement in myalgic encephalomyelitis (ME, probably fibromyalgia). Vitamin C has been given very little attention in CFIDS research, but extra vitamin C creates less fatigue in healthy people. If vitamin C supplements are used, it is imperative that copper intake be adequate because vitamin C interferes dangerously with copper metabolism.

A trial with alanthamine hydrobromide which inhibits the enzyme which degrades choline gave dramatic improvement in sleep defects in CFIDS. Richardson believes that correcting the choline deficiency is better than the use of alanthamine hydrobromide [Richardson]. It has been found that homocysteine is very high and vitamin B-12 fairly low in the cerebrospinal fluid. Since the vitamin B-12 is normal in the serum, they suggest that B-12 crosses the blood brain barrier inefficiently [from a dead URL]. Vitamin B-12 and folic acid are said to be cofactors with choline [Richardson]. Melatonin is the hormone which is thought to be central in circadian sleep patterns and has been shown to be helpful [Smit] [Van Haukelom] against depression caused by poor sleep habits. It should be fairly harmless. However its affects on birth defects is said to be not known yet and research has indicated little relief [Williams]. Most indicative of contraindication for melatonin is that it is dramatically elevated in juvenile CFIDS [Knook]. There is a case history of a patient who had a dramatic improvement in sleep taking supplements of the amino acid S-adenylosyl methionein (SAM-e). A couple of hundred milligrams are probably enough, but I have no sure research. It may be obtained here as well as probably in health food stores. Tryptophan is the lowest concentration of the amino acids in food, is the largest amino acid, and is non polar (dissolves poorly in water). There is anecdotal evidence that tryptophan amino acid produces restful sleep. In support of this is that L-5-hydroxytryptophan (L-5-HTP) prevents sleep terror in children. I do not know what doses are desirable although 50 t0 100 milligrams have been reported as very effective for restful sleep in a single case. Fibromyalgia patients taking 300 milligrams per day of 5-hydroxytryptophan, the immediate precursor of serotonin, had a highly significant improvement in pain, anxiety, fatigue, and sleep after 3 months [from a dead URL]. I do not know if there are any safety problems. It is possible that tryptophan supplements would be helpful to sooth at times when the immune system is activated (during infection), during autoimmune disease, and during pregnancy, because increases in interferon causes increases of enzymes that degrade tryptophan. It is suspected that tryptophan interferes with transport of branched chain amino acids (BCAA, which are leucine, isoleucine, and valine) across the brain barrier. BCAA counters the tryptophan. BCAA resulted in increased mental performance in athletes after exercise, maybe because of being less sleepy. There is some evidence that DNA linkages may break in the presence of tryptophan and excess copper. L-5-HTP (L-5-hydroxytryptophan) is on the market also and may be similar in affect to tryptophan,. Tryptophan physiology is complicated and should get more research. However, it is highly unlikely that any major problems could arise from short term use. Tryptophan was taken off the market in the 90s because of a bad batch from Japan, but seems to be OK now [from a dead URL].

Acetylcarnitine supplements caused considerable improvement of mental ability in 59% of CFIDS patients and propionylcarnitine caused considerable improvement in general fatigue in 63%. Strangely both together reduced global improvement to 37% of patients.

There are procedures at bed time that have been proposed to assist in improving sleep.

Because of very low vitamin B-12 in the brain large injections may be in order, which are only available by prescription. Or perhaps less expensively, use of DMSO for skin absorption. If vitamin b-12 is supplemented it is probably a good idea to make sure that there is no mercury in the body. It is suspected that vitamin B-12 methylates mercury, in which form it can cross the blood brain barrier and thus cause great illness.

In any case, all this should be on top of a nutritious diet to start with. In particular it has been proposed that linoleic acid (omega 6) may be deficient in myalgic encephalomyelitis (ME) [Richardson] and very few people take magnesium or potassium in supplements. The ratio of omega 6 to omega 3 oils should be one, but modern diets are much higher [Simopoulos], as much as 25 to 1 (this is a review of osteoarthritis neutraceutical interventions). However it is probably not a good idea to add excessive amounts of these oils to your diet because omega 3 could possibly inhibit the immune system [Grimm] in excess (but apparently not the white cell (T and B cells) functions [Kelley] ). For that matter overwhelming excesses of anything are probably rarely advantageous, especially interminably. However, supplements of omega-3 may be in order if you are afflicted with depression since depression has been negatively correlated with amount of omega 3 oil eaten. There have been dramatic improvements in CFIDS patients from 900 milligrams of omega-3 oil plus 16 milligrams of vitamin E per day by doctor Puri. Wikipedia has a discussion of omega 3.The richest sources of omega 3 oil are flax seed and fish oil. Fish oil has the advantage of furnishing vitamin D as well.

Copper intake in America is about half of the RDA. Researchers fed 24 male subjects low copper diets and found a closely tied drop in the levels of enkephalins (the internally produced substances that provide us with pain relief and pleasure) that were produced in the brain. [Journal of the American Medical Assoc. 224: 1578 (1973) ][Bhathena]. Depression has been relieved with copper supplements [Hansen], so it is possible that the depression often associated with CFIDS could be reduced that way also. Several brain neurotransmitters such as dopamine and norepinephrine are formed and catabolized by copper enzymes such as tyrosine hydroxylase and dopamine-beta-hydroxylase [Tyrer]. Since dopamine in the brain is disrupted in fibromyalgia [Wood], it is possible that copper supplements would help ameliorate the problem. It has been found in the past that copper supplements reduced the inflammation of rheumatoid arthritis. The reason why copper seemed to impact arthritis may be because a copper deficiency increases mast cells half again as much in rats [Schuschke], which in turn increases inflammation caused by histamine released by those cells as stimulated by the immune peptide hormones. Therefore it may be that copper supplements should be tried for people with fibromyalgia, since there is often depression and sometimes some inflammation. There is the additional possibility that relieving the low copper intake characteristic of our society would be helpful in view of the known strong dependence of the immune system on adequate copper. and a copper deficiency halves serum DHEA (dehydroepiandrosterone) in rats [Klevay and Christopherson]. I do not know how this happens or what the significance of it is, but in view of the low DHEA in CFIDS it would seem that a deficiency should be avoided. To see how to increase copper in the diet read this site; mollusks and liver are the richest food sources. However shellfish in some areas have very large amounts of cadmium and are high in lead and arsenic also. I also have concern that shellfish from the tropics may contain ciguatera toxin, as has been mentioned above. Spirulina seaweed is said to be a very rich source of copper, six milligrams per hundred grams of dry weight. Cheney believes that extra copper is damaging, however [from a dead URL] (although I suspect that it would have to be a great excess). Extra copper during a zinc deficiency certainly can be. In any case you may see a table for copper and zinc in food expressed as milligrams per thousand Calories here.

Getting plenty of sunlight has been proposed as increasing DHEA and DHEA is thought to increase the Th1 antiviral response [Petarca-Monero].

It has been found that there is a significant inverse relation between vitamin E and fatigue in CFIDS [Vecchiet]. Wheat germ is a rich source of vitamin E.

NADH (nicotinomide adenine dinucleotide) has helped in CFIDS, and 5-HTP (5 hydroxytriptophan) is thought to increase the brain’s sleep and antidepression hormones [from a discontinued commercial site]. Also SAM-e (S-adenosylmethionein) has reduced pain and depression in fibromyalgia, but it is very expensive. SAM-e is also thought to help in sleep problems. It has been found that depression is relieved somewhat by inositol supplements. If so, it is conceivable that this may be related to increasing the power of the sodium and potassium cell wall pumps. It has been suggested that inositol may actually be able to regenerate the brain neuron’s axons after the destruction of a stroke, although I am a little skeptical that any axons actually destroyed could regenerate. Perhaps it will be found to do the same for CFIDS.

Molybdenum supplements have proved helpful in a majority of patients with chronic fatigue, which the author attributed to destruction of poisons generated by candida infection.

There is an unessential nutrient called d-ribose, one of the sugars, that has been found to give great improvement to a majority of CFIDS and fibromyalgia victims. D-ribose at 5000 milligrams per day, which was well-tolerated, resulted in a significant improvement in energy; sleep; mental clarity; pain intensity; and well-being. Approximately 66% of patients experienced significant improvement while on D-ribose, with an average increase in energy of 45% [Teitelbaum]. It has been proposed by Dr. Sarah Myhill that the process of converting glucose sugar to ribose by the mitochondria is an important part of the loss of energy in CFIDS. She further says that l-carnitine in red meat is an important part of this process and helps explain why vegetarians are hit harder by CFIDS. She recommends l-carnitine supplements if red meat is not available, magnesium supplements, and co-enzyme Q-10, as well as adequacy in all thee other nutrients. Eating extra ribose she considers helpful. Loss of energy in mitochondria is probably a secondary effect, not a primary cause of CFIDS.

While individual nutrient supplements may prove to be in order for CFIDS, it is futile to think that any patient can get nourishment just right by eating processed food with varied nutrient losses, additions, and poisons, and then exactly correcting with pills. This is so even if the macronutrients like potassium, calcium, phosphate, and magnesium are supplemented adequately also and even for people who are expert dietitians. There is NO GOOD SUBSTITUTE FOR GETTING UNDAMAGED, NUTRITIOUS FOOD IN THE DIET before the criminally incompetent junk food processors wreck it.

Food elimination strategies have been said to produce significant clinical responses in 50-80% of patients with particular benefits seen in gastrointestinal complaints, migraine, arthralgias, recurrent upper respiratory tract infections including the sinuses and urinary tract infections. It is also thought that weight gain during CFIDS could be largely from food sensitivity [from a dead URL], although high caloric foods low in undigestible fiber are probably the main culprit. There is another elimination that was found to eliminate headache That was the elimination of monosodium glutamate additive [from a dead URL]. I also suspect that acid foods such as vinegar or potassium chloride can augment headache from other causes. Adding potassium chloride to a junk food diet should have the same affect as adding hydrochloric acid to a normal diet. I also suspect that something in raw cashew nuts and peanuts can also produce a headache in some people based on personal experience. There is a report of relief from intestinal bacterial overgrowth by means of enteric coated peppermint oil [Logan and Beaulne]. I would be hesitant about such a strategy if other means were available however. Natural medicines can be just as risky as artificial ones. Digitalis, ricin, ciguatera, and cyanide are all natural for instance. It has been proposed, though, that lactic acid bacteria can have therapeutic value [Logan, Venket, and Irani]. If so, I would suspect that they would be most affective introduced encapsulated in enteric capsules to get past stomach acids and taken with milk.

CFIDS RELIEF BY EXERCISE

Exercise has also been found to be helpful in CFIDS by numerous experiments [Hakkinen][Mengshoel]. Both moderate and intense exercise has shown to be helpful [Hadhazy] (it is possible that his patients were misdiagnosed). However, over training can precipitate CFIDS [Shephard] and exercise brings on a severe fatigue which lasts for days [Johnson H p329-330, 491-492] so it seems to me that exercise should be very mild (such as slow walking [Coutts] ) or better yet swimming for both CFIDS and fibromyalgia. This is supported by an experiment which showed that exercise in a pool gave less pain, anxiety, depression, and more days of feeling good [Jentoft] than terrestrial exercise and the effects lasted more than six months [Mannerkopf]. Short, mild treadmill exercise caused no obvious problem [Clapp]. I suspect that many short periods of mild exercise across the day would be the preferred routine. I suspect "across the day" partly because clearance of blood through the liver in order to remove electrolyte hormones such as aldosterone [Messerli] (which removal decreases potassium losses and sodium retention) is probably an important part of the value of exercise. A rocking device has been found to increase nitric oxide similar to actual exercise, so this may prove to be a mild substitute for exercise and thus avoid the deleterious effects from rigorous exercise during CFIDS. Exercise in waist high warm water has been found to be beneficial for fibromyalgia patients [Gusi]. Even robust exercise had beneficial results in some of the symptoms other than the symptoms mentioned above [Hadhazy], but it is conceivable that these patients had a different part of their brain affected by the disease and most researchers believe that if robust exercise made an improvement the situation was misdiagnosed. Lerner has a hypothesis that the poor tolerance to exercise in CFIDS is because the heart is infected with various herpes viruses and has considerable autopsy evidence [from a dead URL]. If so, exercise that puts a strain on the heart would be dangerous. There have been a number of situations in Queensland, SA and NSW Australia where CFIDS children, mainly in a hospital setting, have been made quite ill by excessive exercise, and when parents intervened to halt the harm, were threatened with loss of the child if they do not allow the practices to continue. If this happens to your child, it might be a good idea to bring the child to a less tyrannical country or area if at all possible. Athletic ability before becoming ill has nothing to do with post-illness exercise capacity, and often sedentary persons become less ill than those who were athletic. In some of the outbreaks, the bedridden hospital patients were the only ones to escape contracting the disease [Bruce]. My own experience with viral diseases is that exercise makes them worse. Until researchers get it figured out it would be a very good idea to approach exercise cautiously and very moderately indeed. It is rare in life when moderation is harmful.

DEVICES

There are many clever devices which have been invented for other degenerative diseases. There is no reason why these devices can not be made available if they can be financed by society. Societal support would be necessary for most because severe CFIDS is so debilitating that it is impossible for some of these people to support themselves. The most debilitating infirmity other than fatigue is loss of memory. CFIDS patients should carry maps with them showing the way home and notebooks with important information like phone numbers and grocery lists. This should help considerably. It has been found that eating fish improves memory, so perhaps that would be advantageous for CFIDS also. For those who have lost fingerprints [Johnson H p345] a good ID should always be on them and perhaps name and phone number imprinted on their arm with a dye. Another procedure, which should be effective, would be to set up a system whereby a CFIDS patient could carry a cell phone with a button which automatically dials a central office which has people on duty familiar with the important information in the patients life. That office should be skilled at giving emotional support in order to deal with the depression often present. For a dozen or so clever devices to use during the fibromyalgia type CFIDS see this site.

POSSIBLE NATURAL MEDICATIONS AND OTHER FOODS

It has been suggested that not eating or drinking caffeine before going to bed will aid in muting restless legs syndrome, which often also afflicts people with rheumatoid arthritis, diabetes, and some types of anemia [from a forbidden URL]. Coffee, tea, cocoa, and many soft drinks are sources of caffeine. Keep in mind also that caffeine is suspected of increasing potassium excretion and some coffee contains fluoride. There is a proposal that polyphenols in 85% dark chocolate are responsible for the amelioration of symptoms from dark chocolate. However, it is not advantageous for everyone. The affects are probably from stimulation by medicines such as caffeine and will have adverse side effects eventually, which will include mild addiction and maybe headaches. For those affected it may prove to be a crutch in an emergency. As with any other medicine it should not be used interminably, especially by anyone suffering from migraine headaches, anyone with sensitivity to tannins, vaso- constrictive amines, has very poor immunity, or is an insomniac. Also see this site.

There is evidence of opportunistic herpes infection since 77% of CFIDS patients contain antibodies to HHV-6 EA as IgM and IgG [Patnaik]. It may therefore be prudent for these CFIDS people also to eat sparingly of foods high in arginine continuously after CFIDS or maybe until tests determine that the immune peptide hormones [Patarca] and natural killer cells [Caligiuri] are all normal again. This is because the amino acid, arginine, accentuates the symptoms of herpes [McCune] and maybe will even trigger a resurgence of a dormant infection such as shingles (which disease is a resurgence of dormant chicken pox virus from nerves near the spine). Foods high in arginine are peanuts, cashews (peanuts are 50% higher than cashews but cashews are substantial), chocolate, and many seeds other than the grass family derived grain. (see here for a table which gives lysine and arginine values) Lysine supplements may be in order during an actual disease also because lysine helps to mute the effects of the herpes virus (such as chicken pox, shingles, infectious mononucleosis, roseola) significantly, reducing the occurrence (when taken routinely before the disease), severity, and healing time of herpes simplex virus [Griffith, 1981][Griffith, 1987]. It probably does so by interfering with the absorption of arginine by the virus. Lysine has removed fever or cold sores according to two case histories. If you should supplement with lysine, be sure not to take more than about 3 grams per day routinely since it is thought to be able to damage the liver eventually in large amounts. You can recognize shingles by large patches of a painful rash that appears on one side of the body in people under emotional stress [Irwin], older people, or people whose immune system has been compromised. An additional reason for decreasing arginine intake may exist. It is said that the enzyme that creates nitric oxide, which in turn stimulates neural sensitization, does so by acting on arginine. Some individuals have attained dramatic relief from virus with large lysine supplements, including one person who claimed dramatic relief from CFIDS. You may see an excellent table of nutrients including amino acids ( Just divide the values by the Kcal figure to get valid comparisons. Gain access by typing in food desired and then using the enter or return key). There are also links in it to PDF types of printouts from the table for individual nutrients available here Just click on the "A" or "W" button for the nutrient you desire.

You should keep in mind that arginine is normally a desirable nutrient and is necessary for optimum development and function of the thymus and its T cells.

It is said that injections of adenosine monophosphate and interferon gamma will also help heal herpes infections [Nikkels][Casrouge]. There is evidence that the prescription drug Kutapressin now remarketed as Nexavir, which are extracts from pig liver, can prevent the Epstein Barr herpes-6 infection. Since these are both hormones in the body they probably are safe to take together.

There is evidence that L. Acidofilis bacteria, found in yogurt, significantly raises the level of interferon-y in the body of over trained fatigued athletes. Since this hormone is a hormone that fights viruses, it has been proposed to be of assistance in CFIDS, If the bacteria must be alive to be effective, dry powders or pills would be useless. Yogurt has been found to increase IgA immune hormone against cholera toxin also [Tejada-Simon]. Lactic acid bacteria also stimulate interferon 1 and 2 immune hormones and to reduce allergen-stimulated production of IL-4 and IL-5 in some cases [Cross]’. This would suggest that yogurt may be of some value when resisting some infections.

12 CFIDS patients who had been given the powerful drug valganciclovir, which targets the human herpes virus (HHV-6), and nine of the patients experienced a great improvement. This sounds promising. Valganciclovir is a preferred medicine for HIV-6 virus (roseola) because it is easily absorbed in the intestines, after which it converts to acyclovir. It has now been found to markedly improve CFIDS, with 8 out of 9 patients regaining ability to think well. Ten milligrams per kilogram of body weight four times per day is said to be optimum for CFIDS. Doctor Montoya of Stanford University is said to be using this procedure.

Zinc has been proposed as being able to prevent and kill cold viruses and other viruses. This it is thought to do by making the cell membrane less permeable and by inhibiting viral replication. Zinc concentration in fluid outside the cell is normally 0.015 millimoles per liter. Zinc at 0.1 t0 2.0 millimoles is as effective in controlling virus as the most effective interferon-beta concentration. Recommended topical application is 0.2 to 2.0 per cent or 9 to 90 millimoles. Zinc is most available as the acetate [Eby]. Keep in mind that zinc interferes with copper and must not be taken interminably without about a third as much copper. There are two medicines, BHT and hypercin, which have some case history evidence for inhibiting herpes virus, but with safety unknown to me.

Sitosterol, a steroid present in plants, has evidence to indicate that it boosts the immune system [Bouic]. Wheat germ is said to be a rich source. This is another hint that whole foods are in order. Lauric acid is said to inhibit viruses by preventing attachment to the cell wall. It is the antiviral in human milk. It is also found in coconut oil. The ester of lauric acid, monolaurin, is said to be much more active against viruses. About 2000 milligrams is a therapeutic dose [Lieberman]. N-acetylcysteine (NAC) is said to inhibit viruses by stimulating production of immune peptide hormones and is more potent when combined with vitamin C and glutathione (GSH) [Lieberman]. Potassium orotate increased the content of ascorbic acid in tissues and the content of reduced glutathione in blood [Kuzdenbaeva]. It is also used to restore liver detoxification function from damage by acetaminophen (Tylenol). Therapeutic doses are 2000-4000 milligrams per day and is more affective when combined with 1000-2000 milligrams of glutathione [Lieberman]. Eating glutathione should be no more effective than eating each of its constitutive amino acids, but much more expensive. However, it is not absorbed as the intact molecule.

In regard to resisting diseases, especially bacterial, there is probably another reason for keeping cell potassium normal with adequate nutrition. It seems that the white cell vacuole requires an alkaline medium in order to both kill and digest microbes. To achieve this it must pump potassium into the vacuole using a calcium activated (Bkca) pump. This is known because, when a chemical blocks this pump channel, microbes are not killed in spite of normal phagocytosis (engulfing of microbes) and oxidase activity [Ahluwalia]. So it seems plausible to me that, even when the pump is operating normally, a cell low in potassium would make it more difficult to achieve the enhanced alkalinity. This may be the reason why potassium deficient kidneys are susceptible to infection [Woods].

Those who have CFIDS should not be afraid to experiment with nutrients. The human body is very resilient. As long as you do not use a poison or procedure known to be harmful, there is not much chance that irreversible harm will occur with reasonable amounts. Experimenting has some risk but doing nothing is even riskier. You may see an article which gives a diet for fibromyalgia arrived at by experimenting at this site. If you do come across a nutrient, combination of nutrients, or procedure or other circumstance which produces perceptible positive or negative effects, perhaps you could see yourself clear to email the information to me (isoptera at morrisbb.net). Several single case histories can sometimes be more effective in moving forward research than blind experiments averaged [Buchanen][Urowitz] and are certainly less expensive and more likely to be done.

As to NOT eating something in order to test the possibility of food allergy (although often intolerance rather than true allergy), which is often present, the chances of irreversible harm are extremely small. Some of the reactions to foods were pain, headache, and gastrointestinal distress in one study. The most common problem-causing foods or ingredients for the patients in this study were corn, wheat, dairy food, citrus and sugar [Edman]. I am inclined to doubt the citrus, although it could be acting in a non allergic way as mentioned above. It is very unlikely that sugar can produce an allergy. However sucrose and fructose can interfere considerably with copper metabolism so a different mechanism could be involved with sugars that mimic allergy such as the increase in histamine during a deficiency as mentioned above. Wheat is another matter. Some people are genetically unable to digest the gluten protein in wheat and as a result are afflicted with coeliac (celiac in the USA) disease. This is probably not an allergy as allergy is usually defined. It is conceivable that the damage to the intestines that this causes may be interfering with absorption of potassium and other nutrients. You should consider the following from a CoCure post by Dr. Charles Shepherd;
“1. 'Irritable bowel' symptoms are quite common in ME/CFIDS but it's worth screening for adult onset coeliac disease (AOCD), especially if the onset of ME/CFIDS is gradual.
2 Anemia is not caused by ME/CFIDS (a fairly common misconception). When anemia occurs, another explanation should always be sought.
3 Before experimenting with a gluten-free diet it's a good idea to be screened for coeliac, especially in people who have 'irritable bowel' type symptoms.
4 Some people who claim to have been 'cured' of ME/CFIDS by a gluten-free diet may not have had ME/CFIDS at all. The real explanation may have been coeliac - important because treatment of this condition isn't just a gluten-free diet. There are a number of other management issues (for instance increased risk of osteoporosis and small bowel adenocarcinoma) which need to be considered as well. Some physicians even recommend an annual lifelong review of their coeliac patients.
Gastroenterologists believe that we are currently only seeing the tip of the 'coeliac disease iceberg' with many people remaining undiagnosed or being misdiagnosed with irritable bowel syndrome, depression, ME/CFIDS etc.”

Of course your single case history exploring for allergy or deficiencies is almost useless epidemiologically (the study of health statistics) by itself. However, perhaps it could become useful if you became a member of a group that keeps records and is willing to make the records public anonymously. Millions of people eat things about which no records are kept, such as hydrogenated oils and additives. If they are not studied by the people who sell them, the government agencies, or the universities, then it would be a good idea if the people who eat food did so. Keep in mind that adverse connections to food probably usually take as much as twelve hours to materialize. Desirable connections to essential nutrients can take days or weeks, such as potassium for instance, and can often depend on synergistic affects or be affected by antagonistic affects with other nutrients.

MEDICAL PROCEDURES

Mycoplasma bacteria can be killed by antibiotics such as the tetracyclines or erythromycins such as doxycycline that do not act on a cell wall. When mycoplasma bacteria are involved, it takes a long time for doxycycline to take affect. It is said that that medicine has anti-inflammatory affects also, so one can not draw certain conclusions yet. As already mentioned, doxycycline may cause greater magnesium excretion, so supplements might be necessary with this medicine. Long time use also creates nausea and photo sensitivity. There is said to be a benign treatment for mycoplasma and other intracellular pathogens using glutathione from whey (at the end of the site you are reading). Some people have reported feeling much better after injecting or even eating glutathione. Most people feel worse, however. Because Mycoplasma are thought to be possible ancestors of gram positive bacteria it may prove possible to kill them with anacardic acids in raw cashew nuts as has been shown to work for tooth infection. You may see a list of laboratories that test for bacteria at this site, as well as some doctors’ experience with treating bacteria using antibiotics. You may see an overview of Mycoplasma at this site along with a description of a successful treatment of CFIDS.

An opioid antagonist drug called Naltrexone has shown dramatic affect against several diseases and may prove advantageous against CFIDS. See this site for some links to health articles.
For a procedure that discusses tetrathiomolybdate for removing copper and thus preventing further solid cancer growth and Hodgkin’s, see this site. This might buy some time until you can persuade a doctor to try tumor necrosis factor or interferon or an opioid antagonist drug called Naltrexone (Naltrexone in the large 50 mg size, originally manufactured by DuPont under the brand name ReVia, is now sold by Mallinckrodt as Depade and by Barr Laboratories under the generic name naltrexone) that blocks some endorphin receptors. Said blockage is thought to cause the body to temporarily secrete more endorphins, especially after midnight at night. These endorphins are thought to stimulate the immune system, and in particular to stimulate the TH-1 or type 1 antiviral response by decreased interleukin-4 and with increased gamma interferon and interleukin-2 and a simultaneous decrease of type 2 anti bacterial response [Sacerdote]. It appears to be especially effective for minimizing symptoms and retarding progression of multiple sclerosis (MS) (also see these sites; this site and this site and a trial) . A few doctors have had encouraging results in Crohn's Disease, and even to some extent in cancer. Low doses of Naltrexone (LDN), 1.5 to 4.5 milligrams, at bedtime is used (timing is important, and it is important not to buy slow release forms). It is said to have no known bad side effects at those doses other than insomnia the first week or two in some. There is also reports from an extensive survey in this site. I think some clinical studies on Naltrexone are in order, and it should not be a prescription drug (I have a petition to make Naltrexone an over the counter drug with the Center for Drug Evaluation and Research FDA Rockville MD 20857, Re; Docket No. 2006P-0508-CPI. Perhaps if enough people wrote supporting the petition it could be enacted). Though side effects appear unlikely, it is not proven over longer periods. If you try it (it is a prescription medicine in the USA), it seems likely that you should discontinue if you get a bacterial infection in view of its inhibition of antibacterial response. Dr. Gale Guyer of Advanced Medical Center located in Zionsville, Indiana also is using it for cancer. Dr. Bihari has shown promising results for a large percentage of his cancer patients. Naltrexone (Naltrexone in the large 50mg size, originally manufactured by DuPont under the brand name ReVia, is now sold by Mallinckrodt as Depade and by Barr Laboratories under the generic name naltrexone) blocks some endorphin receptors. Said blockage is thought to cause the body to temporarily secrete more endorphins, especially after midnight at night. These endorphins are thought to stimulate the immune system, and in particular to stimulate the TH-1 or type 1 antiviral response by decreased interleukin-4 and with increased gamma interferon and interleukin-2 and a simultaneous decrease of type 2 anti bacterial response [Sacerdote]. It appears to be especially effective for minimizing symptoms and retarding progression of multiple sclerosis (MS) There is information in this site for mitigating side effects, including starting with one milligram doses. Advice how to proceed if you have been taking cortisol may be seen here.

There are suggestions on how to obtain Naltrexone without a prescription in this site.

Also see these sites; this site and this site and a trial. A few doctors have had encouraging results in Crohn's Disease. and also this study., and even to some extent in cancer. Low doses of Naltrexone (LDN), 1.5 to 4.5 milligrams, at bedtime is used (timing is important, and it is important not to buy slow release forms). It is said to have no known bad side effects at those doses other than insomnia the first week or two in some. There is also reports from an extensive survey in this site. I think some more clinical studies on Naltrexone are in order, and it should not be a prescription drug. Though side effects appear unlikely, it is not proven over longer periods. If you try it (it is a prescription medicine in the USA), it seems likely that you should discontinue if you get a bacterial infection in view of its inhibition of antibacterial response. Naltrexone is currently being used by Dr. Enlander, a New York City doctor, but with limited success using 3 to 4.5 milligram doses for CFIDS. It is also being explored for AIDS by Dr. Bernard Bihari, 29 W 15th St. New York, NY 10011, 212) 929-4196 who is still prescribing Naltrexone for HIV/AIDS. (and currently Executive Director of the Community Research Initiative). Dr. Gale Guyer of Advanced Medical Center located in Zionsville, Indiana also is using it for cancer. Dr. Bihari has shown promising results for a large percentage of his cancer patients.

Olive leaf extract has shown clinical evidence of effectiveness against a wide range of viruses, including AIDS [Bihari], herpes, and cold viruses. It sometimes produces a Herxheimer or pathogen die off symptoms (from effectiveness against bacteria?). There is evidence that it is synergistic (reinforce each other) with Naltrexone. There have been a few case histories of improvement in what were probably arthritis patients and CFIDS patients. The active ingredient is said to be oleuropein or enolate. There has been very little follow up research done on it

About 30% of CFIDS patients are afflicted with chlamidia. It is thought that aspirin strongly inhibits this pathogen. One case took ten days using 325 milligrams per meal to heal. Aspirin is not free of disadvantageous side effects.

Just do not engage in any procedures out of the ordinary which go on interminably, especially medication or pain deadeners (analgesics) since pain deadeners have been proposed as a risk factor for CFIDS [Johnson H p574]. Also several pain deadeners have been found to damage the kidneys. Among the prescription and over the counter medications that predispose patients to such damage are acetaminophen (Tylenol, Anacin-3, Liquiprin, Panadol, and Tempra) but not aspirin [Schwarz]. Kidney damage is extremely serious. Also it is plausible that anything which can damage kidney cells could damage immune cells as well. Tylenol (acetaminophen) also damages the liver. The chance that a pain deadener will have any direct curative affect is extremely small, so it usually is better to tolerate the pain if at all possible unless it is interfering drastically with sleep. A 1998 medical report estimated that adverse reactions to prescription drugs kill about 106,000 Americans annually, roughly three times as many as are killed in automobile accidents. If for some reason a pain deadener is essential, glucosamine reacts synergistically with non steroidal analgesics so that less pain killer is necessary. Some commercial glucosamine products are also a potassium supplement, since they contain large amounts of potassium chloride (this site evaluates commercial glucosamine, chondroiten, and MSM). Potassium chloride raises blood pressure somewhat, unlike potassium in other forms. And I suspect that the chloride can enhance pain itself. One exception to adverse affects of pain medicines may be Methylsulfonylmethane ( MSM). It is said to be fairly effective and virtually free of side affects. It may be that it warrants more investigation [Parcell]. However some people report an adverse reaction to it, which could conceivably be due to a bad batch. Another pain deadener which is said to work by inhibiting brain transmitters is the drug, Neurontin. I do not know if it has side effects or not. Cheney says that the medicine called Klonopin protects brain cells from over stimulation and cell death without dangerous side effects. There is a new medicine under investigation in the UK that markedly reduces fatigue caused by fibromyalgia called Provigil (modafinil). A survey was conducted of people with fibromyalgia (with a link to the full article). The most commonly used medications were: acetaminophen, ibuprofen, naproxen, cyclobenzaprine, amitriptyline, and aspirin. The medications perceived to be the most effective were: hydrocodone preparations, aprazolam, oxycodone preparations, zolpidem, cyclobenzaprine, and clonazepam. Most of these medicines probably do no more than mask the symptoms. Maybe better them than constant pain, but I would advise to take as small a dose as possible and as seldom as possible.

It is useful to know that smoking enhances pain but not fatigue [Yunnus]. Fibromyalgia seems often to be made worse in hypertensive patients who are treated with ACE (angiotensin conversion enzyme) inhibitors and ACE receptor blockers. A study of the side effects of these medications shows muscle pain as a potential side effect [from a dead URL]. Medications by name include accupril, altace, atacand, avapro, capoten cozaar, diovan, hyzaar, lotensin, mavik, micardis, monopril, univasc, vasotec, and zestril. Ask your doctor if your medications for high blood pressure are any of the above and of course eliminate high blood pressure as much as possible by adequate potassium, preferably from food.

For a long time it has been assumed that it was the sodium in salt that contributed to high blood pressure. I have always had the sneaking suspicion that they were ignoring the chloride, and thus taking the chance of barking up the wrong tree, and now it looks as if my suspicions were in order. Experiments with potassium chloride supplements show that such supplements often raise blood pressure; . Now it is known that sodium must be combined with chloride to raise blood pressure. Sodium alone causes blood pressure to fall in salt sensitive people [McCarty 2004]. Sodium bicarbonate lowered blood pressure 5mm of mercury [Luft], perhaps so little because the subjects were probably already on high salt intake (along with most of the rest of the country ). Also see Boegshold [Boegshold]. This must be intimately involved with pH regulation in some way, because adding sodium bicarbonate to potassium chloride neutralizes the affect of potassium chloride on pressure [McCarty 2004]. This should have the same net affect as adding a sodium chloride supplement to a normal diet high in potassium. It has been known for a long time that higher potassium to sodium molar ratios have an inhibiting affect on blood pressure from salt hypertension [Dahl 1972]. The link to pH regulation is plausible because 18 OH-DOC is deeply involved in one of the, at least three, forms of hypertension [Melby] and 18OH-DOC is probably the steroid hormone that regulates hydrogen ion excretion [for further discussion, see my book]. There is no significant risk of cardiovascular disease statistically for serum potassium between 4.1 and 5.3 Meq per liter (4.8 is what the body aims for), but the incidence of hypertension is 3% in a 4.1 meq average, to 2% in a 4.5 meq average, to 1% in 4.8 meq average or 5.1 meq average [Walsh]. With at least three different forms of high blood pressure, as above, and all the other nutrients wildly varying in people’s diet, the situation is hopelessly complicated. But in so far as potassium being involved is concerned, supplements are not the way to depend on solely as a rule. Everyone should get as much potassium as possible from food. The reason is that you avoid the possibility of imbalances or deficiencies with other nutrients. This is especially important with respect to magnesium since potassium is absorbed with difficulty in a magnesium deficiency, and a magnesium deficiency takes months to correct. There is another reason why so far as my own emotions are concerned. It seems kind of nutty to me to deliberately pay hard cash for food that has been ruined, and then try to correct the debacle with supplements, and I get itchy whenever I get involved in nutty procedures.

Attempting to correct the low cortisol in CFIDS with cortisol is useless because there are no significant good effects [Levine ( Copies of the complete article are available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworthpressinc.com ) ]. In any case cortisol or any other glucocorticoid should not be taken during any infection because of its known considerable dampening of the immune system. If cortisol is used, a single daily dose is probably not effective because cortisol is rapidly converted to an inactive form [Ulrich 1958]. There is an extensive discussion of drug and herbal medicine adverse interactions at this site. There is a suspicion that isotretinoin (brand name Roaccutane, for acne) can trigger an attack of chronic fatigue syndrome. The American Food and Drug Administration has a program called MEDWATCH for people to report adverse reactions to untested substances, such as herbal remedies and vitamins. Call 800-332-1088.

Infusions or injections of the immune hormone IgG, especially intramuscularly (probably this way because the IgG was not degraded too quickly by the blood enzymes), to pregnant mothers has shown to give very effective protection in preventing birth defects in the babies when the mothers showed titers to a Coxackie virus. 500 mg weekly provided the affect [Richardson]. The affect was probably from enhancement of the immune system.

There is a report that hypobaric treatment (increased oxygen pressure) will ameliorate the symptoms of fibromyalgia. If valid, this would seem to indicate another reason for providing plenty of ventilation, especially while sleeping.

When surgery is necessary for CFIDS patients (including dental procedures) it is imperative that doctors become familiar with contraindications for medication because CFIDS patients are very susceptible to adverse reactions from some anesthetics and other medications and usually much smaller doses are indicated.

EMOTIONAL SUPPORT

Depression often shows up in CFIDS. Therefore it is almost certainly desirable for those who love the sufferer to apply as much emotional support as possible. Emotional abuse has been found to be correlated with fibromyalgia [Walker]. Good jokes, camaraderie, and tactile approval (like hugs) will not cure the disease since psychological state has little affect on the disease itself (as opposed to the disease creating the psychological state [Tiersky] ), but there is a good chance they will mute or distract some of the symptoms and make an eventual defeat of whatever infection is involved or become involved opportunistically a little more likely since emotional stress increases hormones that mute the immune system. It has been found that secretion of IgA is increased merely by watching humorous stories [Labott] (IgA is the peptide hormone that guards the body against diseases that invade through mucous membranes and diarrhea). However many CFIDS patients say that laughing more than ten minutes is as exhausting the next day as physical exercise for them. Therefore humor must be low keyed and pleasant, evidently. I believe that music can have soothing effects. There is a nice site that plays music in the background of your computer using songs of the 1950s on. There has been a study which indicates that women seek female companionship when stressed and that this soothes them. It is proposed to operate through the oxytocin hormone with an assist from estrogen. Considerable health and lower mortality benefits are statistically obtained [Taylor]. Massage has been helpful for fibromyalgia [Field] [Lund], massage being the most helpful of physical manipulations [Hong], especially vibratory massage [Alentorn-Geli], but there is a good chance that this is also a placebo effect on the immune system (thought to be possible [Evans] ). Massage of the neck is said to make the situation worse if there is a compression of the neck vertebrae. Emotional support for children is especially important since emotional abuse is said to be a very important risk factor for children who have been emotionally abused [Imbierowicz] [Heim 2006] and children who have had psychiatric problems in the prior year were much more affected by their CFIDS [Rangel]. Just be sure to make kissing or eating and drinking out of the same plate not part of the procedure because there is a suspicion that the last of the two is a risk factor for others and also increases the chance of opportunistic infections.

Staying warm will also probably prove to be advantageous since it has been shown that staying warm enhances immunity [Hanson] [Weber]. Additional evidence of this is that the ability of lizards to resist infection is directly proportional to their temperature [Kluger]. Permanent improvement was attained in two patients with a dry sauna [Masuda]. This is similar to the Waon treatment whereby marked improvement was attained for fibromyalgia after ten fifteen minute sessions at 60 degrees centigrade in a dry infrared treatment plus staying warm for half an hour afterwards [Matsushita].

I have often cured a cold within a couple hours with an infrared heat lamp directed to my nose and it has been advantageous against infections near the surface of the body such as sore throats and tooth abscesses (scroll down). A goose neck floor lamp with a ceramic socket extender to protect the switch from heat is the most practical lamp holder. I have heard of people who claimed to have eliminated CFIDS with infrared saunas. How to make or acquire a sauna is discussed here. It is dangerous to use any kind of sauna in which perspiration occurs because of excessive loss of potassium. Some patients have suffered long lasting relapses from this. I suspect that one or a few electric light infrared bulbs on goose neck lamps would be all that are required for both comfort and colds. Fringe benefits of this last is a considerable saving in heating costs since you are comfortable at a much lower room temperature with the resulting higher relative humidity to result in fewer colds. There is a suspicion that CFIDS is accompanied by less susceptibility to colds anyway, however.

Guarding the sufferer from fear and tapping spiritual resources for fear is well known to affect the immune hormones. Fear may be contributing to the lower potassium in CFIDS by increasing aldosterone as well and ways of coping with emotions. There is a site that enables singles with CFIDS to contact each other. I have no experience with the site. Do not allow anyone convince you that the disease is hypochondria, or hysteria, or a spell from the wicked witch of the west. Everything is something, even if the something is unknown.

SOCIETY EFFORTS

CFIDS and fibromyalgia are potentially extremely dangerous to society because of their severity and length of recovery time. The vector for this disease or these diseases is unknown at present but there is a good chance that pathogens are causal. 6.4% of patients in an unreported study were triggered by a blood transfusion [from an unreported study]. If a mosquito ever "learns" how to transmit it, the situation will be desperate for society. Therefore enormous research effort should be mobilized to not just ameliorate it, but like smallpox, to eradicate it.

If all the mitigating factors which have been discovered so far that are harmless are all implemented, in my opinion there is a good chance that people with CFIDS and fibromyalgia will be able to lead reasonably satisfactory lives of higher quality and maybe even cure themselves. Be very cautious of medicines based on chemicals, however. In particular it is important to eat a nourishing diet. This means much more vegetables and ruling out almost all processed food and making sure that people do not leach or boil out any nutrients themselves. I warmly recommend this even for healthy people. It is by no means necessary that such a diet be unpalatable. If many vegetables are blended together in salads and soups they will taste much better than eaten separately in my opinion. Also there are many harmless foods with strong flavor such as lemon juice for instance, which can add "zing" to the food, as well as spices, many of which are probably reasonably harmless (although I do not know which ones). If you use lemon juice or vinegar, be sure they contain no sulfites, which degrade vitamin B-1 in the intestines, and keep in mind that these acids may yet prove to be disadvantageous. I am almost certain that vinegar gave me a headache during the days immediately after I was poisoned with toluene, for instance. It is possible that supplements may prove to be necessary, but if so, they should be on top of a good, UNPROCESSED nutritional platform and will almost certainly have to include adequate amounts of the macro nutrients, magnesium, potassium, calcium, and phosphate if the diet is not already adequate. It is impractical to put those elements into all purpose pills. Also be aware that phosphate is very dangerous in the presence of a heart attack. Take a look at a marvelous site that gives average RDR multiples for most of the essential elements in graphical form from several food groups along with average costs. Vegetables are the winners. The health of people in the USA is abysmal and a major part of it is poor nutrition. As the 12th century physician trying to cure by diet before he administers drugs said; "No illness that can be treated by diet should be treated by any other means" or as Hippocrates expressed it in 460 - 377BC; "If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health." It would seem that a healthy life style has been known for a long time. Those who don't smoke, eat five servings of fruits and vegetables daily, exercise regularly and maintain a normal weight account for ONLY 3 PERCENT of the adult population in the United States, according to the report in an April 25 issue of the Archives of Internal Medicine.

You may see abstracts of the 2nd World Congress on chronic fatigue syndrome and related disorders with 73 paragraphs on almost every of the then current line of research at this site. or a list of CFIDS abstracts here. You can join a group that explores and discusses new treatments at this site. It furnished some of the information in the site you are viewing.

Thyroid problems can cause fatigue. See this site for thyroid. It is possible for people with CFIDS to have low thyroid secretion, but use of thyroid hormones (thyroxine) must be done with extreme care and be carefully monitored, because cortisol is usually low in CFIDS and thyroid hormone can have serious consequences during low cortisol, with heart rhythm or especially to the adrenal glands. Endometriosis is said to be associated with low thyroid. There is something in soy food which considerably inhibits thyroid secretion. It is thought that something in cruciferous vegetables (the cabbage family) inhibits the thyroid that is destroyed by cooking. However, it is thought that it operates by inhibiting iodide absorption, so eating iodide supplements at an uninhibited meal may solve the problem. Fluoride, as in drinking water, will cause low thyroid. A diet composed of unprocessed soy bean flour, yeast, sugar, butterfat, sodium chloride and calcium carbonate, when fed to rats, produces thyroid enlargement of four times normal in an experimental period of 7 weeks. The minimum iodine requirement of rats fed that goiter producing diet is two times normal. It probably operates by inhibiting absorption. (you may see an extensive discussion of iodide by using the arrows at the bottom) Thiel believes that iodide, l-tyrosine, and selenium should be the first line treatment for thyroid dysfunction [Thiel]. Cadmium is thought to cause low thyroid.

It has been proposed that coconut oil strengthens the thyroid.

See this site for explanations of standard blood tests (this is a medical encyclopedia). Click on the name of each test, and it will tell you what could cause any value to be high or low. Interpretation of tests for thyroid function can be unreliable because of too broad a bell curve used and the peculiar, complicated thyroid system.

The health of people in the USA is abysmal, and a major part of it is poor nutrition. As the 12th century physician, trying to cure by diet before he administers drugs, said; “No illness that can be treated by diet should be treated by any other means" or as Hippocrates expressed it in 460 - 377BC; "If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health." It would seem that a healthy life style has been known for a long time.

It is my belief that an unprocessed, unfrozen, not canned, high in vegetables diet would keep a large majority of people reasonably healthy and without the need for fad diets. The World Health Organization of the UN agrees with this, and maintains that the majority of deaths are from nutrition preventable chronic diseases. 80% of Americans do not eat adequate vegetables, but even though 72% of Americans take vitamin or mineral supplements daily or sometimes [Sardi p148], their health is atrocious, especially old people. And now people with primitive diets are switching over to up to date destroyed diets world wide with corresponding decline in health.

One third of the world’s children are under weight and malnourished. 20,000 die of hunger each year [Gitlin]. They can ill afford for processors to deliberately destroy any of their food (or yours).

I would suggest that a partial solution to the problem of poor potassium nutrition would be to place a tax on all food that has had potassium or magnesium removed by food processors and completely fund all Medicare, Medicaid, and workman’s compensation for injuries and disease that relate to rheumatoid arthritis, heart disease, high blood pressure and maybe CFIDS. This would also take the onerous tax burden now incurred for them and place it on the shoulders of those who cause the problem. And this tax burden is not the only burden. Half the bankruptcies in the USA are caused by medical bills. Achieving this would be much more likely if the money was removed from politics and there were runoff elections. If you click on this last logo, you can get a free bumper sticker for your car, with no donation necessary, that urges impeachment of the supreme court justices who ruled that the CEOs of corporations can buy elections.

Michael Jacobson and Kelly Brownell of the Center for Science in the Public Interest have proposed a small tax on soft drinks and candy to finance public nutrition education. My vote would be for a large tax. The Health Freedom Foundation is currently attempting to solve the problem by lobbying government legislatures to change the laws and agencies’ organization. Another idea to help the nutrition of our society by Dan O’Keefe is to require all supermarkets to provide a computer that tells a shopper which brands should not be eaten for each of the degenerative diseases (for instance food containing sulfite not to be eaten by those suffering from beri-beri caused heart disease).

It took 150 years for the medical profession to accept cod liver oil for use against rickets, almost that long to adopt penicillin, and 2500 years to abandon blood letting. Let us hope that we do not have to wait that long before they accept potassium and magnesium as essential for health.

SOME HEALTH SITES

Anacardic acids in raw cashew nuts for tooth abscess and maybe for acne, leprosy, and tuberculosis.
For a discussion of some Speculation about diabetes, including possible causes such as chili pepper and potassium affects.
For a procedure that discusses Tetrathiomolybdate for removing copper and thus inhibiting solid cancer growth and Hodgkin’s, see this site.
See this site for evidence of a correlation between magnesium deficiency and cancer.

There is evidence that cell phones can produce tumors. Using remote ear phones would seem to be a good idea.

Fluoride in city water will cause fluorosis discoloration of teeth, weakened bones, damage to the kidneys, thyroid, and immune system, bone cancer, and, worst of all, damage to the nerves resembling Alzheimer’s disease. It will also cause damage to ligaments resembling arthritis.

A site is available which shows. foods which are high in one nutrient and low in another (including calories). This last site should be especially useful for a quick list of foods to consider first, or for those who must restrict another nutrient because of a genetic difficulty with absorption or utilization.

See this site for some links to health articles.
For a procedure that discusses tetrathiomolybdate for removing copper and thus preventing further solid cancer growth and Hodgkin’s, see this site. This might buy some time until you can persuade a doctor to try tumor necrosis factor or interferon or an opioid antagonist drug called Naltrexone (Naltrexone in the large 50 mg size, originally manufactured by DuPont under the brand name ReVia, is now sold by Mallinckrodt as Depade and by Barr Laboratories under the generic name naltrexone) that blocks some endorphin receptors. Said blockage is thought to cause the body to temporarily secrete more endorphins, especially after midnight at night. These endorphins are thought to stimulate the immune system, and in particular to stimulate the TH-1 or type 1 antiviral response by decreased interleukin-4 and with increased gamma interferon and interleukin-2 and a simultaneous decrease of type 2 anti bacterial response [Sacerdote]. It appears to be especially effective for minimizing symptoms and retarding progression of multiple sclerosis (MS) (also see these sites; this site and this site and this site and a trial) . A few doctors have had encouraging results in Crohn's Disease, and even to some extent in cancer. Low doses of Naltrexone (LDN), 1.5 to 4.5 milligrams, at bedtime is used (timing is important, and it is important not to buy slow release forms). It is said to have no known bad side effects at those doses other than insomnia the first week or two in some. There is also reports from an extensive survey in this site. and an extensive discussion at this site. I think some clinical studies on Naltrexone are in order, and it should not be a prescription drug (I have a petition to make Naltrexone an over the counter drug with the Center for Drug Evaluation and Research FDA Rockville MD 20857, Re; Docket No. 2006P-0508-CPI. Perhaps if enough people wrote supporting the petition it could be enacted). Though side effects appear unlikely, it is not proven over longer periods. If you try it (it is a prescription medicine in the USA), it seems likely that you should discontinue if you get a bacterial infection in view of its inhibition of antibacterial response. There are suggestions on how to obtain Naltrexone without a prescription in this site. Naltrexone is currently being used by Dr. Enlander, a New York City doctor, but with limited success using 3 to 4.5 milligram doses for CFS or CFIDS. . It is also being explored for AIDS by Dr. Bernard Bihari, 29 W 15th St. New York, NY 10011, 212) 929-4196 who is still prescribing Naltrexone for HIV/AIDS. (and currently Executive Director of the Community Research Initiative). Dr. Gale Guyer of Advanced Medical Center located in Zionsville, Indiana also is using it for cancer. Dr. Bihari has shown promising results for a large percentage of his cancer patients.

EPILOGUE

Dr. Reza Rastmanesh from Iran has recently performed a large controlled clinical trial testing potassium supplements against rheumatoid arthritis with dramatic decreases in pain in all subjects and increases of cortisol. He would now like to continue his clinical research testing potassium in conjunction with other nutrients, especially magnesium, in an English speaking country. His credentials are impressive. If you know of any rheumatology or nutrition department able to employ him, please contact me with isoptera at morrisbb.net .

You may find useful for searching for journal articles the Pubmed search engine. and a site that has many links to nutrition sites around the world.

There is a free browser called Firefox, which is said to be less susceptible to viruses or crashes, has many interesting features, and imports information from Iexplore while leaving Iexplore intact. You can also install their emailer. A feature that lists all the URLs on a viewed site can be useful when working on your own site.

If you have Iexplore, there is a tool bar by Google that enables you to search the internet from the page viewed, mark desired words, search the site, give page rank, etc. Its “Scholar” feature may be the best in the world for searching journal articles only. It is also available for Firefox.

There is a free program available which tells on your site what web site accessed you, which search engine, statistics about which country, statistics of search engine access, keywords used and their frequency. It can be very useful.

The author has a degree in chemistry and a master of science degree in soil science. He has researched potassium and copper nutrition for 50 years, primarily library research, and CFIDS for several years. He has cured his own early onset of arthritis. He has published articles on allied subjects in; The Journal of Theoretical Biology (1970, 1983), The Journal of Applied Nutrition (1974) which gained the best article of the year award, Clinical and Experimental Rheumatology (1983), and Medical Hypotheses (1984, 1999, 2007, 2008). This article is solely funded by the author.

Confidentiality of data relating to individual patients and visitors to a medical/health Web site, including their identity, is respected by this Web site. The Web site owners undertake to honor or exceed the legal requirements of medical/health information privacy that apply in the USA. While it is not the policy of this author to use testimonials, you may, if you wish, tell of the outcome of health strategies to this site. You may see a proposal for institutionalizing collecting medical information from case histories here.

The information contained in any of my articles may be duplicated in whole or in part in any electronic medium as you wish, other than to publish a book.

For your interest, comments by the editor about the response to the insulting obituary about Dr. Horrobin, former editor of Medical Hypotheses, calling him a snake oil salesman, in the British Medical Journal; "The Lancet's obituary, and other obits in the national press, wimpishly parroted the version sent out by Horrobin's former PA [press assistant]." Asked if she was surprised by the venomous response, Richmond (the editor) says she realizes now that Horrobin had a cult following, especially among people with chronic fatigue syndrome. "If I'd been as conscious of this as I am now, I would have pre-empted their response as far as I could." I wonder how.

Email to Charles Weber = isoptera at att.net
Phone is; 828 692 5816 (USA)

REFERENCES

(many are from the abstracts and some were provided by Co-cure, a free email mailing)

All references published since 1966 are listed here.

[*] I do not have a reference available for these.

Abou-Donia et al 1996 A combined exposure to high doses of pyridostigmine bromide (PB), N,N-diethyl m-toluamide (DEET), and Permethrin leads to a significant toxicity and neurological dysfunction J. Toxicol. Environ. Health, 48: 35-56.

Ahluwalia J Tinker A Clapp LH Duclien MR Abromav AY Pope S Nobles M Segal AW 2004 The large-conductance Ca2+ - activated K+ channel is essential for innate immunity. Nature 427; 853—858.

Al-Allaf AW, Mole PA, Paterson CR, Pullar T. 2003 Bone health in patients with fibromyalgia. Rheumatology (Oxford). June 16 [Epub ahead of print].

Alentorn-Geli E Padilla J, Moras G, Haro CL, Fern=E1ndez-Sol=E0 J 2008 Six weeks of whole-body vibration exercise improves pain and fatigue=20 in women with fibromyalgia. J Altern Complement Med. ;14(8):975-81.

Amerine MA Ough CS 1972 Recent advances in enology. CRC Critical Reviews in Food Technology V2 issue 4407-526.

Amouroux I, Pesando D, Noel H, Girard JP. 1999 Mechanisms of cytotoxicity by cosmetic ingredients in sea urchin eggs.Arch Environ Contam Toxicol. 1999 Jan;36(1):28-37.

Anonymous 1994 Potassium and sodium and potassium in the skeletal muscle. Laeger Ugeskr 156; 4007-4010.

Bassin EB Wypij D Davis RB Mittleman MA 2006 Age specific fluoride exposure in drinking water and osteosarcoma (United States). Cancer Causes and Control. 17; 421-428.

Bell DS Bell KM Cheney PR 1994 Primary juvenile fibromyalgia syndrome and chronic fatigue syndrome in adolescents. Clin. Infect. Dis. Suppl. 1; S21-3.

Bell IR Baldwin CM Schwartz GE 1998 Illness from low levels of environmental chemicals: relevance to chronic fatigue syndrome and fibromyalgia. Am. J. Med. 105; 74S-82S.

Bell IR Baldwin CM Stoltz E Walsh BT Schwartz GER 2001 Concomitant Environmental Chemical Intolerance Modifies the Neurobehavioral Presentation of Women with Fibromyalgia. Journal: J of Chronic Fatigue Syndrome, Vol. 9(1/2) 2001, pp. 3-19

Benjamin F 1959 Release of intracellular potassium as the physiological stimulus for pain. Journal Appl. Physiol. 14; 643.

Besunder, James B., D.O. and Smith, Paul G., D.O.1991 Toxic Effects of Electrolyte and Trace Mineral Administration in The Intensive Care Unit, Critical Care Clinics, (3):659-693.

Beulens JW et al 2009 High dietary Menaquinone intake is associated with reduced coronary calcification. Artherosclerosis 203; 489-493.

Bhathena S.J. et al American Journal of Clinical Nutrition vol. 43, p. 42 Jan 1986

Bian J, Cui J, McDonald TV 2001 HERG K(+) channel activity is regulated by changes in phosphatidyl inositol 4,5-bisphosphate. Circ Res. 89(12): 1168-76.

Biddle R et al 1992 A chronic illness characterized by fatigue, neurologic and immunologic disorders, and active human herpesvirus type 6 infection. Annals of Internal Medicine 116; 103-13.

Bihari B 1995 Efficacy of low dose naltrexone as an immune stabilizing agent for treatment of HIV/AIDS [letter]. AIDS Patient Care 9; 3.

Blahd WH et al 1963 Body potassium content in patients with muscular dystrophy - body composition part 1. Ann. N. Y. Acad. Sci. 110; 282-290.

Boegshold M Kotchen TA 1991 Importance of dietary chloride for salt sensitivity of blood pressure. Hypertension 17 (suppl) I 158-I161.

Bouic PJ. 2001 The role of phytosterols and phytosterolins in immune modulation: a review of the past 10 years. Curr Opin Clin Nutr Metab Care. 2001 Nov;4(6):471-5.

Brouwer I Verhoef P Urgert R 2000 Betaine supplementation and plasma homocysteine in healthy volunteers. Arch. Intern. Med. 160; 2546-2547.

Brouwers FM Van der Werf S Bleijenberg G Van der Zee L Van der Meer JWM 2002 The effect of a polynutrient supplement on fatigue and physical activity of patients with chronic fatigue syndrome: a double-blind randomized controlled trial Q J Med 2002; 95: 677-683.

Bruce M. Carruthers, ; Anil Kumar Jain, Kenny L. De Meirleir, Daniel L. Peterson, Nancy G. Klimas, Lerner AM, et al. 2003 Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols. J of Chronic Fatigue Syndrome, Vol. 11 (1) 2003, pp. 7-116.

Buchanan WW Kean WF 2001 Evidence Based Medicine: The Median Is Not the Message. Journal of Rheumatology, Vol. 28, No. 11 2371

Buchwald D Sullivan JL Leddy S Komaroff AL 1988 "Chronic Epstein-Barr virus infection" syndrome and polymyalgia rheumatica. J. Rheumatol. 15; 479-82.

Buchwald D Cheney PR Peterson DL Henry B Wormsley SB Geiger A Ablashi DV Salahuddin SZ Saysinger C Biddle R, et al 1992 A chronic illness characterized by fatigue, neurological and immunological disorders, and active herpes virus type of infection. Annals of Internal Medicine 116; 103-113.

Buchwald, D Garrity 1994 Comparison of patients with Chronic Fatigue Syndrome, Fibromyalgia and Multiple Chemical Sensitivities," Archives of Internal Medicine; 154; 2049-53.

Burnet RB Yeap BB Chatterton BE Gaffney RD 1996 Chronic fatigue syndrome: is total body potassium important? Med. J. Aust. 164; 384.

Caligiuri M, Murray C, Buchwald D, Levine H, Cheney P, Peterson D, Komaroff AL, Ritz J 1987. Phenotypic and functional deficiency of natural killer cells in patients with chronic fatigue syndrome. J. Immunol. 139(10):3306-13.

Casanova JL Abel L 2002 Annu. Rev. Immunol. 20; 561.

Casrouge A et al 2006 Herpes simplex virus encephalitis in human UNC-93B deficiency. Science 314; 308-312.

Cannon JG Angel JB Abad LW Vannier E Mileno MD Fagioli L Wolff SM Komaroff AL 1997 Interleukin-1 beta, interleukin-1 receptor antagonist, and soluble interleukin-1 receptor type II secretion in chronic fatigue syndrome. J. Clin. Immunol 17; 253-261.

Chan JM, Stampfer MJ, Ma J, Gann PH, Gaziano JM, Giovannucci EL. 2001 Dairy products, calcium, and prostate cancer risk in the Physicians' Health Study. Am J Clin Nutr 74(4):549-54.

Charalampous FC 1971 Metabolic functions of myoinositol: VIIII - Role of inositol in Na+-K+ transport and in Na+ and K+ activated adenosine triphosphate of KB cells. Journal of Biol. Chem> 246; 455 & 461.

Chaudhuri A Watson WS Peam J Behan PO 2000 The symptoms of chronic fatigue syndrome are related to abnormal ion channel function. Medical Hypotheses 54; 59-63.

Clapp LL, Richardson MT, Smith JF, et al. Acute effects of thirty minutes of light-intensity, intermittent exercise on patients with chronic fatigue syndrome. Phys. Ther. 1999;79:749–56.

Clark MR Katon W Russo J Kith P Sintay M Buchwald D 1995 Chronic fatigue: risk factors for symptom persistance in a 2 and one half year study. Am. J. Med. 98; 187-195.

Classen HG Marquardt P Spath M Schumacher KA Grabling B 19?? Experimental studies on the intestinal uptake of organic and inorganic magnesium and potassium compounds given alone or simultaneously. Arzeneim Forsch. 28 807-811.

Coutts R Weatherby R Davie A 2001The use of a symptom "self report" inventory ro evaluate the acceptability and efficiency of a walking program for patients suffering with chronic fatigue syndrome. J. Psychosom. Res. 51; 425-29.

Cox IM, Campbell MJ, Dowson D. 1991 Red blood cell magnesium and chronic fatigue syndrome. Lancet Mar 30;337(8744):757-60.

Cross ML Stevenson LM Gill HS 2001 Anti-allergy properties of fermented foods: an important immunoregulatory mechanism of lactic acid bacteria? International Immunopharmacology 1; 891-901.

Dahl, et al 1972 Influence of dietary potassium and sodium/ potassium molar ratios on the development of salt hypertension. Journal of Experimental Medicine 136; 318-330.

Dahle LO Berg G Hammar M Hurtig M Larsson L 1996 The effect of oral magnesium substitution on pregnancy induced cramps. American Journal of Obstet. Gynecol. 175; 233-234.

Davis DR 1997 Some algae are potentially adequate sources of vitamin B-12 for vegans. J Nutr. 127(2); 378; discussion 380

DeFreitas E Hilliard B Cheney PR Bell DS Kiggunde E Sankey D Wroblewska Z Palladino M Woodward JP Koprowski H 1991 Retroviral sequences related to human T-lymphotropic virus type II in patients with chronic fatigue immune dysfunction syndrome. Proc. Natl. Acad. Sci. 88; 2922-2926.

Demitrack MA, Dale JK, Straus SE, Laue L, Listwak SJ, Kruesi MJ, Chrousos GP, Gold PW 1991 Evidence for impaired activation of the hypothalamic-pituitary-adrenal axis in patients with chronic fatigue syndrome. J. Clin Endocrinol. Metab. 73(6): 1224-34.

Department of Health, Education and Welfare 1969-1970 Cumulative percentage diet of thiamine intake values of females sixty years of age and older. Tennessee State Nutrition Survey DHEW Public No.(HSM) 72-8133 pv296 (table 30)

Dennis K 1990 Naltrexone. GMHC Treatment Issues; Volume 4 no. 1.

Donaldson M Speight N Loomis S 2001 Fibromyalgia syndrome improved using mostly raw vegetarian diet: an observational study. BMC Complimentary and Alternative Medicine 1;7.

Dow, Steven W., DVM, et al 1992 Taurine Depletion and Cardiovascular Disease in Cats Fed a Potassium-Depleted, Acidified Diet, l, American Journal of Veterinary Research, 53(3):402-405.

Dyckner T 1990 Relation of cardiovascular disease to potassium and magnesium deficiencies. Am. Journal of Cardiol. 65; 44k-46k.

Dyckner T Nyhlin H Wester PO 1985 Aggravation of thiamine deficiency by magnesium depletion.Acta Me. Scand. 218; 129-131. Eaton, K.K. and Hunnisett 1001 A Abnormalities in Essential Amino Acids in Patients With Chronic Fatigue Syndrome, Journal of Nutritional Medicine, 12:369-375.

Eby GA 1997 Zinc ion availability---the determinant of efficacy in zinc lozenge treatment of common colds. Chemother Oct. 40 (4); 483-493.

Emsley J, et al 1981 An unexpectedly strong bond: Ab initio calculations and spectroscopic studies of amide fluoride systems. Journal of the American Chemical Society 103; 24-28.

Englebienne P (Corresponding Author), M. Verhas, C. V. Herst and K. De Meirleir. 2003 Type I interferons induce proteins susceptible to act as thyroid receptor (TR) corepressors and to signal the TR for destruction by the proteasome: possible etiology for unexplained chronic fatigue. Medical Hypotheses 60, Issue 2; 175-180

Erdman JS 2001 Lead investigator Dr. Joel S. Edman of the Center for Integrative Medicine at Thomas Jefferson University Hospital in Philadelphia, Pennsylvania, presented the findings at the annual meeting of the American College of Nutrition in Orlando, Florida.

Evengard B Schacterle RS Komaroff 1999 Chronic fatigue syndrome: new insights and old ignorance. Journal Intern. Med. 246; 455-469.

Evans D 2005 Suppression of the acute-phase response as a biological mechanism for the placebo effect. Medical Hypotheses 64;1-7

Fagin D 2008 Second thoughts about fluoride. Scientific American, January issue.

Field T 2002 J Clinical Rheumatology. 8(2):72-76.

Fitzhugh DG Knudsen L Nelson A 1946 The chronic toxicity of sulfites J. Pharm. Exptl. Therap. 86; 37-48

Folis RH 1942 Myocardial necroses in rats on a potassium low diet prevented by thiamine deficiency. Bulletin Johns Hopkins Hosp.71; 235-241

Foran SE, James G. Flood, Kent B. Lewandrowski, 2003 Measurement of Mercury Levels in Concentrated Over-the-Counter Fish Oil Preparations: Is Fish Oil Healthier Than Fish? Archives of Pathology and Laboratory Medicine: Vol. 127, No. 12, pp. 1603–1605.

Fujita T Ando K Nod H Ito Y Sato Y 1987 Effects of increased adrenomedullary activity and taurine in young patients with borderline hypertension. Circulation 75; 525-532.

Fullea S, Beliab S, Vecchieta J, Morabitoa C, Vecchieta L, and Fano G 2003 Modification of the functional capacity of sarcoplasmic reticulum membranes in patients suffering from chronic fatigue syndrome Neuromuscular Disorders 2003; 13: 479–484.

Gaby AR 2002 Altern. Med. Rev. 7; 389-403.

Gaudin-Harding F, Claverie-Benureau S, Armier J, Davy J, Lebel B.Aromatic amines (serotonin and histamine) and magnesium deficiency in the rat. 1980 Int J Vitam Nutr Res. 1980;50(2):185-92.

Gerard SK Hernandez C Khayarn-Bashi H 1989 Extreme hypermagnesia caused by an overdose of magnesium-containing cathartics. Ann. Emerg. Med. 17; 728-731.

Gherardi RK 2003 Lessons from macrophagic myofasciitis: towards definition of a vaccine adjuvant-related syndrome [Article in French]Journal: Rev Neurol (Paris) Feb;159(2):162-4.

Ghosh HN Glover WE Hutchison KJ 1963 The effect of introarterial potassium chloride infusioons on vascular reactivity in the human hand. Journal Phys. , London, 168.

Glerup H, Mikkelsen K, Poulsen L, Hass E, Overbeck S, Thomsen J, Charles P, Eriksen EF 2000 Commonly recommended daily intake of vitamin D is not sufficient if sunlight exposure is limited. J Intern Med. 2000 Feb;247(2):260-8.

Golf SW, et al. 1998 On the Significance of Magnesium in Extreme Physical Stress, Cardiovasc Drugs Ther, 12;197-202.

Gotze FR Thid SK Kyllerman M 1998 Fibromyalgia in hyperkalemic periodic paralysis. Scand. Journal of Rheumatol. 27; 383-384.

Gould SE, ed 1968 Pathology of the Heart and Blood Vessels - 3rd ed. Charles C. Thomas, Springfield, Ill 508.

Grace ND O'Dell BL 1970 Effect of magnesium deficiency on the distribution of water and cations in the muscle of the guinea pig. J. Nutr. 100; 45-50

Griffith RS, DeLong DC, Nelson JD 1981 Relation of arginine-lysine antagonism to herpes simplex growth in tissue culture. Chemotherapy ;27(3):209-13.

Griffith RS, Walsh DE, Myrmel KH, Thompson RW, Behforooz A 1987 Success of L-lysine therapy in frequently recurrent herpes simplex infection. Treatment and prophylaxis. Dermatologica ;175(4):183-90.

Grimm H, Mayer K, Mayser P, Eigenbrodt E. 2002 Regulatory potential of n-3 fatty acids in immunological and inflammatory processes. Br J Nutr. Jan;87 Suppl 1:S59-67.

Grinde B 2008 Is chronic fatigue syndrome caused by a rare brain infection of a common, normally benign virus? Medical Hypotheses 71; 270-274.

Groom NC 2010 Absence of xenotropic murine leukaemia virus-related virus in UK patients with chronic fatigue syndrome.. Retrovirology 7; 10.

Gusi N, Tomas-Carus P, Hakkinen A, Hakkinen K, Ortega-Alonso A. Arthritis Rheum. 2006 Feb 6;55(1):66-73 [Epub ahead of print]

Hadhazy VA Ezzo J Creamer P Berman BM 2000 Mind-body therapies for the treatment of fibromyalgia; a systematic review. J. Rheumatol. 27; 2911-8.

Hansen C.R. Jr., 1983 Copper and zinc deficiencies in association with depression and neurological findings Biological Psychiatry 18 (3): p. 395-401.

Hanson, D.E.; Murphy, P.A.; Silicano, R.; Shin, H.S. 1983 The effect of temperature on the activation of thymocytes by interleukin I & II. Journal of Immunol. 130: 216, 1983.

Heim C 2006 Early Adverse Experience and Risk for Chronic Fatigue Syndrome: Results From a Population-Based Study. Journal: Arch Gen Psychiatry. 63; 1258-1266.

Heim C. Nater UM Maloney E Boneva R Jones JF Reeves WC 2009 Childhood Trauma and Risk for Chronic Fatigue Syndrome: Association With Neuroendocrine Dysfunction. Journal: Arch Gen Psychiatry. 66(1):72-80.

Authors: Christine Heim, PhD; Dieter Wagner, PhD; Elizabeth Maloney, MS, DrPH; Dimitris A. Papanicolaou, MD; Laura Solomon, MPH; James F. Jones, MD; Elizabeth R. Unger, MD, PhD; William C. Reeves, MD, MSc Hendricks SB 1964 Salt transpoty across cell membranes. Amer. Sci 52; 306.

Hinds G, Bell NP, McMaster D, McCluskey DR. 1994 Normal red cell magnesium concentrations and magnesium loading tests in patients with chronic fatigue syndrome. Ann. Clin. Biochem. Sep;31(Pt 5):459-61.

Holmes GP et al 1987 A cluster of patients with a Chronic Mononucleosis-like Syndrome: Is Epstein-Barr virus the cause? Journal of the American Medical Association 257; 2297-302.

Hove EL and Herndon JF 1953 Potassium deficiency in the rabbit as a cause of muscular dystrophy. J Nutr. 55; 363-374.

Hong C-Z et al 1993 Immediate effects of various physical medicine modalities on pain threshold of active myofascial trigger points. J Musculoskeletal Pain 1(2)pp37-53

Huisman A M White KP Algra A Harth M Vieth R Jacobs JWG Bijlsma JWJ Bell DA 2001 Vitamin D Levels in Women with Systemic Lupus Erythematosus and Fibromyalgia.J of Rheumatology, Vol. 28: No. 11, November 2001 pp. 2535-9.

Irwin M, Costlow C, Williams H, Artin KH, Chan CY, Stinson DL, Levin MJ, Hayward AR, Oxman MN: Cellular immunity to varicella-zoster virus in patients with major depression J Infect Dis 1998 Nov;178 Suppl 1:S104-8.

Jenthoft ES Kvalik AG Mengshoel AM 2001 Effects of pool based and land-based aerobic exercise on women with fibromyalgia / chronic widespread pain. Arthitis Rheum. 45; 42-7.

Johnson H 1997 Osler's Web. Penguin's Books, Ontario Canada.

Imbierowicz K, Egle UT 2003 Childhood adversities in patients with fibromyalgia and somatoform pain disorder. Eur J Pain 2003;7(2):113-9.

Johnson S 2001 the multifaceted and widespread pathology of magnesium deficiency. Medical Hypotheses 56; 163-170.

Karlin A Jones DG 1993 Treatment of ciguatera fish poisoning with intravenous mannitol. ASHP Annual Meeting Vol. 50 ISS Jun, PP-30D,(REF)

Kelley DS. 2001 Modulation of human immune and inflammatory responses by dietary fatty acids. Nutrition. Jul-Aug;17(7-8):669-73.

Kim SH, Kim DH, Oh DH, Clauw DJ. 2008 Characteristic electron microscopic findings in the skin of patients with fibromyalgia--preliminary study. Clin Rheumatol. 3;:407-11.

Klein R, Bänsch M, Berg PA. 1992 Clinical relevance of antibodies against serotonin and gangliosides in patients with primary fibromyalgia syndrome. Psychoneuroendocrinology. Nov;17(6):593-8.

Klevay LM Christopherson DM 2000 Copper deficiency halves serum dehydroepiandrosterone in rats. Journal of Trace Elements in Medicine and Biology 14 (3); 143-145.

Kluger MJ 1978 The evolution and adabtive value of fever. Am. Scientist 66; 38-43.

Knook L, Kavelaars A, Sinnema G, Kuis W, Heijnen CJ. High 2000 Nocturnal melatonin in adolescents with chronic fatigue syndrome. The Journal of Clinical Endocrinology & Metabolism Vol. 85, No. 10 3690-3692.

Knox K 2011 No evidence of murine-like gammaretroviruses in CFS patients previously identified as XMRV-infected. Science 333; 94-101.

Krapf MW Muller S Mennet P Stratz T Samborski W Muller W 1992 Recording muscle spasm in the musculus erector spinae using in vivo 31P magnetic resonance spectroscopy in patients with chronic lumbalgia and generalized tendomyopathies Z Rheumatol. 51(5):229-37.

Kuratsune H., Yamaguti, K., Sawada, M., Kodate, S., Machii, T., Kanakura, Y and Kitani, T. 1998 Dehydroepiandrosterone sulfate deficiency in chronic fatigue syndrome. International Journal of Molecular Medicine, 1, 1, 143-146.

Kuzdenbaeva R. S., et al. 1980 Effect of anabolic substances on the state of the individual components of the glutathione-ascorbic acid system. Farmakol Toksikol. 43(5):607-609.

Labott SM, Ahleman S, Wolever ME, Martin RB. 1990 The physiological and psychological effects of the expression and inhibition of emotion. Behav Med. 1990 Winter;16(4):182-9.

Ladefoged K Hagen K 1988 Correlation between concentrations of magnesium, zinc, and potassium in plasma, erythrocytes and muscles. Clin. Cim. Acta 177; 157-166.

Levallois P 2002 Hypersensitivity of human subjects to environmental electric and magnetic field exposure: a review of the literature. Environ Health Perspect. 2002 Aug;110 Suppl 4:613-8.

Lawson K & Eisinger J (2001) Pharmacological agents to treat Fibromyalgia Syndrome, Exp. Opin. Invest. Drugs, in press.

Lawson K (2000) Is there a role for potassium channel openers in neuronal ion channel disorders? Exp Opin Investl. Drugs 9(10) 2269-2280.

Lawson K, Barras M, Armstrong JM & Hicks PE (1997) Effects of K channel inhibitors and antagonists on NS-004 evoked relaxations in guinea-pig isolated trachea. Fundam. Clin Pharacol 11, 78-82.

Lawson K (1996) Potassium channel activation: a potential therapeutic approach? Pharmacol. Ther., 70, 39-63.

Lawson K & Hicks PE (1993) Potassium channel openers: Pharmacological anomalies suggest heterogeneous sites of action. Curr. Opin. Invest. Drugs, 2, 1209-1216.

Levine PH Klimas N Armitage R Fredericks R Stewart J Torch W Schwartz S Suhadolnik R Reichenbach NL Rhodes L 2001 Nevada Chronic Fatigue Syndrome Consensus Conference. Journal: J of Chronic Fatigue Syndrome, . 9 (1/2) , pp. 53-62.

Li W Tian Y Feng H Tu B 1998 Effects of taurine and extraction of cristata L on serum Zn, Cu and Ca in rats. Wei Sheng Yan Jiu (Journal of Hygiene Research) 30, 27(5) 341-243. (article in Chinese)

Lieberman, S 2004 Antiviral intervention for chronic fatigue syndrome. Townsend Letter for Doctors and Patients.Feb. and Mar. 247/248; p74.

Liu PT Stenger S Li H Wenzel L Tan BH Krutzik SR Ochoa MT Schauber J Wu K Meinken C Kamen DL Wagner M Bals R Steinmeyer Zugel U Gallo RL Eisenberg D Hewison M Hollis BW Adams JS Bloom BR Modlin RL 2006 Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response. Science 311; 1770-1773.

Logan AC, Beaulne TM 2002 The treatment of small intestinal bacterial overgrowth with enteric-coated peppermint oil: A case report. Journal: Altern. Med. Rev. Oct;7(5):410-417.

Logan AC, Venket Rao A, Irani D 2003 Chronic fatigue syndrome: lactic acid bacteria may be of therapeutic value. Medical Hypotheses 2003 Jun;60(6):915-23.

Lu Y, Sun ZR, Wu LN, Wang X, Lu W, Liub SS 2000 Effect of high fluoride water on intelligence in children. Fluoride 33; 74-78.

Luft FC Zemel MB Sowers JA Fineberg NS Weinberger MH 1990 Sodium bicarbonate and sodium chloride: effects on blood pressure and electrolyte homeostasis in normal and hypertensive man. Journal of Hypertension 8; 663-670.

Lund, I., Lundeberg, T., Carleson, J., Sonnerfors, H., Uhrlin, B. and E. Svensson. 2006. Corticotropin releasing factor in urine – a possible biochemical marker of fibroymalgia. Responses to massage and guided relaxation 403, 166-71.

MacIntyre I & Davidson D 1958 The production of secondary potassium depletion, sodium retention, nephrocalcinosis and hypercalcemia by magnesium deficit. Biochem. Journal 70; 456-462.

Maekawa, K., Clark, G. and T. Kuboki. 2002. Intramuscular hypoperfusion, adrenergic receptors and chronic muscle pain. The Journal of Pain 3, 251-260.

Maes M, Mihaylova I, Leunis J-C 2006 Increased serum IgA and IgM against LPS of enterobacteria in chronic fatigue syndrome (CFS): Indication for the involvement of gram-negative enterobacteria in the etiology of CFS and for the presence of an increased gut-intestinal permeability. Journal: J Affect Disord. Sep 26; [Epub ahead of print]

Magaldi M, Moltoni L Biasi G Marcolongo R 2000 Role of intracellular calcium ions in the physiopathology of fibromyalgia syndrome. Boll Soc Ital Biol Sper Jan-Feb;76(1-2):1-4.

Magaldi M, Moltoni L Biasi G Marcolongo R 2000 Role of intracellular calcium ions in the physiopathology of fibromyalgia syndrome. Boll Soc Ital Biol Sper Jan-Feb;76(1-2):1-4.

Matsushita K, Masuda A, Tei C. 2008 Efficacy of Waon therapy for fibromyalgia. Intern Med. 47(16):1473-1476. Epub 2008 Aug 15.

Manitius A 1965 Some physiological effects of magnesium deficiency p28. in: Electrolytes and Cardiovascular Diseases, Bajusz E, editor. S. Karger, New York.

Masters RD and Coplan M 1998 Water Treatment with Silicofluorides and enhanced lead uptake, Fluoride, Vol. 31, No 3, Aug,

McCarty 2004 Should we restrict chloride rather than sodium? Medical Hypotheses 63; 138-148.

McCarty MF 2006 Rationale for a novel neutraceutical complex K-water: potassium taurine bicarbonate (PTB) Medical Hypotheses 67; 65-70.

Mannerkopf K , Ahlmen M, Ekdahl C 2002 Six- and 24-month follow-up of pool exercise therapy and education for patients with fibromyalgia. Scand J Rheumatol 2002;31(5):306-10.

Marcel B, Komaroff AL, Fagioli LR, Kornish RJ 2nd, Albert MS. 1996 Cognitive deficits in patients with chronic fatigue syndrome. Biol Psychiatry 1996 Sep 15;40(6):535-41.

Masterjohn C 2007 vitamin D toxicity redefined: vitamin K and the molecular mechanism. Medical Hypotheses 68; 1026-1034.

Masuda A Kihara T Fukudome T Shinsato T Minagoe S Tei C The effects of repeated thermal therapy for two patients with chronic fatigue syndrome. Journal of Psychosomatic Research 58, 4; 383-387.

McCarty 2004 Should we restrict chloride rather than sodium? Medical Hypotheses 63; 138-148 McCune MA, Perry HO, Muller SA, O'Fallon WM 1984 Treatment of recurrent herpes simplex infections with L-lysine monohydrochloride. Cutis Oct;34(4):366-73.

McDonald JT Margen S 1979 Wine vs etanol in human nutrition. Fluid sodium and potassium balance. American journal of Clinical Nutrition 32; 817-822

Melby JC et al 1972 18-hydroxy 11 deoxycorticosterone (18 OH-DOC) secretion in experimental and human hypertension. Recent Progress in Hormone Research. 28; 287-351, on page 323.

Mengshoel AM Haugen M 2001 Health status in fibromyalgia - a follow up study. J. Rheumatol. 28; 2085-9.

Messerli FH, et al 1977 Effects of angiotensin II on steroid metabolism and hepatic blood flow in man. Circ. Res 40; 204-207.

Merchant RE Andre CA Wise CM 2001 Nutritional Supplementation with Chlorella pyrenoidosa for Fibromyalgia Syndrome: A Double-Blind, Placebo Controlled, Crossover Study. Journal: J of Musculoskeletal Pain, Vol. 9(4) ; 37-54.

Mineno T 1969 Effect of some vitamins and other substances on K metabolism in the myocardia of vitamin deficient rats - Experiemtal investigation. J. Nagoya Med. Assoc. 92; 80-95.

Mittedorf R et al 2005 Brain lesions in newborns exposed to high-dose of magnesium sulfate during preterm labor. J. Perinatol.

Murphy BE, Abbott FV, Allison CM, Watts C, Ghadirian AM. 2004 Elevated levels of some neuroactive progesterone metabolites, particularly isopregnanolone, in women with chronic fatigue syndrome. Journal: Psychoneuroendocrinology. Feb;29(2):245-68.

Nasralla M, Haier J, Nicolson GL.1999 Multiple mycoplasmal infections detected in blood of patients with chronic fatigue syndrome and/or fibromyalgia syndrome. Eur. J. Clin. Microbiol. Infect. Dis. Dec;18(12):859-65.

Nater, et al 2007 Attenuated Morning Salivary Cortisol Concentrations in a Population-based Study... J Clin Endocrinol Metab.

Neumann L, Buskila D. 2003 Epidemiology of fibromyalgia. Curr Pain Headache Rep. Oct;7(5):362-8.

Nicolson, GL. Nasralla, MY, De Meirleir K, Gan, R., Haier J 2003 Evidence for Bacterial and Viral Co-Infections in Chronic Fatigue Syndrome Patients. Journal of Chronic Fatigue Syndrome 2003; 11(2):7-20.

Nijs J Nicolson GI De Becker P Coomans D De Meirleir K 2002 High prevalence of Mycoplasma infections among European chronic fatigue syndrome patients. FEMS Immumol. Med. Microbiol. 34; 209-214.

Nikkels AF, Pierard GE.1994 Recognition and treatment of shingles. Drugs. Oct;48(4):528-48.

[No authors listed] 2001 DHEA. Monograph. Altern Med Rev. 2001 Jun;6(3):314-8

Orcel P, et al 1990 Stress fractures of the lower limbs in osteoporotic patients treated with fluoride. Journal of Bone and Mineral Research 5 Suppl 1:S191-4.

Paiva ES, Deodhar A, Jones KD, Bennett R. 2002 Arthritis Rheum May;46(5):1344-50.

Pall ML. 2001 Cobalamin used in chronic fatigue syndrome therapy is a nitric oxide scavenger. J Chronic Fatigue Syndrome 8(2):39-44.

Pall ML. 2002 NMDA sensitization and stimulation by peroxynitrite, nitric oxide, and organic solvents as the mechanism of chemical sensitivity in multiple chemical sensitivity. FASEB J 16; 1407-1417.

Pall ML. 2003 Elevated nitric oxide/peroxynitrite theory of multiple chemical sensitivity: central role of N-methyl-D-aspartate receptors in the sensitivity mechanism. Environ Health Perspect. 2003 Sep;111(12):1461-4.

Pall ML, Satterlee JD 2001 Elevated nitric oxide/peroxynitrite mechanism for the common etiology of multiple chemical sensitivity, chronic fatigue syndrome, and posttraumatic stress disorder. ANN NY ACAD SCI 933: 323-329.

Parcell S. 2002 Sulfur in human nutrition and applications in medicine. Altern Med Rev. 2002 Feb;7(1):22-44.

Patarca R Klimas NG Lugtendorf S Antoni M Fletcher MA 1994 Dysregulated expression of tumor necrosis factor in chronic fatigue syndrome interelations with cellular sources and patterns of soluble immune mediator expression. Clin Infect. Dis. Jan 18 Suppl. 1; s147-s153.

Patarca-Monero, R, Klimas, NG and Fletcher, MA. 2001 Immunotherapy of chronic fatigue syndrome: therapeutic interventions aimed at modulating the Th1/Th2 cytokine expression balance. Journal of Chronic Fatigue Syndrome, , 8, 1, 3-37.

Patnaik M Komaroff AL Conley E Ojo-Amaize EA Peter JB 1995 Prevalence of IgM antibodies to human herpesvirus 6 early antigen (p41/38) in patients with chronic fatigue syndrome. J. Infect. Dis. 172; 1364-67.

Pendrys DG Katz RV 1989 Risk of enamel fluorosis associated with fluoride supplementation, infant formula and fluoride dentifrice use. American Journal of Epidemiology 130; 1199-1208.

Petersen VP 1963 Potassium and magnesium turnover in magnesium deficiency. Acta Med. Scand. 174; 595-604.

Plotnikoff GA, Quigley JM. 2003 Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clin Proc ;78:1463-70.

Pratt R, Johnson E 1966 Production of pantothenic acid and inositol by Chlorella vulgaris and C. pyrenoidosa. J Pharm Sci. 1966 Aug;55(8):799-802.

Prins MA, Woertman L, Kool MB, Geenen R. 2006 Sexual functioning of women with fibromyalgia.. Clin Exp Rheumatol. 2006 Sep-Oct;24(5):555-61.

Racciatti D Vecchiet J Ciccomancini A Ricci F Pizzigallo E 2001 Chronic fatigue syndrome following toxic exposure. Sci. Total Environ. 270; 27-31.

Rogers, Sherry 1992 Chemical Sensitivity: Breaking the Paralyzing Paradigm: How Knowledge of Chemical Sensitivity Enhances The Treatment of Chronic Disease. Internal Medicine World Report, 7(8):13-41.

Rude RK1998 Magnesium Deficiency: A Cause of Heterogenous Disease in Humans," K., Journal of Bone and Mineral Research, 13(4):749-758.

Rangel L, Garralda ME, Hall A, Woodham S. 2003 Psychiatric adjustment in chronic fatigue syndrome of childhood and in juvenile idiopathic arthritis. Journal: Psychol Med Feb;33(2):289-97.

Rauma AL, Torronen R, Hanninen O, Mykkanen H 1995 Vitamin B-12 status of long-term adherents of a strict uncooked vegan diet ("living food diet") is compromised. J Nutr. 125(10); 2511-5.

Richardson J 2002 Myalgic Encephalomyelitis: Guidelines for Doctors. Journal:of Chronic Fatigue Syndrome 10(1) 2002. 65-80

Rier, S and WG Foster. 2002. Environmental dioxins and endometriosis. Toxicological Sciences 70:161-170.

Ritchie G, Kerstan D, Dai LJ, Kang HS, Canaff L, Hendy GN, Quamme GA 2001 1,25(OH)(2)D(3) stimulates Mg2+ uptake into MDCT cells: modulation by extracellular Ca2+ and Mg2+. Am J Physiol Renal Physiol. 2001 May;280(5):F868-78.

Roberts ADL Wessely S Papadopoulos A Cleare AJ 2004 Salivary cortisol response to awakening in chronic fatigue syndrome. British Journal Psychiatry 184; 136-141.

Russell IJ, et al 1995 Treatment of fibromyalgia syndrome with super mali: a randomized, double blind, placebo controlled, crossover pilot study. J. Rheumatol. 22; 953-958.

Ryan MP Whang R 1983 Interrelationships between potassium and magnesium. In; Potassium: Its Biologic Significance. CRC Press, Boca Raton, FL.

Sacerdote P Manfredi B Gaspani L Panerai AE 2000 The opioid antagonist naloxone induces a shift from type 2 to type 1 cytokine pattern in BALB/cJ mice. Blood. 2000 Mar 15;95(6):2031-6.

Schlebusch, H., et al, 1992 Bioavailability of Magnesium as Magnesium-Orotate and Magnesium- Hydroxycarbonate", Med Welt, 43; 523-8.

Schochat T, Beckmann C 2003. Sociodemographic characteristics, risk factors and reproductive history in subjects with fibromyalgia - results of a population-based case-control study.[Article in German] Z Rheumatol Feb;62(1):46-59.

Schwartz A, Perez-Canto A. 1998 Nephrotoxicity of antiinfective drugs. Int. J. Clin. Pharmacol. 36(3):164-7.

Scott LV Dinan TG 1999 Small adrenal glands in chronic fatigue syndrome: a preliminary computer tomograph study psychoneuroendocrinology 24; 759-768.

Scott LV Svec F Dinan T 2000 A preliminary study of dehydroepiandrosterone response to low dose ACTH in chronic fatigue syndrome and in healthy subjects. Psychiatry Research. 97; 21-8.

Schlebusch, H., et al, 1992 Bioavailability of Magnesium as Magnesium-Orotate and Magnesium- Hydroxycarbonate", Med Welt, 43; 523-8.

Schwartz RB, Garada BM, Komaroff AL, Tice HM, Gleit M, Jolesz FA, Holman BL. 1994 Detection of intracranial abnormalities in patients with chronic fatigue syndrome: comparison of MR imaging and SPECT. Am. J.

Shephard RJ 2001 Chronicfatigue syndrome: an update. Sports Medicine 31; 167-194.

Sharma YD, 1982 Effect of Sodium Fluoride on Collagen Cross-Link Precursors, Toxicological Letters, Vol. 10, pp. 97-100.

Susheela AK and Mukerjee D, 1981 Fluoride poisoning and the Effect of Collagen Biosynthesis of Osseous and Nonosseous Tissue," Toxicological European Research, Vol. 3, No.2, pp. 99-104.

Simopoulos AP. The importance of the ratio of omega-6/omega-3 essential fatty acids. Biomed Pharmacother. 2002 Oct;56(8):365-79.

Sinaii N, Cleary SD, Ballweg ML, Nieman LK, Stratton P 2002 Journal: Hum Reproduction Oct;17(10):2715-2724. (from the abstract)

Singer AJ, Gulla J Thode HC Jr. 2002 Parents and practitioners are poor judges of young children’s pain severity. Academic Emergency Medicine 9; 609-612.

Smith JD, Terpening CM, Schmidt SO, Gums JG 2001 Relief of fibromyalgia symptoms following discontinuation of dietary excitotoxins. Ann Pharmacother. Jun;35(6):702-6.

Smith JP, M.D.,1 Heather Stock, M.D.,1 Sandra Bingaman, R.N.,1 David Mauger,Moshe Rogosnitzky,3 and Ian S. Zagon, 2007 Low-Dose Naltrexone Therapy Improves Active Crohn’s Disease. American Journal of Gastroenterology by Am. Coll. of Gastroenterology doi: 10.1111/j.1572-0241.2007.01045.x

Smits, MG van Rooy R. Nagtegaal, JE 2002 Influence of Melatonin on Quality of Life in Patients with Chronic Fatigue and Late Melatonin Onset. Journal: J of Chronic Fatigue Syndrome, Vol. 10(3/4) 2002, pp. 25-36.

Staud R, Robinson ME, Vierck CJ, Price DD 2003 Diffuse noxious inhibitory controls (DNIC) attenuate temporal summation of second pain in normal males but not in normal females or fibromyalgia patients. Pain 2003 Jan;101(1-2):167-74.

Steele L 2000 Prevalence and patterns of Gulf war illness in Kansas veterans: association of symptoms with characteristics of person, place, and time of military service. Am J Epidemiol. 152; 992-1002. Ibid idem 2001;154:406-7.

Sterzl I, Prochazkova J, Hrda P, Bartova J, Matucha P, Stejskal VD. 1999 Mercury and nickel allergy: risk factors in fatigue and autoimmunity. Neuroendocrinol Lett.;20(3-4):221-228.

Strobel ES Krapf M Suckfull M Bruckle W Fleckenstein W Muller W 1997 Tissue oxygen measurement and 31P magnetic resonance spectroscopy in patients with muscle tension and fibromyalgia. Rheumatol Int. 16(5):175-80.

Tavera-Mendoza LE White JH 2007 Cell defenses and the sunshine vitamin. Scientific American 297; 62-72.

Roentgenol. 1994 Apr;162(4):935-41.

Schwarz A, Perez-Canto A. 1998 Nephrotoxicity of antiinfective drugs Int. J. Clin. Pharmacol. Ther. 36(3):164-7.

Taylor, S. E., Klein, L.C., Lewis, B. P., Gruenewald, T. L.,Gurung, R. A. R., Updegraff, J. A. 2000. Female Responses to Stress: Tend and Befriend, Not Fight or Flight. Psychological Review, 107(3),41-429.

Teitelbaum JE Johnson C St. Cyr J 2006 The Use of D-Ribose in Chronic Fatigue Syndrome and Fibromyalgia: A Pilot Study. The Journal of Alternative and Complementary Medicine Vol. 12, No. 9 : 857 –862.

Tejada-Simon MV Lee JH Ustunol Z Pestka JJ 1999 Ingestion of Yogurt Containing Lactobacillus acidophilus and Bifidobacterium to Potentiate Immunoglobulin A Responses to Cholera Toxin in Mice. Journal of Dairy Science 82; 649-660.

Thiel R. Fowkes SW 2007 Down syndrome and thyroid dysfunction: should nutritional support be the first-line treatment? Medical Hypotheses 69; 809-815.

Thompson AD (2000) Mechanisms of vitamin deficiency in chronic alcohol misusers and the development of the Wernicke-Korsakoff syndrome. Alcohol Alcohol Suppl. 35: 2-7.

Thornalley P. et al. (2007) High prevalence of low plasma thiamine concentration in diabetes linked to a marker of vascular disease. Diabetologia 50:2164–2170.

Tiersky LA, Matheis RJ, Deluca J, Lange G, Natelson BH. 2003 Functional status, neuropsychological functioning , and mood in chronic fatigue syndrome (CFS) Relationship to psychiatric disorder. J Nerv Ment Dis. 2003 May;191(5):324-331.

Ting JY, Brown AF 2001 Ciguatera poisoning: a global issue with common management problems. Eur J Emerg Med. 2001 Dec;8(4):295-300.

Tomoda A Jhodoi T Miike, T 2001 Chronic Fatigue Syndrome and Abnormal Biological Rhythms in School Children. Journal of Chronic Fatigue Syndrome, Vol. 8 (2); 29-37.

Tyrer SP Delves HT Weller MP 1979 CSF copper in schzophrenia. American Journal of Psychiatry 136; 937-939.

Ulrich F 1958 Studies of the metabolism in vivo of cortisol by the rat liver. The Biochemical Journal 68; 361-367.

Ulrich F 1959 Ion transport by heart and skeletal muscle mitochondria. Amer. Journal Phys.197; 997.

Urowitz MB 2001 How Do I Know Thee.? Let Me Count the Ways. The Varieties of Medical Evidence. Journal of Rheumatology, Vol. 28,. 2373

van Heukelom RO,. Prins JB,. Smits MG and. Bleijenberg G 2006 Influence of melatonin on fatigue severity in patients with chronic fatigue syndrome and late melatonin secretion. Journal: Eur J Neurol. Jan;13(1):55-60

Van Rensburg, SJ., Potocnik, FC., Kiss, T., Hugo, F., van Zijl, P., Mansvelt, E., Carstens, ME., Theodorou, P., Hurly, PR., Emsley, RA and Taljaard JJ. 2001 Serum concentrations of some metals and steroids in patients with chronic fatigue syndrome with reference to neurological and cognitive abnormalities. Brain Research Bulletin, , 55, 2, 319-325.

Varner, J.A., et al., 1984 Chronic administration of aluminum-fluoride or sodium fluoride to rats in drinking water: Alterations in neuronal and cerebrovascular integrity. Brain Medicine, Vol. 4, pp. 151-157.

Vecchiet J, Cipollone F, Falasca K, Mezzetti A, Pizzigallo E, Bucciarelli T, De Laurentis S, Affaitati G, De Cesare D, Giamberardino MA 2003.Relationship between musculoskeletal symptoms and blood markers of oxidative stress in patients with chronic fatigue syndrome. Journal: Neurosci Lett Jan 2;335(3):151-154.

Vernon SD Unger ER Dimulescu IM Rajeevan M Reeves WC 2002 Utility of the blood for gene expression profiling and biomarker discovery in chronic fatigue syndrome. Disease Markers 18; 193-199.

Vieth R 1999 Vitamin D supplementation, 25-hydroxyvitamin D concentrations and safety. American Journal of Clinical Nutrition 69; 842-856.

Visser J, Lentjes E, Haspels I, Graffelman W, Blauw B, de Kloet R, Nagelkerken L 2001 Increased sensitivity to glucocorticoids in peripheral blood mononuclear cells of chronic fatigue syndrome patients, without evidence for altered density or affinity of glucocorticoid receptors. J Investig Med 2001 Mar;49(2):195-204.

Visser, J., Graffelman, W., Blauw, B., Haspels, I., Lentjes, E., de Kloet, ER and Nagelkerken, L. 2001 LPS-induced IL-10 production in whole blood cultures from chronic fatigue syndrome patients is increased but supersensitive to inhibition by dexamethasone. Journal of Neuroimmunology, , 119, 2, 343-349.

Walker EA, Keegan D, Gardner G, Sullivan M, Bernstein D, Katon WJ. 1997 Psychosocial factors in fibromyalgia compared with rheumatoid arthritis: II. Sexual, physical, and emotional abuse and neglect. Psychosom Med 1997;59:572-577 (from the abstract).

Walsh, et al 2002 Serum potassium and risk of heart disease. Archives of Internal Medicine 162; (9) 1007-1012.

Watson, WS., McMillan, DC, Chaudhuri, A and Behan, PO. Increased resting energy expenditure in the chronic fatigue syndrome. Journal of Chronic Fatigue Syndrome, 1998, 4, 4, 3-14.

Weber CE 2006 Creation of a local ‘fever’ using an infrared lamp to cure a tooth abscess. Medical Hypotheses, Volume 68, Issue 2; 458-458.

Weglicki WB, Phillips TM 1992 Pathobiology of magnesium deficiency: a cytokine/neurogenic inflammation hypothesis. Am J Physiol. Sep;263 (3 Pt 2):R 734-737.

Weglicki WB, Mak IT, Stafford RE, Dickens BF, Cassidy MM, Phillips TM. 1994 Neurogenic peptides and the cardiomyopathy of magnesium-deficiency: effects of substance P-receptor inhibition. Mol Cell Biochem. 1994 Jan 26;130(2):103-9.

Wei W, Franz KB. 1990 A synergism of antigen challenge and severe magnesium deficiency on blood and urinary histamine levels in rats. J Am Coll Nutr. 1990 Dec;9(6):616-22.

Weisman G et al 1972 Lekocyte proteases and the immunologic release of lysosomal enzymes. American Journal of Pathology 68; 539-569.

White KP, Harth M 2001 Classification, epidemiology, and natural history of fibromyalgia. Curr Pain Headache Rep 2001 5(4);320-9.

Williams G, Waterhouse J, Mugarza J, Minors D, Hayden K 2002 Therapy of circadian rhythm disorders in chronic fatigue syndrome: no symptomatic improvement with melatonin or phototherapy. Eur J Clin Invest. 2002 Nov;32(11):831-7.

Williams MH 1999 Facts and fallacies of purported ergogenic amino acid supplements. Clin. Sports Med. 18(3) 633-649.

Wilson JL ,Adrenal Fatigue: The 21st Century Stress Syndrome. Smart Publications, PO Box 4667, Petaluma CA 94955.

Wong R Lopaschuk G Zhu G Walker D Catellier D Burton D Teo K Collins-Nakai R Montague T 1992 Skeletal muscle metabolism in the chronic fatigue syndrome. In vivo assessment by 31P nuclear magnetic resonance spectroscopy Chest. 102(6):1716-22.

Wood, et al 2007 Reduced presynaptic dopamine activity in fibromyalgia syndrome demonstrated with positron emission tomography: a pilot study. J. Pain 8; 51-58.

Woods JW Welt LG Hollander W Jr. 1961 Susceptibility of rats to experimental pyelonephritis during potassium depletion. Journal of Clinical Investigation 40; 599-602.

Yeaman.MR 1997 The role of platelets in antimicrobial host defense / Clinical Infectious Diseases 25; 951-970.

Yunus MB, Arslan S, Aldag JC 2002 Relationship between fibromyalgia features and smoking. Scand J Rheumatol. 2002;31(5):301-5

This page has been visited times
and has been updated March 2014

Contact by telephone (USA) 1 828 692 5816 --- by email; isoptera at att.net