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| Chronic Fatigue Syndrome/Myalgic Encephalomyelitis
Research Group Nutritional Support Protocol
Martin L. Pall
Main Web Page
Chronic Fatigue Syndrome/Myalgic Encephalomyelitis
Multiple Chemical Sensitivity
Other NO/ONOO- Cycle Diseases
Let me remind the reader that I am a PhD, not an MD and nothing I say or write should be viewed as medical advice. The over-the-counter supplements described here are not sold to treat or cure any disease. The statements here are not approved of by the FDA.
I designed a set of nutritional supplements with the Allergy Research Group that may be predicted to down-regulate the NO/ONOO- cycle biochemistry. Four of these products were designed explicitly for this purpose and three others were already being produced by the Allergy Research Group but fit well within the overall goals of the protocol. We are calling this that Allergy Research Group nutritional support protocol. I do receive a small royalty on sales from the Allergy Research Group and so do have a conflict of interest that the reader should be aware of. My recent suggestions for dosage regimen is as follows:
1. #75930 CoQ-Gamma E with Tocotrienols & Carotenoids: one capsule per day in the morning. Those with body weights over 100 lbs should add a second capsule at mid-day.
2. #75780 FlaviNox: one capsule, four times per day, three preferably with or after meals. Those with body weights over 120 lbs, should add a second capsule with each of three meals.
3. #75940 MVM-A Antioxidant Protocol, multivitamin mineral supplement with added N-acetyl carnitine: one capsule, four times per day, three preferably with or after meals. Those with body weights over 120 lbs, should add a second capsule, with breakfast and with dinner.
4. #75960 NAC Enhanced Antioxidant Formula: one each twice per day, with or after breakfast and supper.
5. #71250 & #73870 Super EPA (fish oil): one per day in the morning after breakfast. Those with body weights over 100 lbs, should add a second capsule at mid-day, taken with or after lunch.
6. #75910 FibroBoost (Ecklonia cava extract): one each twice per day, with or after breakfast and supper.
7. #70010 Buffered Vitamin C: one capsule, four times per day, preferably three with or after meals.
I am suggesting that the three products that are to be taken four times per day, be taken at the same times, with three being taken with or after the three meals of the day and the fourth taken at bedtime.
suggest that for those intending to try all seven, that you
start with the first, trying it alone for three days to see if
it is well tolerated, adding second for three
days, and so forth. By doing this you should
find if there are any products that are not well tolerated, such
that they can be eliminated for the time being and perhaps be
tested later with either the same or possibly lower dosage.
It will take 21 days, in this way, to get to the end of
the initial period, into a period where all tolerated products
are being taken.
You can get much more information about these products from the Allergy Research Group web site:
There are 23 distinct agents/classes of agents found in these products that are predicted to down-regulate the NO/ONOO- cycle biochemistry. Most of these predictions are discussed and documented in Chapter 15 of my book “Explaining ‘Unexplained Illnesses’”. All 23 of these are described in the following Table 1:
Agent or class Mechanism Comments
can be seen from the above-described combination of Allergy
Research Group nutritional supplements supply nutrients that
help down-regulate various aspects of the NO/ONOO- cycle.
Many act as antioxidants, lowering oxidative stress,
blocking oxidative chain reactions, and in some cases scavenging
such oxidants as peroxynitrite and superoxide or acting to
increase superoxide dysmutase activity. Some
agents act to help restore tetrahydrobiopterin (BH4) levels and
thus lower partial uncoupling of the nitric oxide synthases.
Some agents lower nitric oxide levels. Some
agents act in various ways to restore energy metabolism.
Some act to lower excitotoxicity including excessive NMDA
activity. Some act to lower certain
inflammatory aspects including lowering NF-kappa B activity or
lowering inflammatory prostaglandin synthesis. Thus
all of the various aspects of the NO/ONOO- cycle mechanism as I
have proposed it should be lowered to at least a certain extent.
The nutritional components are available in the EU as follows.
Dr. Michael Ash (in the UK)
at Nutri Link
+44(0) 8704 054 002
And in continental Europe:
(+31) 77 396 9161
It does lower essentially all aspects of the NO/ONOO- cycle mechanism and I and others have received a large number of anecdotal reports and reports from physicians and other health care providers of apparent efficacy, some with dramatic apparent responses. These reports are from patients ME/CFS, MCS and fibromyalgia and other possibly related diseases as well, such as asthma. I would estimate (and this a very rough estimate) that about 85% of the patients who use these ideas for nutritional support get distinct improvements.
However, I received feedback from patients that higher doses than I suggested earlier were better for many people, leading me to increase the suggested doses. The dosage regimen suggested at the beginning of this article included such increasing doses.
People should, in general, consider their body weight in adjusting these suggested dosages further, either up or down, so that the amount of well tolerated supplements are maintained at approximately the levels per unit body weight given here.
There appears to be one group of individuals who respond very negatively to several of the capsules in this protocol. These are patients who have a high level of mercury stored in their bodies. They apparently react negatively because the alpha-lipoic acid mobilized stored mercury, allowing it to produce increased impact on areas the the body including the brain. Unfortunately, when we formulated this protocol, we placed alpha lipoic acid in four of the different capsules. Clearly those suffering from high levels of mercury in their bodies will have to undergo thorough mercury detoxification before they can take this or similar protocols. Mercury can up-regulate the NO/ONOO- cycle because its methyl mercury metabolite can increased NMDA activity.
Agents that are designed to lower the NO/ONOO- cycle biochemistry will only be effective if people taking them can avoid agents that will otherwise raise the cycle and thus exacerbate their symptoms. Such agents that raise the cycle will include chemicals in the MCS group, excessive exercise leading to post-exertional malaise in the ME/CFS group, chronic infections particularly in the ME/CFS and fibromyalgia group, food allergens in those with food allergies, and psychological stress in many but especially in those suffering from post-traumatic stress disorder.
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Allergy Research Group Nutritional Support Protocol