PATHOPHYSIOLOGY OF CFIDS
CFIDS is a subset of a larger group of diseases, post viral syndrome or post infectious disease. Similar disease syndromes from the past are the following:
BRIEF DESCRIPTION OF THE IMMUNE SYSTEM ACTIVATION
Alpha interferon is released to defend against an intracellular invasion. This activates the three RNaseL pathways, 80kDa, 42kDa, and 37 kDa. These pathways "chew up" messenger RNA in order to kill intracellular pathogens. They are "idiot savants" in that they chew up all RNA but are more damaging to the viruses than to the human cells. No one is sure why. In CFIDS the 37 kDa is very high. Interestingly, this is not true in fibromyalgia, only in CFIDS. This may turn out to be the distinguishing marker for CFIDS.
In the body 37kDa is a disaster. It goes wild and causes a host of symptoms. It is very distructive to all human body systems including brain, muscle, liver, and heart, among others. Indeed, every organ system is affected, giving rise to the multitude of confusing symptoms which we call CFIDS. The 37kDa enzyem MAY destroy the infectious agent. However in doing so may continue doing damage to the body after the infection is gone.
Of the four systems, brain, muscle, liver, or heart, Cheney said that the damaged liver causes the most pain and fatigue. He mentioned that people with brain damage or severe heart conditions would still feel reasonably well in the framework of their disease, whereas those with liver damage would be extremely ill. This is because the liver detoxifies the GI tract, the most poisonous part of the body. The intestines, by design, must be permeable, and when they are not working right the toxins can get into the lymphatic system. This in turn poisons the brain. Reye's Syndrome is an example of a post-infectious disease which knocks out the liver.
The most toxic entity in the body is candida or yeast. It is very xenobiotic. When the liver is healthy it will clear these mycotoxins through the urine. Therefore, we can test the urine for toxins to see how the liver is functioning. Research from Australia has shown a toxin called CFSUM-1 is found in the urine of CFS patients. Since then many other toxins have been found, and they cause PAIN. The toxins produced by candidiasis are Tartaric Acid and Arabinose. Cheney described two boys diagnoses as autistic. When their urine was tested they had high levels of Tartaric Acid and Arabinose. Both boys had been on repeated antibiotics for recurring ear infections and had not been autistic until recently. They were about six years old. Tartaric Acid looks like Malic Acid and poisons cells by interferring with the Krebs Cycle. Arabinose poisons the brain. When the two boys were treated with nystatin for candidiasis they both recovered and were no longer autistic.
CFIDS resembles lupus. It elevates cytokines which, in turn, reactivate inactive infections.
CFIDS patients test low in glutathione, a substance produced by the liver. Glutathione reduces viruses and helps to remove heavy metals from the body. With low levels of glutathione heavy metals such as mercury can enter the brain and damage the hypothalamus.
Cheney discussed mercury fillings. He gave a very informative aside concerning research from Duke University. Dr. Roses worked on genes which protect or predispose to Alzheimers. The same genes which protect against Alzheimers enable the body to clear toxic mercury. Those who have this gene will never get Alzheimers and will never need to worry about being poisoned by their mercury amalgam fillings. When an audience member asked if we should have our fillings removed Cheney's advice was probably not. Those who were protected genetically didn't need it, and those who were not probably could not be helped at this point. Also, there was risk of even worse exposure by improper removal.
Cheney commented on the dangers of root canals at length. He said that
they could be a major source of unrecognized infection, poisoning the body.
He said he know of cases who totally recovered when they had their root
canalled teeth removed. Again someone asked if we should have our root
canals removed. Cheney replied that if you had one it might be worth it.
If you had several there was a great risk that the bone below the teeth
would be infected, and the risk was too great.
Neuroprotection - The brain is injured in a monotonous way. It fires at lower threshold levels. Therefore, information density will confuse, sensitivity to light, pain intensified, cannot sleep, hearing is amplified. Drugs which treat this are magnesium, klonopin, neurontin, doxapin, nicotine, and narcotics. These need to be titrated at small optimum doses different for each patient. These drug perserve the brain from damage.
Antioxident Therapy - Under heavy oxidative stress the antioxidants
shovel free electrons into a bioflavinoid buffer. The problem is if we
are deficient in bioflavinoids the free electrons will simply be freed
again to cause more damage. We need to take bioflavinoids as well as antioxidents.
Beware of iron and copper supplements. These minerals cause free radicals.
One evidence of this is that the best protection against heart disease
is donating blood twice a year or menstuating every month. This reduces
iron levels in the blood. Selenium and zinc were minerals which Cheney
recommended as functioning to reduce free radicals.
B12 shots were the treatment most CFIDS patients found to be
effective in relieving their symptoms. Two thirds of tested CFIDS patients
had no detectable levels of B12 in their brains. B12 serves to remove toxins,
especially heavy metals such as mercury, from the body. Cheney reported
on a case of cyanide poisoning in Great Britain which was treated with
massive doses of B12. The B12 bonded with the cyanide removing it from
the body and those poisoned recovered. Cheney prescribes B12 shots of 10,000
mcg to be given at bedtime. This Hydroxycabalamin is bonded with water,
not cyanide, as most B12 is. Cheney also mentioned B6, but warned not to
take the peredoxine form, as it turns into ammonia in the body. He warned
that B vitamins can feed yeast.
Liver, gut - Glutatione is useful, but Cheney did not know any
way to get an effective form of it at this time. He did not recommend any
capsules currently for sale. He also mentioned testing for toxins, staying
away from antibiotics, and treating yeast infections.
Low Molecular Weight Protein - Ampligen is an experimental drug which holds promise. Kutapressin may be another form of the same drug. Cheney mentioned three difficulties with Ampligen.
1. Treatment was only being given in 10 locations in a double blind study.
2. Treatment was very expensive. One would have to "mortgage the farm" to afford the treatment. Once off the study the medicine would cost thousands of dollars.
3. Hemisphrix would not quote their relapse rates, so Cheney quoted his own from his initial studies. 85% of his patients relapsed when they went off Ampligen.
Nevertheless, he was hopeful that Ampligen might be effective when used
over a long period of time and at optimum dosage.