Neurotoxins-Treatment Information Sheet (concept developed by Dr Shoemaker)

[Guest guest]

Neurotoxins-Treatment Information Sheet

http://www.ei-resource.org/articles/cfs-art29.asp

by Jacob Teitelbaum M.D.

www.Vitality101.com

 

 

This is a brilliant concept developed by Dr. Ritchie Shoemaker. He theorizes

that many different infections can produce toxins. These are toxic chemicals

that can persist in the body even after the infection is gone. Normally, the

body is able to excrete toxins through the liver and kidneys and eliminate

them

from the body. What makes these toxins unique is that only the liver

excretes

them. The liver excretes the toxins into your bowel (via the bile) so that

they can be eliminated from the body with your stool. Unfortunately, these

toxins

are able to be reabsorbed from the bowel and therefore cannot be eliminated

(they continue to re-circulate to the liver and then back to the blood).

 

Dr. Shoemaker believes that one common situation where this occurs is in

Lyme's disease. The Lyme infection has often already been eliminated by

using

antibiotics but the toxins continues to persist in the body. Therefore

people

continue to be ill. He also believes that many other infections, including

fungal

infections that can be found in sick building syndromes and many waterborne

infections can also produce similar toxins. It is possible that in the case

of

certain viral infections or after some traumatic injuries, the body's own

genes

may even be able to be tricked into continually making the toxins.

 

In addition to getting rid of the neurotoxins, it is important to support

the

body in two other key ways. These were developed and popularized by Dr.

Russel Jaffe Ph.D. and are called the Vitamin C flush and the " Alkaline Way

Diet " .

How to do these will be discussed below after we've discussed how to clear

the

neurotoxins.

 

So how can I test for these toxins?

 

Although there are no blood tests currently available, Dr. Shoemaker feels

that your nervous system is very sensitive to these toxins. The retina in

the

back of the eye is part of the nervous system. He uses a test that examines

the

body's ability to discern different shades of black and gray. This VCS

vision

test (called the FACT) can be done on his web site (

www.ChronicNeurotoxins.com -see this site for more info) for ~ $9. If you

see a halo/glare around

lights at night (which may cause trouble with driving), light sensitivity

during

the day, or have shooting pains, these symptoms (along with most of the

other

symptoms of CFS/fibromyalgia) are also suggestive of possible neurotoxins.

 

What is the treatment?

 

Because the liver is able to pull the toxins out of the body and excrete

them

into your bowel, the trick is to keep the toxins in your bowel so that they

go out in the stool. Fortunately, there is an old medication called Questran

(cholestyramine). It is a powder that acts like a sponge, and it used to be

prescribed to pull cholesterol out of people's bodies. Dr. Shoemaker

recommends

that people take one scoop or one packet four times a day (although not as

effective, you can sometimes get by with 3 times a day, however). Within a

month

(usually within 3 days to 2 weeks), those who are going to improve with this

treatment will often start feeling better or at least have their vision test

improve. Insomnia, pain and spastic colon symptoms can sometimes improve in

1-3

days with this treatment! If the Questran does not help symptoms or the

vision

test after 6 weeks, I have people stop the treatment. Most people are better

and can stop cholestyramine after one month, but it can take 2 months for

Lyme's

patients and those who have been ill with continuing toxin contact for a

long

time. When you improve and feel well with no further improvement in the

symptoms or vision tests for 2 weeks in a row, suggesting that all of the

toxin has

been removed from your body, you can stop treatment. If symptoms recur, it

suggests that something (e.g.- persistent infection or being in a " sick

building "

) is still making neurotoxins. This then should be treated as well. In this

situation, I would continue the medication until it is no longer needed

(e.g.

-- try stopping it or lowering the dose every month). The main problem with

Questran is that it soaks up everything. This means that you will likely not

absorb a lot of the medications or supplements you are taking if they are

taken at

the same time as the Questran. Because of this, take the

Questran/cholestyramine exactly this way:

..

 

1- Take your thyroid as soon as you wake (leave it at your bedside with a

glass of water). A half-hour later take your Daily Energy Enfusion vitamin

powder, lipoic acid 300 mg and nystatin (and Cortef if prescribed). You can

also

take any other medications that are needed for other problems at this time.

Take

the Questran one hour later (1 scoop mixed in eight ounces of apple juice or

distilled water followed by 12 ounces of distilled water). Exactly one-half

hour after taking Questran, eat something that has at least a teaspoon of

healthy

fat (e.g. -- one egg or a pat of butter). Eating makes your body pour the

neurotoxin containing bile into your gut. Eating ½ hour after the Questran

puts

the medicine right where it needs to be (like a catchers mitt) to soak up

and

bind the neurotoxins.

 

2- Also take the next 2 doses of Questran (each day) as close to a half hour

before lunch and dinner as you can. Take your last (4th) daily dose one-half

hour before bedtime and eat some turkey or an egg right at bedtime. Take

your

sleep medications/herbals an hour before the nighttime Questran.

 

3- Drink 12 ounces of water after taking the Questran. It is best if the

water is pure without any minerals. Distilled water is inexpensive and would

be a

good choice. Constipation is normally a problem while on the Questran, so

drink a lot of water and use prunes or other laxatives as needed to have at

least

1 BM a day for the time you are on it. Dr, Shoemaker uses 70% sorbitol, 1-3

tsp three times a day as needed for constipation (available by mail from

Cape

Apothecary@ 410-757-3522). Using a laxative called " Cleanse More " from

http://www.renewlife.com/ prunes, or other laxatives may be gentler (see tr

eatment

protocol for constipation treatments). You should have at least 1-2 bowel

movements every day while on the Questran. You need to keep things moving to

get

the toxin out of your body!

 

It is not uncommon for people to have their symptoms worsen -- sometimes

dramatically -- when one first kills off a chronic infection. This is called

a

Herxheimer reaction and was first noted in the early days of treating

syphilis.

Since then, it has been seen in many infections, including fungal

infections.

Interestingly, some people also experience this when they begin Questran to

remove the toxins. In speaking with Dr. Shoemaker, he recommends that those

who

flare with the Questran be tested and treated for Lyme disease and that they

take a medication called Actos 45 mg a day for 7 days before restarting the

Questran (and continue it for 3 days after resuming Questran) to decrease

the die

off reaction. While you're taking the Actos, you should also be on a diet

that

is very low in sugars (a " low amylose diet " ). For this diet you should also

avoid any root vegetables such as potatoes, carrots, etc. and you should

also

avoid all grains during that ten-day period as well. Because people with

CFS/fibromyalgia tend to be very sensitive to medications anyway, you may

choose to

begin with one teaspoon of Questran once or twice daily for 1-2 days and

then

increase the dose as able to decrease the risk of getting a severe die off

reaction. Although the infection/toxin die-off reaction is uncomfortable, it

is a

good sign that things are being cleared out and is worth going through. If

you get the die-off, fill and take the Actos as discussed above for a week

before resuming the Questran and let us know so we can look for Lyme's and

treat

it. Fortunately, most people who do not have chronic Lyme's syndrome improve

without an infection/toxin die-off reaction. Although the Questran has ~ 1

tsp of

sugar per scoop, it is still OK to use in this situation. Using unsweetened

cranberry juice (add stevia) instead of apple juice, or simply mixing it

with

water if even minimal sugar is a problem will decrease the amount of sugar

you'

re getting as well. You can also get Questran lite with NutraSweet.

 

The vitamin C flush

 

Human beings, monkeys, and guinea pigs are just about the only animals that

cannot produce their own vitamin C. Adjusted for weight, most animals would

make about 5-15 thousand mg of vitamin C a day, making even more during

illness.

During health, the vitamin C in your body usually lasts for about 30 hours.

During illness, however, it can be used up in as quickly as a half hour.

Experience suggests that during the detoxification phase (i.e. while you're

on

Questran) your vitamin C requirements may skyrocket. Because of this, doing

the

vitamin C flush can be critical to this treatment working. You only need to

take

the extra vitamin C for as long as you're taking the Questran.

 

As everyone's needs are different, it is important that you tailor the

vitamin C dose to your body's needs. You can do this by seeing how much

vitamin C it

takes to create watery diarrhea similar to what you would have after taking

an enema. To determine how much vitamin C to take each day, do a " vitamin C

calibration " . Take 3 to 6 grams (1 to 2 teaspoons) of vitamin C every

fifteen

minutes until ~1 to 2 pints of watery diarrhea occurs (do not stop when you

simply have a loose tool). This usually takes about one to four hours and is

sometimes associated with a " flush " during which people feel much better.

The period

where you feel better lasts longer and longer over time. The total daily

dose

of vitamin C you will need is three-quarters of the dose that it took to

cause the diarrhea. For example, if you took 3 grams every fifteen minutes

for two

hours (i.e. 8 doses) before you had the watery diarrhea, this would be 3

grams times 8 doses (or 24 grams). Divide 24 by three-quarters and that

would mean

that you would need to take 18 grams a day. Beginning the next day spread

your daily dose through the day (i.e. take it at least two to four times a

day)

while you're awake and do not take more than 4 grams during any half hour

period.

 

Around once a week, repeat the test to see how much vitamin C your body

still

needs by repeating the " vitamin C calibration " . The Questran is

constipating,

so it may take a higher dose of vitamin C than it usually would to cause the

 

diarrhea. Because of this, do not increase the vitamin C by more than 25

percent above the dose you took the first week. Normally, the dose you need

will

decrease as your body gets saturated with vitamin C and your health

improves.

 

 

Some important tips for doing the vitamin C calibration:

 

1 -- Use only buffered calcium/magnesium ascorbate (available from Perque -

from our web site at www.endfatigue.com or your practitioner can order it

from

Perque at 800-525-7372). Use the powdered form, which contains three grams

of

vitamin C per teaspoon for the calibration. Dissolve it in at least one

ounce

of water per gram of vitamin C. Be sure to record the total amount of

vitamin

C that you take as you are doing the calibration. When dissolving the

vitamin

C wait until it stops bubbling to drink it (approximately one to two

minutes)

 

2 -- you may get some gas or rectal burning during the flush. This can be

decreased by going a little more slowly and being sure to use plenty of

water to

dissolve the vitamin C. This is unpleasant but improves with time.

 

3 -- start the vitamin C calibration early in the day before eating and give

your self the opportunity to stay home all day in case it takes a higher

dose

than normal to get the watery diarrhea. Most people get the diarrhea/flush

at

between three to eight teaspoons of vitamin C .For those whose illness is

more

severe however, it may take over twenty teaspoons. If you start with 1 tsp

every 15 min and you experience no rumbling (feeling of having to evacuate

soon)

after 4 doses (1 hour) you should double the dose to 2 tsp every 15 min.

Otherwise it may take 4-5 hours to flush. If you flush at a dose of over

48gm you

should take 1-2 tsp the evening of your flush

 

4-- although it is easier to use the powder for the one-day vitamin C

calibration, you may find that for day-to-day use, the tablets are in the

for more

convenient. Use only the buffered vitamin C tablets or powder. I recommend

you

use the brand from Perque (1 - 800 - 525- 7372).

 

5 -- you can stop the vitamin C when you're done with the Questran, as the

amount in the vitamin powder will likely be adequate. You do, of course,

have

the option of staying on a higher dose of vitamin C, which you can adjust to

 

what feels best if you find this to be helpful.

 

 

Creating an alkaline diet

 

Chronic infections and poor circulation at a cellular level can cause

increased acid production in the body in some people with CFS and

fibromyalgia. This

can aggravate the symptoms and make it harder to eliminate the toxins. Dr.

Jaffe has also popularized what he calls " The Alkaline Way Diet " .

 

It can be very helpful to follow this diet from the start of treatment. Once

you're done with the Questran you can liberalize the diet and see how you

feel. You can get an idea of how much of an acidity problem you're having by

testing your morning urine.

 

To do this, get a packet of pH hydrion test paper from your local pharmacy

or

from 800- 553-5472. Each morning use a 2-3 inch strip of the paper tape to

test your urine. This can be done by either urinating directly on the strip

or

urinating into a cup and dipping the strip into your urine. Match the color

of

the test strip with the color chart that comes with a pH strips. The number

that goes with the color indicates the acidity. Any number under 7 indicates

an

acidic urine, with the acidity being mild between 6 and 7. The optimum

morning

urine pH is between 6.5 to 7.5. If your reading is below 6.5, I would switch

to an alkaline diet as discussed below.

 

Look at the chart to see which foods are most alkaline and which ones are

most acidic. When possible, eat foods from the alkaline side and in the

beginning

avoid foods in the 'more acid' and 'most acid' columns. In general, high

acid foods include beef, chicken, sugar, coffee, tea, cheese, wheat and

dairy.

When you look at this list, you can understand why Americans tend to be

acidic.

Alkaline forming foods include most fruits and vegetables, oats (which would

be good to have for breakfast), wild rice, and most seeds. Fish and lamb are

only mildly acidic.

 

In the beginning, you may do best to have 80 percent of your food come from

the alkaline lists. As you feel better and your urine becomes more alkaline

(be

patient -- it may take a few months for this to happen) a 60 percent

alkaline

food diet and 40 percent acidic food diet will generally work fine. It's

okay

to simply let your morning urine be your guide by keeping the pH between 6.5

in 7.5. A simple rule of thumb is to eat two portions of vegetables and one

of

fruit for each portion of meat or grains.

 

How to organize and apply this information.

 

1 -- day one -- order the vitamin C from Perque at 800-525-7372). I would

get

both the powder and tablets. Get the pH urine test strips from your local

pharmacy or from 800 553-5472. Meanwhile, you can start the Daily Energy

Enfusion

Powder and B-complex, your thyroid hormone and Cortef (if prescribed),lipoic

acid 300 mg, nystatin, any treatments that are dissolved under your tongue

or

applied to the skin, and your treatments for sleep. Go to the "

www.ChronicNeurotoxins.com " website and do the VCS/FACT vision test. If the

test is

positive this is great news because there is a good chance this protocol can

make

your symptoms go away! You'll probably be repeating this test four to six

times.

If you have a history of being sensitive to bright lights (do you wear

sunglasses a lot?) or the glare of lights at nighttime (do you have trouble

with

night driving?), or a metallic taste in your mouth I would consider doing

the

Questran protocol even if your vision test is normal. If your urine pH is

under

6.5, begin the alkaline diet as discussed above.

 

2 -- as soon as is convenient find a day that you can stay home. Begin the

vitamin C calibration in the morning.

 

3 -- the next day began the following schedule. Take your thyroid as soon as

you wake (leave it at your bedside with a glass of water). A half-hour later

take your vitamin powder and nystatin (and Cortef if prescribed). You can

also

take any other medications that are needed for other problems at this time.

Also began to take your vitamin C (spread through the day -e.g. -- take

vitamin

C when you take the vitamin powder in the morning, your sleep medications at

night, and with meals -- or whenever you feel like it). One hour after

taking

the vitamin powder take your first dose of Questran (1 scoop mixed in eight

ounces of apple juice or distilled water). Exactly one half-hour later eat a

meal

with some fat (e.g. -- a teaspoon of healthy oil or a pat of butter) and

protein (one egg would do the trick). Take the Questran three more times

during

each day mixed with water (distilled if available), each time eating a meal

with

some fat and protein as close to a half-hour after as is possible. Always

drink another 12 ounces of water after taking the Questran. You may choose

to

take your last dose one-half hour before bedtime and eat some turkey or an

egg

right at bedtime. Take your sleep medications/herbals an hour before the

nighttime Questran.

 

4 -- Stay on the schedule in the paragraph above for at least four weeks.

Check your vision test and fill out the brief symptom questionnaire every

one to

two weeks. When your symptoms and the vision test at

www.ChronicNeurotoxins.com have improved to where there's no further

improvements for two weeks (or if

there's no improvement in your symptoms OR the vision test by 4-6 weeks) you

can stop the Questran and vitamin C. If symptoms recur, you can go back on

the

vitamin C and/ or Questran at the lowest dose needed to feel good for as

long

as you need to. If you need Questran long-term, time the doses so that they

are at least one hour after or four hours before any other oral

medications/supplements that you need to take. If symptoms recur within one

to three days

after stopping the Questran, consider the possibility of a toxic mold

exposure in

your home or office (e.g. -- sick building syndrome). If your

CFS/fibromyalgia symptoms worsen (this does not include digestive symptoms)

on the Questran,

stop the Questran and fill the Actos prescription. Take one 45 mg Actos

tablet

a day for ten days. On the seventh day, resume the Questran. This will

decrease the severity of the 'intensification reaction'. In addition, be

sure to

stay on a low amylose diet (i.e. no grains, root vegetables like potatoes or

carrots, or bananas) while on the Actos. It is worth putting up with the

flare

for the one to four weeks after which you'll feel much better than before.

This

intensification reaction is most likely to occur in people with a history of

Lyme's disease, ciguatera, or in those with a certain bacterial infection in

their nose (in most CFS patients the sinusitis is from yeast). This is why

you

should let us know at some point if you have the intensification reaction so

we

can look for and treat these other problems as well.

 

Once you are done with the Questran, you can begin to slowly increase your

walking, stretching (e.g. Yoga for Beginners- a VCR tape by Patricia Walton

--

do the first four standing poses), and strengthening exercises (using five

to

ten pound weights).

 

Questran can be very constipating. Be sure to have at least 1-2 bowel

movements daily so that you are flushing the toxin out of your body! Try to

drink

close to a gallon of (distilled if available) water a day, and use the "

Cleanse-More'' formula from www.renewLife.com (two capsules two to three

times a

day), prunes, sorbitol 70% 1 to 3 teaspoons three times a day, increased

magnesium, or whatever else it takes to avoid constipation (see the

treatment

protocol for ideas). If you get acid reflux/ indigestion, you can use the

over-the-counter medicine Zantac or call for a prescription for Prilosec if

needed while

on the Questran.

 

5 -- when done with the Questran (or after eight weeks -- whichever comes

first) begin to add in the rest of the treatments. The natural treatments

can be

started immediately. One new prescription medication can be added in every

one

to three days.

 

As we are just beginning to use this treatment, we ask that you call our

office (410- 590-9010) or e-mail us at endfatigue let us know if

your

vision test was positive or negative, and whether the treatment helped you

or

not and to what degree. This way we can get a better idea of how helpful the

treatment is.