Botanicals in ME/CFS. Kevin Spelman, PhD, MCPP. Health, Education & Research

Transcription

1 Botanicals in ME/CFS Kevin Spelman, PhD, MCPP Health, Education & Research

2 ME/CFS CFS was formally defined in 1988 as a disabling fatigue of at least 6 months duration of uncertain etiology Besides fatigue, symptoms can include: mild fever sore throat painful lymph nodes weight gain exertional malaise muscle weakness muscle and joint pain headaches depression light-headedness anxiety visual and cognitive impairment disturbed sleep patterns Holmes GP, Kaplan JE, Gantz NM, et al. Chronic fatigue syndrome: a working case definition. Ann Intern Med Mar;108(3):387-9.

3 ME/CFS United States Centers for Disease Control and Prevention (1994): 1. Having severe chronic fatigue for at least 6 months or longer with other unknown medical conditions (that can cause fatigue) excluded by clinical diagnosis Prevention CfDCa. CFS case definition [cited; Available from:

4 ME/CFS United States Centers for Disease Control and Prevention (1994): 2. Concurrently having four or more of the following symptoms: - post-exertional malaise - impaired memory or concentration - unrefreshing sleep - muscle pain - multi-joint pain without redness or swelling - tender cervical or axillary lymph nodes - sore throat - headache Prevention CfDCa. CFS case definition [cited; Available from:

5 CFS United States Centers for Disease Control and Prevention (1994): 3. The symptoms must have persisted or occurred during 6 or more consecutive months of illness and must not have predated the fatigue. Currently there is no accepted biochemical test for the condition

6 Somatic Syndrome Crossover Wessely et al Lancet 354: IBS pt may also have sx of other syndromes Atypical facial pain CFS/FM Non-cardiac chest pain Food allergy Chronic hyperventilation Tension HA Chronic pelvic pain PMS

7 Hypothesis on Etiology

8 A Mosaic for Understanding Fatigue Fatigue Mitochondrial Neurologic Immunologic Cardiovascular Transport ETC Membrane Glial Cytokines DTH Autonomic Dysfunction Postural orthostatic tachycardia Hypotension Heart Rate Variability

9 A Mosaic for Understanding ME/CFS Fatigue Mitochondrial Neurologic Immunologic Cardiovascular Transport ETC Membrane Glial Cytokines DTH Autonomic Dysfunction Orthostatic tachycardia Hypotension Heart Rate Variability Energy Loss Muscle Weakness Post-Exertional Malaise Increased Recovery Times CNS Inflammation Unrefreshing Sleep Depression Brain Fog Hypotension Headache Inflammation Sickness Behavior Defense Compromise Muscle/Joint Pain Tender Lymph Nodes Sore Throat Orthostatic Hypotension Orthostatic Tachycardia

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11 Biasutto L, Szabo I, Zoratti M Mitochondrial Effects of Plant-Made Compounds. Antioxidants & Redox Signaling 15(12):

12 Mitochondrial Functions & Processes Biasutto L, Szabo I, Zoratti M Mitochondrial Effects of Plant-Made Compounds. Antioxidants & Redox Signaling 15(12):

13 Mitochondrial Ca 2+ Handling Biasutto L, Szabo I, Zoratti M Mitochondrial Effects of Plant-Made Compounds. Antioxidants & Redox Signaling 15(12):

14 AMPK Integrates Signals To Coordinates Mitophagy Biasutto L, Szabo I, Zoratti M Mitochondrial Effects of Plant-Made Compounds. Antioxidants & Redox Signaling 15(12):

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20 Morris G, et al. A narrative review on the similarities and dissimilarities between myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and sickness behavior.

21 Morris G, et al. A narrative review on the similarities and dissimilarities between myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and sickness behavior.

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24 In searching for T-cell gateways into and out of the meninges, we discovered functional lymphatic vessels lining the dural sinuses. These structures express all of the molecular hallmarks of lymphatic endothelial cells, are able to carry both fluid and immune cells from the cerebrospinal fluid, and are connected to the deep cervical lymph nodes. The discovery of the central nervous system lymphatic system may call for a reassessment of basic assumptions in neuroimmunology and sheds new light on the aetiology of neuroinflammatory and neurodegenerative diseases associated with immune system dysfunction.

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31 Phytotherapeutics

32 Fatigue Mitochondria Neurologic Immunologic Cardiovascular Transport ETC Membrane Glial Cytokines DTH Autonomic Dysfunction Postural orthostatic tachycardia Hypotension Heart Rate Variability Adaptogens Autophagic Restoratives Trophorestoratives Nootropics Anti-Inflammatories Anxiolytics Hypnotics Immunomodulators Immunostimulants Anti-Inflammatories Analgesics Adrenal Tonic Trophorestoratives

33 General Tonics

34 Lycium barbarum

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36 Theobroma cacao

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39 Adaptogens

40 Eleutherococcus senticosus

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46 Panax ginseng

47 Schisandra chinensis

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49 Withania somnifera

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51 Avena sativa

52 Glycyrrhiza glabra

53 Rehmannia glutinosa

54 Rhodiola rosea

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56 Immunomodulators & Immune Stimulants

57 Astragalus membranaceus

58 Echinacea spp.

59 Picrorhiza kurroa

60 Antiviral Herbs

61 Andrographis paniculata

62 Hypericum perforatum

63 Thuja occidentalis

64 Anti-Inflammatory Herbs

65 Bupleurum chinense

66 Boswellia serrata

67 Other strategies

68 Blood Flow

69 Ginkgo biloba

70 Salvia miltiorrhiza

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72 Zanthoxylum clava-herculis

73 Sleep Disorders

74 Valeriana officinalis

75 Passiflora incarnata

76 Piper methysticum

77 Cardiac & Circulatory

78 Crataegus spp.

79 Venous Tonics

80 Ruscus aculeatus

81 Aesculus hippocastanum

82 Remember that we only look where we already know/understand MOAs We cannot see what we do not see

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84 Don t ever underestimate your own clinical observations

85 Thoughts and/or Questions?