Posted by TENA/DIAMOND on 3/26/2009, 3:12 am, in reply to "Re: Live Chat with Martin L. Pall, PhD – July 6, 2007: Professor of Biochemistry Explains Mechanisms of "
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: Live Chat with Martin L. Pall, PhD – July 6,
: 2007: Professor of Biochemistry Explains
: Mechanisms of Chronic Fatigue Syndrome and
: Fibromyalgia & Suggested Protocol#3:
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: Re: Live Chat with Martin L. Pall, PhD – July 6, 2007: Professor of Biochemistry Explains Mechanisms#3
Q: What part do you think diet and antioxidants can play in controlling depression then, Dr. Pall?
Dr. Pall: I'm not sure I can answer that, although I think that by down-regulating the NO/ONOO- cycle, all of the symptoms should improve at some point. I suggest in my book that excessive nitric oxide in certain parts of the brain has a role in generating depression, so this suggests that the nitric oxide scavenger hydroxocobalamin (a form of vitamin B12) may be especially useful in lowering depression. Not sure if there is any data on this.
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Q: Realistically, how much benefit do you think the antioxidants you recommend can offer patients? And is there any research showing evidence of benefits yet?
Dr. Pall: I think there is much benefit. But the combinations of antioxidants must be well-chosen. Many people have had the notion that antioxidants are largely interchangeable and that one antioxidant is likely to be as useful as another. In fact, it is much more complex than that. And I think that the antioxidant trials that have been focused on using high dose synthetic alpha-tocopherol (the most commonly used form of vitamin E) and high dose synthetic beta-carotene have not been well thought out.
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Q: Does a treatment plan for the cycle require a physician, or can it be implemented and maintained by the person suffering from the illness?
Dr. Pall: I have worked with a leading supplement research company to develop an all over-the-counter nutritional protocol to lower the NO/ONOO- cycle biochemistry. [See “Antioxidant Suggestions for Down-regulation of the NO/ONOO- Cycle from Dr. Martin Pall, PhD.”] ProHealth is working with this company to help make these preparations available. Again I must caution that these suggestions are intended as nutritional support, not as a replacement for medical treatment of any condition. Any decisions regarding a change in your healthcare plan or regimen should be made in collaboration with your professional healthcare team.
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Q: How long does it take on the protocol to observe favorable results?
Dr. Pall: I think as we have gotten better at this, the response has become more rapid. I'd expect to see a response in a few weeks, certainly in less than three months. I would add, however, that the approach requires that one avoid stressors that will otherwise up-regulate the NO/ONOO- cycle biochemistry. In CFS, that would include exercise as such a stressor - and many individuals may also have to avoid foods that they are allergic to, and psychological stress.
It is important that the approach not only involves taking certain nutritional supplements but also avoiding anything that might otherwise up-regulate the cycle biochemistry.
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Q: Must all of the supplements from your protocol be taken to get full benefit, or can you take only a few?
Dr. Pall: I would expect that there will be a better response to all of them, or at least all of them that a person tolerates well. But individual components may, nevertheless, be helpful. For example, I have gotten some feedback from a group of people in Spain who are only taking the MVM-A part of the protocol and report favorable responses to that. I don't suggest that, but it nevertheless seems to be helpful to them. [Note: the MVM-A formulation is a multivitamin/mineral with acetyl-L-carnitine and R-alpha-lipoic acid.]
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Q: In your protocol, do supplement dosages differ? In other words, do you make any distinction between a 200 lb man and a 110 lb woman? Often supplements don't make a distinction, and those of us who are small have problems.
Dr. Pall: No it does not, but clearly you may wish to consider this when deciding on your personal regimen.
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Q: Can you over-use antioxidants?
Dr. Pall: Some antioxidants, especially when used alone and at high dose, can cause problems. And I criticize the use of high dose synthetic alpha-tocopherol (form of vitamin E) as well as high doses of synthetic beta-carotene, in my book. We have tried to consider possible negative effects of antioxidants in developing the Allergy Research Group protocol.
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Q: I am a CFS patient. My uric acid level is typically below normal range. I understand that uric acid in the blood helps protect against peroxynitrite, and that the purine inosine can boost blood levels of uric acid. Do you think that supplementing with inosine might be helpful too?
Dr. Pall: There are three types of agents that may be expected to raise uric acid levels, and they may all be helpful. One is inosine – others are D-ribose and RNA [ribonucleic acid]. Each has some positive aspects, but each may well have some drawbacks as well. I think that one or more of these may be worth trying.
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Q: During a lecture by Dr. Paul Cheney he said he had seen adverse reactions to NAC [N-acetyl cysteine] supplementation. What dosage of NAC do you consider to be helpful?
Dr. Pall: NAC - N-acetyl cysteine - is well tolerated in most people, but Cheney has found that some of his patients do not tolerate it. We are using a low dose (about 40% of the usual dose) in the Allergy Research Group protocol, and suggest using it after starting to take magnesium. Magnesium should lessen any sensitivity to NAC.
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Q: What can you do if you develop reactions to drugs, herbs, or various vitamins?
Dr. Pall: Avoid them or cut the dose. In some cases reactions may be due to impurities, in which case finding a purer source may be helpful.
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Q: Are there certain amino acids that can be taken which will help the mytochondria to produce more energy?
Dr. Pall: Yes. I have tended to stay away from suggesting using amino acid supplements because they have so many complex interactions. But I may be wrong about this. The Petrovic protocol uses such amino acid supplements. [Note: This refers to a nonprescription CFS protocol developed by Nash Petrovic, MD, that reportedly includes “a complex mixture” of more than 200 microantioxidant compounds.]
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Q: Could you please explain the use of Ecklonia cava extract (SEANOL-F)? It was recommended as a supplement that you use but it was not covered in your book. Thanks.
Dr. Pall: I’ve gotten some recent feedback from physicians that this polyphenolic antioxidant is very useful. It may well act in similar fashion to other phenolic antioxidants discussed in my book.
TENA/DIAMOND
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