arrow20 Comments
  1. Mary Silvey, RN
    May 21 - 1:45 pm

    Cort, I am looking at neuroinflammation as a result of an infectious assault on the brain, not the cause. Serotonin and glutathione insufficiencies are also happening as the continuous assault on neurological function. Yet, it is hard, once again, to say for sure, what happens in what order, and I seem to stay with the original models of this illness, and personal experience. Research can be interpreted in different ways, so if this is what you are seeing, then that is your opinion. Natural enhancements for the production of serotonin are preferable to taking antidepressants, if one is not depressed. I only found one drug responsible for increasing glutathion, appeared to be a psychiatric drug. When reading about the multiple effects of this illness on the brain, one can be overwhelmed. Yes, there were epidemics responsible for so many taking ill, yet tinnitus can occur in a perfectly healthy person. (failed to connect here…) I watched my father deal with tinnitus and other hearing issues until he had a synthetic stapes (stirrup formation in inner ear) implanted, and I was amazed at a young age. (He has been visiting an aircraft carrier and was not given headphones, thus the stapes shattered.) I must have been misunderstanding, as I thought tinnitus could be the result of hearing bloodflow through the area, and took an aspirin one time for it and it worked. (Placebo effect!) So sorry if this is appearing disconnected, bad day….

  2. floydguy
    May 21 - 1:47 pm

    I am back to torture you again! I am surprised you don’t bring up neurotoxicity in your discussion of neuroinflammation. It seems quite possible that the neuroinflammation is coming from toxins that have either passed into the brain or have affected the brain through inflammation. The neurotoxicity could be caused by an onslaught of mold, chemicals, etc.

    Not surprisingly excess glutamate is also associated with mold exposure. Dr. Shoemaker performs (or used to anyway) a special MRI that looks for excess glutamate of which I have.

    It’s also worth looking at the genetic possibilities concerning certain halotypes. Many alternative docs find that a much higher percentage of their patients than would normally be expected have particular genetic profiles.

    • Marco
      May 21 - 2:26 pm

      :) I am sincerely sorry floydguy, in the light of our recent discussions (especially as I’d stated that ‘mood disorders wouldn’t be mentioned much again) that this blog started with the aforementioned.

      I can only say that these blogs were written months ago and that’s just the order they came up in – whereby I felt these symptoms could be dispensed with fairly quickly.

      Not torture at all – a constructive discussion which is what I was hoping for; after all, any theory has to be tested to destruction.

      Re neurotoxins – it is very plausible that they are one of the triggers. Just because mold exposure doesn’t figure in my background doesn’t mean it isn’t a factor for other people. I currently live in a approx 130 year old French farmhouse where the exterior walls are black from the fungus that feeds off the fumes from the Cognac distilling process. I don’t feel any better or worse than when I lived in a modern bungalow back in the UK.

      I just don’t feel its the one answer – which I’ll get on to subsequently. On this issue I recommend the writings of the Gulf War illness researcher Beatrice Golomb who lays out a model for how the various putative exposures could result in the same pathology (in GWI and other ‘overlap’ conditions such as ME/CFS :

      http://precedings.nature.com/documents/6847/version/1

      • Cort Johnson
        May 21 - 3:14 pm

        I should note that I create the titles; the reason, believe it or not, that I put mood disorders in there is that it went well with MCS – a bit of alliteration – that was catchy. There’s also an issue of space…I put MCS in there because it was just three letters :)

        • floydguy
          May 21 - 4:52 pm

          Ha. I think you just wanted to torture ME!!

          • Marco
            May 22 - 1:10 am

            The mood disorders make me do it :)

      • floydguy
        May 21 - 4:26 pm

        So do you propose any triggers aside from mold exposure and pestide exposure? I think it is highly likely there are multiple roads leading to Dublin. For example, I’ve been told that at a cellular level I am close match to the Gulf War vets yet I’ve never served in the military and have not had unusual exposures – however there are few things that I am suspicious of like high exposure to Roundup.

        • Marco
          May 22 - 1:13 am

          Most definitely multiple routes either singly or in combination as I’ll discuss next. A similar model to that proposed by Mady Hornig who’ll be leading the pathogen study.

  3. A.B.
    May 21 - 2:42 pm

    Aside from organic solvent exposure, mercury is also potentially causative. Mercury inhibits glutamate uptake and stimulates the release of glutamate in brain cells at micromolar concentrations. It is also linked to many of the biochemical abnormalities mentioned in this article and known to persist for decades in the human brain after oxidation to Hg++.

    • Cort Johnson
      May 21 - 3:11 pm

      Mercury is another one of those interesting factors that MD with alternative bents test for and devise therapies to reduce it but which gets absolutely no play in the research world (that I can see). What a disconnect there is between physicians and research priorities in this area.

  4. Forebearance
    May 22 - 12:31 pm

    What about people who take L-glutamine supplements? I’ve been taking them for years and they seem to have positive effects rather than negative ones. And, could we draw any conclusions from this hypothesis about natural supplements to try? Should we all be taking GABA in supplement form, for example?

    • Marco
      May 23 - 10:25 am

      Sorry I missed you post yesterday.

      In a healthy body and brain glutamine is necessary and supplementation is proposed to help with mental alertness (presumably why you take it?).

      Given that, in the brain, glutamine is a substrate for both glutamate and GABA (and glutamate converts to GABA) I’m not sure if the problem is glutamate levels per se or extracellular glutamate (either not being cleared via glut transporters or converted to GABA).

      If you’re finding benefits by all means carry on – this is a hypothetical model.

      As regards GABA supplementation it may be worth trying but many patients use GABAergic drugs and supplements.

      Long term changes in the brain due to neuroplasticity may take a prolonged period of treatment to resolve.

  5. Forebearance
    May 24 - 6:29 pm

    Thanks! I’ve been taking L-Glutamine for years as general digestive and immune system support.

  6. John Jones
    Jun 11 - 6:50 am

    Interesting, I think neuroinflammation could explain a huge part of what is going on. I’ve taken LSD 3 times since being ill with CFS/ME (been ill for 2 and a half years now, I am virtually housebound) and each time my symptoms have gone away COMPLETELY for 3 days afterwards. LSD is a powerful anti-inflammatory and I did feel very much like i had received a deep massage from the inside of my body out-wards, like cooling balm being rubbed on a hyperactive frazzled nervous system. I was able to walk a few miles and play the guitar and sing for hours with strong fingers and a strong voice (can’t usually do that at all!) as well as read much more during the 3 days post-tripping. My symptoms returned quickly however and a week later (on all 3 occasions) I was just as ill as before I took it, so it’s positive effects are short.

    This has led me to the theory that neuroinflammation is causing a lot of my CFS symptoms. Sadly one cannot take LSD regularly as the profound spiritual and emotional experience it induced need integrating in to daily life and it’s just not convenient. But I am curious about BROMO-LSD, a non-hallicinogenic form of LSD being developed for cluster headaches. Perhaps that would have the same effect and could be taken regularly enough to be beneficial long term for CFS/ME sufferers? I wonder if you have come across anyone else with similar experience, as I seem to be one of the only CFS sufferers to have tried LSD while ill…

    • Cort Johnson
      Jun 11 - 7:24 am

      Really interesting, John. I hope you can dig into this more and figure out what LSD did that worked so well…Never heard of Bromo-LSD – sounds really interesting as well.

    • Marco
      Jun 11 - 8:05 am

      Quite a story John!

      I didn’t know that LSD was anti-inflammatory but did turn this up (in relation to schizophrenia :

      “Serotonin (5-HT) and Schizophrenia

      The idea that serotonergic alterations might have a role in the pathophysiology of schizophrenia initially developed from several indirect findings. Firstly the observation that Lysergic Acid Diethylamide (LSD), a psychedelic agent which shares structural similarities with 5-HT, can cause schizophrenia-like symptoms such as hallucination and perceptual abnormalities. This led to the hypothesis that psychosis may be caused by brain serotonergic dysfunction

      However the findings from the LSD studies were later found to be more complex to interpret, not least because some of the effects of LSD on 5-HT receptors result in enhanced glutamate transmission”.

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3662992/

      The last sentence might seem to be the opposite of what I’m suggesting (high glutamate) but as the above paper discusses in relation to dopamine, negative effects are seen with too high or too low dopamine. The same U shape response also seems to apply to glutamate.

      Plus the model I suggested relates to the neuroinflammatory effects of high ‘extracellular’ glutamate. ‘Enhanced glutamate transmission’ may mean just that. Glutamate is being transported, used and taken up again efficiently rather than building up in the extracellular spaces where it causes neuroinflammation.

      Interesting stuff.

  7. Kelly
    Jun 18 - 8:50 pm

    It’s the mercury. Google “Andrew Cutler, PhD” for accurate info on how to safely chelate it out of the body. Takes 2-4 years, but people have actually recovered.

  8. Christiana
    Jul 19 - 1:38 pm

    Wow! Great article, though I must admit, as sick as I am it took me a week to read through it + a lot of re-reading.
    I found this article b/c I was trying to find a correlation b/w neuroinflammation and severe fatigue. I’ve been diagnosed with CFS (took 10 yrs) but there are so many unanswered questions and no CFS doctor has been able to help at all. Then I was diagnosed with PANDAS syndrome – suggesting neuro-inflammation.

    For me the first symptoms were overactive bladder at age 7. Now the bladder is one of my worst symptoms. At 15 I was injured but the pain never went away, this has repeatedly happened so I just have severe pain where there was once an injury. At 18 sudden onset of anorexia nervosa, depression, and fatigue though by CFS standards I would be considered “high functioning” though could not sleep, onset of insomnia that no doctor has been able to treat (even trialed xyrem).

    I went through every AD and psych med out there then did ECT without any benefit from any of them. 2008, sudden onset of adrenaline and anxiety 24/7, 6 months of no sleep. Antipsychotics and xanax would get me a couple hours of sleep. 2009 – bedridden + new onset of severe mental fatigue and headaches. 2010 sudden onset of ocd, worsening of fatigue, excessive daytime sleepiness, inability to sleep though extremely tired and sleepy, to present: mostly stuck in bed or on couch, ocd all the time, no quality of life.

    Just typing this to see if anyone has any ideas. I had major violent reactions to tiny doses of the stupid immunomodulators……….. CFS docs unable to treat symptoms. Have severe OI. Neurologist bailed on me after diagnosing PANDAS. I have been referred to Dr. Souhel Najjar who specializes in treating neuro-inflammation connected to psychiatric ailments, but not sure if I’ll be accepted.

    Excellent article though. I can see how this would explain a lot of “CFS” symptoms. BUT BIGGEST QUESTION – what is the treatment? Steroids seem risky b/c of all the infections we have, insurance won’t cover IVIG……. ETC. etc.

    • Cort Johnson
      Jul 19 - 2:08 pm

      It was a toughie but goodie :)….

    • Marco
      Jul 20 - 1:12 am

      Thanks Christiana

      Until researchers investigate ME/CFS as a neuroinflammator disorder we can only speculate on how to treat it. Re PANDAS perhaps the Lipkin/Hornig and Rituximab research will turn up something valuable.

      Something you could try (as its cheap and safe) is high dose thiamine (B1) as Cort discusses here :

      http://www.cortjohnson.org/blog/2013/07/05/is-simple-relief-from-fibromyalgia-mecfs-found-early-reports-spark-interest/

      As discussed above B1 deficiency is neurotoxic and would exacerbate existing neuroinflammation. Some anecdotal reports are very positive.

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