IVIG – Intravenous Gamma Globulin Therapy for Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia
Intravenous Gamma Globulin Therapy or IVIG is…
an antiviral treatment and immunomodulator used to treat active infections or regulate immune functioning in those with immune deficiencies or autoimmune disorders. IVIG contains antibodies (IgG immunoglobulins) that target pathogens found in the bloodstream for destruction.
The gamma globulins are pooled from the blood products of many blood donors that have been treated to kill any infections present. Gamma globulin therapy is FDA approved to treated several diseases but is used off-label in a many others including many auto-immune ones.
Gamma globulins downsides include high expense and low availability although both have improved somewhat recently. It can be administered intramuscularly or intravenously.
Chronic Fatigue Syndrome (ME/CFS)/Fibromyalgia (FM) Studies
Significant interest in gamma globulin resulted in several clinical trials in the 1990′s which had mixed results. Hickie et. al found improved mood and immune functioning in a smaller 1992 IVIG trial and Lloyd’s placebo-controlled 1990 trial found significant improvement in approximately 40% of patients with many resuming work and other activities. Lloyd’s larger followup trial, however, was unsuccessful, as was a smaller American trial that targeted IgG deficient individuals.
Rowe’s 1997 IVIG trial, on the other hand, found significant functional improvement as did her five year followup. Rowe’s five year followup – reported in a publication – Journal for Chronic Fatigue Syndrome that was not included in medical indexes- was not widely disseminated.
Fibromyalgia patients with evidence of nerve demyelination caused by immune dysfunction responded positively (reduced pain, tenderness, increased strength) to a short-term IVIG trial.
Chronic Fatigue Syndrome (ME/CFS) Doctors Report
Given its expense Dr. Teitelbaum turns to IVIG only after other means of fighting chronic infections have been exhausted. He has, however, found that IVIG can ‘dramatically help’ some patients. Dr Tae Park of Korea uses IVIG extensively and reports high levels of success. Dr. Peterson finds it very helpful in some of his patients. Dr. Chia has found it helpful for fibromyalgia patients. Dr. Susser and Rosenbaum call it their most effective treatment.
Dr. Teitelbaum recommends intramuscular injections of 2 cc a week or 4 cc every other week (or weekly) but notes that even 1 gram a week for six months can be helpful. He recommends using IVIG for six weeks or longer. De Meirleir uses low doses of IgG1 or IgG3.
IVIG therapy can be extremely expensive costing several thousand dollars a month. Both Dr. Teitelbaum and Dr. De Meirleir have found that using low doses to cut costs can be effective. Finding no extra benefits from IV’s Dr .Teitelbaum advises using the less expensive intramuscular injections (@$50/vial).
can include fevers, chest pain, muscle aches, headaches, shortness of breath, etc. Die-off reactions can occur with the first few injections. Dr. Teitelbaum recommends that one to three weeks of Nexavir be given prior to IVIG therapy.
Teitelbaum, J., From Fatigued to Fantastic, Avery Press. 2007.