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The Shift: Top Science Journal Asserts Shift in Attitude Towards ME/CFS Has Occurred

“Chronic Fatigue Syndrome is a biological disease” Dr. Ian Lipkin’s Center for Infection and Immunity at Columbia University

From NIH Director Francis Collins’ high profile blog “Moving Toward Answers in ME/CFS“, to the New York Times Opinion piece “Getting It Wrong on Chronic Fatigue Syndrome” exposing the failures of the PACE trial, to the coverage of the Australians’ search for a biomarker, the chronic fatigue syndrome (ME/CFS) community has been treated to some excellent press lately.

difference-maker

Influential journal suggests a shift is occurring in how researchers are viewing ME/CFS

Now comes a piece “Biological underpinnings of chronic fatigue syndrome begin to emerge” from the news section of Nature, one of the world’s most read and most prestigious scientific journals. The article, written by Amy Maxmen, proclaims that a “shift” from viewing ME/CFS as psychosomatic to viewing it as a real disorder has occurred.

The article is a far cry from some of sentiments of the “Life After XMRV” piece Nature did in 2011 in which Simon Wessely asserted that the patients’ reactions to that finding would lead another generation of researchers to avoid ME/CFS research.  (He rather memorably suggested that researchers would rather “work on images of Mohammed” than study it.) Even advocates for the disease, though, worried that the controversy would turn off researchers.  Others, however, felt that the XMRV finding would galvanize researchers to use new technologies to understand ME/CFS.

They were right. Wessely, it appears, was wrong.

World-Class Researchers Beginning to Take ME/CFS On

The Nature article makes it clear that a major cause for the shift occurring is the presence, for the first time ever, of world-class researchers willing to take ME/CFS on.

Dr. Ian Lipkin, an immunologist with an unmatched resume, has not only lent his name and prestige to this disease, but his Columbia team’s published findings  – two of which have outlined dramatic changes in immune functioning in ME/CFS –  have been at the center of this shift. The Columbia team’s findings have been built on collaborations with expert clinicians, including Dr. Daniel Peterson and the Simmaron Research Foundation he advises. (Check out the slideshow that dominates the website for Lipkin’s Center for Infection and Immunity (CII): one of the slides simply says, “Chronic Fatigue Syndrome is a biological disease”.)

Ron Davis, with his many awards and the stunning story of his son’s illness, is also reaching deep into the scientific world to find answers. The stunning picture of Davis holding the printed circuit he’s using to decipher ME/CFS could be a metaphor for the search for the answer to ME/CFS itself.  The answer is there in that maze somewhere, and it’s going to be technology – probably new technology – that uncovers it.

These two men, with their willingness to publicly take bold stands for this disease, have been at the forefront of the “shift” that appears to be occurring. Both men have had the ear of the NIH Director, Francis Collin.  Their credibility has gone far in helping the National Institutes of Health, the largest funder of biomedical research in the country, take a reinvigorated approach to ME/CFS.

Dr. Avi Nath

Dr. Avi Nath, National Clinical Center, NIH

Next, Nature cites the conclusion from the IOM report’s “expert panel” that  chronic fatigue syndrome is an under-studied physiological illness. Then comes mention of the intramural study led by Avindra Nath, the widely published and respected clinical director for the National Institute of Neurological Disorders (NINDS). An infectious neurologist, Dr. Nath is conducting the first intramural study in ME/CFS in decades at the National Institutes of Health Clinical Center. Dr. Lipkin and Dr. Peterson are advisers on this intramural study.

Others could have been mentioned: Mark Davis of Stanford, Derya Unutmaz of the Jackson Laboratory, Lasker Award winner Michael Houghton of the University of Alberta, Patrick McGowan of the University of Toronto and others new to the field.  As the names line up, you do get the idea that, as Dr. Nath told Nature, “Researchers are thinking deeply about how to build the field.”

Building the field, of course, is what the NIH’s recent decision to fund three ME/CFS research centers is all about. Yes, much more is needed, but this article, showing up in a highly cited journal, suggests that the tide may be slowing turning where it needs to turn the most – in the research community.

Ian Lipkin and the Center for Infection and Immunity Step Forward

 Ian Lipkin is featured twice in the article, first stating:

“We now have a great deal of evidence to support that this is not only real, but a complex set of disorders. We are gathering clues that will lead to controlled clinical trials.”

Lipkin has been a vocal advocate for ME/CFS

Lipkin has been a vocal advocate for ME/CFS

Three studies from Lipkin and Hornig at Columbia are expected to be published shortly with one to be published next week. Don’t be surprised if, based on Lipkin’s comments, the CII lays the groundwork for something the chronic fatigue syndrome (ME/CFS) community has been waiting for a long time: evidence of biologically determined subsets, or in Lipkin’s words, direct evidence that ME/CFS is made up of a “complex set of disorders”.

The Simmaron Research Institute / Center For Infection and Immunity Collaboration

Simmaron CII partnership

Simmaron and the Center for Infection and Immunity: working together to understand ME/CFS

In its efforts to scientifically redefine ME/CFS, the Simmaron Research Foundation regularly partners with Dr. Lipkin’s Center for Infection and Immunity. Recent efforts included the spinal fluid study which showed dramatic alterations in immune functioning in the brain, the immune study which differentiated short from long duration ME/CFS patients, and the gut study about to be published. Simmaron is currently collaborating with the CII on additional phases of spinal fluid research and more.

Stay tuned for a Simmaron/CII study that will help to reshape our understanding of what ME/CFS is and how it should be treated.

Simmaron

The Gut and ME/CFS

The gut with its immense effect on the immune system is proving to be a fertile area of research on ME/CFS (see below). Perhaps no other team has pushed the ME/CFS gut connection more effectively recently than Ian Lipkin and Mady Hornig at the CII.

The Nature piece tantalized us a bit with news from Ian Lipkin that one of those studies showing an unusual pattern of gut flora in people with ME/CFS and IBS will be published soon.

A quick look at what studies have told us (see below) about the gut and chronic fatigue syndrome (ME/CFS) suggests that reduced gut floral diversity, possibly characterized by increased numbers of inflammatory bacteria may be common in ME/CFS.

Importantly, every study that has looked for leaky gut – which involves the translocation of gut bacteria into the blood – where it could spark an immune response causing fatigue, pain and other symptoms – has found it.  Most intriguingly, the research suggesting that exercise may negatively affect ME/CFS patients’ gut flora and increase their leaky gut issues could help explain post-exertional malaise.

The Gut and ME/CFS – Recent Findings

  •  Exercise in ME/CFS produces changes in gut flora, leaky gut and Inflammation  – Shukla’s 2015 study suggests that exercise not only changes the composition of the gut flora in people with ME/CFS but results in increased levels of gut bacteria leaking into the blood (possibly causing inflammation and post-exertional malaise.) The fun didn’t stop there. The ME/CFS patients also had more trouble clearing the gut bacteria from their blood than the healthy controls.
  • People with ME/CFS have reduced gut flora diversity and leaky gut – Gilotreaux’s 2016 study suggests more pro-inflammatory and fewer anti-inflammatory gut species are present in ME/CFS, and provides more evidence of bacteria sneaking through the gut lining and ending up in the blood.
  • Gut bacteria/viruses are infectious triggers in ME/CFSNavaneetharaja’s 2016 review paper suggests that gut bacteria and/or viruses have been overlooked in the search for an infectious trigger in ME/CFS.
  • ME/CFS is associated with reduced gut microbiome diversity and increased gut viral activity – Gilotreaux’s 2016 case report of twins found reduced VO2 max, decreased gut bacterial diversity and increased gut viral activity in the sick ME/CFS twin.
  • Antibiotics can improve gut flora and sleep in some ME/CFS patientsJackson’s 2015 Australian study suggests that erythromycin improved the gut flora and sleep in about a third of ME/CFS patients but not in the rest.
  • Altered gut flora diversityFremont’s 2013 study shows increased abundance of the same bacterial family (Firmicuties) in ME/CFS as found in Shukla’s 2015 study.
  • Leaky gut is associated with an autoimmune processMaes 2013 study suggests that increased bacterial translocation (leaky gut) is associated with high levels of antibodies targeting serotonin. Patients with these antibodies had evidence of increased inflammation.
  • Leaky gut is associated with inflammation and symptom severityMaes 2012 study suggests ME/CFS patients are mounting a very strong immune response to intestinal bacteria found in the blood that is leading to increased inflammation.
  • IBS/leaky gut subset is present in ME/CFSMaes 2012 study shows one subset of ME/CFS patients (60%) has leaky gut and IBS while another subset does not.
  • Treating leaky gut in ME/CFS can reduce symptomsMaes 2008 study shows that treating leaky gut with natural anti-inflammatory and anti-oxidative substances (NAIOSs), such as glutamine, N-acetyl cysteine and zinc in conjunction with a leaky gut diet can significantly improve symptoms in ME/CFS

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39 Comments

  • Troy

    March 31, 2017 at 9:46 pm - Reply

    It seems like some of this progress at the NIH would be devastated by the proposed cuts directly to CFS funding by the Trump administration.

  • konijn

    March 31, 2017 at 10:29 pm - Reply

    thanks cort,

    you saved again my life and hope. I am verry severely ill and it gets every week worser. Really problems withe getting food, etc Do not know what to do anymore. But reading this makes me a bit les desperate. How I must survive another 5 your’s I do not know.

    • Cort Johnson

      April 1, 2017 at 12:13 am - Reply

      Sorry to hear you are having such difficulty Konjin! I hope that you can get someone or some government program to help out. On Health Rising we’re going to create a program that allows patients who live near each other contact each other. I hope that will help.

    • soofke

      April 2, 2017 at 8:13 am - Reply

      ja fijn he dit soort artikelen en sterkte <3

  • Learner

    April 1, 2017 at 4:21 am - Reply

    Wow – great stuff, Cort!

    Thank you for explaining this landscape so well… wish we didn’t have to wait for all these studies to be complete before they knew how to cure us. It would be nice if any of these brilliant people could make an educated guess as to what we can try now.

    And, much as everyone seems to be wishing for the magic pill, these kinds of things are more complex… it’s still vexingly multiple interventions that would fix an unhappy microbiome, heal a leaky gut, and ensure adequate nutrient uptake.

    (…said while searching for thrnrxt probiotic to try…)

    • Cort Johnson

      April 1, 2017 at 3:40 pm - Reply

      Yes. it is complex. I think we should just resign ourselves to that fact. It is going to take time but every good study that Ian Lipkin, Simmaron and others publish opens the door a bit wider and exposes ME/CFS for what it is – a real and serious biological disease – to the research community.

  • Mark Camenzind

    April 1, 2017 at 5:40 am - Reply

    Please be sure to ask NOW that your congressional rep sign letter by Lofgren for adding MORE funds to 2018 appropriatons, for M.E.

    See: http://www.meaction.net/2017/03/29/calling-all-u-s-activists-ask-your-house-rep-to-sign-letter-that-supports-funding-for-me/

    MUST get signed by Tuesday April 4th, so please do this NOW!!

    We have 55 signatures in Sept 2016 to NIH Francis Collins, so challege all to get on board and double to 110 signatures this time.

    • Cort Johnson

      April 1, 2017 at 3:42 pm - Reply

      Thanks Mark! Somehow I missed this. Will do :)

  • Audrey Brimson

    April 1, 2017 at 5:51 am - Reply

    Having had ME and Food & Chemical Sensitivity for over 30 years, I KNOW that a leaky gut has been very much involved. Also Candidiasis which through the leaky gut became systemic. They say bacteria permeates through a leaky gut but so does imperfectly digested food particles, i.e macromolecules which are recognised as foreign invaders by the immune system. Many of the worst symptoms for many years were eased by a huge reduction of Carbohydrates. Oils or fats helped me cope with the limited amount needed for continued existence. Yes lost a lot of weight but it was worth it. 14 years struggle has reduced reactions as long as I remain on a low carb diet, and try to stay away from chemicals. Yes hard to do, but I stay at home a lot. Physical limitations are worth it to keep the grey cells active. I think they are!!! Thanks for the posts, so comforting to watch what is now happening.

    • Cort Johnson

      April 1, 2017 at 3:42 pm - Reply

      Thanks for sharing that Audrey. A more ketogenic diet has helped me: it’s no cure for me but it certainly is a step in the right direction.

      • Jacob Wright

        April 1, 2017 at 4:37 pm - Reply

        This ketogenic diet promotion needs to STOP. When patients are also prominent advocates they need to stop promoting diets and/or serums, homeopathic treatments, supplements, etc. that I doubt work and are out of reach financially for most, and people are incapable of getting all the “right” foods (no not that food item, “I” did THIS food item and this time of day after drinking this) and I doubt very much it has helped you at all.

        • Cort Johnson

          April 1, 2017 at 7:28 pm - Reply

          Please check out this blog – https://www.healthrising.org/blog/2015/04/06/clean-energy-ketogenic-diet-chronic-fatigue-fibromyalgia-courtney-craig/

          This diet really does help SOME people – not everyone! – but some people..:)

        • Resinator

          April 4, 2017 at 4:18 am - Reply

          WHY would you suggest anyone stop sharing with others what they found helped? Your angry reply to a simple and frankly profound observation is in itself confounding.. Are you an MD? You sound like too many ignorant MD’s I have had to endure for too long.. Ketogenic saved my life dude, and I tell everyone about it since it is proven to build mitochondria faster than especially high carb american diets which are horrible for anyone’s health outcome. Ketogenic works better than ANY other diet, and I am a health researcher for decades, I know this stuff. I also have severe ME-CFS and do more experiments than anyone I have ever met, this is how I know it works, first hand. I share this info with many people because I CARE and wish to HELP. If you want to make everyone paranoid about helping others by sharing information, please keep you ignorant comments under the rug you seem to be living under.

    • PamC

      April 4, 2017 at 4:05 pm - Reply

      I am just like you Audrey and relate to everything that you say regarding how long you have been ill and how a low carb diet helps you plus lots of fats.

      Thankfully I can walk quite well on most days but only for a maximum of 25 minutes and then all energy gone but I get so many viruses which bring back the ME/CFS and I am back on the couch.

      Cannot wait for all these wonderful researchers to agree what is going on with us but I am convinced the gut has to be involved. Often when I get a virus it will be my gut where it seems to start before moving to my throat the next day and with it comes the exhaustion and feeling of being ill.

      I am also sure that we don’t actually all have the same illness but that there are subsets.

      Thanks to Cort for keeping us all up-to-date, these are encouraging times.

      • Cort Johnson

        April 4, 2017 at 9:34 pm - Reply

        Thanks Pam…check out the next blog for some interesting stuff on subsets!

  • Ben

    April 1, 2017 at 8:39 pm - Reply

    I read articles like this and the recent ones in the NYT/Journal of Health Psychology against the psychosomatic model and think “wow, I picked an excellent time to contract ME!”. Dark humour aside, as somebody who is still grappling with his diagnosis, stuff like this gives me hope that therapies will be available in the coming years and that this is not a life sentence.

    • Cort Johnson

      April 2, 2017 at 7:56 pm - Reply

      :) This is the best time ever to contract ME – unless you were to contract it tomorrow or the next month etc. Still a lot better than contracting it 5 or 10 or 20 years ago.

      • soofke

        April 3, 2017 at 7:04 am - Reply

        don’t you think someone said, probably not typed ;), the exact same thing in ’69 when it was named ME

        and then again after xmrv, and…. and..

  • Melee

    April 3, 2017 at 5:43 pm - Reply

    Not only is the US government not going to work hard to research this disease, but they continue to be doggedly committed to their determination to disappear this disease. Anything positive they write, is all blown to smithereens by the first Link entitled: “Chronic Fatigue Syndrome (Medline Plus, National Library of Medicine/NIH)”, which is an endorsement of the fraudulent, damaging and often fatality-causing PACE Trials. People with ME don’t just get sicker from PACE-type treatments, they can die – GET can escalate our illness and even cause death to us.

    Simply by attaching duplicitous, deceitful, ME-deniers such as Shorter and Wallitt at the NIH, we all stand on notice that this government is still committed to the knowing suppression and willful obfuscation, and disappearance of this disease. They know what it is. They know what can help. They know how much money it will take. But they will use up all resources available to obfuscate and frustrate any and all efforts at progress by whatever means necessary:

    -Judy Mikovits did not have to go to jail or be put through a nightmarish legal battle. (Read PLAGUE)

    -There is no reason the Canadian Consensus Criteria, or even the International Consensus Criteria, are not the medical standards for this disease; that the governments continue to cling to Fukuda, etc., should be sufficient notice to all that they have no intention whatsoever of proceeding honestly and straightforwardly.

    -PACE should have been retracted and denounced, publicly, by every governmental official in the world. Lancet should be punished. Tuller should be rewarded and revered by every governmental agency on the planet.

    -The name of the disease should not have been changed to “Chronic Fatigue Syndrome” in the eighties. (See the whistleblower’s leaked joke-letter they openly posted at the CDC; and how the Board Members all laughed their heads off when one of them suggested that they slap the frivolous and degrading term “CFS” on us). (See David Tuller’s blog: http://www.virology.ws/2011/11/23/chronic-fatigue-syndrome-and-the-cdc-a-long-tangled-tale/) (Read OSLER’S WEB)

    -The CDC should not have published an Official Government Document to legitimatize the change of the disease’s name to the humiliating “CFS,” and then fully fund a “CFS PUBLIC AWARENESS” campaign

    -Dr. Peterson and Dr. Bell should not have wandered and worried in the dark, alone, while the CDC covered up the epidemics and outbreaks.

    -The Royal Free Hospital and Los Angeles Outbreaks should not have been relabeled “hysteria” events.

    -No governmental official should ever refer to this disease as a “mystery disease,” or publicly state that “there is very little known about ME/CFS.” There is so much known about this disease it is difficult to comprehend and catalog.

    -It isn’t necessary to continue to say “there are no biomarkers” (Read anything by Dr. Byron Hyde) (See Dr. Robert K. Naviaux’s August 2016 discovery of a chemical biosignature) (See Fluge & Mella’s findings) (See the Australian’s findings) (See the Japanese findings)

    -It isn’t true that there are no known treatments. (See Dr’s Fluge and Mella; Dr. Jay Goldstein; Dr. Pridgen, etc.)

    -There is no reasonable excuse – outside of mercenary obfuscation and opportunistic politics – that Ampligen hasn’t already completed all testing, met FDA compliance, and isn’t in use.

    -Brian Wallit does not have to be attached to this study for any reason. (See Power Point TILTING AT WINDMILLS to see how openly he mocks and abuses ME patients, and belittles women)

    -Ed Shorter does not have to be the face of the knowledgeable historian of this disease. (Read anything by Jane Colby)

    Koroshetz & Collins are possibly gasping their last breaths with this publication – they’re hoping that anyone reading will miss the fact that they destroyed their credibility on its face with the insertion of the first Link in the References Section of this Article. Yeah, they’re not working for you – for us – for the sick and isolated victims of this cruel, disabling, and deadly disease. They think you’re stupid and won’t notice how the one Link destroys their big glossy facade. And those of us who see right through their cloak and dagger show? Well, they could care less about us – we don’t matter because we’re too sick and weak to do anything about it anyway.

    This is not a U.S. thing, it’s a world government thing. It’s the deep state. It’s the government you don’t understand and can never know.

    And there’s not a thing you can do about it.

    So get used to it – lie alone in your dark, silent rooms, in your rancid beds, and hurt, and rot, and cry, and die. There isn’t anybody coming except Christ.

    • Resinator

      April 4, 2017 at 4:45 am - Reply

      I just cleared 8+ years of ME brain fog on Dec, by coming to a FULL STOP for weeks. I was a competitive athlete in motocross, mtn biking, and tennis, and absolutely at the top of my life game and health when I got a mosquito bite that changed my life. I am an example of someone who could NOT slow down in time to save years of lifespan I am sure.. I was trying to maintain any semblance of my life, trying to keep friendships alive, social things, activities I USED to have tons of energy for.. I too was prescribed graded exercise by KP in CO, and suffered through a multitude of pcps and specialists, not a one in over 7 years got even a clue of the deep impact this is. I was constantly tossed in the mental health bin, and an ekg shows my heart to look perfect in fact.. but they do not tie a fundamental lack of energy-producing issues to this, atp-recycling is certainly involved. I found the answer and saved my brain, but cannot seem to get my physical body to respond the same, ie when I exert much at ALL, I pay for days.. I still think I can do more than I can, and even do feel like working when it is sunny out because i LOVE to work, I am an admitted workaholic, but my work is also enjoyable to me. I am not allergic to work, in fact please let me get my hands dirty.. what depresses me is the lack of what I can accomplish, vs beforehand. I was a whirlwind of energy and ran circles around everybody in my very physical work career, even today being at only 10% of the energy I had..

      • Cort Johnson

        April 4, 2017 at 9:42 pm - Reply

        A powerful post resinator! Simmaron is collaborating with Konstance Knox to find patients just like you = people who became sick after an insect bite.

  • Natalie S

    April 4, 2017 at 1:52 am - Reply

    Great summary and commentary on the recent articles about ME/CFS. My 28-year old sister has been suffering from ME/CFS for several years and we’re just waiting and hoping for science and medicine to come through. The attitude really does seem to be changing thanks to people like Ron Davis and Ian Lipkin, who already had well established research programs and reputations before they got involved. They aren’t just providing their highly valuable expertise – they are using their reputations to a) give the field the credibility it has desperately needed and b) shine a light on a disease few researchers might have wanted to get involved with if they hadn’t heard that one of the leaders of human genetics, and the famous ‘virus hunter’ were now working on ME/CFS. They’ve pushed for higher impact publications, which bring wider impact (more people read higher impact journals), and demonstrate that the research is high quality (the higher the impact, the tougher it is to get a paper past review). Perhaps I am naive as my sister is young and has not been ill for as many years as many other patients; but to me, it seems that slowly, the science is being pieced together – and the stigma surrounding ME/CFS is finally starting to slip away.

    • Cort Johnson

      April 4, 2017 at 9:43 pm - Reply

      I agree! We are getting automatic credibility from the fact that some really accomplished researchers are working with us.

  • marta

    April 4, 2017 at 3:54 am - Reply

    i have never lost hope, and i am more hopeful all the time. anger and bitterness just make us more ill.

  • Sue Klaus

    April 4, 2017 at 4:14 am - Reply

    It wasn’t long after getting sick in 1979 that I feared the technology would have to catch up with us. But despite the hard lessons of the past, here we are, now awaiting real help, real treatments. I hope to get my life back before there’s no life to get back.
    But finally, I think we have turned a corner.

  • aquafit

    April 4, 2017 at 7:18 pm - Reply

    I agree that research has to make sense for us; I applaud Cort’s success in maintaining positivity when sometimes the research going on is well, stupid.

    Something I find encouraging: researchers/doctors at a Toronto Canada hospital viewed multi system symptoms of a young boy not as psychiatric or benign but as the sign of a genetic problem. They discovered the gene they feel causing the problem, and proposed a solution. Stem cells. This is not the end of the situation but a beginning. Too many researchers focus on quieting the Autonomic Nervous system rather than asking why is it going haywire other than “overreaction”. https://www.thestar.com/news/gta/2017/04/03/toronto-doctors-discovery-of-new-disease-comes-as-real-relief-to-boy-10.html

  • Beatriz Wild

    April 10, 2017 at 6:28 am - Reply

    I have known for suresince 1993 that ME/CFS is a physiological malfunction and this has kept me alive. Briefly, I had the following experience:

    Some 20 years ago I read an article [possibly a UK study, read in Australian mag] in an ME/CFS magazine, that MgSO4 had helped some people with ME. I managed to persuade a doctor to give that to me as 2 ml 50% MgSO4 IM (buttocks). I thought nothing had happened, then 36 hours later ALL my energy returned. I woke up one morning with my internal battery fully charged and available. I took my dog for a walk twice around the park at 7.30 in the morning, whereas until 2 days before I had trouble getting myself together for a shuffle around the block by 5 pm [for the previous 10 years].

    I had weekly injections, and severe withdrawals and the shakes if I overdid myself. I was able to work a 40 hour week. Then after a year I moved house and would have had trouble getting injections, so I started taking Mg Orotate by mouth. This took away the withdrawal effect but the next injection did NOTHING for me. I try again every year, but I am back in bed and perplexed by why it worked for a year and then didn’t.

    Because the effect of the injections when they were working was so marked and lasted for a year rather than a few weeks, a placebo effect can be thoroughly discounted. I studied Physiology whilst becoming sick and I feel there must be a mechanism for it both working and not working. The experience bolstered my confidence because I came to realise that this condition is entirely physical. I now call it Flat Battery Syndrome which is immediately understood, or say I have Faulty Battery Status.

    My experience was real and powerful. To me, PEM [Post Exertional Malaise] is the same as having a flat battery. I am trying to keep my question short so am happy to be contacted for more details if desired.

    If you have had a profound experience with Mg injections, please comment here. Its part of the puzzle for some of us. Please don’t let this be too hard a question for someone to take up.

    • Cort Johnson

      April 10, 2017 at 6:52 pm - Reply

      I have heard of others who found great relief from a treatment only to find that it stopped working for some reason. What a mystery!

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