Townsend Letter The Examiner of Alternative Medicine
Alternative Medicine Conference Calendar
Check recent tables of contents


From the Townsend Letter
February/March 2008


reviewed by Jule Klotter

Search this site

Fibromyalgia and Sensory-Motor Conflict
A pre-existing sensory-motor conflict may contribute to the pain and sensory perceptions reported by people with fibromyalgia syndrome (FMS), according to a study by C.S. McCabe, H. Cohen, and D.R. Blake (
Rheumatology. 2007; 46(10): 1587-1592). McCabe and colleagues created motor-sensory conflict in 29 adults with fibromyalgia by having them perform congruent/incongruent limb movements with one limb hidden behind a mirror, set at a right angle to the subject's body. Results from this cohort were compared to data from a previous cohort of age- and gender-matched healthy volunteers. McCabe and colleagues performed the study to explore the hypothesis that "symptoms of FMS arose from ‘central neuromodulatory disregulation' evident by augmented pain processing."

In the
Rheumatology study, the researchers asked the FMS subjects to move the limb that they could see parallel to a marker and then move the hidden limb in a position that matched the other. (Subjects had been told that the study was assessing limb position sense.) The researchers then asked open-ended questions such as, "How did that feel?" and "Were you aware of any changes in either limb?" Twenty-six of the 29 FMS participants reported sensory effects, including disorientation, pain, and perceived changes in temperature, limb weight, or body image. They also said that the feelings were very similar to the symptoms that occur during FMS flare-ups.

"In conclusion," the authors write, "we would propose that sensory-motor conflict may perpetuate some of the somaesthetic disturbances reported in FMS. This may occur either because an individual has an innate vulnerability to sensory-motor disturbances and/or they develop a heightened awareness, or reduced threshold, to the daily minor sensory changes that are generated when predicted sensory feedback does not match actual." An autonomic stress response due to the perceived conflict may provide additional fuel to the conflict.

McCabe CS, Cohen H, Blake DR. Somaesthetic disturbances in fibromyalgia are exaggerated by sensory-motor conflict: Implications for chronicity of the disease?
Rheumatology. September 1, 2007; 46(10):1587-1592. Available at: Accessed November 21, 2007.

Fibromyalgia and Intravenous Micronutrient Therapy (Myers' Cocktail)
David Katz, MD, director of the Integrative Medicine Center at Griffin Hospital (Derby, Connecticut), has been investigating the use of intravenous micronutrient therapy (IVMT) to help people with fibromyalgia. Under his lead, the Yale-Griffin Prevention Research Center initiated a National Center for Complementary and Alternative Medicine-sponsored study of IVMT in 2004. IVMT, also known as Myers' cocktail, is a high-dose combination of B-complex, vitamin C, magnesium, and calcium given in a slow intravenous drip, allowing for greater absorption than is possible with oral supplements. John Myers, a Baltimore doctor, began using a similar intravenous "cocktail" in the 1960s to help patients with fatigue, depression, chest pain, and other problems. Alan Gaby, MD, took on the care of some of Dr. Myers' patients after his death in 1984. Dr. Myers did not leave printed information about his formula, so Dr. Gaby researched and formulated his own version based on what was known about the original.

Dr. Katz says that about 80% of his fibromyalgia patients benefit from IVMT with "about one in five" feeling better after the first treatment. Most patients experience changes by the fourth or fifth treatment. IVMT does not make the pain go away forever, but it does provide short-term relief: "A lot of patients come back within a month, saying their symptoms are starting to recur…." Dr. Katz does not recommend IVMT for people with medical conditions that may react negatively to IVs or extra fluid, e.g., blood disorders such as hemophilia, or kidney disease, or congestive heart failure.

Arnold J. Spotlight on fibromyalgia. Alternative Medicine. February 2005:31-34.

Katz D. The Promise and Pitfalls of Intravenous Micronutrient Therapy: From Practice to Theory and Back Again. (Power Point presented at ACAM Conference in Dallas, Texas, May 4, 2006). Available at:,38,Bibliography,cont. Accessed November 21, 2007.
(Note: The PowerPoint begins at, 153KB)

Cognitive Behavior Therapy, Exercise, and CFS/FM
Cognitive behavior therapy (CBT) helps people with chronic fatigue syndrome (CFS; a.k.a. myalgia encephalomyelitis) and fibromyalgia learn how to pace their activities and develop an accurate perspective of their energy levels. People with these conditions often live in fear that symptoms will flare. That fear can incapacitate them. CBT therapists teach patients self-help strategies that let them gain some control over their symptoms. CBT strategies include keeping an energy diary that tracks symptoms, energy level changes, and activities; doing relaxation exercises and meditation; finding ways to promote better sleep; prioritizing and delegating tasks; learning flexibility; pacing daily activities; and performing gentle physical exercise.

CBT is very controversial among the CFS/FM community because some practitioners have pointed to its effectiveness in clinical studies as evidence that the illness stems from "wrong thinking." Such practitioners use graded exercise therapy (GET) in their CBT programs. GET assumes that CFS/FM symptoms have no physiological cause, that "deconditioning, depression, and believing one is ill are at the root of CFS," according to Moira Smith. Graded exercise therapy encourages patients to stick to ever-increasing exercise goals, like an athlete in training. In reality, CFS/FM symptoms vary from day to day. Trying to stick to an inflexible schedule may compound the problem. Interestingly, the clinical studies that recommend CBT/GET as an effective treatment rarely include the most disabled and tend to have high drop-out rates.

Pacing, on the other hand, acknowledges a biological dysfunction and recognizes that a relapse will occur if patients overextend their energy. "Pacing," Moira Smith explains, "is all about ‘listening to your body' (instead of your conscience or other people) and accepting that this means your activity levels will vary a lot." Cognitive behavior therapy that uses pacing strategies helps patients learn how to work with their energy levels instead of pushing themselves to the point of symptom flare-ups and disability.

Carruthers, et al. Myalgic encephalomyelitis/chronic fatigue syndrome: clinical working case definition, diagnostic and treatment protocols. Journal of Chronic Fatigue Syndrome. 2003; 11(1): 46-49. Available at: Accessed November 22, 2007.

Parks R. Cognitive-behavioral therapy for chronic fatigue syndrome. WebMD. May 15, 2007. Available at: Accessed November 8, 2007.

Smith M. Pacing and graded exercise compared. Available at Accessed November 8, 2007.

Stulemeijer M, de Jong LWAM, Fiselier TJW, et al. Cognitive behaviour therapy for adolescents with chronic fatigue syndrome: randomized controlled trial. BMJ. January 1, 2005;330(14). Available at: Accessed November 8, 2007.

Chronic Fatigue Syndrome and Abnormal Heart Function
An August 2003 study, performed by Arnold Peckerman, PhD, and colleagues, found a correlation between poor cardiac function and symptom severity in people with chronic fatigue syndrome (CFS). In this study, the authors explain that previous research had identified circulatory-related problems in CFS patients such as autonomic dysfunction, lower plasma volume and/or red cell mass, neurohormonal abnormalities that affect circulation, post-exercise reduction in brain blood flow (using nuclear imaging), and reduced blood flow in exercising muscles (using magnetic resonance spectroscopy). This information caused Dr. Peckerman and colleagues to hypothesize that people with CFS have reduced cardiac output. They collected symptom data and measured cardiac output using impedance cardiography in 38 people with CFS and 27 matched, sedentary controls.

In Peckerman's study, heart stroke volume and cardiac output were significantly lower in 18 of 38 CFS patients. These patients also reported the most severe symptoms (ratings = three on a scale of zero to five). They had a higher percentage of severe ratings for post-exertional fatigue, joint pain, headache, swollen lymph nodes, fever-chills, and sore throat, compared to the remaining CFS patients and controls. The study's authors report that "post-exertional fatigue and flu-like symptoms…were predictive of lowered cardiac output (p<0.0002)….neuropsychiatric symptoms showed no specific association with cardiac output." Heart rate and mean arterial blood pressure were similar in the three groups.

In an interview conducted by Mark Giuliucci, Dr. Peckerman explains that CFS patients do not show the clinical signs of hypoperfusion, in which cardiac output cannot meet metabolic demand. Nonetheless, he believes that the reduced blood flow found in CFS patients may have clinical significance. Dr. Peckerman took part in another study that used cardiac stress testing. Preliminary evidence from that test indicates that some CFS patients have heart failure.

Why do some people with CFS develop heart failure? Dr. A. Martin Lerner believes that chronic mononucleosis infection in the heart leads to left-ventricular dysfunction in a large subset of CFS patients. Dr. Lerner owns "U.S. patents for the diagnosis of ME/CFS in the chronic mononucleosis subset of this disease using 24-hour Holter monitoring," according to Myalgic Encephalomyelitis Society of America. Paul Cheney, MD, PhD, hypothesizes that mitochondrial dysfunction and low ATP energy in the heart, not chronic infection in itself, lead to diastolic cardiomyopathy. "Many of the symptoms of CFS could be explained by heart failure…," Dr. Sarah Myhill writes in her explanation of Dr. Cheney's mitochondrial hypothesis. "Cardiologists and other doctors are used to dealing with heart failure due to poor blood supply to the heart itself. In CFS, the heart failure is caused by poor muscle function…." Mitochondria, including those in the heart's cells, are simply not producing enough energy (ATP).

Denoon D. Abnormal heart pumping after exercise linked to chronic fatigue syndrome. WebMD Medical News. April 14, 2003. Available at: Accessed November 21, 2007.

Giuliucci M. Cardiac output linked to severe CFS cases. Available at: Accessed November 26, 2007.

Myalgic Encephalomyelitis Society of America. Cardiac insufficiency hypothesis. Available at: Accessed November 21, 2007.

Myhill S. CFS is heart failure secondary to mitochondrial malfunction. Available at: Accessed November 21, 2007.
(March 2008: Above link does not work. Use:

Peckerman A, Lamanca JJ, Dahl KA, et al. Abnormal impedance cardiography predicts symptoms severity in chronic fatigue syndrome. The American Journal of the Medical Sciences. August 2003: 326(2):55-60. Available at (283KB .pdf) Accessed November 26, 2007.

RNase L Pathway and CFS
Paul Cheney, MD, PhD, believes that abnormalities in the RNase L pathway, first reported by R. J. Suhadolnik and colleagues (Clin Infect Dis. 1994 Jan; 18 Suppl 1:S96-104) may explain the progression of chronic fatigue syndrome (CFS). RNase L destroys all cellular and viral RNA within a cell. All viruses, particularly herpes virus (e.g., Epstein-Barr, cytomegalovirus) and intracellular bacteria (e.g., Mycoplasma and Chlamydia pneumoniae), stimulate RNase L activity. In people with CFS, RNase L is more active than in healthy controls. In addition, the level of bioactive 2-5A (the molecule that "turns on" RNase L) is higher and the level of latent 2-5A is lower than in controls. Researchers have also identified a more potent form of RNase L in CFS patients that is less than half the normal molecular weight of 80 kilodaltons (kDa). Studies have linked these abnormalities to impaired health.

Dr. Cheney hypothesizes that CFS moves through three distinct stages that begin when an intracellular organism activates the RNase L pathway. Normally, the immune system attacks viral pathogens after RNase L prohibits viral replication; then all systems downgrade to normal. In people with CFS, however, RNase L changes into the lower- weight, more potent form, and the pathway remains activated longer. Abnormal RNase L damages liver enzymes necessary for detoxification. Phase II of CFS, according to Dr. Cheney, occurs when the liver's ability to remove toxins from the blood becomes impaired. "[The shift from Phase I to Phase II] usually sounds like this," says Dr. Cheney. "'You know, I felt like I had the flu or mono, and then my disease changed. The sore throats went away, the glands got better, the fever came down – but now I'm even sicker. My basic problem now is that I can't think anymore. My fatigue is worse than ever. And I'm beginning to hurt – a lot.'" The amount of pain depends upon the toxins involved, according to Dr. Cheney. Toxins can also inhibit liver enzymes. After a time, circulating toxins injure the hypothalamus and other brain structures, leading to Phase III. At this point, "dynamic hormone response" (ability to respond to signals for more or less hormone activity) becomes impaired. Toxins may also damage mitochondria (which produce cellular energy). As a result, patients at Phase III cannot cope with too much stress; they must maintain a restricted sphere of activity to function.

A beginner's guide to the RNase L pathway. Available at: Accessed November 12, 2007.

Englebienne P. RNase L in health and disease: what did we learn recently? Journal of Chronic Fatigue Syndrome. 2003;11(2):97-109. Available at: Accessed November 12, 2007.

RNase L. Wikipedia. Available at Accessed November 12, 2007.

Sieverling C. The three phases of chronic fatigue syndrome: dr. paul cheney's theory. Available at: Accessed November 8, 2007.

Suhadolnik RJ, Reichenbach NL, Hitzges P, et al. Upregulation of the 2-5A synthetase/RNase L antiviral pathway associated with chronic fatigue syndrome (Abstract). Clin Infect Dis. 1994 Jan; 18 Suppl 1:S96-104. Available at: Accessed November 21, 2007.

The Council on Wireless Technology Impacts
Because we cannot see or feel electromagnetic radiation, most of us do not give its effects a second thought. Yet, electromagnetic fields (EMF) do affect biology. Widespread use of mobile and cell phones, computers, and other electronic devices generates EMF in amounts previously unknown to biological systems. The Council on Wireless Technology Impacts and Ecological Options Network has produced a DVD that documents California activists' attempts to restrict cell phone towers and WI-FI (wireless computer systems) and educates viewers about EMF effects.

The first documentary on this DVD, Public Exposure: DNA, Democracy and the "Wireless Revolution," focuses on Californians' uphill battle to restrict the placement of cell phone towers and to educate legislators about the effects of EMFs. The US Telecommunications Act of 1996 prevents state and local governments from blocking cell towers because of health concerns. This 59-minute documentary also contains interviews with Swedish scientists and participants of the June 2000 International Conference on Cell Phone Tower Siting (Salzburg, Austria).

Sweden is more advanced in its recognition of electrosmog than the US. Stockholm, considered "the Silicon Valley of Europe," is dependent on its telecommunications industry. Unlike the US, however, profits do not blind the Swedish government to the biological effects of EMF. The Swedish government has accepted electro-sensitivity as a reason for disability. Two percent of the Swedish population are electrosensitive, according to official statistics. Dr. Olle Johansson, a neuroscientist at Sweden's Karolinska Institute, explains that double-blind studies have shown that EMF sensitivity exists; people are not making up symptoms or talking themselves into having symptoms. Per Segerbeck, also interviewed in the documentary, is a senior electronics engineer who became electro-sensitive in the early 1990s. He says that 80 to 90% of his work team also became hypersensitive to EMF within a year, after working about 40-50 yards from a bay of mobile antennae. Segerbeck must wear a HazMat suit with steel fibers to protect himself from microwave radiation while going to and from work. If he doesn't, he becomes unconscious within ten minutes of exposure. The international segment of Public Exposure was the most interesting part to me. Except for the scientists at the Salzburg conference, this documentary lacks details about EMF's health effects, portraying instead public fears and activists' interaction with government.

The second presentation on this DVD, however, makes up for Public Exposure's lack of scientific detail. Electromagnetic Fields is a 25-minute presentation by Dr. Ted Litovitz, made before Congressional staff on July 12, 2001. Dr. Litovitz, a physicist and EMR researcher, directed the BioElectromagnetics Laboratory at Catholic University of America before his death in May 2006. In the film, he explains that today's EMF safety standards are based on its thermal effects – its ability to heat biological tissue. Published studies, however, have documented biological effects at exposure levels far below radiofrequency radiation (RFR) signal strength that government agencies deem safe. The standard RFR for a cell phone is 1.6 watts/kg of body weight. Studies show RFR affects the immune system at 0.015 watts/kg, increases calcium ion efflux (flow out of cells) at 0.005 watts/kg, induces DNA damage at 0.0024 watts/kg, affects blood/brain barrier at 0.0004 watts/kg, and enhances cell proliferation at 0.000021 watts/kg. Dr. Litovitz says that genetics affects a person's susceptibility to RFR exposure, just as genetics affect a person's reaction to pharmaceuticals. He does not view all EMF radiation as being hazardous to health. "Everything is a poison. It is only a question of dose," Dr. Litovitz says, quoting Paracelsus. "Weak electromagnetic fields can induce non-thermal biological effects. They can be adverse. They can be beneficial. They can be inconsequential. It is only a question of dose. To protect public health, we must determine the allowable dose for each of the above conditions."

The Council on Wireless Technology Impacts has Dr. Litovitz's presentation available online ( The DVD containing both productions is also available from that site for $25 (US)/ $30 (Canada). Contact for more information.

The Council on Wireless Technology Impacts. Public Exposure (DVD) Novato, California; 2001. Available at:

The Council on Wireless Technology Impacts. Electromagnetic Fields (DVD). Novato, California, 2007. Available at:

Cox S. Are your cell phone and laptop bad for your health? AlterNet. July 31, 2007. Available at: Accessed September 28, 2007.

Ribose for Chronic Fatigue Syndrome
In 2006, Jacob Teitelbaum, MD, and Valen Labs released the results of a study that looks at the effect of D-ribose on people with fibromyalgia (FM) and chronic fatigue syndrome (CFS) (J Altern Complement Med. 2006 Nov;12(9):857-62). D-ribose is the sugar that mitochondria use to make ATP (cellular energy). Usually, the body makes plenty of ribose from glucose. People with CFS/FM, however, may not be able to convert enough because of a lack of cellular energy, according to Dr. Sarah Myhill.

In this open-label, feasibility study, 41 people with FM and/or CFS took five grams of D-ribose (CORvalen™), three times a day for a total of 280 grams. Patients completed questionnaires before and after the treatment period. About 66% of the participants reported improvement, not cure, in their symptoms. Average energy levels increased from 3.8 to 5.5 on a scale of 1-to-10 (about 45%). Sleep, mental clarity, pain intensity, and well-being average ratings also showed improvement. Dr. Teitelbaum says that patients must take five grams, three times a day, for at least the first three weeks for the supplement to be effective. A CORvalen representative told Cort Johnson that patients can cut back to five grams, twice a day, after a month if they want. As with many supplements, it can take several weeks for patients to notice an effect.

CORvalen™ (D-Ribose) improves pain and quality of life in fibromyalgia and chronic fatigue patients. Medical News Today. February 9, 2006. Available at: Accessed November 8, 2007.

Johnson C. D-Ribose treatment of chronic fatigue syndrome. Available at: Accessed November 8, 2007.

Myhill S. CFS is heart failure secondary to mitochondrial malfunction. Available at (102 KB) Accessed November 21, 2007.

Teitelbaum JE, Johnson C, St Cyr J. The use of D-ribose in chronic fatigue syndrome and fibromyalgia: a pilot study (Abstract). J Altern Complement Med. 2006 Nov;12(9):857-62. Available at: Accessed November 8, 2007.

Minocycline and Strokes
Minocycline, an antibiotic and antiprotozoal, appears to protect against stroke damage in humans, according to an Israeli study published in Neurology (October 2, 2007). The antibiotic produced significant neuroprotective effects in earlier studies involving animal models of multiple sclerosis, Parkinson's disease, Huntington's disease, amyltrophic lateral sclerosis, and stroke. To see if minocycline has a similar effect in humans, the Israeli research team performed a randomized, open-label study on patients arriving at an emergency department too late for tissue-plasminogen activator to be effective. One group received 200 mg of minocycline orally for five days, and the other got a placebo, beginning six to 24 hours after stroke onset. Blinded evaluators used the National Institutes of Health Stroke Scale, modified Rankin Scale, and Barthel Index to measure outcomes at baseline, days 7, 20, and 90. Results showed a clear benefit. The final mean NIHSS score in the minocycline group was 1.6 (little or no disability) compared to the placebo group's 6.5 (near upper limit for mild disability).

"The improvement was already apparent within a week of the stroke," said study author Yair Lampl, MD, in a statement from the American Academy of Neurology. "This is exciting because many people who have had a stroke cannot be treated if they don't get to the hospital within three hours after symptoms start, which is the time frame for currently available treatments." Minocycline treatment in this study did not correlate with a lower risk of death, myocardial infarction, recurrent strokes, or hemorrhagic transformation. The researchers call for a larger double-blind study to confirm their results and to determine the most effective dosage and the best time to start treatment.

The ALS Association. Phase III Trial of Minocycline. Available at: Accessed November 8, 2007.

Antibiotic, minocycline, may reduce stroke damage, study suggests. AMA Member Communications. October 2, 2007.

Jeffrey S. Minocycline may improve stroke outcomes out to 24 hours. Medscape Medical News 2007. October 1, 2007. Available at: Accessed November 8, 2007.

National Institute of Neurological Disorders and Stroke. Minocycline Information Summary. Available at: Accessed November 8, 2007.

Osterweil N. Minocycline reduces stroke damage in late-presenting patients. Medpage Today. October 1, 2007. Available at: Accessed November 8, 2007.

Dimethyl sulfoxide (DMSO), a by-product of paper manufacturing, is a powerful solvent that has several physiological effects. It relieves pain, reduces inflammation, softens scar tissue, increases vasodilation, and increases hydroxyl radical scavenging. US investigation of its therapeutic possibilities began in the early 1960s. Robert Herschler, PhD, a researcher at Crown Zellerbach, and Stanley Jacob, MD, who taught at Harvard Medical School at the time, collaborated on research involving DMSO's ability to relieve arthritic pain and inflammation. They also investigated ways to use the solvent for drug-delivery. DMSO easily penetrates the skin, and any substance that comes in contact with this solvent will also be carried into the body. FDA interest in DMSO as a therapeutic agent ended in 1965, after the death of an Irish woman who had received DMSO for a sprained wrist. No autopsy was performed on the woman. Some believe that she had an allergic reaction to the solvent, but the actual cause of death is unknown. The agency did, however, approve its use to treat interstitial cystitis (a very painful, chronic bladder inflammation) in 1978. Also, US veterinarians use DMSO to treat musculoskeletal disorders in dogs and horses. Elsewhere, Dutch physicians use DMSO to relieve the pain of reflex sympathetic dystrophy, and many Russian doctors use it to treat arthritis.

Over the years, Dr. Stanley has used a mixture of DMSO and DMSO2 (intravenous, oral, and topical) to help people with fibromyalgia. He estimates that 70% of his fibromyalgia patients experienced improvement after about two months. Dr. Stanley is now investigating DMSO's effect on closed head trauma, including traumatic brain injury and stroke. Intravenous DMSO reduced swelling, caused by head injury, within five minutes in early studies (1978 to 1982).

DMSO has no known serious side effects, although a serious allergic reaction is possible. D.W. Gregg says, "Start with one drop and if there is any allergic reaction, don't use it at all." Garlicky breath odor, occasional nausea or drowsiness, and temporary itching, flaking, and burning at the application site are more common side effects. I know of one case in which a nasty, itchy rash developed when it was applied, then covered by polyester sweat pants.

Most veterinary DMSO and over-the-counter products are industrial grade and vary in quality. Pharmaceutical-grade DMSO is available by prescription only.

Gregg DW. DMSO and MSM: The biochemical oxygen transport pair. Available at: Accessed November 8, 2007.

Jacob SW. Current Status of DIMETHYL SULFOXIDE (DMSO). March 2002. Available at: Accessed November 8, 2007.

Kovach S. The untapped healing potential of DMSO. LIFE EXTENSION. July 2007;63-68



Consult your doctor before using any of the treatments found within this site.

Subscriptions are available for Townsend Letter, the Examiner of Alternative Medicine magazine, which is published 10 times each year.

Search our pre-2001 archives for further information. Older issues of the printed magazine are also indexed for your convenience.
1983-2001 indices ; recent indices

Once you find the magazines you'd like to order, please use our convenient form, e-mail, or call 360.385.6021 (PST).


Who are we? | New articles | Featured topics |
Tables of contents
| Subscriptions | Contact us | Links | Classifieds | Advertise | Alternative Medicine Conference Calendar | Search site | Archives |
EDTA Chelation Therapy | Home


© 1983-2008 Townsend Letter for Doctors & Patients
All rights reserved.
Website by Sandy Hershelman Designs
March 17, 2008

Order back issues
Advertise with TLDP!

Visit our pre-2001 archives