ME/CFS in the Department of Medicine

Enteroviruses

Treatment Options

Physician Perspective: John Chia, MD

There are currently no FDA-approved drugs for the treatment of enteroviruses. However, there are a few things that Chia has found to be helpful for some of his patients.

  1. Equilibrant, an herbal preparation made in the U.S. also known as "Oxymatrine," is an immune modulator that helps to shift immune response to the Th1 direction (see note below). Patients should start slowly and work up to no more than 2-3 tablets twice a day. Patients can order equilibrant from www.equilibranthealth.com or find out more information by emailing info at equilibranthealth dot com [info equilibranthealth.com]. It helps about 50% of the patients and is affordable. No prescription is necessary. However, symptoms can sometimes worsen initially as the immune system adjusts, so it is important to be able to follow up with a physician while taking this herbal preparation.

    NOTE: Th1 and Th2 are acronyms for T-helper cell 1 and T-helper cell 2 responses. These two responses can be imagined like the two ends of a see-saw. At rest, the two responses are neutral, symbolized by a horizontal see-saw. In order to fight viral infections, the immune system shifts up the Th1-side. When the viral infection is gone, the see-saw will return to a neutral position. If the virus infection is fought with the Th2 response, the Th1-side is shifted downwards, the viruses would survive the immune attack, and persist in the body. Thus shifting immune response back in the Th1 direction can be beneficial for some patients.

  2. Intravenous immunoglobulin is an option for patients who have hypogammaglobulinemia and CFS. (Hypogammaglobulinemia is a disorder caused by a lack of B-lymphocytes and a resulting low level of immunglobulins, or antibodies, in the blood.) It works in approximately one-third of patients. This treatment is expensive (generally around a few thousand dollars) if the patient’s insurance company denies the treatment. It is given at a dose of 0.4 gram/Kg as infusion over 4-6 hours. This treatment needs to be prescribed by a physician familiar with its usage.
  3. The combination of alpha and gamma interferon can help patients with debilitating myalgia but it is also expensive (about $5000/month for 3 months). It is poorly tolerated but severe myalgia can resolve within 2 weeks. This treatment needs to be prescribed by a physician familiar with its usage.

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