Can anyone explain TH1/TH2 shift and possible drugs to alter it?

[hixxy]

I'm wondering if a less forceful way of flushing gallstones would be to just take the malic acid long term by itself. Surely as the stones dissolve they will pass on their own. There seems to be so many reports that the full liver flush thing is bogus and there's no way I would tolerate it anyway.

hixxy

 

[Adster]

Another Th1/Th2 modulator is beta glucan. I'm trialling this at the moment, the first thing I've noticed is periods of much freer nasal passages.

Thymus extract is another Th1 promotor that I have here to try at some stage.

It seems that science is many years away from getting any real handle on this stuff though. I think that the Th1/Th2 shift hypothosis as it is at the moment is probably way too simplistic. I'd be very happy to be wrong about that, though.

I've seen it mentioned that some viruses will cause a Th2 shift by mimicking cytokines? in order to survive in the host.

And lets not forget there's a Th3 cell that apparently lives in the gut.

 

[baccarat]

Low cortisol levels are the hallmark of CFS.
It's the only biological marker that puts some doubt even in the minds of the proponents of the biopsychosocial model of CFS. I was told by my CBT therapist that CFS patients typically have low cortisol, whilst in depression cortisol tends to be high. That's anyhow what saved me when I was in the hands of these guys.
I doubt one can successfully raise cortisol levels with this illness. If you can do that, you probably don't have it anymore.

 

[hixxy]

Low cortisol levels are the hallmark of CFS.
It's the only biological marker that puts some doubt even in the minds of the proponents of the biopsychosocial model of CFS. I was told by my CBT therapist that CFS patients typically have low cortisol, whilst in depression cortisol tends to be high. That's anyhow what saved me when I was in the hands of these guys.
I doubt one can successfully raise cortisol levels with this illness. If you can do that, you probably don't have it anymore.

I'd have to say I disagree with this completely. Low cortisol is a common symptom of this disease, but far from universal.

hixxy

 

[baccarat]

I haven't seen any study that found high cortisol in CFS. Consistently they find low cortisol. Especially post-exertion.
In my mind, anyone with high cortisol should challenge their diagnosis. It's impossible to have normal cortisol levels and suffer from the typical fatigue or PEM we have in ME/CFS.

 

[hixxy]

I haven't seen any study that found high cortisol in CFS. Consistently they find low cortisol. Especially post-exertion.
In my mind, anyone with high cortisol should challenge their diagnosis. It's impossible to have normal cortisol levels and suffer from the typical fatigue or PEM we have in ME/CFS.

That completely ignores mitochondrial failure and oxidative stress as means for causing fatigue. From what I've read, PEM is typically caused by an explosion of reactive oxygen species during energy produced as a result of physical activity.

The cortisol theory flies completely in the face of the glutathione depletion in the krebs cycle theory.

Now glutathione depletion IS universal.

hixxy

 

[baccarat]

I'm saying that if I had high cortisol, I'd look for other causes of fatigue. For e.g. thyroid issues which are often hard to pinpoint. There must be many others.
I can't explain how cortisol levels link to glutathione and oxidative stress. There's probably a link but it's beyond me.

 

[taniaaust1]

Low cortisol levels are the hallmark of CFS.
It's the only biological marker that puts some doubt even in the minds of the proponents of the biopsychosocial model of CFS. I was told by my CBT therapist that CFS patients typically have low cortisol, whilst in depression cortisol tends to be high. That's anyhow what saved me when I was in the hands of these guys.
I doubt one can successfully raise cortisol levels with this illness. If you can do that, you probably don't have it anymore.

A CDC ? cortisol study (yeah they dont use good diagnostic criteria) but anyway it found that one third of CFS women had low morning cortisol.

I found that interesting as i do have abnormally low 24 hr cortisol overall but mine is normal in the mornings (so it must be really ditching at another time to be able to throw a 24 hr reading out of wack)

I have known people with our illness in which had high cortisol at the beggining of it but now have low.. so do think that low cortisol may be more common in those who have been sick longer (my own theory formed over time with observations of our community).

There is no study at all which says those with ME ALL have low cortisol.

Low cortisol does appear in some mental health things too .. eg Thou those with depression tend to have high cortisol but those who have post traumatic stress disorder people (PTSD) tend to have LOW cortisol. (maybe that is why some of us have it?)

 

[Dufresne]

I'm saying that if I had high cortisol, I'd look for other causes of fatigue. For e.g. thyroid issues which are often hard to pinpoint. There must be many others.
I can't explain how cortisol levels link to glutathione and oxidative stress. There's probably a link but it's beyond me.

Hi baccarat,

I've had low-normal cortisol and I've had high-normal cortisol at different times in my illness. I'm actually high-normal these days and I continue to grow worse. If cortisol were a big part of PEM then supplementing with hydrocortisone would offset this and be a staple of treatment. It doesn't seem to work this way for the vast majority of us. There's no doubt in my mind that the fatigue in my illness is caused by oxidative stress. I'm not so sure as to what causes the PEM though. My guess would be that it's in some way a regulatory mechanism because of the oxidative stress.

 

[taniaaust1]

On various sites online.
Written by Carol Sieverling who taped Cheney explaining it back in 2000 and posted it various places online back then. (So note..its 11 years old).

The way Dr Cheney explains Ive awlays found the easiest to understand the TH1/TH2 stuff.

" Dr. Cheney gave permission to share this information, but has not reviewed or edited it.

CFIDS patients are Th2 activated. This means they over-respond to toxins, allergens, normal bacteria and parasites, and under-respond to viruses, yeast, cancer and intracellular bacteria. Dr. Cheney suggests six products that can help rebalance the immune system.


Dr. Cheney explained that the immune system has two different modes of attack, based on the type of invader. One is Th1 (T Helper 1). It goes after organisms that get inside our cells intracellular pathogens. It is also known as cell-mediated immunity. The other is Th2 (T Helper 2). It attacks extracellular pathogens organisms that are found outside the cells in blood and other body fluids. Some call this humoral or antibody-mediated immunity. A healthy immune system is dynamic, able to switch back and forth as needed, quickly eradicating one threat and then resting before responding to the next.


(Dr. Cheney began this conversation by drawing a large inverted "V". At the top point he wrote "Th0", which he called "Th naught". The left arrow pointed down to "Th1" and the right arrow to "Th2". The arrow on the right was much darker and thicker, indicating that CFIDS patients are Th2 activated.)


Th0 are the naive, or unformed, cells of the immune system. They are resting, just waiting for an invader. When infection occurs, they convert to either Th1 or Th2, depending on the type of threat. When the resting cell is exposed to a virus, cancer, yeast, or intracellular bacteria (like mycoplasma or chlamydia pneumonia), the Th1 response is initiated. (Dr. Cheney wrote these organisms beside the left arrow.) The weapons of the Th1 system include cytotoxic T cells and Natural Killer (NK) cells. (Cheney drew these below "Th1".)


On the other side are normal bacteria, parasites, toxins, and allergens. (Likewise written beside the right arrow.) These trigger a predominately Th2 response. Its weapons include eosinophiles (Eos), polymononuclear cells (PMN), and antibody secreting cells (Ab). (Likewise written below "Th2".)


How does the naive cell know which pathway to take? It depends on the cytokine information received. The presence of any organism from the left side triggers production of a cytokine called Interleukin 12. IL-12 causes the Th0 cell to move down the Th1 path. On the other hand, organisms on the right side trigger the production of Interleukin 10 (IL-10), which causes the Th0 cell to move down the Th2 path. (Cheney added small vertical dotted lines on each side, pointing upward to "IL-12" on the left and "IL-10" on the right. He then drew horizontal dotted arrows from "IL-12" and "IL-10", each pointing inward toward the "Th0", indicating that these cytokines determine whether it will become Th1 or Th2.)



Cheney said this is the point where it gets very interesting. Viruses, especially herpes viruses like EBV, CMV and HHV6, make proteins that mimic IL-10. The virus deceives the immune system into thinking that the threat is coming from the opposite side! So the immune system shifts from the Th1 mode that attacks viruses to the Th2 mode that does not. The virus increases its chances of survival by diverting the immune system. It is now thought that many, if not most, pathogens have this ability. (To represent this effect, Cheney drew a horizontal arrow about half way down the inverted "V", originating from the left side and pointing toward, but not quite touching, the right side. The line was labeled "IL-10 like peptides". Below it he drew a similar arrow from the right side that almost reached the left side. It was labeled "IL-12 like peptides".)



Researchers have demonstrated that most CFIDS patients end up stuck in Th2 mode. This has several consequences. When the Th2 system activates, it blocks the Th1 system. This suppresses the Th1 weapons, particularly NK function. Accordingly, there is also an increase in the Th2 weapons - the white cells and antibodies. Most notable is increased antibody production. Dr. Cheney said that if you measure antibodies to anything a CFIDS patient has ever been exposed to, they will very likely be elevated. (At this point he drew small arrows beside the "weapons": They pointed down on the left side to indicated suppression / lower levels; and they pointed up on the right side to indicate activation / higher levels.)



Cheney notes that other problems ensue. Patients get into trouble on both sides: they overreact to things on the right side and under-react to those on the left. When they are Th2 activated, they no longer have the defense mechanisms to keep dormant all the things they caught in the past. They cannot suppress or control them anymore, and the EBV, chlamydia pneumonia, CMV, etc. reactivate. The yeast also begins to appear.



The only defense against being eaten alive at this point is RNase L. (For more information about RNase L, see The Three Phases of CFIDS and other articles in the Cheney section of our website.) RNase L cannot kill any of these things. It only stops them from reproducing. According to Cheney, "It's a line in the sand saying 'No more replication', and it waits for Th1 to come and kill them. But Th1 never comes. RNase L sits there and grinds away, possibly going up and down as the pathogens activate and reactivate. But they never get wiped out. RNase L holds the line, waiting for the cavalry that never arrives."



While it is valiantly trying to hold the line, it is also chewing up human messenger RNA, inhibiting all the enzymes in the body, disrupting protein synthesis, and generally making patients miserable. As RNase L grinds away, it eventually shifts into "after-burner" desperation mode - the more powerful and deadly low molecular weight form discovered in CFIDS patients by Suhaldonik.



Cheney commented "RNase L is a very good anti-cancer defense. So as long as you're involved in this scenario, you don't get cancer. But a lack of growth hormone will wipe out RNase L, and we now know there is profound loss of growth hormone in CFIDS. Growth hormone is responsible for protein synthesis, and RNase L is a protein. So if you lose growth hormone, you lose protein synthesis, including RNase L. That may explain why, as the disease wears on and you get more injury, you stop seeing high levels of RNase L. You can't make it anymore."



He believes this is a very scary situation. Patients are Th2 activated and Th1 suppressed. The things on the left come out and there is nothing to stop them. There is no Th1, and eventually no Rnase L. He also believes patients need to balance the immune system - to push it a little more towards Th1. That way they will lose some of the overreaction on the right and gain some control on the left.
"

 

[Charles555nc]

If you try the gallblader flush yourself, just once, you will know its not "bogus". That seems like a glib thing to say.

But you may be right that you couldnt tolerate it, which is why I suggested it for those who are improving. Malic acid helps to minorly shrink stones, but they wont just pass on their own, though malic acid itself has been shown to help most people with Cfs and fibromyalgia.

Gallbladder flushes can be difficult to do because that old blocked up bile can and often does become infected and can make you feel bad when it finally comes out. But you feel so much better afterwards, your skin glows, you lose weight, your digestion improves. But like I said, Im on a long list of other vitamins, that are helping as well.

Taniaaa- as you said, that list is old. Most of those suggested items are no longer suggested by Dr Cheney. I would try lysine, glycine, proline, Sodium ascorbate, and 7 keto DHEA and see if you feel better. And maybe also try Rich's methylation protocol. I started taking NAC and glutathione and crashed hard, and only recovered when taking methyl folate, so there are some subtleties.

 

[taniaaust1]

T aniaaa- as you said, that list is old. Most of those suggested items are no longer suggested by Dr Cheney. I would try lysine, glycine, proline, Sodium ascorbate, and 7 keto DHEA and see if you feel better. And maybe also try Rich's methylation protocol. I started taking NAC and glutathione and crashed hard, and only recovered when taking methyl folate, so there are some subtleties.

Thanks for letting me know.. I'll remove the last part of that post where the suggestions are.

 

[baccarat]

Hi baccarat,

I've had low-normal cortisol and I've had high-normal cortisol at different times in my illness. I'm actually high-normal these days and I continue to grow worse. If cortisol were a big part of PEM then supplementing with hydrocortisone would offset this and be a staple of treatment. It doesn't seem to work this way for the vast majority of us. There's no doubt in my mind that the fatigue in my illness is caused by oxidative stress. I'm not so sure as to what causes the PEM though. My guess would be that it's in some way a regulatory mechanism because of the oxidative stress.

I also have had cortisol levels fluctuating. One reason for this might be that we are never tested under conditions that make us feel unwell.
For e.g. I'd like to see a cortisol chart of when I'm under either physical and mental stress and when I have PEM symptoms after overexertion.
I think the problem lies in being unable to raise it when it's required, whilst we may be ok at rest.
But then again, cortisol levels are probably a symptom of something deeper being wrong, what that is anybody's guess.

 

[taniaaust1]

I also have had cortisol levels fluctuating. One reason for this might be that we are never tested under conditions that make us feel unwell.
For e.g. I'd like to see a cortisol chart of when I'm under either physical and mental stress and when I have PEM symptoms after overexertion.
I think the problem lies in being unable to raise it when it's required, whilst we may be ok at rest.

My cortisol I know dont raise when Im in pain or understress. A doctor on seeing my low cortisol 24hr result suggested it was cause I didnt exercise. So I exercised (and was in agony due to that) while doing another 24 hour test and it hardly shifted at all with pain and exercise So yes I do think quite possibly our cortisol may not react like it should but it isnt low cortisol which causes our symptoms (I was on cortisol medication but it didnt help).

Probably a new thread should be started if we want to discuss cortisol.

 

[Jenny]

Low cortisol levels are the hallmark of CFS.
It's the only biological marker that puts some doubt even in the minds of the proponents of the biopsychosocial model of CFS. I was told by my CBT therapist that CFS patients typically have low cortisol, whilst in depression cortisol tends to be high. That's anyhow what saved me when I was in the hands of these guys.
I doubt one can successfully raise cortisol levels with this illness. If you can do that, you probably don't have it anymore.

I and others I know have high cortisol.

 

[Charles555nc]

I did a stress bicycle test a couple years ago and my core temp actually decreased. That cant be good.

 

[heapsreal]

i think for cfs/me it might be more accurate to say inappropriate cortisol secretion. wrong time, wrong amount, wrong place. Could explain many of our symptoms.

cheers!!!

 

[taniaaust1]

I did a stress bicycle test a couple years ago and my core temp actually decreased. That cant be good.

Good sign of an oncoming crash.

 

[Waverunner]

Revised Gallbladder flush: ...

You will pass green stones and debris in your bowel movements. I lost 35 lbs of fat over 4 or 5 flushs this way and Im up to about my 12 cleanse. My skin and energy improved a bit and I am actually did one last night. They can be very tough to do though.

This sounds a lot like quackery, I highly doubt that most PWCs have "stones" of any kind.

http://www.quackwatch.org/01QuackeryRelatedTopics/flushes.html

In the usual flush, half a cup or more of a vegetable oil is consumed together with citrus juice and Epsom salts (magnesium sulphate), usually after a brief fast. Many green, brown, yellow or black blobs of various sizes may later appear in the bowel movements. Some bear a slight resemblance to gallstones, but they are not stones. They are merely bile-stained "soaps" produced by partial saponification (soap formation) of the oil. A recent demonstration found that mixing equal volumes of oleic acid (the major component of olive oil) and lemon juice produced several semi-solid white balls after a small volume of potassium hydroxide solution was added. After air-drying at room temperature, these balls became quite solid and hard. When formed in the intestine, these objects absorb bile and become green [5]. It has also been shown that red dye will appear in the interior of the stones if consumed with the oil [1].

The fact that the material is due to some kind of transformation of the oil is clear from user descriptions and ultrasound images. The most obvious evidence is that the alleged stones float on the toilet water [2,3,6], as might be expected of a largely oil-based substance. Gallstones sink. Patients with medically diagnosed gallstones may be able to confirm this for themselves by looking at their own ultrasound scans.The stones, if free to move, will settle at the lowest part of the gallbladder, even though bile is much denser than water.

 

[hixxy]

I'm not overly confident of liver flushes of being much use, but I'm definitely confident that quackwatch is not a good source of information for deciding what medical practices are quackery or not.

hixxy