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Dr Paul Marik's Sepsis/SIRS Protocol for ME/CFS? (Vit C / Hydrocortisone / Thiamine)

Discussion in 'General Treatment' started by Jesse2233, Sep 9, 2017.

  1. Jesse2233

    Jesse2233 Senior Member

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    Dr Paul Marik (of Sentara Norfolk General Hospital) has recently developed a novel treatment protocol for life threatening sepsis.

    [Edit: full protocol]
    • IV Vitamin C (1.5 gm every 6 hours for 4 days)
      Infused over 30 to 60 minutes and mixed in 100ml normal saline / D5W in water

    • IV Thiamine (200 mg every 12 hours for 4 days)
      Infused over 30 minutes 50 ml of either normal saline / D5W following IV Vitamin C

    • IV Hydrocortisone (50 mg every 6 hours for 7 days followed w/ 3 day taper)
    Thus far it has been quite successful;
    Given the latest research, I can't help but wonder if this might be an effective treatment for ME/CFS.

    At the recent OMF Stanford Symposium Dr Wenzhong Xiao indicated that gene expression data matches ME/CFS more closely to SIRS than any other disease. Drs Jose Montoya and Kenny DeMeirleir have made similar statements. When I spoke to KDM earlier this year he told me ME is essentially a low grade chronic sepsis.

    Obviously these treatments have been used individually in many ME patients, but Dr Marik has shown that the protocol's true benefit for SIRS comes from the unique combination.

    My layman's guess at a mechanism of action...

    Hydrocortisone lowers systemic inflammation, Vitamin C fights any underlying infection / acts as an antioxidant, Thiamine supercharges metabolism to fuel the process.

    Has anyone tried this combo or heard of success with it? It seems reasonably safe and low cost

    Of course SIRS is not ME, they are distinct in their presentation and prognosis, but the similarities are too close to ignore

    Tagging
    @Janet Dafoe (Rose49) and @JaimeS in case this is useful to Ron
     
    Last edited: Sep 9, 2017
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  2. Jesse2233

    Jesse2233 Senior Member

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    From Dr Marik's study
     
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  3. ljimbo423

    ljimbo423 Senior Member

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    Those are very impressive treatment results in that study! I have hydrocortisone, thiamine and vitamin C all on hand. I might give it a shot and see how it goes. Although the last couple of times I tried hydrocortisone, I didn't fair so well.

    Chris Armstrong seems to agree-

    LINK


    Jim
     
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  4. Paralee

    Paralee Senior Member

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    I was just wondering if taken orally would work.
     
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  5. Jesse2233

    Jesse2233 Senior Member

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    If you do it, let us know how it goes!

    Going to some digging to find the exact protocol. It's very likely IV, but one might still see results if taken orally
     
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  6. Paralee

    Paralee Senior Member

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    @Jesse2233 , I'm sure in the hospital or a medical setting it would be IV. However, you can buy cortisone cream across the counter (not as strong) or if you had your own for adrenal problems you would probably up it to the point that I read people do for extra stress, etc. The vitamin C and Thiamine would be (according to article) increased considerably. Does sound interesting.
    My DIL lost her mother a few months ago from sepsis that should not have happened in an ICU setting. It scares me to the point of wondering if I would go into a hospital to be treated.

    Edit: Sorry, those were your words, I should have checked first. Anyway, still......
     
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  7. JES

    JES Senior Member

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    You might want to try liposomal Vitamin C. Liposomal achieves somewhat higher (about 30%) concentration in serum than normal vitamin C (article), although it's still far below what IV can achieve. But even the IV peak concentration only stays for a couple of hours.

    I trialed liposomal vitamin C during the past summer. Even from a small dosage of liposomal vitamin C, I can feel the effect within an hour or so. It does intensify some of my immune system related symptoms, such as the small fiber neuropathy. Unfortunately, I couldn't carry on testing it for many weeks, as some of my symptoms worsened too much, which I think is due immune stimulation causing excessive inflammation, as it happens with other immune stimulating herbs as well.

    Anyway, reading this was inspiring, so I plan to trial vitamin C again, this time in combination with some immune suppressing thing (not steroids, but bupropion for example), and see if I can tolerate it better that way, because I definitely felt it did something, and vitamin C is also active against herpesviruses at high dosage.
     
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  8. Paralee

    Paralee Senior Member

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    @JES , buproprion is an immune suppressant? That's Wellbutrin, right?
     
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  9. dannybex

    dannybex Senior Member

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    I went into what I would call a 75% remission with just 2-3 months of thiamine injections alone (and high-dose probiotics) back in 2003, which then lasted 2 years, until I ran out of $$. Then of course later completely forgot that I had done the thiamine injections...thanks brain fog.

    Sepsis is one of the key things that interferes with the pyruvate dehydrogenase enzyme, let alone many other things. Just taxes the body overall.

    It's worth noting though that some people have high cortisol during certain times of the day. I haven't read the study yet, but perhaps the cortisone was only given for a very short period at the beginning...?
     
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  10. JES

    JES Senior Member

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    Yeah, it suppresses TNF-alpha and seems to help in Crohn's disease. I bet it would be used a lot more for immune disorders if it wasn't for the fact that it's a 30 year old antidepressant. Science is about to discover that many existing drugs have off-label potential to treat completely different diseases than what they were intended for, but sadly money still dictates and it's probably the reason why doctors ignore perfectly safe and often times helpful treatments like Wellbutrin or LDN.
     
  11. Learner1

    Learner1 Professional Patient

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    I was getting high dose (50-75g) vitamin C IVs weekly for over 2 years + 4g day orally + B vitamin IVs with lots of B1 + 500-600mg B1 orally, with a lot more stuff.

    I credit it for keeping me functioning as well as I do, I weight lift carefully, work 12-16 hours a week but am a patient the rest of the time...

    Edit - while taking 25mg of hydrocortisone daily

    So, I'd say it has merit, but is not a cure for everyone.
     
    Last edited: Sep 9, 2017
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  12. Jesse2233

    Jesse2233 Senior Member

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    Dr Marik's detailed treatment protocol for sepsis:
    • IV Vitamin C (1.5 gm every 6 hours for 4 days)
      Infused over 30 to 60 minutes and mixed in 100ml normal saline / D5W in water

    • IV Thiamine (200 mg every 12 hours for 4 days)
      Infused over 30 minutes 50 ml of either normal saline / D5W following IV Vitamin C

    • IV Hydrocortisone (50 mg every 6 hours for 7 days followed w/ 3 day taper)
    Source: https://sci-hub.cc/https://www.ncbi.nlm.nih.gov/pubmed/27940189 / Page 9
     
  13. Jesse2233

    Jesse2233 Senior Member

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    @Learner1 as usual you are one step ahead :)

    It seems like Dr Marik's protocol had more frequent and higher doses of hydrocortisone and likely higher doses of thiamine though your dose of vitamin C was much higher (albeit less frequent).

    Might the magnitude of effect be dose and frequency dependent?
     
  14. Jesse2233

    Jesse2233 Senior Member

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    Very interesting, do you recall how long it took you to see improvement from the thiamine and what dose you were taking?
     
  15. Learner1

    Learner1 Professional Patient

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  16. Jesse2233

    Jesse2233 Senior Member

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    The study's discussion of potential mechanism of action:
     
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  17. Learner1

    Learner1 Professional Patient

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  18. Learner1

    Learner1 Professional Patient

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    I'd just like to see someone with sepsis actually get that protocol in a hospital, though...:rofl:
     
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  19. Jesse2233

    Jesse2233 Senior Member

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    To summarize the Marik protocol's rationale / mechanism of action:

    Vitamin C

    • Direct antioxidant
    • Restores other antioxidants
    • Co-factor for iron and coper containing enzymes
    • Enhances T-cell and macrophage function

    Vitamin C / Hydrocortisone
    • Inhibit NF-KB activation (down regulate proinflammatory mediators)
    • Increase tight junctions between endothelial and epithelial cells
    • Preserve endothelial function and microcirculatory flow
    • Fuel synthesis of catecholamines
    • Increase vasopressor sensitivity
    Synergistic complements of Vitamin C & Hydrocortisone
    • Vitamin C reverses oxidation of cysteine thiol groups and improves efficacy of glucocorticoids
    • Synergistically preserves endothelial integrity

    Thiamine
    • Protects kidney from increased oxalates caused by high dose Vitamin C
    • Restores thiamine deficiency found in sepsis

    ---------------------------

    The authors don't discuss it, but I wonder if thiamine is also boosting the efficiency of pyruvate dehydrogenase

    Also I wonder if the increase of tight junctions between endothelial and epithelial cells might repair intestinal permeability in ME/CFS

    And I wonder if the effects on endothelial function, microcirculatory flow, and vassopressor sensitivity might ameliorate POTS/OI
     
    Last edited: Sep 9, 2017
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  20. Jesse2233

    Jesse2233 Senior Member

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    lol I know right? but apparently thanks to Dr Marik it's now being used regularly at Norfolk General Hospital
     

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