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Response to Vitamin B12 and Folic Acid in Myalgic Encephalomyelitis and Fibromyalgia

Discussion in 'Latest ME/CFS Research' started by Kati, Apr 24, 2015.

  1. Kati

    Kati Patient in training

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    http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0124648

    Response to Vitamin B12 and Folic Acid in Myalgic Encephalomyelitis and Fibromyalgia
    • Björn Regland ,
    • Sara Forsmark,
    • Lena Halaouate,
    • Michael Matousek,
    • Birgitta Peilot,
    • Olof Zachrisson,
    • Carl-Gerhard Gottfries
    Abstract
    Background
    Patients with myalgic encephalomyelitis (ME, also called chronic fatigue syndrome) may respond most favorably to frequent vitamin B12 injections, in vital combination with oral folic acid. However, there is no established algorithm for individualized optimal dosages, and rate of improvement may differ considerably between responders.

    Objective
    To evaluate clinical data from patients with ME, with or without fibromyalgia, who had been on B12 injections at least once a week for six months and up to several years.

    Methods
    38 patients were included in a cross-sectional survey. Based on a validated observer’s rating scale, they were divided into Good (n = 15) and Mild (n = 23) responders, and the two groups were compared from various clinical aspects.

    Results
    Good responders had used significantly more frequent injections (p<0.03) and higher doses of B12 (p<0.03) for a longer time (p<0.0005), higher daily amounts of oral folic acid (p<0.003) in good relation with the individual MTHFR genotype, more often thyroid hormones (p<0.02), and no strong analgesics at all, while 70% of Mild responders (p<0.0005) used analgesics such as opioids, duloxetine or pregabalin on a daily basis. In addition to ME, the higher number of patients with fibromyalgia among Mild responders was bordering on significance (p<0.09). Good responders rated themselves as “very much” or “much” improved, while Mild responders rated “much” or “minimally” improved.

    Conclusions
    Dose-response relationship and long-lasting effects of B12/folic acid support a true positive response in the studied group of patients with ME/fibromyalgia. It’s important to be alert on co-existing thyroid dysfunction, and we suspect a risk of counteracting interference between B12/folic acid and certain opioid analgesics and other drugs that have to be demethylated as part of their metabolism. These issues should be considered when controlled trials for ME and fibromyalgia are to be designed.
     
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  2. barbc56

    barbc56 Senior Member

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    No control group

    At first glance something doesn't add up but I need to read this again as I can't put my finger on it.

    Maybe the fact that surveys were used and no blood analysis or were they? I can't tell from the abstract.

    Barb

    Edit. I now see you can access the full paper.
     
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  3. barbc56

    barbc56 Senior Member

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    Anyone have a problem with this statement? It seems a bit naive?

     
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  4. Kati

    Kati Patient in training

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    Right, no control group and it seems to me they only recruited patients who had some kind of response to B-12. There are people out there who haven't got a response to B-12

    Disclosure: I only read the abstract.
     
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  5. Valentijn

    Valentijn WE ARE KINA

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    It also sounds like (based on the abstract) they only found significant correlations when subgrouping people according to whether or not they responded to the B12 and folic acid. Which is a nice way of saying that B12 and folic acid help people who are helped by them. It's a bit circular, and doesn't seem to have much to do with the diseases being discussed.
     
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  6. barbc56

    barbc56 Senior Member

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    I think you hit what was bothering me. It is circular reasoning!

    Thanks!

    Barb
     

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