Nitric Oxide: Good or Bad, High or Low in CFS/ME?

[Lotus97]

There was a thread started about this in the Methylation/Chelation forum, but since not everyone follows that forum and the General Treatment forum I thought it would be a good idea to start a thread about it here also. I think everyone is in agreement that peroxynitrite is bad. It's been suggested that increasing nitric oxide (NO) would be bad because it could lead to more peroxynitrite (ONOO), but I don't know if there's any consensus about whether or not it would be a good idea to take supplements that increase nitric oxide.

 

[Lotus97]

I'm confused by this person's article. They quote Dr. Pall, but then conclude that taking arginine is a good thing. I haven't read the whole article, but these are the sections I'm referring to:
http://www.naturdoctor.com/Chapters/Research/CFS.html

Infection and Inflammation
A new theory has been published by Dr. Martin L. Pall (Professor of Biochemistry and Basic Medical Sciences at Washington State University). The theory involves a chain of events:
· Chronic infections that often precede CFS act to induce excessive production of inflammatory cytokines.
· Inflammatory cytokines induce nitric oxide synthase (iNOS) which synthesizes excessive amounts of nitric oxide
· Nitric oxide reacts with superoxide to produce the potent oxidant peroxynitrite (nitrogen dioxide).
· Peroxynitrite acts to increase the levels of both nitric oxide and superoxide which react to produce more peroxynitrite
In this way, once peroxynitrite levels are elevated, they may act to continue the elevation, thus producing a self-sustaining vicious cycle. It is this cycle, according to the theory, that maintains the chronic symptoms of CFS and it is this cycle, therefore, that must be interrupted to effectively treat this condition. [8]
Figure: Peroxynitrate metabolism

Breaking the infection-inflammation cycle

Breaking the chain of inflammation caused by chronic viral infections would require a three-part protocol:
· First, the underlying viral infection should be addressed with antiviral supplements (such as ginseng, echinacea and lactoferrin) and those that shift the Th1:Th2 ratio (such as essential fatty acids and vitamin E).
· Second, inflammation should be reduced with anti-inflammatory agents (such as essential fatty acids and curcumin).
· Third, the nitric oxide system should be supported with supplements such as arginine, vitamin B2 (riboflavin), vitamin B3 (niacin), and folate.

Arginine
Arginine is made in the body from glutamic acid, and is therefore considered semi-essential. Arginine stimulates the first step in the urea cycle, which rids the body of nitrogenous waste. Arginine is concentrated in muscles, where it is responsible for the high energy compounds guanidophosphate, phosphoarginine and creatine.
An article published in the European Journal of Clinical Investigation described a study of the effects of L-arginine on NK cell function in 20 subjects with chronic fatigue syndrome and 21 healthy individuals. Arginine was found to increase NK activity in the healthy subjects but not those with CFS. Further investigation, however, found that the effect of arginine on NK cell activity was mediated by nitric oxide. That is, the increase in NK activity induced by arginine was blocked by the addition of an inhibitor of inducible nitric oxide synthase. NK activity was increased by incubation with a nitric oxide donor. The authors concluded that a dysfunction in the nitric oxide mediated NK cell activation may exist in CFS patients. [40]
Caution – Arginine has been found to promote the growth of Herpes simplex, especially if lysine levels are low.
Both lysine and arginine contribute to immunity and have antiviral properties. Proteins (meats, fish and cheese) usually contain slightly more lysine than arginine, with eggs containing equal amounts. Supplementation with equal amounts of lysine and arginine is recommended for those considering this therapy. One 500 mg capsule of each can be taken once or twice daily..

 

[Lotus97]

Someone posted this article about Dr. Pall in another thread:
http://www.prohealth.com/library/showarticle.cfm?libid=12896

My response was the same as AFCFS

It is very interesting - and gets very complicated. I think, like most of us, we would prefer an easy to digest bit of information: NO = Good or NO = Bad. But instead we get something like this:

 

[kyzcreig]

This is a good post. It's true, perhaps NO isn't the problem as much as a dysregulation of the ONOO cycle, leading to potentially too much peroxynitrate and iNOS while eNOS and nNOS are depressed.

 

[peggy-sue]

NO itself only ever exists for nanoseconds (or less).

 

[Ema]

NO itself only ever exists for nanoseconds (or less).

So is there any point in measuring it with those testing strips if it is so short lasting?

 

[MeSci]

Lots of info about nitric oxide in these threads:

http://forums.phoenixrising.me/inde...ible-implication-in-me-cfs-part-1-of-2.32218/

http://forums.phoenixrising.me/inde...ible-implication-in-me-cfs-part-2-of-2.32304/