Hip
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Some thoughts —eating collagen , proline. Hyaluronic acid injection into ligaments?
Vitamin c intake
Bpc-157 , a peptide That @Hip mentkoned. Also nandrolone , an anabolic steroid often used in aids patients for muscle wasting, but also has progestogen effects.
My feeling is that supplements which are touted to help tendon and ligament repair probably will not do much to help strengthen the assumed lax ligaments in CCI/AAI, with perhaps the exception of BPC-157.
20 years ago, due to a yoga mishap, I managed to permanently stretch the ligaments which connect my right pelvis to my spinal column (at the sacroiliac joint). Ever since, my right pelvis has remained slightly loose, and when I walk there is almost a limp.
At the time, I started looking into supplements that might potentially aid healing of a stretched ligament, and found lots of them: vitamin C, silica, copper, goto kola, xylitol, lysine, proline, vitamin B2, glycine, PABA, glucuronolactone and arginine (to boost NO which helps ligament healing). So I took a cocktail of all of these for some time, but this did not help one iota in improving my stretched pelvic ligaments.
So in my experience, healing stretched or lax ligaments is not really aided by nutrition.
I've not properly tried BPC-157 for my pelvis, but I suspect it might have mild benefits (it caused some anxiety side effects when I took it, so had to stop). I really need to get some prolotherapy done to try to fix my pelvic girdle, but this is now low priority for me, since ME/CFS is always the main issue.
There is also a new alternative to prolotherapy called prolozone, which injects ozone rather than glucose into the ligaments, and is less painful.
Recently I found that the oral supplement GABA at 100 mg daily increases elastin synthesis and dramatically increases elastin fiber formation in human skin fibroblasts: see here. So this is a new one on my radar to try for both my loose girdle, and I guess potentially useful for CCI/AAI.
Fibroblasts are the cells which secrete substances like collagen and elastin needed to maintain and repair connective tissue.
Pulsed electromagnetic fields have been shown to help ligament healing, but when I tried this, I did not notice much improvement in my loose pelvis.
Intriguingly, the audio frequencies at which cats purr are supposed to increase bone, tendon and ligament healing. The frequency of 120 Hz is shown effective for tendons, and this is one of the harmonics of normal cat purrs (which have a fundamental frequency of 25 to 50 Hz). This healing effect of purring is thought might explain why cats heal faster and better than dogs. See this article.
So perhaps setting up a loudspeaker close to your neck playing a 120 Hz tone might promote ligament healing and strenthening in cases of CCI/AAI.
But my feeling is that if the CCI/AAI in ME/CFS patients is due to lax ligaments, then we need to figure out what it causing the laxness, and address that. (Though note that lax ligaments are not the only cause of CCI/AAI; it can also be caused by soft bones).
I suggested in this post that connective-tissue degrading enzymes called matrix metalloproteinases (MMP) might be the cause of the lax ligaments in CCI/AAI. These MMP enzymes are secreted by the immune system during viral infection.
In this post I listed some agents that can inhibit MMP. The classic MMP inhibitor is low-dose doxycycline.
But there are also other enzymes which can break down connective tissue, such as neutrophil elastase, and fibroblast elastase. One Dr Kenny De Meirleir study I believe found elevated neutrophil elastase in ME/CFS. So neutrophil elastase might be the culprit causing CCI/AAI in ME/CFS. Indole-3-carbinol (I3C) is a potent neutrophil elastase inhibitor.
If there is a process constantly breaking down connective tissue (such as these MMP enzymes or neutrophil elastase), then you probably want to address that first, to prevent the continued breakdown, as well as trying to boost the repair and re-building processes of connective tissue.