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Findings from the UK NHS Long COVID Clinic treating patients with neurological symptoms

xebex

Senior Member
Messages
840
@Countrygirl I started wentzels stack a week ago, not sure about the other supps (I’ve tried them before with no change but I am taking them all this tIme, along with the niacin) the niacin is having a positive impact, I’m managing slightly More steps a day, my circulation seems better, my muscle fatigue is improved it seems I can take the niacin when I feel I’m crashing and make the crash go away so it’s substantially reducing PEM.

It seems to lower blood pressure if I take too much and make me feel POTSy but I didn’t crash from that. I don’t yet feel I can go massively over my regular step count as I think I need to figure out this new version of me - I still don’t feel quite right. But I’m tracking my activity with an HR monitor and it seems I can function in a higher activity zone - ie heart rate increase doesn’t trigger crash quite as fast and If I do start to crash I can just take another niacin. I’m taking 25 or 50mg depending on how I feel. So far I would say I have gone from 40% functional to 50%.
 
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bertiedog

Senior Member
Messages
1,740
Location
South East England, UK
@Countrygirl Thanks so much for posting the video, it really is fascination if complex.

I wanted to post that I have been taking zinc, vitamin C daily, nicotinamide and occasional selenium for years but no great obvious benefit. I have checked my vitamin D level and it shouldn't be any higher than it is. I also take essential fatty acids and coenzyme q10 plus a few other supplements.

Recently, after my first Pfizer vaccine I developed a horrible massive HISTAMINE reaction to something in my breakfast so have since added in Quercertin and found out the reaction happens whenever I have any type of gluten free product except oats so naturally I have stopped these.

Nine days ago I added in NMN which stands for NICOTINAMIDE MONONUCLEOTIDE 150 mg which is half a capsule of the supplement I bought from eBay. I started to notice a difference in my energy from the second day which has continued until yesterday when I had a severe migraine caused by something else.

I have noticed an ability to be able to stand and do jobs in the kitchen for almost double the time to what I would normally be able to do and last week my number of steps according to my Fitbit were considerable up, actually to just over 10,000 a day which is ridiculous for me. Normally at this time of the year it would be more like 8000 as long as I stayed virus free. I had no PEM even though on some days I knew I was pushing it but there were lots of gardening jobs I wanted to do. I did end up with a respiratory virus which made me unwell for one day but got over it in 4 days. (I do of course realise I am extremely fortunate to be able to do what I do but often it isn't without out symptoms of severe IBS and migraines).

Its very early days but it is looking very promising. My sleep has also improved in its quality but not in the length of time I am asleep which is fairly short at around 6 1/2 hours a night. I also hadn't had a migraine for over a week until messing things up yesterday.

The thing that threw me off was that I added in some DHEA having had a urine test which showed I was very low in this. I am steroid dependent so have to take a low dose of Prednisolone plus I have to take desiccated thyroid medication and a dash of oestrogen daily. The DHEA undoubtedly caused the stubborn migraine so it goes to show that for some of just sorting out our energy/immune system as the NAD+ theory goes won't be enough, we have to sort out our individual hormonal issues too for it to really work.

Good luck with your programme, I really hope you get good results. You really do deserve it for everything you have done to help the ME community.

Pam
 

godlovesatrier

Senior Member
Messages
2,554
Location
United Kingdom
Really interesting Pam. Don't suppose you could create a thread just for the NICOTINAMIDE MONONUCLEOTIDE ? I only ask so that more people will see it and we can track your progress as you go :)

I figure it it helps you it might help someone else! :D I've added it to my list of experiments. Thanks for letting us know about it.
 

bertiedog

Senior Member
Messages
1,740
Location
South East England, UK
Really interesting Pam. Don't suppose you could create a thread just for the NICOTINAMIDE MONONUCLEOTIDE ? I only ask so that more people will see it and we can track your progress as you go :)

I figure it it helps you it might help someone else! :D I've added it to my list of experiments. Thanks for letting us know about it.

I can do that and copy the above post. However I have just found some very depressing research which is probably the reason why I still have the nasty migraine. Excess nicotinamide raises serotonin and HISTAMINE which for me is a real issue as I don't possess the enzymes to degrade it. The research paper also shows it can inhabit other parts of the methylation cycle.

Always feels like one step forward and then two backwards!

Here is the quote from the research article - Compared with those before nicotinamide load, five-hour postload plasma serotonin and histamine levels significantly increased. These results suggest that excess nicotinamidecan disturb monoamine-neurotransmitter metabolism.

Excess nicotinamide increases plasma serotonin and histamine levels
Yan-Jie Tian 1, Da Li, Qiang Ma, Xin-Yi Gu, Ming Guo, Yong-Zhi Lun, Wu-Ping Sun, Xin-Yuan Wang, Yu Cao, Shi-Sheng Zhou

  • PMID: 23426511
BTW They used 100 mg nicotinamide and I have been taking 150 mg.
Pam
 

livinglighter

Senior Member
Messages
379
You have to advocate for yourself so hard.
I’ve complained to management, pointed out the NHS classification of ME, provided NHS specialist documentation, enlisted help from private doctors and even changed GP just to get access to some of the right type of treatment on the NHS. My battle still isn’t over, my medical records are a mess, but the conversation is just starting to move away from me having a pychosomatic illness.

A while back NICE advised to wait until the new guidelines are published before making complaints. Look through the BACME documents all the illness management and recommended testing is in there, it even declares CFS/ME is not a mental illness. The question is who did they provide it to?

https://www.southtees.nhs.uk/content/uploads/BACME-Guide-5815.pdf

Read the document, this is what fatigue services should be following regarding ME/CFS. Show your GP, get them to communicate with the services about how they should be managing you based on your symptoms in primary care. Exercise intolerance is autonomic dysfunction. PEM related to a ridiculously low anaerobic threshold.

The NICE draft guidelines highlighted the lack of specialist information sharing. I attended fatigue clinic and didn’t get access to what the BACME guide suggests. The whole thing is a mess but if you can collate information and present it, it helps.
 
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livinglighter

Senior Member
Messages
379
What do you do when your GP passes the carefully researched documents you have offered to him back across the desk without so much as a cursory glance?

"You can lead a horse to water . . ." and all that.

Indicates the need for a different GP……. I made a patient care concern (informal complaint) and directed management to the NHS website which sates ME is a relapsing neurological condition. The GP cannot say it’s functional because they want to. It’s not your problem they have been misinformed.
 

livinglighter

Senior Member
Messages
379
He WAS the "different" GP, the latest in a long list of many. At least he didn't roll his eyes and sigh heavily before handing back my paperwork, as most do - I call that a win . . . almost! :D

I know it’s hard and discouraging when you have been through a string of GP’s who don’t get it and refuse to listen. I’ve almost given up countless times myself.

My practice manager also advised it could be difficult for me to get a doctor to change their stance towards how they treat the illness if they strongly believe it is a mental illness despite my supporting evidence. I was lucky to have been provided another one who understands a bit more about CFS or is willing to listen.

Do you think your GP will follow the guidance of a specialist such as Dr Weir? If yes, then that can be one way of going about it. Dr Weir provides a lot of information following the first consultation to your GP to help with better care, testing, etc. You’ll need a GP who will care for you according to specialists. Me and my family agreed that was the basic criteria in trying to find a new GP for accessing better medical care on the NHS.
 

Revel

Senior Member
Messages
641
Do you think your GP will follow the guidance of a specialist such as Dr Weir?
@livinglighter, in a word, "no".

What did work in my favour for a while was that I received a POTS diagnosis and my GP was much more comfortable believing that my symptoms were entirely due to this condition.

In fact, I self-diagnosed POTS and then asked the GP to refer me to the local NHS POTS consultant, which he was more than happy to do.

There, I received my clinical diagnosis. Unfortunately, after numerous failed attempts at controlling my POTS (drug intolerances), the consultant wrote back to my GP, stating that he was unable to make any progress with me, owing to the ME!

He later dropped me from his POTS clinic, partly because I refused to accept his suggestion of a referral to a psychologist at the neighbouring county's Chronic Fatigue Clinic (turned out he was a huge fan of Wessely's work on ME/CFS) but also, I suspect, because I was adversely affecting his exemplary success rate. So now, I have nobody overseeing my care.

I even had a severe reaction to the AstraZeneca vaccine back in March (transient limb paralysis) and my GP clinic showed scant interest at best, and has done nothing to help me recover my balance and normal gait.

I've managed to survive with ME/CFS through almost half a century of both private and NHS gaslighting. At this point in time, I am done with doctors.

PS. Apologies for taking the thread off track. :oops:
 
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Countrygirl

Senior Member
Messages
5,476
Location
UK
@Countrygirl I started wentzels stack a week ago, not sure about the other supps (I’ve tried them before with no change but I am taking them all this tIme, along with the niacin) the niacin is having a positive impact, I’m managing slightly More steps a day, my circulation seems better, my muscle fatigue is improved it seems I can take the niacin when I feel I’m crashing and make the crash go away so it’s substantially reducing PEM.

It seems to lower blood pressure if I take too much and make me feel POTSy but I didn’t crash from that. I don’t yet feel I can go massively over my regular step count as I think I need to figure out this new version of me - I still don’t feel quite right. But I’m tracking my activity with an HR monitor and it seems I can function in a higher activity zone - ie heart rate increase doesn’t trigger crash quite as fast and If I do start to crash I can just take another niacin. I’m taking 25 or 50mg depending on how I feel. So far I would say I have gone from 40% functional to 50%.

@xebex
@bertiedog

Apologies for my late response! I have missed this thread until today.

I was very interested in your experiences with the 'stack'.

However, I think you are taking the wrong form that won't get you very far, if this is so. You need NICOTINIC ACID NOT NICOTINAMIDE. This is very important.

You must take the flushing form of niacin. You also need vits C and D, quercetin, selenium, and zinc.

A few days ago, I attended a Zoom meeting with Dr Wentzel with a small group and was rivetted by the information.

In one group on Facebook to which I belong, 70 Long Covid patients are on the stack and 68 improved considerably. Of the two who didn't, one was taking too low a dose and the other had other serious comorbidities and they have been referred to Dr Wentel to sort out.

Dr Wentzel has 700 now on his stack and he says it is treating them successfully.

I am yet to write up my notes of the two-hour chat which I shall be sending to Dr Weir. I doubt I can post them publically as he has another paper coming out shortly so some of the information cannot be in the public domain yet.

He has been tweaking the protocol and I was fascinated to listen to him describe how it works as it was like reading one of Prof Ron Davies's explanations of ME where he discusses the kynurenine pathway They seem to have both discovered the same pathway abnormalities. When I spoke with Dr Wentzel, he said he had never heard of Prof Davies. I think it would be worthwhile if they communicated with each other.

It is very important to take the flushing form and to build up slowly and not become alarmed if you flush. That is a sign that you are deficient in niacin. Patients find they experience an improvement within 24 hours and they continue in this 'honeymoon' stage for about 3 weeks, and then they plateau, but it is important to continue although the improvement is then 'slothlike'.

He thinks that Covid (and other viruses?) cause permanent genetic damage which means that niacin deficiency becomes permanent and so supplication is required for the rest of your life. In other words, the disease is something akin to chronic pellagra which includes such symptoms as sensitivity to light, sound, etc which are all familiar to us.

Dr Wentzel has also tweaked the protocol and now adds vitamin B12, B6 and resveratrol.

He has now created a product in capsule form which contains all the ingredients you need instead of having to buy several bottles of vitamins and minerals.

One word of warning: you do have to take care not to trigger serotonin syndrome so it is important to get clearance from your doctor.

I am hoping that Dr Weir will do a UK trial of the 'stack' with Dr Wentzel as the next stage is to discover whether it is successful with ME. Dr W could use his clinic patients from East Devon, Northern Ireland and perhaps from London as trial participants. I am encouraging him to do this at the moment.
 
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bertiedog

Senior Member
Messages
1,740
Location
South East England, UK
You must take the flushing form of niacin.

As mentioned in my PM I cannot tolerate any vasodilators like niacin because they give me non stop severe migraines. Also NMN isn't normal nicotinamide, it's chemically different and directly feeds into NAD +. There are some good diagrams around that I have seen.

The NMM really helps my energy until one of these viral type episodes come along which has been happening all too frequently since I had my Pfizer vaccines. Everything tends to fall apart because with the swollen gland behind my left ear, the very sore swollen throat, bits of sneezing and coughing comes complete exhaustion. Thankfully these episodes only last 2 to 3 days but they come along much too frequently since April and my second vaccination.

I would love to know what is going on!

Pam