Hi Rich,
Thanks for the update! I like this improved model, particularly given the recent Mella & Fluge study where they lowered the immune stress on CFS patients and had some patients with dramatic improvement. Seems we do need to focus more on finding and reducing our oxidative stress load in order to improve our natural methylation, going to whatever is the source of that load. That seems like a major 'aha' about the SMP. More of a focus on freeing our natural methylation, which of course includes supporting the process with the bypass supplements.
So right now I am thinking of the SMP as a supportive and perhaps adjunctive therapy, with the main emphasis for treating CFS in the future being to find the original causes of the glutathione depletion and treating those causes. So if there is autoimmune, treat that. If there are chronic enteroviruses, treat them. If lyme, treat that. Treat mold problems, digestive, leaky gut, candida, etc. Pretty much Dr. Nathan's approach, or the approach of a competent integrated or functional medicine doc. And during all this support the methylation with SMP type therapies.
But we also need to support all the damaged and low-functioning biological processes for any of this to work. And stop any adrenal-looping or other internal stress. I think that is where many patients get stuck, not knowing how to treat the broken adrenals, low blood volume and dehydration, dysfunctional immune system, developing stress management and coping skills, etc. We do well self-treating with nutrients, not hard today to find vitamins and supplements to get better nutrients. But treating these specific functional problems, while at the same time sorting out the original cause of the glutathione depletion and also supporting methylation seems like a real chicken-or-egg problem. Pretty hard for brain-fogged patients.