Treating patients suffering from ME/CFS with sodium dichloroacetate (pilot trial)

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Twenty-two consecutive patients suffering from refractory myalgic encephalitis/chronic fatigue syndrome (ME/CFS) were treated with an innovative nutriceutical containing sodium dichloroacetate in a proof-of-principle, pilot, open-label prospective cohort trial. Ten patients experienced significant improvement of their health condition with reduction to almost half of their score in the fatigue severity scale. In twelve patients treatment failed to exert any beneficial effect. In the latter patients several other diseases have commonly been revealed by extensive biological and imaging investigations. These preliminary findings sustain the hypothetical role of mitochondrial hypo-metabolism due to inhibition of the activity of the pyruvate dehydrogenase in the pathogenesis of primary ME/CFS, and suggest a possible benefit of nutriceutical treatment by sodium dichloroacetate.
http://www.medical-hypotheses.com/article/S0306-9877(18)30105-1/fulltext#s0040
 

Ema

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I think it's a great idea.

The biggest problem with DCA seems to be tolerability around peripheral neuropathy.

I was afraid to take my dose up that high, but now am feeling inclined to try again sometime!
 

Hip

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I wonder what you think of this Hip.
@Hip
That's an amazing study, thanks for tagging me. So the study found sodium dichloroacetate (DCA) works well for 10 out of 22 ME/CFS patients (45%).

On this forum in 2016 we were talking about using DCA, after the Fluge and Mella metabolomic study found evidence for impaired pyruvate dehydrogenase functioning in ME/CFS. Because DCA stimulates the pyruvate dehydrogenase complex, it seemed like DCA would be worth trying. Here it says:
Dichloroacetate indirectly activates the pyruvate dehydrogenase complex by inhibiting the pyruvate dehydrogenase kinases by the same mechanism as pyruvate.

So at that time I decided to try some DCA. I took DCA 350 mg in two divided dose on the same day. But I found it made me sleepy for a few hours, rather than boosting energy. And the following day I felt depressed and frail, and this depression then lasted for nearly a month, and was hard to get rid of, and may have been triggered by the DCA (but I do get such periods of neurologically-caused depression anyway). So this put me off trying DCA further, and it's been on my shelf ever since. However, in the light of this new study, I think I may consider gingerly trying DCA again.



DCA is used as a cancer treatment, and you can find it for sale by Googling dichloroacetate cancer buy.

I believe the usual DCA doses for cancer are (for an 80 kg person) around 800 mg a day as preventative anti-cancer maintenance, and around 1,600 mg a day for cancer treatment — see this post.

But this ME/CFS study used only 400 mg DCA daily, which is a lower and thus safer dose.



There are some risks of developing neuropathy from higher doses of DCA, but taking benfotiamine, acetyl L-carnitine and alpha lipoic acid can help protect against this (see this post).

In the study on DCA for ME/CFS, they used these supplements as a safeguard:
The initial 10 patients were treated with a nutriceutical consisting of the 400 mg of sodium salt of dichloroacetate (DCA) plus 100 mg Vitamin B1. Afterwards the formulation was extended by adding alfa-lipoic acid (ALA), acetyl-l-carnitine and the oxidoreductase ubiquinone Q10


Some people on this forum found that DCA is beneficial for ME/CFS:

@XenForo reported that DCA gives him/her much more energy.

@nanonug recently posted this protocol he takes containing DCA which reduces brain fog.

@Mya Symons reported that DCA seemed to help his ME/CFS and fibromyalgia, but found DCA caused some stomach pain and nausea.



Nausea, vomiting and indigestion are known side effects of DCA that can appear in some people, but these can be countered with a proton pump inhibitor drug (see this post). Alternatively, DCA might be administered transdermally to try to avoid these stomach issues (DCA has a molecular weight of around 129 daltons, which is well below the 500 dalton limit for transdermal absorption, so should absorb transdermally).

DCA has unusual half-life characteristics: when you first take it, the half-life is less than 1 hour, but DCA possesses some unknown mechanism by which it inhibits its own metabolism and elimination, so with continued use, the half life goes up to several hours (ref: here).
 
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nanonug

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https://www.dcalab.com/products has it for about $0.80 per capsule. Seems like the cheapest.
This is the brand that I use and they ship pretty much everywhere and from several warehouses (US/EU/Canada.) They are a Lithuanian company.

PS. They are the Lithuanian company from which the product used in the study was obtained.