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Ritalin vs. Modafinil vs. Selegiline


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#1 steelsky

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Posted 18 October 2008 - 10:54 PM


I have a case of chronic fatigue which is characterized by "sleepiness" rather than lack of energy. This distinction is important as I've been experimenting with several "energy enhancing" supplements, without any major success. My main problem is feeling "sleepy", not necessarily tired.
The distinction is apparent when I'm taking Ritalin (either Concerta, LA or the regular kind) for functioning normally - while I'm filled with boosting energy (which keeps me awake and functioning), I nevertheless still feel an urging inclination to close my eyes, like feeling the sleepiness "underneath" it all.

Since I've seen some posts here about Modafinil and Selegiline, I was wondering about the differences in their effects compared to Ritalin (which, in its defence, HAS had a major positive effect on me, both nootropic and antidepressing... the latter is also distinctive from Prozac, which I also take, where the Ritalin relates more to my motivation and "drive", and Prozac is more for general satisfaction and wellbeing).

#2 Iam Empathy

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Posted 19 October 2008 - 01:19 AM

I have a case of chronic fatigue which is characterized by "sleepiness" rather than lack of energy. This distinction is important as I've been experimenting with several "energy enhancing" supplements, without any major success. My main problem is feeling "sleepy", not necessarily tired.
The distinction is apparent when I'm taking Ritalin (either Concerta, LA or the regular kind) for functioning normally - while I'm filled with boosting energy (which keeps me awake and functioning), I nevertheless still feel an urging inclination to close my eyes, like feeling the sleepiness "underneath" it all.

Since I've seen some posts here about Modafinil and Selegiline, I was wondering about the differences in their effects compared to Ritalin (which, in its defence, HAS had a major positive effect on me, both nootropic and antidepressing... the latter is also distinctive from Prozac, which I also take, where the Ritalin relates more to my motivation and "drive", and Prozac is more for general satisfaction and wellbeing).


I normally take 2.5mg Selegiline together with 50 - 100mg Modafinil. I take the Selegiline about 30 minutes or 1 hour before taking the Modafinil. Although I've only been experimenting myself with these two drugs for a little less than one month. What I do is take them irregularly and "as needed".

I feel cognative enhancement with Selegiline. Whereas, I feel 'extremely motivated' for about eight hours every time I take Modafinil. Together they really seem to compliment each other. That is why I mention that I take them together as a combination.

I've never taken Ritalin, but I use to take Adderal. I can truly reiterate what many people say: That Modafinil is almost as good as Adderal, except without all the "negative" side effects of Adderal, Methamphetamine, and probably to a lesser degree Ritalin.

Just my two cents.
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#3 Ghostrider

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Posted 19 October 2008 - 01:28 AM

I have a case of chronic fatigue which is characterized by "sleepiness" rather than lack of energy. This distinction is important as I've been experimenting with several "energy enhancing" supplements, without any major success. My main problem is feeling "sleepy", not necessarily tired.
The distinction is apparent when I'm taking Ritalin (either Concerta, LA or the regular kind) for functioning normally - while I'm filled with boosting energy (which keeps me awake and functioning), I nevertheless still feel an urging inclination to close my eyes, like feeling the sleepiness "underneath" it all.

Since I've seen some posts here about Modafinil and Selegiline, I was wondering about the differences in their effects compared to Ritalin (which, in its defence, HAS had a major positive effect on me, both nootropic and antidepressing... the latter is also distinctive from Prozac, which I also take, where the Ritalin relates more to my motivation and "drive", and Prozac is more for general satisfaction and wellbeing).


I normally take 2.5mg Selegiline together with 50 - 100mg Modafinil. I take the Selegiline about 30 minutes or 1 hour before taking the Modafinil. Although I've only been experimenting myself with these two drugs for a little less than one month. What I do is take them irregularly and "as needed".

I feel cognative enhancement with Selegiline. Whereas, I feel 'extremely motivated' for about eight hours every time I take Modafinil. Together they really seem to compliment each other. That is why I mention that I take them together as a combination.

I've never taken Ritalin, but I use to take Adderal. I can truly reiterate what many people say: That Modafinil is almost as good as Adderal, except without all the "negative" side effects of Adderal, Methamphetamine, and probably to a lesser degree Ritalin.

Just my two cents.


It's funny that you post all this now. I have been considering trying modafinil. As I mentioned in one of my other posts on here, I am kinda going through a tough time in my life. I feel tired most of the time, but my sleep is cut off around 5 or 6 am when I am awaken for no reason other than general anxiety and uncertainty about my future. I have never felt this level of doubt and resulting distraction / lack of focus before. I read up on Modafinil on wikipedia and it sounds like a good fix for all my current symptoms. Question is, how did you get Modafinil? I would imagine that it is difficult to acquire.

#4 steelsky

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Posted 19 October 2008 - 02:20 AM

Modafinil, from what I've researched so far, has a general similarity to the effect of Ritalin; namely influencing dopamine and norepinephrine neurotransmitter, yet their mechanism of action is different. Modafinil also influences serotonin and glutamic acid (which is related to learning and memory), as oppose to Ritalin.
Selegiline works on MAO-B mainly, which refers to phenethylamine, yet I don't know much about this specific neurotransmitter. Among the three it is the one most associated with a nootropic effect.

I am also interested in Piracetam, which to my surprise is sold in the US as a supplement, yet is considered a drug anywhere else.

#5 Moonbeam

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Posted 20 October 2008 - 01:14 AM

Thanks for this thread; I use modafinil sometimes and selegeline sometimes but I was worried about the combination.

Could somebody who does this indicate dosages and timing? Thanks.

#6 steelsky

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Posted 20 October 2008 - 02:56 AM

Thanks for this thread; I use modafinil sometimes and selegeline sometimes but I was worried about the combination.

Could somebody who does this indicate dosages and timing? Thanks.


could you point out the difference in the effect of each? For what purpose are you taking them?

#7 mystery

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Posted 20 October 2008 - 03:35 AM

I have a case of chronic fatigue which is characterized by "sleepiness" rather than lack of energy. This distinction is important as I've been experimenting with several "energy enhancing" supplements, without any major success. My main problem is feeling "sleepy", not necessarily tired.
The distinction is apparent when I'm taking Ritalin (either Concerta, LA or the regular kind) for functioning normally - while I'm filled with boosting energy (which keeps me awake and functioning), I nevertheless still feel an urging inclination to close my eyes, like feeling the sleepiness "underneath" it all.

Since I've seen some posts here about Modafinil and Selegiline, I was wondering about the differences in their effects compared to Ritalin (which, in its defence, HAS had a major positive effect on me, both nootropic and antidepressing... the latter is also distinctive from Prozac, which I also take, where the Ritalin relates more to my motivation and "drive", and Prozac is more for general satisfaction and wellbeing).


I know of the distinction between drowsiness & being tired. Did this problem start when taking Prozac?

I would start with modafinil, as I seem to notice a specific anti-drowsiness effect after a few hours of taking it. Initially though, I seem to be more drowsy which is odd. I did notice more alertness & less drowsiness on selegiline, but there were lots of other effects too and not just a specific effect countering drowsiness.

#8 Ghostrider

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Posted 20 October 2008 - 05:29 AM

I have a case of chronic fatigue which is characterized by "sleepiness" rather than lack of energy. This distinction is important as I've been experimenting with several "energy enhancing" supplements, without any major success. My main problem is feeling "sleepy", not necessarily tired.
The distinction is apparent when I'm taking Ritalin (either Concerta, LA or the regular kind) for functioning normally - while I'm filled with boosting energy (which keeps me awake and functioning), I nevertheless still feel an urging inclination to close my eyes, like feeling the sleepiness "underneath" it all.

Since I've seen some posts here about Modafinil and Selegiline, I was wondering about the differences in their effects compared to Ritalin (which, in its defence, HAS had a major positive effect on me, both nootropic and antidepressing... the latter is also distinctive from Prozac, which I also take, where the Ritalin relates more to my motivation and "drive", and Prozac is more for general satisfaction and wellbeing).


I normally take 2.5mg Selegiline together with 50 - 100mg Modafinil. I take the Selegiline about 30 minutes or 1 hour before taking the Modafinil. Although I've only been experimenting myself with these two drugs for a little less than one month. What I do is take them irregularly and "as needed".

I feel cognative enhancement with Selegiline. Whereas, I feel 'extremely motivated' for about eight hours every time I take Modafinil. Together they really seem to compliment each other. That is why I mention that I take them together as a combination.

I've never taken Ritalin, but I use to take Adderal. I can truly reiterate what many people say: That Modafinil is almost as good as Adderal, except without all the "negative" side effects of Adderal, Methamphetamine, and probably to a lesser degree Ritalin.

Just my two cents.


What condition are you taking these drugs for? I thought Selegiline was only for people with Parkinsons disease.

#9 Pulptor

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Posted 20 October 2008 - 10:41 PM

I use both selegiline and modafinil. Selegiline (at 5 mg) doesn't do anything to wake me up. It does lift my mood a little. That's why I occassionally take it. Modafinil is a "wakeful agent", and does exactly that. For me, modafinil is better than caffeine. I like to cut a 200 mg pill in half, take the half when needed (typically early afternoon).

Some docs will prescribe modafinil only for diagnosed cases of narcolepsy. Other docs will give you a prescript if you just say you're chronically sleepy. Still others are open to using it as an anti-depressant (he was my favorite). Or you could buy it online.

Edited by Pulptor, 20 October 2008 - 10:47 PM.


#10 steelsky

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Posted 21 October 2008 - 01:56 AM

I use both selegiline and modafinil. Selegiline (at 5 mg) doesn't do anything to wake me up. It does lift my mood a little. That's why I occassionally take it. Modafinil is a "wakeful agent", and does exactly that. For me, modafinil is better than caffeine. I like to cut a 200 mg pill in half, take the half when needed (typically early afternoon).

Some docs will prescribe modafinil only for diagnosed cases of narcolepsy. Other docs will give you a prescript if you just say you're chronically sleepy. Still others are open to using it as an anti-depressant (he was my favorite). Or you could buy it online.


Thank you for the input. That is good news for me (at least potentially), as I use Ritalin for staying awake. I enjoy the other benefits of Ritalin, but there is just the problem that it doesn't relieve my sleepy feeling, it just sorta "forces" me to keep awake. Modafinil is strongly advocated as a nootropic, which makes my interest in it stronger.
Just one question, though - what's the modafinil's half-life? When I take Ritalin, even in the "longest release" forms, it doesn't last long (maybe because I take small dosages anyway) - about 7 hours at most.
In any case, I hope I would be able to get someone to prescribe both Ritalin and Modafinil (would like to still take Ritalin when desiring a boost).

#11 Pulptor

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Posted 21 October 2008 - 11:04 PM

Thank you for the input. That is good news for me (at least potentially), as I use Ritalin for staying awake. I enjoy the other benefits of Ritalin, but there is just the problem that it doesn't relieve my sleepy feeling, it just sorta "forces" me to keep awake. Modafinil is strongly advocated as a nootropic, which makes my interest in it stronger.
Just one question, though - what's the modafinil's half-life? When I take Ritalin, even in the "longest release" forms, it doesn't last long (maybe because I take small dosages anyway) - about 7 hours at most.
In any case, I hope I would be able to get someone to prescribe both Ritalin and Modafinil (would like to still take Ritalin when desiring a boost).


Wikipedia says the half life is 10-12 hours. For me, there's a definite effects curve. The strong peak seems to last about 3 hours, with a gradual tapering from there to nothing after 8-10 hours. A more even response is probably possible with smaller doses taken more often. Don't be afraid to cut the pills and experiment. Like food, sometimes less more often is better than a lot all at once.

#12 Wedrifid

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Posted 22 October 2008 - 04:52 PM

In any case, I hope I would be able to get someone to prescribe both Ritalin and Modafinil (would like to still take Ritalin when desiring a boost).


You are a smart boy. I'm sure you can think of a way to get around that potential problem.

#13 Moonbeam

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Posted 23 October 2008 - 12:45 AM

could you point out the difference in the effect of each? For what purpose are you taking them?


selegeline - recreational dreaming.

modafinil - the day after, if I'm tired.

I use both selegiline and modafinil. Selegiline (at 5 mg) doesn't do anything to wake me up. It does lift my mood a little. That's why I occassionally take it. Modafinil is a "wakeful agent", and does exactly that. For me, modafinil is better than caffeine. I like to cut a 200 mg pill in half, take the half when needed (typically early afternoon).


Thanks.

#14 steelsky

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Posted 24 October 2008 - 04:22 AM

BTW, I've noticed that Ashwagandha (especially the Sensoril extract) is getting some opinions about its similarities to deprenyl (Selegiline). Any thoughts about that? Info?

I've just now added 225mg of it to my daily regimen (to combat stress and fatigue), but I was glad to find it might have some mind boosting effects. I will keep ya'all updated about my experience.

#15 jeromewilson

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Posted 24 October 2008 - 11:41 AM

It's funny that you post all this now. I have been considering trying modafinil. As I mentioned in one of my other posts on here, I am kinda going through a tough time in my life. I feel tired most of the time, but my sleep is cut off around 5 or 6 am when I am awaken for no reason other than general anxiety and uncertainty about my future.


Be careful with Modafinil if you're prone to anxiety anyway, as it can be anxiolytic itself. I'm taking escitalopram at the moment, essentially for generalised anxiety tending to depression, and modafinil seems to combine very well with it, probably because the escitalopram rounds off the modafinil's jagged edges. However, I have still noticed that the modafinil can still exacerbate latent anxiety on occasions, plus one of the main reasons I feel the need to take the modafinil is to combat the larthargy that I'm sure has been caused by the SSRIs...

In your situation I think I'd try to find something to help with the anxiety first (e.g. 5HTP / L-Theanine / Ashwagandha / Rhodiola Rosea) and then think about the modafinil if you still fancy trying it.

Generally speaking, it's pretty easy to get hold of - see the Suppliers topic.

#16 john16

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Posted 24 October 2008 - 12:42 PM

can someone pm me a reliable supplier for modafinil?

#17 jeromewilson

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Posted 24 October 2008 - 07:46 PM

Be careful with Modafinil if you're prone to anxiety anyway, as it can be anxiolytic itself.


Oops, of course I meant anxiogenic.

#18 steelsky

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Posted 27 October 2008 - 10:33 AM

Great news.
Got my doc to prescribe Mod, so I'm going to start taking it (instead of Ritalin) in a couple of days. Problem is - it costs a fortune here! No HMO cover whatsoever.

Anything I should know while taking it? Precautions and things to notice?

#19 Ghostrider

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Posted 29 October 2008 - 04:44 AM

I have a case of chronic fatigue which is characterized by "sleepiness" rather than lack of energy. This distinction is important as I've been experimenting with several "energy enhancing" supplements, without any major success. My main problem is feeling "sleepy", not necessarily tired.
The distinction is apparent when I'm taking Ritalin (either Concerta, LA or the regular kind) for functioning normally - while I'm filled with boosting energy (which keeps me awake and functioning), I nevertheless still feel an urging inclination to close my eyes, like feeling the sleepiness "underneath" it all.

Since I've seen some posts here about Modafinil and Selegiline, I was wondering about the differences in their effects compared to Ritalin (which, in its defence, HAS had a major positive effect on me, both nootropic and antidepressing... the latter is also distinctive from Prozac, which I also take, where the Ritalin relates more to my motivation and "drive", and Prozac is more for general satisfaction and wellbeing).


Are you sure you have chronic fatigue? It's a little more than just being tired all the time. Here are the symptoms from wikipedia:

, unexplained, persisting (lasting six months or longer), "not due to ongoing exertion," and not substantially reduced by rest. The person must have experienced a significant reduction in activity levels.2. Four or more of the following symptoms
  • Impaired memory or concentration
  • Post-exertional malaise, where physical or mental exertions bring on "extreme, prolonged exhaustion and sickness"
  • Unrefreshing sleep
  • Muscle pain (myalgia)
  • Pain in multiple joints (arthralgia)
  • Headaches of a new kind or greater severity
  • Sore throat, frequent or recurring
  • Tender lymph nodes (cervical or axillary)
You might just have excessive daytime sleepiness.

#20 FunkOdyssey

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Posted 29 October 2008 - 01:33 PM

Are you sure you have chronic fatigue? It's a little more than just being tired all the time. Here are the symptoms from wikipedia:

, unexplained, persisting (lasting six months or longer), "not due to ongoing exertion," and not substantially reduced by rest. The person must have experienced a significant reduction in activity levels.2. Four or more of the following symptoms

* Impaired memory or concentration
* Post-exertional malaise, where physical or mental exertions bring on "extreme, prolonged exhaustion and sickness"
* Unrefreshing sleep
* Muscle pain (myalgia)
* Pain in multiple joints (arthralgia)
* Headaches of a new kind or greater severity
* Sore throat, frequent or recurring
* Tender lymph nodes (cervical or axillary)


...and if you have these symptoms, you don't have chronic fatigue (a garbage, meaningless, copout diagnosis just like fibromyalgia), you have chronic infection, be it bacterial (Lyme, etc), viral (Parvovirus B19, CMV, HHV-6, etc), or parasitic (babesiosis, etc). Happy hunting.

#21 steelsky

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Posted 29 October 2008 - 04:37 PM

Are you sure you have chronic fatigue? It's a little more than just being tired all the time. Here are the symptoms from wikipedia:

, unexplained, persisting (lasting six months or longer), "not due to ongoing exertion," and not substantially reduced by rest. The person must have experienced a significant reduction in activity levels.2. Four or more of the following symptoms

* Impaired memory or concentration
* Post-exertional malaise, where physical or mental exertions bring on "extreme, prolonged exhaustion and sickness"
* Unrefreshing sleep
* Muscle pain (myalgia)
* Pain in multiple joints (arthralgia)
* Headaches of a new kind or greater severity
* Sore throat, frequent or recurring
* Tender lymph nodes (cervical or axillary)


...and if you have these symptoms, you don't have chronic fatigue (a garbage, meaningless, copout diagnosis just like fibromyalgia), you have chronic infection, be it bacterial (Lyme, etc), viral (Parvovirus B19, CMV, HHV-6, etc), or parasitic (babesiosis, etc). Happy hunting.


What do you mean?

#22 FunkOdyssey

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Posted 29 October 2008 - 08:12 PM

Here's an example of what I mean:

Stomach Virus a Culprit in Chronic Fatigue Syndrome

By Amanda Gardner

HealthDay Reporter

Washington Post
Thursday, September 13, 2007; 12:00 AM

THURSDAY, Sept. 13 (HealthDay News) -- A father's
concern for his son led to research that now sheds
new light on a disease that has long been shrouded
in mystery.

Andrew Chia, now 24, was diagnosed with debilitating chronic fatigue syndrome in 1997.

This week he is co-author with his father, Dr. John Chia, of a study which links chronic fatigue syndrome (CFS) with enteroviruses, which cause acute respiratory and gastrointestinal infections.

"This is sort of a new beginning. Now we can have development of antiviral drugs," said the elder Chia, an infectious disease specialist in private practice in Torrance, Calif.

"We don't have anything for these poor people, although we've tried a number of things. Now we can study how these viruses behave and how we can kill them."

"Dr. Chia's data was on a substantial number of patients," said Dr. Nancy Klimas, a professor of medicine at the University of Miami Miller School of Medicine and director of the Gulf War Illness Center at the VA Medical Center.

"This could send the field in a new direction."

The findings are published in the Sept. 13 online issue of the Journal of Clinical Pathology.

More than 1 million people in the United States are estimated to suffer from CFS, costing the nation some $9 billion annually.

The condition is more common in women aged 40 to 60 and is marked by a cluster of debilitating symptoms, including unexplained fatigue, problems sleeping, problems with memory and concentration, and pain. CFS can be as disabling as multiple sclerosis.

The illness was first recognized in the late 1980s and, initially dubbed the "yuppie flu," has suffered from a credibility crisis. The causes of chronic fatigue syndrome (CFS) remain unclear.

Several different viruses, including Epstein-Barr virus, cytomegalovirus and parvovirus have been implicated, along with enteroviruses. There are more than 70 different types of enteroviruses that can affect the central nervous system, heart and muscles, all of which is consistent with the symptoms of CFS.

It was, however, difficult to find definitive proof of the viruses' presence. "That's how we judge a disease, if it causes organ damage or death, then it's a real disease," Chia said. "But if it doesn't show up, it doesn't mean it's not there."

Chia started on a Herculean task of drawing some 3,000 blood samples from patients, looking for viral genes. Over a period of five to six years, he found evidence of enteroviruses in 35 percent of patients, but this was after multiple samples from each patient.

"If we were to take one sample from each patient, it would be less than 5 percent," Chia said. "We realized this wasn't the way to look at it. The assumption we made about CFS that we have to find the virus in their blood is totally wrong, so we started looking for the viruses in tissue, meat."

A team of European investigators had found enteroviruses in the brain, muscle and heart of a CFS patient who had committed suicide. But brain and heart biopsies are virtually [??!] impossible to perform in living people.

Chia started looking in the viruses' "area of replication," meaning the stomach. The viruses are resistant to stomach acids.

They eventually took stomach biopsies and performed endoscopies on 165 CFS patients, all of whom had had longstanding gastrointestinal complaints (these are common in CFS patients).

Eighty-two percent of the specimens from CFS patients tested positive for enteroviral particles, compared with just 20 percent of the samples from healthy people. In many patients, the initial infection had taken place years earlier (up to 20 years).

Partly, Chia's work was possible because of technological breakthroughs, Klimas pointed out. He also looked in the right "compartment."

"People were busy looking in the bloodstream, but he looked in the gut. He looked in the right compartment and, lo and behold, he found the viruses," she said. "It depends where you look, what you see."

Chia believes that enteroviruses may cause half of cases of CFS. The disease can also be triggered by other infections.

"It makes sense to me as an infectious disease. This makes all the sense in the world," he said. "If this is a virus, it doesn't destroy the cells, it hides inside the cells. It's one smart little virus."

Chia's son has recovered from the disease although, the elder Chia reported, "he spent a lot of time in the laboratory. Without him, I would not have done this."

Chronic fatigue syndrome is associated with chronic enterovirus infection of the stomach.
Chia JK, Chia AY.

EV Med Research, Lomita, California 90717, USA. evmed@sbcglobal.net

BACKGROUND AND AIMS: The aetiology for chronic fatigue syndrome (CFS) remains elusive although enteroviruses have been implicated as one of the causes by a number of studies. Since most CFS patients have persistent or intermittent gastrointestinal (GI) symptoms, the presence of viral capsid protein 1 (VP1), enterovirus (EV) RNA and culturable virus in the stomach biopsy specimens of patients with CFS was evaluated. METHODS: 165 consecutive patients with CFS underwent upper GI endoscopies and antrum biopsies. Immunoperoxidase staining was performed using EV-specific monoclonal antibody (mAb) or a control mAb specific for cytomegalovirus (CMV). RT-PCR ELISA was performed on RNA extracted from paraffin sections or samples preserved in RNA later. Biopsies from normal stomach and other gastric diseases served as controls. 75 samples were cultured for EV. RESULTS: 135/165 (82%) biopsies stained positive for VP1 within parietal cells, whereas 7/34 (20%) of the controls stained positive (p< or =0.001). CMV mAb failed to stain any of the biopsy specimens. Biopsies taken from six patients at the onset of the CFS/abdominal symptoms, and 2-8 years later showed positive staining in the paired specimens. EV RNA was detected in 9/24 (37%) paraffin-embedded biopsy samples; 1/21 controls had detectable EV RNA (p<0.01); 1/3 patients had detectable EV RNA from two samples taken 4 years apart; 5 patient samples showed transient growth of non-cytopathic enteroviruses. CONCLUSION: Enterovirus VP1, RNA and non-cytopathic viruses were detected in the stomach biopsy specimens of CFS patients with chronic abdominal complaints. A significant subset of CFS patients may have a chronic, disseminated, non-cytolytic form of enteroviral infection, which could be diagnosed by stomach biopsy.


More valtrex, less prozac! :)

Edited by FunkOdyssey, 29 October 2008 - 08:13 PM.


#23 steelsky

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Posted 30 October 2008 - 03:47 PM

Here's an example of what I mean:

Stomach Virus a Culprit in Chronic Fatigue Syndrome

By Amanda Gardner

HealthDay Reporter

Washington Post
Thursday, September 13, 2007; 12:00 AM

THURSDAY, Sept. 13 (HealthDay News) -- A father's
concern for his son led to research that now sheds
new light on a disease that has long been shrouded
in mystery.

Andrew Chia, now 24, was diagnosed with debilitating chronic fatigue syndrome in 1997.

This week he is co-author with his father, Dr. John Chia, of a study which links chronic fatigue syndrome (CFS) with enteroviruses, which cause acute respiratory and gastrointestinal infections.

"This is sort of a new beginning. Now we can have development of antiviral drugs," said the elder Chia, an infectious disease specialist in private practice in Torrance, Calif.

"We don't have anything for these poor people, although we've tried a number of things. Now we can study how these viruses behave and how we can kill them."

"Dr. Chia's data was on a substantial number of patients," said Dr. Nancy Klimas, a professor of medicine at the University of Miami Miller School of Medicine and director of the Gulf War Illness Center at the VA Medical Center.

"This could send the field in a new direction."

The findings are published in the Sept. 13 online issue of the Journal of Clinical Pathology.

More than 1 million people in the United States are estimated to suffer from CFS, costing the nation some $9 billion annually.

The condition is more common in women aged 40 to 60 and is marked by a cluster of debilitating symptoms, including unexplained fatigue, problems sleeping, problems with memory and concentration, and pain. CFS can be as disabling as multiple sclerosis.

The illness was first recognized in the late 1980s and, initially dubbed the "yuppie flu," has suffered from a credibility crisis. The causes of chronic fatigue syndrome (CFS) remain unclear.

Several different viruses, including Epstein-Barr virus, cytomegalovirus and parvovirus have been implicated, along with enteroviruses. There are more than 70 different types of enteroviruses that can affect the central nervous system, heart and muscles, all of which is consistent with the symptoms of CFS.

It was, however, difficult to find definitive proof of the viruses' presence. "That's how we judge a disease, if it causes organ damage or death, then it's a real disease," Chia said. "But if it doesn't show up, it doesn't mean it's not there."

Chia started on a Herculean task of drawing some 3,000 blood samples from patients, looking for viral genes. Over a period of five to six years, he found evidence of enteroviruses in 35 percent of patients, but this was after multiple samples from each patient.

"If we were to take one sample from each patient, it would be less than 5 percent," Chia said. "We realized this wasn't the way to look at it. The assumption we made about CFS that we have to find the virus in their blood is totally wrong, so we started looking for the viruses in tissue, meat."

A team of European investigators had found enteroviruses in the brain, muscle and heart of a CFS patient who had committed suicide. But brain and heart biopsies are virtually [??!] impossible to perform in living people.

Chia started looking in the viruses' "area of replication," meaning the stomach. The viruses are resistant to stomach acids.

They eventually took stomach biopsies and performed endoscopies on 165 CFS patients, all of whom had had longstanding gastrointestinal complaints (these are common in CFS patients).

Eighty-two percent of the specimens from CFS patients tested positive for enteroviral particles, compared with just 20 percent of the samples from healthy people. In many patients, the initial infection had taken place years earlier (up to 20 years).

Partly, Chia's work was possible because of technological breakthroughs, Klimas pointed out. He also looked in the right "compartment."

"People were busy looking in the bloodstream, but he looked in the gut. He looked in the right compartment and, lo and behold, he found the viruses," she said. "It depends where you look, what you see."

Chia believes that enteroviruses may cause half of cases of CFS. The disease can also be triggered by other infections.

"It makes sense to me as an infectious disease. This makes all the sense in the world," he said. "If this is a virus, it doesn't destroy the cells, it hides inside the cells. It's one smart little virus."

Chia's son has recovered from the disease although, the elder Chia reported, "he spent a lot of time in the laboratory. Without him, I would not have done this."

Chronic fatigue syndrome is associated with chronic enterovirus infection of the stomach.
Chia JK, Chia AY.

EV Med Research, Lomita, California 90717, USA. evmed@sbcglobal.net

BACKGROUND AND AIMS: The aetiology for chronic fatigue syndrome (CFS) remains elusive although enteroviruses have been implicated as one of the causes by a number of studies. Since most CFS patients have persistent or intermittent gastrointestinal (GI) symptoms, the presence of viral capsid protein 1 (VP1), enterovirus (EV) RNA and culturable virus in the stomach biopsy specimens of patients with CFS was evaluated. METHODS: 165 consecutive patients with CFS underwent upper GI endoscopies and antrum biopsies. Immunoperoxidase staining was performed using EV-specific monoclonal antibody (mAb) or a control mAb specific for cytomegalovirus (CMV). RT-PCR ELISA was performed on RNA extracted from paraffin sections or samples preserved in RNA later. Biopsies from normal stomach and other gastric diseases served as controls. 75 samples were cultured for EV. RESULTS: 135/165 (82%) biopsies stained positive for VP1 within parietal cells, whereas 7/34 (20%) of the controls stained positive (p< or =0.001). CMV mAb failed to stain any of the biopsy specimens. Biopsies taken from six patients at the onset of the CFS/abdominal symptoms, and 2-8 years later showed positive staining in the paired specimens. EV RNA was detected in 9/24 (37%) paraffin-embedded biopsy samples; 1/21 controls had detectable EV RNA (p<0.01); 1/3 patients had detectable EV RNA from two samples taken 4 years apart; 5 patient samples showed transient growth of non-cytopathic enteroviruses. CONCLUSION: Enterovirus VP1, RNA and non-cytopathic viruses were detected in the stomach biopsy specimens of CFS patients with chronic abdominal complaints. A significant subset of CFS patients may have a chronic, disseminated, non-cytolytic form of enteroviral infection, which could be diagnosed by stomach biopsy.


More valtrex, less prozac! :)


OMG! This was never proposed to me, and wasn't considered.
I'm been suffering from excessive daytime sleepiness or whatever you call it for years now. Went to a sleeping clinic, had blood tests, the works. They did find traces of "mono" in my blood which one doctor suggested might be the cause (infection), but he didn't offer a solution. Best solution I've found was Ritalin.

So, any suggestions other than valtrex (which is said to treat herpes, which I don't have)? How sould I direct my doctor as to finding a proper treatment?

Also - what about probiotics as possible treatment? I mention those because I've recently started taking some and lately I've been feeling a bit better. I can hold off tiredness more than before, but I didn't want to draw any conclusions as this might be one of those periods when I feel slightly better (happened before when I started taking coQ10, which I thought was the perpetrator, but turned out it was just a phase).

Reading the quotes, FunkO - you might have saved my life :)

#24 steelsky

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Posted 01 November 2008 - 11:43 PM

FunkOdyssey (BTW, Jamiroquai rocks!) - Please respond.

#25 Wedrifid

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Posted 02 November 2008 - 07:45 AM

In leeuw of the Funk I'll suggest that probiotics may help, depending on the type of infection. There are some infections that bugger up your digestion so the boost may ameliorate the problem to some extent.

I recommend taking the more direct diagnostic aproach and get someone to take a look so you can target the cause, not the symptoms.

#26 steelsky

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Posted 03 November 2008 - 05:26 PM

In leeuw of the Funk I'll suggest that probiotics may help, depending on the type of infection. There are some infections that bugger up your digestion so the boost may ameliorate the problem to some extent.

I recommend taking the more direct diagnostic aproach and get someone to take a look so you can target the cause, not the symptoms.


That goes without saying. Thanks.

Would still like to receive FunkO's reply.

#27 FunkOdyssey

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Posted 03 November 2008 - 09:50 PM

I would suggest that you pursue the best quality testing available for all of the pathogens that have been associated with CFS or CFS-like symptoms. If that fails to turn up anything specific, you could try an empiric trial of an anti-viral that has seen success in preliminary studies for CFS (with a doctor's supervision). Some food allergies can cause fatigue as well, but it generally waxes / wanes along with intake of that particular food, and your problem seems to be persistent over time.

Ever been bit by a tick?

P.S. It is so rare for me to run into someone online that understands the Jamiroquai reference of my name, that's awesome. ;)

P.P.S. Also get tests to rule out anemia and hypothyroidism.

P.P.P.S. And a sleep study if you suspect or have any risk factors for sleep apnea.

Edited by FunkOdyssey, 03 November 2008 - 09:59 PM.


#28 steelsky

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Posted 05 November 2008 - 08:58 AM

I would suggest that you pursue the best quality testing available for all of the pathogens that have been associated with CFS or CFS-like symptoms. If that fails to turn up anything specific, you could try an empiric trial of an anti-viral that has seen success in preliminary studies for CFS (with a doctor's supervision). Some food allergies can cause fatigue as well, but it generally waxes / wanes along with intake of that particular food, and your problem seems to be persistent over time.

Ever been bit by a tick?

P.S. It is so rare for me to run into someone online that understands the Jamiroquai reference of my name, that's awesome. :)

P.P.S. Also get tests to rule out anemia and hypothyroidism.

P.P.P.S. And a sleep study if you suspect or have any risk factors for sleep apnea.


The only clue to a possible cause for my daytime sleepiness is traces of a mono virus that my doctor has found. In the blood, that is.
The approach about infections weakening the body but are "undetectable" by conventional and popular blood tests is an interesting one. This leads to the theory that a large percentage of the population might be struggling with some sorts of "weaknesses" while not awake they might be "sick". Even more extremely - certain ENTIRE POPULATIONS might be "weaker" than they should be because of common or "considered normal" presence of infections which are not studied properly because they are so commonplace in everyone. What I mean is that there might be epidemics, spanning eras in human history, where certain populations are affected by parasites that are "undetectable" not because they are not detected - but because they are so common that no one considers they might be a "sickness" (because the majority is so).

About ticks - I have a very fluffy dog (that's also her name - fluffy). She sometimes has ticks and I get bitten by them quite a bit. I have yet to stop one of them for inspection, though :)

#29 FunkOdyssey

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Posted 05 November 2008 - 04:14 PM

If you've been bitten by ticks "quite a bit" then you should definitely be prepared to consider "infections that weaken the body and are undetectable by conventional and popular blood tests" because that is what tick bites produce in spades. My Lyme doctor, with his intimate knowledge and years of experience with tick-borne disease, refuses to even walk in the woods or through (or even near) unkempt grass during the warmer seasons of the year (he describes his hobbies as "anything that doesn't involve tick exposure" :))

Chronic fatigue is actually a common presentation for lyme disease. The idea that some kind of arthritis must be involved or is usually involved is a complete myth (joint pain is present in a minority of patients). The standard ELISA test and Western Blot using CDC standards are both garbage -- unfortunately, that is what your family doctor will order if you ask him to check for Lyme Disease. The CDC guidelines for the Western Blot omit two of the most common Lyme antigens because they were to be used in a Lyme vaccine and the vaccine would have produced false positives. Obviously, if you haven't had a Lyme vaccine, you want them to consider those bands. The CDC has repeatedly stated its guidelines are for epidemiological tracking of disease incidence only, not for diagnostic purposes. You can read all about this lunacy if you do some research.

In any event, the best available single test is the western blot with all bands included, and the best lab to perform this is Igenex (http://igenex.com/Website/). If your regular doctor is unwilling to order this test for you, you should find a doctor in your area via a request on the LymeNet forum (http://flash.lymenet...p?ubb=forum;f=2) and set up an appointment expressly for that purpose. And if you do turn up positive, you will DEFINITELY want to be seen by a Lyme specialist, because the complexity of tick-borne disease and nuances of diagnosis and treatment are way over the head of regular doctors.

I hope you will investigate and rule out the other possibilities I mentioned in previous posts as well.

Edited by FunkOdyssey, 05 November 2008 - 04:14 PM.


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#30 steelsky

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Posted 06 November 2008 - 02:17 AM

If you've been bitten by ticks "quite a bit" then you should definitely be prepared to consider "infections that weaken the body and are undetectable by conventional and popular blood tests" because that is what tick bites produce in spades. My Lyme doctor, with his intimate knowledge and years of experience with tick-borne disease, refuses to even walk in the woods or through (or even near) unkempt grass during the warmer seasons of the year (he describes his hobbies as "anything that doesn't involve tick exposure" :) )

Chronic fatigue is actually a common presentation for lyme disease. The idea that some kind of arthritis must be involved or is usually involved is a complete myth (joint pain is present in a minority of patients). The standard ELISA test and Western Blot using CDC standards are both garbage -- unfortunately, that is what your family doctor will order if you ask him to check for Lyme Disease. The CDC guidelines for the Western Blot omit two of the most common Lyme antigens because they were to be used in a Lyme vaccine and the vaccine would have produced false positives. Obviously, if you haven't had a Lyme vaccine, you want them to consider those bands. The CDC has repeatedly stated its guidelines are for epidemiological tracking of disease incidence only, not for diagnostic purposes. You can read all about this lunacy if you do some research.

In any event, the best available single test is the western blot with all bands included, and the best lab to perform this is Igenex (http://igenex.com/Website/). If your regular doctor is unwilling to order this test for you, you should find a doctor in your area via a request on the LymeNet forum (http://flash.lymenet...p?ubb=forum;f=2) and set up an appointment expressly for that purpose. And if you do turn up positive, you will DEFINITELY want to be seen by a Lyme specialist, because the complexity of tick-borne disease and nuances of diagnosis and treatment are way over the head of regular doctors.

I hope you will investigate and rule out the other possibilities I mentioned in previous posts as well.


I must tell you that I seriously do not trust my doctor(s). They'll dismiss any "too specific" of a suggestion by me as a stupid hypochondria from something I've read on the internet, and might dismiss me by referring to a test that isn't exactly what I requested.
This is why I've turned to experiment with supplements for anything that doesn't require immediate medical attention, such as my headaches and back acne, both of which I was able to almost eradicate.
I'm just now finding out the potential of probiotics which I've dismissed in the past because I thought they might be good only for people with stomach or gut issues. But now that I think about it, and my alarm caused by finding out how much antibiotics is in the food that we all consume - probiotics might be an essential supplement for everyone.
So, could you suggest anything that I might try that, following the references you've posted, might be helpful in treating what is presumed the cause of my excessive sleepiness? I've tried addressing the symptom in the past (taking any "energy booster" one can think of), but not potential causes. Are there specific probiotics you may suggest? Or other stuff that I ought to try?




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