Quick Treatment Solution
If you just require a quick recommendation for treatments that help with the symptoms produced by this chronic viral infection, then you might consider the following: yeast-free selenomethionine (a form of selenium) once 400 mcg daily, which I found helps the fatigue and brain fog (possibly via an antiviral effect), and N-acetyl-glucosamine (NAG) 700 mg once or twice daily, which I found greatly helps reduce anxiety symptoms induced by the virus (NAG likely works by reducing viral brain inflammation). Both to be taken on an empty stomach.
Very low-dose amisulpride 12.5 to 25 mg daily helps with the depression and anhedonia caused by the virus, as does amitriptyline 10 mg or more daily, or alternatively moclobemide 150 mg or more daily. High-dose allicin 6 x 180 mg daily helps to combat the blunted emotions, I found.
These are the most effective treatments I have discovered. Most of the other drugs and supplements listed on this page unfortunately are not greatly effective for treating the symptoms of this virus, though they do help a bit. The drugs and supplements detailed below are organized by the symptom they treat.
Treatments are Organized by the Symptom They treat
Click any of the symptom categories below to go straight to the section where treatments for that symptom are given:
For the generalized anxiety disorder precipitated by this virus, the following three supplement have proven very helpful at treating this anxiety, especially N-acetyl-glucosamine. You can take just one, or all three for a stronger anti-anxiety effect.
N-acetyl-glucosamine (NAG) 700 mg twice daily — the most potent anti-anxiety treatment. Not to be confused with glucosamine sulfate. NAG is available at iHerb in the US, and Health Monthly in the UK.
Flaxseed oil 1 tablespoon (15 ml) daily (taking more may cause diarrhea)
Turmeric 1000 mg (1 level teaspoon) twice daily
My hypothesis is that the anxiety symptoms caused by this virus may result from brain inflammation, and that these anti-anxiety supplements treat anxiety by reducing this neuroinflammation. Brain inflammation has been linked as a possible causal factor in several mental health conditions. Further information on these anti-anxiety treatments can be found in the following threads on the Phoenix Rising ME/CFS forum:
Benzodiazepines like clonazepam (Klonopin) or alprazolam (Xanax) are effective for anxiety, though these have tolerance, addition issues and sometimes horrible withdrawal symptoms.
Anhedonia is a mental symptom that can appear after catching the virus described on this website. Anhedonia is defined as a lack of feelings of pleasure or reward from life’s normal activities. In anhedonia, the reward circuitry of the brain is not working properly, so the experience of pleasure and satisfaction is much reduced or absent. There are actually two forms of anhedonia: consummatory anhedonia, which is where you don’t feel much reward or satisfaction on completing a normally enjoyable activity; and anticipatory anhedonia, which is where you don’t get any good feelings when you look forward to doing an activity that is normally enjoyable. I developed both forms of anhedonia after catching this virus.
Severe anhedonia will bring on thoughts of suicide very quickly (as I observed in myself), and studies have shown that suicidal ideation is commonly found when anhedonia is present. Once I developed severe anhedonia from this virus, even though I only had mild depression, I just was praying every day that I would drop dead. It’s very hard to explain this to someone who has not experienced anhedonia; anhedonia creates a vacuum that feels like all you reasons for living have been taken away. However, there are varying degrees of severity, and people with mild anhedonia will probably not feel any suicidal ideation, but may find life a bit flatter.
Unlike depression, anhedonia is a very hard symptom to treat medically, as there are almost no effective drug treatments for anhedonia. However, I found some supplements and drugs slightly helpful in reducing the anhedonia symptoms, which are the following (with the more effective ones at the top of the list):
Very low dose amisulpride (12.5 to 25 mg daily)
Imipramine 25 mg or amitriptyline 10 mg daily; these tricyclic antidepressants help a bit
Colostrum powder 2 heaped teaspoons (14 grams) on an empty stomach
He shou wu (Polygonum multiflorum) 3 grams
Acetyl-L-carnitine 1000 mg or L-carnitine 1000 mg
Hydrogen rich water, drinking several glasses throughout the day
Vinpocetine 10 mg
The anti-anhedonia effects of all these supplements will kick in quickly, within an hour or so of taking them (except colostrum, which can take a few days to start working).
Colostrum is quite good at improving both the anhedonia and depression symptoms this virus causes. Smaller doses of a few grams of colostrum have little effect; you need to take 2 heaped teaspoons of colostrum. Note that colostrum is around 10 times cheaper when bought as a bulk powder compared to buying it in capsules.
See also my forum post about anhedonia and blunted emotion treatments.
Blunted Emotions Treatments
After a year or two with this virus, symptoms of blunted emotions begin to appear. Emotional blunting (psychologists call it “blunted affect”) is a condition in which your normal emotional responses have become weak, and you no longer experience much emotion in circumstances that would normally give rise to emotional feelings. So for example, if you watch a melodrama on TV, you tend to experience the drama in a cold, often cynical way, as you don’t really engage with the human emotions in the story.
Emotional blunting is distinct from anhedonia, though they often appear together, and so people often confuse the two. In anhedonia, it is the experience of pleasure from daily activities, and the sense of reward on completing tasks, that is weak or absent. Whereas with blunted emotions or flat emotions, life’s normal emotional responses (love, sadness, compassion, guilt, anger, joy, surprise, etc) are weak or absent.
There is only one supplement I found that consistently and effectively helps treat the blunted emotions caused by this virus is, and that is the garlic extract called allicin:
Allicin 6 x 180 mg capsules taken once daily (which is a high dose) has good emotion boosting effect.
The following supplements also have a slight emotion-boosting effect, but I found with these that they boost emotions for a few hours, but then stop working if you take them every day:
Royal jelly 1500 mg seems to bring my emotions back online quite strongly, but temporarily (it only lasts for 3 or 4 hours).
Myrrh essential oil 10 drops mixed in 30 ml of a carrier oil (like baby oil), and rubbed on the skin of the body, where is it is slowly absorbed transdermally (not to be taken by pregnant women).
He shou wu (Polygonum multiflorum) 3 grams
Carnosine 1000 mg
Glutamine powder 1 heaped teaspoon (6 grams)
Vinpocetine 10 to 20 mg
Terminalia arjuna herb 7 grams — induces emotions around 5 hours after taking it.
See also this forum post about anhedonia and blunted emotion treatments.
Lack of Motivation Treatments
After I suffered from an episode of meningitis/encephalitis likely caused by this virus, and the chronic fatigue syndrome that ensured, I developed some significant lack of motivation (aboulia) symptoms. This results in a reduced inclination to start or engage in tasks. Lack of motivation differs from anhedonia: lack of motivation means you do not tend to initiate into tasks and purposeful activity; anhedonia simply means that you don’t get the feeling of reward or satisfaction on completion of a task. Lack of motivation is due to problems in the motivational circuitry of the brain; anhedonia is due to problems in the reward system of the brain.
I noticed that vitamin B2 (riboflavin) 50 mg, taken two or three times daily, for some reason would significantly boost motivation. And I noticed that low doses of the drug pramipexole, ½ of a 0.18 mg tablet daily, also seemed to work well for these low motivation symptoms. Within an hour of taking it, vitamin B2 or pramipexole will quickly change me from being apathetic to being focused and task oriented.
Supplements and drugs that were found helpful in alleviating the depression that this virus triggers include: moclobemide 150 mg daily (MAO-A inhibitor antidepressant — this is one of the safer antidepressants), low-dose amisulpride 12.5 to 25 mg daily, amitriptyline 10 mg daily (tricyclic antidepressant), imipramine (tricyclic antidepressant) 25 mg daily, high-dose inositol powder 2 heaped teaspoons (15 grams) daily, colostrum 2 heaped teaspoons (14 grams) twice daily on an empty stomach, Spanish saffron (Crocus sativus) 100 mg twice daily, I used the Nipra brand of saffron (a systematic review found saffron as effective as standard pharmaceutical antidepressants), NADH 5 mg daily. You can take two or more of these supplements in combination, to get a stronger antidepressant effect. All of these supplements kick in within an hour of taking them (except inositol, which takes a good 12 hours before the mood boost appears).
Antidepressant SSRI drugs like escitalopram, citalopram, paroxetine and sertraline can be helpful for many people. However, I found one SSRI called citalopram hugely increased my depression and suicidal ideation within hours of taking it, so be careful. This adverse effect may arise because SSRIs were shown in one study to increase brain inflammation (by increasing the inflammatory cytokines TNF-α and IFN-γ), so assuming brain inflammation is behind the mental symptoms like anxiety and depression caused by this virus, that could explain why SSRIs make these symptoms worse.
Brain Fog Treatments
More or less everyone with chronic fatigue syndrome experiences “brain fog”, more properly known as cognitive dysfunction, and many people with this virus seem to experience some degree of brain fog. Brain fog is typified by: poor short-term memory (for example, you may constantly forget what you were just about to do, or what you just did), poor working memory (so you cannot grasp or juggle more that a few facts or figures in your mind at one time), anomia (problems recalling words or names), slips of the tongue (saying a different word to the one you intended), miscategorization of environmental stimuli (like answering the phone when the doorbell rings), lack of focus (difficultly in keeping focus on the task at hand), confusion (very easily perplexed by situations), and a general lack of awareness (a little oblivious to the things going on around you).
Treatments to help fix brain fog include: piracetam 800 mg daily, choline bitartrate 500 to 1000 mg once or twice daily, L-carnitine 1000 mg twice daily, vinpocetine 10 to 20 mg daily, vitamin B12 5000 mcg daily as a sublingual tablet. These supplements work better when taken in combination.
Dealing with Fatigue and Low Energy
A very good supplement I found for reducing the fatigue and brain fog caused by the chronic fatigue syndrome triggered by this virus is yeast-free selenomethionine (a form of selenium) 400 mcg daily, taken on an empty stomach. For more details, see my thread here:
I found that when you start taking selenium, the boost to your energy levels from selenium will take around 7 to 10 days to appear.
The low energy levels (the mental and physical fatigue) that may result from this virus can also be improved by supplements such as: L-carnitine 1000 mg twice daily, alpha GPC 1000 mg daily, NADH 5 mg daily, malic acid 500 mg twice daily, co-enzyme Q10 200 mg twice daily.
Irritability Symptoms Treatments
After you have had this viral infection for a few years, irritability can become a prominent mental symptom, such that, like it or not, you develop more annoyances with things, both situations and people. This is not a very nice disposition to have, but fortunately there are a few medications that seem to help: I found very low dose amisulpride 12.5 to 25 mg daily pretty effective at reducing irritability. Atypical antipsychotics like amisulpride, aripiprazole and risperidone are effective treatments for irritability and aggression symptoms in autism. Some research has shown that N-acetyl-cysteine can help the irritability in autism, but it is not quite as effective as atypical anti-psychotics. Ref: 1
I found vitamin B2 (riboflavin) 50 mg twice daily is good at reducing irritability.
Chronic Sore Throat Treatments
The following supplements and drugs noticeably reduce the sore throat symptoms and throat inflammation: the antidepressant drug bupropion (Wellbutrin) at a dose of 75 to 150 mg daily is very effective at reducing and almost eliminating the chronic sore throat symptoms (this may be due to bupropion’s ability to inhibit interferon-gamma); very low-dose amisulpride12.5 mg to 25 mg daily works quite well in reducing the chronic sore throat; Gynostemma pentaphyllum herb (jiaogulan) 300 mg twice daily is helpful; selenium 400 mcg daily is helpful, pau d’arco 500 mg twice daily is helpful.
Slow Healing Wounds Treatments
Slow healing minor skin cuts seems to be a characteristic symptom of this virus especially in the first say five years of infection. Once you have this virus, minor cuts or grazes can sometimes take months to heal. A topical treatment that I found works quite well to get a non-healing wound to heal is zinc powder. Zinc powder can be obtained by crushing up zinc supplement tablet. You dab a very tiny amount of this zinc powder (less than 1% of the powder from a crushed tablet) on the skin surrounding the wound.
Lower Back Pain
Some people may suffer with intermittent lower back pain once they catch this virus. This back pain tends to arise only infrequently, but when it does arise, it can last for a week or so, before spontaneously disappearing again. This lower back pain I think is caused by a spasm in the back muscles (muscles spasms are underpinned by muscle inflammation). A good treatment for this back pain is over the counter anti-inflammatories such as ibuprofen. When I had this back pain, I found that an hour or so after taking ibuprofen, there was a major reduction in my back pain.
Paresthesia (Pins and Needles) Treatments
This virus can cause chronic or recurrent paresthesias, the “pins and needles” prickly feelings under the skin. Such paresthesias can be treated with the supplement benfotiamine (a lipid-soluble form of vitamin B1), at a dose of around 300 mg twice a daily when these paresthesias occur.
The virus described on this website precipitated chronic myocarditis (also called inflammatory cardiomyopathy) and pericarditis in some people, which would then trigger a heart attack. Coxsackievirus B is a known cause of chronic myocarditis, and CVB has also been linked to triggering sudden heart attacks (in fact one study found that 40% of people who died suddenly of a heart attack had enterovirus infection in their heart tissues, and in 16%, the specific enterovirus detected was coxsackievirus B — see this post).
Deficiency in selenium, vitamin E and copper have be shown to increase the heart damage and virulence that occurs in coxsackievirus B myocarditis in mice. So if you have viral myocarditis, the following doses of these supplements might help protect against such heart damage: selenium (selenomethionine) 200 mcg daily on an empty stomach, vitamin E 400 IU daily, copper 1 mg daily. Refs: 1 2 3 4
There is a good chance that the virus described on this site is an enterovirus, most likely coxsackievirus B4 (my blood tests showed high titers to CVB4). Unfortunately, there are currently no good antivirals for treating enteroviruses. Ribavirin has antiviral effects for coxsackievirus B, but Dr John Chia found this drug does not work for CVB4 (and in any case, ribavirin is a little toxic and may cause serious side effects if taken long term).
The good news is that the Rega Institute in Belgium have developed two potent new antiviral drugs code named Rega Compound A and Rega Compound 17. The intellectual property rights to these drugs have now been sold to Swiss pharmaceutical company Novartis, who will be performing human clinical trials on these drugs, in order to bring them to market. But these drugs will not be available to buy until around 2021 at the very earliest. Rega Compound 17 is a broad-spectrum antiviral for coxsackievirus B, and Rega Compound A completely eradicates CVB4 in mice.
One option worth trying is the immunomodulator oxymatrine, which is not an antiviral, but rather boosts the Th1 mode of the immune system which fights viral infection. Dr Chia pioneered the use of oxymatrine to treat chronic fatigue syndrome (ME/CFS) linked to chronic enterovirus infection, and found that oxymatrine works well for around 30% of ME/CFS patients (oxymatrine did not help me, but it does not work for everyone).
Oxymatrine can be bought as a supplement online. The target dose is up to 300 mg x 6 times a day. You normally start with one 300 mg capsule daily, and over the weeks, slowly increase to 6 x 300 mg capsules daily, taken in divided doses every 6 hours. Dr Chia suggests that patients with a family history autoimmune tendencies or seizure disorders should not take oxymatrine, as in these cases there is a risk oxymatrine may trigger rheumatoid arthritis — more info here.
Dr Chia formulated his own brand of oxymatrine called Equilibrant, but there is also White Tiger oxymatrine and Alternative Medicine Solutions oxymatrine. Once the benefits of oxymatrine have manifested, Dr Chia says men with ME/CFS can stop taking it after 3 to 6 months, but women with ME/CFS usually have to continue taking oxymatrine, otherwise they relapse and get worse again.
More info on oxymatrine: Dr Chia: Oxymatrine, Oxymatrine, Autoimmunity, ME/CFS and FM, Quixotic: Equilibrant, Invest in ME 2010 conference transcript, oxymatrine effects, immunomodulators info, MEpedia oxymatrine.
Another drug used by Dr Chia for chronic enterovirus infections in ME/CFS is the antiviral Epivir (lamivudine) 150 mg twice daily. Dr Chia says Epivir has anti-enterovirus effects. Dr Chia says 1 in 3 ME/CFS patients respond to Epivir. I tried Epivir for around 10 weeks, but I did not notice much, though it may have made a small improvement.
More recently, Dr Chia has been using the antiviral tenofovir (normal dose is 300 mg daily) to treat ME/CFS, and says this helps perhaps ~25% of those with ME/CFS (see this post and this). Some patients who take tenofovir for ME/CFS find they have to start at a lower dose and titrate up the full dose over several months, otherwise the drug hits them too hard initially. Tenofovir can cause serious life-threatening side effects, so should be taken under the care of a doctor. Tenofovir can cause mitochondrial toxicity in the kidneys, but certain antioxidant supplements like N-acetyl-cysteine may help counter this (see this post). I tried tenofovir myself, but for some reason after a few days it worsened my mental symptoms, so I had to stop.
The treatment that did make a substantial improvement in my ME/CFS fatigue and brain fog symptoms is high-dose yeast-free selenomethionine (a highly absorbable form of selenium) once 400 mcg daily on an empty stomach (selenium is not well absorbed on a full stomach). In mouse studies, as deficiency of either selenium or vitamin E leads to increased virulence of Coxsackie B virus infection (in the case of CVB myocarditis). So it is possible that selenium helps because of an antiviral effect against CVB. I found that when I start taking selenium, the improvements in fatigue and brain fog will take around 7 to 10 days to appear. And every time I stop this high-dose selenium, my brain fog and fatigue worsen again after around 5 days.
More info on my high-dose selenium protocol om my forum thread here: High Dose Selenium Significantly Improves My Fatigue and Brain Fog