Talk presented by Dr. Chitra Bhakta

Discussion in 'Fibromyalgia Main Forum' started by richvank, Sep 18, 2009.

  1. richvank

    richvank New Member

    Summary of talk presented by Dr. Chitra Bhakta on “Adrenal Fatigue, Correction of Genetic Methylation Pathways, and Protocol for Decreasing Inflammation in Lyme, Autism and Chronic Illness”


    Rich Van Konynenburg

    Dr. Chitra Bhakta, M.D., Director of Orange County Integrative Medical Center in Tustin, California, presented a talk on the above topics on Saturday afternoon, September 12, 2009, in Conference Room F in the lower level of the Presbyterian Intercommunity Hospital in Whittier, CA.

    The talk was sponsored by the Southern California Lyme Support group, coordinated by Earis Coram. I heard about it from Al Melillo, who also attended, together with about 30 other people.

    Dr. Bhakta is from India, where she received her medical training. She did her residency at the Los Angeles County Hospital. Her specialty is family medicine.

    It was clear to me from her talk and discussions afterward that Dr. Bhakta puts the best interests of her patients first, and that she continues to search for new developments that will enhance their treatment. The protocols she uses today combine contributions from several front-line researchers.

    A few years ago, she was treating a number of autism patients, and she had become familiar with and used the Defeat Autism Now! (DAN!) approach for treating autism. This was effective for many of the cases, but some of the kids she was treating never got better. She attended the Lyme-Induced-Autism conference and then tested these nonresponding patients for Lyme disease, finding that they all had either Lyme disease or its coinfections. This is how she became involved in treating Lyme disease. She then trained with Dr. Charles Ray Jones (age 82!) in Connecticut. He is the foremost pediatrician treating Lyme disease.

    She integrated the DAN! and ILADS (International Lyme and Associated Diseases Society) approaches to treatment into her treatment protocols, but felt that antibiotics were being used too much to treat Lyme disease. She developed an approach that treats several aspects first, and then uses antibiotics later, if necessary.

    She decided to start her treatment with the gut, as is done by others in autism.

    She has been treating the methylation cycle for about ten years, based on the research of Drs. S. Jill James and Richard Deth.

    She became aware of the later work of Amy Yasko, Ph.D., N.D., who applied the science of nutrigenomics, which had come from the University of California at Davis, to the treatment of autism. She believes that this approach has merit, but she found Dr. Yasko’s treatment to be very complicated.

    She reported that she found my work (involving the Glutathione Depletion—Methylation Cycle Block (GD-MCB) hypothesis for chronic fatigue syndrome (CFS) and the Simplified Treatment Approach based on it) on the internet. She noted that I had applied the methylation cycle related biochemistry to CFS and had been able to explain many of the features of CFS on this basis. She also noted that I had “streamlined” the Yasko treatment approach, making it easier to use.

    She displayed a large chart showing the methylation cycle and associated pathways that had been developed by Dr. Yasko, and explained the relationships between the methylation and folate cycles and the transsulfuration pathway, including glutathione.

    She explained that Dr. James and coworkers had found that genetic “weaknesses” can block several sites in this part of the metabolism. In addition, environmental factors, such as thimerosol in vaccines, can contribute to this as well. A block in the methylation cycle will cause decreases in plasma methionine and the ratio of S-adenosylmethionine to S-adenosylhomocysteine (SAMe/SAH). It will also lower the ratio of reduced to oxidized glutathione (GSH/GSSG).

    She went on to describe the GD-MCB hypothesis for CFS in detail. A discussion of this hypothesis can be found on the internet at

    She noted that according to this hypothesis CFS is caused by a combination of genetic predisposition and stressors, except in the epidemics or clusters, where
    the genetic factor is less important because of the action of a virulent pathogen.

    She suggested that polymorphisms in the enzymes CYP2D6 and COMT may be associated with fibromyalgia, and a polymorphism in NAT2 may be associated with multiple chemical sensitivity.

    She also reported that Borrelia burgdorferi bacteria have been found to deplete glutathione in their host, and noted that I had suggested that this may provide a link between Lyme disease and CFS.

    She reviewed some of the polymorphisms to which Dr. Yasko has drawn attention, including AHCY-1, BHMT-08, CBS C699T, COMT V158M, MTR A2756G, and MTRR A66G.

    She discussed the work of Dr. Ritchie Shoemaker on Lyme and other biotoxin diseases, noting his FACT test for visual contrast sensitivity, HLA DR DQ typing, and other tests.

    She said that she prefers using the K-PAX multivitamin.

    She reported success in raising the glutathione levels in two autistic patients using OSR#1 at a dosage of 300 mg per day, in whom it had not been possible to raise glutathione levels before.

    She discussed KPU or the “mauve factor” as originally discovered by the late Dr. Abram Hoffer and coworkers. This was originally found in the urine of schizophrenia patients. It results from an inborn genetic error in the pyrrole metabolism, which is used to make hemoglobin. Dr. Dietrich Klinghardt has found that this is present in 80% of his Lyme patients, and it causes a depletion of zinc and vitamin B6. Dr. Bhakta recommended getting the $59 test for KPU from She described Dr. Klinghardt’s KPU treatment, which is available on his website. She also discussed his metal detox protocol. Dr. Bhakta said that she prefers to use the Metagenics formulas for detox, i.e. the Ultraclear Renew for fibromyalgia, and the Ultraclear Plus pH for CFS.

    Dr. Bhakta also discussed the Neuroscience approach to testing and treating the neuroendocrineimmune issues. She talked about the stages of adrenal fatigue and noted that correction of this condition must be done centrally, because neurotransmitters are involved.

    She discussed inflammation and noted that there are many chronic inflammatory conditions, which involve inflammatory cytokines. She discussed new research pertaining to the cholinergic anti-inflammatory pathway, and noted that acetylcholine has been found to be important for lowering the levels of inflammatory cytokines and stopping inflammation. She discussed a new treatment called Avipaxin, produced by Neuroscience. Avipaxin contains both a cholinesterase inhibitor to inhibit the breakdown of acetylcholine, as well as supplements to feed the formation of new acetylcholine.

    In starting her treatment with the gut, she recommends three tests: food allergies, stool analysis, and an organic acids test.

    She emphasized that the human body is complex, and it is necessary to address several aspects of these illnesses in order to treat it successfully. She pointed out the importance of eating organic food, locally grown and seasonal.
    She recommended eating 5 or 6 small meals per day, like a diabetic diet.
    For food allergies, she recommends a rotation diet, switching foods each week. She recommended taking Juice Plus to get the nutrients from vegetables and fruits. For omega-3 fatty acids, she recommended EPA-Select. She emphasized that it’s important to raise the EPA intake, but not DHA.

    She favors starting with one new supplement at a time, to see what the response is, before adding others.

    In response to a question, she recommended that vegetables be cooked at first, until the gut is able to handle raw vegetables. At that point, salads are very beneficial.

    For protein, she recommended Alaskan wild salmon and organic meats, such as bison meat.

    She favors removing amalgams, so that they do not continue to introduce mercury into the body.

    She emphasized that in treating these disorders, it is necessary to use a synergistic approach.

    I was of course gratified to learn that Dr. Bhakta had found the Glutathione Depletion—Methylation Cycle Block hypothesis and the Simplified Treatment Approach based on it to be helpful in treating her patients. She has found treatment of the methylation cycle issue to be an important part of her overall treatment protocol, but it must be emphasized that it is not the whole thing. Her treatment also includes several other aspects of these disorders as well.

  2. quilp

    quilp New Member

    Very interesting and certainly crystallises what you have postulated in many of your posts over the last two years on this subject.

    There is a growing sense that this may in part ( at the very least ) prove to be an effective treatment for many of us, as well providing us with a diagnostic test. Would I be overly optimistic in stating this to be the case ? If i am not what sort of time frame could we be looking at ?

    Finally, does the methylation protocol serve to marginalise those theories that a virus/pathogen, possibly of unknown etiology, is prevalent in CFS ?

    Thanks for sharing your knowledge with us, it is greatly appreciated

    KInd regards, Mark
  3. mbofov

    mbofov Active Member

    Thank you for this synopsis. I just scanned it briefly, and appreciate your taking the time to post -

    Best wishes,

  4. richvank

    richvank New Member

    Hi, Mark.

    It's been about two and a half years since I proposed the Glutathione Depletion--Methylation Cycle Block hypothesis for the pathogenesis of CFS, and a simplified treatment approach based on it. About six months ago, I presented a poster paper proposing that Lyme disease is a route of entry into CFS for people who are genomically predisposed to developing a partial methylation cycle block, based on the observed depletion of glutathione by Borrelia burgdorferi.

    During the past two and a half years, I estimate that at least several hundred, and probably now over a thousand PWCs have tried this treatment. There are several physicians who have added methylation cycle treatment to their protocols. Dr. Neil Nathan and I also carried out and reported on an open-label clinical study of the simplified treatment approach on patients in his practice in Missouri.

    There have also been a large number (I don't know how many, but I have probably personally seen a couple of hundred) methylation pathways panels run by Vitamin Diagnostics in New Jersey and the European Laboratory of Nutrients in the Netherlands. For people who have CFS, nearly all have shown a partial methylation cycle block and/or glutathione depletion, most showing both.

    The treatment used by itself seems to help about two-thirds of those who try it. When it is combined with other treatments, it has brought what appears to be complete recovery to at least a few people, who have been able to return to full-time work. Some of the other treatments have been treatments for Lyme disease, mold illness, or toxic metals overload.

    Based on all of this experience, I continue to believe that this model does describe the pathogenesis of CFS for many and perhaps most PWCs.

    With regard to viruses or other pathogens, I believe that they are responsible for the onset of CFS in some cases, especially in the cluster or epidemic cases, such as the one at Incline Village. These cases fit within the GD-MCB model, except that the genomic predisposition aspect does not seem to be as important, or is not involved at all. But the rest is likely the same, i.e. that the viral infection depletes glutathione and brings on a partial block in the methylation cycle. I think the explanation for this is that the virus in the cluster cases has been particularly virulent, at least until it mutated and became less so, ending the local epidemic.

    So as far as the pathogenesis model is concerned, I think it is correct and that it is able to explain essentially all the features of CFS. The model allows for a variety of routes into this pathogenesis, i.e. a variety of etiological factors. These include the whole variety of stressors--physical, chemical, biological and psychological/emotional. The stressors involved in the onset of each case can be differerent from those involved in other cases, but they all channel into causing oxidative stress and a partial methylation cycle block.

    In most cases the oxidative stress is accompanied by a depletion of glutathione, but in a minority of cases, there is a genetic polymorphism in the glutathione peroxidase enzyme. In those cases, glutathione does not drop, but the effect is the same, because it cannot be used effectively to counter the oxidative stress without a functional glutathione peroxidase.

    There's still an issue in the model that is unsolved, and that is how the partial methylation cycle block interacts with glutathione synthesis to deplete glutathione. We know that it does, in both autism and CFS, because when the methylation cycle block is lifted, glutathione comes back up automatically. But the details of this interaction are still undefined from a theoretical biochemical standpoint.

    Note that the issue of whehter the methylation cycle block is at the root of the pathogenesis is a separate issue from what is the best way to treat it. There may be, and likely are, better ways to treat it than the simplified treatment approach. I proposed that as a simple and relatively inexpensive, and thus accessible treatment for PWCs, and at the same time a way to test the model for pathogenesis. I would say that it has been successful in testing the model, and the model has survived the test. I think we still have more to learn about treatment, though the simplified treatment approach has made a significant contribution, and for some PWCS, has been the last thing they needed to get well.

    I don't know if you have been following the "demonstration project" for treating M.E. patients that is going on in Ohio at present, which is updated on the forum called "A New Day," part of Cort Johnson's forums. The approach to treatment being used there involves IV nutrition, homeopathic neural therapy, acupuncture, proliferative therapy, and laser therapy. This is quite an innovative approach to treatment, and I can't say that I understand how it works from a fundamental scientific viewpoint. It does, however, so far appear to be a promising approach, and I am following the updates.

    I don't know the details of what is included in the IVs, and perhaps there is some B12 and folate involved, which would seem to be important for lifting the methylation cycle block. On the other hand, perhaps the other techniques used are able to cause the body to make more effective use of the resources of B12 and folate that it already has. In any case, I do think there is good evidence that many or most PWCs have a methylation cycle block, and to lift this block, the methionine synthase activity has to be increased, which entails greater functional use of B12 and folate. So I'm trying to understand how this treatment intersects with that need.

    You asked about treatment timescale. This seems to vary, depending on a variety of factors. If the simplified treatment approach is used by itself, the experience is that improvements usually occur within a couple of months, but full recovery hasn't happened for many people over a year later, though it has for a few. Lately I've been studying some of the cases with slow improvement, and I think that the lack of enough of the cofactors or enough of the amino acids to feed the methylation cycle and associated pathways may be the reasons for the slow progress in at least some of the cases. B-complex vitamins, minerals including zinc, copper, magnesium and selenium, and amino acids including methionine, serine, and the precursors for glutathione (glycine and glutamine or glutamate) are frequently found to be low.

    Dysfunction of the gut seems to be at the basis of the low amino acids. I think that's why the IV amino acids are an important part of the treatment in Ohio, but for many PWCs, it may be possible to take free-form amino acids in order to increase their absorption, even with gut dysbiosis going on.

    Beyond this, there are other treatments that may need to be added, depending on the particular case. These include attention to food sensitivities, efforts to improve the condition and function of the gut, support for the adrenal and thyroid axes, treatment of infections, treatment for mold illness if present, and treatment of heavy metal toxicity. There are various ways of approaching these issues in treatment, and physicians differ in their methods, but I think these are the things that can be required.

    So in summary, I think the theoretical model and the lab test are holding up well, and though there is more to be learned in treatment, lifting the methylation cycle block and thereby bringing up glutathione seem to be essential parts of the treatment.

    Best regards,

  5. quilp

    quilp New Member

    Thank you ? Well of course that is the very least I can say, but sometimes no matter how hard one searches for words, they can never be enough. I always enjoy reading your contributions, but words that would do justice to your efforts, your insight and your help to me and others, have yet to be revealed.

    Please keep us informed of further developments; I am particularly encouraged by the fact that the data seems to be holding up; this in itself would provide a poweful adjunct to the psychiatric lobby over here in the UK, as well as providing help to millions.

    Kind regards, Mark