Dr. Cheney: Advances in CFIDS Treatment

A Special Issue Devoted to Information From a Conversation with CFIDS Specialist, Paul R. cheney, M.D., Phd

Written by Carol Sieverling, this issue's articles are based on tapes of her October 2000 visit. Dr. Cheney gave permission to share this information, but has not reviewed or edited it. Articles on other topics will be in the April 2001 newsletter and will soon be available on our website in the section on Dr. Cheney. These articles likely apply also to FMs patients experience cognitive difficulties in addition to pain and fatigue, since Dr. Cheney believes they may also have CFIDS. Dr. Cheney plans to speak in the Dallas - Ft. Worth area on October 20, 2001.

Dr. Cheney is refining the use of growth hormone and growth factors for use in CFIDS. Others have been researching this area for years. In particular, Dr. Sam Baxas pioneered the use of human growth hormone and growth factors more than twenty years ago. A discussion of his work can be found in the book "Grow Young with hGH" by Ronald Klatz.

Table of Contents

• Initial Trial of Bovine Growth Factors
• Growth Hormone and Bovine Growth Factors:
  The Construction Workers and the Blueprints of the Human Body
• What does Growth Hormone do?
• CFIDS: GH Deficiency Syndrome
• Dangers of GH Deficiency
• GH Dosing and Frequency
• Two Successful Cases
• Balance the Immune System First
• Risks of Growth Hormone
• Repairing the Deficiency
• Stem Cells
• Documenting Brain Repair
• History of GF Use
• Young People with CFIDS - 90% Recovery
• Which Bovine GF's?

GROWTH HORMONE AND BOVINE GROWTH FACTORS:

The Construction workers and the Blueprints of the Human Body

Dr. Cheney has 16 patients poised to begin his most promising study yet. The six-month trial involves injections of growth hormone (GH) and bovine growth factors (bGF's). Cheney believes this may be helpful to phase III patients "who are symptomatically improved but physically limited", and some phase II patients who are treatment resistant. "The study is an ambitious but promising attempt to stimulate the body's innate healing potential to repair damage done to it over years of CFS related pathology."

Growth hormone acts as the "construction workers" who implement the "blueprints" provided by the bovine growth factors. Together they repair the damage done to the brain and organ systems.

What does GH do?

It stimulates the growth of muscles and bones, regulates metabolism, slows production of fatty tissue, maintains blood sugar levels for the brain, regulates all other hormones, and makes fat available to the cells as an alternative fuel.

In healthy people, GH levels are near zero most of the time, but sharply increase in response to physical stress. GH synthesizes protein, and is therefore needed to repair muscle tissue broken down during exercise. The process of repair makes the muscles even stronger. It's called training! However, if you try to train when you have no GH, you induce micro-trauma and break down the muscles instead of strengthening them.

A major spike should also occur in the middle of your "night", whenever that maybe. GH and stage 4 sleep are interdependent. No growth hormone - no stage 4 sleep; no stage 4 sleep - no growth hormone.

Cheney stated, "At 3 AM the liver comes up and maximally detoxifies. Isn't it interesting that the body spikes GH not long before the liver needs it? It primes the liver. If you don't get the priming with GH at midnight, then your liver doesn't work and you become more toxic."

CFIDS: GH Deficiency Syndrome

CFIDS is a Growth Hormone Deficiency Syndrome. Cheney first learned this when he read Greta Moorkens PhD thesis, published in May 2000. Using the Insulin Tolerance Test (ITT), she found that CFS patients had, on average, a 50% reduction in GH. However, her patients had only been ill an average of 18 months. Cheney suspects patients who have been ill longer may have a more profound deficiency. Cheney also learned that the standard IGF-1 test is not a reliable measure of GH.

For comparison, Cheney used both the ITT and a maximum exercise test a bicycle stress test. He drew blood before the bike test, and again ten and twenty minutes after the test. The ITT was only done on a few patients because this test is so hard on them physically. Cheney believes the bicycle test is safer. Both tests gave the same shocking results: no growth hormone response at all, not even a tiny spike.

Cheney has tested three of our local members using the bike test. Two had no GH response. One had a small spike. Twenty minutes after the test she had a level of 5.6 ng/mL. The middle of the normal range is 24; anything under 10 is deficient.

Dangers of GH Deficiency

Cheney explains that no GH response means serious trouble. "You lack sufficient control of protein synthesis to respond to exercise, to stage 4 sleep, to the needs of detox, and all kinds of other problems."

To make matters worse, if your immune system is Th2 dominant, the only thing standing between you and cancer, viral infections and intracellular bacteria is RNase L, which you can't make without GH. It's a very serious problem.

GH Dosing and Frequency

Six months of experience have convinced Cheney that GH is one of the most powerful treatments for CFIDS patients. However, the dose and the frequency of the dose are critical. The standard dose given three times a week put Dr. Cheney's patients in bed. In his words, they crashed and burned.

To give that much GH to a seriously deficient patient is a "command directive" to increase protein synthesis, including the protein RNase L. That's very expensive in terms of energy. With no energy to spare, the body has to redirect every ounce to protein synthesis. In addition, GH may trigger the production of RNase L, which has both good and bad effects, but too much contributes to the "crash".

Cheney recommends the Pharmacia & Upjohn Company's "bridge" program (800-645-1280) as a source of growth hormone. Prescriptions should be mailed or faxed to them. They sell GH in a variety of dose ranges. Cheney recommends the seven single dose MiniQuick pack. Begin with the 0.2 mg MiniQuick injected subcutaneously into the thigh or buttock once a week. Since it contains no preservative, any unused portion of the 0.25 cc volume syringe must be disposed of.

If you are fatigued or wiped out by the injected dose within 24 hours, lower the dose by 50% until you either feel an energy boost over the next 2 - 72 hours or until you are at least stable and not overly fatigued by the injection. If you feel nothing, double the dose to 0.4 mg given once a week. The dose range for most patients will be between 0.1 and 1 mg per injection.

After you have found the correct dose, you can then determine the correct frequency. For most, it will be once or twice a week. If given too frequently, overall energy levels will slowly drop over several weeks. When the frequency is correct, you should notice a slow increase in your overall energy levels over several weeks to months.

Most patients ultimately benefit from returning to their baseline fatigue state for several days before receiving the next injection. Taking it more often to maintain the initial energy boost will likely provoke a slow downward spiral seen over the following weeks and months.

Two Successful Cases

One very ill patient was sensitive to everything: vitamins, drugs, supplements, food, and the environment. He was very sallow from liver dysfunction and his white count was 2. He's had the most dramatic response so far. His liver and immune system have come back. He's now responding to interventions that never worked in the past.

Another patient was menopausal. She was on thyroid medication, estrogen and progesterone. After beginning GH injections, she cut her thyroid medication in half. Her periods resumed and she no longer needs to take progesterone.

According to Cheney, GH "encodes" the receptors for all the other hormones. (Hormones are like keys and receptors are like locks. Each hormone must fit into certain locks to trigger certain responses. GH "codes" each lock, telling it which key fits.) If you don't have any GH, none of your other hormones can work properly. Many female CFIDS patients appear menopausal, yet estrogen levels in their saliva and urine are sky high. It goes right through them because there are no receptor cites to which it can bind.

Balance the Immune System First

First GH raises immune function, but ramps up the Th2 side in particular. Thus, its is very important to balance the immune system before beginning GH injections.(See next article.)

Risks of Growth Hormone

(2) Sensitivity: CFIDS patients are sensitive to it, so it's imperative to get the dose and frequency right.

(3) Cancer Growth: GH doesn't cause cancer, but it'll increase the growth rate of any undetected cancer. Patients should have routine screening exams. Cheney strongly recommends the AMAS test. (Anti-Malignant Antibody Screen.) This blood test checks for all forms of cancer. It's based on the well-published discovery by two Harvard professors that all cancers express a substance to which the body makes antibodies. Covered by Medicare, the test costs $135. Call 1-800-922-8378 for information or a test kit.

(4) Axis Suppression: (The author thinks Cheney is referring to the HPA axis: hypothalamus, pituitary and adrenal.) Cheney commented, "If I give GH, will I suppress your own endogenous capacity to make it? If I did that, I commit you to GH forever. But this is not a concern if you have no axis to begin with!"

Repairing the Deficiency

Can the damage that caused the GH deficiency be repaired? Cheney believes it's possible. How? The same way doctors cured the Parkinsonian patients featured in the May 22 issue of Newsweek. (Parkinson's involves the death of certain brain cells, causing a progressive loss of muscle control.) In this revolutionary study, doctors grafted fetal stem cells into nineteen recipients. Sixteen of the grafts "took". Of those, the stem cells repaired the damage to the brain and cured the disease in patients who were under age 60. Of those over 60, the process didnÌt work. The difference? Growth hormone! For stem cells to work, you must have enough growth hormone.

Stem Cells

Stem cells are embryonic, undifferentiated cells capable of becoming virtually any cell of the body. "Stem cell differentiation into a neuron and integration to repair the brain is a highly protein synthesis intensive process. Without GH, the stem cells do not work."

"You might say, 'Dr. Cheney, they used stem cells but you're talking about growth factors, not stem cells.' Well, ten years ago when they began this research, they didn't think there were any stem cells in the body, especially at the 60-year mark. But recent research has proven that there are stem cells in the body. All we have to do is turn them on. And growth factors turn them on!"

"They've repaired brain injuries in monkeys now, and it wasn't necessary to give them stem cells. They're already there, just waiting for a message and enough protein synthesis to work. Scientists were able to repair the brains of the monkeys using bovine (cow) growth factors to trigger the stem cells."

"But the monkeys had plenty of GH to start with. So what we need to do is give you GH, then add the bovine growth factors. If this works, then we repair your hypothalamus, your axis comes back, your endogenous capacity to make GH comes back, and then we get you off GH."

Cheney went on to say, "I don't like the idea of injecting this patient population with GH for the rest of their lives. I'd rather just give it to you for a short time, while you heal your systems. But I have yet to determine that. Worst case, you're committed to GH for the duration. Best case, just until such time as we repair the injury that causes the GH deficiency. And if that works, of course, then we have a lot of good things to do in the area of CFIDS. Almost everything else is somewhat secondary to these central features."

Documenting Brain Repair

"How do we prove that we have repaired the brain? One way is functional: give the bicycle test to show that your GH response to exercise, which was deficient initially, comes back after therapy."

Another way to prove it is to actually measure the injury itself. Cheney sent many patients to Columbia Medical Center in New York for an MRS (Magnetic Resonance Spectroscopy). The scan is of the hypothalamus and the cerebrospinal fluid in the left ventricle of the brain.

The readout is a horizontal line with periodic spikes of different heights. Each spike represents a particular substance or chemical. Four substances are of particular interest in CFIDS patients.

Dr. Shungu examines four particular spikes in CFS patients:

1) Coline: It's involved in the myelin sheath, and a decrease indicates Multiple Sclerosis.

2) Creatine Phosphate: It's usually elevated in CFIDS patients and indicates the increased stored energy of the anaerobic system, which tends to be stronger in CFIDS to compensate for the injury to the aerobic system.

3) NAA: If it's decreased, which is typical in CFIDS, it indicates brain cell death.

4) Lactic Acid: There shouldn't be any present, and this is what's glaringly elevated in most CFIDS patients tested. It indicates a high degree of tolerance to the damage to the aerobic system.

Cheney commented, "If the viability spike, NAA, increases after therapy and the lactic acid spike decreases, it means we're repairing the brain."

History of GF Use

GF's were used 18 years ago at UCLA to repair bones that wouldn't heal. The first publication of their use was in 1982. They've been in use in Europe much longer. Cheney noted, "Pope Pius XII received injections on his death bed in 1952 and lived four more years. GF's have been around a long time, but it's only been in the last ten years scientists have begun to discover how they work."

Cheney also stated, "You don't have to use human growth factors. You can use mammalian GF's. They inaugurate stem cell differentiation. It will become whatever is needed. The stem cell will repair any injury. All you need are growth factors and sufficient growth hormone."

Young People With CFIDS - 90% Recovery

"Nine times out of ten, young people with CFIDS recover. But past 20, you're lucky to see one out of ten get through it. Why? Growth hormone. Young people still get hit, some very hard, but they have so much GH that they can loose 50% and still have enough. Once you reach 20, your GH is half what is was at 15. It drops precipitously after puberty."

"I think this syndrome transforms you into a very low GH state, and once that happens you can't really repair the damage. You can get through the syndrome, maybe; get through the pathophysiology of the disease, maybe; but then you're locked in, limited. So, to repair the damage - and the focus of that damage is the hypothalamus - you need GH. And since GH seems to be the center of aging, essentially the treatment of Phase III CFIDS is going to mimic the treatment of age-related injury."

Cheney believes that younger people may only need GH, since they could still have functioning GF's. Older patients will certainly need the bGF's. Even if you have some functioning GF's, taking the bGF's is expected to accelerate the healing process.

The study protocol states "GH is expected to significantly increase the bGF's healing potential as orchestrators of endogenous stem cell migration, differentiation and integration to effect tissue healing. The target tissues for healing in this study are liver, immune system, adrenal gland and especially the hypothalamus."

WHICH BOVINE GF's?

Cheney is not releasing specifics of the protocol related to the bGF's. There is still too much to be worked out regarding dose and frequency. Details may be available at Cheney's presentation in the Dallas area on October 20, 2001. A video of that seminar is expected to be available from this support group.

NOTE: Dr. Cheney is refining the use of growth hormone and growth factors. Others have been researching this area for years. In particular, Dr. Sam Baxas pioneered the use of human growth hormone and growth factors more than 20 years ago. A discussion of his work can be found in the book "Grow Young with hGH"by Ronald Klatz.

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