Oxymatrine in the treatment of post viral fatigue

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This webpage represents a brief summary of issues that were discussed on 26th May 2010 at the Invest in ME International – 5th Conference.

Professor Leonard Jason, Professor Norah Chapman, Dr John Chia, Dr Paul Cheney, Dr Jonathan Kerr, Dr Nancy Klimas, Professor Brigitte Huber and Dr Judy Mikovits

See these YouTubes:

The role of viruses in CFS/ME

The emphasis of this conference was very much on viral causes of chronic fatigue syndrome / ME and the immune responses that go with that. Much discussion went into the classification of types of ME by various sub-groups particularly by Professor Jason and Dr Kerr, but my view is that, at present, this has little implication for treatment. Norah Chapman concentrated on cocksackie B infections, Dr John Chia on enteroviral infections, Brigitte Huber on retrovirus HERV K-18 (which we all have in our genome) and Judy Mikovits on the new XMRV virus - the XMRV debate is well documented but it is difficult to find a simple easy to read summary of the affair- please see the "Historical Note" section below or one could buy Dr Mikovits' 2014 book Plague: One Scientist's Intrepid Search for the Truth about Human Retroviruses and Chronic Fatigue Syndrome (ME/CFS), Autism, and Other Diseases. These viruses (excepting XMRV) are implicated in cases of CFS/ME but what makes the difference between a short illness and recovery and illness and prolonged CFS/ME is the response of the immune system to those viral insults. Studies show the virus continues to be present albeit at very low levels and because the virus is at such low levels this explains why many tests do not pick it up – it is simply below the level of the radar.

However this low level viral persistence may result in chronic inflammation in susceptible individuals wherever that virus happens to be and this would explain many of the symptoms of CFS/ME. So for example Dr John Chia found that in 165 patients with CFS 82% had high levels of entrovirus in the gastric antrum of the stomach. Norah Chapman found low level infection by defective cocksackie B viruses in non-dividing cells in particular muscle cells (including the heart muscle) and by implication brain cells (because these enteroviruses persist in non-dividing cells). Brigitte Huber showed that HERV K-18 MRNA levels are higher in CFS patients.

What this tells us is that patients with CFS/ME are not good at dealing with viral infections, they do not eradicate them efficiently and this viral DNA gets in the way of cell metabolism causing a low grade chronic inflammation which means cells malfunction.

The most important point about all this wonderful work is that it clearly establishes CFS/ME as a physical disorder with physical lesions and physical treatments.

The clinical picture

John Chia made the point that enteroviruses are the commonest cause of ‘flu-like symptoms. Enteroviruses may be picked up as a result of travel, water sports, gut infections or from local epidemics. He specifically mentioned vaccinations and allergies as risk factors. The way to diagnose an enteroviral infection is first of all to have an high index of suspicion! ‘Flu-like symptoms that persist for more than two weeks are highly suspect, but blood testing for antibodies can be misleading. There are often few physical signs, perhaps some ulcers on the tongue, possibly lymphadenopathy (lymph nodes which are abnormal in size) and tenderness of the abdomen particularly in the epigastrium, (please see Location of Epigastrium) left iliac fossa and right iliac fossa (please see Location of Right Iliac Fossa). Sometimes there is sinusitis, colonic inertia (referred to as a motility disorder; that is, it is an abnormal passage of waste through the digestive system) and pelvic pain.

How well one deals with the virus depends on whether the immune system is in a state of Th1 or Th2 activation. Please see Wikipedia article on T helper cells. If one is in a state of Th2 activation one will struggle to get rid of the infection and this state is characterised by allergy, female sex hormones (pregnancy, Pill, between menarche and menopause – ergo women are much more susceptible than men), excessive exercise, vaccinations or another recently acquired infection.

So for example Professor Huber pointed out that we all have HERV K-18 (indeed 8% of the human genome is made up of retrovirus) but the expression of this is induced by Epstein Barr and herpes virus, this activates virus in a way to produce a super-antigen which results in massive T-cell activation, i.e. inflammation. Epstein Barr virus is particularly good at doing this.

An awful lot of the discussion of the day revolved around immune responses to virus. My interest, of course, is in getting patients well and I have to say I dozed off during some of these discussions – partly because I’d had a 4am start and partly because I don’t see the relevance of esoteric immune discussions when it comes to the business of getting patients well! I see the immune system as the army of the body and all the various players have army equivalents. So, natural killer cells are our soldiers with machine guns, B-lymphocytes and T-lymphocytes are the messengers rushing around telling everybody what to do, as well as lobbing cytokines and antibodies - our bombs and grenades. In chronic fatigue syndrome much of this activity is self destructive – it’s as if the army can’t stop fighting foreigners and has embarked on a civil war.

What is clear is that the total load of virus during the early phases is critical. Indeed this is well established in HIV infections. The above issues do, of course, have implications for treatment and this is how I see it all fits together.

During the acute stage

Treatment of the initial viral infection Keeping viral numbers down helps a lot. Viruses are killed by fever, one should rest up in bed to allow the immune system to be active, take high dose vitamin C which effectively kills everything in the gut – indeed in high doses this will cause diarrhoea and strip out virus yeasts and bacteria generally in the gut. An acid stomach will be protective against enteroviral infection because the acid will kill viruses. Do not take symptom suppression medication, which reduces fever and pain, because these are useful symptoms which kill viruses - please see Viral infections - avoid them and treat them aggressively AND please see the "More Reading" section below as well.

Interventions to reduce inflammation

Inflammation is highly desirable in the early stages of viral infection but after two weeks, it is probably counter-productive. Nutritional interventions to reduce inflammation will be very helpful. The problem with Western lifestyles is that with their high levels of sugar and refined carbohydrate, lack of sleep, lack of sunshine, chemical, physical and mental stress etc. they tend to be pro-inflammatory. This predisposes us to states associated with chronic inflammation – please see Inflammation. All this will tend to be made worse by having poor antioxidant status – this is a disease-amplifying process – poor antioxidants means more free radicals means more inflammation. Please see Antioxidants

During the chronic stage

Please see these pages for my protocol -

And please see the "More Reading" section as below.


John Chia looked for Chinese herbs which had anti-viral activity - the idea here is to try to get rid of those last few viral particles that were causing so much havoc in terms of chronic inflammation. He came up with oxymatrine which he has now trialled in 500 ME/CFS patients and seen beneficial effects in said 52%. In the short term this can increase symptoms, but in the medium term beneficial effects were seen in said 52%. In a few of the responders and non-responders, in which he measured cytokines gene expression, there was an increase in the IL12/IL10 ratio in 7/7 and no increase in any of the 10 non-responders. Again those that responded showed low levels of enteroviral protein in stomach biopsies. This suggests that oxymatrine is useful in half of patients with chronic and low grade viral infections. Dr Chia has made up his own product Equilibrant which contains the active principle oxymatrine and he recommends starting at one daily, gradually increasing to 3 twice daily according to clinical response. Expect to get worse initially, hence the need to start with low doses and build up slowly. My guess is Equilibrant will be more effective if the basic work up to treating CFS is followed (as in the Overview and Summary approaches above, and Groundhog regimes below).

See also Health Rising Article on Oxymatrine

See Dr Chia's Equilibrant website here - EqulibrantHealth where you can buy the supplement.

You can also buy oxymatrine at these here, and elsewhere -

This supplement is NOT CHEAP!

"More Reading"

Since writing this page, I have written a book about the issue of chronic infections in ME.

Please see

and these related articles:

In addition, I have developed the Groundhog Regimes, which fall into three categories:

"Historical Note"

Judy A Mikovits, PhD, is an ME/CFS researcher and was previously the research director at the Whittemore Peterson Institute (now the Nevada Center for Biomedical Research). Dr Mikovits led the team that published a paper suggesting a connection between the XMRV retrovirus and ME/CFS. As a result of this paper, Mikovits felt the full force of scientific prejudices regarding ME/CFS, and eventually she was fired from the WPI in 2011. See Detection of an infectious retrovirus, XMRV, in blood cells of patients with chronic fatigue syndrome

After her sacking, there was a legal dispute with the WPI – Dr Mikovits was actually arrested at this time. All charges, including criminal charges of theft, brought by the WPI against Dr Mikovits, were eventually dropped. This website is not the place for a full recounting of the circumstances surrounding these events but, for example, at one time, Dr Mikovits was banned from even setting foot on the NCI (National Cancer Institute) campus, a prohibition which would be enforced by security.

The full story is told in the excellent book, Plague: One Scientist's Intrepid Search for the Truth about Human Retroviruses and Chronic Fatigue Syndrome (ME/CFS), Autism, and Other Diseases, written by Kent Heckenlively (a former attorney) and Judy Mikovits

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