Treating Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia: Infections - IVIG (Immunoglobulin) Therapy
Immunoglobulin Therapy or IVIG consists of giving
patients proteins produced by B-cells called IgG immunoglobulins that
produce antibodies. Antibodies target pathogens for destruction and inhibit
them from infecting cells. Through their interactions with immune cells
antibodies also modulate the immune system - boosting under active and
tamping down over active parts of it.
IVIG therapy is designed to alter the immune response in order to prevent
infections or fight off pathogens in immune deficient individuals or to
reduce inflammation in people with auto-immune diseases.
The immunoglobulins are pooled from the blood products of over a 1000 blood
donors that have been treated to kill any infections present. IVIG therapy
is FDA approved to treated several diseases but is used off-label in a many
others including many auto-immune ones.
Chronic Fatigue Syndrome (ME/CFS)/Fibromyalgia (FM) Studies
– IVIG therapy cured several parvovirus-B19 associated cases of chronic
fatigue syndrome. On the other hand a large place-controlled,
double-blinded, randomized Australian trial using a variety of doses found
no specific therapeutic benefits. FM patients with evidence of nerve
demyelination caused by immune dysfunction responded positively (reduced
pain, tenderness, increased strength) to a short-term IVIG trial.
Chronic Fatigue Syndrome (ME/CFS) Doctors Report –
Given its expense Dr. Teitelbaum turns to IVIG only after other means of
fighting chronic infections have been exhausted. He has, however, found that
IVIG can ‘dramatically help’ some patients.
Dose – Dr. Teitelbaum recommends intramuscular
injections of 2 cc a week or 4 cc every other week (or weekly) but notes
that even 1 gram a week for six months can be helpful. He recommends using
IVIG for six weeks or longer. De Meirleir uses low doses of IgG1 or IgG3.
Cost – IVIG therapy can be extremely expensive
costing several thousand dollars a month. Both Dr. Teitelbaum and Dr. De
Meirleir have found that using low doses to cut costs can be effective.
Finding no extra benefits from IV’s Dr .Teitelbaum advises using the less
expensive intramuscular injections.
Side Effects – can include fevers, chest pain,
muscle aches, headaches, shortness of breath, etc. Die-off reactions can
occur with the first few injections. Dr. Teitelbaum recommends that one to
three weeks of Nexavir be given prior to IVIG therapy.
The Phoenix Rising website is compiled by a layman
with ME/CFS.
It is not a substitute for a
physician and is for informational uses only. It does not present complete
information on this drug. Please discuss any treatments
in these pages with your doctor.
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Caro XJ, Winter EF, Dumas AJ.A subset of fibromyalgia patients have findings
suggestive of chronic inflammatory demyelinating polyneuropathy and appear
to respond to IVIG. Rheumatology (Oxford). 2008 Feb;47(2):208-11.
Kerr JR, Cunniffe VS, Kelleher P, Bernstein RM, Bruce IN. Successful
intravenous immunoglobulin therapy in 3 cases of parvovirus B19-associated
chronic fatigue syndrome. Clin Infect Dis. 2003 May 1;36(9):e100-6
Vollmer-Conna U, Hickie I, Hadzi-Pavlovic D, Tymms K, Wakefield D, Dwyer J,
Lloyd A. Am J Med. Intravenous immunoglobulin is ineffective in the
treatment of patients with chronic fatigue syndrome. 1997 Jul;103(1):38-43
Teitelbaum, J., From Fatigued to
Fantastic, Avery Press. 2007.