Cpn exploits a variety of mechanisms to thwart our immune system. There is one mechanism that is particularly important and can be countered by over the counter supplements. Cpn targets niacin metabolism. In doing so it leads to impaired T-cell function, low melatonin, low serotonin, low tryptophan, low niacin all of which can present as depression, fatigue and insomnia, all familiar symptoms in Chronic Fatigue, Fibromyalgia and a host of Cpn related disorders.
Niacin therapy has been used safely for the treatment of hypercholesterolemia for decades, just the same, niacin levels should be increased slowly to minimize flushing and liver enzymes should be monitored. Expect some endotoxin release (as organisms die) as niacin is increased. Endotoxin release will lower nitric oxide levels temporarily and lead to cold hands and feet and possibly increased muscle aches in the initial stages of niacin treatment. You have to build up gradually on niacin as ingestion causes a flush like a hot flash. This reaction abates as you get used to the increased levels, and you can increase (UP TO???) the dose as tolerance develops.
Eventually time-released niacin can be used after niacin tolerance is established, but this form of niacin can be harder on the liver. Just be careful and make sure your doctor is monitoring liver enzymes and CBC every month or so until tolerance is well established. Unfortunately Niacinamide, ("No Flush Niacin") does not appear to be as effective.
Adding herbs that increase nitric oxide synthase (NOS) activity can also be helpful and can lead to improved immune function and warmer extremities. Garlic, ginseng, & ashwagandha all increase the activity of NOS and may be synergistic in combination with niacin. Increasing nitric oxide usually decreases FM related muscle pain and anxiety. One of the following articles supports the use of niacin for chronic headache (Mayo Clinic article) and another links infection with Cpn to disruption of niacin metabolism and immune evasion.Make sure that you are taking a good multivitamin daily when doing battle with Cpn. Nutritional demands are increased significantly by increased exposure to the endotoxin that is released from dying organisms. Biochemicals made by the the body to fight Cpn are made at the expense of tryptophan, niacin, melatonin, and serotonin all of which also are needed to fight Cpn in other ways. Supplementation with niacin and melatonin should make life more difficult for Cpn.
Best wishes to all of those who striving to be a bad host to Cpn. The last two articles document the effects of nitric oxide and melatonin on Cpn.