Reprinted with the kind permssion of Cort Johnson and Health Rising 
.By Cort Johnson
“She reported a clear improvement on most ME/CFS symptoms during the next days, which she described to be remarkably alike the response she had previously experienced from 6-7 weeks after Rituximab”
Thus, the administration of a NO donor surprisingly allow a treatment of CFS patients for immediate relief of symptoms without any delay as described for e.g. a B-cell depleting agent, like Rituximab, before.?
Thanks to Tate for passing this on. This lady was one of the Fluge/Mella’s original lymphoma patients with ME/CFS. She found that Ritxumab cleared up her cancer and her ME/CFS but she relapsed after she went off the Rituximab.
Now lightning has struck again. She checked into the hospital for transient ischemic heart pain and upon receiving isosorbide mononitrate (Imdur®) she experienced significant symptom relief from her ME/CFS as well.
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Imdur reduces blood pressure and is used in the treatment of angina. Essentially it dilates the blood vessels – letting the blood flow more freely.
Fluge and Mella appear to be using this combination: An alternative strategy was applied, using supplement with relatively high doses of L-Arginine 5 g twice daily combined with L-Citrulline 200 mg twice daily. They note that other combinations may work:
“Examples thereof include compounds inhibiting arginase, e.g. arginase II, a competitor of the NO synthase (NOS). Other examples comprise compounds stimulating the activity of NO synthase, in particular, of the eNOS, either by increasing the amount or level of NOS or the turn over rate of the enzyme.” Plus they discuss using it in combination with Rituximab.
They treated six patients and found a moderate response in all of them. The idea of dilating the blood vessels seems to make sense in FM and ME/CFS. (Lowering blood pressure does not – I don’t think). Fluge and Mella believe ME/CFS may be an autoimmune disorder that attacks the blood vessels. I certainly hope they are right and this woman’s experience suggests they may be – at least for her. An autoimmune treatment (rituximab) and blood vessel dilator achieved the same results. That’s very interesting!Read the patent application here 
About the Author: Cort Johnson has had ME/CFS for over 30 years. The founder of Phoenix Rising and Health Rising, Cort has contributed hundreds of blogs on myalgic encephalomyelitis, chronic fatigue syndrome, fibromyalgia and their allied disorders over the past 10 years. Find more of Cort’s and other bloggers’ work at Health Rising .