XMRV in the Spotlight

November 5, 2009

Posted by Cort Johnson

XMRV was next up at the mike at the CFSAC meeting. First Dr. Peterson went over the published research one more time.  Hearing it again simply reinforced what an extraordinary discovery XMRV may be. His presentation was, in some ways, though, really just a prelude to Dr. Coffin’s  presentation. The co-author of the major text in the field, Dr. Coffin represents the upper tier of  world class researchers that we’ve been wanting to attract for so many years. He was basically our toughest test case; if he was excited about this virus then everyone in his field is.

Good Science! – He was excited. There have been some questions about the demographics side of the study but the science side was better than we patients could tell.  Annette Whittemore said that the Science paper didn’t get easily; Science wanted the virus story but not the CFS part of it. After the WPI dug in their heels and said you’re not going to get one without the other Science made them jump through hoop after hoop. Their ability to do what they did surprised alot of people.

“This is a remarkable finding. Everybody recognizes this is potentially of extraordinary importance”  Dr. John Coffin

A Remarkable Finding – The prostate cancer association with XMRV interested the field in the virus; the Science paper apparently blew the lid off of it. Already the WPI (and NCI and Cleveland Clinic) researchers have accomplished something that its very difficult, even now, to do in HIV which is target the virus in the plasma. Apparently its not difficult to find HIV in cells but its still very difficult to actually capture it in plasma.

The fact they were able to isolate a virally infected cell and put it next to a prostate cancer cell and watch the virus infect the prostate cancer cell was a huge win for them. The fact that Dr. Peterson was able to thaw out some samples that had been frozen for 25 years and then grow virus out of them apparently just blew the virologists minds.

When they looked for it in the ‘activated’ immune cells they found it in a very high percentage of them – which suggests an active infection. (Immune cells become ‘activated’ – basically put themselves into overdrive – once they encounter a pathogen. ) They’ve also been able to induce the virus to grow in a number of cell lines (prostate cells, B and T cells).

None of these steps should be taken for granted.  Getting a pathogen to grow in cell lines is a very important step in studying it. Not only can you grow alot of virus when you do that but you can study  the virus intimately. It’s often, however, difficult to put viruses in a test tube and get them to actually grow in cell lines. For instance, decades later, hepatitis C virologists have still never isolated the hepatitis C virus (they sequenced  its genome instead) and have never been able to grow it in a culture. Because of this essential elements of its biology have escaped them. (VIPdx began offering a culture test for XMRV a week ago).

The Bad Virus on the Block? - Nobody knows what effects XMRV does or does not have but its clear that the family of retroviruses it belongs to is a nasty one. These gamma retroviruses are known to cause a slue of cancers in animals including lymphoma (aka Incline Village) and leukemia.  This is part of what’s fascinating to researchers about the virus; could it set the stage for all sorts of cancers? Annette Whittemore said breast, leukemia, lymphoma, etc. researchers are all going to take their shot at this virus.  Over the next couple of years its possible this virus shoot from near obscurity to being very well understood in the scientific community.

Not HIV! - XMRV is about as different from HIV as a retrovirus can be in several ways.  XMRV doesn’t appear to replicate rapidly which means it has a low mutation rate and suggest it might be relatively easy to create a vaccine for but also gives researchers less of a window on the treatment end to knock it down.

“The potential pathogenecity of the this virus should not be underestimated”  Dr. John Coffin

Treatments - Its  unclear whether HIV drugs are going to work. (The WPI is reportedly testing them and antivirals including Ampligen in the lab).  Interestingly AZT, which had been sitting on the shelf for 20 years before the HIV epidemic hit, was developed against a gamma retrovirus (like XMRV). Even more interesting the drug developers apparently have a good number of anti- retroviral  drugs sitting on the shelves that didn’t appear to work well enough against HIV but could find some promise with XMRV.

Vaccine Yes, Treatment ? – It may not be easy, though. Dr. Coffin reiterated the fact that the viruses remarkable genetic similarity from person to person (even between people located across the country) meant that chances for finding a vaccine were pretty good and, in fact, one has been developed for a similar virus. The low replication rate, however, apparently make it more difficult to target treatments against this bug. (Different HIV treatments target different stages of its replication process).

(Genetic diversity is essentially a function of replication; the more a virus replicates the more small changes in its DNA accumulate. The fact that genetic diversity is so low in this bug suggests that it is not replicating very much. It could also suggest that a contaminant got into the samples but the researchers appear to have discarded this scenario. )

In key ways HIV is the exact opposite of XMRV; it replicates rapidly and demonstrates high rates of genetic variability. Dr. Coffin noted that the HIV virus will mutate more simply living in a person’s body over several months than XMRV has between people living different parts of the country. What we have with HIV, of course, are alot of treatment options (@30 drugs) and, despite years of enormous effort and money – almost zero advance on the vaccine front.

Hopefully the opposite scenario will not prove true with XMRV. Dr. Coffin reported some antiretrovirals were proving effective at least in the lab against the virus. (Ampligen was reportedly working in at least some patients cells.) Translating the results from the lab to an actual patient is, often difficult to do, however.)

Does Low Replication Mean Little or No Disease? – Not necessarily. A virus doesn’t need to replicate in order to effect the body; it simply needs to be alive and pumping out injurious proteins. The idea of a kind of smoldering infection with low replication rates has caught on in some parts of the research community. Dr. Glazer has,for instance, identified enzymes produced by EBV that can cause a number of negative effects.

Add to that the fact that a large percentage of ME/CFS patients T-cells are typically ‘activated’ (turned on by a pathogen) and then throw in Dr. Coffin’s statement that a large percentage of activated cells carry the virus and you get the picture of a virus that may be very prevalent in the body; i.e., it might not need high levels of replication to do its work.

I’ve had many people come up to me and ask how I can get involved.  Dr. John Coffin

XMRV and ME/CFS – How to explain the high apparent rate of infection in the ME/CFS patients but not the healthy controls? Dr. Coffin thought of three main possibilities;

  1. the patients happened to live in areas where outbreaks of this virus had occurred
  2. they had an immune system defect that left them particularly vulnerable to the virus
  3. the virus actually infects everybody but is just easier to find (is more active) in people chronic fatigue syndrome (the opportunistic virus theory).

Those ‘Unhealthy?’ Healthy Controls – the Feds are many times more concerned about the 4% of the health controls that tested positive for XMRV than the 67% of the sick ME/CFS patients who did.  If these healthy controls were close contacts of the XMRV positive patients we would expect that number to go down – but they weren’t- they were taken from the broad population. Expect that 4% figure to stay strong – and research money to keep pouring into  this virus no matter what happens with chronic fatigue syndrome

Some Answers - There are alot of questions but one important one - how widespread is this virus in ME/CFS and what types of patients carry it? – should be answered soon. Dr. Bateman and Dr. Klimas and others have their blood samples lined up and ready to be tested. Dr. Bateman stated she’ll be sharing her results as they come out.

“There have to co-factors” Dr. Peterson

No Simple Answers – Even after we learn just how widespread this virus is the situation will remain complex. Since we know that many people can carry this virus and still remain healthy its clear that the virus is going to need at least one ‘partner’ to work with in order to wreak its damage.  What that other essential element is is, of course, unclear. The virus’s cortisol receptors indicate that it reacts in some way to cortisol. High cortisol levels could concievably trigger its activation but ME/CFS patients, at least in the later stages of their disease, are known to have low cortisol levels. (Could the opposite be true? Could high cortisol levels send it into hibernation and low cortisol levels leave it in an activated state?).

The Money - We’ve seen that the traditional sources of ME/CFS research in the federal government, the ORWH and the CDC’s CFS program have been left by the wayside.  The research money for this virus is coming from other sources. The retrovirologists want in. When something this potentially big comes on the scene they find ways;  they shift funds around at their labs, they drop projects…they basically do what they have to do to get their foot in the door. The CDC’s HIV team started their XMRV project the day after the Science paper came out.  The WPI, the CFIDS Association, basically anyone with blood samples is getting with requests – some of them from world renowned resesarchers. (The CFIDS Association requires their investigators to bank samples for future study)

“There are pockets of money at the NIH that can be tapped” Dr. John Coffin

The researchers will pretty quickly have to tap traditional funding sources, though, which historically has been a problem. Every ‘CFS’ grant to my knowledge automatically goes to the CFS grant review board - often a death trap for ME/CFS grants. These review panels typically have been top loaded with pain (and dental!) researchers and rarely have reviewers with immune expertise. The expertise of the review panel is supposed to match the types of grants before them. Will they this time? Only time will tell.

Doing It Right – Interestingly everyone – the NCI, the CDC, the Blood researchers, are developing their own tests. Dr. Miller explained that you can set up a PCR test for a virus almost overnight.  PCR tests simply screen for select bits of DNA in a virus.  The  problem comes when the different labs choose slightly different sections of DNA to test or prepare the ‘reagents’ the virus comes in differently. (One reagent can be far better at uncovering the virus than another.)   The Dr. Coffin stated that agreeing on the right test – a validated, standardized assay – for XMRV was the critical issue facing the field. He hopes that will be done in six months.

The Other Stuff – Its going to take years and years to figure out how this virus – if it is proved to be a or even the major factor in ME/CFS – creates its effects.  Meanwhile research into its downstream effects of it - the low blood volume, the gastrointestinal problems, the immune, HPA axis and autonomic nervous system problems etc. – will remain vital. People with AIDS don’t die of HIV – they die of opportunistic infections that show up in HIV’s wake and thirty years later researchers are still trying to figure out how to deal with the  ’downstream’ effects of having a retroviral infection. If XMRV turns out to be ‘it’ the same will most likely be true for ME/CFS.

Wanda Jones – Wanda Jones is proving her worth in different ways every meeting; there was the first webcast, then the upgraded webcast, the increased organization, the more expansive website. Dr. Coffin was her ‘catch’. She called him the day before and got him in there.  She’s stuck her neck out on this meeting (3 cameras this time and we took up the Lobby of the building – those are government resources she’s using!) and it paid off –  hence her big smile when she announced almost 900 hits the first day of the videocast and the room was full. Congratulations to everybody who came out or clicked in and good for the CAA as well for targeting her at the Office of Women’s Health (OWH) and pushing for her to come on board.

XMRV Information Center

18 comments

{ 18 comments… read them below or add one }

Sue Jackson November 5, 2009 at 4:42 pm

Cort –

As always, an absolutely wonderful summary of a complex topic – thank you!! I’ve been far too sick lately to follow the CFSAC meeting, but I’ve been very curious about what happened. I really appreciate your comprehensive summary here. I’m too pooped tonight, but I’ll link to it tomorrow. Thanks!!

Sue

Reply

cort November 6, 2009 at 7:47 pm

Thanks Sue I appreciate it and your blog. Hope you feel better soon, Yours truly, Cort

Reply

Kati November 5, 2009 at 11:39 pm

Cort, thank you so much for this review- it made me understand the situation much better- tough feat with a foggy brain.

Reply

MARTIN WHITE November 6, 2009 at 6:17 am

WHITTEMORE-PETERSON INSTITUTE PRESS RELEASE ON NEW XMRV TEST KIT – THROUGH VIPDX LABS. 10/6/09
—————————————————————————————————–
BLOG.BLUERIBBONCAMPAIGNFORME.ORG: WPI announces XMRV test kits through vipdx labs
WPI announces XMRV test kits through vipdx labs
Press Release from WPI http://blog.blueribboncampaignforme.org/2009/11/05/wpi-announces-xmrv-test-kits-through-vipdx-labs.aspx?ref=rss

Viral Immune Pathology Diagnostics Introduces New Test for XMRV Patients and Clinicians
-Net proceeds from test dedicated to further WPI research

RENO, Nev. – The Whittemore Peterson Institute (WPI) has recently published a research study
revealing the prevalence of XMRV in patients with Myalgic Encephalomyelitis/Chronic Fatigue
Syndrome, ME/CFS or what has most recently been called, X associated neuro-immune disease,
(XAND). In response to an overwhelming request for a diagnostic test for XMRV, WPI has temporarily
agreed to allow Viral Immune Pathology Diagnostics (VIP Dx) to begin offering the identical tests that
have been extensively validated using the same technology developed by Drs. Lombardi and Mikovits
and their colleagues as reported in Science.

VIP Dx is a small state certified laboratory in Reno, Nevada that was formed in response to the
September 11, 2001 crisis which resulted in the cessation of blood sample shipments between the United
States and Europe. Faced with the loss of important lab tests impacting patients with neuro-immune
diseases, the Whittemore family made the decision to support the lab in Reno.
“Our family made it possible for the lab to not only continue delivering diagnostic tests to doctors, but
also help the WPI bring cutting edge biomarkers of disease to this field of medicine, such as the tests for
XMRV,” said Annette Whittemore, Founder and President of WPI. “Tests conducted for XMRV, and
other tests that support the diagnostic process in this field, will support the continuation of vital work at
WPI through our donation of all of our net proceeds.”

XMRV test acceptance commenced at VIP Dx this month. For more information about the XMRV test kit, visit http://www.vipdx.com.
Whittemore Peterson Institute

The Whittemore Peterson Institute for Neuro-Immune Disease exists to bring discovery, knowledge, and
effective treatments to patients with illnesses caused by acquired dysregulation of the immune system
and the nervous system, often resulting in lifelong disease and disability. The WPI is the first institute in
the world dedicated to neuro-immune diseases, integrating patient treatment, basic and clinical
research and medical education.
———————————–
FOR IMMEDIATE RELEASE http://www.wpinstitute.org
Frankie Vigil
R&R Partners
775-336-4555
frankie.vigil@rrpartners.com
Viral Immune Pathology Diagnostics Introduces New Test for XMRV Patients and Clinicians
-Net proceeds from test dedicated to further WPI research-
RENO, Nev. – The Whittemore Peterson Institute (WPI) has recently published a research study
revealing the prevalence of XMRV in patients with Myalgic Encephalomyelitis/Chronic Fatigue
Syndrome, ME/CFS or what has most recently been called, X associated neuro-immune disease,
(XAND). In response to an overwhelming request for a diagnostic test for XMRV, WPI has temporarily
agreed to allow Viral Immune Pathology Diagnostics (VIP Dx) to begin offering the identical tests that
have been extensively validated using the same technology developed by Drs. Lombardi and Mikovits
and their colleagues as reported in Science.
VIP Dx is a small state certified laboratory in Reno, Nevada that was formed in response to the
September 11, 2001 crisis which resulted in the cessation of blood sample shipments between the United
States and Europe. Faced with the loss of important lab tests impacting patients with neuro-immune
diseases, the Whittemore family made the decision to support the lab in Reno.
“Our family made it possible for the lab to not only continue delivering diagnostic tests to doctors, but
also help the WPI bring cutting edge biomarkers of disease to this field of medicine, such as the tests for
XMRV,” said Annette Whittemore, Founder and President of WPI. “Tests conducted for XMRV, and
other tests that support the diagnostic process in this field, will support the continuation of vital work at
WPI through our donation of all of our net proceeds.”
XMRV test acceptance commenced at VIP Dx this month.
For more information about the XMRV test kit, visit http://www.vipdx.com.
Whittemore Peterson Institute
The Whittemore Peterson Institute for Neuro-Immune Disease exists to bring discovery, knowledge, and
effective treatments to patients with illnesses caused by acquired dysregulation of the immune system
and the nervous system, often resulting in lifelong disease and disability. The WPI is the first institute in
the world dedicated to neuro-immune diseases, integrating patient treatment, basic and clinical
research and medical education.

Price Sheet
Effective March 15, 2009
TEST DESCRIPTION
TEST
CODE
PRICE
Panel Tests
Complete Chronic Fatigue (CFS) Diagnostic Panel (RNAP, RNAA, Elastase, NKCP, NOAS) CMCP 895.00
Mini Chronic Fatigue (CFS) Diagnostic Panel (RNAP, RNAA, Elastase, NOAS [Nitric Oxide]) MCP1 575.00
Rnase-L Anti-viral Pathway Panel (RNAP, RNAA) RNAL 445.00
Intestinal Dysfunction Immunobilan Test – (IgA & IgM)
(Klebsiella pneumoniae, proteus mirabillis, citrobacter koseri, pseudomonas aeruginosa, pseudomonas putida,
morganella morganii subsp morganii, hafnia alvei)
IMO1 200.00
T-cell Lymphotrophic Virus Profile (HTLV I, HTLV II) HTLV 300.00
Infection Screen Panel – Qualitative (Mycoplasma Fermentans, Mycoplasma Hominis, Mycoplasma
Pneumoniae, Mycoplasma Avium Paratuberculosis, Chlamydia Pneumoniae, Toxoplasma gondii)
INSP 595.00
Herpes Infection Panel (EBV, CMV, HHV6 [with A & B determination], HHV7, HHV8 HHVP 575.00
Mycoplasma+ Panel – Qualitative (Mycoplasma Fermentans, Mycoplasma Hominis, Mycoplasma
Pneumoniae, Mycoplasma Avium Paratuberculosis)
MYCP 495.00
Cytokine Profile (IL1β, IL2, IL4, IL6, IL8, IL10, Il12p70, IFNγ, TNFα) CYT1 400.00
Inflammation Panel (C-reactive Protein, Elastase, Nitric Oxide Synthase [NOAS], Rheumatoid Factor) INFP 435.00
CD4/CD8 Lymphocyte Enumeration Assay (CD3, CD4-CD8 ratio, CD19 Absolute) LYEA 250.00
Natural Killer Cell Enumeration & Functional Assay (LU30) Panel
(NKC1, NKC2, NKC3, NKC4, NKC5, NKC6, NKC9)
NKCP 500.00
Heavy Metals Lymphocyte Proliferation Assay – HELP™ Test
(Arsenic, copper, Lead, Platinum, Thiomersal, Palladium, Mercury, Gold, Silver, Aluminum, Beryllium, Nickel, Organic
mercury, Tin)
HLP1 350.00
Heavy Metals Lymphocyte Proliferation Assay – HELP™ Test
(Chromium 3, Selium, Uranium, Cadmium, Chromium 6, Silicon, Cobalt, Manganese, Titanium)
HLP1 350.00
Individual Tests
Human Herpes Virus 6 – Qualitative (A & B determination) (HHV6) HHV6 300.00
Human Herpes Virus 6, Hair Follicle Chromosomal Integration HV6H 300.00
Human Herpes Virus 7 – Qualitative (HHV7) HHV7 200.00
Chlamydia Pneumoniae – Qualitative (CHP) CHLP 200.00
Elastase Inflammatory Marker ELAS 200.00
Nitric Oxide Synthase Assay NOAS 200.00
Human Herpes Virus 6 [with A & B determination] & Human Herpes Virus 7 HV67 450.00
Other: Call for test requirements & pricing ….. ……
PAYMENT
VIP Dx is a fee-for-service provider. VIP Dx is not a preferred provider for any
insurance carriers.
PAYMENT in FULL is required at time of service. An itemized receipt will be mailed to
the patient. The patient may submit a claim to their own insurance carriers if so desired.
VIP Dx will bill MEDICARE as a courtesy service for their patients. A copy of the
Medicare card and any supplemental insurance must be sent with the test requisition
and specimen. Medicare patients are required to read the Advanced Beneficiary Notice
(ABN) on the back fo the VIP Dx Test Requisition and sign in the designated area on the
front of the test requisition.

Reply

Alyson November 6, 2009 at 5:08 pm

Thanks for the summary! I appreciate the way you’re able to break things down into easier bite-sized pieces for those of us with comprehension problems from brain fog.

Reply

cort November 6, 2009 at 7:46 pm

Thanks Alyson. I appreciate it. Thanks as well to Mike Dessin and the Kralls for getting me over there and my brother for putting me up (again).

Reply

ahimsa November 6, 2009 at 5:30 pm

I sent Dr. Wanda Jones a “thank you” email for making the video for the recent CFSAC meetings available online. I wasn’t able to watch any of it live but over the past week I have watched quite a bit of the video that’s available. I hope to watch all of it eventually.

Anyway, I got a very nice response from Dr. Jones which said (in part) “you keep us energized in this effort!”

While I’m posting I’ll also say “thank you” to Cort for his wonderful blog. I’ve never posted a comment here before but I try to read on a pretty regular basis.

Reply

cort November 6, 2009 at 7:45 pm

Thanks, Ahimsa – I really think it is important that we do keep the federal officials energized in this effort; not all of them are but I think Wanda is. Glad you sent her a note and glad you enjoyed the blog.

Reply

meghan Shannon November 9, 2009 at 7:29 am

BIG Difference between Dr. Wand Jones OWH/DHHS, Office of Research Women and Health /Department of Health and Human Services, in Washington DC (Top Dog in our Health system)
And the ORWH/NIH, Office of Research for Women and Health at National institute of Health, Bethesda Maryland (Dr. Pinn, Hannah’ office)

Whe George Bush JR came in to office he went against congressional policy and disbanded all 12 Coordinating Committees including CFSCC.
Dr. Donna Dean, put it in ORWH/NIH and we hung out there as Dr. Pinn really was not interested nor had staff to do what had been done when we were meeting before Bush JR. (NOT and Excuse to not give us money, which they have…the ORWH/nih has had the largest amount of money all along, but all they did was put us on their website and let use sit.

Now that we are in the DHHS/OWH we are now back with people who have more power and can get more things done. And on top of that Dr. W. Jones knows this diseases and believes in helping us. Dr. Pinn put Hannah in charge and she really just reported to the meetings.
We are now back under the Secretary of Health as the next step up from Wanda Jones.
meghan

Reply

Elizabeth Ann November 10, 2009 at 7:21 am

The thing I love most about the XMRV discovery is that it employs sound science. These are professionals saying something intelligent about a maligned and misunderstood disease. After all these years, what if PWCs have not suffered so much from Chronic FATIGUE Syndrome as an infection due to a Retrovirus? I swear, it makes me hold my head just a little bit higher.

Reply

cort November 10, 2009 at 7:59 am

If XMRV works out I think, or at least I hope, that the medical profession will take a hard look at how terribly they’ve treated alot of people for decades who turned out to have a retroviral infection. The NIH spends about $3 per person per year on this disease. ME/CFS gets far (far) lower funding per person than any other disorder. It’s almost like it doesn’t exist them – and this has gone on for decades. What a misjustice this has been. This has got to be a wake up call for them.

Hopefully they’ll look around and the next time they see something they can’t understand and therefore decide to push off to the side they’ll think about ME/CFS and how horribly they treated millions of people for decades.

Reply

cort November 10, 2009 at 8:06 am

Thanks Meghan, I didn’t realize Wanda was from a different entity. It certainly shows what can happen when you bring a real pro on board. Here’s some more about her: http://www.womenshealth.gov/owh/about/nationalstaff/wjones.cfm.

While she is from the OWH the research program for ME/CFS is still, unfortunately, based in the little, poorly funded, unproductive backwater that is the ORWH (Office for Research on Women’s Health) where – as Meghan pointed out – we receive no extra money. They gave the program to the ORWH and then gave them no money to run it, which meant the ORWH has to take money from their other responsibilities to fund ME/CFS – obviously a recipe for disaster.

Reply

Chris December 1, 2009 at 6:46 am

Thank goodness for the WPI. Even if transpires that XMRV is not the cause of CFS / ME / FM it has done a great service in raising the media profile of this terrible illness. If you suffer from the disease mark yourself on this map designed to identify CFS “hotspots”: http://xmrv.me.uk/me-cfs-global-map.php

Reply

Doubting Thomas December 2, 2009 at 12:24 am

If XMRV works out I think, or at least I hope, that the medical profession will take a hard look at how terribly they’ve treated alot of people for decades who turned out to have a retroviral infection.

Don’t hold your breath. The profession (especially psychiatry) has yet to apologise for the way they treated patients with MS, Parkinson’s, stomach ulcers, etc, etc, etc.

The Wessely’s of this world have far too much political protection and usually only get held to account historically, after they and their political minders are dead and it does not matter any more.

Sorry if that sounds too cynical, but show me more than a handful of counter examples from history.

Reply

Jeanie Pochatko December 8, 2009 at 3:13 pm

Cort.. thank you , once again, for making this all make a little more sense. You are indeed a champion !!

Reply

John Whiting December 19, 2009 at 8:32 pm

If there were a 3.7% carrier rate across the globe (including kids as the transplacental mode of transmission cannot be ruled out), then, assuming a current global population of 6.5 billion people, we have approximately 24 million ‘carriers’. In other words, the prevalence of the carrier state is greater than the apparent prevalence of CFS/ME

Reply

John Whiting December 19, 2009 at 8:39 pm

Would ‘active’ XMRV in say a cocaine or methamphetamine addict be a ‘motivating’ factor in such individuals to takes more such drugs in order to overcome the fatigue caused by the XMRV they have acquired through sharing contaminated needles???

Reply

Ian June 7, 2010 at 1:54 pm

A foremost expert on CFS, Dr. Jacob Teitelbaum, has just put out a new book called Beat Sugar Addiction Now: http://endfatigue.com/. It is written in a simple style and outlines his easy to follow, multi-step plan. He begins by identifying 4 main types of sugar addicts and then outlines a specific plan for each type of addict to follow. He explains how sugar plays into the problems suffered by each kind of addict and goes into detail when clearly and succinctly explaining how to beat the cravings. While Teitelbaum does not provide recipes or meal plans, he does give guidelines for healthy eating and lists of recommended foods as well as the glycemic index for many common foods.This book would probably be helpful not only to people attempting to lose weight, but also to those with illnesses such as Type II Diabetes, Fibromyalgia, and Chronic Fatigue Syndrome, just to name a few. Though Teitelbaum is a medical doctor and is clearly coming from a medical background, he writes in layman’s terms and creates a book that will be easily understood by most people.

Reply

Leave a Comment

Previous post:

Next post: