Japanese Knotweed Rhizome – Polygonum cuspidatum,

I recently purchased 454 gm (1 lb) of the rhizome of Polygonum cuspidatum, in bulk because it is high in resveratrol (read earlier post here)l and far cheaper than prepared Resveratrol capsules. As powder I get 454 gm for the same price that I would pay 72gm as capsules, 6 x cheaper.

This post is about PubMed Article on this supplement.

This is available in bulk on Amazon.

Suggested Dosing

Chinese knotweed supplements are recommended in doses between 8g and 25g per day, or as a tea, according to the Herbal Resource Guide. The Public Health Report notes that Japanese knotweed is the premier herb for Lyme’s disease. It’s suggested as a full-spectrum herb, meaning in its whole root form, in doses of 500mg to 2000mg three to four times per day for eight to 12 months. There may be benefits within two weeks to two months, according to the Public Health Report.

Side Effects

The Herbal Resource Guide notes that Chinese knotweed supplement can be sold in crude or unprocessed forms, as well as those forms that have undergone processing. The unprocessed forms exhibit more of the laxative qualities than the processed forms, and side effects of the supplement may be abdominal upset or loose stools. The Public Health Report says Japanese knotweed should not be used by pregnant women and may lead to a metallic taste in the mouth. The Oregon State University monograph on the concentrated knotweed supplement, resveratrol, notes that a single dose of up to 5g per day has not been found to cause any side effects. It is also not suggested for use in pregnant or lactating women, or in people with estrogen-sensitive cancers because of lack of evidence to prove safety. The herb may interact with several medications, such as blood thinners and drugs metabolized by the P-450 enzyme system in the liver.

Approaches to D-Lactic Acidosis

My last post cites a 2009 article that found:

“Faecal microbial flora of CFS patients and control subjects. The mean viable count of the total aerobic microbial flora for the CFS group (1.93×108 cfu/g) was significantly higher than the control group (1.09×108 cfu/g) (p<0.001). There was a significant predominance of Gram positive aerobic organisms in the faecal microbial flora of CFS patients. …This study confirms the previous observation (22), and those reported by other investigators (23) that there was a marked alteration of faecal microbial flora in a sub-group of CFS patients….. In this study the mean total count for Enterococcus and Streptococcus spp. for the CFS group was 52% of the total aerobic intestinal flora, which is significantly higher than the 12% seen in the control subjects (p<0.01). ” largely old hat to readers of this blog, a microbiome dysfunction.

But the study went on to some new interesting stuff, a possible mechanism:

“In this study the NMR-based metabolic profiles of the three intestinal micro-organisms, E. faecalis., S. sanguinis. and E. coli showed that the Gram positive bacteria (Enterococcus and Streptococcus spp.) produce more lactic acid than the Gram negative E. coli. Not surprisingly, these Gram positive bacteria were shown to lower the ambient pH of their environment in vitro as compared to that of E. coli. This suggests that when Enterococcus and Streptococcus spp. colonization in the intestinal tract is increased, the heightened intestinal permeability caused by increased lactic acid production may facilitate higher absorption of D-lactic acid into the bloodstream, henceforth perpetuating the symptoms of D-lactic acidosis. Increased intestinal permeability is also associated with endotoxin release from Gram negative enterobacteria, leading to inflammation, immune activation and oxidative stress, which are cardinal features in a large subset of CFS patients

This ties in well with observations, for example, some people getting relief by various breathing techniques intended to alter pH of the stomach and intestines.

So, putting on the blinkers and focusing solely on the overgrowth of Enterococcus and Streptococcus, how can someone impact this without getting antibiotics (in some countries, prescribing antibiotics for a condition that is not recognized as needing them, can cost a MD their license)?

  • “Among the plants chloroform and isoamyl alcohol extracts of Cumin ( Cuminum cyminum), Clove (Syzygium aromaticum) and Turmeric (Curcuma long Linn) had significant effect against … Streptococcus pyogenes” [2013]
  • “Cortex phellodendri showed antimicrobial activity against Streptococcus mutans, while Radix et rhizoma rhei was effective against Streptococcus mitis and Streptococcus sanguis. Fructus armeniaca mume had inhibitory effects againstStreptococcus mitis, Streptococcus sanguis, Streptococcus mutans and Porphyromonas gingivalis in vitro.” [2010] – most of these are Chinese/Japanese medicinal herbs
  • “eight herbal extracts could inhibit the growth of Streptococcus sanguinis. Jasmine, jiaogulan, and lemongrass were the most potent,” [2008]
  • ” (common Fig) F. carica and  (Olive leaf) Olea europaea leaves inhibited growth of… Streptococcus pyogenes” [2011]
  • “onion could inhibit E. coli, …   Streptococcus faecalis [1985] – not recommended because of impact on E.coli
  • ” Lemongrass, oregano and bay inhibited all organisms” [1999]
  • “especially those of Origanum glandulosum and  (Mediterranean thyme) Thymbra capitata with interesting minimum inhibitory concentration, biofilm inhibitory concentration, and biofilm eradication concentration values” [2014]

Early post on treating Enterococcus cites: Azadirachta indicaOcimum tenuiflorumMonolaurin. Streptococcus is associated with excessive histamine, see earlier post.  MedScape Article reveal no effective accepted treatment. A fuller article is (here JASN).


Cohen and Woods devised the following system in 1976 and it is still widely used:[1]

  • Type A: lactic acidosis occurs with clinical evidence of tissue hypoperfusion or hypoxia is likely what is seen in CFS. The hypoperfusion is well reported as a signature of CFS.

Word on Likely Dosage

The last article cited an article treating it. I noticed that often there was very high dosages.  My gut feeling (no evidence to back it up) is that for any of the above, we may well be talking 8 – 16 “00” capsules per day of each one, with a possible change of the herb/spice every 7 days. Remember we are talking about reducing from 52% to 12%, not a walk in the park.

As always, consult with your knowledgable medical professional before starting or changing supplements.




D-lactic Acidosis -Sauerkraut is not good for you if you have CFS!

People like Dr. Mercola and Weston Price advocates the use of fermented sauerkraut for good reason — it is very high in lactobacillus bacteria. Lactobacillus bacteria is generally good because it kills off many other bacteria and helps a normal microbiome to be stable.

The problem in CFS is that CFSers are very low in E.Coli [1998] [2001] – a species that Lactobacillus tend to kill off.

First, what species are in Sauerkraut?

The species in home made sauerkraut changes over time, DNA Fingerprinting of Lactic Acid Bacteria in Sauerkraut Fermentations[2007] including

  • L. mesenteroides
  • Weissella sp.
  • L. citreum
  • L. curvatus – inhibits E.Coli [2007]
  • L. fallax
  • L. plantarum — inhibits E.Coli [2014]
  • L. brevis
  • L. argentinum

This article Antagonistic effect of Lactobacillus strains against Escherichia coli and Listeria monocytogenes in milk.[2011], describes the general issue at play.

Bringing up the E.Coli population is likely a significant factor for recovery, not reducing it.

“Patients with chronic fatigue syndrome (CFS) are affected by symptoms of cognitive dysfunction and neurological impairment, the cause of which has yet to be elucidated. However, these symptoms are strikingly similar to those of patients presented with D-lactic acidosis... this might explain not only neurocognitive dysfunction in CFS patients but also mitochondrial dysfunction, these findings may have important clinical implications.”[2009] [Full Text].  “Probiotics Provoked D-lactic Acidosis in Short Bowel Syndrome: Case Report and Literature Review” [2006]

E.Coli produces a lot less lactic acid than lactobacillus, thus when they are diminished, the bacteria replacing them increases the production of D-lactic.

There is literature speculating that lactobacillus may help CFS (Medical Hypothesis 2003), as always, we prefer actual studies instead of “bright ideas with horrible consequences to CFS patients”.


I found some reports of treatment, and this one stands out – multiple antibiotics and probiotics afterwards (note the dosage of probiotics in 3 grams/day — far higher than the typical 4 mg in a commercial probiotic capsule — 1000 times more!!!!).

” The patient received kanamycin (Kanamycin Capsules, Meiji Seika Pharma, Tokyo, Japan) 1000 mg/d.  … metronidazole (Flagyl, Shionogi & Co, Ltd, Osaka, Japan) 500 mg/d and kanamycin 2000 mg/d were administered for 5 days under fasting conditions. Polymyxin B (Polymyxin B Sulfate, Pfizer Japan Inc, Tokyo, Japan) 500 3 103 U/ d and vancomycin (Vancomycin Hydrochloride Powder, Lilly, Kobe, Japan) 1000 mg/d were administered over the subsequent 5 days. After the use of antibiotics, a purgative (Niflec, Ajinomoto Pharmaceuticals Co, Ltd, Tokyo, Japan) was used…..Overgrowth suppression was approached by starting synbiotics, specifically B breve Yakult (prepared by Yakult Co, Ltd, Tokyo, Japan) 3.0 g/d and L casei Shirota (Biolactis Powder, Yakult Co, Ltd, Tokyo, Japan) 3.0 g/d as probiotics, and galactooligosaccharide 8.4 g/d as a prebiotic.” [2013]

Exercise and Lactic Acid

Exercise produces lactic acid which further compounds the issue and result in fatigue. See “Lactic Acidosis and Exercise: What You Need to Know” on WebMd. There appears to be no conventional treatment for Lactic Acidosis.

Alcohol and CFS – The E.Coli Response

While researching the above brief notes, it caught my eye that alcohol kills E.Coli, which would further swing a CFS patient towards D-lactic acidosis.


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