In the last few months I’ve been getting strange calls from friends of the family, and people who go to church with my mother, and various messages through Facebook – all inquiring about glyconutrients…had I heard of them?  Did I know they supposedly cured Lyme?

Then, something else popping up on the Lyme forums: “Ambrotose” – evidently it was the greatest new hope for chronic Lyme.  What was this product that had popped up out of nowhere – seemingly while I took a long nap?

Then came the call.  A friend who had originally written me through the website, and was a wealth of information having personally tried so many protocols and still bumping along at the bottom of the ocean floor.  A new excitement filled his voice as he reassured me that the Ambrotose saleswoman was going to offer a six month full money back guarantee!  We both thought that was quite amazing, and he promised to keep me informed.

What was it?

According to Wikipedia (hopefully unbiased) Ambrotose, Mannatech’s lead product is “a glyconutritional dietary supplement ingredient consisting of a blend of monosaccharides, or sugar molecules.”

I still hadn’t made the connection between Ambrotose and gluconutrients – no, I must admit to missing Bryan Rosner’s blog post before he was forced to remove it, but his website is covered with ads for Ambrotose so I don’t think I’m too far off in my assumption that he supports the product as a valid protocol for chronic Lyme disease.

As I began to look further into the company that manufactures Ambrotose, I found that it is a Multi-Level-Marketing company that went public in 1999.  I was surprised to learn that from 1999, the profitable company eventually posted a net loss in 2006 and the shares dropped to a low of $2 in 2008.

Aside from the financial instability, there appear to be a number of pending lawsuits and a long list of angry doctors who feel that Mannatech’s marketing department took liberties with factual test data versus wishful thinking.  In fact many of the lawsuits arise from “trials” that were not reported accurately.

I will try to keep all of the information as it pertains to Lyme disease and the symptoms of chronic and/or neurological Lyme disease.

One of the highest ranked websites on  Ambrotose was created by Dr. Ray Sahanian called, “Glyconutrients, an Honest Review.” Much of the information written here was found as a result of Dr. Sahanian’s committed work.

A “glyconutrient sham”.

Glycobiology. 2008 Sep; Schnaar RL, Freeze HH. Department of Pharmacology and Molecular Sciences, The Johns Hopkins School of Medicine, Baltimore, MD 21205, USA.

The discipline of glycobiology contributes to our understanding of human health and disease through research, most of which is published in peer-reviewed scientific journals. Recently, legitimate discoveries in glycobiology have been used as marketing tools to help sell plant extracts termed “glyconutrients.”

The glyconutrient industry has a worldwide sales force of over half a million people and sells nearly half a billion dollars (USD) of products annually. Here we address the relationship between glyconutrients and glycobiology, and how glyconutrient claims may impact the public and our discipline.

Humans studies regarding a Mannatech glyconutrient products:

There are some early studies being conducted with these products that I have listed below.

Before claims are made that Mannatech glyconutrients treat or cure ADHD, cancer, immune dysfunction, lupus, etc, it would be helpful to see at least a few of long term double blinded placebo controlled human studies conducted by independent researchers who are not on the payroll of glyconutrient manufacturers.

I am not referring to studies with various monosaccharides, polysaccharides, arabinogalactans, glycoconjugates and other molecules containing sugar chains such as in glycoproteins, glycolipids, and proteoglycans. I am referring to the Mannatech glyconutrients, “the eight essential sugars” that are promoted as cure alls.

Cognition and memory:

Percept Mot Skills. 2009 Feb; Stancil AN, Hicks LH. Howard University, 2400 Sixth Street N.W., Washington, DC 20059, USA.

Neuropsychological tests were administered to 62 college students to assess the influence of glyconutrients on perception, cognition and memory in two randomized, double-blind, placebo-controlled, counterbalanced studies.

Participants were given both a glyconutritional supplement and a control substance prior to testing. In Exp. 1. a Same-Different visual discrimination task, Raven’s Standard Progressive Matrices, and the Stroop test were administered. In Exp. 2, simple and complex working-memory capacity were measured.

Participants receiving the supplement performed significantly more accurately on the visual discrimination task and the first session of the simple working-memory test.

Comments: There are dozens of inexpensive and easily available over the counter herbs and nutrients that influence memory and mental abilities. Examples include acetyl l carnitine, ginkgo biloba, DMAE, choline, cdp-choline, vinpocetine, fish oils, certain B vitamins, etc.

One could easily use these or others and most will be less expensive.

Dr. Sahanian’s opinion:

One in vitro study shows glyconutrients stimulate the immune system.

This really does not give us much information on how glyconutrients, and in what dosage, would have an influence on the immune system in humans when ingested as a supplement.

Furthermore, there are countless varieties of glyconutrient molecules and glycunutrient molecule combinations within an herbal product.

The immune system is extremely complicated with countless cells and substances, tissues and organs, all communicating in unimaginably complicated interactions.

As an aside, there are countless herbs and supplements that have an influence on the immune system.

For the time being, I am not in a position to recommend the use of a Mannatech glyconutrient supplement to enhance the immune system or for other purposes.

There are many more nutrients and herbs that have been studied more thoroughly.  Even the ones that have been studied more thoroughly are not understood that well.

There are hundreds of different glyconutrients and glyconutrient combinations in a variety of different dosages (assuming scientists agree on the definition of a glyconutrient or even feel the need to use such a term). We have no idea on how these interact with each person’s immune system.

Some people may benefit by taking a glyconutrient supplement while another person may find it harmful or get a side effect.

To complicate matters further, there could be a short term benefit but, prolonged use could lead to overstimulation of the immune system and could potentially reverse any initial benefit.

The whole issue of glyconutrient supplementation is very complicated and if you hear of promotional material that makes it appear simple, be skeptical.

I suggest you be even more skeptical if you hear of cure all promises and endless testimonials that tout the benefits of glyconutrients. Most of the time testimonials are made up by the marketers selling the products.

In brief, the use of the term glyconutrients is unnecessary and does not help the advancement of nutritional research.

Following are some of the responses Dr. Sahanian has received in response to his research regarding glyconutrients:

Dear Dr. Sahanian: I am a retired medical doctor and read your web page on glyconutrient with great interest and have several comments that you may find helpful.

If you look at the compositions of these glyconutrients (gum tragacanth, gum ghatti, arabinogalactan, aloe vera gel polysaccharides) you will note they are gums and fibers. These plant polysaccharides are soluble fiber and are not digestible. Therefore, their sugars could never be released and absorbed by the body.

These fiber are destined to be fermented by the colonic bacteria in the gut where they are used as nutrients to make more bacteria. No study has ever shown that the human body absorbs sugars from a diet of fiber.

Mannatech makes the sugars appear to be necessary and also essential by telling people they are no longer in the modern diet. The truth is that these glycontutrient sugars can be obtained in the modern diet from the glycoforms that cover every cells, but these sugars are most likely made by the body from other sugars. They say these glycontutrient sugars are needed for optimal health.

There has never been a study that shows taking more of these sugars has any health maintaining purpose. Mannatech brandishes every piece of scientific literature on glycoscience and glycomics as validating their product when in fact these paper have absolutely nothing to do with their glycontutrient product.

This is a flagrant, although clever and deceptive, example of falsely misleading the consumer. It certainly puts a black mark on the otherwise legitimate dietary supplement industry and needs to be addressed.

This is a quote from a September 2006 newspaper article on glyconutrients written by Denny Robbins for the Star-Telegram: “These and other issues have caused outrage among some advocacy groups, and brought scrutiny from at least two state attorneys general, a class-action lawsuit and questions from some of the world’s pre-eminent scientists.

“My blood boils when I think about all the desperate people who have taken this stuff on,” said Hudson Freeze, a professor of glycobiology at the Burnham Institute for Medical Research in La Jolla, Calif.”"There are authentic, scientific studies that have looked at people drinking these kinds of materials, and it doesn’t really do anything except increase flatulence.”

Independent research states that the body cannot digest Ambrotose, as it lacks the enzymes needed. Prominent glycobiologist Dr Ronald Schnarr of Johns Hopkins told “20/20″ in a June 1, 2007 interview, “All of the sugar building blocks that we need in our body are made from the most common foods we eat.”

UC Berkley has a Wellness Guide that publishes this about glyconutrients:

Sold primarily by the supplement manufacturer Mannatech under the product line Ambrotose, glyconutrients contain eight monosaccharides (that is, simple carbohydrates, or sugars).

Mannatech alleges that our diets are lacking in all but two—glucose and galactose—of these sugars. It is true that sugars are not just “empty” calories but do, in fact, play an essential role in many biological functions, including cell-to-cell communication and immunity.

There’s actually an emerging and important field of science, called glycobiology, which explores the function of carbohydrates in health and disease. But glyconutrient marketers have no basis for saying that consuming sugars in supplements has health benefits.

Claims, purported benefits: Enhances the immune system and treats a wide range of medical conditions, from diabetes and high cholesterol to psoriasis and multiple sclerosis. [and Lyme disease according to some enthusiastic salespeople.]

Bottom line: Our bodies are able to convert the sugars in foods (such as fruits and vegetables) from one form to the other forms as needed.

There is no evidence that toxins, stress, drugs, or other factors interfere with the conversion process, as the marketers of glyconutrients claim. There is no evidence that relying on our bodies to create the sugars instead of ingesting them in food or glyconutrient supplements causes any problems.

Glyconutrient marketers provide long lists of studies that supposedly support the use of glyconutrients for all kinds of medical conditions, as well as for general health.

But these are unpublished conference presentations, anecdotes, and lab or animal studies, or they are from obscure journals of questionable reputation.

No well-designed research shows any health benefits for glyconutrient supplements or suggests that glyconutrient supplements live up to any of the claims or are useful in treating any medical condition.

Don’t waste your money on these expensive products.”

(UC Berkley Wellness Guide)

My final thoughts on glyconutrients are along the same line as other alternative protocols.  Our bodies are so unique, and our immune systems are not fully understood by top immunologists.  Lyme disease in its many presentations refuses to respond uniformly to even the strongest antibiotics.  So why would we expect that it would respond uniformly to glyconutrients?

If you are taking the product and feel better, that is what matters most…your personal results. As I repeat in articles and to friends – the protocol that works without a hitch for one person may be a disaster for someone else.

Hyperbaric Oxygen Therapy (HBOT) has many scientists and researchers looking at the possibility of using oxygen, either as a stand-alone treatment or as a combination treatment to be used with combination of different antibiotics.

Dr. William Fife, a pioneer in undersea medicine first for the Air Force and now  at Texas A & M University, has published extensive research demonstrating profound improvements in Lyme disease patients treated with HBOT. These improvements include pain reduction, return of clarity of the mind, and reduction of depression.

Dr. Fife was active with the HydroLab saturation diving research program funded by the National Oceanic and Atmospheric Administration having spent 28 days in saturation in the habitat performing physiology experiments.

The first uses of hydrox, a gas mixture of hydrogen and oxygen is used as breathing gas in very deep diving are usually attributed to six ocean dive trials by the Swedish engineer, Arne Zetterstrom in 1945.  Dr. Fife later showed that hydrox would allow divers to descend and work at great depths.

Dr. Fife also developed the first decompression tables for the use of the mixture. The French engineering company COMEX later applied Fife’s work in developing their HYDRA dive series.

Much of his other diving medical research was focused on women in diving and spinal cord decompression sickness.

Fife’s interest in clinical hyperbaric medicine lead to several research projects to look for new indications for the use of HBOT. It has been estimated that about half of the 2,000 patient treatments done by his lab were for research.

These projects included the treatment of:

• squamous cell carcinoma in mice with hydrox;
• migraine headache;
• Post-polio syndrome.
• Chronic Fatigue Syndrome;
• radionecrosis;
• brown recluse sites;
• non-union fractures;
• closed head injury;
• chronic Lyme disease.

In 1997, just after Dr. Fife retired from the Air Force, he began a year-long study at Texas A & M University about the benefits of treating Lyme disease with HBOT. A number of Chico, CA, Lyme patients traveled to Texas to take part in the study. Five of those patients showed such dramatic improvement after receiving HBOT that a group of Chico residents banded together in an effort to build a HBOT clinic closer to home. The Chico Hyperbaric Center is a result of that effort.

HBOT is a medical treatment that uses the administration of 100 percent oxygen at controlled pressure (greater than sea level) for a prescribed amount of time-usually 60 to 90 minutes. HBO therapy is commonly used to treat conditions such as burns and difficult or stubborn healing wounds.

HBOT increases the amount of oxygen in the body; which in turn causes several physiological changes that can result in accelerated healing. The basis for these changes is the fact that HBO therapy increases the amount of oxygen in the blood by up to 2000 percent, depending on the treatment depth. This, in turn, dramatically increases the amount of oxygen at the cellular level and creates other physiological changes. These changes can be extremely complex. One scientific research study indicates that Lyme bacteria are micro-aerophilic, or debilitated in high oxygen environments.

In the case of Lyme disease, William Fife, Ph. D., a Hyperbaric Medicine specialist at Texas A & M University (now retired), established the protocols for HBO treatment in his Texas A & M research project, to be discussed later. Dr. Fife’s Lyme disease protocol calls for HBO therapy to be administered at 2.36 ATA (Atmospheres absolute), or equivalent to a depth of 45 feet below sea level. Each treatment lasts one hour and two treatments are prescribed each day, five days per week.

The total number of treatments given in each case varies. It is common to administer 30 to 60 treatments in the first phase of treatment. The question of further HBOT therapy is then resolved after the patient’s condition is reevaluated. However, many believe that if the patient has been impacted by the first phase of HBOT, such as by experiencing a Herxheimer reaction (this can help to confirm Lyme bacteria die-off), then a break of three to six weeks should be taken followed by another 30 to 60 HBO treatments. A physician can prescribe more sets of HBOT based on the patient’s individual evaluation.

Working with Dr. Fife is Mitchell L. Hoggard is a pharmacist. He is also President and founder of the Chico Hyperbaric Center.

All three of his children have received HBO therapy for Lyme disease. Mitchell Hoggard’s son Ted was 14 years old when he took part in William Fife’s HBO research study on Lyme disease.

Are there risks?

HBO therapy is a medical procedure and like any other medical procedure, and there can be risks.

However, when HBOT is administered by trained health care individuals these risks are minimal.  As with any medical procedure, the evaluation and understanding of the current health status of the patient is of prime importance.  It is also critical that patients understand that HBOT does not work for everybody.

Minor ear discomfort is the most common inconvenience related to HBO therapy. It is helpful to remember that the initial stage of each HBO treatment is similar to sitting in an aircraft while it descends. Like the airline passenger, the patient’s ears have to adjust to a change in air pressure. The hyperbaric health care professional works with the patient or parent and teaches them various techniques on how to equalize pressure in the ears, such as swallowing.

If one cannot equalize the pressure in the ears, damage can occur to the eardrum. However, this is very rare. Some individuals who experience ear discomfort may require a procedure called a Myringotomy, or what is commonly called placing tubes in the ears. An ear, nose and throat specialist usually performs this outpatient procedure right in the doctor’s office.

Other complications can occur if a patient has lung abnormalities such as emphysema. However, with proper evaluation prior to HBOT treatment any concerns can be eliminated.

Why does HBO therapy show promise in helping Lyme patients?

First, we are reminded that Lyme bacteria are debilitated in high oxygen environments. Research by F. Austin demonstrated the effect of oxygen on the Lyme organism. The study suggests that the Bb organism is sensitive to high concentrations of oxygen at the cellular level, or what is termed, elevated tissue partial pressures.In other words, the Bb organism doesn’t do well in a biological environment similar to that created in the body during HBOT treatment.

It is also notable that in Dr. Fife’s study, all of the study’s participants were veterans of antibiotic therapy. These were adults and children who had tried and failed antibiotic therapy, including the big gun in the antibiotic arsenal: intravenous antibiotics. It appeared that the study had chosen the most difficult subjects to test. These were Lyme patients with chronic symptoms and most of them probably had nothing to lose. The fact that 85 percent of these Lyme patients showed improvement seems remarkable.

There are other benefits of HBOT that may play a role in treating Lyme disease, but were not mentioned in the Texas A & M study. Some of these benefits are theoretical and not proven; others are well known and considered established fact in Hyperbaric Medicine. Many of these additional benefits are based on the belief that HBO therapy and antibiotic therapy work in a synergistic manner. In this context, synergistic is defined as the combination of both treatments (HBOT and antibiotic therapy) being greater than the effect of either one alone.

Antibiotics and the immune system might not be able to adversely affect (or kill) Lyme bacteria for two distinct reasons.

First, it is believed that the Bb organism is able to switch from an active to a dormant (or sleeping mode) by coating itself in the body’s protein.

Secondly it is believed that the Bb organism can hide in the body’s cells.

Both tactics may result in the immune system failing to react to the Bb organism as a foreign organism that should be destroyed. Some believe that this has the effect of neutralizing the body’s defensive mechanisms and the offensive mechanisms employed by antibiotics.

The benefits of HBOT appear to be promising, although determining the exact mechanism of action that occurs in HBOT remains the most important aspect in the development of a reliable “cure”.

In general, a better understanding of the Lyme bacterium will enable us to develop new and better methods of treating this devastating disease.