Stimulants

The systematic use of stimulants to manage symptoms of fatigue is not recommended.

The following is a list of common stimulants:

• dextroamphetamines and amphetamines (Adderall, Adderall XR, d-amphetamine)
• caffeine
• modafinil (Alertec, Modiodal, Provigil)
• methylphenidate (Concerta, Methylin, Methylphenid, Ritalin)

Caffeine is present in coffee, some sodas, and tea. Although caffeine is not contraindicated for Marshall ProtocolA curative medical treatment for chronic inflammatory disease. Based on the Marshall Pathogenesis. (MP) patients, intake should be minimized. Please note that coffee and tea are high in chlorogenic acidAn antioxidant and phenolic compound which in ways that are not yet fully clear can modulate and/or suppress the immune response, a far more powerful immune modulator, which is contraindicated.

There is no evidence that caffeine is helpful to the recovery trajectory of MP patients. Caffeine may be problematic for the following reasons:

• University of Iowa scientists have identified four different bacteria that actually can live on caffeine including Pseudomonas putida CBB5. The team identified the gene sequence that enables the bacterium to break down the caffeine compound in nature.
• Caffeine can substantially contribute to bone loss.^{1) 2)}
• Finally, caffeine is said to act on the cAMP and PKA pathway, and therefore it is likely to have negative effects on VDRThe Vitamin D Receptor. A nuclear receptor located throughout the body that plays a key role in the innate immune response. homeostasis and on recovery.

Further, there is virtually no precise science on exactly how caffeine works, meaning it could have unknown negative ramifications.

Given that the effects of Provigil (modafinil) on the immune system is unknown, it should not be used by MP patients. Also, there are no long-term studies regarding its safety. Possible side effects include depression, anxiety, hallucinations, psychosis, mania and suicidal thoughts.

According to the Food and Drug Administration, Provigil should be used only in patients who have had complete evaluations of their excessive sleepiness, and in whom a diagnosis of either narcolepsy, Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS), and/or Shift-Work Sleep Disorder (SWSD) has been made.