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Dr Lapp's Recommendations on Supplements

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By Bruce Campbell

[Updated March 2, 2021]

Should you take supplements? If so, which ones and what benefits are reasonable to expect?

For some answers, we turned to Dr. Charles Lapp, founder and medical director of the Hunter-Hopkins Center in Charlotte, North Carolina. Dr. Lapp began treating ME/CFS and FM patients in 1985. The clinic is one of the few medical practices in the United States to specialize in ME/CFS and FM.

Dr. Lapp is one of only a few people to be given the Outstanding Clinician Award by the IACFS (International Association for CFS/ME), an organization of leading ME/CFS researchers and doctors.

Dr. Lapp has developed three tests a supplement must pass before he recommends it.

  • It must be safe.
  • There must be a scientific basis for its use.
  • It must produce a positive effect in at least 50% of people who use it.

He has found 10 supplements that qualify. The first six described below are useful for many people with ME/CFS or FM. The first five together cost together about $20 a month and the sixth about $25 a month. The remainder are used for specific purposes; he recommends them for only some patients.

Dr. Lapp stresses that there is no cure so far for either ME/CFS or FM and supplements are not the heart of treatment, but they may be used to optimize health and may produce modest improvement in some symptoms.

As he has written, the most important treatment of ME/CFS and FM is acceptance of the illness and adaptation to it by means of lifestyle change, which focuses on pacing and includes other adjustments such as stress management.

Dr. Lapp advises that people try only one new supplement at a time, keeping it if it works and dropping it if it is ineffective. He also suggests stopping the use of a supplement for several weeks once a year to test whether it is still effective. If you experience no change in symptoms during that time, you can save yourself some money by dropping that substance. 

1) Multi-vitamin

To optimize overall health, he recommends using a multi-vitamin that includes B complex, folate, vitamin D, calcium and magnesium.

2) B12

He recommends the injectible form and says that up to 80% of people with CFS/FM who use it experience a 10% to 15% energy boost. If parenteral B12 is not an option, consider oral methyl-cobalamin at 1000 to 5000 mcg daily.

3) Vitamin D3
He has found that virtually all his patients have low levels and recommends 2,000 units per day. D3 reduces pain and morning stiffness. Also, it protects against stroke, heart attack and breast cancer, and promotes the absorption of calcium. (Note: Vitamin D is lipid soluble, which means it dissolves in fat. Heavier individuals will require more Vitamin D3, perhaps 4000-6000 units.)

4 & 5) Calcium and Magnesium

The recommended calcium dosage is 1,000 mg to 1,500 mg daily, the amount available in two Tums tablets. The magnesium dosage he recommends is 500-750 mg daily, but magnesium is inappropriate for those with kidney disease and may cause diarrhea. People often take these two together in a calcium-magnesium tablet.

6) D-Ribose

This is a naturally-occurring sugar used in cell metabolism and the production of energy. It is metabolized differently from table sugar and has little effect on blood sugar levels or diabetes. The dose is 5000 mg three times daily for two weeks, then 5000 mg twice daily. Results are usually obvious within three weeks.


This substance, often used with the next item, helps increase ATP in mitochondria. It takes three to six months to produce a response and the response is often subtle. It is available in 10, 20, and 25 mg sizes. 

8) Acetyl-carnitine

This supplement is often used with NADH to increase energy production. Since acetyl-carnitine is frequently low in brain tissue, many believe that supplementation may improve cognition. Dr. Lapp recommends a dosage of 1,000 mg twice a day.


This supplement can help with energy level and libido. It is not needed if a person is already taking estrogen and/or testosterone via hormone replacement therapy. Side effects may include oily skin, acne and excessive hair growth. Dr. Lapp recommends 25 to 50 mg daily for women and 50 to 100 mg for men.

10) Lysine

This supplement can be used to reduce the frequenty and severity of herpetic mouth ulcers (mouth sores). The recommended dosage is 1,000 to 2,000 mg per day.


Note: Before you start taking a supplement, check with your doctor. She can take into account your individual situation, something not possible with the general advice offered in this article.

Note: Article reviewed and edited by Dr. Lapp.

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