The Daily Mail interviews Dr Charles Shepherd about supplement for brain fog and fatigue

Dr Charles Shepherd's interview notes:

Oxaloacetate – possible modes of action:

• Oxaloacetate is involved in chemical pathways that convert nutrients into cellular energy
• It may be involved it mitochondrial renewal. Mitochondria produce energy at a cellular level and mitochondrial dysfunction occurs in ME/CFS and LC
• It may reduce inflammation in the brain – known as neuroinflammation
• So there are some theoretical reasons as to why this food supplement could improve mental and physical fatigue in a number of conditions where these symptoms occur

ME/CFS trial results should be viewed with caution because:

• Not placebo controlled
• Smallish number of participants
• Short duration – 6 weeks
• Lack of objective outcome measures
• No long term follow up
• Commercial conflict of interest in funding

Breast cancer trial results should also be viewed with caution:

• Again, small numbers, short duration, and not placebo controlled

Conclusions:

• We need large randomised controlled trials that address all of the above concerns
• We are not yet in a situation where this food supplement can be a recommended as a treatment for eirher physical or mental fatigue

Cautions:

• Side-effects include gastrointestinal upsets, headaches and insomnia
• Use with care in kidney disease
• Commercial supplements are expensive