Monthly Archives: November 2012

Unknown's avatar lassesen 12:00 am on November 16, 2012  

Antibiotics: Rifaximin -An antibiotic that only enters the gut…

Most antibiotics enter the blood and circulated throughout the body. One antibiotic does not enter the blood and only reaches the gut. This antibiotic requires bile acid to become activated, restricting it to the gut. What is this wonder drug?

Rifaximin is a non-systemic antibiotics that resulted in improvement or remission in IBS. This antibiotic inhibits a broad spectrum of bacteria in the bile-rich small bowel and susceptible bacteria in the aqueous colon, and alters microbial virulence and epithelial cell function. The different mechanisms of action of rifaximin potentially explain the use of the drug in widely varied diseases and syndromes. For Crohn’s Disease, it has resulted in 69% remission and for ulcerative colitis, 76% remission. It is being trialed for IBS with significant success.

Rifaximin resulted in 70% of patients with abnormal lactulose breath test becoming normal. Since the mechanism to keep it in the gut depends on the presence of bile acids, taking Bishop Weed (Ajwain Seeds) to increase bile acids seems appropriate. Lastly, studies found that Rifaximin lowered the viability and virulence of the bacteria even though they developed resistance to the compound.

Why should we consider it for CFS and FM? The answer is simple, up to 90% of CFS and FM patients have IBS. It is very likely that all three have a common cause with variations. The common cause is altered microfloras. The variation of symptoms is caused by the unique bacteria that each person has.

(c) 2012 Ken Lassesen

Unknown's avatar lassesen 12:00 am on November 15, 2012  

Remission from just changing Gut Flora

Evidence for the major role that gut flora has in maintaining CFS/FM/IBS and other autoimmune diseases comes from documented remissions from fecal transplants. This was reported in 2001 by Richard Schloeffel, MD in Australia [Read Report], It was also reported recently in the New Scientist journal in 2010 [Read Report].

I have corresponded with a patient in Australia who has had two transplants. In both transplants, remission of all symptoms lasted about six months and then a relapse happened. After the last relapsed, extensive pathogen testings was done and a member of the Rickettsia family was found.  I believe the continuing RNA fragments and other chemicals from the Rickettsia infection allowed the symptom-causing microflora to get re-established.

Gut Flora appears to be (partially) genetic

Researching fecal transplants, I found that transplants from blood relatives are needed. Unrelated transplants have a poor success rate. As I mentioned in an earlier post, most humans have about 150 out of 1000 possible bacteria in their gut. From lectures on virus and bacteria mutations that I have attended, I can go further and state that it is not just sub-species that are unique; but individuals will likely have different DNA in these subspecies. A flu virus DNA may mutate 6 times in a year. A person’s gut flora will likely also mutate. The mutation that survive will be those that other microfloras permit to exist.

Implication for Treatment

I wish I could say, just find a healthy family member (by blood) and head down to the clinic for a transplant. There is great resistance to this approach. I would suggest reading Wendy Glauser’s article in CMAJ. 2011 March 22; Risk and rewards of fecal transplants for more background.

(c) 2012 Ken Lassesen

Unknown's avatar lassesen 12:00 am on November 14, 2012  

A Mathematical Model for CFS/FM/IBS Onset and Remission

During my research for a forthcoming book, I came across similar information in several studies. The information result in a model that appears to be consistent with CFS/FM/IBS being an alteration of microfloras that persisted.

In probability modelling there are semi-stable processes that are have a random chance of  occurring. A good example is radio-active decay. The pattern that I saw was similar and would be consistent with alteration of microfloras by virus RNA.

The reported data when people with acute onset were followed is shown below. The conditions were technically different, but the onset rates for CFS were surprisingly similar. If we take a view that the infection RNA enters the stomach and result in microfloras mutations, then these mutations will be eliminated over time for most people — however some mutations take a long time to eliminate.

Infection Type Percentage going into CFS-like state at 6+ months
Ross River Virus 11% [583]
Lyme Disease 10-20%[2390]
EBV 11-13% [1651] [1652]
Sarcoidosis 47% [160]
Giardia 50% [1653]
Acute bacterial enteritis patients 7- 33% of IBS [1801]

Some studies tracked people after acute EBV and reported the following rates of these patients moving into CFS. Failure to recover rates for EBV over time

Time after EBV % Failed to Recover
6 months 11%-12%-13%
12 months 7%-9%
24 months 4%

Applying a little mathematical curve fitting to this data, we end up with the result shown below.

Recover Period Percentage Remaining that Recover Patients remaining
6 – 12 Months ~ 50% ~14%
12 – 24 Months (2 yrs) ~ 50% ~7%
24 – 48 Months (4 yrs) ??? 50% ~4%
48 – 96 Months (8 yrs) ??? 50% ~2%
96-192 Months (16 yrs) ??? 50% ~1%

Does this directly helps treat CFS? No — but it suggests that intentional attempts to destabilize microfloras may be beneficial.

(c) 2012 Ken Lassesen

Unknown's avatar lassesen 12:00 am on November 13, 2012  

Improving Microflora without probiotics or antibiotics.

There are several food items that are documented to improve microfloras. I usually get my supplies from the local Haggen’s, Co-op and Trader Joe’s shops. The items are:

  • 85% Chocolate Bars:100 gm (3.5 oz) per day. It has been demonstrated to change microfloras after 2 weeks of continuous use
  • Goat Milk Cheese: Very high in a special sugar, Neu5Gc, that helps E.Coli levels become normal. True milk cheese in general help the appropriate shifts.
  • 100% Rye Bread: This is an excellent FOS source, a PubMed study found that it encourages a wider variety of microfloras then the FOS capsules. This is NOT the soft American-Style Rye — it is a dense heavy rye familiar to many Germans, Poles, and Scandinavians. Note: that the loafs are vacuum packed, have a LONG shelf life(3-6 months) and often baked with Organic, non-GMO ingrediants.  They are also available on Amazon as Subscribe and Save [thus free shipping if you do not have Amazon Prime].
  • Blue Cheese: This is a double bonus because typically it is made from raw milk and uses penicillium roqueforti. This species inhibits leukemia and reduces pro-inflammatory markers and cytokines.
    • Trader Joe’s has an excellent crumbled blue cheese that is also very reasonably priced.
    • I have noticed that if 1-2 oz of this cheese is taken just before bed time that my sleep quality improves (better than the usual sleep supplements)
Unknown's avatar lassesen 12:13 am on November 12, 2012
Tags: Mutaflor   

Recommended Probiotics for CFS/IBS/FM

Unless a mixture of probiotics has been explicitly tested and found effective, it should not be used. The reason is simple:

  • Some species will reduce species that are low already, further
  • Often species in a mixture will fight each other. You may get better result from just one of the species.

Exceptions are when the only way of obtaining a specific species is getting it in a mixture (far from ideal).

My research from reading thousands of PubMed articles are that the following have significant clinical evidence supporting their use for CFS/IBS/FM. One of the interesting results seen was that the dosage was very important for some, too little and there was no effect, too much and there was no effect. The best estimate for dosage is about 10(8) cfu/mL.

All of the others are either untested, have no effect (except on the pocket book), have contrary results (good and bad – thus risky) or bad effect. I have all of the links to the appropriate studies in my forthcoming book. Many of the Lactobacillus will reduce the E.Coli population that are already very low. E.Coli produces NADH which is low in CFS patients . Remember: all E.Coli are not bad; many are needed for your health.

There is a classic test if other probiotics will help, do taking them produce a Jarisch-Herxheimer Reaction? If they do not (especially if you increase the dosage 4x above recommended), then they will likely be of low value.  I have seen Nissle 1917 consistently produce significant to major herx, and some other probiotics less impact (but the person definitely was herxing).

WARNING: Nissle 1917 can cause a major herx at a low dosage, try the other probiotics first. It will also have the greatest change of symptoms in a short period of time.

(c) 2012 Ken Lassesen