This Christmas I sent a care package of various supplements to a CFS friend that is on SSI and having been having increasing problems. He is interested in my gut-bacteria model of CFS as well as needing neurological improvement.

Before sending the pills, I told him that he must run them past his medical professional before starting. There are always drug interactions etc. that are risks…

Often medical professional have no idea of what sequence to add various pills in. I tend to keep to the “no more than one new item every day (or even three days)” philosophy.  To assist his medical professional, I put together the sequence that seems to make the most sense (and why) below. It may be of interest to other readers’ discussions with their medical professionals. The goal is to have high risk of herx items later in the list and items likely to reduce inflammation (degree of herx) earlier in the list. The intent is not to send him to a herx-hell too fast!

4Olive Leaf ExtractProtects brain, will impact some gut bacteria

Notes:

• For chlorine tablets, after mixing 1 tablet in 1 qt of water, allow it to rest in a dark cupboard for 30 minutes. Keep it in a dark cupboard so minimize the breakdown.
• The ideal on day 13 or after a 7-10 pulse has ended, would be the addition of Mutaflor, Lacobacillus Reuteri, etc

I expect him to have a good headache and other signs of herx as he goes through the list (after approval by medical professional). When a herx starts, it is often best to stop adding more stuff until the herx ebbs (usually 4-7 days). If the herx gets too severe, stop the last item and wait 4 days before starting the next item. Often the herx will be a lot less severe on a second round/pulse.

My earlier post on Crohn’s Disease(CD) had some feedback asking for more herbs that are effective against Escherichia coli. This is not what a CFS patient want to use – their E.Coli levels are very low. This feedback was coming from Crohn’s patients because they could not tolerate some of the herbs. A person with Crohn’s that tried Mutaflor – Escherichia coli Nissle 1917 – (up to 3 capsules/day) reports much better symptoms and greater food tolerance since starting the Mutaflor. The Mutaflor replaces some of the bad E.Coli, but does not appear to be able to eliminate all of them.  For some people, several weeks or months of Mutaflor may be needed before trying/tolerating the herbs. Sorry, no overnight cures.

The key for this approach is simple:

We want to nuke the invasive strains and immediately repopulate with Mutaflor.

The following table should be helpful. I have ignored the extract method, I will leave that to advance herbalists. Some may require a visit to an oriental herbalist to obtain. All of these should be reviewed by a knowledgeable medical professional before starting.

It should be noted that resistance to herbs have been reported by repeat use [Study], thus two weeks on two followed by a different pair may be a good approach. Taking one capsule of Mutaflor (separated by 12 hours) may be beneficial. E.Coli is viewed as the most resistive of all bacteria [Study].  Less than 10% of herbs and spices will impact E.Coli – so make sure there is a study supporting the use of any herb, and not personal opinion. Because a herb work for a different bacteria, does not mean it will work for E.Coli.

This Christmas I sent a care package of various supplements to a CFS friend that is on SSI and having been having increasing problems. He is interested in my gut-bacteria model of CFS as well as needing neurological improvement.

Before sending the pills, I told him that he must run them past his medical professional before starting. There are always drug interactions etc. that are risks…

Often medical professional have no idea of what sequence to add various pills in. I tend to keep to the “no more than one new item every day (or even three days)” philosophy.  To assist his medical professional, I put together the sequence that seems to make the most sense (and why) below. It may be of interest to other readers’ discussions with their medical professionals. The goal is to have high risk of herx items later in the list and items likely to reduce inflammation (degree of herx) earlier in the list.

I expect him to have a good headache and other signs of herx as he goes through the list (after approval by medical professional). When that happens, it is often best to stop adding more stuff until the herx ebbs.

I came across an article in New Scientist (22/29 December 2012, p.13) today dealing with the relationship of weight gain and Enterobacteria.  A 175 kilo patient dropped 51 kg by going on a special diet. Before the diet, Enterobacteria was 35% of the gut bacteria, after the diet, undetectable (Enterobacteriaceae went from 13% to 0.3%). The full article is here [PubMed].  When this bacteria (Enterobacter cloacae B29) was added to germ-free mice, “the expression of the tumor necrosis factor-alpha, interleukin-1β, interleukin-6, I kappa B kinase epsilon and Toll-like receptor 4 pro-inflammatory genes increased significantly” – in other words, CFS-like inflammation. The interesting aspect is that with CFS, patients either go rail thin, or beach-ball round over time regardless of calorie intake.

This bacteria is resistant to many antibiotics[PubMed] with ciprofloxacin appearing to be the most effective.

I found one study of unripe papaya being effective against Enterobacter cloacae. Other studies (items are not easily obtained)

• Mitracarpus frigidus – Moderate
• Moringa peregrina
• Blumea balsamifera – sambong or bukadkad
• Dortenia picta
• Bridelia micrantha – Mitzeeri or Coastal Golden-leaf,
• Helichrysum pedunculatum
• Cylicodiscus gabunensis (Mimosaceae).

I was unable to find any easy to obtain herbs that are documented to be effective (I have written the authors of the above article for details on the traditional Chinese medicinal foods that were used).

No Bananas Please!

I found an interesting study where both the peel and the pulp of bananas increased the growth of ” Escherichia coli O157:H7, Shigella flexneri, Enterobacter cloacae and Salmonella typhimurium, as well as two non-pathogenic E. coli strains”.

The exception is if you are a skinny as a rail CFS patient, then you want to encourage E.Coli…

This study found norepinephrine(a usual stress produced chemical) also appears to encourage Enterobacter cloacae. Hence weight gain as a result of stress may be bacterial in origin.

More reading..

•  Enterobacter cloacae on MicrobeWiki
• Occurrence of Virulence-Associated Properties in Enterobacter cloacae – “in patients receiving antibiotic therapy, E. cloacae strains may be selected and may excessively grow in the gastrointestinal tract.”

I have been requested to look at the possibility that Parkinson’s Disease (PD) may also be a stable dysfunction gut bacteria. We know from PubMed, the biodiversity of gut bacteria decreases with age. We also read that neurological and behavior changes can be associated with variation in gut bacteria…. So the concept is worth running up the flag pole!

Doing a little searching, we find:

• [May 2011] Helicobacter pylori is associated with Parkinson’s Ref 1,2 – it is interesting to note that this only occurred with middle-aged mice. Does not occur with younger mice.
• There is an ongoing trial “. The investigators are studying changes in the normal population of gut flora and in intestinal permeability and their associations with early Parkinson’s Disease.”
• [2011] Parkinson’s patients are 8 times more likely to have small intestinal bacterial overgrowth
• [2011]  Parkinson’s patients have abnormal intestinal permeability.

Buried on the internet, was a very interesting paper, “Bacterial Neurotoxicity and Parkinson’s Disease” written as a result of a grant from National Institutes of Environmental Health Sciences. In summary, it states

“high prevalence of PD found in people who work in the soil or drink well water, these patients may be exposed to factors excreted by  soil bacteria”

The paper Identified two bacteria that “fit the bill”

• Streptomyces lividans
• Streptomyces venezuelae

This study is cited in Parkinson’s Disease and Movement Disorders: Laboratory Management and … By Joseph J. Jankovic, Eduardo Tolosa, 2007. A further 2009 study is available on PubMed.

However, Streptomyces platensis produces lergotrile, which alleviate tremors in PD. In other words, there appear to be both friend and foe within the same family. Streptomyces avelmitilis also appears to be helpful according to a 2009 study.

One logical exploration is to examine antibiotics that kill Streptomyces. Unfortunately, this family of over 500 species is often used to produce antibiotics and are rarely associated with infections. They produce over two-thirds of the clinically useful antibiotics of natural origin.

The only recognized infections are due to:

• Streptomyces somaliensis
• Streptomyces sudanensis

There is a little treatment information available for other species in this family:

• novobiocin [One study suggesting usefulness], gentamycin [no studies] and doxycycline [2011 Study]
  • Doxycycline appears to produce positive results in several studies, 1, 2. the related monocycline is an established neuroprotective.
• Rifampicin [1989 Study] – also a neuroprotective and suggested for PD in multiple papers
• amikacin and linezolid [2008 Study] – in this case, a brain abscess was caused by this bacteria. No studies of either with PD.

Bottom Line

Studies are in progress to determine how gut bacteria is altered. Evidence indicate that it is.  Helicobacter pylori is an easy one to test for and treat when found. There is a only one ghostly finger point at a specific bacteria family: Streptomyces, a family that is usually deemed to be very friendly and gives us many antibiotics. Of course, there may be a dark side to this family, a few species that may produce toxins that results in PD instead of unhealthy bacteria. There are a few antibiotics identified above which could help — but no human studies have been done….

Doxycycline/minocycline and rifampicin are two likely candidates on the basis of both being neuroprotectives alone.