Author Archives: lassesen

Unknown's avatar lassesen 12:00 am on April 15, 2014  

Iodine, Microbiome and Chronic Fatigue Syndrome

Many of us more ancient folks remember when if we got a cut, we dreaded the treatment worst then the cut. Iodine tincture was applied to the cut to kill bacteria. It is a very very effective antimicrobial. It’s use has stopped in our society. A reader, who like me, from a location where his ancestors likely had a very high iodine intake due to fish being a stable of the diet, asked about iodine as a supplement. Excellent question because the level of it would likely impact inherited microbiome significantly.

What is inherited microbiome? It is two parts: bacteria obtained from babies putting their fingers into their parent’s mouth, as well as inherited DNA cooperation with certain species-strains.  Conceptually it is easy to understand, but it’s impact on treatment protocols is a lot of complexity.

So what do we know:

  • Nothing on CFS and Iodine on pubmed.  We do know that iodine is essential for thyroid, “Iodine’s main role in animal biology is as a constituent of the thyroid hormones thyroxine (T4) and triiodothyronine (T3). “[Wiki], and there is a lot on thyroid and CFS. Why have there been no published studies on iodine supplementation for CFS?
  • Looking for Iodine and Bacteria results in thousands of hits where iodine was used for staining bacteria… ugh.

Looking at various sites, there is a feeling of dejavu with Vitamin D3.  The official healthy level for Vitamin D3 was defined to be that which stopped rickets from happening. (about 200 IU/day)  and only recently has a level of 5000 -1000 IU/day has been found to be needed to reduce cancer and MS risk as well as decrease in symptoms for CFS and FM. Iodine is not tested for usually. There are procedures for dealing with iodine poisoning.

There is a privately published study Effect of Daily Ingestion of 100 mg Iodine Combined with High Doses of Vitamins B2 and B3 (ATP Cofactors) in Five Subjects with Fibromyalgia that is worth the read. Note that the dosage was 100 mg/day and Vitamin D is strongly recommended with it.

 

A [2008] study found “In conclusion, median urinary iodine 100~200 mug/l may reflect the safe range of iodine intake levels. Serum thyrotropin/thyroglobulin ratio might be a better index of evaluating iodine status.” A [2006, full text] study found “Mild and moderate iodine deficiency was associated with a decrease in serum TSH with age.”, the full text went on to state “Until recently, the iodine intake of many European populations including the Danish (1) was below the level recommended by the international organizations (2)“. For CFS patients there is a tendency to eat too-healthy for their own good. This includes avoiding salt (especially  iodine salt) or use special salts not containing equivalent iodine levels (Himalayan salts, etc).

Further more, “Even if there is consensus on the importance of avoiding iodine deficiency, there are many unanswered questions concerning optimal iodine fortification of food, and optimal iodine nutrition of a population (6).”  One of my favorite CFS MD’s, Dr. Myhill writes “Interest in iodine was re-awoken in 1993, when Gent demonstrated that 5mg a day of iodine is highly effective in the treatment of fibrocystic disease of the breast. A study in Japan showed that the average daily intake of iodine was 13.8mg (because of their high intake of seafood) and the Japanese have the lowest incidence of breast cancer in developed nations.”   Hmmm Iodine and Cancer… sounds like Vitamin D and cancer is echoing! She goes on to describe a protocol using about 50mg/day which resulted in less brain fog and major increase in the level of toxins being excreted by CFS patients.

Bottom Line

There is more that we do not know then what we do know 😦 . There is the appearance that individual generics may play a significant role in determining the appropriate level. The inferred safe range of supplementation seems to be 14mg – 50mg of iodine/day. This is well above the official RDA (Minimal) levels, to quote MyHill “.Furthermore, the recommended daily amount of iodine is 150 μg – that is to say a thousand fold less than the sort of doses that were used in the 19th century.”  The typical iodine supplement is ~5  – 12 mg/tablet and Kelp around 150mcg (0.15mg) each. Myhill recommends:  Iodoral.

As always, consult your knowledgeable medical professional before changing or adding supplements (if you can find said).

 

 

Unknown's avatar lassesen 12:00 am on April 14, 2014  

Chemotheraphy induced CFS Remission

Twice in my life I have sat down and spoke with CFSers that went into remission from cancer treatment. This has also been reported from Norway (“Cancer Drug May Also Treat Chronic Fatigue Syndrome“) and pubmed [2009] and after 3 years, the clinical studies or confirmation of the suspected drug agent has not materialized [Blog 2013]. So it seems that it may not be a single drug doing it, but chemotheraphy as a whole.

Does this fit in with the microbiome model… surprisingly — there was a recent publication that ties the pieces together!

“We observed a steep reduction in alpha diversity and significant differences in the composition of the intestinal microbiota in response to chemotherapy. Chemotherapy was associated with a drastic drop in Faecalibacterium and accompanied by an increase of Escherichia. The chemotherapy-induced shift in the intestinal microbiota could induce severe side effects in immunocompromised cancer patients. “

Very low E.Coli is the dominant microbiome shift seen in CFS.  Chemotheraphy is not a recommended treatment for CFS — however, if you need it and have CFS — you may have a pleasant side-effect!

 

Unknown's avatar lassesen 12:00 am on April 13, 2014  

Arthritis and the microbiome

My earlier post on psoriasis also appears to apply to  psoriasis arthritis.  This opens up the question of other forms of arthritis and the microbiome. A few example articles

There is not enough to develop a good model — the KISS model would be:

  • Bad periodontal bacteria successfully populate the gut resulting in arthritis

Suggested Course of Treatment from that model:

  • Oral Probiotics (consider taking a different one of each after each meal (after brushing teeth)
    • Now Foods OralBiotic on Amazon (60 capsule for $14) – Streptococcus salivarius BLIS K12
    • Oragenics Evora Plus Probiotic on Amazon (30 mints for $16) – Streptococcus oralis, Streptococcus uberis, and Streptococcus rattus
    • [Very Suspect]Swanson Oral Probiotic: Blis K12® S. salivarius, L. rhamnosus, L. plantarum, L. reuteri, L. paracasei, L. salivarius
      • This one was a delight to find because it contains L.Reuteri which is hard to find in a probiotic.
      • On the negative side, it seems that some Lactobacillus are good and some are bad for this condition and since stains are rarely given on anything containing Lactobacillus, it may be best to assume all are suspect of making it worst.
  • Mouth Rinse using EDTA or NAC dissolved in water (breaks down biofilm)
    • Consider doing nasal cleaning with traditional saline solution PLUS EDTA or NAC dissolved in the solution.
  • Reduce use of general Lactobacillus bacteria (yogurt etc)
  • No herbs could be found on PubMed effective against Porphyromonas or Porphyromonas gingivalis or Prevotella
    • Horseradish (Armoracia rusticana) appears effective [2013], it also inhibits biofilms [2012]
    • Omega 3 and Omega 6 [2013] – eat fish a lot, or open capsules and rinse around in your mouth, then swallow (remember the goal is to address the reserve of this bacteria — i.e. the mouth)
      • Take an EDTA capsule immediately after the meal
    • For Antibiotics choices, see [1998] and the Genome Project. As of [2014] the science is “Different aerobic and anaerobic bacterial species were either resistant against a number of antibiotics or showed high minimal inhibitory concentrations against clinically relevant antibiotics.” This same article suggest that biofilms are a major player for resistance.
  • Probiotic supplements (NOT Lactobacillus) in the hope that they will out compete the bad bacteria.

 

Unknown's avatar lassesen 12:00 am on April 12, 2014  

Crohn’s Disease – Bibliography : Part 6

Bibliography

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2 Linskens RK, Huijsdens XW, Savelkoul PH, Vandenbroucke-Grauls CM, Meuwissen SG. The bacterial flora in inflammatory bowel disease: current insights in pathogenesis and the influence of antibiotics and probiotics. Scand J Gastroenterol Suppl. 2001;(234):29-40.

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80 Fu J, Cao H, Wang N, Zheng X, Lu Y, Liu X, Yang D, Li B, Zheng J, Zhou H. An anti-sepsis monomer, 2′,5,6′,7-tetrahydroxyflavanonol (THF), identified from Scutellaria baicalensis Georgi neutralizes lipopolysaccharide in vitro and in vivo. Int Immunopharmacol. 2008 Dec 10;8(12):1652-7. doi: 10.1016/j.intimp.2008.07.017. Epub 2008 Aug 26.

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83 Jaswanth A, Jagannathan K, Heisonrobert SJ, Loganathan V, Manimaran S, Ruckmani K. Antibacterial activity of root extract of trianthema decandra. Anc Sci Life. 2002 Jan;21(3):158-9.

84 Voravuthikunchai SP, Limsuwan S. Medicinal plant extracts as anti-Escherichia coli O157:H7 agents and their effects on bacterial cell aggregation. J Food Prot. 2006 Oct;69(10):2336-41.

Unknown's avatar lassesen 12:00 am on April 11, 2014  

Crohn’s Disease: #5 Probiotics

Escherichia Coli Nissle 1917: Mutaflor

Mutaflor is the only known Escherichia Coli probiotic. There have been many clinical trials demonstrating its effectiveness for Ulcerative Colitis, Chronic Constipation, Crohn’s Disease, Irritable Bowel Syndrome and many related conditions.

According to Wikipedia:

The Mutaflor strain was isolated by Professor Alfred Nissle in 1917 during the First World War. As such, the strain was named after him as Escherichia coli Nissle 1917.2 It has been clinically studied and reviewed for over 80 years to prevent and treat an assortment of gastrointestinal disorders.

Efficacy of Mutaflor for a variety of inflammatory bowel diseases has been tested through 80 years of clinical experience. There are numerous double-blind placebo-controlled studies showing the efficacy of Mutaflor in the treatment and prevention of gastrointestinal disorders.

Mutaflor (E. coli strain Nissle 1917) has no pathogenic characteristics: no production of enterotoxins (Shiga toxins, heat-stable and heat-labile toxins); no production of cytotoxins (CNF); no enteroinvasiveness; no pathogenic adhesion factors (e.g. no CFA I/II, P, M and S fimbriae); no hemolysins; no serum resistance; no uropathogenicity; no antibiotic-resistance genes.

Alternative Probiotics

The probiotics listed here are usually single species or unusual collection of species that have been demonstrated in medical studies to be effective in treating irritable bowel syndrome(IBS). Studies of the same probiotics for Crohn’s Disease are lacking, thus it is by inference only that they are recommended. Most commercial probiotics have failed to show any significant benefits in medical studies for IBS. Probiotics, like antibiotics are effective for some conditions and ineffectual for other conditions.
Bifidobacterium Infantis-35624

Some of the studies on PubMed are listed below. It is available as “Align Digestive Care Probiotic Supplement”

  • Fecal excretion of Bifidobacterium infantis 35624 and changes in fecal microbiota after eight weeks of oral supplementation with encapsulated probiotic.(2013)
  • Effect of probiotic species on irritable bowel syndrome symptoms: A bring up to date meta-analysis.
  • Bifidobacterium infantis 35624: a novel probiotic for the treatment of irritable bowel syndrome.
  • Efficacy of an encapsulated probiotic Bifidobacterium infantis 35624 in women with irritable bowel syndrome.
  • Probiotic Fermented Milk Containing Dietary Fiber Has Additive Effects in IBS with Constipation Compared to Plain Probiotic Fermented Milk.
  • Lactobacillus and bifidobacterium in irritable bowel syndrome: symptom responses and relationship to cytokine profiles.

Prescript Assist

This is an unusual commercial probiotic that lacks the traditional Lactobacillus species seen in most probiotics. It has had excellent results in the treatment of Irritable Bowel Syndrome. There have not been trials with other conditions. The species are listed below

  • Anthrobacter agilis,
  • Anthrobacter citreus,
  • Anthrobacter globiformis,
  • Anthrobacter luteus,
  • Anthrobacter simplex,
  • Acinetobacter calcoaceticus,
  • Azotobacter chroococcum,
  • Azotobacter paspali,
  • Azospirillum brasiliense,
  • Azospirillum lipoferum,
  • Bacillus brevis,
  • Bacillus marcerans,
  • Bacillus pumilis,
  • Bacillus polymyxa,
  • Bacillus subtilis,
  • Bacteroides lipolyticum,
  • Bacteriodes succinogenes,
  • Brevibacterium lipolyticum,
  • Brevibacterium stationis,
  • Kurtha zopfil,
  • Myrothecium verrucaria,
  • Pseudomonas calcis,
  • Pseudomonas dentrificans,
  • Pseudomonas flourescens,
  • Pseudomonas glathei,
  • Phanerochaete chrysosporium,
  • Streptomyces fradiae,
  • Streptomyces celluslosae,
  • Streptomyces griseoflavus

Some of the studies on PubMed are:

  • Prescript-assist probiotic-prebiotic treatment for irritable bowel syndrome: an open-label, partially controlled, 1-year extension of a previously published controlled clinical trial. (2007)
  • Prescript-Assist probiotic-prebiotic treatment for irritable bowel syndrome: a methodologically oriented, 2-week, randomized, placebo-controlled, double-blind clinical study. (2005)
  • Lactobacillus Reuteri

Not Effective

Experience with Probiotics

Our experience is that taking two probiotics are the same time had less impact then just taking one. Probiotics will compete with other. More is not better. The best time to take the probiotics is shortly before bed. Often the probiotic will result in a headache for the first few days (the Mutaflor inserts actually cites that as a side effect). Some diarehha and unpleasant smells may occur for a few days — this is typically caused by the bacteria being displaced by the probiotic (which is a bacteria).

Our usual practise is to do a probiotic for 7-10 days and then change to a different probiotic, or to one of the above herbs.