Author Archives: lassesen

Unknown's avatar lassesen 4:32 am on April 4, 2014  

How to determine if a Herb or Supplement is a good choice?

I tend to be (excessively) systematic and logical in treating CFS. My last post dealt with antibiotics, which I know many people will stop reading on seeing the word antibiotic.  The same logic applies to herbs and supplements. I will look at a set of herbs known as adaptogens. I pick this set because they alter stress and I speculate that the mechanism may be altering of gut bacteria because of recent articles finding that unstressed mice became stressed after a fecal transplant. Whether we find any research to support this speculation is another question.

The items that I am looking at are mentioned in prior posts[emotions, sleep]are:

So how do you determine if it is a good candidate?

Criteria 1: Has it shown to be effective for IBS? Ideal is X% remissions, acceptable is improvement. Antibiotics for IBS have been far better studied than CFS, and with 90% of CFS having IBS, it’s a good proxy.

.. Magnolia Bark   Ashwaganda    Jujube Fruit  Rhodiola rosea
IBS nothing nothing nothing nothing

 

Criteria 2:  Reduces known overgrowth and does not impact undergrowth.

From an early post, we know what to look for. So take theherb name and each of the items below and see what is known on PubMed. Finding nothing will often be the result — especially for less researched herbs and lesser known bacteria.

.. Magnolia Bark   Ashwaganda    Jujube Fruit  Rhodiola rosea
Klebsiella/Enterobacter HIGH nothing nothing nothing nothing
Enterococcus HIGH nothing nothing nothing nothing
Streptococcus HIGH  good activity against [1995]
E.Coli LOW no impact[2007] reduces[2013] nothing low impact[2002]
Bifidobacterium LOW  nothing nothing nothing nothing
Lactobacillus LOW nothing nothing increases [2007] nothing
Rhodospirillales LOW nothing nothing nothing nothing
Actinomycetales LOW nothing nothing nothing nothing
Fusobacteriales LOW nothing nothing nothing nothing
Flavobacteriales LOW nothing nothing nothing nothing

Criteria 3: Does it release histamines (part of the Herx Reaction)?

.. Magnolia Bark   Ashwaganda    Jujube Fruit  Rhodiola rosea
Histamines inhibits [2001] appears to inhibit appears to inhibit inhibits[1997]

This is an interesting “grand slam” – all of them reduces histamine levels.

Criteria 4: Does it promote coagulation or does it thin the blood? In general, you want no impact or thinners or should have heparin available if it thickens.

.. Magnolia Bark   Ashwaganda    Jujube Fruit  Rhodiola rosea
Coagulation no impact [2007] improves[2000] nothing nothing

Bottom Line: Magnolia Bark and Jujube Fruit looks like the best choices given this limited knowledge.

Unknown's avatar lassesen 3:04 am on April 3, 2014  

How to determine if an antibiotic is a good candidate?

A reader asked me about the antibiotic Rifaximin. Rifaximin is a sweet antibiotic because it does not enter the blood system much.   Lubiprostone, linaclotide and rifaximin with low systemic bioavailability and has been used for irritable bowel syndrome [2014] with some 90 articles on PubMed. On the downside, it is not officially approved and runs $600-$800 /month (likely not covered by US insurance).

So how do you determine if it is a good candidate? I did a brief example in an earlier post.

Criteria 1: Has it shown to be effective for IBS? Ideal is X% remissions, acceptable is improvement. Antibiotics for IBS have been far better studied than CFS, and with 90% of CFS having IBS, it’s a good proxy.

Criteria 2:  Reduces known overgrowth and does not impact undergrowth.

From an early post, we know what to look for. So take the antibiotic name and each of the items below and see what is known on PubMed.

Klebsiella/Enterobacter HIGH lesser activity against species of Enterobacteriaceae [1995]
Enterococcus HIGH  good activity against [1995]
Streptococcus HIGH  good activity against [1995]
E.Coli LOW  inhibited in vitro 85.4% of Escherichia coli, [2014]
Bifidobacterium LOW  an increase in concentration of Bifidobacterium [2010]
Lactobacillus LOW increase in members of the genus Lactobacillus [2012]

And from the gut analysis posts earlier we add:

Rhodospirillales LOW Nothing
Actinomycetales LOW Nothing clear
Fusobacteriales LOW Nothing
Flavobacteriales LOW Nothing

Criteria 3: Does it release histamines (part of the Herx Reaction)? Because this does not enter the system, it is semi-moot.

  • Nothing found on PubMed

Criteria 4: Does it promote coagulation or does it thin the blood? In general, you want thinners or should have heparin available if it thickens.

  • Nothing found on PubMed

Bottom Line: If you are going to supplement with Mutaflor(E.Coli Nissle 1917) and d-ribose  immediately after using this antibiotic, then it is a reasonable choice. If you do not have Mutaflor , it is likely a poor choice because of it’s impact on E.Coli. This may be why it only improved IBS and does not result in remission.

Unknown's avatar lassesen 2:18 pm on March 31, 2014  

West Australian doctor talks about gut issues in CFS

A reader forwarded me these two YouTube talk-segments by a MD from Australia CFS talk.

and

Unknown's avatar lassesen 2:29 am on March 31, 2014  

Psoriasis,CFS and the microbiome

One of the interesting side effects of addressing a dysfunctional microbiome was the major reduction (almost disappearance) of my prior psoriasis. This makes sense because the level of inflammatory chemicals in the body would drop which would affect all aspects of the body.

Of course the question arises — is there any PubMed studies that could back this observation?

” recent research has identified a group of conditions probably resulting from dysbiosis, or alternatively referred to as originating from a misrecognition or aberrant response to the normal microbiota, including inflammatory bowel disease (IBD), psoriasis (PS), bacterial vaginosis (BV) and periodontal diseases (PD) (23–26). These four diseases seem to cluster together from an epidemiological, pathogenic, genetic and microbial standpoint, with similarities between them being recently reported (27–36).” [2014]

This article goes on with:

Over 50 years ago, it was noted that two thirds of patients with the variant guttate psoriasis (GP) had a preceding sore throat and serological evidence of a streptococcal infection (59). This was then confirmed by the isolation of beta haemolytic streptococci [BHS] from the throats of patients with GP (60). Furthermore, guttate flares in chronic plaque PS are associated with streptococcal pharyngitis (61). Microbiological analysis of psoriatic skin report conflicting evidence on types of bacteria associated with the lesions: 16S rRNA gene analysis using swabbing of the skin to recover bacteria, has revealed differences in bacterial colonisation compared to healthy skin, with an increase in Firmicutes and a decrease in Actinobacteria.”

Another article [2014] states “we hypothesize that common immune-mediated inflammatory pathways seen in the “skin-joint-gut axis” in psoriatic arthritis are induced or at least mediated by the microbiome“

Now for actual on human studies with patients with psoriasis [2013]:
“In conclusion, oral administration of a single microbial agent, B. infantis 35624, was sufficient to reduce systemic inflammatory biomarkers in both gastrointestinal and extra-intestinal inflammatory disorders. ” This study included 26 patients with psoriasis.  This probiotic (commonly sold as Align) happens to be one of those that I took.

2019 Study

A reader forwarded me this new study:

Increased risk of chronic fatigue syndrome following psoriasis: a nationwide population-based cohort study [2019]

The relationship between psoriasis and the subsequent risk of CFS was estimated through Cox proportional hazards regression analysis, with the incidence density rates being 2.27 and 3.58 per 1000 person-years among the non-psoriasis and psoriasis populations, respectively (adjusted hazard ratio [HR] = 1.48, with 95% confidence interval [CI] 1.07–2.06). In the stratified analysis, the psoriasis group were consistently associated with a higher risk of CFS in male sex (HR = 2.05, 95% CI 1.31–3.20) and age group of ≥ 60 years old (HR = 2.32, 95% CI 1.33–4.06). In addition, we discovered that the significantly increased risk of CFS among psoriasis patients is attenuated after they receive phototherapy and/or immunomodulatory drugs.

Conclusion: my improvement is psoriasis was indeed due to the probiotics!

Unknown's avatar lassesen 4:54 am on March 29, 2014  

A mouth full – for better or worst

This post deals with the role of Oral Probiotics. My model of CFS is that it is a microbiome (gut bacteria) dysfunction that has become stable. The first question is a real simple one: How did the bad bacteria get to your gut? The answer is real simple — through your mouth? A kiss from a friend, a lick from a pet, air bacteria landing on food, bacteria on dust. The bad bacteria while you were sick found your gut much more friendly than usual and they survived and prosper. Your illness, stress level, immune response to vaccine allow the bacteria to take up residence.

The CFS gut has low biodiversity — how do you correct that! Again thru the mouth, either thru probiotics or food. At this point, my wife would say… oh no, here comes the “A spoon full of dirt make the autoimmune go down” jingle is about to happen. In other words, the hygiene hypothesis.

In the land of CFSers, there is often talk about reserves of infections. If we are talking about gut bacteria dysfunction, we have to consider the bacteria in the mouth as being a reserve for potentially dysfunctional bacteria.  Bacteria that will tag among on your next swallow and attempt to reinfect your gut. Yes, you could brush your teeth and use a mouth wash — but would it not be better to then repopulate with non-harmful bacteria then trust random bacteria? Today there are several oral probiotics available, including:

  • 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
  • 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. This one looks the most promising of all of the Oral Probiotics.

Recently, the question of “soil bacteria” came up in a comment. It seems that while they are often found in the soil they are also found in healthy human guts BUT many of them do a disappearing act in the gut of a CFS person. So, the pointed question is how do you restore biodiversity of gut bacteria to become healthy– that is the question that must really be answered. Eating yogurt will never do that.

To me, Prescript Assist is a start, having an organic garden and not washing every strawberry or blueberry before eating them is also a risk that I am willing to do.

What is your answers to this question? “Somehow” is not an answer — it is an evasion.