I was recently asked, “Does this work for other autoimmune diseases? For example Crohn’s?”. Since this person has Crohn’s, I will work the approach for Crohn’s.

First we need to know the microflora shift

With some effort on PubMed, I found the following description of the changes seen:

• Low faecalibacterium
  • Low faecalibacterium Praunsitzii
• Low Bifidobacteria
• High Enterobacteriaceae
  • High Escherichia Coli
    • Invasive E. coli
• High bacteroides (Bacteroides fragilis)
• High eubacteria
• High peptostreptococcus

Clearly this is a very different microflora than CFS. As I mentioned in an early post, studies have found that microflora is almost a finger print for infections and likely diseases and syndromes.

Fixing the microflora

The art of fixing the microflora is still immature. The following are suggestions to address the above that are herbs with PubMed study backing them. A skilled herbalist may know of additional ones (and you should press them to supply PubMed articles supporting their recommendations). As always, discuss with your knowledgeable medical professional before starting.

• Mutaflor (E.Coli Nissle) to address the invasive E.Coli because it usually push them aside. This could be done with alternative pulses to reduce the total E.Coli population (i.e. kill many, repopulate with Mutaflor).
  • Angelica sinensis and Sophora flavescens [Traditional Chinese Herbs]
  • Zingiber officinale
  • Punica granatum
• Bacteriode Fragilis: inhibited by Rheum officinale
  • US Orders [ 1 lb $20]
• Peptostreptococcus: Chitosan appears to inhibit this according to a 2011 study. This is available as a supplement:
  • US Orders [ 240 capsules @ 500 mg $18]
  • UK Orders [ 240 capsules @ 500 mg £13]

  One 2012 study found that bacteria do develop resistance to herbs. The effectiveness of a “herb” also depend on local variations of the plants, so changing manufacturers/suppliers for each herb is recommended.

  The bacteria that dominates

  A 2007 study found a very clear pattern: “Of all invasive bacterial strains in Crohn’s Disease, 98.9% were identified as E. coli as opposed to 42.1% in  ulcerative colitis and 2.1% in normal controls.”

  Reading on antibiotics against E.Coli, there are many species that are resistant to many of the antibitotics used, or the antibiotics that is effective has nasty side effect, for example: Gentamicin.  The use of rotating herbs (2 at a time) that are known to be effective against E.Coli (with biofilm breakers) followed by Mutaflor, appears to be an approach that deserves investigation.

   

I was recently asked, “Does this work for other autoimmune diseases? For example Crohn’s?”. Since this person has Crohn’s, I will work the approach for Crohn’s.

First we need to know the microflora shift

With some effort on PubMed, I found the following description of the changes seen:

• Low faecalibacterium
  • Low faecalibacterium Praunsitzii
• Low Bifidobacteria
• High Enterobacteriaceae
  • High Escherichia Coli
    • Invasive E. coli
• High bacteroides (Bacteroides fragilis)
• High eubacteria
• High peptostreptococcus

Clearly this is a very different microflora than CFS. As I mentioned in an early post, studies have found that microflora is almost a finger print for infections and likely diseases and syndromes.

Fixing the microflora

The art of fixing the microflora is still immature. The following are suggestions to address the above that are herbs with PubMed study backing them. A skilled herbalist may know of additional ones (and you should press them to supply PubMed articles supporting their recommendations). As always, discuss with your knowledgeable medical professional before starting.

• Mutaflor (E.Coli Nissle) to address the invasive E.Coli because it usually push them aside. This could be done with alternative pulses to reduce the total E.Coli population (i.e. kill many, repopulate with Mutaflor).
  • Angelica sinensis and Sophora flavescens [Traditional Chinese Herbs]
  • Zingiber officinale
  • Punica granatum
• Bacteriode Fragilis: inhibited by Rheum officinale
  • US Orders [ 1 lb $20]
• Peptostreptococcus: Chitosan appears to inhibit this according to a 2011 study. This is available as a supplement:
  • US Orders [ 240 capsules @ 500 mg $18]
  • UK Orders [ 240 capsules @ 500 mg £13]

  One 2012 study found that bacteria do develop resistance to herbs. The effectiveness of a “herb” also depend on local variations of the plants, so changing manufacturers/suppliers for each herb is recommended.

  The bacteria that dominates

  A 2007 study found a very clear pattern: “Of all invasive bacterial strains in Crohn’s Disease, 98.9% were identified as E. coli as opposed to 42.1% in  ulcerative colitis and 2.1% in normal controls.”

  Reading on antibiotics against E.Coli, there are many species that are resistant to many of the antibitotics used, or the antibiotics that is effective has nasty side effect, for example: Gentamicin.  The use of rotating herbs (2 at a time) that are known to be effective against E.Coli (with biofilm breakers) followed by Mutaflor, appears to be an approach that deserves investigation.

   

Recently I was asked by my medical professional (who is also an Instructor at Bastyr University if I was pulsing my artemisia. I said yes, my rule of thumb is to always pulse anti-viral and antibiotics. This came out of the grandfather of all CFS protocols, the Jadin / Rickettsia approach, which found that pulsing was far more effective in dealing with occult infections than continuous application.

My medical professional mentioned that artemisia, if taken more than 2 weeks, will result in the body adapting to it, reducing it’s effectiveness. Unfortunately, I have not been able to find any PubMed studies to confirm it for artemisia.  I did find one 2004 study where pulsing was clearly as effective as continuous dosage. An additional study found that it was more effective against less susceptible bacterial strains as as effective for susceptible strains, which appears to confirm the experience from the 1950’s Rickettsia approach.

A 2012 mathematical modeling study pulsing may be the preferred application of anti-pathogens: “We find that constant dosing is not the optimal method for disinfection. Rather, cycling between application and withdrawal of the antibiotic yields the fastest killing of the bacteria.”

It should be noted that in some cases, supplements use their effectiveness after a few months (there are studies showing this with NADH with CFS patients). So there is a legitimate concern for taking anything continuously — you will likely loose the benefit sooner than with pulsing.

Remission and the wisdom of pulsing

If you are loaded up with substances modifying cytokines, coagulation, etc, how can you tell if there is actual progress to true remission (or are you just addressing the symptoms?).

I find that pulsing almost everything that is intended to lead to remission and then having a 1-3 week washout to see how much benefit persisted. For example, I pulsed Mutaflor(E.Coli Nissle 1917). After the first pulse, the benefits persisted when I stopped. When I proceeded to take Amoxicillian, which kills E.Coli, I noticed that niacin flush returned, but is a very minor manner. Once I stop items that kill E.Coli, I will promptly do another pulse to restore E.Coli levels. The same applies to all probiotics, for example, re-establishing Lactobacillus Reuteri so the need to supplement B12 disappears.

My general impression from reading studies on antibiotics and restoration of gut bacteria after antibiotics, suggests that 2 weeks is the maximum duration needed.

There’s another significant benefit to pulsing, it reduces the costs of treatment without adversely impacting the outcome (in fact, it may improve the outcome).

So what should pulsed? IMHO

• Antibiotics
• Antivirals
• Anticoagulants
• Most herbs (because they often act in the above areas)

To rephrase this another way: If you intend to treat CFS mitochondrial dysfunction by supplementing the vitamins, amino acids and minerals that are deficient, then you likely need to keep on them continuously.  If you intend to treat CFS mitochondrial dysfunction by eliminating pathogens causing it (including gut bacteria), encouraging good bacteria, adding probiotics that is causing the dysfunction, then you should pulse and taper off once the correction is established.

Recently I start corresponding with a CFS patient that has been successfully using Chlorine Dioxide to suppress the infections/symptoms successfully. The problem she was encountering was that the moment that she stops, the infection/symptoms flares.

During my prior flare (11 years ago), I also used Chlorine Dioxide as an adjunct to antibiotics that I was taking. Chlorine dioxide tablets are a standard part of hiking kits to purify water from streams. It kills most bacteria and creatures in the water.

• US Orders [ 50 tablets, $13]
• UK Orders [ 20 tablets, £10]

It was interesting to read that with this alone, she had good success with symptom suppression  My use was as an adjunct to antibiotics.

One of her questions, was whether taking Lactobacillus Rhamnosus (GG)  would counter it. She found a UK source containing just GG. Her concern was whether GG would neutralize the Chlorine Dioxide because GG is an antioxidant. IMHO, it will not — however, the Chlorine Dioxide will likely kill the GG…. oops!  There are no reports of eating yogurt while hiking and using chlorine dioxide tablets results in the tablets not being effective.

Suppression versus Elimination

It was interesting to note that Chlorine Dioxide tablets alone, was an effective suppressor but did not eliminate. It also appear to support the model that CFS symptoms for many is originating in the gut bacteria. It suggests that there may have a prophylactic role for this with recovered CFS patients whenever they have a flu or other infection. It may reduce the odds of the CFS gut flora alteration becoming established.

So, how do you go for elimination? IMHO, there are three routes: via the use of antibiotics OR via herbs used in Ayurveda medicine that have been demonstrated by scientific studies to eliminate probable overgrowth, or doing both at the same time. I will quote from my favorite paper on the herbs (2009)

“Ethanol extracts of Terminalia chebula and Ocimum sanctum exhibited antibacterial activity against Klebsiella pneumoniae. Ethanol extract of Cinnamomum cassia showed maximum antibacterial activity against Pseudomonas aeruginosa while ethanol extract of Azadirachta indica and Ocimum sanctum exhibited antibacterial activity against Enterococcus faecalis.”

For each of these bacteria, the powder or pill is easily available in bulk on Amazon or elsewhere.

• Terminalia chebula: Haritaki
• Ocimum sanctum: Tulsi
• Cinnamomum cassia: Cinnamon
• Azadirachta indica: Neem

The question now becomes dosage and the herx.  I recently wrote to medical professional friend that is very interested in my explorations, “These herbs kick ass — oops,   kick-head. In therapeutic dosages, massive continuous headaches for the first week…”

The dosages that I was taking slowly increased to 3 gms of each a day that was maintained for 2 weeks, then stopping. I stopped probiotics when I started (since most of them would be killed off), and then resume when the pulse was over.  My own positives responses within the first week were stopping of hypersomnia (I was sleeping 10-11 hrs/day), significant improvement in ability to learn and think, and lastly, I started to feel like “my old self”. The negative responses were nasty headaches, stool changed significantly, and if I farted, everyone in the house suddenly decided to take a walk… REMEMBER, the above was what I did after it was reviewed by my (very) knowledgeable medical professional, as always, any change of supplements should be discussed with your medical professional.

Remember, alteration of gut bacteria will usually impact one set of symptoms. It seems that set of symptoms is connected to specific species of bacteria. There appear to be many different species and families involved.