The model that I am assuming for conditions like CFS, is some event triggers a microbiome shift which persists in a dysfunctional state. A few of these events are well known, or suspected:
” an integrative conceptual model is proposed in which stress-induced enteric dysbiosis and intestinal permeability confer risk for negative mental health outcomes through immunoregulatory, endocrinal, and neural pathways. ” [2017]
Vaccinations – in theory should, no studies done on microbiome shifts before and after vaccination (yet!). If the vaccination works, it has been shown that depends on the microbiome being right [2017]
Prior research from the same team revealed a stroke does have an immediate effect on the microbiome, but how long these effects last for was not known. Using animal models the researchers conducted microbiome examinations three days, two weeks and four weeks following an induced stroke…. A notable decrease was seen in Bifidobacteriaceae, a common bacteria found in probiotics, up to four weeks past the stroke, while increases were seen in Helicobacteraceae across the same observational period.
Another intriguing change in the gut seemingly brought on by the stroke were notable abnormalities in intestinal tissue. Normally in healthy animal models this tissue appears structured in orderly ways, almost like branches of coral. However, close examination up to four weeks post-stroke revealed the villi, structures that project off the intestinal wall, were scrambled and visibly quite different from the healthy models.
Another compelling study from 2017 suggested magnetic simulation to specific areas in the brain can affect the composition of a person’s gut microbiome.
The question is then — do cell phones create magnetic fields (that could potentially stimulate the brain). The answer is yes:
Among the valves tested, the settings of the Strata valve, the Hakim valve, and the Sophy valve were affected by magnetic flux densities of 6.0, 17.5, and, 40.0 mT, respectively. Cell phones produce a magnetic flux density of 3.0 to 40.0 mT.
The pure cultures of Listeria monocytogenes and Escherichia coli were exposed to RF-EMFs generated either by a GSM 900 MHz mobile phone simulator and a common 2.4 GHz Wi-Fi router. It is also shown that exposure to RF-EMFs within a narrow level of irradiation (an exposure window) makes microorganisms resistant to antibiotics.
While we know that all of the above can cause microbiome shifts, most people microbiome returns to normal. Most people. As a statistician, I know that as the number of low risk events increases, the chance of a significant event cumulates.
We cannot say: Wifi, vaccination etc causes any specific long term autoimmune conditions, it just increases the risk — like smoking does. There are people who seem immune to the effects of smoking (like the Comedian George Burns who lived to 100 and love smoking cigars).
subtitle: A probiotic that is giving me a nice herx
One aspect of chronic fatigue syndrome is having stress intolerance [US Gov Job Accommodation Site], this is also an aspect of autism spectrum [US Gov Job Accomodation site]. I have both. I was very fortunate back in high school being part of a very gifted child program which included research psychologists evaluation of the selected students (only 0.3% of the students were selected. Mensa is 2%). These psychologists noticed and remarked to me, something that was very unusual for this population — I was stress-dysfunctional. Autism Spectrum was largely unknown in those days. This simple observation altered my behavior for school and subsequently for work.
The unfortunate aspect is when you provide literature to your supervisors (for example the above two links) — some do not get stress intolerance — especially in IT with individuals that function best with stress. They expect everyone to be like themselves.
I have been trying to exit such a situation for a month — especially when a neurological symptom appeared, which disappeared once I got a few days away from work. This symptom was a new one for me, but a sweet one for early warning. The symptom is nicely described as “Some patients will experience paralysis of the lower half of the face leading to drooling, change in speech quality, sagging of the corner of the mouth.” [Src]. With my model it means that metabolites being produced from the stress are impacting my neurological system.
Last Friday, the supervisor went into panic mode and hit me with too much stress (and unrelated to my actual code/work). At 10AM, I could feel a state change in the body and booked off sick for the rest of the day (and still off sick). The usual roller coaster of symptoms seen when leaving remission: difficulty understanding, quick mental fatigue, circulation issues, over a dozen bowel movements a day, tachycardia, dysregulation of blood pressure (POTS etc), atypical spells of depression, problems with sentence construction, etc.
A question arises on interventions — especially given a recent study in Cell finding that intervention after antibiotics is counter productive — how much do you attempt to fix things? I did my usual stress herb — Ashwagandha which appears to impact stress related bacteria (see this list of what it impacts). I happen to recall a recent post on human sourced probiotic mixtures — one of which contained Lactobacillus Fermentum (Post#1 and Post#2 on it) – which happens to be available at my local co-op.
I am trying to keep to few interventions – so not looking for the usual high dosages of antibiotics that I have needed in the past.
I am on day 2, I must say that I am impressed because I am experiencing the classic herx pattern for a few hours after taking it. That’s it — just sharing an observation. Every strain is human sourced, so there is some chance of some taking up residency – but regardless, it seems to be effecting change.
For a man, the above is not expected — but I wanted to have the lactobacillus fermentum.
As for myself, I have lots of sick time and unused vacation, emailed some key people on the issue, so I expect things to be healthy resolved. If not, then time to move on (putting up with stress is not a viable option).
Bottom Line
Enduring stress is not a viable option with stress intolerant conditions.
A reader asked me to assemble a list of known DNA mutations. In my post on Multiple Chemical Sensitivity we see that the MTHFR gene is associated with abnormal blood clotting ( US National Library of Medicine). Coagulation issues are strongly associated with brain fog.
Since this type of question often leads to “where can I get appropriate testing done?” Coagulation issues are outside of “my wheel house” except for being aware of them and knowing about the specific mutation that I have.
“The diagnosis is made by genetic analysis of the prothrombin 20210 gene using blood samples. ” which suggests that 23AndMe style information may be insufficient.
There are some mutations that only occurs in people with Jewish DNA.
A Lab that appears to offer a reasonable set of tests
A reader asked me about this lab, and reviewing what they are doing, it’s a reasonable panel. I would suggest doing BOTH tests
Your body is like a family. Job and expenses are balanced, in fact, the family may be able to do some savings. A sickness comes along and the body/family deals with loss of income for a few weeks and higher medical expenses. The savings are gone and the family borrows. The family gets over the sickness and get back to work. Unfortunately, the family debt keeps growing and growing. Similarly, the body’s coagulation system is working as it was before. The sickness triggers coagulation (expenses) and the available income is not enough to clear it. The sickness is gone, but the side effect persists. Some families may be able to get rid of the debt over time (spontaneous remission), others gets deeper into debt, going down hill.
Statistically significant differences between patient cases and controls were found with respect to rs1801133 (MTHFR), rs174546 (FADS1) and rs1801282 (PPARγ) polymorphisms…. Specific genetic polymorphisms associated with the syndrome or its pathogenesis were not identified.
We observed that high chemical sensitive individuals diagnosed by using Japanese criteria as MCS patients were more significantly associated with SOD2 polymorphisms.
demonstrating an increased risk for MCS in Caucasian females homozygous for the CYP2D6 isoform and for the association of CYP2D6 and phase II NAT-2 polymorphisms [98]. Proneness to MCS was connected with NAT-2 polymorphism and homozygous deletions of M1 and T1 GST genes [99].
A genetic predisposition for MCS may involve altered biotransformation of environmental chemicals. The CYP2D6 enzyme activates and inactivates toxins; the NAT2 enzyme bioactivates arylamines to protein-binding metabolites. A gene-gene interaction between CYP2D6 and NAT2 suggested that rapid metabolism for both enzymes may confer substantially elevated risk (OR = 18.7, P = 0.002)
No significant differences of the allelic distribution of geneticpolymorphisms in the genes for 5HTT, NAT1, NAT2, PON1, PON2, and SOD2 were found between cases and controls. The results are in contrast to the study of McKeown-Eyssen and coworkers (2004) but in accordance with the German MCS multicenter study.
No significant differences in the allelic distribution of genetic polymorphisms in the GSTM1, GSTT1, ALDH2 or PON1 genes were found among the four levels of each subscale, or between cases and controls.
The MTHFR gene provides instructions for making an enzyme called methylenetetrahydrofolate reductase. This enzyme plays a role in processing amino acids, the building blocks of proteins. Methylenetetrahydrofolate reductase is important for a chemical reaction involving forms of the vitamin folate (also called vitamin B9). Specifically, this enzyme converts a molecule called 5,10-methylenetetrahydrofolate to a molecule called 5-methyltetrahydrofolate. This reaction is required for the multistep process that converts the amino acid homocysteine to another amino acid, methionine. The body uses methionine to make proteins and other important compounds.
People with this condition often develop eye problems, abnormal blood clotting, skeletal abnormalities, and cognitive problems.
” These results position Fads1 as an underappreciated regulator of inflammation initiation and resolution, and suggest that endogenously synthesized arachidonic acid and eicosapentaenoic acid are key determinates of inflammatory disease progression and liver X receptor signaling. ”
Peroxisome proliferator-activated receptor gamma (PPARγ) is a member of the nuclear receptor superfamily of ligand-inducible transcription factors that regulate adipogenesis, lipid metabolism, cell proliferation, inflammation and insulin sensitization.
PPAR-gamma decreases the inflammatory response of many cardiovascular cells, particularly endothelial cells.[30] PPAR-gamma activates the PON1 gene, increasing synthesis and release of paraoxonase 1 from the liver, reducing atherosclerosis.[31]
This gene encodes a member of the cytochrome P450 superfamily of enzymes. The cytochrome P450 proteins are monooxygenases which catalyze many reactions involved in drug metabolism and synthesis of cholesterol, steroids and other lipids. This protein localizes to the endoplasmic reticulum and is known to metabolize as many as 25% of commonly prescribed drugs. Its substrates include antidepressants, antipsychotics, analgesics and antitussives, beta adrenergic blocking agents, antiarrythmics and antiemetics. The gene is highly polymorphic in the human population; certain alleles result in the poor metabolizer phenotype, characterized by a decreased ability to metabolize the enzyme’s substrates. Some individuals with the poor metabolizer phenotype have no functional protein since they carry 2 null alleles whereas in other individuals the gene is absent. This gene can vary in copy number and individuals with the ultrarapid metabolizer phenotype can have 3 or more active copies of the gene. Alternatively spliced transcript variants encoding different isoforms have been found for this gene. [provided by RefSeq, Jul 2014]
I usually avoid getting too involved with readers — for a simple reason: this blog and the microbiome analysis site is already a time consuming evening and weekend gig (full time IT day job). I am not a physician or medically trained, so “patient history” is an inappropriate term to use.
This reader came via LinkedIn (where I have started posting items from this blog to confuse all of my technical nerd contacts 😉 ). The number of issues, technical documentation provided, and detail history made if a good review example.
The last time I felt great was in high school, I was eating lots, exercising 2-3 (swimming) hours a day, sleeping well, studying hard. However, even though I was doing well, after a swimming race, I had trouble getting out of the pool and was too tired, no other swimmers were like that. I knew that at age 15 I was sick due to the excessive fatigue.
Ding: typical CFS has a “day-after exhaustion” after exercise. I recall my Stress ECG Test — absolute flying colors. Next morning, horrible. This hints that something else may be in play.
I had mercury fillings since I was about 8 years old and in November 2017 I got them replaced and since then my chelation treatment (DMSA) has been easier in terms of symptoms. My symptoms started when I started college (2006), I wasn’t getting much sleep due to a noisy heating element and had frequent heartburn[GERD – gastroesophageal reflux disorders ]. I would sometimes be sad but I attributed this to a lack of exercise. Also, I have had misophonia a year after starting university (started 2006, finished 2010).
Partial sleep deprivation is associated with shifts in 4 bacteria families, and 20 genus (list). Sadness is associated with depression in medical terms. It is associated with 13 genus (diagram). Cross comparing the genus lists, there was nothing in common (suggesting that sleep deprivation and depression are not strongly connected). It does imply up to 33 genus may be altered. For GERD, we can add a few more … :
Although far from comprehensive (only approximately 24 clones were sequenced per sample), the study found Veillonella (19%), Prevotella (12%), Neisseria (4%), and Fusobacterium (9%) to be more prevalent in patients than in controls.
Reminder that I use: “The microecologic disease theory, or the “Pathogenic Microbial Community” theory, is a new model in which the entire community contributes to pathogenicity, with no individual community members being classified as pathogens.13,14Dysbiosis is a similar concept that refers to an abnormal state of the microbial ecosystem, dividing commensal bacteria into “protective” and “harmful” species. With dysbiosis, the cause of certain chronic diseases is an upset balance between the two groups.13 ” [2014] This model means that AI/Machine Learning is the best tool for analysis.
Reader’s state: ‘sub-clinical dysbiosis’, that is, most gastroenterologists would state “you are fine — I see no issues of concern”.
After university (2011), I went to Asia for a week and a few months after I came back with a duodenal ulcer (found upon endoscopy), it was a stressful experience both emotionally and sleep-wise since I went through 2 12 hour shifts. I presented with fatigue, blood loss, dark stools, coffee ground vomit, collapse, blindness, urinating in bed, sleep loss, pale skin. I then went on to working in one Asian city for about a year (2012), a year after my initial trip to another Asian city , came back to the USA and became very fatigued when I was in my parents home — especially when I was around the carpets (was there for a few months).
Ulcers are usually associated with Helicobacter pylori. (one study found only 27% of these ulcers had H. pylori [2001]). We do see via DataPunk, a large number of bacteria that clusters with (i.e. if you have H. Pylori, you will often find these)
I went back to Asia to a number of cities (after Fukushima) and lived there for 2 years and upon using a new teflon pan, I got a headache, was dizzy, nauseated and got tinnitus (2015).
The carpet scenario with the teflon response implies multiple chemical sensitivity. While teflon is ‘normally considered to be safe’, poorly made or overheated pans are known to release “perfluorooctanoic acid (PFOA) …. it can stay in the environment and in the human body for long periods of time. “[cancer.org] The table below shows the impact of a very closely related chemical.
At this point, my mind go to suggesting an Olestra diet for a few months. YES that ugly horrible synetic fat – Ken, you must be kidding!. Why, see “I would never do this if there was an alternative” in this 2013 post. He is already doing chelation treatment (DMSA) — this is a different form of chelation. I have seen it work for MCS persons after a chemical exposure — they return to normal much faster.
When I came back to the USA and started working in my US office, I started zoning out in the first weeks, then the next week I started having a burning feeling in my tongue, then 2 weeks after I started having headaches, memory loss, and stomach pain. Within 1-2 months, I had short and long term memory loss, I lost sleep, I became fatigued and even though exercise helped in alleviating these symptoms some days I was too tired, then I had nausea, non-blood vomiting, and ulcer symptoms. On a trip to other coast for work, I didn’t sleep well due to some fragrance in the hotel room and being woken by a fire alarm at 3am, I woke up, couldn’t breath, was about to pass out and began losing my vision and ringing in my ears started but I managed to get to some water, prevented passing out, and fell asleep (February 2017).
In fact, a similar set of symptoms appears right before I went to the ER during my first ulcer (2012) but in that case, I lost my sight and hearing and hit a wall, I crawled back to bed based upon feeling my environment. During the second day of the business trip, I noticed a bloody stool and went to a clinic whereby a rectal exam showed I did have blood in my stool, but the doctor said it wasn’t much and I continued on for a week bleeding. During that week, I had flu-like symptoms and my primary care doctor ran some blood work. I got a call from the doctor the next day to go to the ER immediately since I lost half of my blood/hemoglobin, which explained the extreme fatigue and almost passing out. I did, they found a large duodenal ulcer but it was so big they didn’t cauterize it and they also found a hiatal hernia. I continued on with my work in the office after taking some medical leave. I continued having symptoms and eventually was given work from home, but when I came to the office my tongue felt like it was on fire within 15 minutes.
I think it was due to the carpets and did an air quality test that found the VOC’s were high but not higher than the legal limits, no formaldehyde, almost no mold. I got a diagnosis of multiple chemical sensitivities but was dissatisfied with this since I thought something else was at play. I went to see a naturopath in SF since I found a yelp review of someone whose symptoms mirrored my own and that person claimed she was cured by this particular naturopath. Dr. [withheld] put me on a treatment to fix my gut problems, diagnosed me with heavy metals poisoning, and then put me on treatment for the poisoning. I did that for a while and it helped temporarily but I had the same symptoms again.
I then went to another naturopath who suggested that my phase I liver detox was doing too much and my phase II liver detox wasn’t doing enough and his treatment helped me for a while but it seems to not be doing much now. Everytime after I do chelation, I would feel better initially then usually go back to the way I was before I did the chelation a few days after. I did read Cutler’s “Amalgam Illness” and “Hashimoto’s Protocol” by izabella wentz. I did another treatment with QuickSilver Scientific’s “Deluxe Detox Qube”, once again, it helped for a while but then stopped working.
Many experiments later, I noticed that my tongue was white and when I scrapped it my chemical sensitivities were not as bad. I started scraping my tongue, gargling with baking soda and trisodium phosphate, which helped but didn’t cure my chemical sensitivities. I started consuming 2 tablespoons of food grade diatoms and that got rid of more of my chemical sensitivities but I was still sensitive (burning of tongue, headaches, memory loss, fatigue) to perfume.
I know I haven’t gotten rid of candida completely. I have candida, nystatin helped in getting rid of my chemical sensitivities and tinnitus almost completely for a few days but then my tongue was coated in white and my chemical sensitivities were getting worse.
I try to crowd it out with probiotics but it doesn’t seem to work too well. I got my thyroid tests back and they may indicate autoimmunity but according to some thats a reaction to candida. I took diflucan and then later itraconazole to try to treat the toenail fungus, I did have a history of jock itch but that’s gone and I also have dandruff (some naturopaths think all 3 conditions are connected). The itraconazole seems to be working and the probiotics seem to be working on my unhealing abrasions on my body.
I got tested for EBV, turns out I had it in the past and was actively infected at the time of the test but the only symptoms I had related to EBV was fatigue, I took valganciclovir and had less fatigue after the course of treatment. I took metronidazole, tetracycline for a possible ulcer that occurred recently (sleep deprivation). I tried doxycycline and while being on it in the beginning, I got much more access to my intellect and was able to work/study for 6 hours/day straight and exercise for hours/day. It was similar to when I first started liquid nystatin. I still have high TPO antibodies which we at 51 when I got the mercury diagnosis, went up to 100 after a year of treatment and then after the nystatin treatment, it went down to 70. I suspect that I have multiple conditions still left to treat such as SIBO and parasites but am seeking someone to help me get back to normal.
My hypothesis is that there a bacterial dysbiosis in the brain (interpret that as you may). There may be benefits from trying antibiotics and other substances that will pass easily thru the blood-brain barrier. There is an excellent article on this Characteristics of compounds that cross the blood-brain barrier [2009] One simple take-way is items with LOW Molecular weight. For myself, a SPECT scan was (mis)read as Alzheimer’s during my last major episode.
Ongoing problems
Here are my present problems that I seek help with:
toenail fungus
memory problems/brain fog
insomnia
I am frequently too cold
Fatigue, still sometimes
Infections/scars on my lower legs
Tinnitus and sometimes partial deafness of right ear
Misophonia
Multiple chemical sensitivities such as to perfume, laundry detergent, cleaning solutions, fragrances/air fresheners such as cars.
Suggestions to discuss with your medical professionals
As always, not medical advice, just personal observations that could be relevant.
Brain Fog
This can originate from many causes. For myself, coagulation is a major component.
My MD accepted this when I took the maximum dosage of aspirin (per bottle) for 10 days and saw the difference. Subsequently,
Deep coagulation testing by a lab that specialized in that only
Low dosage heparin (originally injection, but we found sublingual worked just as well)
Racetams (Piracetam especially)
Other blood thinners or items that reduced viscosity of the blood.
At one time, nurses were running out of places to draw blood from me because it was so thick.
Get a SPECT scan (not MRI, a SPECT) — my family physician referred me for my last one. A relative got referred to Dr. Daniel Amen from a psychologist that works with him. Both scans were similar results.
Toenail Fungus
I am curious if there was any testing for which particular fungii it is? As well as susceptibility to various treatments. I recall reading that mercury exposure results in reduced susceptibility for many bacteria and suspect it may be the same for fungi.
Insomnia
My first take on this is hypoxia (a.k.a. sea-level altitude sickness). Due to low delivered oxygen level to the brain. ” In the elderly with CVD, SDB mediated by hypoxia can be associated with more insomnia and a worse prognosis. ” [2015] . Brain Fog and hypoxia are associated. Back in 2000, I saw the strong correlation between a subset of CFS symptoms and altitude sickness symptoms.
This issue of poor delivery of oxygen and blood would also account for:
“the tinnitus symptoms even if hypoxia and oxidative stress play a role in the genesis of tinnitus. “
Infections/scars on my lower legs
This one initially stopped me — because I have had a similar issue which I did not get connected to CFS until now. For myself, using Triamcinolone Acetonide ointment reduced it greatly but I still see some ‘rough spots’. I suspect now , as above, that it is an impeded circulation issue which prevents the body naturally addressing issues. As a FYI, over the last 10 years I have had recurrent sepsis on my lower legs. Do you have any foot neuropathy? I have a little on one toe and associated it nerves dying from a lack of oxygen — hypoxia.
Multiple Chemical Sensitivity
There is nothing that I can really add here that I have not covered in prior posts. I do not have it active at the moment, but did experience it for a few months during an acute phrase. My workplace is very saturated with chemicals (although it was suppose to be chemical free a decade ago) – so much so that coming home from work (because my wife has severe MCS)
Infrared sauna for 30-45 minutes
Repeated showers (occasionally vinegar rinse, and vodka rinse are needed)
Clothes go into a plastic bag and often need to be double washed in vinegar.
I do not react physically, but do attempt to avoid fragrances for the sake of my wife.
Only suggestion is OLESTRA chips at least once a day to remove reside chemicals that may be contributing .. Make sure you read about frequent response (toxic smelling stools etc) before you start.
“Ding” revisited
I suspect that the fatigue as a child may be due to impeded circulation. The ability to clear toxins and deliver oxygen was less than other people. If this is correct, then your microbiome would shift to species liking lower oxygen levels. This suggests that increased oxygen levels (oxygen mask or hyperbaric chambers) may assist.
CFS Remission 