Category Archives: Treatment

Unknown's avatar lassesen 6:37 am on January 4, 2014  

Review: The poop on Fecal Transplants

This is a periodic review of what is known reliability about fecal transplants in general, as well as for Chronic Fatigue Syndrome.  Fecal transplants is one way to rapidly correct the gut bacteria. I have corresponded with an Australian with CFS who went into remission twice for 6 months after a fecal transplant and then relapse —  so it is not a guarantee persisting remission by itself. It is definitely an approach that warrants review.

First, the FDA, true to tradition, has attempted to restrict this treatment but was forced to back down [article]. The rational was the same for preventing the over the counter use of Mutaflor(E.Coli Nissle 1917) in the US — it’s a biologic product (in fact, yogurt and keifer would also qualify technically) and thus needs regulation and testing before use. Yogurt and Keifer were probably exempted because they were grandfathered in, Mutaflor, not being a usual AMERICAN probiotics was not grandfathered…. this is a topic in itself.

Let us get back to the poop. There are 60+ articles on PubMed. A recent survey is available in full here. First, the polite name is “fecal bacteriotherapy” or FMT and appear to have been known for some 1600 years. For one condition:

  • 81% remission after one
  • 93% remission after two (89.6% reported in this 2013 study, 92% in 2012 study)

Neurodegenerative and neuro-immunologic disorders improves after FMT.  The summary also states that “studies with germ-free animals or animals given specific gut infections iatrogenically have implicated the fecal microbiome in certain mood disorders, cognition, and pain syndromes ” which suggests that FM may be connected with a dysfunction gut flora.

For CFS and FM, there is one published statistics on the use of FMT. The GI microbiome and its role in Chronic Fatigue Syndrome: A summary of bacteriotherapy, Dec 2012, reported 70% initially responded and 58% had a sustained response (no relapse after 3+ years).

Who is the best donor? According to this Medscape article  ” 75% of donors are first-degree relatives or spouses, and the donor is screened as vigorously as you would screen a blood donor.” I recall reading that the success rate for blood-relatives as donors was 50+% better than strangers. This same article states “A word of caution from Brandt and colleagues is that 2 of their patients had improvement in preexisting diseases, including rheumatoid arthritis and sinusitis. Four patients had subsequent complaints of development of rheumatoid arthritis, idiopathic thrombocytopenic purpura, or neuropathy. Whether these effects are related to fecal transplant remains to be seen.”

A further word of caution: The variety of bacteria decreases with age, so a younger donor would be preferred over an old donor. A very healthy donor is ideal.

 

 

Unknown's avatar lassesen 4:26 pm on January 3, 2014  

Microbiome: Two more members of the CFS Cartel of bacteria?

Another CFS reader forwarded their lab results for bacteria and asked me to comment.

Range: (NG to 4+)

Under Beneficial Bacteria

  • Lactobacillus Species- NG – No growth LOW SHOULD BE 2+
  • Escherichia Coli 4+ HIGH SHOULD BE 2+
  • Bifodobacterium 1+ LOW SHOULD BE 4+

Under Additional Bacteria

  • alpha haemolytic Streptococcus NP 2+ BELOW AVG
  • Pseudomonas aeruginosa NP 3+ LISTED AS POSSIBLE PATHOGEN AT THIS LEVEL

Beneficial Bacteria

Two of the three beneficial results matched the study from Australia in 1998. The last one (the high E.Coli) could be a problem with the test classifying Klebsiella/Enterobacter as E.Coli (since that was not listed), or a variation of the cartel of CFS bacteria.

I would suggest Mutaflor still because it is very effective for Crohn’s Disease — which studies has found to be very high E.Coli. Mutaflor is an aggressive good E.Coli that will reduce the E.Coli in this cartel of bacteria we wish to eliminate.

Troublesome Bacteria

The question is what to do about the two trouble some ones. First pass is always PubMed.

Treatment Suggestions

For Streptococcus, the suggestion would be to take some Oral Probiotics Mints containing streptococcus in the hope that the new species will out-compete  (for example Now Foods Oralbiotic Blis[Streptococcus salivarius], Evora Plus Probiotic Mints [streptococcus uberius, streptococcus oralis, streptococcus rattus ]), I would avoid Udo’s Choice Probiotic Blends: Super5 Lozenge which has only 5% being Streptococcus thermophilus. When I have taken a couple of Evora mints in a day, I did notice digestive changes. Again, the more varieties of streptococcus to compete against it, the better.

The other route is kill and then replace. These article are of interest: Antimicrobial activity of Chinese medicine herbs against common bacteria in oral biofilm. A pilot study. [2010], Prophylactic effect of Andrographis paniculata extracts against Streptococcus agalactiae infection in Nile tilapia (Oreochromis niloticus). [2009]

Antibacterial screening of traditional herbal plants and standard antibiotics against some human bacterial pathogens[2013] found that our old friend turmeric (Curcuma longa Linn) was effective against Pseudomonas aeruginosa, as well as Cumin (Cuminum cyminum) and Clove (S. aromaticum).

In addition to the above, using NAC and/or EDTA in a solution to gargle with (and swallow), should assist in breaking up some of the biofilms that both species use to defend themselves.

As always, consult with your knowledgable medical professional before starting any regime of probiotics or herbs.

Unknown's avatar lassesen 6:47 am on January 3, 2014  

Dairy free probiotics

A reader asked: 
“I was wondering about these products suggested in your latest blog having dairy proteins in them and if there are non-dairy alternatives. I am celiac and allergic (by Elisa testing) to all dairy products (although I don’t feel the symptoms from it). “

So I grab my collection and read the labels:

  • EvoraPlus: Lactitol is listed on the ingrediants but this is not a dairy product. Good.
  • Mutafor: Good
  • Prescript Assist: Good
  • Align (and other pure Bifidobacterium): Good (or should be good)
  • Lactobacillus Probiotics are the highest risk because many are cultured in milk, checking the two that I favor:
    • L. Reuteri via BioGaia products appear to be fine (ingredients) – made in Sweden
    • Fem-Dophilus also appears good (ingredients) – made in Denmark

So, it looks like my recommended probiotics should all be safe for you.

 

Unknown's avatar lassesen 7:23 pm on January 1, 2014  

Model Review: Childhood (and earlier) Stress contribution to susceptibility to CFS

For many years that has been a group of psychologists claiming that childhood abuse was the cause of CFS — and by implication that it was psychological and psychological therapy is what the cure is. This has not been well received by the CFS community. A recent article in New Scientist actually suggests that they be right as to it being a contributor — but at the same time points to their implied therapy as being very wrong.  In other words, their studies showing an association with abuse or other stress factors are likely correct. It is the inferences that these psychologists did from the association that is wrong.

New Scientist, Nov 23rd, 2013, p. 18 “How mum’s stress affects her fetus”, found “bacteria of the stressed mice are remarkably different to those of the unstressed mice… the proportion of one bacteria, Lactobacillus, was notably reduced.”  and then went further on the impact of stress, “pups of stressed mothers showed similar bacterial patterns in their gut.” The author was Tracy Bale. Other works has found that stress impacts epigentics (the DNA genes that are turned on and off)

Low Lactobacillus is a characteristics of CFS and likely a catalyst to onset. Psychological theraphy is unlikely to alter epigentic changes or the gut bacteria. Probiotics, especially Lactobacillus Reuteri — the most common Lactobacillus species in healthy mammals — would likely have much better success.

The next time that some one suggests abuse is the cause of CFS — instead of arguing about it — come back with I can’t help but agree more — recent studies found that the stress that my mother had is the likely cause of my CFS — by modification of epigenetics and gut bacteria that are passed down to me causing CFS …. can you please explain how psycho-therapy would correct the epigentics and gut bacteria alteration?  It sound like you are talking about airy-fairy medical treatment …

P.S. I am trying to arrange a small shipment of a Lactobacillus Reuteri only Probiotic from a supplier in Europe. The cost of this appears significantly lower than what is available in the US as a single species  

Unknown's avatar lassesen 12:20 am on December 28, 2013  

Revisiting Salt-and-C (Vitamin C) Protocol

A few years ago, a protocol of high dosages of salt (Sodium Chloride) and Vitamin C was in vogue. There is still a book on Amazon extolling its benefits. The protocol died off because while it appeared to help some people (but not put them in remission), it was largely dropped in the CFS community. Recently I revisited a different protocol and found that it results and the microbiota model were in sync. The protocol’s antibiotics would correct a significant amount of the dysfunctional microbiota (gut bacteria).  The question thus arise, is Salt-and-C initial success also the result of adjusting the microbiota — but not sufficient to correct the dysfunction.

High Dosage Vitamin C and Microbiota

Vitamin C aka ascorbic acid to scientists:

Bottom line: If the patient’s stomach pH was off, then two low species would do better and there would be less biofilms.

Salt and Microbiota

Like ascorbic acid, salt water is acid — which will also encourage bifidobacterium and lactobacillus species that are pH sensitive.  Practical mechanisms for interrupting the oral-fecal lifecycle of Escherichia coli[2001] reports that E.Coli prefers an acid environment and thus would grow more with a Salt and C diet.

Bottom Line

Salt and C would not shift gut bacteria in the appropriate way by the shift of pH.  Both are acids and would result in a more alkaline digestive system [See this post for studies and explanation]

Making the pH more acid results in:

  • More E.Coli, bifidobacterium and lactobacillus growth (correcting undergrowth)
  • No known impact on overgrowth.

This type of change would occur in other protocols that attempts to alter pH in the CFS patient. Unfortunately, many people seem to take the opposite type of foods because they do not get the reverse relationship between body pH and food in take pH. They will help, but are unlikely to reduce the overgrowths.

“The viable count of D-lactic acid producing Enterococcus and Streptococcus spp. in the faecal samples from the CFS group.. were significantly higher than those for the control group ” Increased d-lactic Acid intestinal bacteria in patients with chronic fatigue syndrome. [2009]