Category Archives: Treatment

Unknown's avatar lassesen 12:55 am on November 20, 2013  

Gluten Sensitivities and Bacteria

Science news has a recent article entitled “Microbiome Changed by Gluten Increases Incidences of Type 1 Diabetes“, since gluten sensitivities is common with CFS and there are similarities to Type-3  diabetes, I thought that I should drill down on this via PubMed.

First, it looks like there may be a probiotic to help in the works [2013]. For celiac disease, we appear to have lower Lactobacillus and Bifidobacterium species/ volume [2012] — which suggests that Lactobacillus Reuteri and Align (Bifidobacterium infantis 35624) has the potential to be helpful. Another 2013 studies suggests that high Bacteroidetes (phyla) and Parabacteriodes (genus) may be a factor. The likely missing bacteria are Rothia bacteria according to this [2011] study (there is already a patent filed on such use), however there appear to be no commercially available probiotics.

I also found a most interesting article indicating the the pH of drinking water impacts gut bacteria — yes drinking water! [5 Nov 2013] This has implication on what you drink — soda pop pH may be a factor for diabetes (beyond the usual sugar issue). There is a chart of pH for some foods here. You may wish to shift the food and drink you consume to higher pH (less acid values). There are various sites that will give lists of acid and alkaline foods – WARNING: sites may disagree – for example one site says orange juice is low ph (acid) and another site say it is alkaline.

The safest approach may be adding ½ a teaspoon of baking soda to a gallon of water. Also, we are not talking about alkalizing blood (which is often an alternative medicine approach), but about drinking alkalize water to alter gut bacteria. Often the alkalizing blood techniques does do by acidifying the stomach (exact opposite of this intent).

Unknown's avatar lassesen 4:00 pm on November 19, 2013  

Gut Bacteria causing Irritable Bowel Syndrome / CFS

While researching my last post I came across an article describing the differences of bacteria seen with IBS. We know that two commercially probiotics are effective for treating IBS, so it is nice to know which bacteria they appear to push out. IBS and CFS are co-morbid, so these results likely applies to most CFS patients.

Real-time PCR analysis of enteric pathogens from fecal samples of irritable bowel syndrome subjects Teemu Rinttilä12, Anna Lyra13, Lotta Krogius-Kurikka1 and Airi Palva1* 

“According to the results, the studied clostridial groups (Clostridium histolyticum, Clostridium coccoides-Eubacterium rectale, Clostridium lituseburense and Clostridium leptum) represented the dominant faecal microbiota of most of the studied subjects, comprising altogether 29-87% of the total bacteria” [2006]

These author and other studies reports high levels of:

  • Staphylococcus aureus [2011]
  • Clostridium perfringens [2011]
  • Veillonella species (if constipation) [2005]
  • Low Lactobacillus sp (if diarrhea) [2005]
  • Clostridium coccoides [2005] (30 -50% of all bacteria [2006] )
  • Bifidobacterium catenulatum [2005]
  • Pseudomonas aeruginosa [2011]
  • Differences in  Coprococcus, Collinsella, and Coprobacillus [2007]

The detection was done by looking at RNA sequences. It should be noted that they tested only for 12 species. There may be other species involved. The likely reality is well expressed in this 2010 article, “data available from a .. do not reveal pronounced and reproducible IBS-related deviations of entire phylogenetic or functional microbial groups, but rather support the concept that IBS patients have alterations in the proportions of commensals with interrelated changes in the metabolic output and overall microbial ecology. ”

” The present study suggests that instability of intestinal microbiota may be involved in IBS.”[2005]. This matches my thinking that it is not a specific bacteria but a collection of cross-supporting bacteria from different species. If you kill one of them, another one that is willing to cooperate with this bad bacteria co-op will move in. You have to destroy the co-op. The coop may account for “the overall gene diversity was 15 % higher in the IBS samples than in the non-IBS samples”[2011]

For new comers to this blog, the two effective probiotics are:

Unknown's avatar lassesen 9:51 pm on November 16, 2013  

Nitrates, Type-3 diabetes and Chronic Fatigue Syndrome

Recently the noted scientist, David Suzuki, “CBC The Nature of Things”, did a program called Untangling Alzheimer’s. In it he interview a researcher that has coined an expression, Type-3 diabetes which has found acceptance in research circles as this 2008 review article attests.

“there is a rapid growth in the literature pointing toward insulin deficiency and insulin resistance as mediators of AD-type neurodegeneration,”

The question arises, reasonably, whether this may part of the mechanism causing cognitive issues with CFS. Diabetics have twice the risk of developing Alzheimer’s and other cognitive impairments.  Diabetics have ZERO RISK of developing CFS — because diabetes is an exclusionary conditions for CFS (thus by the definition of CFS, you cannot have both a CFS and a diabetes diagnosis, only diabetes!– thank you CDC!).

Nitrates

In the same program was presented evidence of the inclusion of nitrates in processed foods with the increasing incidence of Alzheimer’s Disease. This weak evidence was then coupled with lab experiments on mice that would develop dementia when feed commercial food nitrates with their food while their litter mates eating the same food without nitrates did not.

A few articles by the leading researcher, Suzanne  de la Monte include:

Nitrates and the Gut Model

Nitrates are added to food to preserve the food — what does this mean? They inhibit some bacteria growing. So what happens when they are consumed by humans, the nitrates will alter your gut bacteria as many studies have found going back many years, for example Antimicrobial effect of acidified nitrite on gut pathogens: importance of dietary nitrate in host defense (1996)

Bottom Line

Going nitrate free may be in the best interests of all people, not just CFS patients. The levels of nitrates were reduced many years ago because of an association with cancer. The odds are that the only safe level is zero added nitrates. Look at the labels on your food and see if nitrate are added…

There is an excellent study on the amount of nitrates found in different foods here.

Unknown's avatar lassesen 4:45 am on November 15, 2013  

St. Amand, Guaifenesin, Salicylate and MCS

A correspondent reminded me of Dr. St. Amand work, and I recall some 12 years ago corresponding with a person that went into remission taking Guaifenesin, a remission that lasted for 6 months.  I decided it was time to see if the stable dysfunction microbiome hypothesis and these earlier experiences may be connected.

My Model of Multiple Chemical Sensitivity

For several years I have used a model that multiple chemical sensitivity was due to miss-identification by the body of some chemicals as signals of a biological infection (virus or bacteria). I have seen a person with MCS have a coagulation panel immediately before a MCS reaction and two weeks after show a massive jump( 6 standard deviations) in the a coagulation marker with a very short half life (thus indicating active coagulation). The MCS reaction had triggered massive active coagulation which would explain many, if not all, of the symptoms of MCS.  This was later confirm by an experiment with a MCS person with gluten sensitivity who reacted strongly if there was a bottle of beer open in a room, but who had no trouble with the Greek drink Ouzo. It illustrated that many CFS patients may not be alcohol sensitive, rather sensitive to complex hydrocarbons (i.e. aroma, etc) found in beer, wine and whiskies. On the other hand, a pure alcohol with a favoring does not cause a reaction.

I do find that I am extending this model to suggest that these low level chemical signatures may actually be triggering some species of gut bacteria to suddenly over-produce chemicals like histamines. This is speculation, but a 2002 article, Sellge G et al. Gram negative bacteria trigger human intestinal mast cells for histamine and cytokine production. In a 2008 article this same research identified an example E.Coli bacteria that demonstrate this, Selective activation of human intestinal mast cells by Escherichia coli hemolysin.

Guaifenesin

There were no direct PubMed articles on it’s impact on gut bacteria, glyceryl guaiacolate. We find a  anti-inflammatory and analgesic effect[1]. In terms of microbiome, there is almost nothing written, however known side-effects include diarrhea, and constipation[2]  which implies that it does impact the microbiome in some manner. It is related to Guaiacol which is broken down by gut bacteria in some species from plant material.

Salicylate and Bacteria

I know many CFS suffers who have moderate or severe salicylate sensitivities. I very greatly feel for them because this often prevents them from using herbs and other supplements that may improve their gut bacteria. A quick search on pubmed found 900+ articles with both of these words in them. A 2000 article describes the interaction of salicylates and bacteria:

“On one hand, growth of certain bacteria in the presence of salicylate can induce an intrinsic multiple antibiotic resistance phenotype. On the other hand, growth in the presence of salicylate can reduce the resistance to some antibiotics and affect virulence factor production in some bacteria. This review provides an overview of the effects salicylate has on various bacterial species.”

A 2012 study found that salicylates negatively impacts E.Coli (which CFS suffers are low in)

Bottom Line

It appears that all of the above influences gut bacteria. Whether it will make allow your good bacteria to be stronger, or encourage your bad bacteria is unclear.  We know that they impact the gut bacteria — and that is all that we know for sure.

Unknown's avatar lassesen 12:20 am on October 27, 2013  

The challenge of tracking progress in CFS

CFS can be exceedingly difficult to “track” progress because there are no clear markers. My last onset and remission found two indicators were very helpful. The first one, Vitamin 1,25D level which went so far outside of the normal range that the lab repeated the test twice — fearing a lab measurement problem.  The second one, WII Fit, seems ideal for most CFS patients, and repeatedly showed “herx” and improvement over the course of treatment.

Vitamin 1,25 D as indicator of activation level of CFS and other auto-immune conditions

The last time around I was aware of hypercoagulation issues and self-medicated with known and effective anti-coagulants in order to keep working. That is, I did until I started to bruise very easily — at that point I stopped and did a severe crashed in 7 days. Prior to this, testing for hyper-coagulation was constantly returning normal ranges (of what they were willing to test for). Because the items that I were using were non-prescription (or did not require a prescription in the US), the professional medical staff ignored the list. The list included:

  • grape seed extract
  • alpha lipotic acid
  • serrapetase
  • nattokinease
  • lumbrokinease
  • turmeric (very effective against the measure that I was normally high in)
  • racetams (very effective against the measure that I was normally high in)

There was a catch-22 situation. There was hypercoagulation happening but it was being effectively controlled. If I stopped to allow it to spike and thus get significant readings — I would also be unable to work and promoting a situation that could cascade out of control quickly.

Fortunately, Dr. Kim Iller, my physician, was willing to test for vitamin 1,25D (dihydroxycholecalciferol), not a typical lab test, as well as the usual Vitamin D levels. The 1,25D results matched that reported on PubMed for auto immune conditions (Vitamin D metabolites as clinical markers in autoimmune and chronic disease. [2009]. My Vitamin-D levels were at the top of the normal range (intentional) which resulted in the least severity of symptoms (as reported in multiple PubMed studies).

The last test done for 1,25D before I was cleared to return to work had it back in the high normal range instead of being almost off the scale. This appear to correspond well with the change of symptoms.

Some literature:

Suggestion: get a Vitamin D and Vitamin 1,25D lab done at least once every 6 months.

  • If Vitamin D level is not close to the threshold of being high, supplement. Often a daily intake of 15,000 – 20,000 IUs seems to be needed for some CFS patients.
  • 1,25D is used solely as a general state indicator. If it increases, chances are that symptoms have increase and you may wish to re-examine changes that have been made between measurements.

WII Fit as a indicator of CFS state

WII Fit means a WII controller, a WII balance board and the WII fit game. When it first came out, many rehabilitation services adopted them.  Today, you can buy both on the second hand market for around $40-$60 for the game and the board, and $70-$80 for a refurbish WII System.  Often you can find smaller game shops sell them for much less (or garage sales). Craiglist have prices of $20 and $40 often.

Example chart for tracking information on WII FIT

WII Fit is very nice because if offers a wide range of exercises and durations. It also keeps track of a daily status:

  • Weight
  • Performance on two randomly selected tests of cognitive or other processes that are used to predict a “Fit age”.

You can then look at your stats over time to see if things are improving or getting worst. For Fit Age, you typically need to average several days to get a stable number. Some tests you may do very well on and other bad on.

My Experience

I was doing 40-50 min/day of WII Fit before the onset. My WII Fit age was typically in the mid 20’s.  With onset, my performance went up to the 60’s. What I found especially interesting was the change of treatment being reflected in these scores.

  • Starting minocycline, a neuroprotective antibiotic, saw my WII Fit age drop to the high 30’s within a week.
  • Starting Mutaflor (E.Coli Nissle 1917) with it’s headache and severe herx, saw my FIT Age approaching 70 for 10 days and then started to come down.
  • When I was ready to return to work, my average WII Fit age was the high 20’s.

This morning, I did the WII Fit Age and it came in at 21 — not bad for a white haired person!

WII Fit age is helpful for determining if something(drug,  probiotic, antibiotic, elimination) has an impact.

  • Significant improvement after starting is a good sign
  • Deterioration with a herx or similar symptoms when starting something new — suggests that it is having an impact — but the deterioration should reverse itself within 14 days with some improvement over your prior score.

Last but not least, it tracks how much time that you exercise each day.  5 minutes is fine. Just doing the fitness tests is fine. All of the exercises are graded from a MET of 1 (deep breathing only) to an energetic MET of 4. Starting on the yoga choices is strongly recommended.  Do the lowest MET exercises when you start and slowly increase the MET level. Gradual regular exercise helps reduce CFS symptoms — if only by allowing better removal of toxins from the body.

  • If you have payback from doing too much, you can see how much time you spent yesterday and cut that time in half for the next week. Then slowly work upwards again.

CFS patients are absent minded and do not log much information. This is worst because their cognitive abilities are impaired (so what is logged may be very unreliable), see this recent article for more information ( Effects of Time Frame on the Recall Reliability of CFS Symptoms). The WII Fit approach results in information being recorded daily and amount of physical activity recorded.  It is a great encouragement when you see you beating your best scores from two weeks ago — you become competitive against yourself. Fortunately, after every exercise, the WII Fit displays the total time you have been active today. It also nags you to take a break at 30 minutes. You are much less likely to “over-exercise”.