Category Archives: Treatment

Unknown's avatar lassesen 12:18 am on May 18, 2014  

The possible role of Butyricicoccus bacteria is various conditions

IBS is co-morbid (70-85%) with Chronic Fatigue Syndrome and often become other forms of inflammatory bowel disease (IBD) over time.

“Patients with inflammatory bowel disease have lower numbers of Butyricicoccus bacteria in their stools. Administration of B pullicaecorum attenuates TNBS-induced colitis in rats and supernatant of B pullicaecorum cultures strengthens the epithelial barrier function by increasing the TER.” [2013]

This species of bacteria is named because it produces butyric acid.  This acid is significant:

“Several recent studies have identified butyric acid as a potential therapeutic agent for IBD. Some gut bacteria produce butyric acid naturally in the intestines, but in IBD patients some of these strains are heavily depleted. Trials in mice have shown that injecting one such strain Faecalibacterium prausnitzii into the digestive tract is effective at restoring normal levels of gut bacteria and treating the symptoms of IBD. In addition, novel identified butyrate-producing strains, such as Butyricicoccus pullicaecorum, have been shown to exert similar effects.” [2010]

This leads logically into two directions:

  • Bacteria that produces butyric acid
  • Supplementing with butyric acid

Bacteria producing butyric acid

The species cited above is just one bacteria (which does not appear to be available as a commercial product at the moment). There appear to be a group working on producing Butyricicoccus pullicaecorum as a probiotic according to this presentation and a related patent application assigned to the University of Gent, Belgium (any Belgium readers may wish to make some phone calls… )

The known species producing butyric acid are:

  • Faecalibacterium prausnitzii ( low in IBD [2014], [2014]
    • ” this bacterium is highly oxygen-senstive, making it notoriously difficult to cultivate and preserve”[2014]
    • “cysteine can facilitate the survival of F. prausnitzii upon exposure to air,” – unknown if cysteine supplements would help it grow.
  • Butyricicoccus pullicaecorum

  • Roseburia hominis [2013], first identified in [2006]

  • Clostridium butyricum [2000] [1990] [1990] – is easily available in Japan. An application to sell it in the UK was made in 2012. It is available OTC in Japan (so if you have friend going there — tell them what you want to have brought back!). None of the online shops that I could find will ship to the US (Amazon.co.jp lists it – but will not ship it).
    • Summary of studies here.

Butyric Acid Supplements

This is available as a supplement (GABA), for example on Amazon. There are many articles proposing it for treatment of FM, CFS, etc. for example, this article. Another form, sodium butyrate,  is also available as a supplement and a 2011 study found

“In conclusion, our results show that oral administration of sodium butyrate improves mucosa lesion and attenuates the inflammatory profile of intestinal mucosa, local draining lymph nodes and Peyer’s patches of DSS-induced UC. Our results also highlight the potential use of butyrate supplements as adjuvant in UC treatment.”

Unknown's avatar lassesen 11:15 pm on May 12, 2014  

A new probiotic: Advanced Orthomolecular Research AOR, Advanced Series, Probiotic-3,

A friend sent me this link and it meets my basic criteria of containing no lactobacillus species.

This is available on Amazon and elsewhere. What is in it and what do we know about the species? Unfortunately, the strains names appears to be marketing names (too common).

It appears to be based on probiotics developed and sold in Japan. One of the characteristics is the suppression of evil E.Coli (good news for Crohn’s suffers) and promotes the growth of Bifidobacterium (good news for CFS folks too).

The bad news is that it contains lactose — which some people cannot tolerate.

Streptococcus faecalis 

The use of perioperative probiotics reduced postoperative infectious complications after pancreaticoduodenectomy, making it a promising potential adjunct therapy for patients undergoing high-risk hepato, biliary, and pancreatic surgery. [2007]

Note: this is also available in Threelac.

 

Clostridium butyricum

“These results suggest that calves given a probiotic had stable ruminal pH levels (6.6-6.8), presumably due to the effects of the probiotic on stabilizing rumen-predominant bacteria, which consume greater lactate in the rumen.” [2014]

“dietary supplementation of CB promotes growth performance, improves immune function, and benefits the cecal microflora in Escherichia coli K88-challenged chickens.” [2014]

“Probiotic therapy restored intestinal flora involved in 7 alpha-dehydroxylation in the dUC group, but not in the pUC group.“[two different subpopulations of ulcerative colitis] [2012]

the probiotic bacterium C. butyricum MIYAIRI strain 588 has preventive and therapeutic effects on EHEC O157:H7 infection in gnotobiotic mice. [2004]

Clostridium butyricum MIYAIRI is effective for both the treatment and the prophylaxis of AAD in children, as it normalizes the intestinal flora disturbed by antibiotics.[2003]

These results suggested that the inhibition of Shigella in the mixed culture with C. butyricum was not due to a single factor such as pH or fatty acid etc. but due to multifactors including live cells of C. butyricum. [1990]

The use of perioperative probiotics [TO-A] reduced postoperative infectious complications after pancreaticoduodenectomy, making it a promising potential adjunct therapy for patients undergoing high-risk hepato, biliary, and pancreatic surgery. [2007]

 “This study suggested that butyrate produced by C. butyricum TO-A downregulates TLR4 mRNA level in human colonic epithelial cells.” [2007]

. Stimulation of bacterial growth of some strains of Bifidobacterium by a crude preparation of metabolites from Bacillus mesentericus TO-A

– Biomedical Letters; 48, 73-78, 1993

Bacillus mesentericus TO-A

The use of perioperative probiotics [TO-A] reduced postoperative infectious complications after pancreaticoduodenectomy, making it a promising potential adjunct therapy for patients undergoing high-risk hepato, biliary, and pancreatic surgery. [2007]

was identified as 3,3-dihydroxyazetidine, and it promoted the growth of several strains of Bifidobacterium. [2000]

Unknown's avatar lassesen 12:00 am on April 16, 2014  

My favorite probiotic: E.Coli Nissle 1917 (Mutaflor)

In NOTE: There is an alternative E.Coli probiotic available, Symbioflor-2, less studied but in terms of demonstrated and reported traits desired for CFS, superior.

I thought it was time to revisit what is on PubMed for Mutaflor (the probiotic E.Coli Nissle 1917). There are 213 studies at the moment.

  • “Probiotics as E. coli Nissle could be used as alternative to mesalazine for maintenance of remission in patients with ulcerative colitis. “[2014]
  • “ The probiotic E. coli strain Nissle 1917 (EcN) is known to be effective in the treatment of several gastro-intestinal disorders. While both in vitro and in vivo studies have described strong inhibitory effects of EcN on enteropathogenic bacteria including pathogenic E. coli, the underlying molecular mechanisms remain largely unknown.” [2014]
  • “Our results indicate that EcN can inhibit many of the pathological effects of C. perfringens in vitro conditions.”[2014]
  • “Its beneficial effects in the treatment of UC have been demonstrated in several controlled clinical studies” [2014]
  • “The data can be explained according to our “restaurant” hypothesis for commensal E. coli strains, i.e., that they colonize the intestine as sessile members of mixed biofilms, obtaining the sugars they need for growth locally, but compete for sugars with invading E. coli pathogens planktonically.“[2014]
  • “Our results show that coseasonal treatment with EcN in grass pollen-allergic subjects was not superior to placebo” [2014] – i.e. does not cure allergies – no big deal
  • “By administering Escherichia coli strain Nissle 1917, which assimilates iron by similar mechanisms, we show that this nonpathogenic bacterium can outcompete and reduce S. Typhimurium colonization“[2013]
  • “Intestinal bacteria compete for the essential nutrient iron, leading to replacement of pathogenic Salmonella by the probiotic Escherichia coli Nissle, which is better equipped with iron acquisition systems, and resolution of infectious colitis.” [2013]
  • “The combination of Lactobacillus, Bifidobacterium, Saccharomyces boulardi and the treatment with Escherichia coli Nissle were found beneficial in inducing and maintaining remission of disease activity of gut inflammation and moderately severe ulcerative colitis.” [2014]
  • EcN “ consumed on average 65% glucoiberin and 78% glucoraphanin, transforming them into glucoiberverin and glucoerucin, respectively, and small amounts of iberverin nitrile and erucin nitrile. The lactic acid bacteria did not accumulate reduced glucosinolates, consuming all at 30-33% and transforming these into iberverin nitrile, erucin nitrile, sulforaphane nitrile, and further unidentified metabolites. ” [2013]
  • “Probiotic EcN shows effects in irritable bowel syndrome, especially in patients with altered enteric microflora, e.g. after gastroenterocolitis or administration of antibiotics.”[2012]
  • “In conclusion, EcN supplementation to minocycline treatment improves the recovery of the intestinal damage and prevents the reactivation of experimental colitis.” [2011]
  • “In the mouse model E. coli Nissle can not be used alone to eradicate IBD associated E. coli; rather, 3 days of ciprofloxacin are apparently efficient in eradicating these strains, but surprisingly, after ciprofloxacin treatment (3 or 7 days), the introduction of E. coli Nissle may support re-colonization with IBD associated E. coli.” [2011] – interesting but some distinct study issue.
  • “ oral administration of EcN might be an effective strategy in prevention and potentially therapy of allergic inflammatory skin diseases.” [2011]

Do NOT take with C. butyricum MIYAIRISAN Probiotics

“1.1 C. butyricum MIYAIRI antagonistic effects on toxinogenic Escherichia coli and 20 E. coli strains isolated from live stocks (cows, pigs and chickens) were evaluated by the plating method. C. butyricum MIYAIRI inhibited the growth of all E. coli strains tested” [Source]

Concerning Mutaflor, a reader wrote:

Here is one places to get Mutaflor in the US:

No longer available…Uriel Pharmacy in Wisconsin, if ordering as a prescription item. 100 mg. tablets are $2.95 ea. and 20 mg. tablets are $2.15 each (at March 2014). The 100 mg. tablets can be cut if one wants to start at a smaller dose. The pharmacy number is 866 642 2858.

http://urielpharmacy.com/index.php

Feel Good Natural Health Store in Canada
You MUST pay for the Express shipping if you live outside Canada, which is about $23. Even though the sales page says “Canada Only”, when you get to the shopping cart, you can select any state in the U.S. I ordered from here and received my order in a couple of days.

Home page:

Home

In Italy it is also being manufactured.

ecn-web

20 Euros for 20 capsules.

http://cadigroup-shop.eu/shop2/colite-ulcerosa/ecn-p-27.html

Unknown's avatar lassesen 12:00 am on April 15, 2014  

Iodine, Microbiome and Chronic Fatigue Syndrome

Many of us more ancient folks remember when if we got a cut, we dreaded the treatment worst then the cut. Iodine tincture was applied to the cut to kill bacteria. It is a very very effective antimicrobial. It’s use has stopped in our society. A reader, who like me, from a location where his ancestors likely had a very high iodine intake due to fish being a stable of the diet, asked about iodine as a supplement. Excellent question because the level of it would likely impact inherited microbiome significantly.

What is inherited microbiome? It is two parts: bacteria obtained from babies putting their fingers into their parent’s mouth, as well as inherited DNA cooperation with certain species-strains.  Conceptually it is easy to understand, but it’s impact on treatment protocols is a lot of complexity.

So what do we know:

  • Nothing on CFS and Iodine on pubmed.  We do know that iodine is essential for thyroid, “Iodine’s main role in animal biology is as a constituent of the thyroid hormones thyroxine (T4) and triiodothyronine (T3). “[Wiki], and there is a lot on thyroid and CFS. Why have there been no published studies on iodine supplementation for CFS?
  • Looking for Iodine and Bacteria results in thousands of hits where iodine was used for staining bacteria… ugh.

Looking at various sites, there is a feeling of dejavu with Vitamin D3.  The official healthy level for Vitamin D3 was defined to be that which stopped rickets from happening. (about 200 IU/day)  and only recently has a level of 5000 -1000 IU/day has been found to be needed to reduce cancer and MS risk as well as decrease in symptoms for CFS and FM. Iodine is not tested for usually. There are procedures for dealing with iodine poisoning.

There is a privately published study Effect of Daily Ingestion of 100 mg Iodine Combined with High Doses of Vitamins B2 and B3 (ATP Cofactors) in Five Subjects with Fibromyalgia that is worth the read. Note that the dosage was 100 mg/day and Vitamin D is strongly recommended with it.

 

A [2008] study found “In conclusion, median urinary iodine 100~200 mug/l may reflect the safe range of iodine intake levels. Serum thyrotropin/thyroglobulin ratio might be a better index of evaluating iodine status.” A [2006, full text] study found “Mild and moderate iodine deficiency was associated with a decrease in serum TSH with age.”, the full text went on to state “Until recently, the iodine intake of many European populations including the Danish (1) was below the level recommended by the international organizations (2)“. For CFS patients there is a tendency to eat too-healthy for their own good. This includes avoiding salt (especially  iodine salt) or use special salts not containing equivalent iodine levels (Himalayan salts, etc).

Further more, “Even if there is consensus on the importance of avoiding iodine deficiency, there are many unanswered questions concerning optimal iodine fortification of food, and optimal iodine nutrition of a population (6).”  One of my favorite CFS MD’s, Dr. Myhill writes “Interest in iodine was re-awoken in 1993, when Gent demonstrated that 5mg a day of iodine is highly effective in the treatment of fibrocystic disease of the breast. A study in Japan showed that the average daily intake of iodine was 13.8mg (because of their high intake of seafood) and the Japanese have the lowest incidence of breast cancer in developed nations.”   Hmmm Iodine and Cancer… sounds like Vitamin D and cancer is echoing! She goes on to describe a protocol using about 50mg/day which resulted in less brain fog and major increase in the level of toxins being excreted by CFS patients.

Bottom Line

There is more that we do not know then what we do know 😦 . There is the appearance that individual generics may play a significant role in determining the appropriate level. The inferred safe range of supplementation seems to be 14mg – 50mg of iodine/day. This is well above the official RDA (Minimal) levels, to quote MyHill “.Furthermore, the recommended daily amount of iodine is 150 μg – that is to say a thousand fold less than the sort of doses that were used in the 19th century.”  The typical iodine supplement is ~5  – 12 mg/tablet and Kelp around 150mcg (0.15mg) each. Myhill recommends:  Iodoral.

As always, consult your knowledgeable medical professional before changing or adding supplements (if you can find said).

 

 

Unknown's avatar lassesen 12:00 am on April 14, 2014  

Chemotheraphy induced CFS Remission

Twice in my life I have sat down and spoke with CFSers that went into remission from cancer treatment. This has also been reported from Norway (“Cancer Drug May Also Treat Chronic Fatigue Syndrome“) and pubmed [2009] and after 3 years, the clinical studies or confirmation of the suspected drug agent has not materialized [Blog 2013]. So it seems that it may not be a single drug doing it, but chemotheraphy as a whole.

Does this fit in with the microbiome model… surprisingly — there was a recent publication that ties the pieces together!

“We observed a steep reduction in alpha diversity and significant differences in the composition of the intestinal microbiota in response to chemotherapy. Chemotherapy was associated with a drastic drop in Faecalibacterium and accompanied by an increase of Escherichia. The chemotherapy-induced shift in the intestinal microbiota could induce severe side effects in immunocompromised cancer patients. “

Very low E.Coli is the dominant microbiome shift seen in CFS.  Chemotheraphy is not a recommended treatment for CFS — however, if you need it and have CFS — you may have a pleasant side-effect!