Dr. Jacob Teitelbaum's Column
...expert advice on CFS, Fibromyalgia and other Health Topics.
You can benefit from Dr. Teitelbaum's wisdom and experience by visiting us at The Environmental Illness Resource regularly to read articles from his latest newsletter!
Monday, July 7th, 2008:
Infection Update - Biofilms, HHV-6, Valcyte and CFS
by Jacob Teitelbaum MD
New research is coming out giving us a clearer understanding of what is needed to fight infections in general, and especially in chronic illnesses like Chronic Fatigue Syndrome and Fibromyalgia. In this article, we will talk about two new concepts that offer us more tools for, and insight into, eliminating these infections:
1. Biofilms. Just as we have learned to fight infections by using antibiotics, bacteria are also adapting to survive. One way that they're doing this is by creating Biofilms. Biofilms represents a layer of bacteria and other organisms that live together in a jelly like film. This film protects them from antibiotics, ultraviolet light and other "predators" and makes them hard to kill. New research is suggesting ways to kill them—despite their protective layer.
2. HHV-6 viral infections. As discussed in an earlier article on viral infections, HHV-6 is an important viral infection in CFS and other illnesses. New research presented this week at the HHV-6 conference in Baltimore Maryland showed that:
a) HHV-6 makes a chemical that may contribute to the "brain
fog" seen in CFS.
b) Using Valcyte to kill HHV-6 can improve the cognitive
dysfunction ("brain fog") seen in CFS.
c) HHV-6 infection may also be responsible for many cases of bipolar illness and depression.
In standard medicine, we are used to looking for bacterial infections by taking a few bacteria and putting them into a growth medium to see how they will grow. We then add antibiotics to the growth medium to see which ones are effective against the bacteria and what dose is needed.
For early acute infections, this approach can be effective. What medicine has ignored, however, is that in chronic infections, both in humans and in nature in general, infections form their own "cities" called "biofilms." These biofilms are like a mucus (called "Extracellular Polymeric Substances" or EPS) secreted by the organisms, and leave the infections highly resistant to antibiotics. Often, a number of different bacteria or fungi live in the same biofilm.
Because standard culturing techniques will not pick up most biofilms, medicine tends to treat these as if they are sterile fluid collections. Common examples of these would include "nonbacterial" prostatitis, dental infections, sinusitis and infections of medical materials such as implants or catheters.
Although just starting to become available, new tests such as PCR or antigen testing offer new hope for being able to diagnose and treat these biofilm infections. This is critical, as it is estimated that 65-80% (according to Center for Disease Control estimates) of human infections are caused by biofilms—which our current testing routinely misses.
As our awareness of biofilms increases, new approaches are being developed to help fight them. For example, a simple mineral called "bismuth" has been shown to markedly disrupt biofilms in very low dose. Interestingly, this mineral is sometimes found in toothpaste. Dental plaque is one of the most common forms of biofilm infections, and has been decreasing considerably—possibly because of the bismuth (and also because of dental floss). Bismuth is now also being added to medical catheters to prevent infections. I suspect that fairly soon, as Medicine realizes that sinusitis also reflects a biofilm, bismuth will be tested in nasal spray form. In the interim, the Sinusitis Nose Spray I recommend (available from ITC Pharmacy by prescription: 303-663-4224) contains xylitol, which may have a similar effect.
For more information on biofilms: Biofilms and Chronic Infections. JAMA June 11, 2008. P 2682-3
HHV-6, Valcyte and Brain Fog
At last week's HHV-6 conference in Baltimore, Maryland, Dr. Montoya presented his research on the use of Valcyte to eliminate HHV-6 viral infections. As summarized by Kristin Loomis, president of the HHV6 Foundation: "Dr. Jose Montoya, an infectious disease specialist at Stanford University, released preliminary findings on his double-blind placebo-controlled antiviral trial of Valcyte for a subset of patients displaying high antibody levels to human HHV-6 and Epstein-Barr virus (EBV). Statistically significant cognitive improvement was noted in the Multidimensional Fatigue Inventory (MFI-20) Mental Fatigue subscale and on patient self-reported of cognitive functioning, but there was not a significant result on the overall MFI-20 index. Data from treadmill testing, cytokine analysis, gene expression and other viral markers is still pending and will be announced at a later date."
Basically, the early data suggest that the antiviral Valcyte is most effective against the symptoms of brain fog. Clinical experience suggests that in a significant number of people with CFS, the Valcyte can be very effective overall as well. As the Valcyte will not eliminate the infection completely, it is critical to treat with the entire "SHINE Protocol." This way your immune system can recover enough to eliminate the infection. We have found that by using the Valcyte along with the "SHINE protocol," we often get excellent results. I look forward to the release of Professor Montoya's complete study.
Interestingly, another study presented at the conference suggests that chronic HHV-6 infections can create a special protein that is commonly found in the brains of those with CFS but not in those that are healthy, and that this protein may contribute to the brain fog often seen in Chronic Fatigue Syndrome. "Causes of many chronic diseases are unknown and chronic viral infection is one of the most suspected candidates," said Dr. Kondo, who spent 20 years trying to identify the latent protein responsible for chronic CNS disease and mood disorders.
Research suggests that other "psychological problems" may also be caused by HHV-6 infection. 71% of CFS patients with psychological symptoms, 53% of depression and 76% of bipolar patients possessed the antibody against the SITH-1 protein—but healthy patients showed no evidence of this protein. Although there are many causes of depression, it is quite possible that Medicine has been trying to treat a brain infection with Prozac!
Used with permission from Dr Jacob Teitelbaum's free newsletters-available at www.Vitality101.com
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