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    Below is the letter that I had received from Dr. Nicolson on the results of my blood test, the explanation, and the treatment.

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The Institute For
Molecular
Medicine

Department of Molecular Pathology
Huntington Beach, CA 92649-1014
Phone (714)903-2900 Fax (714)379-2082

http://www.immed.org

December 19, 1997

Mr. Joseph G. Miller
Box 125, 805 N. Jefferson Ave.
West Jefferson, NC 28694

 

Dear Joseph G. Miller,

    We received blood from Joseph G. Miller on 10/14/97.
    You ordered: Test for
Mycoplasmal spp. in blood leukocytes. Test for Mycoplasmal fementans in blood leukocytes.
    The tests had following results:

Test Results Control Reference
Mycoplasmal spp.
blood leukocytes
Positive positive Polymerase Chain Reaction
Mycoplasmal fementans Negative positive Polymerase Chain Reaction


    Mycoplasmal are small self-replicating bacteria of the class bacteria of the class Molecules, consisting of gram-positive bacteria lacing a cell wall and dependent on a host for nutrients. Although mycoplasmal can exist in the oral cavity and gut as relatively normal flora, when they penetrate into the blood and organs they can cause acute or chronic diseases. Members of this class are important pathogens in animals and humans and cause atypical pneumonia, nongonococcal urethritis and other signs of and symptoms. Some members of this class,
mycoplasmal penetrans, Mycoplasmal fementans and Mycoplasmal pirum, can enter a variety of cells and cause systemic or system wide signs and symptoms. These specific mycoplasmal have also been implicated as co-factors in AIDS, and they may be associated with accentuated pathology, such as AIDS-associated nephropathy, adult respiratory distress syndrome and enhanced HIV cenotaphic effects. However, a cause and effect relationship between mycoplasmal infection and AIDS pathogenesis has not been established. Mycoplasmal infections have also been documented Persian Gulf War Illness. In particular, M.fermentans (incognitus strain) has been found in the blood leukocytes of patients with Gulf war Illness, and patients have been successfully treated for these infections. Mycoplasmal have been shown to share a complex relationship with the immune system. They have specific and nonspecific stimulatory suppressive effects on lymphocytes, as measured by B- and T-cell activation and induction of cytokine secretion. Mycoplasmal are very effective at evading the immune system and synergism with other infectious agents has been seen.
    Mycoplasmal infection can be confirmed by molecular analysis using Polymerase Chain Reaction (PCR) and Nucleoprotein-DNA hybridization analysis (Nucleoprotein Gene Tracking). At the first level of detection, presence in the blood of any type of mycoplasmal (
Mycoplasmal spp) is examined. Further analysis is then usually undertaken to identify if the species is one of the pathogenic species. Species such as M.fermentans are detected by use of specific PCR primers and specific DNA probes technique. PCR is a diagnostic process covered by a U.S. patent owned by Roche Diagnostic Systems, and Gene Tracking is a research test developed to identify specific genes associated with nucleo-proteins. Since the FDA has not given final approval for the use of these tests for mycoplasmal infection, the results should be considered for research only.

References:

1. Baseman, J.B. and Tully, J.G. Mycoplasmal: Sophisticated, reemerging, and burdened their notoriety. Emmer.Infect.Diseases 3(1): 21-32, 1997
2.
Ainsworth J.G., Datseni V., Hourshid, S., Waldron, S., Ball, S., Catell, V. and Taylor-Robinson, D. Mycoplasmal fementans and HIV-associated nephropathy. J. Infect.Dis. 29: 323-333, 1994.
3.
Bauer, V.A., Wear, D.J., Angritt, P. and Lo, S.C. Mycoplasma fermentans (incognitus strain) associated nephropathy: a light microscopic, immunohistochemical and ultra structural study. Human Pathol. 22: 63-69, 1994
4.
Rawadi, B., Roman, S., Castredo, M., Dutrlleul, V., Susin, S., Marchetti, P., Geuskens, M. and Kroemer, G. Effects of Mycoplasma fermentans on the myelomonocytic lineage. J.Immunol. 156: 670-680, 1996
5.
Rosenberg-Nicolson, N.L. and Nicolson, G.L. The isolation, purification and analysis of specific gene-containing nucleoproteins and nucleoprotein complexes. Methods Molecular genet. 5: 281-298, 1994
6.
Nicolson, G.L. and Nicolson, N.L. Diagnosis and treatment of mycoplasmal infections in Persian Gulf War Illness-CFIDS patients. Int.J.Occup.Med.Immunol.Tox 5: 69-78, 1996
7.
Nicolson, G.L. and Nicolson, N.L. Mycoplasmal infections-Diagnosis and treatment of GWS/CFIDS. CFIDS Chronical 9(3): 66-69, 1996.

For further information contact our web site: http://www.immed.org.

Garth L. Nicolson, PhD

Chief Scientific Officer and Research Professor
The Institute for Molecular Medicine

Professor of Internal Medicine
Professor of Pathology and Libratory Medicine
University of Texas Medical School at Houston

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    The following is the treatment that Drs. Garth and Nancy Nicolson suggests that veterans take when they find out they have the Gulf War Illness.

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Antibiotics Recommended When Indicated
for Treatment of Gulf War Illness/DFIDS/FMS

by Prof. Garth L. Nicolson
The Institute for Molecular Medicine
P.O. Box 52470
Irvine, California 92619-2470
Tel: (714)476-0204

Doxycycline (aka Vibramycin, Monodox, Doxychel, Doxy-D, Doryx)

    Doxcycline is a broad spectrum tetracycline with a good lipid solubility and ability to penetrate the blood-brain-barrier. This antibiotic acts by inhibiting microorganism protein synthesis, it is readily absorbed by the (normal) gut, and peak blood concentrations are maintained between 2-18 hours absorption, and alcohol, phenytoin [Dilantin] or barbiturates reduce blood half-life.
    Gulf War Illness/Chronic Fatigue Syndrome/Fibromyalgia Syndrome (GWI/DFIDS/FMS) use, the recommended dose is 200-300mg/day (oral, 2-3x100 mg capsules) for each 6 week cycle of therapy. Initially, Doxycycline initially exacerbates symptoms (Herxheimer reactions or adverse antibiotic responses, such as transient fever, skin, gut discomfort, etc.) but these are usually gone within a week or so. Patients usually start feeling better with alleviation of most major signs and symptoms within 2-6 weeks, but in some patients major symptoms are not alleviated until the second 6-week course. Severe reactions or prior damage to the gastrointestinal system may require i.v. administration of 200 mg/day (rapid i.v. administration is to be avoided) for 2-3 weeks, then the remainder of the 6 week course should be on oral antibiotic (to avoid thrombophlebitis complications which can occur with prolonged i.v. therapy). Some react to the starch filler in the capsules and must use Doryx, a granular for of Doxycycline. Virtually all patients relapse (show the same major signs and symptoms) after the end of the first and second 6-week course of therapy, and these can be run together without a pause. In a pilot study, ~85% relapsed after 2 cycles, and after 5 and 6 cycles, 27% and 11%, respectively, still relapsed after discontinuing antibiotic therapy. In some cases Doxycycline has been used successfully with other antibiotics in situations where either antibiotic alone appeared to have minimal effect (for example, Doxycycline in combination with ciprofloxacin).
    Doxycycline is primarily bacteriostatic and effective against the following organisms: gram-negative bacteria (
N. gonorhoeae, Haemophilus influenza, Shigella species, Yersinia pestis, Brucella species, vibrio cholera); gram-positivebacteria (Strepococcus pneumoniae, Streptococcus pyogenes); mycoplasmas (Mycoplasma pneumoniae, Mycoplasma fermentans [incognitis], Mycoplasma penetrans); others (Bacillus anthracis [anthrax], Clostridium species, Chlamydia species, Actinomyces species, Entamoeba species, treponema pallidum [syphilis], Plasmodium falciparum [malaria] and Borelia species).

    Precautions:
Avoid direct sunlight and drink fluids liberally. Doxycycline therapy may result in overgrowth of fungi or yeast and nonsensitive microoganisms (see Other Considerations). Patients on anticoagulants may require lower anticoagulant doses. Last half of pregnancy, infancy, and children under 8 years are not recommended, in the latter case due to tooth discoloration, but lower does of doxycycline have proven to be very effective in children under 8 with GWI/CFIDS (if weight 100 lbs. or less, 1-2 mg/lb divided into two doses; if is weight over 100 lbs. use adult doses). Patients with impaired kidney function should not take doxycycline, and the following drugs should not be taken with doxycycline: methoxyflurane [Penthrane], carbamazepine [Tegretol], digoxin or diuretics. In case of complicating bacterial infections, a 2 week course of Augmentin (3 X 500 mg/day) should be taken between courses of doxycycline or other antibiotics. For fungal and yeast complications, please see the instructions under Other Considerations at the end of this page.
    Reactions:
In a few patients doxycycline causes gastrointestinal irritation, anorexia, vomiting nausea, diarrhea, rashes, mouth dryness, hoarseness and in rare cases hypersensitivity reactions, hemolytic anemia, skin hypersensitivity and reduced white blood cell counts. In general, doxycycline is considered a safe drug, in that there are few adverse reactions reported in the literature.

Ciprofloxacin (aka Cipro, Cifox, Cifran, Ciloxan, Ciplox)

    Ciprofloxacin is a broad spectrum synthetic fluoroquinolone antibiotic with good absorption characteristics. This drug acts on bacterial DNA gyrase to inhibit bacterial DNA synthesis. Ciprofloxacin is secreted rapidly in the urine and has a half-life in the blood of about 4 hours. Food delays the absorption of antibiotic (by ~2 hours) but not the total absorption; antacids containing magnesium, aluminum or other salts reduce absorption and should not be taken at the same time of day.
    For GWI/CFIDS/FMS use, the recommended dose is 1500 mg/day (for oral use, 3X500 mg capsules) for each 6 week cycle of therapy. Ciprofloxacin may or may not bet taken with meals. Initially, ciprofloxacin may exacerbate some symptoms but these are usually gone within a week or so, and some patients report that doses of 1000 mg/day or lower are not effective in alleviating GWI/CFIDS/FMS symptoms. Patients usually start feeling better with alleviation of most major symptoms within 1-4 weeks, but in some patients major symptoms are not alleviated until the second 6-week course. Ciprofloxacin has been used in patients in which doxycycline cannot be tolerated or in some patients that no longer respond to doxycycline. In a few cases ciprofloxacin has been used simultaneously with Doxycycline, but the usual course is one type of antibiotic alone. Herxheimer reaction, if present, usually passes within a few days to a week or more; prior damage to the gastrointestinal system may require i.v. administration of 400 mg/day (over one hour per each infusion, rapid i.v. administration is to avoided) for 2-4 weeks, then the remainder of the 6-week course should be on oral antibiotic (oral doses). Virtually all patients relapse (show the same major signs and symptoms) after the end of the first or second 6-week course of therapy. Additional cycles of antibiotic result in milder relapses after drug is discontinued. Subsequent cycles of antibiotics may require the use of doxycycline instead of ciprofloxacin.
    Ciprofloxacin is effective against the following organisms: gram-negative bacteria (
Shigella species, Nitrobacteria diversus, Citrobacter freundii, Escherichia coli, Klebisella pneumoniae, Haemophilus influenzae, Enterbacter species, Proteus vulgaris, Psuedomonas aeruginosa, Yersinia pestis, Vibrio cholera); gram-positive bacteria (Streptococcus pneumoniae, Streptococcus pyogenes, Staphlococcus hominis, Staphylococcus saprophytieus); mycoplasmas, moderately active (Mycoplasma species); others (Clostridium species, Chlamydia species, Mycobacterium tuberculosis).
    Precautions: Direct sunlight is to be avoided, and patients should not take ciprofloxacin and theophylline concurrently. Ciprofloxacin therapy may result in drug crystals in the urine in rare cases, and patients should be well hydrated to prevent concentration of urine. Pregnant women and children should not use this drug due to reduction in bone and cartilage development.
    Adverse Reactions: Adverse antibiotic responses resulted in discontinuing drug in ~3.5% of patients, and such reaction included nausea (5%), diarrhea (2%), abdominal pain (1.7%), headache (1.2%), and rash (1.1%). In rare cases cirprofloxacin may cause cardiovascular problems (<1%) and central nervous system (dizziness, insomnia, tremor, confusion, convulsions and other reactions (<1%). Small numbers of patients have experienced hypersensitivity (anaphylactic) reactions which have required immediate emergency treatment.

Azithromycin (aka Zithromax)

    Azithromycin is a azalide (macrolide) antibiotic with good absorption and a serum half-life of 68 hours. This class of drug acts by binding to 50S ribosomal subunit of susceptible organisms where it interferes with protein synthesis. Food decreases absorption rate, but absorption is unaffected by antacids containing magnesium or other salts.
    For GWI/CFIDS/FMS use, the recommended dose is 500 mg/day (for oral use, 2x250 mg capsules) for each 6-week cycle of therapy. Azithromycin should not be taken with meals (1 hour before or 1 hour after). Initially, azithromycin may exacerbate some symptoms but these are usually gone within a week or so. Patients usually start feeling better with alleviation of most major signs and symptoms within 1-2 weeks, but in some patients major symptoms are not alleviated until the second 6 week course. Azithromycin has been used in patients in which doxycycline cannot be tolerated or in some patients that no longer respond to doxycycline. Herxheimer reactions are rare and passes within a few days to a week or so. Virtually all patients relapse (show the same major signs and symptoms after the end of the first or second 6-week course of therapy. Additional cycles of antibiotic result in milder relapses after drug is discontinued. Azithromycin has been shown to be safe for pediatric use (10 mg/kg/day is recommended for children under 14).
    Azithromycin is effective against the following organisms: gram-negative bacteria (
Bordetella pertussis, Shigella species, Haemophilus influenzae, Chlamydia species, Yersinia pestis, Brucella species, Vibria cholera); gram-positive bacteria (Streptococci group C, F, G); mycoplasmas (Mycoplasma species); others (Clostridium species, Treponema pallidum [syphilis], and Borelia sp).
    Precautions: Azithromycin is principally absorbed by the liver, and caution should be exercised with patients with impaired liver function. Antacids containing magnesium, aluminum or other salts should not be take at the same time of day with azithromycin. Macrolides and terfenadine (Seldane) or astemizole (Hismaral) may dangerously elevate plasma antihistamine and cause arrhythmias and increase serum theophylline levels in some patients, particularly those receiving ethylated xanthine causing nausea, vomiting, seizures. Plasma levels of carbamazepine (Tegretol) can also be elevated, leading to carbamazepine toxicity and nausea, vomiting, drowsiness and ataxia.
    Adverse Reactions: Adverse antibiotic responses were mild to moderate in clinical trials and included diarrhea (5%), nausea (3%), abdominal pain (3%). In rare cases (<1%) azithromycin may cause cardiovascular problems (palpitations, tachycardia, chest pain) and central nervous system (dizziness, headache, vertigo), allergic (rash, photosensitivity, angioderma), fatigue and other reactions (<1%). In pediatric patients >80% of the adverse responses were gastrointestinal.

Clarithromycin (aka Biaxin)

    Clarithromycin is a broad spectrim macrolide antibiotic with good absoption and serum half-life. This class of drug acts by binding to the 50S ribosomol subunit of susceptible orgainisms and interfering with protein synthesis. The drug is mostly bacteriostatic but high concentrations can be bactericidal. Food decreases absorption rate, absorption is unaffected by antacids containing magnesium, aluminum or other salts.
    The recommended dose is 500 mg/day (for oral use, 2x250 mg capsules for each 6-week cycle of therapy. Clarithromycin should not be taken with meals (1 hour before or 1 hour after). Initially, Clarithromycin may exacerbate some symptoms due to Herxheimer reaction and bacterial death but these are usually gone within a week or so. Patients usually start feeling better with alleviation of most major signs and symptoms within 1-2 weeks, but in some patients major symptoms are not alleviated until the second 6-week course. Clarithromycin has been used in patients that do not respond to doxycycline or in patients that cannot tolerated doxycycline. Herxheimer reactions usually passes within a few days to over a week or so. Virtually all patients relapse (show the same major signs and symptoms) after the end of the first or second 6-week course of therapy. Additional cycles of antibiotic result in milder relapses after drug is discontinued.
    Clarithromycin is effective against the following orgainisms: gram-negative bacteria (
Neisseria gonorhoeae, N.menigitidis, Moraxella catarrhalis, Campylobacter jejuni, Eikenella corrodens, Haemophilus ducreyi, Bordetella pertussis, Shigella species, Salmonella species, Haemophilus influenzae, Chlamydia species, Yersinia pestis, Brucella species, Vibrio cholera, Aeromonos species, E.coli, gram-positive bacteria Streptococcus pyogenes, S. pneumoniae, anaerobic streptococci, Enterococcus facials, Staphlococcus aureus, S. epidermidis, Bacillus anthracis, Corynebacterium diptheriae, C. minutissimum, Listeria monocytogenes, Actinomyces israelii); mycoplasmas (Mycoplasma species, M. pneumoniae, Ureaplasma urealyticum); others (Clostridium species, Treponema pallidum [syphilis], Legion Ella pneumophilia, L. micdadei, Mycobacterium avium, M. chelonae, M. chelonae abessus, M. fortuitim, Rickettsia species and Borelia species). Yeasts, fungi and viruses are resistant.

    Precautions:
Clarithromycin is principally absorbed by the liver, and caution should be exercised with patients with impaired liver function. Antacids containing magnesium, aluminum or other salts should not be taken at the same time of the day as azithromycin. Macrolides and terfenadine (Seldane) or astemizole (Hismaral) may dangerously elevate plasma antihistamine and cause arrhythmias and increase serum theophylline levels in some patients, particularly those receiving methylated xanthine leading to carbamazepine toxicity and nausea, vomiting, drowsiness and ataxia. Macrolides should not be used with cyclosporin (Sandimmune).
    Adverse Reactions: Adverse antibiotic responses were mild to moderated in clinical trials and included diarrhea, nausea, and abdominal pain. In rare cases (<1%) azithromycin may cause cardiovascular problems (palppitations, tachycardia, chest pain) and central nervous system (dizziness, headache, vertigo), allergic (rash, photosensitivity, angiogerma) and fatigue.

Other [Important] Considerations

    GWI/CFIDS/FMS patients are often low in vitamins (B, C and E) and minerals. Sublingual (under the tongue) natural B-complex vitamins (Total B, Real Life Research, Norwalk, CA) can be ordered from Vitamin Park (Irvine, CA). General vitamins plus extra C and E and general mineral supplements are also useful, but not at the same time of day that antibiotics are taken because mineral can affect the absorption of the antibiotics. Selenium and magnesium are two of the minerals that are low in GWI/CFIDS/FMS patients. Some have recommend 300-500 mg/day sodium selenite for a few days, followed by lower maintenance doses. Some zinc supplementation is recommended. L-cysteine supplementation has been proposed but should not be taken at the same time as minerals.
    Antibiotics can result in yeast overgrowth, expecially in female patients. Gynecologists recommend Nizoral, Diflucan, Mycelex, or anti-yeast creams for women on antibiotics. In some cases, simultaneous use of metronidazole (Flagyl, Prostat) have been used to prevent fungal and parasite overgrowth or antifungals (Nystatin, Amphotericin B, Fluconazole) have been administered for fungal infections that can occur while on antibiotics. To replace bacteria in the gastrointestinal system yogurt,
Lactobacillus acidophillus tablets ore recommended. In some patients 'organic' food has been beneficial. Caffeine should be avoided. Earlier noted on this page are instructions for suppressing bacterial overgrowh (if necesary) in between cycles of antibioctics with a 2 week course of Augmentin (3x 500 mg/day). Augmentin can be taken concurrently with the other antibiotics, if necessary.
    A number of natural remedies, such as ginseng root, whole lemon/olive oil drink or an extract of olive leaves with antioxidants (Eden or Immunoscreen of Covina, CA), and a mixture of herbals and vitamins (Nu-Life Formula, Sophista-Care of Indian Wells, CA) have been used to boost immune systems. Although these products appear to help CFIDS/FM patients, their effectiveness in GWI/DFIDS/FM patients has not been examined. They appear to be useful after antibiotic therapy.
    Finally, GWI/CFIDS/FMS patients should not smoke and not drink alcohol, caffeinated products or eat refined sugar, and they should avoid pollutant exposure, especially those who are chemically sensitive. Flying, excessive exercise and lack of sleep can make signs/symptoms worse; some exercise (don't over do it!) and dry saunas help rid the system of contaminating chemicals.

Additional Considerations when Undergoing
Treatment for Gulf War Illness/CFS/FMS

by Prof. Garth L. Nicolson
The Institute for Molecular Medicine, P.O.Box 52470,California 92619-2470
Tel: 714-476-0204 Fax: 714-757-0419 Web Site:
www.immed.org
e-mail = gnicimm@ix.netcom.com

    There are a number of considerations that should be taken into account even undergoing therapy for Gulf War Illness/Chronic Fatigue Syndrome/Fibromyalgia [GWI/CFS/FMS]. A few are mentioned below, and some product examples are given. The Institute for Molecular Medicine is a nonprofit institution and does not endorse commercial products. The products mentioned below are only examples of the types of substances that could be beneficial to patients. Consult with your physician.

Antibiotic Therapy for Associated Chronic Infections

    Please consult Antibiotics Recommended When Indicated for Treatment of Gulf War Illness/CFS/FMS for general information. We are finding that subsets of GWI (~45%) and FMS/CFS (~50%) patients have chronic mycoplasmal infections, and probably other chronic infections as well. We usually recommend to physicians that antibiotics (doxycycline, ciprofloxacin, Biaxin, minocycline, azithromycin) be given for several 6 week cycles with 2 week cycles of Augmentin in between or concurrently, if needed. To overcome Herxheimer reactions or dir-off that cause chills, low grade fever, night sweats, muscle aches, joint pain, short term memory loss and fatigue) or adverse responses i.v antibiotics have been used, and a whole lemon/olive drink is useful (1 blended whole lemon, 1 cup fruit juice, 1 tabs olive oil-strain and drink liquid). This period usually passes within 1-2 weeks. During recovery which is often slow and take over a year with ups and downs in your condition, a number of additional nutritional and immune problems be considered.

General Nutritional Considerations

    GWI/CFS [or CFIDS]/FMS patients are often immunosuppressed and could be susceptible to a variety of opportunistc infections, so proper nutrition and exervise are important. GWI/CFS/FMS patients should not smoke or drink alcohol or caffeinated products. Drink as much fresh fluids as you can, lots of fruit juices or pure water are best. Try to avoid high sugar and fat foods, such as military (MRE) or other fast foods and acid-forming, allergen-prone stressing foods or junk foods. Increase your intake of fresh vegetables, fruits and grains, and decrease your intake of fats and eliminate simple or refined sugars that can suppress your immune system. To build up your immune system cruciferous vegetables, soluble fiber foods, such as prunes and, wheat germ. yogurt, fish and whole grains are useful. In some patients exclusive use of 'organic' foods have been beneficial.

Vitamins and Minerals

    GWI/CFS/FM patients are often depleted in vitamins (especially B,C and E) and certain minerals. Unfortunately, illnesses like GWI result in poor absorption. Therefore, high doses of some vitamins must be used, and others, such as vitamin B complex, cannot be easily absorbed by the gut (oral capsules). Sublingual (under the tongue) natural B-complex vitamins in small capsules or liquids (such as Total B, Real Life Research, Norwalk, CA, 310-926-5522) should be used instead of oral capsules that are swallowed. General vitamins plus extra C,E, CoQ-10, beta-carotene, folic acid, bioflavoids and biotin are best. L-cysteine, L-tyrosine, L-carnitine and malic acid are reported by some to be useful. Certain minerals are also often depleted in GWI/CFS/FMS patients, such as zinc, magnesium, chromium and selenium. Some recommend doses as 300 mg/day sodium selenite for a few days, followed by lower maintenance doses. Minerals should not be taken at the same time of day that antibiotics are taken because the minerals can affect the absorption of certain antibiotics.

Replacement of Natural Gut Flora

    GWI/CFS/FMS patients are often undergoing treatment with antibiotics and other substances that can destroy the normal gut flora. Antibiotic use that depletes normal gut bacteria and can result in over-growth of less desirable bacteria. To supplement in the gastrointestinal system yogurt and especially Lactobacillus acidophillus tablets are recommended. One product is a mixture of Lactobacillus acidophillus, Lactobacillus bifidus and FOS (fructoologosaccharides) to promote growth of these "friendly" bacteria in the gut (example, DDS-Pusor Multi-Flora ABF,UAS Labs of Minnetonka, MN, 800-422-3371). L. acidophillus should be taken daily to restore gut flora. A human bowel culture, Replete (Interplex) has proven useful to restore natural gut flora.

Natural Immunoenhancers or Immunomodulators

    A number of natural remedies, such as ginseng root, teas, whole lemon/olive extract drink or an extract of olive leaves with antioxidants are available and are potentially useful, especially during or after antibiotic therapy has been completed. Some examples are botanical mixtures, such as Eden, Echinacea-C (NF Formulas, 800-547-4891), Super-Immunotone (Phyto Pharmica, 800-553-2370), olive leaf extract (Immunoscreen of Covina, CA, 818-966-1610), NSC-100 (Nutritional Supply, Carson City, NV, 888-246-7224), a mixture of herbals and vitamins (Nu-Life Formula, Sophista-Care, Indian Wells, CA, 619-345-5919) or Super Defense Plus (BioDefense Nutritional, Grand Terrace, CA, 800-669-9205). These have been used to boost immune systems. Although these products appear to help some CFS/FMS patients, their clinical effectiveness in GWI/CFS/FMS patients has not been evaluated. They appear to be useful during therapy to boost the immune system or after antibiotic therapy in a maintenance program to prevent relapse of illness.

Yeast/Fungal or Bacterial Overgrowth

    Yeast overgrowth can occur, especially in female patients (vaginal infections). Gynecologists recommend Nizoral, Diflucan, Mycelex, or anti-yeast creams for women on antibiotics. In some cases, use of metronidazole (Flagyl, Prostat) have been used to prevent fungal or parasite overgrowth or other antifungals (Nystatin, Amphotericin B, Fluconazole, Diflucan) have been administered for fungal infections that can occur while on antibiotics. As described above, L. acidophillus should be taken daily to restore gut flora. Bacterial overgrowth can also occur, for example, in between cycles of antibiotics or after antibiotics have been stopped. This can be controlled with 2 week courses of Augmentin (3 X 500 mg/day) in between cycles or concurrent with other antibiotics.

Flying and Exercise

    Flying, especially in unpressurized aircraft, excessive exercise and lack of sleep can make GWI/CFS/FMS signs/symptoms worse. Some exercise (Please don't over do it! A common problem when recovering from this illness is over-exertion followed by relapse!) is useful and even necessary for recovery. The main problem here is to adjust your exercise level to help the recovery process without causing a relapse. Dry saunas help rid the system of contaminating chemicals, and saunas should be taken at least 3-5X per week--moderate exercise, followed by 15-20 min of dry sauna and tepid shower. The sauna can be repeated, by not more than two per day. The idea is to raise body temperature enough to work up a good sweat, eliminating chemicals without placing too much stress on your system. During exercise GWI/CFS/FMS patients should always try to avoid pollutant and allergen exposures. For recovery after exercise and to decrease muscle soreness, some use a Jacuzzi or hot tub, but only after a sufficient cool-down period. Don't get overheated in the process.

    For further information consult our web site : www.immed.org

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