From Fatigued to Fantastic!

by Jacob Teitelbaum

  There are two natural remedies that can keep the E. coli from sticking to the bladder wall—cranberries and D-mannose. In addition, taking high doses of vitamin C (500 to 5,000 milligrams a day) can acidify the urine, making it inhospitable to the bacteria. Drinking a lot of water also helps wash out the infection.

  CRANBERRIES

  Because approximately 20 percent of the female population suffers from UTIs, several studies have been done to find a remedy.12 They showed significant benefits to drinking six to sixteen ounces of cranberry juice a day. Because most cranberry juice products have a lot of sugar, which can promote yeast overgrowth and aggravate other symptoms in CFIDS/FMS, I think it is much better to use pure cranberry juice powder in capsule or tablet form. Choose a cranberry product that is standardized to contain 11 to 12 percent quinic acid. The therapeutic dose is one to two capsules a day. You can also use unsweetened cranberry juice and add stevia as a natural sweetener if needed.

  D-MANNOSE

  D-mannose is even more effective for bladder infections than cranberry juice and is what I most strongly recommend. Mannose is a natural sugar (not the kind that causes symptoms or yeast overgrowth) that is excreted promptly into the urine. Unfortunately for the E. coli bacteria, the “fingers” that stick to the bladder wall stick to the D-mannose even better. When you ingest a large amount of D-mannose, it spills into the urine, coating all the E. coli so that the E. coli are literally washed away with the next urination.13–15

  The nice thing about the natural approach, as opposed to antibiotics, is that cranberries and D-mannose do not kill healthy bacteria, and therefore do not disturb the normal balance of bacteria in the bowel. In addition, D-mannose is absorbed in the upper gut before it gets to the friendly E. coli that are normally present in the colon. Because of this, it helps clear the bladder without causing any other problems.

  D-mannose is quite safe, even for long-term use, although most people need it for only a few days. People who have frequent recurrent bladder infections may, however, choose to take it every day to suppress the infections. The usual dose of D-mannose is 1/2 to 1 teaspoon every two to three waking hours to treat an acute bladder infection or 1/2 to 1 teaspoon a day to prevent chronic bladder infections. It is best taken dissolved in water. If you get bladder infections associated with sexual intercourse, you can take a teaspoon of D-mannose one hour before and/or just after intercourse to prevent an infection. If you cannot find the D-mannose at your local health food store, it is available at www.vitality101.com.

  You should feel much better within twenty-four to forty-eight hours on D-mannose. If you don’t, see a doctor for a urine culture (you may want to get the culture at the first sign of infection) and consider antibiotic treatment after two days if the culture is positive. Some evidence exists that the antibiotic nitrofurantoin (also sold under the brand name Macrobid) causes less yeast overgrowth than do other antibiotics.16 Even with other antibiotics, most bladder infections are knocked out by one to three days of antibiotic use, instead of the old seven-day regimen.

  Prostatitis

  Although women tend to be the ones plagued with bladder infections, men also have problems to deal with. It is very common for men with CFIDS/FMS to have prostatitis, an inflammation or infection of the prostate that is usually seen in men between the ages of twenty and fifty. There are three main types of prostatitis:

  1. Bacterial prostatitis. This is an acute or chronic infection in the gland that causes prostate swelling and discomfort, and in which an infection can be found by doing a culture. Although normal bacteria are the most common causes, some bacteria transmitted through sexual contact can also cause prostatitis.

  2. Nonbacterial prostatitis. This is a condition that causes you to feel swelling of the prostate with no detectable infection. My suspicion is that it is not uncommon for nonbacterial prostatitis to be associated with yeast overgrowth or other infections that cannot be cultured.

  3. Prostadynia. This is a general irritation of the prostate that causes a burning sensation with urination, urinary urgency, and frequency, without any infection or swelling of the prostate. This can come from a number of causes including, I suspect, chronic spasm or tightening of the muscles of the pelvic floor. Although there are several causes of prostatitis, contributing factors include excessive consumption of caffeine, alcohol, and spicy foods. Sitting for long periods while traveling (for example, as a truck driver) can also cause irritation of the prostate.

  The symptoms of chronic prostatitis can come and go and be mild or severe. They include:

  Pain or tenderness in the area of the prostate. It is also common to have burning on the tip of the penis.

  Discomfort in the groin and, occasionally, lower back pain.

  Urinary urgency and frequency with pain on urination.

  Pain with ejaculation.

  In some cases, a slight discharge from the penis. If the discharge is cloudy, it is most likely bacterial prostatitis and you’ll need to go to your doctor for antibiotics. Your doctor will probably also check to make sure that the discharge is not indicative of a sexually transmitted disease before beginning treatment.

  Severe symptoms accompanied by fever, chills, and extreme fatigue point to acute bacterial prostatitis, requiring treatment with antibiotics. The main medications used for bacterial prostatitis are tetracycline antibiotics (for example, doxycycline), ciprofloxacin (Cipro), or sulfa drugs (such as Bactrim or Septra DS). Unfortunately, since it is hard for antibiotics to be absorbed into the prostate, symptoms often recur, even after six weeks of treatment. I recommend that people with CFS/FMS ask their doctor to prescribe either doxycycline or Cipro because these may be effective against other hidden infections that contribute to their underlying disorders. In many cases of prostadynia, the cause is an underlying fungal infection. Diflucan can help, though it may require six to eighteen months of treatment. If symptoms persist, however, it is reasonable to consider a therapeutic trial of the antibiotics noted above.

  To help relieve prostatitis and prostadynia symptoms while taking antibiotics, you may wish to take 500 milligrams a day of the bioflavonoid quercitin.17

  Bowel Parasite Infections

  Parasites should not be thought of as just a problem encountered when traveling. In some places throughout the United States, the water supply is contaminated with parasites—something we may never consider a problem here in our country. You may remember the news reports a number of years ago, when an infection by a bowel parasite called cryptosporidium killed scores of Milwaukeeans. Doctors in the United States also frequently see cases of infection by giardia, amoebae, and numerous other bowel parasites.18 The symptoms of parasitic infections can mimic those of CFS, and, in immune-suppressing situations like CFIDS, all parasites should be treated.19–21 Indeed, people with suppressed immune function are especially unable to combat parasitic attack.

  DIAGNOSING BOWEL PARASITES

  Most laboratories miss parasites when they do stool testing. I initially tested for bowel parasites by sending my patients’ stool samples to a respected local lab. The tests kept coming back negative, so I eventually stopped testing. Finally, I started doing my own laboratory stool testing. Doing the testing properly was time-consuming, taking up to five hours per specimen. However, when the tests were processed properly, they frequently turned out positive. In my experience—and in that of other physicians as well—when you treat a patient for parasites, the person’s fatigue, bowel symptoms, and achiness often improve dramatically.20, 21

  If you would like your stool tested, make sure that the laboratory doing the test specializes in this area. The routine random tests performed in most standard laboratories are generally not adequate or reliable. In speaking with several lab technicians, I was told that they had less than one hour of training in looking for parasites—which they found to be useless. In fact, a gastroenterologist friend once noted that during a bowel exam he had performed, he saw a large number of parasites swimming in the patient�
�s bowel. Yet when he sent a sample for confirmation and identification, it came back negative. This is why I stress that stool testing must be done at a lab that specializes in parasitology. I no longer have to do the testing in my office because I can mail specimens to two excellent labs: Parasitology Center and Genova Labs, previously called the Great Smokies Diagnostic Laboratory (see Appendix E: Resources).

  TREATING BOWEL PARASITES

  Common parasites include giardia, blastocystis, and amebic infections. The appropriate treatment for bowel parasites depends on which organism is causing the problem. For an updated list of treatments for some of the more common infections, see the “Treatment Protocol” link at www.vitality101.com. When a parasitic infection is suspected, but no parasites have been identified, it is reasonable to ask your doctor to consider treating you empirically with albendazole (Albenza).

  NATURAL IMMUNE BOOSTERS AND ANTIVIRALS

  There are several natural products that both stimulate immune function and have anti-infectious properties. I discussed Pro Boost (see Chapter 5) and silver (Chapter 5) earlier in this chapter. Some other excellent ones (from Ultracenticals) include:

  1. Leuko-Stim. This mix mostly stimulates immune function, but the olive leaf may also have antiviral properties. It contains olive leaf extract, Beta 1, 3, glucan, maitake mushroom extract, and arabinogalactan (larch).

  2. Maitake D-Fraction. This contains 330 milligrams of maitake mushroom and extract (an immune stimulant).

  3. Antiviral. This contains a mix of milk thistle extract (80 percent silymarin), phylanthus amarius, phylanthus uraria, monoammonium glycyrrhizinate, L-lysine, N-Acetyl-L-Cysteine, astragalus herb powder, lactoferin, olive leaf extract, dionea (Venus flytrap extract), and selenium (Selenomethionine).

  If a chronic viral or bacterial infection is suspected, consider treating it with a three-month antiviral regimen, using Leuko-Stim or Maitake D-Fraction, plus Pro Boost. Adding the silver solution may also help. These natural supplements can be taken on their own or with antibiotics and antivirals. Though these are more expensive than many other natural supplements, they can be very helpful in fighting these infections and are well tolerated. You’ll see effects from treatment in about three months.

  * * *

  Natural Antiviral Treatments Available by Prescription

  Two treatments deserve special mention. The first is a natural antiviral derived from animal livers. Called Nexavir (formerly sold as Kutapressin), it is given by daily injection, either subcutaneously or intramuscularly. In my practice, I have seen dramatic improvement with regular use of the Nexavir. However, daily injections are a must, and the few patients who used it only three times a week did not get much, if any, benefit. The downside is that it costs about twenty dollars a day, and the symptoms may return when the injections are discontinued.

  The second natural antiviral prescription treatment is gamma globulin. These are the actual antibody infection fighters derived from the serum of numerous blood donors. The serum is first treated to kill off any infections the donors may have had and then the antibodies are harvested. Although these antibodies can be helpful against both bacterial and viral infections, in patients with the latter we have seen a die-off reaction (initial flaring of symptoms) with the first few injections of gamma globulin. I am now advising patients to start with the Nexavir first and add the gamma globulin one to three weeks later. I recommend that 2 cc be given intramuscularly one to two times a week for six weeks, and then as needed. Although it can also be given through an IV, this delivery method is expensive and does not seem to bring any additional benefit.

  Both Nexavir and gamma globulin are expensive treatments, and few people find them necessary. However, if you are unable to resolve your chronic infections using any of the other methods described in this chapter, you may wish to discuss these treatments with your CFS/FMS specialist.

  * * *

  THE IMPORTANCE OF FILTERING WATER

  As demonstrated in the Milwaukee example, drinking water can be a major source of parasitic infection. As the American water supply becomes more contaminated, parasitic bowel infections will likely become more common. These infections, as well as the overgrowth of yeast or toxic bacteria caused by the use of antibiotics, contribute to the problems of people with CFS/FMS.

  Water filters can be helpful in the fight against parasitic infection, and can help to improve health in general. However, not all units are designed to filter out parasites. For a water filter to remove parasites, it must be rated by the National Sanitation Foundation (NSF) for cyst removal. A good example is the Multi-Pure water filter (see Appendix E: Resources). Most filters on the market do not remove parasites and a wide range of contaminants. Solid carbon block filters and reverse-osmosis filters are the best types of units.

  When shopping around for a water filter, request the NSF International Listing. The NSF is an independent, not-for-profit organization that tests and certifies drinking-water-treatment products. The unit you buy should meet both NSF Health Effects Standard 53 for cysts (giardia, cryptosporidium, entamoeba, toxoplasma), as well as their standards for the following contaminants: VOCs (pesticides, herbicides, and chemicals), endocrine disrupters (PCBs), trihalomethanes (cancer-causing disinfection by-products), heavy metals (lead, mercury), MBTE (a gasoline additive), chloramines, and asbestos. Solid carbon block filters can reduce chlorine, taste and odor problems, particulate matter, and a wide range of contaminants without removing healthful, naturally occurring minerals. They also require no electricity and add no salt to the water. Any unit that does not meet all of these standards, particularly the health standard, is inadequate.

  In addition to verifying that a water filter meets the NSF standards, ask to see its Product Performance Data Sheet. Many states require that this sheet be given to all prospective customers of drinking-water-treatment devices. Also ask about the range of contaminants that the unit can reduce under NSF Health Effects Standard 53. Most units certified under Standard 53 list only turbidity and cyst reduction. The number of units that also reduce all of the contaminants listed above is very small. Make sure that the water filter you are considering can remove the specific contaminants that concern you without removing beneficial minerals. Beware of sales agents who tell you that NSF certification is not important.

  Be sure to ask if the unit is licensed in such states as California, Colorado, and Wisconsin, which have some of the toughest certification procedures in the United States. Finally, ask about the unit’s service cycle, which is stated in gallons of water treated. Find out how often you will need to change the filter and what the replacement filters cost. Proper investigation into these details will ensure that you find the water filter that is best for your needs. I recommend getting one from Pure Water (see Appendix E: Resources).

  Antibiotic-Sensitive Infections

  People with CFS/FMS are at high risk for multiple viral and antibiotic-sensitive infections because of their immune system dysfunction. That people usually have not just one but several infections simultaneously is significant. It suggests that although these infections may be a trigger for the illness in some cases, most of the infections occur because of the illness, setting you up for multiple and sometimes unusual infections that persist. These infections may then drag you down, further suppressing your immune system.

  Fortunately, most people improve (and often get very healthy) by simply treating sleep, hormonal, nutritional, and yeast problems. Once these areas are treated, your body can often eliminate many persistent infections by itself. Some people, though, have infections that need treatment with antivirals and/or antibiotics.

  How can you tell if you need such treatments? First, I would try the other approaches discussed in this book. I would consider drug treatments if the following symptoms persist:

  Predominantly flu-like symptoms, with debilitating fatigue and little or no pain or fever. People with these symptoms are more likely to have an underlying persistent viral infection, such as
HHV–6, CMV, or EBV.

  A fever over 98.6°F—even 99°F—and/or lung congestion, sinusitis, a history of bad reactions to several different antibiotics (people misinterpret this die-off reaction as an allergic reaction), scabbing scalp sores, or other chronic bacterial infections. People with these symptoms seem to be more likely to have bacterial, mycoplasma, or chlamydia infections that respond to special antibiotics.

  Let’s look at these two situations and how to approach them.

  Viral Infections

  Human herpesvirus 6 (HHV–6) is a virus that is related to the Epstein-Barr virus (EBV), cytomegalovirus (CMV), and the herpes viruses that cause cold sores and genital herpes. All of these are in the human herpesvirus family and stay in the body (usually in an inactive latent form for EBV, CMV, and HHV–6) for the rest of your life. Usually HHV–6 is transmitted like the common cold, and more than 90 percent of adults have had HHV–6, as well as EBV and the cold sore virus, by the time they are twenty years old.

  THE PROBLEM WITH LAB TESTING FOR INFECTIONS IN CFS

  Unfortunately, there is no test that clearly distinguishes old dormant infections from viral reactivation. When you first have an infection, antibodies in the IgM family (M antibodies are like your body’s storm troopers) are elevated for six to twelve weeks, telling doctors that you have an active new infection. After that time, the IgM test will be negative. The IgG antibody levels then stay elevated (G antibodies are like regular troops, suppressing the latent infection) for the rest of our lives. Because of this, when you check the standard IgG antibody testing almost everybody (including healthy people) tests positive for EBV and HHV–6 and many will test positive for CMV. That the IgG test is elevated, however, does not tell you if you have an active infection because of viral reactivation or simply an inactive, dormant infection. Other tests available to your doctor, such as PCR testing, are also still unreliable for a number of reasons, and the IgM test will not be positive in the vast majority of those with reactivated viral infections.