by Dr. Bill Rawls
Updated 12/9/20
Mycoplasma is the stealthiest of all stealth microbes. It may be a major player in many chronic diseases associated with aging, but remarkably, most people — including most doctors — have limited awareness of it.
If you have Lyme disease, fibromyalgia, chronic fatigue syndrome, autoimmune disease, or possibly any other chronic illness, however, mycoplasma is a microbe you should know about.
Mycoplasma: The Master Manipulator
Mycoplasma is a parasite, meaning it can’t live without a host. And it’s the smallest of all bacteria: 4,000 of them can fit inside a single red blood cell in your body. By comparison, only 10-15 average-sized bacteria would fit in the same cell.
Unlike other bacteria, mycoplasmas don’t have a protective cell wall, creating an interesting survival strategy: They can shape-shift and fit into areas where other bacteria can’t go. For example, it also allows them to slip inside cells of the host. The lack of a cell wall makes mycoplasma resistant to some commonly prescribed classes of antibiotics like penicillins, which normally work by interrupting a bacteria’s cell wall so that when the bacteria divides, it falls apart.
More than 200 known types of mycoplasma (and probably many yet to be discovered) can infect animals and plants. There are at least 23 different varieties of mycoplasma that can infect humans. A few of them are considered harmless normal flora, but most have the potential to cause disease.
Mycoplasma is spread by biting insects (ticks, mosquitoes, fleas, biting flies), sexual contact, contaminated food, and airborne droplets. Most everyone has been exposed to some form of mycoplasma. Several mycoplasma species have been closely associated with many chronic degenerative diseases like multiple sclerosis and Alzheimer’s disease, according to publications like the International Reviews of Immunology and the British Journal of Medical Practitioners, respectively.
Even beyond its tiny size, shape-shifting qualities, and proliferous nature, mycoplasma is a master at manipulating and outmaneuvering the host’s immune system. Half of its genetic makeup is devoted to that exclusive purpose.
While it has little ability to cause direct harm, it can use the host’s immune function to its advantage: Mycoplasma generates chronic low-grade inflammation and steals vital nutrients from the body.
In fact, everything that this stealthy microbe needs for survival — vitamins, minerals, fats, carbohydrates, and amino acids — must be scavenged from the host; it makes nothing itself. Mitochondria, which are the energy powerhouses of cells, are prime targets to sustain the microorganism, which helps explain why fatigue is always a factor in mycoplasma infections.
Mycoplasma favors infecting the cells of tissues that line different areas of the body. Common sites of infection include:
- Nasal passages
- Sinuses
- Lungs
- Lining of the intestinal tract
- Genital tract
- Vesicles inside the brain
- Synovial lining of joints
They also commonly infect white blood cells, red blood cells, and brain tissue. Different mycoplasma has a preference for certain tissues, but all mycoplasma species possess the ability to infect any type of tissue and all organ systems.
The most common mycoplasma, Mycoplasma pneumoniae, has a preference for lung tissue. Initial infection with M. pneumoniae typically causes pharyngitis (sore throat), cough, fever, headache, malaise, runny nose — all the common symptoms of a basic upper respiratory infection.
If the person’s immune system is not full strength, the infection can progress to bronchitis and even pneumonia (about 20% of pneumonias). The type of pneumonia caused by mycoplasma, often called “walking pneumonia,” is rarely severe enough to result in hospitalization, though it can drag on for weeks or even months.
But even when those respiratory symptoms are cleared, it may not be the end of the story. That’s because after mycoplasma enters the body, it also infects white blood cells. And once inside a white blood cell, it can be carried to all parts of the body, infecting tissues and organs.
The potential for widespread infection is very much influenced by the status of the host’s immune function. If immune function is optimal, the microbe is contained after the initial infection, and no long-term harm occurs. Approximately 30-70% of people carry at least one species of mycoplasma without having symptoms. It essentially becomes like normal flora of the microbiome, which are the non-threatening microbes found on the skin, in the gut, and body cavities.
But most mycoplasma species aren’t normal flora, and they are just waiting for an opportunity to gain a foothold. If immune function slips for whatever reason, chronic, systemic infection becomes possible. Mycoplasma begins stealing vital nutrients and causing a wide range of symptoms that are unrelated to the initial infection. The general breakdown of tissues by stealth microbes like mycoplasma accelerates the aging process and is likely a primary factor in many, if not most, chronic degenerative diseases.
Stealth Characteristics of Mycoplasma
Stealth microbes are a stronger force together than when alone. In other words, mycoplasma may not be a problem unless another stealth microbe (or microbes) is present. Lyme disease may be a good example of this phenomenon.
Mycoplasma is a common Lyme coinfection: It’s present in 75% or more of Lyme disease cases. Mycoplasma is known to be carried and spread by ticks, but it is also possible that mycoplasma is already present in the body when a bite from a tickcarrying borrelia — the primary bacteria associated with Lyme — occurs.
Immune dysfunction caused by the new tick-borne infection or possible other coinfection allows mycoplasma to proliferate and cause multi-systemic symptoms throughout the body. Many symptoms that occur in Lyme disease can be caused by mycoplasma, too.
Body Systems Affected by Chronic Mycoplasma
Mycoplasma infection may be localized to certain areas of the body (such as the lungs), or it can be more widespread and systemic. Parts of the body where symptoms can manifest include:
- Joints: Mycoplasma commonly infects the synovial lining of joints, the lining protecting the joints. Ninety percent of people with rheumatoid arthritis test positive for mycoplasma in the synovial fluid.
- Muscles: Muscle pain from breakdown of muscle fibers is common with systemic mycoplasma infection.
- Heart: Mycoplasma can lead to inflammation of the heart, such as endocarditis, myocarditis, pericarditis.
- Nerves: Mycoplasma scavenges fats from the myelin sheath covering nerve tissue. Not surprisingly, mycoplasma (and other microbes, including chlamydiaand borrelia) has been linked to multiple sclerosis and other neurodegenerative diseases, including ALS (Mycoplasma fermentans is most common) and Parkinson’s disease.
Nerve involvement can be associated with neuropathic pain like burning and tingling in the hands and feet. Brain inflammation, contributing to insomnia, brain fog, depression, and anxiety, is common with systemic mycoplasma infection.
- Immune system: Mycoplasma is a top candidate for explaining autoimmunity; it stimulates host self-damage, and it can live inside cells while simultaneously turning off the ability of the immune system to recognize the cell as abnormal.
- Lungs: Mycoplasma in the lungs contributes to respiratory symptoms like sore throat, cough, fever, headache, malaise, runny nose, bronchitis, and pneumonia.
- Digestive tract: Intestinal mycoplasma infection destroys villi — fingerlike projections in the small intestine that aid food absorption — and compromises the intestinal barrier. This allows accelerated damage by lectins in grains (especially wheat), beans, soy, nightshade vegetables, and dairy.
Mycoplasma may contribute to leaky gut, or increased intestinal permeability. Severe mycoplasma intestinal infection can lead to nutritional deficiencies and weight loss. Infection of the gastric mucosa (stomach lining) can cause chronic gastritis with nausea and stomach discomfort.
- Ears: Mycoplasma infection has been associated with hearing loss and ringing in the ears.
- Eyes: The eyes may be impacted by mycoplasma with such issues as conjunctivitis, eye swelling, and vision loss.
- Reproductive system: Research suggests mycoplasma has been found in ovarian cancer tissue. It may also contribute to interstitial cystitis, a bladder condition marked by severe pain and urinary frequency.
- Blood: Mycoplasma has been found in the bone marrow of children with leukemia.
Diagnosing Mycoplasma and the Limitations of Testing
When it comes to testing, PCR (polymerase chain reaction) is the most accurate method for testing mycoplasma. It’s cost-effective and evaluates for the presence of mycoplasma’s genetic material, a test that’s easy, sensitive, and quick test to obtain at most laboratories.
However, PCR testing has limits because it only tests for a handful of mycoplasma species and primarily focuses on diagnosing acute respiratory or genital mycoplasma infections — not chronic, low-grade infections.
Another problem with diagnosing mycoplasma is that conventional science does not recognize chronic mycoplasma infections as being significant. Even though mycoplasma is commonly found in association with chronic degenerative diseases, it’s also found in one-third to two-thirds of any population without causing symptoms. In other words, it is assumed that mycoplasma just happens to be there but isn’t really a contributing factor in disease.
This type of thinking is simply a reflection of not understanding how stealth microbes operate. Mycoplasma does not cause disease unless it has an opportunity to do so. Individuals with a healthy immune system can harbor mycoplasma and suffer few ill effects. If immune function is disrupted by environmental factors or a coinfection with other stealth microbes, however, mycoplasma can definitely contribute to chronic disease.
When testing for mycoplasma, it is best to order a complete PCR mycoplasma panel, which will include:
- M. fermentans
- M. genitalium
- M. hominis
- M. penetrans
- M. pneumoniae
- M. synoviae
- Ureaplasma urealyticum
But these are only the commonly-known species of mycoplasma; other lesser-known species could also be present.
Another problem with testing is that other stealth microbes can be associated with chronic infections with similar symptoms of mycoplasma infection, adding confusion to the clinical picture of what’s making a person ill. The list of knowns includes:
- Yersinia enterocolitica
- Chlamydophila pneumoniae
- Chlamydia trachomatis
- Campylobacter jejuni
- Babesia
- Bartonella
- Ehrlichia
- Anaplasma
Laboratories that test for mycoplasma include Medical Diagnostic Laboratories (MDL)and Armin Labs. Your healthcare provider may have additional recommendations for you.
But complete testing for the full range of all stealth microbes can cost hundreds or even thousands of dollars. Possibly the best course of action is assuming mycoplasma and other stealth microbes are there.
Stealth microbes only cause problems when immune function is suppressed. Addressing the causes of the underlying chronic immune dysfunction that allowed mycoplasma to flourish in the first place is the most effective solution for overcoming chronic infections.
Conventional Medical Solutions
The nature of mycoplasma makes it very resistant to conventional therapies. Many antibiotics target cell walls; since mycoplasma doesn’t have one, several classes of antibiotics are ineffective against the microbe. Some other antibiotics (doxycycline, erythromycin, clarithromycin, or azithromycin), block internal functions of bacteria and have some activity against mycoplasma, but activity is limited by the fact that mycoplasma bacteria only live inside cells where antibiotics have minimal penetration.
When it comes to chronic mycoplasma infections, the best approach is supporting the body’s natural healing potential.
Natural Solutions for Mycoplasma
Natural herbal therapy is the best therapeutic alternative for chronic mycoplasma. Herbs (especially medicinal mushrooms) work by:
- Suppressing cytokine cascades
- Reducing inflammation
- Restoring normal immune function
- Suppressing a wide range of covert pathogens
Consider the following herbs to get you started:
Cordyceps (Cordyceps sinensis)
Native to Tibet, cordyceps is a medicinal mushroom that reduces cytokines and normalizes immune system functions. It is highly protective of cells, which reduces invasion by microbes.
Suggested dosage: 1-3 grams (1,000-3,000 mg) of whole mushroom cordyceps powder or 400-800 mg extract (standardized to >7% cordyceptic acid is preferred) two to three times daily.
Side effects: Mild nausea can occur, but in general, side effects are rare, even with higher doses. Allergic reactions are rare.
Chinese Skullcap (Scutellaria baicalensis)
When combined with other herbs, Chinese skullcap has potent synergist properties. Additionally, it has strong antimicrobial and immunomodulating properties that are beneficial for suppressing mycoplasma and protecting tissues and organs infected with the microbe.
Suggested dosage: 400-1,000 mg two to three times daily. Root extract standardized to >30% baicalin is preferred. Note: American skullcap does not offer the same antimicrobial properties and should not be substituted.
Side effects: Gastrointestinal upset can occur, but side effects tend to be rare, even at high doses.
Bidens (Bidens pilosa)
The herb offers potent antimicrobial and anti-inflammatory properties against mycoplasma, affecting mucous membranes of the body.
Suggested dosage: Bidens is most potent when prepared as an alcohol tincture. The dose may vary depending on the company, but tinctures are an excellent way to begin at a low dose and increase drops as tolerated.
Side effects: Some plants can be contaminated with heavy metals, so make sure you purchase the product from a reputable company that takes steps to minimize exposure. You should not take this plant if you are diabetic, as it can cause fluctuations in blood glucose or insulin levels.
Houttuynia (Houttuynia cordata)
Native to India and Nepal, houttuynia is a potent antiviral with activity also against mycoplasma.
Suggested dosage: The dose may vary depending on a company’s preparations.
Side effects: The herb can have a fishy smell but is otherwise well tolerated.
Anamu (Petiveria alliacea)
Found in tropical, Amazonian regions of Central and South America, anamu offers excellent antimicrobial coverage for mycoplasma.
Suggested dosage: The daily dose of powdered herb is 1,000-2,000 mg twice daily.
Side effects: Note that anamu will give urine and feces a strong garlic-like odor. Generally, the herb is safe and well-tolerated, but it should be avoided in pregnancy.
Mullaca (Physalis angulata)
Mullaca is another Amazonian herb with antimicrobial qualities to fight mycoplasma, and it works well as a complement to anamu. It can be found online as a loose powder (add it to smoothies or make your own capsules) or a tincture.
Suggested dosage: The daily dose for powdered herb is 1,000-2,000 mg twice daily.
Side effects: The herb is generally regarded as safe, however, it should be avoided during pregnancy or breastfeeding.
The Bottom Line
In addition to herbal therapy, the optimal path to recovery from chronic mycoplasma involves eliminating artificially-processed foods in favor of whole, nutrient-dense meals, reducing exposure to toxins, and managing chronic stress — all of which disrupt immune function and pave the way for stealth microbes to flourish. By minimizing these factors and implementing a comprehensive herbal therapy protocol, you can begin to curb chronic mycoplasma infections and support your body in the healing process.
Dr. Rawls is a physician who overcame Lyme disease through natural herbal therapy. You can learn more about Lyme disease in Dr. Rawls’ new best selling book, Unlocking Lyme.
You can also learn about Dr. Rawls’ personal journey in overcoming Lyme disease and fibromyalgia in his popular blog post, My Chronic Lyme Journey.
REFERENCES1. K Waites and D Talkington, Mycoplasma pneumoniae and its Role as a Human Pathogen, Oct 2004, Clinical Microbiology Reviews
2. Hakkarainen, Turrunen, Miettinen, Kaitik, and Jannson, Mycoplasmas and Arthritis, Ann Rheu Dis, 1992, Oct 5 (11): p. 1170-1172
3. Baseman, Joel, et.al., Mycoplasmas: Sophisticated, Reemerging, and Burdened by Their Notoriety, CDC, Journal of Infectious Diseases, Vol 3, No.1, Feb 1997
4. Leslie Taylor, ND, Mycoplasmas – Stealth Pathogens (Review article), Jan 2001
5. Razin, Yogev, Naot, Molecular Biology and Pathogenicity of Mycoplasmas, Microbiol Mol Biol Rev, 1998, Dec; 62(4): p. 1094-1156
6. J Rivera-Tapia, N Rodriguez-Preval, Possible role of mycoplasmas in pathogenesis of gastrointestinal diseases, Rev Biomed 2006 17: 132-139
7. Berghoff, W, Chronic Lyme Disease and Co-infections: Differential Diagnosis, Open Neurol J., 2012, 6, p. 158-178
8. Gilroy, Keat, Taylor-Robinson, The Prevalence of Mycoplasma fermentans in patients with arthritides, Rheumatology, Vol 40 (12), p. 1355-1358
9. Zhang et al, Mycoplasma fermentans infection promotes immortalization of human peripheral blood mononuclear cells in culture, Blood 104 (13), p. 4252-4259
10. Walter Berghoff, Chronic Lyme Disease and Co-infections: Differential Diagnosis, Open Neurol J, 2012, 6: p. 158-178
11. Buhner S H, Healing Lyme Disease Coinfections, Healing Arts Press, Copyright 2013
http://www.cdc.gov/pneumonia/atypical/mycoplasma/index.html12. Libbey JE, Cusick MF, Fujinami RS. Role of pathogens in multiple sclerosis.
Int Rev Immunol. 2014;33(4):266-283. doi:
10.3109/08830185.2013.82342213. BJMP 2009:2(4) 20-28
14. Huang S, Li JY, Wu J, Meng L, Shou CC. Mycoplasma infections and different human carcinomas.
World J Gastroenterol. 2001;7(2):266-269. doi:
10.3748/wjg.v7.i2.266
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Madison Area Lyme Support Group 
Rapid Response:
Re: Tick bite
Dear Editor
Razai et al, in their consultation on tick bite, missed an important message to learners (1).
The most common infectious agents transmitted by Ixodes species ticks in North America that have the potential for co-infection with B burgdorferi are Anaplasma phagocytophilum, Babesia species, deer tick (Powassan) virus, Borrelia miyamotoi, and the Ehrlichia muris–like agent (2).
A phagocytophilum is transmitted by the same Ixodes ticks as B burgdorferi in the United States and causes fever, chills, headache, myalgia, and fatigue arising 1 to 3 weeks following tick exposure. Most cases are mild and self-limited. However, severe manifestations may include respiratory failure, adult respiratory distress syndrome, peripheral neuropathy, rhabdomyolysis, acute renal failure, pancreatitis, and coagulopathies.
It has been found that in Wisconsin, approximately 3% of I scapularis ticks examined were co-infected with B burgdorferi and A phagocytophilum (3). A similar study in 11,000 ticks in public parks of New York State’s Hudson Valley Region found that co-infection rates of nymphs and adults were 0.5% and 6.3%, respectively (4).
The frequency of humans with Lyme disease simultaneously co-infected with A phagocytophilum from various studies ranges from 2% to 10% (5,6). Similirly, Babesiosis is transmitted through the bite of infected I scapularis and I pacificus ticks. Most patients are asymptomatic or have mild, self-limited disease but may be complicated by renal failure, acute respiratory distress, and shock.
In a study of patients with Lyme disease from southern New England, approximately 10% were co-infected with babesiosis (7).
Unlike Lyme disease and Anaplasmosis, doxycycline is not an effective treatment of babesiosis and requires atovaquone and azithromycin or combination of clindamycin with quinine, making it imperitive to consider this diagnosis in mind in patients with tick bite.
Of the 3 species of Ehrlichia in United States, only E muris–like (EML) agent is transmitted by I scapularis is the vector of this emerging pathogen(8).
Possible co-infections should be considered in any patients who are diagnosed with tick bite or Lyme disease, especially those who have unexplained leukopenia, thrombocytopenia, or anemia, or who fail to respond to treatment for Lyme’s disease.
References:
1- Razai MS, Doerholt K, Galiza E, Oakeshott P. Tick bite. BMJ 2020;370:m3029
2- Caulfield AJ, Pritt BS. Lyme disease Coinfections in the United States. Clin Lab Med 2015;35:827–846.
3- Lee, X, Coyle DR, Johnson DK, et al. Prevalence of Borrelia burgdorferi and Anaplasma phagocytophilum in Ixodes scapularis (Acari: Ixodidae) nymphs collected in managed red pine forests in Wisconsin. J Med Entomol 2014;51:694-701.
4- Prusinski MA, Kokas JE, Hukey KT, et al. Prevalence of Borrelia burgdorferi (Spoirochets: Spirochaetaceae), Anaplasma phagocytophilum (Rickettsiales: Anaplasmataceae), and Babesia microti (Piroplasmida: Babesiidae) in Ixodes scapularis (Acari: Ixodidae) collected from recreational lands in the Hudson Valley Region, New York State. J Med Entomol 2014;51:226-36.
5- Horowitz HW, Aguero-Rosenfeld ME, Holmgren D, et al. Lyme disease and human granulocytic anaplasmosis coinfection: impact of case definition on coinfection rates and illness severity. Clin Infect Dis 2013;56;93-9.
6- Steere AC, McHugh G, Suarez C, et al. Prospective study of coinfection in patients with erythema migrans. Clin Infect Dis 2003;36:1078-81.
7- Krause PJ, Telford SR, Spielman A, et al. Concurrent Lyme disease and babesiosis – evidence for increased severity and duration of illness. JAMA 1996;275:1657-60.
8- Pritt BS, McFadden JD, Stromdah E, et al. Emergence of a novel Ehrlichia sp. agent
pathogenic for humans in the Midwestern United States. 6th International Meeting
on Rickettsiae and Rickettsial Diseases. Heraklion (Greece), June 5–7, 2011.
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**Comment**
This important letter to the editor highlights many contentious issues Lyme/MSIDS patients have to muddle through. From where I sit, I disagree with the author’s statements that these infections are ‘mild and self-limited’, but I deal with sick people – not healthy. If there’s one thing I DO know, it’s that these infections have been downplayed for far too long, and it’s been a real problem. Patients haven’t been taken seriously for over 40 years!
The consideration of coinfections; unfortunately, is not common in mainstream medicine regarding Lyme/MSIDS. They still treat this as a one germ disease with doxycycline curing it, when nothing could be further from the truth: https://madisonarealymesupportgroup.com/2018/10/30/study-shows-lyme-msids-patients-infected-with-many-pathogens-and-explains-why-we-are-so-sick/