Archive for the ‘Treatment’ Category

Bartonella Treatment

Bartonella

By Ceshencam – Own work, Public Domain, https://commons.wikimedia.org/w/index.php?curid=3798662

In order to come up with the best strategy it’s first important to know thy enemy.

http://townsendletter.com/July2015/bartonellosis0715_3.html  Fifteen species of gram-negative aerobic Bartonella are known to infect humans; however Dr. Ricardo Maggi’s statement is quite telling, “This case reinforces the hypothesis that any Bartonella species can cause human infection.”  

http://www.medicinenet.com/script/main/art.asp?articlekey=5848  History records one strain, Bartonella quintana, as causing Trench Fever, a major problem in the military that often resembled typhoid and influenza; however, urban trench fever still occurs in the homeless, alcoholics, and in injection drug users.  The unusual rickettsial organism multiplies in the gut of the body louse and is spread by rubbing infected louse feces into dry skin or eyes.  http://www.nejm.org/doi/full/10.1056/NEJM199901213400303  Among the homeless in France, B. quintana infections presented with nonspecific symptoms or no symptoms.  It has also been found responsible for a disease called bacillary angiomatosis (purple lesions on or under the skin, subcutaneous tissue, bone, or other organs) in people infected with HIV and the immunocompromised and for infection of the heart and great vessels (endocarditis) with bloodstream infection (B. henselae can do this as well & importantly can cause subacute endocarditis – infection of heart valves, which is often negative upon culturing).  Trench fever is also called Wolhynia fever, shin bone fever, quintan fever, five-day fever, Meuse fever, His’ disease, His-Werner disease, Werner-His disease.  Symptoms of Trench Fever:  Fever that comes and goes in a 5-day cycle, headache, pain behind the eyes, pain in the shin bones, general body aches, classic rash – pink-red patches and small bumps that appear and disappear, usually on the chest, as the fever comes and goes.

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702008000200013  Another strain, B. henselae causes Cat Scratch disease, has caused aseptic meningitis (often viruses that cause inflammation of the lining of the brain), neuroretinitis (inflammation of the retina and optic nerve), and regional lymphadenopathy (swollen lymph node(s) in one local area) in one patient.  Others have had vision problems, headaches, resistant neurological deficits, and seizures. Bacillary peliosis causes vascular lesions in the liver and spleen.

While swollen lymph nodes (lymphadenitis) is considered a hallmark symptom, this study https://www.ncbi.nlm.nih.gov/pubmed/26551620, looking at 100 cases of confirmed B. henselae infection found that nearly half lacked the typical abscesses only identifiable by microscopy but rather mimicked other reactive (acute or chronic) infectious lymphademopathies.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4835656/#__ffn_sectitle  Here a 6 year old had fevers up to 101, a dry cough, intermittent periumbilical abdominal pain, and night sweats.  Misdiagnosed with a urinary tract infection, only to return to the ER with persistent fevers and cough.  She was sent home after a chest radiograph showed perihilar peribronchial thickening and was told she had atypical pneumonia.  Back to the ER she went with persistent fevers.  Upon hospital admittance tests discovered an echogenic liver and enlarged spleen with lesions as well as a positive Bartonella henselae titer.  Previously a kitten had scratched her on her chest.

https://www.lymediseaseassociation.org/index.php/about-lyme/other-tick-borne-diseases/bartonellosis  Ticks that transmit Bartonella include Ixodes Scapularis (also called the blacklegged tick or deer tick) and Ixodes Pacificus (western black legged tick), both of which also transmit Lyme disease.  More than one co-infection can be transmitted from the same tick bite.  A paper by Martin Fried and Aswine Bal, both MD’s,  https://www.lymediseaseassociation.org/images/NewDirectory/Studies-Papers/Fried_Bartonella-2002.pdf, found it to cause heartburn, abdominal pain, skin rash, gastritis (inflammation of the stomach lining) and duodentis (inflammation of 1st portion of the small intestine) in children and adolescents, as well as mesenteric adenitis (inflammation in abdominal lymph nodes).

Bartonella has an affinity for endothelial cells, red blood cells, microglial cells, macrophages, and CD34 progenitor cells hindering nutrient, oxygen, and antibiotic delivery to tissues. This causes fatigue, pain, and cognitive and mood issues. They hide in red blood cells to evade the immune system and utilize hemin, and can cause persistent infection, with some species actually deforming red blood cells. Some remain in the cells for the life of the cell while others kill the cell outright. Every 3-6 days there is a new infection wave.

Various strains have been found in eye fluid, the heart (myocarditis and endocarditis), and cysts, and can infect by nearly anything puncturing the skin and exchanging bodily fluids – including needles. Evidence also suggests congenital transmission.

https://wwwnc.cdc.gov/eid/article/22/3/15-0269_article  This article identified 6 species in patients with chronic, subjective symptoms who were bitten by ticks.  While three strains were B. henselae (Cat scratch fever), 3 were associated with animal infections (B. doshiae, B. schoenbuchensis, and B. tribocorum).  They also found hemangioendothelioma (vascular tumors) in 2 case patients.  The authors stated that Bartonella spp. may be the cause of unclear and undiagnosed chronic illness in humans previously bitten by ticks.

https://www.youtube.com/watch?v=g5g_PVSIA_0  Approx. 3 min

Dr. Ed Breitschwerdt, professor of internal medicine at North Carolina State University, discusses recent research into the Bartonella bacteria. Animals and humans can both become infected with the bacteria from insect bites. It may be possible for an infected mother to pass the bacteria to her unborn child in utero, the professor has found. To download a transcript of the complete 25-minute interview in PDF format, visit http://ncsu.edu/project/nsaudiovideo/…

https://www.youtube.com/watch?v=Sz9e-is-UuY Approx. 4.30 min

Published on Oct 15, 2014
Dr. Breitschwerdt talked about Bartonella at the NorVect conference 2014. This is an excerpt of his presentation: Bartonellosis: A One Health Approach to An Emerging Infectious Disease.

https://www.youtube.com/watch?v=2s2o_oPGYM8  Approx. 12.30 min
Published on Oct 14, 2015
Dr. Mozayeni talks about Bartonella as one of the major co-infections of Lyme disease. It’s more prevalent than Lyme, as there are many more ways to contract the disease (eg. flees, cats). In a study, that Dr. Breitschwerdt and Mozayeni published in The Journal of Emerging Diseases, about 60% of Lyme patients tested positive for Bartonella.  Dr. Mozayeni also talks about the importance of looking at Biofilm when treating Lyme, Bartonella etc. as biofilm can harbor many of these microbes and be the cause of many symptoms.

Symptoms are largely associated with where the blood flow is compromised. The reason many have pain in the soles of their feet is due to inflammation caused by microvascular trauma. It has been known to cause cysts around dental roots leading to chronic and hard to diagnose head and face pain as well as root canals. This microvascular trauma is also to blame for brain issues causing psychological issues such as anxiety, anger, and suicidal thoughts, since the small vessel disease affects executive function. A cog is literally caught in the wheel. As neurotransmitters become depleted due to overstimulation, depression rears its ugly head. A vicious cycle ensues.

Due to the cyclical nature of Bartonella and that it exists in very low amounts in human blood, blood tests are unreliable. It also has a long division time between 22-24 hours and requires a special growth environment. There is a Triple Draw through Galaxy which collects blood over 8 days to maximize the test, stating a 90% reduction in false negatives.

http://townsendletter.com/July2015/bartonellosis0715_3.html
Mode of Transmission: Arthropod vectors including fleas and flea feces, biting flies such as sand flies and horn flies, the human body louse, mosquitoes, and ticks; through bites and scratches of reservoir hosts; and potentially from needles and syringes in the drug addicted. Needle stick transmission to veterinarians has been reported. There is documentation that cats have received it through blood transfusion. 3.2% of blood donors in Brazil were found to carry Bartonella in their blood. Bartonella DNA has been found in dust mites. Those with arthropod exposure have an increased risk, as well as those working and living with pets that have arthropod exposure. 28% of veterinarians tested positively for Bartonella compared with 0% of controls. About half of all cats may be infected with Bartonella – as high as 80% in feral cats and near 40% of domestic cats. In various studies dogs have close to a 50% rate as well. Evidence now suggests it may be transmitted congenitally from mother to child – potentially leading to birth defects.

https://madisonarealymesupportgroup.com/2011/09/25/the-bartonella-checklist-copyrighted-2011-james-schaller-md-version-11/

Print out this checklist and complete it.  If you have symptoms, discuss with your doctor.

If you find a doctor willing to be properly educated on tick borne illness, please give them this link:  https://madisonarealymesupportgroup.com/2017/06/20/help-doctors-get-educated-on-lyme-and-tick-borne-illness/

Bartonella Treatment: This is for educational purposes only. Please discuss treatment options with your health care practitioner.

The predominant antimicrobial drugs for Bartonella are intracellular; however, while reducing symptoms there are relapses. According to IDSA, the best drugs are erythromycin and doxycycline with clarithromycin or azithromycin as alternatives. A combination therapy of doxy and rifampin is preferred for those with CNS involvement and those with repeated relapses may need indefinite treatment.

Also, due to the nature of the organism some have responded miraculously to blood thinners such as heparin or Lovenox – or other agents that reduce clot formation, including alkalinizers such as apple cider vinegar, vegetables and vitamin C. Reducing the stickiness of the blood by taking fish oil or a low-dose baby aspirin also may help.  Boluoke, lumbrokinase, serrapeptase, Wobenzym, and InflaQuell may also help.

The following have been found to be helpful:

doxycycline
erythromycin
rifampin
doxy with rifampin
doxy with gentamycin
gentamicin and ceftriazone with or without doxy, chloramphenicol, ciprofloxacin, or streptomycin
azithromycin or doxy combined with rifampin, clarithromycin, or a fluoroquinolone

http://www.treatlyme.net/treat-lyme-book/kills-bartonella-a-brief-guide

According to Dr. Ross one needs to correct sleep, decrease inflammation, improve the immune system, correct hormonal imbalances, provide nutrients, and remove yeast in order to beat Bartonella. He also feels it is best to use antibiotic combinations as do Drs. Horowitz and Jemsek. Ross has three tiers, with tier 1 working 90% of the time, tier 2 at about 80%, and tier 3 (herbs) working 70% of the time or less (Dr. Horowitz has found this to be true of herbs as well).

**UPDATE 2022**

Dr. Ross’s Bartonella treatment update includes information about:

  • fluconazole (Diflucan) or itraconazole (Sporonax) to kill persisters and growing bartonella
  • liposomal Cinnamon, Clove and Oregano Oil to kill bartonella persisters which is better than oregano oil alone
  • lumbrokinase to treat Bartonella-fibrin nests.

Tier 1: Rifampin 300 mg 2 pills 1 time a day with one of the following:
Minocycline 100mg 1 pill 2 times a day
bactrim DS 1 pill 2 times a day or
azithromycin 500mg 1 pill per day
Doxycycline 100mg 1 or 2 times a day can be substituted for the mino but rifampin decreases doxy levels in the blood. Clarithromycin 500mg 1 pill 2 times a day can be substituted for azith but rifampin also decreases clarith blood levels.

Levofloxacin 500mg 1 pill 2 times a day or ciprofloxacin 500mg 1 pill 2 times a day with one of the following:
minocycline 100mg 1 pill 2 times a day,
doxycycline 100mg 1 to 2 pills 2 times a day, or
bactrim DS 1 pill 2 times a day
Clarith and azith are not used with flouroquinolones because they may cause heart rhythm problems.
Clarithromycin 500mg 1 pill 2 times a day and Bactrim DS 1 pill 2 times a day

Tier 2: Clarithromycin 500mg 1 pill two times a day, or
Azithromycin 500mg 1 pill two times a day
Combine these with a tetracycline:
doxycycline 100mg 1 or two pills 2 times a day,
minocycline 100mg 1 pill 2 times a day, or
tetracycline 500mg 1 pill 3 times a day

Tier 3:  Start Houttuynia at 5 drops 2 times a day and increase daily by 1 drop per dose till at 30 drops 2 times a day. Take Sida Acuta concurrently at 1/4tsp 2 times a day and after 1 week if tolerating, increase to 1/2 tsp 3 times a day.

According to Ross, treatment requires 4-6 months with an exception of levofloxacin which usually requires 1-3 months. Treat until most symptoms are resolved. His experience is that 95% recover from Bartonella when using the immune supports and either tier one or two.
*Long-term tendon damage and ruptures, retinal detachment, and other symptoms have been connected with fluoroquinolones – resulting in fluoroquinolone toxicity syndrome – or being “floxed,” however, one of the most experienced LLMD’s in Wisconsin has noted that he has used these drugs for over 30 years without this ever happening. The fluoroquinolones are made with fluoride and go deep into muscle tissue, which is what makes them so effective. Often, the best usage is using a fluoroquinolone that paves the way for other antibiotics to do their jobs better.

http://www.lymebook.com/antibiotic-treatment-for-babesia-bartonella-ehrlichia-co-infections

Dr. Singleton also reports that in his experience tendonitis is rare, but if it happens – stop – until symptoms are resolved and then restart in a few days at a lower dose. He also suggests putting the patient on 600-1,000mg of magnesium for a few weeks prior to treatment with a fluoroquinolone to prepare tendons and muscles and to continue taking through treatment, separating it by three or more hours. And, as always, drink plenty of water to help the body detox.

*Many react strongly to Rifampin, perhaps due to a rapid metabolism of sterol hormones, which causes severe symptoms with low adrenals and low cortisol. In the very ill, Dr. Mozanyeni starts with herbal antimicrobials and assists the adrenals until the patient is able to tolerate antibiotics. When the antibiotic regimen is finished he puts them back on more natural antimicrobials if treatment is needed long term.

http://townsendletter.com/July2015/bartonellosis0715_3.html

Dr. Mozanyeni uses clarithromcin or azithromycin, later adding rifampin with clarithromycin. If a patient is on meds that impact rifampin, he may then use Mycobutin. He has not found the need to use IV therapies except in cases where patients can not take pills. He has noted that antibiotics used for Lyme may push Bartonella further into cells making treatment more challenging.

While the current drugs for treating bartonellosis, include rifampin, erythromycin, azithromycin, doxycycline, and ciprofloxacin, they had very low minimal inhibitory concentration (MIC) against growing B. henselae, they had relatively poor activity against stationary phase B. henselae, except aminoglycosides

Recent research has shown many other things have higher activity than current Bartonella treatments:  https://madisonarealymesupportgroup.com/2019/05/05/good-news-for-bartonella-patients-identification-of-fda-approved-drugs-with-higher-activity-than-current-front-line-drugs/

The identified top drug candidates include:

  • pyrvinium pamoate
  • daptomycin
  • methylene blue
  • zole drugs (clotrimazole, miconazole, sulconazole, econazole, oxiconazole, butoconazole, bifonazole)
  • aminoglycosides (gentamicin and streptomycin, amikacin, kanamycin)
  • amifostine (Ethyol)
  • antiviral Lopinavir/ritonavir
  • colistin
  • nitroxoline
  • nitrofurantoin
  • verteporfin
  • pentamidine
  • berberine
  • aprepitant
  • olsalazine
  • clinafloxacin
  • clofoctol

Pyrvinium pamoate, daptomycin, methylene blue, clotrimazole, and gentamicin and streptomycin at their respective maximum drug concentration in serum (Cmax) had the capacity to completely eradicate stationary phase B. henselae after 3-day drug exposure in subculture studies.

The identified FDA-approved agents with activity against stationary phase B. henselae should facilitate development of more effective treatments for persistent Bartonella infections.

**Personal experiment**

As my husband and I have always relapsed with Bartonella symptoms and have always responded to and herxed from the combined usage of rifampin and clarithromycin.  While I did not record the exact dosages, I found this which is near to if not identical to our protocol.  Rifampin (10-20mg per kg per day) or 300mg – 600mg twice a day and Clarithromycin – 500mg twice a day.  Following this protocol for 2-3 months sets us right every, single time – in fact, even better than we were previously.

Keep in mind this protocol for a Bartonella relapse came after intensive combination therapy for FIVE, long years.  We treated for Lyme and focused on Babesia for an entire year.  Rotating, pulsing many antibiotics, taking numerous herbs, doing ozone, having mercury amalgams removed, focusing on the gut, addressing inflammation, etc. were all a part of what we did.  Nothing about it was simple or easy!

I also decided to try Berberine when I developed severe lower back pain out of the blue.  I tried numerous combinations but after further reading about MIC levels, I decided upon 500mg three times a day to keep it in the blood stream.  I’m happy to report I herxed immediately and later had the direct response of diminished pain.  Time will tell but Berberine appears to help substantially.  Please see:  https://draxe.com/nutrition/berberine/https://articles.mercola.com/sites/articles/archive/2015/06/22/berberine-benefits.aspx

Alternative Treatments:

allicin, sulforaphane, Sida acuta, Isatis, Houttuynia, Alchornea cordifolia, Japanese knotweed, EGCG, hawthorn, cordyceps, L-arginine, Cryptolepis, Samento, A-BART, Curcumin, quercetin, astaxanthin, Xymogen, AngiNOX, L-arginine, Profusia Plus, Salvia miltiorrhiza, Vinpocetine, Cratoxy, Ginkgo biloba

http://buhnerhealinglyme.com

Master Herbalist, Stephen Buhner’s Bartonella protocol – research is ongoing, but this is the most up to date. The following herbs are to be taken for 30 days. If the symptoms come back when the protocol is stopped the dosage was probably not high enough – so the protocol should be modified and continued until the blood cell infection is gone. He recommends Woodland Essence for all the tinctures. Remember – herb dosages are extremely individual.

Sida acuta tincture – 1/4tsp 3Xday
Hawthorn tincture, same
Japanese knotweed, same (or 2 capsules 3Xday from Green Dragon Botanicals)
EGCG (green tea extract) 400mg/day – approximately 4 cups of green tea
Houttuynia 1 Tbs daily (Yu Xing Cao – 1st Chinese Herbs, powder – use Lyme code at checkout for 10% off)                                                                              
     L-arginine 5000 mg daily in divided doses                                                               Milk Thistle seed, standardized, 1200 mg daily

PLEASE NOTE: If you have active herpes, chicken pox, or shingles DO NOT USE L-arginine.

Closing in on the 8%

cropped-untitled-11.jpg

http://lymewhisperer.com/2015/12/13/kripalu-closing-in-on-the-8/

We are closing in on the 8%, Dr. Horowitz whispered.

At the Beyond Lyme and Other Chronic Illnesses: Reclaiming Your Health and Well-Being, conference, Dr. Horowitz and Ying Zhang from John Hopkins, revealed they are having success with mycobacterium drugs, such as dapsone (pyrazinamide) for their most serious cases – the 8% of folks who do not respond well to treatment. These drugs are used in leprosy and tuberculosis to target the bacteria that have become “persisters,” which do not respond to typical antibiotics.

http://beforeitsnews.com/health/2015/10/lyme-disease-persister-drugs-dr-ying-zhang-2593390.html  Interview with Professor Ying Zhang at the NorVect Converence 2015. Zhang’s work with TB helped him see the similarities to Lyme concerning persisters.

Horowtiz, the General MacArthur of MSIDS, has laid out most of his battle plan in the book, Why Can’t I Get Better? Solving the Mystery of Lyme and Chronic Disease. In a nutshell, he combines 2-3 intracellular antibiotics to reach the persister bacteria inside the cells. He calls this the “triple persister” cocktail. Then he pulses with a cellular antibiotic, which is based on work by professor and researcher Kim Lewis of Northeastern University.  http://aac.asm.org/content/early/2015/05/20/AAC.00864-15.abstract

http://www.northeastern.edu/news/2015/06/researchers-discovery-may-explain-difficulty-in-treating-lyme-disease/

“This is the first time, we think, that pulse-dosing has been pub­lished as a method for erad­i­cating the pop­u­la­tion of a pathogen with antibi­otics that don’t kill dor­mant cells,” Lewis said. “The trick to doing this is to allow the dor­mant cells to wake up.”

Horowitz has found this regimen to be very successful, but the addition of dapsone for the most difficult cases could be the magic key.

At the seminar they discussed why so many are getting MISDS. The reasons given were:

  • Sexual Transmission
  • Maternal Transmission to fetus
  • Blood transfusions (4 out of 1,000 transfusions are now believed to transmit Babesia.
  • Constant discovery of new borrelia species and new co-infections
  • Horrible diagnostic standards
  • Fox population decrease. This increases the mouse population – probably the number one reservoir for ticks.
  • The reality of persisters – bacteria that persist despite antibiotic treatment
  • Migrating birds – why the Lone Star tick is now in the eastern U.S. This tick can detect body heat and carbon dioxide from 15 feet away and will aggressively move towards the source.
  • Infected tick mothers pass infections to their off spring
  • Climate change – ticks are emerging 3 weeks early
  • Healthcare politics

Overview of different forms of Borrelia:
http://www.lymebook.com/top10forms

Overview of antibiotics that attack different forms:
http://www.treatlyme.net/treat-lyme-book/kills-lyme-germs-a-brief-antibiotic-guide

Horowitz is optimistic about the future and already feels things are starting to change in the diagnostics world with work on a new “C6 Elisa Test” that picks up more strains of Borrelia. Also, more are starting to believe that having ONE band is enough for a clinical diagnosis of Lyme, if other diseases have been ruled out. He feels a final hurdle; however, is for the PCR test to address additional strains of Borrelia.

Horowitz will publish this work on his patients in the upcoming year.

Tips for Newbies

gallery-thumbnails.php       Helpful Hints for Successful Treatment

Treating Lyme Disease or MSIDS (multi systemic infectious disease syndrome) is unlike treating for common diseases such as bronchitis where you start feeling better upon taking antibiotics.  It is my experience that your best bet for appropriate treatment is to get to a Lyme literate doctor who is educated on the complexity of diagnosing and treating Lyme/MSIDS.

With MSIDS, antibiotics kill the pathogens leaving them floating around in your blood stream for your immune system to finally notice. This causes a herxheimer reaction in which your body starts attacking itself and is a type of autoimmune response.

Detoxing these dead pathogens is paramount for successful treatment and the following have had success:

Sweating. Your skin is the largest organ and sweating causes impurities to get out of the body. There are many ways to sweat including hot baths. Putting things like epsom salts in the bath also will give your body needed magnesium which can help with muscle pain.  https://madisonarealymesupportgroup.com/2017/09/29/epsom-salts-for-lymemsids/  Some like to use hydrogen peroxide and/or baking soda. Depending upon tub size a cup of any of these agents is a good place to start. Make sure the water isn’t hot enough to burn but warm enough for sweating. Also, drink plenty of good filtered water during the bath.  Other baths:

  • Apple Cider Bath:  Add 2 Cups of apple cider vinegar to bath.
  • Epsom Salt Bath:  Dissolve 1 Cup Epsom Salts
  • Clay Bath:  1/2 C Bentonite clay, 1/2 C Epsom Salts, 1 Tablespoon yellow root powder
  • Essential Oil Bath:  Add 5 drops lemongrass or coriander to bath with sea salt or 1/2 C epsom Salts.

Saunas are good as well, particularly infared. Exercise is another way to sweat just make sure you don’t overdo it as fighting MSIDS is taxing enough. Walking is safe, effective, free, and gets you outside in the fresh air and sunshine. If you haven’t exercised much, start by going around the block. As you develop more stamina, go further.  Patients have used things like the Biomat successfully as well.  https://www.biomat.com

One word of caution: start slowly and see how you respond.  For some, these hot baths wipe them out.  If this is a problem for you – perhaps do it at night before bedtime.  Also, be careful you aren’t dizzy as you don’t want to slip and fall.  It’s wisest to have someone close by in case you need help.

Drink plenty of fluids, particularly water. Some have squeezed lemon juice into their water for taste and its tonic properties. Coffee and green tea have great properties as well – just don’t overdo the caffeine.

Coffee Enemas and Colonics:  https://madisonarealymesupportgroup.com/2016/06/06/the-coffee-enema/  Anything which helps move toxins out of the body is beneficial.  Many find coffee enemas and colonics extremely helpful while in treatment.  I’ve done both and can attest to the benefits.  In the link above, there are tools to help make this simpler for you as you probably won’t keep these things up unless it’s simple.  Some use a bulb syringe for quick application, others use the stainless steel bucket as in the video.

Herbs. Parsley is a wonderful herb for detoxing as well as milk thistle (detoxes the liver). Nutrimedix has a line of herbs, also sold on Amazon, such as Burbur, Parsley, and Pinella. For more information on these herbs and their properties go to: http://www.nutramedix.ec/ns/lyme-protocol.  You can click on the herb and will get a video and pdf with valuable information.  Master Herbalist, Stephen Buhner, has also written many excellent books on treating MSIDS with herbs.  You can use these alone or in conjunction with antibiotics.   http://buhnerhealinglyme.com

Alpha Lipoic Acid (ALA):  Found in every cell of the body, it chelates and neutralizes harmful chemicals and increases the formation of glutathione which helps remove them.  Some warn to not use unless you’ve had your mercury (silver) fillings removed:  https://www.healthnutnews.com/vaccine-detoxes-for-adults/

Fiber: a roto-rooter for the colon, it cleans and absorbs toxins.  Celery and other green leafy vegetables do wonders as well as plain psyllium husk fiber.  Check ingredients as you don’t want added sugar and colors.

Chelation. At some point in your treatment you may want to consider chelating as it removes heavy metals from your body which very well might stand in the way of healing.

Dry Skin Brushing. Get a natural bristle brush to clear pores of debris. It will also stimulate the lymphatic system which harnesses toxins. Start at your feet and move toward your heart by making wide sweeping motions, overlapping the areas as you brush.

Jump on a Trampoline. This will also move your lymphatic system.  Don’t do this if you have dizziness.

Eat plenty of Cruciferous Veggies. Kale, Collard, and Cabbage increase the detox activity of cells in the liver. Steam for 2 -4 min to keep the living enzymes then add sea salt, black pepper, diced avocado and extra virgin olive oil.

Ozone. Blood ozone with or without UV light puts valuable oxygen into your body much like exercise does but even more effectively. This will help every cell in your body do what it’s designed to do and will help with detoxification as well.

NUCCA Chiropractic Care:  https://nucca.org/what-is-nucca/

When the craniocervical junction (head and neck) is compromised, the NUCCA process works to reduce interference to the nervous system using a precise, gentle, non-invasive spinal adjusting technique. By using precise and objective x-rays of the head and neck, along with mathematical measurement analysis, NUCCA doctors are able to establish a misalignment pattern unique to every person.  There is no twisting, cracking, or popping.  Being out of alignment means dysfunction to the central nervous system.  To find a doctor:  https://nucca.org/search/

Massage:  There are numerous types of massage to consider.  Do what feels best to your body.  Due to the fact many of these pathogens love muscle and tendon tissue, you may find massage painful.  Tell your practitioner you are a Lyme/MSIDS patient and that you may need to go slowly to work up to the full strength of the massage.  Some find lymphatic massage particularly helpful as it gets the lymph moving to assist the body in detoxing.

Cupping:  Cupping is a technique often used with massage to help the body detox.  The practitioner puts cups along the muscles of the spine which pulls the fascia away from muscle tissue allowing blood to flow better.  Along with better blood flow you get better circulation of oxygen, treatment, and valuable nutrients.

Raindrop Technique:  Using essential oils and massage, the practitioner applies specific EO’s onto the spine and feet allowing the body to detox better.  Many of these EO’s are also antimicrobial in nature and are being directly absorbed into the blood stream, particularly in the spine where many pathogens hide.

Accupuncture:  This Chinese medicine technique uses needles to help the body be stronger.

Accupressure:  Using similar technique as acupuncture, there are no needles involved in accupressure.

For more ideas: http://www.tiredoflyme.com/detox-methods.html  Chris, the author of the website Tired of Lyme, has far more examples and has asked folks to rate their favorite detox methods.  Please add your own experiences, and always remember that what worked for one person may not work for another, which is why you sometimes need to keep experimenting to find what works for you.

Unless you have an acute case (a recent tick bite), treatment may take anywhere from months to years. This is important from many aspects.

  1. Now is the time for pristine health habits. You might need help with your diet so you can heal. Many have allergies, food and or chemical sensitivities and/or leaky gut which need to be addressed so you can heal.  Most literature states to avoid sugar, gluten, and alcohol as well as anything that causes allergy type symptoms.
  2. You may need treatment to help you sleep. One of the hallmark symptoms of MSIDS is fatigue and sleep issues. Many have insomnia which leads to extreme day-time fatigue. If this is a problem, make sure you discuss this with your doctor.  Many have found help with the use of things like Gabapentin, LDN (low dose naltrexone) https://madisonarealymesupportgroup.com/2016/12/18/ldn/, natural progesterone, Valerian Root, and other sleep aids.  Without sleep you will not heal.
  3. You need to fix the imbalances in your body. Based on your exams, Many LLMD’s will order lab work to determine your body’s weaknesses and imbalances. Many need to go on thyroid medication and perhaps low dose hydrocortisone and/or other bioidentical hormone supplementation as MSIDS often puts the body into adrenal fatigue.  It is quite common to be low in Magnesium which is an important major mineral responsible for some 350 biochemical reactions in your body (it also helps sleep).  Your lab results will indicate what you need; however, here’s a great article showing you what to look for.  One possible sign is constipation.  http://articles.mercola.com/sites/articles/archive/2015/01/19/magnesium-deficiency.aspx You may be tempted to opt out of this part of treatment due to cost.  Don’t.  Your body needs all the support it can receive as it is in a major war.
  4. Now is NOT the time for vaccinations.  Despite what you hear in the media about immunizations, there is another side to the coin and you need to do your own research to determine what is best for you – particularly since your immune system is compromised due to a serious infection(s). Every single MSIDS patient I know who got vaccinated had a relapse or worsened.  For starters, read: https://madisonarealymesupportgroup.wordpress.com/2015/06/19/a-word-on-vaccines/  https://madisonarealymesupportgroup.wordpress.com/2015/07/15/vaccines-continued/  https://madisonarealymesupportgroup.wordpress.com/2016/02/05/zika-sexually-transmitted/
  5. You probably will need emotional support. Another unfortunate thing that happens to MSIDS sufferers is isolation. People don’t understand what you are going through or don’t believe it. Frankly, I wouldn’t believe it myself if I hadn’t lived it!  Sometimes these people are in your own family leaving you with a great sense of loss and helplessness. Often you just need someone to understand. There are many excellent support groups here in Wisconsin. Trust me, we get it.  If you would like to become a “follower,” to this website, clicking the blue “follow” button, and you will receive an email each time I post.  I do post M-F typically 3-4 articles a day.  Delete what doesn’t interest you and read what does.  Learning about Lyme/MSIDS is like receiving information via fire-hose.  There’s a lot to know as it is imperative you are a partner in your own healing. If there isn’t a support group in your area, start one!

A few words about treatment

Each LLMD has their own approach to treatment.  You will find each practitioner quite passionate about their regimen.  This is one of the challenges as a patient; to find a practitioner you agree with as treatment is highly variable.  It is not uncommon to change doctors sometime in treatment.  Often people start out very inexperienced and desperate.  As time progresses you become more knowledgable and develop an opinion of your own about treatment.  There is nothing wrong with changing doctors; however, we hope to help explain the various doctors and their approaches to you at meetings so you can make an informed decision at the onset.  And if you live in a state other than Wisconsin, please contact your local support group for important and helpful information regarding doctors, fees, approach, etc.  Feel free to ask questions as someone in the group probably has experience one way or the other.  Also, it has been a goal of mine to post the talks given by these WI LLMD’s so you can see them for yourself firsthand.  If you type the doctor’s name in the search bar you will be directed to their talk to the group.

Some doctors use a straight antibiotic approach, some pulse, some use ozone or herbal products, or a combination of all these approaches.  Some put high value on diet, chelation, ozone, and other supportive measures, where others don’t even discuss these options.  Whatever approach your doctor takes, quality pro and prebiotics are extremely important for your GI tract.  As antibiotics take a toll on your GI, and since treatment is usually months to years long, it is quite easy to develop Candida, or yeast issues.  Some doctors sell these products right in their offices, where others just tell you to find good quality sources.  This again is an area where the support group can help you find good sources as there is much experience within the group as to what works and what doesn’t.  Also, these same folks usually have found the cheapest sources as finances become a top priority as well.

It is daunting in the beginning of treatment to keep all of the various meds and supplements in order – particularly the timing of them.  It is important to separate your antibiotics from your pro and prebiotics as well as your supplements.  Take your morning probiotic when you first wake, giving it at least 30 minutes to an hour before you take your antibiotics. If you are taking thyroid and hydrocortisone, you may take that with your morning probiotic. Try and take your evening antibiotics early enough that you have a number of hours before taking your evening probiotics and/or prebiotics before bedtime.  Supplements also need to be separated from antibiotics by a number of hours as they will interfere with absorption.  Feel free to ask these types of questions at the support meeting as folks have been doing this for years and have it nailed down.  And of course run everything by your doctor and even a pharmacist who is privy to everything you are taking.  Pharmacists can give very helpful information about drugs and their interactions.  Here’s a nifty site you can type in all your meds for yourself to see possible interactions:  http://www.rxlist.com/drug-interaction-checker.htm

Herxing may be felt within minutes to days of taking antibiotics. Common symptoms include: increased fatigue, muscle or joint pain, rashes, sight, sound, or touch sensitivity, irritability, dizziness, insomnia, cramping, night sweats, hyper or hypotension, headaches, swollen glands, chills or fever, nausea, bloating, constipation or diarrhea, low grade fever or feverish feeling without fever, heart palpitations, facial palsy, confusion, ringing in the ears, uncoordinated movement, and severe itching.  (Although herxing can manifest in a thousand different ways). Go here for some of the more bizarre symptoms.

While herxing is never fun, you can relish the fact you are killing pathogens.  If the herxes are too strong; however, you need to communicate that with your doctor.  Sometimes people need to slow treatment down or even stop altogether until their body detoxes properly.

To make your appointments are as efficient as possible I highly recommend getting a month-at-a-glance calendar that has lines for writing on it.  On a daily basis you should log your major symptoms and changes down.  Appointments with LLMD’s are typically only every 2-3 months – a long time to have to try and remember symptoms.  By keeping a daily tally, you can write/type up an executive summary with the main symptoms for your doctor to look at during your appointment.  This will help you stay focused on how treatment is affecting you.  I had to do this for myself and my husband and I found this practice indispensable.  Some of you are having to track multiple people!  This will definitely make your life easier and your time with your doctor more fruitful. Remember, there aren’t any accurate tests for any of this.  Symptomology is key for proper treatment, but you need to have a way to remember them in order to be properly treated!

Then there’s the issue of coinfections.  Remember, Lyme is typically just the tip of the spear and there are many other pathogens ticks can transmit.  In the beginning it is common to perhaps have only a few major symptoms.  As you begin treating you may notice that some symptoms wax, wane or entirely disappear or entirely new ones will crop up out of the blue.  This is horribly frustrating as it is one of the hardest aspects of treatment.  No two patients look alike (although there are often similarities) and no two patients respond identically to treatment.  It’s hard enough just to keep track of what your own body is going through on a daily basis!  Over time you will notice trends and you will become experienced, but in the beginning it’s a wild ride.  Hang on and don’t let go!

Lastly, be gentle with yourself. Remember your body is in a battle and you will feel it physically, mentally, emotionally, and spiritually. While many will not be able to see this battle going on externally, I guarantee you will feel it internally. It’s also important to remember that once Lyme/MSIDS is in the brain it can cause a whole host of psychiatric symptoms that are not well acknowledged, understood, or discussed. For instance, I spoke with a patient who got lost on the way to work and had to return home.  He took this road for some 20 years but his brain couldn’t remember how to get there.  Yes, it can get pretty crazy.

Remind yourself and your loved ones often to treat the sick person gently.

Here’s to the beginning of a journey, with many pilgrims walking the same, albeit slightly different path.

Herxheimer Die-Off Reaction Explained

With most infections, people feel better after starting treatment.  Often within 24 – 48 hours there is sweet relief of symptoms.  MSIDS (multi systemic infectious disease syndrome) is unique in that you often feel worse after starting treatment.  The following article written by Marty Ross, MD, explains why.

http://www.treatlyme.net/treat-lyme-book/herxheimer-die-off-reaction-inflammation-run-amok  Written by November 7, 2014

“If you feel worse after herbal anti-microbials or prescriptive antibiotics to treat Lyme are started it is likely you are having a Herxheimer die-off reaction.”

A die-off reaction, also called a Herxheimer reaction, can occur when treating the Lyme germ, some co-infections, and yeast. It occurs as bacteria or yeast die during antibiotic treatment. It is common to have Herxheimer die-off reactions when starting herbal anti-microbials or antibiotics when treating Lyme. These reactions can also occur when new antibiotics are introduced into a treatment.

In a die-off reaction, there is a release of toxins, proteins, and oxidizing agents that results in an increase in inflammatory cytokines such as tumor necrosis factor alpha, interleukin-6, and interleukin-8.

The symptoms of a die-off reaction are generally a worsening of the underlying symptoms of Lyme disease and its associated infections. A majority of Lyme disease symptoms are actually excess inflammatory cytokine symptoms. So in a die-off reaction there is a worsening of many Lyme disease symptoms including: fatigue, brain-fog, muscle and nerve pain, chills and sweats, and/or memory and thinking.

Cytokines: The Good and The Bad

Good: Cytokines are proteins made by various types of white blood cells to fight infections. They perform a number of functions that include:

  • making antibodies work more effectively,
  • increasing active white blood cells to fight infections,
  • recruiting white blood cells to the location of an infection,
  • turning on white blood cells to fight infections, and
  • decreasing viral and bacterial replication.

Bad: Too many cytokines:

  • suppress the immune system,
  • cause pain,
  • decrease hormone production from organs like the thyroid and the adrenal glands,
  • disturb sleep,
  • decrease brain function,
  • increase fatigue and tiredness,
  • waste muscles,
  • cause depression, and
  • decrease the function of various organs throughout the body resulting in many other symptoms and medical problems.

Cytokines: How They are Made

Cytokines are made when immune cells are stimulated by germs, oxidizing agents, cytokines, toxins, and other agents. Once the immune cells are stimulated an intracellular messenger called NF-kB causes genetic programming for the production of cytokines and the turning on of white blood cells to fight infections. Within the white blood cell cytokines are then produced in chemical reactions which require enzymes called kinases.

Cytokines in Lyme: What’s the Problem?

Cytokines are good, right? Well yes and no.

In the right amount they promote healing. In excess, they are harmful. The problem in chronic Lyme and associated diseases is that they are made in excess. This occurs even more so in a Herxheimer die-off reaction.

How to treat a Herxheimer Die-Off Reaction

To treat Herxheimer die-off reactions there are a number of interventions to:

  • lower oxidizing agents,
  • decrease NF-kB genetic programming of cells,
  • block kinase enzymes,
  • block inflammatory prostaglandins triggered by cytokines,
  • promote liver detoxification, and
  • lower blood acid levels.

Based on the work of Martin Pall, PhD, it is critcal to lower oxidizing agents that trigger cytokine production. Ecklonia cava extract derived from sea weed is a potent oral anti-oxidant which seems to have greater affect than other ones. In addition to this, alpha lipoic acid (ALA)n-acetyl cysteine (NAC), and glutathione are helpful. Glutathione and its precursor building blocks ALA and NAC also support liver removal of toxins. In addition the antioxidants quercetin and curcumin decrease NF-kB induced genetic signals to produce cytokines and block the production of inflammation prostaglandins. Quercetin also blocks kinase enzymes required in the production of cytokines. Blocking kinases with quercetin interferes with the cytokine production line. Prostaglandins are inflammation and pain chemicals that are triggered by inflammatory cytokines.

My Recommendations

Step 1: The Beginning of Treatment to Prevent Herxheimer Die-off Reactions.

Use a good multivitamin that includes alpha lipoic acid n-acetyl cysteine, antioxidants, and other micronutrients that decreases oxidizing agents and supports liver detoxification. I prefer multivitamin products in powder form made by Thorne or Integrative Therapeutics.

  • Curcumin 500mg 1 pill 3 times a day.
  • Multivitamin. Use multivitamin powders by Thorne or Integrative Therapeutics. Use as directed on the product label.

Step 2: Moderate Herxheimer Die-off Reactions.

For more severe cases add oral glutathione while continuing the multivitamin and curcumin. Glutathione is also a great choice if there is nerve pain or numbness. If the addition of glutathione is not effective than add ecklonia cava and consider adding quercetin. You can use all four. This combination works to block the cytokine production line and decreases oxidizing agents that trigger production. These treatments can take 1-2 weeks for maximum effect.

  • Glutathione (as oral liposomal glutathione) 500mg 1 or 2 times a day.
  • Quercetin 250mg 2 pills 3 times a day.
  • Ecklonia Cava 400mg 2 pills 2 to 3 times a day

If glutathione is not tolerated then work with one or a combination of the following anti-oxidants that are used to make glutathione.

  • Alpha Lipoic Acid 350mg 1 pill 2 times a day.
  • N-Acetyl Cysteine 500mg 1 pill 3 times a day.

Step 3: Severe Herxheimer Die-off Reactions.

For severe die-off reactions use IV glutathione as a potent antioxidant and to support liver detoxification. This is administered in an integrative medicine physician’s office. Another option is to use glutathione in a nebulizer. Glutathione IV is stronger than glutathione by nebulizer in my experience. Using a nebulizer you breath in a fine mist of the glutathione which is absorbed into the blood throught the blood vessels in the lungs. Sometimes I will start a person with four IV glutathione treatments and then change to glutathione by nebulizer to continue the treatment.

  • Glutathione IV 1200mg to 2500mg 2 times a week for a minimum of four treatments. If it helps but there are still improvements with the last treatment, consider weakly treatments until improvements plateau. You will likely feel more tired after the first treatment.
  • Glutathione by nebulizer 200mg/ml 2ml 2 times a day for adults. Children can take 100mg/ml 1ml to 2ml 2 times a day.

In addition to Ross’s suggestions, there are other methods that can help you detox which should lessen your herxes:

  1.  Take hot epsom salt baths and basically anything that makes you sweat.  Your skin is your largest organ and you can sweat toxins out.  In as hot of water as you can stand, put 1-2 Cups of Epsom Salts and try and get as much of your body to soak in the water.  Make sure you don’t burn your skin and drink plenty of good quality water.  Some people add in 1 Cup of hydrogen peroxide and a half a box of baking soda as well.  It is all helpful.  Light exercise in which you break a sweat is helpful too, but make sure your doctor is in agreement and don’t overdo it.  Walking is free and gets you out in the fresh air and sunshine – all of which are healing.  Infrared saunas, hot tubs, Biomats, anything that makes you sweat will help you detox.  https://madisonarealymesupportgroup.com/2018/06/01/yes-you-do-sweat-out-toxins/
  2. Drink lemon water.  Lemon water helps reduce inflammation by decreasing acidity and by removing uric acid from your joints.  It encourages healthy digestion by loosening toxins in your digestive tract and relieves heartburn, burping, and bloating.  It contains pectin fiber which assists in fighting off cravings and enhances enzyme function which stimulates your liver and detoxes your blood.  Lemon juice is full of Vitamin C which beefs up your immune system and it is higher in potassium than apples or grapes.  It diminishes viral infections and sore throats.  If you weigh less than 150, squeeze half a lemon in to a glass of water and drink.  If over 150lbs, use an entire lemon’s juice.  According to Dr. Sara Solomon, rinse your mouth out with water immediately after drinking lemon water as it is tough on enamel.  Do NOT brush your teeth for 60 minutes because acid leaves the enamel softened and more prone to erosion during brushing. Also, chemical reactions increase with temperature so drink it at room temperature.  http://www.drsarasolomon.com/hot-lemon-water-and-enamel-erosion/
  3. Colon Cleanses.  Since 60-70% of our immune system is in our gut, keeping this pathway going is crucial.  Some use Bentonite, psyllium husk powder (plain, no sugar or additives), chlorella, herbal bowel cleanses, coffee enemas, colonics, pro and prebiotics, Slippery elm, marshmallow root, aloe vera, plain yogurt or kefir, kombucha and fermented foods, garlic and onions, and anything else that heals leaky gut syndrome and strengthens your gut flora.  Most improve considerably by going on a no sugar no gluten diet.  Some have to remove dairy as well as any other foods that cause allergy type symptoms. (Often colonic practitioners will add anti-parasitic and/or other essential oils if you ask)
  4. Detoxing herbs:  Some have found major relief by using milk thistle, pinella, burbur, parsley, nettle, andrographis, dandelion root, and other herbs that help them detox.  http://www.nutramedix.ec/ns/lyme-protocol  When you click this link you will see the herbs used in the Cowden protocol.  Scroll down to the herbs listed in green and then read up and even watch a short video explaining the herbs that have “detox” listed after them.  If you had to pick one herb it would be Japanese Knotweed.  According to Master Herbalist, Stephen Buhner, it crosses the blood-brain barrier and is a drug and herb synergist, facilitating the movement of other herbs and drugs into hard to reach places.  It modulates and enhances immune function, is active against a number of gram-negative and gram-positive bacteria including leptospira and Treponema denticola spirochetes, is anti-inflammatory for both arthritic and bacterial inflammations, protects the body against endotoxin damage, helps reduce herxes, and protects the heart by increasing blood flow.  A very helpful, common, invasive ditch weed indeed!
  5. Diet.  Besides avoiding food allergens which cause leaky gut syndrome, many have found help by avoiding inflammatory foods.  Gluten, casein (found in dairy), and sugar cause inflammation and can make everything worse.  Eat foods high in nutrients and fiber.  Many do very well vegetable juicing which cleanses the body but makes the blood alkaline which promotes healing and prevents Herxes.  Notice I didn’t say “fruit” juicing.  Breaking down fruit and taking away it’s fiber content in juicing will spike insulin and therefore cause inflammation.  Use veggies instead.  Also, make sure you get plenty of good Omega 3 fats.  Most of us need fish oil, as well as cod liver or krill oil for vitamin D3 as we Northerners are typically abysmally low in D3 which can only be increased by getting sun onto the skin which then causes our body to make it.  Since the sun angle is so much lower here we need to supplement.  You should have your vitamin D levels checked at least yearly.
  6. Stimulate the Lymphatic System.  Exercise is listed above under sweating, but it also should be mentioned that movement causes lymph drainage, which is quite helpful in detoxing.  Jumping on a trampoline or just doing jumping jacks will assist in this.  Getting a Swedish massage feels great and also gets the lymph system working.  There is actually something called “Lymph drainage massage.”  Dry brushing does this as well.  Purchase a soft, natural brush, preferably with a long handle to reach everywhere and begin brushing at your feet and moving in long sweeping motions toward your heart, making sure to brush several times in each area, overlapping as you go.  Follow this up with your detox bath listed above, sipping on your lemon water and you really will get things moving and detoxing all in one fell swoop.
  7. Heavy Metal Detoxing.  Metals compromise our immune system and inhibit enzyme systems vital to cellular function so it only makes sense to eliminate them.  Some doctors use IV methods while others use zeolite, chlorella, citrus pectin, or HMD (a synergistic blend of chlorella growth factor, coriandrum stadium and a homaccord of chlorella pyrenoidosa).  You should also consider getting any mercury amalgams removed as mercury can cause a wide range of serious health problems, but make sure you get a qualified biological dentist who uses the correct procedures.

For more:  https://madisonarealymesupportgroup.com/2017/06/28/jarisch-herxheimer-a-review/

https://www.lymedisease.org/lymesci-herxing/

https://madisonarealymesupportgroup.com/2015/12/06/tips-for-newbies/

https://madisonarealymesupportgroup.com/2018/02/24/top-3-lyme-detox-myths-busted-dr-rawls/

 

Audio on Hormones and Adrenal Support

Recently Kathy Lynch, Pharmacist from Women’s International Pharmacy (WIP), spoke to our group.  Since adrenal insufficiency is common in MSIDS (multi systemic infectious disease syndrome) patients, it’s important to rule it out or treat whatever imbalances exist.  Similar to MSIDS testing, testing for adrenal function is poor and is best treated clinically by doctors with experience, with testing used mostly to confirm suspicions.

One thing that is clear is that all MSIDS patients should have their thyroid, cortisol, vitamin D, and basic hormones checked.  Kathy lists some of the more common symptoms for these disorders but a quick Google search should help you and your practitioner know fairly well if you need treatment.  While it is not true across the board, another quite common ailment with MSIDS is low magnesium.  All of these supplements are fairly inexpensive and can make a world of difference in how you feel.

WIP is a local compounding pharmacy and takes great effort and care in making the most bioidentical forms of hormones.  In other words, their hormones are as close to what your body makes as possible.  The beauty is your body processes it more naturally with fewer side effects and usually it is less expensive.

Due to the length of the presentation it is in 5 parts for your convenience.  I feel strongly that this very well might be the “missing link” in many treatments.  If you have low magnesium, low thyroid and cortisol, I guarantee you are going to feel lousy.  The little thyroid gland controls our body temperature.  If you are hypothyroid your temperature is going to be lower making you an excellent habitat for bacteria and viruses.  Just by taking thyroid medicine you make yourself a tougher target for disease.  Same goes for vitamin D, magnesium, and many other levels.

If you do not feel your practitioner is qualified in this area, contact WIP for their list of practitioners who use them frequently.  The phone # is 1-800-279-5708.  The pharmacists are quite knowledgeable and helpful.  They also put out wonderful articles on topics from fatigue to high blood pressure, hormone testing, liver, vitamin D, and yeast – all subjects MSIDS patients contend with.  If you have a subject you need information on, contact them and they will send you literature on it.

Part 1:

Part II:

Part III:

Part IV:

Part V: