CIDPUSA.org Autoimmune diseases

By Gabe Mirkin M.D.

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Chronic Fatigue Treatment

Chronic fatigue means that the primary symptom is exhaustion, but most also have constipation and diarrhea. Fibromyalgia usually means that muscle and joint pains are major symptoms, but muscle biopsies are normal, pressure points are not reproducible and ultra sound is normal. Multiple chemical sensitivities mean that patients think that their symptoms are caused by factors in their environment or they consult doctors who think the same thing. Untreated, the symptoms that that lead to any of these diagnoses will usually continue in adults for the rest of their lives. I have prescribed doxycycline 100-mg twice a day for several months, and sometimes azithromycin 500-mg twice a week, and some of my patients get better. However, this treatment is not accepted by most doctors. Please check with your doctor.

Ulcerative Colitis and Crohns Disease

When a person has bloody diarrhea and doctors find ulcers in the intestines, they look for cancer, infection or parasites. When they cant find a cause, they should say that they dont have the foggiest idea why the person has intestinal ulcers. Instead, they deceive their patients by saying that the person has Chirons disease and explaining that the persons immunity is so stupid that it punches holes in the intestines, rather than doing its job of killing germs. They prescribe medications that suppress immunity or cut out parts of intestine.

Normal intestines are so loaded with bacteria that doctors cant possibly tell which belong there and which may be causing disease. The conventional treatment offers no cure and is associated with many complications that shorten life. Exciting research from France show that a variant of E. Coli, a bacteria that lives in normal intestines, sticks to the intestinal lining and produces an alpha hemolytic that punches holes in the intestines to cause at least some cases of Crohns disease.

Further studies show that heat shock protein can be removed from the common intestinal bacteria, E. Coli, and when given to mice, causes terrible bloody ulcers to form in the intestines. Under the microscope, intestines looked exactly the same as those of people who suffer from ulcerative colitis or Crohns disease. Extensive data show that people with this condition have leaky intestines that allow germs to pass into the bloodstream and their immunities are trying to kill these germs.

Antibiotics can reduce swelling and ulcers in Crohns disease. Dr. Joel Taurog of the University of Texas has shown that a bacteria called bacteroides causes ulcerative colitis and Crohns disease in mice who are genetically programmed to have an HLA-B27, a special gene that causes arthritis. Special tissue staining techniques show that tissue taken from patients with Crohns disease and ulcerative colitis contain parts of two common bacteria called E. Coli and streptococci. Many studies show that infections may cause Crohns disease and that antibiotics, particularly Cipro with or without metronidazole, control ulcerative colitis and Crohns disease. Although many doctors disagree, I treat Crohns disease with Cipro 500-mg twice a day continuously and metronidazole 250-mg four times a day on alternate weeks and check liver tests monthly. I tell patients to stop the metronidazole if they feel any strange nerve sensations.

Stomach Problems

If you have belching, burping, a sour taste in your mouth, mouth odor, a white-coated tongue or a burning pain in your stomach or chest that gets worse when you are hungry and better when you eat, you probably have too much stomach acid. Doctors may say you have ulcers, esophagitis, gastritis, duodenitis, achalasia, chalazia, hiatal hernia or reflux. These terms mean that stomach acid is burning your gastrointestinal tract. Most people who have these symptoms have an infection with a bacteria called helicobacter pylori.

If you have these symptoms, you need blood tests to see if you have helicobacter and a special x-ray called an upper GI series to rule out a cancer. Since there are several bacteria that cause stomach cancers ulcers, a negative blood test does not rule out an infection. I usually treat all people with gastritis symptoms with a one-week course of antibiotics: metronidazole four times a day, clarithromycin 500-mg twice a day and omeperazole 20-mg once a day for one week. At least 12 weeks later, you need a follow up blood test for helicobacter.

If your symptoms are gone and the titer drops, you are probably cured. If your helicobacter titer is still high, your helicobacter is probably resistant to metronidazole and your need to be treated for at least ten days with amoxicillin 500-mg four times a day, tetracycline 500-mg three times a day and omeperazole 20-mg once a day. If you have regurgitation of stomach acid into your esophagus (reflux, hiatal hernia), you may need to be treated with 20-mg omeperazole once a day and 10-mg cisapride four times a day. Virtually all physicians have now accepted the infectious causes of stomach problems. Only the manufacturers of over-the-counter remedies still try to make you believe that stomach pain is caused by stress.

Doxycycline, Minocycline and Tetracycline

Many doctors have asked why I treat some of my patients with acne, arthritis, chronic fatigue syndrome, and late on-set asthma with antibiotic, doxycycline, when minocycline is probably more effective. Doxycycline is a fairly safe drug, although it can cause a sore throat, sunlight sensitivity, pigmentation and abnormal liver tests. It causes sore throat and heartburn when it gets stuck in your esophagus, so take it with large amounts of water to wash it down to your stomach. To prevent sunburn, avoid excessive exposure to the sun. Minocycline is fairly safe, but it can cause more serious serum sickness-like reaction, hypersensitivity syndrome reaction, and drug-induced lupus: characterized by fever, joint pain, a rash, a feeling of being sick, hives itching and severe pain. Other reported side effects include dark colored eyeballs, and liver damage.

Minocycline is more effective than doxycycline because it achieves much higher concentrations in the tissues where it does work in reducing swelling, killing germs, and stopping pain. Although minocycline and doxycycline are in the same class of antibiotics as tetracycline, we rarely use tetracycline because it does not achieve high tissue concentrations. Doxycycline achieves much higher tissue concentrations than tetracycline, while minocycline penetrates tissue far more effectively than doxycycline.