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

Prof. Garth Nicolson The Institute for Molecular Medicine +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

Intern. J. Medicine 1998; 1: 115-117

by Prof. Garth L. Nicolson The Institute for Molecular Medicine, 15162 Triton Lane, Huntington Beach, California 92649-1041 Tel: (714) 903-2900 e-mail: gnicimm@ix.netcom.com Website: www.immed.org

There are a number of additional considerations when undergoing therapy. The IMM is a nonprofit institution and does not endorse commercial products. The products mentioned below are only examples of the types of substances that could be beneficial to patients. Consult with your physician.

Antibiotic Therapy for Chronic Infections

Please consult Antibiotics Recommended When Indicated for Treatment of Gulf War Illness/CFS/ FMS for general information. We are finding that subsets of GWI (~45%) and FMS/CFS (~60%) patients have chronic mycoplasmal infections, and probably other infections as well. We usually recommend several 6-week cycles of doxycycline, ciprofloxacin, azithromycin, clarithromycin, or minocycline, etc. with 2-week cycles of Augmentin in between or concurrently , if needed. To overcome Herxheimer reactions or die-off that cause chills, low grade fever, night sweats, muscle aches, joint pain, short term memory loss and fatigue) or adverse responses i.v antibiotics have been used, and a whole lemon/olive drink is useful (1 blended whole lemon, 1 cup fruit juice, 1 tbs olive oil--strain and drink liquid). This period usually passes within 1-2+ weeks. Some physicians add the antiviralFamvir (500 mgX3/day) for first 2 weeks in each 6-week cycle of antibiotics. The rational is that mycoplasmas have some characteristics of viruses, and antivirals can have a useful effect. Alternatively, viral infections may also be important in these illnesses.

Other Therapies for Chronic Infections

One therapy that appears to be useful is oxidative therapy. This can be done at home with peroxide baths(2-4X 16 oz. bottles of 3% hydrogen peroxide in 20 inch bath (or Jacuzzi) with 2 cups of Epsom salt. Soak in hot water + salt until pores open (about 5 min), then add peroxide solution. Repeat daily or 3X per week at bedtime; no vitamins 8 hr before bath. Peroxide (3%, one 16 oz. bottle) can also be directly applied to skin after a work-out or hot shower/tub. (For better effect apply Swedish Beauty type A tanning accelerator for 5 min before peroxide.) Leave peroxide on for 5 min and then wash off. For oral irrigation, mix 1 part 3% peroxide with 2 parts water 3X per day and use like a mouth wash.

General Nutritional Considerations

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

Vitamins and Minerals

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

Replacement of Natural Gut Flora

GWI/CFS/FMS patients are often undergoing treatment with antibiotics and other substances that can destroy the normal gut flora. Antibiotic use that depletes normal gut bacteria and can result in over-growth of less desirable bacteria. To supplement bacteria in the gastrointestinal system yogurt and especially Lactobacillus acidophillus tablets are recommended. One product is a mixture of Lactobacillus acidophillus, Lactobacillus bifidus and FOS (fructoologosaccharides) to promote growth of these “friendly” bacteria in the gut (example, DDS-Plusor Multi-Flora ABF, UAS Labs (800-422-3371); Intestinal Care-DF, Ethical Nutritionals (Vitamin Park, 714-251-1800). L. acidophillus or mixtures above should be taken 3X daily to restore gut flora.

Natural Immunoenhancers or Immunomodulators

A number of natural remedies, such as ginseng root, herbal teas, whole lemon/olive extract drink or an extract of olive leaves with antioxidants are available and are potentially useful, especially during or after antibiotic therapy has been completed. Some examples are Eden, Echinacea-C (NF Formulas, 800-547-4891), Super-Immunotone (Phyto Pharmica, 800-553-2370), Immunocal (800-337-2411) olive leaf extract (Immuno-screen, 818-966-1610), NSC-100 (Nutritional Supply, 888-246-7224), Nu-Life Formula (Sophista-Care, 760-837-1908), Tahitian Noni (Morinda, 800-445-8596) or Super Defense Plus (BioDefense Nutritionals, 800-669-9205). These have been used to boost immune systems. Although these products appear to help many CFS/FMS patients, their clinical effectiveness in GWI/CFS/FMS patients has not been evaluated. They appear to be useful during therapy to boost the immune system or after antibiotic therapy in a maintenance program to prevent relapse of illness.

Yeast/Fungal or Bacterial Overgrowth

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

Flying and Exercise

Flying, especially in unpressurized aircraft, excessive exercise and lack of sleep can make signs/ symptoms worse. Some exercise is essential (Don’t over do it! A common problem!). Adjust your exercise level to help the recovery process without causing a relapse. Dry saunas help rid the system of contaminating chemicals, and saunas should be taken at least 3-5X per week--moderate exercise, followed by 15-20 min of dry sauna and tepid shower. The sauna can be repeated, by not more than 2X per day. The idea is to work up a good sweat, eliminating chemicals without placing too much stress on your system. During exercise GWI/CFS/FMS patients should always try to avoid pollutant and allergen exposures. For recovery after exercise and to decrease muscle soreness, some use a Jacuzzi or hot tub, but only after a sufficient cool-down period. Don’t get overheated in the process.