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STEALTH INFECTION IN CHRONIC DISEASE-PART 2

In my last blog post, Part 1 of this series, I introduced the concept of stealth infection as a cause of chronic disease.  I explained that many persistent illnesses with many different symptoms-diseases like autoimmune disease, diabetes, thyroid disorder, adrenal fatigue, heart disease, and even cancer- may in fact  be manifestations of the presence of harmful microscopic organisms called pathogens within the body.  Since stealth germs are often very difficult to identify and recover in the body, the concept of stealth infection has been underappreciated by many health care providers.  I explained how diseases such as HIV/AIDS, chronic viral hepatitis, chronic neuroborreliosis (Lyme Disease) and others are explained by this phenomenon.  I discussed how symptoms like chronic fatigue, chronic pain, arthritis, depression, brain fog, irritable bowel are common symptoms associated with stealth infections.Germs

In Part 2 I will dive a little deeper into this subject and attempt to answer some common questions about stealth infection.

Why are stealth infections sometimes difficult to diagnose?

The answer to this question requires a brief explanation of how infection is generally diagnosed.  Infection is first suspected clinically based on symptoms and signs that the patient exhibits.  Often symptoms of infection are caused by the immune system’s response to infection that is sometimes referred to as inflammation.  If the immune system does not recognize or respond to infection, symptoms of disease are often absent or diminished.  This may not be a good thing since the pathogen proceeds unchecked.  When there are symptoms of inflammation-classically fever or warmth, local or generalized pain, swelling or induration, and redness-infection is likely at fault.  Infection may be diagnosed by growing the pathogen in appropriate culture conditions from a specimen (urine, blood, sputum, etc.) of the sick person.  In the case of a Strep throat or a bacterial urinary tract infection this is straight forward.  In many other infectious diseases it if very difficult if not impossible to culture the disease-causing germ.  Viruses are especially resistant to culture.

Infection is sometimes diagnosed by seeing the pathogen usually under a microscope since they are very tiny.  Again this can be routine as when the germ causing tuberculosis is seen under the microscope in a sample of a sick patient’s sputum.  Many germs that cause stealth infection are difficult to see.  Viruses because they are extremely tiny are not typically seen under the light microscope but may be seen under an electron microscope.  Many germs that cause stealth infection have adapted the ability to enter our human cells and may be more difficult to see even under the microscope.  Special staining techniques can assist in seeing these pathogens within cells.  Stealth germs may reside in nests of sticky material known as biofilms and not be readily visible.  When stealth germs are present in specimens in small numbers, which is often the case, they may be overlooked with microscopic visualization techniques.  Techniques are sometimes employed to try to increase the numbers of pathogens in a specimen using tricks to concentrate their numbers in order to make it more likely that they may be seen.

What are some of the tests use to diagnose stealth infection?

Very commonly infection is inferred by indirect tests that depend on measuring factors from the patient that are specific for infection.  These tests are sometimes referred to as serologic tests (present in the patient’s serum/blood) or antibody titer tests.  Often, but not always, when a stealth pathogen is present it will trigger the immune system to form antibodies which are proteins produced by specialized cells of the immune system.  Of course this requires that the patient’s immune system is capable of making enough antibody to measure.  Sometimes the amount of antibody is measured at the onset of suspected infection and again later to see if the quantity of antibody rises (acute and convalescent titers).

Are some germs that cause stealth infection able to defeat our immune system?

Some stealth pathogens have developed the capability of preventing the patient’s immune system from making antibodies that would normally assist in the control or elimination of the disease.  These stealth pathogens have “learned” to become immune system disruptors in order to give them a survival advantage in evading immune system attempts to control or eliminate them.  Some stealth pathogens make enzymes that break down or digest elements of our immune systems rendering it ineffective in combating disease.  In other cases antibodies that are produced by the body may not be specific for the germ that is causing the stealth infection and the infection may be wrongly diagnosed.  These types of antibodies are said to be cross-reactive.

More recently molecular diagnostic techniques are emerging that attempt to identify molecules within the patient that are unique to a specific stealth infection-causing germ.  Often the DNA or RNA molecules of the stealth pathogen are the targets for this type of testing which sometimes goes by the name PCR testing.  DNA and RNA, of course are the unique instruction-containing “molecules of life” that differentiate one living being from another.  They are “fingerprints” so to speak that identify each creature.  Testing techniques which attempt to identify DNA or RNA of a stealth pathogen are rapidly being developed.  One drawback is that there must be enough DNA or RNA to pass the threshold of detection within the specimen being evaluated.  The exact sequence or makeup of the DNA or RNA of the stealth germ must have been previously determined in order to diagnose a specific infection much in the same way that to catch a criminal with a fingerprint, the fingerprint of that criminal must have been determined previously.  Even though the DNA or RNA of a specific stealth germ is identified in a patient’s specimen, there is no guarantee that the presence of the germ in question is directly causing the patient’s chronic disease.

Later we will explore how stealth germs actually cause disease once they enter the body.

Aboutdr_tyler Wally Taylor MD

Dr. Taylor practices integrative medicine at Texas Integrative ENT and Allergy in Austin, Texas.  After obtaining a general medical doctorate degree from University of Texas Southwestern Medical School in Dallas he completed a general medical internship and residency training in head and neck surgery ENT and allergy.  After 20 years service in the US Army Medical Corps and practice in Colorado and Texas he founded Texas Integrative where he now offers a functional holistic approach to disease which treats the entire individual instead of each separate symptom.  He has found more satisfying results using this Systems BioIndividualized approach.  His motto is Health and Wellness from Head to Toe”.   www.texasintegrative.com     office phone-512-420-9300  

STEALTH INFECTION IN CHRONIC DISEASE

stealth (definition)- cautious and surreptitious action or movement. synonyms: furtiveness, secrecy, surreptitiousness, sneakiness, slyness.

  Varro, in the first century B.C., had said that swampy land was dangerous because “certain minute animals, invisible to the eye, breed there, and borne of the air reach the inside of the body by way of the mouth and cause disease.”

Since the days of great early physician-scientists including Pasteur, Koch, Jenner, and Lister it has been accepted that human disease often results from the presence and activity of tiny living creatures that we know as germs.

When a microorganism or germ infects an individual often disease occurs quickly which is characterized by fever, swelling, pain, redness and symptoms including vomiting, cough, malaise, and fatigue.  This classic presentation of infection which is readily apparent is appropriately termed active infection or acute infection.

Medical discovery is now demonstrating that a wide array of symptoms and signs of disease are associated with infection of a different sort.  The concept that microorganisms are able to persist in the body and continue to produce illness over weeks, months, or even years is becoming more widely appreciated.

This concept is really nothing new at all.  Examples of persistent infection which continues to cause disease is readily accepted in diseases including syphilis, tuberculosis, AIDS, Lyme Disease, and chronic hepatitis just to name a few.  In addition, the reemergence of symptoms following prior infection is readily accepted in diseases including recurrent Herpes sores, shingles following chicken pox, rheumatic heart disease following Strep infection, pneumonia following Histoplasmosis fungus infection, and many others.  What is less commonly appreciated is the relationship of many other cases of long-lasting illness associated with a wide and diverse group of microorganisms capable of causing stealth infection.

Today many patients with persistent, unexplained symptoms of disease are very likely to be manifesting illness resulting from persistent stealth infection.

A list of symptoms that are associated with stealth infection include fevers, sweats, chills, flushing, weight gain, weight loss, fatigue, tiredness, exhaustion after limited exertion, unexplained hair loss, swollen glands, sore throat, pelvic pain, unexplained menstrual irregularity, breast pain, irritable bladder, sexual dysfunction, loss of libido, upset stomach, constipation, diarrhea, abdominal bloating, chest pain, rib soreness, shortness of breath, cough, heart palpitations, rapid heart beat, joint pain, joint swelling, joint stiffness, neck pain, neck stiffness, back pain, back stiffness, muscle pains, muscle cramps, twitching muscles, twitching face, headaches, numbness, tingling, burning sensations, stabbing sensations, tremors, seizures, facial paralysis, blurred vision, double vision, dark vision, ringing of ears, light headedness, poor balance, difficulty walking, muscle weakness, ear ringing, vertigo, hearing loss, motion sickness, ear pain, difficulty concentrating, confusion, disorientation, getting lost, poor memory, trouble talking, trouble writing, mood swings, irritability, depression, anxiety, panic attacks, disturbed sleep, excess sleepiness, and headaches.  Some of these symptoms may be seen in diseases not resulting from stealth infection.  Different combinations of these symptoms are seen in different cases of stealth infection.

Medical science is discovering an emerging connection between stealth infection and many well-known diseases that have not commonly been associated with an infectious cause in the past.  Some examples of diseases possibly caused by stealth infection include Alzheimers, autism, arthritis, epilepsy, diabetes, obesity, heart disease, stroke, certain cancers, hepatitis, Crohn’s disease, Ulcerative colitis, Chronic Fatigue Syndrome, fibromyalgia, chronic depression, Schizophrenia, eczema, psoriasis, asthma, cardiomyopathy, infertility, interstitial cystitis, endometriosis, Polycystic Ovarian Syndrome, Hashimoto’s thyroiditis, Lupus, Sarcoidosis, Parkinson’s disease, Amyotrophic Lateral Sclerosis (ALS/Lou Gehrig’s disease), adrenal disease, immunodeficiency syndromes, chronic inhalant allergy, chronic food allergy, autoimmune syndromes, and many others.

In this serious of articles I will explore the answers to a number of questions regarding stealth infection in an effort to better familiarize the reader with this group of diseases and how to more effectively diagnose, prevent, and treat these ever-present sources of human misery.

Why have stealth infections not been appreciated and previously recognized?

Probably the main reason that stealth infection has not been more widely appreciated is due to the fact that the microorganisms that cause stealth infection have been very difficult to recover and grow in the laboratory.  In fact the presence of certain germs causing stealth infections have been difficult to find and identify at all.  Although some scientists use the term “germ” to refer only to a bacterial organism, in this series of articles I am using the term to also include viruses, molds, fungi, yeasts, rickettsia, and single cell parasites.  In the last several decades the ability to find, isolate, and identify these microorganisms has rapidly advanced.  There is still a lot of work yet to do in this area.  Diagnosis of stealth infection continues to be plagued by issues of cost and unreliability but improvements are occurring rapidly.

Why doesn’t everyone manifest symptoms of stealth infection?

We now know that each one of us has a different susceptibility to manifest disease.  This means that two different individuals infected with the same stealth infection-causing germ can manifest completely different symptoms.  In fact one person may be very ill while another may have no symptoms at all. This difference in susceptibility is due to many factors.  One of the most important factors is our genetic makeup.  Another factor is the presence of environmental toxins that affect our susceptibility to disease.  Yet another factor is our diet and our levels of various critical nutrients that regulate all our cellular functions including our immune system and our ability to remove harmful toxins from our bodies.  Our stress levels alter our susceptibility to manifest disease due to stealth infection. The presence of combinations of different stealth organisms can lead to different manifestations of disease.

In Part 2 I will explore the ways in which stealth infections injure our cells and tissues resulting in the symptoms of disease.  I will discuss the role of our immune system in controlling these microorganisms and why we have difficulty in getting rid of them.  I will also discuss how our immune system accounts for much of the damage caused by the presence of stealth infection.

METHYLATION AND MTHFR-WHY SHOULD YOU CARE?

There has been a lot said about methylation in healthcare blogs in the past few years-and for good reason.  Methylation is arguably the most important metabolic process in our human body.  For many of us, it is not going as it should.  Let me explain.

Many of our most important molecules will not behave normally if they lack the addition of a methyl group.

A methyl group is a portion of a molecule made of of four atoms-one carbon atom and 3 hydrogen atoms abbreviated -CH3.

We have over 100 different enzymes in our body dedicated to moving a methyl group to where it is needed.  These enzymes are known as Methyl Tranferase enzymes.  Methyl groups are necessary to signal when a DNA gene will be expressed (turned on) or not expressed (turned off).  A methyl group is required to make some of the most important molecules in our bodies like serotonin, dopamine, epinephrine, serine, methionine, choline, creatine, and melatonin.  Our body uses methyl groups in the process of removing undesirable substances like histamine and other toxins.

Healthy-FamilyBalanced methylation is critical for normal brain function and mood (neurotransmitter balance), removal of toxic chemicals (detox), normal immune function, normal hormone balance, normal cell division, and normal energy metabolism.  In short just about all of our critical body functions depend on normal and balanced methylation occuring each and every second of our lives.  Disorder of methylation plays a role in many chronic disease states including autism, autoimmune disease, chronic fatigue syndrome, hormone imbalance and deficiency, anxiety, depression, insomnia, migraine, heart disease, Alzheimer’s, immune deficiency, allergy, infertility, and weight gain just to name a few.         In fact methylation is so important that a website  http://www.mthfr.net    is dedicated to a more thorough understanding of this important process and the disorders associated with it.

 

S-Adenosyl Methionine (also known as SAM-e) provides the methyl groups needed for these methyl transfer steps.  In fact SAM-e is the second most commonly used chemical substance in our bodies after Adenosine TriPhosphate (ATP) which is number one.  Our body must constantly regenerate SAM-e in a cycle known as the Methionine Cycle.

The cycle to regenerate SAM-e which is needed for billions of reactions in our cells every second requires the cofactors vitamin B12 and Folate to proceed normally.  The cycle needs a special form of B12 and a special form of Folate if it is to occur normally.

The form of Vitamin B12 which the body uses to regenerate SAM-e is called MethylCobalamine (sometimes called MethylB12 for short).  Other forms of B12 must first be converted to MethylCobalamine before methylation can proceed.

The form of Folate needed by the body to regenerate SAM-e is called by several different names but a common name is                                                 L-5-MethylTetraHydroFolate (often abbreviate MTHF for short).  This active form of Folate is formed by an enzyme known as MethyleneTetraHydroFolate Reductase (often abbreviated MTHFR).  This enzyme and the DNA genes which code for its formation in the body are the subject of much attention and some controversy.  This is due to the fact that gene variants or pre-existing mutations are very common in the population and result in a slower rate of formation of MTHF (active folate).  The best known gene variant which is quite common is the variant known as MTHFR C677T.  In some human populations it can occur in over 40% of individuals.  You can see that methylation imbalance is quite common.

Depending on the availability of MethylB12 and MTHF in our cells the formation of SAM-e may be going too fast (a condition sometimes referred to as OverMethylation) or too slow (UnderMethylation).  Either condition is associated with observable symptoms and signs.  Methylation like in Goldilocks and the three bears is best when it is neither too fast nor too slow but “just right”.

The form of Folate known as Folic acid refers to a synthetic (manmade) form which is not useful to the cell unless it is converted to the active form.  Synthetic Folic acid is an additive in many foods and vitamins.  For individuals who lack the ability to convert synthetic folic acid to the active form properly, folic acid can be a liability and may block the function of the active form.  There is currently a movement to eliminate the addition of synthetic folic acid for this reason.

We know that over half of the SAM-e generated in the Methionine Cycle goes to the formation of two molecules- choline and creatine.  Since so much of our SAM-e is used up making these two vital molecules, it makes sense that providing choline and creatine can free up SAM-e for other important methylation steps.

Methylation is a very important piece of our metabolic puzzle and plays a critical role in our normal physiology.  Methylation plays a key role in normal aging, health maintenance, and recovery from disease.  Learning to optimize your methylation process appears to be important in achieving true health, sustained wellness, and long life.  Dr. Wally Taylor at Texas Integrative Medicine understands the importance of a balanced and normally functioning methylation system in the body and has experience in the evaluation and treatment of methylation disorders.  Call Dr. Taylor’s Austin, Texas office at 512-420-9300 if you have questions or to arrange for an appointment.

Lyme Disease Continues to Generate Controversy

Everything from the name to the treatment of this disorder that seems to be affecting more and more Texans seemingly creates disagreement.

In an effort to be able to better evaluate and help the ever-increasing number of people who seek out my integrative medicine services  for persistent chronic disease that is not responding adquately to conventional medical treatment, I will be traveling to Ft Lauderdale, Florida, to attend the International Meeting of the International Lyme and Associated Diseases Society (ILADS) later this month.

One area that all groups seem to agree upon is the fact that Persistent Lyme Deer Tick FemaleBorreliosis can mimic a number of other better known diseases including multiple sclerosis, Parkinson’s disease, Chronic Fatigue Syndrome, and Alzheimer’s disease.  It has been called “the Great Masquerader”.

Controversy continues in regard to the exact diagnostic criteria and treatment.  The ILADS providers contend that persistent Lyme is greatly underdiagnosed (estimates of as many as 90% of cases going undetected) and undertreated.  This continues to cause suffering and ultimately increasing disability.  Experts at the meeting will be presenting the latest information on new and improved diagnostic tests and treatments to help control this mysterious yet debilitating disease.

Recent studies in Texas and in many other parts of the USA have demonstrated that the ticks that carry the Borrelia germ that causes Lyme and a number of other associated germs like Babesia, Bartonella, and Ehrlichia are known to be fairly common in wooded areas.

It is broadly appreciated among health care providers that the earlier the infection by tick-borne germs like the Lyme-causing Borrelia are treated, the greater the likelihood of complete eradication of the disease and the less the chance of persistent disease and disability.  The longer the disease persists, the harder it is to get rid of.

erythema_migransTreatment depends not only on antibiotics to kill the disease-causing germs, but also treatment to reduce inflammation, remove bacterial toxins, and improve the function of the immune system which is disrupted by the presence of the germs.

Suspect infection any time a tick is found attached to the body.  Even a fairly short period of tick attachment can lead to infection by the germs involved.  The classic rash associated with early infection called a “Bull’s Eye Rash or Erythema Migrans” is only appreciated in less than half of confirmed cases.  If you are concerned about Lyme disease or persistent undiagnosed disease I would like to help you get to the root cause of your disease process.  Call 512-420-9300 for an appointment.