Low Body Temperature & Disease

By Dr. David Jernigan:

In Chronic Fatigue Syndrome there are many theories as to the cause. Some say it is the effects of heavy metal and chemical toxicity. Some say it is chronic infections, while others say it is the side-effects from vaccines and the use of suppressive medicines such as acetaminophen, aspirin, and ibuprofen, still others say it is dysregulated hormones or the effects of emotional trauma.

It this author’s opinion everyone is correct in the same way as the proverbial three blind men describing an elephant from the head, tail, and the side are correct in each one’s description but only from his unique vantage point. However, in Chronic Fatigue Syndrome there is one common overriding finding…low body temperature!

This article deals primarily with the very predictable problems seen in low body temperature and the profound importance of restoring and maintaining normal core body temperature. This is true not just in Chronic Fatigue Syndrome, but in every degenerative disease of our day.

Your core body temperature is the temperature taken under the tongue. When human physiology books refer to the “normal” core body temperature it is presented as a range sometimes listed between 97.0-99.0°F . Understand that the “Normal Range” for temperature or even the normal ranges in blood tests are based upon the average person of our day. That is why “normal” changes periodically, because as our average population continues to get sicker the normal ranges must be adjusted. So in this discussion I am speaking about what is an optimal core body temperature – 98.6-99.6°F.

Much emphasis in conventional medicine is usually placed upon feverish conditions; however, a low body temperature can be a much more sinister condition. Where a fever can be viewed as an active developmental and corrective process of the healthy body, a low body temperature can never be viewed as a normal or healthy condition, nor is it a mechanism for a learning or developmental process in the body.

A low body temperature creates a happy home for viruses and chronic infections, and is a sign of degeneration and gradual cellular death. The problem with a low core temperature is that no effective immune response can be mounted therefore no fever is generated and infections go undetected. The sickest person is one who gets the same infections but never miss a day of work because there is no response by their immune system, so they have a false sense of wellness as healthier individuals go through healthy fevers and immune responses that may cause them to miss work.

Low body temperature is the plague of the 21st century. People with low body temperature have a weak reaction to even the most ideal medicines and therapies.

As the body’s core temperature decreases all cellular energy also decreases thereby leading to profound and chronic fatigue that is not relieved by sleep.

The effects of low temperature:

The cooperative and collective intelligence of the human organism is short-circuited as the body temperature cools. As a result, all cellular functions decrease. There is a decrease in the production of all hormones, neurotransmitters, and other body chemicals necessary for healthy regulation of energy.

In this mild hypothermia condition there is an increased susceptibility to infectious disease as temperature drops the acidity of the body increases and the normally predominantly negative polarity of the cells become more positively charged.

The colder the body becomes the more prone to depression and other psychological abnormalities and all degenerative illnesses of the body, mind and spirit.

Until the causes of the lowered temperature are addressed and corrected, the best that can be hoped for is only temporary or mild improvement of symptoms and a gradual but steady overall decline in health.

Viruses prefer and promote a cold environment and replicate at a much more rapid rate when the body is cold. Viruses are killed and further replication is impeded by maintaining a warm body. Some bacteria such as Lyme spirochetes also prefer and promote a cold environment and can remain in a chronic state as long as their cold environment is maintained. Therefore, in the interest of the prevention and treatment of any viral, bacterial, or chronic illness, this topic must be understood.

The ultimate body coldness is seen in death. When observing a corpse many clinical gems can be gleaned and correlated to degenerative states of human suffering. In death, the blood and lymph fluid of the body solidify and the body becomes stiff and cold. In the same way many chronic cold illnesses such as, fibromyalgia, chronic fatigue, cancer, Lyme disease, Multiple Sclerosis, diabetes, and heart disease, we see that the body becomes progressively colder. As the body cools, the electrical oscillations of the fluids in the body slow down and there is a shift in the body’s polarity which promotes infectious microbes and cancer.

We can see the same principle of what happens in the body by observing the same dynamics in a water molecule. When the electrical oscillations of a water molecule slows down it becomes a solid, ice, as we speed up a water molecule’s electrical oscillations it liquefies and ultimately becomes a vapor.

The colder a body becomes, the slower the electrical oscillatory rate and therefore the thicker, more viscous, or syrupy the body fluids become. The more viscous the fluids become the more difficult it is for the body to push the fluids through the body. The lymph fluids that are normally supposed to bathe the outsides of all of your cells become progressively stagnant as it is too thick to move efficiently.

Now, consider the fact that just like your skin is constantly dying and flaking off and being replaced, so it is that every cell in your body is in a constant state of dying and being replaced. Only now the cold, syrupy lymph fluid cannot wash the dead cellular debris away. As a result the body becomes a toxic waste dump!

Muscles normally have a high demand for energy. Through contraction and relaxation muscles assist in eliminating their own cellular waste products. In a cold body however, the liquidity of the fluids inside of the muscles is gone, and the muscles cannot move the toxins and cellular debris.

The deeper you go into belly or center of the muscle, the colder and more difficult it is to move the toxins. Without normal viscosity of the body fluids, muscular contraction and relaxation grinds to a halt, like an engine with no lubricating oil. The belly of the muscle develops a knot that can be felt when massaging the muscle. This is the knotted, painful, muscle condition commonly known as “trigger points” of Fibromyalgia Syndrome, which is being diagnosed in millions of people every year.

If the low body temperature is allowed to persist and no therapies are applied, even in a palliative manner as in massages to move toxins manually out of the belly of the muscle, the condition follows that of the water molecule. The belly of the muscle, due to the increasing coldness and decreased muscular activity progressively over time reaches the point of zero electrical oscillations at which time the tissue solidifies in a calcified stone in the belly of the muscle.

Interesting research that supports this concept has been performed by Dr. Carolyn McMakin, D.C. using the electro-therapy called microcurrent. The microcurrent is applied through direct contact on these trigger points via vinyl/graphite gloves connected to the microcurrent machine.

The trigger points virtually vanish under the gentle touch of the glove when applying the correct electrical frequency. What may be happening here is that the stimulation of the muscle through microcurrent is externally increasing the electrical oscillatory rate of the thickened fluids in the muscle resulting in temporarily restoring the normal liquidity of the fluids allowing the muscles to once again contract and pump out the toxic accumulation.

The results are somewhat temporary due to the fact that the underlying condition that created it in our scenario, the overall low body temperature, remains unchanged. However, used in combination with various other corrective measures, this microcurrent therapy can speed healing in many cases. Relief of Fibromyalgia Through Microcurrent Therapy by John W. Addington ImmuneSupport.com 7-11-2001

Organ Circuits and low temperature

The body is set up with dedicated electrical circuits all of which are interdependent and interconnected. A circuit in the body has a specific organ, gland, teeth, muscle, and nerves. If anything goes wrong in one of these organ circuits the circuit energy goes down approximately 60% of normal.

The laws of thermodynamics state if we decrease energy we decrease temperature. Due to the interconnectedness of all the circuits, one circuit in the body cannot go down without ultimately affecting the whole.

Therefore, if the muscle is seizing up and becoming progressively rigid and solidified, what do you suppose the organ that is also on that same electrical circuit is doing? It is likely that to some degree it is also progressively seizing up and solidifying.

In the 50,000 miles of blood vessels, the cold thick blood is more difficult to flow through the veins and arteries. Arteriosclerosis, the progressive hardening of the arteries, and the clogging of the blood vessels is manifesting the exact same problem that is being experienced by every tissue in the too cold body.

Edema in the extremities is seen as the muscular walls of the blood vessels seize up and can no longer maintain tone and the fluids leaks out of the pores in the vessels.

I look at many older patients, and some not so old, who are experiencing all the signs and symptoms of death in the extremities. They are dying in their extremities first, from the feet and hands up to legs to the torso. To touch their feet is just like touching an icy, stiff, dead corpse. The foot is deathly whitish blue and etched in blue/black blood vessels from devitalized, stagnant blood.

The overcooling of peripheral blood returning from cold legs and feet causes depression of the temperature in the vital organs with slowing of metabolic processes, particularly in the brain and medullary centers. Cotran R.S., Kumar V., Robbins S.L., Robbin’s Pathological Basis of Disease 4th ed. 1989 pp501. Death occurs when a vital organ reaches the point of being too cold.

Your physician can name your disease, he can call it cancer, he can draw your blood and show you everything that is wrong with it, but he is simply describing the process I have just outlined. When the core temperature of the body is cold every organ, gland, and tissue is affected and becomes hypo-functional or may even become hyper, as in the case of hyperthyroidism, in a last ditch effort to compensate for the hypothermic condition of the body.

Hypo-function in the body means that there are fewer hormones, and less of every chemical involved with normal body and brain function. Even the psyche is affected leading to virtually any type of psychological problem, especially depression. How many people are told that they have psychological depression from a deficiency of a certain brain chemical?

Many!

Can you see that of course they are deficient in “happy” brain chemicals possibly due to the overcooling of the body?

It might be said that you are dying in direct proportion to the coldness of your body. Follow this logic: Cells degenerate and die in direct proportion to the depletion of oxygen. Blood that is overcooled from a cold core temperature is too thick to efficiently carry oxygen and the lung vital capacity is reduced leading to shallow breathing.

This means that the oxygen to carbon dioxide exchange rate in the lungs is minimal. Now combine the degenerative effects of the oxygen deprivation and the cold temperature and the fact that all of this and the overgrowth of microbes promote an acidic environment and you have greatly accelerated cellular degeneration and the onset of life-threatening disease.

There is an optimum body temperature is which all chemical reactions in the human body need in order to maintain health...98.6° F. I can honestly say that I rarely see a new patient come into my clinic with a normal body temperature. One 66 year old woman came in as a new patient with a temperature of 94.6! She was in dire straits for certain. She could not feel her feet and to touch her legs was like touching the legs of a corpse, the legs even looked dead and grey, streaked with blue/black veins of stagnant devitalized blood.

In classic hypothermia, as seen in people stranded in blizzards, it is well known that the circulation of blood in the arms and legs is reduced dramatically, almost to zero, in order to provide protection and warmth to the vital organs. These people will also cease to feel cold and will experience numbness, loss of coordination, mental confusion, and heart rhythm problems. It sounds like I am describing many elderly people, and some cancer sufferers doesn’t it?

One way to treat weather related hypothermia is to give the person warm sugar drinks. Sugar is a cheap, fast burning fuel for your body and therefore generates a lot of heat in the process. This may be why so many people suffering from lifestyle induced cold core temperature are plagued with sugar cravings.

Many of them consume copious amounts of sugar in the form of soda pops, chocolate, pastries, and various candies. It may be a craving that is driven by the body’s desire to generate fast heat to keep the body functioning. Sugar cravings should diminish as the core body temperature problems are resolved.

Keep in mind that the body has been too cold possibly since birth, due to multi-generational use of suppressive medicines, vaccines, fever-reducers, heavy metal and chemical toxins, and from the consumption of energetically dead food.

The retraining and resetting of the body’s thermostat is just the beginning of healing the body of chronic illnesses. The normal body temperature must be held steady possibly for a year or more in some cases before the body can undo the damage of a lifetime of coldness.

Understanding your Temperature

Everyone can afford a simple thermometer. Track your temperature when you first awaken in the morning, before even getting out of bed. This reflects your core body temperature, when it is not being influenced by what you just ate, drank, or your activity level. Many of you will likely be surprised to see just how cold you already are. This is the result of generations of suppressive therapies and an imbalanced life. You must save yourself.

Many doctors will undoubtedly say that you need to take a thyroid medication to bring up the body temperature; however this is the same mentality of taking a Tylenol for a headache. If you don’t believe me then ask anyone on the prescription thyroid medicines- what happens when they go off of the medication? The body returns immediately to the previous cold, hypo-functional condition.

One should definitely support the normal functioning of the thyroid, by detoxification, organic iodine, adrenal glandular supplements, and nutritional support, but see the coldness for what it really is, a sign of multi-organ system breakdown, and longstanding or even generational imbalance. Besides, it is the hypothalamus that regulates your core body temperature, along with regulating your degree of motivation and sex drive. The hypothalamus is actually “upstream” from your thyroid, helping the pituitary regulate the thyroid.

The healthy body has daily temperature fluctuations (diurnal) with the coolest temperature upon awakening in the morning hours of 6-8 a.m. and the warmest being in the evening between 8-10 p.m. Tracking of the difference between morning and evening temperature should reveal, in a healthy person, a difference of at
least 0.9° F (0.5° C).

People with a low body temperature and an overall degenerative condition will find that this temperature variation is minimal. Another unusual finding of dysregulated body temperature is that the evening is often colder than the morning reading.

The body’s best chance at long-term healing increases in direct proportion to the restoration of normal body temperature. The effect of even the most perfectly selected medicines is limited by the available energy in the body to correctly utilize those medicines.

You and your healthcare team must address your body from every direction and with every balancing tool available. You can never truly overcome this condition with pills. Therapies must engage and reactivate and stimulate the rhythmical, metabolic, and nerve/sense aspects of your body, addressing the body, mind, and spirit.

Other supporting therapies designed for restoring the rhythms of the body must be applied. These therapies might include color and sound therapy, hot and cold contrast therapy, life-activity planning, breathing and voice therapy, rhythmical massage therapy, curative movement therapies, and indeed every other treatment from your doctor will address in some way the rhythmical aspects of your body.

Low body temperature must be addressed to bring the body back to balance. The temperature must be elevated to end the dying process of the body and to help the body eliminate the cellular debris or the “sludge” in the body.

Treatment:

· Temperature monitoring and graphing (upon awakening before getting out of bed, and between 8-10 pm after a 30 minute resting period)

· CRT (Computerized Regulation Thermography) for identifying problem areas and tracking of progress.

· Core Warmth™ herbal formula (Hansa Healing Products, Inc.) to open all meridians and restore proper fluid dynamics and warmth regulation in the body.

· Sleep on an Amethyst Infrared BioMat,  provides detoxification and restoration of fluid viscosity and core body warmth through variable infrared heat and negatively-charged ions from amethyst crystals.

Fibromyalgia, Chronic Fatigue Syndrome and Lyme Disease

Fibromyalgia, Chronic Fatigue Syndrome and Lyme Disease

by Bonnie Gorman RN

Dr Sam Donta presented a comprehensive, compassionate, cutting-edge lecture to Mass. CFIDS/FM Association members on November 3rd, 2002. His topic was "The Interface of Lyme Disease with CFS and FM: Diagnostic and Treatment Issues." Dr. Donta is a nationally recognized expert on Lyme disease. He is the Director of the Lyme Disease Unit at Boston Medical Center and a Professor of Medicine at BU Medical School. He is a bacteriologist and an infectious disease specialist, who views CFS and FM from that vantage point. He is also a consultant to the National Institutes of Health (NIH), and presented at NIH's scientific meetings on CFS research.

What does Lyme disease have to do with CFS and FM you might be asking? Some people believe that Lyme disease may be one of the causative factors in both CFS and FM. Others believe that some CFS and FM patients are really misdiagnosed chronic Lyme disease patients and vice versa. Some believe that there is no such thing as chronic Lyme disease, instead these patients actually have CFS or FM. We asked Dr. Donta to help sort all this out.

Parallel Symptom Patterns

Dr. Donta presented the symptom lists for chronic Lyme disease, chronic fatigue syndrome (CFS), fibromyalgia (FM), and Gulf War Illness (GWI). He pointed out the similarities between them, and found there were few differences. He has treated hundreds of patients with these illnesses. He found that CFS and GWI have identical symptoms, and FM is only distinguished by a positive tender point exam, that is often positive in CFS and GWI as well. Clinically it is almost impossible to distinguish or differentiate these illnesses.

He has concluded that chronic Lyme disease is remarkably similar to CFS, FM, and GWI. These multi-symptom disorders have similar symptom patterns consisting of fatigue and neurocognitive dysfunction, along with numerous other symptoms that probably relate to altered neurological function. Musculoskeletal symptoms may be more frequent in FM and in some patients with chronic Lyme than in CFS, but the definition of CFS and GWI also includes muscle aches (myalgias) and joint aches (arthralgias).

Lyme Disease Symptoms

Flu-like illness, fever, malaise, fatigue, headache, muscle aches (myalgia), and joint aches (arthralgia), intermittent swelling and pain of one or a few joints, "bull's-eye" rash, early neurologic manifestations include cognitive disorders, sleep disturbance, pain, paresthesias (including numbness, tingling, crawling and itching sensations), as well as cognitive difficulties and mood changes.

The only symptom difference in Lyme disease is the expanding circular rash with a clearing area and center resembling a "bull's eye." He pointed out that Lyme has multiple types of rashes and half of the rashes are not typical, they may not even include the "bull's eye" rash. They can appear from two day after the bite, then go on for a week or so. Patients who are infected may not develop or see the rash, and may not develop any future symptoms. In studies, only one third of the patients were actually aware of their tick bites.

30-50% of acute Lyme disease patients went on to develop chronic Lyme disease. Additionally, some previously asymptomatic patients may reactivate their infection following various stressors such as trauma, surgery, pregnancy, coexisting illness, antibiotics treatment, or severe psychological stress. The Lyme vaccine can also reactivate their infection. Similar triggers such as trauma, surgery etc. are known to precipitate CFS, FM and GWI as well. This is not a new phenomenon with infectious diseases. We know infectious diseases (i.e. TB) will reactivate after illnesses or surgery-- any stressor.

Dr. Donta reported on the effects of gender on host susceptibility in Lyme disease, CFS, FM and other multi-symptom diseases. In all these disorders, women appear to be more affected than men, usually at about 2:1 ratios. He noted that neural cells contain estrogen and progesterone receptors, and that herpes viruses can utilize estrogen receptors to gain access to the reservoir in the cell nucleus. Treatment of chronic Lyme disease also seems to be gender-dependent to some degree, with men generally having more speedy and complete recoveries compared to women. He concluded that gender relationships are known for a number of infectious diseases, so it would not be surprising that such a relationship exists for chronic Lyme disease, CFS, FM and other multi-symptom disorders.

Etiology

Lyme Disease: A distinct difference between Lyme disease, CFS and FM is that the origin of Lyme is clear. Lyme disease is caused by spirochetal bacteria transmitted by the bite of an infected deer tick. This bacteria is the Borrelia burgdorferi bacteria. It was identified in the late 1900s in Europe. The US was late to recognize what Europe had described. Lyme disease was not formally identified by the CDC until 1977 when arthritis was observed in a cluster of children in and around Lyme, CT. Since that time Lyme disease has been identified in many states. The CDC reports that it causes more than 16,000 infections per year in the US. Some researchers feel that the prevalence is higher than that.

CFS and FM: Dr. Donta feels that Lyme disease is an important cause of CFS and FM. In addition to Lyme, there are a number of other possible causes. The evidence is still circumstantial though. Epstein-Barr virus (EBV), the major cause of infectious mononucleosis, continues to be debated as a cause of CFS. It is uncertain whether EBV can cause symptoms other than fatigue, such as myalgias and arthralgias that are not seen during acute or reactivated EBV infection in patients who are being immunosuppressed, but it remains possible that EBV could cause one type of chronic fatigue disorder. There are also other herpes viruses i.e. HHV6 that are being evaluated as potential culprits.

Dr. Donta reported that recently recognized species of Mycoplasma (Mycoplasma fermentans, Mycoplasma genitalium) have been implicated in CFS, FM and GWI. These same bacteria have also been implicated as causative agents of rheumatoid arthritis, based on PCR-DNA evidence in patients with these disorders in which 50 percent are found to have the DNA of the Mycoplasma in circulating white blood cells, compared to 5-10 percent of a normal population. Whether the presence of this DNA represents past exposure or ongoing infection remains to be resolved. No long-term studies have yet been performed in patients with CFS and FM to determine whether the finding of Mycoplasma DNA persists over months or years or whether such patients have any evidence of other infection such as Lyme disease or infection with Chlamydia species.

Central Nervous System Involvement

Dr. Donta reported that in Lyme disease, the nervous system seems to be the primary target for the bacteria causing the disease. Patients with Lyme disease express many neurologic symptoms such as pain, paresthesias including numbness, tingling, crawling and itching sensations, as well as cognitive difficulties and mood changes. Even the joint pains and occasional arthritis appear to be neuropathic in origin, as anti-inflammatory agents such as ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAID) have little if any effect on the pain. Experimental evidence from animal models also affirm the localization of B. burgdorferi DNA to the nervous system. Dr. Donta postulates that the disease mechanisms could involve inflammatory responses, autoimmune responses or toxin-associated disruption of neural function. Any inflammatory responses appear to be weak, and there is no compelling evidence that Lyme disease is a result of immunopathologic mechanisms.

Commenting on his research, Dr. Donta speculated that if they are correct, and lyme bacteria is a nerve toxin that interferes with the transmission of the nerve impulse, then that is all you need to impede the normal flow of information. There is a lot of cross-talk in the nervous system. This toxin will decrease that cross-talk causing delayed responses resulting in cognitive problems-- the brain fog so commonly described in all these multi-symptom disorders.

Although the disease pathways for other possible causes of CFS and FM have not been defined, Dr. Donta postulates that the central nervous system would appear to be a logical target for other pathogens or other disease processes. These illnesses clearly affect the brain and are bound to cause many neurological manifestations. Any changes in immunologic function would not appear to be sufficient to explain the various symptoms, and are likely to be secondary to other disease processes.

He feels we have been thinking too simplistically about finding whole organisms replicating in chronic diseases. It is highly likely that there is no single cause for these illnesses. It's more likely that there are multiple causes-- different organisms causing the same final set of symptoms. Researchers need a better algorithm to study these fatiguing illnesses. We need to be more inclusive, rather than trying to separate the illnesses. Sometimes in medicine, if an illness is too complex to study, research interest dwindles. We have the technology to do the research, but there hasn't been the will and the momentum to get it done.

Clinical Diagnosis

Dr. Donta reiterated that the diagnosis of Lyme disease is primarily based on clinical grounds, just as with CFS and FM. Once other disorders are ruled out, the combination of symptoms over months is sufficient to make a presumptive clinical diagnosis. The diagnosis of Lyme is made easier if a typical rash is present during the early phase of infection. After that, it is difficult to distinguish the flu-like illness that can occur a few weeks later, or can recur over a number of months.

Dr. Donta reported that some patients develop severe headaches and an aseptic (infection free) meningitis, which frequently is diagnosed instead as viral meningitis. If a Bell's palsy occurs (drooping of one side of the face), the possibility of Lyme disease is likely. If an unprovoked arthritis occurs, causing swelling of a single joint, especially the knee, but sometimes more than one joint, then the possibility of Lyme disease should also be given high consideration.

He emphasized that it is the chronic phase of the disease that causes most problems for physicians and patients, because of the lack of objective signs and the presence of so many symptoms that it causes some doctors to attribute psychological reasons for the patients' symptoms. Many patients then receive a diagnosis of CFS or FM, when they may have underlying chronic Lyme disease as the cause of their symptoms.

Diagnostic Tests

Tests for Lyme disease, like tests for other infectious diseases, are often confusing and circumstantial, and their analysis and interpretation has often been flawed. In infectious diseases you do a Western blot test to see if you have a specific reaction. Western blot separates out proteins antigens of an organism you are looking for. It tells you if a person has been exposed. It is not a direct measurement of the organism. It is a measurement of whether the person has antibodies to it. Antibody tests are useful in the early stages of illness as with other acute infectious illnesses. Once the illness is in a chronic phase, antibody tests are not useful.

Just as viruses change from year to year, we know the Lyme bacteria mutates. There are a number of organisms that can shift their surface protein in a matter of hours and that is how they evade detection and patients test negative. These organisms attach themselves to proteins and conceal themselves-- creating a cloaking mechanism that defies detection. This allows them to get where they want to go-- the nervous system. Once they are inside a cell, the immune system can't see them.

That said, Dr. Donta explained that lab tests have been helpful is some patients with Lyme disease, especially those with arthritis, in whom there are stronger antibody responses than in those with the chronic, multi-symptom form of Lyme. The criteria for the laboratory diagnosis has been patterned after the arthritic form of the disease, and not the chronic form; as a result, there are many physicians who are misinformed about the test's lack of value in chronic Lyme disease. The Lyme Western Blot is helpful when it shows reactions against specific proteins of B. burgdorferi, but can be negative in 25-30 percent of patients who otherwise have chronic Lyme disease.

PCR-DNA tests for Lyme in blood, urine and spinal fluid are rarely positive, most likely because the bacteria and their DNA are not present in those body fluids, but inside nerve cells. Additionally, PCR-DNA studies are very easy to contaminate.

In chronic Lyme disease, the MRI exam of the brain is positive in about 10-20 % of patients. It can show some white spots (unidentified bright objects- UBO) in various areas, similar to those seen in multiple sclerosis (MS), a neurologic disease of unknown cause that has some overlapping symptoms with Lyme disease, CFS and FM, such as the numbness and tingling or paresthesias. (There are also positive MRI findings in CFS and FM patients as well.)

Dr. Donta reported that the brain SPECT scan shows some changes in blood flow to various parts of the brain, primarily the temporal (cognitive processing) and frontal (mood) lobes in about 75 percent of patients with chronic Lyme disease. Patients with CFS have also been reported to have some brain SPECT scan changes, frequently involving the occipital lobe. No comparative studies have been made among patients with chronic Lyme disease, CFS and FM. The mechanisms underlying these changes remain to be defined, but may be due to a mild vasculitis (inflammation of blood vessels) or to a signaling problem within the nerve network of the brain in those specific areas. It is promising that these changes are reversible in most patients treated with antibiotics that appear to be effective in treating the chronic Lyme disease. These MRI changes are often slow and may take a year to reverse themselves.

These are covert organisms we are dealing with. We need more direct detection methods for blood, spinal fluid and other body fluids. How do you detect organisms in spinal nerve roots or brain? Right now we can't. Nobody is going to biopsy patients. We need an illness registry so we can do direct detection studies, particularly of the brain, after death.

Treatment: Persistence Pays Off

Dr. Donta reported that there are lots of drugs that are active against the Lyme bacteria in the test tube, but the big question is whether the drug can get to the bacteria? Lyme bacteria lives in the cells of the nervous system, perhaps other cells. Dr. Donta has experimented with various intracellular-type antibiotics. He reviewed his journey through various antibiotics. After listening to his patients he decided that some antibiotics were better than others. He then looked at clarithromycin (Biaxin) and azithromycin (Zithromax) which he found had powerful activity against Lyme bacteria in a test tube.

But the antibiotics, by themselves, did not seem to do any good. He found that you need to change the cellular pH (the degree of acidity or alkalinity), making it more or less acidic, to maximize the effectiveness of the antibiotic. This allows the antibiotic to work better i.e. doxycycline seemed to work better when the pH was higher. Dr. Donta has experimented with various agents to adjust pH i.e. amantadine (used to treat flu) and plaquenil (used to treat malaria). He just submitted proposals to NIH to study various agents to determine which is most effective.

Dr. Donta emphasized that the most important aspect of treatment is that it must be long-term-- 12-18 months, sometimes 24-36 months. This length is not unusual in the treatment of infectious diseases i.e. TB. In the first few months of treatment patients can expect an adverse reaction, symptoms will increase and you'll feel worse. You need to be able to hang in through this period, and allow 3-6 months of a treatment trial to determine if it is working. The earlier in the disease process that you start on treatment, the more successful it is. The more chronic the condition the less successful it is, and you'll need to treat over a longer period of time. This treatment resulted in substantial improvement and cures in 80-90% of patients with chronic Lyme disease. There are 10-20% who do not respond-- generally those with a strongly positive Lyme test.

Dr. Donta reported that similar results have been found in some patients with CFS and FM of unknown cause, supporting the hypothesis that some patients with CFS and FM have an underlying infection responsive to those antibiotics. Antibiotic trials in CFS and FM have been limited to one month, a duration that is inadequate to properly evaluate the potential of certain antibiotics to have a positive effect on the disease. Additional studies, examining both potential etiologic agents of CFS and FM as well as treatment trials should lead to a better understanding of both the cause and treatment of patients with CFS and FM.

Questions & Answers (Q&A)

Q: If the Lyme lab tests are inadequate and the symptoms are the same as CFS and FM, why not just treat all CFS and FM patients with the Lyme protocol?

A: You want to be conservative with your medicines. I think we have enough info now to tell CFS and FM patients to consider going on a 3-6 month trial of antibiotics and see if you're better. Consider all the other meds you are already taking that just treat symptoms and not the cause of your illness. They all have side-effects that can be hazardous. Is it worth it to you to consider a primary treatment aimed at a cause? There will be resistance from some MDs. They need to be educated. Your primary MD will need to consult an LD specialist re the treatment protocol.

Q: Do patients with Lyme disease also have bowel and bladder problems like interstitial cystitis (IS) and irritable bowel syndrome (IBS)? How are they affected by treatment?

A: Yes, many patients with Lyme have IS and IBS. He was surprised how much the bowel disorders affected treatment. Tetracycline generally helps the IBS. Plaquenil can sometimes irritate the bowel.

Q: I have received different results for the western blot Lyme test. Why?

A: Lyme test results are not reproducible from one lab to the next. You will get different findings from different labs. The western blot is not a great test for Lyme since the responses to Lyme bacteria are already very small responses.

Q: I've been sick for 15 years with CFS and my Lyme test was negative. Is there any value in treating now?

A: If the test was negative but you have the complex of symptoms and there is no other obvious answer, why not give antibiotics a try.

Q: I had the Lyme vaccine then got Lyme symptoms. Why?

A: Lyme vaccine was pulled from the market because it was causing reactions and reactivating a slow onset of Lyme disease.

Q: What are the ocular problems in Lyme?

A: He sees optic neuritis, similar to that seen in atypical MS patients.

Q: Is there any Lyme connection to cutaneous lymphoma?

A: He has looked closely for any cancer/ Lyme associations, but has not seen many.

Q: Is there a connection with thyroid problems?

A: Thyroid problems are a very common co-existing condition with Lyme, as they are with CFS.

Q: How do I differentiate itching from allergic reactions?

A: The same sensory nerve fiber pathways that carry pain carry itching, numbness, tingling etc. Rash is common symptom. Rashes could be caused by medications, especially if they are body-wide. Is it an allergic reaction or hypersensitivity reaction? Get a complete blood count (CBC) with differential. Eosinophils will be elevated if allergic reaction. If not, then it's a hypersensitivity reaction. Treatments are similar.

Q: How do we get funding for research to advance these illnesses?

A: He stressed how important it is to combine advocacy and research efforts. Ultimately it will be a political solution. Get active legislatively in DC. The CFS Coordinating Committee is a very good forum. Lyme does not have anything like that. Groups need to work together, not fight with each other. There should be a coalition of all these groups. We also need to show insurance companies the benefits of primary treatment to patients, as well as to insurer's bottom line.