Short and Long Term CFS and other autoimmune conditions

This last week there has been much news about CFS and markers, “Columbia University’s Mailman School of Public Health, looked at 51 proteins, also known as cytokines, released by cells involved in the immune system. Among 646 patients studied, including CFS patients and healthy controls, people who were ill for three years or less had higher protein levels than the others, the researchers found.” Wall Street Journal To me this is just confirmation of a pattern that I have seen reported in related diseases where fatigue persisted after a technical recovery. The typical onset scenario consists of two items: a probable viral infection with stress. This is not only true for CFS but for many co-morbid conditions such as:

Going through a series of studies that looked at fatigue after a severe stomach infection, I derived the table below.

Recover Period Percentage Remaining that Recover Patients remaining
6 – 12 Months ~ 50% ~ 14%
12 – 24 Months (2 yrs) ~ 50% >~7%
24 – 48 Months (4 yrs) ? 50%> ~4%
48 96 Months (8 yrs)

? 50%

96-192 Months (16 yrs) ? 50% ~1%

My take of the mechanism is that infection setups a gut alteration that keeps triggering production of cytokines. The alteration was an appropriate response when the infection occurred. The normal gut flora did not suppress it after the infection was take care of. Recently I had a bug, and after I recovered from it, I found that my psoriasis flared and I had post-infection signs of inflammation. My wife reminded me of a reader reporting that her psoriasis disappeared like magic from taking the probiotic Align (which she tried after I posted about it). I took it, and hit the probiotics hard for 2 weeks (almost all of them were bifidobacterium) and these post-infection symptoms faded. This is echoed in some recent studies:

Doing a PubMed search for the main cytokine reference and microbiome found over 120 articles.

New Probiotic on Market: L Reuteri NCIMB 30242 (ONLY)

There are eight PubMed studies on this strain.

  • Significantly changes ehe size and composition of the circulating bile acid [2015
  • a greater proportion of L. reuteri-treated subjects showed improved general GI health status (p = 0.042) and improved diarrhea symptoms (p = 0.03). [2013]]
  • the first report of increased circulating 25-hydroxyvitamin D in response to oral probiotic supplementation[2013]

For general information about L.Reuteri see my earlier post.

Available from manufacturer and on Amazon .

I have just ordered some myself.

Probiotics with Demonstrated Health Benefits and Other Gems

Tonight I found two gems that I wish to share

“The major effects of stress on gut physiology include:

  1. alterations in gastrointestinal motility;
  2. increase in visceral perception;
  3. changes in gastrointestinal secretion;
  4. increase in intestinal permeability;
  5. negative effects on regenerative capacity of gastrointestinal mucosa and mucosal blood flow; and
  6. negative effects on intestinal microbiota.

Mast cells (MC) are important effectors of brain-gut axis that translate the stress signals into the release of a wide range of neurotransmitters and proinflammatory cytokines,”[2011]

Histamine released from Mast Cells cause many of the symptoms of a Jarisch-Herxheimer reaction. So I was about to do a quick review of PubMed for candidates that reduced Mast Cell release:

  • Lactobacillus GG (LGG) [2014] – strong impact – Commercial Probiotic: Culturelle
  • L. salivarius HMI001 [2012]
  • L. casei Shirota (LCS)  [2012]
  • Lactobacillus plantarum depends on the specific strain — if not known, avoid
    • LS/07 CCM7766 [2015] – moderate impact
    • L. plantarum WCFS1 – INCREASES Mast Cell release [2012]

At this point of browsing PubMed, I discovered the 2014 article (World J Gastroenterol. 2014 Aug 28; 20(32): 11023–11032.) and it distracted me because it had some nice tables based on recent literature which warrants reposting.

Recommendations for probiotic use from [2014]

Clinical condition Effectiveness Organism


Infectious-adult-treatment A Saccharomyces boulardi, LGG
Infectious-childhood- treatment A LGG. Lactobacillus reuteri
Prevention of infection B S. boulardii, LGG
Prevention of AAD A S. boulardii, LGG, L. casei, L. bulgaricus, S. thermophilus
Treatment of recurrent CDAD B S. boulardii, LGG
Prevention of CDAD B LGG, S. boulardii


Preventing and maintaining remission A VSL#3
Induce remission C VSL#3

Ulcerative colitis

Inducing remission C Escherichia coli Nissle, VSL#3
Maintenance C E. coli Nissle, VSL#3
Crohn’s C E. coli Nissle, S. boulardii, LGG


B Bifidobacterium infantis
IBS C Bifidobacterium animalis, VSL#3, Lactobacillus plantarum
Immune response A LGG, Lactobacillus acidophilus, L. plantarum, Bifidobacterium lactis, Lactobacillus johnsonii


Atopic eczema assoc. with cow milk allergy
Treatment A LGG, B. lactis
Prevention A LGG, B. lactis
Radiation enteritis C VSL#3, L. acidophilus
Vaginosis and vaginitis C L. acidophilus, LGG, L. reuteri

Reproduced with permission from reference Floch et al[31].

  • An ‘‘A’’ recommendation is based on strong, positive, well-conducted, controlled studies in the primary literature, not abstract form;
  • A ’‘B’’ recommendation is based on positive, controlled studies but the presence of some negative studies;
  • A ‘‘C’’ recommendation is based on some positive studies.
  • IBD: Inflammatory bowel disease;
  • LGG: Lactobacillus GG;
  • S. boulardii: Saccharomyces boulardii.

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