Getting Healthier Now

A Blog About Digestive Health

Tag: rosacea

Uh-oh… Copper Deficiency Mimics Low B-12

It’s been quite a health adventure the last year or more, and you can read a quick update here. I had thought correcting a B-12 deficiency was all I needed to reclaim my health, but things got a bit more complicated.

It turns out copper deficiency can mimic low B-12, with many of the same symptoms of neurodegeneration, fatigue, skin inflammation and joint pain, due to disruption of collagen. I’ve been losing bone mass and developing arthritis – these are also signs of low copper. Here’s a full list of symptoms I’ve had during the last year.

The prevailing naturopathic attitude is we’re all copper toxic, so few of us would believe we could be deficient. Compounding the likelihood in an otherwise healthy population are corporate farming practices. Copper-rich foods simply can’t be grown in depleted soil. And sadly, few doctors ever think of copper deficiency when doing differential diagnosis. I’ve never once had copper levels tested by a physician, despite years of GI problems.

What’s most unsettling – unlike B-12 where there’s a fair amount of lag-time between low serum levels and permanent harm – copper deficiency neurodegeneration often cannot be reversed with supplementation. What does get repaired, eventually, may take months – or even years – of repletion. You can imagine my shock after reading this.

wake-up

Next, I looked up dietary sources of copper. Due to my food intolerances I wasn’t eating any copper-rich foods. Couple this with years of gut inflammation, malabsorption, and regardless of any testing I might do with my doctor, it was clear I needed to supplement with a modest 2 mg of copper soon, just based on my symptoms and diet.

The proper way to take it is in combination with zinc. Too much zinc will deplete copper, so a proper balance is important. Also worth noting is colloidal silver, if taken orally or by IV, can deplete copper, sometimes with dramatic results. This may have happened with me a few years ago after taking colloidal silver for SIBO.

The good news is a few short days after I started taking 2 mg copper my eyesight was much sharper, mood and cognition improved a bit, and I got a noticeable reduction in fatigue. A week later I increased my dose to 4 mg, plus 30 mg zinc, and noticed less joint pain and stiffness. Shortly thereafter, my skin began feeling less fragile. Perhaps my collagen synthesis has been improving, and I may be correcting an anemia due to this deficiency.

Copper is also essential to keep blood vessels and arteries flexible and strong, which could explain my increased vericose veins and petechiae in the last year. It’s thought most cases of aortic rupture are preventable if people get adequate copper in food.

My face has had a red glow for the last couple of years, in recent months my chest and abdomen, and sometimes even my whole body has, too. This flushing could be due to histamine intolerance, and it’s important to note copper (along with B-6 and vitamin C) is required to create DAO enzyme to break down histamine. Sure enough, one thing I noticed after a few weeks supplementation is I’m no longer flushed from head to toe most of the day. Perhaps eventually I’ll be able to tolerate some higher histamine foods.

Given the risk of nervous system damage from long term deficiency, I decided not to wait for testing before supplementing with safe amounts. My plan is to stay at 4 mg copper daily with 30 mg zinc (which is what healthy people get in a copper-rich diet) until I can schedule hair analysis and serum tests to determine the correct protocol for repletion.

Where I’m still hoping to see improvement is more subtle, which appears to be low dopamine. Given its effect on brain health, copper is required to generate important neurotransmitters. Among other things, low dopamine (key to reward and accomplishment) was probably making it tough to update this blog for the last 16 months. With that said, onward and upward.

How many of us diagnosed and treated for B-12 deficiency are also copper deficient? If any of this sounds familiar, please join us in the comments section, and share your own story.

A Long-overdue GHN Update

Since my last post here, many months ago, I got short term improvement from B-12 shots, but my serum levels were sky high and my doctor suggested I stop the injections. After an initial bounce I crashed, and began to have widespread inflammatory and neuroinflammatory issues. He theorized this may have been triggered by saturation with B-12. My serum B-6 was also quite high, despite never supplementing it.

A methylmalonic acid test was elevated, so after being off it for a few months, I continued to take 2,500 mcg oral B-12 and requested referral to a specialist who could check for genetic issues with methylation, but as my neck and back became more inflamed, and cognitive problems worsened, I was instead sent to a neurologist, who did a full workup: brain MRI, a soft-tissue MRA, hearing tests due to increasing tinnitus, a carotid artery test, and an EEG.

Other than a few white matter brain lesions (no change since a 2008 MRI) which may be congenital, these new tests were inconclusive. While I do have some degenerative changes to my cervical spine, autonomic dysfunction was the neurologist’s primary diagnosis. At this point, my symptoms were growing – you can read a list of them here.

A few weeks later, I saw a neurosurgeon and explained how pressing in various places on my neck, the base of my skull, and near the mastoid process behind my right ear, could often improve my autonomic issues. He pointed out a Chiari Malformation on my brain MRI but said “we don’t operate to fix dysautonomia”, which was yet another blind alley. I’ve yet to see an autonomic specialist for non-surgical treatment of this.

Flushing, at first just a red glow on my face, then eventually from near head to toe, has also been happening for about 14 months. My doctor tested for Carcinoid, and so far results don’t indicate it, which is a relief. Instead this may be related to a  mast cell disorder. I’ve learned certain kinds of flushing, even the rosacea which I have, can be caused by neurological problems.

What’s the root cause? It’s likely multifactoral, but nerve damage from repeated doses of fluoroquinolone antibiotics over the years, like Cipro and Levaquin, likely plays a huge role.  It was after a final dose of Levaquin in 2008 that I developed symptoms of hyperadrenergic POTS – primarily a vagus nerve malfunction – which triggers heat intolerance, trouble handling physical and emotional stress, and orthostatic intolerance.

However, these antibiotics did more than nerve damage, they wrecked my gut flora, and POTS is now thought to be autoimmune.

The best I’ve felt in recent years was while I hosted hookworm (small therapeutic doses) and did fecal transplants. Both of these protocols may boost vagus nerve tone, by lowering inflammation in the gut and boosting signaling from the enteric nervous system back to the brain, the “rest and digest” parasympathetic, which works opposite of “fight or flight” sympathetic.

My doctor suggested I try probiotics and hookworm again because he noted they seemed to help me, so I’ve been taking VSL#3 daily, plus Miyarisan tablets, which contain c. butyricum, and 15 weeks ago I did a dose of 50 necator americanus. While the initial side effects of helminthic therapy were rough, with spikes noted in blood work for eosinophils, I’m now feeling more benefits than allergic response, including no more asthma, healthier sinuses, and a big improvement of ulcerative colitis.

Concurrent with this, I remembered how good I felt one Summer when sunbathing for 15 minutes a day. I’ve had chronically low vitamin D and low testosterone. Sun exposure boosts both. I started laying out at noon each day a few months ago and it has been a great mood lifter. I also find I have better sleep quality when I get my daily 15 minutes. To discuss light therapy, its effect on mood, hormonal production and balancing sleep/wake cycles, join us here on Facebook.

I wanted to cover all the bases, and since sinusitis has been an ongoing problem for me, too, with green mucus indicative of staph colonization, I’ve begun daily rinses, which you can read about here. Two weeks later the mucus is thinning and has no color. I credit both the hookworm treatment and rinses to this recovery. Reducing sinus inflammation has improved anxiety, and my sleep is deeper. There’s a theory sinus inflammation from gram negative sinus flora can generate lipopolysaccharide (a potent inflammatory molecule) which in turn triggers brain inflammation.

Waking in the night gasping for air has been a problem during these last few months, and while I was scheduled for a sleep study I noticed a sudden improvement after a few days of sunbathing. There’s a vitamin D and sleep apnea correlation, mainly with regard to metabolic activity, so it’s possible Sun is good medicine for it. While I still have some brain fog, my mind feels sharper while sunbathing and I’m no longer waking at night. Since obstruction of upper airways can also contribute to apnea, sinus rinses are likely helping, too.

I’ve also been to see an oral surgeon after my dentist thought I could have dental infections contributing to fatigue and cognitive problems, but an oral surgeon did a panoramic x ray and said it looked fine. He noted sinus inflammation and recommended I keep doing my daily rinses.

I feel fortunate testing was able to rule out a lot, but if you see a pattern here, it’s that each protocol has helped a little – yet nothing has totally solved – what first appeared to be symptoms of low B-12. Now, just in the last month, I’m pretty sure I’ve figured out a key factor, and it may be a different deficiency, with very similar presentation.

Conquering Advanced SIBO – Lactoferrin to the Rescue

I’ve probably had small intestinal bacterial overgrowth since childhood, and I’m now in middle age. This is a difficult-to-treat condition where colonic bacteria drifts up, beyond the gateway between the colon and small intestine, known as the ileocecal valve. This happens because the valve is stuck in the “open” position, either due to neurological impairment or constipation, which backs up the entire GI tract and keeps the valve propped open with the fecal stream.

In the early stages people might notice they’re developing rosacea. Most western medical doctors claim there’s no known cause for this skin condition, but in recent years practitioners with a more holistic approach, like Chris Kresser, and others, identified a study from decades ago where common probiotics were proven to be an effective treatment for it. Look for more on this in future GHN blog articles.

Besides rosacea and acne, other early stage SIBO symptoms might include low-grade fatigue, mild mood disturbances and cognitive impairment, minor food intolerances, aches and pains, low-grade, intermittent tinnitus (usually after meals), urinary and sinus infections, ear aches, gingivitis, halitosis, trouble staying warm, mild insomnia, IBS, trouble gaining weight.

Unenlightened doctors were treating my SIBO symptoms, such as sinus infections and prostate problems, with more antibiotics, which was unfortunate considering these drugs (Cipro, for example) likely caused SIBO in the first place. Fluoroquinolones contain fluoride, which binds iodine receptors and (among other things) impairs thyroid function.

SIBO

About six years ago I began to feel my whole gut, from the front around to my lower back, becoming burning hot. I could feel that same heat in my neck. Along with this came increasing brain fog and tinnitus. What’s happening with SIBO is simply upper gut fermentation – a low grade infection of the abdomen. With every single meal consumed, bacteria is fed first, then we get the scraps.

In healthy people the small intestine does have some protective bacteria in low concentrations, but in SIBO the ranks and type of flora resemble the lower gut populations, and these misplaced microbes can cause a lot of damage, by inflaming the small intestinal wall, and running amok systemically, with both toxic byproducts of fermentation and the bacteria themselves in the bloodstream.

This is made even worse when gram-negative bacteria are involved because they boost levels of lipopolysaccharide, a part of their cell membranes, and LPS is one of the most potent triggers of inflammation in our bodies.

Diet plays a role, with the distinct possibility that higher fat consumption fuels the growth of gram-negative bacteria. Paradoxically, this suggests those of us who switched to a higher-fat Paleo approach might be inadvertently increasing inflammation from gram-negative flora and LPS. It’s a  controversial theory, with a lot of strong opinions on all sides, so count on reading more of this in future GHN articles, too.

As SIBO becomes more advanced, think of those 14 feet or so of narrow tubing, the small intestine, where scopes and medicines have trouble penetrating, and how hard it might be to remove these uninvited guests. Bacteria and yeasts, such as candida, build biofilms that act as hardened bunkers against the gut wall. Think of tartar on your teeth, which is also biofilm, and it becomes clear how impossible it might be to cure.

Sadly, SIBO can become “self-worsening” because toxins further impair nerve function, which means the “migrating motor complex“, or MMC – which are peristaltic cleansing waves that normally clear colonic bacteria from the upper gut – this safety mechanism gets even weaker, resulting in more accumulation of bacteria and yeasts, then further inflammation develops.

Another paradox is mounting mineral deficiencies, from malabsorption, yet being unable to take vitamin and mineral supplements without fueling the problem. I am finding magnesium is especially difficult to take when upper gut fermentation is happening.

Later stage SIBO symptoms include crushing fatigue (which I’ve had since my last dose of Levaquin in 2009) to the point where it’s tough to get out of bed. Most people also have wide-ranging food intolerances, loud and constant tinnitus, major brain fog, personality changes (depression/anxiety, cognitive decline), tremors, hormonal problems, cardiovascular issues (tachycardia, hypertension) severe weight loss, and chronic, widespread joint pain.

A link is being established now, in recent studies, between rising fasting glucose levels, which I have, systemic inflammation, and metabolic disorders. Is SIBO a common denominator? I wouldn’t be surprised, and indeed, this isn’t a trivial condition that should be left alone.

I did seek conventional medical treatment a few years ago for SIBO. My gastroenterologist wanted me to avoid a “breath test” (patients breathe into a tube and gases are analyzed) because the sugar solution taken prior to the test could have flared my ulcerative colitis. Her caution was sensible. Instead, we just treated for it.

I took a 10 day course of Rifaximin antibiotic, which stays in the gut rather than acting systemically. It worked for the first two days, which my doctor thought was confirmation enough of SIBO. I had a big surge of energy, clarity. It was fantastic. Then on day three the drug had no effect. This is not uncommon, and makes sense considering I’ve got a gut full of antibiotic resistant bacteria. Historically, herbals and fermented foods plus diet and fasting have been more beneficial.

SIBO is insidious – if you didn’t know what was wrong, you might think you were just aging badly, since most people tend to do better when younger. As time goes by, you lose the ability to fight it because your mind is too scattered to do focused self-treatment. Even cooking meals becomes difficult, especially because SIBO can lead to a loss of appetite. Starving it becomes the easy way out – symptoms are reduced when fasting – but any further loss of nutrition compromises an already weak immune system.

So despite my years of struggle with SIBO, including most all the symptoms listed above, I was confused when it flared the last time. This is because it came on strong with pain in my joints. I would wake in the late morning, feeling as if I’d never slept, and my whole body was throbbing. I figured this couldn’t be SIBO, it must have been something entirely different like arthritis. Instead, it was just the worst flare I’d ever experienced.

I started doing a lot of the old fixes, which are quite good: intermittent fasting (I cut out all food after 4pm) to starve the bacteria daily. I took peppermint oil with meals – a surprisingly good antifungal and antibacterial. I boosted my water consumption to about a gallon of distilled water daily, with trace minerals added. I went to 1 cup of coffee in the AM, cut out fibrous vegetables, I added Interfase Plus, to dissolve biofilms.

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The whole time I kept reading, and came across references to bovine-sourced lactoferrin, which is a substitute for the human lactoferrin babies get in breast milk. We adults also have it in our tears, and it can be found throughout the body. Lactoferrin is a bone-builder, a binder of iron (which pulls that fuel away from pathogenic bacteria), it’s also antiviral, used by some people to treat hepatitis C, and a potent antifungal. Throughout the literature, I read of its ability to harm pathogens while protecting, or even nurturing, healthy flora.

This makes lactoferrin a perfect choice for me, because as effective as peppermint oil, olive leaf, or berberine might be, these herbals also kill a lot of good bacteria. I am an avid sauerkraut and kefir-consumer, so I’m putting some flora back, but I don’t want to lose important lower gut microbes that fermented foods cannot replace.

Here’s perhaps the most exciting thing of all: lactoferrin’s interaction with lipopolysaccharide. Very encouraging, to say the least.

My results: it’s been a very exciting few days. The fatigue is still pretty bad, but it’s getting better. I’m finding my mind is clearer, my mood is brighter, and I can at least go for a walk and feel a bit stronger. A few days ago if I ventured out at all, I could hardly get down the block and back.

This makes me wonder how many of us with CFS/ME actually just have advanced SIBO. New science is beginning to understand the “gut-brain axis”, how the brain is linked to a “gut-brain”, our enteric nervous system, and CFS is a condition where that connection is obvious. In this thread “Lisa” did incredibly well with lactoferrin, for a time. For her, it seemed to provide energy as well as clearing the fog.

So far, I’ve had some toxic die-off symptoms (LPS!), but not as much as in the past when using antibiotics (such as the Rifaximin) for SIBO. My joint pain is not entirely gone, but it’s a lot better, same with my sleep patterns.

One very notable fact is I tend to feel more energetic while in motion than I do when I am laying down or sitting. I’ve heard this is a classic hypothyroid symptom, although not often documented, and back to the subject of LPS, I may have found a source of thyroid inflammation. Look for a lot more on this topic in future articles.

My plan from here forward is to reduce the broad spectrum herbal antimicrobials, be more strict about intermittent fasting, eat a lower fat diet with a few more simple carbs to reduce LPS (this is complex – kudos to Paul Jaminet), and continue on taking the lactoferrin. The brands I’m trying are Life Extension and Jarrow. The dose has varied. I started slowly, just two pills a day of Jarrow, but have since gone to 4 of each kind as of today.

I am also still a believer in supplemental iodine, but my dose is lower now, about 2.5mg a day, which is one drop of Lugol’s 2%, and I always take 200mcg a day of selenium to protect my thyroid. I have reduced iodine because if LPS is a factor in my hypothyroidism, I want to heal my SIBO first.

Lactoferrin to the rescue. Let’s see how this goes.

To be continued.

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