Getting Healthier Now

A Blog About Digestive Health

Tag: sinus infection

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.

Day 25, signals from old friends…

Spring has come early, bringing with it high winds that fill the air with seasonal allergens. My body doesn’t like this time of year, but today I was on a roller coaster where my stuffy nose would suddenly clear up for no apparent reason. Hello, hookworm. I came in from a walk and lay in bed a while, taking note of how my body was reacting, and felt my parasympathetic nervous system activating, too. For those who are sympathetic-dominant like me, which is basically a tendency toward “fight or flight”, this flip-side (the relaxation circuit firing) can feel wonderful.

My sinus infection is finally healing now, and I’ve been inhaling a 30ppm solution of colloidal silver to treat a mild lung infection (triggered by the sinusitis). As a result, I’m now waking with signs of higher testosterone in the AM, and feeling increased mental clarity and express vpn steadiness. I have had low free testosterone and low LH (luteinizing hormone) on my last few blood tests, and this appears to be resolving, which is a relief. Low grade infections can often cause this, and the body doesn’t waste any time bouncing back as this type of physical stress is eliminated.

In terms of the hormonal balancing, I don’t want to ascribe all my improvements to one thing, be that the hookworm or the CS. It really seems to be a combination of each.

On the not so pleasant side of the ledger, I still have some tinnitus in my right ear, which may be a transient immune response triggered by the hookworm, or it could also just be left over middle ear dysfunction from my flu — sinus/ear related. I am also experiencing some insomnia, and epigastric pain for the first time since reinoculating with these 75 hookworm. This is simply a diffused ache in my upper and mid-abdomen — the same thing happened last May, if I recall, as the hookworm were developing.

All good signs, as far as I’m concerned.  Any indication my worms are ‘moving in’ puts me at ease. Here’s to accruing some benefits soon!

Day 34 — Tinkering.

So I woke up late again, with pretty intense fatigue, but discovered something unexpected — symptoms of a sinus infection. I thought I had banished it weeks ago, using my neti pot, but it appears to have been smoldering away, dormant, and is now flaring up again.

I’m not surprised — allergy season is still going full bore, predisone (even the small doses I took) may have weakened my immunity some, and the helminths themselves have a reputation for giving those of us with hyper-vigilant immune systems the vulnerability of mere mortals.

I’m back using my neti pot, twice so far today, with a pinch of salt and baking soda. It’s a simple solution that worked before, and this time around I plan to stick with it for maintenance after the “all clear” is sounded.

Again, I’m a witness to this process, and willing to be encouraged by things that aren’t altogether positive. It’s comforting to actually have a low-grade infection, whether it’s viral or bacterial, simply because the “sick” me never got them for the last 10 years. I think my defenses were always too reactive to let it happen.

And I’m realizing that if it weren’t for my sinus issues, I might actually be bouncing out of bed by now. My body feels pretty good, otherwise — no real GI issues anymore, more clarity in my head, and a brighter mood.

Let’s go, sinuses. Stop your sniveling. Onward!