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Do antibiotics help or hinder M.E patients?
Maggie leathely, a former health visitor, considers the

M.E recently grabbed the headlines when a woman who had been
seriously ill for five years made an apparently miraculous recovery,
(daily express, 25 June) Julie Copley, a former nursery nurse in her
early forties, suffered severe Neurological symptoms and considerable
pain and needed to spend much of her time in bed and could walk only
with difficulty. After extensive investigations she had eventually been
diagnosed with M.E

Then a serious infection turned out to be a blessing in disguise. In April
2001 Julie had severe abdominal pain and high fever so bad that she
had to be admitted to hospital. There she was given intravenous
antibiotics to treat a suspected bacterial infection, astonishingly within
72 hours not only was Julie recovering from the abdominal infection, but
all her symptoms of the past five years were beginning to recede. She
said "as soon as my temperature began to go down, the fatigue went".

Julie is now overjoyed and considers her self to be cured but in need of
rehabilitation and physiotherapy, after five years of illness, she is well
aware of the possibility of relapse but so far she is making good
progress with fitness.

Dr Ronald Strachan another M.E sufferer discovered that antibiotics
helped him by chance in 1997 when he was suffering from a severe
chest infection, for which his doctor prescribed a course of KLARACID
or (clarithromycin). He found after two weeks of treatment, not only
was his energy level much higher than usual he also felt less toxic. A
second month of taking this drug brought similar improvements
(another antibiotic, vibramycin, had no effect.)

Dr strachan then contacted Dr garth nicolson, a researcher into
mycoplasma infections in CFS patients in the USA. he was tested for
mycoplasma and the result came back positive, so he took an 18 month
course of treatment, following Dr nicholson's protocol ( for more details
see Dr nicholson's website details in the reference list at the end of this

Dr strachan said "although I am not cured I have seen a lot of
improvement in the general severity of my illness as a result of this
treatment" . he now takes antibiotics when he needs them for his chest
which still troubles him, he points out that not everyone with M.E can
benefit from antibiotic treatment and he cautions that anybody who
suffers from allergies or gut problems be especially vary.

so why might antibiotics be helpful for some people with M.E.? Dr sarah
Myhill, who has treated hundreds of sufferers, points out that it all
depends on what is causing the illness, In some cases the cause may be
a low -grade bacterial infection, in which case antibiotics would be the
appropriate treatment. in other cases there may be a chronic viral
infection, for which antibiotics are of no value unless bacteriological
complications arise (e.g. flu followed by pneumonia).

a second problem lies in distinguishing weather an infection is indeed
the primary cause of illness or is a secondary consequence of poor
immune function. some doctors disagree as to the usefulness of
directing treatment at a secondary or opportunistic infection, which is
only a problem because the patient is already ill. however Dr Myhill
believes that 'eradication of a low grade or persistent infection is one
way to reduce the load on your immune system, and thus improve tha

some possible culprits
chlamydia pneumoniae
This common bacterium should not be confused with it's better known,
sexually transmitted relative (although Dr Myhill points out that the latter
could also cause chronic fatigue). chlamydia pneumoniae is widely
known as a cause of respiratory infections such as coughs, colds and
bronchitis. some researchers suspect it may also be involved in a
number of chronic diseases. Larger scale research is needed before it
will be possible to judge how significant this organism is in M.E.'

chlamydia pneumoniae is not easy to recognise. it can be identified in
body fluids using specialist molecular tests, but these may not be
available locally on the NHS. These tests can give false positives so it is
important to ask how specific the test is. Eradication of the organism
may require several different antibiotics.

helicobacter pylori
this is a bug now known to be responsible for causing stomach ulcers.
In some cases it is even implicated in the development of cancer.
thought that up to 40% of the population harbour this bacterium without
becoming ill - but for those who are susceptible, it can have very serious
effects. The test for helicobacter pylori should now be generally on the
NHS. It would be reasonable for anyone who has stomach problems as
part of their M.E., or whose family members have had stomach disorders
such as gastric ulcers, to ask their GP to run a test for it.

like any chronic infection helicobacter can drag down a person's health,
and for this reason Dr Myhill recommends that people with M.E. should
have this infection treated conventionally using a combination of
anitbiotic therapy with an antacid and sometimes also a bismuth
compound such as denol.

These are not strictly bacteria but are a special form of micro-organism
which is like a bacterium but without a cell wall. there are many different
strains of mycoplasmas, and many of them are found in healthy
individuals in the mouth, nose, gut or vagina. These are not a problem,
but certain strains are able to penetrate into the blood cells and other
body tissue.

some doctors in the USA have found that up to 60% of their patients
with CFIDS ( the equivalent of M.E. ) are infected in this way, and claim
to have had good results with long , sometimes pulsed (e.g. six weeks
on six weeks off ) courses of the right antibiotics. This treatment is still
not widely recognized by doctors in Britain, and studies of UK M.E.
sufferers have not found the same prevalence of the organism.

sensitive molecular testing for mycoplasmas are not available within the
NHS or PHLS (public health laboratory service ), but can be obtained

lyme disease and brucellosis
These are extremely rare in Britain, but can cause chronic infections
which have similar symptom profile to M.E. which respond to treatment
with antibiotics. Lyme disease is transmitted by tick bites, and is
endemic in some parts of the world including areas of the USA and
Australia. brucellosis is contracted from infected cattle or unpasteurised
milk, and is not carried by British cattle but is endemic in some

Dental infections
Chronic bacterial infections can linger in the mouth especially where
there have been root-filled teeth or where teeth have been removed.
Sometimes these infections are 'walled in' and can be very hard to
eradicate. In a healthy person they may not be a problem, but can be a
serious additional source of problems for someone who is already ill so
are important to treat.

parasites and protozoal infections
usually caught from contaminated water or food, or via insect bites,
these can lead to chronic health problems and may respond to treatment
with certain antibiotics or antimicrobials. They may be suspected when
illness followed foreign travel, or exposure to untreated water form
rivers etc.

The downside to antibiotics
Dr Sarah Myhill feels that antibiotics are a "double edged sword" and
said that "he had seen people who have had there M.E triggered by a
violent allergy to antibiotics such as septrin".

Jasmine believes that repeated courses of antibiotics when she was a
child contributed to her developing severe M.E. at the age of ten. Now
21, she is extremely wary about taking them especially since she had a
very adverse reaction to the antibiotic she was given to treat
helicobacter pylor.

She developed a nasty itchy rash on her chest and body, began
wheezing and coughing, and became so weak she was unable to feed
her self, within hours of taking the first tablet. 'I felt as if I was dying' she
remembers, she has had antibiotics twice since then only ' under
extreme pressure from the doctor' when she has seemed unable to
shake off a severe bacterial infection.

Her doctor takes great care to prescribes the antibiotics which she can
best tolerate. She feels that she is always made worse by taking them,
even though they have been effective in getting rid of particular

Jan has had M.E. for over ten years and believes that antibiotics always
make her worse, causing an increase in all her symptoms which include
muscle pain, trembling limbs, and general weakness. On several
occasions this has been so severe it has caused her to collapse.

She has also experienced nausea and either constipation or diarrhoea
whilst taking antibiotics. she does acknowledge though that at times she
has needed to take them, in order to clear a persisting infection. As she
is allergic to penicillin she is usually given erythromycin.

Why antibiotics can cause problems for people with

Antibiotics can effect the balance of many different strains of
bacteria found in the gut. These bacteria have an important role to
play in the immune system as well as in the digestion and keeping
the gut wall healthy. When disrupted this can cause dysbiosis and
damage to the gut wall known as leaky gut syndrome, this may even
be a cause of M.E in some cases .

Some antibiotics directly damage or suppress the immune system
All antibiotics have side effects which can be unpredictable.
Occasionally severe damage to kidneys and liver, since people with
M.E have problems with their liver detoxification, they are more likely
to experience toxic side effects from drugs including antibiotics.

People have allergic reactions to antibiotics in which case a
substitute may be found. Not life threatening but people with M.E are
particularly prone to allergic reactions, some people with M.E. also
suffer from chemical sensitivity and so are likely to react badly to any

Alternatives to Antibiotics
Fighting infections can be tackled in many other ways than by taking a
course of antibiotics, although there is no other option for certain
bacterial disease of sudden onset.

Many of these alternative methods approach the problem by improving
the body's own defences. doctors as well as natural therapists now
recognise the value of complementary approaches to improving immune
function and fighting infection.

These include dietary measures, relaxation and meditation, nutrition
supplements, homeopathy, herbal medicines, and probiotics which
restore the beneficial bacteria to the gut. examples include aloe vera ,
tee tree oil olive leaf extract, colloidal silver, Echinacea, and grape fruit
seed extract, all of which are less likely to harm friendly gastro-intestinal
bacteria. More information can be found in health food shops, books like
alternatives to antibiotics by john Mckenna

potentially life saving -in moderation
it should not be forgotten that antibiotics can save lives in the case of
acute bacterial infections. They may also be invaluable for deep- seated
chronic infections. However antibiotics are generally over prescribed
and it has been estimated that up to 70% of prescriptions for antibiotics
are 'inappropriate and unnecessary '.

Bacteria are constantly evolving and are developing resistance to
existing antibiotics. It is therefore imperative to use antibiotics when
they are really needed, and then to ensure that the right antibiotic and
dosage is chosen for the job e.g. by taking swabs and samples before
the drugs are prescribed.

A preparation with a narrow mode of action is also less harmful over the
long run to the body's balance of microbial inhabitants than a 'broad
spectrum' antibiotic.

The small minority with M.E. who've improved on antibiotics most likely
either had an underlying bacterial infection or the burden of a secondary
infection which was dragging them down. The latter group are not 'cured
but feel somewhat better. However it's likely that most GPs will feel the
risks are too great to justify a prescription of antibiotics 'on spec',
however keen you may be to try them.

Reference: and further information1. breaking research reveals common bacterium chlamydia pneumoniae may be the culprit in CFIDS, FM, and MS online news article by DrC mitchell&Dr K stratton at 2. info see www.CFSresearch.org3. books by chaitow & Mckenna 19964. see also newsletters www.immed.org5. Dr betty Dowsett tel 01708 378050 the national M.E. support center6. university of warwick micropathology ltd tel 02476 323 222 inter action issue 38 September 2001


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