Dr. Garth Nicolson interview on Chronic Fatigue

[Guest guest]

Chronic Fatigue Syndrome Radio ShowJan 4th, 1998Dr. G. Mazlen, HostwithDr. Garth Nicolson Dr. MazlenWe are going to have with us, today, Dr. Garth L. Nicolson. He's the Chief Scientific Officer of the Institute for Molecular Medicine in Huntington Beach, California and as well, he is the Professor of Internal Medicine at the University of Texas Medical School at Houston. He's going to be talking to us about something very important for the 90's, the new emerging infectious disease, which is mycoplasma infection. And we're going to go right now to Dr. Nicolson. Dr. Nicolson, welcome to our show today. Dr. NicolsonWell, it's a pleasure to be on. Dr. MazlenWe're going to let you start off and maybe define for our audience, what this organism, the mycoplasma is about. Dr. NicolsonThe reason that this is important to patients with Chronic Fatigue

Syndrome or Fibromyalgia Syndrome or Gulf War Illness is that we found that 50 - 60% of the patients that have these syndromes have infections, chronic infections that are the underlying cause of a lot of their morbidity or their illness and the evidence for that is that we can find these micro-organisms deep inside the white blood cells in the blood and they're systemic. They go to all the tissues of the body and all the organs of the body and they cause all these complex signs and symptoms that occur all over the body and we know them collectively as these names like Chronic Fatigue Syndrome or Fibromyalgia Syndrome, but the important thing is that once we can identify if these chronic infections are there, a patient can be treated. We have patients that have been sick with Chronic Fatigue Syndrome or Fibromyalgia Syndrome for decades and they have not really received an adequate diagnosis. Yes, we know they had the syndrome but we didn't know what the underlying cause

of the syndrome was. Well, one of the underlying causes of the syndrome is, we feel, are these chronic infections and once they can be identified these patients can be treated. And we have patients that are now recovering after years of illness. They're getting their health back. It's a slow process of recovery but they are recovering. They are going back to work, they're going back to a normal life again. And I think that's the good news is for a large number of people. We can actually help them recover from this disease. Dr. MazlenWell, that's very exciting news and we are delighted to have you say that here on this show. It offers hope to a lot of these people. What type of illnesses or syndromes are associated with mycoplasma infection? Dr. NicolsonWell, mycoplasma first are a very simple subclass of bacteria. They don't have a rigid cell wall like most bacteria and they have usually less genetic information inside them and because of that they

have to grow associated with cells in the case the mycoplasma that invades, for example, mammals or us, and either they have to grow associated with the cells or inside the cells in our tissues. So they really don't do well outside the body. They're not viruses because they have the ability to self-replicate but they're very fastidious, that is, they require a lot of metabolites themselves. So these types of infections have to be associated very closely with cells or tissues and when they get in the body they can penetrate, many of them, into virtually any tissue or cell. Now there are about 50 different types of mycoplasma so we concentrate only on about 6 and these are the 6 that are known to cause human diseases and these 6 are very interesting, because in the case of a very specialized type of illness, like Gulf War Illness, we find principally one species of mycoplasma and you have to realize the Gulf War Illness started in 1991 and a lot of people came home. Now we

have over a 100,000 veterans of Desert Storm that are sick and if you count their family members it's probably double that, so these diseases are contagious, although they're not wildly contagious, they can be passed at a very slow rate between members of the same family is the usual way it's passed. People that have close contact. It requires close contact to pass these types of illnesses because they're not very invasive in terms of infectivity. But once they're passed to another patient, that patient will slowly start to have the signs and symptoms that we see in Chronic Fatigue Syndrome, Fibromyalgia, Gulf War Illness. It often starts with a low grade fever or flu-like condition in the lungs, because they're airborne, that's how they're passed, and this doesn't resolve very easily. It sort of becomes chronic and so instead of completely resolving it goes into a chronic phase and then all the other signs and symptoms like joint pain, reduced mobility, chronic fatigue,

vision problems, cognitive problems, muscle spasms and burning, then all these other different 20 to 40 different signs and symptoms, one by one, tend to come on very slowly. And in fact, if you look at Chronic Fatigue Syndrome or Fibromyalgia, most people that have had these illnesses have had them for years and they have a very slow onset so they have a long phase in which this chronic condition slowly becomes worse and worse and worse. Now, in some cases it resolves, but in most cases, most patients it does not resolve. And it is there and there is really no real effective treatment that will eliminate it completely. There are treatments that will shelf some of the signs and symptoms, but none that really eliminate all of the signs and symptoms, so what we have found is that if these chronic infections are the underlying reasons and there could be many reasons that people have these chronic illnesses, if they're chronic infections that are involved, once these are

identified, then we can prescribe the correct antibiotics to treat them and it's a slow process but people can recover. Dr. MazlenWe're going to come back and talk about treatment in a little while. I want to mention that information with regard to your institute can be obtained through your website, www.immed.org. Dr. Nicolson, talk to us now a little bit about how treatable are these diseases. If you catch them early is it different then when you catch them late or are they all treatable more or less with the same effectiveness? Dr. NicolsonWell, you know these illnesses, these syndromes, they're very complex and they often have a number of underlying reasons for the illness. We've concentrated on illnesses that are caused by infections. These are chronic infections that can be identified in about 60% of Fibromyalgia patients, about 60% of Chronic Fatigue patients and 50% of Gulf War Illness patients. Once these are identified then they can

be treated with a regimen with antibiotics, vitamins and nutritional support and some other important nutritional considerations that are involved in these treatments. Dr. MazlenDoes everybody respond to treatment? Dr. NicolsonSo far, we've found that at least three quarters of the people that start this treatment have recovered. Not everybody recovers and we attribute that to the fact that a lot of people have multiple reasons for their chronic conditions. Some people have severe chemical exposures, for example, and those are not treated at all by the antibiotic regimen. Other people have viruses that are very important in the etiology of their illnesses and those aren't touched by the antibiotics, although recently, we found a combination of antivirals and the antibiotics. In fact, there are 2 or 3 physicians that are using this now in various parts of the country, in Toronto, for example, and in various locations, and these have proved to be very

effective and that might go along with the idea that these diseases are multifocal. They're caused by a number of different insults on the body and viruses are one of the insults. These primitive mycoplasma are another insult. Chemicals are another insult. And so we kind of have to treat these in combination to really get the maximun affect. Dr. MazlenNow, you had mentioned to me when we were talking on the telephone previously, at another time, that in the Gulf War Syndrome, that the mycoplasma might be genetically altered. Do you want to comment on that? Dr. NicolsonWell, this is quite different from what we found in the civilian populations of the US and Canada. We don't see any evidence for any genetic alteration of these micro-organisms but we did find in the Gulf War Illness patients that there were some unusual genes that were associated with the mycoplasma that we found deep inside the cells in these patients bodies. And one of those genes was

the HIV-I envelope gene and this a gene that encodes a capsid or surface component of the HIV or AIDS and this is a component that the virus uses to bind to and enter cells and so we think that this gene may have been put into this primitive bacteria to increase its penetration in the cells. Now, this was the only gene we found from the HIV. We couldn't find any of the other genes, so it wasn't that the HIV virus entered the mycoplasma somehow. It appears as if a part of this gene or the whole gene, we don't think the whole gene but a part of it, may have been placed into the bacteria or the mycoplasma to increase its pathogenicity. That's really a theory at this point. It hasn't really been proven, but it's very suspicious that we find this in some of the Gulf War Illness patients who are extremely sick, some of them have actually died from their illness. Dr. MazlenI just want to make it clear to our listening audience that this is not what you find in the

Chronic Fatigue Syndrome or Fibromyalgia patients who are here in the United States that you're studying, is that correct? Dr. NicolsonThat's absolutely correct. We have not seen that except in one exception, and that's in a group of prison guards and their family members in Texas that we were studying because they had Gulf War Illness before the Gulf War. Now unfortunately, there was some experimentation going on in this particular prison unit that we were studying and we think that we the Dept. of Defense may have been involved in some illegal testing and I don't want to go into that because it's very contentious at this point and it's being hotly denied by the government and you can imagine why. Dr. MazlenOK, we won't go into it. We'll focus more on Chronic Fatigue Syndrome which is basically what our listening audience is composed of. Now you mentioned that 75% may recover but you also mentioned to me when we were talking privately that this

organism is partially anerobic so for that reason, sometimes, when people go through air travel, let's say they're traveling to some destination, their disease may worsen. Can you explain that? Dr. NicolsonWell, we think that one of the problems that many patients that have Fibromyalgia or Chronic Fatigue Syndrome have is that when they travel by air they relapse very heavily, that is their signs and symptoms become worse. This is commonly found and it's not just so much the stress of traveling, we think there's another element involved and that's that when they travel they fly under conditions of reduced oxygen pressure, so the partial pressure of oxygen is actually reduced in the cabin of the aircraft flying at 20 - 30,000 feet. This is especially apparent in people who fly in helicopters so we have a lot of pilots that have contacted us, particularly helicopter pilots that become very sick after flying. And in some cases the people get temporary relief by

going on hyperbaric oxygen, that is oxygen under pressure that increases the partial pressure of oxygen. All of this is consistent with what happens with a mycoplasma infection. These infections are what's known as borderline anerobes. That is, the micro-organism prefers low oxygen tension, so if you over exert, for example, and you starve your tissues for oxygen, that will actually stimulate the growth of these micro-organisms, or if you fly in an aircraft for a long period of time, a long flight, that can stimulate these, and so the signs and symptoms can become worse after such an event. Dr. MazlenNow, it's important before we get through the show today which is obviously a half hour show, to talk briefly about testing patients for this. How do you test a patient if they want to find out if they have this? What are the options? Dr. NicolsonFirst, we have developed these tests over the last 5 or 6 years and they're very sensitive tests and there are

only a few places that can conduct these tests. We use blood as the starting point. We analyze the white blood cells. We use two different types of extremely sensitive techniques. Both of them are molecular biologic techniques, one is called nucleoprotein gene tracking and the other is called forensic polymerase chain reaction. Now without going into any detail, both of these are based upon the genetic makeup of the micro-organism and they're extremely sensitive. In fact, we have a contract from the Dept. of Defense to train Dept. of Defense personnel. They'll be coming out to our institute in a couple of weeks to be trained on how to do these different tests. People can call our institute at 714-903-2900 or go to our website which you gave and get informatiion on how to be tested. We're a non-profit institute so we accept a donation in lieu of paying for the test and once people give the donation, then we do their test. We obviously have to recover the cost of doing the

test. We have thousands of people contacting us for information on how to get the tests run and so we provide that information, we send them a package of publications, for example, reports and how to sign up for the test, how to send the blood, information they can take to their physicians and so on. They send their blood, they usually get their results back in three or four weeks. Dr. MazlenWell, that's exciting because a lot of times testing is not available when a new organism or a new disease is being looked into. And now we're going to wrap up this most exciting topic which we're going to have to continue again at a later date with Dr. Garth Nicolson. Dr. Nicolson, I have a question for you as we close the show. I'd like to know, in terms of the extent of this infection, we know it's present in Fibromyalgia, Chronic Fatigue Syndrome and the Gulf War Illness as describe in your excellent work. Is is also more prevalent than that? Do other people have

it? Dr. NicolsonWhat we're finding is that we can't detect these highly pathogenic mycoplasma species in normal adults, so it's obviously much more prevalent in the patients with disease. We're looking at a number of other disorders, the most recent one we're looking at is Inflammatory Bowel Disorder and we're finding it there as well. It's very interesting, these different disorders, depending upon the organ system that's involved may involve a different species of mycoplasmas. The highly penetrating types of mycoplasmas are the ones that cause the most systemic or system-wide illnesses and those are the most dangerous and we're very conscious of this. A lot of people, for example, are having heart problems because of endocarditis, because of infection of the heart by these different micro-organisms. So that's something that we're looking into right now that's very important. Dr. MazlenYes, that would be very important. Do patients occasionally die

from this infection? Dr. NicolsonOh, yes, it's documented not only in the medical literature, but we've been in contact with people that tested their blood that were severely ill that were on, for example, coronary care units waiting for transplants and we found that their hearts were severely compromised because of these illnesses. I even had an occurrence in my own family where the heart valve was attacked by one of these micro-organisms. So, this is a very serious problem and you can't let these illnesses progress to the extent where they involve major organ systems like the heart. Dr. MazlenWell, we're going to make a date right now to have you back on the show later in the year and we're certainly going to want to talk in more detail about many of these things that you are doing. I'll give your website again, www.immed.org. I want to mention one more time that Dr. Garth Nicolson is the Chief Scientific Officer of the Institute for Molecular

Medicine. His phone number in California is 714-903-2900. This is a major, extremely important issue. We'll be back commenting on it again. I want to thank you, Dr. Nicolson for taking time out from your day to be with us today. We look forward to having you back on the show as a guest. Transcribed by Carolyn Vivianicarolynv@... Permission is given to copy, distribute and repost this transcript provided that my name not be removed from it.