Practitioner Mentorship Module 2.2

Co-Infections, Pt. 2: Miscellaneous OpportunistsWith Hillary Thing, MS, LAc., Cert. Herbalist

2.2: Co-Infections Part 2: Miscellaneous Opportunists

Learning Objectives:• Learn about the clinical presentations of some of

the other most common co-infections and co-existing infections;

• Look at diagnostic markers, and how to identify hallmark signs and symptoms of these infections;

• Discover the natural treatment strategies that we can use to approach recovery from these infections;

• Receive specific protocols for the treatment of these co-infections.

Co-Infections & Additional Infections

• Ehrlichia family of bacteria, which includes Anaplasmosis

• RMSF• Brucella

• Mycoplasma• Chlamydia• Viruses– Cytomegalovirus– EBV– Herpes – simplex, zoster, HHP6

Ehrlichiosis & Anaplasmosis

• Tick-borne Rickettsial bacterial diseases (E. chaffensis, E. ewingii, and A. phagocytophilum)

• Common symptomology and treated with the same abx.

Ehrlichia / Anaplasma Infection Cycle:

• Tick borne: several types of ticks across the country can carry E. chaffeensis; Anaplasma is carried by Ixodes ticks, such as the black-legged tick.

• Resevoir animals include deer, dogs, mice and others.

• Not well-understood, but seems to mirror Borrelia burgdorferi and Babesia microti in many respects (parasitic in nature).

Ehrlichia / Anaplasma Pathogenesis

• Both Ehrlichia and Anaplasma must find their way into WBCs to survive and reproduce.

– Ehrlichia has an affinity for lymphocytes, monocytes and macrophages;

– Anaplasma favors neutrophils, basophils, and eosinophils.

• Once inside the WBC, the bacteria multiply, overwhelm the WBC and cause it to die. This weakens the body’s defense, making it more susceptible to other pathogens.

Ehrlichia / Anaplasma Symptom Onset

• 5 days to 3 weeks following tick bite sx begin to appear;

• Very mild to severe;• Flu-like: fever,

fatigue, chills, headache, muscle aches, nausea, vomiting, loss of appetite;

• Any type of rash.

Ehrlichia / Anaplasma Diagnosis

• Low WBC (typically infections cause a rise in WBC’s)

• Low platelets

• Elevated liver enzymes

• IFA tests for antibodies

• Blood stain looks for bacteria inside WBC’s.

Ehrlichiosis / Anaplasmosis: Treatment

• Treatable with Doxycycline, 10-14 days.• Typically an acute disease, unless it goes untreated.• Main concern is fx on WBC’s and immune system

leaving patient vulnerable to other opportunistic infections, and making a Lyme-Borreliosis infection worse.

• Ehrlichiosis / Anaplasmosis can become severe if left untreated, and cause damage to vital organs.

• Those with already compromised immune systems are at greater risk.

Ehrlichiosis / Anaplasmosis: Natural Treatment Strategies

• Cat’s claw, garlic;• Increase zinc and Vit C;• Add additional herbs to support white

blood cell production: Astragalus, Echinacea

• Medicinal mushrooms: Reishi, shiitake, chaga

• Yogurt containing GcMAF

Rocky Mountain Spotted Fever

• Like the Ehrlichias, RMSF is a tick-borne Rickettsial bacterial disease.

• Occurs most frequently in the Rocky Mountains, the South-Eastern US, and some areas of Central and South America, Mexico and Canada.

RMSF: Symptomology• Sx begin within 1st week

of infection:– Chills– Severe headache– Muscle pain– High fever– Vomiting / nausea– Sleeplessness and

restlessness– Rash on wrist or ankles.

• If untreated, can cause permanent neurologic problems or organ damage (HT, KI).

RMSF: Diagnosis

• Based on symptom picture (which is challenging early on unless the rash appears);

• Confirmed via bloodwork, testing the tick, and/or a rash specimen biopsy.

RMSF: Treatment

• Immediate treatment with abx (Doxy) is important, so doctors may not wait for test results before beginning treatment.

• In addition to abx, natural treatment strategies consistent w/ Lyme-borreliosis also apply.

• Specifically, effective anti-rickettsial herbs include Jap knotweed, rhodiola, ashwaganda and eleuthro.

• Ozone is another excellent therapy to help RMSF clear completely.

Brucella

• Gram-negative rod-shaped bacteria;

• Lives in macrophage cells of immune system;

• 4 species; found worldwide.

Brucella Transmission

• Infected blood sucking insects, such as ticks, fleas, mosquitoes and other parasites;

• Handling infected animals or being in contact with animal fluids; urine, eye fluids, wounds drainage from abscesses and genitals. The bacteria penetrate open cuts or abrasions in the skin;

• Inhalation from air born contaminants (primarily from occupational exposure meat-processing and livestock industries);

• Contact with infected animal feces – farming

• Ingesting contaminated meat, unpasteurized milk, and soft cheeses.

• Human to human by sexual contact or from mother to child may occur through breast milk.

Brucella: Symptomology• Sx begin within 1 month of infection:

– Flu-like symptoms– Chills– Loss of appetite, weight loss, abdominal pain, nausea– Fatigue, CFS– Headache– Muscle pain– Fever – worse in afternoon / evening; sweat may smell odd – Swollen lymph glands– Iritability, depression– Dizziness– Chest pain, cough, difficulty breathing.

• If untreated, can cause infection in many parts of body, including eyes, lungs, heart, CNS, bones.

• Symptoms may disappear for weeks or months and then return.

Brucella: Diagnosis

• Difficult to diagnose; often misdiagnosed.

• Physical exam and labs appear normal.

• Western blot test may detect antibodies; false negatives are common as Brucella live inside the macrophage cells.

Brucella: Treatment

• Difficult to treat; requires long-term antimicrobial treatment.• Often a cocktail of abx is used conventionally for 6-8 weeks.• Herbal antimicrobials include:

– Garlic, Osha (Ligusticum porteri), Lomatium dissectum, juniper berry, Sida acuta, denak (Oliveria decumbens), saffron (crocus sativus), clary sage (Salvia sclarea);

– Combine with herbs that move and clean the lymph such as Isatis (ban lan gen), cleavers, red root

• Liposomal artemisinin• Colloidal silver• Oregano oil• Essential oils of Oreganum syriacum, Thymus syriacus, cinnamon,

peppermint, marjoram, lemon, nutmeg in combination• Biofilm agents – earthworm, enzymes, stevia, etc.• Rife frequency therapy or frequency specific microcurrent

Mycoplasma (pneumonia et al.)

• Smallest free-living microbe found in humans;

• Neither virus nor bacteria (possess characteristics of both);

• At least 7 species;• Ubiquitous

Mycoplasma Transmission:

• Ubiquitous;

• Opportunistic;

• Community acquired (passed through human contact) coughing, saliva, hands, sex, physical contact and fluids.

Mycoplasma Pathogenesis

• Parasitic; attaches to specific cells without killing them.

• Can either over-activate or suppress your immune system.

• They can mimic the proteins in your body and lead to autoimmune illness or complete evasion from the immune system.

• Can live inside WBC’s and in this way travel throughout body, cross BBB, and into CSF and CNS.

• Mycoplasma can infect different areas in the body and can produce symptoms of infection, mucus discharge, pain, arthritis, fatigue, or neurological problems.

• Can cause RNA and DNA mutations -> certain cancers.

Mycoplasma Symptomology

• About 1 week following exposure sx begin to appear;

• M. pneumoniae in lungs is a cause of pneumonia, bronchitis, pharyngitis, asthma

• Chronic sinusitis• PID• Carditis, tachicardia• Hemolytic anemia• Meningitis, seizures• ALS, Alzheimers• Cancer such as leukemia

Mycoplasma Diagnosis

• Low WBC (25%)

• Elevated SED rate (30%)

• ELISA test for M. pneumonia – not 100% reliable, and IgG / IgM may not reach sufficient levels in the immune deficient population

• Culture sputum from respiratory tract - challenging

Mycoplasma: Treatment

• Treatment with antibiotics has mixed results.

• Some Lyme disease patients with mycoplasma get relief with antibiotics like Minocycline, Doxycycline, Ciprofloxacin, Azithromycin, or Clarithromycin. However, mycoplasma infections can return after going off antibiotics.

• A variety of Western and Chinese herbs are helpful in killing and disabling mycoplasma infection, in combination with biofilm agents and colloidal silver nasal spray.

Herbs That Treat Mycoplasma

• Mullein – expectorant, breaks up phlegm; anti-microbial, anti-inflammatory;

• Seneca snakeroot – expectorant, breaks up phlegm, treats asthma / bronchitis type presentation;

• Green tea – esp. for urinary problems: antioxidant, reduces inflammation, strengthens immunity, cancer protective;

• Yu xing cao / houttuynia – lung, colon, bladder• Da huang / rhubarb – heart and blood, liver, and digestive tract• Bai zhi / Angelica dahurica – lungs, sinuses, head, eyes and skin,

internal abscesses• Huang bai / phellodendron – lungs, liver, joints and bones, skin,

UTI, colon• Ban lan gen / isatis – throat, glands, lungs, skin

Chlamydia Pneumoniae

• Intracellular gram-negative bacteria;

• Infectious “elementary body” + reticulate body which makes it able to replicate within cells and protect itself much like Borrelia burgdorferi can.

• 1 of 3 forms of Chlamydia, and the most common;

• ½-3/4 people at some point have this infection.

Chlamydia pneumonia Transmission:

• Transmitted through infected ticks or from infected person via inhaling contaminated droplets.

• Most often infects children age 5-15, the elderly, the immune-compromised, and sometimes healthy adults.

Chlamydia pneumonia Pathogenesis

• Generally first effects cell linings of airways, then begins to spread throughout the body.

• Doesn’t create its own energy, so has to steal energy from other cells, making those cells work sub-optimally.

• A favored place to live is in the cells that line the blood vessels (as is also true for Babesia and Bartonella), as well as new blood vessels formed in response to inflammation and the body’s effort to heal.

• Over time, it can infect other tissues, including the nerves, muscles, heart and brain.

• Can result in suppression of the immune system.

Chlamydia pneumonia Symptomology

• About 1 week following exposure sx begin to appear;

• C. pneumoniae in lungs is a cause of pneumonia, walking pneumonia;

• Typical symptoms include persistent cough, wheeze, headache, chronic fatigue, weakness, fibromyalgia type pain, sore throat, nausea, malaise, fever asthma, ear infection, and even altered mental status, skin disease, formation of plaque in arteries and brain inflammation.

Chlamydia pneumonia Diagnosis

• It can take a few weeks for C. pneumonia antibodies to show up on a blood test after symptoms appear.

• Swab testing of the nose and throat is also useful.

Chlamydia pneumonia Treatment

• Common treatment includes tetracycline abx such as Doxy, rifampin, azithromycin, or erythromycin.

• As with most tick-borne infections, treatment is often not given for long-enough, as Chlamydia can evade the immune system, hide under biofilms, and become drug-resistant, just like Bb.

• Even with prolonged abx, patients can experience recurring symptoms.

• Natural medicine is an important part of successful treatment!

Herbs That Treat Chlamydia pneumonia

• Ligustrum seed, nu zhen zi – strengthens hormonal system, treats signs of aging, back pain, dryness, tinnitus, menopausal sx, fever, night sweats, mood swings, steaming bone, diabetes, protects liver

• Lotus rhizome node, ou jie – treats bleeding and hypercoagulation of blood, nosebleed

• Chaga mushroom, bai hua rong – toxicity, pain, inflammation, strengthens immunity;

• Cryptolepsis• Lomatium• Licorice• Garlic• Astragalus

Herpes Family Viruses

• 8 currently ID’d members of herpes virus family;

• Ubiquitous, extremely well-adapted;

• Greek “herepin” = to creep, describing chronic, latent or recurrent nature of infections.

Herpes Family Viruses

• HSV 1 – Herpes simplex type 1• HSV 2 – Herpes simplex type 2• VZV / HHV 3 – varicella zoster virus

(chickenpox)• EBV / HHV 4 – Epstein-Barr virus***• CMV / HHV 5 – Cytomegalovirus***• HBLV / HHV 6 – Herpes virus type 6***• HHV 7 – Herpes virus type 7• KSHV / HHV 8 – Kaposi’s sarcoma virus

Epstein-Barr Virus Transmission:

• EBV will infect virtually everyone on the planet at some point in their lifetimes. It is possible for EBV to remain dormant in the body throughout the entirety of an individual's life span.

• Typically, the disease is transmitted via saliva and takes 30-45 days to present with symptoms, if it does at all.

• During this period, the host is most likely to spread EBV to others.

• Young children may show no symptoms; adolescents typically develop infectious mono

Epstein-Barre Virus Pathogenesis

• DNA virus that multiplies within the nucleus of its host cells, the human B-lymphocytes and epithelial cells.

• Highly adept at avoiding the immune system.

• Linked with a wide range of diseases, including several types of cancer (Hodgkin’s lymphoma) and auto-immune diseases such as Lupus, RA and MS

• EBV was found in the brains of those with MS and that “although the virus was not actively spreading, it was releasing a chemical message into areas of the brain nearby. This chemical message… was activating the body’s immune system, causing inflammation. This damages nerve cells in the brain and causes MS symptoms.”

• Stealthy and hides in B lymphocytes (dormancy) for remainder of host’s life, unless it becomes reactivated by low immunity, stress, or infection.

• Latent viruses may be activated in the presence of Lyme and other TBD, which tends to accelerate disease progression and worsen prognosis.

Epstein-Barr Virus Symptomology

• Mono: fever, sore throat, swollen lymph glands, elevated WBCs, possible swollen liver or spleen.

• Fatigue – often debilitating; lasting for weeks or months

• CFS• Brain fog• Chronic inflammation and

neurodegeneration• Immune dysregulation• Auto-immune illness.

Epstein-Barre Virus Diagnosis

• Viral capsid antigen (VCA)

– Anti-VCA IgM appears early in EBV infection and usually disappears within 4 to 6 weeks.

– Anti-VCA IgG appears in the acute phase of EBV infection, peaks at 2 to 4 weeks after onset, declines slightly then persists for the rest of a person’s life.

• Early antigen (EA)– Anti-EA IgG appears in the acute phase of illness and generally falls to undetectable levels after

3 to 6 months. In many people, detection of antibody to EA is a sign of active infection. However, 20% of healthy people may have antibodies against EA for years.

• EBV nuclear antigen (EBNA)– Antibody to EBNA, determined by the standard immunofluorescent test, is not seen in the acute

phase of EBV infection but slowly appears 2 to 4 months after onset of symptoms and persists for the rest of a person’s life.

Epstein-Barr Virus Treatment

• No effective medications. EBV is very resistant against anti-viral meds.

• Bed rest and reduced physical activity may needed for both acute and chronic infections.

• Natural medicine is the way to go.– Anti-viral herbs

– Frequency specific micro-current or Rife

– Near and far infra-red light

– Mitochondrial repair

Herbs That Treat Epstein-Barre Virus

• Turmeric• Passionflower• Ginger• Galanga• Artemisia• Citrus peels• Echinacea• Olive leaf

Additional Remedies for Epstein-Barre Virus

• + Immune system tonics such as astragalus, reishi, chaga, rhodiola, ashwaganda

• Zinc citrate (50 mg); Vitamin C (IV, liposomal or regular); Vitamin D

• Anti-viral frequency specific microcurrent or Rife frequency therapy;

• Near and far infra-red light;• Use a combination approach.

Cytomegalovirus (CMV / HHV-5)

• Parasitic, only grows in human cells;

• Transmitted via saliva, respiratory droplets, urine, stool, sexual body fluids and breast milk;

• Common, widespread, easy to catch.

• Diagnose via blood test IgG / IgM.

Cytomegalovirus Symptomology

• Initially, common cold / sore throat / mono – minor or major illness;

• Induces immune suppression by infecting WBC’s;

• Rash, swollen lymph glands, pink eye, sinus / lung infection, heart enlargement, IBS, infections of liver, kidney, testicles, cervix, RBC’s, nervous system, joints and musculoskeletal system.

Herbal Treatment for CMV

Dandelion

Licorice

Isatis

Garlic

Clove, terminalia

Turmeric

Artemisia

Additional Remedies for Cytomegalovirus

• + Immune system tonics such as astragalus, reishi, chaga, rhodiola, ashwaganda

• Zinc citrate (50 mg); Vitamin C (IV, liposomal or regular); Vitamin D

• Anti-viral frequency specific microcurrent or Rife frequency therapy;

• Near and far infra-red light;• Use a combination approach.

Herpes Virus 6 (HHV-6)

• Widespread;• 2 variants – HHV-6A &

HHV-6B;• HHV-6B infects infants and

children (90%); HHV-6A infects adults;

• Found in saliva, presumably spreads this way;

• Main concern is with immune-compromised patients.

HHV-6 Symptomology

• In children, abrupt onset of fever, maculopapular rash;

• Nonspecific febrile illness (or asymptomatic);

• Immunosuppressive; • May reactivate in salivary

glands, kidneys or brain;• Associated w/ CFS,

depression, neurodegenerative dx.

Main Take-Aways

• “Lyme disease” = super-infection

• Microbial disease load -> a burdened, suppressed, and disabled immune system

• Lyme-Borreliosis infection may trigger reactivation of viruses and/or the progression of otherwise latent / carrier bacterial diseases;

• Addressing the multiple layers of infection is complex and takes time, yet the health-generating approach has great potential to diminish infection loads across the board.