Antibiotics and Dysbiosis

There are reports of improvement in CFS patients based on various approaches to improving gut dysbiosis or gut microbial corruption.  Most approaches use a combination of removal of the current gut ecology and the replacement of those corrupted microbial elements with more friendly microbes.  A few investigators have used the stool of healthy adults by homogenating such stool and then by retention enema, inserting such stool with presumed normal gut microbial ecology from a healthy person into a non-healthy person.  The results from such approaches were similar to that reported by a group in Sydney, Australia and by a group at UCLA in the mid 1990′s.  The Australian group of gastroenterologists hospitalized CFS cases and gave IV broad spectrum antibiotics and antifungals.  They did this based on the McGregor and Dunstan article in 1995 that showed a relationship between symptoms of CFS and certain peaks on urinary GC which they called CFSUM1, CFSUM2, CFSUM3 etc.  Mass Spect identified them as mostly toxic bacterial xenobiotics.  I saw this antibiotic study first presented in Sydney, Australia.  About half the patients had a significant clinical response but relapsed in about 6-8 months.  On repeated therapy, the response rate was cut successively in half and relapse was again seen with fewer and fewer repeat responders  They concluded that this apparent gut dysbiosis was likely a secondary problem in CFS and abandoned this aggressive antibiotic approach.

Pimental from a rheumatology group at UCLA did a similar study with FM cases with a similar result.  Given Jeremy Nicholson’s work in the UK on the metabolome and chronic illness, perhaps there is no such thing as chronic illness without some degree of gut dysbiosis  and which accompanies an increasingly corrupted human phenotype and likely evolving corrupted genotype (mutations and Alu insertion region genetic adaptations), especially over time.

I would agree that some sort of gut dysbiosis strategy is appropriate but more as part of a larger strategy which also addresses redox control points as well as human phenotypic and genotypic corruption.  There is as yet, no clear consensus on treating this gut dysbiosis, so I take a pretty conservative approach that follows a 3R strategy (remove, repair and replace) as well as a modified elimination diet and especially fructose elimination or constraints on its use to temperate zone fruits only and no processed fructose ingestion (HFCS) or tropical fruit ingestion.

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