Lyme Maybe yes, Maybe no! Symptoms: common and less common Lyme Disease Misdiagnosed as Photos: Lyme Rash Bartonella Rash Lyme Under the Scope How is Lyme Transmitted? How is Lyme Diagnosed? Treatments Options: Anti-biotics Botanicals Precious Metals Nutrition/Gastro Intestinal Hormonal Dental Heavy metals Co-Infections Parasites – Fungus/Yeast Herxheimer Reactions Hyper coagulation Explaining the Sodium / Potassium Pump Treating Lyme Disease By Steve Hines, N.D. N.E. Co-Founder with Dr. Elio Rivera, M.D. of IMHO - In My Humble Option Disclaimer: 1. Steven serves on the Board of Directors for KS3 Diagnostic Laboratories, Lubbock Texas 2. Steven is a dealer for Bemer America 3. Steven is a dealer for BioMat Infrared Mat 4. Steven is a principal at Hope Wellness Center Inc. Symptoms: Common and Not So Common fatigue joint pains muscle pains / tight muscles headaches/migraines hormone disturbances thyroid problems multiple chemical sensitivity fasiculations-muscle twitches tinnitus-ringing in the ear low grade fever night sweats sleep pattern disturbance most all mental/nervous disorders Lyme Disease Often Misdiagnosed as: Auto Immune: Fibromyalgia, Lupus, Chronic Fatigue Syndrome, Multiple Sclerosis Arthritis/Bone/Joint: Rheumatoid Arthritis, Juvenile Rheumatoid Arthritis, Osteoarthritis, Osteoporosis Neurological: Parkinson's, Autism, Migraine Headaches, Dementia, Alzheimer, ALS Digestive: Gastric Reflux, Irritable Bowel, Constipation, Crohn’s Disease, Hiatal Hernia Dermal: Scleroderma, Eczema, Psoriasis Endocrine: Hashitmotos-hypothyroidism, Cushings or Addison’s disease Cancer: Lymphoma, Leukemia Emotional: Depression, Anxiety Attacks, Panic Disorders. OCD Blood Sugar: Hypoglycemia, Diabetes And a couple hundred more! My Personal Favorite: Nothings wrong - It’s all in your head Lyme Disease a Multi-Faceted Problem Electrolyte Disturbances: K+ / MG++ Dental Toxicity: Mental / Nervous: Root Canals Depression, Anxiety, OCD Mercury Fillings Lyme Hormonal Disturbances: Estrogen Dominance Adrenals, Thyroid Disease Nutritional Deficiencies: B12, B1, Folate, Vit D Gastric Disturbances: Food Allergies, IBS, IBD, Constipation How is Lyme Disease Transmitted? Mosquitoes, Ticks, Horse flies: 22% of horse flies, deer flies and mosquitoes are infected with Borrelia and co‐infections in endemic areas! The etiologic agent of Lyme disease in deer flies, horse flies and mosquitoes, J Infect Dis 154 (1986), 355‐358, LA Magnarelli, JF Anderson, AG Barbour, In utero transmission: Borrellia has been shown to be passed from mother to baby during gestation. Blood Transfusion: This obviously possible because blood banks do not test for Lyme and co-infections. Sexual Transmission: Spirochetes have been cultured out of saliva, semen, the oral mucosa as well as vaginal secretions. Breast feeding moms: Spirochetes can be transmitted through breast milk. How is Lyme Disease Diagnosed? Laboratory test of blood and urine Western Blot: deemed “Standard of Care” yet still results in 30-50% false negatives. Only tests for a few organisms. ELISA: The least sensitive test. Usually used as a rapid screening test for acute stage. Very poor test. Tissue biopsy: tissue culture rarely produce positive test. PCR (polymerase chain reaction): very accurate, if enough antigen is available. Rarely is there enough antigen! IMHO Preferred Test: KS3 Diagnostic Labs KS3 Diagnostic Laboratory A New Era for Detecting Lyme and Common Co-Infection Organisms Rapid identification of a variety of spirochete bacteria and common Lyme related co-infections with high sensitivity of detection. KS3 uses modern molecular assays: Molecular diagnostics are well known to be highly sensitive and specific With molecular methods diagnostic results are not skewed when a patient is receiving immune suppressing medication- looking for Bacterial DNA, not antibodies! Results not dependent on organism viability Detection of non-culturable and slowly proliferating organisms A single, inexpensive two stage testing panel: PCR Component- cutting edge/proprietary methodology and reagents Molecular Sequencing Component-most accurate validation/identification available KS3 Diagnostic laboratories Diagnostic Panel www.ks3labs.com Anaplasma phagocytophila Francisella tularensis Bartonella henselae Leptospira biflexa Afipia 97.5% same as Bartonella Borrelia afzelii Leptospira interrogans Borrelia burgdorferi Leptospira kirschneri Borrelia garinii Leptospira wolbachii Borrelia hermsii Mycoplasma fermentans Borrelia lonestari Mycoplasma hyopharyngis Borrelia parkeri Ricketsia species (9 species) Brachyspira aalborgi Treponema carateum Brachyspira hyodysenteriae Treponema denticola Coxiella burnetii Treponema pallidum Ehrlichia chaffeensis Treponema pertenue Additional test available for Babesia microti. Leptospira borgpetersenii Treatment Options Anti-biotics: “Standard of Care – 28 days of anti-biotics” – Anti-biotics are quite effective in most cases however there are many side effects and the incidence of reoccurrence is very high. Some side effects are: Yeast overgrowth, Nausea, Reflux, Headaches, Liver toxicity, Hematological changes such as IPT, low RBC’s, and Anemia. Botanicals: Herbs are gaining prominence for many reasons. No prescription necessary, highly effective except in Neuro-Borelliosis, No yeast infections, inexpensive. We are still learning which botanicals are the most effective for each particular strain of organism. IMHO Best Option: Hope’s clinical experience has shown a combination of anti-biotics and herbs has been far superior than either one alone. Treatments: Anti-biotics “Standard of Care – 28 days of Doxycycline” At Hope, we generally do not jump to anti-biotics as a first line defense but after we have treated as well as we can with botanicals, minerals and precious metals. The primary exception at this time would be obvious Neuroborreliosis and Lyme carditis. These are very dangerous cases with potential clinical side effects such as seizures and Atrial Fibrillations and heart attacks. Anti-biotics used effectively for Borrelia: Rocephin, usually 1 gram bid, I.V. is most effective. In Mexico, we use Rocephin with DMSO. Flagyl or Tindamax to kill the cyst form of the spriochette. We also use Flagyl I.V with DMSO. Zithromax and Minocyclin are valuable tools. We always give Nystatin 500,000 units bid and 1 foil packet of HLC (probiotic) by Pharmax when using anti-biotics. Fungal infections are rare while on this regime. Treatments: Botanicals Samiento (Uncaria tomentosa) / Banderol combination: At Hope, treatment begins with 3 drops of each in 1 pint of water, sip slowly over 2 hours. Over the next 12 days increase dose a drop or 2 daily. Some people feel so poorly that they cannot bear increasing the dose anymore. This is fine simply stay at the tolerable level until symptoms diminish. Then begin increasing dose again. At Hope, the treatment periods are 12 days on and then 3 days off. After the first 12 days on Samiento/Banderol combo and a 3 day rest, then begin the Cumanda cycle. IMHO Preferred Supplement: NutraMedix www.nutramedix.com Vitamin Research Products www.vrp.com Treatments: Botanicals Cumanda: As with the Samiento/Banderol combo, start with 3 drops in a pint of water, sip slowly over 2 hours. Then each day add a drop or 2 for the next 12 days or up to the level where the Herxheimer is too uncomfortable. This happens often. After 12 days take 3 day break and the switch back to the Samiento/Banderol combo and repeat the cycle. The ultimate goal is 90 drops of each botanical with no pain. If you can take 90 drops of these botanicals with no more pain this is a good sign you have substantially lowered the total body burden of bacteria. IMHO Preferred Supplement: NutraMedix www.nutramedix.com Treatments: Botanicals Takuna: If you suspect viral involvement Takuna is an excellent anti-viral. At Hope, treatment is with 30-40 drops a day in a pint of water for 2 months. IMHO Preferred Supplement: NutraMedix www.nutramedix.com Treatment: Botanicals Olive Leaf Extract (OLE): Olive Leaf Extract has many properties, anti-amoeba, anti-viral, anti-fungal, anti-mycoplasma. At Hope treatment is with 1000 mg bid. IMHO Preferred Supplement: Sea Gate. www.seagateproducts.com. Sea Gate grows their own olive trees and harvest fresh leaves. This is a very potent product. Treatments: Botanicals Lomatium dissectum (LDM-100): Most professionals recommend 20 drops 2-3 times a day. Start low and work up to target dose. Many patients do get a rash, The rash will generally last from 7-14 days. This rash can be severe! Be aware! Lomatium does have anti-viral and anti-fungal properties. Lee Cowden believes many patients who have skin reactions to this herb is do to an undiagnosed chronic measles infection. Be very respectful with this herb! Preferred supplement: Generation II Barlow Herbal Specialties www.barlowherbal.com Treatments: Precious Metals Meso Silver has become one of Hope’s most effective tools for not only spirochetes but many co-infections seem to be responding also. We have found the best treatment is by combining Meso Silver with the Samiento, Cumanda Regime. We start with 1 oz. daily and work up to 2 oz. 3-4 times daily. The Herxheimer can be severe, don’t go to fast! IMHO Preferred supplement: Meso Silver www.purestcolloids.com/mesosilver.htm Nutrition / Gastro Intestinal Poor nutrition and gastric infections greatly contribute to hormonal imbalance. Often there are other infections such as amoebas, tape worms, ascaris, trichinella and fungal/yeast infections. The panel Hope runs is the GI-02 panel. We usually add salivary SIg-A to the panel to test the gastric immune system. The test includes major food allergies: gluten, soy, egg, milk. IMHO Preferred Test: Diagnostechs / www.diagnostechs.com Genova Diagnostics www.gdx.net Nutrition / Gastro Intestinal Fighting disease takes a lot of energy. This is a commodity that most patients fighting a disease need in abundance. Hope recommends a strict diet that contains zero artificial anything, and zero sugar or grains, a no disaccharide diet. The purpose of the this type of diet is to heal the GI tract and minimize the inflammatory process, inhibit the growth of yeast, normalize peristalsis and avoid the most common allergens associated with the Standard American Diet (SAD). IMHO preferred Diet and DVD: “The Road to Health: Overcoming Chronic Illness through Nutrition” by Laura L. Schroeder and Steven W. Hines / www.hopewellness.com/products.html “Learn How to Treat Yourself: Digestion and Digestive Disorders" by Steven W. Hines / www.hopewellness.com/products.html Nutrition / Gastro Intestinal Another important test is the Vasoactive Intestinal Polypeptide(VIP). This peptide is a master regulatory peptide in the gut that can effect many aspects of health from motility, immunity, vasodilatation and Neuronal function. VIP is one of the most abundant molecules found in the respiratory tract. Department of Respiratory Medicine / Hanover Germany IMHO Preferred Test: Aruplabs / www.aruplab.com/guides/ug/tests/0099435.jsp If the test is abnormal, VIP is available in a nasal spray thru: Hopkinton Pharmacy www.rxandhealth.com Nutrition / Gastro Intestinal The FASEB Journal express article10.1096/fj.02-1029fje. Published online August 15, 2003. Vasoactive intestinal peptide prevents activated microgliainduced neurodegeneration under inflammatory conditions: potential therapeutic role in brain trauma Mario Delgado*,† and Doina Ganea* *Department of Biological Sciences, Rutgers University, Newark, NJ 07102; †Instituto de Parasitologia y Biomedicina “Lopez-Neyra,” CSIC, Granada 18001, Spain Corresponding author: Mario Delgado, Instituto de Parasitologia y Biomedicina “Lopez-Neyra,” CSIC, Granada 18001, Spain. E-mail: [email protected] Ritchie Shoemaker has done a tremendous amount of research on this peptide, this is his highly informative website. www.biotoxin.info Nutrition / Gastro Intestinal Supplementation – “The Basics” Supplemental stomach acid is essential. (Betaine HCL) A broad spectrum digestive enzyme Mastic Gum/DGL (Vitamin Research Products) vrp.com Probiotics. IMHO Preferred supplement: HLC by Pharmax, / www.pharmaxllc.com 1 foil packet at bedtime Saccharomyces Boulardii, (friendly yeast) Potassium 400mg bid Zinc 25mg Magnesium 250-1000 mg daily IMHO Preferred supplement: Natural Calm, 1 tsp in hot water at bedtime Hormonal Issues Adrenal maladaption, upregulation of aromatase, 5 alpha reductase and alterations in the conversion of T4 to T3, alterations in binding affinity to carrier proteins and estrogen dominance are some of the major issues. Normalizing hormones can be very challenging. Hope uses Sabre’s Circadian panel to assess Cortisol, DHEA, Testosterone, Estradiol, Progesterone, salivary electrolytes as well as urine amino acids. Sabre will create a custom hormone support formula for each patient based on the lab results. Sabre uses liposomal delivery system to efficiently deliver hormone and hormone precursors as well as adaptagenic herbs and synergistic nutrients to the intracellular compartments. IMHO Preferred Test: Sabre Sciences in Carlsbad California. www.sabresciences.com If bioidentical Estradiol, is needed, Denton Prescription Shop makes liposomal encapsulated hormone support formulas. IMHO Preferred Pharmacy: www.dentonprescriptionshop.com Dental Issues Root canals, Cavatations, Mercury Fillings, Nickel Crowns over Mercury. Root canals are almost always infected, they pose a much greater potential health danger than Lyme disease and should always be placed in priority above Lyme! Root canals should be removed along with the dental ligament (the lining of the tooth socket). Always use a biologically trained dental specialist. Google “Root Canal Cover-up”. Cavatations are an infected socket that should be reopened, ligament removed and reclosed. Charlie’s story. Mercury fillings can cause depletion of Glutathione which in turn lowers anti-viral immunity. Google “Smoking Tooth”. Nickel over mercury creates a battery effect overdriving electrical signals. Have seen negative 56 milli volts and greater when readings should be zero in the mouth. Can produce seizures, head aches, depression, anxiety etc. To find a biological dentist visit www.iaomt.org. Heavy Metals At Hope we often utilize testing to determine toxicities in immune compromised patients. Heavy metals: Mercury, Lead, Cadmium, Arsenic, Antimony How to assess Heavy Metal? Heavy metals challenge test Challenge agents; DMSA, MDF Pre and Post Provocative Challenge IMHO Preferred Test: Metametrix Clinical Laboratory / www.metametrix.com Doctors’ Data, Inc. / www.doctorsdata.com Quick Silver Scientific/www.quicksilverscientific.com (mercury) Treatments for Heavy Metals Heavy Metals Pharmaceutical Natural Mercury DMSA, DMPS IMD, DE, Chlorella, Cilantro, Garlic, OSR, Z naturals Lead DMSA, EDTA, DMPS IMD, DE, Chlorella, Cilantro, Garlic, OSR, Z naturals Cadmium DMSA, EDTA, DMPS IMD, DE, Chlorella, Cilantro, Garlic, OSR, Z naturals Arsenic DMSA, EDTA, DMPS IMD, DE, Chlorella, Cilantro, Garlic, OSR Z naturals Antimony DMSA, EDTA, DMPS IMD, DE, Chlorella, Cilantro, Garlic, OSR, Z naturals Oxidative Stress Reduction (OSR), Intestinal Metals Detox (IMD), Diatomacious Earth (DE), Co-Infections Lyme disease is rarely just a lone spirochete. Most patients are infected with more than one organism. This makes Lyme disease complicated for the clinician trying to treat the patient. Of ticks that carry Borrelia Burgdorferi in the Northeast, they also carry: Bartonella: (Cat scratch fever) 12% Go Ted Nugent! Babesia: over 66% HGE: Human Granulocytic Ehrlichiosis: 8% carry this one Afipia: 97.5% the same as Bartonella, we see 5 times more than Bart Francisella tularensis Coxiella Burnetti: also known as Q-fever, common with ranchers Leptospira: we see 2 to 3 times more than Borrelia species! 95% over lapping symptoms with Borrelia! Co-Infections Other Common Co-Infections seen in Lyme Patients: Mycoplasma: in one study 50% of Lyme patients with primary joint symptoms also had this organism in their synovial membranes. HHV-6, HHV-8: Herpes Virus: Treatments for Co-Infections Organism Pharmaceutical Natural Bartonella Rifampin and/or Plaquenil SSKI? MMS? Meso Silver? OLE? Berberine +( VRP) Babesia Mepron SSKI? MMS? Meso Silver? OLE?, Artimisinin, Berberine +,Gallium nitrate HGE: Doxycycline SSKI? MMS? Meso Silver? OLE?, Berberine + Mycoplasma: Cipro, Levaquin SSKI? MMS? Meso Silver? OLE?, Berberine + HHV-6, HHV-8: Valtrex SSKI? MMS? Meso Silver? OLE? CO, GHW, OSR. LDM Herpes Virus: Valtrex SSKI? MMS? Meso Silver? OLE? CO, GHW, OSR, LDM Q fever: Doxycycline, Quinolones, hydroxychloroquine SSKI? MMS? Meso Silver? OLE?, Berberine + Super Saturated Potassium Iodine (SSKI) Miracle Mineral Supplement (MMS), Green Hull of Walnut – (GHW), Olive Leaf Extract (OLE), Oxidative Stress Reduction (OSR), Glutathione (G), Lomatium (LDM), Coconut Oil (CO), King Solomon Herb (KSH), Ground Papaya Seeds (GPS) Parasites and Fungus/Yeast Parasites: Amoebas Tape worms Ascaris Trichinella Flukes Hook worms Strongyloids Fungus / Yeast: Candida Aspergillis Treatments for Parasites Organism Pharmaceutical Natural Amoebas Alinia, Flagyl, Medenzole, Tindamax SSKI? MMS? Meso Silver? OLE? Artimisinin, Galium nitrate Tape worms Biltricide, Ivermectin OLE? Artimisinin Ascaris Ivermectin, Medenzole, Tindamax OLE? GHW? Cloves, KSH, Artimisinin, GPS Trichinella Ivermectin, Medenzole, Tindamax OLE? GHW? Cloves, KSH, Artimisinin, GPS Flukes Biltricide, Ivermectin, Niclosamide Hook worms Ivermectin, Medenzole, Tindamax OLE? GHW? Cloves, KSH, Artimisinin, GPS Strongyloids Ivermectin, Medenzole, Tindamax OLE? GHW? Cloves, KSH, Artimisinin, GPS Super Saturated Potassium Iodine (SSKI) Miracle Mineral Supplement (MMS), Green Hull of Walnut – (GHW), Olive Leaf Extract (OLE), Oxidative Stress Reduction (OSR), Glutathione (G), Lomatium (LDM), Coconut Oil (CO), King Solomon Herb (KSH), Ground Papaya Seeds (GPS) Treatments for Fungus/Yeast Organism Pharmaceutical Natural Candida Nystatin, Diflucan, Sporanox MMS? CO? OLE? GSE? F? OO? Aspergillis Sporanox MMS? CO? OLE? GSE? F? OO? Super Saturated Potassium Iodine (SSKI) Miracle Mineral Supplement (MMS), Green Hull of Walnut – (GHW), Olive Leaf Extract (OLE), Oxidative Stress Reduction (OSR), Glutathione (G), Lomatium (LDM), Coconut Oil (CO), King Solomon Herb (KSH), Ground Papaya Seeds (GPS), Grapefruit Seed Extract (GSE), Florastor (F), Oregano Oil (OO) Herxheimer Reaction This is one of the most difficult problems in managing Lyme patients. During the Syphilis era, Dr. Jarish and Dr. Herxheimer described the pain that occurred when killing the syphilis bacteria which has become known as the “Herxheimer Reaction”. IMHO the cause of this reaction is the secondary immune response to the dying organisms cell membrane components being attacked by the immune cells. This creates a host of inflammatory chemicals that cause painful joints and muscles. Typical Symptoms: wide spread pain muscle aches Headaches Fatigue Dizziness nausea Managing the “Herx” Z-Naturals Micro Chitosan, a micronized Chitosan from Japan Gallbladder Liver Flush www.hopewellness.com Colonics I.V. vitamin C / 50 grams Magnesium Pushes 1500-2000mg Massage therapy Far Infrared Saunas Saunex.com Biomats FIR hopewellness.com Dietary considerations (no Grain Diet) The Road To Health Hormone replacement therapy (rhythmic dosing) Wiley Protocol and Sabre Sciences 24 hour circadian panel Dental Issues (root canals, cavitations, mercury) Managing Hypercoagulation Nattokinase IMHO Preferred Supplement: [email protected] Serrapeptase IMHO Preferred Supplement: Vitamin Research products (vrp.com) and Nutramedix.com Lumbrokinase Fibroboost IMHO Preferred Supplement: Allergy Research Group www.allergyresearchgroup.com Edta Subcutaneous Heparin Fish Oils Interview with David Berg David Berg is the Director and Cofounder, with Lois Hill Berg, of HEMEX Laboratories. Along with Dr. Harold Harrison and several clinical collaborators, they have developed the idea of the hypercoagulation/ immune system activation of coagulation theory in chronic diseases, a proposed cause of Chronic Fatigue Syndrome and Fibromyalgia, and have proposed an appropriate treatment that reduces many related symptoms. Mr. Berg has a M.S. degree in clinical pathology and laboratory medicine, and has been in practice for 35 years. HEMEX Laboratories offers testing and consultative services relating to the diagnosis, treatment, and monitoring of hematological, clotting and/or bleeding disorders. Interview with David Berg (continued) We first became involved with research in chronic illnesses while we were performing re search regarding hypercoagulability - related infertility in women with one of the local infertility specialists here in Phoenix, AZ. We found that a hypercoagulable state, presumably due to a coagulation protein defect, existed in many women who were infertile and/or who had recurrent spontaneous abortions. Our colleague Dr. Couvaras observed that when he put women on low dose heparin in order to maintain pregnancy, some with CFS/FM-like symptoms, pelvic pain, and migraine-like headaches had amelioration of their symptoms. He asked us “Why?” As a result, we performed a retrospective study on 30 of these obstetric patients with chronic illness symptoms, and determined that all had coagulation system activation. As the hypercoagulability was decreased by heparin injections, the chronic illness symptoms diminished. This was the first clue to the connection between coagulation and chronic illnesses. These findings were published as a poster at the 1998 AACFS meeting in Cambridge, MA. Interview with David Berg (continued) We subsequently refined our test panel for low level activation of coagulation to include Prothrombin fragment 1+2 (F1+2), thrombin/antithrombin complexes (T/AT) and Platelet Activation by Flow Cytometry assays. Thus, the ISAC or Immune System Activation of Coagulation panel consisting of fibrinogen (FIB), soluble fibrin monomer (SFM), F1+2, T/AT, and PA by Flow was born. With our partner and Medical Director, Dr. Harold Harrison and several clinical collaborators, we then designed and conducted a prospective, multi-center, blinded, case control, associative study of non-obstetric CFS/FM patients and controls, with centers in New York, Houston, and Phoenix. When the code was broken, identifying patients and controls, we were able to identify most of the CFS/FM patients based on having two or more positive test results out of the five assays in the ISAC panel. It was the first definitive evidence that, indeed, chronic illnesses have a demonstrable basis in the blood coagulation system. This study was published in the international journal Blood Coagulation & Fibrinolysis, 1999, 10:435-438. In another associative cohort study published in Blood Coagulation & Fibrinolysis, 2000, 11:673-678, we determined that Gulf War illness has similar findings of low level activation of coagulation. Interview with David Berg (continued) In November, 1999, Dr. Joe Brewer (an Infectious Disease specialist in Kansas City) and I developed a model of pathogen activation of the immune and coagulation systems. The model proposes that the end result of such pathogenmediated activation is increased blood viscosity due to 1) an underlying coagulation regulatory protein defect, and 2) activation of the coagulation system by the pathogen. As the blood viscosity increases, the diminished blood flow creates hypoxia (lack of oxygen) and nutrient deprivation within various areas of the body. This is like trying to start your car in Wisconsin in the winter with 60weight engine oil. This model explains the multi-organ symptomatology and also explains why the low dose heparin therapy is effective by increasing blood flow as the blood viscosity decreases. Thus, patients gain relief from their symptoms with this therapy. Interview with David Berg (continued) The model states that coagulation activation generates thrombin, which converts fibrinogen to soluble fibrin monomer (SFM). Soluble fibrin becomes deposited in the micro-circulation (capillaries) as fibrin or fibrinoid-like deposition, blocking oxygen and nutrients transfer to parenchymal tissues. Many pathogens activate the immune system. These include viruses (such as EBV, CMV, HHV6 & others), bacteria (mycoplasma, chlamydia, borrelia, etc), fungi (such as candida), etc. These pathogens are anaerobes, i.e., they live and reproduce in an oxygen deprived cellular matrix or environment. That’s why fibrin deposition becomes important to the survival of the pathogens because it produces decreased oxygen in cells and tissues. One of the biggest challenges to a clinician is to figure out what pathogens are present in the patient, and therefore the most appropriate therapies against these pathogens. The average CFS/FM patient may have anywhere from one to seven pathogens that need eradication. Interview with David Berg (continued) Positivity of two or more tests in the ISAC panel occurs in more than 80% of all patients tested. However, the longer a patient has been ill (many years), the less activation is needed by the pathogens for survival, and therefore fewer tests may be positive. Someone who has been ill for 10 years or more may only have one test positive in the panel. The ISAC panel also works very well for monitoring anticoagulant therapy between 4-6 weeks after therapy has started. It indicates whether or not there is enough heparin being given to the patient, the overall patient improvement and the reaction of the body to the pathogens, such as a Herxheimer-like reaction (relapse from infections or reactivation of pathogens). Interview with David Berg (continued) In addition to the pathogens that can activate the immune system, metals (e.g. mercury, lead, aluminum), exogenous toxins, chemicals, allergens, physical trauma, vaccinations, and/or biological warfare agents can also activate the immune system. This may lead to secondary infections, which may also trigger coagulation activation. If the coagulation mechanism does not shut down properly, then there is continued thrombin generation and soluble fibrin formation, resulting in increased blood viscosity and decreased blood flow. Interview with David Berg (continued) When you look for a genetic basis in this model, one can test for seven different regulatory proteins of the coagulation mechanism plus homocysteine in a panel we call the HTRP (Hereditary Thrombosis Risk Panel). In July 2001, at the International Society of Thrombosis and Hemostasis meeting in Paris, we presented data from a retrospective study of over 400 chronically ill patients, 83% had one or more demonstrable coagulation protein defects. Forty percent of the patients had a thrombophilia defect (decreased protein C, decreased protein S, decreased anti-thrombin, APC resistance/factor V Leiden positivity, or increased prothrombin/prothrombin gene mutation positivity). 39% of the patients have defects in the fibrinolytic system (hypofibrinolysis due to elevated lipoprotein (a) - Lp(a) and/or PAI1-plasminogen activator inhibitor-1. 21% of these patients had a defect in both the thrombophilia and hypofibrinolysis marker groups. This means that not only do they form fibrin easily, but also they are compromised in the ability to clean up the fibrin deposition. Interview with David Berg (continued) Letâ€™s put this in plain English. When a pathogen(s) gains a foothold, especially in the endothelial cells in the blood vessels (as well as other cells), the bug(s) can be protected by the coagulation mechanism of fibrin deposition on top of the infected cells. Half of the patients form fibrin very fast, becoming fibrin(oid) deposition. Half of the patients have an inability to clean up the fibrin, and therefore continue to have oxygen and nutrient starvation of tissues for a long time. For example, if the fibrin deposition occurs in a muscle, it says â€œouch,â€•and you have a tender point as in Fibromyalgia. If it is in the placenta, the placenta is compromised by fibrin deposition and the baby aborts. As blood viscosity increases and blood flow is reduced throughout the body, the patient becomes hypo-this and hypo-that, such as hypothyroid, hypo-HPAaxis, hypo-estrogen, etc. The use of low dose heparin restores blood flow throughout the body and hormones from the endocrine system tend to normalize. Thus, the blood flow issue becomes one of the most important issues of chronic illnesses. Unfortunately there is no easy test to measure blood flow, only the effects of blood flow. Interview with David Berg (continued) If you consider the movie Braveheart (1000 AD) and you went to battle and were wounded, you probably would have bled to death unless you clotted fast. By clotting fast, you saved your own life and passed on this new trait to your children. This hypothesis may explain how these coagulation defects were genetically selected during the last 2000 years in Europe. Life expectancy back then was only 30-40 years. With our life expectancy now of 80+ years, these traits are no longer beneficial, but rather deleterious to our health. It was the Spanish, French, British, Germans, Italians, Scandinavians, etc. (Europeans) that colonized the Americas. This explains why most of the chronically ill patients are white people of European decent. Therefore we have a genetic basis in the coagulation system for chronic illnesses that is very straightforward. Interview with David Berg (continued) The model of reduced blood flow from increased blood viscosity due to activation of coagulation accompanied by a coagulation protein defect gives a scientific basis for a contribution to the pathophysiology of chronic illness. It also gives a measurable or quantifiable, objective aspect to testing the blood of patients with these diseases. It is no longer all in your head but rather in your blood.It is not rocket science, but a simple, logical explanation for what going on in many chronically ill patients. Interview with David Berg HEMEX Laboratories provides testing services and consultative interpretations to clinicians and physicians throughout the United States. For more information, technical reprints, and/or patient information, please see their website at www. hemex.com Read these related articles: Hyper coagulation Linked to Chronic Fatigue, Fibromyalgia, MS, Infertility, Chronic Illness - PART 2 Hypercoagulation & Heparin - A Second Look. Explaining the Sodium–Potassium Pump This is where potassium plays its most important role – at the cell membrane. The sodium pump powers a wide variety of cell membrane processes and may consume as much as one-third of your total food-energy supply to do this. Sodium – Potassium Pumps This is a typical cell, with the cell membrane forming the boundary between the inside and outside. For our purposes, we’ll imagine an unrealistic initial condition in which the sodium and potassium ions are distributed evenly inside and outside the cell. Na+ is a positivelycharged sodium ion, and K+ is a positively-charged potassium ion. Sodium – Potassium Pumps The protein has receptacles to accept three sodium ions and two potassium ions. Sodium – Potassium Pumps Then the protein inverts itself, pulling the sodium ions out and pushing the potassium ions in. After this process has gone on for a while, the protein will have to work against electrical potential because there will be less positive charge on the inside and more on the outside. Chemical energy is used by the protein to move the ions through the membrane against this force. Sodium – Potassium Pumps The protein releases the sodium outside the cell and the potassium inside the cell. Sodium – Potassium Pumps Now the protein flips back, and is ready to repeat the sodium-potassium pumping process. But because there is less potassium outside, and less sodium inside, it takes longer for the protein to pick up the ions for pumping. Sodium – Potassium Pumps This is what the cell looks like after the sodium-potassium pumps has done its work. Sodium, outside, and potassium, inside. But because the exchange is twofor-three, there is a net reduction in positive charge inside the cell. Similar electrical charges, like similar poles of magnets, tend to repel each other. Every positively-charged ion is repelled by every other positively-charged ion, so they are pushed to where the concentration of positive charges is the least. The result is that all positively-charged ions are now strongly attracted to the interior of the cell. Sodium – Potassium Pumps Calcium-flow in and out of muscle cells is one example of a membrane process that is powered by the energy stored by the sodium-potassium pump. Calcium ions (depicted here as Ca++ because they have an electrical charge of +2) enter the cell when the muscle contracts. They are strongly attracted to the inside of the cell, so no energy is required to let the calcium ions in. Sodium – Potassium Pumps For the muscle to relax, the calcium must be removed. This is accomplished by other proteins in the cell membrane, which let three sodium ions for every calcium ion that they push out. Sodium – Potassium Pumps Because three sodium ions with a total charge of +3 are attracted to the inside of the cell even more than is one calcium ion with only a charge of +2, no additional energy is required for this exchange to take place, and the calcium can be quickly removed. Sodium – Potassium Pumps This is a close-up of part of the cell membrane, showing the sodiumpotassium pump protein. This large protein molecule attracts sodium on the inside of the cell membrane and potassium on the outside of the cell membrane. Sodium – Potassium Pumps However, this process has depleted some of the energy stored by the sodium-potassium pump when the sodium was allowed back into the cell. More potassium must be available for the pump to remove the sodium and restore the cell’s supply of electrical and chemical energy.