ENVIRONMENTAL DISEASES
(Louvain) January 2000
A.I Introduction
A family of four presented at our surgery with a common complaint: physical and mental fatigue. They had often been travelling in the bush of Southern Africa (Botswana, Namibia, and Zimbabwe), hiking and fishing At home they are in constant contact with dogs and chickens. Although the children were pale, the general look of the family was healthy and fit.
A.II Individual Case Studies
Father - 39 years old:
Was consulting physicians for the last 18 months for fatigue, chest pains and palpitations. The findings were abnormal liver function and hypercholesterolemia. The stress ECG was normal No treatment was given.
A review of his past medical history revealed:
- A normal childhood, with the usual childhood diseases.
- 3 episodes of tick-bite fever (at 19, 23 and at 33).
His surgical history showed an epigastric hernia repair at 19, a knee operation at 26 and an exploratory laparotomy at 36 to investigate his liver condition, as his liver function test revealed severe abnormalities, while the biopsy was negative.
At the first visit, his symptomatology was:
- Physical and mental fatigue
- Headaches
- Recurrent sore throat and post nasal drip
- Retrosternal chest pain, not exercise related
- Depression and mood swings
- Insomnia
- Allergy to pollen and dust.
• The physical examination was normal, except for an inflamed throat and elevated blood pressure at 140/100.
• The biological investigation was normal, except for:
- Elevated antibodies against: Rickettsia Prowazeki - Coxiella Burnetti - Mycoplasma and Chlamydia Q18
- Elevated gamma GT
- Elevated Triglycerides
Mother - 34 years old:
• Seen one week later, reporting tiredness over the last 18 months
• In her past medical history we found:
- A normal childhood, with the usual childhood diseases
- Tick-bite fever at 20, not treated
• Surgery was performed 2 years ago for cancer of the cervix
• At the first visit, the symptoms were:
- Physical and mental fatigue
- Recurrent sore throat and post nasal drip
- Tinnitus
- Loss of memory and concentration
- Depression and mood swings
- Allergy to pollen, dust etc.
• The physical examination showed:'
- Inflamed throat
- Cervical adenopathies
- A tachycardia with a systolic murmur 1 on 6
- Tenderness in the right iliac fossa
• The biological examination revealed:
- ESR at 30 mm/hr
- Absolute Monocytosis
- Iron deficiency (% saturation at 7)
- CRP at 14.50 mg/L
- Elevated antibodies against: Rickettsia Mooseri - Mycoplasma - Chlamydia Q18 - Chlamydia Trachomatis
- No antibodies were detected against Coxiella Burnetti, although she previously was diagnosed for tick-bite fever (? Immune system deficiency?).
Daughter - 7 years old
Brought by her mother 6 weeks later, because she was always tired
She also suffered from chronic sinusitis since 18 months old, treated unsuccessfully with repeated antibiotics
She had never had surgery
At the first visit the symptoms were:
- Physical and mental fatigue
- Recurrent sore throat and post nasal drip and otitis
- Headaches
- Fibromyalgia, mainly in the legs
- Raynaud Syndrome
- Chronic abdominal pain
- Allergy to dust, grass, dogs, cats
The physical examination showed:
- Inflamed throat
- Cervical adenopathies
- A systolic murmur 1 on 6
- Tenderness in the right iliac fossa
The biological examination revealed
- Elevated antibodies against: Rickettsia Prowazeki - Rickettsia Mooseri - Mycoplasma - Ghlamydia Trachomatis - Biiharzia
- Decreased TSH at 0.5 uiu/ml
Son - 6 years old
Brought by the mother, with his sister, for fatigue, asthma, requiring cortisone and iron deficiency
He never had surgery
The physical examination showed:
- Inflamed throat
- A systolic murmur 1 on 6
- Epigastric tenderness
- Tenderness in the right iliac fossa
The biological examination revealed:
- Elevated antibodies against: Rickettsia Prowazeki - Mycoplasma - Chlamydia Trachomatis
- ESR at 23 mm/hr
- Free T3 elevated at 6 pmol/L
A.III Treatment:
After establishing the previous diagnosis, the following treatment was applied to the 4 patients, taking into consideration their weight and ages:
• Tetracyclines pulse therapy of 7 days, alternated, combined successively for the 2 adults with macrolides, metronidazole, and quinolones. The tetracyclines were not combined for the children. No generics were used. The following adjuvants were given to all of them.
- Vitamin B complex
- Probiotics
- Proton pump inhibitor
• Patients were seen monthly to evaluate the symptoms, the clinical examination and the biological abnormalities were checked every 3 months, except for the microorganism antibodies.
• Treatment was given for
6 months to the father, 5 months to the mother 4 months to the 2 children
A.IV Results
Father:
• Presented an important Herxheimer reaction on the 2 first treatments. Following this the treatment was well tolerated.
« Headaches disappeared after the first treatment
• His energy was restored after the 3rd treatment
• He contracted bronchitis during the 3rd treatment. His stress level was high at this time, due to work pressure and planning their emigration and he regressed mildly
• Biological checkup is not available as the patient did not submit a blood test
• Further treatment is advisable (patient planned to do so, but has moved to Australia, so no further information is available).
Mother:
• Tolerated each treatment easily
• Improved from the start and regularly after each treatment from the point of view of:
- Tiredness
- Tinnitus
- Sinusitis
- Allergy
- Tachycardia
- Depression
• The cervical adenopathies remained
• The biological checkup improved in parallel
- ESR 5 mm/hr
- Iron saturation % from 7 to 41
- CRP 6.3 mg/L (normal)
• Due to these findings, treatment was discontinued. The patient was advised to watch her symptoms, and accordingly to perform a biological checkup.
Daughter
• Tolerated each treatment easily
• Improved from the start and continued to do so
• Biology showed the normalisation of the TSH at 2.5 ulu/ml
• She was considered cured.
Son
• Tolerated each treatment easily
Improved from the start and continued to do so from the point of view of:
- Allergy
- Energy
The biology showed a normalisation of T3 at 5 pmol/L and of the ESR at 3 mm/hr
He was considered cured.
B Conclusion:
The systematic use of a definite biological checklist including the above infectious agents when patients present complaining of fatigue is conducive to treatment of the or a cause of the symptom fatigue, rather than the assumption of psychosomatic problems. This also would be advisable where depression is a symptom before using anti-depressants, as the above microorganisms are known to release neurocytokines in the bloodstream. Equally, the use of cortisone should be restricted before the above infectious investigation.
As well as virulent, obvious diseases, there are attenuated forms of the same diseases. Therefore early detection is important, in order to avoid irreversible cell damage in any type of tissue (heart, CMS, reticulo endothelial) which no longer needs the virulence of the germ to evolve
Following the above cases, we frequently see whole families consulting for the same reason: fatigue, where we can establish the same diagnosis: infection, due to a common environmental exposure and where we apply the same pulse treatment This gives us the same result: symptomatic and biological improvement or recovery
Copyright 2000 Dr. Cecil Jadin
Reprinted where with Permission
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