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ME/CFS and Blastocystis spp or Dientamoeba fragilis, an in-house comparison.

snowathlete

Senior Member
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http://www.ingentaconnect.com/searc...00000063/00000607/art00021&mimetype=text/html

ME/CFS and Blastocystis spp or Dientamoeba fragilis, an in-house comparison


  • David Dunwell

    • Mayfly Cottage, Netton Island, Bishopstone, Salisbury, SP5 4DD. E-mail:
David Dunwell@btinternet.com


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In their Global Health editorial BJGP (October) on exotic infections, Behrens and Coltart did not mention the more mundane high prevalence of protozoal infections in warmer climates.1 We caught the anaerobic protozoa Blastocystis spp and Dientamoeba fragilis in Burma, however they are already common in UK, but little known to practitioners.
Blastocystis was the most common enteric parasite (6.9%) found in routine stool samples in a study in Wales2 and D. fragilis was found in up to 16.9% of samples submitted to alternative practitioners.3 However, the detection of both parasites is difficult and requires specialist laboratories; even then they may not be found. Faeco-oral seems their likely mode of transmission.
The pathogenic nature of D. fragilis is now more accepted,4 but two forms are known;5 while nine different subtypes of Blastocystis have been reported, observed disorders appear to be subtype dependent.6 Both protozoa have been linked to IBS.7,8
Treatment of Blastocystis is varied and metronidazole has shown resistance.9 For D. fragilis, only secnidazole10 and paromomycin11 gave very low treatment failure rates. Although both medicines are old, and both are registered and used within the EU, neither is registered for any use in UK.
My wife and I presented common severely debilitating symptoms of chronic fatigue and inability to concentrate for extended periods. I initially had severe diarrhoea, followed by soreness in the lower bowel, while my wife showed almost no intestinal disturbance or discomfort, however when we both had the same diet, the symptoms were the same. Later, headaches became more prevalent. The addition of milk (2% fat) plus cereals, particularly wheat based, increased the bowel disturbance. We had many blood and stool tests, with essentially no adverse findings. After many months and over 10 stool samples from each, I was diagnosed with D. fragilis and my wife with Blastocystis. Both had been found by microscopic examination of preserved stained specimens.
The parasites were treated: D. fragilis with paromomycin (750 mg tid) for 10 days (28 mg/kg) and Blastocystis with nitazoxanide (500 mg bid) for 3 days. Bowel disturbance continued for several weeks in both patients.
Our experiences, although limited, do offer direct comparisons between the parasites and support the conclusion that both can be pathogenic and the effects of both organisms can be similar, giving the ME (myalgic encephalopathy) symptoms of chronic physical and mental fatigue, with bowel disturbances related to cereal/milk diet. However, for patients and practitioners, the biggest problem is lack of efficacious approved drugs in UK.
I wish to thank the laboratory staff in the Department of Medical Parasitology at the London School of Hygiene and Tropical Medicine for making the diagnoses.
 
Messages
15
Dear David,

I found your superb informative write up by chance whilst researching Blastocystis. I tried contacting you by email with letter of introduction, but sadly bounced back. I've signed up to the site to try and touch base with you. I don't want to include much of the letter here, but I would welcome your answers to the following if possible:

Can and do you both eat gluten and dairy now without consequences, and would you say both your levels of health returned to normal following eradication of the parasites?

Can you remember if many of your failed tests were routine NHS type, or the more accurate three day type such as Genova's?

You wrote, Blastocystis with nitazoxanide (500 mg bid) for 3 days. I am unsure what 'bid' means?

Thank you in advance if you receive.
 

Shanti1

Administrator
Messages
3,139
Hi @mission, Welcome to PR! It is a little confusing the way the article is posted on this thread, but David is not the actual poster of the thread, just the author of the article that was copied and pasted into the post. You can view the original article here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3553628/. However, members of this form still may have useful information for you.

I myself tested positive for Blastocystis hominis and D. fragilis at one time after living in Mexico for 7 years. The lab I used was DiagnosTechs stool analysis which included an O&P x3. I had taken both metronidazole and nitazoxanide in Mexico to treat entamoeba histolytica and found nitazoxanide much more tolerable. Because these amoebas have another "cycst" form that is quite resistant to treatment, in my experience, meds need to be taken for longer than a few days and several cycles need to be used in order to eradicate them. I tested positive for the B. hominis and D fragilis once I was back in the states and ended up using antiparasitic botanicals to get rid of them. I have since had several stool tests with O&P x 3 from Doctors Data and a retest from DiagnosTechs, all showing that they were cleared, along with my candida krusii, which I think was causing me much more trouble than the other two "travelers".

b.i.d. (on prescription): Seen on a prescription, b.i.d. means twice (two times) a day. It is an abbreviation for "bis in die" which in Latin means twice a day. It is just medical short-hand.
 
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15
Hi Shanti1, Many thanks for taking the time and trouble to help and advise. I'm very pleased to hear you managed to get rid of the 'bugs' you wanted out.

I checked the link, but cant find a direct contact to the authors. I would like to know the answers to the questions but it was a long time ago. A very interesting story mind.

I found an interesting study undertaken by NUC Singapore, published online March 2022. This study identifies subtype ST4 and believes it to be beneficial. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8902775/

A further study also undertaken by at least one of the same scientists a few years earlier, published March 2019, looking at subtype ST7 and believes this one to be detrimental.

All very confusing and difficult to know which way to go if any.

What anti parasitic botanicals did you use?

I know your circumstances were different from how you described with other 'bugs' at the same time, but, did you notice a significant positive change to your health once all 'bugs' were eliminated?

Did you notice any allergic changes in having the 'bugs', and after getting rid of them, n a similar manor to the couple in the original posted article, with regards to dairy and gluten?

Thank you for your time.
 

Shanti1

Administrator
Messages
3,139
I checked the link, but cant find a direct contact to the authors. I would like to know the answers to the questions but it was a long time ago.
I couldn't find contact info either.

I found an interesting study undertaken by NUC Singapore, published online March 2022. This study identifies subtype ST4 and believes it to be beneficial. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8902775/

A further study also undertaken by at least one of the same scientists a few years earlier, published March 2019, looking at subtype ST7 and believes this one to be detrimental.

All very confusing and difficult to know which way to go if any.

That is interesting about the subtypes. I have always thought of blastocystis sp. as commensal at best, but possibly pathogenic depending on the state of the host. I'm not aware of any commercial labs that will tell which of the subtypes you have.
Dientamoeba fragilis seems like it may be more problematic and if you have symptoms, you may want to target it. I do not know of any medications that would target one and not the other, much less botanicals, so if you aim to get rid of one, you will probably eliminate both.

What anti parasitic botanicals did you use?

I was mainly targeting the candida krusii because my test came back with "heavy growth". The odd thing is I never had gas, bloating, IBS, or any other intestinal symptoms except for some mild constipation. I did have severe cognitive dysfunction, skin problems, depression, PMS, and worsening of symptoms after eating sugar/carbs.

Anyhow, as soon as I got the results back, I did a "carpet bomb" and used combinations of oregano oil, colloidal silver, grapefruit seed extract, garlic caps, caprylic acid, ozone water, biofilm-targeting enzymes, and various other herbal combination products (pau'd arco, neem, black walnut, wormwood etc). I also started an anti-candida diet. At first I took many of these all on the same day but eventually began rotating them through. For the first three months, I took something every day. Later, I would just hit it hard on the weekends. Anyhow, it was a long and drawn-out battle against the candida, and along the way, the amoebas/protozoa also bit the dust. If I were just targeting the blastocystis and D. fragilis, I probably would have used a different strategy.

I know your circumstances were different from how you described with other 'bugs' at the same time, but, did you notice a significant positive change to your health once all 'bugs' were eliminated?

Did you notice any allergic changes in having the 'bugs', and after getting rid of them, n a similar manor to the couple in the original posted article, with regards to dairy and gluten?

After a week of "die-off", my cognition and energy began to improve. My PMS, depression and skin issues completely resolved. I was eventually able to tolerate some low-sugar fruits, chocolate, some grains, and sweet potatoes. This was quite a few years ago. Unfortunately, I didn't realize I still had another "stealth infection", which was EBV, and my cognition and energy later went into decline again which lead up to full ME/CFS and an official diagnosis. With EBV treatment, my ability to tolerate various foods has increased further. I never had true "allergy" symptoms, my reaction to foods has always manifested as cognitive impairment.

Regardings dairy and gluten specifically, I was always able to tolerate dairy and still eat cheese in moderation with no problem. I have never done well with wheat and it remains the worst of the grains for me. However, if I have a small amount, I do tolerate it better than I used to.

I hope that helps.
 
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15
Thank you for your clear and detailed response, very good.

Genova Laboratories used to subtype. They gave up following conflicting reports over subtypes. Following this latest on ST4, I've asked the question if they will reconsider. We are awaiting their answer and will update once I hear back.

What tests and treatments did you use for EBV please?
 

Shanti1

Administrator
Messages
3,139
What tests and treatments did you use for EBV please?
I used EBV antibody titers, my mono history, and persistent viral symptoms to support an EBV hypothesis and then found a doctor four hours away who believed that FM and ME/CFS have a viral etiology. He prescribed valacyclovir 1g three times a day, which I have been on for the past year. I did not have success with "natural" antivirals.

Here are the EBV titers:
https://testdirectory.questdiagnost...barr-virus-antibody-panel?p=r&q=ebv&cc=MASTER
https://testdirectory.questdiagnost...ly-antigen-d-antibody-igg?p=r&q=ebv&cc=MASTER

They aren't definitive, just help with putting the puzzle together.
 
Messages
15
Thank you. I am sorry to hear you did not have success with natural products.

This may be useful info for you. It seems to have substantial gains for people recovering from ME CFS MCS EBV and even now, long term COVID etc, to regain their health. Starting out, gaining an overview of ones genetic snp's, which are readily available, and nowadays more affordable. This gives an insight to susceptibility only, but allows one to tailor day to day changes / awarenesses, to reduce present and, or future burdens to the body. Next, Glutathione-S-transferase studies, as for reasons unknown but believed to be lipid associated, these are more often than not problematic and dysfunctional in recovering cases of the above symptomatic 'diseases'. Cardiolipin studies in mitochondrial, DNA adducts and iEC studies, also used by the very few specialist doctors in Germany, Switzerland, UK, Israel and in part the USA (I believe there's some issue with licensing in the USA that causes issues in obtaining some of the tests I've mentioned). The follow on part, the 'repair' work / rebalancing use Red Cell Membrane Lipid Fatty Acid levels to check. The last one is available in the USA.

This approach cuts a lot of time by getting to the nitty gritty of what is really going on in the building of the cells. If toxins or high levels of reactivity to toxins are discovered with the DNA adducts and iEC tests, more basic older forms of testing are a good idea to get a better overall picture.

I believe, and its only my opinion that illness follows toxicity which has simply overburdened the genome. This in turn produces weaknesses in the body, for further 'invasion' and symptoms. Every genome is different and peoples suceptabilities to toxicities therefor process at different rates. By toxicities I mean mainly from environmental and from our own internal chemical reactions of the Sympathetic Nervous System. The trick is, and its only my option to identify our baselines to work back from.

Sorry if thats a boring lecture. I just want to help wherever I can. Also, excuse me if its badly written, I'm very tired and off to bed.