Editors Note: Garth Nicolson, Ph.D. is a leading researcher into the causes and treatment of Chronic Fatigue Syndrome. He is a professor and Chief Scientific Officer at the Institute for Molecular Medicine in Huntington Beach, California and has published over 500 studies in peer-reviewed journals such as the Clinical Practice of Alternative Medicine, the Journal of Chronic Fatigue Syndrome and Infectious Disease Journals. What follows is an overview of Nicolson’s main theories and findings from his several years of investigation into chronic illnesses.
Gulf War Syndrome and the Link With CFS
A primary area of interest for Professor Nicolson has been the investigation of the link between several chronic diseases. Nicolson took a personal interest in Gulf War Illness (GWI) when his stepdaughter, a veteran of the Gulf War, returned home and became sick with unusual signs and symptoms, that were definitely not psychologically based (such as in post traumatic stress.)
Gulf War illness is a collection of illnesses, not just a single illness. What has interested Nicolson greatly is the fact that so many of the signs and symptom profiles of CFS/ME, FMS, GWI illnesses are similar. He studied 650 veterans and found their signs and symptoms were very similar to CFS patients.
In the introduction to his research paper published in the Clinical Practice of Alternative Medicine, Nicolson explains that “syndromes such as CFS/ME, FMS and Gulf War Illnesses (GWI) share many complex, multiorgan signs and symptoms, including immune system abnormalities, but are distinguishable as separate syndromes that have muscle and overall fatigue as major signs.” Nicolson also “feels strongly that stress alone is unlikely to cause most of the chronic illnesses discussed.”
Nicolson also discovered that quite often the immediate family members of patients with GWI displayed similar chronic signs and symptoms. The professor believes that since the family members developed signs only some time after the veteran returned home, then it is probable that the civilians contracted their illnesses from their sick relative.
In an interview conducted last year with Dr. Mazlen of the CFS National Radio Program, Nicolson explained that ‘there was often a delay anywhere from six months to two years before (family members) showed signs and symptoms. There’s usually a significant delay.”
Although these findings may add to the complexity of determining how a person became infected with the disease in the first place, they do at least provide a clue to scientists working in the field of prevention. If it becomes clear with more studies that some cases of CFS can in fact be passed between family members, then perhaps researchers can target their efforts to halting the spread of the disease this way.
Role of Mycoplasmas and Other Chronic Infections in CFS, FMS, and GWI
According to Nicolson’s research published in The Journal of Chronic Fatigue Syndrome, “chronic infections can be caused by viruses, fungi, or bacteria. Mycoplasmal infections are small bacterial microorganisms lacking cell walls that are capable of invading several types of organs, tissues and cells. Mycoplasmal infections are associated with a wide variety of human disease as causative agents, cofactors or opportunistic infections.” Some patients have both bacterial (mycoplasma, chlamydia, etc) and viral (HHV-6, CMV, etc.) infections.
In research studies, significant frequencies of mycoplasmal infections in the blood, were found in CFS, FMS and GWI patients. In fact, the testing found that 40% of people with GWI tested positive for mycoplasma, and almost all of the patients had the type called fermentans. However, a variety of different species of mycoplasma infections were found in civilians. In a recent publication in the European Journal of Clinical Microbiology and Infectious Disease multiple mycoplasmal infections were found in most CFS and FMS patients.
During his investigations, Nicolson also discovered that if patients were sick for a long period of time (about five years or more), they had multiple infections that constantly compromised the immune system. He therefore emphasizes the importance of supporting and maintaining the immune system to help prevent the already sick patient from relapsing after therapy is stopped, and to prevent patients from becoming reinfected with different microorganisms in the environment.
Unfortunately, even when mycoplasmas are successfully treated, Nicolson does not then consider the patient completely cured because they usually have small amounts of infection buried deep inside their tissues. Patients will have to be cautious with their immune system for the rest of their lives. As he explains, “once someone is immune compromised they have to deal with it forever.” However, the good news is that any minor infections remaining in the body can be suppressed and dealt with to the point that they are no longer a problem.
Nicolson also points out that some people can be infected with a single strain of mycoplasma and never get sick, either because their immune system is well enough to handle it, or because it is a less virulent strain of mycoplasma.
Another interesting conclusion that has important implications for the possible causes of chronic disease like CFS is that “chronic infections do not have to be causative in these illnesses to be important; they could be cofactors or opportunistic infections and cause significant patient morbidity (sickness).”
Diagnosis with Polymerase Chain Reaction Technique (PCR) Test
Nicolson uses this forensic test to diagnose infections in CFS and other chronic illnesses. The test uses some of the tools of forensic pathology to isolate very small amounts of DNA from blood. Contained within the blood are cells such as white blood cells that contain their own DNA plus DNA from intracellular infections. Using this amplification technique, the polymerase chain reaction, these sensitive tools can find infections inside a patient’s blood cells. Compared to other tests such as standard antibody testing, PCR has proven to be much more accurate and sensitive.
Nicolson describes PCR testing as the “most sensitive type of testing you can receive for these types of infections.” Sensitivity is the crucial element because “these microorganisms reside primarily in tissues and organs not in the blood. Only small amounts of the infection can be found in the blood but PCR can detect the infection in the white blood cells. Initially, we were criticized because anybody can have microorganisms such as various bacteria in the oral cavity. But when it’s in the blood, it’s in your system and can make you sick.”
PCR testing is gradually becoming a valuable diagnostic tool. It’s a specialty test so only a few places can perform it. Nicolson’s own clinical diagnosis laboratory, International Molecular Diagnostics, specializes in this type testing.
Various Treatments Employed for CFS:
Recently treatment of CFS with high doses of antibiotics has received a lot of attention, especially with the recent publicity surrounding the work of Dr. M. Michael Lerner. Nicolson has also used this type of protocol, and he agrees that Lerner’s work is very important because of his discovery of the heart’s infection by bacteria and viruses. The infection of the heart also has a major impact on the immune system.
In the interview with Dr. Mazlen he explained that “actually we’re using several different antibiotics, and sometimes these have to be cycled in. And in some patients that are severely sick we often have to combine different antibiotics.”
Although Nicolson believes that antibiotics are very useful in suppressing infections he stresses the importance of rebuilding the immune system in immune compromised people. He recommends proper nutrition and supplementation with vitamins and minerals. Gastrointestinal (GI) problems are another symptom that can be helped with proper B vitamins and other materials such as probiotics or friendly bacteria that can restore gut microflora. Nicolson reminds patients that there are many factors at play in these serious illnesses so it is not just a matter of suppressing the infection.
Professor Nicolson supports the use of hyperbaric oxygen treatments, also known as oxygen therapy. He believes that such therapy is “a very simple and straightforward way to suppress chronic infections while helping the immune system.” In this treatment, pressurized oxygen is used to suppress chronic infections like mycoplasmal infections, which he describes as ‘borderline anerobic infections.” During a mycoplasmal or similar infection, Nicolson believes that the mycoplasma affects the endothelium, the cell lining of the vascular systems, and causes changes in blood coagulation as well as changes in the exchange of oxygen into the tissues.
Some infections prefer a low oxygen environment. Nicolson has found oxygen therapy to be effective for many but not all CFS patients, especially for patients with acute episodes or in patients with diagnosed chronic infections. He also warns that it does take a long time to work and must be used in conjunction with other treatments. High amounts of oxygen will suppress infections but will not eliminate them completely. The other benefits of the therapy include increasing the effectiveness of antibiotics and supporting the immune system.
Tests for CFS/FM patients can be ordered through International Molecular Diagnostics, Inc., Tel: 714-799-7177, ext. 202 (Client Services). Order forms and additional information are available on The IMD Web site www.imd-lab.com. On this site you will find additional information about testing and disease. The Institute for Molecular Medicine Web site is www.immed.org. On this site you will find publications and documents on CFS/ME, FMS, and other autoimmune conditions.