Consequence of Misdiagnosis II:
Intestinal permeability (Leaky Gut):
Intestinal Permeability increases during protozoan infections causing damage to the intestinal wall while non-pathogenic protozoan infections have no effect on IP. The increase in IP in patients with B. hominis brings forth the idea that B. hominis can be a pathogenic protozoan.
Protozoon infections and intestinal permeability. Dagci H, et al. Acta Trop 2002 Jan;81(1):1-5
Stress, depression and brain damage:
Most people I hear from list depression as a one of a myriad of symptoms, usually triggered with having to cope with long term chronic health problems.
The effect of stress and depression on our brain long term, and overall health, is documented in the medical literature:
Stress can have a significant and negative impact on our immune system (Selye, 1956; Pelletier 1977).
(My doctor) says Blasto belongs in my body and doesn't do anything. She also said that if I eradicate it, I will still have the same problems. Actually, what she said is that I will either not get better and have to deal with that, or it is all in my head....It really broke me for the first time in 18 months. I've been strong untill now, but really don't know anymore. Have been sitting on the couch crying and called some friends who said they find me not depressed, but sick with a good spirit and told me that I come across as organized (but sick) with no psychological disorder (they are not doctors, but they know me well).
Vitamin and Mineral Deficiencies
Studies show that magnesium levels are reduced in B.hominis patients. Low magnesium can lead to osteoporosis:
Magnesium levels were found to be clearly decreased (in B.hominis patients), whereas no change was observed in zinc levels in the patients with Blastocystis compared to controls.
Serum zinc and magnesium levels in patients with blastocystosis.
Kilic E , Yazar S , Saraymen R .
Biol Trace Elem Res. 2004 Apr;98(1):21-6.
Relatively few animal studies have assessed the skeletal and hormonal impact of long-term low Mg intake; however, these studies have demonstrated that Mg deficiency results in bone loss.
Magnesium deficiency and osteoporosis: animal and human observations.
Rude RK , Gruber HE .
J Nutr Biochem. 2004 Dec;15(12):710-6.
Low dietary magnesium (Mg) may be a risk factor for osteoporosis
Dietary magnesium reduction to 25% of nutrient requirement disrupts bone and mineral metabolism in the rat. Rude, RK et al. Bone. 2005 Aug;37(2):211-9.
B.hominis and growth in children:
A number of parents have written to me about their Blasto. infected child's failure to to thrive/gain weight. According to a study in the Medical Science Monitor there is a correlation between the presence of B. hominis and lower anthropometric indexes in children. The effect of Blastocystis hominis on the growth status of children. Ertug S et al. Med Sci Monit. 2006 Dec 18;13(1):CR40-43
Blasto., Low Iron and Birth Defects
Iron is an essential nutrient for the growth of most pathogenic microorganisms. Our immune system fights back by restricting iron available to parasites and iron levels can drop noticeably. I’ve heard from many people over the years whose depeleted iron levels reverted to normal after the triple therapy:
Low iron during pregnancy can reduce the carriage of oxygen to a developing embryo or foetus and cause birth defects, according to this article: Birth defects blamed on low oxygen levels. SMH April 2012).
The risk of developing iron deficiency anemia during pregnancy has prompted a recommendation for routine testing of Blasto. (and hopefully D.fragilis) at all anti-natal clinics. Blastocystis hominis as a contributing risk factor for development of iron deficiency anemia in pregnant women. Parasitol Res. 2011 Dec 14. El Deeb HK, Salah-Eldin H, Khodeer S.)
More about low iron and parasites:
Restriction in the availability of free iron in the host, the so-called nutritional immunity, plays a key role in nonspecific defence strategy against potential pathogens. To overcome the lack of free iron, microorganisms produce substances that chelate iron and they are called siderophores. The outcome of every infection is therefore dependent on both the level of free iron present in the host and the efficiency of siderophore-mediated iron uptake system of the pathogen. Iron and infection Lijec Vjesn. 1991 Sep-Oct;113(9-10):343-7.
Iron deficiency anemia (IDA) is a frequent health problem. Gut parasites such as N. americanus and A. duodenale are known to cause blood loss, but the role of Blastocystis hominis is uncertain. Blastocystis hominis may play a role in the development of IDA either on its own or in conjunction with some other agent. Is Blastocystis hominis a new etiologic factor or a coincidence in iron deficiency anemia? Eur J Haematol. 2008 Jul;81(1):47-50. Epub 2008 Apr 4.
Yavasoglu I, Kadikoylu G, Uysal H, Ertug S, Bolaman Z.
Intestinal parasitic infection increases the risk of developing iron deficiency anemia (IDA) during pregnancy. The objective of this study was to assess Blastocystis hominis as a contributing risk factor for development of IDA in pregnant women. Findings of the current study showed that B. hominis infection contributes to the development of IDA in pregnant women. Hence, parasitological diagnostic tests are recommended in routine examination at all antenatal clinics.
Blastocystis hominis as a contributing risk factor for development of iron deficiency anemia in pregnant women. Parasitol Res. 2011 Dec 14.
El Deeb HK, Salah-Eldin H, Khodeer S.
Spread of Blasto:
Blasto. has been ignored by health professionals for many decades, so naturally it's spreading further into the community:
The prevalence of B. hominis reported herein (23%) is one of the highest ever reported in the United States and may be epidemiologically significant. Increasing prevalences are noted in more recent years. Omar Amin. Am. J. Trop. Med. Hyg., 66(6), 2002
I've heard from many people with Blasto. over the years whose previously healthy flatmate, new partner or child came down with exactly the same symptoms and ended up testing positive.
Low carb diets and mental health:
Carbohydrate intolerance is common in people with D.fragilis and Blasto. Carb restriction is often a necessary strategy for people living with chronic symptoms. Such diets may do a good job of reducing the symptoms - but there's a price to pay. Years of dietary restrictions is not only an unnecessary burden on those struggling with difficult symptoms, it can also cause nutritional imbalances which are associated with depression and anxiety disorders:
There is a strong link between higher levels of nutrient intake and mental health. Researchers found significant correlation between Global Assessment of Functioning (GAF) with dietary intake of carbohydrates, fibre and other minerals. Nutrient Intakes Are Correlated With Overall Psychiatric Functioning in Adults With Mood Disorders. Karen M Davison, PhD, RD1; Bonnie J Kaplan, PhD. Can J Psychiatry. 2012;57(2):85–92
Chronic caloric restriction in young rats may lead to the development of depressive and/or anxiety disorders. Chronic food restriction in young rats results in depression and anxiety-like behaviors with decreased expression of serotonin reuptake transporter Jeong Won Jahng et al. Brain Research.
Volume 1150, 30 May 2007, Pages 100–107.
Further links between nutrient intake and mood disorders are documented in these studies:
The intake of carbohydrate is associated with improved mood. Poor mood stimulates the eating of ‘comfort foods’ such as chocolate. A deficiency of many micro-nutrients is associated with poorer mood, in particular thiamine and iron. Nutrient Intakes Are Correlated With Overall Psychiatric Functioning in Adults With Mood Disorders. Karen M Davison, PhD, RD1; Bonnie J Kaplan, PhD. Can J Psychiatry. 2012;57(2):85–92
Considering how common these parasites are in patients with IBS it should come as no surprise that carb intolerance is also common in patients with IBS:
Perceived food hypersensitivity is a prevalent, but poorly understood condition. In this review article, we summarize narratively recent literature including results of our 10 years' interdisciplinary research program dealing with such patients. The patients (more than 400) included in our studies were all adults referred to a university hospital because of gastrointestinal complaints self-attributed to food hypersensitivity. Despite extensive examinations, food allergy was seldom diagnosed. The majority of the patients fulfilled the diagnostic criteria for irritable bowel syndrome. In addition, most suffered from several extra-intestinal health complaints and had considerably impaired quality of life. However, psychological factors could explain only approximately 10% of the variance in the patients' symptom severity and 90% of the variance thus remained unexplained. Intolerance to low-digestible carbohydrates was a common problem and abdominal symptoms were replicated by carbohydrate ingestion.
Perceived food hypersensitivity: A review of 10 years of interdisciplinary research at a reference center. Lied GA, et al. Scand J Gastroenterol. 2011 Jun 17.
People with milder symptoms typically end up self-treating through life style changes, food avoidance, and non-prescription remedies.
People who battle for years with debilitating symptoms are at risk of aquiring post traumatic stress disorder (PTSD), because studies show that repeated exposure to traumatic “events” affect the risk of developing PTSD. Long term illness, where patients suffer repeatedly debilitating symptoms over a prolonged period, can increase the risk of patients ending up with PTSD:
Individuals experiencing chronic diseases have been studied with regard to depression, anxiety and a variety of coping maladaptions, but negligible attention has been given to the PTSD potential of chronic disease over the life course. Yet, growing evidence suggests that the traumatogenic potential of chronic diseases, some sudden and unexpected onsets, and the traumatogenic changes in life circumstance, may produce maladaptive illness coping over the life course. The experience of chronic illness and post-traumatic stress disorder: the consequences of cumulative adversity. Soc Sci Med. 2000 May;50(10):1475-84. Alonzo AA.
In the past, researchers have developed an in vitro model using B. hominis culture filtrates to investigate its ability in triggering inflammatory cytokine responses and transcription factors in human colonic epithelial cells. Studies have also correlated the inflammation by parasitic infection with cancer. Parasitol Res. 2010 Mar;106(4):941-5. Epub 2010 Feb 18.Solubilized antigen of Blastocystis hominis facilitates the growth of human colorectal cancer cells, HCT116. Chandramathi S, Suresh K, Kuppusamy UR.
Impaired concentratation, depression, panic attacks, and other psychological disturbances are frequently reported by people with Blasto. and D.fragilis.
"My experiences have been similar to yours with Blastocystis hominis. At present I am able to work only half time. Perhaps more troubling than the fatigue is the brain fog. Ever since Peace Corps India 35 years ago, I have suffered recurrent bouts of various parasites, often in combination! I have never been tested for Dientamoeba fragilis. In fact, I only know about it from your website. ". Jan 02 - Specialised testing revealed B.hominis and D.fragilis.
"I felt vague, forgot words, felt extremely tired, weak and sick. Wierd head sensations were always present - felt foggy and unfocussed."
US man since recovered from B.hominis. 2001.
This 1992 study indicates that psychological symptoms are high in people with "unexplained gastrointestinal symptoms".
When compared with those reporting no gastrointestinal symptoms, subjects who report at least one of these symptoms were significantly more likely to have also experienced lifetime episodes of major depression (7.5% vs 2.9%), panic disorder (2.5% vs 0.7%), or agoraphobia (10.0% vs 3.6%). Subjects with two gastrointestinal symptoms had even higher lifetime rates of depression (13.4%), panic (5.2%), or agoraphobia (17.8%). Lifetime rates of affective and anxiety disorders in the general population are higher in subjects with gastrointestinal symptoms compared with subjects without gastrointestinal symptoms. An even higher prevalence of affective and anxiety disorders is found in patients with medically unexplained gastrointestinal symptoms in tertiary-care clinics.
Comorbidity of gastrointestinal complaints, depression, and anxiety in the Epidemiologic Catchment Area (ECA) Study. Walker EA, et al.
Am J Med 1992 Jan 24;92(1A):26S-30S.
When the parasite is eliminated psych. symptoms settle:
"What I am most pleased about is that I have clarity of of mind and reduced gut pain. I am feeling optomistic, these past few days I haven't experienced brian fog or dizziness or long periods where I haven't been able to concentrate."
Parasites and arthritis:
A 46-year-old female patient developed a chronic diarrhea and oligoarthritis some days after returning from a trip to Senegal. Arthritis was refractory against treatment with NSAID and corticosteroids. Finally, a 3-week course of treatment with metronidazole resulted in a complete remission of arthritis, gastrointestinal symptoms, and inflammation signs (ESR, CRP). The course in our case, as well as the detection of Blastocysts hominis in synovial fluid in another case, implicate an infectious rather than a reactive etiology of arthritis.
Blastocystis hominis as a rare arthritogenic pathogen. Kruger K, et al. Z Rheumatol 1994 Mar-Apr;53(2):83-5
A patient with rheumatoid arthritis taking prednisone developed Blastocystis hominis acute diarrhea, which was associated with increased inflammation and effusion of the left knee. B hominis organisms were found in synovial fluid from the left knee. The patient responded dramatically to metronidazole treatment. B hominis may become disseminated in immunosuppressed patients with diarrhea and may cause infective arthritis.
Infective arthritis due to Blastocystis hominis.
Lee MG, Rawlins SC, Didier M, DeCeulaer K., Ann Rheum Dis 1990 Mar;49(3):192-3
Other published cases of arthritis:
Reactive arthritis from Blastocystis hominis. Arthritis Rheum 1991 Feb;34(2):251-3, Lakhanpal S, Cohen SB, Fleischmann RM.