More and more evidence-based research is recognising that stealth pathogens are associated with fibromyalgia, chronic fatigue, autoimmune conditions from rheumatoid arthritis and thyroid disease to diabetes and irritable bowel disease not to mention weight gain, stress and more. Find out if a chronic stealth pathogen infection is the hidden culprit behind your ill health.
This article provides the ins and outs of the world of microbes, why some bacteria and viruses, and other microorganisms, stealth pathogens can adapt to avoid (and hide) from our immune system (as well as our detection through blood or swab samples) and what we can do to treat them.
- are in your mouth
- in your stomach
- hide in your brain
- circulate in your blood
- cling onto your lungs
- swim in your bladder
- and lurk among your gut flora
Any pathogenic micro-organism employing strategies to persist in the body by hiding from, evading, misdirecting or even suppressing immune response, leading to chronic disease or lack of well being.’ Kerry Bone
Microbes rule the world. They always have, and they always will. Microbes are tiny, single-cell organisms that include germs, bacteria, and viruses. They far outnumber humans and they will still be here long after we are gone.
The spectrum of potentially harmful microbes is broad; microbes play a major role in virtually all disease processes—ranging from infectious diseases such as the plague and smallpox, to chronic conditions like autoimmune diseases, chronic fatigue and fibromyalgia
Friendly bacteria vs. harmful microbes
Microbes can be divided into two broad groups: normal flora (friendly bacteria) and pathogens (harmful microbes). Microbes cannot be defined in terms of bad or good; they simply need resources for survival. How they get those resources is what matters.
Normal flora, the friendly bacteria that inhabit your gut and skin, have developed a symbiotic relationship with you; they get what they need without causing harm. In many cases, they actually provide benefit by inhibiting the growth of other potential pathogens or by breaking down substances in the gut to provide essential nutrients.
Pathogens are disease-causing microbes. Under the right circumstances, even normal flora can cross the line and become a pathogen. For example, E. coli (a normal gut flora) commonly causes urinary tract infections and can become a toxin-producing gut pathogen. And an open wound is an invitation for a staph infection.
What is virulence?
Virulence determines a pathogen’s ability to infect and cause disease. The most virulent pathogens take an aggressive break-down-the-door approach, taking the resources, they need and causing significant harm in the process. They are uninvited and must get through the barriers of the immune system to get what they want.
Virulent pathogens are easily identified by the diseases they cause (strep throat, pneumonia, malaria, polio, smallpox, yellow fever, influenza, AIDS, etc.). They can be lethal, but their virulence is often their Achilles’ heel.
Because they are so visible, modern science has had significant success in defining them and creating tools that work against them—modern sanitation, antibiotics, and vaccines have dramatically reduced the threat of the most virulent microbes.
That said, high-virulence microbes are not the ones we worry about with fibromyalgia and other chronic conditions.
Stealth (low virulence) microbes
Just possibly the most successful microbes are not the most virulent. Success in the microbe world is defined by the ability to propagate and flourish. Killing or severely disabling the host can be counterproductive. A stealthy approach offers great advantage. Persistence instead of virulence is how they win. Collectively, these microbes can be referred to as low-virulence pathogens.
Most everyone on the planet is frequently exposed to low-virulence pathogens, almost daily. Many of those pathogens never gain access beyond the initial barriers of the immune system and are hardly noticed.
Some, however, do get a foot in the door, and a tug-of-war ensues between the microbe and the host’s immune system until the microbe is disposed of properly. A common example of this is how mycoplasma pneumoniae bypasses the immune system and contributes to fibromyalgia.
During an acute infection with one of these pathogens, the degree and nature of symptoms depends on the type of microbe, the site of initial infection, and the reaction of the immune system to the microbe(s). Multi-microbial infections are not only possible but common; low-virulence pathogens tend to work together.
If the immune system is compromised from the start or the microbe is stealthy enough, the gateway is left open for chronic infection (and chronic disease) to occur.
Considering that much of the population lives in a state of immune compromise (high stress, lots of processed foods, poor sleep, etc.), associating pathogens of low virulence to chronic disease (and certainly fibromyalgia) is not a challenge.
Stealth pathogens are at the heart of many chronic health conditions. Infection with a pathogen (bacteria, protozoa, mycoplasma, helminth or virus) can be vector-borne (mosquito, tick, sandfly, etc), airborne or transmitted through fluids (water, food, body fluids etc). Once a stealth pathogen has invaded the host it uses strategies to evade the immune system including molecular mimicry and forming biofilms. Not all individuals will develop a chronic condition or illness after infection with a pathogen. Ability to overcome an infection is related to constitution, health at the time of infection, length of time before treatment is sought and genetic predispositions.
Conditions often associated with stealth pathogens include
Autoimmune conditions. An autoimmune condition occurs when the body’s immune system becomes unbalanced. It usually manifests with inflammation and damage to body tissues. Stealth pathogens such as Epstein-Barr Virus (Glandular fever), Helicobacter pylori, Borrelia and CMV) are often associated with autoimmune conditions. There are around eighty autoimmune conditions – common ones include:
- Rheumatoid arthritis
- Multiple sclerosis
- Crohn’s disease
- Ulcerative colitis
- Hashimotos (underactive thyroid)
- Graves disease (over active thyroid)
- Type 1 diabetes
- Coeliac disease
- Sjögren’s syndrome
- Ankylosing spondylitis
- Polymyalgia rheumatica
- Vasculitis …
Chronic Fatigue Syndrome and Fibromyalgia. Fibromyalgia (FM) is a chronic illness characterised by a combination of chronic widespread musculoskeletal pain and tenderness, accompanied by varying degrees of other symptoms, including fatigue, sleep disturbance, muscle and joint pain and stiffness, poor memory, low concentration, brain fog and high levels of distress. There are often associated conditions such as headache, restless legs syndrome, irritable bowel syndrome, multiple chemical sensitivities, anxiety and depression.
Chronic fatigue syndrome (CFS) and fibromyalgia share a significant cross-over with symptoms, however CFS is dominated by fatigue with brain fog. Pain and immune dysfunction are usually secondary presentations.
Which pathogen is often the culprit
Examples of stealth pathogens include: Bartonella, Babesia, Borrelia, Parvovirus, Mycoplasma, Helicobacter pylori, Epstein-Barr Virus, Helminths such as hookworms and others
Epstein-Barr virus, frequently referred to as EBV, is a member of the herpes virus family and one of the most common human viruses. The virus occurs worldwide, and up to 95% of adults between 35 and 40 years of age have been infected with it. Infants become susceptible to EBV as soon as maternal antibody protection (present at birth) disappears. Many children become infected with EBV, although usually have no symptoms or are indistinguishable from other mild, brief illnesses of childhood. However, when EBV infection occurs during adolescence or young adulthood, it causes the more serious infectious mononucleosis, or glandular fever, in 35% to 50% of cases. Mononucleosis is characterised by swollen glands, fever, and commonly spleen enlargement, and profound fatigue that may continue for months or longer.
It is thought that Lyme disease is rare or nn- existent in NZ however, some doctors and mcrobiologists disagree. Lyme disease is caused by a tick-borne bacterium. Borrelia burgdorferi is the microbial organism most commonly associated with Lyme disease, however, other Borrelia species can cause both Lyme and other tick-borne illnesses. In the acute stage, Borellia infection and Lyme disease cause fatigue, fever, sweats, rash, swollen glands, headaches and joint pain. Chronic Lyme disease patients can present with a range of symptoms including fatigue, neurological symptoms (e.g. nerve pain, tingling and numbness), musculoskeletal pain or stiffness and symptom pictures that may mimic a range of autoimmune conditions. Many patients suffer from severe and often debilitating symptoms that greatly impair their quality of life. Acute Lyme disease, and its associated flu-like symptoms, usually respond well to short-term antibiotic treatment. However, up to 60% of Lyme patients develop a range of chronic nonspecific symptoms including chronic fatigue, muscle and/or joint pain, neuropathies, and cognitive dysfunction, known as post-treatment Lyme disease syndrome (PTLDS).
How can we treat Stealth Pathogens?
Stealth infections can affect multiple body systems and it is common for symptoms to ‘move’. For example, joint pain may be the predominant symptom, then it changes to neuralgia and fatigue, then extreme irritability, insomnia and/or depression. Hence, treatment strategies need to have a multipronged approach and are chosen based on the individual and their symptoms. Core strategies utilise dietary modification, herbal medicines, nutrients and lifestyle changes.
Key factors to address in treatment include:
- Improving the immune response and eliminating persisting pathogen/s
- Supporting key endocrine responses (e.g. adrenal, thyroid) where indicated
- Enhancing mitochondrial function and supporting energy production
- Reducing microbial load in cases of gut dysbiosis
- Break down of biofilms* (enabling the immune system to attack stealth pathogens)
- Reducing inflammation, including neuroinflammation (poor memory, brain fog, neuralgia, depression)
Following are examples of treatments used:
- Herbal Medicines: Artemisia, Myrrh, Golden Seal, Sarsaparilla, Cat’s Claw, Rehmannia, Bacopa, Boswellia, Echinacea, Garlic, Wormwood, Oregano, Phellodendron, Turmeric, Devil’s Claw, Rosemary, Ginkgo, St John’s Wort, Astragalus, Andrographis and others.
Please note Sheena Hendon is a qualified nutritionist, naturopath and medical herbalist. Please contact her for an individually prescribed herbal medicines and plan.
- Nutrients: Selenium, Iodine, Vitamin D3, Activated B Vitamins, Zinc, Vitamin C, Magnesium and others
- Probiotics: Lactobacillus rhamnosus GG (LGG), L. paracasei (LP-33), L. plantarum (299v), Bifidobacterium lactis (BB-12) and others
- Binders: Charcoal, diatomaceous earth, pectin, high tannin teas and others
- Diet: Anti-inflammatory diet, Identify food intolerances, low alcohol and caffeine, minimise processed foods
Contact Sheen Hendon Health to find out more or book here for a consultation to treat the cause and symptoms of your health complaints
1.Merrell DS, Falkow S. Nature 2004; 430(6996): 250-256
2.Marcos CM, de Oliveira HC, de Melo WC et al. Front Cell Infect Microbiol 2016;6: 142.
- Domingue GJ Sr, Woody HB. Clin Microbiol Rev 1997; 10(2): 320-344
- Beran V, Havelkova M, Kaustova J et al. Vet Med 2006; 51(7): 365-389
- Radolf JD. Trends Microbiol 1994; 2(9): 307-311
- Radolf JD, Desrosiers DC. Mol Microbiol 2009; 72(5): 1081-1086
- Blaser MJ, Kirschner D. Nature 2007; 449(7164): 843-849
- Bensky D, Clavey S, Stoger E. Chinese Herbal Medicine: Materia Medica, 3rd Edn. Eastland Press, Seattle, 2004.
- Pharmacopoeia Commission of the People’s Republic of China. Pharmacopoeia
of the People’s Republic of China, English Edn. Chemical Industry Press, Beijing, 1997.
- Chang HM, But PP (eds). Pharmacology and Applications of Chinese Materia
Medica. World Scientific, Singapore, 1987.
- White NJ, Hien TT, Nosten FH. Trends Parasitol 2015; 31(12): 607-610
- Brown GD. Molecules 2010; 15(11): 7603-7698
- Weathers PJ, Towler M, Hassanali A et al. World J Pharmacol 2014; 3(4): 39-55
- Hsu E. Br J Clin Pharmacol 2006; 61(6): 666-670
- Elfawal MA, Towler MJ, Reich NG et al. PLoS One 2012; 7(12): e52746
- Elfawal MA, Towler MJ, Reich NG et al. Proc Natl Acad Sci USA 2015; 112(3): 821-826
- Sen R, Ganguly S, Saha P et al. Int J Antimicrob Agents 2010; 36(1): 43-49
- Islamuddin M, Chouhan G, Farooque A et al. PLoS Negl Trop Dis 2015; 9(1): e3321
- Costa IN, Angeloni MB, Santana LA et al. Placenta 2009; 30(10): 884-890
- Frezza TF, Oliveira CNFD, Rehder VLG et al. Rev Patol Trop 2013; 42(3): 309-321
- Räth K, Taxis K, Walz G et al. Am J Trop Med Hyg 2004; 70(2): 128-132
- Feng J, Weitner M, Shi W et al. Antibiotics 2015; 4(3): 397-410
- Mishina YV, Krishna S, Haynes RK et al. Antimicrob Agents Chemother 2007; 51(5): 1852-1854
- Merali S, Meshnick SR. Antimicrob Agents Chemother 1991; 35(6): 1225-1227
- Romero MR, Efferth T, Serrano MA et al. Antiviral Res 2005; 68(2): 75-83
- Paeshuyse J, Coelmont L, Vliegen I et al. Biochem Biophys Res Commun 2006; 348(1): 139-144
- Goswami S, Bhakuni RS, Chinniah A et al. Antimicrob Agents Chemother 2012; 56(9): 4594-4607
- Lubbe A, Seibert I, Klimkait T et al. J Ethnopharmacol 2012; 141(3): 854-859
- Hsu E. Br J Clin Pharmacol 2006; 61(6): 666-670
- Chougouo RDK, Ketchiozo W, Kouamouo J et al. 6th MIM Pan-African Malaria Conference, 6-11th October 2013, Durban, P148.
- Onimus M, Carteron S, Lutgen P. Med Aromat Plants 2012, 2(3): 125
- Tiruneh G et al, cited in Weathers PJ, Towler M, Hassanali A et al. World J Pharmacol 2014; 3(4): 39-55
- Blanke CH, Naisabha GB, Balema MB et al. Trop Doct 2008; 38(2): 113-11634. ICIPE. Whole-leaf Artemisia annua-based antimalarial drug: report on proof-of concept studies. International Centre of Insect Physiology and Ecology (ICIPE), Nairobi, Kenya, April 2005. Available for download: https://plutgen.files. wordpress.com/2012/12/revicipetablets.pdf. Accessed May 2016.
- Mueller MS, Runyambo N, Wagner I et al. Trans R Soc Trop Med Hyg 2004; 98(5): 318-321
- Mueller MS, Karhagomba IB, Hirt HM et al. J Ethnopharmacol 2000; 73(3): 487-493
- Daddy NB, Kalisya LM, Bagire PG et al. Phytomedicine [Ahead of print]
- Meshnick SR, Taylor TE, Kamchonwongpaisan S. Microbiol Rev 1996; 60(2): 301-315
- Khin HS, Aung T, Thi A et al. Malar J 2016; 15(1): 286
- de Vries PJ, Dien TK. Drugs 1996; 52(6): 818-836
- Gordi T, Huong DX, Hai TN et al. Antimicrob Agents Chemother 2002; 46(4):1026-1031
- Alin MH, Ashton M, Kihamia CM et al. Br J Clin Pharmacol 1996; 41(6): 587-592
- Hassan Alin M, Ashton M, Kihamia CM et al. Trans R Soc Trop Med Hyg 1996; 90(1): 61-65
- Tran TH, Arnold K, Nguyen TH et al. Trans R Soc Trop Med Hyg 1994; 88(6): 688-691
- Mesa LE, Vasquez D, Lutgen P et al. Rev Soc Bras Med Trop 2017; 50(1): 52-60
- Yan L, Junping H, Tingting W. Henan Zhong yi 2012; 4: 433-435
- Yang M, Guo MY, Luo Y et al. Chin J Integr Med [Ahead of print] Accessed May 2017.
- Ribeiro IR, Olliaro P. Med Trop 1998; 58(3 Suppl): 50-53
- WHO Model Prescribing Information: Drugs Used in Parasitic Diseases, 2nd Edn, World Health Organization, Geneva, Switzerland, 1995.
- Mihara K, Svensson US, Tybring G et al. Fundam Clin Pharmacol 1999; 13(6): 671-675
- Svensson US, Ashton M, Trinh NH et al. Clin Pharmacol Ther 1998; 64(2): 160-167
- Leng X, Ye ST. Asian Pac J Allergy Immunol 1987; 5(2): 125-128
- Zheng G, Zhang C. Concise Chinese Materia Medica. The Series of Traditional Chinese Medicine for Foreign Readers. Shandong Science and Technology Press, Jinan, 1997.
- Osborne F, Chandler F. Can Pharm J 1996; 129(5): 48-51
- Osol A, Farrar GE et al. The Dispensatory of the United States of America, 24th Edn. Lippincott, Philadelphia, 1947.
- Leung AY, Foster S. Encyclopedia of Common Natural Ingredients used in Food Drugs and Cosmetics, 2nd Edn. John Wiley, New York-Chichester, 1996.
- British Herbal Medicine Association. British Herbal Compendium, Vol 1. BHMA, Bournemouth, 1992.
- Felter HW, Lloyd JU. King’s American Dispensatory. 18th Edn, 3rd revision, Vol 2. First published 1898-1900, reprinted Eclectic Medical Publications, Portland, 1983.
- Butler T. Am J Trop Med Hyg 2017; 96(1): 46-52
- Pound MW, May DB. J Clin Pharm Ther 2005; 30(3): 291-295
- 61. https://rawlsmd.com/health-articles/what-is-a-stealth-microbe