THE OVERLOOKED RELATIONSHIP
BETWEEN INFECTIOUS DISEASES AND
By Dr. James Howenstine, MD.
September 13, 2004
Psychiatric disease should be diagnosed only after careful exclusion of medical conditions that could produce the patients symptoms. Unfortunately very few mental health care providers are aware of the multitude of circumstances in which mental symptoms are precipitated by an infectious illness. A valuable clue that a mental problem may be infectious rather than psychiatric is sudden onset in a previously stable individual.
Dr. Paul Fink, past president of the American Psychiatric Association, has acknowledged that every psychiatric disorder in the Psychiatric Diagnostic Symptoms Manual IV (DSM-!V) can be caused by Lyme Disease. This proves that every known psychiatric disorder can be caused by an infection (Borrelia burgdorfi Bb spirochete). So far all cases of Alzheimer's disease tested for the Borrelia burgdorfi Bb spirochete, which causes Lyme Disease, have tested positive.
Conventional medical practice in the United States largely ignores the possibility of parasitic disease. There are several reasons for this:
- When a disease is never diagnosed it is easy to assume that it does not exist. Parasites are often overlooked in the U.S.
- There is a shortage of technicians who are skilled in identifying parasitic organisms.
- Spending one's day studying microscopic sample of stool specimens probably does not attract very many laboratory personnel.
- There is a common misconception that parasitic problems are primarily found in tropical countries and are rare in countries like the U.S.A.
To illustrate how many health care practitioners can be fooled by parasitic disease consider the case of Carolyn Razor. Upbeat, healthy, energetic, psychologist Carolyn Raser returned from a vacation in Bhutun with severe depression, exhaustion, and such swelling in her joints she was unable to open a hotel room door. Her third M.D. diagnosed rheumatoid arthritis and started multiple drugs. Her depression, lethargy and exhaustion persisted after 100 treatments by assorted acupuncturists, chiropractors, and rehabilitation specialists. A call to the Research Institute for Infectious Mental Illness led to the discovery of three protozoan parasites and a compromised secretory IGA system. Three weeks after eliminating her infection she was no longer depressed, her exhaustion was gone and her zest for life had been restored.
To make the proper diagnosis of psychiatric symptoms even more complex it is now well established that the overgrowth of candida (yeast) organisms, fungi, mycoplasma, and dangerous anerobic organiasms in the intestinal tract after antibiotic therapy, high sugar intake, and illnesses which injure the lining of the intestine can cause impaired brain function (seizures, confusion, poor memory, depression, learning difficulties, headaches and short attention span). These brain symptoms are caused by absoption of neurotoxic substances produced by mycoplasma, fungi, borrelia, yeast and anerobic organisms. These neurotoxic substances also commonly cause injury to the hypothalamus which leads to impaired production of endocrine hormones. Therefore, patients with intestinal pathogen overgrowth often manifest impaired function of the thyroid gland (hypothyroidism) and adrenal insufficiency (Addison's Disease). Another factor that may contribute to this hormonal failure is the consumption of cholesterol by mycoplasma in nervous tissue which decreases the building substance (cholesterol) needed to make estrogen, testosterone, progesterone, aldactone, and cortisone. Persons with hypothyroidism (underactive thyroid gland) often do not manifest fever when they have infections which may lead the clinician away from considering an infectious problem.
The psychological treatment of chronic mental illness is often lengthy and of marginal value. Frank Strick, Clinical Research Director of the Research Institute for Infectious Mental Illness, has gathered a large amount of information about how commonly mental symptoms are not appreciated to be originating from infectious problems.
Four types of infectious problems are capable of producing mental symptoms. These are infections well recognized for causing psychiatric problems (pneumonia, urinary tract infections, sepsis, malaria, Legionaires Disease, syphilis, chlamydia, typhoid fever, diphtheria, HIV, rheumatic fever and herpes). Research done at Johns Hokins Children's Center and published in the Archives of General Psychiatry in 2001 disclosed that mothers with evidence of Herpes Simplex Type 2 infection during pregnancy were 6 times more likely to have a child who later developed schizophrenia than mothers without herpes infections.
Parasitic infections which invade the brain (neurocysticerccosis) manifest depression and psychosis in more than 65 % of cases. These tapeworms produce cysts, swelling, and encephalitis in brains of patients. Other parasitic infections can produce psychiatric symptoms without direct brain invasion (giardia, ascaris psychosis, trichinosis, Lyme Disease) which clear after effective therapy. Meningitis or encephalitis was found in 24 % of 1300 cases of trichinosis reported from Germany.
Acute infection with Toxoplasmosis Gondi can produce personality changes and psychosis including delusions and auditory hallucinations. T. Gondii can alter behavior, neurotransmitter function and accounts for approximately 25 % of chorioretinitis usually contracted congenitally. A large study of mentally handicapped persons revealed that the incidence of t.gondii infection in schizophrenic patients was twice that of control subjects. German research has revealed that first onset schizophrenia patients have a 42 % incidence of antibodies to toxoplasma compared to 11 % in control subjects. T. Gondi usually is spread to humans from cats. Two studies have revealed that exposure to cats in childhood was a risk factor for the development of schizophrenia.
Two of the drugs used to treat psychosis and bipolar disorder (Haldol and Valproic Acid) inhibit the growth of t. gondii in cerebrospinal fluid and blood at concentrations below that being treated with these therapies suggesting that improved mental status might actually be due to killing t. gondii not anti-psychotic effects. The antipsychotic drugs thorazine, haldol and clozapine inhibit viral replication. Patients with recent onset of schizophrenia have a 400 % increase in reverse transcripyase activity in their cerebrospinal fluid which is seen in patients with infectious retroviruses. Cerebrospinal fluid CSF from these recent onset schizophrenia patients inoculated into New World Monkey cell lines caused a ten fold increase in reverse transcriptase activity suggesting that this injected CSF contained a replicating virus. Dr. Darren Hart of Tulane Univ. Medical School found evidence of antibodies to retrovirus in the blood of half the patients he tested who had a diagnosis of schizophrenia and bipolar disorder. Malhotra has demonstrated that the absence of CCR5?32 homozygotes in more than 200 schizophrenic patients sharply increased the susceptibility to retroviral infection. These pieces of evidence have led Johns Hopkins virologist Robert Yolken and Psychiatry Professor Dr. E. Fuller Torrey to believe that toxoplasmosis is one of several infectious agents that cause most cases of schizophrenia and bipolar disorder. Dr. Torrey noted that schizophrenia and bipolar disorder went from rare diseases in the late 19th century to common as cat ownership became popular. Yolken designed studies that showed that mothers of children who later developed psychosis were 4.5 times more likely to have antibodies to toxoplasmosis than mothers of healthy children. Yolken also learned that patients with schizophrenia of average duration of more than 22 years who also tested positive for cytomegalovirus (21 patients) experienced significant improvement in psychiatric symptoms when treated with Valacyclovir an antiviral drug for 8 weeks.
Streptococcal infections have been followed in some children by the abrupt onset of Obsessive Compulsive Disorder within a few weeks.
Use of the antiviral drug Amantadine has produced greatly shortened hospitalizations and rapid remission of psychiatric symptoms in Germany when given to patients testing positive for Borna Disease Virus BDV. Smaller studies in the U.S. disclosed that up to half of Bipolar and Schizophrenic patients test positive for BDV compared to none in healthy controls.
For obvious reasons toxoplasmosis has attracted the most attention. However, many other infectious agents particularly parasitic infections can disable normal mental function by depleting the host of essential nutrients, interfering with enzyme and neuroimmune function, and releasing massive amounts of waste products, enteric poisons, and toxins which disable brain metabolism. Mature tapeworms can lay a million eggs a day and roundworms, which afflict 25 % of the worlds population, can lay 200,000 eggs daily. The brain requires 25 % of the body's oxygen, nutrients, and glucose even though it makes up only 3 % of the body's weight. Mental patients were found to have a 53.8 % incidence of parasitic infection in a 2 year study conducted by the Univ. of Ancona involving 238 inpatient residents in 4 Italian psychiatric institutions.
Cognitive dysfunction and chronic emotional stress with symptoms of apathy, exhaustion, confusion, poor appetite, memory loss, nervous stomach, social withdrawal, loss of sex drive and motivation are often attributed to depression when they were actually caused by infection.
Many parasitic infections escape diagnosis because standard stool parasite studies pick up only 10 % of active infections. At times this is caused by inconsistent shedding patterns and other cases are missed because the parasites are outside the intestine. The World Health Organization states that 2 billion people have worms but these are rarely seen in stool exams. Many restaurants are staffed by persons from foreign lands where parasites are common so exposure to parasitic infection can occur in most U.S. restaurants.
To overcome these failures the Research Institute for Infectious Mental Illness suggests ova and parasite microscopy, multifluid antigen and antibody detection, stool cultures, enzyme immunoassays, imaging techniques, and extensive evaluation of the patients history and clinical information to discover chronic infections. Patients diagnosed as chronic candidiasis (yeast) may actually have more significant infections which are preventing long term cure. Curing hidden infections often results in return of normal brain metabolism. Fever and antibody elevation often disappear in patients with neurotoxin injury to the immune system and thyroid hypofunction caused by hypothalamic toxicity. Rebuilding the host's immune system and restoring integrity of the intestines will help prevent relapse. Care to not provide premature nutritional supplements that are growth factors for certain microorganisms is vital. Screening tests for heavy metal toxicity, environmental chemical exposure, molds, electromagnetic stressors, abnormal glucose metabolism, brain allergies, food sensitivities, hormone imbalances, neurotransmitter imbalances, nutritional deficiencies, ph abnormalities, and dietary correction can improve cognitive function.
In my opinion the arguments about the failure to diagnose infections causing brain symptoms presented by Frank Strick are persuasive and sound. Most psychiatric consultations almost certainly are not concerned with exploring diagnostic considerations outside the psychiatric realm. This whole field of psychiatric diagnosis needs to be reconsidered in view of the strong evidence that toxoplasmosis, parasitic infections, borrelia burgdorfi, candida, borna disease virus, streptococcus, and other infectious agents are capable of producing impaired brain function with symptoms that will generate a psychiatric diagnosis in a conventional psychiatrist's office. There is a real possibility that many, perhaps most patients, have an infectious illness that is correctable not a permanent psychiatric impairment. This failure to discover infectious causes for psychiatric symptoms is tragic because many persons are vegetating in psychiatric facilities for the remainder of their lives, instead of recovering full health when their infection is cured. My suggestion to readers is to consider exploring a consultation with the Research Institute for Infectious Mental Illness before accepting a psychiatric diagnosis that is likely to lead to a lengthy and minimally effective therapy.
The Research Institute for Infectious Mental Illness is the first comprehensive institute of its kind in the U.S. They provide testing, clinical and consulting services to clients all over the world and help in educating professional persons. Phone consultations are offered. by calling 800-699-2466 then press pound (#) 831-425-5555 (patient scheduling only) or by e-mailing firstname.lastname@example.org. The director is Frank Strick and the institute is in Santa Cruz, Ca.
- Strick, Frank Townsend Letter for Doctors &Patients April 2004 pg. 123-125
- Yolken, Robert American Journal of Psychiatry December 2003