Quercetin is a natural antioxidant found in red grapes, red apples, green tea, onions, and broccoli and belongs to a class of compounds called bioflavenoids, pigments found in thousands of plants. Quercetin is benefecial in reducing bladder irritation from various causes and improves the quality and duration of sleep for patients. Quercetin is also believed to enhance visual performance, and has been claimed to improve upper respiratory symptoms in allergies and colds. The effect is thought to be the result of a stabilizing effect on the break-up of certain infection-fighting cells called mast cells. These cells contain histamine, which produces many of the symptoms that we associate with colds and allergies. In the presence of a chemical or biological irritant, these cells rupture and release their contents into the circulation at the site of irritation, producing pain, swelling, and increased secretion of fluids in the area. Quercetin is believed to prevent the rupture of the cell walls of these inflammatory mast cells.

Now, for the first time, a placebo-controlled study has demonstrated the beneficial effects of a natural antioxidant on reducing illness.  Dr. David Neiman, a professor at Appalachian State University’s Department of Health, Leisure, and Exercise Science, conducted a 5 week study with 40 athletes to test the effects of quercetin on the immune system under conditions of physical stress.  Half of the study group received 1,000 mg of quercetin daily, and half received placebo.  Three weeks into the study, the athletes rode a bicycle three hours a day for three days to the point of exhaustion. After the extreme exercise period, 45 percent of the placebo group reported illness, versus only 5 percent of the quercetin group. Furthermore, an alertness test was given to both groups after the exercise period, and there was a significant performance difference between the groups, with the quercetin group able to maintain the ability to react to the alertness tests when exhausted.

This study specifically proves quercetin’s  beneficial effect on health under conditions of physical stress. Dr. Nieman plans further studies in an attempt to define the benefits of quercetin under conditions of mental stress as well. Fibromyalgia and CFIDS are characterized by unstable and overreactive immune responses, and the potential benefits for most of our patients through Quercetin are clear.

The Herxheimer Reaction was discovered by two German dermatologists (Jarisch & Herxheimer) when studying the reactions produced by treating syphilis with mercury.  The reaction is seen in 50% of primary syphilis patients and 90% of secondary syphilis patients.  It also has been seen in several other infectious treatment protocols for Lyme Disease, Candida albicans, CMV (cytomegalovirus), EBV (Epstein Barr Virus), Q fever and several other infections.  The Herxheimer reaction (also known as Jarisch-Herxheimer or herx) occurs when large quantities of toxins are released into the body as bacteria die, due to antibiotic treatment.

Typically the death of these bacteria and the associated release of endotoxins occur faster than the body can remove the toxins via the natural detoxification process performed by the kidneys and liver. It is manifested by fever, chills, headache, increased joint pain, myalgias (muscle aches), a drop in blood pressure, hives, and exacerbation of cutaneous (skin) lesions. Duration in syphilis is normally only a few hours but can be much longer in other diseases. The intensity of the reaction reflects the intensity of inflammation present.  The Herxheimer Reaction has shown an increase in inflammatory cytokines during the period of exacerbation, including tumor necrosis factor alpha, Interleukin-6 and Interleukin-8.

Worth noting is that hives and rash are sometimes mistaken for an allergic reaction. It is up to one’s physician to determine this, but with close observation and the use of medications such as Benedryl often prevents stopping antibiotics prematurely. In more severe cases of the Herxheimer Reaction, a reduction of the dosage or temporarily cessation of the treatment is an alternative.  Many times, patients think they have a bad reaction to an antibiotic, when in reality, they are actually having the Herxheimer reaction.

The timing, frequency and duration of the Herx reaction are individualistic and Herxheimer can occur within days to weeks after the onset of antibiotic therapy. In some patients they occur only once or twice (if at all) and with others continue throughout the course of treatment, usually lessening in severity. They can occur and are more often described in cycles (example: every 4 weeks) and have been reported to last from days to weeks.

It can be very beneficial to document these exacerbations. Some physicians use this as a guideline for treatment. Further it may help differentiate Herxheimer’s from the normal symptoms or progression of Lyme disease.
Herxheimer reactions can be very difficult on patients and affect compliance with therapy so supportive measures should be sought or utilized to lessen discomfort if needed. The use of aspirin, NSAIDs (non steroidal anti inflammatory drugs), pain medication, muscle relaxers, hot baths or others remedies can be appropriate. Of note, some have found Benedryl helpful even in the absence of rash or hives.  An herbal product, Burbur, has often been used with good success as well as Benicar (prescription blood pressure medication) in reducing Herxheimer reactions.

The good news is that the Herxheimer is thought to indicate that the antibiotics are indeed working and that following each worsening may bring about more improvement. However the lack of Herxheimer reaction should not cause anxiety if symptoms are improving.

Something often overlooked but can present with similar symptoms as a Herxheimer is Candida (yeast) infection. Treatment with acidophilus and, if needed, prescription medications such as Nystatin or Diflucan can be utilized.

Chronic yeast infections that affect multiple regions of the body are routinely overlooked when doctors approach patients with Chronic Fatigue Syndrome and/or Fibromyalgia. These infections typically occur when one’s immune system is compromised by this disease state and routinely caused by overuse of antibiotics and prednisone (steroids) to treat various inflammatory conditions. The yeast normally suppressed by one’s immune system and beneficial bacteria that may have been killed off by too much antibiotic use now have an opportunity to grow. Common symptoms of this condition include fatigue, muscle tenderness, diarrhea along with irritable bowel syndrome, premenstrual syndrome, and loss of sexual desire to name but a few. Lab tests to help doctors diagnose this condition are routinely inaccurate. Physicians most successful at making this diagnosis are by history and clinical exam.
 
Managing yeast involves dietary changes including avoiding free, refined sugar-containing products, breads, cheese, pasta, and potatoes. In addition, many times treatment with prescription antifungals is needed along with utilizing natural therapies such as oregano, uva ursi, and grapefruit and olive leaf extracts. The length of treatment will vary depending on the patient’s response but the usual duration is about 3 months.

Most of our patients have been to several medical specialists seeking help and treatment for their condition, and many have tried several holistic treatments, hoping to find relief.  The key to success in overcoming Fibromyalgia and Chronic Fatigue Syndrome is a comprehensive plan that addresses all the underlying isues that have overcome  previously healthy bodily functions.

The science and knowledge of conventional medicine is effective at treating acute and specific diseases, when there is one underlying cause and one treatment. The need for a different approach to chronic conditions is being acknowledged by the development of chronic care subspecialty disciplines, designed to improve medical care for complex, chronic problems like congestive heart failure and insulin-dependent diabetes. These are multifactorial medical problems requiring highly complex treatment plans. Similarly, our patients have multiple underlying causes and secondary body system malfunctions that have brought them to this point, and require a multitude of specific therapeutic interventions to correct them.

Recovery begins with nutritional support and sometimes repair of a yeast-infested gastrointestinal tract along with sleep disorders that must be corrected. The production of the Neuroendocrine system must be optimized and the imbalance of the immune system must be compensated, as it can result in impairment of many other organ systems. For some patients, chronic, smoldering infections must be treated, and can take a considerable amount of time. For others, a build-up of heavy metals in the body, or a heavy concentration of certain proteins, can be interfering with the natural passage of nutrients from the bloodstream into the tissues.