Today we have a very important show from both the medical and research standpoints, this
is a highlight. We're going to be talking live in just a minute with Dr. Garth L.
Nicolson, Chief Scientific Officer and Research Professor, Professor of Internal Medicine
and Chief of the Institute for Molecular Medicine which is in Huntington Beach,
California. With no reservation, Dr. Nicolson, in my opinion, is one of the foremost
authorities in the world on the mycoplasmas and related infections. Welcome to our show,
Thanks for having me on board.
We're delighted to have you on board. It's an exciting thing for us because a lot of
people's health and lives may hang in the balance on the work that you're doing and
publishing. Could you tell our listening audience some of the advances in this area of
mycoplasma disease causation, since you were a guest in the year?
Well, I think what we've done in the intervening period of time is that we've really
nailed down the fact that chronic infections are a very important aspect of a variety of
different chronic illnesses, from rheumatoid arthritis, chronic fatigue syndrome,
fibromyalgia syndrome, inflammatory bowel disease, a lot of respiratory diseases, chronic
asthma, and so on and not only mycoplasma but a variety of other chronic infections as
well and people, I think, in the past did not realize the extent, or the involvement of
these types of infections in these chronic disorders and the fact that these disorders can
be either causative or they can a cofactor in the disease, that is be an important element
in the disease or it can even be operative if the infections after the disease are
triggered by something else and they're involved in the progression of the disease and
making it worse.
How many years can you have a mycoplasma infection without being aware of it by a
Well, it's not really well known. We do know, for example, from the Gulf War that it took
some patients as long as three years before they started exhibiting signs and symptoms of
infection that we felt occur in 1991 and their family members, when they came down there
was often a delay anywhere from 6 months to 2 years before they showed signs and symptoms.
So, there's a significant delay.
How long can it stay in your body if you don't treat it?
Well, we don't know. This is one of the important questions to which we'd like the answer.
We do know that some people in the general population will test positive, a few percent,
for example, and we don't know if these are people that will ultimately become sick
because of the long latency of this type of infection or whether they're just carriers.
Of course, and you make the point, in many of your papers that this is a slow growing
It's very slow growing and I think that's why these problems show up only after a very
long latency period.
Now, you mentioned in the letter that you wrote to me recently, that you've learned that
as of 1994 over 6,000 U.S. soldiers have died of infectious, chemical exposures and other
causes from operation Desert Storm and that the numbers are much higher. What's going on
there in your opinion?
Well we don't know the actual numbers, because the actual numbers are classified. We've
heard everything from 15,000 to more than 20,000 of our veterans have died of a variety of
different illnesses including these very unusual chronic infections that can progress.
And, of course, I want to congratulate you on your efforts to bring this to the attention
of Congress where you have testified. Now, you mention also that there is a study ongoing,
a multi-center clinical trial based on your work on treatment with the VA. What's that
Well, that 6 million dollar trial is really to diagnose and treat Gulf War Veterans who
have mycoplasma illnesses and it's taking place at over 30 VA and DoD institutions around
the country and we hope within a year, a year and a half that we'll get information about
the antibiotic treatment that we've, of course, developed to treat these types of
We're going to get back to that in a few minutes, but maybe you could just tell us very
briefly... you mentioned that you're now using a forensic PCR or polymerase chain reaction
technique for diagnosing this disease and I know it's going to be available because you're
opening up a new center, you have a new international diagnostic lab which is now open.
What does this forensic PCR test mean?
Well the forensic PCR test is simply using some of the tools of forensic pathology where
you can isolate very small amounts of blood, blood cells like white blood cells that have
DNA and then couple that with an amplification technique, polymerase chain reaction, you
have a very sensitive tool to find these infections inside the blood of a patient, and up
until just a few years ago when we first started using this it was very difficult to find
these types of infections and that's why you didn't hear very much about it.
Well, I've noticed that already in my practice, because I've been applying the variety of
tests to patients based on your early work, I've been finding that the standard antibody
testing which is typical IgG and IgM for mycoplasma pneumoniae, for example, is not at all
a valid test compared to PCR. Just how bad is it in terms of making the diagnosis? How
Well, I think it's very inaccurate and the reason for that is that these infections are
intracellular, that is, they get inside the cells in your tissues and because they reside
inside the cells they don't stimulate much of an immune response. There's been some very
interesting animal studies that were published by the army, the Armed Forces Institute of
Pathology, that shows that if you take these types of infectious agents like mycoplasma
fermentans and inject them into monkeys, they don't show any antibody response until years
later and only a few months before they die. So these can cause a fatal progressive
disease, so they can be dangerous and antibodies won't really pick this up until a person
has very well progressed in the disease process.
Well that, of course, is alarming and it also points out the opportunity to use the new
testing in order to be able to offer therapy to patients early before this type of
progression and for that, we thank you for bringing that to the attention of the medical
community at large and to Congress as well. Now, what about Chronic Fatigue Syndrome,
what's happening with the patients there who might have mycoplasma infections?
We're finding about 60% of these patients do have these types of infections and we're also
looking at other types of chronic infections like chlamydial infections. There are a very
high percentage that have those. And we just have a study coming out in a European
microbiology journal showing that with time, Chronic Fatigue Syndrome patients tend to
collect these infections and so patients who've been sick a decade or more tend to have
multiple infections and they also tend to have worsening signs and symptoms, that is
patients that have the multiple infections, there signs and symptoms slowly become worse,
so we can actually tag the number of infectious agents, the number of different types, the
severity of the disease and also the length of the disease process. So this explains why
so few patients with Chronic Fatigue Syndrome ever recover from their illness. With time
their immune systems are compromised, they can collect these opportunistic infections and
they will make them worse or keep them just as sick as they were before and they can't
seem to recover.
That's certainly true from what I've seen over 20 years. In addition to that I have
patients that you've diagnosed with your laboratory testing who have multiple infections
of mycoplasma and the ones with m.hominus, in particular, are pretty sick and they have
that in combination with others which you mention in your paper and the paper entitled
"Multiple Mycoplasma Infections Detected in Blood of Chronic Fatigue Syndrome and
Fibromyalgia Syndrome Patients" and that's in the European Journal of Clinical
Microbiology and Infectious Diseases. I'll give you the number where you can reach the
Institute for Molecular Medicine and, of course, Dr. Nicolson which is 714-903-2900. Also
you may fax your messages to them at 714-379-2082. Garth, tell me about some progress in
the area of treatment. What have you been seeing and what are you recommending. I know
that doxycycline is one of the staples, but what else are you using.
Actually, we're using several different antibiotics, sometimes these have to be cycled in.
And in some patients that are really severely sick we often have to combine different
antibiotics. I'll be glad to send people information on that if they write to me at the
Institute for Molecular Medicine or they could go to our website at www.immed.org and find information about treatment, but
the antibiotics I think are very useful in suppressing the infections but as you know,
this is not the whole story, most people that have these infections have compromised
immune systems and so we have to worry about building them back up. Proper nutrition is
very important, proper vitamins and minerals are important. A lot of these patients have
poor absorptions so they're not getting the proper B vitamins and other essential
materials that they need to overcome these illnesses so we have to attend to a lot of
different problems with these people, not just a matter of suppressing the infection.
Also, one interesting thing, because we know that these patients tend to have relapses
when there's low oxygen tension like in air travel, for example, which you pointed out in
an earlier show, and we're going to get back to that in terms of treatment with hyperbaric
oxygenation in a minute, but what does the mycoplasma do to the oxygen delivery system in
Well, we're not exactly sure what the mycoplasma does to that in these patients but we do
know that it does infect the endothelium, the cell lining the vascular systems and causes
changes, we think, possibly in the exchange of oxygen in the tissues. We do know that
higher oxygen will suppress these types of infections because basically they're what you
call borderline anerobic infections, so we know that the people that take long flights
often in pressurized aircrafts at high altitudes, often have relapses after they land if
they have Chronic Fatigue Syndrome or fibromyalgia or other chronic illnesses. We often
see this is air crews and airline pilots and we're working with a number airline pilots on
this. We just established near our institute a hyperbaric center, it's called Molecular
Hyperbaric Medicine and this is headed by Dr. Robert Irwin, he's actually the son of the
former Deputy Surgeon General of the Navy and he's very interested in hyperbaric medicine,
so we'll be offering that to patients along with some of the other therapies that we've
been trying to develop to treat these chronic illnesses.
So you see that as an adjunctive therapy along with antibiotics.
Yes, we do, and particularly people that have acute episodes, I think it's quite useful.
It's not in itself going to help people overcome these types of infections, because the
generally high oxygen will suppress these infections but will not eliminate them. It will
suppress the growth of them and some of the signs and symptoms will be temporarily
alleviated but they eventually come back again, so we have to really get at these
infections and that just requires long term antibiotics and nutritional support.
OK. That's all very important and people can write to you for that information. I have an
important question to ask you. It's a leading question. You may not be able to answer it.
But can these chronic mycoplasma infections, in some way, maybe not yet known, contribute
to the causation of cancer?
Well, this is a hot topic right now because we know that these microorganisms give off
genotoxic substances, that is substances that can modify our genes and actually mutate
them. Some of these are activated oxygen species that will attack DNA. We do know that if
you take these types of mycoplasmas that we found in patients and put them into cell
cultures that they will result in spontaneous transformation of those cells eventually and
lower their threshold to chemicals thousands of fold, so in effect, what they may be doing
is lowering the threshhold of carcinogenesis. You if you have these infections, it might
make you more prone to have cancer. We just don't know, there's not enough information on
this right now, but it's certainly a troubling sign.
Well, that's exactly why I asked you and I appreciate your candid answer about it. What
about the actual damage to chromosones themselves because some people have reported, and
this is Urnovitz's work with others, that there's been nucleic acid or pieces resulting
from chromosomal damage found in Gulf War patients. What about that?
Right now we don't know if the damage that they're looking at is the damage caused by
mycoplasmas or not because they only find it in one half of the specimens that they look
at that's about the same percentage that we find are infected with mycoplasma and we know
that the mycoplasma gives out substances which can cause the same kind of chromosome
damage that they're looking at. The chromosome damage is not a new thing. This has been
seen for years. In fact, there's about a 20 year literature history on this, and what's
been found is even if you look at smokers compared to non-smokers, there's an increase in
chromosome fragility or chromosome damage, so this is something that you see quite often
in people that have been exposed to toxic materials of any type, be it biological or
chemical or radiological.
OK, now that's fair and that's certainly in the literature. There's no question about the
fact that that's been shown. What about, however, the possible connection from this
genotoxic stuff that's put out by mycoplasma and the birth defects noted in the children
of the Gulf War veterans?
Well, again, we just don't know. There's just not enough research on this to know whether
this contributed to, in fact, the birth defects that are found in Gulf War famililes,
particularly in their offspring, or whether that was caused primarily by chemicals or
both. It's just a very very difficult area to work in because of the multiple toxic
exposures that occurred during the Gulf War.
Well, of course, I knew it was a difficult question. But I wanted to ask you because we
needed to get even your theoretical thinking about it and how other people start looking
at it and thinking about it also and for that I appreciate even mentioning even a
tentative possibility of it's connection because it needs to be explored. Garth, I have a
question for you about the mycoplasma's effect on the host immune system. You've had
papers published on this and you call it a stealth type of response. Talk to the audience
about this mycoplasma stealth activity is.
Well, these types of microorganisms, as I mentioned, penetrate into cells and tissues and
they can virtually go into any organ or tissue in the body. We find some patients, for
example, that have coronary problems because of these infections. My own father has this,
by the way, when he had a mycoplasma pneumoniae infection and he had endocarditis, and was
really headed for a major heart attack. We were able to diagnose it and turn that around
and now he's made a full recovery. We just don't know how many people are in this
situation that might have liver failure, lung problems with chronic pneumonia, heart
problems, coronary problems, renal problems, problems with their kidneys because of
infections. These types of infections are insidious because when they hide inside the
cells they can really escape from the immune system, but these types of infections also
have another property that also helps them escape from the immune system and that is that
they can suppress the immune system. They can actually attack the immune system, just like
they attack other cells in our body, and this ends up in some cases resulting in a
suppression of immunity in general. And so we can have patients whose immune systems are
compromised and this leaves them wide open to a variety of other opportunistic infections.
And these patients, which are the worst, I think, to deal with, they have a variety of
different infections. They yeast infections, they have other bacterial infections,
viruses, and so on and it's extremely difficult dealing with these patients, because
building back their immune systems is very very difficult.
I certainly can second that because I've seen that, and I'm dealing with it currently in
my practice. And I want to say that Dr. Nicolson has helped me greatly by his work and by
his advice over time and he has protocols which you can also get for your treating
physicians and healthcare personnel. Once again his phone number at the Institute for
Molecular Medicine is 714-903-2900 and can you give your website again?
Yes, it's www.immed.org. If you remember
"immediately" you can remember the website.
I think, Garth, and I'm extending an information to you to come to New York and we'll
organize a symposium on mycoplasma illnesses. I want to help put it together with you so,
let's work on that or something like it in the future because your work is just extremely
important. A lot of people's health is slipping by the boards, or as they say, slipping
through the cracks, so to speak, and they're not being treated adequately and not enough
serious attention is being paid to these problems. I've actually had infectious disease
specialists call me to ask me about things like this looking for advise with Chronic
Fatigue Syndrome, for example, in terms of what type of multiple infections may be present
and this really is pandora's box. Almost anything is possible, as you pointed out. And as
you mentioned about your father with the infected endocarditis, people could even go on to
die, I've seen it happen. We can't work fast enough or do too much in this area. I urge
you to support the Institute for Molecular Medicine. This is my personal appeal to you and
I want to say that we're delighted. We're going to want to have you back again but we're
going to want to do some other things to get this information out and we're going to try
to work it out in the future. How contagious is it, Garth?
Well, it's only moderately contagious. It does seem to require some time to pass it. The
most at risk are immediate family members because they make the closest contact with an
individual who is sick.
What about children?
Well, children can pick this up. We have a lot of family members who have gotten sick
because of it. Children's immune systems are a little bit stronger and some of them are
able to withstand it, but we have a lot of children in Gulf War Illness families who are
sick because of this.
Permission is given to repost, copy and distribute this transcript as
long as my name is not removed from it.
© 1999 Roger G. Mazlen,