Long-Term Antibiotic Use

• As a result, antibiotic resistance may develop, enabling bacteria to evolve and withstand future treatments.

• While probiotics have recognized benefits for gut and immune health, research highlights the need to evaluate potential risks. A study on the Escherichia coli Nissle 1917 strain suggests that certain probiotic strains may carry genotoxic risks, emphasizing the complexity of restoring gut health after long-term antibiotic use (Benefits and concerns of probiotics: an overview of the potential genotoxicity of the colibactin-producing Escherichia coli Nissle 1917 strain)

• Probiotics, although helpful, cannot replace a diverse, healthy microbiome.

• An increased risk of infections exists even with the assistance of probiotics.

For instance, opportunistic pathogens may continue to thrive, leading to infections with Clostridium difficile (C. difficile) and Candida.

• The gut microbiome plays a crucial role in immune function.

• Increased gut permeability (leaky gut) and malabsorption

Consequences of Misdiagnosis and Unnecessary Treatment

• In many cases, antibiotic treatment lasts for months or even years.

• However, the treatment often fails to address the actual cause of symptoms.

Impact on Quality of Life

Notably, gut and immune system issues are not the only factors affecting quality of life. Additionally, long-term antibiotic therapy may cause side effects such as fatigue, dizziness, allergic reactions, and neurological issues.

• Importance of Informed Consent

Given these risks, it is crucial to approach chronic Lyme disease treatment with caution. Therefore, healthcare providers should encourage fully informed consent.

• Moreover, financial concerns play a role. Patients may invest in costly, long-term treatments with little evidence of effectiveness. As a result, the risk of overdiagnosis and unnecessary treatment increases.

Chronic Lyme Disease as a “Catch-All” Diagnosis

Chronic Lyme disease sometimes serves as a ‘catch-all’ diagnosis for patients whose conditions do not fit established medical categories. Because Lyme disease symptoms vary and are nonspecific, misdiagnosed patients may receive unnecessary treatments that fail to address the root cause of their symptoms.

Use of “Lyme-Like” Labels

Some refer to symptoms commonly associated with Lyme disease as ‘Lyme-like illness’ or ‘chronic Lyme syndrome,’ even without a confirmed diagnosis. This can lead to confusion and over-diagnosis.

Factors Contributing to Misdiagnosis of Chronic Lyme Disease

Lack of Reliable Testing

Inappropriate test usage or misinterpretation can play a role.

Standard Lyme disease testing approach follows a two-tier system:

• ELISA screening test (initial screening)
• Western blot (confirmatory test for positive ELISA results)
This method aims to reduce false positives and improve diagnostic accuracy.

• Challenges with Western Blot Testing

Variable Accuracy and Interpretation Difficulties:

• Western blot detects IgM and IgG antibodies against Borrelia burgdorferi antigens, relying on specific antibody bands for interpretation. Cross-reactivity with other infections may lead to false positives. (Misdiagnosis of Lyme Disease With Unnecessary Antimicrobial Treatment ).

• Using the Western blot alone can lead to misdiagnosis.

Any positive result from a test that relies solely on Western blotting is most likely a false positive (Lyme Disease: How Reliable Are Serologic Results?).

Diagnoses that prioritize self-reported symptoms over objective testing are more prone to misdiagnosis.

Misdiagnosis and Unnecessary Treatment

A study reviewing 1,261 patients referred for Lyme disease evaluation found:

• Only 26.5% received an accurate diagnosis.
• Many misdiagnosed patients were female.
• Co-infections were wrongly diagnosed, increasing the risk of unnecessary antimicrobial treatment. (Misdiagnosis of Lyme Disease With Unnecessary Antimicrobial Treatment).

There are other conditions with similar symptoms as chronic Lyme disease that need to be excluded. This is to avoid misdiagnoses:

Thyroid disorders (hypothyroidism or hyperthyroidism)

Multiple sclerosis (MS)

Chronic infections like Epstein-Barr virus, herpes simplex virus, and cytomegalovirus

Neurodegenerative and autoimmune conditions

Serious Conditions Missed

A study published in JAMA Internal Medicine illustrates how neoplasms were misdiagnosed as “Chronic Lyme Disease” This resulted in delayed treatments for the patients.

Such delays underscore the critical need for accurate diagnosis (Mistaken Identity: Many Diagnoses are Frequently Misattributed to Lyme Disease).

Tests that assist with the correct diagnosis of disseminated manifestations of Lyme disease include cerebrospinal fluid tests, brain imaging, EMG/nerve conduction studies, skin biopsy, and neuropsychological testing (Columbia Lyme and Tick-Borne Diseases Research Center).

Impact of Unconventional Treatments

Some treatments lack scientific backing and may carry health risks.

A multidisciplinary approach—drawing from neurology, immunology, and rheumatology—helps ensure accurate diagnosis and effective care.

Scientific accuracy should accompany raising awareness about the condition. Less risky treatment solutions should be encouraged.

An evidence-based approach remains essential for proper diagnosis and treatment.

Medical Disclaimer

The information provided in this article is for informational purposes only and is not intended as medical advice. It should not be used as a substitute for professional medical guidance, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider regarding any medical concerns. Please always seek medical advice timeously.

Related: Bacterial Antibiotic Resistance Bacterial Antibiotic Resistance – EMFSA

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Abstract

The recent worldwide rise in idiopathic immune and inflammatory diseases such as multiple sclerosis (MS) and inflammatory bowel diseases (IBD) has been linked to Western society-based changes in lifestyle and environment. These include decreased exposure to sunlight/UVB light and subsequent impairment in the production of vitamin D, as well as dysbiotic changes in the makeup of the gut microbiome. Despite their association, it is unclear if there are any direct links between UVB light and the gut microbiome. In this study we investigated whether exposing the skin to Narrow Band Ultraviolet B (NB-UVB) light to increase serum vitamin D levels would also modulate the makeup of the human intestinal microbiota. The effects of NB-UVB light were studied in a clinical pilot study using a healthy human female cohort (n = 21). Participants were divided into those that took vitamin D supplements throughout the winter prior to the start of the study (VDS+) and those who did not (VDS−). After three NB-UVB light exposures within the same week, the serum 25(OH)D levels of participants increased on average 7.3 nmol/L. The serum response was negatively correlated to the starting 25-hydroxy vitamin D [25(OH)D] serum concentration. Fecal microbiota composition analysis using 16S rRNA sequencing showed that exposure to NB-UVB significantly increased alpha and beta diversity in the VDS− group whereas there were no changes in the VDS+ group. Bacteria from several families were enriched in the VDS− group after the UVB exposures according to a Linear Discriminant Analysis (LDA) prediction, including Lachnospiracheae, Rikenellaceae, Desulfobacteraceae, Clostridiales vadinBB60 group, Clostridia Family XIII, Coriobacteriaceae, Marinifilaceae, and Ruminococcus. The serum 25(OH)D concentrations showed a correlation with the relative abundance of the Lachnospiraceae, specifically members of the Lachnopsira and Fusicatenibacter genera. This is the first study to show that humans with low 25(OH)D serum levels display overt changes in their intestinal microbiome in response to NB-UVB skin exposure and increases in 25(OH)D levels, suggesting the existence of a novel skin-gut axis that could be used to promote intestinal homeostasis and health.

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Abstract

The microbiota-gut-brain axis encompasses a bidirectional mode of communication between the microorganisms residing in our gut, and our brain function and behavior. The composition of the gut microbiota is subject to diurnal variation and is entrained by host circadian rhythms. In turn, a diverse microbiota is essential for optimal regulation of host circadian pathways. Disruption of the cyclical nature of this microbe-host interaction profoundly influences disease pathology and severity. This review aims to summarize current knowledge on this bidirectional relationship. Indeed, the past few years have revealed promising data regarding the relationship between the microbiota-gut-brain axis and circadian rhythms and how they act in concert to influence disease, but further research needs to be done to examine how they coalesce to modulate severity of, and risk for, certain diseases. Moreover, there is a need for a greater understanding of the molecular mechanisms underlying the close relationship between circadian-microbiome-brain interactions.

Copyright © 2020 Elsevier Inc. All rights reserved.

The post When Rhythms Meet the Blues: Circadian Interactions With the Microbiota-Gut-Brain Axis appeared first on EMFSA.

Excerpts:

The sun can indeed shine out of your backside, suggests research. Not because you’re self-absorbed, but because you’ve absorbed gut-altering UV radiation.

This is the first study to show that skin exposure to UVB light alters the gut microbiome in humans. Published in Frontiers in Microbiology, the analysis suggests that vitamin D mediates the change—which could help explain the protective effect of UVB light in inflammatory diseases like MS and IBD.

Exposure to UVB in sunlight is well-known to drive vitamin D production in the skin, and recent studies suggest that vitamin D alters the human gut microbiome. However, that UVB therefore causes gut microbiome changes, via vitamin D production, has so far been shown only in rodents.

In a new clinical pilot study, researchers tested the effect of skin UVB exposure on the human gut microbiome.

Healthy female volunteers (n=21) were given three one-minute sessions of full-body UVB exposure in a single week. Before and after treatment, stool samples were taken for analysis of gut bacteria—as well blood samples for vitamin D levels.

Skin UVB exposure significantly increased gut microbial diversity, but only in subjects who were not taking vitamin D supplements during the (winter) study (n=12).

“Prior to UVB exposure, these women had a less diverse and balanced gut microbiome than those taking regular vitamin D supplements,” reports Prof. Bruce Vallance, who led the University of British Columbia study. “UVB exposure boosted the richness and evenness of their microbiome to levels indistinguishable from the supplemented group, whose microbiome was not significantly changed.”

The results also showed some agreement with mouse studies using UVB, such as an increase in Firmicutes and decrease in Bacteroidetes in the gut following exposure.

Prof. Bruce Vallance: “The results of this study have implications for people who are undergoing UVB phototherapy, and identifies a novel skin-gut axis that may contribute to the protective role of UVB light exposure in inflammatory diseases like MS and IBD.”

https://m.medicalxpress.com/news/2019-10-sun-doesnt-skin-uv-exposure.html?fbclid=IwAR29Sk681AauWIeZW_O7EifmFxBA8_KVwoaKBkD6GANRZ64_5cUEltsBJXg

More information: Frontiers in Microbiology, DOI: 10.3389/fmicb.2019.02410 , https://www.frontiersin.org/articles/10.3389/fmicb.2019.02410/full

The post Where the sun doesn’t shine? Skin UV exposure reflected in poop appeared first on EMFSA.

Image credits: Dr  Erica Mallery-Blythe

Interview after the presentation by UK expert, Dr Erica Mallery-Blythe on health and environmental impacts associated with exposure to electromagnetic radiation, with an especial focus on 5G, to an invited audience including Bath MP Wera Hobhouse, some Bath City Councillors and members of the public. Guildhall Bath – 5th July 2019

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The post Ultraviolet Irradiation of Skin Alters the Faecal Microbiome Independently of Vitamin D in Mice. appeared first on EMFSA.