Clostridium difficile loves sugar and resists disinfectant

Story at-a-glance

• The Centers for Disease Control and Prevention reported that 15,000 die every year from Clostridium difficile, a bacterium that may trigger watery diarrhea, fever, dehydration and kidney failure. It is evolving to a superbug, and has adapted to sugars commonly found in a Western diet. It also produces spores capable of resisting disinfectants
• Antibiotics are what has turned this minor player, accounting for up to 3% of bacteria in normal flora, to a major health concern; when antibiotics disrupt the normal flora, harmful bacteria such as C. diff are able to thrive and spread in the environment
• Although fecal transplants are new to Western medicine, they were reportedly being used as far back as 1,700 years ago. Colonoscopies have been the most successful means of using the treatment, but they come with risks; one study compared administration using capsules or colonoscopy and found a 96.2% prevention of recurrence in both groups
• Fecal transplants should only be done by a trained team as the donor stool must be free of disease; even under investigational conditions lethal mistakes have been made
• Handwashing is the single most effective means of preventing the spread of infection and reducing your risk of needing antibiotics. Hand washing supports a strong gut microbiome, which is another means of prevention

The Centers for Disease Control and Prevention¹ calls antibiotic resistance one of the biggest public health challenges of our time. Conservative estimates find at least 2 million are infected and 23,000 die each year with antibiotic resistant bacteria. When a germ develops the ability to withstand drugs designed to kill them, they become antibiotic-resistant² and are called superbugs.³

Antibiotic resistance happens naturally as bacteria adapt to drugs. Resistance is helped along by the inappropriate use of medications, such as antibiotics for viral infections⁴ and their use in agriculture.^5,6 The World Health Organization⁷ warns emerging resistance to antibiotics threatens the ability to treat common infections that may result in prolonged illness, disability and death.

Simple medical procedures may become high risk, which means the cost of health care rises. In what researchers believed was the first national estimate⁸ of the cost for treating antibiotic-resistant infections, they found a national cost of $2.2 billion in 2014, having doubled since 2002.⁹

Antibiotic resistance is a worldwide crisis¹⁰ with the potential to threaten people at any age.¹¹ One bacterium known to be fatal to the elderly and sick is clostridium difficile, or C. diff. In a recent study it was reported that this¹² bacterium has become highly adapted to spreading inside hospitals, and they may have found the reason why.

Bacteria and sugar make a deadly combination

A mild to moderate infection with this bacterium affects the gut, causing watery diarrhea for two to three days and mild abdominal cramping and tenderness.¹³ A severe infection can trigger diarrhea, fever, kidney failure, dehydration and weight loss.¹⁴

The bacteria are now able to take advantage of high sugar diets and resist disinfection commonly used in the hospital. In a recent study¹⁵ researchers showed how C. diff can exist for long periods of time on disposable equipment and vinyl surfaces, even after having been cleaned with disinfectant.

In one study published in Nature¹⁶ it was reported that C. diff has adapted and diverged, and is close to becoming a new bacterial species. Through a large-scale analysis of 906 cultures taken from humans, animals and the environment¹⁷ the researchers sequenced the bacterium’s DNA and were able to demonstrate the evolving formation of a new species¹⁸ with a change in metabolism and sporulation.¹⁹

The new evolution of C. diff is producing spores more resistant to hospital disinfectants that have the capacity to grow in the presence of glucose and fructose. The researchers found the new species in 70% of hospital patient samples taken for the study.

They also found this new species could colonize mice better when the animals’ diet was supplemented with sugar. Analysis found this emerging species made its first appearance 76,000 years ago and has more recently begun to thrive in hospital settings. Senior author Trevor Lawley commented:²⁰

“Our study provides genome and laboratory-based evidence that human lifestyles can drive bacteria to form new species so they can spread more effectively. We show that strains of C. difficile bacteria have continued to evolve in response to modern diets and healthcare systems and reveal that focusing on diet and looking for new disinfectants could help in the fight against this bacteria.”

C. diff is commonly found in the environment

Another author of the paper, Nitin Kumar, Ph.D., a senior bioinformatician at the Wellcome Sanger Institute, told Popular Science:²¹ “The study shows how the pathogen C. difficile is evolving in response to the Western sugary diet and common hospital disinfectants.”

A New York Post journalist suggests pudding cups and instant mashed potatoes, common fare at hospitals, may be just the food this superbug is looking for.²² According to Harvard Health, C. diff accounts for up to 3% of bacteria in a normal intestinal flora. Although present, it is usually harmless as good bacteria keep it under control.

It turns out that antibiotics have turned this minor player into a major problem.²³ Once antibiotics have disrupted the normal flora in your gut, this allows harmful bacteria to thrive, including C. diff. This in turn triggers diarrhea.²⁴

C. diff forms spores that may get into the environment through those who are infected, when they touch surfaces. When others touch the newly-contaminated surfaces and then touch their mouths, the infection spreads.²⁵

Health care workers may also spread the bacteria when their hands are contaminated. Since antibiotics alter the normal flora found in the intestinal tract, and a large number of patients receive antibiotics in health care settings, this can lead to C. diff outbreaks.

Poop pills may help combat an outbreak

C. diff can trigger a life-threatening condition in those who have been on antibiotics or have a compromised immune system. According to the CDC, there are 500,000 C. diff infections each year resulting in 15,000 deaths.²⁶ One treatment methodology is a stool transplant, which has been used throughout history.

Although new to Western medicine, fecal transplants were described as far back as 1,700 years ago by a Chinese researcher who first used what he called “yellow soup” to treat patients with severe diarrhea.²⁷ In World War II, the stools of camels was used to treat bacterial dysentery in German soldiers.

In 1958, the treatment was described in a report for a patient with antibiotic-associated diarrhea. But it was not until 1978 that the value was recognized in the treatment of C. diff.²⁸ The treatment goes under several different names including fecal biotherapy and fecal floral reconstitution.

In the past, colonoscopies have been the most successful way of introducing fecal matter into patients, but a new poop pill-popping protocol may be less invasive while still offering a life-saving option. In a trial at the University of Alberta,²⁹ researchers compared the administration of fecal matter using a capsule or colonoscopy.

All participants in the study had suffered a minimum of three bouts of C. diff. Both groups showed prevention of recurrent infection in 96.2% of the participants.³⁰ While the colonoscopy was invasive, the patient chosen to swallow pills had to down 40 capsules in one sitting.³¹

Using poop pills is noninvasive, less expensive, free of risks associated with sedation and may be done in the doctor’s office. It is not, however, a treatment method you should experiment with at home. Even under investigational conditions, mistakes can be made.

In June 2019, the FDA released a statement that two immunocompromised adults had received a transplant that unwittingly transmitted a multidrug-resistant organism. At least one of those patients has died.³²

Prevention is still the best medicine

To date, the FDA has not approved fecal transplants and continues to monitor the development as it is essential for a healthy donor to be used.³³ Open Biome maintains a list of current studies being done on fecal transplants including those to treat C. diff, inflammatory bowel disease, liver disease, obesity and depression.³⁴

The single most effective means to prevent the spread of infection is through hand washing. The CDC³⁵ recommends cleaning your hands to prevent the spread of germs. However, they find on average health care workers do this less than half the time they should.

In one cross-sectional study³⁶ conducted in Nepal to assess the habits of nurses, nursing students, doctors and medical students, the researchers found a significant difference in hand washing both before and after patient care.

After exposure to instruments, blood or bodily fluid, more than 90% washed their hands. However, on average the participants tended to wash their hands selectively.

A second study of hand washing in six intensive care units revealed a high level of variability in adherence to best practices with a compliance rate ranging from 3% to 100%.³⁷ Take care to use proper handwashing techniques to thoroughly clean your hands and reduce the risk of transmitting disease.

A second preventive strategy includes protecting your gut microbiome from the effects of antibiotics. It is important to take antibiotics only when they’re necessary. You should not use them for viral infections, which may contribute to the development of antibiotic resistance.³⁸

Antibiotics have no effect on viruses and you’ll likely get greater relief by using a combination of natural remedies described in my previous article, “Natural Cold Remedies: What Works, What Doesn’t.”

Support strong gut bacteria for good health

Supporting the growth of beneficial bacteria in your gut microbiome may affect your mental and physical health. Sugar is one of the most negative culprits because it contributes to a dysfunctional gut microbiome. A study³⁹ published in January 2019, found that sugars affect a regulator of gut colonization for beneficial bacteria.

In essence, glucose and fructose turn off the expression of a protein regulating gut colonization by beneficial microbes. Sugar disrupts the generation of proteins that foster the growth of beneficial bacteria found in lean, healthy individuals.⁴⁰

Since gut dysfunction may lead to a system-wide inflammatory response, it is important to address the needs of your gut bacteria consistently. As a general rule, once you start healing your gut, you should start feeling better in a couple of weeks to a few months. Discover several strategies to help you get started in my article, “Healthy Gut, Healthy You: A Personalized Plan to Transform Your Health.”

What Is Same

By Anne Underwood On 7/4/99 at 8:00 PM EDT Share News

She was making lunch for herself and a friend one Saturday this spring when an unfamiliar feeling swept over her. The 50-year-old social worker had fallen deep into depression two years earlier, and had given up on prescription antidepressants when the first one she tried left her sluggish, sexually dormant and numb to her own emotions. Then, in mid-March, she heard about a naturally occurring substance called SAMe (pronounced “Sammy”). She had been taking it for just a few days when she began setting the table that Saturday morning. A ginger-miso sauce was chilling in the fridge, and she was garnishing her finest plates with fresh anemones. Suddenly, there it was: a sense of undiluted pleasure.

This woman (who asked not to be named) has taken SAMe ever since, and her mood isn’t the only thing that has changed. Until this spring she took prescription-strength anti-inflammatories for her arthritis, and still had trouble bending her knees. She’s now off those drugs–and feeling more nimble than she has in 20 years.

Could an over-the-counter tonic really do all this? Pills purporting to cure everything from hemorrhoids to hangnails are usually worthless and sometimes dangerous. And because SAMe has not been studied extensively in the United States, many doctors are leery. Beware, says Dr. Gilbert Ross of the American Council on Science and Health, a conservative watchdog group. Supplement dealers are once again trying to “flimflam the public into using untested remedies instead of FDA-approved pharmaceuticals.”

The Food and Drug Administration has not rigorously evaluated SAMe, let alone approved it. (Federal law permits the unregulated sale of naturally occurring substances as long as marketers avoid therapeutic claims.) And the studies that researchers have conducted are not of the magnitude the FDA would require for a drug approval. But that doesn’t mean SAMe is “untested.” In dozens of European trials involving thousands of patients, it has performed as well as traditional treatments for arthritis and major depression. Research suggests it can also ease normally intractable liver conditions. SAMe doesn’t seem to cause adverse effects, even at high doses. And doctors have prescribed it successfully for two decades in the 14 countries where it has been approved as a drug.

Until recently, few Americans had heard of the stuff. An Italian firm developed it as a pharmaceutical in the early 1970s but lacked the will or the resources to make a run at a drug approval in the United States. Then, this spring, two U.S. vitamin companies, GNC and Pharmavite, started importing large quantities of SAMe to sell as a supplement. The product took off quickly–Pharmavite’s Nature Made brand now ranks 25th among the 13,000 supplements sold in grocery and drugstores–and the impact is still growing. When you consider that some 50 million Americans suffer from arthritis or depression, the implications are staggering.

SAMe (known formally as S-adenosylmethionine) is not an herb or a hormone. It’s a molecule that all living cells, including our own, produce constantly. To appreciate its importance, you need to understand a process called methylation (chart). It’s a simple transaction in which one molecule donates a four-atom appendage–a so-called methyl group–to a neighboring molecule. Both the donor and the recipient change shape in the process, and the transformations can have far-reaching effects. Methylation occurs a billion times a second throughout the body, affecting everything from fetal development to brain function. It regulates the expression of genes. It preserves the fatty membranes that insulate our cells. And it helps regulate the action of various hormones and neurotransmitters, including serotonin, melatonin, dopamine and adrenaline. As biochemist Craig Cooney observes in his new book, “Methyl Magic,” “Without methylation there could be no life as we know it.”

And without SAMe, there could be no methylation as we know it. Though various molecules can pass methyl groups to their neighbors, SAMe is the most active of all methyl donors. Our bodies make SAMe from methionine, an amino acid found in protein-rich foods, then continually recycle it. Once a SAMe molecule loses its methyl group, it breaks down to form homocysteine. Homocysteine is extremely toxic if it builds up within cells. But with the help of several B vitamins (B6, B12 and folic acid), our bodies convert homocysteine into glutathione, a valuable antioxidant, or “remethylate” it back into methionine.

SAMe and homocysteine are essentially two versions of the same molecule–one benign and one dangerous. When our cells are well stocked with B vitamins, the brisk pace of methylation keeps homocysteine levels low. But when we’re low on those vitamins, homocysteine can build up quickly, stalling the production of SAMe and causing countless health problems. High homocysteine is a major risk factor for heart attack and stroke. During pregnancy, it raises the risk of spina bifida and other birth defects. And many studies have implicated it in depression.

How, exactly, might taking extra SAMe improve a person’s mood? Researchers have identified several possibilities. Normal brain function involves the passage of chemical messengers between cells. SAMe may enhance the impact of mood-boosting messengers such as serotonin and dopamine–either by regulating their breakdown or by speeding production of the receptor molecules they latch on to. SAMe may also make existing receptors more responsive. These molecules float in the outer membranes of brain cells like swimmers treading water in a pool. If the membranes get thick and glutinous, due to age or other assaults, the receptors lose their ability to move and change in response to chemical signals. By methylating fats called phospholipids, SAMe keeps the membranes fluid and the receptors mobile.

Whatever the mechanism, there is little question that SAMe can help fight depression. Since the 1970s, researchers have published 40 clinical studies involving roughly 1,400 patients. And though the studies are small by FDA standards, the findings are remarkably consistent. In 1994 Dr. Giorgio Bressa, a psychiatrist at the University Cattolica Sacro Cuore in Rome, pooled results from a dozen controlled trials and found that “the efficacy of SAMe in treating depressive syndromes… is superior [to] that of placebo and comparable to that of standard… antidepressants.”

This isn’t the first natural substance to show promise as a mood booster. Small studies suggest that St. John’s wort can ease low-grade melancholy, but SAMe has been tested against far more serious disorders. In one of several small U.S. studies, researchers at the University of California, Irvine, gave 17 severely depressed patients a four-week course of SAMe (1,600 mg daily) or desipramine, a well-established antidepressant. The SAMe recipients enjoyed a slightly higher response rate (62 percent) than the folks on desipramine (50 percent).

No one has found SAMe significantly more effective than a prescription antidepressant, but it’s clearly less toxic. The drugs that predate Prozac (tricyclics and MAO inhibitors) can be deadly in overdose, or in combination with other medications. Newer antidepressants, such as Prozac, Zoloft and Paxil, are less dangerous, but their known side effects range from headaches and diarrhea to agitation, sleeplessness and sexual dysfunction. And SAMe? Studies suggest that like other antidepressants, it may trigger manic episodes in people with bipolar disorder. Aside from that, the most serious side effect is a mild stomach upset.

Until large U.S. studies confirm these findings, few American doctors will recommend SAMe to severely depressed people. “The evidence looks promising,” says Harvard psychiatrist Maurizio Fava, “but it’s not definitive. In some European countries they have different marketing standards than we do.” UCLA biochemist Steven Clarke echoes that concern, saying the nation is embarking on a large, uncontrolled experiment in which consumers are the guinea pigs. A key concern is that depressed patients will drop other treatments to try SAMe, and end up suicidal. Columbia University psychiatrist Richard Brown warns of that hazard in “Stop Depression Now,” a new book coauthored with Baylor University neuropharmacologist Teodoro Bottiglieri. Yet Brown himself has treated several hundred patients with SAMe in recent years, sometimes combining it with other drugs, and he has never had a bad experience. “It’s the best antidepressant I’ve ever prescribed,” he says flatly. “I’ve seen only benefits.”

If the world needs a better antidepressant, it could also use a better arthritis remedy. Nearly a third of the 40 million Americans with chronic joint pain use drugs like aspirin and ibuprofen. In arthritis-strength doses, these so-called NSAIDs, or nonsteroidal anti-inflammatory drugs, can have devastating gastric side effects. Some 103,000 Americans are hospitalized annually for NSAID- induced ulcers, and 16,500 die. Even when NSAIDs don’t destroy the digestive tract, they may ultimately worsen people’s joint problems, for they slow the production of collagen and proteoglycans, the tissues that make cartilage an effective shock absorber.

Could SAMe provide an alternative? In a dozen clinical trials involving more than 22,000 patients, researchers have found SAMe as effective as pharmaceutical treatments for pain and inflammation. But unlike the NSAIDs, SAMe shows no sign of damaging the digestive tract. And instead of speeding the breakdown of cartilage, SAMe may help restore it. You’ll recall that after giving up its methyl group, SAMe becomes homocysteine, which can be broken down to form glutathione (the antioxidant) or remethylated to form methionine (the precursor to SAMe). As luck would have it, the reactions that produce glutathione also yield molecules called sulfate groups, which help generate those joint-sparing proteoglycans.

What does this mean for patients? The Arthritis Foundation, a mainstream advocacy group, recently said its medical experts were satisfied that SAMe “provides pain relief” but not that it “contributes to joint health.” The evidence that SAMe can repair cartilage is admittedly preliminary, but it’s intriguing. When German researchers gave 21 patients either SAMe or a placebo for three months, using MRI scans to monitor the cartilage in their hands, the SAMe recipients showed measurable improvements. That wouldn’t surprise Inge Kracke of Cologne. She was an active 48-year-old when a 1996 auto accident mangled her left knee and left her hobbling on a cane. Dr. Peter Billigmann of the University of Landau prescribed a regimen that combined SAMe (1,200 mg a day for three months) with injections of hyaluronic acid, a cartilage component. Cartilage injuries don’t normally heal, but a year later Kracke’s knee looked better on X-rays. She now plays golf three times a week.

SAMe may have other benefits as well. Studies suggest it can help normalize liver function in patients with cirrhosis, hepatitis and cholestasis (blockage of the bile ducts). SAMe has also been found to prevent or reverse liver damage caused by certain drugs. As patients hear more about this supplement, they may try treating themselves for all these conditions and others. But many of them will be disappointed–either because they expect miracles that SAMe can’t deliver, or because they take the wrong dose or form.

The first challenge is to buy full-strength SAMe. “Some companies are very reliable manufacturers,” says Dr. Paul Packman of Washington University in St. Louis. “But some aren’t. You can’t always tell from the label on the bottle how much active ingredient is actually in it.” Pharmaceutical-grade SAMe comes in two forms, one called tosylate and a newer, more stable form called butanedisulfonate. Only Nature Made and GNC sell the new butanedisulfonate version, but several U.S. retailers import reliable tosylate products. And because SAMe is absorbed mainly through the intestine, it’s best taken in “enteric coated” tablets that pass through the stomach intact. None of the products comes cheap. The price of a 400-mg dose ranges from $2.50 (Nature Made) up to $18.56 for an uncoated Natrol product called SAM sulfate. Promoted Content

Assuming you buy full-strength SAMe, the second challenge is to use it effectively. Experts advise taking it twice a day on an empty stomach, but different people may require different amounts. Though studies suggest that 400 mg a day is an effective dose for arthritis, the daily doses used in depression trials have ranged as high as 1,600 mg. Clinicians generally start people with mood problems at 400 and ratchet up as necessary.

Unfortunately, there is no convincing evidence that SAMe can make healthy people happier or more mobile than they already are. But there are lessons here for everyone. We now know that methylation is vital to our well-being. It’s equally clear that the modern Western diet–rich in protein, light on the plant foods that supply folate–is a prescription for stalling that vital process. “SAMe works as a medication to treat certain diseases,” says Paul Frankel, a biostatistician at the City of Hope National Medical Center in Duarte, Calif. “But for most people the problem is undermethylation of homocysteine.” In other words, many of us could arm ourselves against low moods, bad joints and weak hearts simply by upping our intake of B vitamins. That may sound less exciting than taking a miracle supplement. But with luck, it could keep you from ever needing one.

1. Be open to everything. Be attached to nothing.
2. You can’t give away what you don ” have ..
3. There are no justified resentments. No more blame.
   Blame has to go. Take responsibility for everything in your life.
   Send love in response to hate.
4. Don’t die with your music still in you.
5. Embrace silence.
6. Give up your personal history.
   Embrace.
   Accept.
   Toss.
   Merge into now.
7. You can’t solve a problem with the same mind that created it.
8. Treat yourself as if you already are what you would like to become.
9. Treasure your divinity.
10. Wisdom is avoiding all thoughts that weaken you. Think thoughts that empower.
    

This is from an older metaphysical/new thought book
from 1954, by U.S. Andersen.  It’s entitled Three Magic Words.
He suggests repeating the words, I’ve appended below, after
a daily 10-minute period of stillness and when you have entered
a calm and peaceful place, and only then.  For you eft tappers,
this could also be turned into an eft script.

It’s really quite beautiful, note the language: law of attraction,
as you get further into it.  He also had some exposure to
Ernest Holmes and Holmes also used that terminology.

 “I know that I am pure spirit, that I always have been, and that I always will be.  There is inside me a place of confidence and quietness and security where all things are known and understood.  This is the Universal Mind, God, of which I am a part, and which responds to me as I ask of it. 

This universal mind knows the answer to all of my problems, and even now the answers are speeding their way to me.  I needn’t struggle for them; I needn’t worry or strive for them.  When the time comes, the answers will be there. 

I give my problems to the great mind of God; I let go of them, confident that the correct answers will return to me when they are needed.  Through the great law of attraction, everything in life that I need for my work and fulfillment will come to me.  It is not necessary that I strain about this, only believe.  For in the strength of my belief, my faith will make it so. 

I see the hand of divine intelligence all about me, in the flower, the tree, the brook, the meadow.  I know that the intelligence that created all these things is in me and around me and that I can call upon it for my slightest need.  I know that my body is a manifestation of pure spirit and that spirit is perfect; therefore, my body is perfect also. 

I enjoy life, for each day brings a constant demonstration of the power and wonder of the universe and myself.  I am confident.  I am serene.  I am sure. 

No matter what obstacle or undesirable circumstance crosses my path, I refuse to accept it, for it is nothing but illusion. There can be no obstacle or undesirable circumstance to the mind of God, which is in me, and around me, and serves me now.”

U.S. Andersen 1954