Drug-resistance in tuberculosis has recently risen to new levels. I have read articles indicating that there are strains of TB that are resistant to all of the first-line TB drugs and many of the second-line ones. These strains are reported to kill more than 90% of the infected within a short period of time. The possibility of successful treatment is said to be so low that in some cases, the treatment includes permanent isolation.
The purpose of this article is to explore other perspectives on this topic. I want to suggest 3 things. (1) It is illogical to use ever-increasing amounts of antibiotics against a pathogen that has developed high levels of antibiotic-resistance, (2) The exceptionally drug-resistant TB (XDR TB) is not really extremely deadly, and (3) It is very reasonable to expect to overcome XDR TB through improving general health and the immune response.
If the Drugs Aren’t Working – Use More Drugs !
Decades ago, antibiotic treatment of TB used to be a much simpler matter. Many fewer drugs were used, and because no drug-resistance had developed, results were excellent. Then, as drug resistances did develop, the pattern was laid down. The two-drug therapy turned to three and then to four. More recently, when treating the exceptionally drug-resistant strains, the number of drugs used on a single patient may be up to 8.
With very high levels of antibiotic usage, it is important to be looking at side-effects. Here is a partial list from some common TB drugs:
Chemical-induced hepatitis, liver failure, stomach upset, nausea, dizziness, and allergic reactions (occasionally fatal), headache, bloody diarrhea, bleeding disorders, skin rashes, itching, fungal infections, immune and digestive problems related to the kill-offs of “good” bacteria, and heart rhythm abnormalities,
Here are the factors that limit the effectiveness of drug therapy for TB:
1. The people who develop the disease are typically those with the worst immune systems.
2. They many times have other concurrent infections (such as HIV).
3. TB has developed a wide variety of drug-resistant strains.
4. The side effects of aggressive drug therapy are exaggerated because of the multi-drug approach.
5. Drug therapy for TB usually lasts at least 6 months (and as long as 2 years), so side effects can become severe, and newly-developed drug resistances can occur during treatment.
I contacted the CDC about MDR TB (multiple drug-resistant) and XDR TB. In their reply, they made the following statements.
Drug resistant TB requires 4-6 expensive drugs to treat for 24 months or more…. Patients with drug-resistant TB also have worse treatment outcomes (death or treatment failure. 1
It is apparent that the “bad” side of the antibiotic treatment of TB has been maximized, while the “good” side has been minimized. 1
It seems that, after decades of near-100% reliance on antibiotics to treat bacterial infection, our best medical minds have gotten stuck in a rut. When their antibiotics don’t work, they can only think of higher doses of antibiotics, different antibiotics, newer antibiotics, or combinations of antibiotics.
What Makes XDR TB So Deadly ? I have found no indication that XDR TB has become any more deadly than TB has been for centuries. It is my opinion that there are two major factors that generate high mortality rates.
1. XDR TB occurs frequently in AIDS hospitals.
2. The frantic application of minimally effective antibiotics wears down the patients much faster than it wears down the TB. The treatment might be more deadly than the disease.
Looking For A Different Approach
Before the 1940’s, TB was treated in “sanitoriums”. These were like small TB resorts. These sanitoriums were typically located in places that were considered to have “good air”. In Europe, the mountain areas of Switzerland were favored. In the US, sunny and dry areas, such as Prescott, AZ had excellent reputations. The patients led a low-stress life with moderate exercise. Mortality in this setting was around 50%. This sounds terrible, but I instead focus on the 50% who did not succumb to TB. My preferred statement is that with little or no medical intervention, half of TB patients will survive the disease. This makes me wonder what else (other than antibiotics) could be done to improve their chances.
TB Targets Low-Functioning Immune Systems
About 90% of those infected with Mycobacterium tuberculosis have asymptomatic, latent TB infection (sometimes called LTBI), with only a 10% lifetime chance that a latent infection will progress to TB disease 2. I have run across nothing to indicate the XDR-TB behaves any differently. In fact all indications are that a person with an immune system in good condition will not develop TB (regardless of how many drugs it is resistant to).
In support of this theory, the CDC reports that mortality in the US from XDR-TB was strongly associated with HIV infection 1.
Could Improving Nutrition and Immune Function Be The Answer ? I have looked to see if any medical professionals today are checking for nutrient levels critical to immune function. There are many, but none of them “mainstream”, so that all the “official” sources mentioned none of this. Some articles are current, but many sources recount stories from before the age of antibiotics.
Dr. Max Gerson, MD had become famous for running a “cancer clinic” in the New York area in the 1940’s and 1950’s. His therapy was based upon aggressive nutrition, detoxification, and rebuilding the liver. What many casual observers may have missed is that his treatment wasn’t specific to cancer. It started out as a migraine cure, that accidentally cured tuberculosis, cancer and other degenerative diseases. I saw homeopathic web pages with many suggestions.
One webpage (http://www.regenerativenutrition.com/content.asp?id=338) described an autoimmune component of TB and laid out a fairly comprehensive plan to treat TB herbally.
In addition, there is an endless supply of stories of “spontaneous” remissions. Hint - no remission is spontaneous, but in some cases, the curative agent can’t be described in terms of a placebo-controlled double-blind study, so many in the medical world just cover their eyes. My favorite was the story (see below) of Galen Clark taken from a webpage (http://www.4nutrition.com/bcnchapter_exsum.htm) under the name of Patrick Quillin, PhD, RD, CNS.
The number one cause of death throughout most of the 19th century was tuberculosis. Galen Clark went to Yosemite Valley to die of endstage tuberculosis at age 42 in the fall of 1856. His doctor told him that coughing up chunks of his lungs meant he had up to 2-6 months to live. There was no cure for this disease. Clark reasoned that “if I’m going to die soon, then I’m going to die in Yosemite, the prettiest place I’ve ever seen.” He got happy. Scientists now tell us that happiness brings on the flow of endorphins, which supercharge our immune system and may slow down disease.
Next, Galen Clark carved his own tombstone, thus accepting his mortality, a ritual that would give us all a better appreciation of our finite time on earth. He then started eating what was available in Yosemite in those days; clean and lean wild game, mountain trout, nuts, berries, vegetables, and lots of clean water. No sugar and no dairy products. He then began doing what he wanted to do, hiking and creating trails, in the place he treasured the most, Yosemite Valley. He didn’t die 6 months later, but rather 54 years later, just shy of his 96th birthday. He bolstered his “non-specific host defense mechanisms” with good thoughts and good nutrition.
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Daniel Cobb is a Doctor of Oriental Medicine practicing at the Integrative Holistic Healing Center in Santa Fe. (424-9527) He is at his best convincing patients that they can overcome the vast majority of chronic diseases through nutrition and detoxification.
Footnotes: 1. e-mail from Ruth, Jennifer L. (CDC/CCID/NCHHSTP), 6/27/07 2. Wikipedia http://en.wikipedia.org/wiki/Tuberculosis