Shifting from “shock & awe” to “nourish & support”

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I had a great conversation with a colleague yesterday. We were talking about parasites, chronic infections and cancer. The conventional understanding is that pathogens cause disease and must be eliminated to restore health. This makes sense, on the surface, and it’s certainly true in the case of some virulent infections.

But what’s missing here is an understanding that the body is an ecological system. There are over 100 trillion microorganisms living in our gut alone. That’s 10x the number of human cells in our entire body. When you look at it from this perspective, we’re actually more bacteria, parasites and yeast than we are human.

In health, there’s a balance between the pathogenic organisms and the beneficial ones. It’s not that healthy people don’t have pathogens in their body; it’s that they have a lot more of the beneficial micro-organisms that keep the harmful ones in check. This is how it works in ecological systems. An invasive species is much more likely to proliferate in the absence of other species that normally inhibit its growth.

A perfect example of this is Clostridium difficile (a.k.a “c. diff”). C. diff is a virulent bacteria that can cause florid diarrhea and, if untreated, death. But consider the following facts about c. diff:

  • C. diff infections are most likely to occur after a course of broad-spectrum antibiotics. Why? Because the antibiotics kill the beneficial gut flora that normally keep the c. diff in check.
  • At least 20% of c. diff carriers are asymptomatic. Why? Probably because they have enough good gut flora and a strong enough immune system to inhibit its growth.
  • By far the most effective treatment for c. diff known today is fecal bacteriotherapy, where the gut flora from a healthy human host is transplanted to the infected person via colonoscope. This suggests that creating a healthy internal environment that crowds out the pathogen is more effective than trying to kill it with antibiotics.

A lot of oncologists and cancer researchers now believe that all of us have cancer. But those of us that are healthy are able to keep it in check. When we say someone “has cancer”, what we’re really saying is that the growth of cancer cells in their body has gone out of control. Or, put another way, we could say that a person with cancer is someone who has lost the ability to fight the growth of cancer cells already in their body.

Likewise, we evolved in concert with parasites. There’s even evidence that certain parasites play a beneficial role in “tuning” our immune systems, and may be necessary for health. This theory is called the “hygiene hypothesis”. It’s based on the observation that autoimmune diseases are much more prevalent in developed parts of the world where standards of hygiene and sanitation are higher, and much lower in undeveloped parts of the world where sanitation and hygiene are poor.

In fact, there’s even a treatment for Crohn’s disease and ulcerative colitis that involves patients swallowing thousands of eggs of a particular parasitic worm. They use a pig whipworm that is capable of modulating the human immune system, but not colonizing the human host. This way there’s no danger of chronic infestation, but the patient still gets the “immune tuning” effect. This might be gross to think about, but considering it has a remission rate of higher than 70%, and is virtually free of side effects, it’s far better than almost any other option available for these conditions.

There’s also some intriguing evidence that H. pylori, the bug that causes peptic ulcers, paradoxically may protect against several other gastric diseases. Studies indicate that H. pylori was once more common, perhaps nearly universal in humans, than it is in our postmodern society. Even today, it’s estimated that 1 in 2 people around the world have H. pylori.

This brings the current strategy of completely eradicating pathogenic organisms like H. pylori into question. If we eliminate H. pylori completely, that might help the peptic ulcer to heal, but it could potentially cause other problems. The same dilemma may very well exist for other pathogens.

I think a better strategy for dealing with pathogens is to move away from the “shock and awe” antibiotic campaigns currently favored in conventional medicine, and toward a “nourish and support” protocol that involves boosting the body’s natural protection against the overgrowth of pathogens. Instead of focusing on eradicating the pathogen, we focus on supporting the body to keep it in check. Balance, rather than elimination, becomes the goal.

There are certain cases, of course, when the infection is so virulent and the host so weakened that it makes perfect sense to eradicate it completely – presuming that’s possible. But I believe this approach is far too common, and is too often employed in situations where supporting the body’s natural self-healing mechanisms would be safer and more effective.

As always, I’d love to hear your thoughts.

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Comments Join the Conversation

  1. ani says

    I’m always curious what role vaccines play in this. Are there potential benefits which we are not experiencing be/c of vaccinations?

  2. says

    Nice post, Chris. You’re right, nourishing and supporting the body, and building a cooperative microbiome of commensal bacteria, are critical steps to health. In many infections, antibiotics don’t work if the diet is bad. On bad diets, they can make things worse.

    One caveat: There’s little hope of eradicating any of these pathogens. Antibiotics certainly don’t achieve that. Antibiotics change the balance of power between pathogen and immune system. Most are protein synthesis inhibitors, not pathogen killers.

  3. chriskresser says

    I agree, Paul. Like so many other issues in health, there’s no “one-size fits all” approach. For some, antibiotics are definitely helpful in re-establishing that balance. For others, antibiotics may actually upset the balance rather than restoring it.

    We’ve spoken offline about this, but the one part of the Marshall Protocol that I can get behind is their use of low-dose, pulsed antibiotics for chronic infections. I think that may be the best of both worlds: reducing the pathogenic population without completely wiping out beneficial bacteria.

  4. Jesse says

    Good article. The situation is certainly more complicated than “take in pathogen, contract disease.” I don’t know that “pathogens cause disease and must be eliminated to restore health” is an accurate description of “conventional understanding” (whatever that is) in every case, but science is still trying to work out all the details.

    There’s a researcher at Michigan State University, Christopher Waters, who is trying to find compounds that inhibit certain bacterial functions, such as biofilm formation I think, rather than killing the cells. The goal is to inhibit virulence without making it beneficial for the bacteria to gain resistance… sort of a “living-together-in-harmony” drug, you might say. Certainly we need to do SOMETHING differently from the “blast with antibiotics” approach that has been standard practice, and I think that this need is widely recognized.

  5. chriskresser says

    Biofilm disruption is gaining traction as a strategy for dealing with pathogens. I use this approach in my practice and the results have been positive so far. There are a variety of enzymes such as glucoamylase, chitosanase and beta-gluconase that have been shown to be effective, and EDTA (ethylenediaminetetraacetic acid) also shows activity against biofilms.

    I agree that awareness is changing even in conventional med, but I can tell you I see firsthand every day patients who’ve been over-aggressively treated with antibiotics without being offered any treatment to restore their gut flora or intestinal barrier integrity.

  6. Julie says

    Have you ever heard of Candida? I was diagnosed w/ it and I am noticing that there are very few foods that I can eat. Is the only way to cure it is to starve it? How long does it take to starve it? There is not much information out there about it. Can you help me?

  7. Mikayla says

    I am interested in your opinion of the use of antibiotics as anti-inflammatories.

    I have cystic fibrosis and chronic MRSA and psuedomonas infections in the lungs. For the last several years I have been heavily dependent on oral antibiotics to suppress my low-grade fever and let me do daily activities. However, I am very worried this has all but destroyed my gut flora and is contributing to my inability to digest well, which then leads to even more inflammation and mucus production. More and more I am thinking that these antibiotics are acting primarily like anti-inflammatories, not antibiotics, simply suppressing my immune system and the fever – but killing good gut bacteria in the process. Do you have any thoughts on this? Do you think trying to restore my gut bacteria and reboot my digestion via the SCD would help?

  8. Tania says

    I know this has been around for quite some time, but I’m hoping it’s still being followed. My blood sugar is a weird case, my doctor doesn’t seem to be concerned and doesn’t even want to look into anything if they’re even one point less than 110, so I bought a home meter. My blood sugar seems to be too stable for comfort – stable at a danger zone that is. My fasting and pre-meal blood sugar seems to always hover around 100 plus or minus a point or two, but what’s surprising is that an hour after a normal meal of about 50 grams of carbs it doesn’t seem to ever exceed 108, except for one experiment I did where I ate a whopping 80 grams of carbs and got a 123 reading an hour later which dropped right back to my magical 100 number at the 2 hour mark. I thought something was wrong with the device so I replaced it and still got the same readings, I later bought a different brand. Same story… I thought something must be wrong with me.

    I’m a 32 year old woman and I have a strong family history of diabetes, both my uncle and my grandmother are insulin dependant. I’m morbidly obese (working on it, lost 54 pounds so far in 5 months and currently at 243 for a 5’6 frame). I spend most of my time in bed due to a back injury but I plan to be more active in a few months once I can move. What could cause blood sugar to be barely reactive to carbs and stable at a high level?

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