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Mycoplasmas are a specific and unique species of bacteria - the smallest free-living organism known on the planet. The primary differences between mycoplasmas and other bacteria is that bacteria have a solid cell-wall structure and they can grow in the simplest culture media. Mycoplasmas however, do not have a cell wall, and like a tiny jellyfish with a pliable membrane, can take on many different shapes which make them difficult to identify, even under a high powered electron microscope. Mycoplasmas can also be very hard to culture in the laboratory and are often missed as pathogenic causes of diseases for this reason.

The accepted name was chosen because Mycoplasmas were observed to have a fungi-like structure (Mycology is the study of fungi - hence "Myco") and it also had a flowing plasma-like structure without a cell wall - hence "plasma". The first strains were isolated from cattle with arthritis and pleuro-pneumonia in 1898 at the Pasteur Institute. The first human strain was isolated in 1932 from an abscessed wound. The first connection between mycoplasmas and rheumatoid diseases was made in 1939 by Drs. Swift and Brown. Unfortunately, mycoplasmas didn't become part of the medical school curriculum until the late 1950's when one specific strain was identified and proven to be the cause of atypical pneumonia, and named Mycoplasma pneumonia. The association between immunodeficiency and autoimmune disorders with mycoplasmas was first reported in the mid 1970s in patients with primary hypogammaglobulinemia (an autoimmune disease) and infection with four species of mycoplasma that had localized in joint tissue. Since that time, scientific testing methodologies have made critical technological progress and along with it, more mycoplasma species have been identified and recorded in animals, humans and even plants.

While Mycoplasma pneumonia is certainly not the only species causing disease in humans, it makes for a good example of how this stealth pathogen can move out of it's typical environment and into other parts of the body and begin causing other diseases. While residing in the respiratory tract and lungs, Mycoplasma pneumonia remains an important cause of pneumonia and other airway disorders, such as tracheobronchitis, pharyngitis and asthma. When this stealth pathogen hitches a ride to other parts of the body, it is associated with non-pulmonary manifestations, such as blood, skin, joint, central nervous system, liver, pancreas, and cardiovascular syndromes and disorders. Even as far back as 1983, doctors at Yale noted:

"Over the past 20 years the annual number of reports on extrapulmonary symptoms during Mycoplasma (M.) pneumoniae disease has increased. Clinical and epidemiological data indicate that symptoms from the skin and mucous membranes, from the central nervous system, from the heart, and perhaps from other organs as well are not quite uncommon manifestations of M. pneumoniae disease."⁽¹⁵⁾

This single stealth pathogen has been discovered in the urogenital tract of patients suffering from inflammatory pelvic disease, urethritis, and other urinary tract diseases ⁽⁸⁾ It has been discovered in the heart tissues and fluid of patients suffering from cardititis, pericarditis, tachycardia, hemolytic anemia, and other coronary heart diseases.^{(9, 10, 14)} It has been found in the cerebrospinal fluid of patients with meningitis and encephalitis, seizures, ALS, Alzheimer's and other central nervous system infections, diseases and disorders.^(11-13) It has even been found regularly in the bone marrow of children with leukemia.^{(16- 18)} It is amazing that one single tiny bacteria can be the cause of so many seemingly unrelated diseases in humans. But as with all mycoplasma species, the disease is directly related to where the mycoplasma resides in the body and which cells in the body it attaches to or invades.

Today, over 100 documented species of mycoplasmas have been recorded to cause various diseases in humans, animals, and plants. Mycoplasma pneumonia as well as at least 7 other mycoplasma species have now been linked as a direct cause or significant co-factor to many chronic diseases including, rheumatoid arthritis, Alzheimer's, multiple sclerosis, fibromyalgia, chronic fatigue, diabetes, Crohn's Disease, ALS, nongonoccal urethritis, asthma, lupus, infertility, AIDS and certain cancers and leukemia, just to name a few.^(1-6) In 1997, the National Center for Infectious Diseases, Centers for Disease Control and Prevention's journal, Emerging Infectious Diseases, published the article, Mycoplasmas: Sophisticated, Reemerging, and Burdened by Their Notoriety, by Drs. Baseman and Tully who stated:

"Nonetheless, mycoplasmas by themselves can cause acute and chronic diseases at multiple sites with wide-ranging complications and have been implicated as cofactors in disease. Recently, mycoplasmas have been linked as a cofactor to AIDS pathogenesis and to malignant transformation, chromosomal aberrations, the Gulf War Syndrome, and other unexplained and complex illnesses, including chronic fatigue syndrome, Crohn's disease, and various arthritides."

Mycoplasmas, unlike viruses, can grow in tissue fluids (blood, joint, heart, chest and spinal fluids) and can grow inside any living tissue cell without killing the cells, as most normal bacteria and viruses will do. Mycoplasmas are frequently found in the oral and genito-urinary tracts of normal healthy people and are found to infect females four times more often than males, which just happens to be the same incidence rate in rheumatoid arthritis, fibromyalgia, Chronic Fatigue and other related disorders.⁽⁷⁾ Mycoplasmas are parasitic in nature and can attach to specific cells without killing the cells and thus their infection process and progress can go undetected. In some people the attachment of mycoplasmas to the host cell acts like a living thorn; a persistent foreign substance, causing the host's immune defense mechanism to wage war. This allergic type of inflammation often results in heated, swollen, and painful inflamed tissues, like those found in rheumatoid diseases, fibromyalgia and many other autoimmune disorders like lupus and MS, Crohn's and others. In such cases the immune system begins attacking itself and/or seemingly healthy cells. Some species of mycoplasmas also have the unique ability to completely evade the immune system. Once they attach to a host cell in the body, their unique plasma and protein coating can then mimic the cell wall of the host cell and the immune system cannot differentiate the mycoplasma from the body's own host cell.

Mycoplasmas are parasitic in nature because they rely on the nutrients found in host cells including cholesterol, amino acids, fatty acids and even DNA. They especially thrive in cholesterol rich and arginine-rich environments. Mycoplasmas can generally be found in the mucous membrane in the respiratory tract. They need cholesterol for membrane function and growth, and there is an abundance of cholesterol in the bronchial tubes of the respiratory tract. Once attached to a host cell, they then begin competing for nutrients inside the host cells. As nutrients are depleted, then these host cells can begin to malfunction, or even change normal functioning of the cell, causing a chain reaction with other cells (especially within the immune and endocrine systems). Mycoplasmas can even cause RNA and DNA mutation of the host cells and have been linked to certain cancers for this reason. Mycoplasmas can also invade and live inside host cells which evade the immune system, especially white blood cells. Once inside a white blood cell, mycoplasmas can travel throughout the body and even cross the blood/brain barrier, and into the central cervous system and spinal fluid.

FOOTNOTES

• Mycoplasmas are able to hide inside the cells of the host (patient) or to attach to the outside of host cells.
• Whether they live inside or outside the host cell, they depend on host cells for nutrients such as cholesterol, amino acids, etc. They compete with the host cells for these nutrients which can interfere with host cell function without killing the host cell.
• A mycoplasma has very little DNA of its own, but is capable of using DNA from a host cell. When a mycoplasma takes over the DNA of the host cell, anything can happen - including causing that cell to malfunction in many different ways and/or die, or can cause DNA mutation of the host cell.
• Mycoplasmas attach to host cells with a tiny arm coated in protein which attaches to the protein coating of host cells. For this reason, antibiotics like tetracycline, which are classified as "protein synthesis inhibitors" are often used against mycoplasma infections. While these antibiotics may block this protein attachment and very slowly starve it from the nutrients it needs from host cells to thrive and replicate, it still takes a healthy immune system to actually kill the mycoplasma for good.
• Mycoplasmas are highly adaptable to changing environments and can move anywhere in the body, attaching to or invading virtually any type of cell in the body.
• The mycoplasma adhesion proteins are very similar to human proteins. Once adhered to the host cell, the mycoplasma can completely mimic or copy the protein cell of the host cell. This can cause the immune system to begin attacking the body's own cells; an event that happens in all autoimmune diseases.
• Certain Mycoplasma species can either activate or suppress host immune systems, and they may use these activities to evade host immune responses. Mycoplasmas can turn on the chain reaction called an immune system response. This includes the stimulation of pro-inflammatory cytokines (chemical messengers of the immune system) which is generally found in most autoimmune and inflammatory diseases and disorders.
• Mycoplasma can also attach to or invade immune system cells, like the very phagocytes (natural killer cells) that are supposed to kill them. Inside these phagocytes, they can be carried to new locations of inflammation or disease - hidden away like a spy who has infiltrated the defending army.
• When a mycoplasma attaches to a host cell, it generates and releases hydrogen peroxide and superoxide radicals which cause oxidative stress and damage to the surrounding tissues.
  

1. Krause DC, Taylor-Robinson D. Mycoplasmas which infect humans. In: Maniloff J, McElhaney RN, Finch LR, Baseman JB, editors. Mycoplasmas: molecular biology and pathogenesis. Washington (DC): American Society for Microbiology, 1992:417-44.
2. Murray HW, Masur H, Senterfit LB, Roberts RB. The protean manifestations of Mycoplasma pneumoniae infection in adults. Am J Med 1975;58:229-42.
3. Baseman, Joel, et.al., Mycoplasmas: Sophisticated, Reemerging, and Burdened by Their Notoriety. CDC, Journal of Infectious Diseases, Vol 3, No.1, Feb 1997
4. Blanchard, A., et.al., AIDS-associated mycoplasmas. Ann.Rev.Microbiol. 1994; 48:687-712.
5. Hawkins, et.al., Association of mycoplasma and human immunodeficiency virus infection: detection of amplified mycoplasma fermentans DNA in blood. J.Infec.Dis. 1992: 165:581-585
6. Hussain AI, et.al., Mycoplasma penetrans and other mycoplasmas in urine of human immunodeficiency virus-positive children. J Clin Microbiol. 1999 May;37(5):1518-23.

The negative impact of a mycoplasmal infection on the human immune system is undisputed. Due to it's ability to either activate or suppress the immune system, it is now being considered one of the culprits of many autoimmune diseases. Yet, scientists still argue over the "chicken or egg first" type of sequence of events. Do the mycoplasmas begin growing and replicating first and then weaken or deregulate the immune system? Or does a weaken immune system caused by stress, poor diet or other illness allow the mycoplasmas to take hold and begin their opportunistic growth and infection resulting in chronic disease and to weaken and deregulate the immune system even further? The answer is probably both, and it becomes one of the most critical treatment aspects of mycoplasmal infections. In immunodeficient patients it can be very difficult to treat these mycoplasma infections with appropriate broad spectrum antibiotics which are immunosuppressive themselves. Although the tetracycline and erythromycin types of antibiotics are effective for some mycoplasmal infections, M. fermentans, M. hominis and M. pirum strains are usually resistant to erythromycin, and tetracycline-resistant strains of M. hominis and U. urealyticum have been reported. However, these antibiotics have a very limited ability to directly kill these mycoplasmas, and their efficacy eventually depends on an intact host immune system to eliminate the mycoplasmas. These types of protein inhibiting antibiotics will stop the protein adhesion of the mycoplasma to host cells but won't directly kill the mycoplasma itself. With an already weaken immune system, many patients lack the ability to mount a strong antibody response against these deadly stealth pathogens to kill them effectively.

Regardless, many physicians and rheumatologists are treating their arthritis, CFISD, fibromyalgia and other mycoplasma infections with long term antibiotic therapy. One of the more popular conventional protocols involves rotating multiple 6 week cycles of Minocycline or Doxycycline (200-300 mg/day), Ciprofloxacin (1,500 mg/day), Azithromycin (250-500 mg/day, and/or Clarithromycin (750-1,000 mg/day) among others.⁽¹⁾ Sometimes the side effects of these strong antibiotics can be as bad as the symptoms of the diseases they are treating since a minimum of 6 months and up to two years of antibiotic therapy may be required. Many doctors now believe that antibiotics should not be used solely or exclusively to treat mycoplasmal infections, without addressing rebuilding the immune system which is imperative for a complete recovery and eradication of infection. Others are using more natural antibiotics found in plants which can be as effective or more effective with fewer side effects or negative impact on the body. 

One of the main side effects of antibiotics, whether it is a natural plant antibiotic or a chemical antibiotic, is the loss of friendly bacteria that is needed in the gastrointestinal system for proper digestion and elimination. No antibiotic can differentiate a friendly bacteria from a harmful one. Therefore, any time an antibiotic must be taken, especially long term, taking a probiotic formula to replace friendly bacteria is indicated and helpful in avoiding side effects like candida and fungi overgrowth which can cause digestive and elimination difficulties and other side effects. Several probiotic products are widely available over-the-counter which combine these friendly bacteria - live cultures of Lactobacillus acidophilous, Lactobacillus bifidus and other bacteria with FOS (fructoologosaccharides) to promote growth in the gastrointestinal system. It's important to take this type of supplement when taking antibiotics of any kind and best to be taken either 3-4 hours prior to, or after taking the antibiotic dosage. Full live-cultured yogurt contains acidophilous and is a good food source for these friendly bacteria.

Another common side effect when taking antibiotics is called a Herxheimer Reaction. This occurs from the organism die-off and generally is the first indication that the antibiotic therapy is working. Symptoms that are associated with a Herxheimer include: chills, fever, night sweats, muscle aches, joint pains, lymphatic pain, mental fog, and extreme fatigue. Depending on the severity of the infection and resulting die-off, these symptoms can last 1-2 weeks and sometimes longer and can vary in intensity. Drinking at least two quarts of filtered or distilled water every day to flush the organisms from the body is helpful in reducing the length and severity of a Herxheimer reaction. Another natural remedy to reduce Herxheimer reactions and thought to be helpful in helping the lymph glands to filter and remove dying organisms is a Whole Lemon-Olive Oil Drink. To prepare this natural remedy, place one whole unpeeled lemon (washed) in a blender with 1 cup of juice or water and 1 tablespoon of extra virgin olive oil. Blend in blender until smooth, then pour through a wire strainer. Discard pulp and drink liquid.

Once the mycoplasmas are being controlled by some form of effective natural or chemical antibiotic, re-nourishing and replacing the nutrients drained from the infected host cells can help speed recovery and reduce symptoms. A general multi-vitamin supplement plus extra C, D, E, CoQ-10, beta-carotene, quercetin, folic acid, bioflavoids and biotin are necessary and helpful when recovering from a mycoplasmal infection.

Supplementing back the depleted amino acids has been reported to be helpful in some recovering from these infections. These include L-cysteine, L-tyrosine, L-glutamine, L-carnitine, and malic acid. Remember, however, that mycoplasmas thrive on arginine! Avoid L-arginine supplements and multi-amino acid formulas containing L-arginine, as well as foods rich in arginine to avoid feeding the mycoplasmas. The richest food sources of arginine (to avoid) are nuts and seeds, including the oils derived from seeds and nuts which should be eliminated or drastically reduced in the diet.

Vitamins A, C and E, and other antioxidants found in natural plants, have also been reported to help speed recovery and to minimize the oxidative stress caused by mycoplasmas. One of the most popular antioxidants sold today are various extracts of grape seeds. Remember however, most seeds are rich in arginine, including grape seeds, and should generally be avoided.

Other helpful supplements to replenish drained nutrients from parasitic mycoplasmas are generally indicated based upon which specific cells the mycoplasma might be feeding on and which nutrients are being depleted. Specifically with fibromyalgia patients, leading research indicates that many of the hormones and enzymes produced in the neuroendocrine system and Hypothalamus-Pituitary-Adrenal Axis are depleted or malfunctioning which have the ability to cause many of the symptoms found in these patients. Some hormonal replacement therapy with thyroid hormones, or other natural hormone supportive supplements like DHEA, progesterone and pregnenolone, and the endocrine supportive herb, Maca (Lepidium meyenii) have been shown to be helpful with many fibromyalgia patients.

Finally and most importantly is nutritionally supporting the immune system. There are various natural products sold today which can stimulate and support immune function. See Protocols for fibromyalgia/Gulf war syndrome

FOOTNOTES

1. Nicolson, et.al., Diagnosis and Integrative Treatment of Intracellular Bacterial Infections in Chronic Fatigue and Fibromyalgia Syndromes, Gulf War Illness, Rheumatoid Arthritis and Other Chronic Illnesses. Clinical Practice of Alternative Medicine 2000; 1(2) 42-102
   

FOOTNOTES

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