How to Recognize and Fix a Brain Infection

I thought I’d pull up an interesting tale from the comments. It is a great illustration of what we’re trying to accomplish on this blog.

Thomas first commented here on December 31:

I just got your book from a relative for Christmas (I told them to buy me it!) and am reading through it now. Very interesting, although some of it is beyond a simple layman like me.

The part of this blog post that starts “Thus common symptoms of a bacterial infection of the brain are those of cognitive hypoglycemia and serotonin deficiency” and continues for several paragraphs describes precisely the mysterious changes I have experience over the last decade of life (I am now 33), with the one variation being that I suffer extreme fatigue rather than insomnia or restlessness. Every other sympton, including the odd mental state you mention, is a perfect match, and I experience them all to a marked degree….

I have been diagnosed with general anxiety but never depression. I do not feel sad ever, just irritable and anhedonia-ac, if I may coin a word. Anti-depressants, and I’ve tried a bunch, do absolutely nothing for me.

Brain infections are widespread – I wouldn’t be surprised if 20% of the adult population has a brain infection of mild severity – but they are hardly ever diagnosed or treated.

Fortunately, there are some symptoms that are almost universally generated by brain infections, so it’s not necessarily that difficult to diagnose them. But I think no one knows the symptoms. Infections are generally allowed to progress for decades.

One of my crucial steps forward was when I recognized that I had the cognitive symptoms of hypoglycemia when my blood sugar was normal. I could relieve the symptoms if my blood sugar became highly elevated. Thinking about why that might be led me toward the idea of bacterial infections.

Thomas went on to describe the origin of his symptoms:

I began to decline after suffering the second subdural hematoma of my life at age 20 when I was in Italy, followed by a 5 year binge on alcohol.

This was another clue. Traumatic brain injuries, such as hematomas, often initiate brain infections, because they breach the blood-brain barrier. Alcohol is also a risk factor, as I pointed out in my reply to Thomas:

Alcohol abuse depresses bacterial immunity and would be a risk factor for a brain infection: http://www.ncbi.nlm.nih.gov/pubmed/16413723, http://www.ncbi.nlm.nih.gov/pubmed/20161709. Subdural hematomas frequently show infections, e.g. http://www.ncbi.nlm.nih.gov/pubmed/20430901.

We next heard from Thomas on February 22, when he had been on our diet for 7 weeks and had just tried his first ketogenic fast:

I’ve been doing PHD for about 7 weeks now, and tried a ketogenic fast this past weekend. I ended up going 33 hours with some coconut oil and cream. It was a bit tough having to eat a bunch of oil on an empty stomach, but nothing too bad.

I can’t say there was any improvement cognitively or with anhedonia, but there seemed to me to be a pronounced calming effect after about 24 hours of fasting. I often stutter or stumble over words (again, for about 10 years now), which usually goes away only with two or three alcoholic drinks. But the speech problems stopped almost completely during the fast, which makes me thing that there is some link to anxiety and stuttering.

Positive changes in brain function during ketosis suggest that the brain isn’t functioning normally when it relies on glucose as a fuel. There are several possible causes of this, but one is a bacterial infection. Another clue.

I generally recommend getting on our diet and supplement regimen, and reaching a stable health condition, before starting antibiotics. There are several reasons for this, which I’ll elaborate on later, but briefly:

  • Antibiotics work well on a good diet but may fail on a bad diet.
  • Pathogen die-off toxins can cause significant neurological damage and this toxicity may be substantially increased on a bad diet.
  • There is considerable diagnostic value in being able to clearly discern the reaction to antibiotics. Rarely is it certain that a brain infection is bacterial, or that the antibiotic in question is the correct one. To judge whether the antibiotic is working, it’s important that health be stable and as good as possible.

I therefore recommend being on our diet and supplement regimen for 3-4 months before starting antibiotics.

Thomas seems to have followed this advice, since he has just reported starting antibiotics:

I’ve been on PHD for a few months, and about a month ago went to the low-carb therapeutic ketogenic version of the PHD. After reading some of Paul’s posts, I believe that I might have a brain infection as a result of a head injury from more than a decade ago (Paul, if you recall, my condition has a lot of similarities to the one you once had). I started taking doxycycline a few days ago, and I have already noticed pronounced improvement (whether due to the diet or the antibiotic or both) in controlling the irritability and anxiety that have plagued me for years….

I definitely feel great since making the diet changes. My blood pressure, which has been creeping upwards over the last few years to 135/80 or so, is back down to 110/70. My testosterone is 824, and I am pleased to see that I maintaining my strength in the gym despite being on a ketogenic diet.

Pronounced improvement in the first days of doxycycline is quite possible, because doxy acts as a protein synthesis inhibitor. It essentially blocks bacterial functions and switches them into a state of hibernation. The bacteria are still there, but they are not interfering with brain function as much as before.

This improvement is confirmation that Thomas has a bacterial infection of the brain. If there were no infection, he wouldn’t notice an effect from the antibiotics.

Over a period of months, the doxycycline plus ketogenic dieting should help his innate immune defenses clear the brain of most bacteria. Combination antibiotic protocols may be even more effective.

In a follow-up comment, Thomas mentioned Ben Franklin and the blessing of good health:

Thanks for the response Paul, as well as all your help. If this works, I owe you my first-born child and then some! Ben Franklin (I think it was him) might have been right about health being the greatest blessing. The improvements I’ve seen recently have done more for my well-being than anything in the last decade, and I am profoundly grateful to you for all your excellent advice.

It’s comments like this that make blogging and book writing worthwhile.

It’s probably hard for those who have never had ill health to appreciate how enjoyable it can be for those with chronic diseases to recover good health. I’ve blogged on this before (Of Recovery, Hope, and Happiness, July 13, 2010 – don’t miss Ladybug’s painting).

Thomas, antibiotics and ketogenic dieting will work, I’m pretty sure. May you come to perfect health, and always remain grateful for the many blessings that are yours.

Leave a comment ?

183 Comments.

  1. Hello Paul
    Terrific post. My experience accords somewhat with Thomas’ but much milder. A couple of months after starting PHD there was an obvious improvement in mood and cognitive function. Now12 months later the mental improvements persist but do not seem to be growing. I have a mild joint problem; prone to tendonitis and my joints “click”. By accident I discovered an unexpected correlation between local blood glucose partition involving an acute case of “little league elbow”. BG readings taken at the abdomen were about 25% higher than those taken in the palm, after gently flexing the elbow for a few minutes. This may suggest that glucose is apparently being disproportionately consumed at the injury site. I posted about this before. I am now almost clear of the elbow problem. Since most of my joints click, I have been doing flexing exercises for all major joints on wakeup (usually a time at which clicking is the most pronounced) and after 6 weeks there seems to be some mild improvement. But what is interesting is the effect of flexing my neck (which has a mild click) on my eyes and ears. Tinitus in the right ear (the left stopped ringing early on) always occurs after waking, even after a short nap but then subsides to virtually nothing after a meal, but sometimes reappears during the day. Pulling on the ear lobe at wakeup produces “clicks” but reduces the time for the tinitus to disappear. During the day the ear either does not click or very faintly. After a week of ear pulling the tinitus duration has been reduced by about 50-70%. I have had “floaters in both eyes for about a dozen years but they are noticeably diminishing after starting neck flexing. I should note that bacteria are very likely involved as I have had a refractive periodontal disease for many years which ebbs and flows, local gum abscesses and jaw bone pain come and go. So my naïve assumption is that there may be local competition between cells and bacteria for nutrients. I am considering taking tetracycline but I hesitate due to the potential negative consequences, particularly as my GI tract and digestion seem to be in fine working order.
    Couple more points. A chiropractor suggested “prolotherapy” for my elbow after his ART method failed to produce a result. Prolotherapy apparently involves injection of a glucose solution into the affected tendon. Voodoo or not it gave me the idea of trying to “pump” blood glucose by flexing the attached muscles and it seems to work.
    I have been unable to find a plausible explanation for joint clicking mechanism and wonder if it may involve separation of glyscosaminoglycans (GAG’s). GAG’s are giant polysaccharide molecules, about 95% water. If the water is ordered as Gerald Pollack describes in his very interesting book “Cells & Gels ..”, GAG condensation may be a plausible mechanism. Thanks again for these interesting ideas.

  2. I’ve had tinnitus in one ear since April 05. So I’m curious about this as well.

    Paul– what about memory loss. Is memory loss normal part of aging? or is it a normal result of stress from elevated cortisol or is it a symptom of a brain infection? I’m really interested in this topic specifically. Will you cover it at some point?

  3. Andreas van Wyk

    Paul, I don’t know if you remember but I contacted you a few times over the last 8 months or so, with regards to anxiety and depression as well. I can also honestly say that my anxiety and depression has lifted to a large large extent since eating a predominantly perfect health diet. I’m very sensitive to supplements, so don’t take a multivitamin (but eat lots of chicken livers instead) but do take magnesium and zinc and try eat as high quality food as I can including lots of liver and bone broth (bone broth is an absolute god send and probably the best food I’ve found in helping “chill out” and “calm down”).

    I tried the ketogenic version of the diet briefly but had a very difficult time getting down 12 tablespoons of coconut oil with only 50g worth of starchy carbs to play with. I wonder if you or Thomas have any input as to how to do this? I can’t eat coconut bark every day of my life!!!

    I seem to feel better eating smaller amount of protein (200-300g of meat a day – eating more than this seems to make me aggressive and anxious), about 600-800g of potatoes and sweet potatoes mixed and A LOT of coconut oil (this food is truly a miraculous antidepressant – I am for 8-12 tablespoons a day with my starchy carbs). Would be keen to try the ketogenic version of the diet, but it will be super difficult to maintain without a way of getting in coconut oil without wanting to gag.

    Thanks for the fantastic website!

  4. Andreas,

    When I need to get in some coconut oil by itself, I heat just enough to liquify it, then pour in water with a small squeeze of lemon and “swig” it down. No taste, quick and easy. Hopes this helps getting it down.

  5. Hi Andreas,

    I’ve been doing the ketogenic version of the diet since February. I too found 8-12 tablespoons of coconut oil a challenge, both in terms of the gag reflex and stomach ache inducing effects when eating too much at one time. What is working for me right now is a combination of MCT oil and coconut oil. During my morning fast I take a tablespoon or two of MCT oil, which, as I understand it, is more ketogenic than coconut oil so you don’t need as much. I eat two meals, lunch and dinner, and I cook everything in coconut oil. I also usually have some MCT oil sometime in the afternoon. The MCT oil initially gave me a stomach ache, so I had to start with a teaspoon at a time. It no longer bothers me. Indeed, if I am under a period of stress and the headaches start threatening, I up the oil and that usually takes care of it.

    Thomas, I am so happy for you. I hope it gets better and better.

  6. Beautiful story Paul. As time goes buy and the knowledge of your work progresses, I am sure there will be only more of these success stories to come. Excellent work as always.

  7. As I recall from Dr. Lustig’s lecture, the liver, wanting to get toxic ethanol out of the bloodstream, very quickly metabolizes it into glycogen. Might there be a connection between Tom’s brain hypoglecemia and his craving for alcohol, a fast-acting source of blood glucose?
    As I have witnessed, when alcoholics are withdrawing, they crave candy, sugary soft drinks, etc.

  8. Thank you for the very interesting post.

    I am curious about the relationship between brain infections (are they generally bacterial rather than fungal?) and the fungal infections of the gut often discussed in the comments of this blog.

    Someone suspecting both types of infections simultaneously might want to try a ketogenic version of the PHD to attack the brain infection, but you have recommended that people with candida infections avoid ketosis. Generally speaking, what would be a sensible approach for people with both types of infections (bacteria in the brain and candida in the gut)? Could a fungal infection by itself also cause the common symptoms of a bacterial infection of the brain (hypoglycemia and serotonin deficiency)?

    Best of luck to Thomas and all other PHDers with similar challenges.

    Sincerely,
    Vincent

  9. Hi Morris,

    Those are fascinating experiments you are doing.

    I’m still surprised at the blood glucose drop you have in your periphery. Typical glucose drops during circulation are 5% (http://www.ncbi.nlm.nih.gov/pubmed/21463548). It’s hard for me to imagine what could pull so much glucose out of your blood as it transits the arm. GAG condensation is an interesting idea, but with every heartbeat?

    Flexing the joints should stimulate healing, and it’s very pleasing that the exercises are working so well.

    Hi Ellen,

    Well, memory loss was a major symptom of my infection, and my memory got much better as soon as I started antibiotics. So I think bacterial activity must have been responsible in my case.

    In general, any loss of energy to neurons can cause memory loss. So mitochondrial damage, and loss of transport of mitochondria to the extremities of neurons, can also cause memory loss.

    Personally, I don’t consider memory loss a normal part of aging. It is a pathology. It may be inevitable that pathologies are more frequent among the elderly than the young, but that doesn’t mean memory loss is inevitable – or untreatable.

  10. Hi Andreas,

    That’s great news! I’m glad you’re doing well.

    For alternative ways to support ketosis, I think Kate’s advice to try MCTs is good. Also you can take some leucine daily, this is also ketogenic. Finally, you can experiment with quantities to see how different amounts affect your mood. Perhaps less coconut oil will work as well.

    It sounds like you’re already on the ketogenic version of our diet, just with slight alterations in quantities!

    Hi Peter,

    I think Thomas no longer drinks much alcohol – he was doing that when he contracted his disease.

    I am not sure that alcohol-induced hypoglycemia is the reason alcohol promotes infection, although it might because hypoglycemia increases permeability of the blood-brain barrier (http://www.ncbi.nlm.nih.gov/pubmed/21619558).

    More likely the issue is that although most alcohol gets metabolized in the liver, something like 20% of it gets metabolized in the brain. And alcohol may be very effective at feeding brain infections, as many pathogens can metabolize it or the products of its metabolism.

    Alcohol is metabolized like a sugar, very much like fructose, so candies are a close substitute for alcohol cravings.

  11. Hi Vincent,

    Multiple infections is indeed a problem. The optimal diet for one may exacerbate the other. I have had this issue myself, with a bacterial brain infection and systemic Candida infection.

    In my case the brain infection was disabling so I went after that first, and now that that’s gone (symptom-wise anyway) I’m focusing on Candida.

    I don’t think fungal infections commonly cause these brain problems, although new research has come out indicating that Candida can infect the brain and alter behavior. But it seems that bacteria, viruses, and some protozoa such as Toxoplasma gondii are more common sources of brain infection.

    And no, I think the eukaryotic pathogens would have different symptoms. The bacteria and viruses are more parasitic, they don’t do much other than steal resources. The fungi and protozoa are more dangerous, perhaps why they tend to cause more acute symptoms. But I will have to look more into what their effects might be.

    Best, Paul

  12. “But it seems that bacteria, viruses, and some protozoa such as Toxoplasma gondii are more common sources of brain infection.”

    bingo. In my case.

    What kind of antibiotics did you take Paul? I’m seeing my doc tomorrow and I’d like to discuss this with her.

  13. Also– can I jump right into antibiotic therapy if my doctor approves? or would you recommend the ketogenic approach first and then antibiotics?
    Thanks, as always Paul. Looking forward to Saturday!

  14. Hi Ellen,

    I just used doxycycline which seemed to work fine in my case. Combination protocols have a better success rate at fully clearing infections. I think diet may be worth 2 antibiotics, diet + doxy beats 3 antibiotics.

    I would normally recommend adopting intermittent fasting with a bit of MCT oil or coconut oil during the fast. I think it’s best not to change two things at the same time, that makes it easier to see effects. The antibiotics will work best if you’re in ketosis part of the time (assuming it’s a bacterial infection). So I would recommend starting intermittent fasting and/or ketogenic dieting first, then antibiotics. But you may be able to follow up with antibiotics fairly quickly.

  15. Thanks Paul. So– the fasting, intermittent and ketogenic dieting… for about how long before starting antibiotics? days, weeks or months?

  16. Hi Ellen,

    I think the main thing is to feel that you are stable in how you feel day to day and will be sensitive to whether the antibiotics are having an effect, and what that effect is.

    If you’ve been eating our diet for a while, you may not need very long on a more ketogenic program to feel stable. But go by how you feel.

  17. Gotcha! thanks.

  18. Dear Paul,

    here is my recipe for cappuccino for those who can tolerate grass-fed heavy cream. I can get down a lot of coconut oil with this one.

    melt coconut oil (I use 2-3 tablespoons)
    add heavy cream (as little or as much as you need to make the coconut oil palatable, more cream = more froth)
    whip together with a stick blender
    add coffee (decaf if needed)

  19. Hi Paul
    Thanks for the reply. I too disbelieved the apparent variation in BG and changed BG monitors and got about the same results although sometimes there was only minimal difference (instrument artifact?). I am unable to find the review article re blood circulation rates and gluscose level variation which suggested that under stimulated conditions (I think insulin was used)highly variable levels were locally detected. Most papers I saw suggest arterial, venous or capillary test sites give essentially same results for fasting BG as you say. Glucose meter instructions recommend against finger as test site if hypoglycemia is indicated. I wrote to Abbot Labs but received no reply about possibility of such occurences. Don’t understand your comment re GAG’s and every heartbeat.

  20. Rene,

    That’s a great idea, I’m going to try it. I drink coffee with heavy cream in the morning anyway.

    For anyone out there trying to pound down 8-12 tablespoons of coconut oil a day, I would like to add to my previous comment a recommendation for tropical traditions expeller-pressed steam deodorized coconut oil. http://www.tropicaltraditions.com/expeller-pressed_coconut_oil.htm As much as I like the taste of coconut, when it flavors everything it quickly became nauseating. The above oil is completely neutral in flavor.
    I saute meat, veggies, and safe starches in this and everything turns out great. You can add whatever herbs, spices, garlic et al. that you want.

  21. Thanks very much for your reply, Paul.

  22. so i followed the links back to the post that thomas commented on originally and all i read about was SSRIs. what about NDRIs like bupropion? i’ve struggled with similar issues my whole life, taken many many medications. SSRIs would work for the first 2 weeks and then all my issues would come back even stronger. i started taking bupropion about 2 years ago and haven’t looked back. i understand the complexity of allostatic balance in the body-mind(neurotransmitter balance and external influences, like diet or infection), but what about dopamine? how does it interact in all of this infection business? i’ve been researching the role of inflammation in mental disorders (as well as gut dysbiosis) but i haven’t read much about the role of dopamine in this complicated pathway of sorts.

  23. Paul:

    Have you considered writing an article specifically on your recommendations for Toxoplasma infection, since it’s so common?

    JS

  24. Hi Paul,

    For those with infections that decrease blood cholesterol, should’t a diet high in cholesterol (with lots of eggs yolks) recommended? It seems to work very well with tuberculosis:

    http://pmid.us/15706008

    On a side note: Ricardo is, saddly, closing his amazing Canibais e Reis blog. I urge anyone who has benefited from his blog to write a farewell to him at:

    http://www.canibaisereis.com/2011/07/21/encerramento-deste-blogue-o-ultimo-artigo/

    Mario.

  25. Hi Morris,

    It is mysterious. My comment about heartbeats was that the blood circulates fairly rapidly, so any removal of glucose has to happen fairly rapidly too.

    Hi daniel,

    It’s a good question but that’s an area I have to research. I know from Emily Deans that some microbes can affect dopamine and norepinephrine, but I haven’t looked into the matter. All bacteria and viruses will affect serotonin, so it’s more of a universal symptom. I’m not aware that my personal infection affected norepinephrine or dopamine, so I never had occasion to look into it. Fascinating subject however.

    Hi JS,

    Yes, it’s a great subject, but I figured I’d do Candida first as an introduction to eukaryotic pathogens. Figuring out what to do about protozoa is still a research problem for me.

    Hi Mario,

    In most cases yes, eating cholesterol should support immunity, but Candida may be the exception, as Candida seems to benefit from cholesterol.

    So sorry to hear that we’re losing O Primitivo, but hopefully the freed time will do him good. Perhaps we can get a guest post out of him once in a while.

  26. Hi Paul,

    Speaking of doxycycline, that’s what my dermatologist puts me on when I have a rosacea flare-up. (I’ve been on and off doxy for at least 8 years now.) However, I’m of the opinion that this kills off the “good” bacteria in my stomach, and ultimately exacerbates the rosacea problem (by negatively impacting gut health, digestion, etc).

    I know you have (had?) rosacea as well; what are your thoughts on this? I’ve tried simply relying on diet to treat it, but I saw no decrease in bumps/pustules even after a few weeks. (And it’s extremely stressful feeling I *have* to be that restrictive.)

    At any rate, your thoughts on rosacea treatment and long-term antibiotic use would be greatly appreciated!

  27. Hi Vanessa,

    Rosacea is a complex condition but I’ve come to the conclusion that in my case, (systemic/vascular) Candida is a key cause of diffuse redness and circulating toxins originating from the gut are responsible acne/bumps/pustules/flushing.

    I would try cholestyramine (or, over the counter, bentonite clay or charcoal) to reduce circulating toxin levels, and then antifungals.

    Doxy can provide transient help, partly via antiinflammatory mechanisms and partly by moderating bacterial co-infections, but if the cause is Candida, doesn’t get at fundamental causes and can make rosacea worse in the long run.

    But rosacea seems to be a somewhat diverse condition which can be brought on by multiple pathogens, so I don’t know if this guidance is appropriate for everyone.

    In my case, rosacea began during a long course of antibiotics and I think this is a fairly common occurrence. It suggests Candida as a cause.

    Best, Paul

  28. Paul –

    For how long do you think someone with depression would need to continue on antibiotics and keto diet? And perhaps more important, do you have any suggestions for how to obtain the antibiotics, given that many doctors will be reluctant to prescribe for An unconventional treatment like this?

  29. Thanks for the fast reply, Paul! You’re very helpful. I have a moderate flare right now, and I need to be clear a week from now, so I’m on the fence about going on doxycycline to get a “quick fix,” or trying charcoal. If you have any thoughts as to which would be the better option, I’d appreciate hearing them, but if not, you’ve been more than helpful enough already!

    Thanks again. (I’d already considered Candida, actually, and found that after my last round of doxy, taking Threelac [anti-candida product] did seem to help. Unfortunately it has canola oil and fructose, but you take the good with the bad, I suppose.)

    One lats question: What type of antifungal do you recommend?

    Thanks a million, really,
    Vanessa

  30. Hi Straw,

    I have no personal or direct experience with depression, so it’s hard to say. You might notice an effect very quickly. If you haven’t noticed anything within 2-4 weeks, I would stop the antibiotics and look elsewhere. If you do notice improvement, then I would continue until symptoms clear plus a month longer, perhaps adding in another antibiotic because combination protocols usually work better.

    It is tricky to get antibiotics out of doctors. In my case I was helped by my Candida co-infection. That produced a urinary tract infection, evidenced by dead white blood cells, and while my doctor was reluctant to give antibiotics for cognitive symptoms of unknown cause that he had no tests to measure, the UTI gave him a defensible cover (“I was just prescribing the antibiotics for the UTI”). So if you have any other kind of infectious symptom that could plausibly be ascribed to bacteria, that may help your doctor give the prescription.

    Hi Vanessa,

    Go for the charcoal. Cholestyramine is even better if you can get a prescription. From the medical literature bentonite clay is probably also better than charcoal, but I have no personal experience with it.

    Antifungals – nystatin and fluconazole are the prescriptions of choice, because they have the least toxicity. Chinese medicine has also worked well for me, many plants contain antifungal compounds.

  31. Paul- I’m so sorry. I see a lot of my questions were addressed in your entry above. See? I did read it but I didn’t retain anything 🙁

  32. For those looking to add more palatable forms of coconut oil into their diet try adding a few (liquid) tablespoons of CO over frozen blueberries-or any frozen fruit-and stirring quickly so as to coat the berries moderately. Obviously not for a fast but quite a sweet little treat for dessert during the dog days.

  33. Thanks to Kate and everyone else for their kind words and well wishes- they are much appreciated. And thanks as always for you help, Paul- you are a gentleman and a scholar.

    Andreas, I too dislike coconut oil, both for its taste and texture. I aim for 12+ tablespoons a day by drinking four large mugs of hot water with 3 tbsps of refined coconut oil. (I used to have 4 mugs of tea but it stains my teeth too much). The texture is still unpleasant, but much better than the alternatives. Also, I always have the coconut oil with a little bit of food like some cheese because having a lot of oil on an empty stomach is tough for me. And I cook most meat in a lot of coconut oil to get a little more than way.

    Ellen, I know very little about the subject, but IIRC there are a number of studies showing the adverse effects of stress on memory. I think the hippocampus part of the brain can actually shrink as a result of too much stress/cortisol.

    Paul, when you state “One of my crucial steps forward was when I recognized that I had the cognitive symptoms of hypoglycemia when my blood sugar was normal. I could relieve the symptoms if my blood sugar became highly elevated,” it made me think of the relief I get from my symptoms when I have alcohol. I seldom drink anymore, especially since starting the ketogenic version of PHD, but when I do I temporarily improve. Just takes 2-3 beers, and it’s been that way for years. I wonder if there is any relationship between that improvement and the phenomenon you describe in your quote above, or whether perhaps my temporary improvement might be due to alchol’s effects on GABA.

    And thanks for the chocolate chip cookie recipe! If there’s one food I miss since starting PHD it’s CC cookies.

  34. With a history of alcohol abuse, memory problems and anhedonia, I suspect a possible brain infection. But my symptoms are not acute and I am not wanting to experiment with antibiotics. Will just the ketogenic diet and perhaps some nutrients or herbs be effective over time? Are their any herbs you would recommend? Thanks, Sue

  35. Hi Susan,

    I’m not aware of any herbs that are useful against brain infections. The blood-brain barrier shields the brain from most plant compounds.

    A ketogenic diet should help, and should be the first step. Whether it will be enough by itself, I don’t know. Maybe.

    If a few months of ketogenic dieting has not made a significant improvement, I think you should consider a short (1 week) trial of doxycycline. You may notice an immediate improvement in mood. If so that would have great diagnostic value.

    Best, Paul

  36. “I often stutter or stumble over words (again, for about 10 years now), which usually goes away only with two or three alcoholic drinks. But the speech problems stopped almost completely during the fast, which makes me thing that there is some link to anxiety and stuttering.”

    Alcohol is metabolized like fructose, not like other sugars. It’s metabolized into ketones. Interesting that a ketogenic diet would have the same effect on the brain as alcohol, but I suppose it makes sense. If bacteria are competing with neurons for glucose, than providing an alternate substrate to the neurons should allow them to resume normal functioning.

    I’ve thought a bit that this might explain some cases of alcoholism, that it’s an alternative source of ketones… But this is the first time I’ve ever heard of a person deriving the same therapeutic benefit from a ketogenic diet or alcohol…

    Apparently it’s not uncommon for alcohol to have this effect:

    http://www.sciencedirect.com/science/article/pii/S0741832997001109

  37. Thank you, Tuck. That’s a great point, a valuable insight. I think you’re right, it may explain some cases of alcoholism.

    A lot of people with brain infections become glucose drink addicts, since elevated blood sugar also relieves the hypoglycemia. It makes sense that alcohol would work similarly.

  38. I also would also say that at this point when I have a strong craving for alcohol it seems like a very physiological hunger coming from my brain. It is often accompanied by a mania type state of mind. I call it crazy brain and it subsides within a couple drinks. Is crazy brain really maybe hungry brain?

    If alcohol makes the brain more susceptible to infections, then the relief is also making the problem worse, which is pretty much the addict’s situation. If this is common, and it can be explored, it could save countless lives. ~Sue

  39. “Is crazy brain really maybe hungry brain?”

    That is my hypothesis. Alcohol is known as “liquid fat”… I make sure I’m getting enough animal fats in my diet. Coconut oil’s probably a good idea also…

  40. When I had my brain infection I became addicted to Coca Cola. Perhaps alcohol would have worked as well, but it wasn’t available in the vending machines at my workplaces.

    Susan, it’s an interesting idea that antibiotics might be an under-appreciated therapy for alcohol addiction. Wouldn’t surprise me a bit if it worked in some people.

  41. Since so many people, especially elderly and addicts, seem to have brain infection symptoms, would you recommend a course of the doxycycline for these people in general? I also have rosacea, so this seems another common piece of the puzzle.

    You mentioned a one week trial of the doxycycline for me, what dosage would this be? If I notice any effect, how long do I then continue the doxy? Is a high dose course of probiotics necessary after this?

    Thanks so much, this is fascinating, and of course, gives one hope…Sue

  42. And when you say “addicts”, include food addicts. I would bet that this is also the problem for a subset of obese people who try every diet and self help group out there but always end up binging on carbs. Then on top of being fat they hate themselves for lack of control

  43. Hi Susan,

    Yes, I would recommend a course of antibiotics for anyone with possible symptoms of brain infection. It has a big potential payoff at little risk.

    I would try 200 mg/day doxy, maybe 100 mg twice a day. It’s possible to do 100 mg/day but I think for diagnosis, best to try a higher dose, make it easier to detect if it’s having an effect.

    If it works then you have to work with your doctor to try to figure out the likely pathogen, whether other antibiotics might work better, whether a combination protocol is desirable, those sorts of things.

    You should also be monitoring biomarkers through the process. For instance, C. pneumoniae infects white blood cells (which is how it travels to the rest of the body including the brain, monocytes are precursors to brain microglia cells) and often on starting antibiotics your white blood cell will drop, bottoming at 7-10 days after starting. So a CBC just before starting antibiotics and 10 days in is a good diagnostic tool for C pn. Any biomarkers of chronic disease that you may have are worth monitoring too.

    You should take probiotics during and after antibiotics. During antibiotics you just want large numbers of bacteria, type doesn’t matter much, so go for the cheapest source of high numbers. Critical Care may be a good choice. After antibiotics numbers don’t matter but diversity of species does. So something like Primal Defense is good, plus other odd species. Fermented vegetables like kimchi are good throughout. Yogurt is good.

    Hi Ellen,

    Great point. Yes, it’s very possible that often people engage in “bad” behavior because in some way it is “good” for them, or seems so.

    Best, Paul

  44. If the loss of energy to neurons can induce cognitive impairment, might a lack of energy in the hair cells of the cochlea be a cause of acquired sensorineural hearing loss conditions not resulting from noise exposure (e.g., presbycusis and Ménière’s disease)?

    Poor hearing at the high and low frequencies is an issue I’ve been dealing with since my teenage years, and which seemed to abate quite rapidly after a few weeks on a hypocaloric/subnutritious fruit diet, returning shortly after resuming normal eating. More than ever, this symptom–together with the others, some of them described in the first long paragraph here (the potato was a red herring)–now seems to me to have its genesis in infection, my vegan experiment producing a result somewhat similar to Paul’s experience with antibiotics. During my high school and college years I was excessively reliant on Coca-Cola, too; in the past few years Coke-free I’ve had more stable mentation–no more slurring words, for example–but at a level where I still struggle to concentrate, think clearly, etc., even as my general health has improved considerably. My weight and body composition in particular have never been better, despite my eating an average of 2800 kcals/day this year with little activity besides walking (I had previously been quite small).

    Other evidence that seems to indicate a body dealing with infection are a TSH of 3.2, and the dry eyes and mouth, which may be symptomatic of depleted vitamin C. My next steps are to begin to supplement iodine and C, as well as to do a 36-hour fast at least three times a month instead of once in a blue moon. Antibiotics may come after that.

    Does it sound like I’m on the right track? Chronic infection as a cause seems almost too good to be true, but, to simplify things, with an unhealthy diet (raw veganism) making me feel awesome and a perfect diet making me feel OK (not miserable, though with significant fatigue and cognitive deficits) despite objectively greater health, what else could it be?

  45. Hi Gary,

    There doesn’t seem to be a strong case for hypoglycemia causing hearing loss. See http://forums.webmd.com/.eec063e, http://www.ncbi.nlm.nih.gov/pubmed/5472677, http://www.ncbi.nlm.nih.gov/pubmed/17493401 for some weak evidence.

    There’s better evidence for the hyperinsulinemia of Meniere’s causing hearing loss. Eg http://www.ncbi.nlm.nih.gov/pubmed/15645695, http://www.ncbi.nlm.nih.gov/pubmed/14964957, http://www.ncbi.nlm.nih.gov/pubmed/10753400.

    Your symptoms do sound like an infection. It’s common for the body’s health to improve greatly as the diet improves, while the brain is unaffected. This is because the brain is a metabolically controlled environment. Nutrition entering the brain is the same whether the diet is good or bad, to a close approximation. Really, a ketogenic diet is the only diet that will tend to produce significant brain changes.

    Elevated TSH and mild hypothyroid symptoms are often caused by infection, but don’t guarantee that an infection exists. Dry eyes and dry mouth — I assume you read this post: http://perfecthealthdiet.com/?p=1077. Yes, vitamin C deficiency could be a cause.

    Fasting is a good idea if your infections are bacterial or viral, a bad idea if they are fungal or protozoal. I suspect most brain infections are bacterial or viral, but don’t have data.

    Fatigue is usually caused by immune activity which can sometimes be brought about by toxins entering the body from the gut. That could explain why a vegan diet could help, because if it was low-fat (eg macrobiotic) then it might bring fewer toxins into the body.

    Overall, I would tend to agree with you – it’s almost certainly a chronic infection of some kind – and fasting and then antibiotics is a worthy experiment that might fix the problem. But there are still a lot of variables to explore.

  46. Paul,

    Aha! More likely to have contributed to my hearing loss are cardiovascular issues, of which I had plenty before adopting a PH Diet (namely high blood pressure, which also resulted in an enlarged left ventricle, diagnosed this year).

    Your comments are appreciated — and thanks especially for your and Shou-Ching’s brilliant book and website. With them in mind and put to practice, I hope to update you in three to 12 months with news that this business is behind me.

    But, this being a health blog and all, I’ll cut short my dilettante conjecture and rambling in the name of your readers’ well-being…

    Thanks again,

    Gary

  47. Thanks for the link, Tuck. That is really interesting and would explain a lot. I guess if the ketogenic diet/antibiotic don’t work for me I can always go with Plan B and resume being a drunk 🙂

  48. Hi people,
    i have a brain infection which my Dr is totally ignoring, i have a disease called melidosis and spread to every part of my body and i actually do not know how i am still alive, blood test in thailand found disease, gram negative bacteria, and bone scan found infection in skull, thing is it makes biofilms so no antibiotics work! i must have tried over 10 different types now, only thing thats helped me is enzymes to dissolve the biofilms and it also kills the infection, one enzyme i use is protease, digests any protein, which pathogens are mostly protein.

    My disease has caused me panic attacks and major anxiety, i found out through one amazing test i did that the bacteria pathway is, protein, and it terns into nor-epinephrine and dopamine, and i had seriously high amounts! many times i been in and out of hospital with light sensitivity and ridged neck, could not swollow or un-hunch my self, just waiting to die, at the under my skull i felt burning like fire was under my skull.

    Anyways i do not trust hospitals any more they seen all my medical reports and refused to treat me,

    i have had more amazing success on my enzymes than any antibiotic i have ever been on due to its ability to dissolve bio-films.

    My question is, enzymes do not cross bbb so how could i eradicate an infection in the brain that biofilms?
    I do use a low dose h202 which does miracles but does nothing to biofilms!
    Many thanks!

  49. Hi Ljayne,

    So sorry to hear about your trouble. The good thing at least is that you have a diagnosis – Burkholderia mallei or pseudomallei. It’s very valuable to know your pathogen.

    There are treatments. This free full access paper reviews them: http://www.ncbi.nlm.nih.gov/pubmed/15831829. Antibiotics will help even if the pathogen forms biofilms.

    I think you need to find a doctor who can confirm the diagnosis and prescribe treatment. Especially because this particular infection is contagious and dangerous to others as well as yourself.

    As far as brain infections go, ketogenic dieting, eating spinach (for nitrates), and supplementing iodine can help. But it is hard without antibiotics.

    Best, Paul

  50. Many thanks for your relpy,
    Yes i was diagnosed and treated in Thailand, i was on correct meds IV for a whole 6 months but it would not eradicate it, it was still in all my bones! I has seen many Drs and they said nothing i can do. So now i am on My enzymes and Earthworm enzyme is helping amazingly plus i use some H202, now i will also add in this Diet you explained.

    I have had better results on my own treatment than these antibiotics i was given!

    many thanks again!

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