Love’s Labors Lost

One of my favorite writers is Elizabeth Scalia, “The Anchoress,” now a blogger for First Things. She has long suffered from a condition diagnosed as lupus, an autoimmune disease, but now after many years has been discovered to have Lyme disease. Lyme is a treatable infectious condition. Elizabeth writes:

A too-long-undiagnosed bout with Lyme Disease has left me challenged with arthritis and some neurological damage. The arthritis has its uses: I can predict rain, and the pain gives me something to offer up in prayer, or as penance.

Not so the neurological issues. At the peak of my illness I was unable to figure out how to do the dishes; my organizational skills have never fully recovered, and verbally I sometimes wander into strange lands, referring to cereal as cookies, or to hats as helmets.

Regular readers of this blog will know that I am not surprised that an “autoimmune” disease has turned out to be an infectious disease. Autoimmunity (where it genuinely exists – chronic infections are often misdiagnosed as autoimmune conditions even where no autoimmunity is present) seems to be mainly a side effect of chronic infections – collateral damage in a guerilla war with pathogens that conceal themselves behind human “cellular shields.”

Antibodies against the thyroid and gut engendered by gluten disappear within six months after cessation of wheat eating. [1, 2] I suspect that most autoantibodies engendered by pathogens will disappear on similar time scales once the underlying infection is cured.

I have previously written of my conviction that Alzheimer’s is an infectious disease. This conviction that grew out of my own experience: I had a 17-year chronic illness characterized by increasingly severe and embarrassing memory loss. At its worst I could not remember a friend with whom I had shared a small office for a year, and could not write (because I could not remember the previous paragraph when starting a new one, nor recall illustrative examples). The whole illness was cured by diet and antibiotics, and my memory is back to normal. I suspect that nearly all cases of Alzheimer’s can be cured by the same methods (the most important of which can be found here).

Elizabeth writes of the effect these diseases can have on a marriage:

CBS News correspondent Barry Petersen recently filed a report on the early-onset Alzheimer’s that began affecting his wife, Jan Chorlton, at the age of forty. It is an undeniably moving story; after introducing the viewer to images of the beautiful and lively Chorlton, the report shows us Petersen’s sixty-year old, still-beautiful wife, now living in what appears to be a top-notch assisted-living facility. She is unable to sustain simple conversation or to recognize her husband. Chorlton talks of a man she will always love, while Petersen openly weeps. When he asks his wife if she can name that man, she giggles, “Mr. Happy.”

Medical experts are introduced and they declare that there is no treatment for Alzheimer’s Disease, and no way to prevent it. In the near-future, we are told, sixteen million Americans will be diagnosed with Alzheimer’s Disease.

Petersen reveals that he is now in a relationship with a widow; they live together, and they both love Jan in what one of them calls “this very peculiar new American family.” The piece closes challenging anyone to gainsay them, who has not walked in their shoes.

But, was it not precisely for such situations that marriage vows were designed? “For better, for worse, for richer, for poorer, in sickness and in health, together or apart.” Love, which is limitless, is supposed to be strong enough – even if we do not think we are – to survive these challenges.

One of the saddest aspects of chronic illness is the damage it can do to marriages. A perusal of chronic disease message boards, like the one I followed at, can easily turn up tales of disease sufferers abandoned by their spouses.

It terrifies me to consider where I would be had I not had the persistent support of a loving wife. It is hard to believe I could have recovered without her.

Our motive for writing The Perfect Health Diet is to help people regain and maintain good health – to create healthy centenarians. But perhaps one side effect will be to save a few marriages – to encourage “Mr Happy” to be “Mr Persistent-In-Love.”

Caring for a chronically ill spouse is a labor of love. The laborer deserves his wage, and love deserves its reward. If there is one bit of advice that is more important than any other, in marriage and in disease, it is this: Don’t give up! Don’t ever give up!


[1] Berti I et al. Usefulness of screening program for celiac disease in autoimmune thyroiditis. Dig Dis Sci. 2000 Feb;45(2):403-6.

[2] Mainardi E et al. Thyroid-related autoantibodies and celiac disease: a role for a gluten-free diet? J Clin Gastroenterol. 2002 Sep;35(3):245-8.

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  1. Paul: In your link, you discuss a 36-hour ketogenic fast. I’m going to give this a try, but I have some questions. Was this a part of your own cure? How long/often did you do it? Are there any scientific or other references that this is effective for chronic problems like yours (and mine)? Thanks.

  2. Hi Dennis,

    Excellent question. I have a complicated history with fasting.

    The ketogenic fast is great against bacterial infections such as those that cause Alzheimer’s, but risky with fungal/Candida infections, because the anti-fungal immune response consumes a lot of glucose/glycogen which should be met with dietary starches.

    I had both types of infection. (This is fairly common, most people have co-infections, and gut damage from fungal overgrowth often precedes and enables systemic bacterial infections. Intracellular bacteria can penetrate a leaky gut, infect macrophages in the gut lining, and be carried by immune cells around the body.)

    In 2007 for about a year I did regular 36-hour fasts, one every two weeks, but without the coconut oil that I now recommend. This ended up backfiring for several reasons:
    (1) The main problem was that I was eating a too low-carb diet in between the fasts, so I wasn’t restocking glycogen. I should have been including starches, like the 300-400 calories of starch daily that we now recommend. I was eating a lot of vegetables, but as I now know they contribute hardly any glucose to the diet. I was eating what I considered to be the standard low-carb Paleo diet, but it was too low-carb.
    (2) The absence of the coconut oil during the fasts also contributed to glycogen depletion. Coconut oil is neuroprotective and actually improves the anti-bacterial efficacy of the fast.
    (3) At the time I wasn’t supplementing with vitamin C which is depleted on extreme low-carb diets. Someone without an infection can get away with this, but fungal and bacterial infections also deplete vitamin C.

    So the fasting helped in some ways but, combined with the too-low-carb diet, ultimately led to both an infection-induced scurvy and bloating of my bowel and gallbladder impairment from fungal overgrowth.

    At that point I stepped back, sifted through the literature and tried to really understand the biology. That process led to the first draft of our diet book in 2008, and inclusion of starches in the diet. By 2008 the diet was nearly optimized, and by 2009 I had nutritional supplements nearly right.

    For a while I didn’t dare fast, but then began again in late 2009. I believe it has contributed significantly to my recovery, though antibiotics had the most substantial effect at restoring my memory.

    My current practice is to have a daily 17-hour fast with only coffee and cream during that period; I eat solid food only between 2 pm and 9 pm. I also occasionally do the 36-hour fast with coconut oil — once or so per month, will probably increase that to twice per month. So I think I’m doing a fair amount to stimulate autophagy.

    Now that I’m including coconut oil, vitamin C, glutathione, good starch intake between fasts, iodine, and selenium supplementation, my fungal symptoms have receded and everything keeps getting better.

    As far as cognitive symptoms, they have been gone since February. I found in March that I could bring them back with high-dose niacinamide supplementation — NAD+ is a rate-limiting factor in bacterial metabolism. Stopping niacinamide caused those symptoms to disappear over a week or two. So the infection was still there, just at a low level. I don’t want to repeat that experiment often, so I am continuing with the fasting and other techniques and will try the niacin test again maybe next year. If I can still revive the symptoms then, I will ask for another round of antibiotics.

    But I really haven’t had any symptoms since that niacin test in March, and my general health keeps improving noticeably month-on-month, so I believe the fasting is benefiting me.

    Yes, there is a large scientific literature in support of fasting and autophagy promotion. When I did the “Eleven Steps” post I planned a series of 11 posts, spelling out in detail the scientific literature behind each step. I will still do that, but probably not until September – I am focused now on getting the book out. But if you can’t wait, here are a few links:

    Keep in touch and let me know how things go with you. As my 2007 experience shows, there are some pitfalls that it’s easy to fall into.

  3. Interesting point on the Alzheimer issue. While I believe it can be prevented by a proper diet and lifestyle, I still have not make up my mind on the underlying causes. But like what you said, infection could be a trigger or one of the cause(s).

    I see that you recommend vitamin C supplement. According to this study:
    Antioxidants like vitamin C can prevent the benefits of exercise. But do you think it could be useful if we are following a low carb diet and suffering from infection?

    • Hi Daniel,

      I’ll have another post in a week or two on evidence for C. pneumoniae as the primary cause of Alzheimer’s.

      Regarding vitamin C, I’m aware of the downsides. I suspect intermittent vitamin C supplementation may be optimal for that reason (i.e. one month on, one month off). But overall, the disadvantages of high doses of C are small and the disadvantages of C deficiencies are immense (potentially life-threatening), so risk-reward ratio favors supplementation. Exactly what dose/pattern is optimal is still an open research issue of course.

      And yes, infections make a stronger case for vitamin C, as does low-carb (below 400 calories/day glucose).

      Best, Paul

  4. Great! Looking forward to that post, Paul. My current view is our increasing intake of statins, low fat food and toxins are the major causes but I am open to new ideas.

  5. Hi Paul, I haven’t seen this information on the blog (unless I missed it) and it wasn’t mentioned in the book. Do you know what your bacterial infection was? What antibiotic did it respond to?

    Did you take/consider taking antifungals?


  6. Hi Yves,

    Probably Chlamydophila pneumoniae. Doxycycline worked great. Yes, I’ve taken fluconazole but Chinese medicine seems to have made the biggest difference.

  7. Thank you for the response. I found I responded better to nystatin than fluconazole myself. I have a long history of brain/neurological/sleep problems (migraines, memory, cognition, mood, insomnia, sleep apnea, etc.). I was hoping some of these things would clear up by getting rid of GI infections (fungal and protazoa). They infections are gone now and my digestive problems in remission, but I’ve only achieved moderate relief on other fronts.

    Low-ish carb and following reccomendations in the book help for sure, but I am looking at potential infections to go after. Based on my history, babesia or bartonella are high on the list (tick and cat exposure) or t. gondii (raw meat consumption), but I’m looking for other possible culprits. Unfortunately testing can be pricey for infections. C. pneumoniae is $350 for example (link below) and testing not always fool proof..

    On another thread you mentioned Niacin flared up your infection. Recently I took a small, single dose of 10mg and actually seemed a bit calmer. I would need to experiment more, but do you think niacin supplementation could act as a proxy for determining if one is dealing with a bacteria infection? High carbohydrate consumption make all congntive issues much worse. I did go ketogenic some years ago for a short period and felt euphoric at first, eventually it just led to fatigue and weight gain.

    Doxycycline is used against tick borne infections too so it may be something I try… I am considering experimenting with LDN and supra normal vit. D first to avoid causing any gut problems with antibiotic use.

    Huge cheers for the book/blog. I think you are light years ahead on identifying the significance of pathogens in chronic disease.


  8. Hi Yves,

    Getting rid of GI fungi and protozoa was a good thing to do, it can only help. But I think gut problems cause peripheral symptoms mainly due to circulating toxins which don’t usually cross the blood-brain barrier, so cognitive/CNS symptoms are usually due to infections in the brain itself.

    You’re right that testing is far from foolproof. You can get false negatives, and if you get a positive you still don’t know if it caused your disease.

    10 mg is such a small dose of niacin, perhaps your response was a placebo effect. Multivitamins have 20 mg and I tried 300 mg/day. Some doctors recommend gram doses.

    Niacin might be a diagnostic tool, in that it probably helps against most viral infections but hurts against most bacterial infections, but I’d say the evidence is too limited at this point. Effects of high-dose niacin on infections are really unknown.

    You’re right to try an experimental approach. I wouldn’t worry about testing doxy for 10 days or so, you may notice an immediate effect as Tim and I did (

    Thanks for the cheers!

    Best, Paul

  9. Paul, thanks for the comments. Great timing on the latest post too! I can relate to the general feeling of loss of happiness, yet not “depressed” per se, with an underlying anger/irritation that is kept under the surface. A few years of SSRIs a decade ago I’m sure cemented the infection. Over the years the worse has always been the decline in cognitive function; stealing away from both professional (I’m an engineer) and personal pursuits. There is a real joy to be had to experience the world with the beauty and knowledge it has to offer with the full function of a healthy brain. The stories of improvements from chronic suffers are very inspiring.


  10. Hi,

    I’m a Ph.D. scientist with degrees in biochemistry and nutrition. Since graduation, I’ve worked primarily in the area of host defense peptide biology at UCI and UCLA, though nutrition is still one of my hobbies (I’m forever experimenting on myself).

    I’ve been very interested in your blog and this thread in particular, as I (as well as my daughter and one son) contracted Lyme disease at a family camp in 2008. We’ve also tested positive for a number of co-infections, babesia, ehrlichia etc. While I figured out I was infected and began treatment very early (day 19), my case has been severe. Even with uninterrupted antibiotics, including an early 90-day course of IV ceftriaxone, I’ve never been able to stop antibiotics without relapse (exhaustion, cough, cognitive problems, headaches and neck pain) for more than four days.

    I was recently trying to help someone break through a weight loss plateau, and tried the fat fast (ketogenic diet) on myself. While I did loose some weight, (I was about 5 lbs over my ideal), I noticed a very significant cognitive effect. My verbal fluency went way up (no more writers block with research papers!), and I felt like my IQ may have jumped some as well (I’ve been writing grants sort-of non-stop since starting the diet – a first for me since my post-doctoral days).

    Anyhow, while I’d be interested to hear if you had any enhancements in cognitive function with the ketogenic diet (actually there is a paper supporting this phenomenon in Alzheimer’s patients), I’m most interested in your hypothesis regarding the effect of this diet, combined with fasting, as a mechanism for combating neurological bacterial infections. I’ve currently been in mild “ketosis” for about 6 weeks, and my typical Lyme induced neurological issues are significantly diminished. My short term memory is nearly normal right now, and as described above verbal fluency is excellent (no incorrect word substitutions) also physico-cognitive errors, grabbing incorrect objects, etc. are now gone as well. I find these improvements to be nothing short of remarkable. And as so many individuals are severely debilitated by Lyme, I wonder if the ketogenic diet should be recommended for this population in general.

    I’m curious about your determination that your infection was likely due to Chlamydophila pneumoniae, as the cognitive symptoms you describe, are virtually identical to what many Lyme sufferers experience. Just curious if you ever had a Lyme test, or ruled out infection with Borrelia burgdorferi based on any other evidence. Sorry to probe, it would just be very interesting to know of a case of Lyme that was eliminated by dietary modifications.

    One final comment, is that while I’m thrilled regarding the abatement of my Lyme symptomology and overall cognitive improvements, I’ve also suddenly had a recurrence of UTI-like symptoms (and have tested positive for microbes (unidentified) in the urine). So, I’m interested in your theory that host-defense vs. fungal pathogens is diminished on the ketogenic diet, and am wondering if I should back off on the diet some (i.e. add more CHO).

    Again, this is a fascinating thread.

    Thanks for listening.


  11. Hi Nanette,

    Congratulations on your improvement!

    My cognitive symptoms were similar to those of Lyme because they are really stereotypical immune reactions to any interferon-gamma stimulating infection. This is why it’s so hard to diagnose the pathogen involved in brain infections: you see the immune response but you don’t know what it’s reacting to.

    I never did have a Lyme test. I asked my doctor about it but he didn’t want to order the test. They’re not terribly reliable anyway.

    My pattern was consistent with C. pneumoniae, including a drop in white blood cell count after starting antibiotics. The antibiotics were important for me.

    I think ketogenic diets are generally good against CNS bacteria, potentially bad against systemic eukaryotic pathogens including fungi and protozoa. Since Babesia is a protozoan, that could be a concern for you. It’s tremendous that the ketogenic diet relieves your cognitive symptoms, but watch for other symptoms flaring up elsewhere.

    Best, Paul

  12. Dr. Jaminet,

    I was diagnosed with Lyme disease and told antibiotics wouldn’t help and that I should just take cumanda extract to slow the damage being done. Your post makes me wonder what your recommendations would be. Should I seek antibiotic treatment or just focus on good diet?

    Any info would be so appreciated.


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