I. The Many Faces of H Pylori….Do You Know All The Symptoms Of H Pylori ?
dr.vanta
When you think H pylori, digestive symptoms like bloating and stomach upset would come first in your mind. However, there is a lot more going on. There are a lot more symptoms of h pylori that you may not be aware of. This little bacterium infected human beings for the last 58000 years; it is very smart and can affect your entire body and mind. Can H pylori cause anxiety or depression, hair loss, headaches or significant fatigue for no reason ….or get involved in autoimmunity ? Yes, H Pylori can alter the body’s physiology and immune response in a profound way [1]. Let’s look at the scientific evidence.
This is Part I
1. About H Pylori
2.H Pylori Symptoms (Classical Symptoms and Diseases)
3.H Pylori Symptoms (Symptoms/Diseases Outside the Stomach/GI Tract)
4.Nutrient Deficiencies Associated with H Pylori
5.H pylori Linked with Diabetes, Heart Diseases, Skin, Neurodegenerative Conditions and More
6. H Pylori, Allergies and Autoimmunity. Could H Pylori Infection Be Beneficial for MS… ?
More than half of the population worldwide is infected with H.pylori, yet the majority of people (80-90%) is unaware simply because most people are asymptomatic [2].
We need to thank Drs. Marshall and Warren, the doctors who re- discovered and isolated H pylori from the gastric mucosa in the early 1980s ( this bacterium was first described by German and Polish scientists in 1875)[5]. It was Dr. Marshall who experimented on himself this infection, by drinking a broth infected with H pylori. H pylori had been classified as a group I carcinogen in 1994 by the World Health Organization, which means is a strong risk factor for certain types of stomach cancers.
H pylori is commonly known to infect the stomach, and the complications of H Pylori infections include gastritis, peptic ulcer disease and stomach cancer.
H pylori has a few important virulence factors through which infect the body.
Technical : virulence factors include urease, flagella, vacuolating cytotoxin A (VacA), cytotoxin-associated gene antigen (Cag A), BabA,SabA and many others. For example, infection with cagA-positive strains might result in severe gastric inflammation and gastric cancer. Unlike most bacteria that cause diseases, H. pylori typically colonizes the host for life unless is treated[3], [4], although children may experience spontaneous eradication of the infection[39] .
2. H Pylori Symptoms (Classical Symptoms and Diseases)
Indigestion, upset stomach
Excessive bloating
Nausea
Loss of appetite
Heartburn/acid reflux
Frequent burping
Changes in bowel movement (diarrhea and/or constipation)
Unintentional weight loss
Bad breath
Complications of H pylori infections: gastritis, ulcers and cancer
Gastritis: Acute gastritis (inflammation of the stomach, affecting the entire stomach) symptoms : stomach discomfort with nausea develops soon after the infection. There is low stomach acidity, which explains troubles digesting the foods. Chronic gastritis can affect some parts of the stomach, or can be diffuse.
Ulcers: Most stomach and duodenal ulcers are related to H Pylori infections although medications (NSAIDs) and stress are also a common cause of infection. Symptoms: dull pain in the stomach, weight loss, lack of appetite, nausea, vomiting, bloating, burping, heartburn and acid reflux, and dark, tarry stools. Not all ulcers will progress to cancer, the location is important. Click on this link for details
Stomach cancer: similar GI symptoms, but are persistent and aggravate over time(where in ulcers ameliorate). There is more weight loss and signs of anemia, sometimes accumulation of fluid in the abdomen. There are different types of cancer- for example the majority of H. pylori–positive MALT lymphoma are treated successfully just by eradicating H Pylori. Infected people are 3 to 6 times more likely to develop stomach cancer [32].Cancer risk is also affected by socioeconomic factors (less prevalent in developed countries), nutrition and diet [6].
I know that more digestive symptoms/conditions are now associated with H pylori infections, for example:
Bad breath: if it doesn’t originate in the mouth (ie infections), the next two most common reasons for bad breath are h pylori infection and acid reflux
I will describe food intolerances, SIBO and IBS in separate blog posts. In my opinion, H pylori infections should be ruled out in every single case of suspected or confirmed SIBO, IBS , food intolerances, functional dyspepsia, fibromyalgia, chronic fatigue syndrome. H pylori causes low acidity (a risk factor for SIBO/IBS) and disrupts the gut brain axis [8]. By altering the stomach and intestinal microbiome [9],[10], H pylori infections will lead to a wide range of symptoms and conditions (beyond GI tract).
Key points : Why some people get symptoms of H Pylori while most don’t ? Symptoms related to H pylori infections (whether the symptoms are affecting the stomach or other parts of the body’s systems or both) indicate 1.the presence of more virulent H pylori strains (some strains may be harmless)[34], 2.a genetic predisposition to disease and 3.environmental factors.
Just as H. pylori is not responsible for all cases of gastric cancer or ulcers, H. pylori should not be considered the sole cause of other disorders described below, but rather playing a a role in/ aggravate these conditions.
Infection with H Pylori Symptoms (Symptoms/Diseases Outside the Stomach/GI Tract)
Stress
Anxiety
Depression
Deadaches/Migraines
Hair loss
Various skin rashes
Extreme fatigue and weakness
Brain fog
Rapid heart rate
Low blood pressure
Brittle nails and hair
Sleep problems & more
Let s look into the details.
H Pylori is more than just a stomach bug (as it is described in most medical textbooks and all over the internet). Based on current research, we know now that H.Pylori is found in many other parts of the body, way beyond the stomach. If you click on this image ,and you’ll see how HPylori was detected in many bodily tissues : along the digestive tract including mouth, large intestine, liver, gallbladder but also in the eye, coronary arteries, skin, peritoneum, nose and middle ear.
H Pylori infection can have a profound effect on the metabolism, hormones, how you absorb nutrients from food and has even an impact on your mood and emotions.
Why ? Because H Pylori disrupts the gut brain axis [11]. The gut brain axis (GBA)- GBA is a bidirectional link between the central nervous system and the enteric( intestinal) nervous system of the body. The GBA involves complex crosstalk between the hormones (hypothalamic-pituitary-adrenal axis), immune system (cytokine and chemokines) and the autonomic nervous system (which includes sympathetic nervous system involved in “fight or flight” reactions and parasympathetic nervous system involved in “ rest and digest” reactions).
A few more details about these less known symptoms.
Stress, anxiety and depression : there is a strong correlation between H pylori infection, stress, anxiety and depression and dyspepsia (indigestion) ; females more effected than men (3:1) [12] ,[13], [15]. More stress and depression had been detected in cases of H pylori associated with atrophic gastritis [14] . Back to the question… Can H pylori cause anxiety ? The answer is yes. One study found anxiety and not depression to be more likely correlated with H pylori [15]. Note: In case you read my articles on histamine, here is one more thing to consider: anxiety and depression can increase the number of mast cells and their release of histamine through degranulation) [16]. I see this association working both ways : stress can promote H Pylori infection and the infection can trigger stress and anxiety.
Headaches/migraines ; H. pylori infection is strongly related to the outbreak and severity of migraine headaches, and H. pylori treatment reduces migraine headaches significantly.
Technical: bacterium can cause the secretion of serotonin from platelets, releasing PAF, it can play a role in creating migraine headaches by increased secretion of serotonin [17].
Significant hair loss/ alopecia areata is seen in cases of H Pylori infections [18], [19].
Various skin rashes , especially rosacea are associated with this infection [20].
Toxicosis associated with H Pylori. A very interesting topic. Have you heard about it ?
Several symptoms from the list below can develop together, in addition to the common digestive complaints like loss of appetite, changes in bowel movements, bloating, etc
Significant fatigue
Lack of strength and energy, weakness
Malaise (feeling sick)
Sleep disorders (like insomnia, nightmares)
Lack of creative activity, lack of initiative, brain fog
Dr. Belascu has done extensive research on this topic, and he labeled this condition as “ toxicosis associated with H Pylori”). More details in his research paper [21]. Simply put, the symptoms described above went away after treating H pylori with antibiotics.
While the concept of toxicosis associated with H Pylori is not well established, future research will support it. Toxicosis does exist, and had been previously researched in infections with other microorganisms. Some of these symptoms appear unusual, yet they can be explained, if we think a bit.
For example, severe fatigue is seen in many bacterial and viral infections [22], but very little is known about fatigue associated specifically with H pylori. Fatigue, along with brittle hair nails, pale skin, tachycardia and digestive complaints may be signs of iron or B12 deficiency anemia (both deficiencies found with H pylori infections) and other nutrient deficiencies. More important, H pylori disrupts the gut-brain axis, causes inflammation – this would explain pretty much all the symptoms [23].
4.Nutrient Deficiencies Associated with H Pylori
You may try to eat healthy, yet not see the benefits. That’s because H pylori causes low stomach acidity leading to multiple nutrient deficiencies : iron, vitamin C, vitamin A, E (α-tocopherol), vitamin B12 and folic acid [24], [25]. The absorption of macronutrients -the metabolism of fats and carbs is impaired by H pylori [26]. You can’t properly digest the proteins either, since proteins are broken down pepsinogen/stomach acid. H pylori significantly decreases the stomach acidity, and disrupts the gut-brain axis. The result : multiple food intolerances [27].
5.H pylori Linked with Diabetes, Heart Diseases, Skin, Neurodegenerative Conditions and More
Many studies looked at the link between H pylori and various conditions, and found that people with certain diseases are more likely than healthy individuals to have H Pylori infections and eradicating H pylori often helped improved those conditions.
Iron deficiency anemia is strongly associated with H Pylori. These bacteria use the iron to grow. H.pylori causes low stomach acid leading to decreased bioavailability of iron in our bodies. 3. H pylori infections cause an increase in TNFα ( a marker of inflammation that can also induce anemia)
Cardiovascular conditions: H. Pylori had been associated with unhealthy cholesterol levels, atherosclerosis, unstable angina, heart attacks, strokes [28], as well as atrial fibrillation [38].
Diabetes/ insulin resistance and metabolic syndrome : H. Pylori infections altered sugar and fat metabolism (insulin resistance, diabetes/metabolic syndrome). Some strains of H. Pylori had been linked with poor glycemic control
Skin diseases rosacea has the strongest correlation with H pylori (as many as 80% having digestive complaints and many testing H Pylori positive), and also with urticaria, chronic prurigo, psoriasis (one study found that 100% of patients with moderate or severe plaque psoriasis were H. pylori positive).
H pylori during pregnancy: can cause morning sickness, pre eclampsia with fetal growth retardation.
ENT (ear nose and throat) conditions associated with H Pylori infections :some ear infections (otitis media with effusion) and nasal polyps.
Eye conditions: open angle glaucoma, and central serous retinopathy (CSR)
Other cancers (besides stomach cancers) associated with H Pylori: colorectal cancer ( adenocarcinoma), peritoneal cancer, lymphoma, laryngeal/pharyngeal cancer.
Neurodegenerative conditions: There is a link between H. Pylori infection and development of Alzheimer’s and Parkinson’s diseases. The bacteria can bind L-dopa (drug used in Parkinson’s) and impact the absorption of L-dopa treatment. Some symptoms may improve, while some may worsen following eradication of H Pylori infections in those with Parkinson’s disease. Regarding Alzheimer’s disease, H Pylori is clearly detrimental : older adults infected with H Pylori showed poorer cognition and treating the infection lead to improved cognition [4].
5. H Pylori & Allergies and Autoimmune conditions. Could H Pylori Infections Be Beneficial for MS ?? When The Bad Bug Starts To Play The Good Bug
Many microbial organisms can lead to loss of self-tolerance, in other words – to autoimmunity and H pylori is one of them. Paradoxically, H Pylori may seem to aggravate some autoimmune conditions, while showing protective effects on others – including MS.
Technical : H pylori & mechanisms that trigger autoimmunity: molecular-mimicry, polyclonal activation, epitope spread, bystander activation and superantigens [27].
Some studies found that H Pylori infections are more prevalent in people with MS than healthy individuals, and suggesting that this infection may trigger the development of MS [28].
Other studies found exactly the opposite (decreased prevalence of H pylori in people with MS), and even a protective effect of H. pylori infection on multiple sclerosis [29]. You can read this article from MS Society Canada .
This theory ( H pylori being protective for MS) lead some scientists to even consider H. pylori antigens as a treatment for multiple sclerosis, but the idea had been dropped because would cause way more risks than benefits.
H pylori also appear protective against inflammatory bowel disease(Crohn’s disease and ulcerative colitis) and other conditions like food allergies, celiac disease, and allergic rhinitis and asthma [29],[4].
On the other hand, H Pylori infections have (as usual ) detrimental effects on thyroid autoimmune conditions (Graves disease and Hashimoto), scleroderma, Guillain Barré syndrome ( an autoimmune attack on peripheral nerves), idiopathic thrombocytopenic purpura (ITP- an autoimmune destruction of platelets)[4],[30].
Base on the current studies, I don’t think H Pylori infection offers protection against MS. I am aware of the hygiene hypothesis, T1 vs T2 dominance (which would explain the protective role of this infection). These two theories are connected by the way, and have pros and cons.
Proof of principle of the hygiene hypothesis is brought by studies in animals, there is little scntific proof in humans of this hypothesis[33].
I am also aware of cases of miraculous cures, medically known as “spontaneous remission” following an infection (not with h pylori, but other microbes), yet many of these cures don’t last for too long [34],[35],[36],[37].
I think the immune system is more sensitive to those tens of thousands of chemicals we are exposed to on a regular basis, to chronic stress, poor sleep and diet, sedentarism rather than a limited exposure to microbes.
H Pylori kills people (think stomach cancer, complicated ulcers). Impairs brain-gut axis, thus triggering inflammation and affecting the digestive tract, hormones, immune system and the nervous system. H Pylori does not allow you to properly absorb the food- you are not what you eat- you are what you can absorb. H Pylori has detrimental effects and aggravates so many conditions – from diabetes to heart diseases, cancers and autoimmune conditions. Did you know that having one autoimmune condition increases the likelihood to develop other autoimmune reactions, to different tissues? H Pylori seems to worsen most autoimmune conditions. There is evidence that H pylori induces immune responses that cross-react with components of nerves, causing direct nerve tissue damage [31]. H pylori infections are associated with increased Th22 [32], a subset of the immune T cells involved in inflammation and autoimmunity. Th22 cells area already high and thought to play a role in the development of MS [33].
Who knows, maybe future research would reveal specific h pylori strains that are not only harmless, but actually beneficial for our health. It is possible. However, based on what we know now, the best thing to do is to treat the infection.
