The Silent Bacterial Cause of Fatigue and Infertility

Are you battling chronic low energy? Is it hard for you to get through the day with enough energy to do all that you set out to accomplish?

You’re not alone.

Fatigue is one of the most common symptoms we see in our clinic. While there are many different causes of fatigue and we are passionate about looking at multiple possible factors, there is one cause that is often left unaddressed: H. pylori.

Helicobacter pylori (H. pylori) is a strain of bacteria that commonly inhabits the stomach and very first section of the small intestine, the duodenum. It is estimated that half of the world’s population has H. Pylori inhabiting their digestive system.

For a long time, it was really hard to test for the presence of this particular bacteria. H. pylori, like any bacteria, is very intelligent. It uses its many defensive mechanisms to make a comfortable home in the epithelium (cell lining) of the stomach and remain safe from eradication by our normal defense systems. However, these virulence factors can cause numerous secondary conditions including:

• Adenocarcinoma (gastric cancer)

• Hypochlorhydria (low stomach acid)

• Peptic ulcer

• Mood symptoms (anxiety, depression, irritability)

• Fatigue

• Infertility

If H. pylori is so common around the world, why is it called here the “silent” bacteria?

H. pylori has a number of significant virulence factors that contribute to its ability to make a safe home in the lining of the intestines (epithelial cells). These virulence factors contribute to a more severe manifestation of disease (cancer) and allow it to be present in the body for many years, undetected.

Associated symptoms of H. pylori overgrowth include:

• Acid reflux

• Diarrhea

• Upper abdominal pain

• Upper abdominal bloating

• Esophageal or upper abdominal burning

• Belching after meals

However, the majority of people we see with a positive H. pylori value on testing, don’t have the above symptoms. Their primary symptom is fatigue.

The H. pylori bacteria contributes to fatigue by significantly altering the ability to extract nutrients from food. Low stomach acid decreases production and secretion of digestive enzymes from further down in the GI system, in turn diminishing the absorption of nutrients from food. Additionally, once H. Pylori has taken up its “home” in the stomach lining it very intelligently steals nutrients such as iron. Iron deficiency anemia is a common finding and common contributor to fatigue, exercise intolerance, shortness of breath and easy bruising. In menstruating women, iron deficiency anemia can also contribute to heavier menstrual flow.

H. pylori also impacts our normal body function by secreting its virulence factor and the neurotoxin: LPS (lipopolysaccharide). LPS presence has been linked to many chronic diseases such as Alzheimer’s disease, Parkinson’s disease, multiple sclerosis and more functionally, brain fog, depression, anxiety and irritability.

Lastly, a link that isn’t always discussed is the connection between H. pylori and infertility. Low nutrient status can contribute to low hormones required for healthy production of egg and sperm cells. Research has also found follicular fluid with H. pylori antibodies result in an immune reaction against spermatozoa - a possible link to immune mediated infertility. It has also been postulated that the neuroinflammation caused by the presence of LPS can lead to suppression of hormones required for conception in males and females.

In summary:

H. pylori can be a major factor in chronic fatigue, mood symptoms and infertility. Untreated, it can set the stage for those symptoms to persist and could lead to more serious sequelae such as gastric cancer, peptic ulcer or infertility. Previously, testing for H. pylori has been limited. Now, with advancements in genomic testing (testing for bacterial DNA), H. pylori is more easily detectable. Treatment can be challenging as H. Pylori has become resistant to most antibiotics. However, naturopathically we have many tools in our toolbox that successfully eradicate H. pylori while healing the intestinal lining.

PS: H. pylori also secretes histamine, yep. Stay tuned for a discussion on that later!