repeat fevers Archives - Hormones Matter

Repeated Fever, Swollen Glands, and Infections

Published on July 17, 2023

8847 views

Tonsillitis, Ear infections, and Swollen Glands

While working as a pediatrician at Cleveland Clinic, I encountered so many fascinating cases that I kept a diary between August 4, 1975 and May 14, 1976. One of the most interesting was a five year old boy. His mother brought him because of “repeated swollen glands”. The history she reported was that between the ages of 2 and 2 1/2 he had experienced a weight loss of as much as 18 pounds. This was followed by repeated episodes of tonsillitis, ear infections, and swollen glands in the neck, accompanied by fever between 102 and 103°. Of course, they had always been treated with antibiotics as an infection. Each episode would last approximately between seven and nine days, with as little as 3-4 days of freedom between each episode.

There were other disturbing features. He began to sit up at the age of nine months, but was not walking until the age of 14 months and speech had been delayed until 18 months, all symptomatic of developmental delay. He was said to have experienced 12 to 15 “colds“ in the first year, together with recurrent asthmatic bronchitis. He complained constantly of fatigue, feeling unwell and his appetite was extremely poor. He experienced feeling cold in an environment where others were comfortable. Another important feature was that each of these febrile episodes began with him being extremely irritable, vomiting repeatedly and complaining of abdominal pain after food. They were associated with profuse sweating. There was a family history of an adolescent sibling who had died with a diagnosis that implied defective function in the nervous system but the condition was unspecified. A first cousin reportedly had Hodgkin’s disease, a malignancy of lymph glands.

Hospitalizations and Elevated Vitamins B12 and Folate

Over the summer of 1975, the child had been admitted to a hospital three times. During one of these admissions a swollen gland in the neck had been removed for pathological study and the histopathology had been described as “non-specific”. The wound left by the removal of this gland was complicated by the formation of an abscess. Another interesting detail mentioned by the mother was that blood levels for vitamins B12 and folate had been found to be elevated at the hospital where the gland had been biopsied. In fact the doctor had told her that she was giving too many vitamin supplements to her child. Although she had no idea why these blood levels were measured, she told the doctor that she was not giving any vitamin supplements to her child and was extremely puzzled by the information. Of course, her denial was not believed.

The physical examination was extremely important. As would be expected in a constantly sick child, he was pale and had shadows under the eyes. This was the “face of stress”, precisely what Selye had observed when he decided to study how humans become sick from any form of stress, including infection. His pulse was 104 bpm, but there was a rhythmic change in association with breathing which reflected an unusual activity of the autonomic nervous system (ANS). Although the blood pressure was normal for a five-year-old child, the diastolic pressure repeatedly fell to zero, also a reflection of unusual activity of the ANS. The ANS is the automatic nervous system that controls the adaptive actions of body organs under the control mechanisms in the lower part of the brain. This part of the brain is peculiarly sensitive to energy deficiency.

It had presumably been treated as recurrent bacterial or viral infections occurring in a slightly mentally retarded child with an unknown reason for the complete lack of immunity. The question that occurred to me was whether the manifest mental delay, the changes observed in the function of the ANS and the recurrent episodes of swollen glands were in any way related under one causative factor. The report of blood tests to measure the levels of folate and vitamin B12, for whatever reason they had been done, pointed to the suspicion of a metabolic underpinning and I elected to repeat them. To my great surprise, the vitamin B 12 level was unequivocally elevated at 1050 pg/ml (normal 160-900) and the folate was similarly elevated at 29ng/ml (normal 4-18). It was not therefore surprising that the hospital doctor had accused the mother of giving vitamins to her child although the reason for these measurements remained obscure. In addition, he had a history of infancy ear infections and asthmatic bronchitis. In the present medical model, this would mean that he had experienced three or four different disease entities, each with its own cause .

Because even at this stage of my career, I was deeply concerned with energy metabolism as the root cause of disease, I subjected him to a series of tests, the net result of which showed that he was indeed suffering from thiamine deficiency in the brain. I therefore subjected him to a clinical trial with megadose thiamine given by mouth. The effects were remarkable.

Treating Thiamine Deficiency

Between January 21, 1976, when treatment had started, and March 26, 1976 he had experienced one episode of vomiting, slight fever and swollen neck glands. His body weight had increased from 43 pounds to 44 1/4 pounds and his stature had increased from 41 3/4 inches to 42 3/4 inches. This unusual increase in stature is actually evidence of improved functional activity in the ANS. I had observed a similar increase in a 14 year-old boy with autonomic dysfunction. One of the statements made by the mother was that “we can’t wait to get him back to school. He is too peppy.” The vitamin B12 measurement had dropped form 1052 to 740 pg/ml and the folate had dropped from 29 to 12.6 ng/ml, both in the normal range.

I managed to persuade the reluctant mother to stop giving the child the thiamine and he returned on May 12, 1976 with the following story. He had relapsed just about three weeks after the thiamine was withdrawn. The symptoms were recurrent abdominal pain, irritability, return of fatigue, fever and swollen glands in the neck. Physical examination revealed a huge lymph gland in the back of his neck, a smaller one in the front of the neck and there were some swollen glands in the arm pits making me wonder whether the swollen lymph glands of his cousin’s diagnosis of Hodgkin’s disease could have a genetically causative relationship. With reinstatement of thiamine, he completely recovered and remained well.

There is fundamental reasoning behind the decision to attempt a clinical trial with megadose thiamine. First of all, a lab test that was too technical to be described here showed an important relationship with thiamine metabolism. From that, it was easy to draw a conclusion that there would be a degree of energy failure in the brain because thiamine is vital to energy production. To explain the elevation of folate and B12, their activation depends on energy consumption. Lacking energy, we can conclude that they simply accumulated in the blood in their inactive form and when thiamine was provided, the improvement in energy metabolism would enable them to become active. They were then able to do their job instead of accumulating in an inactive state. Like any man-made machine, the body requires energy to be produced. It then uses that energy for its many physical and mental functions.

Reconsidering Fever, Sore Throat and Swollen Glands

The common cause of tonsillitis with fever and swollen neck glands is infection as we all know. But what we have failed to realize is that the presentation that we call an illness is really evidence that the brain has set up a complex of defense against the invading organism. It is an automatic response to an infectious invasion. However, what we know about a mild degree of brain energy deficiency is that it becomes more sensitive to all sensory input. It can therefore start a defensive program, even though there is no attacking microorganism, perhaps reacting to an unknown stress such as a weather change. An infection, identified as a microorganism, is a known stressor, whereas in this child it was a false perception. We do not know why he had developed thiamine deficiency but the family history suggests the possibility of a genetic link. His developmental delay might be explained also by lack of brain energy and this was the underlying solution for lack of development as well as the recurrent episodes. The formation of an abscess in a surgical wound when a gland was removed for biopsy demonstrated a complete lack of immune defense. We know that the immune mechanism is controlled through the nervous system via the spleen and it also requires energy. Finally, his rapid growth and mental development after receiving thiamine demonstrated that there was sufficient energy for “catch up” growth, additional evidence of improvement in energy metabolism.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter.

Photo by Kelly Sikkema on Unsplash.

This article was posted originally on March 9, 2020.

More Thoughts on Thiamine Deficiency

by Derrick Lonsdale MD, FACN, CNS

Published on March 31, 2022

16147 views

Thiamine Dependency and Intermittent Ataxia

Readers of this blog will recognize that there are many posts concerned with thiamine deficiency and that is associated with a huge number of symptoms. I want to use this post to illustrate the difficulties experienced by a boy whose thiamine deficiency was proved. His case was written up in the medical literature because it was the first example of thiamine “dependency“. That meant that he was required to take massive doses of the vitamin in order to prevent intermittent recurrences of the brain disease known as cerebellar ataxia. Curiously, each episode was self-limiting, but as they recurred, each one left him with a little bit more brain effect. It was this case that forced me to devote myself to library study and change in medical practice throughout the remaining years before my retirement.

Although this boy’s problem was an example of a condition, thought to be extremely rare, it illustrated the kind of medical problems that occur as a result of dietary deficiency. In fact, I have come to the conclusion that prolonged dietary deficiency of this vitamin will make it difficult to restore health by its administration as a supplement. The enzymes in the body that require it seem to degenerate over time if the deficiency persists. Huge doses are required and it is not a simple vitamin replacement. We are using the vitamin as a drug in an attempt to coerce the enzymes back into a healthy state. We know from the history of beriberi, the traditional vitamin B1 deficiency disease, that large doses of the vitamin were required to restore health.

This case was reported in 1969 and the last time that I saw him was in the 70s. He had grown into a handsome boy with a marvelous personality. For example, he cut the grass for the neighbors without charging them and his customers were delighted with him on his paper route. This escape from a potentially lethal disease by the use of what might be called a megadose of vitamin B1 was incredibly impressive to me, making me wonder whether a healthy dose would benefit everyone. Is the modern diet so artificial that vitamin deficiency is common, in spite of their enrichment by the food industry?

I recorded the fact that the family had visited Florida. While they were in a store that was cooler than the outside temperature, it was without air conditioning and John became suddenly unconscious and was taken to an emergency room where his examination proved to be quite normal. On the following day, he went from a 95° temperature into a store with an estimated air-conditioned temperature of 60 to 65°. He immediately experienced difficulty in breathing and produced a kind of strident asthma that was self-limiting. He was again taken to the emergency room where his examination once again proved to be quite normal. The diagnosis given at the time was that it was due to “nerves”. A similar episode occurred on the way home when the air-conditioning was put on in the car. Note that an environmental temperature difference was enough for him to lose consciousness on one occasion and produce asthmatic breathing in another similar situation. He had never been known to experience asthmatic breathing previously. One can readily see that he would be a complete mystery to the doctors in the emergency rooms to which he was taken.

My interpretation would be as follows: as repeatedly pointed out in various posts on this website, his brain had an energy problem from the poor association of thiamine with its energy enabling enzymes and the stress of a sudden change in temperature, requiring an energy surge to adapt, could not be met. The energy deficiency affected the functions of the brain, causing syncope in one example and asthma in another. The diversity of this response illustrates the fact that different parts of the brain can be affected by the overall deficiency, perhaps even on a day to day basis. It is not surprising that such episodes are a diagnostic problem for ER physicians or any physician for that matter.

Syncope and Sudden Death

A very common incident occurring in dietary deficient people is a sudden fainting attack, known as a syncope. They invariably wind up in the ER where it is usually written off as being due to “nerves”. It is impossible to understand this without knowing the chemistry involved. It reminds me of two siblings, a boy and a girl, both of whom had been surviving on a junk-filled diet. The girl was a champion swimmer and was practicing one day by swimming laps. She swam the last lap, touched the pool wall and remained still. When she didn’t start to climb out of the pool, someone investigated and found that she had evidently died as she touched the pool wall. Her brother had been climbing ropes in a gymnasium. After he came down from a climb, he passed out and was taken to a hospital where he received intravenous fluids. It was recorded that he had 11 bloodstained bowel movements and expired. Although there was no proof that thiamine deficiency was the cause of death, I would be willing to bet that the fluid given intravenously to the boy was glucose saline and we know that an excess of sugar will seriously precipitate marginal thiamine to a deficiency state that would produce symptoms. It strongly suggests that the death was from thiamine deficiency.

Febrile Lymphadenopathy

In another post, I recorded the history of two boys with recurrent acute febrile lymphadenopathy (fever, swollen neck glands and high-temperature), both of whom responded completely to thiamine supplementation. The story bears repeating. This kind of illness is inevitably thought of as throat infection and treated with an antibiotic. Both boys had a marked increase of folate and vitamin B 12 in their blood that returned to normal levels after thiamine administration. I won’t go into the mechanism but it is interesting to speculate on how often children with a very common condition like this would have a similar underlying cause that would never, under any circumstances in the climate of modern medicine, be considered. The two cases were published in a medical journal but I have never seen a reference to it, probably because it is totally unbelievable.

I kept a diary at the time and want to make a few comments about one of these boys. When the supplemental thiamine was removed to see what would happen, he relapsed about three weeks later. The relapse began with recurrent abdominal pain, irritability, and a return of the fatigue, causing him to nap during the day as he did when he had his recurrent episodes. There were some abnormalities in his blood pressure, which are too technical to describe here. When I stroked the skin of his leg gently, it provoked a white streak that gradually faded, a phenomenon that is associated with abnormal activity of the autonomic nervous system, a system that is inevitably damaged with thiamine deficiency. He had large lymph nodes in his neck and there was an elevation of folate and vitamin B12 measured in his blood. All of this resolved when the thiamine was restored. It is interesting that he had a first cousin who suffered from Hodgkin’s disease, a malignant form of lymphadenopathy. I wondered whether this recurrent swelling of glands was potentially precancerous. From my reading of the vitamin B1 deficiency disease beriberi, I found that swelling of the glands in the neck could be seen in infants dying from the infantile form of the disease and fever was almost always present.

Mononucleosis: A Mistaken diagnosis?

On May 14, 1976, I made a note that we had a new patient admitted under the care of another physician. He had massively swollen lymph glands in his neck and the diagnosis was mononucleosis. The history recorded that his brother had also “died from mononucleosis” the previous April. A biopsy of one of his glands was reported that it was definitely not malignant. His case was discussed among my pediatric colleagues and I asked the responsible physician what he would do if the lymphocytes in the gland were reported as healthy and mature. The answer surprised me because it was obvious that the diagnosis of mononucleosis had been rejected. He stated that the boy would be treated for cancer “but we would soft-pedal it” I found his answer extremely confounding. We were confronted by a familial situation with an unknown diagnosis and yet he was to be treated as though it was known.

This reminded me of a situation that affected one of my granddaughters. She came home from school and went white water rafting with her friends. Evidently she fell in the water and when she got home she was so fatigued that she went to bed. Her mother, who was a university nurse took her to her workplace where a diagnosis of mononucleosis was made. I persuaded my son to bring her to my office where I gave her several infusions of intravenous vitamins. Her response was so good that she was able to return to school well. The obvious question that I asked myself was whether the diagnosis of mononucleosis was valid or whether it was an inappropriate mistake. The reader may or may not know that a diagnosis of mononucleosis, also known as “kissing disease” is associated with extreme fatigue and can prevent the unfortunate adolescent from returning to school sometimes for months. Once again I am confronted with the question, is our present medical model even close to being accurate?

I am reporting actual cases of thiamine deficiency that are a sampling of literally hundreds of similar cases that I encountered over the years. It should not surprise anybody when I question the current medical model for its accuracy and the use of potentially toxic compounds that often make things worse or do little or nothing toward relieving the disease. It is high time for sick people to seek the services provided by Alternative Medicine physicians whose medical societies are known as the American College for the Advancement of Medicine (ACAM) and the International College of Integrated Medicine (ICIM).