Frequently Asked Questions

1. I would like to start the antibiotic treatment for my disease, and want to test for mycoplasma before starting treatment. Can I send my blood to your laboratory?

We accept blood for mycoplasma testing at the request of your physician. We can fax or mail the information to him/her for collecting and shipping your blood sample for testing.

2. I have been on medication and have taken some antibiotics. Will this affect the test?

The (MCF) mycoplasma antibody test was developed by Dr. Brown's staff specifically for detecting mycoplasma infections in his patients and monitoring the patients’ progress. The current mycoplasma antibody test that is done in this laboratory is the ELISA test. Mycoplasma antibody tests are not affected by medication.

The PCR test detects the mycoplasma antigen. This test is affected by medication that could kill the organism; therefore patients must test for the antigen before beginning antibiotic treatment.

3. I have been on antibiotics for a while and have seen no improvement. Can you comment?

For best results, all pertinent information should be gathered prior to the beginning of treatment and the patient should be thoroughly monitored, e.g.

Frequently by the time a patient sees the physician and is diagnosed, the patient may have had the disease for a long time. The longer a patient has had the disease, the longer it takes for improvement. Detectable change in such patients could take from 2 - 5 years. Also, there may be signs of improvement within weeks of starting treatment that may not be obvious to the patient. The laboratory test results are a good indicator of the patient’s progress.
Did the physician establish that there was an infection prior to starting the antibiotic treatment? If so, is the suspected organism susceptible to the antibiotic that is being prescribed?
A proper treatment schedule involves more than just the administration of antibiotics. Other factors that were deemed necessary for proper therapy by Dr Brown included proper nutrition and bed rest followed by gradual introduction of exercise. Your physician will advice you of these additional requirements. The importance of a proper diet is often overlooked, but it ensures that the body has all the components necessary to fight the infection and rebuild the damaged areas. One should try to avoid putting too much strain on the weight bearing joints therefore excessive exercise was usually not recommended by Dr. Brown. If the collagen had been destroyed during the disease process, after it is rebuilt the muscles would gradually gain strength through exercise. Dr. Brown often recommended swimming and his patients exercised in a deep whirlpool tank at the National Hospital.
The patient may alleviate some stress and the severe pain caused by the release of toxins causing the Herxheimer flare by having adequate bed rest. For a very long time, Dr. Brown was able to admit patients at the National Hospital in Arlington, Virginia at the beginning of the treatment, until Insurance concerns prevented their admission.

If all the proper precautions have been taken and the therapy fails, this could be due to several reasons.

Some mycoplasmas, especially the M. hominis group, develop resistance to the antibiotics that are being used. Your physician may decide to switch antibiotics.

The antibiotics need to penetrate the tissues to get to the antigen. Depending on the localization and concentration of the organisms, successful penetration might not be obtained and the mycoplasma antigen will not be eliminated.

Patients with long standing diseases may have been exposed to multiple infections, viral as well as bacterial. Removal of one organism could cause proliferation of another. Some patients reported having a rash characteristic of the Epstein-Barr virus (the causative agent of infectious mononucleosis), prior to developing arthritis. Others reported that the arthritis developed after measles infection and still others reported RA-like symptoms after vaccinations. For this reason, Dr. Brown and other physicians have found use of an antibiotic combination therapy useful, i.e. treating of the first organism with antibiotics and eliminating the underlying with another.

Dr. Brown's success rate was about 75-80% for rheumatoid arthritis patients. The percentage of positive response varied for other rheumatic diseases. Because some patients will not respond to antibiotics it is very necessary for your physician to look for the presence of mycoplasma infection ( prior to commencing treatment).

4. I have been on other treatment. Are there any problems with switching to antibiotics?

The physician is aware that there could be drug-drug interactions that could be antagonistic and would make recommendations; it is advisable to have a washout period before starting the antibiotic treatment. Dr. Brown often used six weeks as a guideline if the patient could tolerate the length of time without severe pain.

5. I have heard that dental problems may affect the disease. Is this true?

Quite often, individuals with oral mycoplasma infections have no symptoms and are totally unaware of it.

M. salivarium is one of the mycoplasmas frequently found in the human oral cavity. This mycoplasma strain was isolated from a gorilla (animal model) with severe disease symptoms strongly resembling those of human rheumatoid arthritis. The gorilla responded to treatment with antibiotics.

Patients with dental problems may harbor mycoplasmas that were not killed by the usual antibiotics administered after they have undergone procedures like root canal etc. Killing off bacteria with antibiotics that do not affect mycoplasmas may result in opportunistic growth of the mycoplasmas, some of which have been observed to produce collagenase, an enzyme that breaks down collagen. Oral mycoplasmas could travel via the bloodstream and localize in the joints where they could cause disease. M. salivarium has also been isolated from the joint of an immune-suppressed patient with arthritis.

6. My mycoplasma test results came back negative but it still looks like I have an infection. Can you comment?

Physicians should be aware that, sometimes, when a patient mycoplasma test reads negative, it could be due to the formation of immune-complexes where the antigen and antibodies form aggregates that remain in muscle-tissue; since the antibodies are complexed, they would not be detected by a test looking for the bare antibody. Trace amounts of the mycoplasma antigens is detectable only after dissociation of such complexes. Furthermore, synovial fluids¹ (especially in rheumatoid arthritis patients) frequently have higher concentrations of antibodies than serum. These situations require the physician's discretion in deciding on the use of this treatment. Deciding on administration of the antibiotic becomes dependent upon other factors such as patient history, inflammation, rheumatoid factor etc.

1. Harold W. Clark, Ph.D., Millicent Coker-Vann Ph.D., Jack S. Bailey, M.S., Thomas McP. Brown, M.D.: "Detection of mycoplasmal antigens in immune complexes from rheumatoid arthritis synovial fluids" Ann. of Allergy 1988;5:60.