Yersinia enterocolitica is one of the most common infections I see in my patients who have Hashimoto’s disease. Let us explore some basic information about Yersinia so you can understand it better and how it relates to Hashimoto’s thyroiditis.

 

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What is Yersinia enterocolitica?
Yersinia enterocolitica is a gram-negative bacteria that causes yersiniosis usually caused by drinking contaminated milk or water or eating raw or undercooked meat, usually pork (chitlins). Human-to-human infection is possible if the carrier doesn’t thoroughly wash his or her hands before preparing food. You can also get yersiniosis from a blood transfusion.

Approximately 117,000 people every year in the US get yersiniosis and it mostly affects children in the winter. Additional carriers of Yersinia enterocolitica include cats, dogs, birds, deer, rodents, rabbits, sheep, cattle and horses.
What are the symptoms of Yersinia enterocolitica infection?
This bacteria infects the intestines causing diarrhea (usually watery or bloody), vomiting, abdominal pain, and fever which lasts about 4-7 days but can last up to three weeks. Many people think they just have some food poisoning which eventually goes away unless medical attention is required.

Yersinia can cause right-sided abdominal pain which may be confused for appendicitis. A skin rash called erythema nodosum (red or purple lesions) is sometimes present 2-20 days after infection mainly on the legs and torso in women but it usually goes away within one month.

Joint pain can develop called reactive arthritis which can last for 1 to 6 months. Yersiniosis can become life-threatening when it spreads into the liver, spleen and bloodstream due to a compromised immune system.

Yersinia enterocolitica loves iron so infection could be problematic in someone with low ferritin levels when we are trying to improve iron stores in a patient’s body.
What is the best test for Yersinia enterocolitica?
This infection can be detected in a stool analysis or blood test. Stool testing is best for an acute infection but it can miss many infections when the infection is chronic. It can take up to two weeks for the stool test to be positive after infection.

Blood testing checks for IgG, IgA and IgM antibodies. A positive IgG test indicates a past infection. If IgG and IgM are positive then we know the infection has been present for 1-3 months. If IgG and IgA are positive but IgM is negative, then we know the infection has been ongoing for greater than three months in the intestinal barrier. IgM is not entirely necessary if you aren’t concerned about knowing if it is recent or not, so IgG and IgA will usually suffice. If IgG, IgA and IgM are all present then you know it is an active infection in the last 3 months.

Always check for Yersinia in stool and blood for the best chance of identifying the infection.

It is possible that the Yersinia enterocolitica blood test may cross-react with a virus or the bacteria Borrelia burgdorferi which causes Lyme disease. If you use an effective treatment for Yersinia and then retest the blood and it is still showing active infection, this may mean that the positive test was actually for a virus or Lyme disease.
How is Yersinia enterocolitica treated?
Yersinia usually goes away on its own but if not, then it is treated with antibiotics. If Yersinia comes back positive in a stool analysis, then the lab will run a sensitivity to identify herbal medicines that will eradicate the bacteria. Berberine, black walnut, caprylic acid, oil of oregano, uva ursi, grapefruit seed extract and silver can all eradicate this bacteria. The sensitivity will tell you which one of these will work best.

If we only have a positive in blood,