Natural/Homeopathic Vs. Antibiotic Treatment

A very common question when faced with a Lyme diagnosis is how do you treat it?  People often have reservations when it comes to taking antibiotics for prolonged periods of time.  Antibiotics can destroy gut flora, disrupt the micro biome in your body, are hard on the liver, and some classes of antibiotics can lead to an increased risk of tendon rupture.  Also, I have heard several stories of people starting with antibiotics and getting nowhere so in frustration they jump ship to herbals.  Some see improvement some don't.


Here are some things to consider about herbals.  The FDA does NOT regulate herbs or supplements nor  does it control statements made by these companies (as long as they don't claim to cure something).  There is little to no scientific evidence that supports the effectiveness of herbals in the treatment of various diseases especially Lyme.  Since herbs and supplements are not FDA regulated it is not known what kind of harm these products may cause you.  The common logic I see naturalist use is that, "well its from the earth so it has to be good for you".  However, there is nothing natural about consuming copious amounts of highly concentrated herbs extracted from different parts of the world. It is well known that certain vitamins in high amounts are toxic for your body.  So what are the implication of all these herbs that naturopaths are prescribing?  The truth is they don't even known because they haven't been tested!  If you really want to fallow a natural approach to the letter of the law then you would only consume products in your immediate environment that are in their natural unaltered form. 


There are various other factors that should influence how you treat Lyme such as age and stage of infection.  If an adult or child has been recently infected with Lyme I believe you are taking a HUGE risk by NOT taking antibiotics.  Most people that are treated with antibiotics for early Lyme are cured and never have problems down the road.  Why would you want to risk a proven approach (antibiotics), with an unknown (herbals)?   (As an aside, when I first contracted Lyme I didn't know I was infected.  Through a good diet and exercise my immune system was able to suppress the infection only to have it resurface years later and now it has been very difficult to treat.  I believe children are at an increased risk of this happening because their immune systems are so strong.  Resolution of symptoms does not necessarily mean thier infection is gone.)  For those suffering from late stage Lyme and who have been on antibiotics for years I can understand the frustration and wanting to jump ship to herbals.  In my opinion it is not a bad idea to try something new if you are seeing no results.  This could mean taking herbals and using adjunctive therapies like Hyperbaric Oxygen Treatment. 


So taking these points into consideration which approach is the best?  Both!  Although there is no definitive research that shows herbals work for Lyme there is a lot of anecdotal evidence.  Similarly, there is both scientific and anecdotal evidence that antibiotics work for all stages of Lyme.  My guess is that if you are reading this you have Lyme and know how difficult it can be to treat.  My personal philosophy is that using all the tools you have available to you will only increase the probability of you finding something that leads to recovery or cure.                            


Personally, I have used banderol, samento, Mineral Miracle Solution, Colloidal Silver, Lymogen, Microgen, Borellogen, cats claw, ATP support, Stamina R, ciprofloxacin (oral), rifampin (oral), biaxin (oral), tinidizole (oral), Zithromax (oral), IM rocephin, and Hyperbaric Oxygen Treatment (HBOT).  I have found that the right combination of antibiotics and HBOT have been the most effective.  Herbals have done nothing in regards to symptoms improvement or  infection resolution as proven by lab work.  Still, following my philosophy, I continue to look for other herbal treatments.  As always your results may vary, but I would encourage anyone to take as many treatment approaches as you possibly can. 

How to Treat Lyme: Co-infections first?

One of the worst things about being a Lyme patient is the lack of congruence amongst doctors when it comes to treatment.  This is largely the results of poor diagnostic testing, lack of research, and the use of medications that are over 70 years old.  As if treating Lyme wasn't hard enough patients are often co-infected with multiple tick borne diseases such as Babesia, Erhlichia, Bartonella, Mycoplasma, and Rickettsia.  Patients that struggle with multiple infection are undoubtedly much harder to treat and I have found that doctors are dramatically divided in their treatment approach of such individuals.  So if you have multiple infections which doctor do you believe and what approach do you take?


The best that I have been able to do is consult multiple LLMD's and follow the treatment approach that makes the most sense to me.  Some context is definitely in order here.  I was diagnosed with Bartonell, 2 types of Erhlichia, and 2 types of Rickettsia.  My western blot and PCR for Lyme from Igenex was negative, but I was diagnosed with Lyme based on my symptoms, multitude of co-infection, Low NK CD57, and high C4a.  One of my doctors, we will call this individual Doctor A, firmly believes that Lyme cannot be treated unless you treat all the co-infections first.  Another doctor I am seeing, Doctor B, believes co-infections and Lyme can be treated at the same time.  Another valuable resource I have found online, Doctor C, suggests that if you adequately treat Lyme your own immune system will likely be able to get rid of the co-infections on its own.  In all likelihood these doctors are all right and all wrong depending on what patient they are treating. 


I had to start somewhere so I went with Doctor A's approach.  After 8 months of antibiotic treatment I am no longer testing positive for Bartonella or Erhlichia.  However, NONE of my symptoms have improved or worsened during this time.  Also, my C4a and NK CD 57 have remained relatively steady.  I say relative because I did 40 treatment of Hyberbaric Oxygen Therapy (HBOT) and my C4a dropped considerably, and my NK CD57  had a 7 fold increase.  Unfortunately these numbers returned to their pre-treatment levels once I stopped HBOT.


Never the less, this experience revealed something.  If I got rid of two co-infections why have none of symptoms improved even a little?  Why did the HBOT have such a positive impact on my C4a and NK CD57 when the antibiotics, which were co-infection specific, did not?  Why do I not have ANY symptoms that are specific to these infections?  Also, I was incredibly healthy before I became I'll.  That is to say that the onset of my illness was rapid.  When my first symptoms started to show I had been living on the West Coast for about 8 months.  Prior to my move out west I had lived in New England.  All my doctors are in agreement that I was originally infected out there, and was probably infected years ago.  So, if I was infected years ago from a tick bite, and am now just becoming symptomatic, what are the chances that I simultaneously reactivated 6 different things as opposed to 1. Remember that most test's look at antibody titers against a certain infection.  A positive test does not necessarily mean that you have an active infection (I am going to write a separate blog about this).  Considering all the above information it seemed to me that my co-infections were not really an issue that needed to be addressed.  Was I just wasting precious time going after these infections?  I ran this theory past Doctor A and this individual does not agree with my theory and maintains that we have to resolve the rest of the co-infections before going after Lyme.


I then decided to consult Doctor B regarding this issue and this individual was in partial agreement with my theory.  Doctor B decided to add a Lyme specific antibiotic to the mix on top of the co-infection specific antibiotics prescribed by Doctor A.  This approach seems to be casting a wider net and is allowing me to take care of more things at one time. 


I recently came across Doctor C's recommendations and feel this approach is more applicable my personal situation.  I have a feeling that many individuals walk around with asymptomatic diseases.  This isn't a problem because for the most part your immune system is in a sort of equilibrium with these diseases.    


The point I am trying to make here is that Lyme and co-infection are a clinical diagnosis.  The tests we have are terribly unreliable.  A positive test result doesn't necessarily indicate an active infection, and similarly a negative test does not necessarily mean you are not infected.   Simply looking at a test result without looking at the whole clinical picture is a voluntary dismissal of relevant data.  When you put all the pieces of my story together it looks more like I have 5 resolved co-infections, and 1 unresolved Lyme infection. 


Everyone's situation will be different and require a different approach.  However, you need to educate yourself as much as possible and question your doctors.  It's clear that the science behind Chronic Lyme treatment is still being written which means you have to assume some level of responsibility for your treatment.  No one will ever care about your health as much as you do. 

Chroinc Lyme........A Tale of All or Nothing

Chronic Lyme Disease continues to frustrate both clinicians and patients.  Some patients are able to make a complete recovery on prolonged antibiotics while others are not.  The exact cause of this is not known but several LLMDS theorize that there is an immune complex that prevents patients from achieving full recovery.  This immune complex involves various way's in which the body is impaired in it's ability to function normally.  For example, mold sickness, heavy metal toxicity, adrenal insufficiency, thyroid dysfunction, co-infections, reactivated viruses, and hormonal imbalances to name a few.

I want to preface what I am about to say with acknowledgment and appreciation for all of the LLMD's out there that continue to fight for their patients health.  They unselfishly treat patients knowing that their protocols are controversial and could ultimately end up with license revocation and law suits. However, the paths we are starting to journey in an attempt to achieve recovery are no doubt a testament to the desperation of our situation.  At some point we have to take a step back and ask ourselves if we are truly seeing the forest for the trees. 

What do you think the probability is that you have a chronic persistent Lyme infection, along with co-infections, heavy metal toxicity, mold, and food intolerance?   I hear time and time again of patients trying to treat all of these things.  Meanwhile back on planet earth you have people that live on cigarettes, alcohol, fast food, and copious amounts of caffeine, and for all intensive purposes they are healthier than Chronic Lyme patients.  Something is not adding up.  Is it really this difficult to be healthy?

I'm sure there are people out there that have treated these things and gotten better but I'm also sure there are people who haven't.  Furthermore, Chronic Lyme patients are often on several medications and herbs at once so how can you tell what is really working? 

I'm not saying this immune complex is not significant and shouldn't be considered.  However, we must always remember that the science of treating Chronic Lyme is still being written.  Almost every treatment you are given is experimental in nature.  Before being convinced that you need to address all these problems its good to put your life health into context.  Were you healthy all our life and then one day became sick and never got better?  What do you think the probability is that you have a complex of issues to address as opposed to one thing?  On the other hand if you struggled with your health all your life and had a multitude of symptoms before you became ill with Lyme then it's not a far stretch to assume you may have more than a Lyme infection going on. 

Again, each patients case is different.  Just because a patient is not progressing with treatment does not mean that person has multiple issues that need to be addressed.  There are several scientific studies that show how fastidious Lyme bacteria is when presented with antibiotic challenge.  The significance of this is that antibiotic treatments may not be doing their job.  Additionally, we struggle just to diagnose Lyme never mind trying  to determine if it is cured or in remission.  Careful consideration is needed when dealing with a patient that is not progressing.  Before grasping at straws it's necessary to identify whether or not you have fully adjudicated the root cause of illness.

Oh, but there is an alternative here.  You can go see an IDSA affiliated doctor and be told you have absolutely nothing wrong with you!

Intense Exercise to Aid Lyme Disease Treatment?

I recently came across a few sources that champion the idea that intense exercise can be an adjunctive therapy in helping manage/cure Lyme disease.  Although they solicit such advice there is no research that directly supports this claim.  Further the underlying assumptions made by these individuals is not clearly expressed.  Although I would agree that exercise is necessary in making a full recovery the intensity and the timing of integration needs to be practiced with caution and individualized based on the patients level of recovery. 

Proponents for intense exercise as an adjunctive therapy suggest doing this immediately following administration of Lyme treatment (antibiotics, homeopath, etc.).  I have not come across any details as to why this is helpful.  The only thing I can conclude is better antibiotic perfusion as a result of increased blood flow.  Although there might be some truth to this it’s important to consider the consequences of exercise while fighting an active infection. 

1.)  HIGH INTENSITY EXERCISE=ANAEROBIC ACTIVITY. 

It is well established in the sports science community that intense exercise generally constitutes efforts above one’s aerobic threshold.  At this point your body starts working anaerobically which results in localized oxygen debt and an increase in blood pH.  For patients that are untrained and have been sick for a long time their threshold are likely to be very low.  A brisk walk could be enough to force their body to work anaerobically.  The result of exercising anaerobically is localized hypoxia in muscle tissue.  In fact, some studies have implicated these hypoxic events with Overtraining Syndrome in elite athletes.  It's also worth noting that Borrelia Burgdorferi, the causative agent of Lyme Disease, is an anaerobic microbe meaning it thrives in low oxygen environments. 

A better argument could be made for low intensity aerobic exercise.  Such exercise have been shown to increase capillary density and mitochondrial function, the benefits of which are obvious.  Even though the intensity is lower there is still an increase in blood flow.  Assuming the patient is far enough along in the recovery process (i.e lower levels of inflammation and reduced morbidity) then low intensity aerobic exercise could be safely and gradually integrated into the treatment process. 

2.)  IL-6 CONCENTRATIONS HAVE A POSITIVE CORRELATION WITH EXERCISE INTENSITY

What do you do with patients suffering from a disease that results in chronic inflammation?  You don’t introduce more inflammation!  Several studies have shown that exercise results in an acute increase in pro-inflammatory cytokines, namely interleukin 6.   More importantly, there is a positive correlation between IL-6 levels and exercise intensity.  Most patients with Chronic/Late Stage Lyme already have elevated cytokine levels.  It seems counterproductive to voluntarily add to the level of inflammation that is already present.  Further, recovery from this high inflammatory complex is not understood.  Other than a study with CFS/ME patients, which showed the negative effects of exercise via increased C4a levels (inflammatory marker), there have been no studies to show how the chronically ill cope with and recover from exercise.

3.)  INTENSE EXERCISE SUPPRESSES THE IMMUNE SYSTEM

In addition to increases in pro-inflammatory cytokines high intensity exercise results in an increase of catecholamine’s.  Cortisol, epinephrine, and norepinephrine are immunosuppressors.    In healthy individuals this increase in catecholamine’s is acute and generally returns to baseline within minutes to hours following exercise.  Again, the effects of intense exercise on chronically ill patients is not well understood/studied.  In untrained individuals the central nervous system is driven by sympathetic dominance.  This dominance is likely exaggerated in chronically ill patients, especially those dealing with a lot of inflammation.   As a result it takes longer for the body to return to baseline following a stress stimulus.  Therefore, you are exposing an already stressed immune system with more stress. 

4.)  RISK OF TRAUMA

Several antibiotics, such as quinolones, have a caustic effect on soft tissue.  This should be an increased concern in Chronic Lyme patients due to the duration of antibiotic treatment.  Combine this with high intensity exercise in untrained individuals and you have a recipe for ligament and cartilage damage.  Other classes of antibiotics, such as macrolides, can cause irregular heartbeat via QT prolongation.  This can result in dizziness fainting, and in rare cases death. 

This is by no means an exhaustive list, but should underscore the consideration that need to be taken when introducing chronically ill patients to exercise regimens.  Practitioners need to be cautious when and if they decide to prescribe a workout protocol for such patients.  A logical route would be to consult an exercise physiologist or physical therapist that has a background in treating chronically ill patients.

What Has The IDSA Done For Patients?

Several studies, both in vivo and in vitro, spanning over the past few decades have definitively shown the persistence of  Lyme spirochetes despite antibiotic challenge.  This should warrant some attention considering that the IDSA maintains that short durations of antibiotics effectively treat Lyme Disease.  Patients that remain ill following the CDC/IDSA treatment protocol are said to be suffering from Post Treatment Lyme Disease Syndrome (PTLDS).  What is this exactly?  No one knows, not even the IDSA who coined this term.  The CDC states that the cause of PTLDS is "UNKNOWN".   It could be an autoimmune type reaction similar to what is seen in other infectious diseases or could be from the persistence of Lyme spirochetes.  However, the IDSA maintains that there is no credible evidence that patients who remain ill are suffering from persistent infection.

I want to play devil's advocate for a moment even though there is plenty of scientific proof that patients do suffer from persistent infection with Lyme spirochetes.  If there is any truth to this "autoimmune" like effect following Lyme disease where is the research?  Take a stroll on pubmed or google scholar and type in Post Treatment Lyme Disease Syndrome and see what you come up with.  There is not much and it reiterates everything you can find on the IDSA or CDC websites.  So even though these organization acknowledge that a certain percentage of patients remain ill following their recommended treatment for Lyme disease they have done nothing to figure out why.  NOTHING.  Most of the studies you will find online from IDSA proponents are studies that refute any research that contradicts their recommendations.  Why are they always on the defensive?  Why are they not championing new research to bring these ill patients relief?  I'll let you fill in that blank.

At the other end of the spectrum you have ILADS that suggested these ill patients are still fighting an active infection or what is known as Chronic Lyme.  So what have proponents of this theory done for patients?  Well a lot.  They continue to treat patients with antibiotics for as long as necessary.  They have developed novel treatment approaches to address all three form of the Lyme spirochete (cyst, biofilm, and L-forms).  They have discovered new bio-markers to aid in the differential diagnosis of Lyme such as SPECT scans, NK CD57, High levels of active Vitamin D, C4a, and many more.  They discovered alternative and adjunctive treatments such as samento, banderol, cats claw, teasel root, CoQ10, Hyperbaric Oxygen Treatment, grape fruit seed extract, Epsom salt baths,  Low Dose Naltrexone, Glutathione and many more.  They also recognize that patients that have been severely ill for extended periods of time often suffer from other comorbidities such as adrenal insufficiency, reactivated viruses, thyroid dysfunctions, and other hormonal imbalances.  One ILADS proponent, Dr, Richard Horowitz, has described an entire paradigm that must be gone through if a patient remains ill. 

I will admit that we need better science to describe what is going on with these patients that remain ill.  Above all else we need better and more reliable diagnostic tests.  However, it's clear that there is a subset of doctors that are fighting to get patients better and one that is not.  So why is the group that is not helping patients establishing treatment guidelines for Lyme Disease?