Lyme disease can be a challenging adversary for physician and patients alike.
Often misdiagnosed and with no definite guidelines or vaccine for treatment, Lyme disease can be a dangerous and lingering infection. And while a vaccine is currently under development, if left untreated, Lyme disease can allow the bacteria to travel through the bloodstream and attach to various body tissues, leading to swelling of the joints and even heart and nervous system complications.
Lyme disease is more common than once thought and more prevalent during the warmer months of the year. According the Centers for Disease Control and Prevention (CDC) approximately 300,000 Americans each year are diagnosed with Lyme disease and that number is on the rise. It comes from a bacterium called Borrelia burgdorferi and is most commonly spread by deer ticks in North America and Europe.
Lyme disease is often identified as a bull’s-eye-shaped rash called erythema migrans that can appear within a few days of infection, can appears in more than one location on the body, and affects approximately 70 to 80 percent of those with the disease. Symptoms include joint pain and flu-like signs, including fever, headache and general fatigue. More severe symptoms can include nerve damage, including memory loss, difficultly concentrating, and changes in mood or sleep habits.
Natural Medicines (formerly Natural Standard) identifies three separate stages of Lyme disease, each with different symptoms: 1. Localized early disease stage: This is the onset of the disease where the bite site expands slowly in size over several days and is usually not painful. However, many individuals do not realize they have been bitten by a tick.
2. Secondary stage: Symptoms and evidence of a more widespread infection usually begin to develop.
3. Third stage: Approximately 20 percent of people with Lyme disease go into remission after stage two but most move into this third stage which finds the individual struggling with conditions that involve the heart, nervous system, and joints and can linger for weeks, months or even years.
Diagnosis and Treatment Options
One of the biggest concerns with Lyme disease is that many who contract the disease may not even know that they have it, at least at first. It can mask itself as any number of illnesses or conditions, from simple flu-like symptoms to more serious concerns, such as chronic fatigue syndrome (CFS), autoimmune conditions or even fibromyalgia. In his book, Why Can’t I Get Better? Solving the Mystery of Lyme & Chronic Disease,” author Richard I. Horowitz, MD, refers to Lyme disease at the “Great Imitator” and points out the inaccurate testing combined with a fierce, ongoing debate that questions chronic infection, “makes it difficult for suffers to find effective care.”
“It is important to understand that numerous infections trigger a secondary chronic fatigue syndrome/fibromyalgia, with Lyme simply being one of these,” said Jacob Teitelbaum, MD, director of the Practitioners Alliance Network and a leading expert on effective treatments for fibromyalgia and CFS. “Antibiotics can be helpful for Lyme and are best used in conjunction with other treatments that augment immunity and treat the overall fibromyalgia. Supplements that are especially helpful include, ribose, topical comfrey and BCM-95 curcumin. Antibiotics and natural remedies are best used together.”
The good news for patients regarding Lyme disease is that most make a full recovery if the infection is treated promptly and properly. Without swift diagnosis and treatment, however, the disease can continue to progress and affect multiple parts of the body. On very rare occasions, Lyme disease can even lead to death, which is why both physicians and patients alike must heed the warning signs of the disease and act quickly to put it in its place.
“Lyme disease is a very difficult infection to treat and can have effects on a patient for many years to come,” said Chris Oswald, DC, CNS. “Currently our understanding of chronic Lyme disease infections needs growth, but one of the most important things associated with better outcomes is rapid identification and prophylactic treatment of the potential infection.
“When it comes to the chronic effects of Lyme disease, I tend to focus on the effects of post-infectious inflammation. A large priority of mine is to improve the function of the eicosanoid pathway with high dose EPA and DHA. This will promote the formation of SPMs to help with the final resolution of inflammation and help to support balance within the immune system. Once the levels of inflammatory molecules have fallen, there is less pain associated with joint destruction and the body can start to mount an appropriate immune response and heal tissue that had been damaged due to the effects of the infection.”
One such product is ProOmega from California-based Nordic Naturals, which provides high levels of the omega-3 fats EPA and DHA and has been shown to support healthy glucose and lipid levels, bronchial health, and the body’s ability to respond to stress. The first line of defense against Lyme disease is usually a three or four-week dose of antibiotics to help combat the infection. Acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) are also usually recommended for pain and inflammation but can cause additional side effects such as nausea. Natural remedies can also play a large supporting role here, as can exercise and physical activity to help improve range of motion.
“I want to emphasize that the standard medical approach of antibiotics in the treatment of acute Lyme’s disease is appropriate,” said Michael T. Murray, ND. “During this time, natural products can be used as supportive care. Foremost in this goal is the use of a probiotic supplement to prevent the side effects of antibiotics on the intestinal flora. A good dosage during this time would be 12-24 billion live bacteria daily. Beyond that, my recommendation would be to focus on general supplementation recommendations to support the immune system, such as taking a high potency multiple vitamin and mineral formula, extra vitamin D to provide an intake of 2,000 to 5,000 IU daily, and the use of immune supportive botanicals or mushroom extracts.”
New Jersey-based Mushroom Wisdom offers its Super Reishi supplement that contains both hot water and alcohol concentrated extracts to provide the maximum range of beneficial constituents of the mushroom. It is also enhanced with the company’s proprietary Maitake D-Fraction for added immune support. “Immune, inflammation, liver and stress support seem to be major areas of concern when dealing with or recovering the Lyme disease,” said Donna Noonan, president of the company. “The specific immune-related research substantiates that certain mushrooms may be able to help accelerate the healing process, while other general support benefits may help rebuild and strengthen the body. While no mushroom supplement is intended to treat or cure any disease, I believe that certain mushroom supplements should be considered as one of the supportive components of any natural or integrative plan.”
“Boosting the immune system to help combat Lyme is of utmost importance and along with the herbs from the herbal Lyme protocol (devised by master herbalist Stephen Buhner) such as Japanese knotweed, and cat’s claw I would use probiotics, as well as correct for nutrient deficiencies, especially zinc, vitamins A, C and D and selenium,” said Frank Aieta, ND. “I also get great results with the use of medicinal mushroom extracts, specifically Shitake, Reishi, Coriolus versicolor, Agaricus blazei, Maitake and cordyceps.”
Prevention, of course, is the ideal counterpunch to Lyme disease, according to Terry Shirvani, ND, director of product innovation at Texas-based Progressive Laboratories, Inc. “Prevention is generally much easier,” said Dr. Shirvani. “In regards to antibiotics, the danger must outweigh the adverse effects. In other words, the patient’s condition must be serious enough to warrant the potentially huge impact on the gut and immune system. There is a tradeoff here. The health care practitioner and patient must consider this thoughtfully.”
A Lyme disease vaccine is under developments but not yet available. As an alternative to antibiotics—or as an adjunct—Dr. Shirvani also recommends a number of natural antimicrobial and immune supporting ingredients, including several mushroom extracts and beta-glucan.
Building a strong foundation with a comprehensive multivitamin and probiotic along with fish oil can also be beneficial in combating the effects of Lyme disease, according to Adam Killpartrick, DC, chief scientific officer for Vermont-based DaVinci Laboratories. “CoQ10 in the form of ubiquinol is also something to consider as part of a foundational protocol,” Dr. Killpartrick said. “Beyond foundational support, liquid bound curcumin, which ensures absorption provides support for healthy inflammatory response, may be clinically beneficial.”
Immune Support and Inflammation
As mentioned previously, support for the immune system has been cited as one of the goals of Lyme disease treatment, along with reducing inflammation to allow for joint pain relief. According to Natural Medicines, most individuals with advanced Lyme disease experience attacks of arthritis involving one or only a few joints, usually the larger joints, such as the knees. In some cases, neurological problems can exist.
“My favorite options for helping those suffering with Lyme disease revolve around the idea of supporting both healthy eicosanoid modulation and optimal immune function,” Dr. Oswald said. “Eicosanoid modulation carries tremendous importance as it has an impact on both healthy inflammation and healthy immune function. This pathway uses the fatty acids available within cell membranes to create many different molecules that interact with immune function, inflammation, and the resolution of inflammation.
“I view supporting healthy immune function as a twofold process. Support can be had directly with medicinal mushrooms, such as Coriolus versicolor, Ganoderma lucidum or Grifola frondosa, or indirectly through supporting the healthy function of systems which can impact overall immune function. An infection such as Lyme, especially once it has become chronic, can become a major endogenous stressor on the body. I am a big fan of the use of adaptogenic herbs to aid in supporting healthy signaling mechanisms with in the HPA axis.”
Dr. Murray holds that in the treatment of chronic Lyme disease, “it’s not so much about boosting the immune system as it is about helping restore proper immune system function.”
Another promising supplement to consider for Lyme is propolis, according the Mark Kaylor, MH, CN, PhD, a natural products industry consultant and formulator. “The primary reason to consider including propolis in any anti-Lyme program would be its direct anti-microbial actions against a vast array of microbes, Dr. Kaylor said. “Brazilian Green Propolis can reduce the parasitic load by improving macrophage activation as well as by acting directly on the microbes.”
Inflammation appears to go hand-in-hand with immune support when it comes to battling Lyme disease. While immune system support appears to be vital, tackling inflammation can also go a long way toward patient relief.
“Inflammation is another obstacle when treating Lyme disease,” Dr. Aieta said. “My favorite anti-inflammatory is curcumin. Not only is it a great anti-inflammatory but it balances the immune system and can normalize stress response in the body.” “Using a bioidentical vectorized highly-absorbed omega-3 along with special forms of curcumin and boswellia help dramatically with inflammation,” added Dr. Teitelbaum.
Diet & Exercise
Of course reducing inflammation also has a lot to do with eating a proper diet, getting regular exercise, and making smart and healthy lifestyle choices.
“Diet can be a big instigator of and contributor to inflammation—especially the standard American diet (SAD),” Dr. Shirvani said. “Limiting or eliminating highly processed foods laden with refined sugar, salt, unhealthy fats and artificial ingredients is a good start. I recommend a Paleolithic or Mediterranean-type diet to help reduce inflammation.”
“There is much that can be done with diet and supplementation in regard to reducing chronic inflammation,” Dr. Murray added. “The diet should be on that is free of allergens, focuses on whole foods with an emphasis on plant foods, and provides the right types of fats. In terms of additional supplements to help with persistent symptoms with Lyme disease, I would recommend a good high potency proteolytic enzyme and a highly absorbable curcumin product.”
Exercise, too, helps reduce inflammation. But after the onset of Lyme symptoms, such as joint pain, should patients be instructed to continue with regular physical activity?
“Fibromyalgia secondary to Lyme disease is associated with exercise intolerance, and too much exercise can leave the person bedridden for several days,” warned Dr. Teitelbaum. “On the other hand, deconditioning is devastating in this illness, so some exercise is critical. Because of this I recommend a walking program along with a low-sugar, high-protein diet.”
Dr. Oswald says the foundation of his patients’ treatment plans lies in lifestyle and believes that exercise and diet are incredibly importance. At the same time, he too warns against overdoing it when it comes to Lyme disease. “Exercise plays a huge role, but can be very difficult due to common symptoms of musculoskeletal pain. I recommend refraining from aerobic types of exercise and instead focusing on building strength and muscle mass through resistance exercise performed at the highest intensity tolerated.”
There are several adjunct therapies that can aid in the treatment of Lyme disease, including acupuncture, as well as physical therapy and message.
“I do acupuncture as an adjunctive treatment in most of my Lyme disease patients,” Dr. Aieta said, “especially those that are late-stage or chronic. I also recommend massage and physical medicine in most cases. Infrared saunas tend to work great to help raise body temperature to fight off the organisms as well as facilitate detoxification. I also recommend the use of IV nutrients, such as glutathione, vitamin C and magnesium.”
Dr. Killpartrick recommends ‘Series Therapy,’ a homeopathic approach that may provide effective support through all stages of Lyme, along with SilverSol, often referred to as Smart Silver, which can provide added immune support not found in other formulas. For symptomatic relief on later-stage Lyme when the musculoskeletal system is effected, “upper cervical chiropractic, cranial therapy such as Cranial Release Technique, as well as Low Level Laser Therapy, have all provided both short and long-term relief in my practice.”
For More Information:
DaVinci Laboratories, (800) 325-1776, www.davincilabs.com
Mushroom Wisdom, (800) 747-7418, www.mushroomwisdom.com
Nordic Naturals, (800) 662-2544, www.nordicnaturals.com
Progressive Laboratories, (800) 527-9512, www.progressivelabs.com