Due to space constraints this article will ONLY cover the treatment of borrelia, the causative agent of Lyme Disease. To see treatments for the various co-infections, type Bartonella, Babesia, Mycoplasma, Toxoplasmosis, or Powassan Virus into the search bar for those articles. I hope to add to this list in the future.
Lyme Disease or borreliosis is caused by a Gram-negative bacterium belonging to the class of Spirochaetes, which have flagella allowing it to migrate through fluids and burrow through tissues, making it highly invasive. Borrelia burgdorferi is known for its outer surface proteins OspA and OspC which have a role in transmission into the host cell, whose metabolism is limited requiring Bb to rely on its host for energy precursors. Bb is slow growing, with a doubling time of 12-18 hours, unlike Strep or Staph which doubles every 20-30 minutes, which factors into the difficulty of diagnosis. This also necessitates longer treatment time for Bb as most antibiotics kill bacteria only when they divide. There are at least 37 known species, 12 of which are Lyme Disease related to date, and an unknown number of genomic strains; however, these numbers are constantly changing due to greater strain diversity than previously thought. Further complicating things, the strains differ in clinical symptoms and/or presentation as well as geographic distribution; however, again, to put Bb strain diversity into a geographical box is a huge mistake as the bird, reptile, fox, rodents, and humans are never confined to one location and migrate freely. Further complicating things, borrelia exists in three different forms. These are the spirochete, L-form (lives in cells), and microscopic cyst form or non cell wall. The form can change shape whenever it feels threatened and can lie dormant until conditions are beneficial.
Graphics used with permission from lymestats.org.
Lyme Disease (LD) is the most common vector borne disease in the U.S with the CDC estimating that there are at least 300,000 new cases of LD diagnosed yearly, with actual infection rates much higher.
“We know that routine surveillance only gives us part of the picture, and that the true number of illnesses is much greater,” said Paul Mead, M.D., M.P.H, chief of epidemiology and surveillance for CDC’s Lyme disease program. “This new preliminary estimate confirms that Lyme disease is a tremendous public health problem in the United States, and clearly highlights the urgent need for prevention.”
This makes LD more prevalent than AIDS, breast cancer, West Nile Virus, H1N1, and Ebola.
http://www.medicaldaily.com/lyme-disease-contagious-clues-hint-it-may-be-sexually-transmitted-disease-267964 . There are over 300 strains of Bb worldwide and 100 strains in the U.S. to date.
It has since been determined that Lyme disease (named for the town in which it was first identified) can be caused by any number of different species in the genus Borrelia, such as: B. andersonii, B. japonica, B. valaisiana, B. lusitanie, B. turdae. B. tunakii, B. bissettii, and B. lonestari, and the most recent discovery of B. mayonii.
Borrelia inhabits the lumen of a tick’s digestive tract. The disease is transmitted to humans from a tick bite when the bacteria migrates up to the ticks salivary glands, and through the opening created by the tick. Ticks increase salivation during gorging, prompting the migration of the saliva from the digestive tract. Because migration from the gut takes a few days, transmission of the disease usually does not happen until after the first 24 hours of attachment. Please keep in mind; however, if spirochetes are in the tick’s salivary glands, theoretically, transmission could happen immediately despite the common CDC rhetoric that a tick must be attached for 36 to 48 hours or more. http://www.cdc.gov/lyme/transmission/
Excellent video on transmission time by Lyme Action Network:
For information on ticks, go to:
Clinical diagnosis must consider any skin rash, regardless of its resemblance to the bull’s-eye. Many people never recall a rash or tick bite. “Researchers note that multiple textbooks and websites prominently feature the bull’s-eye image as a visual representation of Lyme disease.” They write, “This emphasis on target-like lesions may have inadvertently contributed to an underappreciation for atypical skin lesions caused by Lyme disease.” — Some Visible Signs of Lyme Disease Are Easily Missed or Mistaken, Science Daily, Apr 22, 2013 https://www.sciencedaily.com/releases/2013/04/130422132507.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fhealth_medicine%2Flyme_disease+%28ScienceDaily%3A+Health+%26+Medicine+News+–+Lyme+Disease%29
An excellent primer on LD by Lyme Action Network (Approx. 5 min)
The CDC also states there is NO EVIDENCE that Bb is sexually or congenitally transmitted or spread through transfusion if a person has been treated with antibiotics, http://www.cdc.gov/lyme/transmission/, despite the fact Bb is a cousin to Syphilis, is in the spirochete family, and has been found in semen and vaginal secretions. http://www.onlineprnews.com/news/454866-1390261507-lyme-disease-may-be-sexually-transmitted-study-suggests.html, http://asp.cumc.columbia.edu/lymedisease/askthedr/for_pt/displayanswer1-lyme.asp?Departments=LymeDisease&Controlnumber=347 , http://archderm.jamanetwork.com/article.aspx?articleid=1899258, and the DNA of Bb has been found in breast milk. http://www.lymediseaseassociation.org/index.php/about-lyme
They also emphatically state pets cannot spread the disease to their owners and that you can not become infected by air, food, water, or bites of other insects. Please glance at the following animal studies on Bb before you believe everything you are told: http://www.lymerick.net/Transmission-Bb-contact.htm and http://www.ncbi.nlm.nih.gov/pubmed/20618647# (spirochetes found in mosquitos and black flies)
https://www.youtube.com/watch?v=ow53uy1qElI (Approx 50 min) Excellent video explaining the horrible testing, possible biowarfare agents including Lyme Disease (Bb), lab workers becoming infected at work, Plum Island’s work with ticks, the anti-trust investigation with excellent testimony at 18:50 by Dr. Phillip in case after case for persistent (chronic) Lyme, at 35:30 clips of pathologist Alan MacDonald who’s getting 100% positive Bb in autopsies of Alzheimer patients, testimony of a woman who miscarried due to Bb, and much more).
Why the CDC continues to make such bold claims is foreign to me when there is so much at stake and much that is unknown or unproven. Prudence would err on the side of caution. Just a year ago a doctor showed up in an airport donning a hazmat suit and sign that read, “The CDC is lying!”
Due to this brave man’s actions, the CDC changed their position on transmission of Ebola.
The box of myths the CDC, NIH, and ISDA has conveniently thrown all of the factors of this complex illness(es) into are already beginning to claw their way out with a new species of Bb and Bartonella being “discovered” just this past week. I predict much more yet to come.
Before beginning any treatment, please read the article on the Herxheimer Die-off reaction:
https://madisonarealymesupportgroup.wordpress.com/2015/08/15/herxheimer-die-off-reaction-explained/ as well as the article, Tips for Newbies.
FOR EDUCATIONAL PURPOSES ONLY. PLEASE DISCUSS ALL TREATMENT OPTIONS WITH YOUR HEALTH PROFESSIONAL.
A successful treatment should treat all three forms of borrelia. There is disparity between LLMD’s as to the timing of this but many state you should treat all three forms at the same time. However, at the first treatment take care to avoid an intense die-off reaction by starting one prescription antibiotic only. Too much inflammation is unhelpful.
LLMD, Ken Singleton states there are five classes of antibiotics commonly used for Lyme Disease (borrelia).
Tetracyclines are commonly used due to their ability to penetrate cell walls.
doxycycline (100-300mg twice a day with food, but not with dairy or minerals)
minocycline (100mg) twice a day
Both of these must produce high blood levels and may require monitoring. If they are not tolerated due to side effects, doxy may be administered intravenously and the dosage for that is 300-400mg once a day.
*NOT TO BE USED IN PREGNANT AND BREASTFEEDING WOMEN OR CHILDREN 8 AND UNDER (current information debunks this – talk to your doctor)
*SPACE ANTACIDS, DAIRY, AND IRON AN HOUR OR MORE AWAY FROM TETRACYCLINES
*Notify your LLMD if you experience a severely unrelenting headache upon taking a dose
Macrolides and Ketolides, similar to Tetracyclines penetrate cell walls and tissues.
Telithromycin (800mg/day) – need to check electrocardiogram and liver function regularly
Azithromycin (250-600mg/day) IV dose: (500mg/day)
*Blood tests are needed to monitor liver function and white blood cell count.
*Macrolides can interfere with other drugs. Make sure to talk to your doctor and pharmacist about other medications you are taking prior to beginning macrolide treatment.
Cephalosporins ideally should be combined with antibiotic classes that target the L-form of borrelia and, ideally, the cystic form also.
Ceftin (500mg 2X/day – some require higher dosages)
Omnicef (600mg daily)
Rocephin (IV) 1-2gms every eight hours and Claforan (IV)- 2gms daily – high blood levels need to be reached and levels should be measured regularly.
*Regular blood testing should be done to detect any adverse reactions. Ceftriaxone can cause gallstones, which can be prevented by using ursodiol.
*People allergic to penicillins are also allergic to cephalosporins.
Penicillins also should be combined with other antibiotic classes that target the L-form (such as macrolides & Ketolides) and cystic form (Metronidizole).
amoxicillin (1,000-2,000mg every eight hours) sometimes combined with probenecid (500mg) or Augmentin helps to keep blood levels high.
IV penicillin (1,200,000 units 2-3X/week). The LA form of Bicilin is more effective but painful than the CR form
*NEVER USE IF ALLERGIC TO PENICILLINS
Metronidazole kills borrelia in the cystic form. Use in combination with one or more of the above classes to kill all three forms.
Metronidazole (250-500mg 2-3X/day)
*Do NOT use Tetracyclines with metro because they inhibit metro’s effectiveness)
*Do NOT use if on blood-thinning medications
*Do NOT use if pregnant
*Do Not use alcohol while on this medication
Dr. Marty Ross’s borrelia treatment:
According to Ross, a successful borrelia treatment needs to boost the immune system, kill the infections, protect and repair the negative effects upon the body, and speed recovery.
He recommends staying on each of the natural medicines until you have marked improvement, then you can stop all naturals but probiotics, curcumin, ashwagandha, and a good multi-vitamin.
L-Theanine 100mg 1-6 pills a night an hour before bedtime. Do not exceed 1200mg a day, and/or
Herbal Combinations 1-4 pills one hour before bed (valerian, hops, yam, wild lettuce, l-theanine, and others)
Prescription: Zolpidem (Ambien) 10mg 1 pill 30 min before bed (use if you have trouble getting to sleep as it is short acting), and/or Clonazepam (Klonopin) 1 mg .5-2 pills 30 min to 1 hour before bed. (use if you have trouble staying asleep). If you have both getting to sleep and staying asleep issues, try Ambien first.
CYTOKINE CONTROL: (At the beginning of treatment and when you change antibiotics, an excessive amount of cytokines are made making you feel worse.)
Curcumin 500mg 1 pill 3X/day
Good multi vitamin
ADAPTOGEN: (based on animal studies, adaptogens improve energy, immune function, and adrenal/thyroid function)
Ashwagandha 400mg 1-2 pills am and 1-2 pills between 1-2pm. Taking late will disturb sleep.
HORMONES: A person could have normal range testing for each of the hormones but still have clinically low hormones. Because of the unreliability of testing, treatment for low hormones should occur if there are clinical symptoms of low hormones as long as treatment does not increase hormone levels above the upper end of normal. Hormones provide many functions in the body. Proper levels improve energy and help the immune system to work more effectively.
Symptoms: fatigue, recurrent infections, poor recovery from infections, low blood sugar with shakiness and irritability relieved by eating, low blood pressure and dizziness on standing, afternoon crashing, and sugar cravings.
Naturals – Ashwagandha (same dosage and timing as listed above in Adaptogen)
Prescription – Cortef 5mg 1-2 pills am and 1-2 pills from 1-2pm. Taking late will disturb sleep.
Symptoms: Low thyroid: fatigue, achiness, low body temperatures averaging below 98.0 F, cold intolerance, weight gain, constipation, and changes in menstrual periods.
Naturals – good multivitamin to provide essential micronutrients for the thyroid
Prescription – Desiccated Thyroid 1/2 grain or Armour Thyroid 1/2 grain. 1 pill in the morning 30 min before anything else but water (empty stomach). Increase every 3-4 weeks by 1/2 grain if low thyroid symptoms persist.
According to Ross, “Low hormones occur often in chronic Lyme disease. Inflammatory cytokines made by white blood cells to fight Lyme decrease the effective functioning of an area of the brain called the hypothalamus and pituitary. This part of the brain produces chemicals that induce sleep and that regulate hormonal systems. Normally this part of the brain releases messengers such as thyroid stimulating hormone (TSH), adrenocorticotropin hormone (ACTH), and follicle stimulating hormone (FSH) to stimulate the thyroid, adrenal glands, and sex hormone organs respectively. Because of the dysfunction caused by the cytokines, these regulatory messengers are released based on an incorrect interpretation by the brain of the hormone environment. Thus measurements of these messengers is an unreliable way to determine the hormone status. Another way to check hormone status is to measure the actual hormone levels like T4/T3 (thyroid), or cortisol/dhea (adrenals), or estrogen/progesterone/testosterone (sex hormones). These tests give a broad range of normal, however.”
It has been my personal experience that most general practitioners do not think for themselves when it comes to hormones. Similarly to how they hide behind the CDC guidelines, they hide behind test results and refuse to diagnose and treat patients clinically.
For excellent information on thyroid disorders please watch:
Dr. Brownstein: https://www.youtube.com/watch?v=ku2lylX13h4 (He starts by giving an intro of how he ditched what he’d been taught in med school and at 7:30 starts with the thyroid talk. He states thyroid disorders are epidemic – 60% of the population has an undiagnosed thyroid problem and they are not being diagnosed or treated properly by mainstream medicine. At 10:56 he hits vitamin D deficiency, and dispels myths about skin cancer and sunscreen. At 18:00 he gives hypothyroidism symptoms. Lab tests do not reveal everything and many go undiagnosed. Approx 1.5 hours (Sorry, nothing is simple)
Multivitamin: Use a vitamin that has numerous amino acids, antioxidants, minerals, and various vitamin Bs including b12 and folate. He prefers vitamin powders from Thorne and Integrative Therapeutics.
Probiotics – use a product shown to repopulate the intestines in scientific studies. Take at least 10 billion live cultures 1 hour away from antibiotics. During an active yeast infection consider increasing to 20 billion cultures one time a day or divided in to two doses.
Natural medicine: Herbal Combinations. 2 pills 2 times a day. (Common herbs found individually or mixed together include: pau d’arco, caprilic acid, rosemary oil, thyme oil, garlic, and grapefruit seed extract.) Will take 3-4 months to get yeast overgrowth under control.
Prescription medicine: Nystatin 500,000IU 2 pills 2 times a day.
*You may add Fluconazole (Diflucan) 200mg 1 time daily for 30 days combined with nystatin for prevent drug resistance for a yeast overgrowth problem.
(Take either the naturals or the prescriptions, but not both together at the beginning; however, you may do so later on)
Naturals (work 85-90% of the time)
Otoba Bark Extract and Cat’s Claw 5 drops 2X/day of each and increase every 2 days by 1 drop per dose till taking 30 drops 2X/day. Take on an empty stomach. Do not take 30 min before through 2 hours after having food, medicines, or supplements. If you Herx, do not advance dosage until it decreases.
Doxycycline 100mg 2 pills 2X/day or 4 pills 1X/day. Take with food to prevent nausea. Do not take with calcium supplements or dairy or milk substitutes like rice milk. OR
Clarithromycin (Biaxin) 500mg 1 pill 2X/day
*Both of these antibiotics treat the L-form and the spirochete form.
B. After First Month
Remain on same as they kill all 3 forms of Lyme.
Work with LLMD to add additional antibiotics to treat all 3 forms of Lyme. You need to add an antibiotic to kill the cyst form of Lyme.
For an interesting article on what researcher Eva Sapi discovered about the effectiveness of various antibiotics: (Tindamax or Tinidazole was found to be the most effective drug overall killing 90% of cysts and spirochetes. It also works against biofilms.)
Avoid gluten, alcohol and tobacco, and synthetic scents
Multivitamin to support liver detox
Drink good water (1/2 of your ideal body weight in lbs. as ounces)
2-3 servings of beans, legumes, or whole grains/day. Fiber helps you detox.
Exercise – at a tolerable level
*Special Considerations for 6 months & beyond:
Detox treatments for MTHFR methylation defect, lyme and mold biotoxins, and heavy metals
Chronic viral infection treatments
Autoimmune illness treatment such as Low Dose Naltrexone (LDN)
(Ups and downs in treatment is normal; however, if there is a significant decline after you are doing better, consider yeast (increased sugar cravings, intestinal gassiness or bloating, recent vaginal yeast infection, oral yeast, and/or vaginal or rectal itching), or a co-infection such as Bartonella, Babesia, or Mycoplasma. Please do Dr. Schaller’s checklists for these coinfections and discuss these possibilities with your health care professional)
Dr. Horowitz’s Lyme Treatment: (Derived from Why Can’t I Get Better? Solving the Mystery of Lyme and Chronic Disease)
Combine antibiotics to address the 3 forms. Use enzymes to address biofilms, and continue until patient is symptom-free for 2 months.
Cell Wall form:
amoxicillin (500-875mg 2-3X/day) with probenecid 500mg 1X/day with meals. He states to check the peak (12-15 is optimal) and trough levels which may necessitate increasing the dose. Avoid probenecid if there is a sulfa sensitivity or use with caution if has kidney stones.
Augmentin (875-1,000mg 1-2X/day) alone or with amoxicillin.
IM Bicillin 1.2 million units 2-4X/week. Use Emla or lidocaine cream 1 hour prior to injection & massage area 2-3 minutes after and repeat several times per day.
Ceftin (500mg 1-2X/day)
Omnicef (300mg 1-2X/day)
Cedax (400mg 1-2X/day)
Suprax (400mg 1-2X/day)
*For those with significant CNS disease, or who have failed oral medications:
IV Rocephin (2g daily 5-7days/week, up to 2g every 12 pulsed 4-5 days/week). Use Actigall (300mg) 1X/day to prevent sludge and gallstones. Check CBC and CMP with liver functions every two weeks and use liver support (NAC, ALA, Hepa #2, milk thistle) as necessary.
IV Claforan (2g every 8-12 hours) may used instead of Rocephin if there are gallbladder problems. Check blood work as with Rocephin.
IV vancomycin (1-1.25gm/every 12 hours)
IV Primazin (500mg every 6 hours)
IV Cleocin (600mg every 8 hours or 900mg every 12 hours)
Cystic Forms: (also known as L forms, S-forms, spheroplasts, and non cell wall forms)
Grapefruit seed extract (use when can’t take plaquenil or when have yeast issues)
Flagyl – pulse either several days in a row per week or two weeks on, two weeks off
Tindamax – pulse same as Flagyl
*Avoid alcohol when taking Flagyl and Tindamax
*Horowitz uses high doses of B6 and B12 and nystatin to decrease side effects
Intracellular Forms: Macrolides
Zithromax (250mg 1X/week with meals.
Biaxin or Biaxin XL (250mg 1X/day)
Tetracyclines: (Do not mix with dairy, antacids, or vitamins and minerals, avoid direct sunlight, and do not lie down within an hour of ingestion to avoid reflux esophagitis)
Doxycycline (100mg 2X/day with meals)
Minocycline (50-100mg 2X/day)
Tetracycline 250mg or 500mg 1-2 g per day total, 2X/day
Quinolones: (Do not use if pregnant, do not mix with antacids, or vitamins with minerals)
Cipro (500mg 2X/day)
Levaquine (500mg 1X/day)
Avelox (400mg daily)
Factive (320 daily)
*Check QT interval on Quinolones as well as drug interactions
*Advise patients of tendon issues and do not exercise vigorously. Discontinue if tendon pain starts. Take ALA, curcurmin, and magnesium to decrease side-effects.
*Consider pulsing these in 5 day cycles to reduce tendon damage.
Rifampin: (150mg to 300mg 2X/day) Do not use if pregnant. Use with another intracellular to avoid resistance.
http://www.immed.org/treatment%20considerations/LymeTickTwnsndLet2007.285.93.98.pdf An excellent PDF with treatment suggestions from Dr. Garth Nicolson. Please remember that you can jump immediately to late disseminated Lyme without noticing any of the previous stages and while the literature often categorizes these stages with time frames, it is often the case that reality is far different. He also goes into co-infection treatment as well.
The Cowden Protocol: https://www.youtube.com/watch?v=DLuQk5Zs2Fo and
http://www.nutramedix.ec/ns/lyme-protocol (PDF’s and videos to watch)
This herbal program utilizes 14 different Nutramedix products including 6 Microbial Defense herbals that are taken rotationally over at least 6 months. Richard Horowitz, MD in New York State has found the Cowden Support Program to be effective in markedly improving the condition of 70-80% of the advanced Lyme Borreliosis patients with co-infections over 4 to 6 months’ time, even if the patients had previously failed to improve on multiple courses of antibiotics.
Master Herbalist Stephen Buhner’s Herbal Protocol:
http://buhnerhealinglyme.com (Please check this website for updates on treatments)
Japanese knotweed – Source Naturals Resveratrol with 500mg Polygonum cuspidatum per tablet) 1-4 tablets 3-4X/day for 8-12 months or for tincture dosage:
150lb – 1 tsp 3X/day
100lb – 2/3 tsp 3X/day
60lb – 1/3 tsp 3X/day
30lb – 1/5 tsp 3X/day
Cat’s claw (Uncaria tomentosa) Raintree brand, 1-4 tablets 3-4X/day for 2-3 months, then 2-3 capsules 3X/day or for tincture dosage: same as knotweed above.
Eleuthero (Eleutherococcus senticosus) HerbPharm tincture, 1/2 to 1 tsp upon rising and at lunch for all weights.
Astragalus (Astragalus membranaceus) 1,000mg daily (not to be used in chronic Lyme) or for tincture dosage: same as knotweed except for:
60lb – 1/2 tsp 3X/day
30lb – 1/3 tsp 3X/day
Ashwagandha (withania) 1,000g at night before bed for sleep issues and brain fog.
If you have questions, you may post them to Stephen at: www.PlanetThrive.com/category/experts/buhner/. I highly recommend all of Stephen’s books.
Byron White Protocol:
As to duration of treatment – this varies highly; however, according to the most experienced Lyme literate doctor in the state of Wisconsin, treatment cases in the 70’s resolved within a month to a year, while current cases are taking three and more years. Many LLMD’s (Lyme literate doctors) recommend a maintenance program for life.
I know this is overwhelming. Take a deep breath and put one foot in front of the other. One day at a time. Trust me, before long you will be a quasi expert in all things TBI (tick borne infections).
You do need to get to an LLMD (Lyme literate doctor). Regular practitioners at this point do not believe in the severity and complexity of MSIDS (multi systemic infectious disease syndrome or Lyme with friends). They will not treat you properly with various and extended antibiotics and/or naturals. Research shows that most are infected with more than borrelia, the causative agent of LD, and have various coinfections such as Bartonella and Babesia complicating our cases. According to Horowitz, research shows that a person with both Babesia and borrelia are three times sicker than if they just had LD. This is important to acknowledge and frankly, most GP’s are clueless on all of this. These stealth pathogens are experts at fooling your immune system and they work symbiotically together and actually morph inside your body by changing their outer surface proteins to be different than when they entered.
If you find a doctor willing to be properly trained, please give them this link: https://madisonarealymesupportgroup.com/2017/06/20/help-doctors-get-educated-on-lyme-and-tick-borne-illness/
Realize you have a lot to learn. Learn it. Then, be your own advocate. This is not going to be a sprint, and it’s far from fun. It’s going to be a marathon, so strap yourself in for a wild ride. If you are able, get to a Lyme Support Group to learn and be around others on the same journey. We learn from each other. If you aren’t able to get to a physical support group, I highly recommend getting on an on-line support group. You can ask questions and read others’ experiences. On the right hand side of the website, scroll down until you see “On-line Support Groups.” Click and join. Also, if you want to receive an email each time I post educational materials or meeting times for the Madison Lyme Support Group, pop me an email, I’ll send you an invite, and you will get an email directly to you when I post. This is convenient because I always send reminders for meeting times! You can also type in words in the search bar for articles to help you learn. For instance, from here, I’d recommend “Tips for Newbies,” as this complex is far different than anything you’ve experienced. Also, if you are struggling with cognitive and/or psychological issues, please type “Psychological Aspects of Lyme,” into the search bar.
No, you aren’t crazy, you have a brain infection which makes you feel crazy. Treatment will resolve these issues.