Archive for the ‘Sleep’ Category

Try These Alternatives Instead of Wasting Your Time on a Detox

Try These Alternatives Instead of Wasting Your Time on a Detox

Beth Skwarecki
We don’t have to tell you that 2020 was a terrible year. We can’t promise 2021 will be any better, but this week, we’re sharing our best strategies to help you reboot your life and start clean.

By now we all know that new year “detoxes” and “resets” don’t detox or reset anything. Depending on which you choose, they are either unsustainable diets or pure pseudoscience—often a mix of both. And yet, they still appeal.

A “detox” in 2021 may be a week’s worth of smoothies and juices, often guided by a guru who makes big promises about how amazing you’ll feel after you spend a week drinking what you’ve purchased from them. Or it may be a challenge to eliminate certain foods from your diet—no sugar, for example. Whatever the mechanics, these are all restrictive diets branded as self-care.  (See link for article)



Sometimes the simplest things are truly the best.

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Differentiating RA from Lyme, Sleep Meds, & CD-57 Test

lyme warrior

by Jennifer Crystal

Every few months, Jennifer Crystal devotes a column to answering your questions. Do you have a question for Jennifer? If so, email her at

How do you differentiate rheumatoid arthritis (RA) from Lyme disease?

These two diagnoses are often mixed up, since symptoms are similar. A good Lyme Literate Medical Doctor (LLMD) should be able to distinguish Lyme from rheumatoid arthritis (RA) and other conditions that Lyme can mimic, such as Chronic Fatigue Syndrome, Multiple Sclerosis (MS), and lupus. They will run specialized tests for Lyme and other tick-borne diseases, and will be able to make a clinical diagnosis.

Though both Lyme and RA can cause joint inflammation and pain, the way this pain presents can help doctors distinguish between the two. Pain from RA tends to be symmetrical; a patient might experience it in both hands, both wrists, or both knees. Conversely, Lyme pain tends to be localized and/or migratory; a patient might only have pain in one wrist, or might have an aching left elbow one day and an inflamed right knee the next.

In his book Why Can’t I Get Better? Solving the Mystery of Lyme & Chronic Disease, Richard I. Horowitz, MD notes, “Rheumatoid arthritis can look a lot like Lyme disease. Like lupus, it is a chronic systemic inflammatory disease that primarily affects the joints, but it also may involve inflammation in tendons, ligaments, muscle, bone, and many organs in the body. To establish a diagnosis of rheumatoid arthritis, the joint score (counting and mapping the joints involved at each visit), the presence of synovitis (inflammation in the synovial membrane surrounding the joints), and the physical exam (range of motion, presence of increased fluid in the joints, nodules, and deviations in the joints) are the focus of the criteria. We can get signs of inflammation in both diseases (including positive ANAs and rheumatoid factors), but the presence of positive anti-CCP antibodies differentiates it from Lyme disease and is a more specific marker for true rheumatoid arthritis.”

In one of your articles, you mentioned that you take medication to help you sleep. I am worried about being on an addictive sleep medication. I am happy to be able to sleep through the night now, but I struggle with the knowledge that I’m on this drug. Any advice?

I had these exact same concerns when I first started taking sleep medication more than ten years ago. I didn’t want to be on an addictive medication; I worried about long-term effects; and I wanted to be able to sleep naturally. Luckily, my doctors gave me some good advice. My LLMD reminded me that without sleep, my body could not heal from Lyme disease, babesiosis, ehrlichiosis, and chronic Epstein-Barr virus. My sleep doctor told me that Western medicine is good for a crisis situation, while Eastern medicine is good for getting at the root cause of a medical issue; both are necessary for optimal health. At my worst points of illness, I had literally been awake for weeks. That was a crisis situation that required narcotic sleep medication.

After a short period, that medication helped restore my system to a point where I could sleep with a non-addictive sleep aid. If I hadn’t taken the narcotic—which I did not become addicted to, despite my worries—I might never have gotten to that point.

The sleep medication I still take is considered non-addictive, though I’m sure I wouldn’t sleep without it. I have been on it under close supervision from my doctor for over a decade, and we have not seen any issues. I have never increased my dose. Would it be nice to be able to sleep naturally? Sure. But I’d prefer to be able to sleep at all, and if that means taking a controlled medication, then that’s what my body needs to function. My doctor calls this effective use of medication, versus abuse.

In addition to medication, I also do neurofeedback, and practice good sleep hygiene: I keep the same sleep and wake times, I shut down screens and do quieter activities before sleep, I don’t read or watch TV in bed, I keep my room quiet and dark, and I nap in the early afternoon. If you’re following good sleep hygiene and following your doctor’s recommendations for safely using medication, I think you can rest easy.

Is the CD-57 test accurate?

The CD-57 test is a marker of natural killer cells and T lymphocytes. In layman’s terms, it is a way of measuring immune function against persistent conditions such as Lyme disease. The IGeneX lab website states, “In cases of chronic diseases, including Lyme disease, the number of CD57 NK cells has been shown to be below normal.” They also recognize, though, that “the utility of this test is controversial…This test measures only the CD57 NK cells and may be useful for patients with known Lyme disease who present with chronic symptoms. If the count is low, the cause of symptoms may be from Borrelia burgdorferi. If the count is normal, the cause may still be from Lyme disease, but it could also be due to some other agent.”

I’m not a medical practitioner and I can’t give medical advice, but I can tell you about my own experience with this test. When I was first sick, my doctor ran this test often, but he was afraid I was getting too connected to the results when the real marker of whether I was getting better was how I was feeling. Since then, we haven’t tested it that often, but we have used it at critical junctures as a way to corroborate clinical evidence of relapse. The first time I thought I was in remission, my CD57 was very low (16; below 60 is considered active infection), but I felt great. Just a few months later, I completely relapsed, after a perfect storm of stress factors and no antibiotic defense enabled spirochetes to flare. The low CD57 marker, then, should have forewarned me that my body was in danger of relapse.

A decade later, I experienced another flare up of symptoms that felt closer to relapse than I’d been in a long time. Again, my CD57 was low. After some tweaks to treatment and additional rest, I started to feel better, and the number came up. So in my experience, the CD57 test has been helpful, but it isn’t a tell-all; I would not recommend using it strictly as a diagnostic tool.

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jennifer crystal_2

Opinions expressed by contributors are their own.

Jennifer Crystal is a writer and educator in Boston. Her memoir about her medical journey is forthcoming. Contact her at


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More on the CD-57 test:

How to Strengthen Your Immune System This Winter

How to strengthen your immune system this winter


A balanced immune system is key to protect your body from illness

Dec. 22, 2020

In a year upended by COVID-19, it seems as if our immune systems have received more attention than ever before. But many unhealthy behaviors brought on by the pandemic make it harder for our bodies to fight off infections. Here are some tips on maintaining a balanced immune system that can protect you this winter:

Strengthening your immune system

The first line of defense is a healthy lifestyle. These factors can put you at risk:  (See link for article)



A great general article and reminder how we can make ourselves tough targets for disease.

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Article for natural remedies for strengthening the immune system:

Illness-Related Fatigue: More Than Just Feeling Tired

Illness-related fatigue: More than just feeling tired

A common refrain during the COVID-19 pandemic is, “I’m so tired.” After months of adjusted living and anxiety, people are understandably weary. Parents who haven’t had a break from their kids are worn out. Those trying to juggle working from home with homeschooling are stretched thin. Between concerns about health, finances, and isolation, everyone is feeling some level of additional stress during this unusual time, and that’s tiring. We all could use a good, long nap — or better yet, a vacation.

But while a break would be nice, most people — except those who are actually sick with COVID-19 or other illnesses — are able to push through their fatigue, precisely because they aren’t sick. “Tired” is a nebulous word that covers a broad spectrum of levels of fatigue. A crucial distinction, however, is between regular fatigue and illness-related fatigue.

Regular fatigue

Everyday fatigue that is not illness-related starts with a baseline of health. You may feel sleepy, you may in fact be sleep-deprived, or your body and mind may be worn out from long hours, exertion, or unrelenting stress — but you don’t feel sick. Your muscles and joints don’t ache like when you have the flu. You are capable of getting out of bed and powering through the day, even if you don’t want to. A cup of coffee or a nap might perk you up.

This type of fatigue is usually related to external factors: lack of sleep, stress, an extra-hard workout. But internally, your body is working well: your glands and organs are operating properly; infection is not depleting your body of energy; your nervous system may be overtaxed, but it’s not frayed from actual impairment.

Illness-related fatigue

When I was acutely ill with persistent Lyme, babesiosis, and ehrlichiosis (all tick-borne illnesses), as well as chronic Epstein-Barr virus, a good night’s sleep did nothing. Naps were staples of my day that helped me survive but didn’t improve my energy. Drinking a cup of coffee was akin to treating an ear infection with candy. No matter how much I rested, my exhaustion persisted.

I felt like I had the flu, except it lasted for years. My whole body ached. I suffered migraine headaches. I had hallucinogenic nightmares. Exercise was out of the question; at times, I was literally too tired to walk up a flight of stairs or sit at the dinner table. I couldn’t concentrate, unable to read or watch TV. Sometimes I was too tired to talk.

There was no pushing through this level of fatigue, because it was caused by internal factors: illnesses that were ravaging my body. Only when they were adequately treated did I start to get my energy back.

For me, the root causes were bacterial infections (Lyme, ehrlichiosis), a parasite (babesiosis), and a virus (Epstein-Barr). Profound fatigue may also result from a host of other diseases and conditions, including chronic fatigue syndrome, fibromyalgia, and multiple sclerosis.

Is it everyday fatigue or illness-related fatigue?

When determining whether your tiredness is everyday fatigue or illness-related, consider the following questions:

  • Do you feel worn out, or do you feel sick?
  • Have you experienced this before, or does it feel more extreme or unrelenting?
  • When you lessen the load of external factors (work, stress, long days) does the fatigue improve, or does it persist?
  • Do you feel refreshed after a good night’s sleep or a nap?
  • Can you go about your day, or is it impossible to get out of bed?
  • Has the fatigue persisted longer than you would expect?
  • Are you experiencing other symptoms that might point to illness?

The bottom line

No one knows your body better than you do. You know what feels normal, and you know what you feel like when you’re sick. If you are not responding to regular fatigue remedies, your fatigue has persisted over time, you have other symptoms, or you just don’t feel right, it’s probably time to call your doctor.



I had a Lyme/MSIDS patient state, “I could fall asleep standing up.”  Yep, that about describes it.

The author doesn’t mention it, but a large part of the problem is the unrelenting insomnia.  You would do anything to sleep at night.  But you can’t.

The great news is that appropriate tick-borne disease treatment fixes this or improves it greatly. There are also medications both natural and pharmaceutical that can help.

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Lyme Disease is Associated With Various Sleep Disorders


woman awake in bed with lyme disease and a sleep disorder

Patients with post-treatment Lyme disease syndrome (PTLDS) may experience sleep disturbances, according to a study by Johns Hopkins University School of Medicine. Researchers found,

“PTLDS participants reported significantly worse global sleep and sleep disturbance scores and worse fatigue, functional impact, and more cognitive-affective depressive symptoms compared to poor-sleeping controls.” [1]

Dr. Robert Bransfield, a New Jersey-based psychiatrist who specializes in the diagnosis and treatment of tick-borne illnesses, has seen a broad range of sleep disturbances in Lyme disease patients treated at his practice. He describes the various sleep disorders in the article “Neuropsychiatric Lyme Borreliosis: An Overview with a Focus on a Specialty Psychiatrist’s Clinical Practice.” [2]

The patients experienced:

  • Non-restorative sleep
  • Early insomnia
  • Middle of the night insomnia
  • Early morning insomnia
  • Excessive daytime sleepiness
  • Loss or reversal of circadian rhythm
  • Restless leg
  • Paroxysmal nocturnal limb movements
  • Sleep apnea (central and/or obstructive)
  • Sleep paralysis
  • Hypnagogic hallucinations
  • Sleep attacks
  • Cataplexy
  • Narcolepsy

The combination of “non-restorative sleep and chronic unremitting stress appear to play a significant role in disease progression,” explains Bransfield.

“Both non-restorative sleep and the chronic unremitting stress seen in these chronically ill patients contribute to disease perpetuation and progression and are associated with fatigue, cognitive impairments, decreased regenerative functioning, compromised immunity, decreased resistance to infectious disease and neurodegenerative processes,” he writes.

Editor’s note: I have also found that Lyme disease patients can suffer from a broad range of sleep issues. However, it can be difficult to determine whether Lyme disease or a comorbidity is responsible for the sleep disturbance. I have found that antibiotic treatment often improves sleep disorder symptoms.

  1. Weinstein ER, Rebman AW, Aucott JN, Johnson-Greene D, Bechtold KT. Sleep Quality in Well-defined Lyme Disease: A Clinical Cohort Study in Maryland. Sleep. 2018.
  2. Bransfield RC. Neuropsychiatric Lyme Borreliosis: An Overview with a Focus on a Specialty Psychiatrist’s Clinical Practice. Healthcare (Basel). 2018;6(3).
Chronic lack of sleep is a terrible thing.  Parasites notoriously cause insomnia.  Appropriate treatment for infection(s) is the most important step but often times other adjunctive therapies are needed as well.