Archive for the ‘Supplements’ Category

What Helps Improve Cognitive Function for Lyme Patients?

When Lyme disease bacteria (spirochetes) cross the blood-brain barrier, they can cause myriad neurological impairments and nervous system inflammation. Neurological Lyme disease can manifest as brain fog, memory loss, word and song iteration, confusion, anxiety and depression, sleep disturbancesand more. “Lyme brain” is terribly frustrating for patients who could once multitask, but now lose their train of thought mid-sentence, or can’t find their way to the store. Many have written to me to ask what helped me improve cognitive function. Here’s what helped the most:

  • Pharmaceutical treatment: Lyme is a bacterial infection, and you can’t improve cognitive function without killing the bacteria that’s causing it. Sometimes symptoms can get worse as bacteria die off faster than your body can eliminate them (a Herxheimer reaction), but in my experience, the payoff is worth the temporary increase in discomfort and decrease in capabilities. Your doctor may want you to pulse antibiotics in order to give your body time to recover. There are particular antibiotics that work best to penetrate the blood-brain barrier and improve cognitive symptoms. Because every single case of tick-borne illness is unique, there is no set protocol, but your Lyme Literate Medical Doctor (LLMD) can tailor one to your needs.
  • Supplements: Certain supplements can help reduce inflammation and neurotoxins. Glutathione and Essential Fatty Acids are two that are commonly used (but again, I can’t give specific medical advice; you need to check with your LLMD about which supplements, and what dosage, would be appropriate for you). I’m wary of doctors who sell supplements themselves (you want to make sure your health, not their financial gain, is their top priority). Though supplements may seem good because they’re “natural,” they can have side effects and contraindications, so don’t always assume that natural is better. For me, I’ve needed a combination of both pharmaceutical treatment and supplements to improve all of my symptoms of Lyme disease, babesiosis, and ehrlichiosis.
  • Rest: Your body needs adequate sleep to heal. This can be really hard to come by for Lyme patients, and it also can be aggravating and downright boring to be in bed all the time. But your body is working really hard to fight infection, and it needs all the rest it can get in order to do so. Even now, a decade into remission, I still can get neurologically overstimulated and experience a flare-up of cognitive symptoms. When that happens, I need to wind down, give myself some quiet time, and get extra sleep.
  • Anti-inflammatory foods: In my post “The Lyme Diet,” I discuss foods that help with reducing inflammation. There are good foods to avoid, like gluten and processed sugar, and good foods to include, like fruits, vegetables, and proteins. Certain foods have antioxidant properties. Whether eating them has helped my cognitive function, I can’t say for sure, but I know it hasn’t hurt, and I’ll take any excuse to have a piece of dark chocolate!
  • Pacing: It can be enticing to keep reading a book that you’re really into, or to binge watch a show, but doing either can be taxing on a Lyme-riddled brain. Often, I don’t know I’m overstimulated until it’s too late. I feel fine reading one page, and then another, and then all of a sudden, my head feels like it’s full of molasses. I’ve learned to stop while I’m ahead. You might tell yourself, “I have to stop reading after two pages, even if I feel fine, and rest for twenty minutes.” Eventually, as your infections get better, you’ll be able to do more, but you have to think of improving cognitive function as a marathon, not a sprint.
  • Making lists: Because memory can be so impacted by tick-borne illness, it can help to make to-do lists for each day. You can literally write down tasks like “shower” and “eat lunch,” and check them off when you’ve done them (it’s especially helpful to set reminders, either in writing or on your phone, to take your medications). Write out only what you can handle for one day at a time, and put other items on lists for later in the week. Remember to include self-care items, too, like “rest” or “take a bath.”
  • Neurofeedback: This non-invasive brain training program helps your brain to work optimally (the system I use is called Neuroptimal). I use it to help quiet my brain down; others use it to sharpen their thinking. The process uses your brain’s own information to figure out what it needs. It’s a relaxing process that involves watching kaleidoscope images on a screen (you can close your eyes if those feel overstimulating) and listening to gentle music while sensors are attached to your head. You’ll hear occasional skips in the music, which are signals that help your brain get back to its optimal state. Neuroptimal is great because it works on the whole brain at once. The neurofeedback practitioners I’ve worked with have cautioned against doing neurofeedback that only works on one section of the brain at once, saying this can actually worsen Lyme brain. I first got connected with my practitioner through a sleep clinic (which meant that sessions were covered by insurance). Your LLMD may want to do a sleep study, or refer you to a practitioner; you can also find one through the Neuroptimal site.
  • Body work/cranial sacral massage: I do a type of hands-on therapy called Integrative Manual Therapy, which encompasses cranial sacral therapy and neurofascial processing. This gentle, light touch helps lymphatic drainage, and often calms my limbic system Easing these symptoms reduces my brain fog, allowing for better cognitive function. Some physical therapists offer this type of therapy (which again means that insurance can cover it).
  • Play word and memory games: To help sharpen my brain (and keep me busy), a friend used to play writing games with me over email. He’d set rules such as, “Tell a story about a dog using only three syllable words” or “Tell me the name of someone we went to school with, and then come up with another using the first letter of that person’s last name.” I think these games helped improve my memory. It was nice to do them over email because I could take as long as I needed to complete them.
  • Recall the music or games of healthier times: Memory care units for the elderly sometimes use music therapy to help prompt long-term memory. People struggling with short-term memory are often able to recall and sing entire songs from their youth. In the midst of convalescence, I played an old card game, “Scrooge.” This elaborate version of double solitaire requires memory, quick thinking, and strategy. These were not functions that I could generally execute well in those darkest days of illness, but while playing that card game, I suddenly could. When I won handily, my opponent quipped, “There’s nothing wrong with that brain of yours!”
  • Limit stimulation: I quickly learned that loud noises, crowded rooms, and flashing screens would stimulate my brain to the point of shut down, and then brain fog would settle in. By limiting the amount of time I spent on screens, and avoiding particularly fast-paced shows, I was able to keep my brain calm so I could engage in other activities like writing and reading.
  • Accept that there will be setbacks: Healing from tick-borne illness is not linear. You will regain some cognitive function, and then have periods of brain fog, and then start improving again. Eventually, if you follow your doctor’s protocol and stick to some of these tips, you should start to see more good days than bad. I still sometimes struggle with cognitive issues, but they are slight now. When I was at my sickest, I couldn’t read or watch TV. I mixed up my words. My head ached. Now, I can write, teach, read and watch TV in short segments, and generally carry on with good cognitive functioning, so long as I work to maintain my health.

Jennifer Crystal


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 using her email.


Clinical Considerations of Clostridia Bacterial Concerns Go here for presentation (Approx 22 Min)

Part 1: Clinical Considerations of Clostridia Bacterial Concerns – Pathogenicity Mechanisms

Biocidin Education Series

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Do You Really Need a Multivitamin? You REALLY Need a Multivitamin?

Do You REALLY Need a Multivitamin?

By Dr. Bill Rawls Posted 05-07-2021

I’ve been on the fence as to whether or not to take multivitamins for my whole life. Growing up in the 60s and 70s, there was always a bottle of multivitamins on the breakfast table. Every morning, each person at the table would take their turn. The basic “One A Day” was popular at the time, but chewable products were also making their debut. Flintstones were my favorite — they tasted like candy.

The idea of taking a multivitamin came with America’s shift toward processed food products in the mid-20 century. Fast food was a radical change from freshly prepared meals that had been the norm, but ready-made foods seemed to be a better fit for the fast pace of American life. Not only that, processed foods were specifically designed to appeal to our preferential tastes for carbohydrates and fats. I don’t think anyone thought that these new foods were nearly as nutritious as the freshly prepared foods people had been eating before, but that was okay; multivitamins were there to fill the void.

Both fast foods and multivitamins became the standard that is still with us today. Currently, half of all Americans and 70% of those over 65 take a multivitamin product.

The big question is: does taking a multivitamin really do anything?

white plastic bottle, tablets arranged into a question mark, blue background

Most average “once-daily” multivitamin products contain synthetic forms of vitamins and minerals. These aren’t the same as the forms of vitamins and minerals found in natural whole foods. When someone takes a standard multivitamin, the body has to expend energy to convert these synthetic substances into a form the body can actually use, which seems to defeat the whole purpose.

On top of that, numerous clinical studies failed to show a clear benefit of taking multivitamins for improving health or reducing the incidence of chronic illness and cancer. As recent as 2018, research published in the Journal of the American College of Cardiology reviewed data from 179 individual trials and concluded that multivitamin supplements did not help prevent or improve cardiovascular disease. Another study examined data from more than 30,000 people over six years. It likewise found that people who took multis and other nutrient supplements had about the same risk of dying as those who didn’t take a multivitamin.

That being said, some people still feel more comfortable taking multivitamins just for peace of mind. They believe by taking extra vitamins and minerals, their bases are covered if they don’t always eat healthily or are stressed.

And who isn’t stressed sometimes? Maybe when people are under stress or even as we age, we do need a little extra support.

At different points in my life, I’ve gone back and forth between taking and not taking multivitamins regularly. Growing up, I took them every day. After becoming an adult and shifting to a healthier diet, I felt that multivitamins weren’t as necessary, and I gave them up. Later in middle age, a health crisis precipitated by Lyme disease caused me to rethink a lot of things, including whether to take multivitamins.

two types of Homeopathic supplements on wooden spoon

I read opinions from experts who felt that the reason why studies consistently failed to show benefit was that they were all using unnatural synthetic forms of vitamins and minerals. They reasoned that if the natural forms of the vitamins, termed bioavailable, were used, the outcomes could have been different.

There’s no doubt that our body burns up a lot more vitamins and minerals when we’re stressed, and I was definitely stressed. Though I was particular about following a healthy diet, I wanted to give my body any advantage it could get. I again decided to take a multivitamin, but this time, not just any multivitamin off the grocery store shelf.

I found a top-quality product that exclusively provided bioavailable forms of essential vitamins and minerals and started taking it regularly. Did I notice any difference? Maybe a little. I certainly couldn’t say it was more than embracing a healthy diet, but it did give me peace of mind. Though I was confident that it wasn’t doing any harm with the doses I was using, it certainly wasn’t a total solution to my ongoing health issues either. Perhaps I needed more than just a multivitamin.

Nourishment vs. Protection

Multivitamin products and herbal products often get lumped together under the category of natural supplements, but they couldn’t be more different. They both have value, but that value is as different as apples and oranges.

To understand the difference, you have to think about the body as a complex collection of living cells. The body contains several trillion cells of about 200 different types. A person’s health is a reflection of the health of the cells that make up that person’s body. If a person’s cells are all healthy and all the cells in the body are functioning in harmony, then that person is the definition of good health.

To function properly, a cell must receive a steady supply of pure water, oxygen, and nutrients. Nutrients, including carbohydrates and fats to generate energy, amino acids to synthesize new proteins, and vitamins and minerals for enzymatic functions, must all be absorbed through the intestinal tract.

Everything that happens inside a cell is a function of enzymes. We need vitamins and minerals because they are key components of enzymes. To function properly, cells need an adequate supply of vitamins and minerals, but having more than the cell can use at one time doesn’t add any benefit. In fact, saturating a cell with excessive vitamins and minerals could even be harmful.

Healthy green salad with avocado, mangold leaves, red beans and cherry tomatoes. Vegan snack, vitamins, vegetarian food and diet concept

No doubt, the best source of vitamins and minerals is a healthy diet. Still, if a healthy diet isn’t consistent, logic would suggest that supplementing with essential vitamins and minerals could be beneficial. That being said, supplemental vitamins and minerals must be supplied in the form that the body can easily use — dumping unnatural synthetic forms of vitamins in the body is like putting cheap gas into your car; it works, but it’s not the best thing for the engine.

The key takeaway is that bioavailable vitamins and minerals are necessary for normal cellular functions and that greater quantities of vitamins and minerals are required when cells are stressed, but that vitamins and minerals alone do nothing to protect cells from being stressed.

This is where a group of plant chemicals, called phytochemicals, goes above and beyond the benefits offered by multivitamins. Plants produce a spectrum of different types of phytochemicals to protect cells against a wide range of physical, chemical, and biological (insects and microbes) stress factors. When we consume phytochemicals, either from foods or supplements, all those benefits are transferred. When our cells are protected from stress, they function better, burn out slower, and require less in the way of vitamins and minerals.

A few protective phytochemicals have become household words. Resveratrol, a phytochemical found in grapes and wine, is a potent antioxidant known for slowing aging. Resveratrol has also been found to protect mitochondria, the source of energy for cells. Less well known, pterostilbene is a phytochemical with similar properties found in blueberries. Phytochemicals called catechins, found in green tea, slow aging and prevent chronic illness by protecting cells from damaging antioxidants.

Though fruits and vegetables are an important source of protective phytochemicals, our food plants have been cultivated primarily to provide high yields of nutrients, especially carbohydrates. That has come at the expense of protective phytochemicals. This where the plants we define as herbs have a clear advantage.

Mushrooms growing on tree trunk, surrounded by greenery

Herbs are wild plants. Their value isn’t supplying nutrients. If you had to depend on eating herbs as a sole food source, you’d go hungry. Herbs, however, are an excellent source of protective phytochemicals — their true value is protecting cells. The wild plants defined as herbs are plants that humans have selectively been using for thousands of years for both culinary and medicinal purposes.

Adding Herbs for Organ and Cellular Protection

Adding herbs into your life provides a level of protection to your cells unmatched by any food source or multivitamin product. A good place to start is taking a few herbal ingredients along with your multivitamin. Some possible choices that provide exceptional protection for cells of the body against every type of possible stress include:

green leaves with white flowers

Trans-resveratrol from Japanese knotweed

Trans-resveratrol, the most bioavailable form of resveratrol, is well-known for offering cardiovascular support and antioxidant properties.

brown pine bark pieces

Pine Bark Extract

Potent antioxidants and other chemical compounds in Pine Bark Extract help the body maintain vascular tissue and support the integrity of blood vessels. PBE is also supportive to the immune system.

purple milk thistle flower

Milk Thistle Extract

Silymarin, the primary chemical component of milk thistle, offers potent support for the liver; it increases natural antioxidants found in liver cells. It is the most widely researched of all liver-related herbs and is well known for low toxicity and safety.

red hawthorn berries

Hawthorn Leaf Extract

Supports the cardiovascular system, blood flow to the heart, oxygen delivery to tissues, and healthy blood vessels.

purple powder

Maqui Berry

Maqui Berry is a Patagonian berry that is wild-harvested by the Mapuche people of Chile and Argentina. Their traditional Maqui Berry beverage is credited for contributing to their extraordinary strength and stamina.

orange flowers

Lutein & Zeaxanthin

These twin carotenoid compounds account for the yellow color in vegetables. They build up in the retina of the eye and maintain a healthy retina during normal exposure to sunlight. They also accumulate in the skin to support its health. Prevention Plus contains the same amount of these substances as compared to ocular supplements recommended by ophthalmologists.

Adding Herbs for Stress and Optimal Health

If you’re under stress or want to gain even more protection for your cells, consider adding on some herbs with adaptogenic properties. All herbal traditions recognize herbs with nonspecific properties that can be used daily to invigorate the body and promote longevity. In Traditional Chinese Medicine, they’re called tonics. In Ayurvedic medicine, the traditional medicine of India, they’re referred to as rasayanas. In the second half of the twentieth century, Western science began categorizing these and other herbs as adaptogens.

Herbs that fit the definition of adaptogen have been defined by science to:

  • Assist the body in resisting a wide range of physical, chemical, and biological stress factors.
  • Have nonspecific actions in the body that do not cause drug-like effects.
  • Are non-toxic and do not harm or disrupt normal functions in the body

collage of nine herb photos, mixture of leaves, mushrooms, powders, and bark

There are many herbs defined as adaptogens or herbs that complement adaptogens that can be taken daily to protect cells from stress and support optimal health. A few to consider are:

  • Rhodiola
  • Reishi
  • Cordyceps
  • Ashwagandha
  • Gotu kola
  • Turmeric
  • Japanese knotweed
  • Chinese skullcap
  • Shilajit

The Bottom Line

Your cells must have vitamins and minerals to function. A healthy diet is the best source, but admittedly, eating healthy all the time can be challenging. A multivitamin can help fill the void, but bioavailable forms are always the best choice. The limitation of multivitamins must be respected, however; multivitamins have little capacity to protect cells from stress and therefore shouldn’t be expected to reduce risks of chronic illness and cancer.

Herbs have a clear advantage for protecting cells against stress — the spectrum of phytochemicals in herbs protect cells against all types of stress. When cells aren’t stressed, they don’t have to work as hard, use fewer nutrients, and burn out slower.

Why not take both? Why not ensure your cells have a ready supply of bioavailable vitamins and minerals and protect your cells with herbal phytochemicals at the same time? Combining a daily herbal product with bioavailable vitamins and minerals may be the best of all possibilities!

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1. Jenkins, DJA et al. “Supplemental Vitamins and Minerals for CVD Prevention and Treatment.” J Am Coll Cardiol. 2018 Jun 5;71(22):2570-2584.
2. Chen, Fan et al. “Association Between Dietary Supplement Use, Nutrient Intake, and Mortality Among US Adults: A Cohort Study.” Ann Intern Med. 2019 May 7; 170(9): 604–613.
3. Harvard Health Publishing, Harvard Medical School. “Vitamins and your heart.” Healthbeat. Retrieved from
4. Tapsell, Linda C. et al. “Foods, Nutrients, and Dietary Patterns: Interconnections and Implications for Dietary Guidelines.” Adv Nutr. 2016 May; 7(3): 445–454.
5. Diabetes Prevention Program Research Group. “Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin.” New England Journal of Medicine. 2002 Feb 7; 346(6): 393–403.
6. Dehghan, Mahshid et al. “Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study.” Lancet. 2017 Nov 4; 390(10107): 2050-2062
7. National Center of Complementary and Integrative Health. “Rhodiola.” Retrieved from
8. Hewlings, Susan J. and Kalman, Douglas S. “Curcumin: A Review of Its’ Effects on Human Health.” Foods. 2017 Oct; 6(10): 92.
9. Ratan ZA, Youn SH, Kwak YS, et al. Adaptogenic effects of Panax ginseng on modulation of immune functions. J Ginseng Res. 2021;45(1):32-40. doi:10.1016/j.jgr.2020.09.004
10. Liao LY, He YF, Li L, et al. A preliminary review of studies on adaptogens: comparison of their bioactivity in TCM with that of ginseng-like herbs used worldwide. Chin Med. 2018;13:57. Published 2018 Nov 16. doi:10.1186/s13020-018-0214-9
11. Panossian AG, Efferth T, Shikov AN, et al. Evolution of the adaptogenic concept from traditional use to medical systems: Pharmacology of stress- and aging-related diseases. Med Res Rev. 2021;41(1):630-703. doi:10.1002/med.21743

Lyme & Memory Loss

What causes memory loss specifically? And what does it feel like to experience it?

My long-term memory has always been sharp as a tack. I can repeat verbatim a conversation that happened two decades ago; I can tell you what a friend was wearing on the first day of third grade; I know what I ate at the restaurant my family went to on the last night of a vacation we took when I was in high school. People say, “It’s incredible that you can remember so much,” to which I often respond, “Just don’t ask me what I had for breakfast.”

The joke gets a good laugh, but it’s actually a serious matter: despite my unusually strong long-term memory, my short-term memory has been affected by the tick-borne illnesses Lyme disease, babesiosis, and ehrlichiosis. Some evenings I truly couldn’t tell you what I had for breakfast, and other times I need to look at my calendar to remember what I did that day. Once jogged, the memory comes back to me like a slow Google search, but the hang time between someone asking me about my day and my response can be embarrassingly long.

What causes memory loss specifically? And what does it feel like to experience it?

Though our central nervous systems are generally protected by the blood brain barrier, Lyme bacteria (spirochetes) are sneaky and smart, and can spiral their way across the border. Once that security breach occurs, a patient may experience “Lyme brain”, which can manifest as brain fog, word or song iteration, depression and anxiety, tremors, mini-seizures, headaches, burning extremities and memory loss.

As described in the book Conquering Lyme Disease: Science Bridges the Great Divide by Brian A. Fallon, MD and Jennifer Sotsky, MD, “Lyme disease can directly affect brain and sensorium in multiple ways: via direct infection, immune system effects, changes in neurotransmitter balance, and altered neural pathways.” Inflammation in the brain, as well as impaired oxygen flow to the brain as is often seen with babesiosis, can impact cognitive function. Drs. Fallon and Sotsky write that short-term memory problems are one of the most common cognitive effects of neurological Lyme disease. The book includes images of low blood flow in the brain of patients with memory impairment after Lyme disease (referred to as post-treatment Lyme encephalopathy).

In her book Lyme Brain, Nicola McFadzean Ducharme, ND, references studies in which Borrelia burgdorferi spirochetes were found in the brains of Alzheimer’s patients. While many Alzheimer’s patients don’t have Lyme, and many Lyme patients won’t develop Alzheimer’s, the studies show both how easily Lyme bacteria can cross the blood brain barrier, and how easily their presence can be misdiagnosed as dementia or Alzheimer’s when a chief symptom is memory loss.

The extent to which a patient’s memory is affected depends largely on their response to treatment.

When I started antibiotic therapy, some of my neurological systems worsened at first, as I experienced Herxheimer reactions, and the antibiotics chased those clever spirochetes deeper into my brain. After a couple months, my brain fog decreased, I had better concentration, and my memory improved. Sticking to an anti-inflammatory diet and taking supplements to help rid my brain of neurotoxins also helped. I learned to pace myself and to stay away from overstimulating activities (like big movie theaters or fireworks shows) that rile up my neurological symptoms, including memory loss.

Luckily, my long-term memory was never affected, which is a blessing as a writer. But while my short-term memory problems have improved, they are not fully gone. I especially notice them now when I am over tired or over worked. During those periods, I might leave someone a voicemail in the morning and then leave a similar message later in the day, forgetting about the first. I find myself asking friends, “Did I already tell you this story?” I’m hyper-aware of the deficit, but friends and family assure me that my lapses are relatively infrequent. Rest, quiet time away from screens, and relaxation usually have me back in “working order” in just a couple days.

If you are in an acute stage of neurological tick-borne illness, it’s possible that you’ve read this post and forgotten what it said; that you lost track of where you were whiling reading; or that you’ll tell someone about what you read more than once. Know that you’re not alone, and that with proper treatment through a Lyme Literate Medical Doctor (LLMD) and good self-care, a time will come when everything will seem much clearer.

[1] Fallon, Brian A., MD and Sotsky, Jennifer, MD. Conquering Lyme Disease: Science Bridges the Great Divide. New York: Columbia University Press (2018), 314.

[1] McFadzean Ducharme, Nicola, ND. Lyme Brain. California: BioMed Publishing Group, LLC (2016), 15-16.

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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

Candida & Lyme

Strategies and treatments for Lyme patients to avoid Candida overgrowth

When I was a teenager, I used to get yeast infections during the summers because I was always in a wet bathing suit. At least, that was the rationale I was given by doctors and other females, and it made sense. What I didn’t know then was that recurring yeast infections can also be a sign of a weakened immune system, something that would come back to haunt me in college when I started wrestling mysterious flu-like symptoms. The yeast infections persisted then, too.

People generally don’t talk about yeast infections because they seem like a private topic. But we should, because candidiasis—a fungal infection caused by yeast (Candida) overgrowth—is not exclusive to females or the vagina. In fact, many men and women alike suffer from Candida overgrowth and may not even know it. Candidiasis often occurs in the gut, causing symptoms typically associated with the gastrointestinal tract such as bloating, constipation, diarrhea, gas, blood sugar swings, and cravings for sweets; and those that aren’t, such as fatigue, depression, dizziness, itching, and hives. Candida can also manifest in the mouth as thrush, causing bad breath, a funny taste, soreness, white lesions, or a pasty white tongue.

I was first diagnosed with intestinal yeast overgrowth when I was wrestling a bad case of mononucleosis that slipped into chronic active Epstein-Barr virus. The naturopathic physician I was seeing told me excessive Candida could cause fatigue, inflammation, and headaches. In more serious cases, systemic candidiasis can, according to the Centers for Disease Control and Prevention (CDC) affect the blood, brain, heart, eyes, bones, and other parts of the body.

So, what does this have to do with Lyme disease? Many Lyme patients may already be dealing with candidiasis infections that are exacerbating or causing some of their symptoms. Coupled with Lyme disease, these symptoms become overwhelming. Moreover, antibiotics, a standard and critical treatment for Lyme, cause Candida overgrowth because they kill off the good bacteria in the gut. As Richard Horowitz, M.D. explains in Why Can’t I Get Better? Solving the Mystery of Lyme & Chronic Disease, “Although we all normally have Candida organisms present in our gastrointestinal tract in limited amounts, taking antibiotics for bacterial infections will encourage an overgrowth of Candida…Furthermore, many Americans have diets high in sugar and refined carbohydrates, which help promote yeast overgrowth.” Immune suppression due to stress—common for Lyme patients—and other factors such as medications that decrease the acidity of the gastrointestinal tract can also lead to Candida issues.

What can Lyme patients do to avoid and/or treat Candida overgrowth?

Diet: We often hear of the “Lyme diet” to treat inflammation, which it does. It also combats Candida overgrowth. I have had success by eliminating simple sugars, gluten and wheat, and alcohol. In his book, Dr. Horowitz also recommends eliminating malt, vinegar, carbohydrates (including fruit early in treatment), all yeast-containing foods (most bread and cheeses, mushrooms), and fermented foods. How extreme you need to be with this diet depends on how acute your infection is. Because I am still on low-dose antibiotics, I have stuck to a gluten-free, low-sugar, alcohol-free diet while in remission. I avoid mushrooms and most yeasty foods but do eat dark chocolate, cheese, and whole grains. Talk to your Lyme Literate Medical Doctor (LLMD) about the best dietary changes for you.

Probiotics: When you’re on antibiotics, you must take probiotics to replenish your system with good yeast. However, you must take the probiotics at least two hours before or after the antibiotics, or the antibiotics will kill the probiotics.

Anti-fungal medication: For persistent candidiasis, some LLMDs prescribe anti-fungal medication, some of which have also been known to be effective against Lyme bacteria. They are not without side effects (some can cause liver or heart damage), so doctors use these sparingly and in low and/or pulsed doses, and you should have regular bloodwork to test your liver and other functions while you’re on these medications.

Monitor symptoms and adjust accordingly: I can tell when yeast levels are getting high because I get a pasty tongue, have vaginal symptoms, or feel some gastrointestinal discomfort. This usually happens after I’ve cheated by eating several gluten-free brownies (naturally sweetened, but the sugars still add up). I will then be extra-careful with my diet in the following days, and it sometimes helps to eat something that tastes acidic, like grapefruit or tomato but is alkaline once digested (you’re trying to keep a healthy pH balance).

Don’t cheat: With some diets, especially those that are just about losing or maintain weight, having a “cheat” day once in a while won’t have too many adverse effects. That’s not true with Lyme disease, especially if you are dealing with an acute infection. Eating a regular pizza or a chocolate chip cookie will probably make you feel horrible for a few days, and that’s not worth it. There are plenty of great alternative foods available.

If you find yourself craving sweets or experiencing unexplained fatigue or digestive symptoms, talk to your doctor about Candida, especially if you are being treated for Lyme disease.

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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


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 using her email.



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Both my husband and I took diflucan, an anti-fungal medication twice a week throughout our entire treatment journey (over 5 years).  I believe this saved us from many problems antibiotics can cause.  We also tried to limit sugar.  We also took a strong, refrigerated probiotic daily as well as a prebiotic (feeds the good guy bacteria), specially formulated for Lyme/MSIDS patients with many and varied strains of bacteria.