by Jenny Lelwica Buttaccio
Posted 2/17/20

Forgetful. Zoned out. Unable to concentrate. These are just a few ways people describe the disconcerting constellation of neurological symptoms associated with chronic Lyme disease known as Lyme brain, a muddled mental feeling that impairs some degree of a person’s cognition.

Although the exact prevalence of the condition isn’t known, the majority of chronic Lyme patients will cycle through episodes of Lyme brain from time to time. It can be frustrating and debilitating. Missteps like showing up to a doctor’s appointment on the wrong day, forgetting to refill a prescription before it runs out, or desperately searching for your glasses only to discover they’ve been on top of your head all along can make you feel as though you’re losing your mind. Some people will even notice problems with word finding, reading comprehension, and writing.

Is there a way to stop it? Here, we look at some of the underlying causes of this neurological phenomenon, plus ways to help improve the distressing symptoms.

Cause #1: Untreated Infections

Lyme disease and Lyme coinfections like babesia, bartonella, and mycoplasmacontribute to metabolic and immune changes in the body because the microbes can be low-grade and persist for long periods of time. While no system of the body is off-limits, the central nervous system and the endocrine system are particularly vulnerable.

“When pathogens invade the nervous system, white blood cells — immune cells like lymphocytes and plasmocytes — flood into the white matter of the brain and the spinal cord,” says Dr. Bill Rawls, Medical Director of RawlsMD and Vital Plan. “This causes a cascade of inflammatory immune messengers, called cytokines, in cerebrospinal fluid.”

This influx of proinflammatory cytokines causes neuroinflammation in the brain, which can contribute to a range of neurological symptoms, including those associated with Lyme brain. Because most Lyme patients have a compromised immune system, the body struggles to keep the offending pathogens in check.

The outcome? You continue to experience a prolonged inflammatory response and resulting symptoms until you’re able to suppress the harmful, stealth infections.

Solution: Suppress Harmful Microbes and Support Brain Health

To improve brain function, you’ll have to address persistent, low-grade infections. There may be a time and a place for heroic therapies such as antibioticsgut microbiome, too.

A more restorative approach to subdue harmful pathogens is using herbal therapy, which has a balancing effect on the microbiome and the various systems of the body. Plus, some herbs can safely pass into the brain.

Not sure where to begin? Dr. Rawls’ preferred herbs specifically for brain health include:

1. Lion’s Mane: This mushroom contains compounds called erinacines and hericenones, which cross the blood-brain barrier. There, they support normal levels of nerve growth factor (NGF), a peptide produced by the body that’s essential to nerve cell growth, maintenance, and survival. When NGF levels are in a healthy range, you notice that you have improved mental clarity, focus, and memory.
2. Cat’s Claw: Native to the Amazon, cat’s claw has a long history of traditional use for the treatment of a wide range of inflammatory conditions, and it’s well-known among Lyme disease patients. The herb supports immune function and helps balance the body’s microbiome.
3. Bacopa: A traditional Indian herb, bacopa has been used to bring balance and calm to the nervous system for thousands of years.
4. Ashwagandha: Native to India and Africa, ashwagandha is used for its ability to balance, energize, and rejuvenate. Ashwagandha is a calming adaptogen that is particularly useful in balancing the HPA axis in the brain (the control center for hormone regulation), which leads to improved stress resistance, better sleep, and reduced brain fog.
5. Ginkgo biloba: Ginkgo is one of the oldest living trees on earth. Current and traditional uses of the herb include enhancing blood flow, protecting brain and nerve functions, and supporting cognition.

Cause #2: Toxic Build-Up

As you treat Lyme disease, you’re likely to experience a Herherimer reaction (or herx). With the use of any antimicrobial (prescription or otherwise), a large number of bacteria die off, causing an inpouring of dead bacteria called endotoxins throughout the body. This forces the immune system’s inflammatory response into overdrive.

Bacterial die-off can also produce byproducts that are toxic to the nervous system (neurotoxic) like quinolinic acid, ammonia, and acetaldehyde, which can exacerbate cognitive symptoms like brain fog. These toxic byproducts can also come from a microbiome imbalance such as a small intestinal bowel overgrowth (SIBO) and candida overgrowth.

Solution: Augment Your Body’s Detoxification Efforts

Start with the antioxidants glutathione, alpha-lipoic acid (ALA), and N-acetyl cysteine (NAC). These were shown to help to support the liver’s ability to detoxify, mitigate the neurocognitive symptoms of Lyme disease, and lessen the accumulation of toxins as a result of treatment in a 2018 article in the journal Healthcare.

Additionally, supplementing with molybdenum and yucca root can be beneficial, too. Molybdenum is a trace mineral that is normally present in small amounts in the body, similar to magnesium, iron, or manganese. Though a molybdenum deficiency isn’t common, adding a small amount of molybdenum — prepared in microgram doses — may help to neutralize excess ammonia and acetaldehyde and curb Lyme brain.

Similarly, the herb yucca root can be used to decrease ammonia levels. Typically, yucca comes in a capsule or powder.

Cause #3: Poor Sleep

Stress, inflammation, and infections can all disrupt your sleep, which only serves to worsen the symptoms associated with Lyme brain. Indeed, some short and long-term consequences related to poor sleep that are reminiscent of Lyme brain include mood disorders, cognitive dysfunction, memory problems, and performance deficits, among others, according to a 2017 review in the journal Nature and Science of Sleep. Sleep dysfunction alone could be the cause of Lyme brain in certain individuals.

Although it’s easy to see how a lack of sleep could be a significant factor contributing to neurocognitive issues, knowing how to improve the situation is a whole different battle. Generally, it will take some trial and error to find the repertoire of tricks and sleep hacks that will be helpful to you, but practicing solid sleep hygiene is paramount to decreasing the symptoms of Lyme brain.

Solution: Implement Good Sleep Hygiene

Going back to the basics of sleep hygiene can help you get a better night’s rest. They include:

• Maintain a consistent bedtime routine. Try to go to bed and get up at the same time each day, even on the weekends.
• Get exposure to sunlight. The majority of us spend a substantial part of our day indoors. But getting sunlight throughout the day, especially in the morning, can help to reset your circadian rhythm so you’re tired when you’re supposed to be.
• Wind down at night. Many people with Lyme disease experience a tired-but-wired feeling when they try to go to bed — they’re utterly exhausted, but their bodies won’t calm down enough to let them drift off. If this describes you, try spending 10-15 minutes before your bedtime doing some gentle stretching to relieve muscle tension, reduce pain, and bring on the calm.
• Turn off electronics by 9 PM. When you’re lying in bed wide-awake and waiting for sleep to come, it can be very tempting to pass the time by watching your favorite TV show or scrolling on your phone. But the blue light that’s emitted from electronic devices can disrupt the sleep-inducing hormone melatonin. So, instead of helping you fall asleep, electronic devices may be contributing to wakefulness. If you must be on your computer or phone at bedtime, try blue-light-blocking devices such as filters or glasses to keep your exposure to a minimum.
• Make sure you have a comfortable bed. If you notice that you feel stiff or have greater pain in the morning, that’s a clue that your mattress could be an obstacle to quality sleep, and it might be time to invest in a new one. Most mattress companies will offer financing options so that you don’t need to shell out the funds all at once if you don’t have them.

Cause #4: Exposure to Mold

About 50% of homes have experienced some amount of water damage and contain mold. When exposure to toxic mold is coupled with Lyme disease and Lyme coinfections, all of your symptoms can intensify, including the cognitive issues that accompany Lyme brain, such as:

• Trouble focusing
• Sleep disturbances
• Feeling lethargic
• Mood swings
• Delayed reaction times
• Forgetfulness

Solution: Locate and Clean Up Moisture and Mold

To avoid further exacerbating your symptoms, you may need to consult with a professional to safely find and remediate sources of mold in your home — a good idea in general, since doing it yourself will ramp up your exposure. In the meantime, here are some things you can do on your own:

1. Place a HEPA air purifier in the areas of your home where you spend the most time, especially your bedroom. Reducing your exposure to mold while you sleep may help you wake up feeling more alert and refreshed.
2. Reduce your humidity levels to as low as possible — ideally, between 30% to 50%. Dehumidifiers and air conditioners can be useful tools to keep in check the humidity mold loves.
3. Routinely inspect your heating and air conditioning systems for mold, and if necessary, have them cleaned.
4. Consider eliminating rugs or carpet in rooms that are known to contain high levels of moisture, such as the bathroom or basement.
5. Keep your kitchen, bathroom, and laundry rooms well ventilated.
6. If you have an attic, make sure the space is dry and doesn’t contain moisture.

There’s no doubt that Lyme brain can be a frightening and overwhelming symptom of Lyme disease, and many of the potential causes overlap with one another, which can make sorting things out a bit tricky. But begin to chip away at the causes as best you can. Over time, you’ll start to notice clearer thinking, improved memory, and better cognitive functioning. There is light at the end of the tunnel, and you can recover!

Dr. Rawls is a physician who overcame Lyme disease through natural herbal therapy. You can learn more about Lyme disease in Dr. Rawls’ new best selling book, Unlocking Lyme.  You can also learn about Dr. Rawls’ personal journey in overcoming Lyme disease and fibromyalgia in his popular blog post, My Chronic Lyme Journey.