Fibromyalgia is a complex pain disorder characterized by muscle pain, joint stiffness, and fatigue. It affects over ten million Americans, (4% of the population), primarily women. Although there is no known treatment that works for everyone, following a healthy diet by eliminating processed foods, caffeine, aspartame (artificial sweetener), food additives and nightshades may reduce the symptoms.
Fibromyalgia (FM) is a very real condition that affects millions of Americans and its symptoms include chronic widespread pain, fatigue, sleep disorders, joint pain, problems with cognitive functioning, migraines, IBS (irritable bowel syndrome), anxiety, depression, and environmental sensitivity – learn more about fibromyalgia symptoms here.
Unfortunately, FM is a condition rather than a specific illness and presents itself as an array of complex symptoms; believed to be caused by biological, psychological, and environmental factors and there is no specific universal treatment for the condition.
Sufferers of FM may be able to find some relief by following a healthy diet, which includes eliminating some foods while adding or increasing others. Kent Holtorf, M.D., Medical Director of the Holtorf Medical Group says,
“We’re at the point now where we know diet plays a role in this disease – it’s just the same diet for everybody. And not everybody is helped in the same way.”
However, there are a number of secondary health conditions such as gluten intolerance, gout (a form of arthritis), and restless leg syndrome that coexist with fibromyalgia causing an overlapping of symptoms or exacerbating the FM symptoms. Treating secondary conditions through dietary control may also bring some relief to the pain and fatigue brought on by fibromyalgia.
Foods to Avoid When You Have Fibromyalgia
Due to the nature of fibromyalgia that it is non-specific condition, these dietary guidelines may not be right for all FM sufferers but appear to make a difference for a significant number of those suffering.
1. Aspartame (NutraSweet)
Aspartame is classified as an excitotoxin, which stimulates NMDA pain receptors, which are already overly active with fibromyalgia.
2. Food additives including MSG (monosodium glutamine) and nitrates
MSG is an additive or flavor enhancer and nitrates are preservatives. Both are found in many processed foods and are also classified as an excitotoxin. Nitrates and MSG can often difficult to tolerate in people without fibromyalgia and are extremely difficult to tolerate in those who do.
3. Sugar, fructose, and simple carbohydrates
There is not clear evidence that cutting out simple carbohydrates will have an impact on fibromyalgia but it will reduce symptoms of chronic yeast infection, which may be a secondary condition contributing to the pain of fibromyalgia.
High fructose corn syrup, which is found in carbonated beverages, is prone to cause a metabolic reaction resulting in much more sugar pouring into the blood at a quicker rate. The quick rise is followed by a fast fall with can exacerbate the fatigue element of fibromyalgia.
4. Caffeine – including coffee, tea, colas, and chocolate
Caffeine does create a boost in energy; however, it is followed by a longer and deeper sedative effect. People with fibromyalgia already suffer from fatigue therefore amplifying the downside.
5. Yeast and gluten
Yeast and gluten are frequently found together, particularly in baked goods. Cutting both out can have equal benefit. Cutting yeast out of a diet may yield yeast fungus overgrowth, which may cause or exacerbate joint and muscle pain. Cutting gluten can improve digestive problems, stomach ailments, and fatigue associated with fibromyalgia.
6. Dairy
Dairy has been known to aggravate symptoms in some fibromyalgia sufferers but not all. If avoiding diary does not seem to relieve symptoms, then drinking skim milk provides calcium to build bones and protein to build muscle.
7. Nightshade Plants
Common nightshade plants include tomatoes, chili, bell peppers, potatoes, and eggplant. However, there are over 2,000 other varieties of “nightshades.” Edible nightshades can trigger flares on various types of arthritis and symptoms associated with fibromyalgia. If by eliminating nightshades there is no noticeable relief from symptoms of FM, then bring them back into your diet because these are some of the most nutritious vegetables.
Important Dietary Changes for Fibromyalgia Patients
Nutritionist, Samantha Heller, MS, RD, says, “When you body is healthier overall, you may be better able to cope with any disease, and better able to respond to even small changes you make.” A vegetarian diet consisting mostly of raw whole foods has shown to reduce symptoms caused by fibromyalgia. It also produces improvement of mitochondria dysfunction, which according to Holtorf, “This is the area of the cell where energy is made. Consequently, it’s necessary to have high levels of nutrients to get the mitochondria to work and for energy to by produced.”
Included in a healthy diet should be a high-quality vitamin supplement as well as supplements containing omega 3 fatty acids – we recommend HoltraCeuticals’ Ultra Omega – and eating “good fat” foods such as foods rich in fish oil, flax seed, walnuts, some fortified cereals and eggs. All of which have been show to have an impact on inflammation.
At Holtorf Medical Group, our physicians are trained to utilize cutting-edge testing and innovative treatments to uncover and address the underlying cause of fibromyalgia. Additionally, our Health and Nutrition Coach can work with you and your Holtorf physician to create a diet specifically for you! If you are experiencing symptoms of fibromyalgia, but aren’t getting the treatment you need, call us at 877-508-1177 to see how we can help you!
Lyme Disease Cases Are Exploding. And It’s Only Going to Get Worse.
Climate change and human sprawl have triggered a pandemic
By Alex Bhattacharji
This story is part of “Tickpocalypse,” a multi-part special report.
Kelly Oggenfuss is walking into the woods. Leading her team of four young researchers through a thicket of slender oak trees, she doles out assignments by letters corresponding to a grid. As early morning light filters through the canopy, Oggenfuss and her colleagues pull on latex gloves then disperse to gather surveillance data.
For 20 years, this has been a post-dawn ritual for Oggenfuss, a senior research specialist at the Cary Institute of Ecosystem Studies in Millbrook, New York, a bucolic town in the state’s Hudson Valley region. Four times a week from April to November — traditionally the most active tick season in the Northeast — she leads a platoon of field researchers as they don white coveralls, drive a pair of old Chevy Tracker SUVs down an overgrown dirt road, and hike to a five-acre tract designated “Henry Control” on the grounds of the institute. Their mission is to seek out and study ticks in one of the most tick-infested areas in America.
Oggenfuss and the others work methodically across a grid of 242 spring-loaded box traps, checking for rodents lured overnight by whole-oat seeds. Sharing updates via walkie-talkie, the team gathers after a squirrel is found in one of the traps. The new researchers transfer the animal to a plastic mesh sleeve and take turns examining it. A similar process unfolds with chipmunks.
Most often, the traps capture mice, which Oggenfuss and her team carry with them, still in the trap, until the grid check is complete. Then the group convenes around a collapsible table. As one researcher records data (grid location, gender, tag number, etc.), the others apply tags to the mice and collect blood, urine, and stool samples. Finally, Oggenfuss and her team meticulously comb the mice with tweezers and blow on their fur, pushing it aside in search of ticks.
Researcher Kelly Oggenfuss tags a chipmunk. Ticks frequently contract the bacteria that causes Lyme disease from small animals, then pass it to humans.
“Look there’s a nymph,” says Oggenfuss. “And I’ve got one, two, three larvae. Can you see them?” She pulls a patch of the mouse’s fur back to reveal a blacklegged tick no bigger than a poppy seed burrowed into its head. The larvae are barely perceptible.
A researcher named Agi holds up another mouse. “Look,” she announces. “That’s a larva on top of that nymph. We have a co-feeding situation here.” The theory is that their feeding sites are so close that pathogens move between them easily, Oggenfuss explains. The potential result is one tick sharing infectious material directly with another through the host mouse as if it were a straw, speeding the spread of disease. “That could have an effect on infection prevalence,” Oggenfuss adds. “It’s one of the things we’re studying.”
Since 1992, the Cary Institute has been compiling a record of tick ecology that they believe to be the longest continuous study of this kind in the U.S. and possibly the world. Mostly its researchers encounter the blacklegged, or deer, tick (Ixodes scapularis), but in recent years, they’ve also been seeing increasing numbers of lone star ticks (Amblyomma americanum), which are native to the American Southeast but now range from northern Mexico to Canada. Over the years, an alarming number of ticks in the surrounding area have been revealed to carry Borrelia burgdorferi, the bacteria that causes Lyme disease, while others have tested positive for the pathogens that cause other tick-borne illnesses, including the potentially fatal Powassan virus.
Because ticks acquire pathogens from hosts, understanding tick-borne diseases means understanding ticks’ so-called disease reservoir, especially mice. If the urban rat was the primary carrier of bubonic plague, the country mouse is it for Lyme disease. And just as the fleas that fed on infected rats spread the plague, ticks that feed on infected mice transmit Lyme.
On this early May morning, the team’s trap yield is relatively modest — four mice, two squirrels, and a chipmunk. “It’s early days still,” says Oggenfuss. In August, during the so-called larval peak, the researchers sometimes catch as many as 220 mice and can find 150 or even 200 tick larvae crawling on a single mouse. It can be an unnerving moment. “When the ticks are looking for a feeding site,” Oggenfuss says, “the mouse fur just seems to move on its own.”
The process for counting ticks not affixed to hosts is called a drag — the researchers pull a one-square-meter sheet of fabric along the ground for 30 meters then tally the number of ticks affixed to it. Oggenfuss holds the Cary Institute record for ticks collected in a single drag: 1,700. As horrifying as that haul was — and it would, by extrapolation, put the tick population on the Cary Institute’s 2,000-acre campus at 2 billion — Oggenfuss is quick to note it was exceptional, and tick density is irregular. Her more conservative calculations of average tick populations, based on drags done during the same time of year (August, the larval peak), are only reassuring by comparison: upward of 20,000 ticks per acre, more than 100,000 on the Henry Control grid, and more than 40 million on the Cary Institute grounds.
Tick “drags,” like the one pictured here, are used to count tick populations. The Cary Institute grounds alone may be home to 40 million of the bugs.
The scary thing is, that’s nothing. Experts say the worldwide tick population is exploding,triggering a dramatic spike in the incidence of Lyme disease and a rise in other tick-borne illnesses, some of which, like Powassan, are far more dangerous than Lyme.
First identified in 1975 in the leafy New England town of Old Lyme, Connecticut, Lyme disease has now reached what experts consider pandemic proportions. According to the Centers for Disease Control and Prevention (CDC), the number of confirmed cases of Lyme disease in the U.S. has more than doubled in the two decades leading up to 2017 (the most recent year for which final figures are available) and increased 17% from 2016 to 2017 alone. More than half the counties in the U.S. are considered high-risk areas for Lyme, according to the CDC, and in some areas, as many as six out of 10 ticks carry the infection.
“It’s been a relentless expansion since the 1980s,” says John Aucott, director of the Lyme Disease Clinical Research Center at Johns Hopkins University School of Medicine. “There may be down years and up years, but the trends are in place, and there’s no indication that they’re going to reverse.”
We now live in a frightening new normal: It’s estimated that 300,000 people contract Lyme every year in the U.S., with victims found not just in traditionally tick-heavy areas like upstate New York and Maine, but also in all 50 states and Washington, D.C. While most people are cured quickly with antibiotics, some go on to experience lingering symptoms characteristic of Lyme, like headaches, fatigue, and joint and muscle pain, for months or longer after they’ve been treated, a condition known as post-treatment Lyme disease syndrome (PTLDS). According to a recent study led by experts at the Brown University School of Public Health, the number of people in the U.S. with PTLDS was estimated to be 1.5 million in 2016 and is predicted to rise to nearly 2 million by 2020.
“There is little doubt that [Lyme disease] is pandemic. It calls for a huge national and concerted international effort to bring it under control.”
Tick populations now exist on every continent, even Antarctica, and Lyme disease can be found throughout most of Europe, where it ranks as the most common vector-borne disease, and beyond. “To me, there is little doubt that it is pandemic,” says Mary Beth Pfeiffer, author of Lyme: The First Epidemic of Climate Change. “It’s in China, Russia, Japan, Australia. It’s moving fast into Canada. It is all across the U.S. It calls for a huge national and concerted international effort to bring it under control.”
The incidence of other tick-borne illnesses is also sharply rising. According to the CDC, the occurrence of those diseases in the U.S. has nearly tripled since 2004 and increased more than 22% from 2016 to 2017. In addition to Lyme, ticks transmit a slew of pathogens, including those that cause babesiosis, ehrlichiosis, anaplasmosis, southern tick-associated rash illness, tick-borne relapsing fever, tularemia, Colorado tick fever, Q fever, Rocky Mountain spotted fever, and Powassan encephalitis. Most of the bacterial diseases are treatable if diagnosed early. Others, like Rocky Mountain spotted fever, are potentially fatal, particularly in children, if not treated quickly. Incidences of spotted fever rickettsiosis, which includes Rocky Mountain spotted fever, increased more than 12-fold from 2000 to 2017 (up from 495 to 6,248). And while more rare still, cases of Powassan virus, which can kill one in 10 people who are infected and for which there is no treatment, are rising as well. In 2008, only two cases were reported. In 2016, that number jumped to 22 and again in 2017 to 33.
“Ticks account for more diseases than all other biting insects and arthropods in the United States,” says Ben Beard, deputy director for the Division of Vector-Borne Diseases at the CDC. “It’s hard to know what the maximum or the ceiling might be. All we can say is that the number of cases is growing every year.”
Alarms are going off all over the globe. South Africa, where tick-bite fever (a form of rickettsias) is common, has seen an increase in incidences of Crimean-Congo hemorrhagic fever (CCHF), which is deadly in 30% to 40% of cases. The tick that carries CCHF, a native of sub-Saharan Africa and eastern Europe, has been found in Spain, Portugal, Germany, and the United Kingdom, where it is believed to have been brought from Africa by migratory birds. Bites from the lone star tick have been shown to cause alpha-gal syndrome, which manifests in rapid-onset allergies to meat, typically beef and pork, that can result in unexplained anaphylactic reactions. There is no treatment, other than eschewing the consumption of red meat.
In North America, news reports in Maine and southern Canada this spring featured a shocking number of sightings of what are called ghost moose — skeletal-looking, malnourished, denuded animals that have rubbed off their fur in response to tick irritation after hosting up to 75,000 feeding ticks through the winter. Many emerged anemic after being the source of so many blood meals, and a number of calves died after losing too much blood to ticks — a vampire-like end to life known as exsanguination.
If Lyme disease has reached pandemic proportions, why haven’t we heard more about it? Because, experts say, Lyme doesn’t strike fear into people’s hearts the way some other illnesses, like Ebola or Zika, do. People respond to dramatic pictures or dramatic mortality, says Aucott.
“It’s hard for them to have a perspective on the real impact of Lyme disease because it doesn’t cause visible changes. People with Lyme disease don’t look sick.”
The same dynamic holds true for other tick-borne illnesses, says Beard. “People don’t have to be dying all over for this to be a huge health problem. These are serious illnesses, and some do result in deaths.”
In a report on the dangers of ticks, the Institute of Medicine, the health arm of the National Academies, called ticks “the Swiss Army knife of disease vectors,” emphasizing their remarkable adaptability and efficiency in spreading illness. Although conspiracy theorists have suggested — falsely — that Lyme disease was created in a U.S. military lab, it is true that in the years following World War II, the U.S. employed top German scientists who explored the tick’s potential in biological warfare for Nazi Germany. The researchers were investigating the tick’s ability to spread pathogens across wide areas with the potential to incapacitate entire populations.
Seventy-five years later, the tick timebomb is detonating on its own. Thanks to climate change, globalization, and other factors, ticks are not only proliferating but also becoming more malignant, more aggressive, and more likely to carry infection. A public health crisis is hiding in plain sight, with tick-borne diseases creating millions of sick people at an economic cost running into the billions, and little has been done so far to mount a meaningful defense. On every walk in the woods or picnic in the park, we are encountering more ticks. And as Willy Burgdorfer, the entomologist who identified the bacteria that causes Lyme disease, once proclaimed:
“There is no such thing as a clean tick.”
It’s late morning when Oggenfuss and her team return to the Cary Institute research building with the field samples they’ve collected and make their way past a room called the Insectary, marked with a large biohazard symbol and the shapes of various tick species, to the lab. The research assistants transfer the mouse blood, urine, and fecal samples they’ve gathered to an Igloo cooler marked “NIH” and send them to be tested for, among other things, the pathogen that causes Lyme disease.
A dozen or so clear plastic canisters labeled “extra ticks” are strewn across Oggenfuss’ desk, all marked with a collection date and grid location. Inside of each, on a bed of plaster of Paris, are groups of ticks, some nymphs, some adults. Oggenfuss reaches up, grabs a pair of high-magnification granny glasses that are resting on a deer skull, and hands them to me.
“Use these,” she says. She hasn’t confirmed the species of each tick yet. “They’re probably all blacklegged, but I’ve been surprised before.”
Taxonomically, the 800-plus species of ticks fall into one of three families — Ixodidae(hard ticks, like the blacklegged tick and dog tick), whose life spans range from one to two years; Argasidae(soft ticks), which can live as briefly as several months or as long as a dozen or more years; and Nuttalliellidae(a single elusive species in sub-Saharan Africa). They are part of the order of Parasitiformes and the classification arachnid (although many varieties emerge as larvae with six legs and develop eight legs as nymphs). Ticks progress through four stages — egg, larva, nymph (argasid ticks will go through up to seven phases of the nymph stage), and adult. Adult female blacklegged ticks have a bright orange-red body; adult males are dark brown to black. Even at their biggest, ticks are small — measuring between three and five millimeters long, or slightly larger than a sesame seed when mature — with a diminutive head on a plump, pear-shaped body. When engorged, they can swell to many times their unfed weight: 200 to 600 times in hard ticks, five to 10 times in soft ticks.
In order to survive, ticks must feed on hosts, which can be mammalian, avian, amphibian, and reptilian, a minimum of three times — once at every stage after they hatch from the egg — before adult males die and females lay eggs, between 2,000 and 5,000 of them. Depending on the species, ixodid ticks will feed on either one, two, or three separate hosts in the course of their life cycle; argasids will feed on more depending on how many nymphal stages they undergo. Multihost ticks present the greatest risk: On each feeding after the first, either on a different host species or a different member of the same species, a tick can transmit bacteria and viruses from one host to the next. Hence, ticks, like mosquitoes, are known as disease vectors.
According to some researchers, ticks veered off from the mite family tree as far back as 450 million years ago; other scientists date their emergence to the Cretaceous period, approximately 100 million years ago. Thanks to specimens trapped in amber, we know ticks were feeding on feathered dinosaurs 99 million years before they began being featured on identification charts in veterinarian’s offices and in hiker’s handbooks.
Contemporary ticks “don’t look much different at all from those preserved specimens,” says Rick Ostfeld, a distinguished senior scientist at the Cary Institute, the leader of the Tick Project, and arguably the country’s preeminent researcher into the ecology of tick-borne diseases. “They are very conserved morphologically throughout their evolutionary history, more so than most groups.”
The tick’s early adaptations have aged well, starting with its barbed feeding tube, called a hypostome, which penetrates the host’s skin and is moored in place by a glue-like secretion produced by the salivary glands. Tick saliva itself contains an almost alchemist’s mix of elements: Pain-killing enzymes called kininases make bites barely, if at all, noticeable to hosts; anti-inflammatory compounds keep the wound site from becoming irritated and the tick from being detected during its sometimes days-long feeding period, and anticoagulants keep the blood meal flowing freely all the while. Over time, ticks have become adept at sensing hosts when questing for a blood meal, learning to detect movement, body heat, odor, moisture, respiration, and carbon dioxide. Some species can even detect shadows cast by nearby creatures.
The characteristics that have helped ticks endure for eons — surviving numerous periods of warming and ice ages (including the 2.5-million-year Pleistocene ice age), mass extinctions, and years of plenty and years of famine thousands of times over — also help them from season to season. “They have massive reproduction, they have super long lives, especially for a parasite, they don’t need to feed often, they’re very tiny, and they are very resistant,” Ostfeld says. “They are able to escape nasty conditions. They just go into suspended animation in the cold. They have antifreeze molecules they mobilize seasonally. They don’t need much oxygen — a close to zero rate of respiration when not feeding — so they can be underwater for a few days, even a few weeks.” Although they are deceptively easy to kill in a lab with extreme heat or cold — or at home by putting tick-covered clothes in the dryer or freezer — in the outdoors, ticks are adept at finding shelter in the leaf cover or soil to insulate themselves from severe temperatures.
It seems surprising Hollywood hasn’t tried to mine the star power of relentless, blood-eating, disease-spreading creatures that reproduce by the thousands and can’t be killed off. “I’m not an expert in that area,” Beard says, “but it seems like you could create a pretty good horror film out of all that.”
It’s a common trope of such cinema that mankind’s actions will trigger the tragic consequences visited upon it. While the relationship between changes to the climate and the spread of ticks and tick-borne disease is complex — tied to host populations and hosts’ food supplies, among other factors — this much is clear: Human-driven climate change is making tick season longer and tick country larger. As winters get warmer and shorter, ticks become dormant later in the year (if at all should it fail to fall below freezing) and active earlier. Ostfeld has observed the timing of spring nymphs move up by a month in the past two decades. Lyme Disease Awareness Month, May, now arrives after Lyme-carrying blacklegged tick nymphs do in the Northeast U.S.
Tick maps are changing as fast as the calendars, as species like the deer tick have spread northward from temperate zones to regions with boreal forests. This helps explain why the Public Health Agency of Canada only began tracking cases of Lyme disease in 2009. From that year through 2017, Lyme cases in Canada increased more than 14-fold, from 144 to 2,025. In 2017, Maine had the highest per-capita incidence rate of Lyme of any state in the U.S. and reported a 23% year-over-year increase in cases.
There was a time when human impact on the environment helped suppress the threats posed by ticks. The radical clear-cutting of forests and overhunting of deer in the 19th and early 20th centuries lowered the transmission of Lyme disease. In recent decades, however, changes in land use, reforestation efforts, and other factors have combined with warming temperatures to exacerbate it. “You’ve got climate change moving it north, you’ve got suburban growth into wooded areas, you’ve got rebounding deer populations,” says Beard.
To compound matters, ticks themselves are undergoing a simultaneous, seemingly unrelated evolutionary change. Disease ecologists have observed the ascendance of a particularly aggressive genetic population, or clade, of blacklegged ticks that are overtaking more docile clades in the southern U.S. “This northeastern clade moving southward is causing more cases of human Lyme disease,” Beard says, “because these ticks’ behavior is changing. They’re more likely to bite people.”When Aucott joined Johns Hopkins in 1996, Lyme disease had been a mounting concern for a number of years, but conventional wisdom held that the illness would not spread south of the Potomac River. However, he soon began seeing case referrals from first northern then southern Virginia. Lyme is now endemic in North Carolina and has moved westward to Tennessee, Kentucky, and Ohio.
“It jumped,” Aucott says. “We also know there’s no geographic barrier to the spread of Lyme disease south of Maryland and literally out through to the Mississippi River Valley.”
In early May, the United Nations’ Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services released a devastating report that concluded that 1 million species of flora and fauna face extinction due to human activity. Disease ecologists who study ticks say biodiversity is critical in curbing the spread of Lyme disease: “High diversity dilutes transmission,” says Ostfeld. “As you lose diversity, the species that remain typically are the ones that amplify the disease.” Among the species sure to survive the coming die-off are ticks and the rodents that serve as disease reservoirs for them. “We’ll never lose mice,” Ostfeld explains. “Mice are cockroaches with fur.” So even as the biome is depleted, ticks will not only survive, but will become more likely to carry disease.
Globalization is also heightening the threat posed by ticks. Although U.S. Department of Agriculture officials screen livestock traveling internationally for parasites, they do not screen pets, migratory birds, planes, boats, or people for them. Among the CDC’s greatest concerns is non-native and invasive tick species that have the potential to spread across the country unabated. One already has.
In October 2017, Andrea Egizi, a research scientist with the Monmouth County, New Jersey, Tick-Borne Disease Lab, was one of a team of experts who investigated an unusual infestation of ticks. A resident in nearby Hunterdon County had become covered in larval ticks while shearing one of her sheep. “The reason this raised a red flag,” Egizi recalls, “was because there were just so, so many ticks.” There were hundreds on the sheep in question and more than 1,000 more in the paddock — an inordinately high count for the type of ticks normally found in the region, none of which these specimens resembled under a microscope.
Sure enough, Egizi couldn’t find the tick on any of the taxonomic keys that identify species from the region. She and her colleagues contacted the Smithsonian for help to no avail. “We were pretty sure it was something exotic, but we didn’t know what,” Egizi says. “Then I did the DNA barcode.”
Her sequencing search returned with a match to Haemaphysalis longicornis, the Asian longhorned tick. It was the first time the tick had been reported in the United States. Egizi, who had never heard of the species, began doing additional research. “That’s when I realized it could be a big problem.”
The Asian longhorned tick transmits an emerging hemorrhagic fever found in China, Korea, and Japan called severe fever with thrombocytopenia syndrome. Experts suspect it spreads Rickettsia japonica, which causes Japanese spotted fever. The species previously spread to New Zealand and Australia, where it has wreaked havoc on livestock populations, particularly cattle (it is a vector for a frequent condition called fatal bovine theileriosis). What’s more, in Asia, the longhorned tick carries pathogens that are also present in North America, including forms of anaplasma, babesia, borrelia, ehrlichia, and rickettsia.
As of now, it has not been found to feed on rodents or carry human pathogens in the U.S., although CDC research on its so-called vector competence is ongoing.
“It may just be a matter of time,” Beard says. “Then it gets to the issues of how much does it feed on rodents? How much on people? What is the relative risk to humans? It’s hard to know whether it will be a game changer or if it will just incrementally to add to the concerns we already have. The jury is still out.”
The particular strain of Asian longhorned tick found in New Jersey is parthenogenetic — that is, it can reproduce without mating. A single female can lay 2,000 genetically identical eggs every six months as opposed to every two years for most North American ticks. That may explain the startling numbers of tick larvae found on the sheep. Scientists generally refrain from using the term “self-cloning,” but it is hard to avoid in this case.
In less than two years since Egizi’s discovery, there have been more than 50 reports of Asian longhorned ticks around the United States. Most were found on wildlife and domestic animals, but two were found on humans. The species has been reported as far north as Connecticut and as far south as Arkansas, and Egizi says the tick is likely to have spread elsewhere. “There are definitely places where no one’s found it yet,” she says, “because no one’s looked.”
An examination of previously unidentified samples done after the discovery of the Asian longhorned tick in New Jersey revealed that the species had actually been in North America years before 2017. One specimen found at the USDA’s National Veterinary Services Laboratories was collected from West Virginia in 2010. That was deeply unsettling, says Beard. “That, of course, raises the question: Is it possible we have other invasive species here that we’ve not even recognized yet?”
It’s also possible they are present but not able to proliferate — yet. One working hypothesis at the CDC is that the Asian longhorn tick had been in the U.S. in low numbers but only began to spread rapidly after adapting to its new environment.
Meanwhile, Egizi is comparing the DNA of her sample with those of specimens around the world, trying to find the most likely population from which it came. The goal is to determine just how it arrived. “It’s a concern how vulnerable our systems are,” she says. “For example, the fact that dogs are not checked for extra parasites when they come into the country, that is shocking to me. There’s also concern about ticks expanding their distribution within the U.S. or within North America. It’s not just from overseas that we need to be concerned about.”
That very scenario is playing out on the U.S.-Mexico border in Mexicali, where a particular clade of brown dog tick has caused a massive outbreak of Rocky Mountain spotted fever, which can be fatal in up to 30% of cases and causes more deaths than any other tick-borne disease in North America. This tick, a tropical variety, differs from the common temperate clade of its type found in North America, which almost exclusively feeds on canine hosts.
“The one in Mexicali is a very aggressive tick that is more predisposed to bite people,” says Janet Foley, a professor of veterinary medicine and epidemiology at University California, Davis who specializes in disease ecology. “If it spreads to the United States in numbers, that’s dangerous.”
As of 2018, three years after the Mexican Ministry of Health declared an epidemiologic emergency, more than 4,000 people had been diagnosed with Rocky Mountain spotted fever in Mexicali, which has a population of approximately 700,000. Several hundred have died, including, according to reports, at least four who were infected in Mexicali and later crossed into the U.S. Foley co-authored a study with researchers at Universidad Autónoma de Baja California that concluded the epidemic is not contained — it has spread to other parts of Baja California and is moving into the United States. The most immediate fear is an outbreak in a major city like Tijuana, with a population of more than 2 million. “Hundreds of people have already died, and millions more are at risk,” says Foley. The tick is already there and has already moved north. Recently it’s been reported in San Diego and Los Angeles.
While ticks need moisture to survive, the common brown dog tick requires far less than most. This particular clade takes that to the extreme, suggesting its spread could be hastened by climate change. “This tick needs it hot and it needs it dry. This tick is rooting for global warming and drought,” Foley says. As places like California and Arizona become hotter and drier, the tick’s reach will expand, she says. To compound matters, research has shown that the hotter the temperature, the more aggressive this tick becomes. “You can actually do experiments and bring the temperature up and increase the bite rate of that tick,” Foley says.
She remembers driving through Mexicali with a local tick expert and being struck by the lack of leaf cover. When she asked where the ticks were found, he pointed not at vegetation but a patch of dirt in a front yard and mentioned they also like the stucco on the sides of houses. Foley experienced it herself, standing in an infested courtyard.
“The ticks sense that there’s a body there,” she recalls, “and they start to crawl out of cracks in the walls. It’s unnerving.”
While Lyme disease may not be as lethal or communicable as Ebola or SARS, its impact shouldn’t be underestimated.
Lyme can be difficult to diagnose. To identify it, doctors generally rely on symptoms (the bull’s-eye rash) and circumstances (having been in a tick-infested area) rather than a blood test because the antibodies that indicate the presence of the disease can take weeks to appear in tests, resulting in false negatives. The lack of a reliable test means people often go untreated longer than necessary.
“This disease has been very much underestimated. We don’t have a good test. We have treatments that fail. We seem to have very little urgency to respond.”
PTLDS is both physically and psychologically debilitating. Some people’s symptoms can leave them in pain for months or years, and the lack of effective treatments and skepticism among some people that their condition is real can leave people feeling anxious and depressed.
Because children are especially vulnerable to Lyme disease (kids tend to spend more time outdoors than adults and are less cautious about where they venture), the threat of the illness is a source of widespread anxiety among parents. Studies have shown that tick-borne diseases disproportionately affect the rural poor, people employed in manual and farm labor and other outdoor vocations, and people with limited access to health care. Lyme also contributes to the overuse of antibiotics and the rise of drug-resistant bacteria, which is a serious public health threat of its own.
Recent studies estimate the medical costs of Lyme disease at $1.3 billion per year. When accounting for indirect costs, including loss of work, that figure is thought to be between $50 billion and $100 billion. But that number doesn’t factor in PTLDS cases. “That is a tiny fraction of the true cost,” says Pfeiffer. “It only reflects [people who] are diagnosed and treated quickly. Those aren’t the ones for whom treatment failed or who don’t get diagnosed or who get diagnosed with something else.”
What’s more, Pfeiffer says, the Lyme outbreak is being badly mismanaged. “This disease has been very much underestimated. We don’t have a good test. We have treatments that fail. We seem to have very little urgency to respond. That lack of urgency means we simply have not spent the money needed on this epidemic.”
After the morning’s lab work is complete, Oggenfuss and her team make their way to the Cary Institute auditorium for the final talk in a seminar series called “Forecasting Outbreaks of Infectious Diseases,” a presentation being given by Jeffrey Shaman, director of the Climate and Health Program at Columbia University’s Mailman School of Public Health. In the hall, Oggenfuss, Ostfeld, and the others listen intently to the process of building a predictive computer modeling system for the flu.
Later, Ostfeld and Shaman meet to discuss similar methods for forecasting the spread of Lyme disease. Although the expression is “mighty oaks from little acorns grow,” mice too survive on the tree seeds. Ostfeld’s field teams are creating a model that links high annual acorn production to a surge in the mouse population through the summer and fall, which in turn leads to spikes in the number of Lyme-infected nymphs the following spring. It’s light-years from Shaman’s detailed weekly predictions for 108 U.S. cities.
But that model is for the flu, which caused the most severe pandemic in modern history from 1918–1920 and is now the subject of concerted and coordinated worldwide health efforts. Each year, the WHO Global Influenza Surveillance and Response System selects the strains of the influenza virus to target with its seasonal vaccine, which is manufactured and distributed worldwide. In the U.S., it is administered free in many workplaces and widely available at local pharmacies.
Lyme and other tick-borne diseases have yet to receive anything like that sort of attention. In 1998, the Food and Drug Administration approved a Lyme disease vaccine called Lymerix, administered in a three-injection cycle, that reduced infections in adults by nearly 80%. But it was discontinued three years later after sales bottomed out, due in large part to public fears driven by negative news reports over its side effects (most notably arthritis) and a class-action lawsuit whose claims were debunked. It was an early victory for the anti-vaccine movement, which gained momentum thanks to a now-retracted study linking autism to the measles-mumps-rubella vaccine that was released the same year as Lymerix.
“That actually scared me,” says Joyce Sakamoto, an entomologist at the Center for Infectious Disease Dynamics at Pennsylvania State University who has researched public engagement strategies to improve tick-borne disease literacy. “That was a case where the anti-vax community was able to effectively kill something entirely without a lot of scientific evidence.”
For now, the only vaccines in use for humans against tick-borne diseases target viral, not bacterial, infections (for instance, tick-borne encephalitis, which is endemic in central Asia as well as Europe, where widespread vaccination has proven effective). Over the past 10 years, however, there has been increasing scientific inquiry into a one-stop shop — a vaccine that would inoculate against all tick-borne diseases by targeting the proteins in tick saliva to block the transmission of pathogens. This would be a game changer, but the research is still in early stages.
More immediately, a new Lyme vaccine called VLA15, developed by French biotech firm Valneva, is undergoing clinical trials in Europe. Although it was given fast-track status by the FDA and seems likely to be approved in the United States, there is no guarantee it will be adopted by the public. As a result of low demand and anti-vaccine agitation, there is a chance the drugmaker will choose not to distribute it in the U.S.
“I don’t know how that’s all going to work out. They are trying to address the potential PR fail that could happen, even if you have a really good product,” says Sakamoto. “If the risk of disease outweighs the risk of the side effects — and this is true of any drug — people are more likely to take the drug. But if they feel like it’s something they can survive, it’s not a big deal, they’re going to disregard it.”
According to the National Institutes of Health database, there are eight ongoing trials involving Lyme disease, and there have been 59 since its cause was identified in 1982. Lyme advocates say that’s far too few. “There is a very solid case to be made that Lyme disease deserves a lot more attention and a lot more money,” says Pfeiffer. “It’s a source of great consternation to me and to a lot of other people.”
In 2016, Congress passed the 21st Century Cures Act, which authorized the Health and Human Services Department to establish a Tick-Borne Disease Working Group to advise Congress and the secretary of HHS on research priorities and coordination. In late May, Sens. Susan Collins of Maine and Tina Smith of Minnesota, both of whose states are now hotbeds of Lyme disease, introduced S.1657, a piece of legislation called the Ticks: Identify, Control, and Knockout (TICK) Act, which allocates $100 million over the next several years for the study of tick-borne disease and new treatments. Although a companion bill was recently introduced in the House of Representatives, the legislation is currently languishing in committee, and its prospects remain unclear.
Those whose jobs it is to foresee and prepare for real-life disasters and apocalyptic events, the Department of Defense and DARPA Defense Advanced Research Projects Agency, are acting more decisively. Along with the EPA, they are funding Ostfeld’s research into the links between ticks and climate change.
Through the Tick Project, Ostfeld is also investigating tick control methods. Historically, most tick eradication efforts have done as much harm as good — the Soviet Union’s widespread use of DDT, for instance — largely because chemical agents that kill ticks also exterminate all other bugs and endanger water supplies. Ostfeld and the Tick Project are focusing on environmentally sensitive bioagents that kill ticks but affect as few other creatures as possible.
“We’re using a naturally occurring native fungus,” Ostfeld says, “and it is pretty specific to ticks.”
To be exact, he and his team are studying a type of pathogenic fungus called Metarhizium brunneum strain F52, which is applied to foliage and soil. Its spores then attach to passing ticks, penetrate their exoskeletons, and reproduce inside them until they die.
The compound is not some closely held secret — it’s sold commercially as MET52. When Ostfeld had to halt research last year after being unable to order an adequate supply, it was not because a foreign government or the World Health Organization had started stockpiling it.
“California pot growers were buying up huge amounts,” he says, noting that it control whiteflies and other crop-eating insects. “They can use it and still sell their pot as organic.”
At least as Ostfeld envisions it, the bioagent would not be carpet-bombed across large regions, but rather used to create buffer zones around homes, woods-adjacent communities, and the like. That is the same application Ostfeld envisions for another product he is testing called the Tick Control System — a small box that attracts mice and other small mammals to enter, then applies a small dose of fipronil, the active ingredient in Frontline, which is widely used to kill ticks on dogs and cats.
The Cary Institute sells “I Brake for Opossums” bumper stickers. The decals don’t do anything to curtail tick-borne diseases themselves, but preserving opossums populations can. Unlike mice, opossums are not so-called “permissive hosts,” Ostfeld explains. They are efficient at eating ticks while grooming and are not a disease reservoir. Unfortunately, Ostfeld explains as we sit in his office, mice are far more numerous than possums, and they are like magnets to tick larvae.
“Look, a larva would be lucky to crawl from me to you across this table in five hours, right? But it’s likely to find a mouse passing on the forest floor,” says Ostfeld, walking his finger slowly across his desk toward me. Once that larva feeds on a mouse, or any infection-carrying host, everything changes, he says. The tick is effectively weaponized.
We’re already losing the war on ticks and Lyme disease, Ostfeld says; most of us just don’t realize it.
“People ask me all the time, when they find out what I do, whether we’ll live to see the age of the tick. We’re already in it. The real question is, what do we do now?”
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**Comment**
I purposely left the crawling ticks….very creepy.
Glad they mentioned “co-feeding” and the probability they are spreading more pathogens into us more quickly, increasing prevalence.
Glad they state this is a pandemic and the increase of ticks is everywhere making maps a joke. Throw them away. They’ve been used against patients from the get-go.
Although Lyme disease has been around forever, tinkering with it in a lab and making it more pathogenic isn’t a “theory,” it’s what bioweaponization means, and it’s far more than just Lyme. I’d say the experiment has been highly successful.
They briefly mention the role of birds but fail once again by bringing the climate into it. Out of one side of their mouth they state ticks are marvelous ecoadaptors and then out of the other side of their mouth they blame the climate. You can’t have it both ways.Please note the DOD, DARPA, & the EPA are funding the supposed “link” between ticks & climate change….that is quite telling. They would rather blame the weather than take responsibility for tweaking ticks in a lab that perhaps gave them the ability to live on stucco & in dirt and be more aggressive….hmmm. Yeah, blame the climate.
Having the EM rash is highly variable from 25%-80%. It should not be used as criteria for entrance into research studies nor as a required sign by doctors for diagnosis as so many do not get it. If you do have it – you have Lyme, but if you don’t, you could still have Lyme.
“The authorities have been using tick expansion and climate change to get research dollars. Climate change is a popular topic right now, and that is a great source of funding for related research. However, any research on ticks and climate change is inconclusive––in essence, there is no validity. The long-range, futuristic projections and statistical models are bogus science because blacklegged ticks have already been found in northern Canada. In fact, we documented blacklegged ticks on migratory songbirds in northern Alberta dating back to 1998. Any allocation of government funding for ticks and climate change research is a complete waste of taxpayers’ money. It will not help Lyme disease patients one iota.”
Ouch.
An independent researcher who doesn’t have strings attached to his work points out all the marionettes on strings in the research world, who by the way, refuse to even acknowledge his work…..and even advocates are guilty of jumping on a Bandwagon built upon faulty science.
Let us never stoop as low as the enemy who has twisted science to suit their purpose from the beginning.
Lastly, please note the TBDWG has taken a supposed new turn and is leaving patients out of the process. Is this really shocking when you read the above issues?
Lyme disease and dental health: What you need to know
Lyme disease, also known as Lyme borreliosis, is caused by the tick-borne spirochete bacterium Borrelia burgdorfer.
Lyme disease is a multisystem inflammatory disease, and neurologic, articular, and cardiac manifestations may follow untreated early infection. While the B. burgdorferi bacterium does not make toxins or cause direct tissue damage, local inflammation results from host response mechanisms.
Three phases of general clinical manifestations
Early localized: distinct, bull’s eye or target skin lesions in warm areas of the body (groin, axilla or belt line) that may itch, burn or hurt.
Early disseminated: if treatment is not initiated involvement of brain or heart may occur.
Late disease: also called as Post Treatment Lyme Disease Syndrome (PTLDS), this phase leads to muscle and bone involvement.
The link between Lyme disease and dental health
It has been observed that Lyme and many other chronic diseases are fed by the unique bacteria that develop in root canals and where teeth have been extracted. Lyme bacteria exists in the teeth, not in the enamel. The spirochete bacterium love to occupy in the dentin and some three miles of tiny tubules.
Its clinical manifestations may include facial and dental pain (tooth ache), facial nerve palsy, headache, temporomandibular (jaw) joint pain, and masticatory (chewing) muscle pain. The effects that can precipitate when performing dental procedures on a patient with Lyme disease must also be considered. 1
Symptoms of oral presentations
Symptoms associated with Lyme disease include headache and facial pain that often mimics dental pathology and temporomandibular (such as TMJ) disorders.
Other oral symptoms can be:
Dry mouth
Tooth sensitivity
Pulpitis, or the oral inflammation of dental pulp
Bell’s palsy, or partial facial paralysis
Cranial nerve palsy may occur in early disseminated disease. Bell’s palsy is a form of usually temporary facial neuropathy resulting from inflammation/damage to the seventh cranial nerve (i.e., facial nerve)
Involvement of the saliva producing glands may manifest as brief inflammation of the gland
Getting the right treatment
Because Lyme bacteria resides in the mouth, the disease can cause tooth pain unrelated to cavities or any other dental issues, which might indicate Lyme disease to your dentist. However, the misdiagnosis of any of these symptoms by a dental professional could result in unnecessary procedures, like root canals. Knowing the above oral symptoms can help a patient identify Lyme disease early.
Fortunately, oral symptoms will disappear after a successful treatment. That doesn’t mean you should drop your guard though. Another tick bite could mean another bout of Lyme disease. People who have been bitten by a tick or who live in tick infested regions should take these oral symptoms and other symptoms of Lyme disease seriously.
If a patient is worried about contracting Lyme disease, he/she should visit a medical care provider and dental hygienist to check the mouth for indications of Lyme.
References
Lyme disease: considerations for dentistry. J Orofac Pain. 1996 Winter;10(1):74-86.
Lyme disease awareness for the New Jersey dentist. A survey of orofacial and headache complaints associated with Lyme disease. J N J Dent Assoc. 1998 Winter;69(1):19, 21, 62-3 passim.
Lyme disease: College of Dental Hygienists of Ontario
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**Comment**
Lyme disease is not just an inflammatory disease. Let us never forget it is bacterial but also often viral, fungal, and parasitical due to the coinfection involvement in many cases. While these pathogens cause widespread inflammation, it should never be treated solely as inflammatory – which would only be a bandaid on an infectious disease that requires antimicrobials.
Many never go through the three “phases” or “stages” of Lyme or if they do, they can be in any order. The EM rash is often absent.
This Finnish doctor uses herbs to heal Lyme disease and co-infections
By Marjo Valonen, MD
It was the happiest moment of my life, to hold my twin babies for the first time. I am so glad that I didn’t know what was ahead of me: that I would be bedridden and seriously ill for years. That I couldn’t walk, play with my kids, or have the strength to sing to them. Even smiling at them would require all the energy I could muster.
Ever since I was six years old, I wanted to be a doctor. Everything about humans and human health interested me. My first dream was to be a brain surgeon, but when I was actually working as a surgeon, I realized that this wasn’t quite what I wanted. I aspired to understand the whole human body, instead of settling for any single specialty. My thirst for knowledge drove me instead into looking at traditional Chinese medicine and then integrative medicine.
Unexplained symptoms
So, when I fell so ill after giving birth to our twin boys and one and a half years later to our daughter, I was confused. Confused, because I thought that I already knew so much. I consulted countless colleagues, the best in their field, but no one knew what was wrong with me. And sadly, it seems that not knowing, is for many doctors, too difficult a burden to bear. They didn’t think: oh wow, this is something I don’t know, let’s study more and find out! Instead, they got angry at the patient that dared to have symptoms or illness that they didn’t have answers for.
My symptoms included extreme fatigue. Even keeping my eyes open felt like too much work. If I tried to get up and walk, I fainted. So, confined to my bed, I relied on my husband for everything. He brought me my food, carried me to the bathroom, took care of our three small children and maintained his own work outside the home. He is the real hero of this story!
Wracked with pain, I had sinus infections – with pus constantly oozing out of my sinus cavities – for which I underwent numerous operations. However, when doctors couldn’t find anything wrong with my lab tests, they told me that I was just imagining it all, that it was all in my head, and that I was causing myself to be ill. One colleague even said to me, “You’re just lazy. You don’t want to work.”
The search for a cure
The worst of it lasted about two years. After that, I was able to sit and walk a bit, but I still couldn’t do much. I started searching for answers on the Internet and reading recommended books. I did everything I could think of: I healed my gut, I found many food intolerances, balanced my hormones, and supported my thyroid and adrenals.
Finally, I ran into the question of chronic infections. I ran tests on myself and confirmed my suspicion of having Lyme disease. It turns out I had loads of other infections, as well. That started me on the next step of my journey back to health: finding out how to treat these infections.
Initially, I was told that I had to treat it with antibiotics. This didn’t sit well with me – with how I think about life and how we should treat our bodies. But I eventually decided to try antibiotics, since that was the conventional procedure. ILADS is doing great work regarding Borrelia, and I tried the combination of antibiotics suggested by ILADS. But they were too hard on my gut. My system just couldn’t handle them.
The Cowden Protocol
I started looking at herbal solutions. I loved learning about the many different ways herbs can help and support us. I tried many different protocols but none of them worked very well for me. Then, I heard from my colleague Dr. Armin Schwarzbach about the support protocol developed by Dr. Lee Cowden, called CSP (Cowden Support Program). Imagine my joy and gratitude when after a month or two I started feeling better. I could walk and hug my kids and enjoy life!
Sharing my own healing with others
At last, after such a long period of professional inactivity, I began seeing patients again. As I encountered those who had the same problems that I had, I used the Cowden Protocol with them. We’re still amazed at how well it works! I’m glad that I was able to find a way to help my patients without having to use antibiotics.
Typically, patients don’t have many positive test results at first. These usually appear after a short period of initial treatment. When you give patients herbs, their immune system starts fighting against the infection. Some patients are so sick when they first come to my office that their immune system is totally shut down and can’t fight anything. In that situation, all results will be negative.
If their doctor doesn’t know this and understand the underlying mechanisms, they will just look at the negative lab results and declare the patient healthy, when in fact these are the sickest cases needing the most help and support. That is why the diagnosis needs to be based on clinical picture and symptoms, not just lab results.
Of the symptoms, pain and fatigue are typically the worst part of being ill. We ask them to rate both between 0 and 10, with 10 being the worst imaginable. We do this at the beginning of treatment, and we then follow their self-assessments.
Sometimes, both objective lab results and subjective self-assessments improve at more or less the same rate. When that happens, we’re really happy and can trust that the treatment is working. One or the other isn’t enough. If the lab results are great, but the patient is fatigued and in pain, then the infection might just be hiding somewhere. Then, you have to sort of dig it out.
Cure or remission?
Can Lyme disease be fully cured? Or, must we be content with tolerable remission of active symptoms? This is a good question.
I think that we can get our patients cured in such a way that Lyme doesn’t affect their life anymore. The question of whether or not we can ever be totally rid of Borrelia microbes cannot really be answered, since they can spread everywhere within the body. However, we all carry all sorts of microbes and parasites within us, at all times. That’s life. The question is, “Who is in charge: you, or the microbes within you?”
I agree with the assessment of the American cardiologist Dr. Thomas Levy: namely, that Borrelia is normally a commensal bug, requiring an already compromised autonomic nervous system to become infectious.
I contracted Lyme in the womb, from my mother. I carried it within me throughout my early years without noticing it. After the twin pregnancy and the birth of my daughter, during which I had many complications, my immune system took a hard hit. And, that’s when “the enemies” got the upper hand, moving from the incubation state to the acute one.
The immune system is key
I am convinced that my role as a doctor is fundamentally to support my patients’ immune systems. Only then can these microbes be defeated. Sometimes my patients express their concerns about ticks being everywhere. I remind them at those times that we can’t live in a bubble. Some have famously tried it, but it isn’t a very good solution. We neither can nor should stop our children from running and playing in the woods. The best thing is to take care of our own body and immune system so that we are strong enough to resist all of this.
This leads to the whole idea of preventative wellness. This is where medicine is seen not so much as treating diseases as helping people so they do not become ill in the first place. That’s one of the reasons why I think Dr. Cowden’s program is simply genius, because the use of antimicrobial herbs is constantly changing, affecting different kinds of microbes – not just Borrelia, but also the co-infections. The antimicrobial herbs, moreover, are complemented by detoxifying and anti-inflammatory ones, as well as herbs that support energy production. Some people think that it’s enough to take antibiotics or even antimicrobial herbs. But, that’s just killing pathogens. I advocate a much wider approach, one that supports the whole system. Uprooting is not enough. You have to replant.
What happens after symptoms disappear?
Our patients receive an ongoing maintenance program from us for the rest of their lives. By the time that they are fully functional again, we’ve known them for several months or, in the harder cases, several years. So, we usually have acquired a good idea of their genetic composition and their ability to withstand these things on their own. Hence, someone with a robust constitution may need only a basic multi-vitamin and some detox and supporting herbs.
On the other hand, a very fragile person might need other things to support them. I myself have genetic problems with my immune and detox systems, but I’m doing fine with herbs. I am still taking selected herbs as well as some important immune supporting supplements and I’ll never give them up! By taking care of myself, I can live a normal life.
In fact, I travel throughout Europe teaching about herbs. When I speak at conferences and other venues, I like to share patient cases. They are real life, allowing me to demonstrate what we are doing and how well it’s working. I give detailed information on what herbs I use and in what dosages. My mission, the reason why I’m going around Europe, and now also the States, talking about herbs, is to teach other professionals how to help others in the same way.
So, what began as my own personal interest has become my life’s work.
The future of medicine
I believe we’re living already the future of medicine. It’s so great that we have researchers like Professor Eva Sapi, of the University of New Haven. So, we’re constantly getting more information on how herbs work. Of course, there are always those people who think that herbs can’t possibly be that effective. They need to be reminded that the Nobel Prize for Medicine was given in 2015 to Professor Tu Youyou, a pharmacologist at the China Academy of Chinese Medical Sciences in Beijing, in recognition of her work with the herb Artemisia annua. Also, about 50% of conventional medicines are developed from natural substances, including herbs. But, since you can’t patent something derived from nature, then medical companies have to change or break these substances in order to obtain patents and then charge big prices for their products.
On antibiotics
Returning to the question of antibiotics, I think we often use them irresponsibly, which leads to the loss of their efficacy. Bacterial resistance has become a big problem. It is much more difficult for bacteria to develop resistance to an herb, though, which may have tens or even hundreds of different substances with which it fights bacteria.
It’s quite easy for a bacterium to develop resistance to an antibiotic, since it is just this one thing against which it has to fight. But when you send hundreds of things against that bacterium, it has a much harder time developing effective resistance.
I don’t think it’s wrong to use antibiotics when they are needed. The problem is when we use too much of them, for minor conditions. We’re also giving them to our livestock, which results in indirect antibiotic exposure for us. What was designed to help us is really hurting us.
Bringing back hope
Lyme and co-infections can be devastating. Not just to the person who falls ill, but for their loved ones as well. Our family has been through it, and that is why I want to share my story and share my knowledge. I don’t want anyone to have to go through as much pain and suffering as I had to.
With the herbal and supplemental protocols that we use at our clinic, we’ve been able to help even the worst cases of Lyme and co-infections. Even those that have been taking antibiotics for years, without getting better. So, I don’t want anyone to lose hope – there is still lots that can be done. It may take some detective work to find the right protocols, but I am a living proof that it is possible!
Marjo Valonen, MD, is medical director of Astris Medical Centerin Helsinki, Finland. Her clinic specializes in tick-borne and other chronic infectious illnesses. She has also lectured widely at Lyme-related conferences.
Warm weather brings many opportunities for fun, especially for people who enjoy being outside. Whether it’s hiking, camping, picnicking or simply reading a good book in the garden, the spring and summer months have much to offer in the way of outdoor activities.
But along with opportunities for fun, unfortunately, spending time in nature during the warmer months also brings danger in the form of Lyme disease. This is especially true for people who live in regions where the ticks that carry Lyme infection are common. But Lyme disease has been found on every continent except Antarctica, and cases of Lyme disease are growing at such a high rate that almost anyone who spends a significant amount of time outdoors could be at risk of exposure to Lyme disease.
What is Lyme disease and how is it transmitted?
Lyme disease is a bacterial infection caused by a spirochete (corkscrew-shaped) bacterium named Borrelia burgdorferi. This bacterium is carried by rodents and animals like the white-footed mouse and deer that are the preferred hosts of ticks known as Ixodes, deer or black-legged ticks.
When an Ixodes tick feeds on a creature that’s carrying Borrelia burgdorferi, it becomes infected with the bacterium. An infected tick can then transmit Borrelia burgdorferi to humans through a single bite, causing Lyme infection.
People who contract Lyme disease are often bitten by ticks that are still in their nymphal, or immature, phase. Nymphal ticks are tiny – about the size of a poppy seed – and their bite is usually painless, so many of those who have been bitten by a nymphal tick have no idea.
The chance of Lyme infection being transmitted from an infected tick to a human goes up the longer the tick stays attached, so the tiny size and painless bite of nymphal ticks are frightening factors that can increase infection risk.
What are the symptoms of Lyme disease?
Lyme infection can be separated into two phases: acute and chronic. The acute phase is the preliminary stage of Lyme disease and typically includes the following symptoms:
Erythema migrans, an expanding red rash that sometimes resembles a bullseye
Fever
Chills
Headaches
Neck pain and stiffness
Fatigue
Joint pain and swelling
Weakness and paralysis of facial muscles
Lightheadedness and fainting
Heart palpitations and chest pain
Neck pain is one of the symptoms of Lyme disease.
If Lyme disease is caught within the first few weeks of infection, it may be effectively treated with antibiotics. But if it’s not properly diagnosed or treatment fails, Lyme disease can progress to the chronic phase. Symptoms of chronic Lyme disease are many and varied, but some of the most common ones are:
Joint pain
Headaches
Fatigue
Muscle aches
Memory loss, trouble concentrating or ‘brain fog’
Neuropathy (including nerve pain, numbness, or tingling)
Sleep problems
Changes in mood
Digestive issues
What is a Herxheimer reaction and how is it connected to Lyme disease?
Officially known as a Jarisch-Herxheimer reaction (and often called a Herx for short), a Herxheimer reaction occurs when the beginning of an antibiotic treatment course causes a spike in the die-off of spirochetal bacteria. It was named after European dermatologists who were the first to observe that symptoms worsened in syphilis patients being treated with mercurial compounds. This exacerbation of symptoms continued to be observed when penicillin became the main treatment for syphilis, usually occurring within the first 24 hours of treatment.
Like syphilis, Lyme disease is caused by a spirochetal bacterium. Herxheimer reactions sometimes happen to patients with Lyme disease when they first begin antibiotic therapy as a result of the Borrelia burgdorferi dying. The die-off causes your body to release proteins called cytokines. While a moderate amount of cytokines can help boost your immune system, too many of them can cause adverse effects.
Although they are sometimes considered a good thing because they indicate that the medication is working to kill Lyme bacteria, Herxheimer reactions can cause patients experiencing them to suddenly feel very poorly. Herxheimer reactions are characterised by a worsening of existing Lyme symptoms like:
Inflammation
Fatigue
Memory impairment and/or brain fog
Nerve and muscle pain
Chills/sweats
How is a Herxheimer reaction treated?
There’s no question that going through a Herxheimer reaction is difficult, and knowing that it’s a possibility can cause some Lyme patients to delay or even avoid treatment. When they’re already struggling with the symptoms of Lyme disease, the idea of feeling even worse is sometimes unbearable.
Although Herxheimer reactions be a necessary evil when beginning treatment for Lyme disease, there are things you can do to mitigate the damage. Some of the supplements believed to lessen Herxheimer symptoms include:
Glutathione, a powerful antioxidant that can help the liver process toxins
Activated charcoal, which may remove toxins from the body by binding to them
Curcumin, another strong antioxidant that has been shown to reduce inflammation
Epsom salts, which are used externally for bathing and contain magnesium sulfate for relaxing muscles and drawing toxins
Bathing in Epsom salts may help with symptoms of a Herxheimer reaction.
Aside from supplements, lifestyle choices like moderate exercise can alleviate the discomfort of Herxheimer reactions. While working out may be the last thing a Lyme patient experiencing a Herxheimer reaction wants to do, exercising stimulates the body’s lymphatic system, allowing more efficient removal of toxins from the body.
A Herxheimer reaction during Lyme disease treatment can make a bad situation worse, but knowing what to expect and how to support the body during this process arms patients and practitioners alike with the information they need to handle the challenge.
One of the hardest things to understand about this complex disease(s) is that you feel a whole lot worse before you feel better and this can take considerable time. Managing the herx is a challenging job. See links above for ideas.
Can Therapeutic Peptides Revolutionize the Future of Precision Medicine?
Jill C. Carnahan, MD
Founder, Medical Director, Flatiron FunctionalMedicine
By late 2018, it was estimated that 17 million people have had their DNA analyzed by companies like 23andMe and Ancestry. And that number is expected to grow by at least a million every month. You might even know someone who has done one. And you might be wondering: What’s the point?
The truth is, big questions need big data. DNA repositories are now getting so big that the information gained from them can be used in ways we thought we’d only see in science fiction movies just decades ago. And one of the most undeniably significant applications of this data is precision medicine.
Humans are incredibly complex beings — but until recently, modern medicine has treated every patient as if they were one and the same. Doctors had no idea who would benefit from certain drugs, who was at risk of developing Alzheimer’s disease, or even seemingly trivial things like who would go bald. While we certainly have a long way to go in terms of personalizing medicine for each and every patient, recent research suggests that therapeutic peptides could pave the way.
Peptide therapy has been gaining great interest and popularity in recent years as a novel approach to slow down aging and treat diseases. In this article, we’ll discuss what peptide therapy is and how it might benefit your health.
What are Peptides?
Peptides can be thought of as small proteins (less than 50 amino acids long) that typically act as highly specific signaling molecules in many crucial functions in our bodies, including hormone production, cell signaling, and cell-to-cell communication.
Peptides often have attractive properties and pharmacological profiles that make them highly desirable as starting points for drug design and development. There are several advantages of using these small receptor-binding molecules as therapeutics, a few of which are:
Low toxicity
High chemical and biological diversity
High potency and specificity
Good efficacy, safety, and tolerability
Broad range of targets
Low accumulation in tissues
But perhaps the biggest advantage of therapeutic peptides is the fact that they are amenable to rational design. Therapeutic peptides can be designed to be involved in virtually any cellular process. This means that they can be designed to block interactions of proteins as long as enough of the sequence of the target site is known and conditions allow for the peptide to bind it.
Owing to these advantages as well the rapid developments in proteomics and bioinformatics, more than 7,000 naturally-occurring peptides have been identified, and the global peptide therapeutics market is expected to reach over $50 billion by 2024.
But why has it taken so long for peptides to be as well known as they are today? The idea of using peptides for drug design was largely ignored by pharmaceutical companies due to several intrinsic weaknesses, such as :
Poor chemical and physical stability
Small size, which makes them vulnerable to degradation
Prone to hydrolysis and oxidation
Tendency for aggregation
Short half-life, fast elimination
Low oral bioavailability
Low membrane permeability
Higher production costs
Because of these weaknesses, naturally-occurring peptides are not directly suitable for use as therapeutics. However, thanks to recent advances in technology, numerous improvements have been made to the stability, transport, oral availability, and affinity profiles of peptides. These changes have renewed interest in peptides as potential therapeutic drugs.
What Conditions Can Peptides Therapy Treat?
Peptides can be used to treat a wide range of illnesses. The list of potential conditions that can benefit from peptides is nearly endless, but here are just a few:
The thymus gland is located behind your breastbone and between your lungs. Although it’s only active until puberty, it nevertheless plays a crucial role in the development of the immune system and in protecting the body against autoimmunity, a state in which the body’s immune system turns on itself. It is responsible for producing and secreting a hormone called thymosin, which stimulates the development of white blood cells called T-lymphocytes or T cells. For their roles in regulating the immune system, thymosins (also known as thymic peptides) are referred to as immune-modulatory peptides.
There are two thymic peptides commonly used in peptide therapy: Thymosin alpha 1 (Tɑ1) and thymosin beta 4 (Tβ4). Both of these peptides have been shown to have important clinical applications, such as in modulating immune responses, neuroplasticity, blood vessel formation, etc.
Let’s take a closer look at Tɑ1 and Tβ4.
Thymosin Alpha 1 (Tɑ1)
Thymosin alpha 1 is a naturally-produced peptide of 28 amino acids that can enhance the body’s ability to recognize and respond to foreign invaders. At the cellular level, Tɑ1 interacts with proteins called Toll-Like Receptors (TLRs), and it is the interaction with TLRs on dendritic cells and precursor T cells that results in immune-stimulating effects, including:
Increased natural killer cell activity
Increased expression of TH1-type cytokines
Increased levels of cytotoxic T cells
Reduced apoptosis of immune cells
A shift of T helper cells to Type 1 T helper (TH1) cells
Activation of dendritic cells
Studies show that immune dysregulation and/or immunosenescence (gradual deterioration of the immune system associated with age) results in an imbalance of TH1 and TH2. TH1 and TH2 cells secrete proteins called cytokines that exhibit protective effects. TH1 cells produce interferon (IFN) -g and interleukin (IL)-2 which tend to be pro-inflammatory, while TH2 cells produce IL-4, IL-5, Il-6, IL-10, and IL-13 which are anti-inflammatory.
TH1 and TH2 cells produce also differ in the types of immune responses they produce. TH1 cells typically deal with pathogens that get inside cells, such as bacteria and viruses. On the other hand, TH2 cells parasites that attack from outside the cells as well as toxins and allergens.
Both sides need to work together to have a well-balanced immune system. Neither should be in a dominant position. However, in some people, there is a prolonged period of time in which either TH1 or TH2 dominance occurs, leading to health problems. In particular, an increase in TH2 relative to TH1 has been linked to:
This is one of the most significant clinical applications of Tɑ1. As an immunomodulator, Tɑ1 restores balance to the body by increasing TH1 and decreasing TH2, thus breaking the cycle of immune dysfunction so often found in these illnesses.
Several clinical studies have shown that Tɑ1 can benefit a broad range of conditions, some of which include:
Due to the success of these clinical trials, drugs containing Tɑ1 have been approved for clinical use in over 35 countries (including the U.S.) and have had very few reports of adverse effects so far.
Thymosin Beta 4 (Tꞵ4)
Thymosin beta 4 is also produced in the thymus gland and is also the predominant form of thymosin in the human body. This means it can be found in all human cells, although it is typically found in high concentrations in wound tissue and in certain blood cells involved in wound healing.
Despite being a peptide of only 43 amino acids, Tꞵ4 is involved in modulating a wide range of regenerative activities. When the wound healing process begins, Tꞵ4 aids in:
Promoting formation of new blood vessels to the injured area which carry essential reparative substances
Increasing “good” inflammation that can help the wound heal faster
Increasing the amount of cell-building proteins such as actin
Restoring tissue structure and metabolism
Promoting hair growth
Reducing acute/chronic pain
From its anti-inflammatory properties, it’s easy to see why Tꞵ4 has such a huge potential in terms of clinical applications. So far, it has shown to be effective in several injury models, such as traumatic brain injury, stroke, spinal cord injury, a model of multiple sclerosis, diabetes, and cardiac damage resulting from reduced blood flow.
BPC 157
Pentadecapeptide BPC 157 is a synthetic, partial sequence of body protection compound (BPC), a protein that is naturally produced in the gastrointestinal (GI) tract. But the effects of BPC 157 extend beyond the GI tract – studies have also revealed that it has influences on:
Like the other peptides we’ve discussed, BPC 157 has great potential for use in many chronic diseases like HIV, diabetes, cardiovascular disease, and autoimmune diseases. However, a majority of studies investigating BPC 157 have been done only in animal models, which do not always accurately predict effects in humans.
Cerebrolysin
Cerebrolysin is a nootropic, a synthetic drug that may enhance cognitive functions, such as memory, creativity, and motivation. Rather than being a single peptide, Cerebrolysin is a mixture of very small peptides derived from brains of pigs. The small size of Cerebrolysin means it can cross the blood-brain and the blood-cerebrospinal fluid barriers and directly act on the central and peripheral neurons.
The clinical value of Cerebrolysin comes from its neuroprotective effects. It has been shown to be effective when used for:
Studies have indicated that Cerebrolysin is safe in humans for short-term use (up to 3 years). However, it has not been approved by the U.S. Food and Drug Administration (FDA).
What Does the Future Look Like for Peptide Therapy?
As we make advancements toward precision medicine, peptide therapy provides an innovative way to deliver highly potent and cost-effective medicine. Researchers continue to expand the number of peptide-addressable targets for which there are no drugs available, which simply indicate the nearly endless opportunities for new peptide therapeutics.
Now that we’ve discussed a bit about peptide therapy, it’s time to hear from you. Do you have any experience with therapeutic peptides? What are your thoughts about their future in medicine? Share your thoughts in the comments below!
*2019 assessment of the Tick-Born disease Working Group and CALL TO ACTION*
GOTCHA CALL TO ACTION addressing the new Tick-Borne Disease Working Group (TBDWG) 2019
Kristina Bauer
Yoga Mom, Wellness practitioner and LymeEducator
After attending the first TBDWG of 2019 on June 4th in D.C., it was apparent there needs to be a louder voice from the Lyme patient community.
I was encouraged at the Tick-Borne Disease Working Group meeting to write all concerns to the following email address, tickbornedisease@hhs.gov.
I BELIEVE in democracy, and in one new member this year. I was very impressed particularly with Commander Rebecca Bunnell, who is on the federal side.
She is a Senior Advisor at CMS (Medicare and Medicaid). I spent some time talking with her and she is genuinely pushing for a PATIENT CENTERED TBDWG! I believe she has a very powerful impact potential for patients.
This is, I believe where we need to focus as patients and activists. Once Medicare and Medicaid approve covering a treatment and recommended tests etc., the private sector (insurance!) usually will pick up and follow, historically. That’s our goal is better tests, treatment, and insurance coverage.
Here is a sample letter you’re welcome to copy, paste and share in your groups. Add your name at the bottom, take mine off, and email it off to the TBDWG.
DON’T UNDERESTIMATE WHAT YOUR IMPACT CAN HAVE! THINK ACTUP! from the AIDS fight for medical justice. Lyme advocates are involved, strategic and TOGETHER WE CAN do this!
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TO WHOM IT MAY CONCERN,
The Lyme and associated diseases community are pressing for a congressional hearing on the mishandling of Lyme disease of the leadership of NIAID, NIH, CDC and HHS.
We will continue our efforts from across the globe until our demands are met for quality diagnostics, guidelines for treatments that work, and insurance coverage for effective treatments.
We have organized information chronologically from when the CDC took over in the late 1980’s until current time. This revealed inadequate studies were at the source of ineffective guidelines to patient’s detriment and in contrast, to develop a vaccine.
We need funds for research on infection persistence, with special attention be given to drug studies that consider the following:
1.The unusually long replication cycle of the organism
2. Borrelia’s stationary growth pattern, which allows for the formation antibiotic tolerant persister cells, once the stationary phase is reached
3. The tropism of the organism
4. The varied abilities of medications to pass the blood-brain-barrier
5. The formation of biofilm colonies that prohibit medication accessibility
6. The ability of the organism to compromise the immune system, likely necessitating the complete eradication of the organism from the body
7. The non-cultivability of the organism, once it experiences, even a limited exposure to an antibiotic
Advocates around the world are outraged by the conflicts of interest allowed at the table so far, including and especially Dr. Shapiro. We now have almost 23,000 signatures on our change.org petition written by Dorothy Leland of Lymedisease.org requesting his removal from the TBDWG.
Lyme patients worldwide DEMAND he be removed immediately!
Electing him is no approach to a “fair and balanced” working group makeup. He has proven to be against patients’ needs year after year. Another assessment by Mrs. Leland is at this link https://www.lymedisease.org/shapiro-tbdwg/.
As a result of this groups history, public participation has been poor, and faith never established. Allowing IDSA to continue to keep their admission of Shapiro’s appointment on the Tick-Borne Disease Working Group two weeks prior to what the public saw violates your transparency goals outlined in your charter, among many other violations.
IDSA publicly made a shocking omission on their website that they disagree with the TBDWG recommendation to Congress for insurance coverage for Lyme patients. The TBDWG was formed for the patient group not IDSA, correct? This is blatant medical discrimination violating our dignity and human rights. Would they say this about a child with cancer?
We ask the following:
A congressional hearing on the mishandling of Lyme from 1980 to current.
IDSA trained Dr.’s should be denied a place at the table until they prove to incorporate a patient focus to reinforcing the medical human rights of Lyme patients. The WHO’s constitution states that every person has the RIGHT to their best attainable health.
It’s the obligation of the TBDWG to make that happen.
Every member on the TBDWG who has conflicts of interests need to step down, so the direction is squarely centered on the patients without a payday for players. All conflicts of interest of the TBDWG need to be fully disclosed and transparent to Congress and on public record.
We ask for a public announcement for the termination of the use of the term PTLD/PTLDS. It has no scientific backing and negates the user’s credentials immediately to the reader.
Lyme constitutes 80% of all Tick-borne diseases the CDC estimates, therefore Lyme should make up 80% of the subcommittees.
All pregnancies need tested for Tick-borne diseases right away, and ILADS guidelines the standard treatment allowed.
States need to require Doctors to be educated in Lyme and Tick-borne diseases before graduating medical school. It is shameful that didn’t happen out of the first meeting. AMA approved CME’s (Continuing Medical Education credits) offered at ILADEF.org need to become required immediately by all medical personnel.
We ask you protect our Dr.’s. No physician adhering to a reasonable protocol backed by peer reviewed studies should be under scrutiny or harassment by any medical board.
Dr Walker at meeting #9 posed the question,
“what caused the increase in Tick-born disease?”
The answer is in bioengineering the fertility, and force-feeding of pathogens to ticks admitted by government employee, Doctor Willy Burgdorfer for NIH. Per his own account and made public (BITTEN, by Kris Newby), this was the big turn for an increase in the tick population.
The government is responsible for fixing this epidemic today, starting with patients already infected.
Please respond to this email addressing my concerns outlined above and commit this to public record.
Respectfully,
Kristina Bauer, Texas Lyme Alliance and GOTCHA, Global Oversight for Transparency against Corruption in Healthcare Alliance
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**Comment**
While I agree with Ms. Bauer on most points, I am concerned that many of these action points could backfire against patients and doctors. It’s a very delicate situation.
Doctor protection laws have inadvertently put practitioners under the spotlight and they are being singled out and scrutinized more after the so called ‘protection’ than before it. Politics are often counter intuitive.
I’m concerned about the comment that 80% of the subcommittees should be singularly focused on Lyme disease.Many of the coinfections are not reportable diseases and there is absolutely no record of prevalence. In my opinion, the entire Lyme paradigm needs to shift from a singular entity into a far more complex, systemic illnessoften accompanied with other pathogens either directly transmitted by ticks OR that are reactivated via tick bite, vaccinations, or other assaults on the immune system.
In short, few have ‘just Lyme’ anymore.
Part of the current problem is the continued myopic definition of the disease.
Either Lyme has evolved into this complex monster, or it was always present yet under-appreciated. According to many ILADS trained doctors with decades of experience, coinfections weren’t as prevalent years ago as they are now. They admit it it used to be much simpler to treat.
Now, cases are extremely individual and complex.
This is where we can cut our nose off despite our face with legislation that continues to pigeon-hole this beast into something it’s not.
The longer I observe, the more I’m convinced we need to fund our own work to get to the bottom of the chronic/persistent issue as well as recognize concurrent infections, create proper testing that takes both these issues into account, find all the transmission modes, and effective treatments. Notice treatments is plural. The only box this fits into is Pandora’s.
The answers for some of these issues are going to be extremely individualistic. We should quit putting this into a 2-minute sound-bite and mandating a “specific” treatment to all or we will end up no better than we started.
Somehow we need to continue to allow Lyme-literate doctors to treat this appropriately without infringing upon their rights, while encouraging other doctors to become trained. The problem I see is we will never fit into a Western medicine paradigm and a 10-15 minute appointment. This complex disease is far too sticky. So, even if insurance covered it and mainstream medicine treated it, the entire formula wouldn’t work unless it’s a simple acute case. My first appointment with a LLMD was 90 minutes long and I filled out medical chronology going back to infancy. Do you seriously think medical monopolies are equipped for that kind of detail and introspection?
