PROS AND CONS OF DOXYCYCLINE FOR CHILDREN WITH LYME DISEASE
There are times when doctors need to consider whether or not to prescribe doxycycline for children with Lyme disease. The antibiotic is indicated for other tick-borne illnesses including Rocky Mountain Spotted Fever, Ehrlichia and Anaplasmosis. But doctors often avoid prescribing doxycycline to young children for fear that it may cause tooth staining, particularly when used in children less than 8 years old.
In the article, Wormser discusses the risk to benefit ratio of prescribing the antibiotic.
“Tetracycline-induced dental staining does not spontaneously resolve, may have adverse psychological effects, and families may incur considerable expense to correct the problem.”
This risk is greatest for younger children, he explains. “Because calcification of permanent teeth is largely complete by 5–6 years of age, children who are <4 years of age are at highest risk.”
Doxycycline introduced
However, the risk of dental staining was expected to be less after doxycycline, a tetracycline derivative, was introduced to the market.
“Doxycycline was reported to bind calcium less avidly than does tetracycline, which could explain why doxycycline may be less likely to cause dental staining,” writes Wormser.
In 2 small studies, which enrolled 89 children, doxycycline did not lead to dental staining. However, the studies were of short duration and used lower doses of the antibiotic than is typically prescribed for tick-borne illnesses.
“These new studies led to the recommendation in 2018 by the Committee on Infectious Diseases of the American Academy of Pediatrics (AAP) that a course of treatment with doxycycline (for up to 21 days) is safe to prescribe for young children with any infection responsive to this agent, specifically including early Lyme disease,” writes Wormser.
Risk to benefit ratio
“The recommendation to use doxycycline in young children with early Lyme disease should be based on assessment of the risk to benefit ratio of use of this drug compared with that of other recommended antibiotics,” writes Wormser.
“The recommendation to use doxycycline in children <8 years of age should require an assessment of how much doxycycline had previously been taken by a patient, including total dosage, because the risk of dental staining is directly related to cumulative exposure,” he adds.
Based on the number of Lyme disease cases reported each year and the percentage of children likely affected, Wormser estimates that “more than 30,000 children <8 years of age could potentially be treated with doxycycline each year.
If the risk of dental staining were even just 1 in 1000 (0.1%),” he explains, “this would translate to >30 children annually who would develop dental staining from taking doxycycline for erythema migrans.
Use of doxycycline clearly is indicated to treat young children with Rocky Mountain Spotted Fever or with other very serious infections for which doxycycline is preferred,” he adds.
Single dose of doxycycline for a tick bite
In addition, the authors discuss treating a deer tick bite with a single dose of doxycycline to prevent Lyme disease. “It seems unlikely that one dose would cause dental staining in young children,” writes Wormser.
Wormser GP, Strle F, Shapiro ED. Is Doxycycline Appropriate for Routine Treatment of Young Children With Erythema Migrans? Pediatr Infect Dis J. 2019 Nov;38(11):1113-1114.
Daniel J. Cameron, MD MPH, states there has only been one study (Nadelman et al) on the effectiveness of 1 pill of doxycycline and only found a reduction in the number of erythema migraines (EM) rashes compared to the placebo group. According to him, the IDSA 1 pill of doxy approach started in 2006 despite the fact that three previous prophylactic antibiotic trials for a tick bite had failed.
Only one study in 2001 tested this hypothesis at one hospital in New York.
For the study, the bullseye rash was the diagnostic criteria to determine if doxy prevented LD. The study actually showed that people bitten by nymphs were more likely to develop a bullseye rash and therefore diagnosed with LD in comparison with those bitten by an adult tick. None of those bitten by adult ticks developed a bullseye rash.
The Bullseye is a poor indicator of LD.
Only 50% with LD got any kind of rash and only 9% developed a bullseye.
Two pills used at the time of tick bite by a nymph prevented people from getting the bullseye – so they were not diagnosed as having LD and were excluded from the study.
“This Workhorse of an Organ Can’t Signal for Help – Until It’s Often Too Late”
Your liver endures a tremendous amount of stress and toil, 24 hours a day. Hidden from sight, it doesn’t provide many clues as to its well-being. Yet it depends on you to give it the care it needs. Are you doing all you can?
By Dr. Mercola
Your liver might just be the most underappreciated organ in your body.
It is your body’s largest internal organ and one of its important functions is to help remove toxins and harmful substances. Unlike your gall bladder or appendix, you can’t live without your liver, at least not for very long.
And unlike some other organs in your body, such as your heart and lungs, it can be difficult to measure how well your liver is working. That is, until it falls to about 10 percent of its healthy working capacity.
Your liver can’t skip beats or produce a cough to warn you when it needs help…
Just because it sits quietly in your body most of the time doesn’t mean it can thrive without special care. Maybe 20 or 30 years ago, a healthy person’s liver did just fine without extra support, but today we live in a different world.
Today your liver confronts – and must overcome – challenges it’s never faced before.
Live Without Your Liver? Don’t Bet Your Life on It
Your liver serves many life-supporting functions
Your liver, which is made up of two main lobes, is located beneath your diaphragm and on top of your stomach, right kidney, and intestines.
Besides its primary role of protecting your body from harmful substances, your liver plays other key roles, too.
Your healthy liver:
Produces bile, which helps carry away waste and break down fats
Helps regulate the levels of sugar, protein, and fat entering your bloodstream
Clears your blood of drugs, alcohol, and other potentially harmful substances
Processes nutrients absorbed by your intestines during digestion
Produces cholesterol, proteins, and clotting factors to help your blood clot
Regulates many of your hormones
Neutralizes highly reactive oxygen molecules, or free radicals
After your liver breaks down harmful substances, they enter your blood or bile and leave your body either through your kidneys and urine or your feces after traveling through your intestines.
Normally, all these functions go on like clockwork, without much support on your part. But today many potential threats to your liver’s well-being prevail…
Is Your Expanding Waistline Putting Your Liver at Risk?
A renewed reminder of why it’s important to maintain your ideal body weight
Stunning new research suggests that your liver may be aging faster than the rest of your body if you hold excess weight in your waist.
Researchers found that for each 10-unit increase in body mass index, or BMI, the physiological age of the liver grew by 3.3 years.
To put that into real numbers…
Suppose a 5-foot, 8-inch man weighs 130 pounds and has a BMI of 20. A second man of the same height and age weighs 230 pounds, and has a BMI of 35.
The liver of the second man is likely five years older than the liver of the normal weight man.
And here’s another interesting finding… If the second man decided to have surgery to rapidly lose the excess weight, the age of his liver wouldn’t change!
What’s behind this vicious threat to your liver? It may be linked to one of its worst enemies.
One of Your Liver’s Worst Enemies Isn’t What You Might Expect
I’m guessing many people would say their liver’s worst enemy is alcohol. Yes, alcohol is harmful to your liver, but there’s another substance that’s equally so – and far more pervasive.
Unlike alcohol, this other substance can be found in some form in nearly everyprocessed food in your grocery store.
Fructose, the most damaging type of sugar to your body, is particularly hard on your liver, much like alcohol:
Fructose must be 100 percent broken down by your liver. Glucose on the other hand only needs to be partially broken down before it can be utilized.
Fructose is metabolized directly into fat that gets stored in your liver and other internal organs and tissues as body fat, which leads to mitochondrial malfunction
Corn sugars can damage your liver much like drinking alcohol
Fructose produces toxic metabolites and superoxide free radicals when it is metabolized, that can lead to inflammation in your liver
Fructose is a cheap form of sugar that’s found in thousands of food products and drinks. It’s often deliberately disguised by the use of many different names, so the only way to steer clear of it completely is to avoid eating processed foods.
I believe fructose and other non-fiber carbs are important factors behind the rising rates of liver issues and at least 30 other health concerns. Tragically, even children are now showing signs normally associated with alcohol abuse from their consumption of fructose!
Other Silent Slayers of Liver Function
Unfortunately, fructose isn’t the only challenge your liver has to deal with. Plenty more lurk in your home, water, and the air you breathe. Chemicals in plastics like phthalates and BPA/BPS, flame-retardants, and formaldehyde may be found in your:
Many people don’t realize how their living environments can impact their livers
Furniture and carpeting
Vinyl floor coverings
Building materials
Paint
Mattresses
Vinyl shower curtain
Children’s toys
Plastic water bottles and containers
Grocery store receipts
Scented personal care products
These contaminants enter your body through your skin or your lungs, or from the food and beverages you consume.
No matter how they enter your body, they end up in your bloodstream and your liver must process them.
Compared to 20 or 30 years ago, we are exposed to far more chemicals in our food, as well as in our living and working environments.
Yet your liver hasn’t changed – it hasn’t evolved to keep up with the increase in challenges. You still depend on it, day in and day out, to help minimize the effects of potential contaminants.
Simple Ways to Help Support Your Liver
Organic Lacinato kale is a liver-protectant food
Most likely by now you have a healthy appreciation of what your liver is doing for you – or at least trying to do.
Responsible for so many essential tasks, your liver can use all the support it can get. Luckily, there’s much you can do.
Of course, in today’s world you can’t safeguard your liver function 100 percent. But it’s worth doing all that you can…
To help protect your liver, I recommend:
Restricting alcohol consumption, and avoid completely if taking acetaminophen or Tylenol
Minimizing or avoiding the use of potentially harmful acetaminophen or Tylenol (be sure to check labels, it’s found in many over-the-counter products!)
Attaining and maintaining your ideal weight
Restricting your intake of fructose from all sources to about 15 to 25 grams per day (avoid sweeteners in foods, fruit juices, dried fruits, and limit sugary fruits like grapes, pears, plums, and red apples)
Avoiding or minimizing contact with toxic chemicals like pesticides, cleansers, paints and solvents
Buying products packed in glass containers and limiting your use of plastics, including plastic wrap
Adding liver-protective foods to your diet, like fermented vegetables, dark leafy green and cruciferous vegetables, “clean” sea vegetables, sprouts, artichokes, garlic and onions, avocados, berries, whey protein powder from grass-fed cows, and organic pastured eggs and grass-fed meat
In addition to these commonsense measures, there’s another simple way to help support your healthy liver function.
Trifecta Support for Your Liver Function
In my opinion, there are three ingredients that provide healthy liver function support:*
N-Acetyl L-Cysteine (NAC)
Milk thistle
Organic broccoli sprouts
I’ve combined this “perfect trifecta” of ingredients into my Liver Support for regular, daily use to specifically target six areas of concern:
Provide on-going support to help minimize the damaging effects of contaminants on your liver*
Help maintain intracellular levels of glutathione*
Maintain the normal metabolism of alcohol*
Provide antioxidant mitochondria support*
Support your body’s detoxification (cleansing)*
Provide short-term support for occasional acute events*
Let’s take a closer look at the first of these remarkable ingredients…
The Leader of Your Antioxidant Army… And It Helps Save Lives
Glutathione is your body’s principal antioxidant, and exists in each of your cells. With its lead status, it functions by keeping all the other antioxidants in line and performing at their peak.*
This super-antioxidant’s primary task is to help protect your body from free radical damage, wastes, and potentially harmful substances.* Glutathione is one of the most important factors in your body’s detoxification arsenal and is crucial for your liver’s well-being.*
As you age, your body’s ability to produce glutathione declines. And many substances like alcohol, drugs, and contaminants can deplete your glutathione levels.
While a glutathione supplement may sound like a good idea, oral glutathione is merely three amino acids and is rapidly broken down in your stomach by digestive enzymes. Even if it were effective, I still wouldn’t advise taking glutathione in oral form as it may interfere with your body’s ability to produce it naturally.
What I recommend instead for restoring the levels of glutathione inside of your cells is provide the raw materials for making glutathione so your body can produce the right amounts it needs and not any more.
One of the best ways to do this is use a derivative of the amino acid cysteine, called N-acetyl cysteine, or NAC for short.* NAC comes with four decades of scientific validation, and has been used in traditional medicine for over 30 years.
One of NAC’s primary roles in conventional medicine is as a treatment for acute poisoning with acetaminophen-containing pain-relieving drugs – the number one cause of acute liver failure in the U.S.
Too high of an acetaminophen dose can exhaust the body’s glutathione reserves, leading to permanent liver damage. As its precursor, NAC quickly restores glutathione levels, and, in effect, helps save lives.*
NAC’s Actions Beyond Its Role as Precursor to Glutathione
By replenishing your cells’ supplies of glutathione on a regular basis, NAC helps your cells regain their ability to protect themselves against free radicals and other damage.* This is especially desirable as you age.
Researchers have found that NAC does more than just replenish levels of glutathione within your cells. NAC provides additional potential benefits in these areas:*
Helps regulate the expression of many genes involved with your body’s inflammatory response*
Supports normal healthy insulin sensitivity*
Supports respiratory health*
Protects tissues and cells from the effects of oxidative stress from exercise*
Supports normal healthy cellular growth and development*
There’s no question that NAC offers valuable potential for the support of your liver health. Now let’s take a look at the second ingredient in Liver Support…
Don’t Be Fooled by Its Appearance – This Highly Valued ‘Weed’ Offers Potent Liver Support… and More*
Milk thistle contains liver-friendly silymarin
Milk thistle has been treasured for over 2,000 years for its value in supporting liver, kidney, and gall bladder health.*
When the leaves of the plant are crushed, they release a milky sap. Hence the name…
The herb milk thistle is an excellent source of the antioxidant compound silymarin, its primary active component.
Extracted from the plant seeds, silymarin consists of three flavonoids – silibinin, silidianin, and silicristin – all of which may help repair liver cells that have been damaged by environmental pollutants, alcohol, and fructose.*
Silymarin has been found to increase glutathione and help prevent its depletion in your liver.* It also helps support a normal inflammatory response in your cells through its effect on gene expression.
Support Your Liver With Up to 100 Times More of the Sulforaphane Precursor in Fresh Broccoli
Broccoli sprouts contain up to 100 times the glucoraphanin found in fresh broccoli
Glucoraphanin is a precursor to sulforaphane, a potent liver-supporting substance found in regular organic broccoli – its best-known source.
However, fresh, young broccoli sprouts – grown from organic broccoli seeds – can contain up to 100 times the amount of this glucoraphanin!
When animals in studies chewed or swallowed vegetables containing glucoraphanin, the resulting sulforaphane fired up the body’s waste disposal system.
This not only helped the body rid itself of pollutants, it also helped protect the body from potential harm.*
Researchers wanted to see how these substances would work in humans, so they travelled to one of the most heavily industrialized and polluted regions in China to put their theory to the test…
They recruited a total of 291 men and women living in a rural farming community in Jiangsu Province, China, about 50 miles north of Shanghai for their 12-week trial.
The treatment group received a half-cup of a beverage made with broccoli sprout powder containing glucoraphanin and sulforaphane, combined with sterilized water, pineapple and lime juice.
Urine and blood samples were taken during the trail to measure inhaled air pollutants.
The results were astounding… Excretion of a common and potentially hazardous airborne pollutant increased the very first day in the broccoli sprout powder group – by a whopping 61 percent! And increased excretion continued during the entire 12-week period.
Researchers concluded that the sulforaphane in the sprout powder might in some way be signaling to the cells the need to adapt to and survive a broad range of environmental contaminants, including those in water and food.
Based on these studies and more, I decided that organic broccoli sprout powder had to be part of my Liver Support!
Are You Ready to Give Your Liver the Support It Likely Needs?*
As I pointed out earlier, it can be difficult to know exactly how well your liver is functioning. That is, until it’s possibly too late.
But one thing we do know for certain is that your liver continuously labors hard to protect your body from the effects of environmental pollutants and chemicals.
Now you can help give it the support it may need with my Liver Support. With my unique “trifecta” formula, you get:
NAC for its ability to restore glutathione supplies and support mitochondrial function*
Milk Thistle Extract for its silymarin to help repair damaged liver cells and increase glutathione levels*
Organic Broccoli Sprout Powder for its rich supply of sulforaphane precursor to support your rapid excretion of environmental pollutants*
And much more… Liver Support provides the perfect tool to help minimize the damaging effects of everyday pollutants and stresses on your liver. And you can take it every day!
Take control of the health of your liver today and order Liver Support. When it comes to a hard-working organ like your liver, you don’t want to take chances.
The question about herb-drug interactions comes up a lot — and for good reason. All prescription drugs carry risks, and even though most tend to work predictably on their own, various outside factors can interfere in adverse ways, whether in how the medication is absorbed, metabolized, or utilized.
What’s more, drug interactions can be quite serious, even deadly. But it’s important to understand that most herbs function very differently than drugs. And because of that, the majority are safe to take with common medications. In some cases, herbs can even help reduce drug side effects or help you reduce dosage of drugs.
But, like anything, there are exceptions and caveats. Here’s what you need to know to stay healthy and safe if you’re considering combining herbal supplements and prescription medications.
The Difference Between Drugs and Herbs
Most symptoms or illnesses are the result of a dysfunctional process in the body, and prescription medications are largely designed to target those processes and interfere, disrupt, or block them. But that means drugs don’t typically address the causes of the dysfunction, rather only the process that triggers the symptom or manifestation of the problem.
Take heartburn medications, for example. Rather than addressing why too much stomach acid regurgitates up into the esophagus, the drugs block the natural process in the GI system that produces stomach acid in the first place. In that respect, many drugs, especially those used for chronic illnesses, are a little like low-dose poisons.
Restorative or adaptogenic herbs, on the other hand, don’t block those processes. Instead, the herbs help regulate or balance the systems that cause those processes, essentially helping to address the underlying causes of the dysfunction.
For example, restorative herbs help improve cell communication, stimulate healthier digestion, and balance the gut’s microbiome. Many also have anti-inflammatory and antioxidant properties that improve the way cells in the immune system communicate.
So, rather than, say, putting out the flame of overactive inflammation (like an anti-inflammatory drug would,) herbs help you avoid faulty inflammation-triggering signals and reduce the free radicals that can lead to overactive inflammation in the first place. While this process delivers longer-lasting benefits, it also takes longer to go into effect, so herbs don’t usually provide the quick fix that some drugs can.
Another distinguishing characteristic of herbs is that they generally have a high safety profile: Few herbal substances can actually kill you, even if taken in large quantities. They have evolved for the specific purpose of supporting cellular life and natural functioning. That’s in contrast to many prescription medications, which if you take too much can quickly turn lethal.
Effector Herbs Versus Restorative Herbs
As with all rules, there are some exceptions to the herb-drug differences outlined above. For instance, some herbs actually do work more like drugs. Called effector herbs, they produce an acute effect on natural processes.
The results of effector herbs are powerful, but also usually short-lived and with no long-term healing properties. That’s different than restorative or adaptogenic herbs, which tend to more generally balance cellular functioning and communication and support healthy processes in the long term.
Effector herbs also tend to have one specific ability or target, while adaptogens generally support and balance all your systems and are more gentle in their effects. Here’s a simple example to understand the difference:
Say you’re carrying a heavy bag and are in pain. Like a drug, an effector herb could knock out or reduce pain signals temporarily. Adaptogenic herbs, on the other hand, would work to support your muscles and joints to correct your posture, and support your heart and immune health so you could better carry the load without injury and fatigue in the future.
Many herbalists tend to steer clear of effector herbs for the mere fact that they are so powerful and can be potentially dangerous when combined with certain drugs or taken in high doses.
Be Careful with Certain Medications
Although most herbs are safe to take with medications, there are some drugs that require special consideration. Take note if you are prescribed any of the drugs below — it’s not an exhaustive list, but it’s a good overview of Rx categories that can interact with herbs. And as always, talk to your healthcare provider before starting any new herbal regimen.
SSRI Antidepressants
Restorative herbs typically don’t interfere with medications — they can even be beneficial — but steer clear of the effector herb St. John’s wort. It blocks serotonin enzymes and so may interfere with serotonin reuptake, which is what selective serotonin reuptake inhibitors (SSRIs) do. If taken together, too much serotonin could build up in your body and trigger serotonin syndrome, which can cause sweating, agitation, confusion, headache, and other effects.
Prescription Sedatives, Sleep Aids, and Anti-Anxiety Medicines
Many herbs have calming and sedative properties, including strong effector herbs like kava, valerian, and belladonna, as well as milder adaptogens such as bacopa, passionflower, and motherwort. While the vast majority of calming herbs work like a feather compared to their hammer-like drug counterparts, it’s still best to avoid mixing the two, especially in the case of effector herbs, which are especially potent.
Blood Thinners
Many herbs as well as omega-3 fatty acids found in krill oil and fish oil supplements have mild platelet-inhibition properties, meaning they can keep platelets from sticking together and slow down the mechanism that forms clots. In most people, that can be a good thing, because it helps prevent plaque formation in arteries and decreases the risk of blockages. However, if you’re on blood thinners, even the mild effect from herbs could thin the blood too much, causing blood vessels to become leaky and increasing your risk of hemorrhagic stroke or other complications.
Thyroid Hormone
Ashwagandha is known to support and stimulate thyroid function, so if you’re also taking a thyroid hormone, the herb could potentially bump you up to a higher-than-normal hormone level. If you take both ashwagandha and thyroid hormone, have your levels tested as you may be able to lower your dosage of the synthetic drug.
Diabetes Medications or Drugs that Lower Blood Sugar
Most adaptogen herbs, including reishi, rhodiola, and andrographis, naturally help balance blood sugar. If you take these herbs along with glucose-lowering meds, it may cause levels to dip below normal. As with thyroid drugs, rather than avoiding herbs, consider working with your doctor to see if they might enable you to lower your dosage of drugs.
Smart Reasons to Take Herbs with Medications
If your healthcare professional isn’t knowledgeable about herbs, they may be inclined to simply tell you to stop taking herbs or avoid them altogether. But in many cases, there’s no reason you can’t take most adaptogen or restorative herbs — the best of which include rhodiola, reishi, cordyceps, ashwagandha, and andrographis – with your prescription.
Even herbs that have mild effects similar to that of a drug you’ve been prescribed — like those that lower blood sugar or thin the blood — can be okay. After all, herbs naturally support your body’s systems, improve functioning, and help address the causes of illness.
Adaptogenic herbs can also moderate the side effects of many drugs and work in tandem in other ways. For instance, one of the main benefits of these herbs is their ability to help balance the gut’s microbiome and support a healthy immune system, making them a nice complement to antibiotics for an infection, which can throw the microbiome out of whack.
So why not take the herb and lower the dose of the drug, then monitor your response to find the right balance? In the long term, that’s preferable to relying on drugs that only target a symptom and must be taken long-term.
What’s more, when paired with certain lifestyle and dietary changes, you may even be able to get off the drug completely. Just note that this approach can require finding an open-minded doctor and/or a knowledgeable herbalist who can work together to guide you through the proper steps.
ABOUT THE MEDICAL DIRECTOR
Dr. Bill Rawls
Dr. Rawls is a licensed medical doctor in North Carolina and a leading expert in integrative health. He has extensive training in alternative therapies, and is the Medical Director of Vital Plan, a holistic health and herbal supplement company in Raleigh, NC.
WHAT IS BRAIN FOG, EXACTLY? WHAT DOES IT FEEL LIKE? WHAT CAN A PATIENT DO TO GET RID OF IT?
Writing a weekly blog post is a thrilling and rewarding process. I love connecting with readers like me over various aspects of living with tick-borne illness, and I’m grateful to be able to share my story. I’m also thankful to have the physical ability to write on a tight deadline, which I haven’t always been able to do. In my worst days of fighting Lyme disease and two of its co-infections babesia and Ehrlichia, I couldn’t write at all. This was in part due to the achiness of my joints, but mostly, it was due to brain fog.
So what is brain fog, exactly? What does it feel like? What can a patient do to get rid of it? Now that I have greater neurological clarity, I can offer some information and tips on what I’ve learned about this frustrating symptom.
What is brain fog?
Lyme is an inflammatory disease. When Lyme pathogens in the form of spirochetes cross the blood-brain barrier, inflammation occurs in the central nervous system. “Common neurocognitive problems include poor memory, slower speed of thinking, difficulty with retrieval of words, and impaired fine motor control,” writes Brian A. Fallon, MD and Jennifer Sotsky, MD, in their book Conquering Lyme Disease: Science Bridges the Great Divide. “The slower mental processing speed contributes to the patient’s experience of ‘brain fog,’”[i]
A Johns Hopkins study published in the Journal of Neuroinflammation showed that scans done on 12 patients with Post-Treatment Lyme Disease Syndrome (PTLDS) all showed a chemical marker for brain inflammation, compared with 19 healthy controls. In an article published by Hopkins Medicine, Dr. John Aucott, Director of the Johns Hopkins Lyme Disease Research Center said: “What this study does is provide evidence that the brain fog in patients with [PTLDS] has a physiological basis and [that it] isn’t just psychosomatic or related to depression or anxiety.”[ii]
A patient with brain fog can experience delayed response times, making it difficult for them to write clearly or comprehend text or conversation. As Drs. Fallon and Sotsky explain, “Patients may have difficulty reading and find that when they move on to the next paragraph, they have forgotten what they [just]read before….Patients may have spatial disorientation such that familiar routes become suddenly difficult to navigate or appear unfamiliar… [Or] patients may have new on-set dyslexic changes, reversing numbers or letters when writing or words and phrases when speaking. They may confuse left and right and may find themselves making verbal errors that are uncharacteristic of them.…Other examples of cognitive errors might include placing the cereal box in the refrigerator or asking one’s spouse to please put the milk back in the radiator.”i
What does brain fog feel like?
During a relapse of my tick-borne illnesses, I had a brain scan done that showed this precise type of inflammation, which made for a lack of oxygen to the left side of my brain. What did those symptoms actually feel like inside my head? In my post, Living With Lyme Brain, I likened brain fog to thick molasses that slowly pours into all the crevices of your brain, until it feels so full that it might explode out of your skull. When I was at my sickest, I felt this fog all the time and wished I could open a spigot to relieve the pressure.
As I got better, my brain fog dissipated, but it still returns from time to time. It can come on slowly, like mist settling over a valley, and can then build into an impenetrable cloud. I get it when I’m neurologically over stimulated: after watching a fast-paced TV show, while hearing loud music, or after reading for too long. “Too long” is defined differently for every patient; at my lowest points, one sentence was hard to comprehend. Eventually, I could read a short article in a light entertainment magazine. Now I can read a whole book, but I still need to pace it out, chapter by chapter.
If I read for too long, I feel pressure start to build, beginning at the base of my cranium and then spreading up over my eyes. Once my head gets full, I struggle to find the right vocabulary, and sometimes I invert my word order. When the brain fog builds to this intense point, it causes me to be very tired. A graduate school professor once joked, “Sometimes, without warning, Jen runs out of steam.” He was right. Suddenly, my eyes would glaze over and I’d zone out.
Sometimes brain fog comes on not from neurological overstimulation but from physical fatigue. When I exercise for too long, or push myself too hard before an afternoon nap, I feel brain fog come on even if I haven’t been doing anything intellectual.
Once I hit this level of fatigue, it becomes hard for me to think clearly. This doesn’t just mean losing the ability to read a book or grade a student’s essay. I get recurring thoughts and feel sensitive and sad. I ask myself, am I actually feeling upset about a situation, or am I just experiencing brain fog?
What I do about brain fog
Once I’ve determined I’m experiencing brain fog, here’s what has helped the most to alleviate it:
Antibiotics: To alleviate the symptom of brain fog, you have to eliminate the cause: spirochetes. Lyme is a bacterial infection that needs to be treated with antibiotic therapy. My brain fog did not get better until I’d been on enough antibiotic therapy to really get at the spirochetes in my brain. Due to Herxheimer reactions, the brain fog actually got worse before it got better, but long-term antibiotic therapy eventually cleared up my infection enough to check the inflammation in my brain. The appropriate antibiotic protocol, and length of treatment, is different for every patient. What worked for me might not work for you, so it would not help you to learn about my specific protocol. Please discuss your symptoms and treatment with a Lyme Literate Medical Doctor (LLMD).
Anti-inflammatory medication: My LLMD put me on an anti-inflammatory medication that worked in conjunction with my antibiotic to get across the blood-brain barrier. This was a prescription medication, different than over-the-counter anti-inflammatory pills.
Herbal/nutritional supplements: Certain supplements such as essential fatty acids can help reduce inflammation in the brain. Talk with your LLMD about which supplements would be best for you.
Anti-inflammatory diet: For me, it helped to eliminate sugar and gluten from my diet. For others, it also helps to eliminate dairy. Some foods like certain green vegetables, nuts, lemon, ginger, and blueberries are known to have anti-inflammatory properties.
Water: The more you can flush your system, the faster you will eliminate live and dead Lyme bacteria (just be sure to keep your electrolytes balanced; I do so with electrolyte-infused water).
Time limits: To stop my brain fog before it starts, I impose time limits on my screen and reading time. Even if I’m feeling okay after an hour of watching TV, I make myself take a break, so that the fog doesn’t suddenly come rolling in.
Rest: These days, the very best thing I can do when my brain fog flares is rest, rest, rest. This means sleep, but it also means just having some quiet down time lying on the couch or going for a short walk. Many people think of reading or watching TV as resting, but for a patient with neurological Lyme disease, that is not the case. We need quiet, calm activities like coloring, baths, or soft instrumental music. The idea is to shut your brain off—to get away from screens, noises, and other stimuli.
Brain fog can be overwhelming. When you’re experiencing it, you might feel like the pressure in your head will never go away. With time, rest, and proper treatment, though, the fog eventually lifts so you can enjoy clearer skies.
[i] Fallon, Brian A. and Sotsky, Jennifer. Conquering Lyme Disease: Science Bridges the Great Divide. New York: Columbia University Press, 2018 (52, 314).
Jennifer Crystal is a writer and educator in Boston. Her memoir about her medical journey is forthcoming. Contact her at lymewarriorjennifercrystal@gmail.com.
By age 38, the patient’s breast cancer had spread to her bones, a typically fatal turn of events. She became an alcoholic, and her doctors stopped all cancer treatment, instead giving her a drug to discourage her drinking. She died 10 years later, after an inebriated fall from a window. But an autopsy revealed something unexpected: Her bone tumors had melted away, leaving only a few cancer cells in her marrow.
That 1971 case report, along with numerous lab studies, have suggested that the 6-decade-old drug disulfiram (commercially known as Antabuse), which makes people feel sick from drinking small amounts of alcohol, might also be a cancer fighter. Now, researchers have finally figured out how—by blocking a molecule that is part of a process that gets rid of cellular waste…(See link for full article)
Tetracyclines, including doxycycline, are typically not recommended for treating young children with tick-borne diseases because the antibiotic may cause permanent staining of the teeth, explains Wormser and colleagues in a recently published article, “Is Doxycycline Appropriate for Routine Treatment of Young Children With Erythema Migrans?” ¹
Madison Area Lyme Support Group 