If you haven’t delved into Lyme disease literature, it’s tempting to think of the illness in terms of its sound bite: You get it from a tick, and then get rid of it with antibiotics. Even a cursory search for details about the disease reveals that to be a vastly simplified and even inaccurate description. A chat with a Lyme-literate medical doctor or an informed naturopath, nutritionist, other complementary practitioner, as well as Lyme patients and their families, reveals a whole other scenario.
“This is the number-one vector-borne illness, and it’s spreading worldwide,” says Dr. Richard Horowitz, a physician and Lyme disease expert at Hudson Valley Healing Arts Center in Hyde Park. “It is basically an incredible, silent epidemic. Lyme tests are unreliable and they test for just one or two strains, while there are a hundred strains of Lyme in the US, and 300 worldwide.” And antibiotics are not the silver bullet they are made out to be. Horowitz is one of a growing number of physicians who are convinced that a single, few-weeks round of antibiotics is insufficient for a number of patients.
Borrelia burgdorferi, the Lyme-causing spirochete, is a tricky pathogen. It takes three forms, one that succumbs to antibiotics, but two that do not and can escape the immune system’s notice by entering cells or settling in areas with poor immune surveillance. “Unless people get antibiotics in the first few weeks,” says Horowitz, “they have a 99.99-percent chance of relapse. PCR testing [polymerase chain reaction, which detects pathogen DNA] shows that people can be positive after years of treatment. These bugs are very hard to eliminate.” Horowitz adds, “People need to realize that the ticks contain so many coinfections—babesiosis, ehrlichiosis, cat-scratch fever, mycoplasma, viruses—that most patients don’t have just Lyme, but also these coinfections.”
Dr. Allan Sachs, a chiropractor and certified clinical nutritionist in Red Hook, explains that the Lyme spirochete is probably endemic—present in our population at a certain level, including in people who are carriers and show no symptoms as long as they are in good health with an effective immune system. “It’s hard to imagine that anybody who enjoys the outdoors or who has animals hasn’t been in contact with this. People assume they will find a tick, but because tick bites don’t itch or swell, many don’t realize they were bitten. Even the nymphs [one of the tick’s tiniest life stages] can be carriers. So there is a very good chance that there are many more people who have the spirochete than show symptoms.” Among those who are symptomatic, a hallmark of Lyme disease is that symptoms clear for a while and then recur.
This portrait of Borrelia burgdorferi is similar to certain other endemic pathogens, such as herpes viruses. Some herpes carriers rarely have symptoms, except at times of stress or poor health. Streptococcal bacteria are another example: They inhabit the mouth and throat of many of us harmlessly, until the immune system is at a lull. Then they flourish, causing sore throat and serious infections. “These are opportunistic pathogens,” says Sachs. “They are there all the time, but they only manifest symptomologically when there is a drop in immune-system surveillance.”
Enter Complementary Therapies
Antibiotics are meant to work in concert with a healthy body and a good immune system. So Horowitz tests his patients thoroughly for indicators of insufficient immunity or poor health that undermine the antibiotics’ power, rob the body’s ability to tolerate the drugs, and make residual infection more likely. Horowitz finds that “many people have heavy metal toxins, hormonal abnormalities, thyroid problems, vitamin B12 deficiencies, or psychological issues. You need to consider all these if someone is not getting better. So we also go after hormones, look at inflammatory cytokines, open up detox pathways, make sure people are getting enough sleep, and address stresses and psychological issues.”
Horowitz, who is currently vice president of International Lyme and Associated Diseases Society and its past president, says “I don’t want patients to be on antibiotics the rest of their lives, so I use natural protocols. There are many complementary therapies out there.” He has seen many patients get symptom relief with Chinese medicine and Ayurveda, and with individual herbs or combinations. Horowitz currently favors the Cowden protocol, which he learned about at a Lyme disease conference from a colleague who said he had been having 95-percent success in symptom relief. Horowitz’s reaction at the time: “No way.” He decided to test the protocol himself by dividing 200 patients whose symptoms persisted after antibiotics into four treatment groups to compare the full protocol against a subset of the herbs, with or without additional antibiotics. While about 30 percent of people had no response or had problems tolerating the herbs, 70 percent had relief in hallmark symptoms such as joint pain, muscle pain, and numbness. Those who failed to improve, he noted, had resistant coinfections.