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.
Devised by physician William Lee Cowden, the protocol is a several-months’ regimen of diverse mineral, herb, and enzyme preparations taken sequentially to accomplish multiple tasks: kill bacteria, detoxify the body, replenish good nutritional status, alleviate pain, and boost immunity. Some of the herbs in the protocol are pinella, burbur, amantilla, parsley, and samento; there are others, and the specifics of how much and when to take them are complex and adapted to individual health status, body weight, and reactions to the herbs. The protocol should be undertaken only with an expert’s guidance.
Bill Levitt, an art historian and print maker in Red Hook who is now being treated by Horowitz, has had symptoms of Lyme over a span of about 10 years. “Four times I have found a tick or a bite, but not the last couple of times,” he says. His symptoms have been various and changing. “I’ve had a lot of stomach problems, fatigue, and I feel like I’m working with half a brain now, though I don’t know how much of that is aging.” He’s seen several doctors and gotten many explanations. “Once, I was so stiff it was hard to get up and down the stairs,” he says. “I went to a doctor a couple of years ago for muscle and joint pain that moved around. If it were arthritis, or bursitis, it would be in one location. The doctor said it was migratory arthritis, not Lyme, because my Lyme test was negative.” Levitt is being treated by Horowitz, taking the Cowden herbs and probiotics, and is on antibiotics again for ehrlichiosis. He’s found that acupuncture can sometimes alleviate symptoms.
There are myriad alternative Lyme treatments on the market. Horowitz is constantly testing herbs and other therapies, such as glutathione to improve natural detoxification pathways, or DMSA, an oral chelating agent that removes mercury and lead. He warns, though, that alternative therapies are not well monitored, and many of them have not been well tested. Does Horowitz think complementary therapies could replace antibiotics? “The antibiotics are extremely helpful,” he says, “and many people will not get better with herbs alone. It depends on a lot of things. But you can’t leave people on antibiotics forever.”
One of the more popular alternative routes to vanquish Lyme symptoms is a Rife machine. Horowitz says he has never heard of any great success stories about them, but people are definitely trying them. A Rife machine produces light at frequencies to match light emitted by bacteria, and in so doing purportedly destroys them. The machine’s inventor, Royal Raymond Rife, devised special microscopes in the 1920s that had superior optics and illumination techniques that allowed viewing of living bacteria, which is how he observed both the emitted light (“bacterial aura”) and the ability of matching light frequencies to destroy them.
Some people report Lyme disease symptom relief with hyperbaric oxygen therapy, which involves spending an hour or so daily, typically for 30 or more sessions, inside a chamber infused with 100 percent oxygen at a pressure higher than ambient atmosphere. Normally, red blood cells leaving the lungs carry oxygen near their maximum capacity, but the plasma portion of blood is low in oxygen. While under pressure in the chamber, inhaled oxygen dissolves into blood plasma and achieves higher-than-normal oxygen concentrations in tissues and cells. This enhances certain cellular activities, including immune cell function and tissue repair in swollen, inflamed areas where infection is underway and fluid flow is sluggish. Further, studies suggest that Borrelia does not survive well in high-oxygen environments. A study in 1997 at the Texas A&M Hyperbaric Laboratory documented significant improvement in 85 percent of Lyme patients, all previously treated with antibiotics.
Microflora Mayhem
Antibiotics are usually prescribed for just a few weeks because of possible side effects, ranging from minor nausea to life-threatening organ damage, and because overuse drives emergence of drug-resistant bacteria. Antibiotics also wipe one’s bacterial slate clean, eliminating pathogens and benign microbes alike. But we depend on the beneficial bacteria that inhabit our nooks and crannies to take up space and nutrients that harmful bacteria could utilize. A crew of helpful bacteria in the colon not only produces vitamins that we need and assists with the rapid breakdown and detoxification of food residues, but also keep populations of harmful bacteria and yeast (Candida albicans) in check. Yeast and the beneficial bacteria coexist, constituting our intestinal microflora; each make substances that hinder the other’s survival. But when antibiotics wipe out bacteria, yeast can thrive.
Yeast infections and chronic intestinal turmoil are problems that Lyme patients often battle if they take antibiotics for many weeks or months to tackle lingering Borrelia infection or coinfections from tick bites. Sachs, who is an expert in yeast colonization and in restoring microflora balance, says, “With a chronic imbalance in the intestine, yeast can become a real danger. They are fermenting sugar and producing alcohol that gets into your blood.” That problem, termed autodistillery syndrome, damages nearby intestinal cells and harms organs that help detoxify the body and support immune function. Further, bacteria can’t grow in alcohol, so the yeast-dominated imbalance perpetuates itself, blocking the reestablishment of a healthy bacterial population.
“So now you need to treat yeast imbalance,” Sachs says, “which is a whole other treatment from the Lyme. It entails a strict diet low in white sugar and carbs, no alcohol whatsoever, avoidance of fermented foods, avoiding chlorinated water, and taking probiotics to repopulate the intestinal microflora.” Probiotics are oral supplements that contain several essential types of bacteria (foods containing these, in living form, are also an option). Sachs emphasizes that many patients take probiotics only during antibiotic treatment, but they should continue to take them for at least three to four weeks after the end of antibiotics to get the greatest benefit.
Immune Health Essentials
For asymptomatic people with low-level populations of Lyme spirochetes, a period of stress, either physical or emotional, can diminish immune function and allow resident bacteria to proliferate. Symptoms return in the absence of a new tick bite or rashes, stumping doctors who don’t know about or believe in the recurrent nature of Lyme.
“It accentuates the need for holistic care,” says Sachs. An important part of immune health, he explains, is the adrenal glands. “Anything that stresses the adrenals stresses the immune system. They are like the entry point to the immune system. Because they are part neurological and part hormonal tissue, they interface between neurological/psychological stress, and also hormonal stresses.” Because of this, immune support protocols, using herbs and/or minerals, typically include components to replenish adrenal reserves. “Nutrient supports for adrenals include the vitamins B and C, and a variety of herbal supplements such as ginseng, rhodiola, and ashwagandha,” he adds. And avoid the adrenal stimulants, nicotine and caffeine. “Adrenals work best through the natural stimulation of moderate to intense exercise on a regular basis,” says Sachs. “Caffeine should be eliminated or limited to a small amount, but if you can’t manage that, organic green tea might be an acceptable compromise, since it does contain beneficial bioflavonoids and antioxidants.”
Sachs also highly recommends forms of relaxation (drug-free), and finding ways to nurture happiness, contentment, and laughter. These reduce stress and give adrenals a chance to recover. Sufficient sleep is important, too. “Restful sleep, at least seven to eight hours, is what most people need,” Sachs advises. “If that’s a problem, taking drugs to fall asleep is not usually recommended. There is a debate about whether the depth and restfulness of drug-induced sleep is sufficiently rejuvenating.” Instead, he recommends 5HTP (5-hydroxytryptophan) as a good herbal sleeping aid (except for people who are taking antidepressants that influence serotonin; consult your doctor). It is a form of tryptophan, an amino acid that is a precursor in the body’s synthesis of serotonin, and it acts both as a mood enhancer and a sleep inducer.
Good immune function also requires a healthy diet. But it’s also important to look for and eliminate allergens. “Even with a healthy diet and a full range of vitamins and minerals, you may be sensitive to foods,” says Sachs. “Hidden food allergies are often overlooked. If you are constantly having an allergic reaction, like to wheat or milk, it exhausts the adrenals.” A nutritionist or holistic doctor can evaluate food allergies and recommend food choices to maximize immune health.
Another reason to work toward excellent overall health while battling Lyme pathogens or coinfections is that as bacteria succumb to treatments, they rupture, releasing floods of damaging toxins. Symptoms of infection can recur or markedly worsen during this time. This response to a pathogen die-off is called the Jarisch-Herxheimer reaction, or simply Herx reaction. Besides being a serious medical issue in some patients, the Herx reaction is a clinical sign that a patient had an infection that was impacted by the treatment.
If you have Lyme disease, or think you do, don’t be discouraged at the mountain of information erupting about this illness, making its sound-bite characterization close to meaningless. Share your own experience and learning with others. Read Stephen Buhner’s Healing Lyme: Natural Healing and Prevention of Lyme Borreliosis and Its Coinfections (Raven Press, 2005). Watch the documentary film Under Our Skin (recently at the Woodstock Film Festival, now on tour and for sale; www.underourskin.com). Work with a Lyme-experienced nutritionist or herbalist and other complementary practitioners in concert with a medical doctor. Medical experts continue to learn as they go, too. Says Horowitz, as he dashes off to another annual Lyme conference, “Twenty years and eleven thousand patients later, I’m working on pieces of the puzzle.”