Naturopathic approaches to Lyme disease treatment.
Naturopathic medicine is well placed to assist patients with chronic Lyme disease chronic Lyme disease A predominantly neurologic condition ranging from mild–eg, fatigue, paresthesia, arthralgia, memory loss, mood swings, and dysomnia, to severe–eg, spastic paraparesis, tetraparesis, ataxia, chorea, cognitive impairment, bladder . While Lyme is a disease caused by spiral-shaped bacteria called Borrelia burgdorferi, it is clear in Lyme treatment that simply trying to kill bugs with medication is rarely sufficient. I have seen the best results from combining traditional antibiotics with naturopathic supportive care. Some patients who do not tolerate the antibiotics or are opposed to using them will benefit greatly, even reach remission of symptoms, with naturopathic medicine alone. Others can utilize naturopathic support to offset side effects of medication and al low them to tolerate treatment better.
The major goals of Lyme disease treatment are:
1. eradicate pathogens
2. boost immunity
3. support affected organs/systems
4. provide symptom relief
There are multiple areas to address:
* Primary infection - Borrelia burgdorferi spirochete spirochete
Any of an order (Spirochaetales) of spiral-shaped bacteria. Some are serious pathogens for humans, causing such diseases as syphilis, yaws, and relapsing fever. Spirochetes are gram-negative (see gram stain) and motile.
* Coinfections - Erlichia, Bartonella, Babesia Babesia /Ba·be·sia/ (bah-be´ze-ah) a genus of protozoa found as parasites in red blood cells and transmitted by ticks; its numerous species include B. bige´mina, B. bo´vis, and B. , and so on
* Nutritional deficiencies
* General detoxification
* Immune dysfunction
* Systemic inflammation and pain
* GI infections - parasites, Heliocbacter pylori
* Gluten intolerance/food sensitivities
* Viral infections - Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpesvirus herpesvirus, any of the family (Herpesviridae) of common DNA-containing viruses, many of which are associated with human disease. See cytomegalovirus; Epstein-Barr virus; herpes simplex; herpes zoster. 6 (HHV-6), measles
* Yeast overgrowth - candidiasis
* Heavy metal toxicity
* Mold toxicity
* Hormone imbalance (adrenals, thyroid, reproductive)
* Sleep issues
* Imbalance in brain chemistry/ neurotransmitters
Clearly, treatment for this disorder is multifaceted and highly complex. Some treatment considerations are outlined below.
Discussion of antibiotic regimens is complex and beyond the scope of this article. The best-referenced guidelines for medication protocols are those developed by Dr. Joseph Burrascano. Natural antimicrobials have been used quite successfully in Lyme disease treatment. Herbs such as Samento and Guaiacum have antispirochete activity. Teasel teasel, common name for some members of the Dipsacaceae, a family of chiefly Old World herbs found mostly in the Mediterranean and Balkan areas but ranging to India and to S Africa. is also a good antimicrobial, producing anti-inflammatory effects. Colloidal silver, Allicillin (standardized allicin/garlic extract), and others have been used. Artemesinin, extracted from the herb wormwood, is perhaps our best natural remedy against babesiosis babesiosis (bəbē'bēō`sĭs), tick-borne disease caused by a protozoan of the genus Babesia. Babesiosis most commonly affects domestic and wild animals and can be a serious problem in cattle. , a common coinfection with Lyme. Oregano, clove, pau d'arco, and garlic are great preventive measures or treatments for yeast overgrowth secondary to antibiotic therapies.
The enzyme lumbrokinase has been used to break down the biofilm, which can allow for greater exposure and fewer "hiding places" available to the Borrelia spirochetes.
Many Lyme patients are coinfected with viruses from the herpes family such as EBV, CMV, and HHV-6. Larrea tridentata and olive leaf are two key herbs with antiviral activity.
Nutrition and Lifestyle Factors
It is futile to embark on aggressive medication protocols without considering nutritional and lifestyle factors. Most patients fare better on gluten- and dairy-free diets, as those foods can fuel inflammation, which is already a major issue. As digestive function is often compromised, a low-allergen diet is key. Sugar avoidance is a significant help in preventing antibiotic-associated yeast overgrowth, and will assist a healthy immune response. Omega-3 fatty acids can be used for their anti-inflammatory benefits - typically 2 grams of fish oil plus 1 tablespoon of flax oil daily.
Patients should consume at least 2 liters daily of clean, filtered water to help flush waste materials. For the same reasons, adequate fiber is necessary to flush the colon of waste, particularly neurotoxins that can be released when bacteria are killed off.
Lean organic proteins; fruits; vegetables; and healthy fats such as fish oil, flax, olive, avocados, and nuts and seeds will provide adequate nutrition without fueling inflammation.
Sleep patterns are important, although Lyme patients often suffer from insomnia due to pain and neurotransmitter imbalance. Melatonin, 5-HTP, and herbs such as valerian valerian, in botany
valerian, common name for some members of the Valerianaceae, a family chiefly of herbs and shrubs of temperate and colder regions of the Northern Hemisphere; a few species, however, are native to the Andes. and passionflower passionflower, any plant of the genus Passiflora, mostly tropical American vines having pulpy fruits. Some species are grown in greenhouses for their large, unusual flowers of various colors; those seen by early Spanish settlers were interpreted as symbolic of can be helpful.
Lyme patients require detoxification support in three main areas - general phase 1/2 liver detox de·tox
To subject to detoxification.
A section of a hospital or clinic in which patients are detoxified. support, detox of neurotoxins released during treatment as bacteria die off, and heavy metal detox. Many are intolerant of detox regimens, and so this must be addressed carefully. Such patients may benefit from gentle homeopathic and drainage remedies. Liver and kidney herbs can support medication-associated toxic stress. For neurotoxins, some patients benefit from cholestyramine cholestyramine /cho·le·sty·ra·mine/ (ko?le-sti´rah-men) see cholestyramine resin, under resin.
n. , a cholesterol-lowering medication that has binding properties. Chitosan and fiber supplements have been used as natural alternatives.
Recent clinical observation has shown intravenous glutathione to have significant benefit in boosting energy levels and cognitive function in chronic Lyme patients.
Heavy metal toxicity is often present in Lyme patients; but, again, as detox mechanisms are already stressed, caution must be exercised around chelation Chelation
The process by which a molecule encircles and binds to a metal and removes it from tissue.
Mentioned in: Heavy Metal Poisoning
chelation . For some, chlorella chlorella
Any green algae of the genus Chlorella, found in fresh or salt water and in soil. They have a cup-shaped chloroplast. Chlorellas are used often in studies of photosynthesis, in mass cultivation experiments, and for purifying sewage wastes. is sufficient to promote detox. For others, low-dose DMSA DMSA
dimercaptosuccinic acid. (meso-2,3-Dimercaptosuccinic acid), 100 mg every 1 to 3 days, over time will be efficient without stressing the system.
Infrared sauna, Epsom salts baths, colon hydrotherapy, lymphatic drainage, and ionic footbaths have helped many patients.
Boosting immune function so that the body can help to fight the infections is crucial - natural killer (NK) cells and antibodies are frequently low. Transfer factors help to stimulate NK cells, a vital component of cell-mediated immunity, while herbs can be valuable to support both cell-mediated and humoral immunity. Such herbs include astragalus astragalus /as·trag·a·lus/ (as-trag´ah-lus) talus.astrag´alar
See talus. , elderberry, and olive leaf. Low-dose naltrexone has been used in autoimmune disease as well as Lyme/ fibromyalgia illness, and can not only modulate immune response but also help quality of sleep and mood. Mushroom extracts such as reishi reishi (rā·shē),
n Latin name:
Ganoderma lucidum; part used: fruiting body (mushroom); uses: ada-ptogen, antiviral, chemoprevention, immunomodulator, asthma, and maitake are beneficial but may not be tolerated by people with severe Candida problems.
Systemic Inflammation and Pain
Much of the symptomatology symptomatology /symp·to·ma·tol·o·gy/ (simp?to-mah-tol´ah-je)
1. the branch of medicine dealing with symptoms.
2. the combined symptoms of a disease.
n. of Lyme arises from chronic systemic inflammation. Anti-inflammatory herbs, including white willow, turmeric, and holy basil, moderate inflammation and ease pain significantly, while systemic enzymes taken away from food can help break down inflammatory mediators. Cytokines created in the inflammatory cascade can cross the blood-brain barrier, worsening mood problems, anxiety, and depression. Essential fatty acid supplementation (2 to 4 grams daily) and a diet rich in omega-3 fatty acids help combat overall inflammation as well as depression.
To further alleviate pain, magnesium and malic acid are key players for muscle relaxation. For some individuals, magnesium cream applied topically can relax muscles and, with anti-inflammatory herbs, helps reduce pain. Resorting to NSAIDs and narcotic pain relievers, although necessary at times, can result in a host of side effects.
Lyme patients often have digestive issues, which can be caused by the Borrelia and coinfections themselves, by opportunistic infections such as intestinal parasites, yeast overgrowth, and H. pylori, or by food sensitivities brought about by leaky gut and immune activation. H. pylori compromises the stomach's production of hydrochloric acid, making complete digestion of food difficult. Parasites cause symptoms of constipation, diarrhea, gas, and bloating. Specific infections should be addressed during treatment of Lyme, as optimal digestive function will help patients tolerate medications and other treatment protocols, as well as maximize absorption of nutrients from food.
Gluten intolerance and food sensitivities are common in the general population, and can worsen Lyme symptomatology. Most patients fare better avoiding gluten and dairy products because of their potential to fuel inflammation. Specific food sensitivities can be detected using a simple finger-stick blood test, making individualized dietary recommendations possible.
Yeast overgrowth is a consideration, especially when antibiotic protocols are given. Prevention is the best medicine, and high-potency probiotics should be a part of every Lyme patient's protocol. Up to 100 billion organisms a day are used prophylactically. Nystatin nystatin /ny·sta·tin/ (ni-stat´in) an antifungal produced by growth of Streptomyces noursei; used in treatment of infections caused by Candida albicans and other Candida species. is a relatively safe and nontoxic medication to treat Candida; fluconazole fluconazole /flu·con·a·zole/ (floo-kon´ah-zol) a triazoleantifungal used in the systemic treatment of candidiasis and cryptococcal meningitis.
n. (Diflucan, Trican) may be necessary in systemic yeast cases but has higher liver toxicity and more medication interactions.
Heavy Metal Detoxification
Heavy metal toxicity causes neurological symptoms, fatigue, muscle/joint pain, cognitive deficits, and many other symptoms in common with Lyme disease. Chelation protocols can be helpful, but care must be taken not to overwhelm detoxification systems - glutathione and methylcobalamin are helpful "precursors" to chelation, to upregulate detox and antioxidant status. Low-dose chelators given over several months may well be just as effective and easier to tolerate. For gentle but effective heavy metal chelation, 100 mg of DMSA can be given every three nights along with synergistic nutrients such as alpha-lipoic acid, vitamin C, and N-acetyl cysteine. While this regimen is not highly aggressive, it appears to be effective over several months, without triggering major detoxification reactions or placing much stress on the liver.
Ritchie Shoemaker, MD, (www.chronicneurotoxins.com) pioneered recent research on biotoxins and their impact on immune and nervous system function. Mold exposure is a major source of neurotoxins, and many people with Lyme have elevated antibodies to molds such as Aspergillus and Stachybotrys. Cholestyramine is used in such cases as a binding agent (sometimes with Amphotericin B given orally), and a remedy called TriCuarcd Plus also shows promise for addressing mold spores. Obviously, identifying any possible exposures is an important aspect, as reexposure will continue to worsen symptoms.
The hypothalamic-pituitary-adrenal axis is typically stressed in any chronic illness, and Lyme is no exception. Babesiosis is renowned for altering hormone pathways, which worsens the situation. Adrenal support is warranted and should be addressed before any thyroid supplementation is given. Boosting thyroid function without supporting the adrenals is akin to putting one's foot on the accelerator with the parking brake on, and may do more damage in the long run. Bioidentical hormone support, while not addressing the underlying infectious issues, can go a long way toward helping improve patients' mood and energy. Since a hallmark symptom of babesiosis is night sweats, it can sometimes be difficult to ascertain in women of menopausal age whether night sweats are caused by menopause or by Babesia. Female Lyme patients tend to show up with low progesterone levels; low testosterone in men can worsen fatigue, weakness, and depression.
Imbalance in Brain Chemistry/Neurotransmitters
Chronic Lyme disease can disrupt normal neurotransmitter pathways, and depression and anxiety are common in these patients. Chronic pain further exacerbates this. Gamma-Aminobutyric acid (GABA GABA ?.
GABA (gamma-aminobutyric acid)
A neurotransmitter that slows down the activity of nerve cells in the brain. ) and theanine are effective in moderating anxiety, while 5-Hydroxytryptophan (5-HTP) eases the depressive aspects and can be given in fairly high doses (150-200 mg) at night to assist restful sleep. Tyrosine, the amino acid that fuels the norepinephrine pathway, is energizing for the brain and can help patients get up and go in the morning.
Clearly, Lyme disease is complex and multifactorial, and can wreak havoc on every system of the body. While it may be near impossible to evaluate all these factors at once, it is important to keep in mind the widespread effects of the disease and address the person systemically. Simply killing bugs is not enough -immune, digestive, elimination, and hormonal systems must be supported to enable healing on a comprehensive level.
Nicola McFadzean, ND
1111 Fort Stockton Drive, Suite H
San Diego, California 92103
by Nicola McFadzean, ND
Dr. Nicola McFadzean is the founder and owner of RestorMedicine in San Diego, California. Originally trained as a nutritionist and traditional naturopath naturopath
a practitioner of naturopathy.
naturopath A person who practices naturopathy, a drugless system of therapy using physical forces–eg, heat, water, light, air and massage in her native Australia, she later went on to complete her doctorate in naturopathic medicine at Bastyr University in Seattle, Washington. Dr. McFadzean is a Lyme-Iiterate naturopathic doctor, and combines conventional and integrative approaches to treat tick-borne illnesses. She is a member of the International Lyme and Associated Disease Association (ILADS) and has completed the ILADS Training Program under the mentorship of Dr. Steven Harris. She is also affiliated with Dr. Yang's Family Care in Santee, California.