Part 2 of 2 (Part 1)
by D. J. Fletcher and Tom Klaber
Antibiotic Treatment
Every authority the authors spoke with considered antibiotics the primary treatment for Lyme, but that the accepted "standard" antibiotic therapies (of a duration and type acceptable to insurance carriers, HMOs, mainstream physicians, etc.) are insufficient.
Lyme is sometimes classified as having different stages -- early vs. chronic, or localized vs. disseminated. "The biggest distinction is between early-stage and chronic," says Dr. Whitaker.
"In the beginning, many organ systems are invaded while the patient may experience no symptoms.
As time goes on we see multiple system symptoms involving the whole body, especially the central and peripheral nervous systems, and the musculoskeletal, skin and circulatory systems.
Many Lyme cases are diagnosed by psychiatrists. Dr. Brian Fallon is studying cognitive and other neuropsychiatric manifestations."
The problem, says Dr. Barkley, is that "There isn't an adequate treatment model. So if the physician says you have Lyme, and gives you the standard antibiotic therapy, and you aren't better, the thinking is that you must have something else wrong, such as an autoimmune problem, or else you didn't have Lyme disease in the first place.
Short-term oral antibiotics are effective in treating localized Lyme, but with disseminated Lyme, the requirement for either intravenously administered antibiotics or long-term oral antibiotics becomes common."
In his regular practice, Dr. Bock has always tried to avoid antibiotics. But, he says, "If you go back to syphilis, the history of spirochetes is one of being able to hide out and then reappear, causing severe, devastating neurological illness. This isn't a risk I would recommend taking with Bb."
Most of the physicians recommended an immediate short course of antibiotics for anyone bitten by a deer tick, or who exhibits certain symptoms. "It takes a while for the immune system to produce antibodies," says Dr. Barkley.
"So Lyme testing -- other than by a skin biopsy from an active rash within 14 days following the bite -- may yield inconclusive results. Symptoms of Lyme include fever, night sweats, fatigue or a flu-like illness that does not improve within three to five days." Other symptoms reported by physicians include stiff neck, prolonged joint and muscle pain, heart palpitations, brain fog or severe headaches.
"I tally all the initial symptoms and signs, and try to weed them out one by one," says Dr. Jones. However, he cautions, "Treatment duration varies with each individual. If one stops antibiotics prematurely, a more resilient Bb infection will develop that will cause more brain and body injury."
Adjunct Therapies
None of these physicians relied solely on antibiotics; they used immune system-strengthening protocols as well.
"The immune system may be less able to respond if the person is having a hard time clearing toxins," says Dr. Bock. "You're going to add to this overload by taking antibiotics. For general immune support, we've used maitake and reishi mushrooms, ginseng and astragalus.
"Natural medicine approaches include anti-inflammatory eicosanoids such as fish oil and borage seed oil; high-potency multivitamin and mineral formulas; CoQ10 and other mitochondrial nutrients; cognitive enhancement substances such as carnitine and certain herbal extracts.
Acupuncture combined with physical therapy can often reduce pain. I have posted an article online that discusses these alternative approaches in more depth.
Dr. Cowden recited a litany of natural immunotherapy agents. His recommendations include the following: "Transfer factor -- ImmuneFactor 2 and CellResponse are good products; Thymic Protein A; medicinal mushroom combinations such as ImmPower AHCC; glyconutrients like Ambrotose; arabinogalactan (Larix), an immune-enhancing polysaccharide; and Astragalus Supreme."
Dr. Cowden also notes that "if you use a pharmaceutical antibiotic, you need to use an herbal antifungal to reduce stress on the liver and kidneys."
Lifestyle Changes
"Avoid sugars because they feed these bugs," advises Dr. Cowden. "It is most important to balance saliva pH between 6.7 and 7.0. Sufficient dietary minerals bring pH up if low. Reducing stress will raise pH; so will identifying and removing food, nutrient and inhalant allergies. You should identify your nutritional type and then follow the appropriate diet.
Grapefruit seed extract and certain other substances, including vitamin C, can interfere with tissue uptake of the antibiotics and make them less effective. Take as few non-essential supplements as possible -- consult with a physician knowledgeable about nutrition -- and time them as far from the antibiotic as possible."
Dr. Bock reminds us that, "It's also important to support the endocrine system. In some cases, cognitive abilities improved when subclinical hypothyroid problems were treated. Chronic stress can cause suppression of the immune system. Manage the effects of stress on the body
Use relaxation techniques and biofeedback. Find a group for emotional support."
In his practice, Dr. Jones has found that, "Taking acidophilus and other probiotics is always important. [Antibiotics kill the intestinal flora necessary for digestion and immune functions; probiotics like lactobacillus re-inoculate the intestines.]
Stay away from or severely limit alcohol intake. Develop a healthier standard of living. Rest is needed. We've found that a parent who has a child with Lyme is often feeling guilty. One has to work with these difficult feelings. I emphasize that it's not a parent's fault; you can't protect your child from Lyme exposure."
Present Limitations
None of the experts the authors consulted claimed to completely understand Lyme or to be able to completely cure it in every case. Some people infected with Bb may never manifest the symptoms of Lyme.
Others become seriously ill soon after they are infected. Treatment must be customized from patient to patient and can vary widely. "Certain people may clear Lyme without antibiotic therapy," says Dr. Barkley. "However, the other extreme is that even with antibiotics, some people with Lyme have died from this disease."
Says Dr. Jones, "We have seen children from one day old to 18 years of age who have required from three months to six years of antibiotic therapy. We have had some patients on antibiotic therapy for very long periods, and we've done follow-ups for as long as 15 years post-treatment.
The criterion for stopping therapy is that one must be totally Lyme disease-symptom free for two months, with no Lyme flare induced by another infection or menses and no 'Herx' [Jarisch-Herxheimer reaction of the body manifesting symptoms in response to dying Bb]."
"There are very few symptoms where you shouldn't consider Lyme," says Dr. Cowden. "more than 50% of chronically ill people may have Lyme contributing to their condition."
The situation is quite difficult now. "It's sad where we are with this disease," says Dr. Cowden. "You're supposed to go through the 'standard' treatment first before turning to alternative treatments. We need to turn this around, into a logical, integrated approach."
The impetus for this change must come not only from the patients who have been classically infected by a tick bite, but by those who suffer from "unexplained" muscle and joint pain, unrelieved fatigue and cognitive impairment -- and by those who are afflicted with degenerative diseases that can be caused or aggravated by Lyme.
Presently, such patients will find few doctors experienced in Lyme, because of the newness of the disease and lack of understanding about it -- and because those doctors who take a comprehensive approach to diagnosing and treating Lyme are commonly harassed by state medical boards, insurance companies and HMOs.
It is up to patients to actually educate their doctors about the inadequacy of standard testing and the necessity for using techniques such as electrodermal screening and darkfield microscopy. And it is up to patients to become politically involved with Lyme advocacy groups, such as those listed here, to fight for their right to proper medical care.
The earlier Lyme is diagnosed, the easier it is to cure.
For people with chronic Lyme symptoms, the road to recovery can be long. With comprehensive integrative treatment, however -- a combination of the best of conventional and alternative medicine protocols -- their health can be continually and dramatically improved.
Alternative Medicine.com Issue 41
