Thank you Vanessa Holden for taking such great notes from this conference and sharing them with us!
Why am I still sick?
Immune System Dysfunction
What Lyme? Which one or ones?
Borrelia can be sneaky – change over time. Adapt over time.
Birds, reptiles, mammals are carriers. Adapt to their environment
100 more genes than syphilis, Falsenfeld 1971
Pachner – infested mouse. Different Bb in brain than in blood/body.
Rapid transmissions of pathogens
W. Burgdorfer: 5-10% ticks have Lyme. can get it in minutes as it’s in tick saliva
Serologic testing insensitive
All based on only 1-2 lab strains. 71 % missed.
Sensitivity of ELISA: 29-68%
Beware of test results. – highly inaccurate
Lyme Elisa – 18% accurate
Western Blot – commercial kits sensitivity 46-50%
Reference tests – no more than 80% – reading is highly subjective.
Test affected by lab variables
Why Borrelia can cause Chronic Infection?
Lose cell wall
Cell wall deficient.
Spinal fluid, temporary antibiotics. Sequesters in tissues and hidden collagen bundles.
Different antibiotics attack different strains
Lower doses and some meds don’t penetrate
Can survive within cells – they protect Bb and means of dissemination
Produces a protective biofilm
Granular Borrelia – vary in size from little to big
Biofilm formation – bundles
Complex 3-dimensional structure that expands and hardens.
Soaked in Chlorine – still didn’t die!
Channel like structures
Rearrangements over time – one or more antibiotics help – borrelia not static, very slow growth, double in days to weeks.
The slower the growth, the slower time it takes to kill.
Lyme – 4 week cycle: dormant, active, dormant.
Antibiotics kill when active
Periods of dormancy/latency – no division but continued production of toxic products
Epitope switching allows evasions of immune response.
Changes appearance so immune system doesn’t recognize
Different antibiotics must be combined. Borrelia live inside cell and outside cell – need combo to combat this
Cover fluids as well as deep tissues
Cover morphologic forms – spirals, ribosomal and cystic
Cefuroximine + clarythromycin + tindazole
Critical to achieve therapeutic drug levels as resistance and treatment failures are likely –
this varies patient to patient
Must measure peak and trough antibiotic levels whenever possible
Amoxicillin: from 1500 to 3000 mg + add probenecid 1500 mg a day
Doxycycline: 300 mg per day didn’t clear it – never worked
Need to discuss with doctor, especially if you change doctors:
Blood antibiotic levels
Can I cover 1 pathogen with my antibiotic regimen?
Will it cover spiral, CWD and cystic forms of Bb?
Has patient had it in past?
Side effects, allergy
Antibiotics – Route of Administration
Placebos didn’t work
IV – most effective
Abnormal spinal fluid
Synovitis with high ESR
Ill more than 1 year
Over 60 yrs old
Acute in 1st trimester of pregnancy
Prior use of steroids
Standard therapy – 7 days a week
Pulse therapy – 3 days in a row, 4 days off – allows for double dose, higher doses
36+ hours – to affect with CFTX
Takes Bb longer to recover
Safer, Heparin lock possible, less costly, better lifestyle for patient
Current symptoms flare, old ones reappear, new ones arise
Difficult to distinguish between allergy and toxicity
Last 2+ days up to several weeks
Recur every 4 weeks as long as infection is active
May see leucopenia
The worse the Herxheimer reaction:
The more ill the patients
longer duration of illness
severe neurological conditions
chemically sensitive individuals
If treat with overly aggressive antibiotics – scare the patient
Too gentle – borrelia become antibiotic resistant
best to do: interrupt treatment for a few days and rest
Managing Herxheimer Reactions:
Alkalinize: water with lemon, trisalts, Alka Seltzer Gold
Binders: bentonite, activated charcoal, micro chitosan, cholestyramine
Hot baths with 4-6 cups Epsom salts + baking soda
Duration of treatment:
Extended courses needed
Early studies with oral meds
Amoxicillin 17% cure after one month, 67% after 5 months duration
Same with IV – 6 weeks IV
If get thru 4 weeks Herx… If bad, go 8 weeks
Follow 4 week cycle
Minimum 6 weeks to bracket one cycle.
Continue to treat until 4 week cycles stop!
Can we Cure Chronic Lyme?
No foolproof “cure” and relapses occur
Get to where treatment is no longer necessary – where function
6-12 week course and stop – depends on patient/doctor
May not eliminate every spirochete. Get to the point where the immune system is able to fend off.
Banderol/samento – biofilm busters. Then antibiotics kill
Boluke, nattokinsase – enzymes
Chelation out the divalentcations – not proven in patients
Co-Infections in Lyme
Live for 2 years in dirt and drink blood from the variety of wild and domestic animals
Attach to rodents etc
West Nile from Tick Bite
Old viruses can reactivate EBV, HSV, HHV-6, 7, 8 CMV
Intestinal parasitic infections
Lyme – multi system: no sweats, 4 week cycles, slow relapse, joint involvement, afternoon fevers, Bb antibodies
Bartonella – light senstivitiy, anxiety, insomnia, overactive CNS, stomach upset, blood vessels, AM fevers, swollen lymph glands, elevated VFGF
Babesia – abrupt onset, sweats day and night, cycle 5-7 days, headaches, migraine like, air hunger, circulation in lungs, thick blood, cough, severe lyme symptoms, vertigo, feel off balance like on boat, temperature any time
Anaplasma- rash, high fever, sore muscles, low WBC, elevated liver function tests, numbness/tingling, eye-stab headaches, muscles sore
Co-Infection Table (slide – I didn’t get it all but when we see slide you’ll get the rest)
Ehrlichia – relapse gradual
Mycoplasma – relapse gradual
More prevalent in Northeast than borrelia. Different than tualemia “cat scratch fever”
CSD tests insensitive – 80% miss
Galaxy Diagnostics PCR better – still not accurate
CNS (central nervous system) out of proportion to physical. Encephalapathic, irritable, anxiety, seizures, rashes, red bumps form scabs, look like stretch marks (linear)
Treat Bartonella-Like Organism
Levoquin – which irritates brain and tendons. To counteract this take pycnogenol, Vitamin C and magnesium shots
Fluroquinalones first choice to treat
Erythromycin family don’t work – inhibit Levoquin
Erythromycin + tetracycline + rifampin + CW or Bactrim
13 strains. Problem with diagnosis
No tests better than 30% accuracy
Mepron or malarone + Artemisian
Erythromycin + artemesian
Coartem – success with
IV – clindamycin
Ehrlichia/Anaplasma + Rocky Mountain Spotted Fever
Acute and chronic form
Doxycycline – 200 mg at least 2 weeks (oral or IV)
Macrolides and rifampin 2nd choice
Partial response to fluroquinalones – not recommended as sole treatment!
Not sure of source
Seen in immune-suppressed
See with unrelenting fatigue – autonomic dysfunction, pain syndromes
Tests are awful (inaccurate)
How to treat:
Treat with anti-virals. Treat tick-borne disease and correct immune deficiencies unless high viral titers, persistent or significant IgM
4 months – Byron White helps
Immune Dysfunction 1
Bb immune suppressive. Inhibits B + T cells and decrease NK cells. Difficult to clear Lyme and co-infections
Immune Dysfunction 2
Causes defective B-cell signaling
Shut down immune system
Constant flu-like feeling
Hormone receptor blockade
Inhibition of detox pathways
Defect regulation results in autoimmunity
Food sensitivities, new allergies, environmental sensitivities
System more fragile.
Stress, surgery, plane flight, sleep deprivation can all set this off
B-cells make IgG – if low treat with IVIG
T cells – can test blood/skin “Mitogen Stimulation Assays”
If deficient – use vaccines and transfer factors, promote sound sleep and exercise program
If B-cell overactive:
Avoid foods that are sensitizing, take Vitamin D, herbals
High vitamin D can help
Caution: Turmeric/Curcumin can cause GI ulcers – can cause blood thickening, so use only a small amount. Ok in your ‘curry in a hurry’ but be careful.
Excessive exposure – industrial, seafood, accidental
Decreased Excretion – MTHFR defect results in decreased glutathione
Lifestyle – inability to move (exercise) so build up in body
Excessive sensitivity to toxins
Genetic sensitivity to biological toxins – mold, staph, marine toxins
To treat MTHFR – folic acid, glutathione
Eliminate excessive exposure – mold, nasal staph, seafood, environmental, biological toxins
Folic acid – methyl B-12
Administer glutathione directly via IV
Sweating, pooping, peeing
Heavy metals – chelation plus the above
Sauna – sweat – raises body temperature. Dr. B. feels exercise and hot tub better way
Low thyroid, adrenal and sex hormones – replacement doses
Hormone receptor blockade occurs in Lyme
Treat Hormone Dysfunction:
Replace all deficiencies
Treat underlying infections, detox, treat dysfunction to address:
Nervous System – weakness, pain, poor balance, coordination, myelineal/nerves)
Autonomic: pain, gut dysfunction, weakness, poor stamina, light headedness, swelling, rapid pulse, blood pool in veins, musculoskeletal system
Bb infections can weaken collagen and elastic fibers
Inability to get appropriate rehab
Healing Nerve Damage
IVIG – expensive – $15,000 per dose
Helps remyelination – heals fine, unmyelinated fibers
These damaged fibers are the cause of intractable and severe neurological pain as well as autonomic neuropathy.
Moderate cytokine store (anti inflammatory without being immune suppressive)
r-lipoic acid – 150 mg 2 times daily if tolerated (nausea)
CordyMax (Pharmanex) – 6 a day – comes from coryceps mushroom
NT Factor – 6 a day (helps mitochondria to heal) – brand he likes: Research Nutrition
High dose CoQ-10 (Pharmanex nano CoQ-10) – 4 a day or 400 mg conventional type daily
Methyl B12 injections – 25 mg daily for several weeks, then taper off to 3 times a week
Dermal nerve biopsy – shows decreased number of fibers and their disruption
Healing Soft Tissues
Diathermy – dilates capillaries, breaks up rouleaux, improves blood flow, may have membrane healing effects
Great for headaches, even migraines
Stretching but only after heating e.g. after hot yoga
Gentle chiropractic care and physical therapy, acupuncture
Vitamin C, pycnogenol, Vitamin D
Some feel worse after massage, as spreads toxins. Swedish is gentle, Acupuncture has helped, very dependent on the practitioner
Vitamin C doesn’t work without pycnogenol (1 mg. per pound of body weight). Vitamin C dose to bowel tolerance
Required Supportive Measures
Low glycemic diet, low fat diet
No high dose steroids or other immune suppressive unless already on antibiotic regimen
Key nutritional supplements
Psychological and emotional support for patient, family and care givers
Kefir, bifudus, lactobacillus, soil-based organisms (rotate or mix several types)
Multi vitamin with minerals
Essential fatty acids (krill oil plus borage or coconut)
Magnesium – begin antibiotic first, then start magnesium MagTagSR
Trsansfer factors specific for Lyme
Methyl B12 (if not mercury toxic)
To enhance t-cell function
Whole body program, exercising every muscle group every time.
Body sculpting program – gentle with free weights or machines – 2-3 pound weights, many repetitions, 45-60 minutes
Aerobics not allowed at all! (decreases t-cells)
Good slow progressive
Finish with stretches
Hot bath/sauna, nap immediately
Separate several days in between. Rest on days not exercising
Start out once a week. As strength improves, increase weight and resistance but high repetitions. As stamina improves, exercise more often, never daily
Don’t get overtired
Take break before mid-afternoon energy sag
Mid day breaks
Brain Hypoglycemia – awaken with adrenaline, shaky feeling.. Treat with 1 tbls coconut oil at bedtime – stops shakiness (coconut oil lasts in system for 8 hrs)
Tooth decay and Lyme – which came first chicken or egg? Not sure.. Gums show disease e.g. heart disease…
Vaccine – not likely. No lasting immune memory and not protect against co-infections. Can get Lyme multiple times.
Rife – some give off radiation, Dr. B doesn’t like them but said he knows some people have had good success with them.
Sexual transmission – proven in animals, no way to tell in humans