Lyme disease is a chronic inflammatory condition caused when a certain type of bacteria, called Borrelia burgdoferi, is transmitted by the bite of a deer tick or black-legged tick. Other common infections transmitted by ticks—notably Babesia, Bartonella and Ehrlichia—will very often contribute to the severity of the condition. Although Lyme disease is easily treated in its early stages, the condition is difficult to diagnose. This is due mainly to the wide range of symptoms and to the poor reliability of lab tests that are currently used for identifying the Lyme-related infections.
Lyme disease is the most common tick-borne illness reported in the United States. According to the U.S. Centers for Disease Control, annual cases reported in the nation more than doubled between 1991 and 2005. Again, however, most cases are likely to be missed and thus are not reported.
Symptoms commonly linked with chronic Lyme disease include severe fatigue and debilitating joint pain, which some physicians refer to as “Lyme arthritis”. In fact, however, Lyme disease as a multisystem disease that affects the entire body, including muscles, bones, cartilage, brain, heart, skin, eyes, ears, head, neck, and face, as well as the digestive, respiratory, circulatory, reproductive and nervous systems. The symptoms of Lyme and other tick-borne illnesses can be so diverse as to seem mind-boggling in complexity. For example, the digestive problems can include diarrhea, constipation, nausea and stomach pain, as well as symptoms of gall bladder disease. The respiratory and circulatory challenges may include shortness of breath, cough, chest pain, heart palpitations, night sweats, heart blockage, murmurs and even heart attack.
Other signs of advanced Lyme and tick-borne illness include unexplained changes in weight, repeated infections, increased allergic reactivity, pain that moves from one part of the body to another, and symptoms that come and go. For some people, the infection can lay dormant for years and then manifest for no apparent reason. For many others, symptoms manifest within a few months following the initial tick bite—whether or not antibiotic treatment was received at the onset.
Because most physicians do not have adequate training in identifying Lyme and tick-borne disease symptoms, the condition is frequently overlooked or misdiagnosed. Moreover, because some Lyme-related symptoms are psychological in nature—e.g., frequent anxiety, heavy moods, poor concentration and short-term memory lapses—the condition tends to be dismissed as being “all in your head.”
Insights from Dr. Pittman’s Recent Physician Trainings
At this writing, I now have over a decade of clinical experience working with Lyme patients and have regularly attended the International Lyme and Associated Diseases Society Annual Conferences, the “Lyme literate” professional organization of which I am a member. Beginning last year, I decided to intensify my training by participating in one-on-one preceptorships in New York, considered “Lyme Ground Zero” due to the enormous number of cases documented there. My mentors for this training were two of the top Lyme-literate physicians in the world, Dr. Richard Horowitz of Hyde Park and Dr. Bernard Raxlen in Manhattan.
These clinical trainings led me to create a three-week Lyme Stabilization Program, which we have begun implementing at our Raleigh-based Carolina Center for Integrative Medicine. The program provides intensive nutritional, digestive and detoxification support in preparation for targeted antibiotic protocols that include both pharmaceutical and herbal antimicrobials. Our center is a full-service integrative medicine facility that provides various intravenous (IV) therapies, which are immensely helpful in stabilizing very ill patients. Once stable, patients are started on antibiotics and herbal anti-microbials, with many patients requiring IV antibiotics for treatment to be effective. We have taken steps to make this approach as cost-effective as possible and, to some extent, have been able to maximize insurance coverage for our patients.
Upon returning from my recent clinical training with Drs. Horowitz and Raxlen, I realized that many of us who have been treating tick-borne diseases have overlooked a very basic detail: Treatment must be specific for each stage of the life cycle of the Lyme organisms. After being transmitted by the tick bite, the infectious agent actually changes its structure upon reaching each phase of its life cycle within the human host. Unless the antimicrobial treatments target each and all of the life-cycle stages, the disease will persist and treatment success will be relatively short-lived.
Another key insight concerns the severity of tick-borne coinfections, especially blood parasite Babesia. Even though it is difficult to get reliable test results on Babesia’s presence, we know that it is a very common co-infection. Babesia is a very challenging organism to treat, often requiring multiple anti-parasite medications as well as herbal antimicrobials. My training up in New York also helped provide a clearer understanding as to which patients need to be on antibiotics early on (as opposed to trying the herbal antimicrobials first), as well as which patients probably will never get better without IV antibiotics.
Tools for Overcoming Lyme and Other Tick-Borne Diseases
The Carolina Center’s approach to treating Lyme and other tick-borne diseases is grounded in principles laid out in the Physician Training Program, sponsored by the International Lyme And Associated Diseases Society. Our approach utilizes a combination of strategies that address nutrient deficiencies, immune dysfunction and hormone imbalances, along with the careful use of antibiotics, which serve as a first line therapy and thus play a pivotal role in combating Lyme disease. Much of the art of treating this condition is determining when and how to use antibiotics, immune and hormonal support, detoxification, nutritional therapies, and some combination of these options.
Antibiotics are always the first course of action for anyone who has experienced a tick bite and now has acute symptoms of fatigue, body pain, headaches, and generalized flu-like symptoms. Although Lyme disease is easily treated with antibiotics in its early stages, if undiagnosed until it has progressed considerably, then chronic symptoms can develop. This more persistent form of Lyme disease obviously requires a more aggressive treatment approach..
Other factors that affect the ability to recover from Lyme disease include the following: treating the co-infections with other tick-borne organisms as well as other organisms (bacteria, yeast or parasites); removing toxic metals and other environmental pollutants that disrupt the immune system; correcting cellular nutrient deficiencies that ultimately compromise the immune and detoxification systems; and addressing hormonal imbalances that are often due to Lyme-related damage to the hypothalamus, resulting in numerous deficiencies.
The tools we embrace for treating Lyme disease at the Carolina Center are designed to not only eradicate the infection, but to bolster energy, sleep, mood, and overall functioning. These changes, in turn, give our patients the sense of peace and control they need to fully turn this situation around.
The key components of our integrative medicine protocol include:
- Stabilization of chronically ill patients, using a combination of intravenous nutrient therapies (to correct deficiencies) and detoxification therapies (colon hydrotherapy, glutathione support, and other techniques);
- Treatment of the digestive system with a variety of nutrients that improve absorption, bolster immune system functioning, and restore the normal flora to an optimal balance.
- Treatment of chronic gut infections, focusing on removal of the “biofilm” that protects these organisms using a combination of pharmaceutical and natural anti-microbial agents.
- Promotion of elimination and detoxification through the use of colon hydrotherapy
- Implementation of other detoxification techniques including modified fasting, chelation therapy and glutathione therapy.
- The use of hyperbaric therapy to promote cellular repair, immune system stimulation and detoxification.
- The use of immune boosting pharmaceuticals and supplements necessary for the body to ultimately control the infection when antibiotics are no longer being used.
- Note: For patients who have been on extended periods of antibiotic therapy prior to being seen at the Carolina Center, we often recommend a break from those treatments to assist with improving detoxification, immune function and gut repair.
Our overall approach continues to be informed by clinical trainings sponsored by the International Lyme And Associated Diseases Society and through direct work with leading Lyme physicians in the Northeast. Also, by affording increased antioxidant and anti-inflammatory protection, the addition of specific nutritional and herbal supplements can further improve therapeutic outcomes for Lyme patients, as reported by University of California researchers in the September 2009 issue of Evidence-Based Complementary and Alternative Medicine.
A Story of Hope: Janet’s Recovery From Lyme [Case of Barbara Miller]
Two years ago, a 56-year-old woman named Janet came to our Raleigh office complaining of various symptoms that had progressively worsened over several years. These included back pain, muscle weakness, difficulty swallowing, fevers and sweats, numbness and tingling of her lower extremities, shooting pains throughout her body, headaches, dizziness, blurred vision, and irregular heartbeats. She has been to numerous physicians, including three neurologists who claimed they could find nothing wrong with her.
The relentless pain and discomfort took a toll on her normally upbeat disposition. “The symptoms gradually took over my life,” Janet recalls. “I became physically and mentally handicapped. Prior to the diagnosis, I went through a long period of time where the symptoms and intensity increased. It was both stressful and discouraging to be passed along from one doctor to another without any positive results or a diagnosis.” Three of her doctors had suggested that she see a psychologist.
Her initial labs were strongly positive for active Lyme Disease and she had a classic history of numerous tick attachments dating from shortly prior to the onset of her symptoms. Prior to commencement of antibiotic therapy, Janet underwent comprehensive testing to assess her nutritional status and immune, toxic burden, detoxification capacity, and other factors then treatments were employed to redress nutrient imbalances and prepare her digestive system for antibiotic therapy.
We then started her on an aggressive treatment protocol that helped her feel more at peace and in control. “It was a huge relief to finally get on a plan designed to get my healthy life back,” says Janet. “Over the past year I have worked with every person at the Carolina Center and felt totally supported and encouraged. At this point, I have greatly improved, and my attitude is once again positive. I am feeling and functioning much better every day, and am deeply grateful to have my life back.”
As of the spring of 2012, Janet was 75% better, with nearly all body pain eliminated and most other symptoms resolved. However, she still suffered from periodic dizziness, disorientation, and numbness and tingling in her extremities—all symptoms attributed to neurologic Lyme disease. At that point, we realized Janet was not going to fully recover without antibiotic therapy that could penetrate the blood brain barrier and reach the central nervous system.
We started her on a Lyme-specific antibiotic called Rocephin (ceftriaxone), and her oral antibiotic regimen was adjusted so that all life cycle stages of the Lyme bacteria were addressed. We also treated her for the coinfection known as Babesia, which was strongly suspected in her case due to her pattern of fevers and sweats. Janet immediately noticed a more dramatic response to treatment. “I can feel this working in my head like nothing else,” she said soon after starting the new treatment protocol.
Though Janet did experience a brief worsening of her symptoms—the Herxheimer or “die off” reaction that results from toxins being released as microbes are killed by antibiotics—she is now stable and feeling positive about her future. “I have begun to have days when I feel like my old self more than ever,” she says. “It’s been a long journey, but I’m feeling stronger and better than I have in a very long time.”
My hope is that Janet’s story will inspire other patients who are striving to overcome advanced, chronic Lyme disease. Though her recovery from this condition is ongoing, there is little doubt that she has largely reclaimed her life and her health. At least some of the credit must be given to her proactive attitude and willingness to embrace a healthier diet and lifestyle, as well as the nutritional and herbal supplement regimen to which she has been adhering. As she continues to get even stronger, I expect that Janet will motivate others with chronic Lyme disease to face their challenges with authentic hope and with the conviction that they can, indeed, overcome this seemingly intractable illness.
* Dr. Pittman is Medical Director of the Carolina Center for Integrative Medicine, former President of the North Carolina Integrative Medicine Society, and a member of North Carolina’s Vector Disease Task Force. Mark N. Mead, MSc, is a nutrition educator and research consultant. For more information about the Carolina Center, call (919) 571-4391 or visit www.carolinacenter.com