Lyme disease has raised controversy in science, medicine, and public policy. This is mainly due to divergent views on the best approach to diagnosing and treating this illness. The conflict makes it difficult for patients to be properly diagnosed and receive the right treatment.
Treatment for Lyme disease can be divided into two major categories: acute Lyme disease and chronic Lyme disease. In both cases, the most important thing to consider is that Borrelia burgdorferi, the Lyme causing bacteria, has several forms: the cell wall form, cystic forms and organisms in the intracellular compartment and biofilms. Certain antibiotics will only work when the organism is actively dividing and reproducing, so the standard treatment of 2-3 weeks of antibiotic treatment will not work.
After a tick bite, Borrelia burgdorferi spreads rapidly in the bloodstream and, for example, can be found within the central nervous system as soon as twelve hours after entering the bloodstream. This is why even early infections require full dose antibiotic therapy. However, if patients have multiple rashes, or a stiff neck, headaches or tingling/numbness in extremities, then the organism has disseminated and one month of antibiotics is insufficient. These patients often go on to develop persistent symptoms, so they’ll have to continue treatment.
Late Or Chronic Lyme
Experts agree that the earlier you are treated the better. Unfortunately, patients treated with short-term antibiotics can continue to have significant symptoms.
Treatment of chronic Lyme usually requires combinations of antibiotics. B. burdorferi can be found in both the fluid and the tissue compartments, yet no single antibiotic currently used to treat this bacterial infection will be effective in both compartments. This is one reason for the need to use combination therapy.
B. burgdorferi can exist in at least two, and possibly three different morphologic forms: spirochete, spheroplast (or l-form), and the recently discovered cystic form (although, there is controversy whether the cyst is different from the l-form). L-forms and cystic forms do not contain cell walls, and thus beta lactam antibiotics will not affect them. Spheroplasts seem to be susceptible to tetracyclines and the advanced erythromycin derivatives. B. burgdorferi can shift among the three forms during the course of the infection. Because of this, it may be necessary to cycle different classes of antibiotics and/or prescribe a combination of dissimilar agents.
A Lyme literate medical doctor (LLMD) may consider the possibility of tick-borne co-infections. Other factors to consider are immune dysfunction caused by Lyme, silent, opportunistic infections enabled by the immune dysfunction, hormonal imbalance and other complications.
A major key to overcoming Lyme disease is to repair, stimulate and modulate the immune system. Lyme disease becomes chronic because the bacteria are able to evade the immune system by hiding inside the cells, much as viruses do, while also forcing the immune system out of balance. In the case of Lyme, the innate system (Th1) is suppressed, while the adaptive system (Th2) becomes overactive. This overactive TH2 response causes excessive inflammation and a cascade of multi-systemic dysfunction, including neurological, endocrine, and gastrointestinal as well as abnormal activation of coagulation.
Because of the complexity of this illness, the best approach is an integrative one that addresses both the infections directly and the systemic effects of the illness on the body. Depending on the individual’s needs, a Lyme literate healthcare practitioner may use some combination of the following therapies: prescription and/or natural antibiotics, antivirals, antiparasitics, immune modulators, hormone balancers, nutritional supplements, low dose immunotherapy, ozone therapy.
Other Treatment Options
The Cellular Peptide Therapy is an ideal therapy for those suffering from Herxheimer (die off) reactions, which can limit effective treatments for Lyme disease. The peptide growth factors, especially those derived from the thymus and spleen, are shown to boost the innate (TH1, intracellular) immunity, allowing the body to seek and destroy the Lyme bacteria inside the cells, while at the same time reducing the harmful overstimulation of the adaptive (TH2, humoral) that is causing the multi-system dysfunction.
A study by the American Society for Microbiology offered new, interesting information to help develop more successful Lyme treatments. This study demonstrates that Lyme has the ability to transform into a metabolically inactive form, called a persister cell. This lack of metabolic activity makes it totally resistant to any antibiotic at any dose and also any combination of antibiotics. This is in contrast to other methods that bacteria use to become resistant that can be overcome by using larger doses of antibiotics, different antibiotics or a combination of antibiotics. None of these strategies have any effect upon the persister cells.
Upon regrowth back to the normal active form, which occurs when the antibiotic is removed, the persister cells have no antibiotic resistance. By allowing sufficient time off of antibiotics to allow the reconversion back to the standard form, the more defenseless form of Lyme can be treated more efficiently. Such new knowledge may change the way Lyme disease is viewed and treated.
Choosing a specific treatment that is right for you requires an open and informed dialogue. Your doctor should cover the potential side effects and likely benefits of the different treatment options, as well as your goals and preferences.