Lyme disease: We've been hearing about it a lot lately, on the news, online, and from friends.
That's because the disease has spread rapidly across the country in recent years. The number of counties in the U.S. reporting a high incidence of Lyme has surged by 320 percent since the '90s. And the CDC suggests that the number of Lyme disease cases may be 10 times higher than the officially reported number, with an estimated 300,000 incidences each year in America.
Lyme is often called "The Great Imitator" because its symptoms can mimic many other diseases, including fibromyalgia, chronic fatigue syndrome, multiple sclerosis, and dementia. (In fact, some researchers have questioned whether Lyme could actually be a trigger for some of those diseases.)
Sadly, partly for this reason, people with Lyme are frequently misdiagnosed. And those struggling with chronic Lyme are often told that it's all in their head, or that they're simply "just depressed."
As a functional medicine practitioner, here's what I wish more people knew about Lyme disease:
What Is Lyme Disease?
Lyme disease is the most common tickborne infectious disease in the U.S., according to the National Institutes of Health.
It's a bacterial infection: the Borrelia burgdorferi bacteria is transmitted to humans when they're bitten by an infected tick. These parasites are often so tiny that most people don't see them or even notice the bite. Depending on where you live it could be:
- An infected blacklegged tick or deer tick, in the northeastern and central U.S.
- An infected western blacklegged tick, on the West Coast of the U.S.
- An infected sheep tick, in parts of Europe.
In acute Lyme, within about a month of a bite, the symptoms may include:
- Flu-like symptoms including fever, hot flashes, and chills
- Joint pain
- Back pain
- A red "bull's-eye" rash may appear
In mainstream medicine, a patient who exhibits these symptoms will likely have lab work done to confirm the diagnosis. The standard treatment is then antibiotics, and it's believed that most of those infected will recover within a few weeks.
But in some cases, symptoms can persist. In mainstream medicine, the idea that these symptoms are due to a persistent infection is controversial, and "chronic Lyme syndrome" is largely unrecognized. Still, some functional medicine doctors and organizations, such as the International Lyme and Associated Diseases Society (ILADS), insist that chronic Lyme is a growing problem, and one that should be recognized. Some of the recurring symptoms post-treatment might include:
- Severe fatigue
- Muscle and joint pain that moves around the body
- Severe brain fog
- Mood swings
- Anxiety attacks
So why might Lyme be so hard to detect and recover from, even after antibiotics? Here are three main theories:
Problem 1: Lyme is one smart bug.
Research suggests some surprising reasons why Lyme is so hard to detect and kill off. Lyme bacteria actually suppresses our immune system, which allows it to hide and grow stronger. Lyme also seems to have the ability to "cloak" itself, making itself invisible to our immune system.
Borrelia is so smart that some research suggests that when it senses it's being attacked it can change to a dormant state, allowing it to live and survive antibiotics. Other studies suggest that Borrelia can undergo gene mutations that make it resistant to various antibiotics.
Problem 2: Diagnosis is difficult.
Only about half of all Lyme patients actually remember getting a tick bite. Plus, the classic "bull's-eye" rash that people associate with Lyme may not appear in all cases. And some research suggests that conventional Lyme tests may not be sensitive enough for diagnosis, especially during the later stages of disease. False-negative results can also be common.
Problem 3: Conventional treatment may not be enough.
The conventional approach to Lyme typically includes 10 to 28 days of antibiotics. Then what? Well, nothing. The problem with this is that some research suggests that as many as 25 percent of patients with Lyme disease still have some symptoms long after antibiotic therapy.
A Functional Medicine Approach to Lyme
As a functional medicine practitioner, my approach to Lyme is different. Here's what I recommend:
1. A careful health history.
I start by asking a lot of questions about your health history. In fact, so much so that one patient asked me if I was in the KGB. No, ma'am, just want to get to the root issues of what you're experiencing! Consider a free webcam or phone evaluation with my health center to get the conversation started.
2. Comprehensive labs.
It's important to catch Lyme as early as possible so it doesn't become chronic. In addition to using the two conventional tests accepted by the CDC, Elisa and Western Blot labs, I also often screen clients with these labs:
- CD57+/CD8-Absolute count: At this point, we believe that only Lyme bacteria will depress the CD-57. So someone with a high CD-57 is probably sick with something other than Lyme.
- C4a: This is another blood test to assess the immune system. Chronic Lyme disease could be associated with increased levels of C4a.
We might also consider other tests to dig a little deeper.
3. Support healthy biofilms.
Biofilm is a thin, slimy film of bacteria that adheres to a surface. Biofilms are not bad in themselves. Biofilms are just a way that bacteria colonize. It's the composition of the biofilm that makes it probiotic or pathogenic. Functional medicine's goal is to promote a healthy biofilm through foods, lifestyle changes, and natural medicines. Some natural biofilm-modifying tools I might recommend include:
- Colostrum/Lactoferrin supplements: Lactoferrin inhibits pathogens and promotes healthy biofilms.
- Probiotics and prebiotics: These promote probiotic balance.
- Enzymes: These break down biofilm.
- Xylitol: This is a natural anti-biofilm.
- EDTA: This is a strong anti-biofilm.
I recommend talking to your health care practitioner about what might help support your health.
4. Address microbiome issues.
At least 70 percent of our immune system is in our GI tract, and the microbiome is a foundational part of immune health. Addressing any underlying gut dysfunctions, such as candida overgrowth, could help to strengthen the immune system to fight off infections.
5. Integrate natural medicines.
I typically suggest blends of immunity support, such as Siberian ginseng, samento, sarsaparilla, guaiacum, astragalus, resveratrol, and cat’s claw. One study also suggests that stevia could be as effective as antibiotics in treating Lyme disease.
6. Consider antibiotics.
Some functional medicine practitioners will suggest conventional antibiotics to reduce total bacterial load. For example, ILADS recommends 100 to 200 mg of doxycycline twice daily for a minimum of 20 days for all tick bites where there is evidence of tick feeding.
7. Address any co-infections.
I also test my patients for viruses such as EBV (Epstein-Barr virus), HSV 1&2 (Herpes simplex viruses 1&2), HHV-6 (Human Herpes virus), as well as CMV (Cytomegalovirus). These viruses can put more stress on the immune system. In my clinic, I find that olive leaf, larrea tridentata, bee propolis, Melissa officinalis, L-lysine, zinc, and vitamin C can be good antiviral support options.
8. Support gene weaknesses.
There are genes that could predispose certain people to chronic infections. I recommend looking for methylation gene changes like MTHFR mutations and supporting the body’s methylation and detoxification pathways.