Transcript Lyme Disease in Australia

Lyme Disease in
Australia
Nicola McFadzean, N.D.
Naturopathic Doctor
www.restormedicine.com
What is Lyme Disease?
• by definition, Lyme disease refers to an illness caused by the bacteria
Borrelia burgdorferi (and expanded to include other strains of
Borrelia such as afzelii, andersonii, garinii)
• traditionally thought of as a tick-borne illness but various modes of
transmission are possible (fleas, mites, lice, mosquitoes etc).
• research limited by suspicion of Lyme being passed sexually and
mother to baby in utero.
• Lyme disease also involves multiple infectious agents (co-infections)
• Traditionally thought of as not being in Australia but that is incorrect.
This raises major problem with getting adequate medical care.
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Identifying Lyme disease
The Great Imitator
– can mimic MS, ALS, Parkinson’s, fibromyalgia, chronic fatigue
syndrome, rheumatoid arthritis, autistic-spectrum disorders
(kids) etc.
• General – debilitating fatigue, insomnia, malaise, headaches,
dizziness/ lightheadedness
• Neurological – numbness, tingling, paralysis, Bells palsy,
burning/ shooting pain, motor neuron impairment, optic
neuritis, facial numbness
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• Cognitive – short-term memory loss, difficulty concentrating, lack of
focus
• Psycho-emotional – anxiety, depression, OCD, irritability
• Musculoskeletal – joint/ muscle pain – migrating joint pain typical;
muscle weakness, restless legs, stiff neck
• Digestive – nausea, irritable bowel, abdominal pain
• EENT – ringing in the ears, visual changes (blurriness etc), hearing loss
• Cardiac – palpitations, arrhythmias
• Genitourinary – pelvic pain, irritable bladder
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Co-infections & Lyme Disease
• While Borrelia might be the underlying infectious agent in
Lyme disease, there are other co-infections that may co-exist
with Borrelia.
• Most commonly - Babesia, Bartonella, Erlichia, Rickettsia.
• Mycoplasma, Chlamydia and Candida are other microbes
commonly present or out of balance in Lyme disease patients.
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• At least 80% of my patients in the U.S. carry at least one coinfection (based on labs and clinical picture); many Australian
patients are co-infected also.
• Babesia is a parasite, not a bacteria, so requires different
treatment options.
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Some hallmark symptoms of
co-infections
Babesia –
• night sweats, low grade fevers, temperature regulation
problems, shortness of breath/ air hunger, capillary angiomas,
ear ringing, blurry vision, anxiety, nausea, vivid or violent
dreams, hormone imbalance, vasculitis (red skin with white
splotches). Jaw/ head/ neck symptoms.
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Bartonella –
• severe joint pain, ice pick headaches, bowel problems, pain/
burning in the soles of feet, rib pain, abdominal pain, CNS
symptoms out of proportion to skeletal, OCD behavior/ severe
anxiety, straie on skin, subcutaneous nodules, scratches.
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Erlichia/ Rickettsia • knife-like headaches, severe muscle pain, low WBC, rapid
onset, neuro symptoms (seizures, shooting pains), tendon
pain, right upper quadrant pain.
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Diagnosing Lyme Disease
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Textbook presentation – tick bite, EM rash, flu-like illness.
Acute Lyme disease very different to chronic Lyme.
Chronic Lyme disease is predominantly a clinical diagnosis.
Labs are used to back up the clinical impression.
Australian labs may not be highly sensitive.
U.S. lab – IgeneX - specialty Lyme lab in California.
Tests for Lyme and co-infections.
Can have blood drawn in Australian and Fedex’d over.
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Types of tests
• ELISA – first test done as screening test. ELISA is measuring an
immune reaction but is not highly sensitive – most cases
missed. A negative ELISA test does not rule out Lyme disease.
Not a sensitive test.
• PCR – looks for DNA of bacteria in blood. Can do for borrelia
and all coinfections. Specific but not highly sensitive.
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• Western blot – looks at IgM (active, current infection) and IgG
(longer term, more chronic infection or past exposure).
• Certain bands are significant – IgeneX recognizes certain bands
that the CDC does not.
• Need a certain number of bands to be present to make a
positive result – but even one Lyme-specific band may indicate
infection (hence need clinical picture)
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• FISH tests – babesia and bartonella. These are smear tests
where they stain the sample and see the bugs glowing in the
dark!
• Antibody tests for babesia, bartonella, rickettsia, erlichia. IgG
and IgM.
• CD-57 – immune marker that is suppressed in Lyme disease.
Can be used to track progress of treatment over time, but not a
perfect science. Available in Australia/ do not run through
IGeneX.
* Running multiple tests increases the likelihood of making an
accurate diagnosis.
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Treating Lyme Disease
Three key points to be aware of when talking about treatment –
(1) Borrelia exists in three different forms – can morph from one
to another –
1. Spirochete
2. L-form (cell wall deficient)
3. Cyst form
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(2) Need to address co-infections – babesia, bartonella, rickettsia,
erlichia.
(3) Herxheimer reaction – when bugs are killed they release
neurotoxins which can cause a temporary worsening of
symptoms. Things can get worse before they get better. This
can influence greatly how gently or aggressively we can treat.
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Allopathic Treatment of Lyme
Disease
Acute Lyme disease –
• 6-8 weeks, if high enough doses and treatment started early
enough can eradicate infection.
• IDSA guidelines say 21 days is sufficient for all Lyme.
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Chronic Lyme disease –
• Need long term antibiotics – several months up to 2 years and
beyond.
• Need to combine antibiotics for different forms of Borrelia.
• May need IM or IV antibiotics, and/or various combinations of
orals.
• Meds chosen depends on patient sensitivity levels, allergies, coinfections, side effects
• Often higher doses needed than used for other conditions.
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Borrelia – need to address all three phases
Spirochetes
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Penicillins – amoxicillin, Bicillin (IM)
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Cephalosporins – ceftriaxone (IV), cefuroxime
L-forms
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Macrolides – azithromycin, clarithromycin
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Tetracyclines – minocycline, doxycycline
Cysts
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Metronidazole, tinidazole
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Plaquinil (hydroxychloroquine)
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Alinia
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• So may layer one medication from each group; start one at a
time, monitor effects and side effects; be aware of interactions.
• Example regimen – doxycycline, clarithromycin, Bicillin,
tinidazole pulse.
• Prioritize treating Borrelia first or coinfections first ?
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Babesia
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Mepron (atovaquone)
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Malarone (atovaquone plus proguanil)
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Larium
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Coartum
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Alinia
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Septra/ Bactrim
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Bartonella
• Doxycycline
• Rifampin
• Ciprofloxacin/ levaquin
• Septra/ Bactrim
• Zithromax (weak)
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Erlichia/ Rickettsia
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Doxycycline
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Rifampin
Mycoplasma
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Doxycycline/ minocycline
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Levaquin
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Role of Naturopathy in the
Treatment of Lyme Disease
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Holistic approach is important - simply hitting bugs over the head
with a hammer is not enough.
1. Boost immune function
2. Mediate inflammation
3. Antimicrobial – bug killing; synergism with
antibiotics or alternative for those who
cannot tolerate (or access) antibiotics
4. Supportive Herxheimer reactions
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5. Offsetting side effects of antibiotics
6. Adrenal support and hormone balancing
7. Provide symptom relief (pain, muscle
spasms, sleep issues, depression, energy etc)
8. Other issues – heavy metals, candida, GI
infections, mold toxicity, chronic viral
infections (herpes, EBV, CMV, HHV-6)
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1. Immune Function
• Want the body to be able to fight the infection itself.
• Avoid nutritional factors that suppress immune function such
as sugar.
• Transfer Factors – researched to boost NK cell activity. (general
and Lyme specific)
• Beta-glucans
• Colostrum
• Astragalus
• Mushroom extracts – reishi, shitake, maitake, etc.
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2. Mediate Inflammation
• Herbs – curcumin, white willow, holy basil
• Proteolytic enzymes – protease, bromelain, papain,
serrazimes.
• Essential fatty acids – often need 4-6 grams daily. Fish or flax.
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3. Antimicrobials
• Lyme – teasel, samento (cats claw), guaiacum, grapefruit seed
extract
• Babesia – artemisinin, cryptolepis
• Bartonella – Houttuynia (HH2 by Zhang)
• Parasites – black walnut, wormwood, clove, ginger, gentian
• Yeast – oil of oregano, pau d’arco, garlic, cinnamon, caprylic
acid.
• Others – olive leaf extract, colloidal silver
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4. Supporting Herxheimer
reactions/ detoxification
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Glutathione
Smilax glabrae (Chinese sarsaparilla)
Liver/ kidney herbs
Lemon juice in water
Epsom salts baths
FIR sauna (with caution)
Lymphatic drainage massage (with caution)
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5. Offsetting side effects of
antibiotics
• Candida overgrowth – prevention with probiotics – 100 billion
live organisms daily, give before bed, at least 2 hours after last
dose of antibiotics or antimicrobial herbs.
• Saccromyces boulardi can be used in conjunction.
• Liver and kidney function – monthly labwork. Herbs such as
dandelion, milk thistle, burdock, schisandra. Do not give milk
thistle to a patient taking Mepron or Malarone (reduces
efficacy)
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6. Adrenal support and hormone
balancing
• Adrenals under major stress – assess using salivary testing
throughout the day.
• Herbs – rhodiola, ginseng, ashwaghanda. Balancing better
than stimulating.
• Hormone precursors – DHEA, pregnenolone
• Reproductive hormone support – maca, black cohosh (good
for bladder irritability also), progesterone, testosterone.
• Hormones often get out of whack especially in Babesiosis.
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7. Symptom relief
• Pain – herbal anti-inflammatories and proteolytic enzymes
• Nerve pain relief – St John’s wort, lemon balm, Jamaica
dogwood
• Energy –
• Adrenal support, thyroid support (iodine and tyrosine)
• Mitochondrial support – CoQ10 (not with Mepron or Malarone),
NADH, NT factor, carnitine, keto-glutaric acid.
• Ribose
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• Sleep – 5-HTP, melatonin, valerian, lemon balm, passion flower,
chamomile, L-theanine
• Muscle spasms – magnesium, malic acid, potassium
• Depression – amino acid therapy can be helpful –
• Tyrosine – energizing for the brain, also support thyroid
• 5-HTP – supports serotonin, calming, helps depression
• GABA/ L-theanine – good for anxiety/ OCD
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8. Other issues
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Heavy metals
GI infections
Mold toxicity
Chronic viral infections (herpes, EBV, CMV, HHV-6)
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Nutrition and Lifestyle Factors
• Drink 2L daily of clean, filtered water – helps to
flush out waste material
• Reduce foods that cause inflammation – gluten,
dairy, any foods with IgG intolerance
• Diet should comprise mostly of lean, organic
proteins, fruits and vegetables, healthy fats such as
olives, avocado, coconut, flax oil
• Ensure adequate fiber to sweep/ detox bowels –
flax seed, psyllium
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• Minimize sugars, caffeine and saturated fats
• Sleep – maximize sleep before midnight
• Exercise – some gentle exercise is good, but not so
much that it wears the person out or increases pain/
fatigue in following days. Stretching, pilates,
swimming, walking.
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CONCLUSION
• Lyme disease does exist in Australia.
• Lyme disease is complex and multi-factorial.
• Co-infections are important – missing those can hamper
recovery.
• Effective treatment involves so much more than hitting bugs
over the head.
• Natural medicine and a holistic viewpoint very valuable.
• Recovery is slow and steady, but much improvement is
possible!!
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