As a holistic MD I endeavor to get to the root causes of illness.
I attract many patients who suffer from chronic illness; an archetypal patient who has come to see me over the years suffers from chronic fatigue, chronic muscle and joint pains, abdominal distress, anxiety, depression and problems with memory and concentration. He or she has usually been to many other doctors and in most cases the lab tests come back as normal. They are told they have depression and/or fibromyalgia and offered antidepressants, which, if they try, often make them feel even worse.
But when I evaluate them the vast majority of the time I discover they have chronic Lyme Disease and almost always co-infections such as Babesia, Bartonella and Mycoplasma. While these are not easy to treat, they can be treated and these people can be restored to good health.
I have looked for an article that provides a good overview of Lyme and Co-infections to recommend to my patients but I have not been able to find any that I really like, so I finally decided to write it myself; here it is!
Few topics in medicine are more controversial than Lyme Disease. There is a major split within the medical profession.
The mainstream view is that Lyme Disease is not all that common, easy to diagnose and easy to treat.
While it is true that if someone receives adequate treatment within a few days of contracting Lyme they can usually be cured with a few weeks of antibiotics (though unfortunately many doctors fail to adequately treat acute Lyme; Lyme specialists advise Doxycycline 200 mg 2x/day for 20-30 days; some doctors give a single dose!), the mainstream view is that even chronic Lyme can be cured with six weeks of antibiotics and, unfortunately this is almost never the case.
The alternative perspective, held by most “Lyme-literate doctors” (doctors with extensive knowledge and experience in treating Lyme) is that Lyme Disease is much more common than most doctors realize and requires a complex nuanced multi-faceted approach to treatment. However, there is also a split amongst Lyme-literate docs, as some believe that intensive and prolonged use of antibiotics are necessary to treat chronic Lyme while others (such as myself) believe that antibiotics tend to do more harm than good and the best treatments involve herbs, nutritional supplements, homeopathy and other natural therapies.
Here is an excellent article from The New Yorker about “The Lyme Wars” between conventional and alternative medicine:
Lyme disease is extremely common. The CDC reports that there are 300,000 new cases of Lyme disease in the US each year (some doctors believe that this is a vast underestimate). 40% of these people develop long-term health problems. That means there are millions of people in the US with chronic Lyme. It is well-known that Lyme disease is often transmitted by ticks but less than half of those with proven Lyme recall ever being bitten by a tick. Undoubtedly some of those people were bitten by a tick and did not know it, as the ticks that transmit Lyme can be as small as a poppyseed, bite someone and leave without them ever noticing it, but there is good evidence that Lyme can be transmitted by stinging flies, mosquitoes, spiders and other insects. While not acknowledged by authorities, there is evidence that Lyme can also be sexually transmitted, and some babies whose mothers have Lyme are born with congenital Lyme.
Fortunately, not everyone who is bitten by a tick becomes infected. Only some types of ticks carry Borrelia burgdorferi, the bacteria that causes Lyme; the main culprit is the deer tick, known as Ixodes scapularis (the main type in the Eastern and north-central US) and Ixodes pacificus in the West. Not all of these ticks carry Lyme. The longer the tick is attached the more likely it will transmit it. It is thought that ticks are unlikely to spread it unless attached at least 24 hours, but there are rare cases where it appeared to be transmitted within an hour
(towards the end of this essay I have added a section on what to do if you are bitten by a tick).
If a tick bite has caused Lyme (and/or co-infections as discussed below) they will most likely experience mild-flu like symptoms within a few days such as general achiness, headache and low-grade fever. It is typical for there to be some redness in the area around any tick bite, whether it carries infection or not, but a classic sign of Lyme disease is Erythema migrans, the bullseye rash. This rash has a red central area, then a clear area and then a ring around that. If this is present it is a certain sign of Lyme infection. However, less than half of those proven to have Lyme have noticed this type of rash, and some Lyme specialists now believe it only occurs in those who were already infected with Lyme and have been exposed again! So if it is present you can be sure you got infected, but its absence is not a sign that you were not infected.
Perhaps the main reason there is so much controversy about Lyme is that there is no definitive test that proves someone does or does not have Lyme at any given time. The most commonly used screening test misses over half the cases and a more definitive test, the Western Blot, also misses a high percentage of cases. The largest national labs, Quest and LabCorp do a incomplete version of this test that misses many cases, for no good reason. The best version of the Western Blot test is offered by IgeneX in Palo Alto, CA. But this test still misses at least 20% of cases as it is looking at out bodies’ immune response to Lyme and those who are very sick with Lyme have a suppressed immune response so, ironically, those who are most ill from Lyme have the poorest chance of a lab test being positive. However, a new type of test, the EliSpot test, shows potential to be the most sensitive Lyme test yet.
As poor as Lyme testing is, testing for Babesia and Bartonella is even worse as there are at least 20 strains of each and there are only tests for 2 or 3 of these strains.
But Dr. Dietrich Klinghardt has a new technique that involves collecting a urine sample after deep tissue massage and/or ultrasound and looking for evidence of microbes in the urine. Again, this techniques holds great promise.
For a good overview on various tests for Lyme and co-infections see http://www.betterhealthguy.com/lyme/testing
For more information from IgeneX see
The cause of Lyme disease is the bacteria Borrelia burgdorferi. While Borrelia burgdorferi was not discovered until 1982 by Dr. Willy Burgdorfer, there is evidence that the 5,300-year-old ice mummy dubbed Ötzi discovered in the Italian Alps was infected with this bacteria.
However, not everyone infected with Borrelia bacteria develops Lyme disease.
Some who become infected get few if any symptoms while others become completely debilitated, with a huge range of symptoms and severity in between. Lyme is sometimes called the great imitator because it can infect every organ and cause virtually any symptom, thus mimicking just about any disease. As to why the symptoms are so variable in type and severity, it depends on many factors. There are many different strains of Borrelia bacteria and some are more virulent than others.
One of the leading authorities on Lyme, Dietrich Klinghardt MD PhD states that in Bavaria he knew a medical school professor who could guess which valley a Lyme patient came from based on their symptoms, as each valley had a different strain producing distinct symptoms.
The Lyme bacteria has the most complex genome of any known bacteria. Strep bacteria has 8 genes, Syphilis has 27 genes but Borrelia has over 800 genes.
Of course these days there are conspiracy theories about everything and some believe that that the natural Borrelia bacteria was genetically modified to become a biological warfare agent and escaped the lab (the purported site of this is Lab 257 on Plum Island in Long Island Sound which is a mile from Lyme, Connecticut, where the first outbreak was reported. Deer, which often carry infected ticks, are known to swim between Plum Island and the shoreline of Lyme, CT).
There are also differences in our own genetics, with some individuals being much more susceptible to Lyme than others. There is a genetic test called HLA-DR that can determine, in part, susceptibility to Lyme:
But the biggest difference is the presence of co-infections, our toxic load and stress.
If someone who has good genetics and otherwise good health is infected with Borrelia they may have virtually no symptoms. They may have some Borrelia persist in their bodies but essentially peacefully co-exist with it. I would say someone like that, while having Lyme infection, does not have “Lyme disease”.
(PS, a very common mistake made not only by patients but doctors is to call it “Lyme’s Disease; the proper term is Lyme, not Lyme’s.)
The sicker someone is, the more likely they have genetic susceptibility to Lyme as well as co-infections of Babesia, Bartonella, Mycoplasma and Anaplasma, intestinal parasites, intestinal yeast overgrowth, intestinal dysbiosis, chronic viruses such as Epstein- Barr Virus, heavy metal toxicity (and toxicity with aluminum, a light metal), toxicity with pesticides and herbicides such as Round-Up, mold toxicity, sensitivity to electromagnetic fields etc. Also, those who have high levels of stress are much more likely to suffer serious symptoms.
Thus, those who are infected with just the Borrelia bacteria are unlikely to be nearly as ill as those who have co-infections as well, which is why I prefer the term Lyme-Related Complex to Lyme Disease. In most cases the co-infections cause more symptoms and problems than the Lyme bacteria, but the Borrelia bacteria suppresses the immune system and makes it more difficult for our bodies to handle these other infections, so it acts as an enabler for these other infections.
Lyme and Lyme-Related Complex can be the ultimate cause of virtually any symptom; it is sometimes called the great imitator. But the most common symptoms are fatigue, muscle and joint pains and neurological symptoms including “brain fog” (problems with memory and concentration), trouble finding the right word, variable vision and tingling and numbness. It can trigger auto-immune disease so anyone with a diagnosis like Lupus or Crohn’s Disease or Ulcerative Colitis should be evaluated for this. Dr. Klinghardt has found that virtually every patient with Multiple Sclerosis, ALS (Lou Gehrig’s Disease; it is interesting that Lou Gehrig lived near Lyme, Connecticut, where the first outbreaks were reported), and Parkinson’s Disease that he has seen in recent years has LRC. This does not mean that Lyme and co-infections are THE cause. Most with LRC, fortunately, do not get these syndromes, but these microbes may trigger them in those with genetic predispositions, a history of certain types of trauma and toxic exposures. There is also evidence that LRC is often a causative factor in Alzheimer’s Disease.
Treating Lyme-Related Complex (LRC) successfully requires a very nuanced holistic approach, in fact I know of no other illness that demands such a multi-faceted approach. An analogy I have thought of is that treating LRC is like a game of pick-up sticks. You have to carefully treat it in just the right order or you might create a major disruption. Another analogy is by my colleague Wayne Anderson ND who compares treating LRC to a game of chess. We (the doctor and patient) makes a move, then it makes a counter move, then we have to make another move etc. etc. It is a moving target and treatments often have to be adjusted.
The mistake most doctors make is to assume it can be treated like other infections; just give antibiotics and that will take care of it. The reason antibiotics generally don’t do the trick (other than in the earliest stages) is that the Lyme bacteria is very adaptable. As mentioned, Borrelia burgdorferi has the most complex genome of any known bacteria; if you could ascribe intelligence to a bacteria it is the most intelligent bacteria known and has many ways of eluding our immune system, as well as eluding antibiotics. It is also pleomorphic bacteria, which means it can shape-shift. While it is commonly considered a spirochete (which means corkscrew shaped) it can convert to something called the L-form, which can exist inside our cells without a cell wall. This is significant because most antibiotics work by attacking the cell wall, but since Borrelia can exist without a cell wall most antibiotics will be ineffective against this form. Also, it is more difficult to get therapeutic levels of antimicrobials inside the cell than in blood and other extracellular fluids. And if you find a way to destroy the L-form it can then convert into the cyst stage. The cyst stage is inactive, sort of like circling the wagons to wait out an attack. The cyst stage is impervious to antibiotics, hydrochloric acid and temperatures of 600 degrees. Thus, even the most aggressive Lyme treatments will do no more than convert Borrelia into the cyst stage. With our current technology we can not eliminate the cysts. However, once all Borrelia is in the cyst stage it will not cause illness, so my goal is to kill as many as we can and drive the rest into the cyst stage and keep them there. Thus patients can be clinically cured, but must maintain a healthy diet and lifestyle and keep their immunity strong so the cysts do not convert back to active forms.
While it appears to be impossible to fully eradicate Borrelia bacteria from the body, it IS possible to fully eradicate co-onfections like Mycoplasma, Bartonella and Babesia (usually in that order) and when those are eliminated it is much easier for our immune systems to keep the Borrelia in check.
Thus, my general approach to treating Lyme disease is what I call “the indirect approach.” I will enumerate the components of this here:
A crucial aspect of treatment involves DETOXIFICATION of metals, other common environmental toxins like pesticides and herbicides (esp Roundup, as this omnipresent herbicide causes our bodies to absorb much more of the aluminum in our food), phthalates and other plastics, PBB’s, dioxins, fire retardants etc.
It is also important to detoxify the microbial toxins produced by Borrelia and co-infections, discussed further below.
TREATING both tick-borne CO-INFECTIONS like Babesia, Bartonella and Mycoplasma, and chronic viral infections like Epstein- Barr and HHV 6, treating intestinal (and systemic) parasites and imbalances of intestinal flora including candidiasis (yeast overgrowth) and dysbiosis including infections like Helicobacter Pylori, as well as other infections like chronic sinusitis; I primarily rely on herbs for this but IV vitamins and IV ozone can also be very helpful.
Once the co-infections have been treated we can focus on treating Borrelia directly.
HEALING “LEAKY GUT SYNDROME” or increased intestinal permeability caused by intestinal infections, many pharmaceuticals and food allergies;
healing the gut is a key strategy in reducing inflammation; inflammation is central in the symptomatology of Lyme so reducing inflammation may be the best way to improve symptom.
AVOIDING ALLERGENIC FOODS: Most with LRC need to avoid gluten for awhile, and many need to avoid dairy, soy and other common allergens.
Eating a NUTRITIOUS DIET based on organic unprocessed vegetables, nuts and fruits and quality protein while minimizing sugars, simple starches, fried foods and unhealthy oils and avoiding GMO’s.
JUDICIOUS INDIVIDUALIZED SUPPLEMENTATION, such as a high-quality multivitamin and extra Vitamins C and D and omega 3 fatty acids. Many with LRC have a metabolic imbalanced induced by Lyme called pyroluria that results in need for high amounts of zinc and Vit. B6. This is often a missing piece of the puzzle and the reason some who have undergone intensive therapies for Lyme have experienced little benefit.
for a thorough discussion of pyroluria.
AVOIDING ENVIRONMENTAL TOXINS: we live in a very toxic world. Many common household objects contain and emit chemicals such as VOC’s (volatile organic chemicals) and most personal care products and household cleaning products contain toxic chemicals.
Additionally many homes and offices contain mold, often hidden. Mold toxicity can cause most of the same symptoms as LRC. If someone with LRC is regularly episode to mold they will not get better until that is addressed.
A nearly omnipresent and insidious toxin is the electromagnetic fields (EMF’s) produced by electronics, such as the laptop I am typing on, cell towers, cell phones, wi-fi and “smart meters”. Many Lyme patients are very adversely affected by these frequencies and do not realize it. One of the most common symptoms of EMF sensitivity is insomnia, and lack of adequate sleep worsens all symptoms and prevents a meaingful recovery. Minimizing exposure can be a crucial aspect of recovery though is easier said than done.
ADDRESSING anxiety, depression and past hurts, griefs, anger and resentments, what many call “UNRESOLVED EMOTIONS.” While LRC can cause anxiety and depression, those need to be addressed, as being depressed is not only very painful but interferes with our ability to heal. Counseling, treatments like biofeedback, Emotional Freedom Technique, EMDR and hypnosis can be very helpful, and constitutional homeopathy can be miraculous.
STRUCTURAL WORK from a good bodyworker can help relieve pain, improve the flow of energy in the body and help to resolve past emotional traumas.
ENERGETIC MODALITIES such as homeopathy and acupuncture are also very helpful. Some cases of LRC have been cured primarily by homeopathy!
Some of the main toxins that need to be cleared in treating LRC are microbial toxins, that is toxins produced by the Borreiia bacteria as well as co-infections. In fact most LRC symptoms are caused by these toxins and the inflammation they induce. I tell my patients that if I had a magic wand that could instantly remove all the unfriendly bacteria from their bodies they might not feel any better because what is causing their symptoms are the toxemia produced by the microbes. Likewise, if I could remove all the toxins and not kill amy microbes they would likely feel almost 100% better (and with the toxins removed our immune system could do a much better job of fighting these infections and keeping them contained).
When we use antibiotics or herbs (or ozone or electromagnetic fruquencies) to kill microbes they die, releasing more microbial toxins into our bodies. The official name for this is a Jarisch-Herxheimer reacton, more commonly called a Herx reaction or herxing but even more commonly called a die-off reaction. These reactions can be quite severe; extreme fatigue, brain fog, headaches, sort of like the worst hangover you’ve ever had.
One of my mottos is that you never want the treatment to be worse than the disease so it is generally important to focus on detoxification of microbial and environmental toxins and supporting the detox pathways before focusing on killing microbes, and to introduce anti-microbial agents slowly and gradually increasing the doses. Many doctors make a huge mistake in pushing antimicrobial agents while the patent is still too toxic.
The doctor who first taught me about LRC (at workshop in 2002) is Dietrich Klinghardt MD PhD, one of the most brilliant people I have ever met, and his approach to Lyme is still my greatest influence.
Dr. Klinghardt recently stated that “right now the modern thing in our medicine is everybody has Lyme disease or everybody has chronic fatigue and viruses and if you can bring to the table a powerful accurate method of metal detox then these chronic infections become almost irrelevant, they become smaller items than they seem now and people do so much better if you do Lyme disease treatment while also addressing the metals; people with chronic fatigue do so much better taking the metals out along with antiviral strategies.”
Dr Klinghardt has observed that most with LRC have particularly high levels of aluminum and that toxicity with RoundUp, the ubiquitous herbicide found in high levels in many GMO foods, but which contaminates even organic foods, causes our bodies to absorb much more aluminum from our diets and thus measures to reduce the amount to RoundUp in our bodies can be an imporrtant step in detoxing metals. Another common metal in those with LRC is mercury. Many may have mercury residues from childhood vaccines, though since the early 2000’s most mercury in vaccines was replaced with aluminum, which is nearly as toxic, but mercury is still used in some vaccines, esp. most flu vaccines.
Many still have mercury residues from amalgam (silver-colored) fillings, even if those fillings have been removed (Dr. Klinghardt will not see a patient until they have had all of their amalgams removed as he feels people can not fully heal until that is done). Mercury is also commony found in seafood, though some (such as wild salmon, shrimp and sardines) have only trace amounts whie other types such as swordfish and most tuna have fairly high levels. Dr. Klinghardt has also observed a crucial connection between unresolved emotions and metal toxicity, with emotional healing playing a critical role in helping us to release toxic substances.
Testing for heavy metal toxicity is problematic but a new test called an OligoScan is quick and non-invasive and shows tissue levels of essential minerals like magnesium, zinc and chromium as well as heavy metals.
There are a variety of strategies for detoxing heavy metals.
One of the best is saunas, as sweat has lots of metals as well as other toxins like pesticides.
One final thing I want to mention is that Byron White, a naturopath who has created some powerful herbal formulas for LRC, notes that there is a certain type of energy associated with each disease (of course this is also observed by homeopaths) and he has observed that the energy around LRC involves an unfortunate lack of empathy on the part of friends, family and most health care practitioners. People with LRC often don’t look sick even if they feel terrible. When someone is suffering from LRC, instead of getting much-needed support from loved ones they are often told something like “sorry you’re sick, give me a call when you’re better.”
This is, of course, not conducive to healing.
WHAT ABOUT RECENT TICK BITES?
A common question is what to do if you have been recently bitten by a tick.
PLEASE NOTE: Even if you already have Lyme a new tick bite can be a threat. One can become newly infected with a different strain of the Lyme bacteria and/or get new co-infections.
The best way to remove the tick is to have a special tool to remove ticks but, if like most people, you do not have one, try to grab the tick as close to its mouth as you can with tweezers and pull it straight out- no twisting, and do NOT try to apply heat or Vaseline or anything else as that often irritates the tick and increases the odds of getting infected!
It is ideal to identify the tick. See
While other types of ticks can spread other infections, Lyme is primarily spread by Deer ticks.
The longer the tick has been attached the greater the risk of infection. If it has been attached less than 24 hours the odds of infection are relatively small.
It is normal to get redness around the site of the bite, even if not infected. If infected you will likely get mild flu-like symptoms such as headache or achiness within a few days. The famous bullseye rash can take a few days to appear but may not appear even if you are infected. One can send the tick to a lab such as IgeneX and have it tested not only for Lyme but co-infections, but if you think you have been infected do NOT wait for those test results, as the sooner you start treatment the better.
Even if the tick comes back as positive for Lyme or co-infections it does not mean that you got infected! If it was not on for very long, not engorged and you feel fine no treatment may be needed (though Ledum and Astragalus might be prudent no matter what- see doses below).
The best treatment is Doxycycline 200 mg 2x/day with food for 21-30 days, but, while effective for Lyme, Ehrlichiosis, Anaplasma and Mycoplasma may not protect against Babesia and Bartonella. I advise also taking the homeopathic remedy Ledum Pallustrum 1M as a single dose then 30c twice a day for 2 weeks, Andrographis 400 mg 3x/day and Japanese Knotweed 300 mg 3x/day, as well as a good probiotic. Renowned herbalist Stephen Buhner advises “astragalus – 3,000 mg daily for 30 days, 1,000 mg daily thereafter, indefinitely. Also: using a paste made of andrographis tincture mixed with green clay, the paste applied on the tick bite area can often prevent an active infection.”
One way to get a quick determination of whether you were infected is to find a doctor who does Autonomic Response Testing (also known as muscle testing). These tend to be Lyme-literate holistic/integrative MD’s/DO’s/ND’s and chiropractors.
It may be difficult to find a doctor willing to write a prescription for appropriate doses of doxycycline. Contacting ILADS (the International Association of Lyme and Associated Disease Specialists can let you know about Lyme specialists in your area, though many doctors who know how to treat Lyme (such as myself) are not members.
This is a bit longer than I intended so rather than write a book I will give you some resources for further study.
If you search online for information about Lyme you will find thousands of sites, much of which is incorrect as there is a tremendous amount of misinformation.
I can not recommend the website http://www.betterhealthguy.com highly enough.
It is the only website you need. It was created by Scott Fosgren, a LRC patient who, in his search for effective treatments became a professional journalist reporting on LRC. There is a world of information on this site that would take several weeks to read, but to orient you I esp. like the sections on testing (linked where I discussed testing), the articles he has written for publications like the Townsend Letter such as
and the section called Blog
Scott performs the incredible service of going to just about every cutting-edge conference on LRC and taking great notes that he presents in easy-to-digest bullet point form, so you can benefit from the latest expertise of the top practitioners in the field.
Here is a link to one recent great post:
There are a growing number of books about Lyme. I particularly recommend the books of Stephen Buhner, the leading herbalist in this field, especially Healing Lyme (make sure to get the second edition) and
Healing Lyme Disease Coinfections: Complementary and Holistic Treatments for Bartonella and Mycoplasma
and Natural Treatments for Lyme Coinfections: Anaplasma, Babesia, and Ehrlichia
I also highly recommend
New Paradigms in Lyme Disease Treatment: 10 Top Doctors Reveal Healing Strategies That Work by Connie Strasheim with chapters by Dietrich Klinghardt, Wayne Anderson, David Jernigan and 7 other leading practitioners.
This is a lot of information to digest but, whether you are just learning about LRC or have been struggling with it for years, I hope you will find it helpful.
PS My blog posts tend to be works in progress. I have already added an expanded discussion of symptoms of LRC, expanded on the way Borrelia changes forms and the emotional impacts of LRC and will probably be doing further fine-tuning and adding new links. so feel free to check back here for new information.
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Most people think all doctors are rich, but I make less money than any doctor I know (despite the fact that I am fully booked 2-3 months in advance) as I spend so much time with my patients, strive to keep my rates affordable and see many people who are on Medicare, whose fees do not even cover my overhead. I do not own a house, live in a tiny rental and drive a 12 year-old used car. I exhausted most of my savings when my wife was terminally ill for 2 years.
I did not create this blog for fiscal rewards but I believe that it is good karma to give out a bit of positive energy in exchange for valuable information, so again, any donations would be truly appreciated. Money I receive will be used for continuing medical education, buying equipment to help my patients and subsidizing care for those who are indigent.
Thanks and Blessings,
Randy Baker MD