Lyme (Borrelia species) and its Co-Infections
Testing for Lyme isn’t as straightforward as we would like it to be due to the inaccuracy of some of the lyme tests. The inconsistencies are partly related to the tricky nature of the lyme bacteria as it can hide out in different tissues and may not be present in the blood at the time of testing. Despite these testing issues we do the best that we can and use companies that we think provide the most reliable data possible until newer and more advanced testing is on the market. The most common test we use at EVND is the IgM Western Blot and IgG Immunoblot for the most common species Borrelia burgdorferi. There are other Borrelia species that are starting to become more prevalent so expansion of testing additional organisms may be necessary if the initial Lyme testing returns negative. We often have our patients complete the Horowitz Lyme Symptom Checklist as it has been used in research to show its correlation with those who do test positive for Lyme disease.
Most common Co-Infections:
The infection Borrelia Burgdorferi, also known as Lyme disease, was once thought to isolate to the northeastern portion of the United States. It is now known to have spread, and has been diagnosed in the southwestern states, and is now epidemic in parts of Europe and China. Lyme has been a disease of great mystery due to the multiple forms and locations it may hide within the human body. Its effects are wide-ranging, from systemic pain to central nervous system effects, and thus, has been labeled the” great imitator.” Adding to the confusion and difficulty, diagnosis of Lyme disease is not so straightforward. This is probably the reason that modern medicine has failed, and continues to fail, to recognize and treat Lyme disease. In essence, testing of active Lyme disease produces positive results less than half the time.
The inability to accurately assess, and determine the degree of Lyme effects on a single individual, has led to great confusion, even among prominent researchers and clinicians, in how best to treat the disease. Although testing accuracy has improved, Lyme disease is complicated significantly by other immune influencing factors that have, in recent years, just come to light. For example, we now know that ticks, mice, and even mosquitoes are found to carry Lyme disease. In addition, many other infectious agents are co-inhabiting and are passed simultaneously with Lyme disease. These infections include other bacteria, viruses, and even parasites.
Therefore we have two types of Lyme-infected patients presenting in our East Valley Naturopathic Doctors Clinic. Lyme can cause acute symptoms, as can many other infectious agents such as bacteria, virus, parasites, and fungi or yeast. These patients present with new-onset symptoms within days, weeks, and perhaps a few months of exposure to Lyme disease. The other group of patients we most often see have been infected sometime in the past. They may have had some degree of acute symptoms, but they were not sufficient to seek medical help or were misdiagnosed as a mild respiratory infection or Influenza virus. More than 50% of Lyme patients do not recall seeing a bulls-eye rash distinct to acute infections. What can complicate this picture, even more, is that an old infection might have lain dormant for decades, only to be awakened or intensified by a new exposure to mold, viral or bacterial infection.
The most common form of lyme has been Borrelia burgdorferi sensu lato complex, however there are over 2 dozen species of borrelia that have been discovered at this time. Prevalence of ticks were predominantly in the Northeast and Upper midwest but have been migrating and now found in 43 states. The CDC estimates more than 300,000 people are diagnosed with Lyme each year. Lyme can be injected into the body by a bite of an infected Blacklegged tick (Ixodes scapularis), through blood transfusions and an infected mother who unknowingly passes it to her child in utero.
The following are just some of the common symptoms that can be associated with a chronic lyme infection:
- Cognitive dysfunction, meaning poor memory, severe brain fog
- Headaches and neck stiffness
- Migratory muscle and joint pain
- Neuropathic symptoms: nerve pain, numbness, hot/cold sensations, tingling
- Depression and anxiety
- Gastrointestinal symptoms
- Palpitations, chest pain or shortness of breath
Most Common Bartonella Species:
- Cat scratch or bite
- Tick, fleas, sand fly bites or mosquitoes
- Vertical transmission (Passing infection from mother to baby during pregnancy)
- Body lice, ticks and fleas
- Day sweats
- Anxiety, severe depression
- Pain: Muscle, joint, headaches, soles of the feet
- Severe cognitive dysfunction
- Swollen lymph nodes: cervical, axillary
- Skin: Striae, acne
- Neurologic symptoms of numbness or sharp, shooting or burning pain, abdominal pain
- Bladder symptoms of pain, urgency or burning, IC
- GI: GERD, diarrhea, constipation
- Fever of unknown origin
Most common Babesia species:
Babesia microti, Babesia duncani
- Blood transfusions (https://www.ncbi.nlm.nih.gov/pubmed/12430672)
- Vertical transmission- From mother to child during pregnancy (https://wwwnc.cdc.gov/eid/article/18/8/11-0988_article)
Common Symptoms in chronic exposure:
- Temperature dysregulation (extreme sweating that can alternate with chills)
- Night sweats especially
- Poor cognition
- Depression and anxiety
- Air hunger
- Dysautonomia: POTS, irregular heart racing
- Chest pain
It is also very likely, as I will explain later, that a combination of viruses, bacteria, fungi, and even parasites having been kept in check, but, due to reasons still too complex for immunology to understand, they have become reactivated. One example is the patient who has a history of Mononucleosis or Epstein-Barr virus (EBV). Epstein -Barr virus causes both mental and physical fatigue, aggravating even mood, and is often confused by many physicians as depression. It might have lain dormant for years, but now with immune suppression, it will reactivate. This has led to the conclusion that many patients with Lyme disease are, in effect, co-infected with other viral, fungal, parasitic, and bacterial infections. We know because we have tested for them. We find in many cases the most severely affected, and most difficult patients to treat, have a combination of all various infections, with the average being 3-5 infections. A Lyme disease treatment program focused only on one area of the possible disease may have some benefit, but will be limited in its total ability to eradicate all symptoms, or the symptoms will return soon after stopping even initial successful protocols.
Historically and currently the treatment of Lyme disease has required the use of antibiotics. The type, dosing schedule, and duration of antibiotics are dependent on the length and type of symptoms present as well as the co-infections, whether from a new or previous exposure. The use of antibiotics produces its own side effects, such as yeast overgrowth, that is part of the underlying problem, and need to be treated and minimized while on long-term antibiotic therapy. Effective Lyme treatment requires effective co-treatment of yeast and candida species overgrowth.
Depending on the duration of a patient’s symptoms, other bodily systems that support energy, mood, and Autonomic Nervous System (ANS) pathways are often affected. Patients often report that though their recovery is much improved, they rarely feel as good as they did before they became ill. We find that other systems, such as the endocrine and neurotransmitter systems (part of the ANS), have to be restored to their optimal function. This requires not just treating all realized and unrealized infections, but evaluating and treating nutrient, hormone, and neurotransmitter deficiencies, which occur as a result of the body’s attempt to function, while being attacked by serious infectious diseases over months and decades.
The diagnostic workup of chronic Lyme and other infectious agents requires reviewing every functioning system in the body including the immune, endocrine, and the neurotransmitter or stress response systems. With good evaluation and treatment protocols, we can eradicate Lyme and other infectious agents, restore optimal functioning of energy and stress response, improve mood, and calm pain pathways, all leading toward a full recovery.
Lyme disease persists as a controversial infection due to its complexity of diagnosis and difficulty in eradication of seemingly persistent symptoms. In addition, even with the CDC’s recent admission that diagnosed Lyme disease cases exceed 300,000 annually, most primary care doctors deny its existence or are reluctant to support patients who desire to be tested. Even if patients are evaluated, many physicians refuse to treat, or offer the standard prescription of the antibiotic doxycycline, that offers very little benefit to the chronically infected.
Treatment is not likely to occur if testing is not done or fails to be sensitive enough to expose antibodies to Borrelia. Diagnosis must sometimes be made by ruling out all other possibilities associated with the patients symptoms and through a comprehensive lab set that includes immune function and possible coinfections and or mold exposures.
Some of the steps listed below may have already been completed by you prior to your diagnosis of Lyme disease, and thus may not need to be in your current program. We want you to feel comfortable with the complexity of the different prescriptions, herbs and protocols, and why we recommend or feel they are important. Not all protocols are required to be completed at once but can be divided over time and prioritized toward your individual concerns and abilities.
With recent updates in genetics, including lab testing of Lyme, coinfections, and mold, we feel we have one of the most comprehensive and effective Lyme treatment protocols in current use today. After 15 years of developing protocols and trying and discovering newer and more effective Lyme and coinfection treatments, we recommend the following 10 step program for optimal eradication and recovery from Lyme disease, coinfections, and mold.