How does Functional Medicine Treat Lyme Disease?

** Recent research shows that 63% of patients experience persistent symptoms, even after antibiotic treatment for Lyme Disease (Feng J, 2020). **

This figure of 63% includes all patients with Lyme, caught at whichever stage, who took antibiotics as a treatment. Some of these people may have taken the antibiotics early on and some may have only tried antibiotics at a later stage in their disease process.

Given the poor treatment success rate for antibiotics, we need a new approach to treating Lyme Disease. Many factors come into play with Lyme treatment:

• A single tick can carry multiple pathogens. It can carry many microorganisms, such as bacteria, parasites and viruses (Moutailler S, 2016). 50% of all ticks carry at least one pathogen, indicating that a large number of ticks are infected (Moutailler S, 2016).
• Lyme, or the Borrelia bacterium, increases inflammation, downregulates immunity and evades the immune system. It can cause an overactive or autoimmune immune response.
• Lyme bacteria can form biofilms. This means that it hides in cells, burrows into tissue and remains hidden. Once safely inside a biofilm, it stays hidden from antibiotics or other medications.
• The Borrelia bacteria develop persister cells in response to antibiotics. Persister bacteria remain dormant in the body and can survive high dose antibiotics. Once the antibiotics course is finished, persisters start to grow again like normal cells (Rudenko N, 2019). Through persister cells, Lyme can become very difficult to detect (CDC, 2022) and (Columbia University, 2021).

Given these multiple challenges, we need a multi-pronged approach to treat Lyme. We need to address bacterial infection, inflammation, the strength of the immune system and detoxification ability. We may need to look at Lyme co-infections. It is critical to also look into gut health. Remember that 70- 80% of our immune system is based in the gut and requires a well-functioning healthy gut. We may need to look for other root causes, such a HPA axis health, toxic exposure to mold or metals or other root causes.

If you or your patients have been struggling with Lyme for some time, it is crucial to find an expert in Functional Medicine who is also Lyme-literate. A Lyme-literate doctor is one who has experience and expertise in treating Lyme. We offer that in our Medicine With Heart clinic, where we have vast experience in working with very complex conditions.

Treatment for Lyme Disease in our Clinic

There are multiple modalities to employ in a complex case of Lyme. We assess each person on an individual case-by-case basis. Then we use some or all of the following techniques in a protocol designed to treat the Lyme Disease:

DIET – A first key step is to adopt an Anti-Inflammatory diet to fight the inflammation. What we eat can either reduce or increase inflammation and can affect the immune system response. In the case of Lyme, and every other illness, we want to have an anti-inflammatory diet that reduces inflammation and supports good health. This is true for optimal health as well.

We also need a nutrient dense diet to give the body the nutrients it needs to heal and to boost the immune system. It’s also important to have a diet that incorporates good gut health and promotes a healthy microbiome.

Gluten-free, dairy-free, sugar-free, organic, non-GMO whole foods is where we start. We recommend going all organic, especially for animal products. Eat lots of veggies and whole foods. We favor a Paleo-style or gluten-free Mediterranean diet.

And don’t forget to get sufficient hydration and drink clean, filtered water.

ANTIMICROBIAL HERBS – We most commonly treat with herbs which are antimicrobial, antibacterial or antiviral, meaning they can kill microbes, bacteria and viruses.  Herbal medicine has a long history dating back almost 5,000 years (Feng J, 2020). Over centuries, herbal medicines have been shown to be safe in Ayurvedic Medicine and Traditional Chinese Medicine. Recent reviews in Europe and South America show that severe adverse events from herbs are extremely rare (Feng J, 2020).

One study looked at various herbs and natural antimicrobial agents to potentially fight Borrelia burgdorferi (Feng J, 2020). Seven herbs were highly active against Borrelia burgdorferi (Feng J, 2020). These seven herbs were more effective against Lyme bacteria than the antibiotic medications, doxycycline and cefuroxime (Feng J, 2020). They have strong activity against Lyme bacteria, and especially against the dormant persister bacteria, which are not killed by the current antibiotics used to treat Lyme (Feng J, 2020).

These seven herbs are effective against Lyme are (Feng J, 2020):

• Ghanaian quinine
• Black walnut
• Japanese knotweed
• Sweet wormwood
• Cat’s claw
• Mediterranean rockrose (or Cistus incanus)
• Chinese skullcap

The herbs with the highest antibacterial activity against Borrelia burgdorferi are Ghanaian quinine and Japanese knotweed (Feng J, 2020):

• Ghanaian quinine contains the active ingredient, cryptolepine. This is used against malaria, hepatitis, septicemia and tuberculosis.

• Japanese knotweed contains the antioxidant resveratrol. Studies suggest resveratrol has anticancer properties and may protect heart and brain health.

In a separate study, Wild teasel, or Xu duan in Chinese medicine, showed anti-Borrelia properties, with strong antioxidant and antimicrobial activities (Saar-Reismaa P, 2022). It is anti-cancer, anti-inflammatory and has potential against Borrelia burgdorferi (Saar-Reismaa P, 2022).

We might also use herbs to combat any Lyme co-infections found to be present. Babesia is a Lyme co-infection. Certain herbal medicines have good inhibitory activity against Babesia (Zhang Y, 2021):

• Ghanaian quinine
• Sweet wormwood
• Chinese skullcap
• Christmas bush
• Japanese knotweed

Essential Oils – One study looked at essential oils. It found that 10 essential oils have strong activity against Borrelia and against the persister forms of Lyme Disease (Feng J, 2018). These essential oils are based on garlic, myrrh, thyme, cinnamon, allspice, cumin and eucalyptus (Feng J, 2018). These essential oils were better at killing persister forms of Lyme bacteria than standard antibiotics (Feng J, 2018).

BIOFILM DISRUPTORS – As mentioned, Lyme bacteria can form biofilms. Biofilms are a protective defense mechanism the bacteria uses when under stress. They burrow into tissue and hide there. The antimicrobial medication or herbs cannot reach the bacteria once they are hidden in biofilm. There is actually more biofilm formation when bacteria are treated with antibiotics or other antimicrobial substances, because the bacteria try harder to escape the antimicrobials.

Biofilms are a big cause of persisting chronic Lyme Disease. So, getting to the root cause and destroying all of the biofilm involved is key to a successful Lyme treatment protocol. There are various substances that can break down biofilms, allowing the herbs or medication get to the pathogen(s) we are trying to treat for.

One interesting area is antimicrobial peptides or AMPs (Verderosa AD, 2019). A peptide is a small protein, made up of a chain of amino acids. They can be used therapeutically to help with different health conditions. We have previously written on peptide therapy. AMPs are peptides that kill microorganisms. Their antimicrobial mechanism of action is thought to be related to membrane disruption and inhibiting the activity of proteins and enzymes in the biofilm formation process (Verderosa AD, 2019).

LL37 is an antimicrobial peptide. It has antibacterial, antiviral, antifungal, antibiofilm and immune modulating properties (Wang G, 2019). At low concentrations, LL37 can reduce cell attachment to surfaces. At higher concentrations, it can decrease the overall thickness of established biofilms by up to 40% (Verderosa AD, 2019). We have previously written about LL37 here.

Stevia can help to eliminate Borrelia spirochetes and persisters. When tested against attached biofilms, Stevia significantly reduced the biofilm and is effective against Borrelia (Theophilus PAS, 2015).

Other antimicrobials can help to break down biofilms, including various herbs. Specifically, Otoba Bark extract and Cat’s Claw treat the various forms of Lyme bacteria and can reduce biofilms (Datar A, 2010). There is anecdotal evidence that these two herbs used in combination can be as effective as antibiotics (Datar A, 2010).

Antibiotics can also decrease biofilm size.

Finally, we also look to support IMMUNE HEALTH and GUT HEALTH when treating Lyme Disease. These are important to boost immunity, reduce inflammation and maintain a healthy gut microbiome. The anti-inflammatory diet we use helps gut and immune health.

LIFESTYLE HABITS –

• For optimal health, and especially with disease treatment, it is important to get stress under control. We can never get rid of all stress, but we can manage it through mediation, qi gong, tai chi, breath work, yoga or whatever stress management technique works best for you.
• It is important to have good sleep hygiene to sleep well so the body can repair.
• If you smoke and/or drink alcohol, this is a good time to quit (or at least reduce) to help your immune system.
• Exercise and movement can help to treat Lyme (D’Adamo CR, 2015) and (Maksimyan S, 2021).
• We also look at and reduce toxin exposure, including mold, metals, chemicals from processed foods, etc.

What are Other Novel Approaches to Treating Lyme Disease?

Phage therapy (also called bacteriophage therapy) uses viruses to treat bacterial infections. The bacterial virus is called a phage. Each specific phage attacks a specific bacterium and is harmless to humans (Lin DM, 2017). Phage viruses selectively target and kill bacteria and are common in nature.

Phage therapy has been used for 100 years (Lin DM, 2017). It is not widely used nor well-known, primarily because not much research has been done with phage therapy on humans. But it is a potential alternative to antibiotics. And may be part of the solution for increasingly antibiotic-resistant bacteria.

Induced Native Phage Therapy or INPT is a type of phage therapy. In early research, it eliminates infections more quickly and efficiently than conventional treatment does. It is thought to have no side effects or risk to humans (Jernigan DA, 2021). It identifies and isolates specific complex electromagnetic signatures to get the phages to kill their host Lyme Borrelia bacteria (Jernigan DA, 2021). INPT can be considered a boost to the immune system to fight infections.

One small study looked at INPT in the context of Lyme Disease. In the study, 77% of patients with chronic, persisting, long-term Lyme tested negative for Borrelia infection after just two weeks of INPT treatment (Jernigan DA, 2021). Some people required longer INPT treatment. In the end, 92% of the Lyme patients were successfully treated with INPT (Jernigan DA, 2021). All patients experienced mild to substantial clinical improvements without side effects from INPT treatment (Jernigan DA, 2021). Phages against Lyme bacteria were induced and able to eliminate the targeted Lyme bacteria efficiently, with no harm to tissue or to the microbiome (Jernigan DA, 2021). There were no toxic or allergenic side effects in the patient group.

Based on this study and early research, INPT looks to be a safe, effective and innovative way to treatment Borrelia infection. INPT can be used alone or in conjunction with other modalities for LD treatment.

In Conclusion

Lyme is sometimes a diagnosis of exclusion where we rule out other diseases. In our clinic, we conduct a detailed analysis and search for the root causes of the symptoms. Then Functional Medicine principles can be applied to address the root cause issues to improve symptoms, especially if no treatable diagnosis has been found.

In our clinic, we have expertise in treating a range of complicated, difficult-to-diagnose conditions like acute and chronic Lyme Disease. We regularly treat and resolve Lyme, chronic infections and other complex conditions in patients in our Functional Medicine clinic.

** Please stay tuned for our next Blog!  **