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.
www.restormedicine.com
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
www.restormedicine.com
• 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
www.restormedicine.com
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.
www.restormedicine.com
• 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.
www.restormedicine.com
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.
www.restormedicine.com
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.
www.restormedicine.com
Erlichia/ Rickettsia • knife-like headaches, severe muscle pain, low WBC, rapid
onset, neuro symptoms (seizures, shooting pains), tendon
pain, right upper quadrant pain.
www.restormedicine.com
Diagnosing Lyme Disease
•
•
•
•
•
•
•
•
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.
www.restormedicine.com
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.
www.restormedicine.com
• 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)
www.restormedicine.com
• 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.
www.restormedicine.com
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
www.restormedicine.com
(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.
www.restormedicine.com
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.
www.restormedicine.com
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.
www.restormedicine.com
Borrelia – need to address all three phases
Spirochetes
•
Penicillins – amoxicillin, Bicillin (IM)
•
Cephalosporins – ceftriaxone (IV), cefuroxime
L-forms
•
Macrolides – azithromycin, clarithromycin
•
Tetracyclines – minocycline, doxycycline
Cysts
•
Metronidazole, tinidazole
•
Plaquinil (hydroxychloroquine)
•
Alinia
www.restormedicine.com
• 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 ?
www.restormedicine.com
Babesia
•
Mepron (atovaquone)
•
Malarone (atovaquone plus proguanil)
•
Larium
•
Coartum
•
Alinia
•
Septra/ Bactrim
www.restormedicine.com
Bartonella
• Doxycycline
• Rifampin
• Ciprofloxacin/ levaquin
• Septra/ Bactrim
• Zithromax (weak)
www.restormedicine.com
Erlichia/ Rickettsia
•
Doxycycline
•
Rifampin
Mycoplasma
•
Doxycycline/ minocycline
•
Levaquin
www.restormedicine.com
Role of Naturopathy in the
Treatment of Lyme Disease
www.restormedicine.com
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
www.restormedicine.com
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)
www.restormedicine.com
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.
www.restormedicine.com
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.
www.restormedicine.com
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
www.restormedicine.com
4. Supporting Herxheimer
reactions/ detoxification
•
•
•
•
•
•
•
Glutathione
Smilax glabrae (Chinese sarsaparilla)
Liver/ kidney herbs
Lemon juice in water
Epsom salts baths
FIR sauna (with caution)
Lymphatic drainage massage (with caution)
www.restormedicine.com
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)
www.restormedicine.com
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.
www.restormedicine.com
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
www.restormedicine.com
• 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
www.restormedicine.com
8. Other issues
•
•
•
•
Heavy metals
GI infections
Mold toxicity
Chronic viral infections (herpes, EBV, CMV, HHV-6)
www.restormedicine.com
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
www.restormedicine.com
• 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.
www.restormedicine.com
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!!
www.restormedicine.com