Dr. Kenneth F. Kochler, D.O.
Functional Medicine
VA Beach, VA.
www.longevitymedical.org
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Lyme Species and co-infections
Lyme (not Lymes) Lyme Connecticut
Borellia (burgdorferi) a spirochete-classic Lyme
Bartonella-henselea
Babesia-Babesiosis-Babesia microti
Erlichia-Erlichiosis-chaffeensis & ewingii
Mycoplasma & Clostridia
Brucella
Fanciscella-tularensis (Tularemia)
Rickettsia-rickettsii (Rocky Mt Spotted Fever)
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Borrelia burgdorferi-spirocete
Bannwarth Syndrome?
Lyme, CT-1975 as “juvenile rheumatoid
arthritis” by local Mothers
Called Lyme in 1982
Organisms harbored in the tick’s stomach
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Malaria-like protozoan species
Intra-erythrocytic-in RBC’s
Destroys RBC’s-anemia-jaundice-malaise
Asymptomatic in otherwise healthy hosts
Tick-transfusion & transplacental transmission
Victor Babes-1888-in cattle with febrile
hemoglobinuria
Texas cattle fever-1893 (now cats & mice)
1st human case-1957-Yugoslavian cattle farmer
1st US case-1969-Nantuket Mass.
All livestock
 WBC Intracytoplasmic gram negative orgasm
resembling Rickettsia
 Human granulocytic anaplasmosis (HGA),
granulocytes
 formerly known as HGE (ehlichiosis)moncytes
 Type depends on infecting species & leukocyte
type infected
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A.L. Barton-1909-described organisms that
adhered to RBC’s-Bartonia
Later- Bartonella bacilliformis-gram negative
Initially thought to be rickettsiae
B. henselea-catscratch disease
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Hepatitis
H1N1
HIV
XMRV (newly researched retro virus)
Xenotropic murine leukemia retro-virus
An RNA > DNA virus discovered 2006 in
human prostate cancer tissue
67%Assoc with Chronic fatigue Syndrome
(2009-Whitmore Peterson Institute, NV)
Vaccination residuals due to vaccine viral
contaminants (herpes type 6 & 7)
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Mercury, Lead, Cadmium, Antimony, Arsenic,
Aluminum, Nickel (include fluoride)
Heavy Metal toxicity masquerades as
AUTO-IMMUNE DISEASE
“neuro-endocrine disruptors”
Impaired enzyme & receptor function with
yeast overgrowth (candida as an adaptation)
Assayed via NutrEval by Genova Diagnostics
or Doctor’s Data RBC Elements
Mercury: Sources
Thimersol (50% Hg by volume) was the preservative in most
vaccines until approx 2001. (current shift to aluminum)
Cumulative dose in vaccines from birth to age 5 years
exceeded the EPA guidelines for safety.
Large population of older children and young adults have
had significant exposure (Hg thermometers as a child)
Study on NYC adult population revealed 24.8% had blood
levels at or exceeding 5ug/l, the NY State reportable level.
McKelvey W. Environ Health Perspect. 2007 Oct;115(10):143541
Seafood, dental amalgams, and industrial output account for
the major sources of exposure today. (Coal-fired power plants)
WHO. Methyl Mercury. Environmental Health Criteria, vol.
101. Geneva: World Health Organization, 1990
Sallsten G, et.al., J Dent Res 1996; 75: 594–8
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Mercury Toxicity:
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Low level chronic exposure can lead to nervous system
damage resulting in depression, anxiety & cognitive loss
Weiss B, Clarkson TW, Simon W. Environ Health Perspect 2002; 110 (Suppl 5): 851–4
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Autoimmunity Issues
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Paresthesias, insommnia, cognitive difficulties,
neuromuscular changes, headaches and anxiety, third cranial
nerve palsy.
http://www.epa.gov/iris/subst/0692.htm
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Cadmium:
Sources: Color pigment (dyes & paints)
Cigarette smoke
Ni-Cd batteries
Phosphate fertilizers
Jarup L et al. Health effects of cadmium exposure—a review of the literature and a
risk estimate. Scand J Work Environ Health 1998; 24 (Suppl 1): 1–51
WHO. Cadmium. Environmental Health Criteria, vol. 134. Geneva: World Health
Organization, 1992
Toxicity: Kidney damage
Osteoporosis
Cancer-thyroid & Prostate
Jarup, L. Br. Med. Bull. 68:167-182 (2003)
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Lead:
Sources: Gasoline (Worldwide major source but not in US)
Lead in drinking water primarily due to the presence of lead
in certain pipes, solder, and fixtures.
In kids toys and lead based paints in old homes (and especially
in paint that is not interstate transported)
Toxicity: Decreased IQ
Memory deterioration
Cancer
Anemia
Peripheral nerve symptoms
Hypertension especially in menopausal women
WHO. Lead. Environmental Health Criteria, vol. 165. Geneva: World Health
Organization, 1995
Steenland K, Boffetta P. Am J Ind Med 2000; 38: 295–9
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Arsenic:
Sources: Wood preservative
Fish
Pesticides/food
Industrial exposure
Toxicity: Cancer-lung, bladder, & kidney
Peripheral neuropathy
Anemia
GI Effects
WHO. Arsenic and Arsenic Compounds. Environmental Health Criteria, vol. 224. Geneva: World
Health Organization, 2001
Chilvers DC, Peterson PJ. Global cycling of arsenic. In: Hutchinson TC, Meema KM (eds)
lead, Mercury, Cadmium and Arsenic in the Environment. Chichester: John Wiley & Sons, 1987;
279–303 www.epa.gov/ttn/atw/hlthef/arsenic.html
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Testing for heavy metals:
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(Redistribution to the RBC’s)
Blood levels useful for acute exposure, but an unreliable tool for chronic
low level exposures.
Mercury has affinity for fatty tissue and is rarely found in serum.
The half-life of lead in blood is about one month whereas the
half-life in bone is 20-30 years. (35)
WHO. Lead. Environmental Health Criteria, vol. 165. Geneva: World Health Organization, 1995
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Difficult to accurately assess total body burden. Urinary porphyrins
have some utility – currently probably the best clinical test available.
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Hair Mineral Analysis may be helpful, but show false negative in
individuals with compromised detoxification pathways
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Provocative challenge-involves administering a test dose of a chelator
(DMPS, DMSA, or EDTA) and measuring pre- and post- fecal &/or
urine for heavy metals.
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Heavy Metals (con’t)
Treatment:
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Nutritional support during chelation essential
I. Gut binding agents-Bentonite, Charcoal, Zeolite, chlorella, garlic
Cholestyramine-low dose, pulsed, with caution
II. Mineral replacement-depending on the chelator used, replace
minerals aggressively with special attention to Ca & Mg
with EDTA (Suppositories) and Cu & Zn with DMPS/DMSA
III. Antioxidant support-necessary to quench free radicals generated
during heavy metal removal. Supplement with A, C, E, Zn,
selenium, and reduced glutathione.
IV. Hepatic support
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Genomics to determine GST enzyme pathway
adequacy (glutathione-S-transferase)
Serum Glutathione levels-baseline
determination is a must (but largely unknown
or forgotten by most physicians) Lab Corp
offers this testing and is included in the
Genova NutrEval
The MASTER ANTIOXIDANT of the body!
Excellent for natural metal chelation (which
impacts Lyme disease)
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Methyl group (-CH3) donator
Needed for phase II liver detox via COMT
Defects = elevated Estrogen & catecholamines
Role in: NEUROTRANSMITTER chemistry,
cardiovascular disease, cancer, metal detox, and B12 & Folate metabolism
SAMe, TMG, methyl B-12 & THF
SNP on COMT, MTHFR C677T (47% incidence in
caucasians)
Cystathione-beta-syntase enzyme: B-6/P-5-P &
GSH
Methylation Cycle
5,10 MTHF
Methionine
Mg
Zn
SAM
MSR
Methionine
Synthase
MTHR
B12
SAH
5 MTHF
Homocysteine
Homocysteine
P5P
CBS
Cystathione
P5P
Cysteine
Taurine
Glutathione
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A community of bacteria, parasites, etc
imbedded in an extracellular polymeric
substance (EPS) aka slime
Composed of DNA, protein & polysaccharides
NEG CHARGED, and attracts Ca/Mg/Fe to
strengthen its matrix
Organisms communicate and exchange genetic
material (QUORUM SENSING)
EPS creates antibiotic resistance requiring 1001000X concentration of the drug & prevents
phagocytosis (WBC organism eradication)
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NIH states that 80% of all chronic infections are
biofilm mediated (ie: chronic sinusitis)
This jello-like shield created by bacteria
protects against environmental stress and
promotes propagation (it’s everywhere: teeth
to ship hulls) (Imagine the water-mold issue)
Chemical signals serve as intelligent
communication (Quorum Sensing)
Unless biofilms are managed, hosts are subject
to unending recurring symptoms from
infection
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Once bacteria have joined into biofilm
communities, they can no longer be effectively
targeted by the immune system. They persist as
a chronic infection and inflammatory process.
High dose antibiotics and steroids may offer
temporary relief, yet the infection never is
totally eradicated. Initial organisms are
commonly Staph and parasites.
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Borrelia may undergo genome-wide genetic
exchange, including plasmid transfers.
Virulence can rapidly be enhanced.
Conjugal plasmid transfer ability from
Escherichia coli to Bartonella has been
established and documented to transfer
antibiotic resistance genes.
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Hormone decline & Imbalance = aging
Insulin Resistance = aging
Hypoadrenalism w/ decr cortisol = fatigue
Hypothyroidism w/ decr Free T3 & incr rT3
Hormone imbalances: male and female
hypogonadism (declines in DHEA and
testosterone = aging)
Growth Hormone (IgF-1) decline = aging
Melatonin & Melanocyte Stimulating Hormone
(decline as markers for immune deficiency)
MINERALS-especially magnesium & selenium
Trace MINERALS: rhubidium, indium, cesium
VITAMINS-especially C, mixed fractions of E
(gamma), D3 (25-hydroxy) storage pool & 1,25 dihydroxy (active w/ receptor) (Marshall Protocol)
AMINO ACIDS-especially cysteine, glycine,
glutamine (GSH) , methionine & taurine
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DNA MUTATIONS
POLYMORPHISMS
SNP(S) single nucleotide polymorphisms
Defective or incomplete GENE expression
Inadequate enzyme & receptor function
Impaired biochemistry and cellular respiration
Fatigue & degenerative disorders
Assayed via Genovations (Genomic testing)
by Genova Diagnostics www.gdx.net
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Nutritional Assessment-NutrEval (Genova)
Heavy Metal Assessment-NutrEval
Essential Fatty Acid Assessment for cell
membrane integrity and function-NutrEval
Hormone Assessment-NeuroScience
Neurotransmitter Assessment-NeuroScience
Proper mineral and vitamin supplements after
assessment-NutrEval
Glutathione assessment-NutrEval
www.gdx.net (search NutrEval)
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Yeast management
Metal detox via chelation
Biofilm managementEDTA, Proteolytic Enzymes ( Natto or
Lumbrokinase), Inter-Face Plus by Prothera
Chinese Herbs that penetrate biofilm: Berberine
extract from Coptidis Rhizome (Goldenseal)
Herbs that interfere with Quorum Sensing:
Red & blue berries, kale, oregano, basil, rosemary,
turmeric, ginger, garlic.
Probiotics
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Allicin/Garlic (Allicillin)
Aloe, Artemisia absinthium
Echinacea, Grapefruit Seed Extract
Mushrooms, Astragalus, Andrographis
Ashwaganda, Boswellia, Neem
Manuka Honey?
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This is what you actually causes your demise
Cytokine determination to assess level of
inflammation (significant amounts produced in
adipose tissues of the body)
NeuroScience has cytokine panel testing
www.neurorelief.com
Cytokines are managed by downregulating
inflammation
CRP and EFA adequacy are markers
 Peptides of low molecular weight (approximately
5 kDa) and perhaps RNA
 Made by Th1 CD4+ Helper T-cells
 Present in colostrum
 Three components - Antigen specific region, region
that binds to Th1 Helper T-cells, and a connector
 Can strengthen cell-mediated immunity against
specific pathogens
 Can be used to immunize against specific pathogens
Aaron White, PhD
Using Transfer Factor to Strengthen
Cell-Mediated Immunity
Integrative Healthcare Symposium 2010
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 Borkowsky and Lawrence (1979):
“‘Transfer Factor’ was originally coined as a
convenient shorthand to describe the material or
materials present in leukocyte extracts or
dialysates of skin test-positive donors that had
the capacity to transfer cutaneous delayed type
hypersensitivity responses to skin test-negative
human subjects.”
 Now commonly used in the plural – “transfer factors”
Aaron White, PhD
Using Transfer Factor to Strengthen
Cell-Mediated Immunity
Integrative Healthcare Symposium 2010
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 List of known pathogens growing and includes a variety of
intracellular agents (mycoplasma; cell-wall deficient bacteria;
XMRV, HHV6 and other viruses).
 Transfer factors can be (and are) custom made for pathogens
 Many pathogens suppress Th1 immunity (HIV, Lyme) and
require cell-mediated immunity to be beaten.
 Transfer factors strengthen cell-mediated immunity.
 Could be helpful for autoimmune conditions involving too much
Th2 (e.g., lupus) but seem less likely to be effective against
those involving too much Th1 (e.g., multiple sclerosis).
 Cancer treatment
 Could be used to support or even replace many vaccines,
which skew the immune Aaron
system
in the Th2 direction.
White, PhD
Using Transfer Factor to Strengthen
Cell-Mediated Immunity
Integrative Healthcare Symposium 2010
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A small clinical trial study showed a better
increase in CD57 counts using both Multimmune and LymPlus transfer factors
simultaneously.
Patients taking 2 capsules of Multi-immune 2 X
daily showed a 600% increase in NK cells
Lyme testing in this country is poor
 Many false positives and negatives
 Inadequate band assessment
 PCR (Polymerase Chain Reaction) via
www.frylabs.com w/ special staining
 Live Blood Analysis is medically outlawed
 James Schaller, MD favors IGeneX western blot
(does a single + band constitute Lyme spectrum
disease? Not good for the insurance companies)
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* Zyto Bio-Resonance Scan www.zyto.com
Rapidly assessment of stressors and balancers
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Sorted-out via Zyto
Provided by NutraMedix
Excellent response to these broad spectrum
anti-microbial, anti-viral, anti-fungal, and antiinflammatory herbal tinctures
Samento and Banderol were discussed as
excellent remedies for Lyme in the July 2010
issue of the Townsend Letter
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Deseret Biologics (Des Bio) www.besbio.com
Series Remedies: Borrelia, Brucellosis, Chlamydia,
Condyloma, Coxsackie, CMV, Epstein Bar,
Giardia, Hepatitis, Herpes Simplex, Zoster,
Mycoplasma, Parvovirus, Toxoplasmosis, RMSF,
Bartonella, etc.
WOW!
Nothing to loose!...
Detox, Drainage….
Energique- www.energiqueherbal.com
Single remedies
http://www.publichealthalert.org/Articl
es/jamesschaller/18_reasons_lyme_treat
ments_fail.htm
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Lyme is not the hub of he wheel
It’s a spoke
Lyme spectrum illness management is
extremely complex and intricate
Therapy needs to be prioritized and
individualized
You cannot get where you want to be with just
unending antibiotics…
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Treatment of gut and systemic biofilms in Lyme
Disease can greatly reduce the reservoir of Borrelia
and its associated co-infections resulting in a greatly
diminished risk of relapse
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Heavy metals are ubiquitous. They can compromise
immune function, promote overgrowth of candida,
as well as dysbiotic gut flora.
Judicial heavy metal detoxification, either once the
lyme/co-infection load has been reduced, or
concurrently, with appropriate methylation support
as needed, may improve outcome and potentially
reduce the likelihood of relapse
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