Naturopathic medicine is a system of medicine that utilizes natural therapies such as herbal medicine and homeopathy, along with diet and lifestyle changes. The philosophy underlying naturopathic medicine is to treat the underlying cause of disease, to treat the person holistically, and to start treatment using least invasive therapies first, working up the therapeutic order as necessary.
Naturopathic medicine is well placed to assist patients with chronic Lyme disease. While Lyme is a disease caused by spiral-shaped bacteria called Borrelia burgdorferi, it is clear in Lyme treatment that simply trying to kill bugs with medication is rarely sufficient. I have seen the best results from combining traditional antibiotics with naturopathic supportive care. Some patients who do not tolerate the antibiotics or are opposed to using them will benefit greatly, even reach remission of symptoms, with naturopathic medicine alone. Others can utilize naturopathic support to offset side effects of medication and allow them to tolerate treatment better.
The major goals of Lyme disease treatment are –
- Eradicate pathogens
- Boost immunity
- Support affected organs/ systems
- Provide symptom relief
There are multiple areas to address:
- Primary infection – Borrelia burgdorferi spirochete
- Co-infections – erlichia, bartonella, babesia etc
- Nutritional deficiencies
- General detoxification
- Immune dysfunction
- Systemic inflammation and pain
- GI infections – parasites, h pylori
- Gluten intolerance/ food sensitivities
- Viral infections – herpes, EBV, CMV, HHV-6, measles
- Yeast overgrowth – candidiasis
- Heavy metal toxicity
- Mold toxicity
- Hormone imbalance (adrenals, thyroid, reproductive)
- Sleep issues
- Imbalance in brain chemistry/ neurotransmitters
Clearly, treatment for this disorder is multi-faceted and highly complex. Some treatment considerations are outlined below.
Discussion of antibiotic regimens is complex and beyond the scope of this article. Dr. Burrascano’s treatment guidelines are the most well referenced guidelines for medication protocols. Natural antimicrobials have been used quite successfully in Lyme disease treatment. Herbs such as samento and guaiacum have antispirochete activity. Teasel is also a good antimicrobial, also producing anti-inflammatory effects. Colloidal silver, concentrated allicillin extracts, and others have been used. Artemesinin, extracted from the herb wormwood, is perhaps our best natural remedy against babesiosis, a common coinfection of Lyme. Oregano, clove, pau d’arco and garlic are great preventive measures or treatments for yeast overgrowth secondary to antibiotic therapies.
Lumbrokinase has been used to break down the biofilm which can allow for greater exposure and less “hiding places” available to the borrelia spirochetes.
Many Lyme patients are coinfected with viruses from the herpes family such as EBV, CMV, HHV-6. Larrea tridentata and olive leaf are two key herbs with antiviral activity.
Nutrition and Lifestyle Factors
It is futile to embark on aggressive medication protocols without considering nutritional and lifestyle factors. Most patients fare better on gluten and dairy free diets as those foods can fuel inflammation, which is already a major issue. As digestive function is often compromised, a low allergen diet is key. Sugar avoidance is a significant help in preventing antibiotic-associated yeast overgrowth, and will assist a healthy immune response. Omega-3 fatty acids can be used for their anti-inflammatory benefits – typically 2 grams of fish oil plus 1 tablespoon of flax oil daily.
Patients should consume at least two liters daily of clean, filtered water to help flush waste materials. For the same reasons, adequate fiber is necessary to flush the colon of waste, in particular neurotoxins that can be released when bacteria are killed off.
Lean organic proteins, fruits, vegetables and healthy fats such as fish oil, flax, olive, avocados, and nuts and seeds will provide adequate nutrition without fuelling inflammation.
Sleep patterns are important, although Lyme patients often suffer from insomnia due to pain and neurotransmitter imbalance. Melatonin, 5-HTP and herbs such as valerian and passionflower can be helpful.
Lyme patients require detoxification support in three main areas – general phase I/II liver detox support, detox of neurotoxins released during treatment as bacteria die off, and heavy metal detox. Many are intolerant of detox regimens and so this must be addressed gently. Such patients may benefit from gentle homeopathic and drainage remedies. Liver and kidney herbs can support medication-associated toxic stress. For neurotoxins, some patients benefit from Cholestyramine, a cholesterol lowering medication that has binding properties. Chitosan and fiber supplements have been used as natural alternatives.
Recent clinical observation has shown intravenous glutathione to have significant benefit in boosting energy levels and cognitive function in chronic Lyme patients.
Heavy metal toxicity is often present in Lyme patients, but again, as detox mechanisms are already stressed, caution must be exercised around chelation. For some, chlorella is sufficient to promote detox. For others, low dose DMSA (100mg every 1-3 days) over time will be efficient without stressing the system.
Infrared sauna, Epsom salts baths, colon hydrotherapy, lymphatic drainage and ionic footbaths have helped many patients.
Boosting immune function so that the body can help to fight the infections is crucial – natural killer cells and antibodies are frequently low. Transfer factors help to stimulate NK cells, immunoglobulins can be given, with immune modulating herbs such as astragalus, elderberry and olive leaf. Low dose naltrexone has been used in autoimmune disease as well as Lyme/ fibromyalgia illness and can not only modulate immune response, but also help quality of sleep and mood. Mushroom extracts such as reishi and maitake are beneficial but may not be tolerated by people with severe candida problems.
Systemic Inflammation and Pain
Much of the symptomatology of Lyme arises from chronic systemic inflammation. Anti-inflammatory herbs including white willow, tumeric and holy basil moderate inflammation and ease pain significantly, while systemic enzymes taken away from food can help break down inflammatory mediators. Cytokines created in the inflammatory cascade can cross the blood-brain barrier worsening mood problems, anxiety and depression. Essential fatty acid supplementation (2-4 grams daily) along with a diet rich in omega-3 fatty acids help combat overall inflammation as well as depression.
To further alleviate pain, magnesium and malic acid are key players for muscle relaxation. For some individuals, magnesium cream topically with anti-inflammatory herbs help relax muscles and are great remedies for pain. Resorting to NSAID’s and narcotic pain relievers, although necessary at times, can create a host of side effects of their own.
Lyme patients often have digestive issues, which can be caused by the borrelia and co-infections themselves, by opportunistic infections such as intestinal parasites, yeast overgrowth and H pylori, or by food sensitivities brought about by leaky gut and immune activation. H pylori compromises the stomach’s production of hydrochloric acid, making complete digestion of food difficult. Parasites give symptoms of constipation, diarrhea, gas and bloating. Specific infections should be addressed during treatment of Lyme, as optimal digestive function will help patients tolerate medications and other treatment protocols, as well as maximize absorption of nutrients from food.
Gluten intolerance and food sensitivities are common in the general population, and can worsen Lyme symptomatology. Most patients fare better avoiding gluten and dairy, because of their potential to fuel inflammation. Specific food sensitivities can be detected using a simple finger-stick blood test, making individualized dietary recommendations possible.
Yeast overgrowth is a consideration especially when antibiotic protocols are given. Prevention is the best medicine, and high potencty probiotics should be a part of every Lyme patients protocol. Up to 100 billion organisms a day are used prophylactically. Nystatin is a relatively safe and non-toxic medication to address candida; diflucan may be necessary in systemic yeast cases but has higher liver toxicity and more medication interactions.
Heavy Metal Detox
Heavy metal toxicity causes neurological symptoms, fatigue, muscle/ joint pain, cognitive deficits and many other symptoms in common with Lyme disease. Chelation protocols can be helpful but care must be taken not to overwhelm detoxification systems – glutathione and methylcobalamin are helpful “precursors” to chelation, to upregulate detox and antioxidant status. Low dose chelators given over several months may well be just as effective and easier to tolerate. One of the U.S.’s top Lyme disease doctors promotes 100mg of DMSA given every three nights along with alpha-lipoic acid, vitamin C, NAC etc as an effective plan.
Ritchie Shoemaker, MD, (www.chronicneurotoxins.com), pioneered recent research on biotoxins and their impact on immune and nervous system function. Mold exposure is a major source of neurotoxins, and many people with Lyme have elevated antibodies to molds such as aspergillus and stachybotrys. Cholestyramine is used in such cases as a binding agent (sometimes with amphotericin B given orally), and a remedy called TriGuard Plus also shows promise for addressing mold spores. Obviously, identifying any possible exposures is an important piece, as re-exposure will continue to worsen symptoms.
The hypothalamic-pituitary-adrenal axis is typically stressed in any chronic illness and Lyme is no exception. Babesiosis is renowned for altering hormone pathways, which worsens the situation. Adrenal support is warranted, and should be addressed before any thyroid supplementation is given. Boosting thyroid function without supporting the adrenals is akin to putting ones foot on the accelerator with the parking brake on, and may do more damage in the long run. Bio-identical hormone support, while not addressing the underlying infectious issues, can go a long way towards helping patients feel better with regards mood and energy. Since a hallmark symptom of babesiosis is night sweats, it can sometimes be difficult to ascertain whether nightsweats are caused by menopause, or by babesia, in women of menopausal age. Female Lyme patients tend to show up with low progesterone levels; low testosterone in men can worsen fatigue, weakness and depression.
Imbalance in Brain Chemistry/ Neurotransmitters
Chronic Lyme disease can disrupt normal neurotransmitter pathways, and depression and anxiety are common in these patients. Chronic pain further exacerbates this. GABA and theanine are effective in moderating anxiety, while 5-HTP eases the depressive aspects and can be given in fairly high doses (150-200mg) at night to assist restful sleep. Tyrosine, the amino acid that fuels the norepinephrine pathway, is an energizing amino acid for the brain, and can help patients get up and go in the morning.
Clearly, Lyme disease is complex and multi-factorial, and can wreak havoc on every system of the body. While it may be near impossible to evaluate all these factors at once, it is important to keep in mind the widespread effects of the disease and address the person systemically. Simply killing bugs is not enough – immune, digestive, detox and hormonal systems must be supported to enable healing on a comprehensive level.