In some cases, patients prefer chronic lyme treatment without prescription antibiotics. In others, herbal and immune system options may be the best options in my opinion.

 

Treatment of lyme disease without antibiotics

 

Many of my chronic lyme patients have come to me after they have been on repeated courses of antibiotics, with only temporary improvement. In these cases, one option for treatment is a more holistic, naturopathic approach to chronic lyme disease which involves nutritional support to regulate physiology, detoxification, more broad spectrum antimicrobials (silver, ozonated oils, herbs, IV vitamin C, ozone / ultraviolet blood irradiation therapy), and immune system modulation. Many parts of this protocol were learned by Dr Klinghardt’s lecture at a naturopathic conference.

 

Regulate physiology

Dr Klinghardt has stated that up to 80% of the chronic lyme patients that he sees demonstrate higher amounts of kryptopyrroles in their urine. This may be a marker for toxicity that chronic lyme patients may have as a result of infection. The germ produces toxins, which may make the patient produce abnormal hemoglobin breakdown products, which detected as the kryptopyrroles. The kryptopyrroles then vastly increase the excretion of zinc, B6, manganese, possibly giving rise to many of the symptoms of chronic lyme.  This is tested for in the urine with a 24 hour collection and sent to the states for processing.

 

Methyl B12 is often given for neurological support and methylation support. In my experience, B12 in very high doses can help with some of the fatigue and brain fog experienced by chronic lyme patients. The methyl form of B12 also may help with the methylation process in the body, which is intricately involved with detoxification and glutathione production in the cell (glutathione is the intracellular antioxidant and how cells detoxify).  Care must be taken, as rarely some may aggravate with methyl donors, such as methyl B12, methyl folate, SAMe.

 

Fish oil (high in EPA) and systemic enzymes are then often used for cellular membranes and blood fluidity. Nutrient delivery is key in my experience, and is the main thing that improves the symptoms of brain fog and fatigue in the chronic lyme patient. 

 

Detoxification of the toxins produced by lyme infection

This is the arm of treatment that is as important as the antimicrobial arm. In my opinion, the majority of the symptoms of chronic lyme come from the accumulation of toxins that are produced by the germ. This is from my own experience, as well of that of many other clinicians, that finds that patients often get better when a focus on detoxification is made. If the underlying infection is not treated, and the immune dysregulation not treated, then patients may relapse of course, as the toxin burden starts to creep up again.  It is a catch 22 situation though, as the toxins do need to be dealt with otherwise it is also hard for the patient to clear the infection.

 

The main treatments I use for detoxification involve sauna therapy with oxygen, IV vitamin C, IV glutathione for flares, DMSA and EDTA chelation,  and oral chlorella, cilantro, garlic.

IV vitamin C is often given immediately after the sauna, in doses ranging from 25 to 100 g.  IV glutathione may be recommended if a chronic lyme patient is in the process of a flare.  In my experience, I have found that IV glutathione does not need to be a frequent treatment, and most patients do well with the vitamin C alone.

The combination of the IV vitamin C, and sauna, is may be recommended twice a week.

DMSA and EDTA chelation may be recommended.  These are heavy metal chelators.  The EDTA is added to the vitamin C IV bag, and the DMSA is given orally.

Chlorella, cilantro, and garlic are synergistic with the detoxification program. Garlic is rich in the sulfur compounds that the body uses for detoxification, and chlorella and cilantro have specific compounds that directly bind toxins for excretion.

Emotional toxins and other psychological issues can be roadblocks to healing as well. If this is the case, I refer out for EMDR and cognitive behavioral therapy.

 

Lowering of microbial (lyme) burden

Antibiotics may be recommended for this arm of treatment. If a patient has failed or not responded to antibiotic therapy for chronic lyme in the past, in my experience they still may respond if the other three arms of treatment (nutrition, detoxification, immune modulation) are added in.

 

Generally my preference is for a patient to be on first either amoxicillin or doxycycline for a period of time to look for response and tolerability. Combination therapy can also be considered for patients who have not responded to the antibiotics, and with the other three arms of treatment. In this situation clarithromycin in combination with amoxicillin could be used. Combination therapy does raise the risk of adverse events and thus the goal is that the other 3 arms of treatment for chronic lyme would be given priority.

The main non-antibiotic approach has been put forth by Dr Klinghardt, and involves the use of ozonated oils. Ozonated oils have been used with great success in Cuba for a variety of infections, though many of the studies were for infections limited to the gastrointestinal tract.  Ozonated olive oil and ozonated castor oil are options. Dr Klinghardt has an interesting point that the plant kingdom’s defense against infections have also been endoperoxides, which are present in ozonated oils. Interestingly, when I give ozone therapy the ozone, on reacting for the blood, forms numerous fatty peroxides that are then infused back into the patient. In my experience, ozone or oxidative therapy (with UV light) is a very useful adjunct.

 

Many patients on any antimicrobial therapy, be it antibiotic drugs, or ozonated oils or ozone therapy, report a ‘healing crisis’ or ‘herxheimer reaction’ around the time when infections are thought to be killed. This may very well be the case, but there is a theory that the symptoms are actually manifested by an increase in toxin secretion by the microbes when they are threatened with antimicrobial treatment.  In my experience, making sure that arm 2 (detoxification) of this protocol is in full effect minimizes the reaction, while still allowing a reduction in microbial burden.

 

Occasionally though, in my experience, even though the chronic lyme patient is getting full detoxification support, Herxheimer like reactions still occur. In these cases intravenous glutathione can be tremendously useful in my experience. Giving an IV of glutathione can be helpful for symptoms in my experience, especially when it is followed with an alkalinizing IV for hydration, such as with Ringer’s lactate.

 

Immunomodulation

The final arm of treatment is vitally important. Most chronic lyme patients have a subset of their immune system severely compromised, the CD57 group of NK cells (natural killer white blood cells). The NK cells are important in fighting off infection, including chronic lyme and coinfections, in my experience.

 

A patient can often get well with Arm 1 and 2 of treatment, and less recurrence will happen with Arm 3 of treatment, but Arm 4 is vital in order to make sure infections do not recur.

 

Summary

 

4 arms of treatment for chronic lyme patients, can be used with or without antibiotic treatment. Chronic lyme patients are some of the most self-educated patients I have dealt with, and most are well aware of antibiotic approaches to the illness. Remember that antibiotic treatment can be very effective in my experience, but in my mind is only one arm of treatment. If a patient has failed antibiotic treatment, would like treatment without antibiotics, then this protocol should be given good consideration. If a patient has not had antibiotic treatment, my inclination is to discuss risks and benefits of antibiotic drug treatment, and if the chronic lyme patient is willing, to use them along side this protocol.  Follow up care would involve assessing to immune system functioning, lab response, and most importantly, looking for a clinical response that persists. Relapses can occur, and when this happens treatment is started again