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 Klinghardts lecture at a naturopathic conference.
With naturopathic physicians having prescribing rights now, it has been easier to incorporate antibiotic treatment into this protocol as well, particularly for those chronic lyme patients who have only recently been diagnosed and have not been on an appropriate trial or proper antibiotic therapy for chronic lyme.
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 is a marker for toxicity that chronic lyme patients have as a result of infection. The germ produces toxins, which make the patient produce abnormal hemoglobin breakdown products, which we detect as the kryptopyrroles. The kryptopyrroles then vastly increase the excretion of zinc, B6, manganese, 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 given for neurological support and methylation support. 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 helps with 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). I teach the chronic lyme patient how to self administer this by injection. Doses are usually 25 mg per day.
Fish oil (high in EPA) and lumbrokinase (brand Boluoke) are then used to help keep the blood thin and the cell membranes, and capillaries flexible. Nutrient delivery is key, and is the main thing that improves the symptoms of brain fog and fatigue in the chronic lyme patient. Hemex labs has demonstrated that many chronic infections, (which I find to be usually the cause of chronic fatigue syndrome,) cause a detectable thickening of the blood, which impairs oxygen and nutrient delivery. In these cases heparin can be used as well, though this is often not necessary with the other components of therapy.
Detoxification of the toxins produced by lyme infection
This is the arm of treatment that is as important as the antimicrobial arm. 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 get better when a focus on detoxification is made. If the underlying infection is not treated, and the immune dysregulation not treated, then patients can 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 here involve sauna therapy with oxygen, IV vitamin C, IV glutathione for flares, DMSA and EDTA chelation, and oral chlorella, cilantro, garlic.
Sauna with oxygen therapy is a spin off from exercise with oxygen therapy. Older studies in Germany have repeatedly shown that exercise with oxygen supplementation vastly improves nutrient delivery to the tissues by decreasing the space that the nutrients have to diffuse through to get to the tissue. The blood carries oxygen and nutrients through blood vessels, which branch off into tiny branches called capillaries. At the capillaries the nutrients are unloaded, but then must diffuse across the extracellular matrix before they get to the cells. Exercise with oxygen therapy decreases the swelling in the matrix (most likely by helping to remove toxins from this space).
IV vitamin C is then given immediately after the sauna, in doses ranging from 25 to 100 g. Vitamin C directly neutralizes the liberated toxins, and in high enough doses has an antimicrobial effect as well. (Note at this point autohemotherapy is done also as part of the immune modulation.) IV glutathione can be done if a chronic lyme patient is in the process of a flare, as glutathione is the intracellular antioxidant that the cell uses to detoxify. 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 done twice a week.
DMSA and EDTA chelation are given to reduce heavy metal burden. While these are heavy metal chelators, in my naturopathic clinical practice I frequently find that when a patient has their heavy metal burden lowered, they are much better equipped and able to lower the toxins produced by chronic lyme infection as well. 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 can be used very successfully in this arm of treatment. If a patient has failed or not responded to antibiotic therapy for chronic lyme in the past, 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 good choices for therapy. Dr Klinghardt has an interesting point that the plant kingdoms 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. My own experience has shown that such ozone or oxidative therapy (with UV light) can be effective in a great number of patients.
Many patients on any antimicrobial therapy, be it antibiotic drugs, or ozonated oils or ozone therapy, report a healing crisis or herxheimer reaction when the infections are being 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. 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, 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, as glutathione is the molecule that the cells use to dispose of toxins. Giving an IV of glutathione can be tremendously helpful for symptoms, especially when it is followed with an alkalinizing IV for hydration, such as with Ringers lactate.
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 vital in fighting off infection, and keeping various infections including chronic lyme and coinfections, from giving patient symptoms.
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.
Autohemotherapy (3-5 mls of blood) with or without ozone can be very useful in this setting. Dr Klinghardt describes autourine therapy, since the urine concentrates the byproducts of the interactions between the patients cells and the microbes. Most patients are not open to autourine therapy, as it involves injecting 2 ml of urine after it has been filter sterilized, into the muscle. The urine can also be ozonated prior to sterile filtration and injection. Dr Klinghardt has described excellent results in fatigue/brain fog clearing after a short series of injections though.
Intravenous hydrogen peroxide and dilute hydrochloric acid can also be another method of treatment for immunomodulation. My own experience with both has been excellent as methods of stimulating the immune system in treating infection, and also in making sure it is regulated in cases of allergy and autoimmune conditions.
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, 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, for best results. Most patients do see change in their symptoms after 2-3 months of treatment. Follow up care would involve assessing to make sure the immune system is fully functioning again, and that the western blot IgM against lyme has turned negative.