Lyme disease treatment and help
July 12 2018 by
Ray Sahelian, M.D.

Lyme disease is transmitted to humans most often by the bite of deer ticks which can carry the bacterium Borrelia burgdoferi. The Center for Disease Control suggests defending against Lyme disease by using insect repellent, removing ticks promptly, and wearing socks and long pants when walking in wooded areas and areas with long grass, or avoiding such areas.
   According to a 2018 survey, more than 300,000 cases are reported to CDC every year, making it the most commonly reported tick-borne illness in the United States. But some reports have suggested it is far more common than that. Prolonged illness in Americans with Lyme disease is more widespread, serious and costly than previously believed.

Symptoms of Lyme tick disease
Symptoms include fever, headache, fatigue, and a skin rash. If untreated, infection can spread to joints, the heart, and the nervous system.

Clinical manifestations in humans include, in the early phases, erythema migrans, followed several weeks later by neuro-borreliosis (meningo-radiculitis, meningitis or meningo-encephalitis), Lyme arthritis and/or Borrelia lymphocytoma. In dogs, acute signs include fever, general malaise, lameness, lymph node enlargement and polyarthritis, as well as neuro-borreliosis in the chronic form.

Lyme disease treatment
Antibiotics are routinely and typically used to treat patients with Lyme disease, but there is little evidence that prolonged treatment with antibiotics changse the natural history.

This condition is diagnosed based on symptoms, physical findings (e.g., rash), and the possibility of exposure to infected ticks; laboratory testing is helpful in the later stages of disease. Most cases can be treated successfully with a few weeks of antibiotics which usually include doxycycline for adults and children older than 8, or amoxicillin or cefuroxime for adults, younger children, and pregnant or breast-feeding women. A 14- to 21-day course of antibiotics is usually recommended, but some studies suggest that courses lasting 10 to 14 days are equally effective.

Treatment varies with stage of disease, but normally includes doxycycline, amoxicillin, and ceftriaxone. Currently, no vaccine is available. In some areas, patients may be confected with Babesia, Ehrlichia, and Anaplasma since the same Ixodes ticks transmit these germs.

Early treatment with antibiotics, such as doxycycline or amoxicillin, for three weeks usually reduces the risk of chronic disease. Tick control, including the use of tick repellents for both humans and animals, particularly dogs, is highly reliable in preventing transmission.

N Engl J Med. 2016. Randomized Trial of Longer-Term Therapy for Symptoms Attributed to Lyme Disease. The treatment of persistent symptoms attributed to Lyme disease is controversial. We assessed whether longer-term antibiotic treatment of persistent symptoms attributed to Lyme disease leads to better outcomes than does shorter-term treatment. In a randomized, double-blind, placebo-controlled trial conducted in Europe, we assigned patients with persistent symptoms attributed to Lyme disease to receive a 3 month oral course of doxycycline, clarithromycin plus hydroxychloroquine, or placebo. All study groups received open-label intravenous ceftriaxone for 2 weeks before initiating the randomized regimen. In patients with persistent symptoms attributed to Lyme disease, longer-term antibiotic treatment did not have additional beneficial effects on health-related quality of life beyond those with shorter-term treatment.

Am J Med. 2013. Treatment trials for post-Lyme disease symptoms revisited. The authors of 4 National Institutes of Health-sponsored antibiotic treatment trials of patients with persistent unexplained symptoms despite previous antibiotic treatment of Lyme disease determined that retreatment provides little if any benefit and carries significant risk.

Int Med Case Rep J. 2017. Effects of intravenous ketamine in a patient with post-treatment Lyme disease syndrome. Post-treatment Lyme disease syndrome (PTLDS) is a pain disorder for which there remains no gold standard treatment option. Here, we report a case of PTLDS in a female patient whose pain was refractory to treatment options such as radiofrequency ablation, vitamin infusion therapy, opioid analgesics, and other pharmacotherapies. The patient commenced an experimental intravenous ketamine infusion therapy at the Florida Spine Institute (Clearwater, FL, USA) and achieved relief from her chronic pain, an improved quality of life, reduced depression and suicidal ideation, and reduced opioid consumption.

Lyme disease natural or alternative treatment
I am not aware of a home remedy or nutritional treatment. However, you may with to read these two articles regarding ways to improve the immune system and some herbs that can fight infections. Perhaps some of the listed options may be of benefit.

Q. Are there certain supplements / herbs / vitamins indicated as useful to treat Lyme disease?
   A. I have not seen studies yet regarding the treatment of this tick-borne disease with dietary supplements or other forms of natural treatment.

The number of cases of Lyme disease has doubled in the United States since 1991. More than 21,000 cases of the tick-borne disease are now reported every year, making it the most common illness transmitted by bugs or animals in the United States. The northeastern states had the most cases, with 2,335 cases reported in Massachusetts in 2005, 3,363 in New Jersey, 5,565 in New York, and 4,287 in Pennsylvania.

Ticks that transmit Lyme disease are now found in nearly half of all counties in the United States, a much broader swath than was seen in the late 1990s. Black-legged ticks reported in more than 45 percent of U.S. counties, compared with 30 percent of counties in 1998. Black-legged tick is now considered established in twice as many counties as in 1998. Most of the ticks' expansion in range has occurred in the northern United States. Its distribution in southern states has remained fairly stable.

I read with great interest your comments about DHEA and dosages. I was diagnosed with Lyme Disease in 2007. This, after three months of feeling like tired, listless, experiencing cognitive problems and being told by a neurologist and my GP that “I do not have Lyme disease”. I found a specialist who was willing to test beyond ELISA and learned that I did, in fact, have Lyme disease. We embarked on a series of trials with different antibiotics and , while some didn’t like me very well, we have made incremental and important gains. I am working my way back and have some of my old kick back. I continue on Chlarythromycin today and for about two more weeks. In addition to the other symptoms I mentioned, fairly recent testing showed that the Lyme disease had kicked the life out of my free and weakly bound testosterone levels (very common with Lyme patients) and additional results of my CK-57 showed that I am on the very lowest end of the normal spectrum for that test. After discussing many options, my Lyme Doctor put me on DHEA with a recommended dose of 25 mg. Because I am a bit of a skeptic, I researched DHEA and found your web page. As a result of reading your comments I put the 25 mg aside after 2 days and ordered the 5 mg. I have been taking it now for three weeks and will go for another round of tests next week. I will be most interested to see the results. Given my circumstance, and the affects that Lyme has had on my testosterone, do you feel that it might be warranted to utilize higher doses than the 5 mg you recommend? I am back in the gym. Making some gains. But definitely do not have the “pop” I once had not 8-12 months ago.
   A. We wish you optimal healing but we can't make suggestions on what dosage you should use. There are many factors beyond testosterone levels that need to be addressed as a whole to combat fatigue.

I saw on your site that you are not taking any new patients. Our background is, my wife has Lyme and has been on antibiotics for about 1 year. When she discontinues the antibiotics she experiences symptoms again.

Please advise if you have any recommended treatment for lyme disease. I have been diagnosed (as well as, my family). One daughter has lyme, bartonella, and ehrlichia. We've gone through the typical course of treatment. We've gone through extended treatment for almost 3 years. We've used salt and C protocol...extended treatment with Rife Generator (unfortunately machine was on loan, so did not continue usage). I know there are a lot of natural supplements that boost the immune system, and ones that are antibiotic in nature .. I've tried a number of them. Obviously, not with good results. Thank you for your time and consideration in this matter.
   As of 2018 I am not aware of any natural cures for this condition.

I'd like to know of any reputable sources of info on the use of bioidentical hormones in Lyme disease patients. I'm 30 years old, still menstruating and was diagnosed with Lyme disease after 3 years of being ill. Any suggestions for appropriate reading material would be greatly appreciated.
   A. I am not aware of any research regarding the use of bioidentical hormones as a treatment for Lyme disease. I doubt if it would be helpful.

I have been reading your newsletters for several years now and find them very informative. Unlike many advocates of herbal medicine, you have a balanced and cautious approach to the use of supplements, which is laudable. I am a 62 year old man who has suffered for decades from a variety of arthritic, neurological, and cardiac symptoms. Like millions of others, I was on the search for answers to my numerous symptoms. I have had numerous orthopedic interventions including total shoulder replacement and spinal decompression for central stenosis. Finally after one of my surgeries, symptoms became more and more pronounced and my symptoms were suggestive of MS. A also had episodes of tachycardia and arrhythmia. To make a long story short, I was finally diagnosed 2 years ago with chronic disseminated Lyme Disease. Who diagnosed me? I did. My PCP finally came to believe it as well, but I had to drag him kicking and screaming to this conclusion. With mainstream medicine, it is always ABL, "Anything But Lyme". I finally developed a rash which was misdiagnosed by a local walk-in clinic as ringworm. They were wrong. It was the secondary rash of chronic Lyme. Standard testing for Lyme Disease is extremely innacurate, missing as many as 70% of patients. I was one of them. I finally had testing done by a Lyme specialty lab (Medicare approved) and tested positive by their criteria, although not "CDC positive". For 2 years I have been treated by a Lyme specialist with hi-dose multiple antibiotics, supplements, and other drugs. I am getting stronger, but am not yet "cured." Most doctors do not know that the CDC Lyme criteria are for epidemiological purposes only. A negative ELISA or Western Blot must not be used to rule out Lyme Disease in a patient otherwise presenting symptoms suggestive of Lyme. Because I was misdiagnosed for so long, I have what may be permanent nerve damage. I am 62 with the spine and shoulder joints of a 92 year old man. Over the years, doctors injected steroids into my spirochete-riddled joints, which only served to suppress my immune system and cause Lyme to flourish. The psychological symptoms can also be horrific, ranging from depression, panic, OCD (as in my case) to full-blown psychosis. It turns out all my siblings have Lyme as well, and that we got it congenitally from my mother. I know now that she died from Lyme Disease after suffering from it for decades. I recently learned that it can present as gout in some patients (like syphilis it can mimic a host of other diseases), which is how I came to realize my brother had it as well. My point in telling you all this is that many of your readers, perhaps tens of thousands of them, are reading your newsletter regularly hoping to find something that will relieve their horrific suffering which is actually being caused by undiagnosed chronic Lyme Disease. Their "mainstream" doctors are failing them miserably. In my opinion this is a public health disaster. I know someone who has deteriorated for twenty years, is now in a wheelchair, and only recently got a diagnosis of late-stage Lyme. Before that it was "MS", "maybe MS". 'Lou Gehrig's ", in other words, anything but Lyme. There is an excellent documentary about Lyme called Under Our Skin by PBS. Also, see Pam Weintraub's book, Cure Unknown. It chronicles the struggles her entire family faced with this disease. The best websites for accurate and helpful info about Lyme Disease are ILADS dot org and lymenet dot org.

Q. I have followed your website for a while and also read your book about DHEA. Thank you for the excellent provision of information. I wanted to ask you something please. I do appreciate you can't give personal advice, but this is a general question. What is the best way to try to cut down DHEA if one has been taking it for a number of years without getting diabolical withdrawal symptoms? My personal situation is that I have chronic Lyme disease and find that DHEA is tremendously helpful at a low dose (3mg daily), but I am getting very concerned as I have been taking it for 4 years now (I am aged 41) and if I ever don't take it I feel absolutely terrible. I feel completely and utterly dependent on it now to live any kind of normal life. Maybe I just have to accept that my adrenal glands have packed in and I have to keep taking it, I don't know. Thank you so much for any thoughts on this.
   A. One option is to reduce the dose by 1 mg each week and within 3 weeks one should get off it easily. However, each person is different in their reaction to withdrawal. Some may not experience any, others may have symptoms.