Lyme Disease

Introduction

What should I know about Lyme Disease?

Lyme disease is hardly a household word. In fact, unless you live in the Northeastern United States, you might not have heard of this potentially serious and somewhat mysterious illness. Lyme disease is an infection transmitted solely by tick bites. But don’t cringe in fear the next time a friend suggests a walk in the woods. Only two species of ticks, both belonging to the "Ixode" genus, are carriers: deer ticks (Ixodes scapularis), and black-legged ticks (Ixode pacificus). Ixode ticks are found mainly on deer, although field mice, rabbits, sheep, and cattle may also pick them up.

The tick itself is not to blame for the infection, but a small, spiral-shaped bacteria called Borrelia burgdorferi that lives inside the tick. Named for the town of Lyme, Connecticut, where it was first identified back in the early 1970's, Lyme disease has appeared in the Northeast, the Mid-Atlantic, the Pacific Northwest, Wisconsin, and Minnesota. (1) Lyme disease was discovered when young children living in the Lyme area began showing up in doctors’ offices suffering from unexplained bouts of arthritis. After researching these puzzling cases, medical experts traced the problem to tick bites in the children and subsequently identified the guilty bacteria. (2)

Lyme disease is a challenging illness, both to diagnose and to treat. It is a difficult disease for clinicians to spot. For one thing, Ixode ticks are extremely small, about the size of a pinhead, making them hard to see, especially on areas of the body with hair. What’s more, tick bites are virtually painless, so people often have no idea they’ve been bitten.

The infection usually produces no symptoms at first. In about half the cases, a rash appears at the site of the bite. Called a "bull’s eye," this rash is the only visible sign of Lyme disease. Blood tests may not be reliable, since it takes up to four weeks after exposure before antibodies can be found in the blood. After several weeks, a highly sensitive test called "ELISA" can be used to diagnose Lyme disease more accurately. This is followed up with a "Western blot" test for confirmation. A new genetic engineering technique called "PCR" is being developed that can detect genetic material from the Lyme bacteria in tissue, blood, and body fluids. (3)

The symptoms of Lyme disease mimic many other illnesses, adding to the challenge physicians face in diagnosing it correctly. Lyme disease is often misdiagnosed as chronic fatigue syndrome, fibromyalgia, depression, or multiple sclerosis.

Statistic

Centers for Disease Control, 2001.

  • Lyme disease is the most common tick-borne bacterial disease in the world.

Centers for Disease Control, 1999.

    182,000 cases of Lyme disease have been identified since 1982. The number of early diagnosis doubled in 1992.

Signs and Symptoms

[span class=alert]The following list does not insure the presence of this health condition. Please see the text and your healthcare professional for more information.[/span]

Lyme disease progresses through three stages of infection: early, early disseminated, and late. The "bull’s eye" rash mentioned earlier is the main characteristic of the early stage. It begins as a small red spot at the site of the tick bite that grows to a round or oval rash over a period of days or weeks. It may be as small as a dime or as large as a watermelon. By this time, the rash has its "bull’s eye" look--a red ring around a clear middle, with a small red mark remaining in the center. The rash may appear in other places as the infection worsens. The rash is often accompanied by mild, flu-like symptoms (fever, headache, fatigue, and muscle tenderness) that persist for 6 to 8 weeks after initial exposure.

In the "early disseminated" stage, pain and inflammation are the major symptoms. Neurological problems such as Bells’ palsy, which causes temporary facial paralysis and meningitis, signaled by headache, sore neck, and back pain, can occur. Joints may be tender and inflamed. Arthritis marks the beginning of late infection. Several months after initial infection, more than half of those exposed to the Lyme bacteria develop chronic, intermittent arthritis. (4) About 10 percent develop irregular heartbeat, dizziness, and shortness of breath. Other symptoms include mental confusion, conjunctivitis, skin disorders, and poor coordination.

Early Infection

  • "Bull’s eye" rash at the site of the bite that over a period of days or weeks grows to a round or oval rash, which can vary in diameter
  • The rash may appear in other places as the infection progresses
  • Fever, headache, fatigue, and muscle tenderness may be present for 6 to 8 weeks after initial infection

Early Disseminated Infection

  • Headache
  • Sore neck
  • Back pain
  • Tingling mainly in arms and legs due to changes in nerve function
  • Periodic joint inflammation and tenderness

Late Infection

  • Chronic, yet periodic arthritis
  • Changes in patterns of heart beats
  • Dizziness
  • Shortness of breath
  • Confusion
  • Itchy, watery eyes
  • Skin disorders
  • Lack of coordination

Treatment Options

Conventional

Lyme disease is mainly treated with antibiotics. Early intervention is the key to success. The longer the infection goes untreated, the longer therapy will take. Four different classes of antibiotics used to treat the infection.

    Tetracyclines are the first choice for treating Lyme disease. However, tetracyclines can cause a wide range of side effects, including gastric irritation, nausea, vomiting, diarrhea, kidney toxicity, liver toxicity, and alterations in blood coagulation. Permanent staining of the teeth may result if tetracyclines are given to young children. This can also occur in children whose mothers took tetracycline during pregnancy. Like all broad spectrum antibiotics, tetracycline kills good as well as bad bacteria, leaving the user susceptible to Candida yeast overgrowth in the mouth, vagina, and bowel The good intestinal bacteria should be replaced with probiotic supplementation after a course of antibiotics. Penicillins (amoxicillin, penicillin V) are also effective against the Lyme bacteria, but high doses are needed. Cephalosporins (ceftriaxone) are effective in cases where tetracyclines cannot be used for medical reasons, or penicillins have failed. These are not "first choice" drugs because they can only be given intravenously or by intramuscular injection. Cephalopsorins are also expensive. Potential adverse effects include gall bladder inflammation and intestinal overgrowth of Candida yeast. Macrolides (erythromycin) are a class of drugs that prevent bacteria from reproducing. They are marginally effective against the Lyme bacteria, and only at high doses. Disease-causing bacteria quickly become resistant to erythromycin. (5) Azithromycin and clarithromycin, are newer forms of the macrolides, but they cause GI distress and yeast overgrowth, making them unsuitable for long-term use.

Vaccination Vaccination against Lyme disease has been used successfully in animals for many years. A human vaccine is currently under clinical trial. The vaccine works by stimulating anti-Borrelia antibody production. However, there is considerable controversy about the safety of this vaccine, and it has not obtained approval from the FDA.

Nutritional Suplementation

There have been almost no studies testing nutritional and/or other natural products in the prevention and treatment of Lyme disease. However, the following general guidelines are suggested.


Multivitamin

Optimum nutrition, starting with the essential vitamins and minerals, is important whenever the body is challenged. Taking a high potency multivitamin/mineral supplement will help to boost energy reserves and support the immune system.


Vitamin A

Research in animals points to a possible role of vitamin A deficiency in Lyme disease. Studies on mice infected with the Lyme bacteria suggest that vitamin A deficiency may help set the stage for conditions such as Lyme disease by aggravating inflammation. There is preliminary evidence that vitamin A might help relieve arthritis symptoms in Lyme disease by halting production of chemicals in the body called "interleukins" which trigger inflammation. (6)


Lactobacillus, Bifidobacteria

According to one study, patients with inactive Lyme disease have been treated with an average of 3.25 courses of antibiotics. Frequent use of antibiotics should be followed up with probiotic supplements. "Probiotic" literally means "for life." These supplements contains bacteria such as acidophilus and bifidus that are required for a healthy digestive system. Known as "friendly flora," the good intestinal bacteria produce lactic acid in the gut. This keeps the gut mildly acidic, which favors the friendly flora and prevents disease-causing bacteria from multiplying. The intestinal tract is the body’s first line of defense against infectious organisms. The friendly flora support immunity, produce B vitamins, and play a key role in keeping the gut healthy and free of toxins.

Extended antibiotic use can decimate the good bacteria population in the gut, upsetting the natural balance between friendly and unfriendly organisms that is so important for health. Probiotic supplements usually come in capsules containing freeze dried bacteria or powders that contain live cultures.


Omega-3 Fatty Acids

Fish oils such as cod and salmon oil are rich in omega-3 fatty acids. Flaxseed oil is an excellent vegetable source of omega-3 fatty acids. Omega-3's are listed as "essential fatty acids" because the body cannot manufacture them from other dietary fats. They can only be obtained from food or supplements. Omega-3 fatty acids help keep inflammation in check by discouraging production of inflammatory chemicals called "prostaglandins." Omega-3 fatty acids, at a dose of 2 to 6 grams a day, have shown some success in reducing the pain and inflammation of rheumatoid arthritis. (7) They may be helpful for relieving joint pain in Lyme disease as well.


Antioxidant Nutrients

Lyme disease is capable of causing widespread inflammation in many tissues throughout the body. (8) , (9) Since free radical production is a normal part of the bodily processes that cause inflammation, taking extra amounts of antioxidant nutrients may help minimize the damage. A good, comprehensive antioxidant regimen includes vitamins A, C, E, beta-carotene, selenium, coenzyme Q10, and lipoic acid. The body needs these nutrients for strong immune function and energy production. Antioxidants neutralize free radicals, toxic byproducts of metabolism that harm cells and contribute to inflammation if left unchecked.

Herbal Suplementation


Reishi Mushroom

Reishi mushroom, called the "mushroom of immortality" in China, has been prized as a tonic and fortifying medicine for thousands of years. Some of the plant kingdom’s most active polysaccharides are found in rieshi mushrooms. Based on evidence from research studies, reishi is a natural antiviral agent, giving it potential value in Lyme disease. Reishi also demonstrates liver-protecting, blood sugar-lowering, and antioxidant properties.

Reishi research is not limited to lab animals. In a 1992 clinical study, 48 patients with advanced cancer (including renal, gastric, and breast cancers) were given a dose of reishi mushroom extract before undergoing chemotherapy. (10) Patients with compromised immune systems showed improvements in their ratio of "T helper" to "T suppressor" cells, a key barometer of immune function. They tolerated radiation and chemotherapy better, their white blood cell counts went back up (lowered white blood cell count is a typical side-effect of these therapies) and their strength and appetite improved. Reishi also decreased immune system suppression in mice subjected to gamma radiation. (11)


Boswellia

A gummy resin tapped from Boswellia serrata, a tree native to India, boswellia is highly valued in the traditional Ayurvedic medicine as a remedy for arthritis, dysentery, liver diseases, obesity, neurological disorders, ringworm, boils, and other afflictions. (12) Based on recent research showing it to have stellar inflammation-reducing power, boswellia has emerged as an effective herb for relieving symptoms of arthritis. (13)

Extensive animal studies indicate that boswellia extracts influence inflammatory physiology from several different angles. Active ingredients in the herb called "Boswellic acids" block the production of potent, tissue-damaging chemicals called "leukotrienes" that are key players in the inflammatory response, rein in the "complement system, and check the infiltration of white blood cells into tissues. An abundance of scientific evidence paints a clear picture of boswellia as a multi-faceted anti-inflammatory herb. (14) , (15) , (16) In contrast to NSAIDS (non-steroidal anti-inflammatory drugs) which break down joint cartilage over time, boswellic acids appear to protect cartilage and slow the degradation of joints that occurs in arthritis. (17) , (18)


Turmeric

When it comes to chilling out inflammation, turmeric, like boswellia, is no weakling. Turmeric root contains highly beneficial active ingredients called "cucuminoids." Collectively known as "curcumin," these substances give turmeric effective inflammation-soothing, free radical-fighting abilities. Curcumin has been thoroughly researched, in animal and human studies that convincingly demonstrate its antioxidant and anti-inflammatory properties. (19) As an inflammation cooler, curcumin has been found equal in strength to some steroid drugs used to treat arthritis. (20)

Research on curcumin gives a fairly clear picture of how it works, lending solid support to the traditional use of turmeric in arthritis and inflammation-related conditions. The body’s inflammatory response is triggered by chemicals such as prostaglandins and the even more potent leukotrienes mentioned earlier. Production of these substances, like most biochemical processes, is enzyme-driven. Inflammation begins when enzymes convert a fatty acid called "arachidonic acid" into leukotrienes and prostaglandins. Turn off those enzymes and inflammation shuts down. Curcumin does just that. Studies confirm that curcumin inhibits the enzymes which serve as the catalysts for inflammation. In fact, this is precisely how NSAIDs work. Curcumin has been found comparable to NSAIDs in inflammatory enzyme-blocking activity. (21)

Experimental studies that explain how an herb works give valuable insight, but the real test is always: "Does it help real people with real problems?" Curcumin seems up to the task: in a double-blind study of individuals with rheumatoid arthritis, curcumin produced significant improvement in everyone. (22) Curcumin has not been tested as a remedy for Lyme disease, but if it works for a condition as serious as rheumatoid arthritis, curcumin is probably worth trying.


Grapefruit Seed

Grapefruit seed extract has been reported to be a broad-spectrum antimicrobial substance both test tube and human studies. Grapefruit seed appears to break down the cell membranes of bacteria that in invade the body causing them to die. (23)

Grapefruit seed extract also inhibits the growth of H. pylori and C. jejuni, two bacteria that cause gastrointestinal ulcers. (24) This helps to right the balance between the friendly flora and disease-causing organisms in the gut and control Candida yeast overgrowth. Test-tube studies suggest grapefruit seed extract also preserves the structural integrity of gut wall tissue. (25) In one human study, an improvement in constipation, gas, abdominal distress, and night rest were noticed after four weeks of therapy with grapefruit seed extract. Most clinicians now agree on the importance of maintaining the correct balance of gut organisms in health and disease. (26) , (27)


Oregano

Oregano oil is gaining attention as an antifungal and antibacterial agent, so it may prove useful in Lyme disease as well. (28) In a recently published clinical trial, oil of oregano was given orally to 14 adults whose stools tested positive for intestinal parasites. After six weeks of supplementation with 600mg emulsified oil of oregano daily, infection levels dropped sharply, and in some cases disappeared altogether. Gastrointestinal symptoms improved in 7 of the 11 patients. (29) Two constituents in oregano, thymol and carvacrol, have reported antibacterial properties. (30)

Oregano also has reported antioxidant activity. (31) The ingredients responsible for this include flavonoids (rosmarinic acid) and vitamin E. (32)

Rosmarinic acid is yet another anti-inflammatory herbal ingredient. Also found in rosemary and basil, rosmarinic acid works to check the various enzymes discussed earlier that set the inflammatory process in motion. (33) Going one step further, Rosmarinic acid increases the production a beneficial type of prostaglandin that discourages inflammation. This coupled with its supportive influence on the immune system makes oregano a potentially useful herb in natural therapy for cancer, inflammation, immune-related problems, and Lyme disease. (34) , (35)

One note of caution Oregano contains naringin and naringenin, chemical constituents also found in grapefruit juice that alter the metabolism of some drugs in the liver. (36) If you do use Oregano, check with your health care provider or pharmacist to make sure any drugs you may be taking are not affected in this way.


Olive Leaf

Olive leaf is an herb worthy of consideration by anyone with Lyme disease. Olive leaf extract has been reported to be effective against a wide variety of infectious microorganisms, including Salmonella typhi, Vibrio parahaemolyticus, and Staphylococcus aureus (including penicillin-resistant strains); and Klebsiella pneumonia and Escherichia coli, causal agents of intestinal or respiratory tract infections in man. (37) Researchers are fairly certain that oleuropein accounts for this. (38) , (39) In lab studies, oleuropein shows the ability to stimulate immune cells in the body called "macrophages which function as garbage collectors to remove organisms and other foreign substances." (40)

Olive leaf extract may also be effective against viral infections. A byproduct of oleuropein called "elanolic acid" appears to account for this. Experiments have shown that calcium elenolate, a synthetic derivative of elenolic acid, is an antiviral agent. (41) , (42) Recent laboratory studies in laboratory animals reported blood sugar and cholesterol-lowering effects from oleuropein. (43) , (44)

Diet & Lifestyle

Preventing Tick Bites The only way to avoid Lyme disease is to prevent tick bites. Extra precautions should be taken in Lyme-infested areas, especially the coastal regions of the Northeast. However, ixode ticks have been reported in virtually every area of the country. The high-risk season for tick bites is early summer through early fall: especially May, June, and July.

    Avoid densely wooded areas, and regions with tall grass. Wear a hat, long pants, and shirts with long sleeves when working in the yard or walking through areas where ticks may thrive. Check frequently for ticks on the body and head. Ixode ticks are very small; look for a mark that resembles a small freckle or a piece of dirt. Use insecticide on clothing for extra protection. If a tick is found, remove immediately with tweezers. Research indicates that it takes approximately 48 hours for an infected tick to transmit the Lyme bacterium. (45) Remove the tick from the head, do not squeeze or handle the body. Save the tick on a piece of tape sealed in a plastic bag to confirm the identification. Swab the bite with an antiseptic. After outdoor outings, remove and wash clothing immediately.

References

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