What Factors Determine How Patients Respond To Treatment
To find out what made some patient substantially improve or become well, we turned to our academic partners at the University of California at Los Angeles who specialize in artificial intelligence and machine learning. Their team looked at 215 features related to diagnostic factors, treatment approach, duration of individual antibiotics, alternative treatments, symptoms, type of clinician, and functional impairment to identify the 30 top predictive features for treatment response . Most of the top 30 features identified in their study related to chronic Lyme disease treatment , symptom severity , and type of clinician treating Lyme disease. We analyzed three of these factors associated with treatment response:
- Treatment approach
- Treatment durations
- Type of clinician overseeing the patients care
Antibiotics Alone Are Unlikely To Get You Well
This is the second time I am making this point because it is very important. It is essential to your recovery that, at a minimum, your treatment address the steps outlined in my Lyme disease treatment guidelines: The Ross Lyme Support Protocol. Even a year or more into your treatment, these ten steps are essential to resuscitate and support the immune system.
Why Are Antibiotics The First Line Of Treatment For Lyme Disease
The use of antibiotics is critical for treating Lyme disease. Without antibiotic treatment, the Lyme disease causing bacteria can evade the host immune system, disseminate through the blood stream, and persist in the body. Antibiotics go into the bacteria preferentially and either stop the multiplication of the bacteria or disrupt the cell wall of the bacteria and kill the bacteria . By stopping the growth or killing the bacteria the human host immune response is given a leg up to eradicate the residual infection. Without antibiotics, the infection in Lyme disease can evade the host immune system and more readily persist.
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Chronic Lyme Disease Or Postlyme Disease Syndrome
Following an episode of Lyme disease that is treated appropriately, some persons have a variety of subjective complaints . Some of these patients have been classified as having chronic Lyme disease or postLyme disease syndrome, which are poorly defined entities. These patients appear to be a heterogeneous group. Although European patients rarely have been reported to have residual infection with B. burgdorferi , this has yet to be substantiated either in a large series of appropriately treated European patients or in a study of North American patients. Residual subjective symptoms that last weeks or months also may persist after other medical diseases . It has also been recognized that the prevalence of fatigue and/or arthralgias in the general population is > 10% .
In areas of endemicity, coinfection with B. microti or the Ehrlichia species that causes HGE may explain persistent symptoms for a small number of these patients . Randomized controlled studies of treatment of patients who remain unwell after standard courses of antibiotic therapy for Lyme disease are in progress. To date, there are no convincing published data showing that repeated or prolonged courses of oral or iv antimicrobial therapy are effective for such patients. The consensus of the IDSA expert-panel members is that there is insufficient evidence to regard chronic Lyme disease as a separate diagnostic entity.
Symptoms Of Post Treatment Lyme Disease
- Include severe fatigue, musculoskeletal pain, & cognitive problems
- Can significantly impact patients health and quality of life
- Can be debilitating and prolonged
Our research indicates the chronic symptom burden related to PTLD is significant. Although often invisible to others, the negative impact on quality of life and daily functioning is substantial for PTLD sufferers.
The chronic symptom burden related to Lyme disease is considerable, as shown on the left side of the graph above, and statistically significantly greater than the aches and pains of daily living experienced by the control group, on the right.
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For Depression And Anxiety
Both psychotherapy and pharmacotherapy have proven benefits for improving mood. Psychotherapy has many different types such as supportive, dynamic, cognitive behavioral, dialectical behavior therapy, transference focused psychotherapy each of which offers benefit. Pharmacotherapy also has many different types. For depression the first-line options usually are SSRIs, SNRIs, Tricyclics or other agents with more unique modes of action.
A few noteworthy tips on anti-depressant agents:
- Most anti-depressant agents also help in reducing anxiety. However the opposite isn’t necessarily true. Specific anti-anxiety agents such as clonazepam or diazepam may not necessarily help fight depression.
- Most anti-depressants take three to eight weeks before an effect is seen. Therefore, it is unwise to stop an anti-depressant after only three or four weeks, as staying on it another two to three weeks may lead to a good response.
- Dosage makes a difference. Some anti-depressants work fine at low doses some medications however are effective only at higher doses. Some medications are more effective as the dose is i increased. Other antidepressants may have a therapeutic range one has to achieve at least a certain dosage .
Possible Alternative Treatment For Lyme Disease
- University of Oklahoma
- Researchers have described a new antibiotic that appears to have the potential to cure Lyme disease.
As if COVID and RSV weren’t bad enough, incidents of Lyme disease — a potentially serious disease caused by the bacteria Borrelia burgdorferi and transmitted following a bite of an infected deer tick — also are on the rise in the United States.
Lyme disease affects an estimated 300,000 people in the United States alone. Humans and animals can be infected with B. burgdorferi following the bite of an infected deer tick, also known as the black-legged tick. About 80% of those who contract the disease will develop a bulls-eye rash around or near the site of the bite anywhere from three to 30 days following the bite.
Although early antibiotic treatment is effective for most patients, some 10-20% of patients continue to suffer from symptoms that may include fatigue, muscle pain and cognitive impairment for over six months after therapy. The significance of this debilitating disease has been recently brought into focus by a set of very similar symptoms in patients with “Long COVID.”
The antibiotics currently used to treat Lyme disease are broad-spectrum with significant effects on the human gut microbiome and the potential for increasing resistance in non-target bacteria, Zgurskaya explained, adding that the team sought to identify a compound acting with a narrower spectrum of activity against B. burgdorferi.
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Hunting For Alternative Drug
Frustrated by the lack of treatment options for Lyme disease patients with lingering symptoms, Rajadas and his team began hunting for a better alternative in 2011. In 2016, they published a study in Drug Design, Development and Therapy that listed 20 chemical compounds, from about 4,000, that were most effective at killing the infection in mice. All 20 had been approved by the Food and Drug Administration for various uses. One, for instance, is used to treat alcohol abuse disorder.
In this most recent study, azlocillin, one of the top-20 contenders, was shown to eclipse a total of 7,450 compounds because it is more effective in killing B. burgdorferi and causes fewer side effects. Lyme disease affects more than 300,000 people annually, according to the Centers for Disease Control and Prevention. It can affect various organs, including the brain, skin, heart, joints and nervous system, and cause heart problems and arthritis if untreated. Symptoms include fever, headaches, chills, and muscle and joint pain.
Traditional antibiotics, such as doxycycline, are effective as an early course of treatment for the infection in the majority of patients, but it remains unclear why these drugs fail to treat 10% to 20% of patients, Rajadas said.
Early Detection Is Key
Amid the conflicting opinions and research on Lyme disease treatment, one thing is clear: The surest way to avoid needing complex treatment programs is to get diagnosed as soon as possible after being exposed and to include testing for all relevant tick-borne pathogens. The longer Lyme disease and these other infections go unchecked, the more difficult they are to treat.
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Azlocillin Comes Out On Top
The drug, which is not on the market, was tested in mouse models of Lyme disease at seven-day, 14-day and 21-day intervals and found to eliminate the infection. For the first time, azlocillin was also shown to be effective in killing drug-tolerant forms of B. burgdorferi in lab dishes, indicating that it may work as a therapy for lingering symptoms of Lyme disease.
Pothineni and Rajadas have patented the compound for the treatment of Lyme disease and are working with a company to develop an oral form of the drug. Researchers plan to conduct a clinical trial.
Rajadas is also a professor of bioengineering and therapeutic sciences at the University of California-San Francisco.
Other Stanford co-authors are Hari-Hara S. K. Potula, PhD, senior research scientist postdoctoral scholars Aditya Ambati, PhD, and Venkata Mallajosyula, PhD senior research scientist Mohammed Inayathullah, PhD and intern Mohamed Sohail Ahmed.
A researcher at Loyola College in India also contributed to the work.
The study was funded by the Bay Area Lyme Foundation and Laurel STEM Fund.
- Tracie White
How Is Lyme Disease Treated
Lyme disease is most often treated with antibiotics such as doxycycline, amoxicillin, or cefuroxime for several weeks. Please complete the full course of antibiotics as prescribed, even if your child is feeling better, in order to kill all the bacteria.
If your child doesn’t respond to oral antibiotics, or if the Lyme disease is affecting the central nervous system, antibiotics may need to be given intravenously . This usually doesnt require your child to be hospitalized. In many cases, a nurse can come to your home to administer the IV or teach you or another family member how to do it.
Anti-inflammatory medicine may be prescribed for children who are experiencing pain from arthritis.
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Antimicrobial Herbs That Kill Growing Phase Spirochetes & Cysts
Intracellular and Extracellular
Based on my observations, these herbal combination options have as good of a chance as the prescription options. They appear to kill intracellular and extracellular Lyme too based on the clinical benefit I see in my medical practice.
- Cats Claw and Otoba Bark Tinctures 30 drops of each 2 times a day. Start at 5 drops 2 times a day and add 1 drop per dose per day until you reach 30 drops 2 times a day. If you get a Herxheimer reaction, stop increasing the dose until it has passed.
- Cats Claw and Japanese Knotweed 30 drops of Cats Claw 2 times a day and ½ tsp of Japanese Knotweed 3 times a day. Work up to these doses over 30 days. Start Cats Claw at 5 drops 2 times a day and add 1 drop per dose per day until you reach 30 drops 2 times a day. Start the Japanese Knotweed at ¼ tsp 3 times a day and in two weeks increase to ½ tsp 3 times a day.
Recommendations For Treating Lyme Disease
Chronic Lyme disease is a serious and stubborn condition, and theres no simple solution that works for everyone.
Treatments I have used during my years practicing medicine have included intravenous therapies, such as immune-boosting glutathione and vitamin C, which has direct antimicrobial activity. Because Borrelia thrives in a low-oxygen environment, hyperbaric oxygen therapy is great because it saturates the system with oxygen. Medicinal herbs and nutritional supplements that support the bodys ability to fight infection, and low-dose naltrexone, a proven immune enhancer, are also good treatments. Finally, I recommend therapies like neurofeedback and EECP to help patients get on the road back to health.
The International Lyme and Associated Diseases Society is a good source of information and can guide you to experienced physicians.
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Why This Is Important
The use and duration of antibiotics for chronic Lyme disease treatment is controversial because there is no biomarker that can determine whether the Lyme bacteria has been eradicated in CLD patients. Patients are often told that either chronic Lyme disease does not exist or that it is incurable. If this were true, we would not expect more well and substantially improved patients to be taking antibiotics. Instead, we might have expected the percentage of people using antibiotics to be roughly the same among the patient subgroups.
Ongoing Symptoms Of Lyme Disease
A few people who are diagnosed and treated for Lyme disease continue to have symptoms, like tiredness, aches and loss of energy, that can last for years.
It’s not clear why this happens to some people and not others. This means there’s also no agreed treatment.
Speak to a doctor if your symptoms come back, or do not improve, after treatment with antibiotics.
The doctor may be able to offer you further support if needed, such as:
- referral for a care needs assessment
- telling your employer, school or higher education institution that you require a gradual return to activities
- communicating with children and families’ social care
Page last reviewed: 05 July 2021 Next review due: 05 July 2024
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Lyme Disease Treatment: What Works/what Doesn’t
Until two years ago, Debra Rae was always on the go. She worked full time, was involved with her familys activities, and enjoyed hiking, snowboarding, Zumba, and mountain biking. Then her health began spiraling downhill.
Within months, I went from active and healthy to feeling old and frail. My migrating symptoms included stabbing and shooting pain, numbness and tingling, stiffness and spasms, memory and attention difficulties, loss of balance and vertigo, vision problems and sensitivity to light and sound, gastrointestinal and bladder issues, shortness of breath and heart palpitations, skin rashes and night sweats, lack of energy, and more. In short, I was a wreck.
I saw five doctors, including a neurologist, a rheumatologist, and an orthopedic specialist, and endured physical therapy for 12 weeks. I received about 50 pages of test results from X-rays, MRIs, and EMGs to blood and urine tests to rule out vitamin deficiency, heavy metal toxicity, hepatitis, lupus, rheumatoid arthritis, thyroid issues, and brain and spinal damage. No one was able to give me a diagnosis. My life was in shambles. I wasnt able to do any of the activities I loved doing. I couldnt even wear shoes because the pain was so bad.
Lyme Disease Treatment And Prevention
10 min. read
Dr. Julian Whitaker
With every new summer comes increased prevalence of blacklegged ticks , the insects that spread Lyme disease. These critters are now found in nearly every state and almost half of all US counties.
As you can imagine, the best Lyme disease treatment is prevention. Ticks thrive in humid, moist, wooded, and grassy environments, so wear long sleeves and pants in these areas, perform tick checks when you return indoors, and watch for fever and rash, two common signs of infection.
Immediate treatment with antibiotics is usually effective, but chronic Lyme disease is another story, and many patients suffer for years with misdiagnoses and ineffective therapies. If youre dealing with chronic Lyme diseaseor symptoms that cant be explained or relievedthis is for you.
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Who Gets Lyme Disease
Anyone bitten by an infected deer tick can get Lyme disease. Most U.S. cases of Lyme disease happen in Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, and Wisconsin. But Lyme disease is found in other parts of the U.S., Europe, Asia, and Australia too.
How To Prevent Post
While you may not be able to prevent post-treatment Lyme disease syndrome, you can take precautions to prevent coming into direct contact with infected ticks. The following practices can reduce your likelihood of getting Lyme disease and developing persistent symptoms.
If a tick bites you, contact your doctor. You should be observed for 30 days for signs of Lyme disease. You should also learn the signs of early Lyme disease and seek prompt treatment if you think youre infected. Early antibiotic intervention may reduce your risk of developing chronic symptoms.
The signs of early Lyme disease can occur from 3 to 30 days after a bite from an infected tick. Look for:
- a red, expanding bulls-eye rash at the site of the tick bite
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Tetracycline Plus Macrolide Plus Grapefruit Seed Extract Plus Japanese Knotweed
- doxycycline 100 mg 2 pills 2 times a day
- clarithromycin 500 mg 1 pill 2 times a day
- grapefruit seed extract 250 mg 1 pill 2 times a day.
- Japanese knotweed½ tsp 3 times a day
- Tetracyclines and macrolides both block protein production by binding to the protein production apparatus in germs called ribosomes. But they each bind to a different part of the ribosome improving the blockade of protein production.
- Japanese knotweed is added here to treat persister Lyme. It also may treat growing Lyme and can lower inflammation cytokines.
Is There A Vaccine For Lyme Disease
A vaccine for Lyme disease was once available in the United States, but it is no longer available. The vaccines manufacturer discontinued its production in 2002, citing low sales.
According to a 2011 analysis, there were likely a number of factors leading to the decision to suspend the vaccine. These factors included:
- Class-action lawsuits
- Low public support due to efforts by anti-vaccine groups
- Concerns that the vaccine could cause arthritis
- A difficult vaccination schedule.
The CDC also notes that the vaccine loses effectiveness over time, meaning that you’re probably no longer protected against Lyme disease today if you received the vaccine when it was available.
In July 2017, the FDA granted Fast Track designation for another Lyme disease vaccine candidate, VLA15. The FDA designation is intended to facilitate development and expedite review of drugs that treat serious conditions in order to get them to patients faster.
Additional reporting by George Vernadakis.
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