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.
Other Pathogens To Blame
Shor and his co-authors, including Maloney, propose that the lingering symptoms are caused by several pathogens from the Borrelia burgdorferi family or other tick-borne pathogens.
Nardelli said theres a variety of symptoms and severity in Lyme disease patients, and those symptoms can be caused by the inflammatory responses against the microbes.
Inflammation is a huge part of the immune response. Its one of the frontline defenses we have, and it has this negative connotation, but it is intended for good, he said. Your immune response trying to kill the bug and in doing so, can cause damage, essentially.
Some theories suggest that variants of the Lyme bacteria are resistant to antibiotics. Others argue that chronic Lyme is caused by a powerful immune reaction or it may even trigger an autoimmune disease. The central neural networks may be altered, having a significant impact on symptoms or a combination of these factors.
Nardelli is investigating Lyme-related arthritis that persists after treatment with antibiotics. He said science can be a slow process of acquiring new knowledge, and its tough for patients who are suffering with no clear answers.
That can lead them to seek out untrustworthy practitioners or fall for costly treatments that dont work. You go out and find doctors that diagnose everything as Lyme disease, Nardelli said.
The whole goal is to get people the right diagnosis so they can get the therapy that they need, she said.
Symptoms Of Lyme Disease
A circular or oval shape rash around a tick bite can be an early symptom of Lyme disease in some people.
The rash can appear up to 3 months after being bitten by an infected tick, but usually appears within 1 to 4 weeks. It can last for several weeks.
The rash can have a darker or lighter area in the centre and might gradually spread. It’s not usually hot or itchy.
The rash may be flat, or slightly raised, and look pink, red, or purple when it appears on white skin. It can be harder to see the rash on brown and black skin and it may look like a bruise.
Some people also get flu-like symptoms a few days or weeks after they were bitten by an infected tick, such as:
- a high temperature, or feeling hot and shivery
- headache
- tiredness and loss of energy
Some people with Lyme disease develop more severe symptoms months or years later.
This is more likely if treatment is delayed.
These more severe symptoms may include:
- pain and swelling in joints
- nerve problems such as pain or numbness
- heart problems
- trouble with memory or concentration
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Type Of Clinician Overseeing Care
We asked patients to tell us the type of clinician overseeing their care. Choices included: family physicians, internists, rheumatologists, infectious disease specialists, and clinicians whose practice focused on tick-borne diseases . Very few patients selected an infectious disease specialist. Seventy-five percent of high responders and well patients report having their care overseen by an LLMD.
Physicians who treat Lyme disease as their primary focus might be expected to have better results than physicians who dont simply because volume of cases handled means a greater experience level. It is commonly recognized in medicine that volume of cases is associated with better treatment outcomes . Just as patients with cancer commonly seek out physicians who specialize in that area, perhaps patients with chronic Lyme disease should also.
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.
Jayakumar Rajadas
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.
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Prevention Of Tick Bites
The best currently available method for preventing infection with B. burgdorferi and other Ixodes-transmitted infections is to avoid tick-infested areas . If exposure to I. scapularis or I. pacificus ticks is unavoidable, a number of measures may help to decrease the risk that ticks will attach and subsequently transmit infection. The use of protective clothing may interfere with attachment by ticks by increasing the time required for ticks to find exposed skin, thus facilitating their recognition and removal. By wearing light-colored clothing , persons in areas of endemicity may also be more likely to see ticks before they have attached.
Daily inspections of the entire body to locate ticks also provide an opportunity to prevent transmission of tick-borne infections . Attached ticks should be removed promptly with fine-toothed forceps, if possible . Tick and insect repellents applied to the skin and clothing provide additional protection .
Testing For Kidney Disease
Tests to diagnose kidney disease include complete blood count, serum biochemistry, and urinalysis. These blood tests will determine if your pet is anemic, determine white blood cell counts, measure blood urea nitrogen, creatinine, and electrolytes. A urinalysis is essential for the proper interpretation of the urea and creatinine values in the serum biochemistry profile and may also provide important clues to the possible underlying cause of kidney disease. A urinalysis will also determine the specific gravity, pH, presence of blood in the urine, and the amount of protein in the urine. An evaluation of the urine sediment will determine the presence of red blood cells, white blood cells, bacteria, crystalline material, and cellular casts all of which provide information to determine the underlying cause of kidney disease in your pet. Further diagnostic tests may be recommended based on the results of these initial screening tests.
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Lyme Controversial From The Start
In autumn 1975, Polly Murray, an artist and mother of four in Lyme, reported to the state health department that she and her children were suffering from mysterious maladies, including stiff and swollen knees and rashes. And neighboring children were having similar hard-to-explain symptoms.
Physicians diagnosed the children with juvenile rheumatoid arthritis. Another mother from the area, Judith Mensch, also contacted the state health department. Finally, the cluster aroused the attention of the Connecticut public health authorities. Yale Universitys Dr. Allen Steere, who was still a rheumatologist-in-training, began searching for a cause.
The following year, Steere told the Journal of the American Medical Association, that he strongly suspected the illness came from some type of infection.
In the early 1980s, Willy Burgdorfer, a medical entomologist at Rocky Mountain Laboratories, identified the bacterium that caused the mysterious affliction. It was named Borrelia burgdorferi after him.
Robert A. Aronowitz, a medical historian at the University of Pennsylvania, said the divide between mainstream medicine and Lyme patient advocates started early with Patty Murray herself. He noted that Murray created local Lyme support groups starting in the 1980s that began to position themselves in opposition to the leading Lyme disease physicians and scientists and their view of the disease.
Questions To Ask Your Veterinarian
If your dog has a positive Lyme test but no symptoms of the disease or protein in the urine, ask your veterinarian why he or she is recommending treatment. Experts currently recommend against antibiotic therapy under these circumstances because the dogs immune system is holding the bacteria in check and antibiotics are unable to eliminate the infection.
Dogs who have contracted Lyme disease do not develop prolonged, protective immunity and can be reinfected at a later date. Talk to your veterinarian about how best to prevent future infections. Options include measures to prevent the ticks that carry Lyme disease from biting your dog and Lyme vaccination.
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What Did This Study Do
This network meta-analysis included 19 randomised controlled trials involving 2,532 people with erythema migrans due to Lyme disease. No trials were based in the UK most were from the United States or Europe.
Each trial compared two or three antibiotics. Doxycycline was the most frequently used antibiotic. A number of doses and treatment durations were represented. For example, treatment length for doxycycline ranged from 10 to 21 days. For the main analyses, doxycycline was used as the reference treatment.
Both direct and indirect data were extracted from the studies. This approach is helpful when there is a shortage of head to head research, but this, and the overall low quality of included studies means that results need to be treated with some caution.
Chronic Symptoms That May Occur Days Months Or Years After Initial Infection
- fatigue and sleep disturbance
- vision]] problems
- hypersensitivity to light, sound, motion
- Psychiatric symptoms such as depression, anxiety, and rarely hallucinations
- Cognitive symptoms such as memory loss and attention problems.
Fatality can occur when the spirochete enters the brain and surrounding fluid, causing meningitis, or due to conductivity defects in the heart.
Lyme disease is sometimes misdiagnosed as multiple sclerosis, rheumatoid arthritis, fibromyalgia, chronic fatigue syndrome , or other diseases, which leaves the infection untreated and allows it to further penetrate the organism. Many of these conditions may also be misdiagnosed as Lyme disease, e.g. due to false-positive Lyme serology. However it should be noted that chronic fatigue syndrome is by definition a diagnosis of exclusion, meaning it would be inaccurate to say that a patient does not have Lyme because he or she has CFS. The substantial overlap in symptomology between Lyme and CFS makes this a crucial point.
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What Did It Find
- Compared to doxycycline, there was no difference between the following antibiotics for treatment response by 12 months: penicillin V , azithromycin , cefuroxime axetil , amoxicillin or ceftriaxone plus doxycycline .
- More than 80% of patients showed a treatment response, 84% at two or fewer months after starting treatment and 80% at 12 or more months following treatment initiation. There was no available data on outcomes for around 15%.
- There were few treatment failures in those people who were followed up 4% by two months and 2% by 12 months.
- Treatment-related adverse effects occurred in around 31% of people and included vomiting and diarrhoea as well as a Herxheimer-like reaction . Only 1% experienced haematologic adverse events, such as low platelet counts.
Postlyme Disease Symptoms And Syndrome
The outcome of treatment in most patients with erythema migrans is excellent. Studies show, however, that when questioned at 6 months or more aftertreatment of erythema migrans, approximately 10% of patients will report purely subjective symptoms such as fatigue or musculoskeletal pains.17 These subjective symptoms are typically mild and may wax and wane in intensity. Patients who have them are referred to as having postLyme disease symptoms or syndrome, depending on the symptom duration and severity. The cause of these symptoms is currently unknown. Carefully done microbiologic evaluations in the United States have failed to find evidence of either persistentB. burgdorferi infection or a coinfection with a secondIxodes-transmitted pathogen. In patients with persistent symptoms attributed to Lyme disease, longer-term antibiotic treatment has been shown to have no additional beneficial effects on health-related quality of life beyond those with shorter-term treatment.A4 Furthermore, retreatment has provided either no measurable benefit or a benefit so modest or ambiguous that it was outweighed by the risks associated with the antibiotic therapy.17b Therefore, symptomatic treatment is recommended for such patients.
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Possible Complications To Watch For With Lyme Disease
Talk to your veterinarian if you have any questions or concerns about your dogs condition.
- Some dogs who take antibiotics can develop loss of appetite, vomiting and diarrhea.
- Once infected, a dog will always have the bacteria that cause Lyme disease in his or her body. Therefore, relapses are possible, and owners should be on the lookout for unexplained fever, swollen lymph nodes, and/or lameness.
- A small percentage of dogs develop kidney failure as a result of Lyme disease. Clinical signs include vomiting, weight loss, poor appetite, lethargy, increased thirst and urination, and abnormal accumulations of fluid within the body.
Antimicrobials That Kill Growing Phase Spirochetes
Extracellular
Penicillins
- Amoxicillin 500 mg 1 to 2 pills 3 times a day. Alternatively as an alternative to IV antibiotics take 3 to 4 pills 3 times a day.
- Amoxicillin/Clavulanic Acid 875 mg/125 mg 1 pill 2 times a day
- Bicillin LA 2.4 million units IM 3 times a week with one day between each injection
Cephalosporins
- Ceftriaxone 2 gm IV 2 times a day for 4 days in a row then off for 3 days of each 7 days
- Cefotaxime 2 gm IV every 8 hours
- Cefuroxime 500 mg 1 pill 2 times a day
- Cefdinir 300 mg 1 pill 2 times a day
Additional IV Antibiotics
Vancomycin, imipenem, and ertapenem are possible alternatives if someone is allergic to Ceftriaxone or Cefotaxime.
Intracellular and Extracellular
- Clarithromycin 500 mg 2 pills 2 times a day
- Azithromycin 500 mg 1 time a day or 500 mg IV 1 time a day
Tetracyclines
- Doxycycline 100 mg 1 or 2 pills 2 times a day or 200 to 400 mg mg IV 1 time a day
- Minocycline 100 mg 1 pill 2 times a day
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Lyme Disease Antibiotic Combination Examples
In my experience, I find the prescription antibiotic combinations below work 85 to 90 percent of the time. The herbal combination options help 85 to 90 percent of the time. I find all these combinations more successful than the Andrographis/Japanese knotweed/cats claw combinations that some like herbalist Stephen Harrod Buhner and Bill Rawls, MD, recommend. The Buhner/Rawls combination helps about 60 to 65 percent of the time in my clinical observations. To reach the success rates I describe here, it is essential to follow the first ten steps of The Ross Lyme Support Protocol to support the immune system.
Key Points: Each combination
- Combines antibiotics to treat all forms of the germ.
- Combines antibiotics to treat Lyme living outside and inside of cells.
- Combines antibiotics that work in different ways to attack the germ from different angles.
- Treats all growth phases of Lyme at the same time – this means treatments include antimicrobials that address persisters in addition to the growth phase of the term.
Macrolide Plus Quinine Derivative Plus Azole Plus Methylene Blue
- azithromycin 500 mg 1 pill 1 time a day
- hydroxychloroquine 200 mg 1 pill 2 times a day
- metronidazole 500 mg 1 pill 2 or 3 times a day
- methylene blue 50 mg 2 times a day
Key Points:
- Since azithromycin is not as effective as other macrolides like clarithromycin, hydroxychloroquine is used to increase the effectiveness.
- Tinidazole could be substituted for the metronidazole because it may remove biofilms more effectively.
- Methylene Blue can treat persister Lyme.
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Proper Removal Of Ticks
There are many urban legends about the proper and effective method to remove a tick. One legend states that something hot should be applied to the back of the tick, which causes the tick to remove its head from the victim. It further states that ticks “screw” their heads into their victims therefore, one must “unscrew” the head. These legends are incorrect and dangerous. Proper removal of a tick: use a pair of tweezers, grab the head of the tick, and pull it out. If the head is not completely removed, local infection of the person/animal bitten may result, and a doctor should be consulted .
What Are The Clinical Signs Of Lyme Disease
Some people with Lyme disease develop a characteristic bull’s-eye rash at the site of the bite within three to thirty days. If this occurs, the disease can be easily diagnosed at an early stage.
However, signs of Lyme disease are more difficult to detect in animals than in people. The characteristic rash does not develop in dogs or cats. In fact, Lyme disease is practically unheard of in cats.
“Affected dogs have been described as if they were walking on eggshells.”
Many dogs affected with Lyme disease are taken to a veterinarian because they seem to be experiencing generalized pain and have stopped eating. Affected dogs have been described as if they were walking on eggshells. Often these pets have high fevers. Dogs may also begin limping. This painful lameness often appears suddenly and may shift from one leg to another. If untreated, it may eventually disappear, only to recur weeks or months later.
Some pets are infected with the Lyme disease organism for over a year before they finally show symptoms. By this time, the disease may be widespread throughout the body. Non-specific signs which may indicate that Lyme disease is affecting the kidneys include vomiting, lethargy, anorexia , and weight loss. The kidney form of the disease is less common, but often fatal.
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