What Treatment Approach Did Well Patients And High Responders Use
We asked patients what their treatment approach was and listed four options a) antibiotics, b) alternative treatments, c) both antibiotics and alternative treatments, and d) no treatment at all. High treatment response was most closely associated with the use of antibiotics compared to patients who were using alternative treatments alone or forgoing treatment altogether. Treatment with antibiotics for Lyme disease was far higher among well patients and high responders compared to non-responders .
As you can see in the chart below, many patients who were taking antibiotics were also taking herbal supplements, which can be antimicrobial . So it is possible that there was a synergistic effect between antibiotics and herbal supplements.
What If I Dont Feel Better After Treatment
If youre treated for Lyme disease and dont feel better after youve finished your treatment, talk to your doctor. He or she may recommend a longer course of antibiotics or may be able to prescribe another medication to help with symptoms like joint or muscle pain.
You might also want to seek a second opinion, especially if your Lyme disease diagnosis was not initially confirmed via a two-step blood test. If your body has not responded to antibiotics, its possible that something else besides the bacteria that causes Lyme disease is making you sick. In 2017, for example, the CDC reported on a woman who was given antibiotics and herbal remedies to treat her chronic Lyme disease, when she actually hadand eventually died fromamyotrophic lateral sclerosis .
Even if you do recover completely from a Lyme disease diagnosis, your immune system may continue making antibodies to fight Lyme disease bacteria for months or even years after the infection is gone. Those antibodies wont protect you from getting a second Lyme disease infection, however, so be sure to take steps to protect yourself from ticks in the future.
What Are The Stages Of Lyme Disease
The stages of Lyme disease are progressive and depend on treatment interventions:
Early localized, just after the infection takes hold. Symptoms begin within hours, days or weeks after the tick bite, and can include skin rashthe characteristic bulls-eye rash as well as flu-like symptoms and joint pain.
Early disseminated, occurring weeks to months after the tick bite. The bacteria are spreading further throughout the body. Because more body systems are infected, symptoms are varied and may not look related. Symptoms include eyesight problems, rash in other areas, irregular heartbeat, pain, and nerve symptoms like numbness in the arms and legs or the face.
Late disseminated stage, occurring weeks, months and extending months after the tick bite. Left untreated, Lyme disease can lead to such chronic conditions as arthritis, migraine, widespread pain, difficulty sleeping, and trouble concentrating.
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What To Try If You Have Failed Years Of Antibiotics
In my practice for those that have failed years of regular antibiotics I offer two persister oriented regimes. Both of these regimens have some published clinical evidence of benefit. One regimen I offer is a Horowitz dapsone persister regimen. The other option I offer is a disulfiram only regimen or a disulfiram combination regimen . You can read more details about how to take both of these regimens in
Herbal And Prescription Antimicrobials By Function
Be aware the doses I provide below are for adults. These same prescriptions can be used with children but have lower doses. For pediatric dosing, talk with your family physician or pediatrician. Tetracyclines can be used in children under eight, but there is a risk of tooth staining. This staining seems not to be an issue if they are used for a month or less.
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Questions To Ask Your Doctor
- I found a tick embedded in my skin, but I cant get it out. What should I do?
- Ive been bitten by a tick. Do I need to be seen?
- Do I need a blood test to confirm Lyme disease?
- Which antibiotic is best for me?
- How long will I have to take the antibiotic?
- What tick or insect repellent should I use for me or my child?
- How long will the symptoms last?
- What should I do if I still dont feel well a long time after I was bitten?
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Tetracycline Plus Rifamycin Plus Disulfiram
- minocycline 100 mg 1 pill 2 times a day
- rifampin 300 mg 2 pills 1 time a day
- disulfiram 4 to 5 mg/ kg body weight. Work up to this dose slowly over 2 months then remain on the disulfiram at the peak dose for 4 months before tapering off.
- This minocycine and rifampin in this combination are as useful for treating a Bartonella co-infection. Co-infections are other germs passed on during a tick bite. If someone has a co-infection, when possible I choose antibiotic combinations that simultaneously treat Lyme germs and the co-infection germs.
- The disulfiram is added here to treat persister Lyme. Note disulfiram does not appear to treat Bartonella.
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Antibiotics For Chronic Lyme Disease
If you have learned that chronic Lyme disease is the underlying cause of your symptoms, the next hurdle is finding effective treatments. The conventional medical model believes Lyme disease can only last short-term, and if symptoms persist following treatment, there is another cause. However, multiple research studies have demonstrated that the bacteria that causes Lyme disease can persist following treatment with antibiotics.
The antibiotics commonly prescribed for Lyme disease are ineffective against chronic or persistent Lyme disease. This article reviews research studies that identified antibiotics that are effective against the persistent forms of the bacteria that cause chronic Lyme disease.
What Is Post Treatment Lyme Disease
Post Treatment Lyme Disease represents a research subset of patients who remain significantly ill 6 months or more following standard antibiotic therapy for Lyme disease. PTLD is characterized by a constellation of symptoms that includes severe fatigue, musculoskeletal pain, sleep disturbance, depression, and cognitive problems such as difficulty with short-term memory, speed of thinking, or multi-tasking. In the absence of a direct diagnostic biomarker blood test, PTLD has been difficult to define by physicians, and its existence has been controversial. However, our clinical research shows that meticulous patient evaluation when used alongside appropriate diagnostic testing can reliably identify patients with a history of previously treated Lyme disease who display the typical symptom patterns of PTLD.
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What Are The Potential Complications Of Lyme Disease
Most cases of Lyme disease can be cured with antibiotics, especially if treatment is begun early in the course of illness. However, a small percentage of people with Lyme disease have symptoms that last for months to years after treatment with antibiotics.
Complications of Lyme disease range from joint pain and stiffness to meningitis and paralysis. About 10 to 20% of untreated or complicated cases of Lyme disease can progress to arthritis.
You can help minimize your risk of serious complications by following the treatment plan you and your healthcare professional design specifically for you. Complications of Lyme disease include:
When Should I See My Healthcare Provider
If you feel sick after having spent time in areas where ticks might live, you should make an appointment with your healthcare provider.
If you received a Lyme disease diagnosis and you dont feel well after taking all of your antibiotics, contact your provider. This is especially true if you have symptoms like a stiff neck or mental confusion.
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Testing Antibiotics For Persister Phase Lyme
In 2014, researchers from Johns Hopkins published the first study to assess the full spectrum of antibiotic susceptibility against persister phase Borrelia. The study, titled Identification of novel activity against borrelia burgdorferi persisters using an FDA approved drug library, screened over 1500 medications and identified 165 that had better activity against stationary Borrelia than doxycycline and amoxicillin.
The B31 strain of Borrelia was grown on a culture medium until the bacteria reached the stationary/persister phase between 6-7 days. The bacterias round body form characterizes the persister phase. This contrasts to the rapidly dividing phase early in infection when the bacteria is still in the spirochete form.
The 165 hits were narrowed to the top 27 drug candidates against stationary phase Borrelia. The antibiotics with the most significant activity against persister Borrelia bacteria were daptomycin, clofazimine, carbomycin, some cephalosporins, and some sulfa drugs. Daptomycin is an intravenous antibiotic and had the highest activity against the persister phase of Borrelia but was not effective against the growth phase. Doxycycline, amoxicillin, azithromycin, clarithromycin, and penicillin G had poor activity against Borrelia persisters.
How Do Doctors Diagnose Lyme Disease
An accurate diagnosis requires a physician experienced with the signs and symptoms of Lyme disease. For early Lyme disease, the most common clinical sign is the bulls eye rash . The doctor also considers the patients confirmed tick bite or probable exposure to deer ticks in a Lyme disease diagnosis. The fact that symptoms associated with Lyme diseasefatigue, difficulty concentrating, flu-like symptoms, and joint painoverlap with several other conditions can delay diagnosis.
If the doctor is not considering the possibility of Lyme disease, it will probably not be diagnosed. If you have signs and symptoms of Lyme disease, it is fine to ask the healthcare provider, Could this be Lyme disease? Remember that symptoms may develop up to 30 days after the tick bite, although typically 7 to 14 days after the bite. If the problem persists and your provider is unable to determine a cause, seeking a second opinion may give you more information and answers.
A two-step blood test that detects antibodies to the bacteria is available to help confirm a Lyme disease diagnosis. Both tests must be positive to confirm Lyme disease. Results are likely to be negative the first few weeks after infection because the body has not yet built up enough antibodies for the test to detect. The Lyme disease test is most accurate a few weeks after infection.
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How To Treat Lyme Disease Naturally Without Antibiotics
Lyme disease, a complicated infection, is difficult to diagnose and treat if the doctors do not have experience and miss the early symptoms. This case often happens. Therefore its treatments are tricky and hard because most of the blood tests done by doctors miss 55 percent of Lyme disease risks. Most patients with Lyme disease have the symptoms like other ailments such as rheumatoid arthritis, chronic fatigue, irritable bowel syndrome and Alzheimers disease. While antibiotics are proven to be effective to cure Lyme disease, there are many ways on how to treat Lyme disease naturally without antibiotics you can try to get rid of this complicated infection.
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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What Should I Do If I Find A Tick On My Child
Dont panic. First Lyme disease is spread by the black-legged tick, not by the larger and more-common dog tick. The risk of developing Lyme disease after a black-legged tick bite is low, especially if the tick has been attached for a short time.
If you find a tick on your child, remove it using a fine-tipped pair of tweezers. Grasp the body of the tick and pull in an upward motion until the tick comes out. Do not squeeze or twist the ticks body. Take note of the ticks size and color, and how long you think it has been attached to your child.
If your child has been bitten by a black-legged tick that has been attached for more than 24 hours and you are in a Lyme disease endemic area, consult with your pediatrician. In some cases, your child may be prescribed antibiotics to prevent Lyme disease from developing.
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A Reasonable Approach To Post
If you are being treated for PTLD, there is no magic bullet to treat this problem, but here are some important steps to consider:
- Choose a doctor you trust and who can work closely with you.
- If your doctor agrees to start antibiotics for several months, make sure you talk about the risks and cost, as this can be dangerous and expensive.
- Make sure not to rely solely on antibiotics. The evidence for a benefit from antibiotics is weak, and we rely mostly on physicians clinical experience and interest in the disease to design a personalized therapeutic plan. For some, a more holistic approach may be the way to go.
- If you try supplements, ask about their source and purity, as they are not FDA-regulated.
- Consider looking for services in medical school hospitals or clinics where they may have programs with ongoing research on how to diagnose and treat Lyme.
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Are There Alternative Treatments For Lyme Disease
There are a variety of alternative treatments aimed at patients who believe they may have Lyme disease. But the effectiveness of these treatments is not supported by scientific evidence, and in many cases they are potentially harmful.
Bismacine, also known as chromacine, is an alternative-medicine drug that some people use to treat their Lyme disease.
The Food and Drug Administration warns that people should not use this injectable product, which has reportedly caused hospitalization and at least one death. 70563-1.pdfâ rel=ânofollowâ> 6)
In addition, the FDA notes that bismacine contains high levels of bismuth, which can cause heart and kidney failure.
Other alternative treatments include oxygen therapy, light therapy, and a variety of nutritional or herbal supplements. But there is no evidence that these treatments are clinically effective in the treatment of Lyme disease.
Oral Antibiotic Process And Effects
Anything taken orally must travel into your mouth, down the esophagus, and into the stomach where it is broken down before being distributed into your bloodstream. Often, as stomach acids break down the oral antibiotic, they lose some of their potency.
This means less of the antibiotic will reach your bloodstream. Less antibiotic is available to fight infection.
Your gut is a vital part of healthy living. Specifically, the good bacteria that are living in your intestines that help fight off harmful bacteria. When you take an oral antibiotic, you remove both good and bad bacteria. Your gut is defenseless.
On top of that, oral antibiotics have caused unpleasant side effects like digestive issues like diarrhea, nausea, bloating, and abdominal pain.
As mentioned, oral antibiotics are best when used early. If Lyme has progressed, intravenous antibiotic treatments are a must.
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Can Lyme Disease Be Prevented Or Avoided
The best way to prevent Lyme disease is to avoid being bitten by ticks. When you are outdoors, follow these guidelines:
- Avoid areas that are wooded, brushy, or have tall grass.
- Walk in the center of trails.
- Use an insect repellent with at least 20% DEET. It can be put on clothing or sparingly on the skin. Dont apply it to the face or hands of children.
- Treat clothing, tents, or other gear with repellents containing 0.5% permethrin.
- Wear light-colored clothing. This makes it easier to see and remove ticks from your clothes.
- Wear a long-sleeved shirt and long pants. Tuck your pant legs into your socks or boots for added protection.
After you get home, check everything and everyone for ticks.
- Bathe or shower as soon as you can to wash off any ticks that have not attached to you.
- Check your entire body for ticks. Use a mirror for places you cant see. Check your children and your pets. Common tick locations include the back of the knees, groin area, underarms, ears, scalp, and the back of the neck.
- Check any gear you used, including coats, backpacks, or tents.
Tumble dry clothes or blankets on high heat in the dryer for 10 to 15 minutes. This should kill any ticks. If clothes are dirty, wash them in hot water and dry on high heat for 60 minutes.
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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