Lyme Disease: Some Thoughts On Its Coinfections

It has become clear the past few decades that many new infections, and others, simply not recognized as being infections (e.g. endocarditis from bartonella infection or arthritis from lyme bacteria), are emerging with greater frequency and virulence in the human population. Those that belong to the Lyme disease group are some of the more worrisome. This includes, but is not limited to, infections caused by various species of Borrelia burgforferi sensu lato, Babesia, Bartonella, Ehrlichia, Anaplasma, and Mycoplasma, and a number of lesser players (at this point) such as the relapsing fever borrelias, Rocky Mountain Spotted fever (Rickettsia rickettsii), Tick-borne encephalitis, Colorado Tick Fever (coltivirus species), Coxiella, and various Wolbachia species. Factually, this group of organisms should be considered to be an arthropod-spread emerging disease complex of parasitic organisms, not specifically lyme and its coinfections, nevertheless . . .

The Lyme-group of infections presents unique difficulties to most Western approaches, whether community herbalism, reductive phytorationalism, or technological medicine. The organisms are especially good at sequestering themselves inside host cells to avoid immune responses. As well, they affect a wide variety of body sites, leading some researchers, such as Lynn Margulis, to refer to their increasing incidence as the "resurgence of the great imitator."

The stealth nature of the organisms and the complexity of their infectious cycle necessitates a very different approach than is usually common in the Western tradition. The paradigm of a silver bullet, i.e. antibacterials, specific to the invading organisms has proven inadequate. The organisms are exception-ally good at generating a swarm of genetic varients in short time lines, creating subtypes that are unaffected by antibiotics. They often infect difficult to reach areas of the body, places antibiotics cannot easily reach. As well, they infect a wide variety of bodily systems, mimicking in their symptoms, a wide range of disease conditions. Thus the infected have been diagnosed with such things as arthritis, bi-polar disorder, multiple sclerosis, schizophrenia (various types), Alzheimer’s, Parkinson’s disease, heart disease, irritable bowel syndrome, and so on.

A successful treatment, I have found, necessitates a break with traditional approaches. A decade of focus on the organisms has found that the best outcomes consistently occur if the following are used when approaching treatment, specifically understanding:

1) the flexibility and infectious dynamics of the organisms;

2) the synergy that occurs between the organisms;

3) the cytokine cascade the organisms initiate;

4) the need for acute attentiveness to the uniqueness of the infected person, that is, the protocol has to be designed to match the person’s ecological reality and as that alters over time, the protocol consistently needs to be adjusted with a high degree of sensitive awareness;

5) the protocols, to be effective, must accomplish the following:

a) reduce the cytokine cascade;

b) enhance immune function;

c) protect the areas of the body that are targeted;

d) address specific symptoms;

e) involve depth human contact between the practitioner and the client;

f) and understand that a focus on killing the organisms as a first line intervention, with certain caveats, is often the least successful approach.

Pharmaceutical/technological medical approaches are generally weak in these areas. Antibiotics, numerous peer reviewed studies have found, only help about 60% of those infected. While some of the more effective antibiotics such as doxycycline initially show up to a 95% success rate there is, in those populations, about a 30-40% relapse rate. That is one of the primary reasons the lyme community is so involved, much as the AIDS community has been. They have found that a combination of pharm-aceuticals and other approaches, specifically herbal medicines, to be the most effective in finding wellness. It is possible to heal from lyme and coinfections; it just takes work, time, and a great deal of sensitivity.

Unfortunately, you can’t treat lyme without encountering lyme politics. The CDC guidelines on lyme and the various coinfections are incorrect. Nevertheless even they note a yearly increase in infections. In 2002, the incidence was 20,000 per year; it is now closer to 40,000. Harvard researchers, however, put those figures at least ten times higher. And this is only lyme, the disease pool for coinfections is considerably larger. Bartonella and mycoplasma infections are very high.

All Lyme-group organisms are undergoing rapid genetic alterations in response to environmental factors such as climate change, habitat damage, and human population increase. They are tremendously genetically flexible and they exist within their hosts as a mosaic of genetic variants. It is more accurate to think of them as a self-organized swarm, not as individual microbial organisms. This provides multiple advantages: it maximizes survival of the swarm when attacked by host immune responses and allows discrete elements of the swarm entry into different physiological niches, e.g. bone marrow or lymph system, again maximizing survival. It is not uncommon that several variants can be found within those niches, the several strains exchanging genetic material in order to stay ahead of the immune response. The outer membrane proteins on the exterior of the cell wall are often altered (as are many of the adhesion molecules they use to attach to host cells) which makes the variants harder to recognize by both the immune system and pharmaceuticals. Simple rearrangements of certain portions of the genome can create as many as 420,000 variants of a species of bacteria in a short period of time.

Each member of the Lyme-group targets specific areas of the body for infection; each has its preferred habitat. In general, once at the target location, the organisms stimulate inflammation in order to break down target cells, freeing the nutrients they need in order to feed. Lyme spirochetes are specific for collagen tissues and the symptoms of infection appear wherever they break down those tissues. If in the joints, arthritis. If in the heart, lyme carditis, in the central nervous system and brain, neuroborreliosis, in the eye ocular borrelliosis, the meninges of the brain, meningitis. They also adhere to endothelial and epithelium cells, differentiated neural cells, brain cells, and glial cells. Each of these cellular locations can degrade in response.

Babesia infects red blood cells (and the spleen), similarly to malarial organisms; the symptoms are similar. Bartonella infects endothelial cells and red blood cells. Mycoplasma organisms tend to infect red blood cells, the reproductive tract, respiratory system, and gustatory system. They have a tropism for cilia, among other things. Mycoplasma have such a reduced genome that they need to scavenge large numbers of nutrients from the body; they affect a much broader range of body systems.

It is crucial to address immune status as part of any treatment protocol, irrespective of orientation. There is an inescapable truth revealed by research on the Lyme-group: The weaker or more compromised the immune system, the more likely someone is to become infected and the more likely they are to have a debilitating course of illness. Improving the immune status of those infected allows the immune system, refined over long evolutionary time, to do what it does best, i.e. use very elegant mechanisms to control and clear infection.

Ultimately, when supported, the immune system will identify the outer membrane proteins of the microbes and create antibodies to them. Depending on the type of infection, the number of coinfectious agents, and the health of the immune system (and the particular ecology) at time of infection, this can take, in those whose immune system can do the work on its own, anywhere from four to 12 months. In those whose immune systems are compromised it may take longer; how long is directly proportional to the health of the immune system. Once the immune system creates the proper antigens, the bacteria are then eliminated fairly rapidly from the body.

Because of the common tropism for neural cells among the Lyme-group a wide variety of brain and neural structures can be affected. These impacts generate a wide variety of neurological symptoms and psychological difficulties. If the amygdala is infected, there is sometimes the tendency to homicidal rage (common during bartonella infection). If the hippocampus is affected, the ability to determine meaning can be affected (common during borrelia infection). Cognitive defects are common including brain fog, memory difficulties, linear reasoning deficits, and extreme emotional lability. Sensory gating deficits are also, unfortunately, common.

Sensory gating is the process whereby the brain reduces the amount of incoming sensory data to protect the conscious mind from overload and fragmentation. Gating deficits generally increase the amount of sensory data that is perceived, a common experience in schizophrenia or when taking hallucinogens. Every sensory modality has its own neural gating stream; any or all can be affected. Lyme-group infections commonly cause increases in visual, auditory, and somatosensory inputs – and occasionally olfactory and gustatory. In the auditory system, this can cause PTSD symptoms and extreme sensitivity to noise. In the visual, sensitivity to light. In the somatosensory, sensitivity to touch. In the olfactory, multiple chemical sensitivity. For some, there is a feeling of being overwhelmed with sensory inputs, as if the whole world were rubbing against the sensory network.

Reducing inflammation in the brain will help reduce the problems over time. The use of neural regenerators will help restore damaged neural networks. The use of anxiety reducing herbs will help bridge the time period before restoration. Sophisticated psychotherapeutic interventions will reduce the hysteria that often accompanies severe cognitive deficits; the feeling of being accompanied in the darkness does produce significant increases in the degree and rapidity of healing.

Lyme borreliosis:

Polygonum cuspidatum root. Uncaria tomentosa.

Primary cytokine cascade inhibitors: Scutellaria baicalensis, Cordyceps, Isatis, Houttuynia, Polygonum cuspidatum.

Primary immune herbs:

Glycyrrhiza, Rhodiola, Eleutherococcus, Cordyceps, Withania.

Red blood cell protectants:

Neural regenerators:

Polygala tenifolia root, Hericium erinaceus

Dosage varies considerably for people with this group of infections. Some people are so hypersensitive that they can tolerate only tiny amounts of herbal intake, from one to five drops at a time. Others need large quantities, up to one teaspoon three to four times daily. For those that can tolerate it, dosages of cytokine herbs should be high in order to flood the body with substances that will keep the cytokine cascade in check. Dosages should start small and then be adjusted for the particular body ecology of the person, down or up as necessary. Ultimately, dosage is an art form, in herbalism and in treating this group of infections. Again, there is no one size fits all approach for this population of clients, nor is there one approach that will help all of them.

This group of infections can be successfully treated; we just need to develop a more sophisticated approach to doing so. There is no way that reductive, linear approaches can keep up with the nonlinear, self-organized identities that these organisms are. The reductive beginnings are a good foundation, ultimately however, the final treatment interventions occur by feel, by a sense of the art, a deep empathy for the client, all rooted in a deep relationship with the plants and a depth understanding of the organisms as discrete intelligent identities acting in concert with their natures in unique, and never-identical body ecologies.