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.
Lyme Disease Antibiotic Treatment Research
For early Lyme disease, a short course of oral antibiotics, such as doxycycline or amoxicillin, cures the majority of cases. In more complicated cases, Lyme disease can usually be successfully treated with three to four weeks of antibiotic therapy.
After being treated for Lyme disease, a minority of patients may still report non-specific symptoms, including persistent pain, joint and muscle aches, fatigue, impaired cognitive function, or unexplained numbness. These patients often show no evidence of active infection and may be diagnosed with post-treatment Lyme disease syndrome .
Multiple clinical trials, funded by NIH and others, have shown no benefit to additional IV antibiotic treatment in patients with Lyme disease, although the interpretation of those results have been challenged by some.
What Are The Side Effects Of Lyme Disease Treatments
Antibiotics, like all medications, have the potential for side effects. Any antibiotic can cause skin rashes, and if an itchy red rash develops while on antibiotics, a patient should see their physician. Sometimes symptoms worsen for the first few days on an antibiotic. This is called a Herxheimer reaction and occurs when the antibiotics start to kill the bacteria. In the first 24 to 48 hours, dead bacterial products stimulate the immune system to release inflammatory cytokines and chemokines that can cause increased fever and achiness. This should be transient and last no more than a day or two after the initiation of antibiotics.
The most common side effect of the penicillin antibiotics is diarrhea, and occasionally even serious cases caused by the bacteria Clostridium difficile. This bacterial overgrowth condition occurs because antibiotics kill the good bacteria in our gut. It can be helpful to use probiotics to restore the good bacteria and microbiome balance.
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Guidelines For Antibiotic Use
Dr. Rawls is a physician who overcame Lyme disease through natural herbal therapy. You can learn more about Lyme disease in Dr. Rawls new best selling book, Unlocking Lyme. You can also learn about Dr. Rawls personal journey in overcoming Lyme disease and fibromyalgia in his popular blog post, My Chronic Lyme Journey.
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.
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What Is Lyme Disease
Lyme disease is an infectious disease caused by the bacterium Borrelia burgdorferi.
B. burgdorferi is transmitted to humans by a bite from an infected black-legged or deer tick. The tick becomes infected after feeding on infected deer, birds, or mice.
A tick has to be present on the skin for approximately 36 to 48 hours to transmit the infection. Many people with Lyme disease have no memory of a tick bite.
Lyme disease was first recognized in the town of Old Lyme, Connecticut, in 1975. Its the most common tick-borne illness in Europe and the United States.
People who live or spend time in wooded areas known for transmission of the disease are more likely to get this illness. Additionally, people with domesticated animals that visit wooded areas also have a higher risk of getting Lyme disease.
Herbal And Rx Antimicrobials That Treat Persisters
This is a newer area in Lyme treatment. To help justify these various antimicrobial options, I describe the experimental basis behind my recommendations. These options are ones I am using with various degrees of success in my Seattle practice. They all have either laboratory experiments supporting their use or published human experiments.
Laboratory-Based Experiment Options
Here is a list of prescription and herbal medicine options shown in lab experiments to kill persisters that I am incorporating into my treatments of Lyme and/or Bartonella.
- Disulfiram – work slowly up to 4 to 5 mg/kg body weight 1 time a day.
- Methylene Blue 50 mg 2 times a day.
- Liposomal Oregano, Cinnamon, and Clove Oils 1 capsule 2 times a day.
- Cryptolepis 5 ml 3 times a day.
- Japanese Knotweed½ tsp 3 times a day – start at ¼ tsp 1 time a day and then increase after two weeks to ½ tsp 3 times a day.
- Cats Claw 30 drops 2 times a day.
Human-Based Experiment Options
Here is a list of prescription medications shown in human experiments to help with persister Lyme.
- Disulfiram – work slowly up to 4 to 5 mg/kg body weight 1 time a day.
- Dapsone – work up to 100 mg or 200 mg 1 time a day.
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How Is Lyme Disease Treated
With early-stage Lyme disease, youâll take antibiotics for about 10 days to 3 weeks. The most common ones are amoxicillin, cefuroxime, and doxycycline. The antibiotics will almost always cure your infection. If they donât, you might get other antibiotics either by mouth or as a shot.
If you donât treat your Lyme infection, you might need oral antibiotics for symptoms like weakened face muscles and irregular heartbeat. You may need antibiotics if you have meningitis, inflammation in your brain and spinal cord, or more severe heart problems.
If your Lyme is late stage, the doctor might give you antibiotics either by mouth or as a shot. If it causes arthritis, youâll get arthritis treatment.
Thereâs no therapy for post-treatment Lyme disease syndrome.
Symptoms Of Lyme Disease
Signs and symptoms of Lyme disease can vary from person to person after being bitten by a tick.
Lyme disease occurs in stages. The signs and symptoms of each stage can overlap. In some people, Lyme disease may present in a later stage without a history of prior signs or symptoms.
The most commonly reported sign of Lyme disease is an expanding skin rash that typically begins at the site of the tick bite. This rash is called erythema migrans. It slowly grows to more than 5 cm in diameter over several days, and can sometimes:
- be circular or oval-shaped
- look like a target or bull’s eye
- go unnoticed, especially if it’s on:
- dark skin
- a part of the body that’s difficult to see
Some people may not develop a rash.
Other early signs and symptoms include:
If left untreated, the infection could spread to the joints, heart and nervous system.
Images of erythema migrans rash
Image 1Footnote a: A rash that looks like a bull’s eye at the site of a tick bite.
Image 2Footnote a: An oval-shaped red rash.
Image 3Footnote a: A red rash that has expanded across the width of a limb.
Image 4Footnote a: A red rash and blisters on a forearm.
Image 5Footnote b: A rash on a shoulder.
Image 6Footnote c: A rash on the back of a knee.
- Footnote a
Later symptoms of Lyme disease can appear days to months after an infected tick bite, and may include:
- more rashes
- migratory pain that spreads in the:
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Quinine Derivatives To Boost Intracellular Antibiotics
Inside of cells, Lyme may live in cave-like structures called vacuoles. In these vacuoles, Lyme germs create a hostile acidic environment that can limit the effectiveness of various antibiotics. Quinine derivatives, like hydroxychloroquine , can make the inside of cells more basic which can help the tetracyclines and macrolides mentioned above work better.
- Hydroxychloroquine 200 mg 1 pill 2 times a day
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
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How Is Lyme Disease Diagnosed
In areas where the ticks that carry Lyme disease are found, when a patient comes to a doctor with probable erythema migrans , blood tests are performed to diagnose the condition, including:
- Step 1: Enzyme immunoassay or immunofluorescence assay – Total Lyme titer or IgG and IgM titers
- Step 2: Western blot testing only performed if step 1 test results are positive
Other tests that may be indicated include:
- Joint aspiration to see if there is another cause for fluid buildup on the joints
- Cerebrospinal fluid analysis – in patients with meningitis
- Electrocardiogram – to identify Lyme carditis or arrythmias
Lyme Disease Antibiotics Overview
The following are four general rules I use to develop a Lyme disease antibiotic regimen.
- Rule 1. Combine antibiotics to treat all forms of the germ.
- Rule 2. Combine antibiotics to treat Lyme living outside and inside of cells.
- Rule 3. Combine antibiotics that work in different ways to attack the germ from different angles.
- Rule 4. Treat all growth phases of Lyme at the same time – this means treatments should include antimicrobials that address persisters in addition to the growth phase of the term.
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What To Expect At The Vets Office
If your pet has been diagnosed with uncomplicated Lyme disease, this is what you can expect to happen at your veterinarians office.
- Depending on the type of test used to screen for Lyme disease, a confirmatory test may be necessary.
- Urine protein screening — In general, only dogs who have symptoms of Lyme disease or protein in their urine should be treated with antibiotics.
- Dogs with protein in their urine should have regularly scheduled rechecks to monitor their condition.
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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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.
For Memory Concentration And Focus
Improving memory is a challenge. In Lyme disease, short-term memory problems and word-retrieval problems are common. These often improve substantially with appropriate antibiotic therapy. Over time, most patients regain their cognitive function.
When memory is a problem, consider that this could be due to a primary problem with attention or with mood. An individual who can’t focus won’t be able to remember because he/she didn’t “attend” to the item in the first place. This happens to all of us when we hear someone’s name at a party if we don’t focus on the name and perhaps make a mental association to the name to enhance memory storage, we will forget that name within minutes. Patients with depression often experience problems with memory and verbal fluency when the depression is resolved, the memory and verbal fluency typically resolve as well.
- Medications: Attention can be improved with certain medications, such as bupropion , atomoxetine , modafinil , or stimulants . Medications that temporarily slow cognitive decline in Alzheimer’s disease or memantine ) have not been studied in Lyme disease.
- There is some evidence that online brain training programs can enhance concentration or processing speed.
- Neurofeedback may be helpful in improving attention, as well as in improving sleep and reducing pain. This has been studied for migraines, fibromyalgia, and ADHD.
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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.pdf” rel=”nofollow”> 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.
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.
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What Causes Lyme Disease
Lyme disease is caused by infection with the spirochete Borrelia burgdorferi. In regions of the U.S. where Lyme disease is common, risk factors for getting bitten by a tick include:
- Spending a lot of time outdoors
- Proximity to areas between forest land and lawns, particularly if the area contains low-lying grasses or shrubs
Ticks can also attach to pets who may bring them into the home. The pet may become infected with Lyme disease. If the tick does not attach to the pet, it can attach to a human and transmit the infection.
Look How Far Ive Come
My initial Lyme test was, in the words of my doctor, lit up like a Christmas tree. Pretty much everything on it was positive: 2 different strains of Lyme, babesia, bartonella, and mycoplasma. I was a mess.
This summer I had a repeat test. Everything came back negative. While this doesnt mean Im definitively negative for Lyme, it certainly indicates weve been able to reduce the load enough that its not showing up on the tests. Ill likely need to continue some level of treatment for quite some time.
There are many Lyme specialist who dont believe its ever possible to be completely cured of Lyme. Its a sneaky bacteria and good at hiding. Many believe, the best you can get is to effectively put yourself in remission and strengthen your immune system. This keeps the Lyme bacterial load low enough that the symptoms are kept at bay.
Another fantastic result of treatment has been a huge decrease in inflammation. My c4a levels were 20,749 when I was first diagnosed. Thats a lot. . At the beginning of this year, after about a year of treatment, they were down at 17,594. This September, I was delighted to see my levels down to 4,090. Im inching closer to being back in the normal levels.
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