{"id":90872,"date":"2019-12-16T19:45:09","date_gmt":"2019-12-17T03:45:09","guid":{"rendered":"https:\/\/selfhacked.com\/?p=90872"},"modified":"2021-11-03T02:06:54","modified_gmt":"2021-11-03T09:06:54","slug":"all-about-chronic-lyme-potential-treatments","status":"publish","type":"post","link":"https:\/\/selfhacked.com\/blog\/all-about-chronic-lyme-potential-treatments\/","title":{"rendered":"All About Chronic Lyme & Potential Treatments"},"content":{"rendered":"

Chronic or Persistent Lyme Disease<\/strong><\/span><\/h2>\n

One of the most controversial issues in Lyme disease is whether it can be easily treated by conventional antibiotics, or whether it is a persistent, recurrent and difficult to eradicate infection [R<\/a>].<\/p>\n

The fact is that some Lyme disease patients continue to experience mild symptoms even after appropriate antibiotic treatment. These symptoms may resolve within six months without further treatment; however, a small subset of patients continue to experience symptoms for longer periods [R<\/a>].<\/p>\n

This condition is called persistent Lyme disease, post-Lyme disease syndrome, or chronic Lyme disease [R<\/a>, R<\/a>].<\/p>\n

<\/a>How Frequent is It?<\/strong><\/span><\/h3>\n

The CDC estimates that 10% to 20% of people appropriately treated for the infection will remain symptomatic for an unspecified and variable period of time<\/strong> [R<\/a>].<\/p>\n

Symptoms include fatigue<\/strong>, muscle and joint pain<\/strong>, brain fog<\/strong><\/a>, and\/or radiating pain persisting for over 6 months<\/strong> [R<\/a>].<\/p>\n

In 9 clinical trials, 10 to 20 days of antibiotic therapy failed to restore 16% to 48% of patients to their pre-Lyme health status [R<\/a>].<\/p>\n

Another study reported that 36% of patients treated with 3 weeks of doxycycline experienced disease manifestations during the 3 to 6 months after the treatment (63 participants) [R<\/a>].<\/p>\n

In a study involving 1k people with persistent Lyme disease, 72% rated their health as fair or poor compared with 16% of the general population of similar age. 39% percent had stopped working, and an additional 28% had reduced their work hours [R<\/a>].<\/p>\n

<\/a>Is it Real?<\/strong><\/span><\/h3>\n

According to the Infectious Diseases Society of America (IDSA), Lyme disease is “hard to catch and easy to cure”. They are of the opinion that chronic Lyme infection is rare or nonexistent [R<\/a>].<\/p>\n

Those who say this syndrome is not real, suggest instead that patients are reporting symptoms commonly seen in the general population or those of a secondary condition such as fibromyalgia or chronic fatigue syndrome<\/a> [R<\/a>, R<\/a>, R<\/a>].<\/p>\n

Sometimes, the symptoms are due to reinfection. In 17 patients, a DNA test showed that each of the subsequent episodes of rash was due to a new infection (presumably transmitted from a new tick bite) rather than a persistent chronic infection [R<\/a>].<\/p>\n

The International Lyme and Associated Diseases Society (ILADS), on the other hand, argues that Lyme disease is not rare. Furthermore, it can be accompanied by other tick-borne co-infections that may complicate the disease [R<\/a>].<\/p>\n

Animal models of Lyme disease in gerbils, hamsters, mice, dogs, monkeys, and horses provided some evidence for persistent Lyme infection. In many of these models, infection persisted despite the equivalent of short-course antibiotic therapy [R<\/a>, R<\/a>].<\/p>\n

An NIH-sponsored study in humans found that uninfected ticks acquired B. burgdorferi<\/em> DNA from feeding on a persistently symptomatic person who had been treated for Lyme disease more than 1 year earlier [R<\/a>].<\/p>\n

<\/a>Mechanisms<\/strong><\/span><\/h3>\n

The mechanisms responsible for persistent Lyme disease are not fully understood.<\/p>\n

Borrelia<\/em> can form cell-wall deficient forms<\/strong>, called cysts or round bodies, that can revert to viable forms of the bacteria. The resistance of cystic forms to antibiotic therapy has been documented [R<\/a>].<\/p>\n

Currently, the only antibiotic that reliably targets the cyst form of B. burgdorferi<\/em> is metronidazole or its derivatives [R<\/a>].<\/p>\n

Another mechanism of chronic infection involves the formation of <\/strong>biofilm<\/strong><\/a>. These protect bacteria from hostile environments and facilitate persistent infection [R<\/a>].<\/p>\n

<\/a>Th1 and Th2 Response in Lyme Disease<\/span><\/h3>\n

After the body has recognized Borrelia<\/em>, it increases NF-kappaB<\/a>, resulting in the production of pro-inflammatory cytokines [R<\/a>]. Cytokines IL-6<\/a>, IL-10<\/a>, IL-12<\/a>, TNF-\u03b1<\/em><\/a>, and IL-1\u03b2<\/em><\/a> are released from innate immune system cells [R<\/a>].<\/p>\n

Subsequently, as T-helper cells are activated, they transform into a combination of Th1, Th2, Th17<\/a>, or T regulatory<\/a> cells, resulting in a polarized immune response [R<\/a>].<\/p>\n

Different individuals can mount immune responses with varying polarization, and researchers think that this polarization may influence the overall outcome of B. burgdorferi<\/em> infection [R<\/a>].<\/p>\n

Children and adults have different immune responses to B. burgdorferi<\/em>. Adults have a strong Th1 response<\/strong> (with high INF-gamma), whereas children seem to have a more balanced Th1<\/strong>\/Th2 response<\/strong> (with both IFN-gamma<\/a> and IL-4<\/a> elevated) [R<\/a>, R<\/a>].<\/p>\n

People with non-chronic Lyme disease-associated nerve disorder (neuroborreliosis) have an initial increase in INF-gamma (Th1), followed by an increase in IL-4 (Th2), corresponding to bacterial clearance. On the other hand, in people who experience chronic nerve disorder, the initial IFN-gamma response is not followed by IL-4 elevation suggesting a persistent Th1 response [R<\/a>].<\/p>\n

Additionally, your genes may have a say in how you react to infection. In animal studies, different strains of mice had reacted differently to B. burgdorferi<\/em> [R<\/a>].<\/p>\n

<\/a>Chronic Lyme Disease Treatment<\/span><\/h2>\n

Clinical trials have shown no significant, sustained benefit of antibiotic therapy for persistent symptoms of Lyme disease [R<\/a>, R<\/a>].<\/p>\n

In fact, prolonged or repeated antibiotic therapy for persistent Lyme disease is potentially harmful and therefore discouraged [R<\/a>].<\/p>\n

Instead, because of the substantial overlap of symptoms with <\/strong>chronic fatigue<\/strong><\/a> syndrome and fibromyalgia<\/strong>, treatment recommendations mainly include nonpharmacological approaches<\/strong>: regular low-impact aerobic <\/strong>exercise<\/strong><\/a> programs<\/strong>, and cognitive behavioral therapy<\/strong> [R<\/a>].<\/p>\n

Exercise<\/strong>, regular activity<\/strong>, sleep<\/strong><\/a> and managing and reducing <\/strong>stress<\/strong><\/a> may all be beneficial in treating persistent Lyme disease<\/strong> [R<\/a>].<\/p>\n

<\/a>Alternative Treatments<\/span><\/h3>\n

There are a variety of alternative treatments that supposedly help with Lyme disease. None of these have been proven effective in humans. Some may be harmful or even deadly. If you’re considering an alternative treatment, talk to your doctor first to make sure it won’t cause harm.<\/strong><\/p>\n

There is a single human study that showed that cholestyramine<\/a> was beneficial in 25 patients with confirmed Borrelia burgdorferi<\/em>\/B microti<\/em> coinfection, in addition to standard treatment. Around 10% of US patients with Lyme disease are coinfected with Babesia microti<\/em> [R<\/a>].<\/p>\n

However, a single small study is not enough to support cholestyramine effectiveness in the general population.<\/p>\n

A review of animal studies:<\/p>\n