Lyme Basics

One medical society, the IDSA (Infectious Diseases Society of America), regards Lyme disease as “hard to catch and easy to cure”. IDSA claims that spirochetal infection cannot persist in the body after a short course of antibiotics. The group also denies the existence of chronic/persistant Lyme disease.

In contrast, the International Lyme and Associated Diseases Society (ILADS), regards Lyme disease as often difficult to diagnose and treat, resulting in persistent infection in many patients. ILADS recommends individualized treatment based on the severity of symptoms, the presence of tick-borne coinfections and patient response to treatment.

LymeDisease.org believes that patients and their doctors should make Lyme disease treatment decisions together. This requires that patients be given sufficient information about the risks and benefits of different treatment options. Then, the patient and health care provider can collaborate to reach an informed decision, based on the patient’s circumstances, beliefs and preferences.

LymeDisease.org  endorses the ILADS guidelines, which allow greater exercise of clinical discretion by physicians and provide patients with more treatment options. It is the doctor’s responsibility to tell patients about the different treatment options so that patients can make an informed choice.

Early Lyme Disease Treatment

ILADS doctors are likely to recommend more aggressive and longer antibiotic treatment for patients. They may, for instance, treat “high risk” tick bites where the tick came from an endemic area, was attached a long time, and was removed improperly. They may treat a Lyme rash for a longer period of time than the IDSA recommends, to ensure that the disease does not progress. They are unlikely to withhold treatment pending laboratory test results.

Late or Chronic Lyme Disease Treatment

Experts agree that the earlier you are treated the better, since early treatment is often successful. Unfortunately, a substantial portion of patients treated with short-term antibiotics continue to have significant symptoms.   A recent study by the Bay Area BioBank found that many patients who are treated for 3 months or less often relapse within several months of stopping treatment.  They recommend follow up visits with your Lyme practitioner to stay on top of the disease.

The quality of life of patients with chronic Lyme disease is similar to that of patients with congestive heart failure. Doctors don’t agree about the cause of these ongoing symptoms. The primary cause of this debate is flawed diagnostic testing. There is currently no test that can determine whether a patient has active infection or whether the infection has been eradicated by treatment.

The IDSA believes that Lyme disease symptoms that remain after treatment represent a possibly autoimmune, “post-Lyme syndrome” that is not responsive to antibiotics. The IDSA essentially regards Lyme disease as an acute infection like strep throat that can be treated with a short course of antibiotics. The IDSA guidelines are now several years old and do not reflect recent science and the new FDA approved tests used by IGenex. (see Lyme Testing)

ILADS physicians believe that ongoing symptoms probably reflect active infection, which should be treated until the symptoms have resolved. These physicians use treatment approaches employed for persistent infections like tuberculosis, including a combination of drugs and longer treatment durations. The ILADS guidelines have just recently been updated using a rigorous review of the medical literature.

The ideal antibiotics, route of administration and duration of treatment for persistent Lyme disease are not established. No single antibiotic or combination of antibiotics appears to be capable of completely eradicating the infection, and treatment failures or relapses are reported with all current regimens, although they are less common with early aggressive treatment.  Furthermore, every patient is different and a treatment protocol that  works on one patient doesn’t necessarily work on another.  There is a real science to treating Lyme patients including a lot of trial and error.

All medical treatments have risks associated with them. While the safety of antibiotics is generally quite good, only the patient (in consultation with his or her physician) can determine whether the risks outweigh the potential benefits of any medical treatment.

An ILADS doctor may also consider the possibility of tick-borne coinfections, particularly if a patient does not respond to treatment or relapses when treatment is terminated. Other factors to consider are immune dysfunction caused by Lyme; silent, opportunistic infections enabled by the immune dysfunction; hormonal imbalance caused by Lyme; and other complications.

Considerations while on Lyme treatment

Antibiotics can wipe out beneficial intestinal flora, leading to a wide variety of additional health problems. It is important to take probiotics while on antibiotics to maintain a healthy balance of gut bacteria. Furthermore, antibiotics may interact with other drugs, supplements or food. Your practitioner and pharmacist are excellent resources to educate yourself on timing of taking your prescriptions, probiotics, and any possible drug interactions.

Alternative Treatments

Patients with Lyme disease use a wide range of treatments to manage the symptoms and complications of their illness. These treatments include antibiotics, other prescription medications, and alternative treatments.

Patients who use alternative treatments either use them in conjunction with antibiotics (38%) or as a sole means of treatment (31%). The most popular alternative treatments included herbal protocols, sauna, chelation, and medical marijuana.

Important considerations for selecting any treatment modality include effectiveness and side effects. Herbal protocols, many of which have antimicrobial proper- ties, are among the most popular, and 68% of patients who used them reported that they were either moderately or very effective, with a low side effect profile.

Stem cell therapy, which can be expensive, was the least popular and reported to be of limited effective- ness. Only 3% of the 271 patients in our sample who used stem cell therapy reported that it was effective. Rife machines and chelation had the highest rate of moderate or severe side effects.

Herbal Treatments

While antibiotics are the standard treatment for Lyme disease, many patients are unable to tolerate antibiotics to treat Lyme disease.  

According to Dr Bill Rawls: At least 20% of people treated with antibiotics for acute Lyme disease develop ongoing symptoms, indicating that antibiotics don’t fully eradicate the bacteria. A 1–3-month course of herbal therapy, in addition to antibiotics, could potentially reduce the likelihood of chronic symptoms later on. While no study has yet proven this, the low toxicity of the most used herbs for Lyme disease suggests that the risk of using this strategy is also low.

For more information on Herbal Treatments, check out our blogs by searching for herbal treatments in our search tool.