Every year, some 30,000 cases of Lyme disease are reported by state health departments to the CDC, and this number has only increased steadily in the past 20 years.

What is Lyme Disease?

Lyme disease (most commonly from Borrelia burgdorferi, miyamotoi, hermsii and turicatae) are complex organisms that are transmitted to humans (and animals) via a tick bite. It has only recently, within the past 25 years, been under extensive study and clinical examination, as the number of those diagnosed with this disease increases every year. But the actual numbers of cases remain underreported meaning that there are more individuals who have Lyme disease without knowing it. This is because Lyme disease can disguise as other illnesses. According to the CDC, Lyme disease is the fastest-growing vector-borne disease in the United States and with more accurate research and projections is believed to be closer to 300,000 new cases diagnosed annually. The most concentrated population of those diagnosed with Lyme disease are in the Northeastern region of the US, however, every state has reported cases of Lyme disease. All along the East Coast, we find thousands of chronic cases of Lyme disease. With extremely complicated pathophysiology and varied presentations of symptoms, Lyme disease is one of the most challenging health issues facing us today.

The Borrelia species, as a whole, are extremely intelligent organisms known as spirochetes. These bacteria have a spiral shape which allows them to burrow or transport themselves more easily than other bacteria. There are over 100 strains of Borrelia in the US and 300 worldwide. Lyme disease is most commonly spread from the bite of an infected tick, specifically deer ticks in the Northeastern US, or the black-legged tick on the West Coast. Once the tick has bitten any area of the body, most officials believe it must be attached for 36-48 hours for the bacterium to infect the human body. However, in some cases research has shown transmission to occur within as little as 6-8 hours. This is why it is extremely important to check yourself for ticks every day, especially if you have been outdoors in woods, grasslands, fields or even your backyard, as a preventative measure.

Reasons for the Spread of Lyme Disease

• Increase in tick populations
• Decrease in natural habitats of tick-carrying animals (deer in particular)
• Climate changes (potentially)
• Epigenetics

Some medical treatments for Lyme disease have been built upon our understanding and treatment of another spirochete called Treponema pallidum, which is known to cause the disease we know as syphilis. This is because their replication and systemic involvement can be similar. But Borrelia can hide and have more nebulous or convoluted symptoms. The Borrelia organism is pleomorphic and evasive. It can cross the blood-brain barrier and “hide” in the central nervous system and in other tissues for weeks, months, or even years before activating a symptomatic reaction. Thus, the symptoms can show up slowly for some individuals whereas for others it can occur suddenly.

Some people are at higher risk of Lyme disease based upon their epigenetics. And in fact, spirochetes like Borrelia can upregulate nearly 350 genes within 24 hours. There are a number of immune enzymes or proteins that we inherit from our ancestors that serve as checkpoints to infectious diseases that enter our bodies such as syphilis or Borrelia. Some inherited immune proteins that can assist in watching over Borrelia include IL-10, TLR1, TLR2, CD40, MMP9, and TRAF1. This is important because based upon our environment, stressors, inheritance or what we call epigenetics we may be more or less likely to manifest Lyme disease. If these immune proteins decide to take a nap or they are less active due to inheritance or stressors, we may see that we are unable to fight bacteria like Borrelia. Thus, we could be more susceptible to Lyme disease.

Common Symptoms of Lyme Disease

The clinical presentation of Lyme disease is varied, and many people can experience some symptoms with the absence of others. Lyme disease can affect multiple body systems from the neurological system where we could see hearing changes or mental confusion to impacting the musculoskeletal system where we may see aches and pains.

Initial/Acute Infection

Upon infection, there can be an immediate response where there can be changes in the immune system. For some people, they may present with a fever or chills while the immune system and the inflammatory response initially respond to the pathogen. Others may see a red, inflamed area on the tick bite, surrounded by what some term a “bulls-eye” rash that may spread. The timing of the rash can vary where most show up within 2-30 days. But in other cases, this visual reaction on the skin may be completely absent. In this situation, a person may not even know they were exposed to a tick bite. Hence why Lyme disease can be elusive. In some of these cases, if the immune proteins do not engage appropriately there could be a suppression of the immune system, allowing for the infection to hide out where it can slowly take over the system or at some point could occur with a quick onset at a later time.

Systemic Inflammation

When the body experiences a foreign invader (viral, bacterial, etc), it stimulates a cascade of pro-inflammatory cytokines to address the invader, and this immune response also activates inflammatory pathways. In the case of the Borrelia organism, there is an increased response in inflammatory markers. The complexity of the infecting organism actually tweaks the immune system upregulating or heightening the symptoms of the body. It’s an unfortunate feed-forward cycle that mimics the presentation of many auto-immune diseases. The point is that if active it upregulates and makes symptoms worse and heightens the damage done with time.

Lyme can affect the nervous system causing severe headaches, joint and neck pain (arthritic presentation) with intermittent pain in tendons, joints, muscles and bones, result in loss of muscle tone in facial muscles (facial palsy), cause heart arrhythmias and rapid heartbeat (known as Lyme carditis), and in severe cases cause inflammation in the brain and spinal cord.

Connective Tissue Degradation

Borrelia travels through the body via collagen-based connective tissue, and can eventually cause connective tissue remodeling. This can affect the synovium and the myelin sheath of our nerves. Symptoms of this degradation include decreased muscle capacity, muscle weakness, hearing loss, facial palsy, and problems with memory.

Cardiovascular Symptoms

People with chronic Lyme seem to have poor blood circulation resulting in poor blood flow to the extremities (cold hands and feet). There may also be symptoms of heart arrhythmias and rapid heartbeat (known as Lyme carditis).

Secondary Symptoms of Lyme Disease

• Liver detoxification issues
• HPA Axis dysregulation & endocrine disorders which can impact sleep and hormones
• Thyroid irregularities
• Exercise intolerance
• Weight gain or loss (most commonly weight gain)
• Increase food sensitivities/allergies
• Autoimmune issues

Our Approach to Lyme Disease

Lyme is a great mimicker. It can be misdiagnosed as other diseases that are very similar to rheumatoid arthritis, fibromyalgia, mold or toxic exposures, or multiple sclerosis. And in some cases, there can be what is known as “co-infection” which is where you may get more than one tick-borne illnesses from one tick bite. In many cases, whether it is Borrelia alone or a co-infection (such as Babesia or Bartonella), people live with undiagnosed tick-borne illness for years until their doctor finally lands on the right diagnosis. In any such case, our approach is always going to begin by listening to your story and learning about your symptoms – with or without a present diagnosis. We want to know when the first symptoms began and also learn more about how your body has responded to illnesses in the past.

The symptoms experienced from a case of Lyme disease can vary from person to person. There is no standard clinical presentation, therefore the response to medical therapies such as antibiotics and other treatments even including herbal medicine for Lyme is also variable. This makes an individualized approach essential in helping those with Lyme disease. Some people are responsive to antibiotics and others are not. Some do best with a combined Lyme regimen of pharmaceuticals and botanical medicine (pharmacognosy). Again, each person is different. Sometimes preparing and stabilizing a person with Lyme is first required before any specific Lyme protocols are initiated. This is because some people can get far worse if their body is in a depleted state. Many people struggle with proper detoxification such as phase I and phase II detoxification and this must be improved first. Thus, identifying what is best for you is imperative.

At this time there is no perfect test for Lyme disease. However, research has found the best option to be the Western Blot. This is because it has the lowest rate of false-negative test results. Even if you have been prescribed antibiotics by your PCP or specialist or if for some reason you have failed antibiotics it is important to know there are additional options to help those with Lyme disease. In fact, there are additional therapies including supplements and pharmacognosy that can support the central nervous system, connective tissue, immune system, gut and digestion, cardiovascular, inflammation pathways, and pain management.

Often, the symptoms of Lyme disease shift and change, and your naturopathic doctor may want to see you routinely, perhaps twice a month, to continually check on your health. Weather, stress and other illnesses can also impact Lyme disease. Secondary areas of support that can be addressed can include weight management support, nutritional recommendations, energy and stamina support, liver detoxification, and supporting any side effects caused by current medications or treatments. We also work with your other health care providers to have a collaborative and supportive plan. When you have an active or chronic diagnosis of Lyme disease, the bacteria can be so variable where you may need different support at different times. In fact, there can be seasonal and hormonal shifts that can improve or exacerbate one’s Lyme disease. Thus, we will work with you if you have seen such seasonal or endocrine trends like this in the past. The goal of naturopathic medicine in these cases is to work collaboratively as a team to enhance your quality of life, address your unique symptoms and to find the strengths and weaknesses of your body that can allow the immune system to engage differently.

If you or a family member suspect the presence of Lyme disease, or have an active or even chronic diagnosis of Lyme disease, and are looking for comprehensive, holistic support, consider scheduling an appointment with one of our naturopathic doctors at Richmond Natural Medicine by calling our office at 804-977-2634 or filling out an Appointment Request Form here.

Our Naturopaths That Work With Lyme

References

Centers for Disease Control and Prevention

Educational Materials on Lyme Disease

Harvard Health: Lyme Disease Presentation, Prevention, and Diagnosis

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3232652/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2827415/