Lyme disease, particularly when compounded by co-infections, is a complex condition that requires a nuanced and comprehensive approach. A survey taken by those with Lyme disease found that 50% of the individuals also have at least one co-infection. While many pathogens can be concomitant with Lyme disease, this survey found the highest rates with Babesia, Bartonella, and Anaplasma. As of 2019, tick-borne-causing illnesses have increased by 25% in the last eight years. With the increase in pathogens infecting humans, our medical system must have assessment tools, interventions, and protocols to address the ongoing demand. In conventional medicine, there is a frequent disregard or delay in investigating Lyme disease and co-infections. Within the Western medical model, the therapeutic toolbox for treating these conditions is also limited. Functional medicine offers a comprehensive method for testing and treating Lyme disease and co-infections. This article explains how this integrative and holistic approach can detect infection and provide effective treatment modalities.

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Understanding Lyme Disease and Its Co-Infections

Lyme Disease is a complex condition most notably contracted from a tick-carrying Borrelia burgdorferi. This microbe is transmitted when an infected deer tick bites a human. The longer the tick is attached, the increased likelihood it has to transmit the disease-causing bacteria. Typically, people do not know a tick has bitten them but will go on to develop acute symptoms within 3 to 30 days. These flu-like symptoms can often be mistaken for other conditions, so individuals should watch for a tall-tale rash called Erythema Migrans. This rash is distinguishable from other types because it has a red bulls-eye appearance. When rashes along with these early-stage symptoms present, it is essential to seek care

Early Stage Lyme Disease Symptoms:

• Fever
• Chill
• Joint pain
• Headaches 
• Muscle aches
• Stiff neck 
• Swollen lymph nodes
• Fatigue

In this early stage, antibiotics are often used to treat the infection. Common antibiotics are doxycycline with amoxicillin or cefuroxime.

Success in treating Lyme disease is more effective when the disease process is in its early stages. It's estimated that about 10% of those treated for Lyme using antibiotics will have persistent symptoms of fatigue, pains, or joint and muscle aches. Chronic Lyme disease, or Post-Treatment Lyme disease Symptoms, has been coined for these individuals. Chronic Lyme disease is also used to describe individuals with similar symptoms without a positive test for B. burgdoferi. Many experts in the medical field do not align with this term since it is used outside the diagnostic criteria for typical Lyme disease. This brings us to the exciting topic of co-infections that can occur alongside Lyme disease.

Co-infections are other bacterial pathogens carried by Lyme-carrying vectors and can be transmitted simultaneously or in place of the well-known B. burgdoferi bacteria. One study found that 2% to 5% of young lymph tick species were reported to be harboring one or more transmittable pathogens. Common disease-causing pathogens from tick bites causing Lyme-like symptoms include Babesiosis (Babesia), Bartonella, and Ehrlichia.

Babesia is a parasite transmitted through a black-legged or deer tick bite and infects red blood cells. Most cases of babesiosis infection occur in the midwest and northeastern parts of the United States and during the warm months. Symptoms are similar to a Lyme infection, presenting as chills, headaches, fever, chills, body aches, fatigue, nausea, and loss of appetite.  Bartonella has a similar transmission via tick but also a well-known transmission through a cat scratch or bite. This causes a condition known as Cat Scratch Fever. Cats infected with fleas carrying the Bartonella bacteria can then infect humans through bites, scratches, licking an open wound, or contact with a flea that may be in the cat litter while cleaning. Symptoms also include the abovementioned, in addition to lymph node swelling and the more specific signs of bumps, cysts under the skin, or a rash starting at the bite or scratch site. Complications of untreated Bartonella include heart and central nervous system damage. The bacterial co-infection Ehrlichiosis arises from a bite of a black-legged or lone start infected tick. The presentation looks very similar to Lyme disease, with the addition of confusion and gastrointestinal symptoms like nausea, vomiting, and diarrhea.

Co-infections must be considered when investigating Lyme disease because they can exacerbate the presentation, cause resistance to therapy, or be the primary culprit. While these can be labeled co-infections, these pathogens can infect people without Borrelia burgdorferi, and these should be tested alongside a Lyme panel. In addition, each tick-borne illness requires its own treatment regimen to cure the person effectively. Taking a proactive approach in testing for all possible culprits can result in early detection and treatment, which leads to better outcomes and reduces the long-term complications of Lyme disease and co-infections.

Comprehensive Diagnostic Strategies for Lyme and Co-Infections

Functional medicine testing can help practitioners and patients gain detailed information and guide treatment. Accurate diagnosis requires advanced testing for Lyme disease and co-infections. The Tick-Borne Disease Panel 11 by IGeneX is a comprehensive laboratory test that looks at 23 markers, testing for the most common pathogens causing Lyme disease or Lyme-like presentations. Specifically, it looks at various immune responses (IgG and IgM) of Borrelia burgdorferi, Babesia, Bartonella, Ehrlichia, and other common tick-borne pathogens. This test provides insightful information for diagnosing Lyme disease and determining if co-infection is an avenue that must also be treated.

The Functional Medicine Approach to Lyme and Co-Infections

Addressing an individual's health holistically and integratively is the basis of functional medicine. Through clinical assessment, comprehensive laboratory testing, and treatments targeting the root cause, patients can overcome diseases and chronic health ailments plaguing their bodies acutely or for years. Regarding Lyme disease and co-infections, the primary focus would be identifying the pathogen, providing a tailored treatment plan that addresses the disease processes, and including overall health tools. Functional medicine takes a systems biology approach, meaning practitioners in this field view the body's systems as interconnected rather than independently functioning parts. Thus, supporting the areas involved in Lyme and co-infections, such as the immune system, gut health, and endocrine organs, is essential. It’s also necessary to consider one's health history, current environmental factors, and lifestyle, such as nutrition, sleep, stress, and movement, to provide well-rounded support. Below are avenues in which functional medicine offers a natural approach to Lyme disease and co-infections.

Nutritional and Herbal Interventions

Optimizing your nutrition and incorporating herbal medicines can support your immune system, reduce inflammation, and address the systemic effects of tick-borne illnesses. Acknowledging that acute co-infections are often best treated with conventional medicine is important. If co-infections are found in chronic stages, it can be challenging to collaborate with traditional medicine therapies unless your practitioner has the right to prescribe antibiotics. When it comes to diet and nutrition, there is no specific diet for Lyme disease and co-infections so there is a consensus that an anti-inflammatory diet can help decrease systemic inflammation, support a healthy immune system, and provide nutrients that your body needs to fight off infections. Eating within this nutrition plan includes whole foods, plenty of antioxidant-rich fruits and vegetables, whole grains rich in fiber, healthy fats, wild-caught fish, beans and legumes, and various herbs and spices. Avoiding processed foods, added sugar, and alcohol can help decrease concomitant infections, especially in Bartonella.

Herbal supplements for Lyme co-infections assist in immune modulation, decreasing inflammation and providing antioxidant support. There is supportive evidence for using botanicals in treating B. burgdorferi, with many of these crossing over to treat co-infection tick-borne illnesses. While there is minimal research on the use of these common botanicals in the treatment of Babesia, a laboratory study found five herbal medicines to cause inhibitory activity of the Babesia ducani pathogen. These herbs include Cryptolepis sanguinolenta, Artemisia annua (Sweet wormwood), Scutelleria baicalensis (Chinees skullcap), Alchornea cordifolia (African Christmas bush), and Polygonum cuspidatum (Japanese knotweed). In terms of effective botanicals for Bartonella, a study showed effective growth inhibition of B. henselae species independently using Cryptolepis sanguinolenta, Julgans nigrans (Black walnut), and Japanese knotweed. In clinical practice, integrative health practitioners using botanicals to treat tick-borne illnesses have experience in effective treatment protocols that include specific herbal medicines to treat these particular co-infection pathogens. This is one reason to work with a Lyme and co-infection literate practitioner who can effectively guide you.

The Role of Detoxification and Gut Health

Detoxification and gut health play a significant role in assisting the body in eliminating toxins and managing infections. When treating Lyme disease and co-infections with antimicrobials, some individuals may experience a phenomenon known as a Herxheimer Reaction. This is a die-off response of the pathogens, exacerbating the symptoms they felt before treatment. This die-off response ignited a release of toxins and cellular debris, which stimulated the immune system to respond to mitigate the inflammatory process. One resource states that 7-30% of Lyme patients who are treated with antibiotics experience a Herxing reaction.

While statistics on using natural antimicrobials and Herxing are not available, it is possible since the mechanism of action is similar. Due to this, it’s essential that detoxification pathways, including the liver, small and large intestines, lymphatics, and kidneys, are all doing their job to assist in excreting these toxins. In addition, the gut microbiome is essential in supporting immune function and protecting against infectious agents. One study found that in patients who developed posttreatment Lyme disease syndrome (PTLDS) after treatment with antibiotics, there was a signature gut microbiome imbalance in these individuals compared to healthy patient controls. Taking detoxification and gut health into consideration when addressing Lyme co-infections can assist patients in better treatment outcomes. A few key ways to support detoxification pathways are staying hydrated, moving your body regularly, reducing sweating, and eating a diet high in detox-supporting nutrients.

This includes vitamins B6, B12, folate, and magnesium. Sulfur-rich foods such as broccoli and cauliflower can also assist in liver detoxification and gut health. Working with a healthcare practitioner who can assist in a gut health protocol, recommend quality probiotics, amino acids, or a customized nutrition plan.

Managing Chronic Symptoms and Pain

Lyme disease and co-infections can cause multiple chronic ailments and pain that are debilitating. Utilizing complementary and alternative therapies for pain management, musculoskeletal aches, and reducing fatigue is an excellent option for a comprehensive treatment plan.

Acupuncture

Utilizing acupuncture to reduce chronic pain is an effective complementary medicine tool. This ancient practice uses fine needles to reduce inflammation, optimize blood flow, and release endorphins, all contributing to chronic pain modulation.

Infrared Sauna

Heat therapy utilizing an infrared sauna has a profound penetration ability, supporting the excretion of toxins. Through circulation promotion, inducing sweating, and reducing oxidative stress, incorporating infrared saunas as part of your therapeutic protocol can significantly assist in muscle aches and pains associated with Lyme co-infections.

Relaxation Therapies

Massage therapy, chiropractic care, Tai Chi, and mind-body practices are all great ways to support your nervous system, reduce pain, and induce relaxation. Managing chronic Lyme symptoms can be exhausting and stressful and leave you feeling defeated. Finding avenues to relieve stress and assist in nervous system recovery is vital to overall well-being in chronic health conditions.

Ongoing Monitoring and Support

Working with a functional medicine practitioner who can provide ongoing support for Lyme co-infections can assist patients in irradicating these pathogens. Addressing the root cause through evaluation and testing and then putting a plan and protocol in place can help improve the damage caused by these pathogens. Monitoring Lyme disease treatment with regular follow-ups and adjusting the treatment plan as necessary is common in chronic health conditions. Realistically, addressing conditions like Lyme and other tick-borne illnesses can be more of a marathon than a race. 

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Conquering Lyme Disease and Co-Infections with Functional Medicine

Lyme disease and co-infections present a complex and challenging health crisis for many who are impacted by it. Timely recognition of early-stage symptoms, such as rashes, fever, joint pain, and fatigue, can lend a way to starting effective therapeutic interventions. Beyond this acute stage, individuals can progress to chronic Lyme disease if untreated or potential post-treatment Lyme Disease symptoms. Functional medicine testing also looks for common co-infections, which include Babesiosis, Bartonella, and Ehrilichoiosis. This allows for targeted treatment using botanicals, nutrition, gut health support, detoxification, and symptom management. Integrative medicine support provides a holistic means to addressing Lyme disease and co-infections. In navigating the marathon of Lyme and tick-borne illnesses, a comprehensive patient-centered approach can offer ongoing support with tools to assist patients in reaching health goals.