Lyme Disease: A Hidden Epidemic March 1, 2014 Susan L...

Lyme Disease: A Hidden Epidemic March 1, 2014

Susan L. Marra, MS, ND Care and Consulting for Chronic Fatigue,

Fibromyalgia, and Tick-Borne Diseases since 1999

11782 Sand Point Way NE

Seattle, WA 98125 Phone: 206-299-2676

www.drsusanmarra.com

Lyme Disease: A Hidden Epidemic

n  Characteristics of Lyme Disease:

n  Caused by the bacteria Borrelia burgdorferi, a spirochete

n  Long, thin cylinder, that is highly mobile with a tail

n  Most common tick-borne infection in US n  Fastest growing infectious disease in America n  Estimated 2-300,000 cases per year occur in US alone

n  Spirochetes have probably inhabited earth in northern Europe and the United States at least, for more than 4 million years


n  What is Lyme Disease?

n  A constellation of symptoms in an individual that results from infection from the bacteria, Borrelia species

n  At least 300 strains of Borrelia and probably more yet unidentified -some are not virulent (mouth)

n  Borrelia is transmitted by a blood-borne vector (ticks, mosquitoes,

lice, spiders, gnats, fleas, flies, etc…) n  Borrelia can be transmitted in utero and through mothers breast

milk most likely (see Under Our Skin)

n  Probably sexually transmitted (a cousin to Syphillis)


n  About Ticks continued: n  They have 4 life cycle stages:

n  Egg n  Larvae – infection can be transmitted n  Nymph – infection can be transmitted (most) n  Adult – infection can be transmitted

n  Life cycle of a tick is about 2 years barring persistent global warming. This elongates their life cycle.


n  About Ticks continued:

n  Irony: ticks have a very primitive immune system but do not get infected by spirochetes

n  Humans have a very elaborate immune system, but are highly vulnerable to spirochetal infections

n  Ticks respond to exhaled carbon dioxide and body heat to locate a host (probably also blood acidity). These are called chemoattractants.


n  Where do Ticks Bite on the Human Body?

n  23% arms n  10% head n  9% neck n  11% on shoulder and back n  11% abdomen and groin area n  3% chest n  2% buttocks n  30% legs


n  What are Spirochetes – Unique Pleiomorphic ancient bacteria

n  1) Cysts – round ball that contains many spirochetes

n  2) Spheroplast – shaped as a half moon (L-form)

n  3) Spirochete – a long thin spiral shaped structure with flagella n  Have a long replication cycle and therefore is slow growing

n  Generally cannot manufacture their own nutrients


n  Signs and Symptoms of Lyme Disease:

n  Less than 20% of people who contract Lyme Disease actually find a rash or Bulls Eye

n  Characteristic Bulls Eye is pathonomonic for Lyme Disease n  High fever lasting several days and can reoccur n  Extreme Fatigue with flu like symptoms n  Migraine Headaches n  Neck Pain n  Severe Migratory Joint Pain n  Loss of Memory n  Mood Irritability n  Muscle Stiffness n  Abdominal Pain n  Diarrhea or Constipation


n  Why is there such variability in symptom expression between patients? Probably due to many factors including: n  Spirochetal load in the host ( is it 10 or 10,000)

n  Virulence of the spirochetal strain that the host is infected with

n  Genetic makeup of the host, and length of time exposed to the bacteria

n  Strength of the host’s immune system

n  How many other infections are within the host (coinfections) and secondary infections (i.e.; Strep, EBV, HHV6, Pneumonia)


n  How To Detect Lyme Disease: n  Serum

n  IgM – Antibodies in blood n  IgG – Antibodies in blood

n  PCR DNA testing through blood or urine


n  Lyme Disease Coinfections: What are they? n  An infection that is transmitted by the tick at the same time that Lyme

Disease is transmitted

n  Babesia (microtii, duncani and several others) n  A RBC intracellular pathogen that resembles malaria

n  Causes night sweats, flushing, profound fatigue n  Causes SEVERE headaches

n  Highly endemic in Europe, Nantucket, Martha’s Vineyard, and probably all along the eastern and western seaboards as well

n  Must be treated with special antiparasitics like Malarone, Mepron, Allinia which are also used to treat malaria

n  Probably found in 20-30% of ticks in US


n  How to Detect Babesia:

n  IgM Antibodies in blood n  IgG Antibodies in blood

n  Babesia FISH test in blood n  Florescent insitu hybridization

n  Measures Babesia RNA in whole RBC

Lyme Disease: A Hidden Epidemic n  Lyme Disease Coinfections continued:

n  Bartonella (henselae and quintana) n  Many other species known to cause disease but few blood tests

n  Also known as Cat Scratch Fever

n  Much more prevalent than previously thought

n  Can cause lymph node swelling

n  Can cause red stria marks on skin (looks like stretch marks)

n  Can cause intestinal disturbances (nausea, vomiting, abdominal pain)

n  Generally a high incidence of neuropsychiatric illness


n  How to Detect Bartonella:

n  IgM Antibodies – Blood n  IgG Antibodies – Blood

n  Bartonella FISH test – Blood

n  Fry giemsa stain n  VEGF


n  Lyme Disease Coinfections continued:

n  Ehrlichia (Anaplasma) n  2 forms: can have either or both forms , HME monocytic or

HGE granulocytic

n  Fatigue n  Muscle aches n  Flu like symptoms n  Neuropathy n  Lymphopenia n  Neutropenia n  CNS symptoms n  Very high fever n  Severe joint pain n  Elevated liver enzymes


n  How to Detect Ehrlichia:

n  Antibody IgM and IgG testing in blood n  Found in 10-50% of Lyme Disease cases in the

US n  Especially found in Maine


n  Lyme Disease Coinfections continued: n  Mycoplasma fermentans

n  A cell wall deficient bacteria n  Difficult to identify n  Usually causes SEVERE neurological problems n  Poor memory n  Attention deficit n  Confusion n  Inability to comprehend new information n  Difficult to treat n  Difficult to eradicate n  No test available right now 02/14


n  How to Detect Mycoplasma fermentans: n  Found in 60-75% of Lyme Disease cases

n  Antibody IgM and IgG blood testing (use to be through MDL labs).

n  Dr. Garth Nicholson thinks MS is a combination of Lyme Disease and Mycoplasma fermentans


n  Lyme Disease Coinfections continued:

n  Rocky Mountain Spotted Fever which is Borrelia hermseii

n  Found mostly in ticks of the midwest n  Very high fever n  Spotted rash on palms as well n  Fatigue n  Flu like symptoms n  Joint pain


n  Lyme Disease Secondary Infections: n  Opportunistic infections resulting from

immunocompromization that occurs when you have Lyme Disease:

n  Mycoplasma pneumoniae n  Chlamydia pneumoniae n  Cytomegalovirus (CMV) n  Herpes virus (HHV6) n  Strep infections n  Epstein Bar Virus (EBV) n  Pseudomonas n  Hepatitis C? n  Candida albicans


n  Viruses that can present like Lyme Disease:

n  West Nile Virus Powassan Encephalitis Cytomegalovirus Eastern Equine Encephalitis n  Epstein Barr Virus HIV n  Herpes Zoster Virus Hepatitis B and C n  Herpes Simplex 1 (HSV1) n  Herpes Simplex 2 (HSV2) n  Human Herpes Virus 6 (HHV6) n  Parvovirus B19 n  Colorado Tick Fever

Lyme Disease: A Hidden Epidemic Treatment for Lyme Disease:

n  Depends on the severity of symptoms, whether you are a child or not and how well you tolerate antibiotics

n  Treatment course is variable n  Treatment may require an antibiotic cocktail or an

antibiotic and a quinine drug with herbs and vitamins n  Treatment can be oral, IM, IV n  Treatment initiated early in the disease is far more

effective, and this is well documented in the literature as well as observed by many clinicians

n  Patients might consider using a combination of traditional medicine as well as alternative medicine techniques to treat the disease


You also need to treat for Candida (yeast) when treating Lyme Disease:

n  Can do so using pulse therapy of antifungals n  Can rotate antibiotics with antifungals n  Can use antibiotics and antifungals

simultaneously with herbs n  Need to monitor liver enzymes and CBC n  Increase Bifido bacterium, Lactobacillus and

Saccharomyces species to support the gut


n  Transmission Rate of Borrelia:

n  A study showed that there was 100% transmission of Lyme Disease if the tick was attached for 3 days

n  Dr. Jones thinks the transmission can occur in as little

as 15 minutes after tick attachment


n  Lyme Disease Versus Autoimmune Disease:

n  AI frequently presents simultaneously with Lyme Disease

n  Difficult to determine which occurred first

n  Lyme Disease may trigger autoimmune disease onset

n  There is evidence that HLA DR2, HLA DR4 and HLA B27 may influence treatment outcome in Lyme Disease

n  The study of genomics in the next decade will help unravel this problem


n  Lyme Disease, Allergies, and Chemical Sensitivities:

n  Chronic Lyme Disease leaves patients immunocompromised

n  Depressed Immune System can cause allergies n  Inflammatory cytokines causing systemic inflammation

Contributes to allergies n  Frequent secondary infections can contribute to

allergies due to immunsuppression n  MCS is probably the result of compromised detox

pathways such as methylation pathways which are likely genetically inherited


n  What is a Herxheimer Reaction?

n  A Herxheimer reaction is probably a combination of:

n  Toxins being released into blood stream after herbal or antibiotic challenges

n  Proinflammatory cytokine flare (IL-2, 6, TNF) n  Poor ability to detoxify

n  Characterized by moderate to severe symptom flares lasting days to weeks


n  Combination Therapy for Lyme Disease Treatment can include:

n  Antibiotics, herbs, vitamins

n  Dosing depends on: n  Age n  Immune system status n  Presence of coinfections n  Diet n  Probably most the effective treatment is the strategic

rotation and pulsing of antibiotics, nutrients and herbs that essentially fool the spirochetes. This requires expertise.

n  Need to train with an LL physician to learn how to do this


n  Lyme Disease and coinfections ARE treatable and CAN be managed. Cure CAN occur, although not in every case. Generally quality of life is enhanced with treatment, and return to function CAN occur. However, treatment may take several years depending on how long that patient has had the disease.

n  Integrated and individually tailored treatment is

likely the most efficacious route for treatment, because specific attention to individual needs, diet, and genetic differences, are some of the keys to getting well from Lyme Disease.


n  COMPLIANCE

n  PERSISTENCE and

n  PERSEVERANCE are the backbone to managing/curing this disease

n  There are NO text book cases

n  Everyone IS completely unique in the way they present with Lyme Disease!

Thank you for your attention!

Lyme Disease: A Hidden Epidemic March 1, 2014 Susan L...

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