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Non-Antibiotic Approaches to the Management of Lyme Disease and Co-infections

Non-Antibiotic Approaches to the Management of Lyme Disease and Co-infections. Steven Harris, MD. Lyme. Affiliations: Clinical Consultant, Igenex Inc. CEO Pacific Frontier Medical Inc. B31 “ This is the most complex bacterial organism I know of. ” Casjens, personal correspondence 11/03.

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Non-Antibiotic Approaches to the Management of Lyme Disease and Co-infections

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  1. Non-Antibiotic Approaches to the Management of Lyme Disease and Co-infections Steven Harris, MD

  2. Lyme

  3. Affiliations: Clinical Consultant, Igenex Inc. CEO Pacific Frontier Medical Inc.

  4. B31“This is the most complex bacterial organism I know of.”Casjens, personal correspondence 11/03 • Linear genomic chromosome with 910 kbp. • 12 linear plasmids. • 9 circular plasmids. • 300% more plasmids than any other known bacteria. • Tremendous amount of prophage DNA. • There are 133 functional genes. • Very few genes are metabolic. • Does not require iron for metabolism. • Casjens, S et al. A Genome in Flux: The twelve Linear and Nine Circular Extrachromosomal DNAs of an Infectious Isolate oof the Lyme Disease Spirochete BorreliaBurgdorferei. MolecMicrobiol. 35: 490-516

  5. Bb FUNCTIONAL CHARACTERISTICS Characteristic Clinical Significance • Avoids antibody detection and avoids lysis from most beta-lactam antibiotics which do not penetrate cells. Bb is not present in high numbers in the blood Often An Intracellular Organism (Dorward D, 9th International Conference on Lyme Borreliosis, 1998.) • Helical Bb will tend to move away from oxygen-rich areas in vivo and reside in fascia, cartiledge, epineureum and other oxygen poor areas. Microaerophilic (Barbour AG, et al. “Borrelia’s Strategies for Survival”, Science, 1987, No. 237, pp. 403-411) • Helical Bb may be inactivated and destroyed upon exposure to temperature of 40 oC for 3 hours. Heat Sensitivity (Barbour AG, et al. Science, 1987)

  6. Bb FUNCTIONAL CHARACTERISTICS Characteristic Clinical Significance • Helical Bb thrives in slightly acidic environments (7.0 - 7.3). It forms an acidic vacuole intracellularly for protection PH Sensitivity Donta ST, Tetracycline therapy for chronic Lyme disease. Clinical Infectious Dis 25:suppl 1(July 1997):352-356 Epitope Switching Seller KP, Weiss JJ. Immunity to Lyme disease: Protecdtion, pathology and persistence. Current opinion in Immunology 1996; 8(4): 503-9 • Bb alternates its outer surface proteins preventing sustained immune recognition & attack. • Jarisch-Herxheimer reactions can complicate treatment, as well as clinically guide physicians in diagnosis and effectiveness of treatment. Stress Mediated Toxin Release

  7. Bb FUNCTIONAL CHARACTERISTICS Characteristic Clinical Significance • In vitro generation time is 12-36 hours. In vivo, it is much longer, perhaps even 14 - 28 days. Length of treatment must contain adequate division cycles, e.g., 10 day course of pcn for Group A beta-hemolytic streptococcus covers about 500 division cycles. A similar course for Bb assuming 24 hour division cycle would last 2 years. Slow Division Cycle (Burrascano J, 9th International Conference on Lyme Disease; 11/03; MacDonald AB, et al. Clinical implications of delayed growth of the Lyme disease spirochete, Borrelia burgdorferi. Acta Trop 1990; 48(2):89-94) Plasma Mediated Resistance • Beta-lactam and tetracycline resistance likely with sustained treatment Bb Surrounds Itself With Host’s Own Lymphocyte Cell Membrane (Doward D, et al. Clinical Infect Dis, 1997) • Avoids detection from immune system.

  8. Bb FUNCTIONAL CHARACTERISTICS Characteristic Clinical Significance • Destroys bodies defensive weapons Bb Actively Attacks Lymphocytes, Macrophages, Natural Killer Cells (Doward D, et al. Clinical Infect Dis, 1997) Bb Selectively Binds Oligodendria cells; These Cells Are Responsible For Synthesis and Maintenance Of Myelin. (Garcia Monco JC, et al. Adherence of the Lyme Disease spirochete to glial cells and cells of glial origin. J Infect Dis 1989; 160: 497-506) • In addition to direct destruction of myelin by bacterium, the host antibodies may in effect attack myelin while targeting Borrelia to which myelin is in close contact, thus simulating genuine MS.

  9. Bb FUNCTIONAL CHARACTERISTICS Characteristic Clinical Significance • Inflammatory response causes severe multisystem effects. Part of effective immune response is blunted. Induction of Cytokine Releases (TNF alpha, IL1, IL6) Prevention of other Cytokine Releases (IL2) (Chiao Jw, Abstract 7th International Conference on Lyme Borreliosis, 1994; Defosse DL, et al. In vitro and in vivo induction of tumor necrosis factor alpha by Bb. Infect Immun 1992; 60: 1109-1113)

  10. Bb FUNCTIONAL CHARACTERISTICS Characteristic Clinical Significance Bb Can Change Its Morphology To Cell-Wall Deficient Cysts Cysts Are Heat, Pressure and Oxygen Resistant. Cysts Are Resistant To All Antibiotics Except Tinidazole, Metronidazole and Hydroxychloroquinine. In Vitro, Cystic Bb Can Readily Revert Back To Helical Bb. Cystic Forms Of Bb Are Probably A Main Reason For Treatment Resistance And Relapse. (Brorson O, Brorson SH, “Transformation of Cystic Forms of Bb To Normal Mobil Spirochetes”, Infection, 1997, No. 25, pp. 240-246; Alban PS, Johnson PW, Nelson DR. Serum-starvation-induced changes in protein synthesis and morphology of Borrelia burgdorferi. Microbiology 2000;146 (P1):119–27. Bruck DK, Talbot ML, Cluss RG, Boothby JT. Ultrastructural characterization of the stages of spheroplast preparation of Borrelia burgdorferi. J Microbiol. Methods 1995; 23:219–28; Preac-Mursic V, Wanner G, Reinhardt S, Wilske B, et al. Formation and cultivation of Borrelia burgdorferi spheroplast L-form variants. Infection 1996; 24:218–26)

  11. PATHOLOGY OF BbLocation within the human host • Bb is often an intracellular organismBrouqui P, Badiaga S, Raoult D: Eukaryotic cells protect Borrelia burgdorferi from the action of penicillin and ceftriaxone but not from the action of doxycycline and erythromycin. Antimicrob Agents Chemother 1996; 40:1552-1554. • Bb can thrive within fibroblastsKlempner MS, Noring R, Rogers RA. Invasion of human skin fibroblasts by the Lyme disease spirochete, Borrelia burgdorferi. J Infect Dis 1993; 167:1074–81. Georgilis K, Peacocke M, Klempner MS: Fibroblasts protect the Lyme disease spirochete, Borrelia burgdorferi, from ceftriaxone in vitro. J Infect Dis 1992; 166:440-444. • Bb can survive within lymphocytes and macrophagesMontgomery RR, Nathanson MH, Malawista SE. The fate of Borrelia burgdorferi, the agent for Lyme disease, in mouse macrophages. Destruction, survival, recovery. J Immunol 1993;150:909–15 Dorward DW, Fischer ER, Brooks DM. Invasion and cytopathic killing of human lymphocytes by spirochetes causing Lyme disease. Clin Infect Dis 1997;25 (Suppl 1):S2–8. • Linder S, Heimerl C, Fingerle V, Aepfelbacher M, Wilske B. Coiling phagocytosis of Borrelia burgdorferi by primary human macrophages is controlled by CDC42Hs and Rac1 and involves recruitment of Wiskott-Aldrich syndrome protein and Arp2/3 complex. Infect Immun 2001;69: 1739–46. • Bb can harbor within endothelial cellsMa Y, Sturrock A, Weis JJ. Intracellular localization of Borrelia burgdorferi within human endothelial cells. Infect Immun 1991;59:671–8. • Bb has a proclivity to remain within synovial cellsGirschick HJ, Huppertz HI, Russmann H, Krenn V, Karch H. Intracellular persistence of Borrelia burgdorferi in human synovial cells. Rheumatol Int 1996;16:125–32.

  12. Pleomorphism / Symbiogenisis MICROFILARIA BABESIA BARTONELLA BACTERIOPHAGES GI PARASITES MYCOPLASMA STREPTOCOCCUS ORAL ORGANISMS MOLD HEAVY METALS YEAST BORNA VIRUS, COXSACKIE CLOSTRIDIA LYME HHV6, 7 BRUCELLA CHLAMYDIA RICKETTSIA NEOSPORA PESTICIDES / ENVIRONMENTAL POLLUTANTS LEGIONELLA CLONORCHIS SINENSIS OTHER SPIROCHETES PRIONS WORMS

  13. Lupus Rheumatoid arthritis Polymyalgia rheumatica Polymyositis/dermatomyositis CFIDS Fibromyalgia Multiple Chemical Sensitivity Bipolar d/o ADHD Autism Chronic EBV Schizoaffective d/o Multiple Sclerosis CIDP Amyotrophic lateral sclerosis Alzheimer's disease Parkinson's Disease Thyroid disease Addison's disease Hyperparathyroidism Reflex sympathetic dystrophy Menopause Lyme Disease is a Chameleon in Plaid

  14. If Lyme can mimic so many diseases, how can it be diagnosed? A Lyme patient will usually experience 6-40+ symptoms at a time.

  15. Joint Pain Joint stiffness Joint swelling Lightheadedness Fevers / Chills GI upset Pelvic pain Blurry vision Myoclonus Fasciculations Severe depression (depressive episode) Body electric Word-finding problems Dysuria Clinical Presentation Lyme Some symptoms wax and wane.

  16. Fatigue Sleep disturbance Headache Tinnitus Muscle pain Worsening symptoms 4 days before menses Neck pain (buffalo hump pain) Joint crepitus Low frustration tolerance Poor executive functioning Low libido Hypoesthesia (regions of numbness) Hyperacusis Clinical Presentation Lyme Some symptoms tend to remain constant.

  17. Dysthymia Neuropathic pain Restless leg Tremor Anxiety Encephalopathy Subdermal fibrous cysts Osteophytes Blood pressure instability Autonomic dysreflexia Muscle weakness Abdominal pain Clinical Presentation Lyme Some symptoms are variable.

  18. Diffuse myofascial tenderness Increased fluid pressure on ballottement of fundi Adies pupil Oscillating pupils Hyperreflexia Vertical ridging in nails Clammy hands and feet Hypothermia 96.0-97.9 Joint fluctuance – fingers, elbows, knees Joint crepitus Arrhythmia Nerve palsy CN 3,4,6,7,8 Paraspinal spasms – especially C7 Physical Exam Lyme

  19. Skin mottling Hypermelanosis Psoriasis Dermographia Horizontal nystagmus Thrush (co-habitation by yeast is common) Oiling of skin Abdominal distension Non-pitting edema Brown exudate on teeth Plantar tenderness SI joint Myofascial bundles Hoffman reflex Cold acral extremities Black flecks within skin ulcers (Morgellons) Subdermal fibromas Vagus nerve instability: vasovagal, hypomotility Physical Exam Lyme

  20. Treatment Lyme Herbals • Samento • Banderol • Cumanda • Quina • Lakato • Houttuynia • Garlic (Allicin) • Coptis • Teasel • Chanca piedra • MC-BB-1 • MC-BB-2 • BLt • AL Complex • Lyme nosodes • Rizoles • Lymogen • Borrelogen • LymPlus Transfer Factor • Bee venom • And more…

  21. Babesia

  22. Clinical Presentation Babesia • Headaches • Night sweats • Fevers • Dry cough • Air hunger • Easy bruising • Tinnitus • Rage • Despair • Chills • Flushing • Sleep disturbance • Vivid or violent dreams • Dysphagia • Psychic phenomena • Severe neurological illnesses • Thirst/Polydipsia • Fatigue • Rheumatoid arthritis • Nausea (severe) • Malaise • Anemia, thrombocytosis, thrombocytopenia • Abdominal pain

  23. Physical Exam Babesia • Temp. above 99 degrees • Cherry angiomas • Babinski reflex • Hypothenar atrophy • Papulovesicular rash • Ecchymosis • Petechiae • Splenomegaly • Increased fundal pressure on ophthalmologic exam • Proptosis • Severe nuchal tension • Myoclonus • Rooting reflexes • Murmurs from tricuspid regurg. • S3+ on auscultation • Expanded apex on percussion • Restrictive lung disease • Rhonchi, crepitations • Onychomycosis of the Hallux • Decreased bowel sounds • Rheumatoid nodules • Abdominal tenderness

  24. Treatment Babesia Herbals • Cryptolepsis sanguinolenta: an herb from West Africa highly effective against Malaria, seems to be quite powerful against most species of babesia. Currently most readily available from Woodland Essence as a lot standardized tincture. Dose titrated to response. • Enula (Nutramedix): 15-50 drops bid • Mora (Nutramedix): 25-40 drops bid is a good addition for those on enula for several weeks. • Rizol ozonated oils (BioPure). Some blends highly effective for Babesia.

  25. Treatment Babesia Herbals • Plant stem cells (PSC):yarrow, sweet chestnut, artemisia, arnica in combination show great promise. • Myco (Raintree Nutritionals): a blend of herbs may work synergistically with atovaquone. • Chanca piedra (various): in high dose may show efficacy. • Crypto-Plus (Clinical Response Formulas):

  26. Treatment Babesia • Herbals • MC-BAB-1 (Beyond Balance) • MC-BAB-2 (Beyond Balance) • MC-BAB-3 (Beyond Balance) • ABab (Byron White Formula) 26

  27. Bartonella

  28. Clinical Presentation Bartonella • Brain Fog • Fever • Headaches (ice pick) • Photophobia • Tachycardia • Bowel problems IBS>>>>IBD • Swollen glands • OCD behavior • Anxiety • Endocarditis • Retinitis • Peripheral neuropathy • Rapid relapse off antibiotics • Immediate illness following tick bite • Psychiatric problems • No response to previous ABX • Plantar pain, costal margin pain • Rapid mood shifts • Development of these symptoms during Babesia treatment

  29. Physical Exam Bartonella • Purple non-blanching abdominal striae • Tiny papulovesicular rash • General Lymphadenopathy (axillary, cervical) • Fever (99-102) • Photophobia • Fasciculations • Hyperesthesia (usually extremities) • Abdominal tenderness • Subcutaneous nodules • Anxiety • Swollen joints • Swollen lymph nodes

  30. Bartonella

  31. Treatment Bartonella Herbals • Boneset • Houttuynia (Nutramedix) • Pau d’Arco • Arnica • Rizol My (BioPure): Rizol pure raw material, Oil of Artemisia, Clove Oil, Black Cumin Oil, Walnut Oil, Majoram Oil

  32. Treatment Bartonella Herbals • MC-BAR-1 (Beyond Balance) • BLT (Clinical Response Formulas) • ABart (Byron White Formula)

  33. Alternative Protocols

  34. Alternative Protocols • Beyond Balance Protocol • Clinical Response Formulas Protocol • Zhang Protocol • Cowden Protocol • Jernigan Nutraceuticals • Byron White Formulas • Maypa herbals • Deseret Biologicals • Researched Nutritionals • Buhner Protocol • Rizoles • Misc

  35. Beyond Balance • Susan McCamish, C.T.N., C.N.C. • http://www.beyondbalanceinc.com

  36. Beyond Balance • Various combinations of MC-BB-1, MC-BB-2, MC-BAR-1, MC-BAB-1, MC-BAB-2, MC-BAB-3, PARAZOMIN and supportive therapies • Typical dosages: titrate to response • 10-20 drops 2-3x/day is highly effective • Some patients are very sensitive. Some can tolerate high quantities.

  37. Ingredients: Queen’s Delight Motherwort Plantain leaf Black walnut Licorice Calendula Properties: Anti-bacterial Anti-parasitic Anti-viral Anti-microbial Anti-inflammatory Anti-septic Designed to work with Borrelia burgdorferi MC-BB-1

  38. MC-BB-2 • Ingredients: • Stillingia • Motherwort • Plantain • Clove buds • Black walnut hulls • Red clover blossom • Licorice root • Calendula • Skullcap • Horsetail • Rue herb • Properties: • Anti-bacterial • Anti-parasitic • Anti-viral • Anti-inflammatory • Blood tonic • Adrenal tonic

  39. Ingredients: Cat’s Claw Sarsaparilla Pau d’arco Burdock Blessed Thistle Mullein Oregon Grape Properties: Anti-bacterial Anti-parasitic Anti-viral Anti-microbial Anti-inflammatory Anti-septic Designed to work with Bartonella MC-BAR-1

  40. Ingredients: Red Clover Rue Wormwood Prickly Lettuce Valerian Nettle Properties: Anti-bacterial Anti-parasitic Anti-viral Anti-microbial Anti-inflammatory Anti-septic Designed to work with Babesia MC-BAB-1

  41. Ingredients: Comfrey Burdock Blessed Thistle Stevia Motherwort Wild Yam Plantain Leaf Damiana Properties: Anti-bacterial Anti-parasitic Anti-viral Anti-microbial Anti-inflammatory Anti-septic Unique to Babesia duncani and other Babesia strains MC-BAB-2

  42. MC-BAB-3 • Ingredients: • Wild lettuce leaf • Parsley leaf • Mistletoe herb • Eucalyptus leaf • Valerian root • Cat’s claw bark • Yucca root • Stevia leaf • Blessed thistle herb • Properties: • Anti-bacterial • Anti-parasitic • Anti-viral • Anti-microbial • Anti-inflammatory • Anti-septic

  43. PARAZOMIN • Ingredients: • Mulllein leaf • White willow bark • Wormwood • Pipsissewa leaf • Hawthorne berry • Black walnut hulls • Shavegrass • Valerian root • Cat’s claw bark • Gotu kola leaf • Burdock root • Properties: • Developed to help fight parasitic and protozoan infestation • Vermifuge properties • Anti-inflammatory • Supports repair of damaged tissue

  44. Ingredients Mistletoe Barberry Red Clover Oregon Grape Burdock Kelp Sheep Sorrel Rosemary Properties: Anti-viral activity Immune builder IMN-V (formerly ImmunoVira)

  45. Ingredients: Goldenseal Burdock Lobelia Rosemary Pipsissewa Sheep Sorrel Hawthorn Berry Properties: Designed to address protozoan activity Supports immune and organ function Aids the detoxification methylation pathway MC-PZ (formerly ProtaZ)

  46. Ingredients: Astragalus Red Clover Fennel Garlic Burdock Mullein Cat’s Claw Mate Oregon Grape Echinacea Angustifolia Properties: Enhances body’s own natural immunity Anti-bacterial Anti-viral IMN-R (formerly Immune Restore)

  47. Ingredients: Mullein Milk Thistle Slippery Elm Parsley Elderberry Rosehips Apple pectin Skullcap Cayenne Vitamin A Bromelain Red Clover Blueberry Properties: Assists the body’s natural detoxifying process Increases assimilation and absorption of nutrients Eliminates pollutants, wastes, poisons Promotes tissue repair and healing Tox-Ease

  48. Tod Thoring, ND http://www.clinicalresponseformulas.com/ Clinical Response Formulas

  49. Clinical Response Formulas • BLt – Microbial Balancer #1 • Ingredients: Ceanothus Americanus (Red Root), Dipsacus(Teasel), Eupatorium Perfoliatum (Boneset), Juglans Nigra (Black Walnut Hulls), Lomatium Dissectum, Smilax (Sarsaparilla), Stillengia Sylvatica • Highly effective in broad spectrums, for detox and anti-microbial properties. • Quite useful in autistic spectrum patients • 40-60 drops 2-3x/day • BLt without Black Walnut

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