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Lyme disease is a confusing, potentially chronic and debilitating disease. There is plenty of information regarding chronic Lyme disease available for public access. One of the difficulties with respect to treatment is that there are two standards of care. The Center for Disease Control (CDC) and Infectious Disease Society recommend short courses of antibiotics, and then assume the infections are treated and resolved. In many cases, this is enough of a treatment for a complete recovery. Other practitioners use a much longer antibiotic approach, with integrative treatments. These groups include the International Lyme and Associated Diseases Society (ILADS/Ilads.org), of which I’m a member. Unfortunately, there are some people who don’t have complete recovery from a short course of antibiotics. There may be many reasons for this treatment failure. Most likely the problem is a combination of inappropriate immune response and the Lyme organisms’ (Borrelia) ability to evade the antibiotic treatment, which it does by forming cysts, hiding in your cells or changing forms. If the antibiotics were enough to completely kill the infection, you should be symptom free. If the antibiotics were not able to kill the infection completely, your immune system responded incorrectly, or you have multiple infections (called co-infections), and your Lyme disease will become chronic which is an extremely difficult thing to treat. To compound matters, testing for Lyme disease is controversial and potentially inaccurate. It’s estimated that 35% of Lyme disease cases are missed with standard testing (www. Ilads.org, 4/16/06), and there is NO follow-up test to determine if the treatment has been successful. If you had the classic “bulls eye rash” (erythema chronicum migrans), you can be certain you have been exposed to Borrelia, but only 50% of people at most get the rash! Other indicators include Bell’s Palsy, migrating muscle and joint pains especially when in concert with heart problems and neurological problems. I strongly suggest getting appropriate testing, which includes an IgG and IgM Western Blot test from IgeneX labs (Igenex.com). Please keep in mind the testing isn’t 100% accurate! You should read more about testing on IgeneX’s website on the publication page. I use natural treatments for most conditions, but I feel antibiotics are an integral part of successful treatment for Lyme disease. However, I do not believe antibiotics are enough for everyone. Some cases of Lyme disease require longer courses of antibiotics and supplemental treatments to facilitate the action of the antibiotic and reduce the effects the Borrelia and co-infections. Most people don’t know what group they fall into, so I feel that aggressive treatment is a good idea initially. Inappropriately short courses of antibiotics, or other treatments like steroids, often drive Lyme into defensive positions and cause chronic disease. As I mentioned, I consider antibiotic use for Lyme critical, but I also think there is MORE that needs to be done, at the same time, to make sure the treatment is successful, especially if you’ve been treating and living with chronic Lyme disease. Treating adrenal and thyroid health, heavy metal toxicity, immune balance, nerve function, heart health, mental function and many other aspects of the Lyme complex is necessary to reduce and resolve your symptoms. I suggest using a Lyme literate doctor, or better yet, a Lyme literate Naturopath to help you with this complicated treatment. Referrals for Lyme-literate physicians may be obtained by emailing kimuffleman@hotmail.com or from the Lyme Disease Association (1.888.366.6611). A common issue in treating Lyme is the Herxheimer reaction. This is a phenomenon that happens when treating spirochetes (spiral-shaped bacteria like Borrelia) and can be summed up thusly: you get worse before you get better! Often symptoms get much worse in 3-week cycles while treating Lyme. This is due to the organisms dying off and is related to Borrelia’s lifecycle. Whether you are treating Lyme disease with antibiotics OR natural treatments, you should expect to get worse in the process before you get better. What usually happens is that people report they are feeling “the best they’ve felt in a long time” for 3 weeks, then “the Herx reaction” hits and they feel very poorly again. Often the Herx reactions come and go. One way to know your treatment is done is that you don’t have Herx reactions for 2-3 months. You may be treating yourself for 6 months to 1 year or more before you get to this point. I’ve researched alternative therapies for Lyme for many years now. I’ve come to the conclusion that it’s essential to treat all aspects of your ill health to get the greatest improvement. Since Borrelia can take different forms in your body, I suggest using various antibiotics that have the potential to access each of the defensive positions of Lyme. The Zhang formula, developed by Dr. Qincia Zhang, is a combination modern Chinese medicine treatment protocol designed to kill Lyme and its co-infections, as well as support various organ systems in healing. Dr. Zhang is currently writing and publishing a book regarding the treatment of Lyme disease with his formulas. Dr. Zhang’s protocol includes some of the steps I consider necessary to treat Lyme disease. All of the information about the Zhang protocol is adapted from Dr. Zhang’s information. Please stay tuned, as the book will be available soon! Dr. Zhang’s reported efficacy: 60% total resolution of Lyme disease 20% resolution only with continued treatment 20% no change in symptoms and no improvement Please keep in mind that treating the infection as early as possible is really what needs to happen. Antibiotics or the Zhang protocol (I recommend both together) can be highly effective in the first few weeks of the infection. But, during the first few weeks, the labs are almost always negative, so you have to treat presumptively. Several months of antibiotics and/or the Zhang protocol will resolve most acute infections. Perhaps shorter courses of antibiotics or Zhang will be equally effective, but I treat aggressively, because I want to know the infection is gone before stopping the treatment. The steps to treat Lyme disease include: 1) Using antimicrobials to kill Borrelia and the various co-infections. This MUST include antimicrobials that can work inside and outside cell membranes as well as against the various forms the Lyme disease can take. 2) Reduce inflammation and immune related damage caused by Borrelia’s ability to alter your immune system 3) Increase circulation to infected areas, because inflammatory modulators produced by Lyme disease reduce circulation to the organism and render the antimicrobials less effective, simply because they can’t get where they are needed. 4) Balance the immune response, because inappropriate immune cellular response triggered by Borrelia can cause severe damage. 5) Support and resolve side effects of Lyme disease to reduce stress on your system, which in turns reduces your immune function (see adrenal treatments) 6) Remove and treat any pathologies that were created during or exaggerated by Lyme. This can include heavy metal toxicity, thyroid damage, nerve damage… 7) Resolve fungal issues that occur with chronic antibiotic treatments. Zhang protocol treatments: Please see the flow chart after this section to understand and evaluate your treatment needs. Treatment essentials for the infections: Allicin: Allicin and HH are used together as a first line of treatment. Allicin is a specific extract of garlic which has high antimicrobial properties and can cross the Blood Brain Barrier. The capsules contain Allitridi, which is metabolized to Allicin which is chemically stable and won’t last in capsule form. If you have a sensitivity to garlic, do not use Allicin, instead use R-5081, Coptis and HH. Allicin does make you smell exquisitely like garlic. You can try a chlorophyll supplement to reduce this effect. If the odor is disruptive to your life, then you should also use R-5081, HH and Coptis (i.e. in place of Allicin). HH Capsule: Used in combination with the Allicin capsule. This capsule has wide spectrum antimicrobial effects and can be used safely for long term treatments. HH is also anti-fungal and can reduce the risk of Candida infection from long term anti-microbial use. Coptis: Used in combination with Allicin, HH, and R-5081, depending on your protocol. Also a broad spectrum antimicrobial. Same description as HH. R-5081: This is a traditional Chinese medicine formula that has been used to treat syphilis for hundreds of years. Since syphilis and Borrelia are both spirochetes, the same treatment is employed. R-5081 can be up to 50% effective in syphilis even in chronic cases. R-5081 is also a broad spectrum antimicrobial, including antifungal. If you can’t use garlic (Allicin) replace those caps with R-5081 and Coptis.
Circulation P: This is a must for all Lyme treatments because it increases blood flow to cells, and helps to repair inflammation-damaged tissues. It also helps your immune cells clean up the inflammatory proteins that settle and cause more damage. Arteminisin: Artemisia is an anti-malarial herbal treatment that has efficacy toward Babesiosis (one of the common co-infections). You should treat Babesiosis for at least 2-3 months with Arteminisin. The antibiotic treatment for Babesiosis should be atovaquone and azithromycin or clindamycin and oral quinine. If present, Babesiosis must be treated or the Lyme treatment will not be effective. The most common symptom of babesiosis is night sweats, sweats in general, fever, chills, fatigue, headaches, muscle pain and anemia. Keep in mind that you must be diagnosed correctly, since cancer can also cause night sweats. You should always be working with a Lyme literate practitioner.
Supplemental treatments to help with symptoms: AI #3: An immune suppressive treatment that reduces the symptoms of muscle aches, joint pain, fibromyalgia, skin rashes, allergies, vasculitis, severe Herxheimer reactions, Raynaud’s, Sjrogren’s and autoimmune antibody production. The max dose is 5 caps/day. Once the symptoms subside the dose is reduced to 1 cap 3X/day. When symptoms are relieved, then AI#3 should be discontinued. AI#3 should not be used for more than 3 months. Cordyceps: Fatigue is a chronic problem in people with Lyme. Cordyceps mushroom helps improve energy level, increases circulation and enhances immunity. Cordyceps has an interesting history. Previously it was only found above 10,000 feet, in the snow, on the back of a caterpillar. This made Cordyceps the treatment of kings, due to its rarity and cost. Now Cordyceps is grown in culture and can bring wonderful healing to us peasants! Puerarin: Increases brain function and helps with the brain fog some patients experience. HerbSom: A natural, gentle, effective and non-addictive sleep aid which doesn’t cause drowsiness in the morning.
The flow chart for the Zhang formula (from Dr. Zhang):
VII-1: Herbal Remedies Developed by and Used in the Zhang Clinic
Allicin dosage by body weight
Note: I commonly recommend combining Allicin with R-5081 and Coptis. In which case 2 caps 3X/day of the Allicin regardless of weight, and then follow the recommendations for the other treatments. Keep in mind that Doctor Clark does schedule phone appointments. You may want to have a phone appointment before starting your integrative Lyme treatment. Ordering info:
Zhang protocol supplies and cost for 30 days:
Standard protocol: Allicin: 3 bottles: #60/bottle $33 each X 3 bottles = $99 HH: 1 bottle #45/bottle $27 each X 2 bottles = $54 Circ P: 1 bottle #45/bottle $28 each X 2 bottles = $56 Total $209 + S&H
Non-garlic protocol: R5081: 4 bottles #45/bottle $33/bottle X 4 bottles =$132 Coptis: 2 bottles #90/bottle $30/bottle X 2 bottles =$60 HH: 1 bottle #45/bottle $27/bottle X 2 bottles =$54 Circ. P: 1 bottle #45/bottle $28/bottle X 2 bottles =$56 Total $302 + S&H Additional treatment for Babesiosis: Artemisiae: 3 bottles #30/bottle $29/bottle X 3 bottles =$87 Optional symptomatic treatment as needed basis: Puerarian: mental function #90/bottle $27 each Herb Som Sleep #60/bottle $26 each AI #3 Immune suppressant/Herx reactions #50/bottle $33 each
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