In its early stages, Lyme disease, an infection caused by the bacterium Borrelia burgdorferi (Bb), is most commonly treated with simple antibiotic regimens. However, at later stages, Lyme can disseminate to other parts of the body – such as the brain, central nervous system, and heart – and require more complex treatment programs. In addition, many of these patients are coinfected with other tick-borne pathogens, and this can affect treatment decisions. Unfortunately, diagnosing these coinfections is often very difficult and usually requires testing at a specialty laboratory that is dedicated to the detection of the ever-increasing list of pathogens associated with Lyme disease.
Currently there is no consensus among the medical and scientific communities regarding the best treatment for late-stage and chronic Lyme and associated coinfections. Uncertainties include the need for and effectiveness of long-term antibiotics and herbal remedies. Read on to learn more about the current outlook on Lyme disease treatment.
Disclaimer: IGeneX is a testing laboratory. IGeneX does not provide medical advice or endorse any particular Lyme disease treatment. If you have been diagnosed with Lyme, chronic Lyme, or another tick-borne infectious disease, it is important that you talk to a trusted physician or Lyme-literate doctor to come up with the best treatment plan for your condition and symptoms.
Antibiotic Treatment for Early-Stage Lyme Disease
The first line of treatment for early Lyme disease is antibiotics. The most commonly prescribed antibiotics include:
- Doxycycline
- Amoxicillin
- Cefuroxime axetil
These antibiotics are most often administered orally, though intravenous administration is necessary for some patients. Programs are typically 2 weeks long but can be as long as 4 or more weeks.
The Centers for Disease Control and Prevention (CDC) and the Infectious Diseases Society of America (IDSA) maintain that most cases of Lyme disease clear up quickly from a short course of antibiotics. However, as you will see later in this article, there is much evidence showing that Lyme that is not detected early can actually be very difficult to treat and that even early treatment can be unsuccessful. The presence of coinfections can also complicate the treatment process, again emphasizing the need for comprehensive testing at a specialty lab.
Finally, as acknowledged by the CDC, some Lyme patients experience ongoing or recurrent symptoms despite having received treatment for Lyme. These patients are said to have “Post-Treatment Lyme Disease Syndrome” (PTLDS). Is this caused by untreated coinfections, persistence of Bb (treatment failure), permanent damage, or an as-yet unidentified immune system problem? The jury is still out, but all may be possible.
Late-Stage and Chronic Lyme Disease Treatment
The claim by the CDC and IDSA that Lyme disease is easily treated with antibiotics appears misleading when you look at the data. Citing research from the International Lyme and Associated Disease Society (ILADS), Lymedisease.org reports that early treatment for Lyme failed in up to 39% of cases. Treatment failure rates for chronic Lyme were as high as 50%. One of the reasons for these poor results is that infection with pathogens other than Borrelia burgdorferi are being missed. That is why many practitioners rely on specialty labs like IGeneX that can test for multiple pathogens. After all, you don’t want people with both early-stage and chronic Lyme to remain ill because of missed pathogens and inadequate treatment regimens.
This is why organizations like Lymedisease.org endorse the ILADS recommendation that patients seek out individualized treatment plans that take into consideration the stage of Lyme, presence of coinfections, the patient’s unique symptoms, and any other factors that might complicate treatment.
Chronic Lyme disease treatment options vary. A person may have to sample and experiment withwth different chronic/late stage Lyme disease treatments before they find the perfect regimen for them. Oftentimes, chronic Lyme disease treatment options will also target the symptoms individually, especially those regarding mental health.
Antibiotics
Antibiotics such as those named above can be used in the treatment of late-stage, chronic, and “disseminated” (CDC) Lyme disease. Some doctors, including Lyme-literate doctors, prescribe longer-term antibiotic programs than the typical 2-4 week regimen as part of late stage lyme disease treatment. These regimens may need to consist of combinations of antibiotics, especially if coinfections are present.
Treating Coinfections
One factor that may contribute to treatment failure rates for even early stages of Lyme is the presence of coinfections. Sometimes, a patient will be treated for Lyme without knowing they are also infected with another disease, such as Babesiosis, Bartonellosis, Anaplasmosis or Tick-Borne Relapsing Fever. Because treatment regimens that target Lyme disease may not eradicate these other agents, even if the Lyme is successfully treated, the other infection(s) may not be.
This is why it is important to get tested early with the most accurate and inclusive testing available from a reputable lab. Before starting treatment, you need to have an accurate diagnosis.
Treating Other Symptoms
Disseminated and chronic Lyme disease are known to cause a huge range of symptoms that can vary over time and from individual to individual. They can also exacerbate other physical and mental health conditions and cause indirect symptoms. As such, treating late-stage and chronic Lyme disease often means treating other symptoms in addition to the bacterial infection itself. Patients may take other prescription medications, or participate in alternative treatments outlined later in this article.
Below are just a few examples of the related problems that may need to be targeted:
- Fatigue
- Headaches and migraines
- Tingling and numbness
- Muscle or joint pain
- Sleep problems
- Mood or emotional problems such as irritability, anxiety, depression, and in some cases hallucinations or serious psychiatric symptoms
- Cognitive symptoms such as trouble thinking and concentrating or “brain fog”
In addition to these symptoms that often severely impact patients’ daily quality of life, chronic Lyme can be associated with dangerous or fatal conditions like Lyme carditis (when Lyme infects the heart). Clearly, if left untreated or undertreated, Lyme disease may require treatment programs that target a much wider (and more challenging) range of symptoms and complications.
Alternative and Holistic Treatments
Alternative Lyme disease treatments are popular with many Lyme patients, especially those with late-stage or chronic Lyme. These alternative chronic Lyme disease treatments and regimens are often given in conjunction with antibiotics; occasionally they are used as primary treatment. Lymedisease.org has reported on the most popular alternative treatments with useful data about their effectiveness and side effects. Below are some of the highlights.
Top 3 Most Popular Alternative Lyme Disease Treatments (from LDo)
- Herbal protocols – rated 68% effective
- Chelation or detox – rated 63% effective
- Homeopathy – rated 55% effective
Of these alternative treatment options, herbal protocols were rated the most effective by participants, but note that 22% rated this treatment method as having moderate or severe side effects. The treatment option with the most moderate or severe side effects was detox, at 29%. The least effective treatment option was rated to be stem cells.
Alternative medicines as a chronic Lyme disease treatment option may be lightly effective in treating side effects like pain, fatigue, and mental health issues, but evidence to support this is purely anecdotal.
As shown in the data above, herbal protocols are a common treatment choice, and there is some exciting new research in this field that may make it an even more popular option. Researchers have found that two plants – Ghanaian quinine and Japanese knotweed – have properties that might make them effective against the Lyme bacteria.
As with any medical intervention, alternative Lyme treatments can come with risks or negative side effects. It is crucial that you discuss these risks with your doctor before beginning any treatment regimen.
Early Detection is Key
Amid the conflicting opinions and research on Lyme disease treatment, one thing is clear: The surest way to avoid needing complex treatment programs is to get diagnosed as soon as possible after being exposed and to include testing for all relevant tick-borne pathogens. The longer Lyme disease and these other infections go unchecked, the more difficult they are to treat.
Learn more about Lyme and other tick-borne disease tests available at IGeneX.