Lyme disease is often known as the “great imitator” as its presentation can mimic over 400 different conditions and affect every bodily system including neurological, psychiatric, musculoskeletal, cardiovascular, hormonal, gastrointestinal, and so forth. Thus Lyme disease is frequently misdiagnosed, poorly treated, and can cause severe chronic symptoms. At Aspen Integrative Medical Center, we are proud to have one of Northern Arizona’s only “Lyme Literate Physicians” in Dr. Paul Despres. Dr. Despres has spent the better part of his career learning how to manage tick-borne infections completing ILADS training while also working alongside experts Dr. Kenneth Mitchell and Dr. Cynthia Keller. Dr. Despres’ clinical approach to Lyme disease continues to evolve alongside new research, discovery of better treatment options, and his clinical experience. If you think you are suffering from symptoms of Lyme disease, please call our office today to schedule an appointment with Dr. Despres. 

Lyme disease refers to an acute or chronic infection by one of the strains of the bacteria Borrelia. It is most often Borrelia burgdorferi, but there are more than 300 known strains of this bacteria. Borrelia is unique in that it is a spirochete (meaning corkscrew shape) which allows it to burrow deep into tissue (nerves, muscle, fat, brain, etc), cells, and evade your immune system. Lyme disease is much more than just Borrelia though. At the time of infection a whole cocktail of other bad bugs aka “co-infections” can enter the body. The most common co-infections are Babesia, Bartonella, Mycoplasma, Ehrlichia, Anaplasma, and Toxoplasma. Whether a co-infection or already present in the body, a person with Lyme disease frequently suffers from viral infections such as Epstein Barr Virus (EBV), Herpes Simplex (HSV), HHV6, Parvovirus, and so forth. The diversity of pathogens that can cause Lyme disease underscores why this condition is frequently poorly treated and people struggle with symptoms for years. 

Erythema Chronicum Migrans (EM), also called the Bull’s Eye Rash, may be seen at the bite site. However a rash (of any kind) is only found in ~25% of patients, making initial diagnosis challenging for conventional doctors. The bite may have come from a tick, mosquito, flea, or mite making identification even more challenging. Other types of rashes anywhere on the body may also occur (rash at other than bite site signals disseminated disease).

Symptoms may include:

• • Fever and flu like symptoms/illness
  • General: unexplained fevers (off & on), chills, sweats, weight change (loss or gain), fatigue, tiredness, hair loss, swollen glands, sore throat, difficulty swallowing, swelling around the eyes.
  • Cardiac/Pulmonary: chest pain or rib soreness, air hunger like shortness of breath, heart palpitations, pulse skips and/or heart murmur.
  • Gastrointestinal: nausea or vomiting, difficulty eating, change in bowel function, constipation, diarrhea, gastritis, abdominal cramping, irritable bladder, bladder dysfunction, or cystitis (irritable bladder).
  • Musculoskeletal: joint/muscle pain in feet, swelling in toes or balls of feet, ankle pain, burning in feet, shin splints, joint pain and/or swelling, stiffness of the joints, neck or back, muscle pain or cramps that may migrate, neck creaks and cracks, neck stiffness, TMJ/Jaw Pain (Temporomandibular Joint). Classic diagnostic sign is muscle and/or joint aches that wander/travel around from site to site.
  • Neurological: twitching of the face, eyelids, or other muscles, headache, tingling, numbness, burning or stabbing sensations, facial paralysis (Bell’s Palsy) dizziness, poor balance, increased motion sickness, light-headedness, wooziness, difficulty walking, tremor, confusion, difficulty in thinking or with concentration or reading, forgetfulness, poor short term memory, disorientation (getting lost, going to wrong place), difficulty with speech, double or blurry vision, eye pain, blindness, increased floaters, increased sensitivity to light or sound, buzzing or ringing in ears, ear pain, deafness, seizure activity, white matter lesions in brain, low blood pressure.
  • Neuropsychiatric: mood swings, violent outbursts, irritability, depression, disturbed sleep (too much or too little, early awakening), personality changes, Obsessive Compulsive Disorder (OCD), paranoia, panic anxiety attack, hallucinations.
  • Reproductive: testicular pain or pelvic pain, menstrual irregularity, milk production (lactation), sexual dysfunction, loss of libido.

Adapted from © Lyme Disease Association, Inc. 2000, 2009, Revised: 2013 www.lymediseaseassociation.org

Commonly associated with a bite from a deer tick, Lyme disease is a blood borne pathogen that can be passed directly between people or through other animals. Many who suffer from Lyme disease do not even remember being bitten by a tick, and less than one-quarter of those who are bitten have the telltale bull’s-eye rash around the area of the bite. Also, if the bite occurred on the back or an area not easily inspected, it may go undetected. It often isn’t even felt because the tick injects a numbing agent to lessen the feel of the bite.

While Lyme disease is primarily transmitted through tick bites, but it can also be transmitted via other biting insects such as mosquitos, fleas, deer flies, house flies, and bed bugs. Ticks in the nymph phase are the most dangerous and the longer the tick is embedded the greater risk of developing disease.

Lyme disease can be transmitted to from mother to child in utero through the placenta.

Whether Lyme disease can be sexually transmitted isn’t well-established, but some believe it is possible because its form is similar to Syphilis. Some doctors claim the spirochete has been found in semen and vaginal fluid. 

Since symptoms of Lyme disease can change daily, it’s vitally important to work with a Lyme Literate Doctor who knows exactly what to look for. Be forewarned that diagnosing Lyme disease can be a process and not immediate. Since the disease and its co-infections mirror so many other diagnoses, it can take time to understand your unique case and eliminate other issues before determining that you are, indeed, suffering with Lyme disease.

Conventional local blood tests are notoriously insensitive for finding Lyme disease as well as the common co-infections and fail to test many of the known markers, so outside specialty labs are frequently needed. Unfortunately, since the disease presents in three different ways, plus it morphs and changes to prevent immune detection meaning a test can be performed one week that comes back negative, then it may come back positive weeks or months later. Lyme Literate Doctor, such as Dr. Paul Despres, can stay on top of your case and know how to best test and interpret results for a true diagnosis.

• • A majority of Lyme disease patients do not have a “bulls-eye rash,” so people often don’t think they have it when they do.
  • Standard testing only tests for ~12 strains of Borrelia when there are over 300 of them.
  • Doctors frequently don’t test for common co-infections like Babesia and Bartonella, which can cause just as severe of symptoms. Co-infections work synergistically, so the presence of one can make the other more resistant to treatment too.
  • Borrelia is rarely circulating in the blood and thus blood testing isn’t an accurate representation of infection.
  • Borrelia suppresses IgG and IgM antibody production. This means antibody testing is frequently negative. It also means the the immune system can’t mount a strong response.
  • Borrelia is excellent at evading immune system detection. It is related to the syphilis spirochete Treponema pallidum, but has 7x the genetic material. This allows the bacteria to change its outer surface proteins (so it’s not recognized by the immune system, adapt to its environment, and persist in the body.
  • Borrelia can live pretty much anywhere in the body including intracellular areas, nerve tissue, brain, joints, muscles, etc.
  • If under environmental threat (treatment for example), it can shift into a “persister round body form” that is metabolically inactive. This allows it to avoid detection and when the threat is gone it starts replicating again.
  • Borrelia can produce biofilms – protecting it from immune system detection and being killed by antibiotics.

Although a quick search online suggests that a two-week course of antibiotics is enough to be rid of Lyme disease, it’s unfortunately not so simple. Remember that the disease morphs and attacks the body in three ways, so all three must to be addressed simultaneously and with the right support in order to facilitate recovery. Biofilms that shield the Lyme, shifting co-infections, and built-in resistance to antimicrobials require a different strategy than used for common infections. Our doctor follows a combination approach that incorporates both allopathic and naturopathic treatment modalities, and is involved at every step along the way to help you receive the support needed in clearing the Lyme with its co-infections while helping restore your health.

Lyme disease treatment must be individualized to each patient’s according to their needs and vitality.

A treatment plan must take into account the following factors:

• • How long have they had the disease? acute recent or chronic persistent?
  • Which infections are present?
  • Which bodily systems are being impaired the most?
  • Are detoxification pathways functioning properly?
  • What is the person’s vitality able to handle treatment?
  • What other conditions are present that would complicate treatment such as mold mycotoxin illness, mast cell activation syndrome, hypothyroidism, high heavy metal load, abnormal sex hormone levels etc?

Primary goals of treatment include: 

• • Support a strong modulated immune system response
  • Calm down autoimmunity, inflammation, and/or heightened mast cell response
  • Kill the infections with antimicrobials – herbs, pharmaceuticals
  • Open lymphatic system
  • Support detoxification and main organs of elimination (liver, kidney, gastrointestinal)
  • Increase nutritional levels
  • Support mitochondrial function
  • Correct hypercoagability
  • Address MARCONS if present
  • Support gastrointestinal health including gut microbiome and digestion

Therapies often used include:

• • Nutrient supports – vitamin D3, vitamin C, zinc
  • Mitochondrial Supports – melatonin, CoQ10, R-Lipoic Acid, methylene blue
  • IV Therapy – ten pass ozone, UBI ozone, high dose vitamin C, meyer’s cocktail, resveratrol, quercetin
  • Antimicrobial Herbs – Japanese knotweed, Crypotlepis, Houttuyia, Cat’s Claw, Andrographis, Chinese skullcap, Neem
  • Pharmaceuticals – antibiotics (Doxycycline, Minocycline, Clarithromycin, etc), Disulfiram
  • Peptide therapy
  • Hyperbaric oxygen therapy
  • Deep tissue laser therapy
  • Nasal treatments
  • Anti-inflammatories – curcumin, Boswellia, quercetin
  • Immune modulators – low dose naltrexone
  • Endotoxin binders – Cholestyramine, Activated Charcoal, GI Detox Plus
  • Detoxification supports – glutathione, NAC, milk thistle 

• • Borrelia can survive abx tx b/c they transform into spiral, cystic, and L-forms in response to environmental stressors. Cyst form is more resistant to medications. A “persister” form enters an altered metabolic state – non-dividing, stationary phase, biofilm form, and non-growing. This is why some patients need on-going abx to keep the Lyme in remission, but never cured.
  • Lyme inhibits and kills B- and T- cells and inhibits maturation of NK cells. This causes continued production of anti-Borrelia IgM and decrease in anti-Borrelia IgG formation.
  • Lyme has a relapse/regeneration cycle of 4 weeks with new gene expression each time.
  • Can survive as an intracellular pathogen, deep in tissues, and in biofilms.