Borrelia is a master at hiding out in the body to survive, going from adult spirochete to cell-wall deficient form to cyst and back.

Chronic Lyme Disease

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August 4, 2010

Getting Rid of Lyme

Lyme that isn’t treated long enough (or at all due to misdiagnosis) can turn chronic, often called Late Stage Lyme disease. The longer the Borrelia burgdorferi (Bb) bacteria stay around and reproduce, the more serious the complications, including immune system breakdown, additional infections, hormonal imbalance, and more.

Under these circumstances, getting rid of the disease takes longer (1-4 years or more). Treatment is often more aggressive and hence more time-consuming and expensive. Quality of life decreases, making normal living difficult.

Mind you, not everyone agrees that’s there IS such a thing as chronic Lyme. Doctors following the guidelines of the Infectious Diseases Society of America (IDSA) treat the illness with an antibiotic for a short period of time. if symptoms persist beyond 6 months, they say the person has Post-Lyme Syndrome, the result of an overactive immune system that hasn’t yet returned to normal after the person is considered “cured.”

Here’s exactly what the IDSA guidelines say (link below):

There is no convincing biologic evidence for the existence of symptomatic chronic B. burgdorferi infection among patients after receipt of recommended treatment regimens for Lyme disease. Antibiotic therapy has not proven to be useful and is not recommended for patients with chronic (>6 months) subjective symptoms after recommended treatment regimens for Lyme disease.

Therapeutic modalities not recommended. Because of a lack of biologic plausibility, lack of efficacy, absence of supporting data, or the potential for harm to the patient, the following are not recommended for treatment of patients with any manifestation of Lyme disease: first-generation cephalosporins, fluoroquinolones, carbapenems, vancomycin, metronidazole, tinidazole, amantadine, ketolides, isoniazid, trimethoprim-sulfamethoxazole, fluconazole, benzathine penicillin G, combinations of antimicrobials, pulsed-dosing (i.e., dosing onsome days but not others), long-term antibiotic therapy, anti-Bartonella therapies, hyperbaric oxygen, ozone, fever therapy, intravenous immunoglobulin, cholestyramine, intravenous hydrogen peroxide, specific nutritional supplements, and others.

You can download the IDSA Guidlines here.

On the other hand, so-called Lyme-literate physicians (LLMDs) agree that the disease can persist far beyond 6 months. They tend to follow the guidelines of the International Lyme and Associated Diseases Society. Click here for the ILADS Guidelines.

You can also download a free PDF of a research article by Daniel Cameron, MD, a respected LLMD from the Department of Medicine, Northern Westchester Hospital, Mt. Kisco, NY, titledProof That Chronic Lyme Exists.

Those of us with Late Stage Lyme, including me, will tell you that our symptoms are not psychosomatic. Borrelia is a master at hiding out in the body to survive, going from adult spirochete to cell-wall deficient form to cyst and back. For those who also have one or more of the common co-infections (Babesia, Bartonella, and Ehrlichia), treatment gets trickier. In addition, along the way Borrelia disrupts the immune system and body metabolism, allowing other normally dormant microorganisms like herpes viruses, parasites, and fungi (yeasts and molds) to activate and also cause symptoms.No two chronic Lyme patients have the same symptoms. Nor do they have the same prognosis or follow the same course of treatment. For those reasons, and the fact that I am not a medical doctor, this is not the space to discuss the specifics of treatment beyond what has already been explained in my prior post Gettng Rid of Lyme.Suffice it to say getting well from this infectious onslaught is often a roller coaster ride of improvement and relapse. Still not well understood, the complex of diseases continues to prove a challenge for both patients and doctors, showing that stages of Lyme need to be taken into consideration during diagnosis and treatment.