Understanding “Chronic Lyme”: How the Infections Work

According to the CDC, the traditional treatment for Lyme disease in adults is a 14-day antibiotic therapy of doxycycline, cefuroxime, or amoxicillin. In acute cases of this condition, this may be enough to eradicate the infection(s) completely. Unfortunately, this can’t be said for those infected longer than a month with Lyme and the associated tick-borne co-infections because by that point, the infection has gotten itself deep enough in our system where it’s difficult for antibiotics to reach. Hence the term “chronic Lyme.” So why can’t people get better quickly?

There are several components for why an individual who was bitten by an infected tick cannot overcome their chronic illness, even after getting treated by the CDC’s recommendation. Lyme bacteria, also known as Borrelia burgdorferi, is an “intelligent” bacteria that is very opportunistic and resilient in its survival in our system. You may be asking yourself why our immune system doesn’t just eradicate it? For that question, there are a few interesting answers.

Borrelia burgdorferi is a spirochete bacteria similar in structure to syphilis. It moves in a corkscrew motion throughout our system, drilling into muscles, tendons, ligaments, nerves, and even bones, making it hard for treatment to reach these places. Borrelia burgdorferi is “intelligent” not only for how it moves but also for how it can evade our body’s immune system. It has the unique ability to change its outer proteins, which our white blood cells typically use to identify a threat and then attack it. By changing its antigens, the Lyme bacteria is effectively always one step ahead of our immune system. Think of it like the missile locking feature on a combat aircraft. Our white blood cells need to lock onto a target before engaging it. Lyme inhibits our immune system from doing this, so while our immune system may be firing missiles all around, it’s constantly missing its target (Lyme) as a result. The cascade effect on our body’s immune system in response to Lyme can be catastrophic, essentially putting it in an even more weakened state. 

When these bacteria can roam our tissues without much opposition, they tend to cluster with one another. When enough of the bacteria get close enough, they can create what’s known as a biofilm, which is a defensive outer shell made of polysaccharides and proteins that protect colonies of these bacteria from our body’s defense cells, white blood cells, and antibiotic therapies. For those suffering from an acute infection, the bacteria often aren’t in your system long enough to develop these protective outer shells, so antibiotic treatment can be pretty effective. However, while those with chronic Lyme may notice a slight improvement while on antibiotics, once they stop, they typically return to their miserable baseline because most of the bacteria were protected by the biofilms the entire time. Suppose an individual is on various antibiotics for long enough, without actually killing the infection because of the biofilms. In that case, the Lyme bacteria can evolve to become resistant to how the antibiotics kill the disease. At this point, whether there is a biofilm or not, antibiotics won’t help and may cause more harm than benefit.

Ticks also carry many other viral, fungal, bacterial, and parasitic infections besides just Lyme. Unfortunately, most primary care physicians don’t test for these. In this case, treatment for Lyme could be effective. However, because the other pathogens weren’t hit on, you still may feel unwell after clearing the Lyme from your system. LymeDisease.org published a survey including 3,000 people who suffered from Lyme disease and found that 50% of them had at least one co-infection in addition to Lyme. The four most common co-infections ticks carry are Babesia (a blood parasite similar to malaria), Bartonella, Ehrlichia, and Mycoplasma. They can often compete for resources in your system, so once one infection is eradicated, another can take its place and cause the same symptoms or new ones. 

What’s important to note is that it is possible to overcome Lyme and the other tick-borne co-infections with the right integrative approach that enables patients to attack these infections from multiple angles. Proper nutrition, exercise, herbal supplements, and sleep are the key to fighting these terrible infections. Personally speaking, it was the key for me. “Understanding Chronic Lyme” will be an editorial series going into depth in each facet of this illness to educate people on tick-borne illness and provide options for recovery, so stay tuned!

Sources

A Biofilm is Composed of Attached Microbial Cells Encased. (n.d.). Retrieved from https://www.nature.com/scitable/content/a-biofilm-is-composed-of-attached-microbial-100450918/

About Lyme Disease Co-Infections. (n.d.). Retrieved from https://www.lymedisease.org/lyme-basics/co-infections/about-co-infections/

Buhner, S. H. (2015). Healing Lyme: Natural healing of Lyme borreliosis and the coinfections chlamydia and spotted fever rickettsioses. Silver City, NM: Raven Press.

Dykstra, M. (2020, February 21). Ethnobotanical medicine is effective against the bacterium causing Lyme disease. Retrieved from https://blog.frontiersin.org/2020/02/21/ethnobotanical-medicine-is-effective-against-the-bacterium-causing-lyme-disease/

Lyme Carditis. (2020, October 26). Retrieved from https://www.cdc.gov/lyme/treatment/lymecarditis.html

Lyme Treatment. (2020, November 03). Retrieved from https://www.cdc.gov/lyme/treatment/index.html

Mervine, P. (n.d.). Ticks Can Transmit Multiple Co-Infections in a Single Bite. Retrieved from https://www.lymedisease.org/ticks-transmit-multiple-co-infections/

Verhey, T. B., Castellanos, M., & Chaconas, G. (2018, May 29). Antigenic Variation in the Lyme Spirochete: Insights into Recombinational Switching with a Suggested Role for Error-Prone Repair. Retrieved from https://www.sciencedirect.com/science/article/pii/S2211124718307174