TGIF: Functional Medicine to Help Treat Chronic Lyme Disease

Katina Makris was living her dream when life derailed. A natural-medicine practitioner with a flourishing career, she had a passionate marriage, a young son she doted on, and a home she had lovingly restored in the New Hampshire woods. But slowly she began to slip.

First, in June 2000, there was an inkling of muscle pain and fatigue. A few months later, she experienced a crippling migraine, and her arms and legs felt numb. The symptoms only got worse. At night she was engulfed in drenching sweat. Her brain became sluggish and confused. The days were a blur of exhaustion and pain. Eventually, she required a wheelchair and was so sick she had to give up her practice.

Unable to care for her child, she hired an au pair. Between trips to doctors and naturopaths, she spent most of her time in bed. Her marriage crumbled, and divorce was followed by financial struggle and more years in bed. Five years into this devastating slide, after visits to teaching hospitals and myriad other physicians and practitioners, Makris happened to consult a well-known nutritionist. “He took one look at me and said, ‘I think you have neurological Lyme disease,’” she recalls.

That hunch was confirmed by lab tests, which came back positive for the infectious agent of Lyme disease, a spiral-shaped bacterium, or spirochete, transmitted by the bite of a black-legged tick. Makris also tested positive for Babesia, a malaria-like blood parasite often inhabiting the same ticks. “I was never so relieved and furious at the same time,” Makris recalls. How could someone immersed in the healthcare profession herself fall so disastrously between the cracks?

Remarkably, Makris eventually recovered from this body blow, emerging whole to write an inspiring book about her experience, Out of the Woods: Healing Lyme Disease — Body, Mind, and Spirit. Even more remarkable, she managed to navigate a path to recovery without prescription antibiotics.

Integrative-medicine colleagues advised that prescription antibiotics might harm her in her fragile state. They recommended she instead consider relying solely on nutritional, herbal, and lifestyle-based treatments to heal her Lyme disease.

The treatment was multipronged. First, her doctors attempted to detox her body with plants known to aid liver function. To lower inflammation naturally, she cut wheat and sugar from her diet. The brain fog diminished, she recalls, “and the worst jet lag of my life started to lift.”

Then her doctors treated her Lyme and Babesia with antimicrobial herbs. “I was able to make small meals again and do simple chores, like emptying the dishwasher,” she says. Along the way, she received acupuncture therapy for pain, boosted her energy with supplements, stabilized her gut with probiotics, and then finally fixed the moldy roof on her house. “A year into treatment I was doing yoga, and I could walk a mile,” Makris says. Ultimately, she and her son moved to a new, mold-free house on a city street in Peterborough, N.H., farther away from the ticks. By 2010 she was finally well.

The recent rise of integrative strategies for treating Lyme comes on the heels of a decades-long fight over the very nature of the disease. The dispute revolved around two key questions: Are Lyme-disease tests accurate? And, can Lyme disease be chronic — that is, can Lyme spirochetes survive two to four weeks of antibiotic therapy and  then continue to make patients sick?

The situation represents a massive health problem, given the scope of the disease. In 2013, the Centers for Disease Control and Prevention announced that Lyme disease afflicts some 300,000 Americans annually, a number 10 times higher than official case reports — yet far lower, opine many physicians, than the actual number of cases.

Since the tests are especially unreliable in the earliest stages of the disease, it’s all too easy for patients to slip through the cracks and join the ranks of the late-diagnosed. Of those, an estimated 20 percent fail the short-term treatment and become chronically ill.

What’s more, many of these hard-to-treat patients, like Makris, turn out to have co-infections transmitted by the same black-legged ticks that gave them Lyme — infections that don’t always respond to treatments for Lyme disease itself. The blood parasite Babesia, for example, must be treated with antimalarial medications. And, the co-infections Anaplasma and Ehrlichia do not respond to amoxicillin, a first-line antibiotic often used for Lyme.

The fallout of Lyme and associated co-infections can inflame the immune system, destabilize hormones, cause sleep disorders, and challenge the well-functioning brain. If not balanced with probiotics, antibiotics can disrupt the microbiome of the gut and cause diarrhea and yeast infections.

The multifaceted medical issues associated with Lyme hit home for integrative physician Sunjya Schweig, MD, and his wife, Lia Gaertner, today a healthcare consultant. They met as undergrads at the University of California, Berkeley, in 1993. Schweig went on to study medicine while Gaertner pursued a graduate degree in ethnobotany. The two visited Ecuador, where they worked with Western doctors alongside shamans and indigenous healers to study integrative medical systems.

Back home in the late 1990s, Gaertner became ill. “I had sudden-onset shortness of breath, rib pain, heart palpitations, and tachycardia [rapid heartbeat], but it was a mystery to my doctors,” she says. “I was constantly doing field work in Lyme-endemic areas, but no one ever told me to check for ticks. None of my doctors tested me for Lyme, although looking back, it was a classic onset of the disease.”

By 2008, Schweig was almost done with his residency specializing in family and integrative medicine. Gaertner was still looking for an answer to her illness when she came down with what was, in retrospect, a second tick exposure in Lyme-prevalent Mendocino County, Calif., and developed a circular red rash.

Soon Gaertner was suffering migrating joint pain, severe neck pain, and the kind of breathlessness doctors call air hunger. She was experiencing a strange tendency to switch words around, plus heart arrhythmias, and tachycardia even more severe than before. She also endured drenching night sweats, a classic sign of Babesia. Although diagnostic tests can be unreliable, she tested floridly positive for Lyme disease. Her doctor diagnosed Babesia clinically, based on the clear symptoms at hand.

At least she now had a diagnosis. She was treated with oral antibiotics and antimalarials according to the aggressive techniques of the Lyme doctors. She also received integrative treatments: acupuncture for pain and nausea; “industrial-strength” probiotics to balance the microbiome in her gut; hormones and hormone precursors to boost energy; and a whole fleet of supplements and herbs to support her immune system and help her detox.

She went to a retreat for a green-juice cleanse, complete with probiotic drinks and wheatgrass colon implants, which are thought to help clean out the liver and revitalize the immune system via the gut. She also changed her diet, avoiding gluten, alcohol, coffee, additives, and any processed foods that might increase blood sugar or inflammation.

A final piece was exercise. “I exercised to capacity each day to prevent my muscles from getting stiff, regulate my hormones and serotonin, and keep my lymphatic fluid moving.” With these last steps, Gaertner finally felt better.

The point, she emphasizes, is that all the treatments were required — the antibiotics to destroy the infection; diet; exercise; and immune, hormone, and other integrative therapies to heal the damage left behind.

“These difficult cases need help from every side,” he says. “They need antibiotics, but they can also benefit from herbs and supplements. They need help with sleep, diet, exercise, and reduction of stress.”

Defeating chronic Lyme may not mean eradicating the infection but battling it into a sort of homeostasis. Then, the damage caused by Lyme and its aftermath needs attending to. Even after Lyme is treated, it’s imperative to stick to healthy regimens — proper nutrition, adequate exercise, stress management, and so on — in order to boost immunity, keep inflammation at bay, and “keep the infections in check,” says integrative physician Daniel Kinderlehrer, MD.

“The endpoint for these chronic infections is remission, not necessarily eradication of the microbes from the body,” he explains. “Ultimately, the goal is for the patients’ immune systems to keep the microbes in check without the need for antibiotics.”

Kinderlehrer also recognized that these patients were suffering not just from Lyme, but also from the downstream complications of chronic inflammation caused by the infection: hormonal imbalances, autoimmune issues, food sensitivities, and more.

“Overcoming it requires that we unite the two hands of healthcare — the diagnostic and pharmaceutical tools of Western allopathic medicine and the restorative therapeutics of complementary medicine.” ~ Katina Makris



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