Chronic Lyme disease

Borrelia are bacterial pathogens that infect the cell interior. All organ systems can be affected (multisystem disease). However, Lyme disease rarely occurs alone: other pathogens (co-infections) and additional stresses (e.g. with heavy metals) are frequent accompanying factors. The symptoms are correspondingly varied. The number and severity of symptoms vary greatly from person to person. In the course of time, the symptoms change when the inflammations, immune phenomena and secondary disorders caused by the pathogens develop a potentiating momentum of their own. Often, it is no longer possible to distinguish between directly pathogen-related symptoms and indirect secondary symptoms.

Neurological symptoms are particularly common. Chronic exhaustion and fatigue (so-called chronic fatigue syndrome = CFS), sleep disturbances, memory and concentration disorders, psychological changes (depression, anxiety), tingling and numbness or nerve pain and headaches are some of them. Some symptoms, such as paralysis, walking and visual disturbances, or even dementia development, not infrequently lead to diagnoses such as multiple sclerosis, Parkinson's syndrome, amyotrophic lateral sclerosis (ALS), or dementia. What all these diseases have in common is that their causes are generally not yet known. However, a chronic infection with Borrelia or other pathogens should be considered in such cases.
These neurological symptoms occurring in the context of chronic Lyme disease must be differentiated from the clinical picture of acute neuroborreliosis. Despite similar terminology, there is an important diagnostic difference: In acute neuroborreliosis, there are always altered cerebrospinal fluid (CSF) findings, whereas in chronic Lyme disease with neurological involvement there are no such findings. A cerebrospinal fluid puncture with an inconspicuous result therefore excludes acute neuroborreliosis, but not chronic Lyme disease.

Furthermore, complaints in the muscles and joints are in the foreground. Alternating joint pain with and without swelling (sometimes here, sometimes there), muscle pain, muscle burning and a feeling of heaviness in the extremities or backbone pain are frequently complained symptoms. Similarities with rheumatic diseases are not always coincidental and must be differentiated.

Internistic symptoms are also regularly encountered: Cardiac arrhythmias and cardiac insufficiency, chronic cough and shortness of breath (especially in co-infections with babesia or chlamydia), digestive problems with mal-colonization of the intestinal flora or chronic sinus and bladder infections (often in co-infections with fungi) are in the foreground here.

Due to the variety of symptoms and the inconspicuous standard diagnostics in most patients, these people are often considered to be psychosomatically ill. It is assumed that the physical complaints have purely psychological causes. However, this is often inaccurate or only half the truth. Almost every Lyme disease patient undoubtedly suffers from psychological symptoms. How can the psyche remain untouched when years of physical limitations and the resulting social consequences (job, withdrawal from friends/family) appear as almost unsolvable problems? So instead of a psycho-somatic (the psyche causes physical symptoms) there is rather a somato-psychic impairment (physical complaints cause psychological symptoms). Psychological or even psychiatric help is also necessary for these people, but not without therapy of the underlying multi-system disease.

• Is a chronic infection present at all?
• If yes, is this active or inactive?
• What consequences are detectable (immune system disorders, metabolic changes, systemic inflammation, regulatory disorders, etc.)?
• Are there concomitant factors (co-infections, heavy metal contamination, vital substance deficiency)?

The medical history already provides initial indications of the presence of a multisystemic disease. Mainly the symptom pattern and its development so far as well as a possible temporal relationship between the first symptoms and remembered tick bites provide corresponding clues. However, it should be noted that a Borrelia infection can also be present even if the patient does not remember a tick bite or a bulls eye rash.

The first diagnostic step is usually performed by the general practitioner with the determination of antibodies against Borrelia.

The standard test procedure, the antibody determination, is intended to answer the question of whether the immune system has already had pathogen contact, i.e. whether an infection with Borrelia has occurred at all. This test can usually distinguish between an acute infection and an infection that occurred some time ago. However, the test does not give an answer to the question whether such an infection has healed or still persists.

A negative test result (no antibodies are found = seronegativity) definitely does not exclude an infection. Often, it are the clinically more severely ill patients who show no or an atypical antibody formation (exclusively short term antibodies = IgM). This may be due to genetic reasons (so-called HLA-DR1 association) or to a severe (infection-related) impairment of the immune system leading to a lack of antibody development. In the latter case, an initial positive detection of antibodies is found over time. Over the years, however, the titer decreases continuously to seronegativity. Such a course is often misinterpreted as a healing of the infection. This is contradicted by the parallel deterioration in the patient's state of health. These people fall through the diagnostic raster, because in the absence of antibody detection, further diagnostics are usually omitted. Unfortunately, this is partly due to legal regulations that prevent the statutory health insurance funds from covering the costs of further tests.

Other test methods are therefore necessary to detect a possible infection. Several methods are available for this purpose, not all of which are mandatory for every patient. However, as mentioned at the beginning, there is no single test that by itself can reliably exclude or prove an infection. Only the combination of different tests allows a largely reliable statement. The selection must be made according to diagnostic criteria and the expected costs.

Possible test procedures for pathogen diagnostics include, in order of application:

• Antibody tests (ELISA, Western blot, recomBead test, immunofluorescence test, B16+ test) examine the response of the humoral (antibody-forming) immune system to a pathogen infection. Antibodies mainly reflect the immune memory and provide information on whether an infection has occurred at all. Statements about the activity of the infection or whether the pathogens against which the person has formed antibodies are involved in the disease process at all are often only possible to a very limited extent.
  
  
• Activity tests (LTT = lymphocyte transformation test or the ELISPOT test) determine the cellular response of the immune system to a pathogen infection. Since the immune cells examined have only a very short life span (6-8 weeks), conclusions about the pathogen activity in the last 6-8 weeks can be drawn from their activation level.
  
  
• The determination of the so-called CD57+ NK cells gives an indication (not proof) of the impairment of the immune system by a multi-infection event. Very low values are an indication of the ability of the pathogens to manipulate the immune system itself. The progression of CD57+ levels allows certain prognostic statements to be made.
  
  
• A PCR test (from blood, urine, liqour or tissue biopsy) detects the genetic material (DNA) of the pathogens, but cannot distinguish between living and dead pathogens. In chronic infections, however, the PCR test plays only a minor role, since at least in the easily accessible body substances (blood, urine), pathogen DNA is usually no longer detectable.
  
  
• In addition, there are other test methods that are scientifically much less proven and therefore controversial. They are therefore not suitable for the reliable detection of pathogens, but can provide initial or supplementary indications of an infection.
  
  
  • Bioenergetic diagnostics: Each element, each substance, each pathogen or each organ can not only be examined biochemically but also have a specific energetic vibration frequency. The detection of the specific oscillation frequency of a pathogen or a substance (e.g. heavy metals) provides indications that can complement comprehensive diagnostics.
    
    
  • Dark field microscopy: Disease-related changes in the blood (e.g. clumping of red blood cells) but also larger pathogens such as bacteria, parasites and fungi are partially visible in dark field microscopy. Corresponding images can sometimes say more than a thousand words.
    
    
  • Phage test: This detects virus-like particles (phages) that are specifically located on the surface of bacteria. Borrelia bacteria have different phages than Chlamydia or Yersinia or other bacterial pathogens. Simply put: If pathogen-specific phages are found, then the pathogen must also be in the body.

A Borrelia infection rarely comes alone. In most cases, the immune system has to deal with a whole range of other infectious agents. These include pathogens that are also transmitted by ticks or pathogens with which the patient has become infected by other means. Examples are:

• Bacterial pathogens: Anaplasma, Bartonella, Chlamydia, Mycoplasma, Yersinia and others.
• Viruses: Epstein-Barr, herpes, cytomegaly and others
• Parasites: Babesia, toxoplasma, worms and others
• Fungi: Candida, molds (aspergillos) and others.

Here, too, a selection must be made with regard to diagnostics based on the clinical probability of the presence of such a co-infection, the therapeutic consequence, and the costs.

In addition, the following examinations should ideally be performed for every infection-related multisystem disease:

• Cellular immune status (provides information on immunocompetence, immune activation and immunotolerance)
  
  
• Autoimmunity diagnostics (as a result of "confusion" of pathogen structures with the body's own tissues, the immune system may attack its own body = autoimmunity)
  
  
• Heavy metal screening (mercury, lead, cadmium or aluminum are not only harmful to the organism on their own, they also induce biofilm formation in pathogens, a resistance mechanism that protects pathogens from heavy metals, from the immune system and, unfortunately, from antibiotics)
  
  
• Vital substances diagnostics (serious chronic diseases lead to an increased need for vitamins, minerals and enzymes)
  
  
• Regulation diagnostics (disturbances in the autonomic nervous system, the control center of all internal processes in the organism, represent an obstacle to therapy and must be recognized and treated accordingly)
  
  
• Detection of metabolic changes which are typical for a multisystemic disease, such as dysfunctions of the mitochondria (the energy power plants of the cells), systemic inflammation, oxidative and nitrosative stress (free radicals) or specific hormonal and enzymatic metabolic disorders

Overall, the diagnosis of suspected chronic Lyme disease or another infection-related multisystem disease is very complex and therefore belongs in the hands of a specialist. Basically: As much diagnostics as necessary to find a holistic and promising therapy approach. However, no diagnosis should be made without a therapeutic consequence resulting from it. The final scope of the examinations to be performed will be determined during the initial appointment in the consultation.

As a multisystem disease, chronic Lyme disease is not simply an infection that can be eliminated by more or less prolonged antibiotic treatment. The pathogens themselves lead to consequences or damage to the affected organ systems. The defense reactions of the immune system (inflammations, development of autoimmune reactions), changes in the metabolic and hormonal systems or regulatory disturbances of the autonomic nervous system contribute to the development and partial "independence" of the clinical picture. The same applies to additional stress factors such as heavy metals, co-infections and vital substance deficiencies.

Antibiotic treatment alone cannot solve these problems. A holistic therapy, which can extend over months or even years, must include the following components:

• Restoration of the immune system (both immune deficiencies and excessive immune reactions must be compensated for), e.g. through
  
  • Thymus therapy
  • phytotherapeutic immunomodulators (e.g. with Samento)
  • Orthomolecular therapy (use of vitamins, minerals or secondary plant substances such as Samento, VitalMedix and others)
  • Enzyme therapy (e.g. Serrapeptase)
  • Regulatory therapy (e.g. bioresonance therapy)
  • Detoxification therapies
    
    
• Elimination and detoxification, mainly of heavy metal contamination
  
  • Chelation therapy
  • Phytotherapeutics (e.g. Burbur-Pinella, Parsley, Sparga, Mapalo, Sealantro, Dandelion and others)

• Treatment of systemic inflammatory reactions
  
  • Procaine base infusion, DMSO
  • Oxyvenation
  • Phytotherapeutics (e.g., Samento, Tangarana, Serrapeptase, and others).
  • All immunomodulatory, detoxification, and pathogen therapy measures contribute equally to inflammation control.

• Substitution of vital substances and treatment of hormonal imbalances
  
  • Orthomolecular therapy
  • Phytotherapy (e.g. Adrenal, Maca or the substitution of human-identical hormones according to the Rimkus method and others)

• Compensation of disturbances in the vegetative nervous system 
  
  • Bioresonance therapy
    Phytotherapy (e.g. Avea, Ezov, Amantilla, Babuna, RelaxMedix, MoodMedix and others)

• Energy build up (mitochondrial therapy)
  
  • Oxyvenation
  • Active Program Immunotherapy
  • Phytotherapy (e.g. Adrenal, VitalMedix, NADH, Maca and others)

• Long-term pathogen therapy, including co-infections.
  
  • This is the most long-term part of the entire treatment. Phytotherapeutic pathogen therapy is based on the Cowden Support Program developed by the American physician Dr. Cowden and extends over at least 12 months, although treatment periods beyond this are not unusual.
  • This is always accompanied by phytotherapeutic methods for detoxification and immunotherapy as well as for combating inflammation.
  • The first part of the therapy lasts about 3 months. In addition to the fight against Borrelia and other bacterial pathogens, the focus in this part is on the treatment of parasites and fungi.
  • In the second part (also lasting 3 months), the therapeutic target is primarily Borrelia as well as viral and bacterial co-infections.
  • During the third part of the pathogen treatment, various antibacterial, antiviral and antiparasitic agents are alternated in order to achieve a comprehensive and lasting suppression of Borrelia and all co-infections. This part is carried out until either freedom from symptoms or a constant improvement in symptoms is achieved. This requires a minimum of 6 months, but often more.
  • If the decision is made to stop treatment, then tapering of therapy over several weeks to months is necessary.
    For some patients, long-term or even lifelong maintenance therapy is inevitable. The means and measures necessary for this depend on the health status achieved as well as some prognostically relevant laboratory parameters.

Promising treatment consists of the right combination of measures at the right time, taking into account the points listed above. The measures actually required in the individual case are coordinated with the patient after a comprehensive evaluation of the diagnostic results and adjusted as necessary during the course of treatment.