In mainstream medicine, a patient who exhibits these symptoms will likely have lab work done to confirm the diagnosis. The standard treatment is then antibiotics, and it’s believed that most of those infected will recover (4) within a few weeks. But in some cases, symptoms can persist. In mainstream medicine, the idea that these symptoms are due to a persistent infection is controversial, and “chronic Lyme syndrome” is largely unrecognized. Still, some functional medicine doctors and organizations, such as the International Lyme and Associated Diseases Society (ILADS), insist that chronic Lyme is a growing problem, and one that should be recognized. Some of the recurring symptoms post-treatment might include:
- Severe fatigue
- Muscle and joint pain that moves around the body
- Brain fog
- Mood swings
- Anxiety attacks
As a functional medicine practitioner, here’s what I wish more people knew about Lyme disease:
The Lyme Disease Conundrum
Why is Lyme so hard to detect and recover from, even after antibiotics? Here are three main theories:
Problem 1: The Lyme bacterium is a survivor.
Lyme bacteria knows how to stay alive inside its host. It suppresses the immune system, which allows it to survive and multiply. Lyme also seems to have the ability to “cloak” itself, making itself invisible to our immune system. In fact, Borrelia is so smart that some research (5) suggests that when it senses it’s being attacked, it can go into a dormant state, allowing it to live and survive against the onslaught of antibiotics. Other studies suggest (6) that Borrelia can actually mutate its own genes to make it resistant to antibiotics.
Problem 2: Diagnosis is tricky.
Only about half of all Lyme patients actually remember getting a tick bite. Plus, the classic “bull’s-eye” rash that people associate with Lyme may not appear in all cases, or may appear somewhere the victim never sees, such as on the scalp, hidden by hair. Some research (7) suggests that conventional Lyme tests may not be sensitive enough to make an accurate diagnosis, especially during the later stages of disease. False-negative results are also common.
Problem 3: Conventional treatment may not be sufficient.
The conventional approach to Lyme typically includes 10 to 28 days of antibiotics. Then what? Well, nothing. That course of antibiotics supposedly kills of the bacteria. The problem with this is that some research (8) suggests that as many as 25 percent of patients with Lyme disease still have some symptoms long after antibiotic therapy, suggesting that some bacteria lingers, or its effects linger in the body.
A functional medicine approach to Lyme
As a functional medicine practitioner, my approach to Lyme is different. Here’s what I recommend:
1. A detailed health history.
Job one is a detailed health history. When I do this with my patients, I ask all kinds of nosy questions. (One patient asked me if I was in the KGB! No, ma’am, just getting to the root issues!) If you think you could have Lyme disease, consider a free webcam or phone evaluation with my health center to get this conversation started.
2. Comprehensive labs.
It’s important to catch Lyme as early as possible, so it doesn’t become chronic. The sooner it is treated, the more likely antibiotics will be able to eradicate it all. In addition to using the two conventional tests accepted by the CDC, Elisa and Western Blot labs, I also often screen clients with these labs:
- CD57+/CD8-Absolute count: At this point, we believe that only Lyme bacteria will depress the CD-57, so someone with a high CD-57 is probably sick with something other than Lyme.
- C4a: This is another blood test to assess the immune system. Chronic Lyme disease could be associated with increased levels of C4a.
We might also consider other tests to dig a little deeper.
3. Support healthy biofilms.
Biofilm is a thin, slimy film of bacteria that adheres to a surface. Biofilms are not bad in themselves. They are simply a way that bacteria colonize. It’s the composition of the biofilm that makes it probiotic or pathogenic. Functional medicine’s goal is to promote a healthy biofilm through foods, lifestyle changes, and natural medicines. Some natural biofilm-modifying tools I might recommend include:
- Colostrum/Lactoferrin supplements: Lactoferrin inhibits pathogens and promotes healthy biofilms.
- Probiotics and prebiotics: These promote probiotic balance.
- Enzymes: These break down biofilm.
- Xylitol: This is a natural (9) anti-biofilm.
- EDTA: This is a strong anti-biofilm.
I recommend talking to your health care practitioner about what might help support your health.
4. Address microbiome issues.
At least 70 percent of our immune system is in our GI tract, and the microbiome is a foundational part of immune health. Addressing any underlying gut dysfunctions, such as candida overgrowth, could help to strengthen the immune system to fight off infections.
5. Integrate natural medicines.
I typically suggest immune support, formulas including herbs and compounds such as Siberian ginseng, samento, sarsaparilla, guaiacum, (10) astragalus, resveratrol, and cat’s claw. One study also suggests (11) that stevia could be as effective as antibiotics in treating Lyme disease.
6. Consider antibiotics.
Some functional medicine practitioners will suggest conventional antibiotics to reduce total bacterial load. For example, ILADS recommends (12) 100 to 200 mg of doxycycline twice daily for a minimum of 20 days for all tick bites where there is evidence of tick feeding.
7. Address any co-infections.
I also test my patients for viruses such as EBV (Epstein-Barr virus), HSV 1&2 (Herpes simplex viruses 1&2), HHV-6 (Human Herpes virus), and CMV (Cytomegalovirus). These viruses can put more stress on the immune system. In my clinic, I find that olive leaf, larrea tridentata, bee propolis, Melissa officinalis, L-lysine, zinc, and vitamin C can be good antiviral support options.
8. Support genetic weaknesses.
Certain genes can predispose certain people to chronic infections. I recommend looking for methylation gene changes like MTHFR mutations and supporting the body’s methylation and detoxification pathways.
How exactly is Lyme connected to diet?
We’re starting to realize that our modern lifestyles are not doing us any favors when it comes to Lyme.
You see, our genetics as humans haven’t changed in over 10,000 years, but the world around us has changed greatly. Factors like processed foods, soil nutrient depletion, and air and water pollution are all likely amplifying and perpetuating the impact that chronic infections caused by viruses, mold, protozoa, and bacteria (like Lyme disease) have on the body. At first this might seem like bad news, but the truth is if certain environments and lifestyle factors can make us more vulnerable to Lyme, certain lifestyle factors and environments can also make us less vulnerable, too.
What’s wrong with the way our healthcare system treats Lyme?
So how does mainstream medicine diagnose and treat Lyme? Most of the time it’s done through lab work and a round of antibiotics—but that’s only if you notice a bite or your doctor has been trained to recognize the many vague and mysterious symptoms of Lyme. And even if you do successfully treat Lyme, chronic Lyme can persist long after you’ve taken those antibiotics, a condition that is now referred to as post-treatment Lyme disease syndrome. Thankfully, post-treatment Lyme disease syndrome is gaining recognition, especially in the functional medicine community and with the support of organizations like the International Lyme and Associated Diseases Society.
As a Lyme-literate functional medicine expert, I take a multi-pronged approach to treating Lyme disease. This includes specific supplements, forms of exercise, and most importantly: using food as medicine.
Can a keto diet support your ability to heal from Lyme?
In my practice, dietary recommendations for Lyme often takes the form of a mostly plant-based ketogenic diet, which I call the Ketotarian diet. The Ketotarian diet avoids the common downsides and risks of the conventional keto diet (AKA, eating a ton of meat and diary), while still allowing you to take advantage of the benefits of nutritional ketosis to fend off Lyme disease and get you back to optimal health.
Want more details? You’ve come to the right place. Here’s how a Ketotarian diet can be a game-changer in healing from chronic Lyme disease:
1. It supports healthy methylation pathways.
Many people don’t know this, but there are certain genetic factors that can make you more vulnerable to falling ill from Lyme disease. One of these is the MTHFR gene mutation, which affects more than a third of the population and impairs a process called methylation. This is a problem because methylation helps control the health of your hormones, inflammatory pathways, and detox pathways—which all help you manage Lyme. The Ketotarian diet is a great way to support healthy methylation. Certain foods like leafy greens and cruciferous veggies acts as extra credit since they are rich in folate and sulfur compounds that directly support methylation. Talk about food as medicine at its best!
2. It helps boost mitochondrial health.
Research shows that oxidative stress can harm the mitochondria in the immune cells of Lyme patients, which results in extreme fatigue. A Ketotarian diet can combat this by increasing (13) mitochondrial biogenesis (AKA, the production of new mitochondria), which happens by way of autophagy. Autophagy is a process in the body that helps remove damaged cells; (14) it’s essentially your body’s own cleaning system. If you want to take things to the next level, you can follow an intermittent fasting plan in combination with your keto diet. Fasting also causes ketosis and is another way to increase autophagy.
3. It combats chronic inflammation.
As I mentioned before, when you’re exposed to Lyme disease over a long period of time, it can trigger autoimmune diseases. (15) To reverse this (Or prevent it in the first place!), it’s imperative that you reduce inflammation in your body. Luckily for us, the ketones produced when your body is in ketosis are anti-inflammatory. In one example, the ketone beta-hydroxybutyrate acts as a signaling molecule and epigenetic modulator, working to activate (16) anti-inflammatory pathways (such as AMPK and Nrf-2) and inhibiting inflammatory pathways like NFkB, COX2, and the NLRP-3 inflammasome.
In plain English, this means that a plant-based ketogenic diet attacks chronic inflammation in multiple ways. This, combined with restored mitochondrial function, can help eliminate debilitating neurological symptoms like brain fog, which often occur with chronic Lyme. Sounds pretty good, doesn’t it?
4. It restores the microbiome to its former glory.
Most Lyme experts can agree on one thing: The gut microbiome is a key player in fighting off Lyme infections. This is because about 80 percent of our immune system is located in your GI tract. The good news is that the combination of healthy fiber and probiotic foods on the Ketotarian diet will help bring balance to your microbiome by killing bad bacteria and inoculating your belly with healthy ones (called probiotics) that help boost the immune system, lower inflammation, and fight disease. The Ketotarian diet is also low in sugar and carbs, foods that are known for promoting inflammation and suppressing immune function.
Should you go Keto to combat Lyme?
More studies need to be done that test this diet on patients with Lyme, but for now I feel it’s a safe and effective way to support your body through the process of healing Lyme. Many of the pathways implicated in Lyme disease are also modulated with a high-fat, low-carb keto diet. Because of this, in my practice I put almost all my patients with Lyme on some form of Ketotarian diet. Depending on how severe your Lyme disease is, I suggest seeking out a Lyme-savvy functional medicine practitioner who’s familiar with Lyme and low-carb, high-fat diets like the Keto diet.
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