Lyme Disease Q + A with Dr. Sal Meli, ND
Q: What is Lyme Disease?
A: By definition, Lyme Disease is an infectious disease caused by the spirochete bacteria Borrelia burgdorferi. More importantly, it has become the general term to describe the complex of chronic symptoms developed from tick-borne infections. I prefer the general term ‘Tick-Borne infections’.
Q: Is Lyme Disease recognized worldwide?
A: The acute Borrelia infection has been recognized world-wide for many decades. The recognition of the chronic nature of this infection is the point where opinions differ. From my research and clinical experience there is no doubt in my mind that tick-borne infections lead to chronic, complex illnesses.
My impression is that the segment of physicians who are unwilling or unable to recognize chronic Tick-borne infections is getting smaller. However, there still remains a very large portion of the medical community who is unwilling to treat the chronic manifestations of these infections due to pressure imposed on them from their regulatory colleges.
Q: What are the early warning signs of Lyme Disease?
A: In the case of a known tick bite, the bull’s eye rash that might follow is a definite indicator of an acute Borrelia infection. If, following a tick bite, there is no rash but general symptoms such as fever or joint pains, then laboratory testing for an infection is warranted. Testing the tick itself is also worthwhile. When no tick bite is noticed, the general acute flu-like symptoms are often overlooked.
In chronically ill cases often diagnosed as chronic fatigue syndrome, fibromyalgia, depression (or not diagnosed at all), it becomes important to re-assess the diagnosis, especially when the prescribed treatments are not helpful.
There is a large subset of the population who have chronic symptoms due to a tick-borne infection and are misdiagnosed.
Q: How come once Lyme Disease has progressed to stage three that it has such a significant effect on organs such as the heart and brain?
A: The third, or chronic phase is typically characterized by multiple infections (bacteria, parasites, viruses and/or fungi) and profound immune system suppression. It is not uncommon that heavy metals accumulate and hormone imbalances are noted. The toxic burden from the various pathogens strain the liver’s detoxification systems and ultimately impede the important functions of the vital organs. It is important to note that no two chronic tick-borne infections are the same. When treating patients at this stage, it is essential to treat the whole person, never simply the infections.
Q: What is the testing process for Lyme Disease?
A: In the acute phase, blood testing for Borrelia and co-infections is recommended. Testing the actual tick, if available, is also very useful. The standard blood tests offered (ELISA) is not sensitive enough and therefore misses too many positive cases. I do not recommend this as a stand-alone test.
The key concept in early testing is to cast a wide net to determine which pathogens are present and which are not. The pathogens worth testing are dependent on geography and symptoms.
Q: Is the current testing for Lyme Disease accurate?
A: The ELISA blood test (the test most commonly run by a general practitioner) is terribly unreliable in the sense that it misses too many positive cases. It is always worthwhile to re-test with a more sensitive test, or to opt out of the ELISA test altogether and use a reputable private lab that specializes on testing tick-borne infections.
Q: Which lab tests and lab providers do you prefer to use?
A: I prefer to use ArminLabs in Germany for the majority of my lab testing. Very rarely will I depend on any single test. Within 2-3days of a tick bite, the EliSpot test is recommended. The Borrelia EliSpot is made up of 3 markers. After about 10days post-bite, the SeraSpot test can be added for additional confirmation. This is an improved version of the western blot test. In chronic cases (longer than 1 year) I run the TickPlex panel which includes the EliSpot, IgG/IgM and T-cell markers (including CD57). This combination of tests provides a good screen for chronic Borrelia infection. ArminLabs offers multiple testing options for co-infections, viral and parasitic markers. I have no affiliation with ArminLabs.
Q: What is the first focus after a positive lab result? Treat the infection, support the immune system, ect.?
A: In acute cases, the initial focus is on treating the infection with a sufficient dose and duration of antibiotics. Additional probiotic and immune support is worthwhile but the overarching goal is to eradicate the infection. Because the possibility of complete eradication is possible at this time (before the spirochete can burrow deeper into the body), it is prudent to prescribe a more aggressive anti-microbial regime.
In chronic cases, there is, unfortunately, no set roadmap because every case is unique. Ultimately the first goal is to support the immune system by addressing all obstacles which might interfere including chronic inflammation, heavy metal burden, methylation defects, mold toxicity, insufficient detoxification, imbalanced hormones etc. Essentially, in the chronic stage, strengthening the body takes precedence over attacking the infection.
Q: What are treatment options for a patient who has Lyme Disease?
A: There are ample treatment options and employing multiple strategies simultaneously has synergistic benefits. You’ll notice that herbal medicine, typically in the form of tinctures, covers most Lyme-related concerns.
Immune support: herbs, transfer factors, LDN, LDI, peptides, mushroom extracts, probiotics, acupuncture, stem cell therapy, blood transfusion etc.
Anti-microbials: herbs, pharmaceutical antibiotics, silver, mushroom extracts, iodine etc.
Oxidative therapies: IV Vitamin C, ozone therapy, IV hydrogen peroxide
Anti-inflammatory: turmeric and other herbs, proteolytic enzymes, NFkB blockers etc.
Detoxification: herbs, saunas, binders etc.
Biofilm busters: Serrapeptidase, lumbrokinase, EDTA, stevia, pharmaceuticals etc.
Nutrition: customized diet, food sensitivity testing, IV nutrients/Myers’ cocktail etc.
Herx support: diet modifications, herbs, saunas, Lymph support, Epsom salt baths, IV therapy etc.
Anti-Viral support: Monolaurin, herbs, mushroom extracts, IV nutrients, ozone therapy
Anti-Parasitic support: herbs, IV artusanate, pharmaceutical agents etc.
Pain management: acupuncture, injection therapies, herbs, IV DMSO, topical compounded agents, massage etc.
Sleep support: herbs, melatonin, sleep hygiene, pharmaceutical agents etc.
Energy support: IV therapy, ozone, mitochondrial co-factors etc.
For access to herbal tinctures for tick-borne illnesses, including all Herbs recommended in the Buhner protocol, click here.
Q: What is the best way to manage chronic symptoms of Lyme?
A: There is no simple answer to this question. A full assessment and continued re-assessment of the various pathogens and immune markers is recommended highly. The more you know why you have the symptoms that you have, the more your practitioner will be able to provide significant, lasting improvement to your overall health.
Keeping a broad perspective and appreciating the inter-connectedness of the body’s systems is very important. Although the infection may be the underlying problem, in chronic cases most symptoms are driven by inflammation, hormone imbalances, immunosuppression etc.
Prevention and Resources
Q: How can you prevent Lyme Disease?
A: The most important measure one can take is to simply be tick-aware. Wearing protective clothing when walking in the woods or tall grasses (ie. long sleeves, pants tucked into socks). Also, getting into the habit of regularly checking your body for ticks after being in the woods and having a partner check areas that are difficult to see.
Q: Do you have any resources that you recommend to patients?
Q: Lastly, what have you learned from your patients?
A: Resilience! My patients are determined, self-educated and motivated to take their life back into their own control.
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