PLEASE NOTE: Because the presentation was so dense and rich with information, there may be some info that was left out.
Dr. Burrascano has treated over 10,000 patients with Lyme since early ‘80s.
“It is up to you. Learn as much as possible. Do as much as possible. Have a positive attitude.”
Dr. Burrascano’s definition of Lyme Disease
“Lyme disease is the illness that results from the bite of an infected deer tick; it’s not one germ.”
Disseminated Lyme – II
Chronic Lyme – III
-for one or more years – immune system breakdown and its consequences
-co-infections become important
-serologic tests less reliable
-treatment must be more aggressive and of longer duration
The sicker you are, the less reliable the tests; lyme burrows deeper and is no longer easily detected in blood
CD-57 test – the one test that shows how long Lyme has been present (See more blow regarding CD57)
Tick Bites
Only 17% recall having a tick bite (Texas Dept of Health)
Only 36% recall a rash
Only 50% have positive western blot
Co-infections: tests are even less sensitive
Ticks: nature’s “dirty needles”; a tick lives for 2 years
Co-infected patients: more ill, more difficult to treat; Lyme treatments do not treat Babesia, Bartonella, or viruses.
**Dr. Burrascano says he has never seen a patient without co-infections.
Sorting Out Co-Infections
Lyme, Bartonella, Babesia, Ehrlichia, Mycoplamsa
Lyme – Gradual onset, no sweats, 4 week cycles, multisystem, afternoon fevers
It is important to take your temperature several times a day (record in journal)
Babesia – Cycles every few days, makes everything worse
Ehrlichia – Sharp headaches behind eyes, low WBC, elevated liver function
Mycoplasma – Made worse with exercise, aka “Chronic Fatigue Germ”, major fatigue, neurological disfunction, found in the sickest and poorest responding; have the worst CD-57 tests
ELISA test – mostly useless; use Western Blot
Spinal Tap – only 9% have + csf
PCRs – 60% sensitivity at best because germ doesn’t stay in blood
LDA – 30% sensitivity
Why Igenex?
Dr. B has no affiliation with them, no professional relationship with them, etc…
If a test is commercialized to be sold as a test kit, it must follow narrow CDC restrictions and guidelines. (Ironically, these restrictions were a result of the Lyme vaccine debacle.)
Most Lyme tests are commercial. Commercial Lyme tests miss 75% of cases.
Based on double-blind government proficiency tests, IGenex did well.
CD-57 COUNT (tracks a type of white blood cell)
Lower counts seen in chronic Lyme
Only Lyme (not co-infections) makes CD-57 low
The CD-57 reading does not change *during* treatment … until Bb is controlled. Then it quickly changes.
Predicts a relapse if low when antibiotics end
The CD-57 test must be done by LabCorp’s method (using the “normal is >200” scale)
<20 – severe illness
20 – 60 most common for chronic patients
> 60 Lyme activity minimal
> 120 – relapse not likely
Why Are Chronic Lyme Patients So Sick?
-High spirochete load (perhaps multiple bites)
-Protective niches in the body and biofilms allow Bb to evade the immune system and antibiotics
-Immune suppression and immune evasion
Biofilms are a protective layer
Lyme germs live in different forms:
Spirochete – surrounded by a cell wall
Spiroplast – balls up, has no cell wall
Cystic form – has hard outer shell
Lyme germs can live *inside* a human cell, inside the vacule
Doxycycline – can get into the cell
Erithromycin – can get into the cell
Rocephin – does not kill germs inside vacule
Treatment - Back to Basics
Form a therapeutic alliance with your Dr.; should be able to have “meeting of the minds”
Pharmacology
-It is *critical* that you achieve therapeutic drug levels – this varies from patient to patient
-Antibiotics – you *must* have extra-cellular and intra-cellular meds as Bb can live in and out of cells
-Antobiotics – must act on blood & tissues
Spirochete forms:
Penicillins, Cephalosporins, Primaxin, Vancomycin,
Spiroplast/L form: no cell wall
Tetracyclines, Erythromycin
Cyst:
Metronidazole, Tinidazole, Rifampin
Spirochete B. burgdorferi – needs sustained levels
L form – Tetracyclines, need a spike in blood levels
Cystic – Metronidazole, sustained levels for 2 weeks +
Antibiotic combinations are necessary
Intracellular and extracellular
Blood and tissue
Intravenous therapy is most effective
Intramuscular Penicillin effective as well
Indications For Intravenous Therapy
-illness for more than one year
-prior use of steroids
-documented immune deficiency
-abnormal spinal fluid
-synovitis with high ESR
-age over 60
-failure or intolerance of oral therapy
Typical
Oral
Cefuroxime + Clarithromycin
Augmentin XR + Telithromycin
Injection
BicillinLA + Clarithromycin
Intravenous
Clarithromycin + Telithromycin
Vancomycin + Clarithromycin
-high doses needed
-combination usually necessary
-check for co-infections
-rotate treatments
Rate of recovery dependent on germ; stronger drug will not speed recovery.
Find a regimen that works and stick with it
Change when you’ve reached a plateau
Treatments: at least 4-6 weeks before changes
Relapses
-relapses occur; retreatment needed
-repeated and/or prolonged antibiotic therapy
Aggressive supportive therapy also necessary:
Sleep cycle
Food
Supplements
Detoxing
As symptoms wind down, DO NOT cut dosage! Resistance develops that way.
Progressively increase exercise program
-exercise is vital and required
-not exercising will increase risk of relapse
If CD-57 is not normal at end of treatment, continue treatment or there will be relapse
Prognosis
-May not cure infections, may need open-ended maintenance therapy
What to Watch For:
Signs of persistence; continued fevers
Four week cycles of ailments
Migrating symptoms
Positive PCR or urine LDA
If you have not relapsed in 3 years, you never will.
What if you’re not sure you’re over it?
Low grade fever still present
Signs of recurrent four-week cycles
Migrating pain
Low CD-57 counts
Bartonella
The Bartonella co-infection with Lyme seems to be clinically different that “cat scratch”.
Instead, they are Bartonella-like organisms; more prevelent that Borrelia in some ticks
Clinical Clues
Encephalopathy
Irritability
Anxiety
Stomach lining
Insomnia
Rashes
AM fevers
Night sweats
Tender skin nodules
Bartonella treatment:
Levaquin Fluoroquinolones
Erithromycins don’t kill this
Rifampin & Metronidazole may be alternatives
1 – 3 months of treatment
Piroplasms – Babesia
Is a parasite
Symptoms
Night sweats
Air hunger
An occasional cough
Persistent migraine-like headache
A vague sense of imbalance without true vertigo
Encephalopathy
Fatigue
Babesia Treatment
Not treated with antiobiotics
Azithromycine & Mepron
Malarone
Coartem – Antimalarial for Babesia (new)
Ehrlichia
Headaches
Muscle soreness
Persistent leucopenia (low WBC)
Treatment
Doxycycline 1st choice
Mycoplasms
“Chronic fatigue” germ
Ubiquitious in environment (in dust, for example)
Treatment is difficult
New species of nematodes in 63 – 75% of patients from Massachusetts
Fatigue
Lives in lungs mainly
(Dr. Eva Sapi, Dr. Larry Klapow – research)
An open mind is important!!
Biofilms
Dental plaque is an example
Gel-like substance in which germs can embed
Biolfilms in the gut are implicated in many digestive diseases & possibly food allergies and mal-absorption
Biofilm busters:
Banderol plus Samento
Enzymes
Methylation Cycle
Key component of metabolism
Need to bring up methylation cycle
This cycle can be blocked when chronically ill
75% of Lyme patients responded better after treating
Crazy or Is It Lyme?
Cytokines – mediators of inflammation, are activated.
When this occurs in the CNS, it triggers diversion of tryptophan into kynurenine
Result: depression, neuropathy, fog brain, “crazy” perception
Bornavirus
Autism-related?
Distant cousin to Rabies and distemper
Brain is the site of infection
Does not damage nerve cells but blocks cell function
Brain fog, fatigue leads to depression
Treatment:
Antiviral Amantading
65 – 70% success rate
XMRV
Xenotropic Murine Leukemia Virus
Virus – is gamaretrovirus, 1st isolated in prostate cancer
68 out of 101 CFIDS samples contained XMRV
XMRV is found on only 3% of healthy samples
XMRV is also found present in cases of: MS, ALS, Parkinsons, Autism, Fibromyalgia
Lyme patients who did not recover: 1005 of them had XMRV
Does it prevent a full recovery from Lyme?
Is it found in ticks?
Treatment – XMRV
Retrovirus is cousin to HIV
-be sure there is not excessive cortisol and DHT
-consider adding antivirals AZT, tenofovir, raltegravir
Basic Advice
NO steroids or other immune suppressives!
No smoking at all
No alcohol (makes germs stronger, weakens immune system)
Clean diet: low carb, low glycemic index, high quality proteins
Maintain hydration (Lyme patients become dehydrated quickly, sense of thirst is altered)
May need mineral supplements
ENFORCED REST
You are NOT allowed to get tired
Take a break before afternoon lag
Work and school – Go in later, leave earlier, take a midday break, take Wednesdays off
Rest on days off
No caffeine, no stimulants
Home should be quiet, comfortable, non-toxic
Nap if needed!!
If you need to sleep late, do it!!
Exercise Program
Body sculpting
Gentle with free weights, exercising all muscles; very light or no weights
NO AEROBICS
Each body sculpting session 45 min; 60 minutes preferred
Begin with good progressive warm-up
Take a hot shower or bath afterward and go to bed. Lie quietly if you cannot sleep.
Never exercise daily
Total rest on off days
As strength improves, increase weight and resistance but maintain high number of repetitions
As stamina improves, exercise more, but NEVER daily.
Dr. B believes: spirochetes choose skin as their final hiding place.
Nutritional Supplements
(These are just examples, not his necessarily his recommendations. Click on the pictures to view the products and read reviews.)
(These are just examples, not his necessarily his recommendations. Click on the pictures to view the products and read reviews.)
Probiotics
Multivitamins w/minerals
CoQ10 or ubiquinone
NT-factor or “ATP fuel”
Vitamin D – maintain upper-normal levels
Magnesium
Methyl B-12
B complex
Transfer Factors
Detoxify
FIR Saunas: Helpful to excrete organic toxins
DEET does not work!! Use Premethrin!
(Developed in cooperation with the U.S. Military, government agencies, universities and others; this Sawyer Clothing repellent offers superior protection from disease-carrying biting insects. The active ingredient, Permethrin is a synthetic molecule similar to those found in natural pyrethrum which is taken from the Chrysanthemum flower. Not only does this product repel insects, but will actually kill ticks, mosquitoes, chiggers, mites and more than 55 other kinds of insects. Sawyer Permethrin repellent is for use on your clothing, tents and other gear. A single application lasts up to six weeks and will remain effective even if you wash the garment once a week. Permethrin is odorless when dry, and during the drying process it tightly bonds with the fibers of the treated garment, it will not stain or damage clothing, fabrics, plastics, finished surfaces, or any of your outdoor gear. Try our two easy-to-use treatment methods: aerosol spray and NEW soak system. Both methods provide protection from mosquitoes and ticks through 6 launderings.)
And the most important part.......
I want to thank you my friend for taking these wonderful notes for me and for all of you!
Thank you Heather Shirkey!
And the most important part.......
"Live with a healthy attitude;
Lose “poor me”, lose anger
Do not become “Lyme obsessed”
Pursue other interests and distractions
Enjoy friends and family
Cuddle with your pets"
I want to thank you my friend for taking these wonderful notes for me and for all of you!
Thank you Heather Shirkey!
1 comment:
Thank you for these notes! Will forward them to my LLMD! Julie
www.justjuliewrites.wordpress.com
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