Tuesday, March 29, 2011

Burrascano Notes from March 21st talk



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.”

 Stages of Lyme

Early Lyme – I
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 Regimen

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

Worms
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.)

Probiotics  
Ortho Molecular - Ortho Biotic 60 Caps

Multivitamins w/minerals
Ortho Molecular Products - KPAX Immune Support Formula - 120 Caps

CoQ10 or ubiquinone
NOW Foods CoQ10 200mg, 60 Vcaps

NT-factor or “ATP fuel”
NTI-Nutritional Therapeutics Inc. - Healthy Aging w/NT Factor - 120 tablets

Vitamin D – maintain upper-normal levels
NOW Foods Vitamin D3 5000 Iu, 240 Softgels,


Magnesium
Source Naturals Magnesium Malate 1250mg, 360 Tablets

Methyl B-12 

B complex
Nature's Bounty Vitamin B Complex Sublingual Liquid, 2 Ounce (Pack of 4)

Transfer Factors
4Life Transfer Factor Classic (90 capsules)

Detoxify

FIR Saunas: Helpful to excrete organic toxins


Far Infrared FIR Portable Foldable Spa Sauna Detox Ion, SI01




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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!




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