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home:diseases:lyme [07.07.2019] – [Caused by multiple microbes] sallieqhome:diseases:lyme [09.13.2022] – external edit 127.0.0.1
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 ====== Chronic Lyme disease ====== ====== Chronic Lyme disease ======
  
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 The Marshall Protocol is an attempt to do the opposite. Rather than use immunosuppression, the MP uses antibiotics but at pulsed low doses in a way that minimizes immunosuppression. Further, antibiotics are optional. The main medication used by the MP is olmesartan, which has antimicrobial properties. The Marshall Protocol is an attempt to do the opposite. Rather than use immunosuppression, the MP uses antibiotics but at pulsed low doses in a way that minimizes immunosuppression. Further, antibiotics are optional. The main medication used by the MP is olmesartan, which has antimicrobial properties.
  
-Autoimmunity Research Foundation has been granted by the FDA [[http://autoimmunityresearch.org/orphan-clindamycin-25jul06.pdf|orphan drug status]] for clindamycin in the treatment of post-treatment Lyme disease syndrome.+Autoimmunity Research Foundation has been granted by the FDA [[https://autoimmunityresearch.org/orphan-clindamycin-25jul06.pdf|orphan drug status]] for clindamycin in the treatment of post-treatment Lyme disease syndrome.
  
- +===== Managing symptoms while on the Marshall Protocol =====
- +
-=====Managing symptoms while on the Marshall Protocol =====+
  
   * **[[home:symptoms:pain|Pain]]** – MP patients should always use 40mg of olmesartan (Benicar) every four hours before resorting to pain medications. However, when the usual strategies for managing immunopathology are not enough to control pain, MP patients rely upon pain medications. Except for corticosteroids, there is no pain medication contraindicated specifically because a patient is on the Marshall Protocol. Opioids are the preferred method of dealing with extreme pain in the MP cohort. //See article [[home:othertreatments:pain_medication|Pain medication and muscle relaxants]].//    * **[[home:symptoms:pain|Pain]]** – MP patients should always use 40mg of olmesartan (Benicar) every four hours before resorting to pain medications. However, when the usual strategies for managing immunopathology are not enough to control pain, MP patients rely upon pain medications. Except for corticosteroids, there is no pain medication contraindicated specifically because a patient is on the Marshall Protocol. Opioids are the preferred method of dealing with extreme pain in the MP cohort. //See article [[home:othertreatments:pain_medication|Pain medication and muscle relaxants]].// 
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 What we who are a part of this forum, who stuck with the protocol long enough, who endured the IP and were able to keep a doctor, report is that this has a better than 50% success rate.  What we who are a part of this forum, who stuck with the protocol long enough, who endured the IP and were able to keep a doctor, report is that this has a better than 50% success rate. 
- 
- 
-=====Antibiotic treatments===== 
-<mainarticle>  [[home:othertreatments:antibacterials:highdose|High-dose antibiotic therapies]]</article> 
-One of the reasons why chronic Lyme disease is so contentious is that advocates for it strongly believe in the value of high-dose antibiotic therapies, any treatment which uses antibiotics at a large enough dose that the immune response is suppressed more than it is not. High-dose antibiotics are ineffective, and this is well-reflected in the published literature. The short-term improvement and long-term crash some patients feel on high-dose antibiotics is due to the fact these drugs interfere with immune activity in dose dependent fashion. With a weakened inflammatory response, a patient's symptoms may temporarily improve, but not because the pathogenic bacteria which drive disease have been eradicated. As a result, these protocols do not generate sustained immunopathology. 
- 
- 
-==== Doxycycline ==== 
-<mainarticle> [[home:othertreatments:antibacterials:doxycycline|Doxycycline]]</article> 
- 
-Although the MP antibiotic minocycline is also a tetracycline, doxycycline and minocycline are significantly different from each other – both in terms of structure and function. Doxycycline's effectiveness over short periods of time is due in part to the relatively high doses at which it is typically administered: 200 mg per day. Doxycycline does not kill as wide a range of bacteria as minocycline. For example, doxycycline doesn't kill //Staphylococcus//, a genus found in at least three recent studies in which the human microbiome was sequenced. 
- 
- 
-==== Cephlasporins including Rocephin ==== 
-<mainarticle> [[home:othertreatments:antibacterials:betalactams|Beta-lactam antibiotics]]</article> 
-{{section>:home:othertreatments:antibacterials:betalactams#cephalosporins&noheader&firstseconly}} 
- 
-===== Other treatments ===== 
-  * **[[home:othertreatments:colloidal_silver|colloidal silver]]** – While colloidal silver is marketed for internal and external use as an alternative medical remedy, there is no scientific evidence of its effectiveness in vivo for any medical condition. Also, it can [[http://www.quackwatch.org/01QuackeryRelatedTopics/PhonyAds/silverad.html|permanently turn]] your skin silver. 
-  * **hydrogen peroxide** – Delivered intravenously. The theory is that hydrogen peroxide releases extra oxygen inside the body, killing microbes. This [[http://www.cbsnews.com/stories/2005/01/12/60II/main666489.shtml|dangerous therapy]] is based on an overly simplistic view of the body's metabolism. There are no large-scale studies proving hydrogen peroxide is effective. 
-  * **[[home:othertreatments:rife|Rife]]** – There is no scientific evidence that the use of a Rife device has the intended effect on infectious bacteria. Instead, most patients using Rife are likely administering themselves nothing more than an expensive placebo. 
  
  
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 ===== Role of infection ===== ===== Role of infection =====
  
-====Caused by multiple microbes ====+==== Caused by multiple microbes ====
  
 <relatedarticles> [[home:pathogenesis:kochs_postulates|Koch's postulates]], [[home:pathogenesis:successive_infection|Successive infection and variability in disease]]</article> <relatedarticles> [[home:pathogenesis:kochs_postulates|Koch's postulates]], [[home:pathogenesis:successive_infection|Successive infection and variability in disease]]</article>
- 
  
 <blockquote>Lyme disease is considered to be caused by //Borrelia// species of bacteria but slowly evidence is accumulating which suggests that Lyme disease is a far more complex condition than //Borreliosis// alone. This hypothesis suggests that it may be more appropriate to regard Lyme disease as a tick borne disease complex. Over recent years numerous different microbes have been found in ticks which are known to be zoonotic and can coinfect the human host. The hypothesis suggests that multiple coinfections are invariably present in the clinical syndromes associated with Lyme disease and it is suggested that these act synergistically in complex ways. <blockquote>Lyme disease is considered to be caused by //Borrelia// species of bacteria but slowly evidence is accumulating which suggests that Lyme disease is a far more complex condition than //Borreliosis// alone. This hypothesis suggests that it may be more appropriate to regard Lyme disease as a tick borne disease complex. Over recent years numerous different microbes have been found in ticks which are known to be zoonotic and can coinfect the human host. The hypothesis suggests that multiple coinfections are invariably present in the clinical syndromes associated with Lyme disease and it is suggested that these act synergistically in complex ways.
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 W. Ian Lipkin's team sampled 286 adult ticks from the two counties in New York State where Lyme disease is endemic, looking for the prevalence of polymicrobial infection with //Borrelia burgdorferi, Anaplasma phagocytophilum, Babesia microti, Borrelia miyamotoi,// and Powassan virus.(({{pubmed>long:19725770}})) Seventy-one percent of the ticks harbored at least one organism; 30% had a polymicrobial infection. Infections with three microbes were detected in 5% of the ticks. One tick was infected with four organisms. W. Ian Lipkin's team sampled 286 adult ticks from the two counties in New York State where Lyme disease is endemic, looking for the prevalence of polymicrobial infection with //Borrelia burgdorferi, Anaplasma phagocytophilum, Babesia microti, Borrelia miyamotoi,// and Powassan virus.(({{pubmed>long:19725770}})) Seventy-one percent of the ticks harbored at least one organism; 30% had a polymicrobial infection. Infections with three microbes were detected in 5% of the ticks. One tick was infected with four organisms.
- 
  
 We collected data from an online survey of 200 of our patients, which evaluated the efficacy of dapsone (diaminodiphenyl sulfone, ie, DDS) combined with other antibiotics and agents that disrupt biofilms for the treatment of chronic Lyme disease/post-treatment Lyme disease syndrome (PTLDS). We also collected aggregate data from direct retrospective chart review, including laboratory testing for Lyme, other infections, and associated tick-borne coinfections. (({{pubmed>long:30863136}})) We collected data from an online survey of 200 of our patients, which evaluated the efficacy of dapsone (diaminodiphenyl sulfone, ie, DDS) combined with other antibiotics and agents that disrupt biofilms for the treatment of chronic Lyme disease/post-treatment Lyme disease syndrome (PTLDS). We also collected aggregate data from direct retrospective chart review, including laboratory testing for Lyme, other infections, and associated tick-borne coinfections. (({{pubmed>long:30863136}}))
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 Human Tick-Borne Diseases in Australia.  (({{pubmed>long:30746341}})) Human Tick-Borne Diseases in Australia.  (({{pubmed>long:30746341}}))
- 
  
 ==== Borrelia and the VDR ==== ==== Borrelia and the VDR ====
 +
 <relatedarticle> [[home:pathogenesis:vitamind:metabolism|Metabolism of vitamin D and the Vitamin D Receptor]] </article> <relatedarticle> [[home:pathogenesis:vitamind:metabolism|Metabolism of vitamin D and the Vitamin D Receptor]] </article>
  
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 Olmesartan is the main medication used by the Marshall Protocol and is believed to act as a VDR agonist, counteracting //Borrellia//'s effect on the Receptor and reversing the disease process. Olmesartan is the main medication used by the Marshall Protocol and is believed to act as a VDR agonist, counteracting //Borrellia//'s effect on the Receptor and reversing the disease process.
- 
  
 [{{ :home:diseases:pone.0017287.g001.jpg?350|**Proteins from the cerebrospinal fluid of patients with Chronic Fatigue Syndrome (CFS), Neurologic Post Treatment Lyme Syndrome (nPTLS), and healthy controls.** This analysis strongly suggests a biological component of these diseases as well as a large role for microbes, which have profound effects on the human proteome.}}] [{{ :home:diseases:pone.0017287.g001.jpg?350|**Proteins from the cerebrospinal fluid of patients with Chronic Fatigue Syndrome (CFS), Neurologic Post Treatment Lyme Syndrome (nPTLS), and healthy controls.** This analysis strongly suggests a biological component of these diseases as well as a large role for microbes, which have profound effects on the human proteome.}}]
- 
  
 ==== Different proteins in cerebrospinal fluid ==== ==== Different proteins in cerebrospinal fluid ====
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 Greco //et al.// claimed to find a variety of autoantibodies including antiphospholipid antibodies in patients with chronic Lyme disease.(({{pubmed>long:21729977}})) Autoantibodies have long been tied to persistent infections. Greco //et al.// claimed to find a variety of autoantibodies including antiphospholipid antibodies in patients with chronic Lyme disease.(({{pubmed>long:21729977}})) Autoantibodies have long been tied to persistent infections.
-===== Psychosomatic explanations for disease ===== 
-<relatedarticle> [[home:alternate:psychosomatic|Psychosomatic explanations for disease]] </article> 
-{{section>:home:alternate:psychosomatic#psychosomatic_explanations_for_disease&noheader}} 
  
 +===== Ticks, what to do when bitten =====
  
 +<mainarticle> [[home:special:ticks|Ticks, what to do when bitten]]</article>
 +Marshall Protocol patients who develop a bulls-eye rash after a tick bite or who think a tick bite has put them at risk for Lyme disease should ask their physician about taking 100mg of minocycline twice daily for 30 days.
  
 ===== Herxheimer reaction ===== ===== Herxheimer reaction =====
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 One of the significant distinctions between a herx reaction in patients taking high-dose antibiotics and those on the MP is the length of that reaction. While it is common to hear Lyme patients experience a herx response for several weeks, patients on the MP may experience sustained immunopathology over the course of years. While this makes the MP harder to complete, the length of the treatment before a decrease in symptoms may be a tribute to how sick some patients with chronic Lyme or any other chronic disease truly are. One of the significant distinctions between a herx reaction in patients taking high-dose antibiotics and those on the MP is the length of that reaction. While it is common to hear Lyme patients experience a herx response for several weeks, patients on the MP may experience sustained immunopathology over the course of years. While this makes the MP harder to complete, the length of the treatment before a decrease in symptoms may be a tribute to how sick some patients with chronic Lyme or any other chronic disease truly are.
- 
- 
- 
-=====Ticks, what to do when bitten ===== 
-<mainarticle> [[home:special:ticks|Ticks, what to do when bitten]]</article> 
-Marshall Protocol patients who develop a bulls-eye rash after a tick bite or who think a tick bite has put them at risk for Lyme disease should ask their physician about taking 100mg of minocycline twice daily for 30 days. 
- 
- 
- 
- 
- 
- 
-=====Chronic controversy over chronic Lyme disease ===== 
- 
-<blockquote>Lyme disease, with 20,000 cases reported annually, ranks low on the list of the most prevalent infectious diseases. But it ranks first in rancor generated in the medical community. 
- 
-//**David Whelan** wrote //  Ticks aren't the only parasites living off patients in borreliosis-prone areas 
-</blockquote> 
- 
-While there is general agreement on the optimal treatment for early Lyme disease, there is considerable controversy over the existence, prevalence, diagnostic criteria, and treatment of chronic Lyme disease. 
- 
-Over the past decade, two opposing camps have emerged in the battle over Lyme. One camp is represented by the International Lyme and Associated Diseases Society (ILADS), which argues that Lyme disease is not rare because its spread is facilitated by rodents, deer and birds, and can be found in an unpredictable distribution around the world accompanied by other tick-borne coinfections that may complicate the clinical presentation. According to the ILADS, tick bites often go unnoticed and commercial laboratory testing for Lyme disease is inaccurate. Consequently, the disease is often not recognized and may persist in a large number of patients, requiring prolonged antibiotic therapy to eradicate persistent infection with the evasive Lyme spirochete.(({{pubmed>long:19072179}})) 
- 
-The opposing camp is represented by the Infectious Diseases Society of America (IDSA), which maintains that Lyme disease is a rare illness localized to well-defined areas of the world. According to the IDSA, the disease is "hard to catch and easy to cure" because the infection is rarely encountered, easily diagnosed in its early stage by distinctive clinical features and in more advanced stages by accurate commercial laboratory tests, and effectively treated with a short course of antibiotics over 2-4 weeks. Chronic infection with the Lyme spirochete, //Borrelia burgdorferi//, is rare or nonexistent, and the concept of chronic Lyme disease rests on "faith-based" opinion rather than "evidence-based" science.(({{pubmed>long:19072179}})) 
- 
-This mainstream view is exemplified by a 2007 review in the //New England Journal of Medicine//, which noted the diagnosis of chronic Lyme disease is used by a few physicians despite a lack of "reproducible or convincing scientific evidence", leading the authors to describe this diagnosis as "the latest in a series of syndromes that have been postulated in an attempt to attribute medically unexplained symptoms to particular infections."(({{pubmed>long:17914043}}))  
- 
-<blockquote>Chronic Lyme disease is the most recent in a continuing series of "medically unexplained symptoms" syndromes. These syndromes, such as fibromyalgia, chronic fatigue syndrome, and multiple chemical sensitivity, meet the need for a societally and morally acceptable explanation for ill-defined symptoms in the absence of objective physical and laboratory findings. We describe factors involved in the psychopathogenesis of chronic Lyme disease and focus on the confusion and insecurity these patients feel, which gives rise to an inability to adequately formulate and articulate their health concerns and to deal adequately with their medical needs, a state of disorganization termed aporia. 
- 
-//**L.H. Sigal**// (({{pubmed>long:12194894}})) </blockquote> 
- 
-Groups of patients, patient advocates, and the small number of physicians who support the concept of chronic Lyme disease have organized to lobby for recognition of this diagnosis, as well as to argue for insurance coverage of long-term antibiotic therapy, which most insurers deny, as it is at odds with the guidelines of the major medical organizations.  
- 
-The term "Lyme-literate medical doctor" or LLMD has been coined to describe physicians who acknowledge the existence of chronic Lyme disease an infectious condition and are willing to treat it with antimicrobial therapies. LLMDs generally operate outside the mainstream of medicine. A number have been brought up before medical board reviews and been the subject of patient lawsuits. 
- 
-The net result of this controversy is that many doctors [[http://www.ama-assn.org/amednews/2008/06/09/hlsa0609.htm|try to avoid]] having Lyme patients in their practice. 
- 
- 
- 
- 
- 
- 
- 
  
 ===== Patient interviews  ===== ===== Patient interviews  =====
- 
  
 <html> <html>
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 Lyme, //Babesia// Lyme, //Babesia//
  
-Read the [[http://bacteriality.com/2007/09/22/interview3/|interview]]+Read the [[https://bacteriality.com/2007/09/22/interview3/|interview]]
  
 <html></div></div> <html></div></div>
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 Lyme disease, irritable bowel syndrome/ulcerative colitis, radiculitis Lyme disease, irritable bowel syndrome/ulcerative colitis, radiculitis
  
-Read the [[http://bacteriality.com/2008/02/17/interview16/|interview]]+Read the [[https://bacteriality.com/2008/02/17/interview16/|interview]]
  
 <html></div></div></html> <html></div></div></html>
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 Post Treatment Lyme Disease Syndrome (PTLDS) Post Treatment Lyme Disease Syndrome (PTLDS)
  
-Read the [[http://bacteriality.com/2008/03/31/interview19/|interview]]+Read the [[https://bacteriality.com/2008/03/31/interview19/|interview]]
  
 <html></div></div></html> <html></div></div></html>
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 Lyme, myoclonus Lyme, myoclonus
  
-Read the [[http://bacteriality.com/2007/10/28/interview6/|interview]]+Read the [[https://bacteriality.com/2007/10/28/interview6/|interview]]
  
 <html></div></div></html> <html></div></div></html>
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 chronic borreliosis ("Lyme"), multiple chemical sensitivities, chronic spinal inflammation, peripheral neuropathy chronic borreliosis ("Lyme"), multiple chemical sensitivities, chronic spinal inflammation, peripheral neuropathy
  
-Read the [[http://bacteriality.com/2007/12/28/interview14/|interview]]+Read the [[https://bacteriality.com/2007/12/28/interview14/|interview]]
  
 <html></div></div> <html></div></div>
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 </blockquote> </blockquote>
  
 +===== Psychosomatic explanations for disease =====
 +<relatedarticle> [[home:alternate:psychosomatic|Psychosomatic explanations for disease]] </article>
 +{{section>:home:alternate:psychosomatic#psychosomatic_explanations_for_disease&noheader}}
 +
 +===== Research =====
 +
 + Many antimicrobial agents (antibiotics, antivirals, antifungals, anthelmintics or antiparasitics) used for treating other infections were found to have better activity than the current Lyme antibiotics. These include antibacterials such as rifamycins (3-formal-rifamycin, rifaximin, rifamycin SV), thiostrepton, quinolone drugs (sarafloxacin, clinafloxacin, tosufloxacin), and cell wall inhibitors carbenicillin, tazobactam, aztreonam; antifungal agents such as fluconazole, mepartricin, bifonazole, climbazole, oxiconazole, nystatin; antiviral agents zanamivir, nevirapine, tilorone; antimalarial agents artemisinin, methylene blue, and quidaldine blue; antihelmintic and antiparasitic agents toltrazuril, tartar emetic, potassium antimonyl tartrate trihydrate, oxantel, closantel, hycanthone, pyrimethamine, and tetramisole. Interestingly, drugs used for treating other non-infectious conditions including verteporfin, oltipraz, pyroglutamic acid, pidolic acid, and dextrorphan tartrate, that act on the glutathione/γ-glutamyl pathway involved in protection against free radical damage, and also the antidepressant drug indatraline, were found to have high activity against stationary phase B. burgdorferi.  (({{pubmed>long:    27025631}}))
  
 ===== Read more ===== ===== Read more =====
-  * According to a [[http://ngm.nationalgeographic.com/2011/11/iceman-autopsy/hall-text|2011 study]], a Neolithic mummy had //Borrelia//, suggesting that Lyme disease has been around for quite some time.  +  * According to a [[https://ngm.nationalgeographic.com/2011/11/iceman-autopsy/hall-text|2011 study]], a Neolithic mummy had //Borrelia//, suggesting that Lyme disease has been around for quite some time.  
-  * [[http://www.chicagotribune.com/health/ct-met-chronic-lyme-disease-20101207,0,5671843.story|Chronic Lyme disease: A dubious diagnosis]] – A 2010 //Chicago Tribune// article portraying Lyme advocates as unscientific. This article well represents the view of many doctors concerning Lyme advocates. +  * [[https://www.chicagotribune.com/health/ct-met-chronic-lyme-disease-20101207,0,5671843.story|Chronic Lyme disease: A dubious diagnosis]] – A 2010 //Chicago Tribune// article portraying Lyme advocates as unscientific. This article well represents the view of many doctors concerning Lyme advocates. 
-  * [[http://www.medscape.com/viewarticle/586226|Chronic Lyme Disease and the "Axis of Evil"]] – A 2009 //Future Microbiology// paper written from the perspective of ILADS and LLMDs.+  * [[https://www.medscape.com/viewarticle/586226|Chronic Lyme Disease and the "Axis of Evil"]] – A 2009 //Future Microbiology// paper written from the perspective of ILADS and LLMDs.
  
   * SPECT scans are abnormal in chronic Lyme patients – According to a 2012 study, 75% of brain SPECT scans are abnormal in patients with chronic Lyme disease.(({{pubmed>long:22889796}}))   * SPECT scans are abnormal in chronic Lyme patients – According to a 2012 study, 75% of brain SPECT scans are abnormal in patients with chronic Lyme disease.(({{pubmed>long:22889796}}))
  
  
 +===== Controversy over chronic Lyme disease =====
  
 +<blockquote>Lyme disease, with 20,000 cases reported annually, ranks low on the list of the most prevalent infectious diseases. But it ranks first in rancor generated in the medical community.
 +
 +//**David Whelan** wrote //  Ticks aren't the only parasites living off patients in borreliosis-prone areas
 +</blockquote>
 +
 +While there is general agreement on the optimal treatment for early Lyme disease, there is considerable controversy over the existence, prevalence, diagnostic criteria, and treatment of chronic Lyme disease.
 +
 +Over the past decade, two opposing camps have emerged in the battle over Lyme. One camp is represented by the International Lyme and Associated Diseases Society (ILADS), which argues that Lyme disease is not rare because its spread is facilitated by rodents, deer and birds, and can be found in an unpredictable distribution around the world accompanied by other tick-borne coinfections that may complicate the clinical presentation. According to the ILADS, tick bites often go unnoticed and commercial laboratory testing for Lyme disease is inaccurate. Consequently, the disease is often not recognized and may persist in a large number of patients, requiring prolonged antibiotic therapy to eradicate persistent infection with the evasive Lyme spirochete.(({{pubmed>long:19072179}}))
 +
 +The opposing camp is represented by the Infectious Diseases Society of America (IDSA), which maintains that Lyme disease is a rare illness localized to well-defined areas of the world. According to the IDSA, the disease is "hard to catch and easy to cure" because the infection is rarely encountered, easily diagnosed in its early stage by distinctive clinical features and in more advanced stages by accurate commercial laboratory tests, and effectively treated with a short course of antibiotics over 2-4 weeks. Chronic infection with the Lyme spirochete, //Borrelia burgdorferi//, is rare or nonexistent, and the concept of chronic Lyme disease rests on "faith-based" opinion rather than "evidence-based" science.(({{pubmed>long:19072179}}))
 +
 +This mainstream view is exemplified by a 2007 review in the //New England Journal of Medicine//, which noted the diagnosis of chronic Lyme disease is used by a few physicians despite a lack of "reproducible or convincing scientific evidence", leading the authors to describe this diagnosis as "the latest in a series of syndromes that have been postulated in an attempt to attribute medically unexplained symptoms to particular infections."(({{pubmed>long:17914043}})) 
 +
 +<blockquote>Chronic Lyme disease is the most recent in a continuing series of "medically unexplained symptoms" syndromes. These syndromes, such as fibromyalgia, chronic fatigue syndrome, and multiple chemical sensitivity, meet the need for a societally and morally acceptable explanation for ill-defined symptoms in the absence of objective physical and laboratory findings. We describe factors involved in the psychopathogenesis of chronic Lyme disease and focus on the confusion and insecurity these patients feel, which gives rise to an inability to adequately formulate and articulate their health concerns and to deal adequately with their medical needs, a state of disorganization termed aporia.
 +
 +//**L.H. Sigal**// (({{pubmed>long:12194894}})) </blockquote>
 +
 +Groups of patients, patient advocates, and the small number of physicians who support the concept of chronic Lyme disease have organized to lobby for recognition of this diagnosis, as well as to argue for insurance coverage of long-term antibiotic therapy, which most insurers deny, as it is at odds with the guidelines of the major medical organizations. 
 +
 +The term "Lyme-literate medical doctor" or LLMD has been coined to describe physicians who acknowledge the existence of chronic Lyme disease an infectious condition and are willing to treat it with antimicrobial therapies. LLMDs generally operate outside the mainstream of medicine. A number have been brought up before medical board reviews and been the subject of patient lawsuits.
 +
 +The net result of this controversy is that many doctors [[https://www.ama-assn.org/amednews/2008/06/09/hlsa0609.htm|try to avoid]] having Lyme patients in their practice.
 +
 +
 +==== Treatments sometimes used by those not on MP ====
 +
 +  * **[[home:othertreatments:colloidal_silver|colloidal silver]]** – While colloidal silver is marketed for internal and external use as an alternative medical remedy, there is no scientific evidence of its effectiveness in vivo for any medical condition. Also, it can [[https://www.quackwatch.org/01QuackeryRelatedTopics/PhonyAds/silverad.html|permanently turn]] your skin silver.
 +  * **hydrogen peroxide** – Delivered intravenously. The theory is that hydrogen peroxide releases extra oxygen inside the body, killing microbes. This [[https://www.cbsnews.com/stories/2005/01/12/60II/main666489.shtml|dangerous therapy]] is based on an overly simplistic view of the body's metabolism. There are no large-scale studies proving hydrogen peroxide is effective.
 +  * **[[home:othertreatments:rife|Rife]]** – There is no scientific evidence that the use of a Rife device has the intended effect on infectious bacteria. Instead, most patients using Rife are likely administering themselves nothing more than an expensive placebo.
 +
 +Selective Essential Oils from Spice or Culinary Herbs Have High Activity against Stationary Phase and Biofilm Borrelia burgdorferi. Some highly active essential oils were found to have excellent anti-biofilm ability  (({{pubmed>long:    29075628}}))
 +
 +=== Disulfiram ===
 +
 +[[https://www.lymedisease.org/disulfiram-kinderlehrer/?fbclid=IwAR2CQcqG97LK_qsGh1QZD37VrD2oQecR70cZKyXlidgdMIyGOWcPgKdLAWA|Activity of disulfiram]]
 +
 +[[https://www.mdpi.com/2079-6382/8/2/72/htm?fbclid=IwAR3l19rcHXqfvUcYXUqlk9F18kZqwGX_QsiJPdgfPrIUYe15SUAAGKltfTo|Three cases]]
 +
 +[[https://clinicaltrials.gov/ct2/show/NCT03891667|Study to examine the safety of disulfiram among patients with post-treatment Lyme disease Sx]]
 +
 +Screening to identify potent candidate drugs that can target the Borrelia persisters.(({{pubmed>long:27103785}}))
 +
 +Not suitable for children (({{pubmed>long:6470872}})), (({{pubmed>long:9093309}}))
 +
 +may be possible for some adolescents (({{pubmed>long:27613346}}))
 +
 +===   ===
 +
 +<blockquote>My doc just prescribed this for me but with a big warning to ramp VERY slowly due to immunopathology, IP/ Herx can be powerful.
 +I have not filled the script yet but will update my progress thread if/ when I embark on this method.</blockquote>
 +
 +=== Antibiotic treatments ===
 +<mainarticle>  [[home:othertreatments:antibacterials:highdose|High-dose antibiotic therapies]]</article>
 +One of the reasons why chronic Lyme disease is so contentious is that advocates for it strongly believe in the value of high-dose antibiotic therapies, any treatment which uses antibiotics at a large enough dose that the immune response is suppressed more than it is not. High-dose antibiotics are ineffective, and this is well-reflected in the published literature. The short-term improvement and long-term crash some patients feel on high-dose antibiotics is due to the fact these drugs interfere with immune activity in dose dependent fashion. With a weakened inflammatory response, a patient's symptoms may temporarily improve, but not because the pathogenic bacteria which drive disease have been eradicated. As a result, these protocols do not generate sustained immunopathology.
 +
 +
 +== Doxycycline ==
 +<mainarticle> [[home:othertreatments:antibacterials:doxycycline|Doxycycline]]</article>
 +
 +Although the MP antibiotic minocycline is also a tetracycline, doxycycline and minocycline are significantly different from each other – both in terms of structure and function. Doxycycline's effectiveness over short periods of time is due in part to the relatively high doses at which it is typically administered: 200 mg per day. Doxycycline does not kill as wide a range of bacteria as minocycline. For example, doxycycline doesn't kill //Staphylococcus//, a genus found in at least three recent studies in which the human microbiome was sequenced.
 +
 +
 +== Cephlasporins including Rocephin ==
 +<mainarticle> [[home:othertreatments:antibacterials:betalactams|Beta-lactam antibiotics]]</article>
 +{{section>:home:othertreatments:antibacterials:betalactams#cephalosporins&noheader&firstseconly}}
 +
 +== Multiple ABx ==
 +
 +[[https://www.discoverymedicine.com/Jie-Feng/2019/03/persister-biofilm-microcolony-borrelia-burgdorferi-causes-severe-lyme-arthritis-in-mouse-model/|persistent disease: compared efficacy of 2-drug and 3-drug combination]]
 +
 +Those affected by persistent Lyme disease, who are unable to follow the Marshall Protocol, could ask a medical practitioner about use of **3** antibiotic drugs in combination, as single drugs and 2-drug combinations appear to be ineffective with some PTLDS Borrelia biofilm.
 +
 + the combination of different antiborrelial agents with synergistic effect seems to be a meaningful alternative and should be included in future studies in vitro as well as in vivo.(({{pubmed>long:    12073540}}))
 +
 +Borrelia burgdorferi persisters in vitro: eradication achieved by using daptomycin, cefoperazone and doxycycline.  (({{pubmed>long:    25806811}}))
 +
 +Sulpha drugs and their combinations(({{pubmed>long:28327498}}))
  
 {{tag>diseases}} {{tag>diseases}}
 ===== Notes and comments ===== ===== Notes and comments =====
 +
 +https://www.ncbi.nlm.nih.gov/pubmed/?term=%22three+drug+combination%22
 +
  
 //broken link removed// //broken link removed//
-Lyme patients [[http://www.topix.net/forum/health/lyme-disease/TLR5VKTCM71F9PEAP|commiserate]] with one another over feeling worse after taking vitamin D. +Lyme patients [[https://www.topix.net/forum/health/lyme-disease/TLR5VKTCM71F9PEAP|commiserate]] with one another over feeling worse after taking vitamin D. 
    
  
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 <blockquote> <blockquote>
-Antibodies linked to long-term Lyme symptoms: Some patients with Lyme disease still show symptoms long after the... http://bit.ly/qbAFjv+Antibodies linked to long-term Lyme symptoms: Some patients with Lyme disease still show symptoms long after the... https://bit.ly/qbAFjv
  
 From: Frenchie From: Frenchie
 Date: 2011-08-09 07:08:55 Date: 2011-08-09 07:08:55
-Reply: http://www.marshallprotocol.com/reply.php?topic_id=13346+Reply: https://www.marshallprotocol.com/reply.php?topic_id=13346
  
 Now Armin Alaedini at Weill Cornell Medical College in New York and  his colleagues have found that patients diagnosed with post-Lyme disease  syndrome have antibodies that suggest they carried the infection for an  unusually long time. The finding, published in  Clinical Immunology1, might help the syndrome to be better understood, diagnosed and treated. Now Armin Alaedini at Weill Cornell Medical College in New York and  his colleagues have found that patients diagnosed with post-Lyme disease  syndrome have antibodies that suggest they carried the infection for an  unusually long time. The finding, published in  Clinical Immunology1, might help the syndrome to be better understood, diagnosed and treated.
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 This finding suggests that patients with chronic symptoms have  experienced a prolonged infection, caused by microbes that have evaded  the immune system by varying the epitopes they carry. As a result of  these variations, the body makes new antibodies targeting the modified  protein. The longer the microbe manages to keep changing, the more  diverse its host's antibodies become. This finding suggests that patients with chronic symptoms have  experienced a prolonged infection, caused by microbes that have evaded  the immune system by varying the epitopes they carry. As a result of  these variations, the body makes new antibodies targeting the modified  protein. The longer the microbe manages to keep changing, the more  diverse its host's antibodies become.
  
-http://www.nature.com/news/2011/110805/full/news.2011.463.html#B1+https://www.nature.com/news/2011/110805/full/news.2011.463.html#B1
  
  
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 From: Dr Trevor Marshall From: Dr Trevor Marshall
 Date: 2011-08-09 07:16:27 Date: 2011-08-09 07:16:27
-Reply: http://www.marshallprotocol.com/reply.php?topic_id=13346+Reply: https://www.marshallprotocol.com/reply.php?topic_id=13346
  
 The group at Weill Cornell did not consider the possibility that their testing procedures might be confused by the thousands of other species present along with the Borrelia. I read this report, and although not junk science, it is of little practical use until their procedures become more precise, IMO. They really don't have much of a clue. The group at Weill Cornell did not consider the possibility that their testing procedures might be confused by the thousands of other species present along with the Borrelia. I read this report, and although not junk science, it is of little practical use until their procedures become more precise, IMO. They really don't have much of a clue.
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 |**Timing**  |Occurs days to weeks after the bite of an infected tick.   |By some, thought to occur months to years after initial infection.  | |**Timing**  |Occurs days to weeks after the bite of an infected tick.   |By some, thought to occur months to years after initial infection.  |
 |**Conventional explanation for cause**  |A tick-borne disease, caused by at least three species of bacteria belonging to the genus //Borrelia//    |Variable and highly controversial. Some argue chronic Lyme is [[#psychosomatic_explanations_for_disease|psychosomatic]].         | |**Conventional explanation for cause**  |A tick-borne disease, caused by at least three species of bacteria belonging to the genus //Borrelia//    |Variable and highly controversial. Some argue chronic Lyme is [[#psychosomatic_explanations_for_disease|psychosomatic]].         |
-|**Laboratory tests**   |A two-tiered protocol is recommended by the CDC for evaluation of the presence of //Borrelia//: the sensitive ELISA test is performed first, and if it is positive or equivocal, then the more specific Western blot is run.   |Variety of (expensive) tests, none of which are widely accepted by the vast majority of mainstream researchers or physicians. The CDC and FDA [[http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5405a6.htm|issued a warning]] about “commercial laboratories that conduct testing for Lyme disease by using assays whose accuracy and clinical usefulness have not been adequately established.       |+|**Laboratory tests**   |A two-tiered protocol is recommended by the CDC for evaluation of the presence of //Borrelia//: the sensitive ELISA test is performed first, and if it is positive or equivocal, then the more specific Western blot is run.   |Variety of (expensive) tests, none of which are widely accepted by the vast majority of mainstream researchers or physicians. The CDC and FDA [[https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5405a6.htm|issued a warning]] about “commercial laboratories that conduct testing for Lyme disease by using assays whose accuracy and clinical usefulness have not been adequately established.       |
 |**Diagnosis**   |Diagnosed clinically based on symptoms, objective physical findings – such as erythema migrans (bulls eye rash), facial palsy or arthritis – or a history of possible exposure to infected ticks, as well as blood tests. Living in a tick-endemic area increases the likelihood of a Lyme diagnosis.    |For those with a negative test for //Borrelia//, getting a diagnosis of chronic Lyme depends largely on whether the doctor is "Lyme literate", that is if he/she even acknowledges the existence of chronic Lyme.  | |**Diagnosis**   |Diagnosed clinically based on symptoms, objective physical findings – such as erythema migrans (bulls eye rash), facial palsy or arthritis – or a history of possible exposure to infected ticks, as well as blood tests. Living in a tick-endemic area increases the likelihood of a Lyme diagnosis.    |For those with a negative test for //Borrelia//, getting a diagnosis of chronic Lyme depends largely on whether the doctor is "Lyme literate", that is if he/she even acknowledges the existence of chronic Lyme.  |
 |**Controversy over legitimacy of diagnosis**    |Some disagreement over validity of tests, but controversy is relatively minimal.       |Diagnosis is most controversially applied to patients with nonspecific symptoms (e.g., fatigue), who show no objective evidence they have been infected with Lyme disease in the past, since the standard diagnostic tests for infection are negative. Most physicians [[#chronic_controversy_over_chronic_lyme_disease|do not accept]] chronic Lyme as a legitimate diagnosis.       | |**Controversy over legitimacy of diagnosis**    |Some disagreement over validity of tests, but controversy is relatively minimal.       |Diagnosis is most controversially applied to patients with nonspecific symptoms (e.g., fatigue), who show no objective evidence they have been infected with Lyme disease in the past, since the standard diagnostic tests for infection are negative. Most physicians [[#chronic_controversy_over_chronic_lyme_disease|do not accept]] chronic Lyme as a legitimate diagnosis.       |
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 <blockquote>Oct. 7, 2005: The problem is actually a lot more complex than it seems. The genome of Borrelia has about 40% of its genes on mobile plasmids, and not on the primary chromosome. So (arguably) there could be hundreds of different versions of B.burgdorferi out there. <blockquote>Oct. 7, 2005: The problem is actually a lot more complex than it seems. The genome of Borrelia has about 40% of its genes on mobile plasmids, and not on the primary chromosome. So (arguably) there could be hundreds of different versions of B.burgdorferi out there.
  
-If you look at the master genome list at [[http://www.ncbi.nlm.nih.gov/genomes/lproks.cgi|820 Complete Microbial Genomes]] you will find only two Borrelia species fully sequenced. One was sequenced by TIGR and one from Germany. Look at the sizes - 1.52 vs 0.99. This is because the Germans are only reporting the Chromosome and 2 plasmids, while TIGR is reporting chromosome and 21 plasmids.+If you look at the master genome list at [[https://www.ncbi.nlm.nih.gov/genomes/lproks.cgi|820 Complete Microbial Genomes]] you will find only two Borrelia species fully sequenced. One was sequenced by TIGR and one from Germany. Look at the sizes - 1.52 vs 0.99. This is because the Germans are only reporting the Chromosome and 2 plasmids, while TIGR is reporting chromosome and 21 plasmids.
  
 Unfortunately the Borrelia genome has proven too complex for many of our institutions to fully assimilate, and this is an excellent example. Both groups are correct, but they are looking at the species in different ways. Unfortunately the Borrelia genome has proven too complex for many of our institutions to fully assimilate, and this is an excellent example. Both groups are correct, but they are looking at the species in different ways.
  
 A similar situation exists within the Mycoplasma species. Look for example, at this species comparison: A similar situation exists within the Mycoplasma species. Look for example, at this species comparison:
-[[http://www.zmbh.uni-heidelberg.de/M_pneumoniae/genome/MP_MG_Comp.GIF|Gene map of the Mycoplasma pneumoniae genome]]+[[https://www.zmbh.uni-heidelberg.de/M_pneumoniae/genome/MP_MG_Comp.GIF|Gene map of the Mycoplasma pneumoniae genome]]
  
 The rapid pace of advance in science's knowledge of the genome has left 99.9% of our infectious diseases specialists behind. It will take a new generation to come along who can understand the new genomic tools. The rapid pace of advance in science's knowledge of the genome has left 99.9% of our infectious diseases specialists behind. It will take a new generation to come along who can understand the new genomic tools.
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 Trevor Trevor
 </blockquote> </blockquote>
 +
 +==== Treatments sometimes used by those not on MP ====
 +
 +  * **[[home:othertreatments:colloidal_silver|colloidal silver]]** – While colloidal silver is marketed for internal and external use as an alternative medical remedy, there is no scientific evidence of its effectiveness in vivo for any medical condition. Also, it can [[https://www.quackwatch.org/01QuackeryRelatedTopics/PhonyAds/silverad.html|permanently turn]] your skin silver.
 +  * **hydrogen peroxide** – Delivered intravenously. The theory is that hydrogen peroxide releases extra oxygen inside the body, killing microbes. This [[https://www.cbsnews.com/stories/2005/01/12/60II/main666489.shtml|dangerous therapy]] is based on an overly simplistic view of the body's metabolism. There are no large-scale studies proving hydrogen peroxide is effective.
 +  * **[[home:othertreatments:rife|Rife]]** – There is no scientific evidence that the use of a Rife device has the intended effect on infectious bacteria. Instead, most patients using Rife are likely administering themselves nothing more than an expensive placebo.
 +
 +Selective Essential Oils from Spice or Culinary Herbs Have High Activity against Stationary Phase and Biofilm Borrelia burgdorferi. Some highly active essential oils were found to have excellent anti-biofilm ability  (({{pubmed>long:    29075628}}))
 +
 +=== Disulfiram ===
 +
 +[[https://www.lymedisease.org/disulfiram-kinderlehrer/?fbclid=IwAR2CQcqG97LK_qsGh1QZD37VrD2oQecR70cZKyXlidgdMIyGOWcPgKdLAWA|Activity of disulfiram]]
 +
 +[[https://www.mdpi.com/2079-6382/8/2/72/htm?fbclid=IwAR3l19rcHXqfvUcYXUqlk9F18kZqwGX_QsiJPdgfPrIUYe15SUAAGKltfTo|Three cases]]
 +
 +[[https://clinicaltrials.gov/ct2/show/NCT03891667|Study to examine the safety of disulfiram among patients with post-treatment Lyme disease Sx]]
 +
 +Screening to identify potent candidate drugs that can target the Borrelia persisters.(({{pubmed>long:27103785}}))
 +
 +Not suitable for children (({{pubmed>long:6470872}})), (({{pubmed>long:9093309}}))
 +
 +May be for adolescents (({{pubmed>long:27613346}}))
 +
 +===   ===
 +
 +<blockquote>My doc just prescribed this for me but with a big warning to ramp VERY slowly due to immunopathology, IP/ Herx can be powerful.
 +I have not filled the script yet but will update my progress thread if/ when I embark on this method.</blockquote>
 +
 +=== Antibiotic treatments ===
 +<mainarticle>  [[home:othertreatments:antibacterials:highdose|High-dose antibiotic therapies]]</article>
 +One of the reasons why chronic Lyme disease is so contentious is that advocates for it strongly believe in the value of high-dose antibiotic therapies, any treatment which uses antibiotics at a large enough dose that the immune response is suppressed more than it is not. High-dose antibiotics are ineffective, and this is well-reflected in the published literature. The short-term improvement and long-term crash some patients feel on high-dose antibiotics is due to the fact these drugs interfere with immune activity in dose dependent fashion. With a weakened inflammatory response, a patient's symptoms may temporarily improve, but not because the pathogenic bacteria which drive disease have been eradicated. As a result, these protocols do not generate sustained immunopathology.
 +
 +
 +== Doxycycline ==
 +<mainarticle> [[home:othertreatments:antibacterials:doxycycline|Doxycycline]]</article>
 +
 +Although the MP antibiotic minocycline is also a tetracycline, doxycycline and minocycline are significantly different from each other – both in terms of structure and function. Doxycycline's effectiveness over short periods of time is due in part to the relatively high doses at which it is typically administered: 200 mg per day. Doxycycline does not kill as wide a range of bacteria as minocycline. For example, doxycycline doesn't kill //Staphylococcus//, a genus found in at least three recent studies in which the human microbiome was sequenced.
 +
 +
 +== Cephlasporins including Rocephin ==
 +<mainarticle> [[home:othertreatments:antibacterials:betalactams|Beta-lactam antibiotics]]</article>
 +{{section>:home:othertreatments:antibacterials:betalactams#cephalosporins&noheader&firstseconly}}
 +
 +== Multiple Antibiotics ==
 +
 +[[https://www.discoverymedicine.com/Jie-Feng/2019/03/persister-biofilm-microcolony-borrelia-burgdorferi-causes-severe-lyme-arthritis-in-mouse-model/|persistent disease: compared efficacy of 2-drug and 3-drug combination]]
 +
 +Those affected by persistent Lyme disease, who are unable to follow the Marshall Protocol, could ask a medical practitioner about use of **3** antibiotic drugs in combination
 +
 + the combination of different antiborrelial agents with synergistic effect seems to be a meaningful alternative and should be included in future studies in vitro as well as in vivo.(({{pubmed>long:    12073540}}))
 +
 +Borrelia burgdorferi persisters in vitro: eradication achieved by using daptomycin, cefoperazone and doxycycline.  (({{pubmed>long:    25806811}}))
 +
 +Sulpha drugs and their combinations(({{pubmed>long:28327498}}))
  
 ===== References ===== ===== References =====
 +
home/diseases/lyme.txt · Last modified: 09.14.2022 by 127.0.0.1
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