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Antibiotic Treatment for Lyme Disease

Written by Dr. Diane Mueller

Antibiotic Treatment for Lyme Disease is much more complicated than just using Doxycycline. In fact, use of doxycycline only can lead to problems as doxy will only address one of the three morphologies of Lyme Disease. (To understand morphologies in more detail please see our blog called Lyme Disease Treatment.)

Since Borrelia (the bacterium that causes Lyme Disease) is able to shift into different shapes, proper antibiotic treatment need to address all three shapes.  There often are multiple rashes present with Lyme Disease. The rash could present in one place or in many. 

Morphologies (shapes) of Borrelia: 

  • S (spiral form) 
  • L (intracellular form)
  • Cystic form
The S form is the form that is initially contracted for Borrelia. Drugs typically used for this stage include: omicef, ceftin, amoxicillin, bicillin, cedax, suprax, and biacin. Doxycycline is often given here. The trouble with doxycycline is that it can cause the Borrelia to morph into one of the other morphologies. Many people feel initially better with doxycycline use, but then find themselves relapsing later. See our blog called Lyme Disease Treatment Doxycycline for more information on this.
Antibiotic Treatment for Lyme Disease

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The L form: Antibiotics such as biaxin, azithromycin, doxy, minocycline, and cipro work well.

The cystic form: Use one of the following: laquenil, grapefruit seed extract, flagyl, tinidazole, metronidazole. Tinidazole tends to be the best tolerated. 

Typically, in order to use antibiotics well to treat Lyme, you will want to use one from all three morphological categories. Many doctors treat in different ways using antibiotics. Our recommendation is that if you go the antibiotic route, you will want to be on antibiotics for all three morphologies, but to add them one at a time.

We also recommend pulse therapy for antibiotics or herbs. Since Borrelia has an ability to move, to hide and to burrow into tissues, but taking breaks from antibiotics, we allow the Borrelia to come out of hiding so that the antibiotics can work better. An example of pulse therapy is three weeks on treatment, one week off and repeating many times.  When working with the cystic forms of borrelia, it is often best to pulse more frequently such as 5 days on 2 days off or 4 days on, and three days off.

Borrelia also has biofilms that can lead to its resistance to antibiotics. Giving a biofilm disruptor such as NAC or serrapeptase can help to eliminate the biofilms.

Also of note with working with antibiotics is the treatment of the coinfections. When insects bite, they do not selectively choose what infections they transfer. Most insects have more than one infection inside of them. Therefore, when you contract Lyme Disease, it is likely that you have not only been infected with Borrelia, but also with another infection carried by the insect. Just like with Borrelia, other infections can be treated by choice of antibiotics or herbal medicine. 

Other infections that are common to have with Borrelia: 

Bartonella: Typically treated with Azithromycin, rifampin, cipro, or clarithromycin. Methylene blue also works well. If you use methylene blue, make sure you have your doctor test you for a G6DP deficiency. This is needed to make sure that methylene blue is safe for you.

Babesia: Atovaquone or Plaquanil. + Azithromycin or Most of the time two drugs are warranted.

One of the reasons why we tend to use herbal medicine first before considering pharmaceutical options it that we have seen so many less rates of recurrence using herbal medicine. Some of this is likely due to the strong negative impact triple antibiotic therapy can have on our microbiome. By microbiome, we are not just talking about the good microorganisms of the gut, but the microbiome all over out body including our skin, gut, genitals, sinuses and more. Since our microbiome is such a huge component of regulating our immunity, disruption of the microbiome using triple antibiotic therapy can wreck people in other ways that can take years to recover from. It is our professional opinion that while sometimes antibiotics are essential, that it is worth trying herbs first as they work most of the time and do not cause the level of side effects that antimicrobial drugs cause. 

For more information on the topic of Lyme Disease Treatment See Our Blog Below:

Herxing is another thing that we need to talk about here. Herxing is a term used for the detoxification reactions that can come from Lyme Disease Treatment. When Borrelia dies, it releases toxins. If your body is subjected to more toxins than it can handle, the toxins will back up in your body. This is called a herxheimer reaction or herxing. While some people try to push through this, it is not recommended. Herxing causes an increase of inflammation and an increase of symptoms. It can actually slow down the treatment process and make your day to day life a lot worse. If you start to herx, it will feel either like the flu or like worsening of your symptom picture. Do not try to push through it. The best thing to do is to slow down the dosage of the antibiotics, add detoxification support and talk to your doctor about it!

The biggest take home message with antibiotics use and Lyme Disease is this: 

Make sure you are treating all three forms of Borrelia (even if you are treating early on)

  • Be sure that you are including a biofilm disruptor
  • Be sure that you are pulsing therapy.
  • Consider treatment of coinfections
  • Be careful about not herxing

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