The Lyme-Autism Connection
Nicola McFadzean, N.D. www.drnicola.com
Lyme Disease
What is it? • A disease caused by a spirochete bacterium called Borrelia burgdorferi • Ticks, mosquitos, lice etc transmit the disease to humans and other animals by biting them • Chronic Lyme Disease manifests as a multisystem inflammatory disease that initially affects the skin and then spreads to the joints, nervous system and possibly other organ systems
Differentiation between acute and chronic Lyme disease
• The acute phase of Lyme disease involves a tick-bite, followed by an expanding rash (erythema migrans) that may resemble a bull's eye. • Rash persists 3 to 5 weeks after disease transmission • Around the time that the rash appears other mild symptoms may be noted: joint pains, chills, fever and fatigue. • Acute Lyme infection may be treated effectively with short term antibiotic therapy if caught early
But …
Many acute infections are not caught, and progress to chronic Lyme disease (35-50%) Less than 50% of chronic Lyme sufferers actually recollect a tick bite; 30-40% show any kind of rash; <10% have classic bull’s eye rash Lyme disease is way more common than we think New England is not the only region affected – California, the Pacific Northwest, and Texas are all Lyme centers
How does this relate to autism?
It is believed that up to 90% of ASD kids may have Lyme disease (per verbal communication with 5 DAN doctors around the U.S.) A study is currently underway to assess the prevalence of Lyme in ASD kids versus neurotypical kids (controls).
It is now thought that Lyme can be transmitted via sexual contact or in utero Pregnant women can pass Lyme disease on to their children
More awareness of the connection Lyme-Induced Autism Foundation at the forefront of education, research and awareness building. Lyme-Autism Yahoo Group has >250 members.
Symptoms • Pain (muscle and joint), fatigue and sleep disturbance are primary symptoms • Headaches and migraines • Sensitivity to chemicals, foods, medications • Neurological symptoms: numbness and tingling of extremities, burning pain, cognitive changes • Behavioral changes • Depression and anxiety
Other symptoms & associated syndromes
• Irritable bowel/ bladder • Restless legs syndrome • Impaired memory & concentration • Skin sensitivities & rashes • Dry eyes & mouth • • • • • • Ringing in the ears Dizziness Vision problems Raynaud's syndrome Impaired coordination Motor neuron impairment • Cardiac problems
Manifestation of Lyme disease in ASD kids – • Emphasis on neurological symptoms • Behavioral issues may be secondary to impact of Borrelia on central nervous system • Immune impairment (cause or effect?) • Hypersensitivity
• Lyme disease is known as the great mimicker • It can produce severe symptoms which may resemble multiple sclerosis, fibromyalgia, chronic fatigue syndrome, lupus, Parkinsonism, rheumatoid arthritis, multiple chemical sensitivity syndrome, autistic-spectrum disorders, psychiatric disorders such as depression and anxiety, Alzheimer's, and/or many more.
And to confuse matters further …
Coinfections – • Along with the B. burgdorferi, there are other parasites and spirochetes that tend to be present in Lyme patients – including Babesia (parasite), Bartonella and Erlichia (spirochetes) • These co-infections compound the symptom picture of Lyme disease
Diagnosis of Lyme Disease
• The Good News: there are tests that can detect Lyme Disease • The Bad News: because the Lyme “bugs” disable the immune system, many tests that rely on an immune response for a positive result will show up negative
Three ways to try and outsmart Borrelia 1. Use different methods of testing to maximize chances of catching it if it is there 2. Use an immune boosting agent prior to testing to stimulate the immune system and eradicate some of the bugs that might be suppressing it. One such natural agent is Samento (more on this later) 3. Use a specialist lab for Lyme testing such as IGeneX
Initial Lyme panel Western Blots – IgG/ IgM – • IgG shows longer term/ chronic exposure, IgM is more recent or active exposure • Western Blot testing more effective than ELISA antibody testing – looks for “bands” that are specific for Borrelia
• IgM Western blot requires at least 2 double-starred bands to be considered positive • NYS/ CDC criteria – 23-25, 39, 41. • IGeneX criteria – 23-25, 31, 34, 39, 41, 83-93. • All bands specific for Lyme except 41 – on it’s own cannot be used for diagnosis of Lyme (only 60% specificity) - general marker for spirochetes, may also be triggered by virus. • Any one of above bands is a red flag for Lyme; once 2 bands present, have >95% specificity (ref: IGeneX). • Early disease – 23-25, 39. • Late disease – 31, 34, 83-93 .
• IgG – needs 5 bands to be present – 18, 23-25, 28, 30, 39, 41, 58, 66, 83-93 (NYS/CDC criteria).
IFA – Immunofluorescence Assay – • New addition to IGeneX panel • Highly sensitive (98%)/ 60% specific • Always run viral panel also – HSV-1&2, HHV-6, EBV, CMV. • Use in conjunction with Western Blot.
PCR testing – • Looks for actual DNA of spirochete. • Highly specific, but not very sensitive (20%) • Can test body fluids (blood, CSF, synovial fluid) or tissues (biopsy) • IGeneX will also test ticks themselves
The bottom line – • Diagnosis should not be made on laboratory tests alone • Testing must be interpreted in conjunction with clinical picture • Negative testing does not necessarily rule out Lyme disease • Follow up testing for co-infections may be necessary
Lyme Treatment Options
Three Options
1. Short term antibiotics – • 3-4 weeks regardless of duration of illness • Supported by Infectious Disease Society of America (IDSA) who published guidelines to this effect • My opinion: even though 3-4 weeks of ABX may be effective in acute Lyme, it will not be sufficient for chronic or late Lyme disease.
2. Long-term antibiotics • Supported by International Lyme and Asssociated Disease Society (ILADS) • May require 6-24 months of antibiotics • Risk/ benefit assessment (side effects etc) • May be necessary for chronically ill adults • My opinion: not appropriate for ASD kids because of developing neurological systems, lack of full understanding of long term effects of medications, and yeast problems
3. Natural/ non-medication protocols • Supported more by the integrative/ alternative medical community • More holistic approach – fits with biomedical autism treatment • Limited research as to efficacy • Fewer side effects and long term problems • My opinion: the best option for autistic kids with Lyme
Natural Treatments for Lyme
Goals of Treatment
1. Anti-microbial therapy to eradicate the pathogens 2. Immune support 3. Support affected organs and systems 4. Alleviate symptoms
Areas to address
1. Primary infection - Bb spirochete 2. Co-infections – erlichia, bartonella, babesia etc 3. Nutritional deficiencies 4. General detoxification 5. Immune dysfunction - neutropenia 6. Systemic inflammation and pain 7. GI infections – parasites, 8. Gluten & casein intolerance/ food sensitivities 9. Viral infections - herpes, EBV, CMV, HHV-6, measles 10. Yeast overgrowth - candidiasis 11. Heavy metal toxicity 12. Mold toxicity 13. Sleep issues 14. Imbalance in brain chemistry/ neurotransmitters
• Most of these areas (3-14) are being addressed in biomedical treatments for autism anyway.
Antimicrobial treatments
1. 2. 3. 4. Cowden protocol Buhner protocol Zhang protocol Other treatment ideas
Cowden’s Protocol
Samento • One of most promising herbs for treatment of chronic Lyme disease • Good for Borrelia and some co-infections but not Babesia • Used pre-testing as will kill off bugs as well as stimulate immune system - 15 drops twice daily for at least 3 weeks (adult dose); 5 drops 2-3x daily (kids dose) • If Lyme spirochetes present, this dose could stimulate major die-off reaction, so start slowly!!
Cowden cont’d • Burbur – safe herb, good support for detox and herx reactions. Can dose quite aggressively. Adult dose – 8 drops 3x daily and before bed. • Cumanda – works well with Samento. Anti-bacterial, anti-fungal, anti-inflammatory and immune supportive. Adult dose – 20 drops twice daily. • Noni – good for babesia and virus. Make sure to dose at least 30 minutes apart from Samento. Adult dose 5-15 drops per day.
Buhner’s Protocol
CORE PROTOCOL
• Andrographis – antispirochete (crosses blood-brain barrier), antiinflammatory, enhances immune function, protects heart muscle, enhances liver function. Adult dose – 1-4 x 400mg caps, 3-4 times daily. • Polygonum (Japanese knotweed) - antibacterial, anti-inflammatory (specific for auto-immune inflammation) , immune-neural-liver support, reduces herx. Good for Bartonella and Erlichia (coinfections). Contains Resveratrol (good antioxidant). Increases blood flow to heart, eyes, skin and joints so helps move other herbs and medications into hard to reach areas to kill spirochetes. Adult dose – 1-4 x 500mg tablets 3-4 times daily. • Uncaria Tomentosa (Cat’s Claw) – anti-inflammatory, immuneneural-cognitive support, helps arthritis and muscle pain, increases CD57 counts.
Adjunct herbs (Buhner) • Sarsaparilla – binds endotoxins in blood stream so good for detox and reducing herx reactions. Also lessens auto-immune reactions, neuroprotective, lessens arthritic inflammation. • Astragalus – immune modulator, safe for long term use; balances CD4/CD8 counts (higher CD4 beneficial for treatment response) ie enhances Th1 response. Helps energy levels. Not indicated for late stage Lyme where Th1 tends to be dominant. • Stephania – Bell’s palsy, arthritis, ocular or neural involvement. Reduces inflammatory cytokines in the brain.
Zhang Protocol (TCM)
First line protocol (all adult doses listed) – Allicin Capsule – 2 three times daily. Active ingredient of garlic which has broad spectrum anti-microbial activity (bacteria, fungus, protozoa, mycobacteria, virus), also immune supportive. Believes odorless forms ineffective. HH Capsule – 1 three times daily. From Houttuynia cordata. Broad anti-microbial activity, also anti-inflammatory and immune enhancing. Circulation P Capsule – 1 cap three times daily. Contains angelica, rehmannia, bupleurum, glycyrrhiza and others. Used to enhance microcirculation and reduce inflammation, and normalize liver function.
Zhang (cont’d)
Second line protocol – Coptis Capsule - used to treat bacterial infections, gall bladder problems and helps regulate blood sugar. R-5081 – contains smilax, coptis, polygonum, scutellaria and others. Alternative formula with anti-spirochete, anti-bacterial and anti-inflammatory herbs.
Zhang (cont’d)
Other herbs – • Cordyceps – specific for fatigue. • Puerarin – specific for cognition problems, problems with memory, concentration etc.
Other Herbs • Artemisinin – active constituent of Artemesia (Wormwood). Most effective against Babesia. Also helps balance microbiology of the gut. May induce detox reactions. Burst therapy good (4 days on, 10 days off). Adult dose – 400mg 3x daily. • Grapefruit seed extract – good for cyst forms of Borrelia, also anti-fungal and balances gut flora.
• Garlic – antimicrobial, also antifungal and immune supportive. Allicillin liquid (NBN) is tasteless liquid without strong odor. • Berberine – constituent of herbs such as goldenseal, barberry, Oregon grape. Antibacterial.
Other immune enhancers – • Garlic • Echinacea • Elderberry extract • Olive leaf • Vitamin C • Astragalus • LDN • TF-LymPlus • Monolaurin (lauricidin)
Other Nutrient Support • L-Carnitine • Alpha lipoic acid • Vitamin C • Glutathione
Sample Lyme Protocol (adult doses)
Remedies selected on case-by-case basis
• • • • • • • • • • • • • • Samento (Nutramedix): 1-5 drops 3x daily Garlic (Pharmax or DFH): 2 caps 3x daily with meals. Para-Gard (Tyler) or Broad Spectrum Complex (Pharmax): 3 caps twice daily Artemisinin (ARG): 4 caps 3x daily Blue Heron (NF Formulas): 3 caps 2x daily. Ther-Biotic Complete (Klaire) or HLC Intensive: 1 cap twice daily. Mycopryl (Neesby): 1 cap 3x daily. NAC: 1 cap twice daily. Alpha-lipoic acid: 1 cap twice daily. Detox Factors (Tyler): 2 caps twice daily between meals. LDA Trace Mineral Complex (Klaire): 1 cap twice daily. Aqua Sel Liquid Selenium (Neesby): 12 drops daily over food. EPA/DHA (Metagenics): 2 daily. Echinacea Complex (Pharmax): 1 twice daily.
Salt and C Protocol
• Based on theory that Lyme is not just bacterial disease, but includes an infestation of microfilarial worms that live symbiotically with Borrelia burgdorferi bacteria. • To kill the worms, a dosage of 8-12 one gram tablets of salt (depending on body weight), and 12 1,000 mg tablets of vitamin C, are taken throughout the day (lower doses for children)
HBOT
• Promising treatment both in Lyme disease and autism. • Requires at least 2.4 atm to be effective (hard chambers only). • Requires 60 minute sessions, 1-2 daily, for 30-60 sessions.
Resources
Books – • Lyme Disease and Modern Chinese Medicine by Zhang, Q. • Healing Lyme by Stephen Harrold Buhner. Websites – www.reserchednutritionals.com (for Lyme-specific TF) http://www.samento.com.ec/sciencelib/medmain.html (info on Cowden protocol, Samento etc) www.lymeinducedautism.com http://www.fettnet.com/lymestrategies/welcome.htm (salt and C protocol)
Summary
• Many kids who present with autism may test positive for Lyme disease • Unless Lyme disease is identified as a causative factor, treatment of ASD will be limited • Diagnosis can be difficult because of limitations of testing, but using specialist labs and doing the preload with Samento will increase reliability of test results
Questions to be answered?
• How many ASD kids are positive for Lyme? • Has the immune impairment associated with ASD secondary to mercury toxicity etc allowed Borrelia to arise as an opportunistic infection, or has Borrelia created a compromised immune system that does not allow an individual to cope with toxic stressors of vaccinations and toxic living? • Do we ever really get rid of Borrelia or do we simply aim to render it dormant? Do we ever really get rid of autism or is it just well-managed?
• What are the best treatment protocols to address the microbial aspects of kids’ health concerns without resorting to antibiotics – protocols that will support their health and not create further side effects? • In 2 of the most politically divided health problems, how do we foster public awareness and acceptance?
Thank you!!
Nicola McFadzean, N.D. 3506 Curlew Street San Diego CA 92103 619-546-4065 www.drnicola.com