Why antibiotics may not work for Lyme disease

Why antibiotics may not work for Lyme disease

For some, early treatment with antibiotics is effective. For others and for those in the late stages of infection, antibiotics may be ineffective for the following reasons:
- Borrelia burgdorferi, the bacteria that causes Lyme disease, has a corkscrew shape that allows it to bore deep into tissues and cartilage (including the brain and nervous system), safely out of reach of most antibiotics.
- Borrelia burgdorferi can give up its corkscrew shape and convert to a form that is able to live inside cells ("intracellular") where again, antibiotics have less reach.
Borrelia burgdorferi, along with other similar microbes, can form dormant cysts that are completely resistant to antibiotics; the harder you hit it, the more resistant it becomes.
- Borrelia burgdorferi is usually accompanied and aided by co-infections of other stealth microbes that also live inside cells.
Antibiotic resistance occurs at a high rate with these types of microbes. An antibiotic is one single chemical substance. Bacteria, such as Borrelia (and also its co-infections), respond slowly to antibiotics and have more time to develop resistance to the antibiotic. In other words, the longer they can hang on, the more likely they are to become completely antibiotic resistant. Using multiple antibiotics at once seems to accelerate this process and alternating antibiotics doesn't seem to help. Resistant bacteria become even more entrenched.

Antibiotics destroy the normal flora (friendly bacteria) in the gut and skin, causing bacterial imbalance and a host of other symptoms in the body. Most importantly, use of antibiotics suppresses immune function, which may present the greatest hurdle to recovery—you cannot get well without optimal immune function.

Borrelia burgdorferi can exist in biofilms, which are protected colonies of microbes that form on a surface (such as plaque on your teeth), but what role this plays in Lyme disease is controversial. The symptom profile of Lyme disease suggests that it is not a biofilm disease and that biofilms are not a big factor in overcoming Lyme.

Doctors Treating Lyme Disease

...he is treating the patient, not the disease.

Some doctors complain that patients who have never been definitively diagnosed with the disease demand treatment for chronic Lyme disease. Other doctors contend that it is rare for a patient with Lyme disease to only suffer from one singular infection as ticks often carry and can infect us with several pathogens at once. In addition, there is not one "Lyme Disease." There are five sub species of Borrelia burgdorferi. Of these subspecies, there are more than 100 strains in the U.S. and 300 worldwide. And many of them are now antibiotic resistant. Even the worst infections may not test positive for Borrelia burdorferi. They may not test positive until initial treatment has occurred, a situation called the Lyme Paradox.

Dr. Richard Horowitz, of Hyde Park, New York, is one of the most sought after Lyme specialists. He states that at least half of his patients are infected with babesiosis. Rather than a bacteria, babesiosis is a microscopic parasite that infects red blood cells. Since most of his patients present with multiple infections and an overwhelmed immune system, he focuses on strengthening the immune system, knowing that he is treating the patient, not the disease.

Patients who are not lucky enough to see a doctor as knowledgeable as Dr. Horowitz often get caught in the crossfire that occurs when doctors are faced with limited understanding of a pathogen, a complicated infectious process, and a treatment modality that does not work the same for every patient. Stories abound of doctors accusing Lyme sufferers of being hypochondriacs or malingerers when they are experiencing very real, debilitating, painful symptoms. Read more