Lyme Disease Treatment
What is Lyme Disease?
Lyme borreliosis (also known as Lyme disease, neuroborreliosis) is a condition typically caused by an infection with Borrelia burgdorferi, bacteria from the family of spirochetes.
The pathogens are usually transmitted through tick bites (not tick bites!). However, it is not ruled out that other blood-sucking insects may also contribute to the spread. Transmission from person to person is considered unlikely.
Lyme disease occurs in almost all forested and plant-covered areas of Europe and North America, but also in countries like Australia and Asia.
The prevalence of Borrelia in tick populations varies greatly by region. Up to 30 percent of ticks can be affected. According to studies in Germany and Switzerland, about 2.6 to 5.6 percent of people developed antibodies indicating Lyme disease after a tick bite. A small proportion, approximately 0.3 to 1.4 percent, exhibited typical Lyme disease symptoms.
Most infections in this region occur in early summer. Since ticks become active at temperatures above 6 degrees Celsius, you should be cautious during walks from April to October. Long before a Lyme disease treatment is needed, you can take precautions. Wear long, light-colored clothing on which the crawling creatures are easy to spot, and check yourself and your pets for ticks after walks. If you find a tick, you should remove it correctly and immediately.
The incubation period for Lyme disease averages between 7 and 10 days. About half of those affected develop a characteristic rash, also known as “erythema migrans”. However, there are individuals who do not show any erythema migrans. In such cases, the symptoms of the disease are more flu-like, including fatigue, swollen lymph nodes, and fever.
A Lyme disease infection can also manifest weeks, months, or even years later. It may present through skin changes (acrodermatitis chronica atrophicans), painful joint inflammations, or neurological signs of Lyme disease, such as pain or paralysis. You should seek treatment or therapy for Lyme disease promptly upon recognition.
Do you suffer from Lyme disease?
Hemoperfusion is a blood purification method used for inflammatory conditions such as Lyme disease. Feel free to contact us for more information about potential Lyme disease treatments or therapies.
Lyme Disease Symptoms and Progression
The progression of Lyme disease is traditionally divided into three stages (Stage I-III). However, since the disease often does not follow the sequential order of these stages, this classification is becoming increasingly theoretical.
Stages I-II
About half of the infections in Europe are asymptomatic, meaning without erythema migrans (the bull’s-eye rash) as an early symptom. The most common symptoms in the first weeks are:
- Fatigue
- Mild fever
- Muscle and joint pain
- Headaches
- Sweating
- Conjunctivitis (inflammation of the conjunctiva)
- Gastrointestinal issues
- Lymph node swelling
It’s not easy to recognize symptoms of Lyme disease, as they vary widely and are not specific to Lyme disease. This means they can have many other causes. If the Borrelia bacteria have already spread to the blood, the erythema migrans may appear in multiple locations.
Organic symptoms can also occur weeks to months after infection without a noticeable tick bite, erythema migrans, or general symptoms. At this stage, an infection of the nervous system leads to early neuroborreliosis. This is characterized by burning pain that often worsens at night and may be locally related to the bite site. At the same time, asymmetrical and nonsystematically distributed flaccid paralysis and general sensory disturbances may occur.
Myocarditis can occur, but it is relatively rare in Europe (more common in the USA). Neurological symptoms often present as unilateral or bilateral facial paralysis. In children, an acute meningitis can also occur.
Stages III
Late-stage symptoms of Lyme disease, starting from Stage III, primarily affect the joints. Lyme arthritis is a chronic and/or episodic inflammation of the joints. Less common late-stage symptoms include acrodermatitis, a chronic skin inflammation, and chronic neuroborreliosis.
Chronic neuroborreliosis, with progressive chronic inflammation of the brain and spinal cord, causes symptoms similar to those of multiple sclerosis—such as gait disturbances, central and peripheral paralysis, speech and visual impairments, and polyneuropathies.
Symptoms of chronic Lyme disease
• Borrelia Lymphoma (benign lymph node enlargement): More common in children. Preferred locations are the earlobes, nipples, and genital area.
• Skin: Acrodermatitis chronica atrophicans usually begins with swelling and bruising on the arms and legs. Subsequently, it can lead to atrophic changes due to the loss of connective and fatty tissue. The tissue may undergo atrophy.
• Gelenke: meist schubweise oder chronisch verlaufende Gelenkentzündung. Häufig betroffen sind: Knie-, Ellenbogen- und Sprunggelenk. Kleinere Gelenke eher selten.
• Nervous system: Late neuroborreliosis typically develops slowly over weeks or months and usually presents with inflammatory symptoms of the central nervous system. Relatively rare in Europe is a late manifestation of borreliosis affecting the heart muscle, such as arrhythmias or perimyocarditis (inflammation of the heart muscle and pericardium).
Do you suffer from Lyme disease?
Hemoperfusion is a blood purification procedure used for inflammatory conditions such as Lyme disease. Feel free to inquire with us about potential therapy options.
Lyme disease diagnostics
The simplest and most reliable way to confirm a Lyme disease infection is by examining the tick. This process takes only a few days, provides certainty, and allows for a prompt start of treatment if necessary.
At the onset of the illness, symptoms such as erythema migrans (wandering rash), fatigue, fever, joint pain, etc., often suggest a Lyme disease infection. If these initial symptoms are absent and symptoms associated with later stages of the disease appear, or if symptoms persist despite antibiotic treatment, a Borrelia serology (antibody test) should be performed.
These tests examine the blood for specific antibodies against Borrelia. However, false positive and false negative results are possible. A negative result does not necessarily mean that there is no Lyme disease infection, as the body may only produce antibodies a few weeks after infection. False positive results can occur due to infections with bacteria similar to Borrelia.
If a test comes back positive, it only indicates that the patient has been infected with Borrelia at some point. The test result does not specify whether the infection is acute or latent. The same applies to the detection of antibodies in cerebrospinal fluid (CSF).
The diagnosis of neuroborreliosis can only be confirmed if inflammatory changes are additionally detected in the cerebrospinal fluid.
Alongside antibody detection, Borrelia can be directly identified. This can be achieved either by culturing the bacteria from skin or cerebrospinal fluid samples or by detecting the Borrelia genetic material using a PCR test.
Borrelia PCR
Genetic fragments can be detected using PCR (polymerase chain reaction). This method is generally faster than culturing Borrelia.
These tests are used when previous results are inconclusive or when a weakened immune system has not produced sufficient Borrelia antibodies.
Additional diagnostic options
Lymphocyte transformation test (LTT)
CD56/57 in chronic Lyme disease
CXCL13 test (detectable in cerebrospinal fluid)
Lyme disease treatment
Antibiotic therapy remains the first choice in the treatment of Lyme disease. When clinical suspicion of Lyme disease is present, antibiotic treatment should be started immediately. However, if one or more courses of antibiotics do not achieve the desired outcome, continuing to treat Lyme disease patients with additional antibiotics is unlikely to be beneficial. This conclusion was reached by researchers at Boston University in a study published in the ‘New England Journal of Medicine.
The controversial discussions regarding the efficacy of long-term antibiotic therapy for patients whose symptoms persist after treatment prompted these investigations. Boston University conducted two randomized studies on this topic. In the first study, researchers examined 78 patients with seropositive IgG antibodies, while the second study focused on 51 seronegative Lyme disease patients.
The controversial discussions regarding the efficacy of long-term antibiotic therapy for patients whose symptoms persist after treatment prompted these investigations. Boston University conducted two randomized studies on this topic. In the first study, researchers examined 78 patients with seropositive IgG antibodies, while the second study focused on 51 seronegative Lyme disease patients.
The studies, which were originally designed to be long-term and involve a larger patient cohort, were discontinued due to the results.
As previously mentioned, Borrelia are spirochetes and thus gram-negative bacteria—they have, in simplified terms, a thicker outer membrane. Most Borrelia species are pathogenic to humans and animals, meaning they can cause diseases. They are capable of altering their shape, penetrating all body tissues, and there is evidence suggesting they can exist both intracellularly and extracellularly. They are temperature-sensitive and microaerophilic, meaning they prefer a low-oxygen environment. Their slow division rate further reduces the effectiveness of antibiotics.
These specific characteristics sometimes make it difficult to treat a chronic infection solely with antibiotics, particularly because Borrelia tend to persist in areas of the body that are difficult for antibiotics to reach. An additional problem can arise from a dysregulated gut; if the microbiome, or gut flora, is damaged, the intestinal lining may be compromised in some areas, leading to ‘leaky gut.’ This allows toxins, bacteria, or bacterial fragments to pass through unchecked. All gram-negative bacteria contain lipopolysaccharide (LPS), also known as endotoxin, in their membrane. The constant irritation from LPS and exotoxins (bacterial toxins) leads to a persistent release of inflammatory substances (e.g., cytokines), which maintain a chronic inflammation.
When antibiotic therapy has been exhausted, what are the alternatives?
There are now complementary medicine clinics and practices that offer hyperthermia (heat therapy) and ozone therapy, achieving good results with these treatments. About twelve years ago, we applied our knowledge and experience from cardiac surgery as perfusionists (specialists in extracorporeal perfusion) in oncology, focusing on regional chemoperfusion. This was a new field, and we learned how to effectively use hyperthermia (heat therapy) and hyperoxygenation (high-dose oxygen administration). Additionally, we removed excess cytostatics using diafiltration (a blood purification technique). Cytostatics slow down cell growth and can cause side effects such as hair loss during chemotherapy. When we began working with new blood purification methods like hemoperfusion about five years ago, we benefited from our oncology experience. The solution we offer is:
Hyperthermic hyperoxygenated hemoperfusion
Hyperthermic hyperoxygenated hemoperfusion is a special type of blood washing. Extracorporeal systems for blood washing can be constructed in different ways. We use a tube set and integrate the adsorber for blood purification plus a heating and oxygenation unit. The heating unit can be used to control the blood temperature safely and precisely. This is slowly increased using the heating unit until the therapeutic range is reached. Since the Borrelia are thermosensitive and die at a temperature of around 41.6 degrees Celsius, the blood is specifically heated. The maximum target blood temperature is 42 degrees Celsius. In the range between the aforementioned 41.6 and a maximum of 42 degrees Celsius blood temperature, we base our calculations on the circulatory parameters, i.e. how much temperature the individual circulatory situation allows. During the entire treatment, oxygen is continuously supplied via the oxygenation unit. This not only ensures the maximum saturation of the erythrocytes (these are the red blood cells) of 100 percent. The partial pressure of oxygen also increases, which influences the so-called oxygen binding curve. The partial pressure of oxygen in arterial blood is normally just over 100 mmHg after oxygen absorption in the lungs. With the oxygenation unit we achieve partial pressures of oxygen between 500-700 mmHg. This leads to a shift to the right on the oxygen binding curve, which improves the delivery of oxygen to the tissue.
Blood hyperthermia and hyperoxygenation support each other:
• Improved microcirculation
• Vasodilation (vasodilation)
• Mobilizes the removal of waste products or toxins into the bloodstream and thus supports the effectiveness of the absorbers
• Venous oxygen administration via the oxygenation unit increases the formation of prostacyclins
• Positive influence on the immune system (immunomodulation)
The combination of perfusion, blood hyperthermia, hyperoxygenation and adsorption has proven effective not only in oncology, but also in chronic infections such as Lyme borreliosis.
If you are affected, we look forward to hearing from you.
If you are also interested in other modern forms of therapy, such as apheresis, we refer you to extracorporeal blood purification procedures in VitaSangiusTherapy, which have been proven to improve metabolism, the immune system, organ functions and thus quality of life.
Therapy procedure with hemoperfusion
The patient (m/f/d) does not have to fast for this treatment. He/she can eat normally and should ensure that he/she drinks enough fluids.
In preparation for the actual therapy and to stimulate microcirculation, we use an infrared heat unit. A so-called Sheldon catheter is then placed in the femoral or jugular vein. This is a minimally invasive procedure that is carried out under local anesthesia and light sedation. The advantage of the Sheldon catheter is that only one puncture is necessary. It is configured so that an extracorporeal system can be connected and higher flows can also be used.
Once the preparations are complete, we determine BGA (blood gas analysis) and ACT (activated clotting time) from the venous blood. In all extracorporeal perfusions, coagulation must be regulated down to such an extent that the blood in the system does not clot. We handle this with an individually adapted and low-dose systemic heparinization under ACT control. The prepared hemoperfusion system can then be connected. The perfusion is painless and the patient (m/f/d) can eat, drink, read or listen to music.
The total time of hemoperfusion is approximately four hours. During this time, blood purification takes place through adsorption, supported by perfusion, blood hyperthermia and hyperoxygenation.
The adsorber we use has a broad adsorption spectrum. The effect can best be described as “garbage disposal”. However, we also have the option of using a specific LPS adsorber. The role that LPS plays in the immune system is explained above.
At the end of the hemoperfusion, the blood from the extracorporeal system is transported back to the patient (m/f/d). After the Sheldon catheter has been removed and the punctured vein has been compressed for an appropriate period of time, the patient (m/f/d) is given a pressure bandage and can go home. The next day and after a wound check, a plaster is usually sufficient.
Sources:
- internisten-im-netz.de
- netdoktor.de
- https://www.deutsche-apotheker-zeitung.de/daz-az/2001/daz-25-2001/uid-900
- New England Journal of Medicine online, Meldung vom 26.06.2001, www.nejm.org, DAZ 2001.Nr.25,S.6, 17.06.2001
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