Presentation on theme: "Multi-factorial contributors to what we label Lyme spectrum disease"— Presentation transcript:
1Multi-factorial contributors to what we label Lyme spectrum disease Dr. Kenneth F. Kochler, D.O.Functional MedicineVA Beach, VA.
2Total Bacterial & Viral Body Burden Lyme Species and co-infectionsLyme (not Lymes) Lyme ConnecticutBorellia (burgdorferi) a spirochete-classic LymeBartonella-henseleaBabesia-Babesiosis-Babesia microtiErlichia-Erlichiosis-chaffeensis & ewingiiMycoplasma & ClostridiaBrucellaFanciscella-tularensis (Tularemia)Rickettsia-rickettsii (Rocky Mt Spotted Fever)
3Lyme Borrelia burgdorferi-spirocete Bannwarth Syndrome? Lyme, CT-1975 as “juvenile rheumatoid arthritis” by local MothersCalled Lyme in 1982Organisms harbored in the tick’s stomach
4Babesia Malaria-like protozoan species Intra-erythrocytic-in RBC’s Destroys RBC’s-anemia-jaundice-malaiseAsymptomatic in otherwise healthy hostsTick-transfusion & transplacental transmissionVictor Babes-1888-in cattle with febrile hemoglobinuriaTexas cattle fever-1893 (now cats & mice)1st human case-1957-Yugoslavian cattle farmer1st US case-1969-Nantuket Mass.
5Ehrlichiosis All livestock WBC Intracytoplasmic gram negative orgasm resembling RickettsiaHuman granulocytic anaplasmosis (HGA), granulocytesformerly known as HGE (ehlichiosis)-moncytesType depends on infecting species & leukocyte type infected
6BartonellaA.L. Barton-1909-described organisms that adhered to RBC’s-BartoniaLater- Bartonella bacilliformis-gram negativeInitially thought to be rickettsiaeB. henselea-catscratch disease
7VIRUSES & VACCINATIONS HepatitisH1N1HIVXMRV (newly researched retro virus)Xenotropic murine leukemia retro-virusAn RNA > DNA virus discovered 2006 inhuman prostate cancer tissue67%Assoc with Chronic fatigue Syndrome(2009-Whitmore Peterson Institute, NV)Vaccination residuals due to vaccine viral contaminants (herpes type 6 & 7)
8Heavy Metal Toxicity Body Burden Mercury, Lead, Cadmium, Antimony, Arsenic, Aluminum, Nickel (include fluoride)Heavy Metal toxicity masquerades asAUTO-IMMUNE DISEASE“neuro-endocrine disruptors”Impaired enzyme & receptor function with yeast overgrowth (candida as an adaptation)Assayed via NutrEval by Genova Diagnostics or Doctor’s Data RBC Elements
9Mercury: SourcesThimersol (50% Hg by volume) was the preservative in most vaccines until approx (current shift to aluminum)Cumulative dose in vaccines from birth to age 5 years exceeded the EPA guidelines for safety.Large population of older children and young adults have had significant exposure (Hg thermometers as a child)Study on NYC adult population revealed 24.8% had blood levels at or exceeding 5ug/l, the NY State reportable level.McKelvey W. Environ Health Perspect Oct;115(10):Seafood, dental amalgams, and industrial output account for the major sources of exposure today. (Coal-fired power plants)WHO. Methyl Mercury. Environmental Health Criteria, vol Geneva: World Health Organization, Sallsten G, et.al., J Dent Res 1996; 75: 594–8
10Mercury Toxicity:Low level chronic exposure can lead to nervous systemdamage resulting in depression, anxiety & cognitive lossWeiss B, Clarkson TW, Simon W. Environ Health Perspect 2002; 110 (Suppl 5): 851–4Autoimmunity IssuesParesthesias, insommnia, cognitive difficulties,neuromuscular changes, headaches and anxiety, third cranial nerve palsy.
11Sources: Color pigment (dyes & paints) Cigarette smoke Ni-Cd batteries Cadmium:Sources: Color pigment (dyes & paints)Cigarette smokeNi-Cd batteriesPhosphate fertilizersJarup L et al. Health effects of cadmium exposure—a review of the literature and a risk estimate. Scand J Work Environ Health 1998; 24 (Suppl 1): 1–51WHO. Cadmium. Environmental Health Criteria, vol Geneva: World HealthOrganization, 1992Toxicity: Kidney damageOsteoporosisCancer-thyroid & ProstateJarup, L. Br. Med. Bull. 68: (2003)
12Lead: Sources: Gasoline (Worldwide major source but not in US) Lead in drinking water primarily due to the presence of leadin certain pipes, solder, and fixtures.In kids toys and lead based paints in old homes (and especially in paint that is not interstate transported)Toxicity: Decreased IQMemory deteriorationCancerAnemiaPeripheral nerve symptomsHypertension especially in menopausal womenWHO. Lead. Environmental Health Criteria, vol Geneva: World HealthOrganization, 1995Steenland K, Boffetta P. Am J Ind Med 2000; 38: 295–9
13Sources: Wood preservative Fish Pesticides/food Industrial exposure Arsenic:Sources: Wood preservativeFishPesticides/foodIndustrial exposureToxicity: Cancer-lung, bladder, & kidneyPeripheral neuropathyAnemiaGI EffectsWHO. Arsenic and Arsenic Compounds. Environmental Health Criteria, vol Geneva: WorldHealth Organization, 2001Chilvers DC, Peterson PJ. Global cycling of arsenic. In: Hutchinson TC, Meema KM (eds)lead, Mercury, Cadmium and Arsenic in the Environment. Chichester: John Wiley & Sons, 1987; –303
14Testing for heavy metals: (Redistribution to the RBC’s) Blood levels useful for acute exposure, but an unreliable tool for chroniclow level exposures.Mercury has affinity for fatty tissue and is rarely found in serum.The half-life of lead in blood is about one month whereas thehalf-life in bone is years. (35)WHO. Lead. Environmental Health Criteria, vol Geneva: World Health Organization, 1995Difficult to accurately assess total body burden. Urinary porphyrinshave some utility – currently probably the best clinical test available.Hair Mineral Analysis may be helpful, but show false negative inindividuals with compromised detoxification pathwaysProvocative challenge-involves administering a test dose of a chelator(DMPS, DMSA, or EDTA) and measuring pre- and post- fecal &/orurine for heavy metals.
15Nutritional support during chelation essential Heavy Metals (con’t)Treatment:Nutritional support during chelation essentialI. Gut binding agents-Bentonite, Charcoal, Zeolite, chlorella, garlicCholestyramine-low dose, pulsed, with cautionII. Mineral replacement-depending on the chelator used, replaceminerals aggressively with special attention to Ca & Mgwith EDTA (Suppositories) and Cu & Zn with DMPS/DMSAIII. Antioxidant support-necessary to quench free radicals generatedduring heavy metal removal. Supplement with A, C, E, Zn,selenium, and reduced glutathione.IV. Hepatic support
16GLUTATHIONE ADEQUACYGenomics to determine GST enzyme pathway adequacy (glutathione-S-transferase)Serum Glutathione levels-baseline determination is a must (but largely unknown or forgotten by most physicians) Lab Corp offers this testing and is included in the Genova NutrEvalThe MASTER ANTIOXIDANT of the body!Excellent for natural metal chelation (which impacts Lyme disease)
17METHYLATION Methyl group (-CH3) donator Needed for phase II liver detox via COMTDefects = elevated Estrogen & catecholaminesRole in: NEUROTRANSMITTER chemistry, cardiovascular disease, cancer, metal detox, and B-12 & Folate metabolismSAMe, TMG, methyl B-12 & THFSNP on COMT, MTHFR C677T (47% incidence in caucasians)Cystathione-beta-syntase enzyme: B-6/P-5-P & GSH
19BIOFILMSA community of bacteria, parasites, etc imbedded in an extracellular polymeric substance (EPS) aka slimeComposed of DNA, protein & polysaccharidesNEG CHARGED, and attracts Ca/Mg/Fe to strengthen its matrixOrganisms communicate and exchange genetic material (QUORUM SENSING)EPS creates antibiotic resistance requiring X concentration of the drug & prevents phagocytosis (WBC organism eradication)
20BIOFILMSNIH states that 80% of all chronic infections are biofilm mediated (ie: chronic sinusitis)This jello-like shield created by bacteria protects against environmental stress and promotes propagation (it’s everywhere: teeth to ship hulls) (Imagine the water-mold issue)Chemical signals serve as intelligent communication (Quorum Sensing)Unless biofilms are managed, hosts are subject to unending recurring symptoms from infection
21BIOFILM & LYMEOnce bacteria have joined into biofilm communities, they can no longer be effectively targeted by the immune system. They persist as a chronic infection and inflammatory process. High dose antibiotics and steroids may offer temporary relief, yet the infection never is totally eradicated. Initial organisms are commonly Staph and parasites.
22BIOFILM & LYMEBorrelia may undergo genome-wide genetic exchange, including plasmid transfers. Virulence can rapidly be enhanced.Conjugal plasmid transfer ability from Escherichia coli to Bartonella has been established and documented to transfer antibiotic resistance genes.
23ENDOCRINOPATHIES Hormone decline & Imbalance = aging Insulin Resistance = agingHypoadrenalism w/ decr cortisol = fatigueHypothyroidism w/ decr Free T3 & incr rT3Hormone imbalances: male and female hypogonadism (declines in DHEA and testosterone = aging)Growth Hormone (IgF-1) decline = agingMelatonin & Melanocyte Stimulating Hormone(decline as markers for immune deficiency)
25GENOMICS DNA MUTATIONS POLYMORPHISMS SNP(S) single nucleotide polymorphismsDefective or incomplete GENE expressionInadequate enzyme & receptor functionImpaired biochemistry and cellular respirationFatigue & degenerative disordersAssayed via Genovations (Genomic testing)by Genova Diagnostics
26SO WHAT CAN WE DO? Nutritional Assessment-NutrEval (Genova) Heavy Metal Assessment-NutrEvalEssential Fatty Acid Assessment for cell membrane integrity and function-NutrEvalHormone Assessment-NeuroScienceNeurotransmitter Assessment-NeuroScienceProper mineral and vitamin supplements after assessment-NutrEvalGlutathione assessment-NutrEval(search NutrEval)
27What else? Yeast management Metal detox via chelation Biofilm management-EDTA, Proteolytic Enzymes ( Natto or Lumbrokinase), Inter-Face Plus by ProtheraChinese Herbs that penetrate biofilm: Berberine extract from Coptidis Rhizome (Goldenseal)Herbs that interfere with Quorum Sensing:Red & blue berries, kale, oregano, basil, rosemary,turmeric, ginger, garlic.Probiotics
29CYTOKINES This is what you actually causes your demise Cytokine determination to assess level of inflammation (significant amounts produced in adipose tissues of the body)NeuroScience has cytokine panel testingCytokines are managed by downregulating inflammationCRP and EFA adequacy are markers
30Transfer FactorsPeptides of low molecular weight (approximately 5 kDa) and perhaps RNAMade by Th1 CD4+ Helper T-cellsPresent in colostrumThree components - Antigen specific region, region that binds to Th1 Helper T-cells, and a connectorCan strengthen cell-mediated immunity against specific pathogensCan be used to immunize against specific pathogensAaron White, PhDUsing Transfer Factor to Strengthen Cell-Mediated ImmunityIntegrative Healthcare Symposium 2010
31Definition of transfer factor Borkowsky and Lawrence (1979):“‘Transfer Factor’ was originally coined as a convenient shorthand to describe the material or materials present in leukocyte extracts or dialysates of skin test-positive donors that had the capacity to transfer cutaneous delayed type hypersensitivity responses to skin test-negative human subjects.”Now commonly used in the plural – “transfer factors”Aaron White, PhDUsing Transfer Factor to Strengthen Cell-Mediated ImmunityIntegrative Healthcare Symposium 2010
32Potential future uses of transfer factors List of known pathogens growing and includes a variety of intracellular agents (mycoplasma; cell-wall deficient bacteria; XMRV, HHV6 and other viruses).Transfer factors can be (and are) custom made for pathogensMany pathogens suppress Th1 immunity (HIV, Lyme) and require cell-mediated immunity to be beaten.Transfer factors strengthen cell-mediated immunity.Could be helpful for autoimmune conditions involving too much Th2 (e.g., lupus) but seem less likely to be effective against those involving too much Th1 (e.g., multiple sclerosis).Cancer treatmentCould be used to support or even replace many vaccines, which skew the immune system in the Th2 direction.Aaron White, PhDUsing Transfer Factor to Strengthen Cell-Mediated ImmunityIntegrative Healthcare Symposium 2010
33A small clinical trial study showed a better increase in CD57 counts using both Multi-mmune and LymPlus transfer factors simultaneously.Patients taking 2 capsules of Multi-immune 2 X daily showed a 600% increase in NK cells
34STRATEGIES-HOW TO DECIDE Lyme testing in this country is poorMany false positives and negativesInadequate band assessmentPCR (Polymerase Chain Reaction) viaw/ special stainingLive Blood Analysis is medically outlawedJames Schaller, MD favors IGeneX western blot(does a single + band constitute Lyme spectrum disease? Not good for the insurance companies)* Zyto Bio-Resonance ScanRapidly assessment of stressors and balancers
35PERUVIAN RAIN FOREST HERBS Sorted-out via ZytoProvided by NutraMedixExcellent response to these broad spectrum anti-microbial, anti-viral, anti-fungal, and anti-inflammatory herbal tincturesSamento and Banderol were discussed as excellent remedies for Lyme in the July 2010 issue of the Townsend Letter
40CONCLUSION Lyme is not the hub of he wheel It’s a spoke Lyme spectrum illness management is extremely complex and intricateTherapy needs to be prioritized and individualizedYou cannot get where you want to be with just unending antibiotics…
41Treatment of gut and systemic biofilms in Lyme Treatment of gut and systemic biofilms in Lyme Disease can greatly reduce the reservoir of Borrelia and its associated co-infections resulting in a greatly diminished risk of relapseHeavy metals are ubiquitous. They can compromise immune function, promote overgrowth of candida, as well as dysbiotic gut flora.Judicial heavy metal detoxification, either once the lyme/co-infection load has been reduced, or concurrently, with appropriate methylation support as needed, may improve outcome and potentially reduce the likelihood of relapse