About The Ross Lyme & Tick-borne Diseases Protocol—Version 4
New in Version 4
The Ross Lyme & Tick-borne Diseases Protocol–Version 4 update, released 6/17/24, has a number of significant changes.
Name change. In Version 4, I have updated our name to include “tick-borne”. This recognizes that people can have Bartonella, Babesia, or other tick-borne diseases, separate from having Lyme (Borrelia) infection.
But there are more significant updates than our name change. Version 4
- Emphasizes plant-based foods recommendations in Part 2. Diet;
- Promotes healthy intestinal microbiome—even on antibiotics with a new Part 3. Healthy Intestinal Microbiome; and
- Includes an herbal antibiotic only option to treat the three Bs (Borrelia, Bartonella, and Babesia) simultaneously in Part 12. Lyme Infection and Part 13. Bartonella & Babesia Infections.
- Moves lifestyle, and related areas, of sleep, diet, healthy intestinal microbiome, and exercise to the front of the protocol to emphasize the key role these areas have in recovery.
Introduction
These are support and treatment guidelines to treat chronic Lyme or tick-borne infections. This protocol addresses most problems that keep a person from getting well. It is more comprehensive than the antibiotic focused Infectious Disease Society of America (IDSA), International Lyme and Associated Disease Society (ILADS), and United States Centers for Disease Control and Prevention guidelines. While herbal and prescription antibiotics may decrease the germ load in chronic Lyme and tick-borne infections, they often do not correct the underlying problems that cause ongoing symptoms.
The Ross Lyme Support Protocol includes essential steps for the beginning and throughout a chronic Lyme disease or tick-borne infection treatment. It is designed to:
boost the immune system,
improve detoxification,
speed recovery,
kill the infections, and
protect and repair from the harmful effects of the infections and the herbal or prescription antibiotics.
- low energy,
pain,
insomnia
brain, neurologic, and thinking problems (brain fog), and
immune compromise and suppression.
Herxheimer Reactions. When a person starts a Lyme disease or tick-borne infection treatment or changes herbal and prescription antibiotics, it is common to experience some worsening in symptoms. See Herxheimer Die-off Reaction: Inflammation Run Amok for more information about this and the steps you can take to treat it.
Treatment Length and Persistence. Generally, it takes a minimum of six months to see if these supports and treatments will help. Supplements can speed recovery, but treating Lyme still takes time. Once you have marked improvement, then you can likely stop many of these nutritional supports except for probiotics, curcumin, ashwagandha, and a good multivitamin. See Getting Healthy: Will I? When? How Do I? for more information about Lyme disease and tick-borne infection treatment length and persistence.
About Supplements. Throughout this protocol I include supplements as nutritional supports based on their known functions. Basic research and my clinical experience show they may help the various symptoms and problems in Lyme disease and tick-borne infections.
Disclaimer
These guidelines are based on the best available research, and what I find clinically useful in my Seattle practice. The ideas and recommendations on this website and in this guideline are for informational purposes only. For more information about this, see the sitewide Terms & Conditions.
Generally I avoid recommending specific supplement products within this protocol, but use generic ingredients instead. However, in Part 3. Intestinal Microbiome, I use specific product names to avoid confusion over products I find useful. Regarding these specific products:
* These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.
Diagnosis, Tests, and Relapse Prevention
Before Treating Lyme Disease and Tick-Borne Infections
Mold toxin illness can look just like Lyme disease or chronic tick-borne infections. Both mold toxicity and chronic infections trigger a reaction in the immune system that produces too many inflammation chemicals called cytokines, which cause most of the problems seen in both illnesses.
If your illness began while you were living or working in a building with obvious mold, I suggest treating for mold toxin illness first. To clarify this point, if you were in good health, then you had an obvious mold exposure, and got sick—treat mold toxicity first. I find correcting this issue may prevent the need to treat Lyme disease or tick-borne infections, even if you test positive for infection. Once the mold toxins are removed, the immune system can keep Lyme or other infections under control.
If it is not clear if Lyme and tick-borne infection or mold toxins are the cause of your illness, then you can treat both problems at the same time.
For more information, read Mold and Lyme Toxin Illness and Positive Lyme Test, No Symptoms, Don’t Treat.
Part 1 . Sleep
Why These Actions May Help
Action Plan
Supplements
- L-Theanine 100 mg 1 to 6 pills a night 1 hour before bed. Do not exceed 1,200 mg a day if using for nerve pain or anxiety during the day, as well. Excessive amounts in the day are very sedating; and/or
- Herbal Sleep Combination 1 to 2 pills 1 hour before bed. Common herbs in sleep combination pills include valerian root, lemon balm, passionflower, hops, yams, wild lettuce, L-theanine, and others.
You can either take these two supplements together or use in combination with the following prescription medicines, if needed.
Prescription Medicines
- Zolpidem (Ambien) 10 mg 1 pill 30 minutes before bed. Use if your primary problem is getting to sleep. It is short-acting; and/or
- Trazodone 50 mg 1/2 to 2 pills 30 minutes before bedtime. Use this if your primary problem is staying asleep.
For more information about these sleep supplements and prescriptions, or for additional options about sleep hygiene, see Sleep in Lyme Disease: The Basic Steps. For information about sleep herbs and supplements, see Sleep: The Natural Medicines. For more information and sleep prescriptions options, see Sleep: The Prescription Medicines.
Part 2 . Diet
Why These Actions May Help
Eat Plants. A healthy diet is one that lowers inflammation and supports a healthy intestinal microbiome. In general, plant-based (with limited animal protein) and plant-exclusive diets are much less inflammatory than the Standard American Diet (SAD) made up of processed foods, inflammatory fats, and immune suppressing sugars. Plant-based diets include prebiotic fibers and polyphenols that promote healthy bacteria in the intestines—even on antibiotics.
Short Term Elimination Diet. An elimination diet helps a person find which foods trigger allergies or inflammation reactions. If you are reacting to foods, consider trying an elimination diet first. Removing allergic and inflammatory foods from your diet also leads to decreased pain and improved energy.
Action Plan
Eat a plant-based diet that uses either plant-based proteins or animal proteins with low levels of inflammatory fats.
For a paleo-based diet rich in plant foods and low-inflammatory animal proteins see The Best Brain, Inflammation, Pain, Energy & Detox Diet Ever.
Mediterranean diets are also a good choice.
If you are new to plant-based eating consider working with the Whole30 diet program to get started.
An elimination diet is another diet to consider starting if you are very reactive to a number of foods. For detailed information, see Elimination Diet to Find Food Problems.
More Information
- See Part 3. Cytokines section for herbal medicines to lower inflammation.
- Read Your Guide to a Healthy Intestinal Microbiome—Even on Antibiotics to find ways to protect your intestinal bacteria while on herbal or prescription antibiotics.
Part 3 . Healthy Intestinal Microbiome
Why These Actions May Help
There is a growing body of science stressing the important role of a healthy intestinal microbiome. The healthy bacteria and other germs living in your intestines make up the intestinal microbiome. The microbiome directs the immune system, brain, heart, bones, hormones, mental health systems and more.
Herbal and prescription antibiotics can hurt the function of the intestinal microbiome. Fortunately—even on herbal or prescription antibiotics, there are steps you can take to promote and maintain health of your intestinal microbiome.
Action Plan
Option 1. Use Supplements
- Polyphenol 2 capsules one time a day. I prefer Polyphenol Booster by Pendulum.*
- Prebiotic non-digestible sugars 1 to 2 pills 3 times a day. I prefer MegaPre by Multibiome Labs.*
Option 2. Eat a Plant-forward Whole Food Diet
Include polyphenols and prebiotic plant fibers in your diet by eating a whole food diet rich in colorful berries and fruits, vegetables, beans, legumes, nuts and seeds. Aim for at least 30 grams of plant-based fiber a day which you can track using an app like MyFitnessPal or by having at least 5 servings a day of the various foods types listed above. In choosing a whole-foods plant-forward diet, it is ok to use animal proteins or plant-based proteins for your protein source.
Option 1. No Leaky Gut Syndrome Symptoms
If you do not have any intestinal symptoms of leaky gut, this option is for you.
Symptoms suggesting leaky gut can include intestinal gassines, bloating, or cramping, or multiple food sensitivities. The general probiotics I recommend here support and promote the health and growth of most healthy intestinal bacteria.
Bacillus spp spore forming probiotic 1 to 2 pills 1 time a day. I prefer Corebiotic and Corebiotic Sensitive by Researched Nutritionals or MegaSporeBiotic by Multibiome Labs.*
Comment. In my experience, probiotic supplement products deliver more probiotics than fermented food sources. I chose a spore-forming probiotic because they are easier to use as they do not require refrigeration. They also do a great job of microbiome rehab and may work even when a person is on antibiotics.
Substitution Consideration. If you have diabetes or are overweight, consider substituting Akermansia mucinphila for the Bacillus spp spore forming probiotic. Akkermansia may raise GLP-1 leading to weight loss and better sugar control. It also supports other intestinal microbiome bacteria like Bacillus spp. Its major drawback is that it is better refrigerated.
- Akkermansia muciniphila 1 or 2 pills one time a day instead of Bacillus spp. I prefer the Akkermansia product by Pendulum.*
Option 2. Leaky Gut Symptoms with or without Intestinal Yeast Overgrowth or Dysbiotic Bacteria Overgrowth.
If you have intestinal symptoms, this option is for you.
If you have intestinal symptoms like gassiness, bloating, or cramping; or multiple food sensitivities, work to rebuild the intestinal lining and mucin layers while promoting the health and growth of good intestinal bacteria. Use this probiotic option regardless of whether you are treating yeast or bacterial intestinal dysbiosis with targeted antimicrobials.
- Akkermansia, Bifidobacterium, Anaerobutyricum hallii, Clostridium beijerinckii, and Clostridium butyricum blend 1 pill 2 times a day. I prefer the Metabolic Daily product by Pendulum.*
Comment. With leaky gut there is injury to the mucin layer of the intestines that covers intestinal cells. Additionally, the intestinal lining develops gaps between the cells. Akkermansia builds the mucin layer. Bifidobacterium, Anaerobutyricum hallii, Clostridium beijerinckii, and Clostridium butyricum produce butyrate which is the leading fuel source for intestinal cells. Mucin in combination with butyrate helps heal the gaps between the intestinal cells.
Part 4 . Exercise
Why These Actions May Help
Action Plan
Part 5 . Cytokine Control
Why These Actions May Help
Cytokines are inflammatory chemicals made by the immune system in chronic Lyme disease. Nutritional supports like curcumin, resveratrol, black tea extract, NAC, and antioxidants found in a good multivitamin (see Part 6 of this protocol below) may lower cytokines. This can
- correct many Lyme and tick-borne infection symptoms,
- boost the immune system, and
- limit Herxheimer die-off reactions.
On the one hand, cytokines are good because they turn on the immune system. They perform several functions that include:
- making antibodies work more effectively,
- increasing active white blood cells to fight infections,
- recruiting white blood cells to the location of an infection,
- turning on white blood cells to fight infections, and
- decreasing viral and bacterial replication.
On the other hand, in chronic Lyme disease and tick-borne infections the immune system makes too many cytokines, which is bad. Too many cytokines
- suppress the immune system,
- cause pain,
- decrease hormone production from organs like the thyroid and the adrenal glands,
- disturb sleep,
- decrease brain function,
- increase fatigue and tiredness,
- waste muscles,
- cause depression, and
- decrease the function of various organs throughout the body, resulting in many other symptoms and medical problems.
At the beginning of treatment or when antibiotics are changed, the cytokines are made in even greater amounts, which causes a person to feel much worse. This is called a Herxheimer die-off reaction.
See Control Cytokines: A Guide to Fix Lyme Symptoms & The Immune System for more information and additional herbal medicine options to use in a Lyme disease treatment.
Action Plan
- Curcumin 500 mg 1 pill 3 times a day. Choose a liposomal product. In such a product, the curcumin is microscopically wrapped in oil like sunflower oil to increase its absorption; or
- Anti-Cytokine Combination 1-2 pills 3 times a day. Anti-cytokine combinations include curcumin, resveratrol, black tea extract, and N-acetyl cysteine (NAC).
Part 6 . Adaptogen
Why These Actions May Help
An adaptogen is a substance that helps the body deal with the harmful medical and emotional stress of being ill. Adaptogens have been used for centuries in Ayurvedic and Chinese medicine with greatly observed benefits. Based on animal experiments, ashwagandha may improve
- energy,
- mmune function, and
- adrenal and thyroid function.
It likely has additional benefits that have not been researched.
Action Plan
- Ashwagandha 400 mg 1 to 2 pills in the morning and 1 to 2 pills between 1-2 p.m. Taking ashwagandha late in the day may disturb sleep.
Part 7 . Hormones
Why These Actions May Help
Diagnose Based on Symptoms
If you have a number of these symptoms, consider using the natural medicine approaches for each respective problem.
- Adrenal Insufficiency: fatigue, recurrent infections, poor recovery from infections, low blood sugar with shakiness and irritability relieved by eating, low blood pressure and dizziness on standing, afternoon crashing, and sugar cravings.
- Low thyroid: fatigue, achiness, dry skin, cold intolerance, weight gain, constipation, and changes in menstrual periods.
Action Plan
- Ashwagandha 400 mg 1-2 pills in the morning and 1 to 2 pills between 1-2 pm. Taking late in the day may disturb sleep.
In my practice, I rarely use prescription medicine for adrenal insufficiency because there is a very small risk of immune suppression using prescription hydrocortisone. However, the doses I recommend are the normal amounts the adrenal glands should make. I prefer ashwagandha because it is a supportive herb that does not suppress the immune system.
- Cortef 5 mg 1 to 2 pills in the morning and 1 to 2 pills between 12 pm. Taking late in the day may disturb sleep.
- Ashwagandha 400 mg 1 to 2 pills in the morning and 1 to 2 pills between 1-2 pm. Taking late in the day may disturb sleep; also use with
- Zinc 20 mg, Selenium 100-200 mcg, and Iodine 200-300 mcg 1 time a day. These are often found in multivitamins, or you can supplement them individually.
Use these nutritional supports first for one to two months before adding or trying the prescription medicine option below. Often, working with these supplements corrects the thyroid so you do not need to take thyroid prescription medicines.
- Desiccated Thyroid 1⁄2 grain or Armour Thyroid 1⁄2 grain 1 pill in the morning 30 minutes before anything else and on an empty stomach with water only. Increase every 3-4 weeks by ½ grain if low thyroid symptoms persist.
For more information about how to manage thyroid, even if your tests are normal, read my comprehensive article, Hypothyroidism. The Best Tests, Meds, & Vitamins.
Part 8 . Essential Micronutrients
Why These Actions May Help
Action Plan
- Multivitamin. Use a vitamin that has numerous amino acids, antioxidants, minerals, and various vitamin Bs, including B12 and folate. I prefer capsules by Researched Nutritionals.
Part 9 . Detoxification
Why These Actions May Help
Action Plan
Reduce the total load of negative environmental influences on your health by
- eating organic foods,
- avoiding gluten, scents, alcohol, and tobacco, and
- decreasing emotional stress.
Support liver detoxification.
- Liposomal Glutathione 400 to 500 mg 1 pill 1 time a day. Glutathione is the master detox chemical used by the liver to remove toxins. It also helps remove neurotoxins and repair brain tissue. It works better than other herbal options, such as Pinella or Burbur. Read more in Glutathione: The Great Fixer.
- Detox Diet: Drink water regularly to support kidney detoxification. A general rule of thumb is to drink half of your ideal body weight (measured in pounds) as ounces of non-caffeinated liquids a day. For example, a person with a 150-pound ideal body weight should drink 75 ounces a day of non-caffeinated liquid. Furthermore, eat a plant-based diet for vitamins and for fiber. Fiber binds toxins in the intestines and promotes their removal from the body through regular bowel movements.
See The Basic Lyme Detox Steps for more detailed information.
Part 10 . Immune System Boosters
The Ross Lyme & Tick-borne Diseases Protocol is entirely designed to support and boost your immune system. Because of this, most people do not need to take specific immune system boosters. The Ross Lyme & Tick-borne Diseases Protocol supports the immune system through:
- sleeping,
- lowering cytokines,
- detoxing,
- using an adaptogen,
- fixing hormonal problems,
- killing Lyme, yeast, and coinfections,
- exercising as tolerated, and
- eating a plant-based diet or elimination diet to fix immune system dysfunction.
In addition to these steps, there are additional supplements you can take. To read more about these options, see How to Boost the Immune System in Lyme. I do not recommend these additional supplements at first. Consider adding them 6-9 months into treatment or during antibiotic holiday periods.
Part 11 . Yeast
Why These Actions May Help
Too many yeasts in the intestines (yeast overgrowth) is a common problem that occurs in those with chronic Lyme disease or tick-borne infections either during or prior to beginning treatment.
Antibiotics used to treat Lyme and tick-borne infections can lead to too many yeasts. Immune suppression prior to starting antibiotics can also cause yeast overgrowth. Yeast overgrowth can result in an ongoing systemic allergic reaction that can suppress the immune system. Yeast overgrowth also leads to inflammatory cytokine excess that causes many of the Lyme disease symptoms and pain. Food allergies and sensitivities can be the result of yeast overgrowth, too.
A reliable test for yeast overgrowth does not exist. While some physicians may test for antibodies to intestinal yeast in the blood, antibodies are common even when yeasts are in balance. In addition, it is normal to have stool cultures grow yeast, therefore, a culture does not indicate if yeasts are in excess. For this reason, yeast is diagnosed using my yeast screening questionnaire. This questionnaire evaluates the possibility of yeast overgrowth based on risk factors and intensity of symptoms. In general, I find people benefit from treatment for yeast overgrowth if the score is 140 or higher.
At the beginning of a Lyme disease treatment, often before antibiotics are started, it is essential to treat yeast. Doing so can limit the severity of Herxheimer die-off reactions from treating Lyme because removing yeast removes one source of inflammatory cytokine excess.
Action Plan
- Probiotic. See my probiotic recommendations based on your intestinal symptoms in Part 3. Healthy Intestinal Microbiome.
- Herbal Combination 2 pills 2 times a day. Common herbs found individually or mixed together include pau d’arco, caprylic acid, rosemary oil, thyme oil, garlic, and grapefruit seed extract.
- Nystatin 500,000 IU 2 pills 2 times a day.
- Herbal Combination. 2 pills 2 times a day. Common herbs found individually or mixed include pau d’arco, caprylic acid, rosemary oil, thyme oil, garlic, and grapefruit seed extract.
Use both of the following together:
- Nystatin 500,000 IU 2 pills 2 times a day, and
- Fluconazole (Diflucan) 200 mg 1 time daily for 30 days. Use in combination with nystatin to prevent drug resistance. This combination will take 30 days to get yeast under control.
Part 12 . Lyme Infection
Why These Actions May Help
These action steps address the different forms and growth states of the Lyme germ.
- Forms: Lyme has two extracellular forms which are called spirochete and cyst. Lyme also lives inside cells as an L-form which does not have a covering.
- Growth States: Lyme spirochetes and cysts exist in a persister (hibernating) phase and a growth phase.
Lab experiments suggest the great majority of spirochetes and cysts are in a growth phase. However, persisters generally do not respond to regular antimicrobials. In my experience, the best outcomes with my patients occur when I address spirochetes and cysts in the growth phase and persister phase at the same time. The Action Plan options below both do this.
Otoba parvifolia extract and Cat’s Claw are supplements that reach all forms of Lyme inside and outside of cells. Because these herbs are dosed using drops, they are more easily regulated to manage a die-off reaction by not increasing the dose until the reaction lessens.
Likewise, in my experience, any oral antibiotic combination works as well as the Otoba parvifolia extract and Cat’s Claw combination, which is 85-90 percent of the time.
Doxycycline or clarithromycin treat the spirochete. They also treat Lyme in and out of cells. Rifampin, rifabutin, tinidazole, and grapefruit seed extract treat the cyst form.
I include liposomal cinnamon, clove, and oregano oil because they are shown in laboratory experiments to eliminate persisters and growth phase Lyme and Bartonella. They also appear to remove biofilm slime layers that cover germs and can block out antimicrobials and immune cells.
More recent lab experiments show Cryptolepis and Japanese Knotweed are effective at killing growing and persister Borrelia and Bartonella.
About Disulfiram. Disulfiram has gotten a lot of press due to its effect on persisters. I do not include it in this protocol, but some of you may want to consider trying it. Disulfiram is a very hard drug to take due to its side effects and dietary restrictions. While it appears effective against persisters in the laboratory, it is only moderately effective against the growth phase of Lyme infection. If you are new to treating Lyme disease, I do not recommend starting with disulfiram alone due to common treatment difficulty and the fact it may miss growing forms of Lyme.
Read More About Persisters. To read more about all persister options, including when it might be okay to try disulfiram, see How to Treat Persister Lyme & Bartonella.
Action Plan
Take the supplements below together for a complete treatment.
- Otoba Bark Extract and Cat’s Claw. 5 drops 2 times a day of each herb, increasing the dosing every day by 1 drop per dose until taking 30 drops 2 times a day. Take on an empty stomach is best. Do not take 30 minutes before through 2 hours after having food, medicines, or supplements. If you get a Herxheimer die-off reaction, do not advance the dose until it decreases.
- Liposomal Cinnamon, Clove, and Oregano Oil Combination. 1 pill 2 times a day.
When a Lyme infection exists, I generally start with oral antibiotics. For considerations about IV antibiotics, see A Lyme Disease Antibiotic Guide.
Take one item from each of the three parts for a complete treatment.
Part 1.
- Doxycycline 100 mg 2 pills 2 times a day or 4 pills 1 time a day. Take with food to prevent nausea. Do not take with calcium supplements or calcium-fortified dairy products like milk, cheese, or milk substitutes like rice milk; or
- Clarithromycin (Biaxin) 500 mg 1 pill 2 times a day.
Choose doxycycline if you have an Anaplasma or Ehrlichia coinfection.
Part 2.
- Rifampin 300 mg 2 pills 1 time a day; or
- Rifabutin 150 mg 2 pills 1 time a day; or
- Tinidazole 500 mg 2 or 3 times a day; or
- Grapefruit Seed Extract 250 mg 1 pill 2 times a day.
Part 3.
- Liposomal Cinnamon, Clove, and Oregano Oil Combination 1 pill 2 times a day.
- Cryptolepis 5 ml (1 tsp) 3 times a day by starting at 1 time a day and increasing every other day if tolerated to 3 times a day.
- Japanese Knotweed 5 drops 2 times a day of each herb, increasing the dosing every day by 1 drop per dose until taking 30 drops 2 times a day. Taking on an empty stomach is best. Do not take 30 minutes before through 2 hours after having food, medicines, or supplements. If you get a Herxheimer die-off reaction, do not advance the dose until it decreases.
- Liposomal Cinnamon, Clove, and Oregano Oil Combination. 1 pill 2 times a day.
Comment: I include the oil combination to break up Borrelia and Bartonella biofilm. In addition, it treats growing and persister forms of these two germs. The research says the clove oil in this combination may help with Babesia as well.
- For many more Lyme infection herbal and prescription antibiotic options, see A Lyme Disease Antibiotic Guide.
- For the latest on herbal antibiotic regimens that can treat more than one of the three Bs (Borrelia, Bartonella, and Babesia) at a time see Best Herbal Antibiotic Plans for Lyme, Bartonella, and Babesia.
Part 13 . Bartonella & Babesia Infections
Why These Actions May Help
Based on my experience, a person will not recover from Lyme if Bartonella and Babesia are not treated when they are present. It is as though they protect Lyme. Conversely, Lyme seems to protect them, as well, which is why it takes months to get rid of Bartonella and Babesia infections.
Recent research from Johns Hopkins University shows Bartonella, like Lyme, has persisters, too. I include liposomal cinnamon, clove, and oregano oil capsules to address this issue. For more information about persister options, see How to Treat Persister Lyme & Bartonella.
Action Plan
Generally, I do not recommend that a person start supplements or prescription medicines that target Bartonella or Babesia coinfections at the initial visit. Wait one month or longer to adjust to the Herxheimer die-off reaction from treating the Lyme infection and to stabilize on the supportive supplements.
If you have both Bartonella and Babesia coinfections, support or treat one first before adding a support or treatment for the other. When both are present, my preference is to address Bartonella first for two to three months and then add support or treatment to address Babesia. You can address these coinfections at the same time you treat or support the Lyme infection.
In my experience, the following supplements work 70-75 percent of the time and take four to six months. If you do not have improvement in Bartonella symptoms by two months, then change to prescription medicines. For best results use all three of these supplements at the same time.
- Houttuynia 5 drops 2 times a day of each herb and increase the dosing every day by 1 dropper dose until taking 30 drops 2 times a day. Take on an empty stomach is best. Do not take 30 minutes before through 2 hours after having food, medicines, or supplements; and
- Sida Acuta ¼ tsp 3 times a day for 1 week, then increase to ½ tsp 3 times a day. It is best to take this without food. It can be taken at the same time as the Houttuynia; and
- Liposomal Cinnamon, Clove, and Oregano Oil Combination 1 pill 2 times a day.
In my experience, this prescription antibiotic-based option has a 10 percent better chance of working than the supplement-only option above. For best results, use the two prescription medicines and the supplement combination at the same time. Note: This option is also a full Lyme infection support and treatment.
- Clarithromycin 500 mg 1 pill 2 times a day; and
- Rifabutin 150 mg 2 times a day or 2 pills 1 time a day or Rifampin 300 mg 2 pills 1 time a day; and
- Liposomal Cinnamon, Clove, and Oregano Oil Combination 1 pill 2 times a day.
- For many more Lyme infection herbal and prescription antibiotic options, see A Lyme Disease Antibiotic Guide.
- For the latest on herbal antibiotic regimens that can treat more than one of the three Bs (Borrelia, Bartonella, and Babesia) at a time see Best Herbal Antibiotic Plans for Lyme, Bartonella, and Babesia.
In my experience, the following supplements work 75-80 percent of the time and take four to five months. If you do not have improvement in Babesia symptoms by two months, then change to prescription medicines. Any of my recommended prescription options works about 80-85 percent of the time.
- Cryptolepis 5 ml 3 times a day; and/or
- Artemisinin 100 mg 2 or 3 pills 2 times a day for 3 days on the medication then take 11 days off. Repeat this 14-day cycle, increasing the dosage each cycle. The goal is to reach 5 pills 3 times a day on the 3 days the medication is taken. I use artemisinin this way because the intestines develop an enzyme that destroys this herbal medicine if it is used longer than three days. Be aware the dose on the 3 days is quite strong. Often, it causes a worsening of the Babesia symptoms beginning on the second day and sometimes lasting until six days later. If a person is very medicine-sensitive, I start at 1 or 2 pills 3 times a day. Artemisinin often does not work well for Babesia from tick bites on the East Coast of the U.S.
- Clarithromycin 500 mg 1 pill 2 times a day; and
- Atovaquone/Proquanil (Malarone) 250 mg/100 mg 1 pill 2 times a day. Note: Do not take rifampin or rifabutin at the same time as this medication. These antibiotics lower atovaquone levels.
- Cryptolepis 5 ml (1 tsp) 3 times a day by starting at 1 time a day and increasing every other day if tolerated to 3 times a day.
- Japanese Knotweed 5 drops 2 times a day of each herb, increasing the dosing every day by 1 drop per dose until taking 30 drops 2 times a day. Taking on an empty stomach is best. Do not take 30 minutes before through 2 hours after having food, medicines, or supplements. If you get a Herxheimer die-off reaction, do not advance the dose until it decreases.
- Liposomal Cinnamon, Clove, and Oregano Oil Combination. 1 pill 2 times a day.
Comment: I include the oil combination to break up Borrelia and Bartonella biofilm. In addition, it treats growing and persister forms of these two germs. The research says the clove oil in this combination may help with Babesia as well.
- See Kills Bartonella: A Brief Guide and/or Kills Babesia: A Brief Guide for prescription approaches you can take to treat these infections.
- For more herbal antibiotic only options see Best Herbal Antibiotic Plans for Lyme, Bartonella, and Babesia.
Part 14 . Supports and Treatments
Many other supplements or prescription medicines can help manage symptoms and problems existing in Lyme disease and chronic tick-borne infections. Wait one month after beginning a treatment to start these. For additional treatment ideas based on your specific medical problems, see articles in the following medical problem chapters. For instance, if you have severe brain fog or numbness, find helpful articles in the Brain & Nerves chapter.
Part 15 . Special Considerations
Disulfiram
One of the strongest Lyme infection persister medications or supplements is Disulfiram. Clinical experience shows it can get over 36 percent of people who have been on extensive antibiotic regimens in the past into enduring remission. This is a repurposed prescription medication that is used to treat alcoholism. Laboratory and human research publications show Disulfiram is helpful for Lyme infection. However, laboratory experiments and my own experience show this is not an effective medication for Bartonella.
As I noted in the Lyme Infection section, I do not suggest a person new to chronic Lyme treatment start with a Disulfiram-only regimen because of the potential for severe side effects and the fact we do not know if it also effectively treats growth phase Lyme. However, in people who do not have active Bartonella or Babesia coinfections that have already tried a year or more of prescription antibiotics, I do think it is worth a try as stand-alone antimicrobial. For more information about the potential benefit, risks, dietary restrictions, and how to take the medication see: Disulfiram for Lyme Update. For additional supplement and prescription medication persister options see: How to Treat Persister Lyme. What Works?
If You Are Becoming More Allergic With Treatment
Two Months: Difficult Babesia or Bartonella
On an effective Bartonella or Babesia antimicrobial regimen, improvements in symptoms that come from the respective infection should start to improve by one to two months of treatment and support. If there is no improvement, then change the antimicrobials to another option.
Another reason the symptoms may not improve by two months is fibrin-germ plaques (also called fibrin nests) that form on blood vessel walls. These include babesia woven into fibrin protein or bartonella woven into fibrin protein. Fibrin is a protein found in blood to help with blood clotting. In plaques, fibrin can block out antimicrobials and the immune system. Lumbrokinase is a nutritional support composed of enzymes that may break down fibrin. Consider adding Lumbrokinase at two months.
- Lumbrokinase 20 mg 1 pill two times a day. Take on an empty stomach except for water by avoiding food, medicines, or supplements one hour before and after taking it.
Six Months and Beyond
Continually review your symptoms to see if you have a coinfection that was missed. Treating Lyme is like peeling the layers of an onion. As you treat, it sometimes becomes more apparent which coinfections are present. In addition, it is possible to have coinfection relapses.
Yeast
If you have a number of these symptoms—such as increased sugar cravings, intestinal gassiness or bloating, recent vaginal yeast infection, oral yeast, and/or vaginal or rectal itching—consider treating for yeast overgrowth in the intestines.
Part 16 . Health Decline after Doing Better
It is common to have ups and downs during a Lyme disease or chronic tick-borne infection treatment. In some cases, there can be a significant decline after a person is doing better. In these cases, consider yeast overgrowth of the intestines or relapse of a Bartonella or Babesia coinfection. In my experience, most major health declines are due to yeast overgrowth in the intestines. This is true even if significant symptoms of yeast do not exist.
Excessive yeast in the intestines lead to increased levels of cytokines. Because excess cytokines cause many of the chronic Lyme disease or tick-borne infections symptoms, it could seem like your Lyme disease or tick-borne infection is getting worse.
Yeast could be the cause of your decline if you have a number of these symptoms: increased sugar cravings, intestinal gassiness or bloating, recent vaginal yeast infection, oral yeast, and/or vaginal or rectal itching. For information on diagnosing yeast, see A Silent Problem: Do You Have Yeast? For yeast treatment information, see Kills & Prevents Yeast: A Brief Guide.