Lyme Disease, Co-infections and Concurrent Symptoms

Lyme Disease, Co-infections and Concurrent Symptoms

Lyme Disease, Co-infections and Concurrent Symptoms

Dr. Amanda Hegnauer, ND


Lyme disease is a bacterial infection primarily transmitted by Ixodes ticks, also known as deer ticks, and on the West Coast black-legged ticks. Although folks may think of Lyme as an East Coast disease, it is found throughout the United States and throughout other countries. Lyme disease is caused by a spirochete, a corkscrew-shaped bacterium called Borrelia burgdorferi. Its symptoms affect any organ of the body, including the brain and nervous system, muscles and joints, and heart. Because of this imitation, patients with Lyme disease are frequently misdiagnosed with chronic fatigue syndrome, fibromyalgia, multiple sclerosis and various psychiatric illness, including depression. This misdiagnosis may delay the correct diagnosis and treatment.

Consider that there are 5 subspecies, over 100 strains in the US and 300 strains worldwide of Borrelia burgdorferi. It’s important to note that until now, Borrelia burgdorferi was the only species believed to cause Lyme disease in North America. The Centers for Disease Control and Prevention, in collaboration with Mayo Clinic and the health officials from Minnesota, Wisconsin, and North Dakota, report the discovery of a new species of bacteria, Borrelia mayonii that also causes Lyme disease in people. This is yet another important piece of information that ads to the complex picture of tick-borne diseases in the United States.

Lyme disease is also considered ‘complex’ because ticks often carry multiple infections inside of them, which can be transmitted simultaneously to the host, perhaps yourself, at the time of the tick bite. These include a wide range of bacterial, parasitic, and viral infections. You may also unknowingly be carrying other bacterial, parasitic, viral, and fungal infections that are completely unrelated to the tick bite. These minute infections may be reactivated or exacerbated by the Lyme bacteria. Co-infections may increase the severity of symptoms by suppressing the immune system and preventing the body from properly fighting off these other unrelated infections.

Patients with multiple systemic infections are often co-infected with multiple organisms simultaneously, and the treatment approaches vary significantly for each organism. Patients must be properly screened and treated for all the co-infections, Let’s consider a few of the most common bacterial co-infections we find in Lyme disease. They include Babesiosis, Bartonella, Ehrlichiosis/Anaplasmosis, Mycoplasma, and Rocky Mountain spotted fever.

Babesiosis (Babesia)

Explanation: Malaria-like parasite that infects red blood cells. Scientists have identified over twenty piroplasms carried by ticks.

Common symptoms: Fatigue, drenching sweats, shortness of breath (“air hunger”), muscle aches, chest pain, hip pain.

Diagnosis: Sometimes can be detected in blood however only reliable in the first two weeks of infection. PCR (polymerase chain reaction) test, FISH (Fluorescent In-Situ Hybridization) can detect rRNA, antibodies in blood.

Treatment: Typically treated with a combination of anti-malarial medications and antibiotics.

Bartonellosis (Bartonella)

Explanation: Bacteria that live primarily inside the lining of the blood vessels. Bartonella henselae is mainly carried by cats and causes cat-scratch disease.

Common symptoms: Fever, fatigue, headache, unusual streaked rash that resembles ‘stretch marks,’ swollen glands.

Diagnosis: PCR and tissue biopsy. Standard blood tests are rather insensitive.

Treatment: Antibiotic therapy, sometimes in combination

Ehrlichiosis (Ehrlichia) and Anaplasmosis (Anaplasma)

Explanation: Ehrlichiosis describes several different bacterial diseases, one of which is also call anaplasmosis. Some are transmitted by Ixodes ticks and other by the lone star tick.

Common symptoms: sudden high fever, fatigue, muscle aches, headache. Severely ill patients can present with

immune suppression, anemia, white blood cell count tends to be low, low platelet count, liver and kidney are affected.

Diagnosis: Ehrlichia parasites multiply inside host cells that can sometimes be seen on blood smear.

Treatment: Antibiotic therapy, sometimes in combination


Explanation: Smaller than bacteria, they invade human cells and disrupt the immune system Common symptoms: fatigue, musculoskeletal symptoms, and cognitive concern.

Diagnosis: Signs and symptoms overlap other diseases therefore perform both Immunofluorescent Antibodies (IFA) and PCR to check for different species.

Treatment: Antibiotic therapy, sometimes in combination Rocky Mountain spotted fever.

Explanation: Bacteria called Rickettsia rickettsii invade cells lining the heart and blood vessels. It is rare that we see an acute case of RMSF due to Rickettsia rickettsii on the East Coast, but often antibody titers can be seen in patients that have been exposed.

Common symptoms: high fever, nausea, vomiting (flu-like symptoms), rash, headache and bleeding concerns.

Diagnosis: clinical diagnosis of rash, similar blood work results as Ehrlichiosis.
Treatment: Antibiotic therapy, sometimes in combination.

Naturopathic Treatment

As discussed above treatment varies per co-infection. Among the multiple systemic infections there are overlapping factors that contribute to a chronic illness. These can include:

  • Immune dysfunction Inflammation
  • Environmental toxins Nutritional deficiencies
  • Endocrine abnormalities Gastrointestinal disorders
  • Pain disorders Allergies
  • Sleep disorders Neuropsychiatric disorders

This being said, each concern should be treated as a piece of the overall puzzle. Specifically speaking consider treating Lyme disease in the same manner. Drug therapy is important when treating Lyme disease and co-infections however also contemplate botanical medicine including anti-fungals and anti- bacterials, gentle detox protocols and nutraceutical therapy supporting the body’s own biochemistry.

There are many therapies that can be used alongside drug therapy however it is very important to consult a healthcare practitioner when doing so. For example some folks have found great success when utilizing the Cowden protocol. The Cowden Support Program is a protocol developed by Dr. Lee Cowden, MD initially for the treatment of late-stage Borrelia and Lyme Co-Infections. Since the protocol helps to resolve the majority of the root causes of most patient symptoms, it can also be used to treat “post-treatment Lyme disease syndrome” and many other chronic health conditions of unclear cause. The Cowden Support Program utilizes 13 different products including 6 microbial defense herbs (3 pairs of herbals) that are taken rotationally.

Excellent results have been revealed when utilizing herbal formulations. Not only do herbs help to kill the infecting variant but aid in supporting the body itself. The strength of the formulation is very important to consider. The strength is determined by the ratio of herbs to alcohol used in production and the length of the extraction time. For example, the Byron White Herbal Formulations are made with a 1:1 ratio. The extraction time of the formula is for one month in comparison to 24 hours – 2 weeks. The formulas are also handmade in glass so that the potency is not reduced or contaminated.

Lyme disease and its co-infections can be challenging to diagnose, as clinical features overlap with many other tick-borne diseases. As we work through the process of diagnosis and treatment consider that each is individualized. Diagnosis can be determined in one individual but not another due to immunosuppression. Or, treatment may work wonders in one individual but not another based on the stage of the disease. As in all chronic illness it is a process of ebb and flow.


Updated March 2016