Lyme Disease Treatment Comparison Guide

A-to-Z Lyme Treatment Ratings: From antibiotics to herbal therapy, ozone, and more, find out how Dr. Bill Rawls rates these popular Lyme disease treatments.

Introduction

As a physician who has personally battled chronic Lyme disease, I’m often asked about the many different treatment options available — from conventional antibiotics to cutting-edge therapies and herbal protocols. For people navigating this complex illness, the sheer number of choices can feel overwhelming, and it’s difficult to know which options are truly safe, effective, and worth the cost.

Through my own journey with Lyme, combined with years of research, clinical experience, and helping thousands of people recover their health, I’ve developed a comprehensive framework for evaluating these treatments. This guide brings together that knowledge, offering you a clear, unbiased look at the pros and cons of various therapies.

My personal preference — and what I found to be most effective for myself and my patients — is herbal therapy, especially for chronic Lyme disease. We will start there, but I also believe in staying open-minded and informed about all options, because every person’s path to recovery is unique. Whether you’re just starting to explore treatment or looking for new approaches after previous treatments fell short, my goal is to give you the tools you need to make confident, informed decisions about your health.

Inside, you’ll find my complete Lyme Treatment Comparison Guide, which rates popular treatments across three key criteria: safety, efficacy, and cost. This resource is designed to help you see how these options stack up — so you can choose a path that supports your health, your budget, and your long-term recovery.

Before beginning any new treatment, therapy, or supplement — including the options discussed in this guide — be sure to consult with your healthcare provider. They can help ensure your choices are safe and appropriate for your individual health needs and medical history.

Don’t do this alone. If you have questions, please join me in the Vital Plan Network and get the answers and resources you need from a community you can trust.

Let’s get started.

Dr. Rawls’ Treatment Rating Scale

Supported by positive clinical and/or lab studies

Has only scattered postive testimonials

High safety profile and few reported side effects

Low safety profile, potential for harm or death

Dr. Bill Rawls MD

Lyme Disease Treatment Comparison Guide

Herbal Therapy

Overview

Herbs are my gold-standard therapy for chronic Lyme disease, and they also have a restorative effect on the body. I prefer herbal remedies because they have a long-standing history of use throughout the world, are backed by solid scientific studies, have an excellent safety profile, and are affordable and accessible. Herbal therapy was critical to my personal healing from chronic Lyme disease.

Herbs serve as a primary therapy or a complement to many other healing tools. The benefits of herbs are far-reaching and include:

• Providing antimicrobial properties against bacteria, viruses, protozoa, and fungi

• Normalizing immune system communications

• Boosting immune system functions

• Reducing inflammation

• Restoring homeostasis or balance in the body

• Protecting at the cellular and mitochondrial levels

• Providing essential nutrients to the cells

• Delivering antioxidant powers

But which herbs are the best options to support the body’s natural healing abilities? The following are foundational herbs to jumpstart recovery, reduce symptoms, and improve your health. It’s important to note that there are many other herbal possibilities as well.

Antimicrobial Support

• Cat’s Claw

Native to the Amazon, cat’s claw is a staple among Lyme disease protocols due to its antimicrobial qualities. It contains immune-modulating properties to dampen an overactive immune system, reduces inflammation, and has historical use in alleviating the pain associated with arthritis.

• Andrographis

Andrographis originates from India and contains antibacterial, antiviral, and antiparasitic properties to combat a variety of microbes. The herb has immune-enhancing, cardioprotective, and liver-protective qualities. It’s often a staple among natural Lyme protocols as well.

Dr. Rawls’ Notes

Chronic Lyme disease treatment

Efficacy:

Safety:

Cost: $$ $$$

Ways to Administer: Oral, topical

Bottom Line: Because herbs have a low potential for side effects, are easy to take, and have a low relative cost, I consider herbs to be the goldstandard treatment for the majority of people.

REFERENCES:

1. Feng J, Leone J, Schweig S, Zhang Y. Evaluation of Natural and Botanical Medicines for Activity Against Growing and Non-growing Forms of B. burgdorferi. Front Med (Lausanne). 2020 Feb 21;7:6. doi: 10.3389/fmed.2020.00006

2. Feng J, Zhang S, Shi W, Zubcevik N, Miklossy J, Zhang Y. Selective Essential Oils from Spice or Culinary Herbs Have High Activity against Stationary Phase and Biofilm Borrelia burgdorferi. Front Med (Lausanne). 2017 Oct 11;4:169. doi: 10.3389/fmed.2017.00169

3. Zhang Y, Alvarez-Manzo H, Leone J, Schweig S, Zhang Y. Botanical Medicines Cryptolepis sanguinolenta, Artemisia annua, Scutellaria baicalensis, Polygonum cuspidatum, and Alchornea cordifolia Demonstrate Inhibitory Activity Against Babesia duncani. Front Cell Infect Microbiol. 2021;11:624745. Published 2021 Mar 8. doi: 10.3389/fcimb.2021.624745

Lyme Disease Treatment Comparison Guide

Herbal Therapy (continued)

• Garlic

Since the beginning of time, garlic has been used for medicinal purposes. Its main antimicrobial constituent is called allicin, and it has antiprotozoal, antiviral, and antifungal properties. It also helps to support the immune system and balance the flora of the microbiome.

• Japanese Knotweed

Japanese knotweed with resveratrol has been used for centuries in traditional Asian medicine, and it’s a potent antioxidant with antimicrobial and anti-inflammatory properties. Japanese Knotweed may assist in eradicating bartonella bacteria.

• Sarsaparilla

The root of this thorny plant has been used throughout the tropics for inflammatory conditions of the skin, connective tissues, and the bowel. Sarsaparilla binds to and helps dispose of endotoxins that are released from microbes during die-off.

Immunomodulation & Symptom Reduction

• Reishi Mushroom

Reishi, a medicinal mushroom, has adaptogenic qualities and is antimicrobial and immune-modulating. The herb reduces inflammatory cytokines and supports the immune system’s ability to combat pathogens. Reishi also supports the liver and heart.

• Cordyceps

Native to Tibet, cordyceps is a fungal species that grows on a specific type of caterpillar. In addition to bolstering immune function, the herb helps combat fatigue, inflammation, and cellular damage.

• Chinese Skullcap

As a multi-purpose herb, Chinese skullcap has antimicrobial properties, decreases cytokines, and supports immunity. It works synergistically with other herbal remedies to enhance their effectiveness. It also has low-levels of naturally-occurring melatonin, which may help to induce sleep.

• Rehmannia

A traditional herb in Chinese medicine, rehmannia inhibits allergic responses and modulates immune functions. The herb may be valuable for reducing autoimmune responses in illnesses like lupus and rheumatoid arthritis. It supports adrenal function, contains potent anti-inflammatory properties, and has adaptogenic qualities to ease stress.

Lyme Disease Treatment Comparison Guide

Herbal Therapy (continued)

Cellular & Detoxification Support

• Glutathione

Glutathione is an essential antioxidant inside cells that protects the mitochondria from free-radical damage during the generation of energy. It’s also essential for phase II detoxification in the liver, and it enhances detoxification processes, contains antioxidant properties, and fortifies immune functions.

• NAC (n-acetyl cysteine)

Another potent antioxidant, NAC is an essential component for the formation of glutathione inside cells. It inhibits cytokines, the inflammatory messengers stimulated by microbes. It also slows the breakdown of collagen, inhibits biofilms, and protects nerve tissue.

Daily Nutrients & Cardiovascular Support

• Hawthorn

Hawthorn supports heart function by increasing blood flow to the organ, strengthening contractions of the heart muscle, and improving circulation by dilating blood vessels. This allows increased oxygen delivery to tissues and assists in normalizing blood pressure.

• Pine Bark Extract

Antioxidants and other compounds in pine bark extracts, such as French maritime pine bark, inhibit platelet aggregation (blood thinner), reduce vascular inflammation, improve the integrity of blood vessels, and enhance blood flow to the tissues.

• Milk Thistle

Native to southern Europe and North Africa, milk thistle has been used in its native lands for thousands of years as a remedy for jaundice and other liver conditions. Silymarin, the primary active component of milk thistle, offers potent antioxidant protection and has been found to induce the regeneration of liver cells.

Efficacy

Herbal therapy has thousands of positive treatment outcomes, a rich history of use worldwide, and supportive clinical and laboratory studies. In the last couple of years alone, Johns Hopkins University released two studies showing the antimicrobial properties of herbs against borrelia and babesia in vitro (outside of a living organism). Plus, herbs have a low potential for side effects, are easy to take, and have a low relative cost.

Lyme Disease Treatment Comparison Guide

Herbal Therapy (continued)

Safety

Because herbs have a low potential for toxicity and an excellent safety profile, they provide an enormous advantage for long-term use in chronic Lyme disease. Additionally, herbs don’t disrupt normal flora; they help to balance the microbiome.

Cost

For many people, herbal therapy offers the most cost-effective, natural solution, and it’s not likely to carry the same sticker shock as different combinations of drug therapies. When you factor in time, energy, and money spent on tracking down treatment approaches, herbs rise to the top for their efficacy and safety for budget-conscious people.

Learn More About My Herbal Protocol »

Lyme Disease Treatment Comparison Guide

Antibiotics

Overview

Antibiotics are synthetic chemical substances that aim to inhibit some aspect of bacteria in certain stages of their life cycles. For instance, they may disrupt bacterial replication or affect another facet of the microbe.

While there’s definitely a place for using antibiotic therapy for treating acute, symptomatic Lyme disease and coinfections, there’s little consensus and available documentation on their use for chronic Lyme — specifically with people who’ve been sick for a significant amount of time and aren’t getting better.

Efficacy

Generally, antibiotics work well to combat extracellular microbes — microbes that live outside of other cells — like a pneumococcal infection of the lungs or when bacteria pass through the bloodstream at initial infection. Bacterial growth rate is the key. During the acute phase of an infection, bacteria grow more rapidly than other microorganisms in the body, and therefore, antibiotics knock down their numbers rapidly, without adversely affecting the microbiome (normal flora) in the gut and on the skin.

In contrast, once the bacteria distribute to tissues throughout the body, they invade cells, which makes them more resistant to antibiotics. This is a fundamental characteristic of all the Lyme microbes: borrelia and coinfections like bartonella, babesia, and mycoplasma are intracellular, meaning they can live inside cells, where they grow slowly and gain protection from antibiotics. Although antibiotics may be helpful for some people, they’re not my first choice for chronic infections.

Safety

The use of antibiotics to target chronic, intracellular infections often requires months, even years, of treatment, which destroys your normal gut flora and further disrupts your immune system, leading to significant safety concerns like candida overgrowth or the diarrhea-causing Clostridium difficile (C. diff).

Cost

The cost of antibiotics will vary depending on your insurance coverage and the length of time you take them. With long-term use, many patients will accrue substantial out-of-pocket expenses — sometimes totaling tens of thousands of dollars.

Dr. Rawls’ Notes

Low efficacy for chronic Lyme disease / significant safety concerns

Efficacy:

Safety:

Cost: $$$ $$

Ways to Administer: oral, topical, intramuscular injections, intravenous (IV) therapy

Bottom Line: Antibiotics work well for acute infections living outside cells. But chronic infections live inside cells where they gain protection for antibiotics.

REFERENCES:

1. Gwynne PJ, Gallagher MP. Light as a BroadSpectrum Antimicrobial. Front Microbiol. 2018;9:119. Published 2018 Feb 2. doi: 10.3389/ fmicb.2018.00119

Lyme Disease Treatment Comparison Guide

Bee Venom Therapy

Overview

Surging in popularity over the last few years as an intervention for chronic Lyme disease is bee venom therapy (BVT). It’s most often administered via live bee stings or injections; some people chose to sting themselves, while others employ a practitioner. BVT may be used along the spine or in conjunction with acupuncture points. BVT participants usually incorporate this modality two to three times per week as part of their health regimen.

Although the idea of stinging yourself with live bees or having a practitioner administer them might creep you out, BVT isn’t new. It’s been used for thousands of years around the world for a variety of ailments. Science recognizes the therapeutic application of bee venom for decreasing inflammation, providing pain relief, and reducing rheumatic conditions.

Efficacy

Over the years, I’ve had many people report lasting benefits from BVT, enough to consider it as an important complement to other therapies, such as herbal therapy, for chronic Lyme disease. Growing evidence suggests one of the primary drivers of symptoms associated with Lyme disease is autoimmunity generated by the immune system’s reaction to intracellular bacteria. BVT may be one way to “reset” the immune system to reduce autoimmunity. The biggest evidence of that is the reduction of symptoms reported by individuals who have autoimmune arthritis.

To date, only two studies exist (1997 and 2017) suggesting melittin, an antimicrobial compound in bee venom, may have some activity against the Lyme bacteria Borrelia burgdorferi. However, neither study has been done on living organisms, so it’s unclear whether BVT treats Lyme disease or provides more supportive qualities that could assist in recovery efforts.

Safety

While the potential benefits may be significant, the documented reports of anaphylaxis reactions, infection at the site, and even death, must be respected. Those who use it must be careful with it. Seek out an experienced and preferably credentialed practitioner to administer therapy.

Cost

There is a range of costs associated with BVT. If you work with a practitioner or acupuncturist, BVT can get pricey, depending on how often you have visits. If you sting yourself, it’s relatively inexpensive after the initial set-up costs for safety and supplies.

Dr. Rawls’ Notes

Primarily symptom relief / inflammation reduction

Efficacy:

Safety:

Cost: $$ $$$

Ways to Administer: Bee stings with live bees or by injection

Bottom Line: Bee venom therapy has some merit when it comes to decreasing inflammation and easing pain, but no research has been done in living organisms, so we don’t know if it would actually treat Lyme disease or just provide symptomatic relief.

REFERENCES:

1. Lubke LL, Garon CF. The antimicrobial agent melittin exhibits powerful in vitro inhibitory effects on the Lyme disease spirochete. Clin Infect Dis. 1997 Jul;25 Suppl 1:S48-51. doi: 10.1086/516165

2. Socarras KM, Theophilus PAS, Torres JP, Gupta K, Sapi E. Antimicrobial Activity of Bee Venom and Melittin against Borrelia burgdorferi. Antibiotics (Basel). 2017 Nov 29;6(4):31. doi: 10.3390/antibiotics6040031

3. Zhang S, Liu Y, Ye Y, Wang XR, Lin LT, Xiao LY, Zhou P, Shi GX, Liu CZ. Bee venom therapy: Potential mechanisms and therapeutic applications. Toxicon. 2018 Jun 15;148:64-73. doi: 10.1016/j.toxicon.2018.04.012

Lyme Disease Treatment Comparison Guide

Coffee Enema

Overview

When it comes to detoxification strategies and ways to minimize Herxherimer reactions from Lyme treatments, coffee enemas are one modality that gets talked about often. There’s a good chance you’ve already tried them or heard of someone who has. They’ve been around for a very long time — at least the early twentieth century and even longer.

When doing a coffee enema, liquid coffee gets infused into the colon and held there for a desired amount of time. The caffeine in the coffee stimulates bile flow from the liver, flushing the system and promoting detoxification.

Efficacy

No studies exist on the use of coffee enemas for Lyme disease, but many anecdotal reports from clinicians and patients suggest coffee enemas may have some value. However, frequent use of coffee enemas may be associated with habituation — where people become accustomed to using them to facilitate bowel movements — which can cause problems down the line. They might be most useful when used intermittently.

Safety

While there could be potential benefits to coffee enemas, there are real safety concerns, such as perforation of the bowel, colitis, bowel infections, and rectal burning. The more you do it, the more risk you’ll have, so you have to be careful with them. Coffee enemas can also disrupt the natural biofilm protecting the lining of the colon.

Cost

Coffee enemas are relatively inexpensive after the initial setup costs for organic coffee and supplies. But the costs vary depending on how often you do them.

Dr. Rawls’ Notes

Detox support / safety concerns

Efficacy:

Safety:

Cost: $ $$$$

Ways to Administer: rectal enema infusion

Bottom Line: Coffee enemas aren’t a treatment for Lyme disease, but they may be useful as a supportive therapy in some circumstances.

REFERENCES:

1. Isaacs LL. Coffee Enemas: A Narrative Review. Altern Ther Health Med. 2021 May;27(3):46-49

2. Sashiyama H, Hamahata Y, Matsuo K, Akagi K, Tsutsumi O, Nakajima Y, Takaishi Y, Takase Y, Arai T, Hoshino T, Tazawa A, Fu KI, Tsujinaka Y. Rectal burn caused by hot-water coffee enema. Gastrointest Endosc. 2008 Nov;68(5):1008; discussion 1009. doi: 10.1016/j.gie.2008.04.017

3. Son H, Song HJ, Seo HJ, Lee H, Choi SM, Lee S. The safety and effectiveness of self-administered coffee enema: A systematic review of case reports. Medicine (Baltimore). 2020;99(36):e21998. doi: 10.1097/ MD.0000000000021998

Lyme Disease Treatment Comparison Guide

Colloidal Silver

Overview

Preparations of silver have long been used in medicine topically for their antimicrobial properties — indeed, I’ve used them in my own practice. Silvadene cream is a commonly used topical medication to treat burn patients, and silver can be infused into bandages and dressings to aid in wound care and infection control.

But colloidal silver is a bit different; it consists of tiny particles of silver suspended in a liquid. Proponents of colloidal silver suggest that, when taken orally or used intravenously (IV), it can have immune-enhancing properties and combat a multitude of infections.

Efficacy

Prescription medications containing silver are effective, topical antimicrobial agents for burns and wounds with well-documented benefits. However, the problem occurs when you take colloidal silver orally or via IV. Although you may notice some systemic effects when you consume it or use it, your body can’t excrete it, so it builds up in your tissues like mercury and other metals.

Although some studies show colloidal silver has benefits as an antimicrobial agent, there is equally as much research to suggest it can be toxic to the body.

Safety

Over time, people who ingest a lot of colloidal silver may start to notice a buildup in their fingernails, skin, or elsewhere, and there are many reports that people can’t get rid of it. Furthermore, IV colloidal silver use has been associated with anemia and low white blood cell counts. Those are significant risk factors to consider before using colloidal silver.

Cost

Generally, over-the-counter colloidal silver is relatively inexpensive compared to other supplements. However, IV colloidal silver can be quite pricey and isn’t covered by insurance. Additionally, research indicates the colloidal silver products you might purchase online don’t always contain the chemical constituents stated on the labels. In my opinion, we’ve got better alternatives to consider for Lyme treatment than using colloidal silver.

Dr. Rawls’ Notes

Chronic Lyme disease treatment / safety concerns

Efficacy:

Safety:

Cost: $$ $$$

Ways to Administer: suspension of silver particles in a liquid, intravenous, or topical antimicrobial creams

Bottom Line: Although some studies might suggest colloidal silver has systemic benefits for infections, there are equally as many studies showing it can be toxic.

Lyme Disease Treatment Comparison Guide

Dapsone

Overview

Dapsone (diaminodiphenyl sulfone) is in the class of drugs known as sulfones, with a sulfur atom connected to two carbon atoms. Dapsone was first synthesized in 1908, but its antimicrobial properties weren’t known until 1937, when the drug began to be used to treat bacterial infections, including leprosy. In addition to its antimicrobial properties, dapsone has demonstrated anti-inflammatory qualities and is also used to treat chronic inflammatory conditions.

In 2016, dapsone was brought into the spotlight for Lyme disease when researchers began testing it with patients and evaluating its ability to target borrelia persister cells. The study included 100 patients diagnosed either with chronic Lyme disease or posttreatment Lyme disease syndrome (PTLDS). Fifty-six patients also had positive tests for the coinfection babesia. During the study, patients were placed on dapsone doses of 100 mg or less in combination with drugs such as rifampin, tetracyclines, and others. One month after the completion of dapsone combination therapy, 59% of patients reported improvements in a range of symptoms.

Then, in 2020, the same researchers completed a second study, involving three cases and a retrospective chart review in which 40 patients were given higher doses of dapsone — “double dapsone” in the amounts of 150-200 mg in combination with medications and supplements for a total of 7-8 weeks. After completing the treatment, 98% of patients reported improvements in long-term Lyme disease symptoms, and 45% achieved remission lasting one year or longer.

Efficacy

Dapsone therapy can be a challenging treatment for many people. After speaking with patients who’ve tried it, I haven’t seen the same benefits as those reported in the study. For patients who complete the protocol, it may take weeks or months to recover from the intensity of treatment and see lab values return to the normal ranges.

Although it might be helpful to some as a last-resort intervention, many people find it extremely difficult to tolerate and need to stop altogether in favor of trying less aggressive forms of treatment.

Dr. Rawls’ Notes

Chronic Lyme disease treatment / transient benefits / significant cost and safety concerns

Efficacy:

Safety:

Cost: $$$$ $

Ways to Administer: oral tablet

Bottom Line: There are other options for treating Lyme disease that don’t come with potentially serious side effects and a hefty price tag.

REFERENCES:

1. Horowitz R, Freeman P. The Use of Dapsone as a Novel “Persister” Drug in the Treatment of Chronic Lyme Disease/Post Treatment Lyme Disease Syndrome. Journal of Clinical & Experimental Dermatology Research. 2016; 7:3. doi: 10.4172/2155-9554.1000345

2. Horowitz RI, Freeman PR. Efficacy of DoubleDose Dapsone Combination Therapy in the Treatment of Chronic Lyme Disease/PostTreatment Lyme Disease Syndrome (PTLDS) and Associated Co-infections: A Report of Three Cases and Retrospective Chart Review. Antibiotics (Basel). 2020 Oct 22;9(11):725. doi: 10.3390/ antibiotics9110725

3. Wozel G, Blasum C. Dapsone in dermatology and beyond. Arch Dermatol Res. 2014;306(2):103124. doi: 10.1007/s00403-013-1409-7

Lyme Disease Treatment Comparison Guide

Dapsone (continued)

Safety

It’s not unusual for patients to report severe Herxheimer reactions, elevated liver enzymes, anemia, low red and white blood cell counts, and more while doing the protocol. Though it’s considered rare, I’ve encountered patients who have experienced methemoglobinemia, a serious blood disorder where not enough oxygen makes it to the cells. Methemoglobinemia requires prompt, emergency treatment.

Additionally, dapsone therapy requires a close watch by your healthcare provider, including weekly to biweekly labs, to monitor the safety of the drug regimen.

Cost

The price of dapsone will vary depending on your insurance coverage and the length of time you take it, but it’s a relatively inexpensive antibiotic. However, the cost for the complete dapsone protocol — with an extensive array of supplements and medications — is exorbitant, costing several hundreds of dollars monthly. Some patients I’ve spoken with have reported spending in excess of $1,000 to $1500 per month for a treatment that yielded few to no improvements for them.

Lyme Disease Treatment Comparison Guide

Disulfiram

Overview

Disulfiram (Tetraethylthiuram Disulfide), a sulfur-containing chemical compound, was originally used in the vulcanization of rubber during the late 1800s. Sulfur is toxic to bacteria, and early on, it was noted to have antibacterial properties. Its use as an antibiotic, however, was abandoned when penicillin was discovered because of the high incidence of side effects associated with it.

In the twentieth century, it again found a use as a treatment for alcohol dependence (Antabuse). Disulfiram blocks alcohol dehydrogenase, the enzyme that breaks down alcohol in the body. If an alcoholic taking disulfiram drinks alcohol, that person will become severely ill. The drug was never very popular, again because of the high rate of undesirable side effects.

More recently, the drug was found to have activity against Borrelia burgdorferi in an in vitro (test tube) study, and it was reintroduced as a treatment for Lyme disease. In a study released from the University of Paris in April 2020, sixteen patients who used disulfiram for the treatment of Lyme disease were polled. All sixteen participants experienced toxic side effects, and only seven patients reported relief of Lyme disease symptoms. Another study published in December 2020 reported higher efficacy (92% of participants reported benefit), with some participants (36%) reporting “enduring benefit,” but they experienced a similarly high rate of side effects.

Efficacy

No doubt, disulfiram has antimicrobial properties against borrelia and a range of other microbes, but the high incidence of potentially severe side effects limits its use to treat Lyme disease. There are much less toxic therapies that are just as effective. (As a side note, disulfiram has also been shown to be toxic to cancer cells and is currently being evaluated as a cancer drug.)

Safety

As with other uses in humans, the increased likelihood of side effects limits the use of the drug for chronic Lyme. Reported side effects include anxiety, paranoid delirium, suicidal thoughts, insomnia, joint pain, tinnitus, fatigue, tachycardia, speech difficulties, flu-like symptoms, elevated liver enzymes, and peripheral neuropathy. Neurological side effects can be severe and persist long after the drug is discontinued.

Dr. Rawls’ Notes

Chronic Lyme disease treatment / transient benefits / significant cost and safety concerns

Efficacy: 

Safety: 

Cost: $ $$$$

Ways to Administer: Oral table

Bottom Line: There are much better options for treating Lyme disease that don’t come with a long list of significant side effects.

Lyme Disease Treatment Comparison Guide

Disulfiram (continued)

Cost

The cost of disulfiram will vary depending on your insurance coverage and the length of time you take it. Patients will likely have a higher out-of-pocket cost when the drug comes from a compounding pharmacy.constituents stated on the labels. In my opinion, we’ve got better alternatives to consider for Lyme treatment than using colloidal silver.

REFERENCES:

1. Trautmann A, Gascan H, Ghozzi R. Potential Patient-Reported Toxicities With Disulfiram Treatment in Late Disseminated Lyme Disease. Front Med (Lausanne). 2020;7:133. Published 2020 Apr 20. doi: 10.3389/fmed.2020.00133

2. Gao J, Gong Z, Montesano D, Glazer E, Liegner K. “Repurposing” Disulfiram in the Treatment of Lyme Disease and Babesiosis: Retrospective Review of First 3 Years’ Experience in One Medical Practice. Antibiotics (Basel). 2020;9(12):868. Published 2020 Dec 4. doi: 10.3390/antibiotics9120868

3. Potula HSK, Shahryari J, Inayathullah M, Malkovskiy AV, Kim KM, Rajadas J. Repurposing Disulfiram (Tetraethylthiuram Disulfide) as a Potential Drug Candidate against Borrelia burgdorferi In Vitro and In Vivo. Antibiotics (Basel). 2020;9(9):633. Published 2020 Sep 22. doi: 10.3390/antibiotics9090633

4. Farooq MA, Aquib M, Khan DH, et al. Recent advances in the delivery of disulfiram: a critical analysis of promising approaches to improve its pharmacokinetic profile and anticancer efficacy. Daru. 2019;27(2):853-862. doi: 10.1007/s40199019-00308-w

5. Sheppard JG, Frazier KR, Saralkar P, Hossain MF, Geldenhuys WJ, Long TE. Disulfiram-based disulfides as narrow-spectrum antibacterial agents. Bioorg Med Chem Lett. 2018;28(8):12981302. doi: 10.1016/j.bmcl.2018.03.023

Lyme Disease Treatment Comparison Guide

Frequency Specific Microcurrents

Overview

Developed in 1995, frequency-specific microcurrent (FSM) is a type of current applied through a device similar to a transcutaneous electrical nerve stimulation (TENS) unit. Electrodes are placed on different parts of the skin, and low-level current is emitted through them. But unlike a traditional TENS unit, the current from an FSM device is so mild that many people don’t feel anything at all.

Targeted frequencies can be used to address pain, inflammation, tissue repair, and swelling in a variety of health conditions, including fibromyalgia and chronic fatigue syndrome (ME/ CFS). Some practitioners of FSM find the device useful for other purposes besides pain relief. I spoke with one patient who successfully used FSM to reduce the nerve pain associated with a shingles outbreak.

Efficacy

Though FSM hasn’t been researched for Lyme disease, specifically, numerous studies support its benefits for softening rigid or spastic tissues in the body, reducing pain, and decreasing inflammation. Research on wounded warriors found that FSM could be used alone or with acupuncture to mitigate pain.

Safety

Overall, FSM is a safe, non-pharmaceutical intervention for the management of pain. However, FSM is contraindicated in people who are pregnant, have a pacemaker, implanted medical pumps, or have uncontrolled seizures.

Cost

There’s a significant upfront cost from the device (about $2,000) however, a good device will last for several years. To help mitigate the risk of a substantial investment, many people first try some FSM sessions with a trained practitioner to see if it’s helpful before purchasing one on their own.

Dr. Rawls’ Notes

Primarily symptom relief

Efficacy:

Safety:

Cost: $$$$ $

Ways to Administer: Electrodes are placed on different locations on the skin

Bottom Line: A good device can cost a couple of thousand dollars, but if pain is a significant limiting factor for you, FSM may be a reasonable investment to consider making to help you feel better.

REFERENCES:

1. McMakin CR, Oschman JL. Visceral and somatic disorders: tissue softening with frequency-specific microcurrent. J Altern Complement Med. 2013;19(2):170-177. doi: 10.1089/acm.2012.0384

2. Sharp SJ, Huynh MT, Filart R. FrequencySpecific Microcurrent as Adjunctive Therapy for Three Wounded Warriors. Med Acupunct. 2019 Jun 1;31(3):189-192. doi: 10.1089/acu.2019.1366

Lyme Disease Treatment Comparison Guide

Glutathione

Overview

Glutathione is a potent antioxidant derived from the amino acids cysteine, glutamate, and glycine; it’s used by all the cells in your body for a variety of purposes. It plays a key role in the body’s ability to detoxify.

The most common forms of glutathione are reduced and liposomal. During my Lyme recovery journey, I developed a significant head and hand tremor, and I was able to eliminate it by taking reduced glutathione powder mixed with coconut milk twice daily. Within two weeks, the tremors were gone.

Efficacy

There’s been a question about whether we absorb glutathione when taken orally, but research suggests certain forms of the compound are indeed absorbed by the body. We don’t get 100% absorption because some of it’s broken down in the gastrointestinal tract, but we can augment our body’s glutathione through supplementation.

Safety

The potential for harm with glutathione is likely quite low and could make a great addition to your recovery protocol, particularly when trying to manage Herxheimer reactions.

Cost

In my experience, reduced glutathione mixed with coconut milk is a more cost-effective option, however, some patients may feel they get better results from the liposomal form, which tends to be a pricier option.

Dr. Rawls’ Notes

Nutrient / detox support

Efficacy:

Safety:

Cost: $ $$$$

Ways to Administer: oral powder, liquid, and capsules. Glutathione can also be administered intravenously.

Bottom Line: Glutathione is a supportive therapy that can boost your antioxidant profile, assist in detoxification, and minimize Herxheimer reactions.

Lyme Disease Treatment Comparison Guide

Hygromycin A

Overview

A 2021 study released in the medical journal Cell detailed a potential “new” antibiotic that is selective for Borrelia bacteria. The antibiotic hygromycin A was found to have specificity for spirochetes like Borrelia, but, at the same time, it didn’t seem to adversely affect flora in the gut.

New, however, is relative. Hygromycin A was first discovered in 1953. It’s a chemical substance produced by a soil bacteria called Streptomyces hygroscopicus. The bacteria produces hygromycin to suppress competing bacteria. Though hygromycin has intrigued researchers for many years, it’s never been put into use as an antibiotic because it has failed to show effectiveness against any major pathogens. That may have changed with the recent study showing specific activity against spirochetes.

Efficacy

The study was conducted both under in vitro (test tube) and in vivo (live model) conditions. In the in vitro testing, hygromycin A was found to suppress a variety of species of Borrelia and other spirochetes, including Treponema pallidum, the bacteria that causes syphilis, but it had little effect on the major categories of gut bacteria. In a second arm of the study, researchers were able to eradicate Borrelia burgdorferi in mice infected with the bacteria with hygromycin-laced food.

However, the biggest limitation of this new information is that Lyme disease isn’t just Borrelia. Ticks carry hundreds of different bacteria, and most people are found to be harboring coinfections as well. Also, how well hygromycin A performs in human populations (as opposed to mice), the impact of eliminating Borrelia exclusively, and whether it has unrecognized side effects in humans have yet to be determined.

Safety

Hygromycin’s safety remains unknown because it was abandoned as an antibiotic after failing to show effectiveness against any major pathogens.

Cost

Because hygromycin is currently being researched, its potential cost for the treatment of Lyme hasn’t been established.

Dr. Rawls’ Notes

Chronic Lyme disease treatment / unproven

Efficacy: Unknown

Safety: Unknown

Cost: Unknown

Ways to Administer: Oral dose

Bottom Line: It may prove to be beneficial for the treatment of Borrelia in the long run, but it’s unproven at this time and doesn’t cover for coinfections commonly associated with Lyme disease.

REFERENCES:

1. Guerrero MD, Modolell J. Hygromycin A, a novel inhibitor of ribosomal peptidyltransferase. Eur J Biochem. 1980 Jun;107(2):409-14. doi: 10.1111/j.1432-1033.1980.tb06044.x

2. Habib el-SE, Scarsdale JN, Reynolds KA. Biosynthetic origin of hygromycin A. Antimicrob Agents Chemother. 2003;47(7):2065-2071. doi: 10.1128/AAC.47.7.2065-2071.2003

3. Leimer N, Wu X, Imai Y, Morrissette M, Pitt N, Favre-Godal Q, Iinishi A, Jain S, Caboni M, Leus IV, Bonifay V, Niles S, Bargabos R, Ghiglieri M, Corsetti R, Krumpoch M, Fox G, Son S, Klepacki D, Polikanov YS, Freliech CA, McCarthy JE, Edmondson DG, Norris SJ, D’Onofrio A, Hu LT, Zgurskaya HI, Lewis K. A selective antibiotic for Lyme disease. Cell. 2021 Oct 14;184(21):54055418.e16. doi: 10.1016/j.cell.2021.09.011

Lyme Disease Treatment Comparison Guide

Hyperbaric Oxygen Therapy

Overview

During hyperbaric oxygen therapy (HBOT), you sit or lie in a pressurized setting, like a room or chamber, while breathing 100% oxygen for a designated amount of time. As oxygen flows through your body, it kills borrelia and other microbes. This therapy works by creating a high-oxygen environment in the body so that borrelia can’t survive. Research suggests it may also stimulate the immune system and reduce inflammation in certain diseases.

Efficacy

HBOT is reasonable to consider, but in my experience, the results are often transient, and many people need additional therapies. Because of cost and long-term safety issues, I wouldn’t place this procedure at the top of my list.

Safety

I have some safety concerns with repeated exposure to high levels of oxygen for an extended period of time and exposure to reactive oxygen species (ROS). Depending on the pressure ranges used during the treatment, there’s a potential to increase oxidative stress on tissues in the body, and the body can take a bit of a hit because of it.

Cost

Patients often require several treatments to see benefits, which can really add up. Because of cost and long-term safety issues, I wouldn’t place this procedure at the top of my list.

Dr. Rawls’ Notes

Primarily supportive / transient benefits

Efficacy:

Safety:

Cost: $$$ $$

Ways to Administer: a pressurized chamber

Bottom Line: Hyperbaric oxygen therapy (HBOT) has potential as a Lyme disease treatment, but the results are often temporary and require further interventions.

REFERENCES:

1. Altinel O, Demirbas S, Cakir E, Yaman H, Ozerhan IH, Duran E, Cayci T, Akgul EO, Ersoz N, Uysal B, Kurt B, Yasar M, Oter S, Peker Y. Comparison of hyperbaric oxygen and medical ozone therapies in a rat model of experimental distal colitis. Scand J Clin Lab Invest. 2011 May;71(3):185-92. doi: 10.3109/00365513.2010

Lyme Disease Treatment Comparison Guide

Hyperthermia

Overview

When undergoing hyperthermia treatments, you’re placed in a special device while under anesthesia. Your body temperature is slowly raised to 106° or, if tolerated, 107° by a trained professional for an average of 45 minutes (the time may vary according to the protocol being used). This type of aggressive heat therapy aims to kill Lyme disease-causing microbes and boost immune function.

Efficacy

I’ve encountered some individuals who’ve gotten better with this therapy. But more often than not, the people I speak with note temporary improvements before experiencing a return of symptoms that require additional treatment strategies to get back on track.

Safety

Documentation on the effectiveness of hypothermia for Lyme disease is sparse, and it can be tough on the body. Some of the side effects of hyperthermia include low blood pressure, tachycardia, seizures, skin lesions, and more. With each repeat treatment, the potential for harmful effects is compounded.

Cost

Hyperthermia isn’t performed in the United States; treatments come with a hefty price tag because patients must travel abroad to countries like Mexico and Germany to receive it.

Dr. Rawls’ Notes

Therapeutic for chronic Lyme disease / significant safety concerns / transient benefits

Efficacy:

Safety:

Cost: $$$$$

Ways to Administer: Patients lie in a special unit capable of being heated to 106° or 107° under anesthesia.

Bottom Line: Hyperthermia doesn’t make it to the top of my list due to its potential side effects, high cost, and lack of documentation for Lyme disease.

Lyme Disease Treatment Comparison Guide

Infrared Sauna Therapy

Overview

Available for home use or at gyms and spas, saunas have long been a wellness tool throughout the world for their healthpromoting properties. In the chronic Lyme disease and chronic illness communities, far infrared saunas (FIR) are the kind of saunas you’re apt to hear about because they generate dry heat, which is usually better tolerated by patients than the heat from steam saunas.

Possibly the most significant advantage is that FIR saunas are portable and cost-effective compared to other types of sauna. They can be broken down or folded into panels and shipped across the country, snapped back together in the corner of a room, and plugged into a regular wall socket.

Efficacy

The deep penetrating heat of FIR (up to a few inches beneath the skin’s surface) increases detoxification by moving blood to flush the buildup of toxic substances and waste products from around cells. Although exercise is a great way to move blood, exercise causes friction in tissues, which isn’t ideal for someone whose body is already severely inflamed. In contrast, FIR saunas move blood without causing friction. Plus, the use of FIR saunas aids circulation and has been shown to stimulate the release of endorphins and other opioid-like chemicals. These are the body’s natural pain-relieving hormones that bind to opioid receptors in the brain to reduce pain, fight inflammation, and support the immune system.

Safety

FIR is a reasonable, supportive therapy to add to your Lyme treatment protocol. But there are a few considerations to be aware of: Excessive heat can be a stress factor for your body, resulting in such symptoms as dizziness or feelings of malaise. New sauna users should start slowly, as little as five minutes, and increase the time to 30 minutes as the body allows.

Cost

The cost to use a sauna will vary from one location to another. However, if you choose to invest in one, the initial cost might be several hundred dollars, but you should expect to have your sauna for many years to come.

Dr. Rawls’ Notes

Exceptional detox support

Efficacy:

Safety:

Cost: $$ $$$

Ways to Administer: You sit in a heated room or a zip-up, fabric, tentlike structure

Bottom Line: FIR can be a useful addition to any Lyme protocol, but consistent use is key for the best outcomes.

REFERENCES:

1. Hussain J, Cohen M. Clinical Effects of Regular Dry Sauna Bathing: A Systematic Review. Evid Based Complement Alternat Med. 2018;2018:1857413. Published 2018 Apr 24. doi: 10.1155/2018/1857413

Lyme Disease Treatment Comparison Guide

Intravenous Vitamin Therapy

Overview

During intravenous (IV) vitamin therapy, a cocktail of vitamins, including vitamin C, B vitamins, magnesium, calcium, and sometimes glutathione, are delivered to your bloodstream by inserting an IV line into your vein. Your cells require nutrients to operate efficiently.

But factors like chronic illness, prolonged stress, and inflammation can deplete your cells of the vital nutrients you need to get well. Patients often report that IV vitamins, sometimes called Myer’s cocktails, help them feel better.

This therapy is becoming increasingly more popular, and it’s available at many IV centers and integrative clinics around the country.

Efficacy

The benefits of IV vitamin therapy are often short-lived. However, I think it’s a reasonable, supportive intervention to consider if you feel like you need to jumpstart your internal battery once in a while.

Safety

IV vitamin therapy is relatively safe, but there can be some issues when trying to insert a needle into a vein. Also, repeated use of IV vitamin C may cause scarring of the veins, so it’s an intervention better kept for the times when you’re feeling low.

Cost

Typically, insurance doesn’t cover IV vitamin therapy, so you’ll need to pay out of pocket for it. The cost will vary from one clinic to another.

Dr. Rawls’ Notes

Nutrient support

Efficacy:

Safety:

Cost: $$$ $$

Ways to Administer: intravenous (IV) administration of vitamins

Bottom Line: IV vitamin therapy can be a supportive therapy to provide a temporary stockpile of nutrients for your cells, but the benefits are usually temporary.

Lyme Disease Treatment Comparison Guide

Ketogenic Diet

Overview

The ketogenic diet is a dietary practice of severely restricting carbohydrates (There are a lot of good reasons to cut back on carbohydrates; they’re heavy contributors to disease in America.

Efficacy

I have spoken to many patients who haven’t been able to complete this diet due to its strict nature. Additionally, when they cut out carbohydrates, they tend to eat a lot more meat instead of vegetables, and a meat-laden diet generates a lot of toxins in the body, which, in my opinion, can be just as toxic as carbohydrates.

Rather than relying on ketones alone, I prefer a carb-neutral diet, where you don’t consume more carbs than you can burn off in a day. This type of diet is called the Vital Plan diet and includes eating lots of vegetables, healthy protein sources, fruits and berries, and limited carbohydrates.

Safety

Fad diets and trends can be difficult to sustain for months or years on end, and some can be harmful. The safest bet is to find a healthy, nutrient-dense eating plan you can stick with for life to provide your body with optimal fuel.

Cost

The cost is roughly the same as any other food you would buy.

Dr. Rawls’ Notes

Dietary support

Efficacy:

Safety:

Cost: $ $$$$

Ways to Administer: Oral

Bottom Line: A nutrient-dense diet will provide your body with the fuel it needs to heal and restore.

Lyme Disease Treatment Comparison Guide

Laser Therapy

Overview

Cold laser therapy — or focused low-intensity light therapy — triggers biochemical changes in tissues without thermal damage. Cold laser therapy has been shown to reduce inflammation, alleviate pain, and promote healing. It has a number of FDAapproved therapeutic applications.

Efficacy

There’s some good data out there supporting the use of cold laser therapy for the symptom relief of musculoskeletal pain, so I think there’s definitely a place for cold laser therapy in your Lyme recovery protocol for easing this type of pain.

Safety

Many health practitioners use cold laser therapy, including chiropractors, physicians, physical therapists, and even dentists. A slight side effect that you might notice is mild tingling of the skin.

Cost

In some instances, your insurance may cover the procedure. If you have to pay out of pocket, the cost can certainly add up. You can purchase devices for home use, but there’s a definite difference between the quality of the units used in a practitioner’s office and the smaller ones you find online.

Dr. Rawls’ Notes

Primarily symptom relief

Efficacy:

Safety:

Cost: $$$ $$

Ways to Administer: low-intensity laser on the skin

Bottom Line: Laser therapy may be a good modality to incorporate when musculoskeletal pain is present.

REFERENCES:

1. Avci P, Gupta A, Sadasivam M, et al. Low-level laser (light) therapy (LLLT) in skin: stimulating, healing, restoring. Semin Cutan Med Surg. 2013;32(1):41-52.

2. Cotler HB, Chow RT, Hamblin MR, Carroll J. The Use of Low Level Laser Therapy (LLLT) For Musculoskeletal Pain. MOJ Orthop Rheumatol. 2015;2(5):00068. doi: 10.15406/ mojor.2015.02.00068

Lyme Disease Treatment Comparison Guide

Low-Dose Naltrexone (LDN)

Overview

Naltrexone is a drug designed to block opioid receptors in the body. Opioid receptors decrease the pain response when activated by endorphins in the body. Opioid drugs reduce pain by mimicking endorphins to activate opioid receptors. The limitation of prolonged use of opioid drugs (narcotics) is habituation and dependence.

Naltrexone was created back in the 70s to help addicts get off heroin. At a standard dose of 50 mg, the drug blocks all opioid receptors in the body. In other words, it blocks all the effects of heroin. In theory, an addict would find heroin useless and stop using it, but it never took off as a popular drug.

Interestingly, someone noticed that low-dose naltrexone (LDN) in 1.5-4.5 mg doses had a different effect: When it’s administered once daily, or sometimes twice daily, an intermittent blockage of opioid receptors causes a surge in natural endorphin production. With daily use, elevated endorphin secretion is sustained, along with pain relief and enhanced feelings of well-being.

Efficacy

Use of LDN in autoimmune disease, chronic pain and inflammation, and a range of health conditions, including fibromyalgia and chronic Lyme disease, is well supported by research documented at lowdosenaltrexone.org.

In my clinical experience, only about half of people benefit from LDN. Of those, some gain significant benefits, but most experience only mild improvements. The other half of people have little or no response, and some experience significant side effects. If a benefit is achieved, it’s okay to stay on LDN longterm. Note that CBD oil also provides similar benefits and works more consistently, and the two can be used together.

Safety

Use of naltrexone at a low dose is generally safe and has a low incidence of severe side effects. It has no narcotic effects and carries zero potential for dependence and habituation. Naltrexone requires a prescription from a healthcare provider and is usually obtained from a compounding pharmacy. To use lowdose naltrexone, you must be off all narcotics for at least a week.

Cost

The cost to fill LDN tends to vary between different compounding pharmacies and the strength of the prescription, but a monthly prescription could cost between $200 to $300.

Dr. Rawls’ Notes

Symptom relief / immunomodulation

Efficacy:

Safety:

Cost: $$ $$$

Ways to Administer: oral dose once or twice daily

Bottom Line: About half of the people who try low-dose naltrexone experience benefits from it, but the risk associated with trying it is very low. It’s primarily supportive, but increased endorphins do support immune system functions.

Lyme Disease Treatment Comparison Guide

Methylene Blue

Overview

Since it was first isolated as a chloride salt compound in the late 1800s, methylene blue (MB) has demonstrated a range of therapeutic benefits, including antidepressant, antimicrobial, antioxidant, and neuroprotectant properties. It was used to treat malaria for nearly 100 years, but it fell out of favor when chloroquine, a quinolone-based drug, emerged on the scene.

Presently, MB is used to treat a life-threatening condition known as methemoglobinemia, a serious blood disorder where not enough oxygen makes it to the cells, and urinary tract infections.

In recent years, researchers have begun to look at some of MB’s other uses – most notably, as an antimicrobial agent against Lyme disease and the coinfection Bartonella. It may also have some power against mold, viruses, and other pathogens and boost ATP levels in the body.

Two studies examined MB’s ability to treat Bartonella. A 2019 study showed that MB has power against persistent Bartonella infections when used alone or with other synthetic or herbal antimicrobials. Then, in 2020, the same group of researchers evaluated a panel of drug combinations and found that MB removed biofilms when used with other antibiotics. However, neither study was performed in human or animal models, so more research is needed to accurately assess its success as a treatment for Lyme or various strains of Bartonella.

Nevertheless, several healthcare professionals are using MB in their protocols, and some patients report improvements from the drug. Typically, the medication is administered in 50 mg doses twice daily, but it may vary depending on the provider. MB may also be used in lower doses as part of a protocol involving the use of red light therapy for deeper penetration of the drug in specific areas of the body.

Efficacy

Emerging research holds promise for using MB as a treatment for persistent Bartonella, so it’s reasonable to consider. MB contains antimicrobial properties, but because it isn’t an antibiotic, it doesn’t destroy the gut flora like synthetic antibiotics do. However, because MB has yet to be tested in humans, the longterm results and side effects are still unknown.

Dr. Rawls’ Notes

Chronic Lyme disease treatment

Efficacy:

Safety:

Cost: $$ $$$

Ways to Administer: Oral preparation

Bottom Line: Methylene blue has potential as a treatment for Lyme disease and coinfections, especially Bartonella. However, long-term results and side effects are still unknown.

REFERENCES:

1. Li T, Feng J, Xiao S, Shi W, Sullivan D, Zhang Y. Identification of FDA-Approved Drugs with Activity against Stationary Phase Bartonella henselae. Antibiotics (Basel). 2019;8(2):50. Published 2019 Apr 29. doi: 10.3390/ antibiotics8020050

2. Zheng, X., Ma, X., Li, T. et al. Effect of different drugs and drug combinations on killing stationary phase and biofilms recovered cells of Bartonella henselae in vitro. BMC Microbiol 20, 87 (2020). doi: 10.1186/s12866-020-01777-9

Lyme Disease Treatment Comparison Guide

Methylene Blue

(continued)

Safety

In therapeutic doses, MB is generally well-tolerated. However, it turns urine blue and can temporarily stain the mouth and teeth. It may also interact with several medications and supplements, so be sure to let your doctor know what you’re taking before starting MB therapy. Higher doses of MB can yield side effects such as chest pain or confusion. Additionally, it’s not unusual for patients to report experiencing Herxheimer reactions while taking the drug.

Cost

Most patients use the liposomal preparation of MB from a compounding pharmacy to increase the rate of absorption through the stomach, so the price can vary depending on the pharmacy and the length of time you take it, but expect to pay somewhere between $250 to $300 for a month’s supply.

Lyme Disease Treatment Comparison Guide

Nosodes

Overview

Nosodes are homeopathic remedies comprised of dilute concentrations of macerated bacteria associated with Lyme disease or secretions from Lyme patients. The remedies are administered by oral preparations and are meant to act as an oral vaccine against Lyme infections. Because many of the preparations are so dilute, they often don’t have much of a taste.

Efficacy

No scientific studies exist to support the efficacy of nosodes for Lyme disease. Although I’ve read some online reviews of people having positive responses for Lyme and coinfections to this type of intervention, I don’t have high expectations that the majority of people would have significant outcomes from it.

Safety

The potential for harm with nosodes is likely quite low, and if you wanted to give it a try, presumably you could with minimal risk.

Cost

Nosodes are relatively inexpensive and cost about the same as herbs.

Dr. Rawls’ Notes

Chronic Lyme disease treatment / low efficacy

Efficacy:

Safety:

Cost: $$ $$$

Ways to Administer: Oral

Bottom Line: Trying nosodes is unlikely to cause harm, but there’s no scientific evidence to show they actually work for people with Lyme disease.

Lyme Disease Treatment Comparison Guide

Ozone Therapy

Overview

Ozone therapy is IV ozone administered in a single injection or by the circulation of blood through a machine. It raises the oxygen levels in your blood to help combat borrelia, an anaerobic bacteria that can’t exist in oxygen-rich situations. However, note that this isn’t true for many Lyme coinfections, which need oxygen to survive. Ozone may enhance immune function and reduce inflammation.

Efficacy

Ozone has some positive benefits associated with it, so it’s reasonable to consider. But in my experience, the results are often transient, and many people need additional therapies to see long-term improvements in their health.

Safety

Ozone may have the potential to increase oxidative stress on tissues in the body and may have some tissue toxicity associated with it. I wouldn’t recommend that people use ozone as a primary therapy, but it might have a complementary place in a treatment protocol to pack a little extra punch.

Cost

Patients often require several treatments to see benefits, which can be expensive. Because of cost and long-term safety issues, ozone therapy isn’t my therapy of choice.

Dr. Rawls’ Notes

Primarily supportive / transient benefits / safety issues

Efficacy:

Safety:

Cost: $$$

Ways to Administer: IV, injection, or a pressurized chamber

Bottom Line: Ozone has potential as a Lyme disease treatment, but the results are often short-lived and require further interventions.

REFERENCES:

1. Altinel O, Demirbas S, Cakir E, Yaman H, Ozerhan IH, Duran E, Cayci T, Akgul EO, Ersoz N, Uysal B, Kurt B, Yasar M, Oter S, Peker Y. Comparison of hyperbaric oxygen and medical ozone therapies in a rat model of experimental distal colitis. Scand J Clin Lab Invest. 2011 May;71(3):185-92. doi: 10.3109/00365513.2010

Lyme Disease Treatment Comparison Guide

Phage Therapy

Overview

A bacteriophage is a virus that only infects bacteria. There are thousands of bacteriophages, and they’re bacteria-specific. In other words, they only infect one species of bacteria. Some bacteriophages are lethal to the bacteria they infect. Phage therapy for treating bacterial infections dates back to the early twentieth century and has been associated with varying success. Interest in phage therapy for the treatment of bacterial infections declined after the discovery of penicillin. But interest has recently been renewed with the growing threat of antibiotic-resistant bacteria.

Because certain bacteriophages are lethal to Borrelia burgdorferi, the bacteria associated with Lyme disease, phage therapy has been proposed as a treatment for Lyme disease. A big advantage over antibiotics is that bacteriophages specific for borrelia don’t harm normal flora in the gut or human cells. While this might seem to put borrelia-specific bacteriophages in the running for an ideal treatment for chronic Lyme disease, there are limitations.

When Lyme disease becomes chronic, the bacteria are intracellular — which means the bacteria survive inside cells in tissues throughout the body. The bacteria cannibalize the nutrients of the cell they infect to make more bacteria and only emerge to infect other cells when a cell has been used up. When inside cells, the bacteria would be completely protected from bacteriophages.

Therefore, bacteriophages can only kill borrelia when the bacteria emerge from cells, which means that to eradicate the bacteria, phage therapy must be administered continually for months or even years, which isn’t practical. Also, bacteria can develop resistance to bacteriophages.

In addition, anyone in the know about chronic Lyme disease is aware that people are infected with a range of different microbes that have the same or greater potential to cause illness as borrelia. Because testing for all possible microbes associated with chronic Lyme disease is limited, and every person is carrying different microbes, treating Lyme disease with specific phages for possible bacteria related to a person’s illness is impractical.

Dr. Rawls’ Notes

Chronic Lyme disease treatment / low efficacy

Efficacy: Unknown

Safety:

Cost: $$$$$

Ways to Administer: Oral, IV, intranasal, and more

Bottom Line: The value of bacteriophage therapy for treating chronic Lyme disease is unknown. It may provide some benefit, but because of its limitations, phage therapy is unlikely to replace other effective therapies, such as herbal therapy.

REFERENCES:

1. Gordillo Altamirano FL, Barr JJ. Phage Therapy in the Postantibiotic Era. Clin Microbiol Rev. 2019;32(2):e00066-18. Published 2019 Jan 16. doi: 10.1128/CMR.00066-18

2. Kortright KE, Chan BK, Koff JL, Turner PE. Phage Therapy: A Renewed Approach to Combat Antibiotic-Resistant Bacteria. Cell Host Microbe. 2019 Feb 13;25(2):219-232. doi: 10.1016/j. chom.2019.01.014. PMID: 30763536.

3. Górski A, Międzybrodzki R, Łobocka M, et al. Phage Therapy: What Have We Learned?. Viruses. 2018;10(6):288. Published 2018 May 28. doi: 10.3390/v10060288

4. Cisek AA, Dąbrowska I, Gregorczyk KP, Wyżewski Z. Phage Therapy in Bacterial Infections Treatment: One Hundred Years After the Discovery of Bacteriophages. Curr Microbiol. 2017;74(2):277-283. doi: 10.1007/s00284-0161166-x

Lyme Disease Treatment Comparison Guide

Phage Therapy (continued)

Efficacy

The greatest advantage of phage therapy is treating specific antibiotic-resistance bacteria, which are extracellular (exist in the body outside cells and therefore exposed to phages). But does it really help those with Lyme disease? It’s unknown because there are no published studies for using phage therapy to treat Lyme.

Safety

Similarly, the safety of phage therapy for chronic Lyme disease is unknown because there are no published studies on it.

Cost

Prices vary depending on where a person receives treatment, but the cost can rise as high as several thousands of dollars.

Lyme Disease Treatment Comparison Guide

Probiotics

Overview

Probiotics are favorable bacteria (lactobacillus and bifidobacteria) or yeast (Saccharomyces boulardii) administered as an oral preparation that we introduce into the intestinal tract to correct imbalances in our gut microbiome. If you’ve used antibiotics, probiotics can help restore some of the gut’s beneficial flora that has been destroyed with treatment.

Efficacy

Although probiotics have been around for many years, research on the topic is still in its infancy. Ultimately, we’re still learning which microbes or combinations of microbes are the most helpful to people or conditions. In my practice, probiotics tend to be hit or miss. It’s about 50/50 — they work well for some people but not for others.

Safety

I gave probiotics four stars for safety because some people may have adverse reactions, especially individuals with small intestinal bowel overgrowth (SIBO). Probiotics may make their situation worse and cause further gut discomfort.

Cost

The cost for probiotics is relatively low and reasonably priced compared to many supplements on the market.

Dr. Rawls’ Notes

Gut microbiome support

Efficacy:

Safety:

Cost: $ $$$$

Ways to Administer: Oral

Bottom Line: Probiotics may work for some people but not for others.

Lyme Disease Treatment Comparison Guide

Qigong

Overview

Qigong is a favorite mind-body activity of mine. It’s an ancient Chinese art of movement, and it’s both meditative and physically stimulating. The gentle, low-impact exercises help to balance energy, increase blood flow, and boost endorphins. Qigong is easy to learn from online sources like YouTube videos.

Efficacy

Due to the gentle nature of qigong, many people find that it’s among some of the first exercises they’re able to participate in during the Lyme recovery process. I recommend qigong or another mind-body exercise program for every Lyme patient.

Safety

Like many mind-body exercises, qigong can be modified to suit your activity level and is restorative to the body.

Cost

Qigong doesn’t require any equipment to begin, so there are no startup costs to participate in it.

Dr. Rawls’ Notes

Supportive

Efficacy:

Safety:

Cost: $ $$$$

Ways to Administer: Gentle movements in an upright position or while lying down

Bottom Line: Mind-body movements like qigong should be a part of every recovery protocol.

Lyme Disease Treatment Comparison Guide

Rebounder Therapy

Overview

A rebounder is a small personal trampoline. Rebounding stimulates an integral part of your immune system called the lymphatic system, a vast drainage network of organs, vessels, and other structures throughout the body. Although it’s not a treatment for Lyme disease, rebounding is a reasonable-priced, supportive therapy that helps many people feel better.

Efficacy

Bouncing for 10-30 minutes per session gets your blood flowing, strengthens the autonomic nervous system, and increases lymphatic flow to support your body’s natural detoxification processes.

Safety

If engaging in exercise is a challenge, a rebounder provides a safe and low-impact way to get some exercise without the energy expenditure and physical demands required by more strenuous activities. Consider one with a support bar for extra safety precautions.

Cost

Most mini-trampolines can be purchased for $100 or less.

Dr. Rawls’ Notes

Supportive

Efficacy:

Safety:

Cost: $ $$$$

Ways to Administer: Jumping on a mini-trampoline, ideally with support bars.

Bottom Line: Rebounding is an excellent way to clear out the lymphatic system, and people often feel better after a session.

Lyme Disease Treatment Comparison Guide

Rife Therapy

Overview

People who’ve been dealing with Lyme for a while have probably heard about the rife machine. In the mid-1930s, an American scientist named Royal Raymond Rife developed a one-of-a-kind microscope capable of seeing bacilli, a class of bacteria that he believed contributed to many diseases, including cancer.

Following his hypothesis, he created the Rife Frequency Generator, a machine he claimed could kill bacilli and diagnose and eradicate several illnesses using electrical impulses emitted by diseased tissues in the body. A short time later, The American Medical Association spoke out against Rife, halting further research into electrical therapies. However, in the last 20 to 30 years, interest in rife therapy has increased, and stories of people seeing improvements in their health abound.

Efficacy

Rife therapy isn’t approved by the FDA. There’s little research to support the therapy’s efficacy, and the devices are unregulated. Maybe it doesn’t actually kill bacteria? Maybe it works by stimulating immune cells in some way?

I would give it higher points for efficacy if the exact mechanisms of action were known. It would be nice to see some evidence because I’m at a loss to explain how the technology specifically targets a few species of bacteria scattered among the other 40,000 different species in the body.

Safety

Though the potential for harm with Rife therapy appears to be low, it’s not regulated and has no supporting research, so the actual safety issues or side effects are unknown at this point.

Cost

Rife therapy is a sizable upfront investment for a technology that hasn’t been well investigated and isn’t regulated.

Dr. Rawls’ Notes

Chronic Lyme disease treatment / low efficacy

Efficacy:

Safety:

Cost: $$$ $$

Ways to Administer: Coil or a handheld device

Bottom Line: I have some reservations because of the upfront cost and lack of evidence and regulation. With that said, the therapy appears to be quite safe.

REFERENCES:

1. Zimmerman JW, Jimenez H, Pennison MJ, et al. Targeted treatment of cancer with radiofrequency electromagnetic fields amplitude-modulated at tumor-specific frequencies. Chin J Cancer. 2013;32(11):573-581. doi: 10.5732/cjc.013.10177

Lyme Disease Treatment Comparison Guide

Stem Cell Therapy

Overview

Stems cell therapy is somewhat new to the scene when it comes to interventions for chronic Lyme disease. There are two ways to obtain stem cells: one way is through embryonic stem cells you get from another human. The other is from fat stem cells gathered from fatty tissues in your body (autologous).

Stem cells are pluripotent cells, meaning they can become any other cells in the body — heart cells, liver cells, immune cells, etc. When they’re injected into parts of the body, like the joints or the bloodstream, they may help restore certain functions. For example, if you have a compromised immune system, stem cell therapy is, theoretically, a way to provide it with some reinforcements.

Efficacy

Our understanding of embryonic stem cells for treating any type of illness is still in its infancy. While it’s promising, there’s still a lot to learn. As for its application to Lyme disease specifically, there’s limited research on the topic. Anecdotally, I’ve known two patients who have had embryonic stem cells so far, and both of them only had mild benefits that didn’t last.

On the other hand, autologous stem cell therapy for joint regeneration is now widely performed and accepted across the country. For individuals with loss of joint cartilage great enough to be considering joint replacement, this is a very reasonable first alternative to consider.

Safety

Because embryonic stem cell therapy is a newer option for chronic Lyme disease, there’s not much information regarding the safety, and we don’t know what their long-term effects might be. However, autologous stem cells don’t require donor cells, so the risk associated with their use is reduced.

Cost

Possibly the biggest drawback for embryonic stem cells is a high initial cost for an unknown procedure with little assurance of a positive outcome. Autologous stem cell therapy may be covered by insurance, depending on the condition that’s being treated.

Dr. Rawls’ Notes

Chronic Lyme disease treatment / limited efficacy / transient benefits

Efficacy:

Safety:

Cost: $$$$$

Ways to Administer: Medical procedure performed at a specialized clinic

Bottom Line: Embryonic stem cells to treat Lyme disease or any illness is in its infancy. Little is known about outcomes, and there’s a high initial cost for a big unknown. However, autologous, fat stem cell therapy is a reasonable alternative to consider for joint health.

REFERENCES:

1. Horowitz R, Freeman PR. Improvement of common variable immunodeficiency using embryonic stem cell therapy in a patient with lyme disease: a clinical case report. Clin Case Rep. 2018;6(6):1166-1171. Published 2018 May 2. doi: 10.1002/ccr3.1556

Lyme Disease Treatment Comparison Guide

Stevia

Overview

Stevia is a natural, non-caloric sweetener that’s 40 times sweeter than sugar. It comes from the plant, Stevia rebaudiana, which grows naturally in South America. People have been using stevia to sweeten their yerba mate and tea for hundreds of years. The chemical compounds in stevia that provide the sweet taste, called steviol glycosides, don’t contribute to calories because they aren’t absorbed through the intestines in appreciable amounts, making stevia an ideal sugar alternative.

Over the past several years, there’s been a lot of talk about stevia being beneficial for treating Lyme disease. This idea comes from an in vitro study published in the European Journal of Microbiology and Immunology in 2015. The study found that whole leaf stevia extract effectively kills Borrelia burgdorferi spirochetes and cyst forms. The operative word is, “in vitro,” meaning the test was conducted in a test tube, not a living organism. When placed in a test tube, whole-leaf stevia extract inhibited the growth of live Borrelia spirochetes and cysts.

Additionally, findings in the above study were contradicted by a 2020 study from Johns Hopkins University. In this study, researchers investigated the potential for antimicrobial activity of 12 herbs reported to treat Lyme disease. Stevia rebaudiana was on the list, but it failed to show any appreciable activity against Borrelia by in vitro testing.

The researchers pointed out that in the 2015 study, the stevia extract contained alcohol, which may have accounted for the antimicrobial activity. The samples in the Johns Hopkins study were controlled for alcohol.

Of significance, the Johns Hopkins study did show that seven of the herbs tested had greater activity against the Borrelia bacteria than the antibiotics doxycycline and cefuroxime. The list included Cryptolepis sanguinolenta, Juglans nigra (Black walnut), Polygonum cuspidatum (Japanese knotweed), Artemisia annua (Sweet wormwood), Uncaria tomentosa (Cat’s claw), Cistus incanus, and Scutellaria baicalensis (Chinese skullcap).

Dr. Rawls’ Notes

Chronic Lyme disease treatment / low efficacy

Efficacy:

Safety:

Cost: $ $$$$

Ways to Administer: Oral

Bottom Line: Stevia is a great alternative for cutting calories, but you shouldn’t depend on it for treating Lyme disease.

REFERENCES:

1. Feng J, Leone J, Schweig S, Zhang Y. Evaluation of Natural and Botanical Medicines for Activity Against Growing and Non-growing Forms of B. burgdorferi. Front Med (Lausanne). 2020 Feb 21;7:6. doi: 10.3389/fmed.2020.00006

2. Geuns JM, Augustijns P, Mols R, Buyse JG, Driessen B. Metabolism of stevioside in pigs and intestinal absorption characteristics of stevioside, rebaudioside A and steviol. Food Chem Toxicol. 2003 Nov;41(11):1599-607. doi: 10.1016/s02786915(03)00191-1

3. Theophilus PA, Victoria MJ, Socarras KM, Filush KR, Gupta K, Luecke DF, Sapi E. Effectiveness of Stevia Rebaudiana Whole Leaf Extract Against the Various Morphological Forms of Borrelia Burgdorferi in Vitro. Eur J Microbiol Immunol (Bp). 2015 Nov 12;5(4):268-80. doi: 10.1556/1886.2015.00031

Lyme Disease Treatment Comparison Guide

Stevia (continued)

Efficacy

Though the finding that chemical compounds found in stevia have antimicrobial properties is interesting, the fact that most of the chemical components of stevia extract aren’t absorbed through the intestinal tract makes it unlikely that stevia would be useful for treating Lyme disease in a living organism.

Safety

Stevia works well as a sugar substitute in your food. However, if you use it regularly, stevia may cause digestive upset in some people.

Cost

Stevia is more expensive than standard table sugar but costs about the same as other natural sugar substitutes like xylitol — anywhere from $10 for a package to $40 for a liquid extract.

Lyme Disease Treatment Comparison Guide

Transfer Factors

Overview

Transfer factors are a part of the immune system’s elaborate communication system. Specifically, transfer factors are peptides (short chains of amino acids) with bits of RNA produced by white blood cells called helper T-cells. Helper T-cells produce transfer factors to guide cytotoxic T-cells and natural killer cells to the right target. Cytotoxic T-cells and natural killer cells specialize in destroying cells that have been infected with intracellular microbes (bacteria, viruses, protozoa, and yeast) and cells that have turned cancerous. There are about 200 known transfer factors.

Transfer factors got their name because when they were “transferred” from a healthy person and given to an ill person, they could help that person fight off infection. It was also recognized that transfer factors from cows and chickens are similar or identical to humans and, given in supplement form, could help humans overcome an infectious illness. Transfer factors are made by exposing a cow or chicken to a particular pathogen and extracting the transfer factors from the cow’s colostrum (milk) or egg yolk.

The use of transfer factors has been applied to a variety of potential indications, including herpes infections, fibromyalgia, rheumatoid arthritis, chronic Lyme disease, influenza, chronic allergies, and cancer.

Efficacy

Despite enthusiasm after their initial discovery of transfer factors, evidence of benefits has been mixed, and the use of transfer factors has never really caught on in the conventional medical community.

Part of the problem may be the lack of absorption through the intestinal tract. For transfer factors to work, they must reach the bloodstream. Peptides are typically broken down by stomach acid. However, some of the research on transfer factors suggests a part of absorption of whole transfer factors does occur through the human intestinal tract.

Another reason why transfer factors have limited or mixed efficacy may be our lack of understanding of the immune system’s network of communication. The communication that occurs between immune cells is a dynamic conversation. Chemical signaling agents, such as transfer factors and cytokines, are the language that immune cells use to talk to one another. Administering a random infusion of transfer factors could be like a person shouting random words at a group of pe ople having a conversation — it wouldn’t make any sense and could even be disruptive.

Dr. Rawls’ Notes

Chronic Lyme disease treatment / low efficacy

Efficacy:

Safety:

Cost: $$ $$$

Ways to Administer: Oral

Bottom Line: Use of transfer factors is safe, but efficacy is mixed. Best results are obtained when transfer factors are used under the guidance of an experienced alternative provider. Transfer factors can be used in conjunction with other therapies, such as herbal therapy.

REFERENCES:

1. Fabre RA, Pérez TM, Aguilar LD, et al. Transfer factors as immunotherapy and supplement of chemotherapy in experimental pulmonary tuberculosis. Clin Exp Immunol. 2004;136(2):215223. doi: 10.1111/j.1365-2249.2004.02454.x

2. Hamblin AS. Transfer factor. J R Soc Med. 1979;72(12):927-929.

3. Macias AE, Guaní-Guerra E. Transfer Factor: Myths and Facts. Arch Med Res. 2020 Oct;51(7):613-622. doi: 10.1016/j. arcmed.2020.06.016. Epub 2020 Jul 9. PMID: 32654883.

4. Viza D, Fudenberg HH, Palareti A, Ablashi D, De Vinci C, Pizza G. Transfer factor: an overlooked potential for the prevention and treatment of infectious diseases. Folia Biol (Praha). 2013;59(2):53-67. PMID: 23746171.

Lyme Disease Treatment Comparison Guide

Transfer Factors (continued)

Safety

Even with those possible limitations on absorption, the use of transfer factors appears to be safe. Few have reported side effects and adverse reactions in more than 600 clinical studies. Possible mild reactions include mild transient fever and malaise.

Cost

Typically, the cost of high-quality transfer factors is between $50 and $75 — on par with other medical-grade supplements.

Lyme Disease Treatment Comparison Guide

UV Light Therapy

Overview

Popular in the U.S. from 1940-1950, just before the discovery of antibiotics, ultraviolet (UV) light was known as a broad-spectrum antimicrobial. But once antibiotics took center stage, research into UV light therapy waned. However, as concerns about the overuse of antibiotics and antibiotic resistance rise to the forefront of healthcare, there’s a renewed interest in the benefits of UV light therapy.

Efficacy

During the therapy, the blood is circulated through a machine and exposed to UV rays, which kill microbes by damaging their DNA. But there’s a problem: chronic Lyme disease consists of stealth infections, which means the microbes are sprinkled throughout your tissues and cells; they don’t reside in your blood where the UV light would be most effective. Although UV light might work well for an active infection, it seems unlikely that it would do much for a chronic, low-grade infection like Lyme.

Safety

UV light therapy could increase oxidative stress on tissues in the body and may have some tissue toxicity associated with it. There are also some safety issues when you circulate blood out of the body and through a machine.

Cost

Patients often require several treatments to see benefits, which can be expensive. Because of cost and long-term safety issues, UV therapy isn’t a viable option for most people.

Dr. Rawls’ Notes

Chronic Lyme disease treatment / low efficacy

Efficacy:

Safety:

Cost: $$$$ $

Ways to Administer: IV with a specialized device in a clinic

Bottom Line: UV light has potential for acute infection, but it seems unlikely that it would do much for a chronic, low-grade infection like Lyme.

Lyme Disease Treatment Comparison Guide

Yoga

Overview

Yoga is a low-intensity, meditative, physical exercise using a range of postures for stretching, strengthening, and restoring health. I find yoga to be a highly valuable tool on the journey to recovery because it enhances blood flow, stimulates endorphins, increases detoxification, and helps to bring the nervous system into a more balanced state.

Efficacy

Because yoga can be adapted to suit a variety of body types and fitness levels, many people find that it’s one of the gentler forms of exercise they’re able to participate in — it’s truly a supportive therapy.

Safety

Like other mind-body exercises, yoga can be modified to your activity level and is restorative to the body.

Cost

Only a yoga mat ($30 to $100) is required to begin the practice, but additional equipment, like blocks, a strap, and a bolster, can be used to adjust your alignment in the postures and make the practice more comfortable for you.

Dr. Rawls’ Notes

Supportive

Efficacy:

Safety:

Cost: $ $$$$

Ways to Administer: low-impact movements in an upright position or while lying down

Bottom Line: Mind-body exercises like yoga should be a part of every recovery protocol.

Lyme Disease Treatment Comparison Guide

Zeolite

Overview

Derived from volcanic aluminosilicate minerals, zeolite is made up of an absorbent lattice that binds to toxic substances, such as ammonia and nitrate—and removes them from the body. Regarding Lyme treatment, it’s often used as a toxin binder.

Efficacy

There are a variety of studies highlighting the benefits of zeolite, which include detoxification, reducing oxidative stress, immune modulation, and gut microbiota balancing, so this is certainly a substance worth adding to the list.

Safety

Some people report constipation when taking it, but that can often be remedied by increasing your intake of magnesium. Zeolite may bind to other supplements and medications, so be sure to take it at least two hours away from any other substances.

Cost

The cost of zeolite depends on the brand used — anywhere from $25 to $75.

Dr. Rawls’ Notes

Detox support

Efficacy:

Safety:

Cost: $ $$$$

Ways to Administer: Oral

Bottom Line: Research suggests zeolite has a range of benefits and can be a supportive supplement to add to your Lyme protocol.

REFERENCES:

1. Salli K, Lehtinen MJ, Tiihonen K, Ouwehand AC. Xylitol’s Health Benefits beyond Dental Health: A Comprehensive Review. Nutrients. 2019;11(8):1813. Published 2019 Aug 6. doi: 10.3390/nu11081813