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Can Lyme Disease and Other Tick-Borne Infections Trigger Thyroid Autoimmunity?

Published June 8 2015

It’s common for people with thyroid and autoimmune thyroid conditions to have infections, including H. Pylori, candida, Epstein Barr, Yersenia Enterocolitica, etc.  While these and other types of infections can be challenging to treat, Lyme disease and other tick-borne infections can be one of the most difficult infections to overcome.  It’s challenging enough to restore one’s health when dealing with a condition such as Hashimoto’s Thyroiditis or Graves’ Disease, but it’s obviously even more challenging when someone has an autoimmune thyroid condition and also has a condition such as Lyme disease.

Lyme disease is the most common tick-borne disease in the United States, as approximately 20,000 cases of Lyme disease are reported annually (1) [1].  However, there are also many cases of Lyme disease which aren’t reported, and so the actual number is much higher than this.  The disease is transmitted to humans through the bite of the Ixodes tick, and in most cases the tick must feed for at least 36 hours for transmission of the spirochete Borrelia burgdorferi to occur (1).  In some cases mosquitoes can also transmit Borrelia burgdorferi (2) [2], but it’s much more commonly transmitted through ticks.  Although treatment with antibiotics for 2 to 4 weeks will frequently help to resolve the problem, some people end up with a chronic case of Lyme disease.

Certain co-infections can also be transmitted along with Borrelia burgdorferi, which can lead to a worsening of the symptoms.  Clinically relevant co-infections are caused by Bartonella species, Yersinia enterocolitica, Chlamydophila pneumoniae, Chlamydia trachomatis, and Mycoplasma pneumoniae (3) [3].  Babesia is another co-infection commonly associated with Lyme disease.  Having one or more of these co-infections can make it even more challenging to treat.

Why Is Lyme Disease So Challenging To Treat?        

There are a few different reasons why it can be very challenging to successfully treat some people who have Lyme disease.  First of all, Lyme disease can invade other areas of the body, such as the nervous system, liver, kidneys, and even the eyes (4) [4] (5) [5] (6) [6] (7) [7] (8) [8] (9) [9].  But another reason why Lyme disease can be challenging to treat is due to the co-infections which are commonly transmitted along with Lyme disease.  And because testing for co-infections can be challenging these aren’t frequently diagnosed.

There are three stages of Lyme disease, and not surprisingly, those people who are in the later stages are more difficult to treat.  Let’s go ahead and discuss the different stages:

Stage #1.  The symptoms of this stage will usually appear a few days or a few weeks after infection.  The symptoms commonly resemble the flu.  Erythema migrans is the most common manifestation of early Lyme disease (10).  Although most doctors are trained to look for a classic “bull’s eye rash”, certain variations are common such as uniform coloration, lesions with necrotic or vesicular centers, and lesions with shapes that are not circular or oval (10) [10].  In most cases administration of antibiotics for 2 to 4 weeks during this stage will successfully eradicate the infection.  However, it’s important to understand that misdiagnosis of erythema migrans does occur, and this can result in severe health consequences when left untreated.

Stage #2.  Early disseminated Lyme disease involves spreading of the disease.  Although it is still possible to eradicate the infection, it is usually much more challenging, and a longer duration of treatment with antibiotics is usually recommended by most Lyme disease specialists.  This stage of Lyme disease can cause cardiac manifestations such as heart block and muscle dysfunction, causing a mild myopericarditis (11) [11].  Dissemination to the central nervous system can also occur within the first few weeks after skin infection (12) [12], yet Lyme disease may have a latency period of months to years before symptoms of late infection emerge (12) [12].  This is yet another reason why early treatment can be very important.  Second-stage Lyme meningitis resembles aseptic meningitis and is often associated with facial palsies, peripheral nerve involvement, and/or radiculopathies (13) [13].

Stage #3.  The third stage is known as late stage Lyme disease, or chronic Lyme disease.  Although Stage 2 Lyme disease involves spreading of the bacteria and can begin affecting the organ systems, it is in the third stage when these symptoms can become more pronounced.  The symptoms in this stage are often severe, as the person might experience arthritis, neurological symptoms such as numbness in the extremities or memory loss.  Third-stage involvement can cause a multitude of nonspecific CNS manifestations that can be confused with conditions such as multiple sclerosis, brain tumor, and psychiatric derangements (13) [13].  This is why Lyme disease is commonly referred to as “the great imitator”, as its symptoms can mimic those of numerous other diseases.

Some refer to chronic Lyme disease as “post-Lyme disease syndrome”, which is defined as continuing or relapsing non-specific symptoms (i.e. fatigue, musculoskeletal pain, cognitive complaints, etc.) in a patient previously treated for Lyme disease (14) [14].  Apparently there is no evidence that post-Lyme disease syndrome is due to persistent infection with B. burgdorferi, which might explain why antibiotic therapy doesn’t seem to offer any sustained benefit to patients with this condition (14) [14].

How Is Lyme Disease and Other Tick-Borne Infections Detected?

Many labs will just offer an IgG and/or IgM Western Blot, but these tests won’t always confirm or rule out Lyme disease.  There are now specialized labs such as IGeneX, as they have something called a Complete Lyme Panel which includes the IFA (Immunofluorescent Assay) to screen for antibodies against Borrelia burgdorferi, the IgG and IgM Western Blots, which determine the type of Borrelia burgdorferi antibodies, and a serum and whole blood PCR to help detect burgdorferi-specific DNAs.

They also offer testing for other tick-borne coinfections.  This includes Babesia, Bartonella, Human Granulocytic Anaplasma, Rickettsia, and Chlamydophila pneumoniae.  What I’d like to do now is discuss some of these common co-infections:

Babesiosis.  Babesia is an intraerythroctyic protozoa which can lead to babesiosis, and can cause symptoms similar to Lyme disease such as fatigue, muscle and joint pains, chills, and fever.  It has a similar pathogenesis and clinical course as malaria (15) [15].  IGeneX uses the immunofluorescent assay (IFA) to detect Babesia-specific IgG or IgM antibodies, as well as a PCR screen and a Fluorescent In-Situ Hybridization (FISH) assay.

Ehrlichia.  Human monocytic ehrlichiosis is a tick-borne infectious disease transmitted by several tick species, especially Amblyomma species caused by Ehrlichia chaffeensis (16) [16].  Two additional Ehrlichia species, Anaplasma phagocytophila and E. ewingii act as human pathogens (16) [16].  IGeneX uses the Ehrlichia Indirect Immunofluorescence Assays and PCR tests to diagnose this infection.

Bartonella.  Bartonella are bacteria, and many people with Lyme disease also have Bartonella infections (17) [17] (18) [18].  Symptoms can include fatigue, headache, fever, swollen glands, along with other symptoms.  IGeneX uses Immunofluorescence Assays and PCR testing to detect bartonella infections.

Rickettsia.  Rickettsia species are gram-negative, obligate intracellular bacteria responsible for the spotted fever and typhus groups of diseases around the world (19) [19].  Rickettsia rickettsii and Rickettsia conorii are transmitted by the bite of a tick, and thus can be a common co-infection associated with Lyme disease.  Rocky Mountain spotted fever, which is caused by Rickettsia rickettsii, is among the deadliest of all infectious diseases (20) [20].  IGeneX has something called the Rickettsia species PCR test, which detects Rickettsia specific DNA.

Mycoplasma.  Mycoplasma pneumonia is a common respiratory pathogen that produces diseases of varied severity ranging from a mild upper respiratory tract infection to severe atypical pneumonia (21) [21]. Apart from respiratory tract infections, this organism is also responsible for producing a wide spectrum of non-pulmonary manifestations including neurological, hepatic, cardiac diseases, hemolytic anemia, polyarthritis and erythema multiforme (21) [21].  The differential diagnosis between Lyme disease and Mycoplasma pneumoniae infection or the recognition of the co-infection by Mycoplasma pneumoniae is problematic because both diseases exhibit similar manifestations (22) [18].  PCR testing is commonly used to detect the presence of this infection.

Is Lyme Disease Associated With Autoimmune Thyroid Conditions?

There is evidence that Borrelia burgdorferi can be a potential trigger of thyroid autoimmunity through a molecular mimicry mechanism (23) [22] (24) [23].  In other words, thyroglobulin, thyroperoxidase, and the thyrotropin (TSH) receptor and proteins of Borrelia burgdorferi can share amino acid sequences which can cause the immune system of someone with Borrelia burgorferi to attack these thyroid structures.  And so there is an increased risk of developing Graves’ Disease or Hashimoto’s Thyroiditis in someone who has Lyme disease.

Some of the co-infections associated with Lyme disease might also lead to an autoimmune thyroid condition.  For example, one case study showed that bartonella henselae can trigger autoimmune thyroiditis (25) [24].  Mycoplasma species might also be a factor in thyroid autoimmunity (26) [25].

What Are The Conventional Treatment Options For Acute Lyme Disease?

When Lyme disease is initially diagnosed, antibiotics are recommended by most medical doctors.  Obviously there are pros and cons of taking antibiotics.  The benefit is that if the infection is caught early enough, two to four weeks of antibiotics might help to completely eliminate the infection.  The downside is that antibiotics affect the good bacteria of the gut as well, and thus can cause intestinal dysbiosis.  In fact, many medical doctors will also give the patient anti-fungals such as Nystatin to help prevent the development of a Candida infection.

However, even in the case of acute Lyme disease, taking a single antibiotic might not be sufficient to eradicate the infection.  The reason for this is because Borrelia burgdorferi can have several forms, including the cell wall form, the cystic form, and there can also be biofilm protecting the organism from eradication through the antibiotics.  As a result, different types of antibiotics might be required in order to be effective.  If the infection hasn’t spread then taking doxycycline for 2 to 4 weeks might be enough, but if the infection has spread and/or the infection is in a cystic form then taking this antibiotic alone probably won’t be sufficient.

Dr. Richard Horowitz is an expert on Lyme disease, and during the first month of a Lyme disease infection he not only recommends for the person to take doxycycline, but also recommends Plaquenil, Nystatin, and either Flagyl or Tindamax, which will eradicate some of the cystic forms.  He also recommends Serrapeptase to help with the biofilms.  He recommends for the patient to take antibiotics until they are asymptomatic for two consecutive months, and then he switches them to an herbal protocol.

Can Antibiotics Help With Chronic Lyme Disease?

Just as is the case with acute Lyme disease, most medical doctors will also recommend for those with chronic Lyme disease to take antibiotics.  However, these are much less effective for chronic cases of Lyme disease.  This is especially true when there are associated co-infections. This isn’t to suggest that antibiotics can’t help with some cases of chronic Lyme disease, but giving antibiotics alone won’t be effective in many people with this condition.

Can Natural Treatment Methods Help With Lyme Disease and Co-Infections?

Although antibiotics are without question overused and abused, if someone has a confirmed or suspected acute case of Lyme disease, antibiotics very well might be the best treatment option.  From reading this article you should understand that once Lyme disease disseminates it becomes much more difficult to treat, and so while I can recommended natural anti-microbials and supplements for immune system support and hope that this works well, if I knew I was bitten by a tick and was pretty certain I had been infected with Borrelia burgdorferi I probably would bite the bullet and take antibiotics.  If it was suspected if I had Lyme disease but I wasn’t certain of this, I’m not sure if I would take the antibiotics, although knowing the potential consequences of chronic Lyme disease I very well might.  Of course if I did end up taking antibiotics I would also do things to minimize the negative impact of the antibiotics on the gut flora, such as taking probiotics.

But what if someone has a more chronic case of Lyme disease, along with accompanying co-infections?  Since antibiotics are not as effective in these cases I’m not opposed to helping people with natural treatment methods.  However, I don’t consider myself to be a Lyme disease expert, and so if someone with Graves’ Disease or Hashimoto’s Thyroiditis consults with me, and they also have Lyme disease and one or more associated co-infections, many times I will refer them out to someone who has a lot of experience dealing with these infections.  However, I have also consulted with some patients who worked with some of the Lyme disease experts but wasn’t thrilled with their frequent recommendations to take antibiotics.

There are a few natural treatment protocols which have helped many people with Lyme disease and related co-infections.  I’m not going to discuss these protocols, as there is plenty of information online which lists the components, but some of the more well known protocols for Lyme disease and co-infections include the Zhang protocol, the Cowden protocol, and the Buhner protocol.  Bryon White also has some formulations which can be beneficial.  As for which of these protocols are more effective, it really does seem to vary from person to person.  For example, some people have received great benefits with the Cowden protocol, while others who claimed to have followed it strictly didn’t receive good results.  And the same is true with the other protocols I mentioned.

Don’t Just Focus On Eradicating The Infection

While each of these protocols consist of numerous herbs and supplements, keep in mind that most people usually need to do more than just take these in order to receive optimal benefits.  For example, if someone has a leaky gut, adrenal problems, and/or heavy metal toxicities, then these problems also should be addressed.  Even though it is important to eradicate any infections, it also is important to improve the overall health of the body.  This not only will increase the likelihood of the natural treatments working, but it will also reduce the chances of developing other infections.

So hopefully you have a better understanding when it comes to the impact of Lyme disease and other tick-borne infections.  There is a higher prevalence of these infections in those with autoimmune thyroid conditions.  The earlier Lyme disease is treated the more likely it is to be eradicated without causing further complications.  On the other hand, chronic cases of Lyme disease and other-coinfections usually won’t respond as well to antibiotics, and so utilizing certain natural treatment methods can be beneficial to help with the eradication of these infections, as well as improving one’s immune system health by correcting other imbalances.