A correspondent shared much of their medical history and lab tests with me. They were discouraged with the failure to get remission. One of their key physicians is well respected by me, in other words, they have had world-class treatment already. The following is a review with suggestions to be discussed with knowledgeable medical professional.
Diagnosis: Chronic Lyme
Tick bite happened 5 years ago. They have done rotations of antibiotics that included:
- Doxycycline (tetracycline),
- Clarithromycin (macrolide)
- Azithromycin (macrolide)
- Rifampicin (Rifampicin)
Diagnosis includes coxellia ricketsia.
There are three families of overgrowth, the first three antibiotics only effect just one of these families (see my chart). The last one appears to reduce at least two of the families that are under growths. If the symptoms are due to a microbiome shift (and not an actual lyme infection), then there is a strong need to add appropriate probiotics.
Lab Tests – Abnormalities
- Borrelia burgdorferi Fully Antigen: 10x the detection value
- Candida Albicans: positive
- Magnesium: Low
- Epstein Barr: 2x the detection value
- C Reactive Protein: 3x the detection value
- Cytomegalovirus Antibodies IgM: 3x the detection value
- Vitamin D (25-OH): low, 18 ng/mL, normal range 30-100 ng/mL
- Immunoglobulin E: 3x the detection level
- Iron Saturation: low, 15%, normal range 25-45
The first action should be raising Vitamin D. See these earlier posts:
The target value is 90-100 ng/mL (200-250 nmol/L). Assuming 60 kg (130 lbs), this means some 450,000 IU of vitamin D3 needs to taken for a normal healthy person. At 15,000 IU/day — it will take 30 days, At 10,000 IU/day – 45 days.
If the person is 20% heavier, than it would take 20% more days (36 days and 54 days). Note that I said normal healthy. There is evidence suggesting that CFS patients may absorb vitamin D at a rate as low as 50% of healthy individuals. This means that after 1-2 month of high dosages, vitamin D needs to be measure again to see how much increase actually happened and the dosage adjusted.
For Magnesium supplements, see this Magnesium and Malic Acid post. Supplement with Magnesium Malate (if available). It is likely low because bifidobacterium is the usual bacteria that extracts it — and that is low in CFS patients.
This can be lowered by taking a probiotic, see my Align – Bifidobacterium infantis 35624 – a demonstrated probiotic for IBS post. “ Achieving 25(OH)D ≥ 75 nmol/l was accompanied by higher circulating LL-37, higher QoL scores and reduced CRP.” ”
Alpha Lipoic Acid also reduces CRP levels (by about 19% in studies ) and improves blood flow.
EBV, CMV and/or Lyme???
The labs show positive for EBV and cytomegalovirus really raise the question of a false-positive for Lyme.
- “False-positive results of serological tests for Lyme disease have been reported in cases of recent primary infection with varicella-zoster virus [1,2], Epstein-Barr virus [3,4], and cytomegalovirus . We report the first association of false-positive results of serological testing for Lyme disease with infection due to another of the herpesviruses, herpes simplex virus (HSV) type 2.” 
My preferred reading is this: we know that we never get rid of a virus infection. Our immune system normally keep them in control. When the microbiome is disrupted, this control can be lost.
The supplements reported include:
- Pro5 Protein Powder,
- vitamin B12,
- vitamin complex of group B ( jarrow formula) ,
- zinc ,
- magnesium malate ,
- ubiquinol ,
- omega3 ,
- burbur ,
- milk thistle ,
- b6 ,
- glutamine ,
- alpha lipoic acid
- Vitamin D3 – 15,000 IU/day
- Check the dosage for magnesium malate against my earlier post, and increase the dosage if it is not at least the level reported in PubMed studies
- Stop the VSL#3 when you finish you your current supply, use Prescript Assist instead
- Add Align (Bifidobacterium infantis 35624)
- Examine the list of probiotics on me-pedia and rotate to different ones when you finish a bottle or a box (hint: never buy two boxes or bottles, just one and then use it all up and rotate to the next one)
- Start using Tulsi Tea or capsule supplements
- Rotate capsules of the “0” and “1” herbs listed on the herb list.