The role and impact of diet in managing Lyme disease

For many Lyme sufferers, antibiotic treatment alone is not enough to cure all symptoms, and many are thought to suffer from food insensitivities or autoimmune issues which are either triggered by, or affected by the infection.

But with a ton of information to sift through on the internet and sometimes conflicting information and experiences to be found in online forums, what diet is best? And how much difference can it really make to your recovery?

As part of our Lyme Awareness Month content, in this blog we are shining some light on this method of managing Lyme, and have posed questions to some of the leading nutritional clinics and consultants in the UK on how diet can play it’s part in fighting Lyme or managing the symptoms.

At what stage of Lyme treatment should patients consider their diet?

Gilian Crowther, Director of Research for the Academy of Nutritional Medicine says: “Right from the beginning is best. Initiating an anti-inflammatory diet from the outset will certainly give your chances of overcoming the infection swiftly a huge helping hand. The pathogen underlying Lyme disease, Borrelia, is a driver of inflammation, as are the coinfections that sometimes come with it, particularly Bartonella.”

Judy Rocher, Nutritional Therapist and Naturopath agrees: “As soon as they start to get symptoms, any Lyme patient should pay particular attention to a clean diet. This means avoiding processed, additive-laden foods, avoiding trans fats, as well as gluten, dairy and sugar and eating a wide variety of organic vegetables and the fruits lower in fructose such as apples, pears and berries. Chicken and meat should be free range and organic. They should avoid any foods they feel they may be intolerant to, and increase intake of organic foods in a rainbow of colours to enable their bodies to get all the nutrients needed in order to recover“.

Lydia Madrigal, Nutritional Scientist at MakeWell says: “Diet should be considered right when the treatment is started, as antibiotic treatments are very demanding on the body. Further, before the treatment, chronic disease and inflammation in most cases have already led to poor vitamin and mineral states, as it is very common that the nutrient resorption in the intestine is impacted in a negative way.

Both during Lyme treatment and afterwards, nutrition is a major component in terms of giving the body the best ability to fully heal, and maintaining health in the aftermath, meaning a balanced diet and the refill of vitamin and mineral storage is very important during all stages of Lyme treatment.

London Clinic of Nutrition says: “Diet should be considered from the beginning. Many infectious agents, including Borrelia, are nutrient-depleting microorganisms and thus a nutrient dense diet to ensure good replenishment of nutrients should be considered from the beginning of any Lyme treatment.

What are the benefits of a healthy diet during Lyme treatment? How can diet and nutrition play a part in supporting the fight against Lyme disease?

Judy Rocher says: “An unhealthy, sugar laden, diet full of processed foods and trans fats places a burden on the digestion and the functioning of many organs including the pancreas, liver and gallbladder. These diets tend to be low in vital vitamins and minerals and lacking in essential fatty acids.

Patients with Lyme disease have compromised immune systems, so supporting immune health through a good diet is vital to recovery. Digestion and absorption may be affected which makes it even more important to have a good diet free from chemicals, additives, hidden sugars, excess sodium, sugar substitutes and heavy metals.”

London Clinic of Nutrition says: “The conventional approach to Lyme disease is that of finding the infectious agent and eradicating it with antibiotics. The holistic approach is that of recognising the bio-individuality response to an infection and that optimising the immune response with diet and lifestyle modifications should be part of any Lyme treatment protocol. Micronutrients are integral to immune function and play key roles at different stages of immune response. “

Lydia Madrigal says: “The benefits of a healthy diet are numerous. Initially, strengthening of the immune system by sufficient supply of all vitamins and nutrients required; anti-inflammatory nutrition can also help to relieve the body of exogenous factors that can trigger further inflammation. A diet rich in fibre and probiotics is critical for gut health, to prevent diarrhoea or constipation, to recover the internal microbiome, and finally to help proper digestion.

How does a healthy diet geared towards Lyme treatment differ from a general healthy diet?

Gilian Crowther says: “A general healthy diet will ideally be sugar-free and low in fast-acting carbohydrates. It will ideally be high in good fats (phospholipids, Omega 3s/good-quality Omega 6s), contain moderate amounts of protein, and be a rainbow diet full of colour.

A diet geared towards Lyme treatment will be particularly anti-inflammatory because of the havoc Borrelia unleashes in the tissues/synovial fluid, etc. The fatty acid component is especially important because of the way Borrelia deplete cholesterol/phospholipids and thus impair cell membrane integrity.

Eating organic as much as possible is more important in someone with Lyme disease than in a “normal” healthy diet, though it is always to be strived for ideally. This is because the Lyme patient’s system is already under stress, and glyphosate disables the microbiome dramatically, making recovery harder. Dr. Stephanie Seneff MIT has written about this in great detail.

Lydia Madrigal says: “Lyme patients often face problems with digestion, and need nutrition that is more easily digestible. They have an even higher demand of nutrients, and in many cases, supplementation is required to refill vitamin stores“.

Is there a Lyme-specific diet that is the same for all sufferers, or are there different types of diet you’d recommend depending on the individual patient?

All contributors pretty much agreed that though there are general principles that all Lyme patients should try to follow, there isn’t one overarching diet for that everyone should follow.

Judy Rocher says: “Diets are very individual and should be adapted for the constitution and condition of the patient. For example, if joint pain is a particular problem for the client, then a diet that removes the nightshade family of foods is highly recommended.

Most Lyme patients have poor gut health and so avoiding gluten is important as this can cause inflammation in the gut and lead to more intolerances. Increasing intake of foods high in both pre- and probiotics to support the microbiome is recommended. In many patients the liver and gallbladder needs support, so increasing intake of foods which stimulate bile production such as radish, beetroot, watercress, rocket, parsley, coriander, artichoke, dandelion, ginger. celery and turmeric can help to support gallbladder and liver function and help to prevent constipation.”

London Clinic of Nutrition says: “There is no single diet that fits all when dealing with Lyme disease. The dietary recommendations are based on the person’s presentation. Some people may benefit from a gut supporting diet, such as a low FODMAP diet, others may benefit from a low histamine diet, as Borrelia burgdorferi has been shown to induce mast cells activation, the immune cells which release histamine and promote inflammation, while for others an elimination diet to identify potential food triggers for two to three weeks might be more suitable.

How critical is a gluten free diet? Is it more important to some than others?

Gilian Crowther says: “If the patient has been diagnosed with coeliac disease, a gluten-free diet is of course absolutely essential. The coexistence of Lyme disease and gluten intolerance/coeliac disease is not uncommon. The study “Borrelia infection and risk of coeliac disease” examines the potential contribution of Lyme disease to the risk of coeliac disease, and does indeed find a moderate link.

Judy Rocher says: “Patients who suffer from IBS-type symptoms such as bloating, gas, diarrhoea and pain, often find relief of these symptoms by removing gluten strictly from their diets. Inflammation in the gastro-intestinal tract is reduced and energy may improve. Although not diagnosed as having coeliac disease, there is often an underlying gluten intolerance or sensitivity which has a negative effect on recovery.”

How does a healthy diet affect our immune system?

Lydia Madrigal says: “In a healthy balanced diet, all nutrients, vitamins and trace elements are present. These all help to ensure proper cell function and immune surveillance. All these elements need to be present and balanced for the immune system to be strong enough to work ideally.

Judy Rocher says: “Diets high in sugar and processed foods full of additives have been shown to lower immunity. Good levels of vitamins and minerals, together with reduction in stress, fresh air, plenty of exercise and a good mental attitude helps us to maintain good health. Research has shown that build up of toxins weaken the immune system. As the body’s terrain becomes more contaminated, the immune system weakens and the pathogenic microbes increase in aggressiveness. This drives chronic illness.

Detoxifying the body of manmade chemicals and heavy metals is of key importance in order to support the immune function. Our microbiome are excellent chelators of heavy metals, so maintaining good gut health or increasing foods high in probiotics such as sauerkraut and kefir is highly beneficial. Good levels of zinc, together with a zinc ionophore which carries zinc into the cell (quercetin is a good example of this found in red onions, berries, apples etc), plentiful vitamin A and vitamin C are important as well as vitamin D acquired through supplementation or sunlight on the skin.”

London Clinic of Nutrition says: “A healthy diet that is rich in nutrients supports our immune system in many ways. The immune system needs over 20 different nutrients to function optimally. Vitamins C & E are anti-oxidants that protect our cells. Vitamin C also improves the performance of our immune cells, helps them to mature and actually has anti-viral and anti-bacterial properties.

Vitamin E improves immune cell function. Vitamin A is needed to maintain the integrity of the digestive tract, lungs and cell membranes and provides resistance to infection. Various minerals, such as Zinc, are needed for the immune system to function properly, protect against infections and are critical for B & T immune cell function.

Proteins are broken down into amino acids and form the building blocks for every function that the body needs and they are needed to make immunoglobulins and other immune cells. So it’s important to eat a varied diet which is rich in colourful vegetables and fruit, wholegrains and lean protein.”

How do you rate the importance or danger of animal products in the diet?

Judy Rocher says: “Animal products, so long as they are free range, grass fed and organic, can be excellent sources of protein, vitamins and minerals. Processed meats should be avoided, but otherwise, a palm-sized portion a few times a week can be helpful if liked.

Some people need to avoid pork products, but chicken or turkey may be easier to tolerate. Organ meats such as liver are highly nutritious, and provide good levels of B12 often deficient in vegan and vegetarian diets.

Fish, such as mackerel, sardines, anchovies, wild alaskan salmon, is a good source of essential fatty acids and protein. It is important to avoid fish high in pollutants like mercury which may be higher in canned tuna and swordfish and to look for line caught deep sea fish rather than mass netted fish.

Gilian Crowther says: “A 2017 study associated red meat with higher levels of arachidonic acid, a mediator that promotes inflammation and ageing. It also elevates levels of hs-CRP (C-Reactive Protein), an indicator of inflammation.

Antibiotics are always used in the rearing of non-organic poultry, so organic chicken and turkey is always preferable.”

Can a suitable diet provide all the nutrients a sick person needs or is supplementation sometimes/usually/always necessary?

Judy Rocher says: “A carefully sourced and rotated diet should provide all the nutrients a person needs, however, due to farming practices which have led to soils being depleted in minerals, many foods are not as nutritious as they were in years gone by. Also, if the illness has become chronic, stomach acid may be low which leads to poor absorption and so supplementing may be beneficial to allow the body to heal.

Krytopyrroluria is a condition which may be present in Lyme patients and this condition causes zinc, B6, manganese, biotin and other minerals to be lost in large amounts. Supplementing these nutrients can help the patient to recover. There may be vitamin D deficiencies during the winter months, or if the patient is bed bound, and so supplementing this can help to improve immunity. If thyroid function is low, then providing additional selenium, zinc, magnesium and iodine if these levels have been shown to be deficient, can help to support the thyroid.

Supplementation is unique to each patient and there is no one size fits all“.

Gilian Crowther says: “Someone who is ill often lacks the energy to source the ingredients required for healthy nutrition of the kind discussed above. They may not have family or friends who can do that for them – and then there is the preparation involved, too. It is therefore almost always advisable to take nutraceuticals – concentrated sources of the vitamins, minerals and co-factors that your organism needs to recover. Which to have will ideally be worked out by identifying the person’s/patient’s key requirements/deficiencies. Tests can do this. Key is to identify how well you are digesting, as if you can’t absorb proteins or fats well, much of what you take in orally will be wasted, in whatever form.

There are concentrated forms of nutrition that may be very helpful, such as protein powders and organic greens in powder form, that can be added to water/soups/stews.

In your experience which are the vitamins/minerals/supplements that are nearly always needed by Lyme patients and would it be sensible for Lyme patients without doctors or advice to use these? And are there any supplements which Lyme patients should NOT dose themselves with?

Gilian Crowther says: “This will vary depending on how entrenched the bacteria are, what co-infections there are, how the Lyme disease has manifested (whether pain, neurological/neuropsychiatric symptoms, autoimmunity, etc.), and what the perpetuating factors are.

Specific supplement lines that have been developed for Lyme disease and co-infections and can be very effective, but the combinations, sequencing and dosage are all very patient and case-specific, and patients should not take herbal remedies/antimicrobials without a naturopath/nutritional therapist or other appropriate medical professional’s advice, as it is important to ensure that these are safe and appropriate within the patient’s overall health situation.

Vitamins and nutrients that are always supportive are vitamin C – ideally food-state, in its most natural form, B vitamins, especially for the mitochondria/energy generation, and vitamin D, usually best combined with K2 for bioavailability, though levels need checking as fat-soluble vitamins remain in the body – you don’t want to risk an excess, either.

Judy Rocher says: “Lyme patients should always consult their healthcare professional before supplementing. The correct testing can be carried out to determine which nutrients are needed. The diet should be altered in the first instance to provide the nutrients that are needed as far as possible. Taking cheap, mass produced supplements which are high in excipients can be detrimental to the client or at best useless and create an additional burden on the system.

London Clinic Of Nutrition says: “A suitable diet that is nutrient rich and filled with colour can go a long way to support a sick person, however our soils are often over farmed and nutrient depleted and very often our ‘fresh’ vegetables and fruit sit on supermarket shelves for long periods of time which lowers their nutrient content. Supplements can provide nutrients at higher, therapeutic doses which many people need to aid recovery.”

What’s the one piece of advice, or the one key diet change would you suggest to Lyme disease sufferers?

Judy Rocher says: “Removing all gluten and sugar from the diet and try to eat organic foods as far as possible.

London Clinic of Nutrition say: “A suitable diet that is nutrient rich and filled with colour can go a long way to support a sick person, however our soils are often over farmed and nutrient depleted and very often our ‘fresh’ vegetables and fruit sit on supermarket shelves for long periods of time which lowers their nutrient content. Supplements can provide nutrients at higher, therapeutic doses which many people need to aid recovery“.

Gilian Crowther says: “Shifting to a fresh, naturally sourced, “from scratch” (non-processed) diet using organic ingredients as much as possible with a high proportion of vegetables with lots of bioflavonoids/phytochemicals (immune-support/defence from nature) will naturally lower your sugar/fast-acting carbs, and provide many of the benefits that have been described above.

What is functional medicine and how can it help?

Gilian Crowther says: “Functional medicine is a science-based whole-systems approach that strives to identify and address the underlying causes of clinical symptoms, rather than just the symptoms. It is ideal for chronic conditions: it looks at environmental, toxicological, infectious, nutritional and genetic drivers – the whole big picture, giving the therapist and patient a set of tools and roadmap to work with in a very systematic way. Functional medicine is not an alternative approach, it is integrative – a 360 approach, rather than just identifying one aspect of health imbalance and treating just that.

The tests carried out by doctors/practitioners who practise functional medicine are also more extensive than those generally available under state health systems, though full blood counts/thyroid profiles, etc. are all first-line tests of great relevance. Further information can be found at for example the Institute for Functional Medicine, https://www.ifm.org/.”

London Clinic of Nutrition say: “Functional medicine encompasses a dynamic approach to assessing, preventing and treating complex chronic disease that is based upon discovering the reason – or root cause – why someone has the symptoms they experience rather than just treating or suppressing those symptoms..  This is based on the concept that each individual person is unique and their current health presentation is based on a combination of genetic predisposition, inputs and events over the course of their lifetime . It is a holistic approach that looks at how well each of the human body’s core systems such as detoxification, communication, energy, digestion and absorption, defence, structural integrity and transport are functioning and interacting with one another.  Once identified, areas of imbalance can be addressed through personalised lifestyle and nutritional interventions with a view to restoring balance, minimising symptoms and optimising individual health.”

When should someone consider doing a detox, and what would the benefits be?

Judy Rocher says: “Detoxification should be an ongoing daily routine, as we are constantly being exposed to a wide variety of toxins. Many degenerative diseases have been linked to build up of toxins in the body, including Alzheimer’s disease, Parkinson’s disease, and Multiple Sclerosis. Preventing build up of toxins in the body can prevent premature ageing, ensure clarity of thought and prevent memory loss which is a common symptom as people get older.”

Can you suggest any natural ways to boost energy levels?

Judy Rocher says: “The cause of low energy should be determined and functional testing is recommended. The patient may be anaemic, with low iron, B12 or folate levels, there may be thyroid issues, poor mitochondrial function due to toxin build up and so on. Ensuring that the patient is getting a good night’s sleep is extremely important if they want to have good energy levels during the day and many Lyme patients have poor sleep. Sleep can be affected by many things including exposure to wifi radiation, watching TV and other screens late into the evening, and sleeping in a room which is not totally dark. These can affect melatonin production which is crucial for the good REM sleep where we regenerate and repair.

Poisoning of the mitochondria, the powerhouses of the cell, with aluminium. mercury and other toxic materials can deplete energy, so embarking on a guided detox program can help to restore energy over time.

There are many supplements which can support energy production, which if deficient, may help energy levels to improve, these include magnesium, B vitamins, Co-enzyme Q10, fatty acids which act as precursors to Acetyl CoA, Acetyl L Carnitine, D-Ribose, NAD and NADH and more.”

Gilian Crowther says: “Energy is the vitality a person feels when they have good levels of ATP – adenosine triphosphate, which is the energy currency continuously produced by our cells, and primarily in the mitochondria, our cells’ powerhouses. To feel we have energy, we need to have ATP beyond that sufficient just to keep our vital functions running.

Natural ways to approach a boost in energy levels include drinking good quality water, increase blood flow and oxygenation to the muscles, look after the microbiome in your gut and looking at supplements.”

London Clinic of Nutrition says:

SUPPLEMENTS – Certain supplements support optimal energy production like CoQ10, magnesium, carnitine, alpha lipoic acid, NADH and Phospholipids amongst others are key supplements for mitochondrial membrane health and energetic chain reactions within the cell.

HERBS – Adaptogens are a well known way to support energy and herbs like rhodiola & ashwagandha do help many patients.

SLEEP – Protecting sleep is the most important way to support energy levels and this should be achieved before pursuing more expensive and complex interventions.

OXYGEN – Breathing is another phenomenal tool. Every cell in the body respirates and ensuring good oxygenation of the body is key so a breathing practice like transformational breath or some of the yogic breathing practices can be very iuseful.

LIGHT – There is much science coming out regarding the importantce of light for the health of the mitochondria (energy factories) in the cells. Sunlight is key but technology now can offer far infrared and near infra red light therapies that can really help energy levels.

TUDCA – One of my favourite supplements for protecting and detoxing the cells so they can function normally.

EXERCISE – From increasing brain derived neurotrophic factor to increasing mitochondria numbers, exercise to tolerance is one of the most significant things that you can do to facilitate an increase in energy.

EMF – This is the unrecognised goliath in the health and wellbeing industry. So many people’s health is undermined through EMF exposure. EMF exposure is probably the most significant and destructive toxin that is in our environment in terms of cell function. Blue light and wifi etc dehydrate the cells and de-structure the water in the cells. When this happens the electron transport chain malfunctions (energy production does not happen as it should).

Contributors

We’re very grateful to all of the contributors to this blog, who took time to answer these questions.

Gilian Crowther MA (Oxon), FBANT, mNNA, CHNC reg. is a Naturopath and registered Nutritional Therapist with a clinic in London. She studied and gained qualifications in complementary therapy in Germany for many years before taking up further training in the UK. As Director of Research for the Academy of Nutritional Medicine (www.aonm.org), Gilian is responsible for clinical training on the range of tests they offer and regularly holds talks on nutrition, mitochondrial therapy,
and Lyme disease and co-infections.

For more information visit https://aonm.org/contact-aonm/ or call 03331 210 305.

Judy Rocher is a fully qualified Registered Nutritional Therapist and Naturopath with a special interest in Lyme disease and other chronic conditions. She passed the Chrysalis Effect training program on ME/Chronic fatigue syndrome with distinction in 2012. She worked as the Education Manager for Rio Trading (a company which specialises in the Cowden protocol for Lyme disease) for 3 ½ years. During her time there she was responsible for training practitioners in natural therapies for chronic illnesses including Lyme.

Judy is the co-owner of the ART Health Clinic Ltd which has clinics in Harley Street London, Brighton and Uckfield. Find out more http://arthealthclinic.co.uk/ or call Judy on 07733 334387.

The London Clinic of Nutrition are a team of highly qualified, award-winning Nutritionists and Functional medicine clinicians, specialising in digestive disorders, IBS, autoimmune disease, thyroid health, hormone health, Lyme disease and complex chronic illness.

For more info head here https://londonclinicofnutrition.co.uk/treatments/lyme-disease/

The contributions from Lydia Madrigal at Makewell were taken from the health blog from their website. The full interview can be found here.

DISCLAIMER: This blog is for information only and is not an endorsement by Caudwell LymeCo if any particular clinic, nutritionist or treatment protocol. It is advisable to seek the advice of a qualified nutritionist, doctor or naturopath when considering changes to your diet.


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