About this video: Dr. Andrew Litchy, ND is a naturopathic doctor who has been treating Lyme Disease in patients over ten years. He works closely with MDs and is a firm supporter of the CDC recommendations of Lyme. Many people exposed to Lyme disease can be treated relatively easily with CDC recommendation. According to him, the problem occurs when Lyme disease goes undetected in the body for a while or if the first line of Antibiotic Therapy fails. We asked our consumers to submit questions on Lyme disease and asked these 32 questions to Dr. Andrew Litchy.
In this first part we start with understanding Lyme disease:
What is Lyme disease?
Types of bacteria causing Lyme disease.
Types of ticks causing Lyme disease.
How Dr. Litchy became interested in Lyme disease? Why it is important to combine Western and Naturopathic Medicine when treating Lyme?
What is the early detection of Lyme disease?
How to determine if a patient should test for Lyme disease?
Understanding the accuracy of Lyme disease testing.
When to work with a Naturopath vs. Western Medicine Doctor?
When is the best time to start Naturopathic treatment for Lyme disease?
Which type of Lyme disease patients benefit the most from antibiotic treatment?
Let's jump right in.
Question: What is Lyme disease?
Dr. Andrew Litchy: Lyme disease is an infection. It is an infection by a particular spirochete, a kind of bacteria, and infects humans, animals, and insects as well.
Question: When you say a “Spirochete,” what is that?
Dr. Andrew Litchy: It is a spiral-shaped bacteria. Bacteria come in three shapes; there are round ones, oval ones and spiral ones. The spiral ones can be particularly virulent. Syphilis is one example amongst others. These tend to be pretty pathogenic types of bacteria. Lyme is like that; it's a spiral-shaped bacteria.
Question: Are there more than one kind of Tick that carry Lyme disease?
Dr. Andrew Litchy: Yes, there are many different kinds of ticks and different kinds of ticks that carry Lyme disease. The most common kind of infection comes from very small ticks called “Deer ticks” and particularly nymphs, which are tiny immature ticks, very tiny, and these tend to be the ones that will infect people with Lyme. There are other kinds of ticks, different shapes, sizes, and colors, which can carry Lyme or other infectious diseases.
Question: These nymphs and ticks, are they all throughout the United States or concentrated in certain regions of US?
Dr. Andrew Litchy: There are ticks all throughout the United States, and hence, Lyme disease is throughout the United States and 50 other countries as well around the world. However, there are concentrations of it; East Coast is one, and actually, here in the Midwest we are in another concentration of Lyme disease
Question: Where do you see more of the issue with Lyme disease as a Naturopathic Doctor? How did you get pulled into studying Lyme Disease and why is combining Naturopathic Medicine with Western Medicine in Lyme disease so important?
Dr. Andrew Litchy: I got into Lyme disease because I had a friend that got it, did not receive proper treatment and became very ill. Lyme disease has different kinds of stages with it, and if it is not caught in time, it becomes rather complicated. That's why I became interested in it, and as I learned more about it in my training I became fascinated with it!
It's a very complex illness. It is called “The Great Mimicker,” it looks like many different kinds of illnesses, and it can affect the brain, liver, connective tissues, all parts of the body; it not only can be devastating, but it is clinically rather interesting to work with.
It is very rewarding to work with it as well because people can make great progress when they have appropriate care. The challenge is whats appropriate care with Lyme disease. When it is caught early, the CDC recommendation of two to four weeks of Doxycycline or a related antibiotic often works very well. This is important to know, that it can be treated early and in most people, it works excellent. If it is not caught early enough, or in some people that first antibiotic course is not effective, then it becomes more complicated, and this is where Lyme literate-MDs or Naturopathic Doctors trained in Lyme disease, can be extremely helpful and important, i.e. when the first round of antibiotics is finished, yet the disease is still happening. This is a difficult place for the patient.
Question: When you say that you can detect and catch Lyme disease early, what does that mean? Do you mean One Week? One Month? How soon after somebody is exposed to a tick that is a carrier of Lyme disease, can someone truly start showing symptoms of Lyme disease, and what are those symptoms?
Dr. Andrew Litchy: They can start showing symptoms within a couple of days after exposure, and sometimes it takes weeks or longer. That is another reason this is complicated because it can present very differently in people. Initial symptoms can be the classic “bullseye rash” (which, around the bites, there can be a red rash, sometimes it is a ring, sometimes it is not), that can show up very quickly, up to two weeks after the bite. That is a clear diagnostic criterion for someone who has a bite or the bullseye rash, they have Lyme disease, and they should be treated. Other symptoms of Lyme disease are flu-like symptoms, swollen tonsils, joint pain, malaise, tiredness, feeling cruddy, and then it can progress into a variety of things including electrical sensations, brain fog, memory issues, and mood changes. A lot of different things can come from Lyme disease.
Interviewer: It seems as you are explaining these symptoms, they sound like a lot of other things that someone could have. I can see why someone may not think that it is Lyme disease right away.
Question: What is the protocol in Western Medicine versus Naturopathic Medicine, when someone shows up in your office, and he or she has never been tested for Lyme disease? They have no idea if they were ever exposed to it or not. At what point do you decide to check for Lyme disease?
Dr. Andrew Litchy: That is an interesting question. It depends on if they have enough of the symptoms that are consistent with it. What is the timing of the onset of symptoms and getting together all the history... and that will make it important to run a careful Lyme test. It is about the clinical diagnosis. If it is a clear tick bite, then they go and get antibiotics. That is what they should be doing first.
Question: When people get tested for Lyme, often the test comes back negative. They may develop Lyme disease later on, or there is some suggestion, that testing of Lyme disease is not always accurate. Is that your experience?
Dr. Andrew Litchy: That is true. Not only do Lyme antibodies do not show up for a couple of weeks after exposure, but you also cannot get a positive test in the first week or two. It can take a couple of weeks for that to develop. That can be confusing. Then the antibodies can go away, even if the person is still very ill. That is the first issue. The antibodies are not consistent.
Another issue is, the test may not be sensitive enough. In different labs, they process antibodies in different ways. We have a limited window where one will test positive by strict CDC criteria, and it can be difficult to perform the test properly. There are a couple of different ways, the ELIZA and Western Blot can be processed, which will lead to different kinds of results.
Question: When somebody is dealing with Lyme Disease do they work directly with you or do they work with a Western Medicine doctor, and do you work in conjunction with an MD?
Dr. Andrew Litchy: It depends on the situation. When people have their first exposure and they know they have a tick bite, or it is very likely, it is very soon; then I always recommend they do the CDC protocol of four weeks of Doxycycline or a related antibiotic. That will work for most people. When that does not work, or a slightly longer course of antibiotics does not work, then it becomes more complicated, and then they may work with me while they are doing long-term antibiotic treatment, or I may work with them without doing the long-term antibiotic treatment.
Question: From a Naturopathic Medicine perspective, does your treatment start after the antibiotic, the initial antibiotic treatment, is done? Or do you start your treatment right away?
Dr. Andrew Litchy: There is supportive therapy for during antibiotic treatment to reduce the likelihood of infections like C-Diff. and other problems with the antibiotic, that can be started right away. In many cases, I recommend they do the antibiotic, so many people, without doing extra treatment, recover exceptionally well with that. Then later again it is a choice if they are doing the antibiotics or not.
Question: What happens if someone goes through the antibiotic treatment, he or she continues to show symptoms of Lyme disease, what is the course of action at that point?
Dr. Andrew Litchy: Then they have a couple of options; some practitioners prescribe long-term antibiotic therapy for Lyme disease and related infections. This can be very involved, and treatment is nine months to three years or so, and up to three to five antibiotics at any given time; IV therapy antibiotics can be included as well. If they catch the attention of an infectious disease doctor which is unlikely after four weeks of antibiotics, they might prescribe a month or so of a very strong antibiotic. That may happen. Or they may choose to do more herbal therapy, supplemental therapies, immune-based therapies, either instead of, or in addition to, antibiotics. It is a bit of a choice there. I have trained with NDs who do the intensive antibiotic protocols as well as NDs that do not. I feel there are populations, people that are extremely sick, that benefit from antibiotics. In other cases, people that are moderately ill, quite ill, but not extremely debilitated where a strictly natural approach, or non-antibiotic approach, is better because it is as effective. The time frame for treatment is the same, and it is easier on the body!
Question: Can you share some statistics with us? From your personal experience, what type of population, and then who, the antibiotic treatment may be more relevant for?
Dr. Andrew Litchy: I think the antibiotic treatment is most relevant for people who are extremely ill, having problems walking, seizures, potentially life-threatening complications of Lyme. Absolutely, they should be doing antibiotics. Then, it is somewhat of a personal choice if they choose to do antibiotics or just natural treatment.
My bias is, most people should not be doing long-term antibiotics unless they had a very good response initially. This is because it can be very hard on the body to be doing these. There can be a higher relapse rate, in my experience, with only doing antibiotics and not doing immune therapies unless the immune system in the whole body is supported. That is my opinion on that. Some organizations’ “standard of care” is the 3 to 5 antibiotics for 9 months to three years, but not everybody agrees with that, for a variety of reasons.
When you start asking these questions about what is “appropriate Lyme care,” you quickly run into a lot of opinions and practice patterns. There is not established protocols for treating people with chronic Lyme.
We are still figuring out how to do this in the best way possible.
Interviewer: Thank you for explaining that to us that makes a lot of sense.
End of Part 1. In part 2 of the video, Dr. Andrew Litchy answers consumer questions on Chronic Lyme
Special thanks to Dr. Andrew LitchyND for being an educator on TrailheadHealth.com and for helping answer consumer questions.
Dr. Andrew Litchy, ND specializes in Chronic Lyme Disease, Integrative Cancer Care, Autism Spectrum Disorder and Botanical Medicine. In addition to his clinical practice at the Neighborhood Naturopathic in Edina, Minnesota, he also teaches at the University of Minnesota. He loves Educating consumers and is offering free initial consultation to anyone who has questions on Lyme and wondering if Naturopathic Treatment can help them. He can be reached at (612) 259-8529 or email at email@example.com