Acute vs. Chronic Lyme Disease: Why Antibiotics Don’t Always Work

Understanding Lyme disease

Lyme disease is a bacterial infection caused by transmission of the Borrelia burgdorferi bacteria when people are bitten by an infected tick, as not all ticks carry this bacteria. These parasites are often so tiny that most people don’t see them or even notice the bite. Researchers are continuing to learn more about Lyme disease and how it influences our health, but they do know that it often manifests into two main stages: acute and chronic.

What is acute Lyme disease?

Acute Lyme disease is the initial stage of the Borrelia burgdorferi infection that occurs anywhere between 2 to 30 days after a tick bite. Common symptoms include:

• Fatigue
• Flu-like symptoms including fever, hot flashes, and chills
• Joint pain
• Back pain
• Headaches

One of the hallmark signs of acute Lyme disease is the development of a distinctive red, circular rash often resembling a bull's-eye, known as erythema migrans. However, not everyone with Lyme disease will develop this rash.

When detected early, acute Lyme disease can often be treated successfully with antibiotics like doxycycline, amoxicillin, or cefuroxime. But Lyme disease is notorious for being challenging to diagnose, as these initial symptoms can mimic other common illnesses like the flu and colds, and the hallmark bulls-eye rash doesn’t always appear for everyone.

What is chronic Lyme disease?

Here’s where problems start. If Lyme disease goes untreated (or isn’t treated properly) during the acute phase, it can progress to the chronic stage. Chronic Lyme disease - also known as post-treatment Lyme disease syndrome (PTLDS) or persistent Lyme disease - is characterized by persistent symptoms that can last for months or even years.

In fact, Lyme is often referred to as “The Great Imitator” because of its ability to mimic symptoms of many other diseases like chronic fatigue syndrome, fibromyalgia, multiple sclerosis, and dementia. Some researchers even believe that Lyme could actually be a trigger for some of those diseases. 

Why antibiotics don’t always work

While antibiotics are the primary treatment for acute Lyme disease, their efficacy in eliminating it to stop it from becoming chronic is a subject of debate within the medical community, with some research estimating that as many as 25% of people (1) can still experience symptoms even after antibiotics. There are several reasons why antibiotics aren’t enough to overcome the Borrelia bacteria and address Lyme disease: 

1. It is persistent

Borrelia burgdorferi is known to assume various forms, including spirochetes, cysts, and biofilm-like colonies that may be less susceptible to antibiotics, making it difficult to fully eradicate the infection. Plus, it is suggested that when the Borrelia bacteria senses it’s being attacked, it can go into a dormant state, allowing it to survive even after the onslaught of antibiotics. 

2. It can live in your tissues

Certain antibiotics may struggle to penetrate deep into tissues where the bacteria can hide. (2) This limited tissue penetration can hinder the eradication of this bacteria, leading to persistent symptoms and the need for continued antibiotics.

3. It disrupts your immune system

Chronic Lyme disease can lead to dysfunction in the immune system. Borrelia is known to evade your immune response, allowing symptoms to continue despite antibiotic treatment and causing further immune dysfunction. That’s why restoring and supporting your immune system is something we focus on in my telehealth functional medicine clinic in order to provide a comprehensive approach to chronic Lyme disease.

4. It can exist with other infections

Lyme disease often coexists with other tick-borne infections from other bacteria, known as co-infections. These co-infections can complicate the clinical picture and may require different treatment strategies. Research estimates (3) that the majority of people with Lyme disease have at least one co-infection while 30% have two or more. Co-infections can go unaddressed for many reasons, leaving symptoms of these infections to persist since the right antibiotics aren’t being recommended to target these additional infections.

A holistic approach to Lyme disease

To treat Lyme disease effectively, functional medicine expands its focus outside of antibiotics alone. By looking at underlying dysfunctions and your specific biochemistry, we are able to tailor a personalized plan to tackle Lyme and help you overcome your chronic symptoms from the inside-out.

1. Comprehensive testing

In functional medicine, we use advanced testing methods to look for the presence of Lyme disease, other co-infections, and other underlying dysfunctions of your immune system, gut health, and more that could be contributing to your symptoms. 

2. Immune system support

If your immune system is weak, it doesn’t matter how many antibiotics you take. By healing your gut (where 80% of your immune system is located) and implementing targeted natural supplements and other immune supporting tools, functional medicine can help strengthen your body’s natural defense system to fight off these infections.

3. Lifestyle changes

Functional medicine understands the impact that certain lifestyle factors have on your overall health. It’s not just about what you eat and how much you exercise. We take into account all of the factors that could be contributing to poor immune function and overall health including stress, toxin exposure, sleep, and more.

Seeking help from a functional medicine expert

Ultimately, there is no “one-size-fits-all” when it comes to healing, especially from Lyme disease. This invasive and elusive condition is something we are continuing to learn more about and how to navigate. But by employing the latest scientific-research and helping improve your body’s natural ability to heal itself, we can put you on a path to finally overcoming your symptoms and putting this condition into remission.

If you or someone you know is struggling with Lyme disease, or has chronic symptoms that can’t be explained or matched with a diagnosis, schedule a telehealth consultation today to learn more about how we can help you with functional medicine.

As one of the first functional medicine telehealth clinics in the world, we provide webcam health consultations for people around the globe. 

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