Interview with Dr. Schweig- The Complicated Story Behind Treating Lyme Disease

Sunjya K. Schweig, MD is an expert in complex chronic illnesses, which require rigorous investigation and management. He has been studying, teaching, and practicing integrative and functional medicine for over 20 years. Dr. Schweig recently partnered with Chris Kresser, Lac., to form the California Center for Functional Medicine (CCFM). To learn more about their treatment philosophy and conditions they treat, please visit their website.

Over the years, Lyme disease treatment has become a specialty of Dr. Schweig’s. Lyme disease is an infection that is transmitted through a tick bite with the bacteria Borrelia burgadorferi. Lyme disease can affect the skin, joints, heart and nervous system. Common symptoms range from a rash at the site of the tick bite, flu-like symptoms to more chronic symptoms like joint pain, numbness, and impaired muscle movement.

Find out how best to utilize functional medicine when treating a patient with Lyme disease and when the best time to refer out to a specialist is if you suspect Lyme disease as the underlying cause of your patient’s symptoms.

The FACTS about Lyme Disease

• Lyme disease is caused by the bacteria Borrelia burgadorferi
• Ticks get infected with bacterium from biting infected animals, like deer and mice
• West Coast: younger ticks (nymphs) tend to carry more bacteria 33-40%
• East Coast: adult ticks can carry up to 70-80% more bacteria due to differences in the life cycle of the ticks
• Transmission can be as short as one hour
• The longer a tick is attached, the more likely a person will contract Lyme disease from an infected tick

The Lyme-Gut Connection:

It is common for people who are exposed to Lyme disease from tick bites, to not show any symptoms or get sick at all. A person can be exposed multiple times and not get sick, until the bacterial load of B. burgadorferi becomes too much or the immune system has been weakened due to stress, gut issues, and adrenal exhaustion to the point where the body is no longer fit to fight the bacteria. Lyme can even spread to the gut, causing bad GI issues such as bloating, diarrhea, abdominal pain, and constipation that often resembles SIBO and irritable bowel syndrome. Co-infections are also very common with Lyme disease since the immune system has become compromised, which means it can be hard to decipher which symptoms are coming from the Lyme disease or even to diagnose that it is Lyme disease to begin with.

As a result, it is important the gut is tested to get rid of any additional bacteria or parasites such as Giardia, H. pylori, and Cryptosporidium. Cryptosporidium can actually be used as an indicator for Lyme disease since most patients should be able to get rid of it on their own. However, patients with a suppressed immune system due to carrying an infection for a long period of time, such as those with Lyme disease, are more susceptible and Cryptosporidium persists.

Dr. Schweig starts with herbals to treat Lyme disease, while treating the gut and adrenals with standard functional medicine protocols in order to get inflammation down and the immune system back in fighting condition. The body needs to be healthy enough to respond and fight back, if not there can be too many other chronic problems for the antibiotics and the immune system to work properly. Depending on the patient, Dr. Schweig will begin antibiotics after a few months of functional medicine protocols, unless someone has a lot of neurological symptoms, pain or has previously responded well to antibiotics, in which case he treats with antibiotics right away.

Taking it Case by Case

There is a huge spectrum of Lyme patients, ranging from those that were recently infected within hours or days to chronic patients that have been dealing with Lyme for months or years. Lyme is a very complicated disease due to the bacteria being able to hide and persist in the body, making it even harder to get rid of.

Dr. Schweig utilizes both an ELISA and western blot to test for the presence of Lyme disease to be thorough. His initial lab intake is comprehensive, ranging from adrenal testing and GI testing, to utilizing organic acids profile markers. Dr. Schweig also gives his patients a symptom questionnaire to help decipher the condition he is working with. He discussed with Dr. Kalish, that after seeing so many patients you begin to see a certain cluster of symptoms for different co-infections or stages of Lyme disease.

For patients that are tested early on and have Lyme it is important to treat it right away to prevent any serious symptoms or damage to the body. On the other hand, if a patient has been sick for many years, it is more important to initially focus on the functional medicine protocols to heal the body. It is essential to first set a foundation in place with a properly functioning immune system, and then go back with antibiotics to fight the Lyme disease in order to get rid of the bacteria thoroughly. Dr. Schweig strongly believes in a comprehensive approach and often sees patients getting better after getting them on a good gluten free diet and treating their adrenals and GI problems; anything to help modulate their immune system. A low dose of Naltrexone, starting at 1.5mg can also help increase a patient’s energy, improve their mood and also boost their immune system. Naltrexone blocks opiate receptors and at a very low dose actually up regulates the production of endorphins.

To Refer or Not to Refer?

Dr. Schweig discussed the importance of referring out to other doctors that specialize in treating patients with Lyme disease due to its complicated nature. Lyme patients often present with a wide range of symptoms causing confusion for doctors that aren’t familiar with treating Lyme. Certain GI issues and those infected with mold can also mimic the symptoms of Lyme disease. As if that wasn’t complicated enough, many times patients with Lyme disease also have co-infections that can cause a lot of issues on their own. Each co-infection then needs to be dealt with using a separate protocol.

It can quickly become overwhelming to juggle so many variables: co-infections, functional medicine protocols, and antibiotic treatments. As a result, it is very hard to treat Lyme disease because of the co-infections often present and the strong herbals and antibiotics at high dosages for long periods of time.

So where do you draw the line of treating a patient with functional medicine protocols before sending them to someone who can help treat their Lyme disease? Dr. Schweig suggests if a practitioner is feeling confused or a patient is not getting better after functional medicine protocols they should think about referring out. Another option would be to utilize lab testing to eliminate the cause of infection in order to see what they are dealing with. It also depends on the severity of the patient. If the patient is someone with many infections and problems going on, they may benefit from a few months of functional medicine protocols. However, the patient could also have very severe symptoms and could possibly benefit more from being under the care of someone who is familiar with the disease and how it manifests. It is important to acknowledge that as a practitioner you can’t fix everyone and that sometimes it is more beneficial for both you and the patient to refer out to another doctor sooner than later, thus earning your patient’s trust because you have their health as your number one priority.