To truly understand Lyme disease, it’s probably useful to understand the nature of microbes by taking a close look at virulence - the level of a microbe’s ability to cause damage or disease in the host.
Lyme is a chronic infection of not just one microbe, but multiple microbes, and why chronic Lyme disease should be treated differently than other acute microbial diseases.
Microbes are literally everywhere. Microorganisms, aka microbes, are microscopic single-celled living organisms that are invisible to the naked eye. The term ‘microbe’ is also very general - it includes mostly bacteria and viruses, but also protozoa and certain types of fungi.
Because microbes are invisible, sometimes we forget how pervasive they really are, yet in reality, they’re everywhere - they can thrive in every environment on earth. Every living organism is colonised by microbes - including the mammalian body, which means us, whether we like that idea or not!
At this very moment, trillions of microbes are living in and on our bodies. The sum total of all the microbes that inhabit our human body is called the microbiome, which in itself is an incredible thing. In human figures it includes somewhere between 20,000 and 40,000 bacterial species, with scientists only just starting to catalogue all the viruses. With an infinite number of different combinations, every microbiome is different from every other person’s microbiome on the planet.
You’ve probably heard of some microbes being called good or bad, but in a way they shouldn’t be defined that way; we term them good (friendly) and bad (unfriendly) by the nature of their relationship with us and how they can affect our health for the good, or not; in microbe world, though, they’re simply trying to survive. The microbes that we encounter are host-dependent, which means they need to obtain the nutrients necessary for their survival from a host like us.
Microbes that inhabit the body are concentrated mostly in the gut and on the skin. Bacteria and other microbes in the gut survive on the leftovers from food that we don’t absorb; on the skin, they survive on oils we naturally secrete to keep skin lubricated.
Availability of food is the primary factor that affects growth of microbes like bacteria – they'll keep growing as long as food is present. Not surprisingly, the highest concentration of bacteria and other microbes is in the intestinal tract where there’s plenty of free food, but because nutrients on the skin are sparse, the concentration of microbes is much lower than in the gut.
Breaking through the barriers
The problem with microbes is a matter of resources. The carbs, fats, proteins, vitamins and minerals that make up the cells of the body are also potentially a source of food, making the cells themselves such an exceptionally good food source for microbes that the body has to put up – and maintain - strong barriers to keep the microbes out.
The primary barriers of the body include:
- Mucous membranes that line the mouth and nasal passages
- Stomach and intestinal linings
- Bronchial passageways in the lungs
- The skin of body openings, i.e. ears, nose
Microbes are always looking for an opportunity to break through barriers - an infection is just a microbe trying to find a way inside the tissues to get at the body’s cells for a feed. If they make it through and enter the bloodstream, then they have access to all the cells inside the tissues of the body, and this is where they cause their damage - by chowing down on the body’s cells. I say ‘cell-deep’ a lot on the website, and this is why, because the damage – the inflammation – starts deep down at cellular level.
Unfortunately, the barriers of the body aren’t nearly as secure as we might hope. A 2015 study found that bacteria from the gut constantly trickle across the intestinal barrier into the bloodstream. It happens in everyone, but it’s more pronounced if the balance of microbes in the gut microbiome has become disrupted by chronic stress and/or and a steady diet of carb-loaded processed, refined, artificial, junk foodstuffs.
Any break or cut in the skin also gives microbes on the skin the opportunity to invade deeper tissues and consume the unprotected cells just below the skin surface. A skin infection is simply bacteria consuming cells in tissues below the surface of the skin.
It's not just what we've already got
However … it’s not just the microbes that are already on or in the body that we have to worry about. Microbes from the outside environment are constantly trying to break through barriers to get into the body too - the nutrients and resources that the body’s cells have to offer are just too good to ignore!
Different microbes choose different pathways. Some microbes, such as influenza and more recently, bluddy coronavirus, ride on air droplets to enter the body by way of the nasal passageways and lungs. All it takes is one infected person in a crowded space to infect the entire room. And we won’t even mention the other popular route for microbes to take into the body - the list of microbes that can be transmitted by naughties in the boudoir is longer than you might expect.
And then we come to the blood-suckers. So who hasn’t been bitten by a horsefly or mozzie, or a flea or … a tick? I had a tick attach to me a few years ago – a tiny one that managed to get up my t-shirt and attach to my ribcage. I only noticed it in the shower – didn’t feel it bite me as they very cleverly have a numbing juice when they bite – so of course I went into a blind panic at the prospect of Lyme disease. One quick trip to the GP later and the blighter was gone, thank all the Goddesses.
Now here’s a thing - only certain ticks carry the microbes that cause Lyme disease, but every tick carries hundreds of different species of microbes. Blood-suckers are nature’s perfect vehicle for spreading microbes – I mean, why wouldn’t gazillions of different microbes take advantage of such an opportunity?
The only thing that prevents microbes from ravaging the cells of the body is the immune system. When a foreign microbe crosses a barrier or enters the bloodstream, it encounters the defences of the immune system.
The immune system’s killer army of white blood cells line every barrier in the body and circulate throughout the bloodstream - a single litre of human blood contains somewhere between 4 and 11 billion white blood cells, so you can see that the immune system is constantly on guard to defend the tissue cells.
The Virulence Factor
The potential of a microbe to break through the barriers and ravage cells of the body is called virulence. Virulence is a function of both the natural aggressiveness of the microbe, and how familiar the immune system is with a particular microbe. Of the two, the immune system’s familiarity is the most significant.
The human immune system is extraordinarily sophisticated. It's evolved over millions of years of repetitive exposure to an enormous number of different microbes. For every trick that microbes have devised to get past immune system barriers, the immune system has developed counter-measures to match them - layer upon layer of different levels of protection are hardwired into the genes for countless numbers of microbial threats.
It means that the more familiar a microbe is to the immune system, the better it can manage it. A pathogen (disease-causing microbe) is just a foreign microbe that the immune system doesn’t know very well and therefore isn’t pre-equipped to handle.
Of course, there are different degrees of pathogens - the higher a microbe’s potential to do harm, the greater its virulence. Possibly the most virulent microbe of our time is the Ebola virus. Just about anyone who comes into contact with Ebola becomes severely ill, and the mortality rate is off the charts. There's an amazing book I read a few years back on Ebola, called 'The Hot Zone: The Chilling True Story of an Ebola Outbreak', by RIchard Preston - https://www.amazon.co.uk/Hot-Zone-Chilling-Story-Outbreak/dp/0552171646/ref=sr_1_1?crid=11Z08MA0K1NND&dchild=1&keywords=the+hot+zone+book&qid=1624002382&sprefix=the+hot+zone%2Cluxury-beauty%2C152&sr=8-1 - it's a shudderingly eye-popping read - I can highly recommend it.
The reason that Ebola is so threatening is because humans have rarely been exposed to it, therefore the immune system has no built-in defences against it - on a scale of 1 to 10, Ebola would be right up there at 10. Other than possibly HIV, there’s not much that can match Ebola's potential to ravage the body’s cells.
At the opposite end of the spectrum are the microbes that dominate the skin and body cavities (throat, lungs, stomach, intestines etc). Defined as normal, or friendly, flora, these microbes would be a 1 on the scale - not quite zero, because even our friendly flora have the potential to do harm, although that potential is very low.
The immune system knows the friendly microbes better than any others - it’s a relationship that’s been honed over millions of years. By being able to keep the natural aggressiveness of these microbes completely in check, a mutually beneficial relationship becomes possible. As a trade-off for the nutrients and resources we as their host provide, they give back by helping to digest food, providing certain vitamins – in our horses, all the B’s, vit.C and vit.K - and they also help prevent the overgrowth of the more threatening microbes that are always present.
Of course, there are a wide variety of microbes that exist between the friendly flora (1) and Ebola (10). As a general rule, the more virulent a microbe happens to be, the less common it is, and vice versa. Obvious I know - the more common a microbe is in nature, the greater the chances of the immune system having had repetitive exposure to it.
This works mostly in our favour - the chances of being exposed to a highly virulent microbe such as Ebola are quite rare for most of us, but we’re all exposed to cold viruses on a regular basis. Viruses that cause the common cold have been following humans around since before time began, so the human immune system is extremely familiar with them. They would come in at around 2 on the virulence scale.
Virulence decreases with exposure. Once someone has been infected with a microbe and recovers, the immune system learns to manage that microbe and it becomes less of a threat – this is what’s called our adaptive immunity and it can provide long-lasting protection, sometimes for the entire lifetime, i.e. someone who recovers from measles will be protected against measles for their lifetime.
As with Covid, the vaccine roll-out has also been about teaching the immune system to learn to deal with the coronavirus microbe, without us having to suffer the consequences of an infection from it. However, virulence can also vary from person to person, as Covid has shown us, where half the population hardly got sick at all with exposure to the virus, but some people got extremely sick.
Then there are the stealth microbes
Foreign microbes don’t necessarily have to be highly virulent to be successful - some of the most successful microbes trade virulence for persistence. Often called stealth microbes or stealth pathogens, these sneaky opportunists specialise in staying just under the immune system’s radar. They enter the body with little fanfare or commotion, and initial symptoms may be mild, if any.
Though the immune system is familiar with them, these microbes are masters at persisting - chronic infections are common. Unlike the friendly flora that call their host's body home, these particular microbes’ mission is about maintaining a presence in their new host’s body tissues and waiting for an opportunity to spread to other hosts. Because of their stealthy nature and because they are remarkably common, these are the microbes we need to worry most about.
One key strategy that stealth microbes use to persist inside the body is invading and living inside cells (called intracellular). Infecting and living inside cells of other living organisms is an ancient strategy that microbes have been honing for billions of years.
By infecting and pirating molecules and resources from larger cells - the ultimate dine-in experience - microbes can survive without having to work very hard. Living inside another cell offers food and protection from the immune system, other bacteria, and … antibiotics. It’s an easy-living strategy used by many bacteria, some protozoa and yeast, and all viruses.
Borrelia burgdorferi, the bacteria commonly associated with Lyme disease, is one such microbe. Borrelia has been infecting humans by way of tick bites for as long as there have been humans — the human immune system is very familiar with it. It’s present in various species of ticks worldwide, from the tropics to the arctic circle. On the virulence scale, it would be around a 4 in most people.
After entering the bloodstream by way of a tick bite, Borrelia infects white blood cells and disperses to pretty much every tissue throughout the body - joints, brain, heart, you name it - where it infects and lives inside the cells. Though the immune system would like to eradicate this invader completely, Borrelia is so proficient at hiding that often a stalemate is reached in which the bacteria maintains a low-grade presence in tissues.
Often people don’t even know they’ve been infected. Tick bites frequently go unrecognised, and symptoms at the time of acute infection are often mild, if any. Once established, the fact that Borrelia lives deep inside the cells and occurs in low concentrations makes it difficult to diagnose, and almost impossible to eradicate with antibiotics.
In a healthy host, the bacteria can stay dormant in tissues for years - even a lifetime - without causing symptoms. But – let the immune system weaken for any reason, and those hidden microbes will erupt and cause symptomatic illness. And because they’re erupting throughout pretty much all the tissues in the body, a wide range of symptoms hit us like a Tsunami - we’re talking fatigue, brain fog, joint pain, muscle pain, gut disruption, and feeling like we’ve got the worst flu ever.
Borrelia is far from being the only stealth microbe. All of the recognized Lyme coinfections are stealth microbes, but we may just be scratching the surface. When chronic Lyme disease sufferers are tested for coinfections, most are found to be carrying more than one of several possibilities including mycoplasma, bartonella, babesia, chlamydia, ehrlichia and anaplasma. Testing, however, is usually limited to just one, or a few species of, certain bacteria, because dozens of species are possible for each bacteria.
Ticks alone carry hundreds of different microbes, but some of those bacteria are more commonly spread by other routes - Mycoplasma pneumoniae and Chlamydia pneumoniae are common respiratory infections that most people pick up as kids. Other species of mycoplasma and chlamydia are commonly spread by intimate contact with other people.
And then there are the viruses. Many people with chronic Lyme disease are also found to have reactivation of Epstein-Barr virus (EBV), cytomegalovirus (CMV), HHV-6 types a and b, HHV-7, HHV-8, and/or parvovirus.
All of these microbes sit within the lower half of the virulence chart, therefore it shouldn’t be surprising that there are so many possibilities - microbes that fit the description of stealth microbes are remarkably common. The fact is that every living organism on earth - plants, mushrooms, animals, and people – we all harbour some cells that are infected with microbes.
Characteristics of low-virulence stealth microbes:
- Initial infection is generally a mild event.
- Asymptomatic chronic infection is common - chronic symptomatic dysfunction only occurs if immune system functions are disrupted.
- Chronic infection is associated with vague, nonspecific symptoms - fatigue, brain fog, tingling in extremities, joint pain, muscle pain - all unrelated to the initial infection.
- Chronic infection is associated with low concentrations of the microbe in the body, often making diagnosis challenging.
- Stealth microbes have a slow growth rate.
- They are intracellular - microbes live deep down inside the cells.
- Chronic infection with stealth microbes typically responds poorly to antibiotics and vaccines.
- Symptoms result from inflammation resulting from manipulation of the immune system by the microbes, not as much from direct harm by the microbe.
- They take the path of least resistance and gravitate toward sites of established inflammation in the body - twisted knee, scratched eye, the liver overburdened with toxins.
- Stealth microbes work together - chronic infection with multiple microbes is the norm.
No doubt, infection with multiple stealth microbes increases virulence. Each of the above-mentioned microbes uses a slightly different strategy for outmanoeuvring the immune system. Several stealth microbes together can disrupt immune system functions enough to open the door to chronic symptomatic infection.
In other words, multiple stealth microbes together will have a higher potential to cause symptomatic illness. Chronic Lyme disease is rarely a disease caused by one microbe – multiple stealth microbes come together to cause chronic Lyme disease.
Infection with multiple microbes does not always occur simultaneously, though it can happen with the same insect bite. A stealth microbe such as mycoplasma or bartonella may be present (possibly for a long time) without causing symptoms. Then a tick bite transmitting borrelia or other tick-borne microbes comes along and disrupts immune system functions enough to allow symptomatic illness.
Borrelia doesn’t even have to be involved - coinfections can occur with any of the above microbes without borrelia. Because stealth microbes cause similar nonspecific symptoms, chronic infections with other stealth microbes can look just like Lyme disease, so the margins start to blur between chronic Lyme disease and other chronic illnesses.
Variations in symptoms depend on the microbes present, with the list of known stealth microbes getting longer every day - who knows how many more are waiting to be discovered ...
Chronic Immune Dysfunction is now considered an epidemic
The steady rise in chronic diseases like Lyme, fibromyalgia, chronic fatigue, and autoimmune and other degenerative diseases over the past 75 years is disturbing, but explainable. The underlying problem is not an epidemic of emerging stealth microbes – they’ve been around for thousands of years - but instead something that we’ve brought on ourselves.
The modern world has become saturated with environmental factors that disrupt immune function, with poor junk food diets, environmental toxins, chronic stress and a sedentary lifestyle doing the bulk of the damage.
These modern-day stressors come together to cause widespread chronic immune dysfunction, which opens the door for stealth microbe-driven chronic infections that otherwise would not have been such a threat. Global warming and a huge explosion in tick numbers will also fit into the equation, but these outward factors matter less than you might think. Stealth microbes have always been there but we’re making it a whole lot easier for them to jump on board!
The best solutions are defined by virulence
There are no absolutes when it comes to stealth microbes - it’s a matter of adding up all the clues, including the symptom profile, prevalence of possible microbes in the geographic area, and any other factors that may be helpful in making the diagnosis. Highly virulent microbes are usually addressed conventionally with a compatible level of potency - targeting specific microbes with specific drug therapy (antibiotics, antivirals, vaccines, other supportive drugs) is the usual approach for controlling highly virulent microbes. Some infections generally respond well to antibiotic therapy, whereas the Ebola epidemic in Africa has been almost completely controlled with quarantine alone.
However, the classic 'Identify, Target & Destroy' approach that works for high virulence microbes is not a good fit for stealth microbes. First up, it’s hard to know what to target. Even if one microbe is revealed by testing, the possibility of many other hidden stealth microbes being present is much too high to ignore.
The very nature of stealth microbes makes them resistant to conventional therapies. Even when stealth microbes come together to cause significant chronic illness, they still retain their individual stealth characteristics. Slow growth, low concentrations of bacteria, and the ability to live inside cells and isolated areas of the body dramatically limit the usefulness of synthetic antibiotics, and the ability of stealth microbes to continually alter their genetic signature makes vaccines worthless.
The best solutions are actually not high tech - normal health can actually be restored by creating a healing environment within the body. I know I bang on about this all over the website, but seriously, lessening immune disruptors with species-appropriate food, avoiding unnecessary toxins, reducing oxidative stress with antioxidants, managing stress, and regular exercise, are all essential for becoming well again.
Natural herbal therapy can reduce inflammation and enhance immune function, while at the same time suppressing stealth microbes and protecting the body’s cells. Because herbal therapy is so remarkably safe, it can be continued for a lifetime.
Top Tips for horse and human
- Glutathione - This essential antioxidant plays a key role in protecting the cellular mitochondria (the powerhouses of cells) from free-radical damage, as well as enhancing detoxification processes and fortifying immune functions. To maintain the natural production of glutathione reserves, you need ...
- N-acetyl cysteine (NAC) - A precursor to glutathione with antioxidant and anti-inflammatory properties, NAC helps to protect cells from damage and oxidative stress.
- Vitamin D - Known as the 'sunshine vitamin', vit. D is critical for normal immune function. Vit.D is created in the skin with exposure to UV rays of sunlight, so rugs off and get your horse outside! For us humans, though, because most of us have low sun exposure (or use sunscreen, which blocks vit.D production), low vit.D levels are common. A simple blood test will tell you if your levels are adequate (> 40ng/ml). Vit.D3 is the preferred form of supplementation but it needs vit.K2 to catalyze it. Personally I aim for 4,000iu but I've got knackered bones so need all the vit.D3 I can get.
- Vitamin C - Another key player in healthy immune function, vit.C has known antiviral, anti-inflammatory, antioxidant and immunomodulating properties. The good news is that our horses' gut system produces all the vit.C they need, in the active form that their body utilises. For us humans, though, we don't so we need to include it in our daily diet. With chronic infections, human stores of vitamin C can become depleted, plus the body needs extra vit.C when under stress. The market out there says to aim for at least 1000mg vit.C daily, but personally I don't think this is anywhere near enough - I take at least 3000mg daily.
- Magnesium - Magnesium levels are often low during chronic illness. Aggressive magnesium supplements, however, can often worsen Lyme symptoms. Generally, magnesium levels will return to normal as health improves.
- Mycotoxins - fungal mould toxins are potent immune disruptors and cause a wide spectrum of nonspecific symptoms, including a chronic inflammatory response, neurological symptoms, and persistent insomnia. Feed Alltech's Mycosorb A+ mycotoxin binder, or if you'd rather not feed a yeast, Spirulina is also an excellent toxin binder.
- Adrenal dysfunction/fatigue is a given in any chronic illness. Elevated cortisol levels, associated with increased physical and emotional stress, contribute to sleeplessness, stress intolerance, agitation and anxiety. Prolonged adrenal stress can deplete cortisol, with resulting symptoms of extreme fatigue, total stress intolerance, and excessive sleeping yet sleep is dysfunctional because the body's wired with adrenalin. Because adrenal dysfunction is always present in chronic illness and generally normalises with appropriate therapy, measurement of adrenal hormone levels is generally not necessary. On rare occasions when a patient is not improving, measurement of cortisol can be beneficial.
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