Introduction
A Nutritional Approach to Lyme Disease
Most commonly reported vectorvector-borne illness in US Most common of all ticktick-borne diseases Highly focused geographic distribution
Primarily focused in the Northeast
Geographic expansion of reservoir mammals & human development into rural/suburban areas main reasons for increasing cases Dubbed “The Great Imitator” Imitator” due to mimicking symptomatolgy of many diseases
Ben Briggs, RPh, RPh, CNC, IACP February 17, 2010
Statistics
RA, MS, Lupus, Bipolar & major depression
Lyme disease distribution in US
19901990-20081 3818 cases in PA in 2008 (30.7% incidence)1 250% ↑ in Lyme disease from 19931993-20081 46% of households in Pocopson twp had at least 1 family member afflicted with Lyme disease2 321,128 cases in US from
1 CDC statistics
2 Lymediseaseassociation.org
Function of Nutritional Approach “The
purpose of using a nutritional approach is to provide an adjunct to traditional therapies as well as to address the multiple nutrient deficiencies that result with Lyme and associated diseases” diseases” - Michael Briggs, Pharm.D. (2010)
Outline
Gastrointestinal Support
Foundational Support
Multivitamin B-complex Magnesium Vitamin D
Antioxidant Support
AlphaAlpha-lipoic acid CoQ10
Immune Support
Probiotics L-glutamine
Cat’ Cat’s Claw Artemisinin
AntiAnti-inflammatory support
Essential fatty acids Combination products
Hepatic Support
Milk Thistle NAC & Glutathione
Energy Support
Joint Support
Lifestyle Support
Rhodiola Glucosamine & Chondroitin Intestinal Candidiasis Sleep
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Gastrointestinal Support
Recommended Products
Probiotics
Friendly flora that normally inhabit gastrointestinal tract
Lactobacillus Acidophilus Bifidobacterium Lactis
Improve nutrient absorption & immune function Discourage pathogen & biofilm growth
Lactoperoxidase Lactoferrins
Synthesize Vitamin K & certain BB-vitamins May be in capsule or powder form
Most are DairyDairy-free
Refrigerated or shelfshelfstable products Rotate or mix brands to confuse pathogens Kefir is only yogurtyogurt-like product that is approved
Note:
Throughout this slide show, there will be slides showing pictures of “recommended products” products”. These products should not be considered an endorsement of these specific branded items but representative of the products that are recommended to assist in well being. The LDASEPA, by showing these slides does not specifically endorse any of these products.
Gastrointestinal Support
Recommended Products
L-glutamine Most
abundant amino acid in body Used for repair of inflamed mucosa & immune support
Stomach, intestines
Promotes formation
of glutathione w/NAC Involved in more metabolic processes than any other amino acid 3-4g in powder form up to 4 times daily
Foundational Support
Recommended Products
Multivitamins
Provide a convenient way to take a variety of nutrients to prevent deficiencies Come in tablet, capsule, powder or liquid form Pick product that allows best compliance
I.e. Once a day product
Should not take the place of a healthy diet Should contain at least 100% of US RDA
RDAs developed when soils were not depleted & are usually inadequate amounts
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Foundational Support
Recommended Products
B-complex
Contains Vitamins B1, B2, B3, B5, B6, BB-12, & folic acid Some people cannot activate • Use metabolically active forms
I.e. P5P, 55-MTHF, methylcobalamin
Necessary for healthy nerve, adrenal, muscle, skin, liver cell function & ↓ homocysteine levels 50mg once to twice daily with meals WaterWater-soluble → excess excreted in urine
No accumulation
Foundational Support
Recommended Products
Magnesium
4th most abundant mineral in body Involved in over 300 reactions in body Commonly overlooked deficiency Helpful for tremors, twitches, weakness, muscle soreness & cramps Chelated forms provides highest absorption I.e. aspartate, citrate
Chronic stress & alcohol consumption depletes magnesium stores → ↓ REM sleep, muscle spasms, constipation, hormone imbalances, low energy, calcification of organs
Dose: As much as the body can tolerate
Too much→ much→loose stools 300300-600mg daily
Foundational Support
Recommended Products
Vitamin DD-3
Active form of Vitamin D 60% deficiency in NE Has >200 mechanisms 25(OH)D levels>40mg/dl
6060-80mg/dl→ 80mg/dl→ ideal >100mg/dl is harmful
40004000-5000IU daily w/food
Liquid or softgel only 10K10K-25K daily x 5 days for viral infections Up to 200K daily safe in studies
Most researched nutrient in industry currently Deficiency associated with cancer, CVD, HTN, stroke, MS, RA, IBD, osteoporosis, chronic pain, falls, viral infections, depression, autism, periodontal disease Antimicrobial peptides combat a variety of viruses
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Antioxidant Support
Recommended Products
CoEnzyme Q10
Intracellular antioxidant essential for energy production
↑ ATP production in mitochondria of cells
Affects most active metabolic cells
Contraindicated during atavaquone use
Depleted by Statin drugs 200200-400mg daily with meals in oil soluble form Use ubiquinol in elderly due to ↓ ability to activate ubiquinone
Heart, immune, GI mucosa
Mepron, Malarone
Antioxidant Support
Recommended Products
AlphaAlpha-Lipoic Acid
Antioxidant that neutralizes free radicals in water & fat soluble regions of cells Facilitates transport of CoQ10 into mitochondria Helps recycle edogenous antioxidants
I.e. glutathione
Provides support for liver detoxification R-isomer is more biologically active 300mg twice daily with meals
Immune Support
Recommended Products
TOATOA-free Cat’ Cat’s Claw (Una (Una de Gato) Gato)
TOATOA-free Cat’ Cat’s Claw has toxic alkaloids removed to prevent liver damage Immune enhancing & antimicrobial properties Contains quinovic acid glycosides
Similar in structure to fluoroquinolones (i.e.Cipro) i.e.Cipro)
Used as an adjunct to Antibiotic therapy Herxheimer reactions possible so titrate dosage to 1 capsule 3 times daily with meals for 66-8 months (3(3-4 life cycles)
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Immune Support
Recommended Products
Artemisinin
Active component of Sweet Wormwood Shown to be beneficial for balancing microbiology of the GI tract Used primarily as an adjunct for coco-infections Contraindicated in pregnant/nursing women Herxheimer reactions possible so titrate dosage to 1 softgel twice daily with meals Used in globally for malaria treatment
AntiAnti-inflammatory Support
Recommended Products
Essential Fatty Acids (EFAs (EFAs)) Must
be consumed in diet as body does not manufacture Improve memory, mood, & cognition AntiAnti-inflammatory properties Manufacturing process is critical for quality
ColdCold-pressed or molecularly distilled
10001000-6000mg daily with
meals Examples include fish, flax, or borage oil
Recommended Products
AntiAnti-inflammatory Support Combination Products Combine
herbs like turmeric, ginger, rosemary, Baikal skullcap, green tea Work on multiple inflammatory pathways compared to COXCOX-1 or COXCOX-2 only in Rxs Shown to decrease CC-reactive protein Used primarily for pain & swelling relief 1-2 softgels/capsules softgels/capsules up to 4 times daily with meals
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Hepatic Support
Recommended Products
Milk Thistle Promotes regeneration of
liver cells Blocks entry of toxins into liver cells Helps maintain glutathione & SOD levels
↓ AST, ALT, & Alk Phos levels
Promotes healthy bile
flow 100100-250mg up to 3 times daily with meals
Recommended Products
Hepatic Support N-acetyl cysteine & Glutathione
NAC SulfurSulfur-containing amino acid precursor to LLcysteine & glutathione Antioxidant & liver protectant actions Immune enhancing capabilities 600600-900mg 22-4 times daily with meals
• Must be in reduced form
Recommended Products
Glutathione One of most important antioxidants in body Essential for Phase I & II liver detoxification Involved in liver, lung, immune, bowel, heart, brain, pancreatic, & eye health 100100-300mg up to 3 times daily with meals
Energy Support Rhodiola & Ginseng Adaptogens
that help with fatigue, stress & immune function Raise ATP in muscle cells NonNon-stimulants safe for use in pts with high blood pressure May be used longlong-term without breaks 1 capsule 22-3 times daily with meals
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Joint Support
Recommended Products
Glucosamine & Chodroitin Sulfate Provide
building blocks of cartilage to rebuild cushioning between joints Sulfate forms more active than HCl forms
Sulfates facilitate old cartilage removal Safe for patients with a sulfa drug allergy
ShellfishShellfish-free forms
now available for patients with hypersensitivities 1500mg/1200mg daily in divided doses
Lifestyle Support
Recommended Products
Intestinal Candidiasis
Intestinal candidiasis is very common in Lyme patients due to extensive antibiotic usage
Affects GI, immune, nervous, urinary, & hormonal systems
Restricted diet a MUST plus cidal Rxs or herbals
NO sugars, HFCS, artificial sweeteners • Stevia, Stevia, Agave, or Raw honey if tolerable
NO fruit juices, sodas, alcohol NO dairy, grains, peanuts, vinegars NO mushrooms or fermented foods
Recommended Products
Sleep Chronic sleep deprivation
linked to immune dysfunction, memory loss, hypertension, diabetes, & cancer