Chronic Lyme Disease Symptoms and Adrenal Fatigue – Full Version

By: Michael Lam, MD, MPH


What Is Lyme Disease?

Tick bites can spread the Borrelia bacteria which can infect and cause chronic Lyme Disease symptomsLyme disease is an illness caused by an infection of several species of the Borrelia genus of bacteria, including B. Burgdorferi, B. Garinii, and B. Afzelli. These pathogens colonize the gut microbiome of the Ixodes scapularis tick, often when the tick feeds on a mouse or rat early in its life cycle. These small rodents often act as carriers for the pathogen. When an infected ticks feeds on a human host, the pathogen is passed on, infecting the host. In many cases, the host never feels the tick bite, and thus cannot recall ever being bitten, meaning the symptoms come as a surprise.

Aside from tick bites, there are no other known methods for transmission and infection by the Borrelia bacteria responsible for causing Lyme disease.

Prevalence of Lyme Disease

Lyme disease is endemic to most continents in the northern hemisphere, with cases reported in Africa, Asia, Europe and the Americas. The different strains of the Borrelia bacteria predominate or are generally constrained to certain geographical areas. B. Burgdorferi is the most prevalent strain in North America, while B. Afzelii and B. Garinii are more endemic in Europe and Asia. There is, however, a great deal of crossover with these three main strains.

There are a total of 13 total strains currently identified including B. Andersoni, B. Miyamotoi and B. Japonica. Many of these strains are only endemic to a defined geographical area; for example, B. Japonica is confined to the eastern hemisphere. Specific symptoms experienced can vary, depending on the specific strain of Lyme disease that is the infectious agent.

Symptoms of Lyme Disease

For most people infected with Lyme disease, the first sign is usually a bullseye-shaped skin lesion or rash that appears at the bite site between half a week and four weeks after being bitten. The rash is not always exactly the same shape or form between different individuals, and can even be absent in between twenty and thirty percent of those infected. Other early symptoms can include headaches, muscle soreness, fever, fatigue and flu-like symptoms.

If unrecognized and untreated, the infection can grow beyond its initial stages and spread throughout the body. A Yale University clinical study found that in a cohort of 314 Lyme disease patients, half began to develop secondary skin lesions and rashes at sites far removed from the original bite. These were accompanied by further symptoms, including migratory musculoskeletal pain, swelling of the lymph nodes, swelling of the testes, and irritation of the meninges of the brain. The bacteria will also attack the nervous system, causing memory loss, sleep problems, brain fog, facial palsy, and can affect the heart’s control system and cause arrhythmia of the heart.

Laboratory Testing of Lyme Disease

Lab tests are not reliable enough to positively rule in or out infection by the Borrelia bacteria with chronic Lyme disease symptomsDiagnosis of Lyme disease is currently complicated by the lack of a reliable and definitive test. A dual step blood test does exist for detecting antibodies against the Borrelia bacteria; however, the blood test often fails to detect the antibodies in the early stages of the infection, before Lyme disease has had a chance to really take hold. In general, it takes four to six week for the immune system to generate enough antibodies to fight against Borrelia infection to show up in standard testing.

Other tests are even less helpful or their accuracy has not been adequately determined; these include urine testing, immunofluorescence staining, reverse western blot, and synovial (joint) fluid testing. If a tick has been caught and retained after a bite, the tick can be tested for the Borrelia bacteria; however, this is also inconclusive, because a bite does not always transmit the pathogen, the specific tested tick may not have been the vector for the pathogen, and tick testing takes a significant period of time for results to be returned, potentially allowing the Lyme disease infection to grow.

Instead of relying solely on tests, diagnosis must be based on a combination of medical history, history of tick exposure and correlation of symptoms, along with available laboratory results. As mentioned before, one challenge to correct diagnosis and timely treatment is that many people may not remember ever being bitten by a tick, and if such an individual also did not develop a skin rash upon infection, detection and treatment may not occur in time.

Acute Lyme vs. Chronic Lyme

Even after seemingly successful conventional treatment of Lyme disease by antibiotics, many people continue to experience lingering symptoms such as joint pain, ongoing memory issues and chronic fatigue. This is known as chronic Lyme disease, as opposed to acute Lyme disease during which the Borrelia pathogen is clearly ravaging the body with an active infection, with high laboratory Lyme titer detected.

The mechanism behind the chronic form of Lyme disease is an infectious state known as a stealth infection. Once symptoms of acute Lyme disease have been suppressed using antibiotics to kill off the pathogens, a small number of the Borrelia bacteria continue to live in the host. Laboratory studies have returned to normal, patients are pronounced cured and treatment ceases.

Animal studies have shown that, even after antibiotic treatment of Lyme disease, live bacteria can continue to persist. In this stealth infectious state, the organisms are in a near-dormant state, and largely do not trigger a general immunologic response from the body’s defenses such as inflammation and leukocyte production. Even in their dormant state, however, the pathogens do continue to secrete minute amounts of toxic metabolites and byproducts as a function of their own metabolism.

Even if treated, the bacteria can remain in the body in a subclinical fashion and cause chronic Lyme disease symptomsIn healthy bodies, these toxins are low enough in quantity that the normal detoxification and internal cleansing systems keep them from doing much harm. A healthy liver, immune system, microbiome, extracellular matrix (ECM) and kidneys are able to flush the toxins out, metabolize and process them in the liver, and excrete them. However, in cases where these normal detoxification functions perform suboptimally or are damaged, problems can appear when the systems are under stress and unable to perform at the level required. These constant, minute secretions of toxins start making the body feel sick, bringing on various symptoms, such as joint pain and fatigue. People continue to feel as if they were never cured, or that they have recurrent or chronic Lyme disease. Multiple visits to the doctor usually lead to even more aggressive antibiotic therapy that may work temporarily, only to relapse when antibiotic treatment terminates.

How Chronic Lyme Disease Affects the Adrenal Glands

From the body’s perspective, the key to health is balance; hormones need to be in balance for many bodily functions to operate, nutrient and energy intake need to be balanced with energy expenditure and excretion, and the rate of cell death needs to be balanced with the growth of new cells. Using this frame of reference, stress is any force that threatens to destabilize or upend these delicate balances inside the body. The body’s stress response system consists of multiple organs and systems working in unison. The neuroendometabolic stress response system is responsible for these functions, with the adrenal glands playing a critical role. It works tirelessly to secrete cortisol, the body’s main anti-stress hormone, in order to counteract the effects of stress and maintain balance within the body.

Illnesses and infections such as Lyme disease are serious destabilizing forces for the body, and it spares no effort in trying to eradicate the invading pathogen by way of the immune system. Both the immune response and the destruction caused by the invading pathogen are acute stressors on the body, and the adrenal glands must work to moderate their effects and keep the body in functional balance until the pathogens are cleared out by the immune system.

The stress caused by chronic Lyme disease symptoms put stress on the adrenalsHowever, in the presence of chronic Lyme disease, where the body is constantly in a stealth infection state, the pathogens do not trigger a general immune response that chases them out of the body. The low-grade infection goes under the radar and remains free to pump minute toxins into the body, causing stress and forcing the adrenal glands into chronic overdrive to maintain balance. If the body is constitutionally strong and there are few other stressors affecting the body, there is little to worry about. The body’s normal housekeeping functions have enough energy and functionality to counteract the negative effects.

However, if the adrenals are otherwise overstressed, or if the body is constitutionally weak, this constant and continuous wear on the adrenal stress response system can take its toll: without rest, the adrenals begin to wear down and degrade in function. The drawdown in adrenal function caused by chronic and unrelenting stress is known as Adrenal Fatigue. This condition has many signs and symptoms across different organ systems, although the hallmark symptom for all sufferers is fatigue.

How Lyme Disease Affects the Brain

The Borrelia bacteria can infect many different areas of the body including the brain, causing neurological and psychiatric chronic Lyme disease symptomsLyme disease is a truly multi-systemic disease, meaning the course of infection affects multiple different systems. Crucially, one of the systems most often affected if the pathogen is given the opportunity to spread throughout the body, is the central nervous system: the brain and spinal cord.

One of the symptoms of Lyme infection in the brain is microedema, or swelling in the brain. As the brain swells, it begins to push on the meninges – the membrane surrounding the brain – and can even begin to squeeze against the interior of the skull. The resulting neurological signs and symptoms of Lyme disease include:

  • Headaches
  • Neuralgias or neuropathic pain, which may feel like stinging or pricking, along with extreme sensitivity to light touch or pressure
  • Cranial nerve disorders: dizziness, tinnitus, hearing loss, double vision, drooping eyelids, numbness, pain and tingling of the face, facial palsy (in one or both sides of the face)
  • Seizures
  • Autonomic nervous system dysfunction – problems in regulation of pulse and blood pressure
  • States that mimic symptoms of other neurological disorders such as Parkinson’s, Bell’s palsy, ALS and multiple sclerosis

These effects also have a cognitive toll as well. The brain’s ability to process information and think straight is negatively affected. It’s like finding out that there’s LSD in the punch, and you’re not sure what’s going to happen next or if you’re going to be in control of your own thoughts. In fact, seventy percent of people dealing with Lyme disease also report changes in their thinking such as memory loss and reduced mental sharpness.

This fact is backed by neurologists from the American Academy of Neurology, who say that patients with nervous system Lyme disease may also have one or more of the following symptoms: sciatica-like nerve pain, weakness or numbness due to nerve damage, or changes in cognitive function such as thinking, reasoning, remembering, and imagining.

Other specific symptoms of cognitive loss include:

  • Impaired memory and memory loss
  • Brain fog
  • Slowness or difficulty in language processing
  • Dyslexia
  • Problems with numerical processing
  • Spatio-visual processing impairment (losing things, getting lost, disorganization)
  • Decline in abstract reasoning
  • Attention issues such as the inability to maintain divided or sustained attention
  • Poor auditory and mental tracking and scanning (loss in ability to follow daily affairs)
  • Increased and persistent distractibility

Not all those infected, even for a significant period of time, will experience all such symptoms; many may find they mainly notice headaches, neuralgias, brain fog and cognitive slowness. Notably, these Lyme disease symptoms are similar to symptoms of adrenal fatigue.

The Neuro-psychiatric Toll of Lyme Disease

Chronic Lyme disease affecting the brain can trigger symptoms such as anxiety, panic attacks and personality changesThe evidence pointing to the connection between neurological infection of Borrelia bacteria and the psychiatric manifestations of Lyme disease continue to mount. Many of the psychiatric symptoms are related to the inflammation and swelling of brain tissue as it reacts to Borrelia infection. This has a marked effect on cognition and mental function. In fact, psychiatric Lyme disease has been linked with virtually every psychiatric diagnosis and can affect people of all ages and from all walks of life.

In one case study, a college student developed panic attacks and severe anxiety along with loss of appetite and insomnia. These were eventually traced back to Lyme disease infection and seemingly successfully treated. However, the student later began to experience a recurrence of the earlier symptoms, now also accompanied by auditory hallucinations, obsessive thoughts and bouts of déjà vu.

These ongoing psychiatric symptoms may herald further and more severe mental and cognitive disruptions. A number of studies have found connections between neurological infection of Borrelia and learning disabilities, mood swings, depression, personality changes, suicidal tendencies, and increased aggressiveness and violent tendencies.

Attack on the Nervous System

Unfettered, Lyme disease has nearly free reign to saddle sufferers with these many debilitating symptoms. In so many cases, however, the Lyme disease connection is often missed. The neurological, psychiatric and physical symptoms can mimic various other illnesses and conditions throughout the various stages of infection, including Epstein-Barr, Lupus, or even adrenal fatigue, presenting a challenge to correct diagnosis. As a result, there are many people who are infected but have never been diagnosed with Lyme disease, and instead suffer from neurological or psychiatric symptoms they may not know come from Lyme disease.

For example, studies have shown that psychiatric in-patients are nearly twice as likely as the average population to test positive for Lyme. The National Institutes of Health are sponsoring a major study of neuropsychiatric Lyme disease in an effort to determine specific changes in the brain.

Conventional Treatment of Lyme Disease

Even if the initial Lyme disease infection is treated, the bacteria can hide in the body and continue to subtly cause chronic Lyme disease symptomsWhen detected early, it is thought that Lyme disease is easily eradicated using a course of oral antibiotics such as amoxicillin or doxycycline; indeed, most sufferers often react quite well to treatment, especially in the early stages, with the symptoms of acute Lyme disease disappearing and the patient able to resume their normal life seemingly free of the infection and all its symptoms. However, as mentioned previously, a low level of the Borrelia spirochete bacteria continues to persist in the sufferer’s body, living but often dormant.

Treatment of Lyme disease once the infection is well established and has spread throughout the body is more challenging. Often, a longer course of antibiotics or antibiotics delivered intravenously is used as a stronger mode of treatment. This long-form treatment has also been used against the chronic form of Lyme disease where symptoms recur after initial treatment. In both use cases, the Lyme disease symptoms tend to show some marginal improvement after treatment; however, complications arise including an increase in allergic reactions.

So why is it so difficult to combat Lyme disease with our current conventional treatment protocols? To illuminate the answer to that, we have to examine how the health of the adrenal glands is tied into the condition.

Adrenal Health and Chronic Lyme Disease

In both Adrenal Fatigue and chronic Lyme disease, most of the body’s systems are experiencing symptoms, making it hard to deal withWe previously discussed how Lyme disease has an effect on adrenal health since Borrelia infection causes chronic stress. This stress forces the adrenal glands to maintain a high level of function for an extended period of time, eventually wearing themselves out and dropping into adrenal fatigue.

When the adrenal glands are in a state of fatigue, they are unable to produce and maintain the proper levels of hormones to keep the body at proper homeostatic balance, which tends to generate more stress that forces the adrenals to try to work harder – creating a vicious cycle. Adrenal fatigue has many nonspecific symptoms as a result of it affecting multiple organ systems throughout the body. This may sound similar to Lyme disease, which is not a stretch, considering that both conditions involve multiple systems in their latter stages. The similarities actually go deeper than this, for example: brain fog, anxiety, migrating pains, insomnia and irritability are all potential symptoms of adrenal fatigue and, as discussed, these are also all symptoms of Lyme disease infection.

Now while Lyme disease has the potential to drive stress and push the body into adrenal fatigue, the relationship is by no means a one-way street. Since adrenal fatigue is a systemic condition as well, the advanced stages of the condition have a marked effect on immune function, opening the door for frequent and recurring infections and increasing susceptibility to illnesses, including Lyme disease. This means the immune system has greater difficulty helping to fight of an initial Lyme infection and crucially, the immune system can be weakened to the point that chronic Lyme disease with Borrelia in its stealth infectious state may be able to stage a comeback and start an active phase of chronic Lyme disease with increased severity of symptoms.

The two conditions interact and strengthen each other in a kind of terrible, malicious synergy; not only do Lyme disease and adrenal fatigue feed into and worsen each other, but they share a large area of symptoms overlap. This deep integration of the conditions makes it difficult to tease them apart and tackle them separately, and this has significant repercussions for recovery.

Fighting Chronic Lyme Disease Aggressively – a Lost Cause

Aggressively using antibiotics to try and eradicate the bacteria generally just wears down the body, exacerbating the chronic Lyme disease symptomsReturning to the topic of conventional use of antibiotic courses for Lyme disease treatment, we can begin to understand why perhaps simply piling on more antibiotics for a longer period of time may not be helpful, and may in fact do harm to the body.

First of all, the immune system is weakened by adrenal fatigue, meaning that even if ninety-nine point nine percent of the bacteria are eradicated by antibiotics, the immune response won’t be able to finish the job off, allowing Borrelia to live and infect another day. In fact, a clinical study published by Dr. Bart Jan Kullberg and his colleagues at Radboud University Medical Center in the Netherlands found that there was actually no benefit to using antibiotics to treat chronic Lyme disease.

Their study followed a group of 280 individuals with Lyme disease, some of whom were treated with a standard 2-week antibiotic course, while others continued the antibiotic treatment course for an additional 12 weeks. When comparing both physiological and neurological symptoms between those who were on a shorter antibiotic course vs those on the extended antibiotic treatment, no significant differences were found. According to study author Kullberg, “This study demonstrates that prolonged antibiotics may not help if you have symptoms after having had Lyme disease.”

Conventional antibiotic treatments simply cannot beat the Borrelia bacteria behind Lyme disease. In acute Lyme disease cases where the bacterial titer is high, antibiotics can help to decimate pathogen population. Once at the level where it enters a stealth infectious mode, however, only the body’s natural defense systems can deal with the constant low level toxic assault. It is important that the body be healthy and energized with adequate nutrition to be able to handle this stealth infection and not become fatigued. Antibiotics do nothing to help this process, and in fact may hinder it, making it utterly unsuited to address chronic Lyme disease symptoms.

Secondly, and perhaps more importantly, antibiotics are a necessary evil in the modern conventional theory of medicine. Antibiotics don’t just attack bad bacteria and organisms, they are indiscriminate in that any organism or cell that is susceptible will be attacked and die. This includes many populations of good bacteria that make up the human body’s internal microbiome and even some of your own human cells. When our microbiome is off-balance, our immune system is in disarray, and the body thrown into a state of inflammation. This ultimately weakens the body, while allowing the Lyme pathogen to prosper. It should come as no surprise that repeated antibiotic therapy invariably fails in chronic Lyme treatment.

Compounding this is the fact that once the cells and organisms are killed off by the antibiotics, their corpses decompose and become toxic detritus that clogs up the body. This release of toxins from the death of microorganisms is known as a die-off reaction, and this can cause a great deal of stress for the liver and kidneys, which are already overburdened due to the general body-wide slowdown caused by adrenal fatigue. Recirculation of such toxins further contributes and triggers a retoxification reaction that can lead to adrenal crashes. Sufferers can be bedridden and incapacitated in severe cases. Of course, the stress on these systems feeds back around to the adrenal stress control center, feeding into a deepening of adrenal fatigue.

So we see that aggressive use of antibiotics, far from helping with the body’s health, actually seems to be detrimental and contributes to the negative health spiral formed by chronic Lyme disease and adrenal fatigue when both are present. Recognizing and appreciating this relationship is a critical step if one is to be successful in fighting Lyme disease, because the recovery strategies can be quite different.

If the adrenal glands are weak, time should be taken to nurture them back to health. The adrenal glands need to be healthy in order to support a body that can stand a course of antibiotics, clear out toxic metabolites and deal with die-off reactions effectively. The longer adrenals are not in optimal performance, the weaker the body becomes over time and the harder it is to get on the road to recovery.

Supporting the Adrenals First – the Smart Move

In order to avoid this negative spiral of worsening health, the first step must be recognizing that recurring and chronic Lyme disease symptoms are deeply integrated and entwined with the state of the body’s adrenal health. This understanding is important because it points the way to a successful recovery from symptoms.

Recovering from Adrenal Fatigue and chronic Lyme disease requires strengthening the body through proper nutrition and lifestyleSince adrenal fatigue is an intrinsic condition where the mechanisms for dysfunction come from the inside, the recovery must focus on the body. Proper adrenal fatigue recovery is primarily concerned with rebuilding the body’s strength and nutritional reserves so that it has the capacity and energy to power all the different internal systems optimally. This is achieved using a combination of proper diet to avoid stressful foods and provide natural nutrition, nutritional supplementation to round out the body’s needed building blocks, and lifestyle changes to minimize stress and keep the body active but relaxed. Care should be taken not to further place excessive stress by stimulating the body with hormones, herbs, and glandulars that potentially have an excitatory effect on the body.

With respect to Lyme disease, once the adrenal system is back to a functioning level of capacity, it should be able to easily beat back the Borrelia invaders and drive them back into dormancy. The liver, kidneys, microbiome and ECM should also be back up to the job of clearing out the toxins excreted by these remainders. When done properly, the unpleasant chronic Lyme disease symptoms will begin to taper off and decrease in severity as the body’s detoxification and cleansing functions come back into full function.

Supporting the adrenals requires extensive clinical experience in order not to trigger adrenal crashes that give the Lyme pathogen an opportunity to resurge. A comprehensive, slow and steady, personalized approach is needed to gently support adrenal function without crashes. Patience is required – most are quite weak after years of a losing battle against Lyme. It is constantly surprising to note how well a slow and steady approach like this works, much better than the aggressive, single-focus antibiotic approach with chronic Lyme. In many cases, it may not be necessary to directly treat chronic Lyme disease once the adrenals are well supported, because a strong adrenal system will release the necessary anti-inflammatory hormones, such as cortisol, to keep the Lyme pathogen under control. The Lyme resurgence and relapse is self-limiting. As long as the body is kept healthy, chronic Lyme disease should remain below symptomatic levels and unable to bother the host.

It takes patience and a comprehensive plan, but chronic Lyme disease symptoms can be reduced and disappear over time as the body strengthensIt is therefore very important to note that proper recovery from adrenal fatigue requires a comprehensive, holistic approach factoring in the adrenal system, with correct timing and patience. Adrenal fatigue is not contracted in a day; it spends months – even years – developing as the adrenal glands are worn down by chronic stress. As a result, the rebuilding of these reserves takes time as well. Using stimulants and energy boosters are ill advised. While they may have a short-term positive effect, the body soon runs into problems. The liver and kidneys are simply unable to handle proper detox and cleaning duties to metabolize and clear out the extra detritus from energy drinks and stimulants. It’s safe to say that, with respect to adrenal fatigue and Lyme disease recovery, slow and steady recovery in the hands of an experienced clinical expert is the way to go.


© Copyright 2016 Michael Lam, M.D. All Rights Reserved.