"Lyme neurotoxin detoxing" is dangerous quackery
Some self-anointed LLMD's (Lyme-Literate Medical Doctors) have jumped on the bandwagon of "chronic Borrelia neurotoxins" and are insisting on the need to "detoxify" them. Since there exists no solid evidence for the existence of such toxins, their treatment guidelines of even those I give the benefit of the doubt contain weasel words such as "it is supposed that", "could be present", "may be found", "has been proposed" etc.
The myth started with patent application nr. 6667038 by Sam Donta and Mark Cartwright.
In it, they claim ownership to any diagnostic/treatment process based on their discovery of a coding sequence in the Bb genome for a toxin they say is similar to Botulin C2 toxin, calling it BbTox1, as if it really has been proven to exist. However, the long patent application never mentions any actual discovery of the alleged toxin, neither in vivo nor in vitro. The mere presence of genes is no guarantee in the slightest for the actual expression of those genes, so their patent is a great leap of faith, a gamble, an investment in the hope that who knows, perhaps some day someone will find significant levels of an actual toxin, expressed by the code discovered in the Bb cDNA. In fact, all the patent does is secure that the discoverers of the sequence will receive royalties if anyone ever does something pertaining to it. However not even after decades of searching, this elusive Borrelia toxin has never been found. Could it be that due to the winding ways of the Good Lord's evolution, that there is all kinds of ancient unexpressed DNA in just about any genome more complex than a simple virus? Lyme neurotoxins are nothing but conjecture, but a veritable cottage industry has been built around it, with a few players raking in the big dough with their dubious "Lyme detoxing protocols".
Until the existence of Lyme neurotoxins is proven (it shouldn't be so hard to find them in a culture broth), we should not risk what remains of our health and spend time, effort and money on trying to "detox" them, because the "detoxifiers" and "toxin binders" such as Cholestyramine (Questran) have never proven their value in any randomized, double-blind, placebo-controlled, peer-reviewed, reproducible trial but they do have very serious potential side effects, including cancer. Those binders bind important nutrients as well, weakening the immune system. "Detoxing" (AKA the ethereal "body cleansing") distracts from the real issue: How to kill the Lyme spirochetes more effectively and how to prevent an extreme immune response to the Bb bacteria/dieoff damaging our tissues. Lymeland still has trouble being taken seriously and the last thing we need is more bunk to muddy the waters. The big issues impeding a speedy resolution of symptoms under treatment are antibiotic resistance, bacterial persistence and excessive immune reactions to relatively low bacterial loads. We don't need one more excuse to deny antibiotic treatment and blame persisting symptoms on "chronic neurotoxins". Neuro-Lyme patients need open-ended antibiotic treatment with high doses of appropriate antibiotic combo's. Any attempt to distract from this fact - especially in a wholly unscientific, vulgarly commercialized manner - is greatly detrimental to our cause. When LLMD's continue to write books and spam websites, evangelizing their "Lyme detox protocols", eventually, ordinary doctors will take the disease even less seriously and will focus less on long-term antibiotic treatment and more on unproven "detoxing".
As to those elusive "fat soluble Lyme toxins" , I can't put it more consise than this mother of a son with chronic Neuroborreliosis:
Fascinating…….but for the fact that B. burgdorferi does not produce any toxins.
No neurotoxins. No cytotoxins. No hemolysins. No enterotoxins. No endotoxins. No exotoxins. No exfoliative toxins.
No classical bacterial toxin. Period.
The closest anyone has come to seeing any toxin activity with B. burgdorferi was some test tube hemolysis back in 1992. And that turned out to be wrong as two guys at Wesleyan showed in 2000 (J Bacteriol. 2000 Dec;182(23):6791-7).
But why believe an online stranger. Ask Burrascano or Shoemaker. Ask them a couple of very fundamental questions such as….
What's the molecular weight of this toxin?
Is it plasmid-encoded?
If it's plasmid-encoded do all strains carry this plasmid and produce a toxin?
Is it a protein or a glycoprotein?
What's its receptor?
Is it released or membrane-bound?
Has anyone produced commercial antibody to it?
Has it been sequenced (like the burgdorferi genome) and can I look it up in GenBank?
If it plays a role in pathogenesis, why hasn't it been attenuated for use as a vaccine candidate?
So are there really no neurotoxins to worry about?
Borrelia has never been proven to produce any kind of toxin, but Lyme infection may indirectly cause a harmful increase of certain brain chemistry products. Particularly QUIN, Quinolinic acid. A fellow Lyme sufferer and attorney named Anthony Murawski has done extensive medical literature research into this phenomenon, and has published a preliminary paper on this, which we mirrored here:
Suffice to say that no currently peddled "Lyme detox regimen" addresses this possible issue. I'll write a separate article about the possible implications of his findings. He remarks that Lyme patients have a severe Tryptophan deficiency in their brains, and so have MS sufferers and other folks with life-threatening CNS syndromes of officially unknown etiology.
I think most high-profile, top-dollar "LLMD's" are charlatans. The more they talk about dozens of highly complex issues surrounding Lyme disease, the more they're deliberately obfuscating the issue, making you think the problem is so difficult that you really need to be under their expensive long-term guidance. Lyme is caused by an antibiotic-resistant, immune system-evading bacterium that causes a hell of an inflammatory immune response. That's all there is to it. It does not produce neurotoxins or form biofilms. Lyme-induced autoimmunity is a chimera. And as long as you lead a healthy lifestyle, you do not need to be on a cornucopia of supplements to recover. All you need to do is live healthily and be on the proper long-term antibiotic combination/pulse therapy - including cyst-busters, if they ever find one that actually works in vivo. That's all you can do to slowly improve. Minocycline with hydroxychloroquine or just plain Doxy alternated with a week of Amoxi on bad encephalitis days, that's about all there is to it. For as many years as it takes. No outlandish, complex "protocols" such as the Marshall protocol have shown credible merit. The MP in fact promotes antibiotic resistance, although there seems to be little danger for that, with Bb. The little buggers are resistant enough to begin with, mind you. No miracle mineral supplement, "detoxer" or "zapper" helps one iota against Lyme disease, whatever patients, practitioners or pushers may preach. Neither does colloidal silver do much - Tom Grier did extensive research into that.
High-profile "LLMD's" promoting the idea of neurotoxins:
Mr. Schaller believes that commercially available "Rife machines" kill Bb spirochetes, albeit not sufficiently. He is on the record for claiming, in writing, on his own website, that Lyme patients need no more than 8 hours of sleep, even when they are desperate to get more. He even prescribes stimulants to keep them awake! He claims that no adult - sick or healthy - needs more than eight hours of sleep, and that sleeping more "just makes one prone to get fired". Of course, few things are more damaging to the immune system than to deprive a sick person of necessary sleep.. He endorses the books of the notorious "Lyme-cure" scam artist and obnoxious forum spammer Bryan Rosner. Schaller exclaimed in an outrageous, all-caps, expletive-filled rant that a reader who gave his Lyme-treatment book a well-argued negative review on Amazon must be mentally impaired due to Bartonella infection. Nota bene: He promises Lyme treatments leading to a "full cure". He minimizes the neurological effects of Neuroborreliosis and blames them on Bartonella - a relatively minor infection with mild symptoms that usually resolve without treatment - instead. Schaller sells "full cures" for a variety of other serious illnesses such as depression on his sites. However, his books do not offer any concrete help, according to several reviewers.
Dr. Schaller was arrested in 2011 for assault with a deadly weapon and was found guilty in court and convicted to four years probation. We added this information because of his recent legal threats and rants against us which may escalate into criminal threats, violating the terms of his probation. We would be delighted seeing him in jail, where he belongs.
Dr. Schaller is alleged to charge 575 dollars for a phone consultation of 20 minutes. Reportedly, he routinely lets patients sign non-disclosure and non-litigation agreements. Update: Mr. Schaller emailed us, stating that he often charges much more than $575 for a phone consultation. Buyer beware.
Dr. Shoemaker believes you can have living Borrelia bacteria in your central nervous system that "do no harm whatsoever" and should "just be ignored"!
(after the 3-minute mark)
Update: The video has been pulled and we could not locate a copy elsewhere. It was available on http://video.google.com/googleplayer.swf?docid=-2674481404665515106
This outrageous statement alone is the highest form of treason to Lyme patients. When even the "LLMD's" say that active infection with living, multiplying, T-cell-invading, Myelin-eating spirochetes is often "harmless", what hope do Lymies have to receive long-term antibiotic treatment? Mr. Shoemaker claims that if he diagnoses you with blurry vision on his VCS test ("Visual Contrast Sensitivity"), that this is almost always caused by "chronic neurotoxins caused by infection", and that his "detoxing" can in 90% of cases greatly help you. Shoemaker further says that when his Lyme treatments don't work, that it must be due to "mold exposure", and that "almost everyone with Lyme is exposed to mold". My advice as a self-treating, 90% recovered chronic Lyme neuroborreliosis patient to Dr. Shoemaker is to lay off the cookies and cigarettes and take a very long hike - perhaps that'll "detoxify" him. Update: Shoemaker has been sued for malpractice. This does not mean that he is necessarily guilty of that though - legitimate LLMD's have been prosecuted and persecuted too. Update: On February 11, 2012, Ritchie Shoemaker was reprimanded for malpractice. This doesn't necessarily mean anything though, since MD's have been routinely punished for doing good work. However in Shoemaker's case he deserved it, and more.
There are numerous Internet marketers posing as "Lyme experts" poised to take a piece of the "Lyme neurotoxin" pie, selling eBooks packed with incredible nonsense and quackery, targeted towards the naive reader. One of the most active is Connie Strasheim AKA Conniekillbug AKA Connie Killabugger, peddling eBooks with no answers. Such books make a mockery of Lyme disease and us Lyme sufferers. Schaller, Rosner and Strasheim work as a team, incestuously glorifying eachother's bogus "Lyme protocols". It would be good if they spend more on medical literature research and less on refined psychological sales tricks.
Then what causes the "Herx"?
Lyme supplement-sellers spread the simplistic idea that when a Lyme patient takes antibiotics, that some bacteria die and release neurotoxins that make you feel bad. The reason the quacks made up this story is because it creates a profitable market for "detoxing" products. What really goes on in the brain when you take antibiotics?
1. Spirochetes are extremely motile. They can move great distances through the brain in a short time, and they can "drill" through brain matter like a hot knife through butter. And that is exactly what they do when they sense that their structural integrity is being compromised by the action of the antibiotics. They will randomly move around until they find a location where they may survive. It's a simple evolutionary adaptation to help escape unfavorable environments. Of course, having those spirochetes frantically drilling holes through your neurons causes neurological discomfort. These processes are known scientific facts.
2. Some spirochetes die, and their fragments enter the bloodstream where they trigger an immune response. Antibodies that pass the blood-brain barrier will enter the brain parenchyma and bind to the Bb s.l. Lyme spirochetes. Others activate glial cells. The immune system's lysing actions (the cell-localized release of strong oxidants) cause collateral damage to surrounding neuronal cells. These processes are known scientific facts.
3. Some chemical components of the Bb cytoplasm may cause damage to neuronal cells, when the spirochetes die. If this happens - and this is a theoretical assumption only - this would be totally unavoidable, unless scientific research identifies the neurotoxins involved and develops a neutralizing agent that can be taken with the antibiotic. All this is conjecture and not based on known facts. It is extremely unlikely, and there is no scientific evidence, that there is any known agent that can help "detox" the brain during a spirochetal dieoff, because there is no Borrelia neurotoxin known to science.
Nearly all infectious disease specialists make the mistake of either prescribing antibiotics that do not sufficiently penetrate the blood-brain barrier, or not prescribing enough of it. You have to understand the terrible truth that infectious disease specialists basically don't know what they're doing most of the time. Antibiotics are a taboo subject in medicine, almost. Apart from Lyme and Syphilis, there is little experience treating neurological infections and it seems that every doctor has his own ideas on how to treat them, instead of listening to microbiologists or successful LLMD's. Obviously, when the patient deteriorates over the years, the doctor is incompetent, since we're talking about bacteria here. There exist antibiotics that can at least reduce the bacterial load over time, when dosed appropriately.
Under-dosing or using the wrong antibiotic(s) is the only reason for antibiotic therapy to fail with chronic neuroborreliosis, and there are no other viable treatment options. Your only option is to get better antibiotic treatment.
Ceftriaxone for example does not penetrate the bbb. Neither does Amoxicillin, to give but an example (except when there is encephalitis involved). Most antibiotics do not. And even if the proper antibiotic treatment is prescribed, the doses are usually too low. Anything below 400 to 500 mg/day of Doxycycline for example will likely lead to ever worsening symptoms. A too low a tissue concentration of the right antibiotic is a slow death sentence for a Lyme patient.