Lyme Disease
Mitchell L. Hoggard, Pharm.
Opinion
(Father of a recovered Lyme Patient)
With respect to the comments about ATA pressure used in the treatment of Lyme Disease, the preferred depth is 2.36 ATA, which is not to say that that is the 'magic number.' It is true that angiogenesis may play a part because of the fact that the Lyme bacteria (Bb) can cause neuronal damage and possibly increase profusion in those areas that are decreased. Thus, the use of HBO with respect to angiogenesis may be helpful in chronic neurologic Lyme. However, not involved in the process of killing the organism.
The Lyme bacteria is a microaerophilic organism, not an anaerobe, but
certainly has been shown that it does not like elevated PO2 levels above 70 to 80. Thus this may play a part in why the organism is not blood bound for the most part and finds its way primarily into the tissue where PO2 levels are more in the neighborhood of 35 to 40.
It is theorized that HBO has the potential to kill by several mechanisms, one of those would be increasing tissue PO2 levels, another would be a synergistic effect with antibiotic therapy, and another might be free radical formation.
With respect to Lyme, in the original Fife study 80% of patients showed
significant reduction in symptoms or elimination all together. With respect to treatment protocol, I prefer 2.36 ATA to 2.4 ATA, two 1-hour treatments per day (based on bottom time), separated by 3.5 to 4 hours, five days per week.
Dr. Fife used 30 treatments as protocol and we certainly have found this to be effective in some patients. The primary reason for using at least 30 treatments, two treatments daily, five days per week, is that that equates to at least covering one life cycle of the organism-or close to it.
My experience, with far in excess of 200 Lyme patients treated with HBO, is that 40 to 60 hours of treatment is much more effective. I firmly believe that the treatment of Lyme does require a multi-disciplinary approach. That is to say analyzing the symptoms, reviewing previous treatment protocols, and including antibiotic therapy during HBO.
The response to HBO is a delayed response, typically, unless large numbers of treatments are involved (120 to 150 hours). By delayed response I mean improvements from HBO are usually not observed until three weeks to three months post-therapy.
Other treatment modalities should be considered post-HBO and antibiotics, such as the use of Actos and Cholestyramine therapies. The delayed response is likely due to the effect of the endotoxins created by the death of the bacteria, which we know to be LPS.
This substance is an immune response potentiator. In other words it stimulates cytokine storms such as TNF, IL-6, 8, 10 and others. Depending on the strain, the LPS may be quite fat soluble, which can slow elimination. Because they are eliminated into the intestinal track and some or all can be reabsorbed.
It is not the Lyme bacteria that are directly creating the entire problem, but indirectly from the endotoxins LPS and other substances like lipoproteins which also stimulate and effect immune response.
Not all individuals respond with HBO, just as not all individuals respond effectively to ABT. That is why it is important to keep in mind that Lyme treatment should be a multi-discipline approach to effectively create wellness or lessening of symptoms in chronic Lyme patients.
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