Part II – Integrating Clinical Expertise with Research Affection Improved Outcome. Dr. Ron Stram, Medical Director at the Stram Centerrefutes IDSA guidelines and their contention that chronic lyme does not exist. IDSA guidelines do not have level one evidence, 55% had level three evidence, which is expert testimony and is the least reliable data set. Failed to convene multi-stakeholders such as lyme physicians that treat chronic lyme and patients, and no management of conflicts of interest, which creates bias against treatment.
Until more data from well designed clinical trials are conducted, physicians should use caution when using current guidelines as the source of treatment approaches. Hence we come back to 85% of the clinical diagnosis, is by your history, and your story: what happened? when did it happen? how were you feeling before this happened? and how are you feeling now?
Discusses ILAD’s guidelines… 17 authors, 800 professional references, exposure of lyme disease, what is the evidence of clinical presentation, the mechanism of persistent infection, what are the clinical presentations, and what are the diagnostic evaluations that can be done. There is no variability in the quality, they don’t limit systemic reviews, their is transparency, conflicting interests are studiously avoided, and they use rigorous methods to come to their conclusions.
Also, covers the mechanism of the disease, as well as common lyme symptoms…
Part 3: The Autoimmune Mimic Symptom Specific Management for Treatment. Dr. Ron Stram. The difficulty of diagnosis. Why the traditional lyme test, the Western Blot may be negative, in the sickest people. Spinal tap will diagnose the neurological symptoms of lyme but only 9% of tests are positive. Band 41 is useless since it can be positive with epstein barr virus, and other infections, despite being in the CDC criteria as one of the three bands indicating infection. Lab results support the diagnosis but don’t exclude it. Only 17% of infected people actually remember getting bit by the tick, and the classic bulls eye rash in studies indicate it only occurs 36% of the time.
Overlapping symptoms of some of the co-infections. What are the distinguishing features to help you tell what you have besides lyme? What the clinical manifestations?
Part 4: Bartonella, Ehrlichia & Whole System Treatment for Chronic Lyme Disease. Dr. Ron Stram, describes how to tell whether you have either of these co-infections in terms of the dominant symptoms. What happens if you don’t get treated and it’s three months, six months, nine months…. the longer the illness the more secondary damage occurs. A whole systems approach requires looking closely at your diet. The bugs like sugar. You have to get sugar OUT OF YOUR DIET. Food is medicine. Gluten products, flour products have to be removed from the diet. Probiotics and pro-yeast type anti-biotics. People with really bad lyme have other things going on. You may have to look at environmental exposures, heavy metal exposures. You may have vitamin deficiencies, B vitamin deficiencies, vitamin D deficiencies… We may have to improve your immune system before beginning any aggressive treatment. This is a tough journey. Meditation, yoga, accupuncture, visualization can all be important. Yes, we use herbal therapies, some prefer just these, and don’t do any antibiotics.
The integrated medicine model does not fit with the insurance model. We believe we need to spend time with you not the treat one thing, spend 15 minutes, like insurance typically covers. We do not take insurance for most things for the survivorship of the practice. The IDSA guidelines can from a group of physicians who had ties to the insurance industry. We believe the insurance industry will catch up, because the treatment outcomes are better with an integrated approach, and ultimately it will be cheaper for them to treat it aggressively on the front end.
Dr. Stram charges based on the complexity of the case between $350 and $450 for the initial appointment. We are in Delaware, and Bennington, VT. His Naturopath, speaks regarding providing support to the immune system with diet, supplements, herbs, and accupuncture.
Before we start antibiotic treatment, we may want to strengthen the body. Myself, Chinese herbalist here, and accupuncturist, formulate herbal formula’s to help with GI symptoms, strengthen the immune system and so on. Vit D for example helps activate your immune cells, and TD cells. Banderol, Samento (specific formula of Cats Claw), artemesiae, berberine, cryptolepsis, and so on geared toward getting lyme in all those life cycles — cyst form, cell wall deficient, spirochette forms, L forms. Accupuncturist discusses Lyme and metals sequestration. Oral chelation versus IV chelation. I usually recommend an IV at least once to get a good reading. HLADR test through LabCore shows genetic tendency of lyme versus mold. Good test to get after going through antibiotics for a while. Most Lyme patients have type A personalities. Lyme is here to teach you something.
The Q and A session continues in this last video. Lab testing and traditional Chinese medicine. What if you have only band 23 positive. Band 23 is highly significant for lyme, if you have that band treat it as a lyme infection. Discusses bio-mats, and infra-red saunas. CD 57 tests are a number that come up slowly over time. It tends to come up after you are off antibiotics, since during antibiotic treatment the antibiotics are essentially doing the job of the immune system. TGF beta one is also a good indicator to look at. We also have a registered nurse at our clinic who works with diet. In the late 90’s they pulled out the bands in the Western Blot which were significant for lyme, because they thought everyone would have taken the lyme vaccine which is no longer on the market. We use IGENX because the test is more sensitive and includes the bands. We like to change the treatment up with patients every six weeks to three months, because the lyme is very adaptable, and that allows us to adjust the treatment approach to the different forms it can take. Accupuncture’s value with Lyme is symptom management can help with joint pain, fatigue, headaches. Herbs, antibiotics, proper nutrition (diet, avoiding sugar) and lifestyle are the core treatment to recover from lyme. We see other conditions with lyme, we see protozoa, mycoplasma, different kinds of bacteria, co-infections and so on. We made a five herb combination with activity against all of these… it has philodendron, coptis (together they are anti-inflammatory and protect the DNA of the cells of the kidney and the liver), Polygonum cuspadatum (We got from Steven Bruhner), and so on.
Lyme Q & A part 2