1. Lyme Disease Holistic Approach Elizabeth Markovich, MSN, NP Integrative Healthcare

3. Holistic Primary care - considers the whole person - Science-based approach Use 11 outside labs for special testing Advise and assist patients with lifestyle changes - Utilize high quality supplements Offer Prolo injections, hypnosis and acupuncture, nutritionist, massage

4. Lyme Controversies Endemic area – outside the northeast? Prevalence – how common is it? Vector – ticks or also sexual transmission? Adequate testing – the expanded VS regular western blot, other tests and sensitivity? Adequate treatment – 10 days or up to a lifetime of antibiotics? Chronic illness status – does it cause persistent infection or autoimmunity?

5. Why all the confusion? Lyme organism borrelia burgdorferi can move inside host tissues and cells and avoids detection by testing. It has evolved to avoid the host's immune system attack – cell wall deficient form It weakens the immune system. Protects itself with a slime biofilm Difficult to culture

6. My observations and thoughts Very clearly present in our area – have seen some classic cases Veterinarians test for and treat it locally Good results with treating within a few weeks after exposure Some people become ill again after antibiotic treatment and usually improve with re- treatment Intravenous antibiotics pose a considerable risk

7. Approach to Testing Igenex – the expanded western blot is the original test & is more sensitive Central Florida Lab – flow cytometry Fluorescecing tags on the organism. May be a better test in immune suppression Local western blot – more false negatives “indeterminate” tests – repeating, use of antibiotics or supplements to enhance testing Testing for co-infections – babesia, bartonella,

8. Navigating treatment Early treatment - fairly straightforward and usually successful Chronic cases present many challenges Dr. Cowden's protocol – uses herbal tinctures Dr. Burrescano's guidelines – middle of the road? Rife, “salt and vit C”, diflucan, Marshall protocol.

9. Challenges in Chronic Lyme Co-infections – especially babesia and bartonella difficult to treat Biofilms – a protective layer the organism produces Other toxins such as heavy metals suppress immunity Immune suppression, Adrenal and hormone dysfunction

10. Holistic approach needed Support the body systems Testing for adrenal stress, and hormones Detoxification regimen Support the immune system - Remove burdens on the immune system test for food allergies Important for the person to have a purpose in life, spiritual connection and social support.

11. Neurological problems, autism connection Wide variety of neurological problems associated with Lyme disease Many kids with autism test positive for Lyme and improve with antibiotics Autistic people may have immune problems and toxic problems and may have inborn susceptibility Detoxification profile or genomic profile Heavy metals testing