How Lyme Disease Is Treated

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The specifics of your Lyme disease treatment will depend on your case. A short course of antibiotics will likely easily cure you if you are in the early stage. Successful treatment for more complicated cases, however, requires three to four weeks of antibiotic therapy and possibly additional treatments. Here's a look at how different stages and symptoms of Lyme disease are treated.

Prescriptions

Your healthcare provider can likely effectively treat your Lyme disease with the appropriate use of antibiotics. In general, the sooner you begin treatment following infection, the quicker and more complete your recovery will be. Antibiotics such as doxycycline, cefuroxime axetil, and amoxicillin, taken orally for a few weeks, can speed the healing of your erythema migrans rash and usually prevent subsequent symptoms such as arthritis or neurological problems. Doxycycline will also effectively treat most other tickborne diseases.

Children and Pregnant or Breastfeeding Women

Because doxycycline can stain the permanent teeth developing in young children or unborn babies if Lyme disease occurs in children younger than 9 years, or in pregnant or breastfeeding women, these individuals are usually treated with:

  • Amoxicillin
  • Cefuroxime axetil
  • Penicillin

Lyme Arthritis

If you have Lyme arthritis, your healthcare provider may treat you with oral antibiotics.

If your arthritis is severe, you may be given ceftriaxone or penicillin intravenously (through an IV). To ease discomfort and to further healing, your healthcare provider might also:

  • Prescribe medications such as non-steroidal anti-inflammatory drugs (NSAIDs)
  • Perform a joint aspiration (drawing fluid from your affected joints)
  • Surgically remove the inflamed lining of your affected joints

In most people, Lyme arthritis will go away within a few weeks or months following antibiotic treatment. In some, however, it can take years to disappear completely. Some people with Lyme disease who are untreated for several years may be cured of their arthritis with the proper antibiotic treatment. If the disease has persisted long enough, however, it may permanently damage the structure of the joints.

Neurological Problems

If you have more severe neurological symptoms, your healthcare provider will probably treat you with the antibiotic ceftriaxone given intravenously once a day for up to a month. Most people recover completely.

Heart Problems

Healthcare providers prefer to treat people with Lyme disease who have more severe cardiovascular symptoms with antibiotics such as ceftriaxone or penicillin given intravenously for about three to four weeks. People with Lyme disease rarely have long-term heart damage.

Post-Treatment Lyme Disease Syndrome

If you have post-treatment Lyme disease syndrome (PTLDS), you may need to have your doctor rule out other illnesses with similar symptoms. Your symptoms may also go away with more time.

The National Institute of Allergy and Infectious Diseases (NIAID) takes PTLDS seriously and funded three placebo-controlled clinical trials to discover the efficacy of prolonged antibiotic therapy in patients with PTLDS. Here's what they found out:

  • In the first trial, patients received 30 days of intravenous (IV) antibiotic followed by 60 days of oral antibiotic. There was no evidence the treatment is beneficial.
  • In the second trial, patients received 28 days of IV antibiotic. Patients reported overall improvement, but there were no benefits for cognitive function and six participants had serious adverse events associated with the antibiotic treatment, four requiring hospitalization. The researchers concluded that additional antibiotic therapy wasn't "supported by the evidence."
  • In the third study, patients with objective memory impairment received 10 weeks of IV ceftriaxone, a cephalosporin antibiotic, and 26 percent had an adverse reaction. Researchers concluded the treatment was not an effective strategy.

The bottom line: Prolonged antibiotic therapy is not any better than short-term antibiotic therapy and may actually be harmful. The NIAID is looking at supporting more research to find a reason for PTLDS and effective treatments, especially those that leave no remnants of the bacteria behind.

Complementary Medicine

Some people have started exploring the use of natural remedies for Lyme disease, such as samento and banderol. A form of cat’s claw—an herb best known as a remedy for arthritis—samento is said to treat Lyme disease by boosting your immune system. Banderol is sourced from the bark of a South American tree known as Otoba parvifolia and is thought to knock out Lyme-related bacteria.

The use of samento and banderol as natural remedies for Lyme disease was popularized in part by Richard Horowitz, M.D., author of "Why Can't I Get Better? Solving the Mystery of Lyme and Chronic Disease." According to Horowitz, both herbal remedies can help treat Lyme disease by ridding the body of bacteria.

Samento and Banderol: Uses and Research

Proponents of banderol and samento recommend them as alternatives to antibiotics, which are the standard treatments for Lyme disease. It's said that these herbal remedies may help patients steer clear of the side effects sometimes associated with antibiotic use, such as gastrointestinal distress.

Supporters also say that banderol and samento aid in the treatment of Lyme disease by reducing chronic inflammation. (Some research shows that inflammation may contribute to Lyme-related health issues like muscle weakness, memory loss, headache, and depression.)

In addition, banderol and samento are sometimes used to control post-treatment Lyme disease syndrome (PTLDS). In people with PTLDS, symptoms linger long after they've completed a course of antibiotics. These symptoms include fatigue, muscle and joint pain, sleep disruption, and mood changes.

At this point, however, there’s very little evidence to back up claims that banderol or samento can help treat Lyme disease. There is some research out there showing that a combination of samento and banderol may help knock out Borrelia burgdorferi, the bacterium responsible for Lyme disease. One study often pointed to, however, lacks rigorous peer review. Scientists have yet to confirm these findings or those of related research in clinical trials involving Lyme disease patients.

Samento vs. Cat's Claw

If you’re thinking of using samento to treat Lyme disease, it’s important to know the difference between samento and cat’s claw. Although they belong to the same species, the two remedies have a different chemical makeup.

Both samento and cat’s claw contain pentacyclic oxindole alkaloids (POAs), which are compounds said to stimulate immune function and help Lyme disease patients to recovery. However, unlike cat’s claw, samento does not contain a class of compounds called tetracyclic oxindole alkaloids (TOAs). TOAs are believed to disrupt the function of the central nervous system and weaken the effects of POAs.

Other Natural Remedies

Samento is just one of many remedies thought to benefit people with Lyme disease. Some proponents of alternative medicine suggest that herbs like astragalus and echinacea can help rev up your immune system and clear your body of microbes. Supplements such as methylsulfonylmethane (MSM) are claimed to relieve joint pain, and gingko biloba is touted as a natural approach to increase mental clarity.

However, as is the case with banderol and samento, there is currently a lack of research to support the use of any of these remedies in the treatment of Lyme disease.

Consult Your Doctor Before Using Natural Remedies

If you’re curious about banderol, samento, or other herbal treatments, talk with your doctor about whether to incorporate any of these remedies into your Lyme disease treatment plan. While it may be tempting to want to try it, improper treatment of Lyme disease can lead to serious complications such as joint problems and nervous system disorders, so self-treating with herbs isn’t recommended.

Also, it's important to keep in mind that the side effects and risks of these herbs in regular or high doses aren't known, nor is their safety in children, pregnant or nursing women, or people with other health conditions. Your doctor can help you weigh the risks with the benefits.

Lyme Disease Treatment Research

Following treatment for Lyme disease, you might still have muscle ache, neurological symptoms such as problems with memory and concentration, and fatigue. These symptoms often go away on their own in time. National Institutes of Health (NIH)-sponsored researchers are conducting studies to determine the cause of these symptoms and how to best treat them.

Studies suggest that people who suffer from chronic Lyme disease, PTLDS, may be genetically predisposed to develop an autoimmune response that contributes to their symptoms. Researchers are now examining the significance of this finding in great detail, as well as conducting studies to find out the best length of time to give antibiotics for the various signs and symptoms of Lyme disease.

NIH conducts and supports biomedical research aimed at meeting the challenges of Lyme disease, and scientists are gaining a better understanding of the human immune response that leads to it. For example, they are uncovering the mechanisms responsible for treatment-resistant Lyme arthritis. Improved understanding of the human immune response may lead to better diagnostic and prognostic tools.

Sources:

Centers for Disease Control and Prevention (CDC). Post-Treatment Lyme Disease Syndrome. Updated December 1, 2017.

Datar A, Kaur N, Patel S, Luecke DF, Sapi E. In Vitro Effectiveness of Samento and Banderol Herbal Extracts on the Different Morphological Forms of Borrelia BurgdorferiThe Townsend Letter. July 2010.

Melia MT, Auwaerter PG. Time for a Different Approach to Lyme Disease and Long-Term Symptoms. The New England Journal of Medicine. March 31, 2016;374:1277-1278. doi:10.1056/NEJMe1502350.

National Institute of Allergy and Infectious Diseases. Chronic Lyme Disease. Updated September 3, 2015.