Learn about Lyme disease treatments, antibiotic options, managing Herxheimer reactions, and alternative therapies to help you navigate your Lyme disease journey effectively.
Every few months, Jennifer Crystal devotes a column to answering your questions. Do you have a question for Jennifer? If so, email her at lymewarriorjennifercrystal@gmail.com.
Do antibiotics get rid of Lyme disease forever?
They can, but it depends on the case. If Lyme disease is diagnosed and treated while still in the acute stage, antibiotics can fully eradicate the disease for many people. However, 10-20% of patients do go on to experience persistent symptoms. Some get better with more antibiotics, and some have periods of wellness and then relapses.
When Lyme disease is not treated right away, the bacterium (spirochetes) disseminate throughout the body and sometimes cross the blood-brain barrier, making the disease much more difficult to treat. In these cases, antibiotics usually help a patient feel considerably better, but the disease goes into remission and doesn’t fully leave; even one dormant spirochete can replicate and eventually wreak havoc again. This is how my own case has gone. Antibiotics have helped keep me in remission, but I do still have Lyme and other tick-borne diseases.
Antibiotics hurt my stomach. Are they the only treatment option?
Antibiotics are the best way to kill Lyme disease, but there are many different options to explore. Oral antibiotics can certainly do a number on the gut, and it’s important to care for your digestive health while on them. Be sure to replenish good bacteria with probiotics (take them at least two hours before or after the antibiotics, otherwise the antibiotics will supersede the probiotics). Sticking to the “Lyme Disease diet” can also really help your gut handle oral antibiotics. Certain antibiotics can cause more digestive upset than others, so before dismissing oral antibiotics entirely, talk to your doctor about trying a different kind.
To help take pressure off the gut and speed up treatment, many patients use intravenous antibiotics, particularly for neurological Lyme disease. I personally started on oral antibiotics, then went on IV for nine months, then went back to oral antibiotics. Talk to your Lyme Literate Medical Doctor (LLMD) about the risks and benefits of intravenous antibiotics.
If antibiotics really aren’t working for you, there are other treatment options to explore, including natural treatments as well as medications typically used for other conditions, such as dapsone.
I have an unbearable Herxheimer reaction every time I start treatment. As soon as I stop treatment, I feel immediately better. How will I ever treat my Lyme disease?
A Jarisch-Herxheimer reaction (sometimes referred to as a “Herx”) occurs when antibiotics kill spirochetes faster than the body can eliminate them, making you feel worse before better. Herxheimer reactions are common with Lyme disease, but many patients find that the reaction subsides after a short period. Some people pulse antibiotics (taking them for a period, then stopping them, then starting again) to not have such consistent Herxes.
Herxheimer reactions can be pretty awful, but they should go away. If yours does not, you might ask your doctor if the reaction is indeed a Herx, or if it’s some kind of allergic reaction to the medication. It could be that the protocol you’re on is simply not right for your body. See if a different type of antibiotic gives you the same reaction. If so, perhaps you need to start with a smaller dose.
If antibiotics don’t work for you, you can explore other treatment options, though these can also cause Herxheimer reactions. It usually takes some trial and error to figure out the right protocol for each patient!
Jennifer Crystal
Writer
Opinions expressed by contributors are their own. Jennifer Crystal is a writer and educator in Boston. Her work has appeared in local and national publications including Harvard Health Publishing and The Boston Globe. As a GLA columnist for over six years, her work on GLA.org has received mention in publications such as The New Yorker, weatherchannel.com, CQ Researcher, and ProHealth.com. Jennifer is a patient advocate who has dealt with chronic illness, including Lyme and other tick-borne infections. Her memoir, One Tick Stopped the Clock, was published by Legacy Book Press in 2024. Ten percent of proceeds from the book will go to Global Lyme Alliance. Contact her via email below.
