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Immune Dysfunction in Post-Treatment Lyme Disease: Using Naltrexone to Balance Chronic Inflammation


Cory Tichauer ND


Persistent symptoms associated with Lyme disease is a controversial topic with conflicting data and clinical opinion regarding the etiology of this illness.  Underlying this controversy is research showing the persistence of Borrelia despite repeated courses of antibiotics.  This data combined with the observation that there is a clear gender disparity in the development of post-treatment lyme syndrome suggests the common denominator is a maladapted immune-mediated inflammatory response.

Validation for this hyperactive immune response can be supported by numerous lab findings including elevations of C4a, CCL19, TGF-b1, IL-4, IL-6 and IL-10 with correspondingly depressed NK Cell function, TNF-alpha and IL-2 levels.  Critical to long term recovery in these patients is modulating the immune system to correct the associated inflammatory response.  By upregulating endorphins and enkaphalins in the body, Low Dose Naltrexone (LDN), acting as a non-selective opioid receptor antagonist, can inhibit proliferation of B and T lymphocytes and the corresponding immune responses. In this way, LDN can be a valuable therapeutic tool for addressing chronic inflammation secondary to persistent Borreliosis. 

Session Learning Objectives:

  1.  Upon completion of this session, participants should be able to describe immune inflammatory lab findings common to patients suffering from chronic Lyme disease. 
  2. Upon completion of this session, participants should be able to appreciate the anti-inflammatory effects of Low dose Naltrexone as it relates to immune modulation.
  3. Upon completion of this session, participants should be able to discuss why Low Dose Naltrexone can be valuable in the treatment of Post-Treatment Lyme Syndrome. 

Session Outline:

  1. Post-Treatment Lyme Syndrome – Infection or Immune Response?

    1. Bacterial persistence post antibiotics
    2. Persistence of antigenic debris in tissue
    3. Common denominator is inflammation
  2. Unregulated adaptive immune response in chronic Lyme disease
    1. Chronic inflammation as evidenced by lab findings
  3. LDN inhibits B-Lymphocyte and T-Lymphocyte proliferation
    1. Reduction in immune reactivity to continuing antigenic presence.
    2. Corresponding reduction of inflammatory cytokines and chemokines
    3. Symptom relief!