Seven top takeaways from the Integrative Practitioner Summit on environmental medicine

1. Chronic Lyme disease is a complex illness, commonly coupled with other infections.

According to Daniel Kinderlehrer, MD, an integrative physician in Denver, Colorado, who specializes in diagnosis and treatment of tick-born illnesses, there are two categories chronic Lyme disease. The first category, he said, consists of patients who have been treated for acute Lyme disease.

“That is, they had a tick bite that they may or may not have noticed, but then they developed a rash, and maybe even a bullseye rash, and then they were treated for acute Lyme disease with a relatively short course of antibiotics,” said Kinderlehrer.

Lyme disease is considered chronic when despite being treated, patients experience symptoms for weeks, months, or years after their original treatment. This is called Post-Treatment Lyme Disease Syndrome (PTLDS). To Kinderlehrer, this name suggests that for these patients there’s no longer a line of therapy to follow to treat their Lyme disease symptoms, which is inaccurate.

“It's a nomenclature I really don't like because it suggests that the line isn't there anymore,” he said.” “The line is there, but there's more than just one line.”

The second category includes those who have developed chronic symptoms despite never getting a tick-borne infection diagnosis, Kinderlehrer said. No matter the category someone fits into, virtually all patients with chronic Lyme disease have additional infections, often caused by other tick-borne microbes. These co-infections commonly come in the form of babesia, bartonella, anaplasma, and mycoplasma. According to Kinderlehrer, co-infections cause a range of different symptoms, making Lyme disease more difficult to treat. This condition is known as Lyme disease complex.