Choosing the “Right” Herbs for Chronic Lyme

Efficacy

Efficacy refers to evidence that something actually works. While scientific studies are the most reputable form of evidence, anecdotal evidence can also be valuable. For over two decades, people have successfully used herbal therapy to treat chronic Lyme disease. Their stories and accounts, shared on the internet and social media, strongly support herbal therapy as a viable option for overcoming chronic Lyme disease.

For academic evidence on using herbal therapy to treat Lyme disease, Stephen Buhner is a key source of information. A certified herbalist and prolific author, Buhner has written a series of books detailing the mechanisms of action of a wide range of herbs commonly used to treat Lyme disease and its most recognized coinfections.

The growing popularity of herbs for Lyme disease even attracted the attention of researchers at Johns Hopkins University. In a study published in 2020, twelve herbs commonly used to treat chronic Lyme disease were evaluated for their activity against Borrelia burgdorferi. Of these, seven herbal extracts were found to have greater activity against both the motile and cyst (dormant) forms of the bacteria than commonly used antibiotics.

Though herbal therapy had been gaining traction for some time, this breakthrough study put herbal therapy on the map for chronic Lyme disease. The herbs highlighted by the study included:

• Polygonum cuspidatum (Japanese knotweed)
• Uncaria tomentosa (Cat’s claw)
• Scutellaria baicalensis (Chinese skullcap).
• Cryptolepis sanguinolenta
• Cistus incanus
• Artemisia annua (Sweet wormwood)
• Juglans nigra (Black walnut)

This study was followed by two similar studies that found Japanese knotweed, Chinese skullcap, and cryptolepis were also effective against Bartonella and Babesia, two of the most common chronic Lyme coinfections. Additionally, Andrographis paniculata, another herb commonly used in Lyme protocols, was found to have good activity against these pathogens. Notably, these same herbs were also found to be effective against SARS-CoV-2, the virus associated with COVID-19, highlighting their broad-spectrum potential.

Low Toxicity

The best choices for chronic Lyme disease are influenced by the potential for toxicity. While antimicrobial herbs generally have lower toxicity than antibiotics, the lowest possible toxicity is crucial for long-term use. Some herbs are more toxic than others.

For example, Artemisia and black walnut have a higher potential for both short-term and long-term side effects and toxicity. Although these herbs are valuable for certain conditions, I typically recommend restricting their use to less than two months and avoid including them in primary protocols.

One product marketed to chronic Lyme sufferers that I reviewed contains lomatium, which can cause skin rashes, and stillingia, which has a higher potential for a variety of side effects compared to many other herbs. While these herbs may have value for short-term use or managing specific issues, I don’t consider them good choices for long-term management of chronic Lyme disease. Another product contains a phytochemical called huperzine A, which has strong drug-like properties.

Making herbal products seem “drug-like” is a common practice among many herbal product companies. I assume this is done to meet people’s expectations of wanting something as potent as drugs. However, this approach contradicts the goal of using natural therapy. The primary goal of herbs is to reduce microbial load while simultaneously restoring cellular integrity. Side effects or drug-like effects indicate cellular toxicity, which is highly undesirable for long-term use.

I also try to avoid herbs that are stimulating. Ginseng, for instance, may be great for healthy individuals looking for a boost, but it isn’t ideal for those overcoming chronic illness. One product I reviewed contains several varieties of ginseng, which are highly stimulating adaptogens that can inhibit sleep and exacerbate sympathetic overactivity.

Purity and quality are also important considerations. Chemical or biological contaminants are common in low-quality ingredients. A person struggling with chronic illness has a compromised ability to purge toxic substances, and taking products with contaminants can increase their toxic load.

The only way to ensure a product’s safety is through testing. Reputable companies conduct multiple levels of testing to ensure the lowest potential for toxic contamination. It should be noted that in the modern world, achieving zero contamination is impossible. All foods and natural products, even organic ones, contain low levels of heavy metals and organic toxicants due to their prevalence in the air and water. The goal is to achieve the lowest possible levels. Quality herbal products contain much lower levels of these substances than most commonly consumed foods.

Potency

The effectiveness of an herbal product largely depends on the phytochemical concentration of its ingredients. The highest concentration of phytochemicals is found in powdered standardized extracts, which are my go-to standard for overcoming chronic conditions.

Second to powdered standardized extracts are tinctures. While tinctures are an acceptable way to take herbs, their phytochemical concentration is lower than that of a capsule containing a powdered standardized extract. This means you need to consume a larger amount of tincture (which contains alcohol) to achieve the same phytochemical effect—unless the tincture is highly concentrated, which some are. Tinctures are ideal for trying out a single herb or for herbs like cryptolepis, which are difficult to find in standardized powdered extract form.

The least desirable herbal preparation is whole herb powder. Whole herb powders are made by drying the plant and crushing it into a powder. The resulting powder is high in inert fiber but very low in the desired phytochemicals.

A capsule of whole herb powder may look identical to a capsule of powdered standardized extract, but the extract typically has 5-10 times the phytochemical concentration. To differentiate, check the label: a standardized extract will list the scientific name of the herb along with the standardization and a milligram quantity (e.g., Scutellaria baicalensis std 30% baicalin 450 mg), whereas a whole herb powder will often only list the common name of the herb.

Buyers should be aware that whole herb powders are the industry standard. Unfortunately, these products often don’t deliver the results people are looking for. Phytochemical concentration matters—so for the best results, it’s important to use powdered standardized extracts or adequate quantities of tinctures.

Synergy

Combining multiple herbs into formulas is a standard practice in herbology. When compatible herbs with restorative properties are blended together, the benefits of the individual herbs are enhanced. There is no absolute number of herbs required for a formula, but most contain anywhere from three to a dozen herbs. My rule of thumb is around 4-5 herbs—this is enough to achieve positive synergy without diluting the benefits of any one herb. That said, some effective formulas in Traditional Chinese Medicine contain up to a dozen herbs.

Immunomodulation

It’s crucial to use herbs that don’t overstimulate the immune system. In chronic Lyme disease, the immune system is already overly revved up and overtaxed, making it ineffective at containing the microbial threat.

This overstimulation is often driven by the microbes, which invade white blood cells and manipulate chemical messengers (called cytokines) to overstimulate certain parts of the immune system that react to foreign substances (leading to conditions like Mast Cell Activation Syndrome), while suppressing parts of the immune system responsible for destroying intracellular pathogens.

Herbs like echinacea and elderberry, which stimulate the immune system, can exacerbate this problem and may also increase autoimmunity. While these herbs are great for short-term use to reduce the severity of an acute viral illness, they are not ideal for long-term use. Some researchers believe that astragalus may also fall into this category, which is why I generally avoid using it long-term in herbal regimens for people overcoming chronic conditions.

The other herbs mentioned above are classified as immunomodulators. These herbs help by upregulating underactive parts of the immune system and downregulating overactive portions, making them ideal for long-term use. Some of the best immunomodulators are reishi and cordyceps, two medicinal mushrooms also classified as adaptogens. I often include these in herbal protocols for chronic Lyme disease.

Using Herbs To Treat Chronic Lyme Disease

If you’re considering herbal therapy on your Lyme disease healing journey, or incorporating it into your current Lyme or chronic illness treatment protocol, my advice is to shift your mindset away from the drug treatment paradigm that guides traditional Western medicine. Many people go into herbal therapy with the idea of replacing a drug, or using the herb like a drug to kill off a specific microbe, so they can feel better.

But comparing drugs and herbs is like comparing apples to oranges. Drugs are designed to block the manifestation of illness in the body. They suppress specific chemical processes, and can effectively reduce symptoms, but only as long as we keep taking them. Drugs don’t address the root cause of the illness, so people don’t get truly well on them. They have to continue taking the drug perpetually to suppress the problems.

When you take an herb, you’re enhancing the body’s ability to take care of itself. You’re getting the plant’s entire system of hundreds or even thousands of phytochemicals, which work synergistically to fight off microbes, support the immune system, balance hormones, and reestablish cellular integrity. All these processes are what lead to true wellness.

Learn more about Dr. Rawls’ approach to treating chronic illness with herbal therapy at RawlsMD.com.

REFERENCES

Heianza Y, Ma W, Li X, et al. Duration and Life-Stage of Antibiotic Use and Risks of All-Cause and Cause-Specific Mortality: Prospective Cohort Study. Circ Res. 2020;126(3):364-373.
https://pubmed.ncbi.nlm.nih.gov/31842690/

Feng J, Leone J, Schweig S, Zhang Y. Evaluation of Natural and Botanical Medicines for Activity Against Growing and Non-growing Forms of B. burgdorferi. Front Med (Lausanne). 2020;7:6.

Zhang Y, Alvarez-Manzo H, Leone J, Schweig S, Zhang Y. Botanical Medicines Cryptolepis sanguinolenta, Artemisia annua, Scutellaria baicalensis, Polygonum cuspidatum, and Alchornea cordifolia Demonstrate Inhibitory Activity Against Babesia duncani. Front Cell Infect Microbiol. 2021;11:624745.