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Diet Recommendations for Lyme Disease

Diet Recommendations for Lyme Disease People who are ill need to be careful of what they put into their bodies. During any illness, the body has to work hard to fight an invader, clear toxins that are the by-product of immune system activation, and make necessary repairs to damaged tissue and organs. If you are taking antibiotics and other pharmaceuticals, your body has to work even harder. While drugs are essential for fighting an infection, they also take their toll on the digestive system and eliminatory organs. No matter how healthy you were before getting sick, it takes a lot out of anybody's system to do all these things simultaneously.

To assist your body in its efforts to keep you alive and restored to good health, it is crucial that it get the nutrients that aid in all of its normal functions, as well as those associated with combating a disease. For those with Lyme disease, it is especially important as Lyme is not necessarily caused by a single entity, but can be the result of multiple infections, and as a consequence may require prolonged and varied treatment.

According to Nicola McFadzean, a naturopath and author of The Lyme Diet: Nutritional Strategies for Healing from Lyme Disease, some benefits of adopting a special Lyme diet are that it:
  1. Reduces inflammation (caused by immune activation)

  2. Supports the immune system

  3. Supports healthy digestive function

  4. Helps detox the body

When the immune system detects a foreign invader, it releases pro-inflammatory cytokines, which are immune messengers that tell immune cells to cordon off the affected area so the infection will not spread. If you cut your finger you can easily observe this process. After the initial injury, the area surrounding the cut becomes red, and a little swollen. If you have a systemic infection, like Lyme, pro-inflammatory cytokines are released throughout the body, causing inflammation in any soft tissue, such as the joints, organs, and brain. Soft tissue inflammation combined with damage caused by the infective agent is what causes many of the symptoms associated with illness.

A surprising number of common foods and spices have anti-inflammatory properties. In an article written in February 2015, Dr. Joseph Mercola lists his top anti-inflammatory foods:
  • Fish high in Omega-3 essential fatty acids (EFA) - Omega-3 EFAs are plentiful in fatty fish, such as salmon and cod. There is a substantial body of research confirming the anti-inflammatory properties of Omega-3s.

  • Leafy greens - Dark leafy greens such as kale, spinach, collard greens and Swiss chard contain powerful antioxidants, flavonoids, carotenoids, and vitamin C - all of which help protect against cellular damage.

  • Blueberries are among the highest-rated fruits in terms of anti-oxidants. They are especially high in lutein, an anti-oxidant and anti-inflammatory. Blueberries have the added benefit of being low in sugar.

  • Turmeric - The bioactive ingredient in turmeric is curcumin, a substance that has antioxidant, anti-inflammatory, antiviral, antibacterial, and antifungal properties. There are over 5,000 research articles in the pubmed database documenting the wide-ranging anti-inflammatory effects of curcumin, from cancer to depression.

  • Cloves contain eugenol, a compound that blocks the COX-2 enzyme that causes inflammation. (NSAIDS block pain by inhibiting COX-2.)

  • Cinnamon contains bioactive substances, such as cinnamaldehyde, cinnamic acid, and cinnamate. A recent review of the medical literature found that "In addition to being an antioxidant, anti-inflammatory, antidiabetic, antimicrobial, anticancer, lipid-lowering, and cardiovascular-disease-lowering compound, cinnamon has also been reported to have activities against neurological disorders, such as Parkinson's and Alzheimer's diseases."
There are many other foods, herbs, and spices that have anti-inflammatory properties - all of which can be found in your local grocery. Most nutritionists recommend that you purchase organic foods when at all possible to minimize your exposure to pesticides and other chemical contaminants.

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Maintaining a Healthy Digestive System

The digestive system is the body's first line of defense against illness. Much of what we consume is laden with micro-organisms such as bacteria, viruses, and fungal spores. In order to prevent these pathogens from doing harm, the immune system must recognize them as invaders and then kill them, which is why a substantial part of the gastrointestinal tract is occupied by lymphoid tissue. The job of lymphocytes (T cells, B cells, and natural killer (NK) cells) is to destroy tumor cells, kill viruses, and to create antibodies against viruses and bacteria. Maintaining a healthy digestive system is especially important for those who are fighting a chronic infection.

Patients with early borrelia infection may have numerous GI symptoms: nausea, bloating, reflux, abdominal pain, constipation, and diarrhea, all of which are considered "non-specific," but are indications that something is amiss. Long-term patients may develop food sensitivities and even allergies to add to their roster of symptoms. In these cases, it is best to take a double-pronged approach: avoidance of foods which are hard to digest, and addition of foods which aid digestion.

The first foods which should be avoided are those to which you know cause digestive problems. If you have always had problems digesting oatmeal, for example, this is an indication that oatmeal taxes your system. Because your system is already strained by having an illness, it will be beneficial to cut oatmeal from your diet, no matter how "good" it may be for you.

There also may be foods which have never caused problems before, but have now become difficult to digest, You should eliminate those from your diet as well. If you have generalized problems with digestion, and can't tell which foods are causing your symptoms, you may want to eliminate one food at a time in order to identify which ones are the worst offenders. (These often fall into the categories of milk products, wheat, sugars, and legumes.)

Foods which can aid digestion are those which stimulate digestive juices, such as ginger, and spices which help relieve gas, such as cinnamon and peppermint. Fermented foods, such as yogurt and sauerkraut help digestion by providing probiotics (beneficial bacteria). Lactobacillus plantarum, which is found in fermented foods, has been shown to reduce inflammation in the gut. Fermented food may prove problematic for Lyme patients with multiple digestive problems, however. Drinking the juice of sauerkraut, or drinking small amounts of unsweetened kefir can provide the benefits of fermented food without the GI discomfort.

It goes without saying that people with a chronic illness should maintain a diet with as wide a variety of fresh, preferably organic, fruits and vegetables as possible. High-quality proteins in the form of poultry, fish, and other meat are also essential for repairing damaged tissue. Avoiding processed foods, which contain emulsifiers and other ingredients that promote intestinal inflammation, is crucial for maintaining a healthy digestive system.

Detoxing the Body

Although borrelia spirochetes are not known to excrete toxins, the by-products of immune system activation, co-infections with other pathogens, endotoxins released by die-off due to antibiotic treatment (Herxheimer reaction), and the slowing of normal body processes involved in clearing waste can combine to create a toxic overload.

The two organs directly responsible for filtering toxins from your system are the liver and kidneys. The kidneys filter liquid and flush waste products through your bladder, while the liver metabolizes potential toxins, and prevents them from entering the bloodstream. In order to keep your body from accumulating toxic by-products of immune activation and die-off it is important to support the function of these two organs.

Detoxing the Body - Drink plenty of water 1/6  

Drink Plenty of Water

Most doctors recommend six glasses of water a day, but when you are ill you should drink between eight and ten glasses a day. Water is essential for flushing waste material from your body. Make sure the water you drink is pure, and preferably unchlorinated.
Detoxing the Body - Avoid fatty and fried foods 2/6  

Avoid Fatty and Fried Foods

Fats are broken down by bile, which is formed in the liver. The more fat you eat, the harder your liver has to work. Consuming lean meats, rather than fatty cuts, reduces strain on your liver.
Detoxing the Body - Eat foods rich in sulfur 3/6  

Eat Foods Rich in Sulfur

Sulfur is needed for the cytochrome P450 detoxification pathways in the liver. Sulfur is found in foods like eggs, broccoli, cabbage, cauliflower, onion and garlic.
Detoxing the Body - Eat foods containing silymarin 4/6  

Eat Foods Containing Silymarin

Silymarin is a potent liver protector. It not only helps stabilize liver cells, it promotes their regeneration. Silymarin also reduces inflammation in the liver, and inhibits the formation of cancer cells. Aside from the herb milk thistle, artichokes are the richest food source of silymarin.
Detoxing the Body - Avoid foods that strain your body's natural detox systems, especially alcohol 5/6  

Avoid Foods That Strain Your Body's Natural Detox Systems, Especially Alcohol

A strict avoidance of alcohol is necessary for two reasons: 1) Alcohol places a huge burden on the liver, and 2) Alcohol is dehydrating, placing a strain on the kidneys. Tea, coffee and other diuretics should also be avoided.
Detoxing the Body - Eat foods high in fiber 6/6  

Eat Foods High in Fiber

Fiber creates bulk in your stools, and stimulates the intestines to move waste material along. (Note: if you have SIBO or other digestive problems, you will have to choose your fruits and vegetables carefully to avoid exacerbating the condition.)

While there are a number of detox diets that profoundly limit the types of food you consume, it is wise to remember that your body needs as many nutrients as you can supply. In order to heal, you should keep your diet as chemical-free and varied as you can.

Antibiotics and Digestion

Antibiotics are a double-edged sword. While they are needed to kill borrelia and other Lyme-associated infections, they cause major disruptions in the composition of the normal bacterial flora that inhabit the digestive tract. These disruptions can cause small intestine bacterial overgrowth (SIBO).

While the large intestine is teeming with billions of bacteria that aid in breaking down large molecules into nutrients that our bodies can use, the small intestine is relatively sterile. Bacteria in the large intestine number between 108 and 1010 , whereas the small intestine contains only 103 (100,000) . These small intestine bacteria are largely aerobic bacteria (requiring oxygen for growth), while the bacteria in the large intestine consist largely of anaerobes (not requiring oxygen). When the bacterial flora of the large intestine colonize the small intestine, the normal processes of the small intestine are impaired. These include synthesizing nutrients, such as producing vitamins K and B12, biotin and folate, maintaining the mucosal barrier of the gut, metabolizing carcinogens, and supporting the immune system.

Common symptoms of SIBO are flatulence (due to impaired digestion of carbohydrates), nausea, bloating, vomiting, diarrhea, malnutrition, and weight loss due to malabsorption. In addition to these, a person with leaky gut, a common side effect of SIBO, can experience symptoms typical of systemic infections: night sweats, achiness, weakness, and malaise. Patients may also suffer from an inability to digest fiber or fats. (Large intestine bacteria deconjugate bile.) SIBO has been linked to Irritable Bowel Syndrome (IBS) and rosacea.

The most common test for SIBO is the hydrogen, or lactulose, breath test. This non-invasive test measures gases produced in the small intestine after a challenge with lactulose, a synthetic sugar used to treat constipation. (Because lactulose is metabolized by bacteria in the large intestine, the small intestine would not typically produce gases after the ingestion of lactulose.) An endoscopy can also verify SIBO by measuring bacterial growth in jejunal aspirates.

Treating SIBO can be a complicated task. Although the most common cause of SIBO is antibiotic treatment, antibiotics are also administered to control the abnormal growth of bacteria in the small intestine. Xifaxan (rifaximin), an antibiotic that is only absorbed in the intestines, is generally recommended to treat SIBO. The drawback of Xifaxan is that while it helps SIBO in the short term, it too upsets the natural balance of flora, and SIBO may return after treatment.

There are a number of other avenues for treating SIBO, which may be used in conjunction with antibiotics, or in tandem. In a 2014 study (Chedid et al.) researchers at John Hopkins found that an herbal supplement performed as well as Xifaxan for treating SIBO.

Study participants with SIBO were given two choices based upon their treatment preference; two 200 mg rifaximin tablets taken three times a day or two capsules twice a day of an herbal preparation; either Dysbiocide and FC Cidal (Biotics Research Laboratories, Rosenberg, Texas) or Candibactin-AR and Candibactin-BR (Metagenics, Inc, Aliso Viejo, California) for four weeks. After the month trial, a repeat breath test was performed. Nearly half (46%) of the patients who had chosen herbal therapy had a normal breath test after treatment, as opposed to 34% of the patients who had been treated with rifaximin. While the authors pointed out that the difference between the two groups did not reach statistical significance, the herbal treatment group did not suffer from any of the side effects associated with the antibiotic group (e.g. diarrhea, C. diff overgrowth), nor did they risk further disruptions of bacterial flora.

There are a number of dietary modifications that can help control SIBO. The bacteria that colonize the small intestine feed on simple carbohydrates, milk, and fiber. Avoiding sugar, milk products, refined wheat, and foods high in fiber (e.g. beans, potatoes, corn, peas) can help mitigate SIBO, especially in combination with herbal therapies.


George Mateljan Foundation - Comprehensive website with a search function for looking up nutritional value of foods, as well as background on specific nutrients and healthy recipes.

Self Nutrition Data

The Lyme Diet: Nutritional Strategies for Healing from Lyme Disease by Nicola McFadzean ND

Recipes for Repair: A Lyme Disease Cookbook by Kenneth B. Singleton MD

SIBO-Dietary Treatments

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