Nutrients for Improving Cognitive Function in Lyme Disease PatientsConnie Strasheim May 2, 2017
When I first became ill with chronic Lyme disease in 2004, I could barely read books, never mind write them, as I do now. I left a fiction novel unfinished because I could no longer string two sentences together. And that was only the start of the cognitive problems that I would battle with chronic Lyme disease.
I used to walk around in a daze, unaware of time and how long it would take me to do things. I would routinely lose my car in parking lots, and occasionally have to call a friend or family member to pick me up—from malls, movie theatres and other places with large lots. I would “space out” for hours as I tried to recall the next thing on my to-do list. I got into two car accidents within a year of becoming sick, because I couldn’t process what was happening on the road fast enough. I even once stood in an aisle of a retail store for three hours as I went back-and-forth trying to decide which coat to buy. I routinely made poor decisions, forgot the names of even my closest friends, and couldn’t carry on a prolonged conversation, never mind remember one. I cringed whenever others launched into detailed stories, and my brain shut down in any situation that required abstract reasoning.
My experience isn’t unusual. Many, if not most people with chronic Lyme disease battle cognitive dysfunction that creates debilitating symptoms, such as difficulties with focus, concentration, word finding, decision-making, reasoning and analysis, as well as short-term memory loss.
The dysfunction occurs for many reasons, such as the presence of Lyme neurotoxins in the brain, which cause inflammation; the destruction of neurons and dysfunctional firing between the neurons, damage to brain and other nervous system tissue, hormone and neurotransmitter dysfunction, reduced blood flow and oxygen to the brain, nutritional deficiencies, food allergies, blood-sugar imbalances and more. Most of these problems are caused either directly or indirectly by Lyme disease-related infections such as Borrelia, Babesia and Bartonella, as well as by some of common Lyme disease co-conditions such as mold and yeast infections, and heavy metal toxicity.
It is beyond the scope of this article to explain the details about why and how Lyme pathogens cause cognitive problems, and I’m not even sure I, or other researchers know all of the reasons. The good news is, there are ways to mitigate symptoms of cognitive dysfunction, which I share here.
The obvious first step is to remove the infections and toxins from the body, but this can take many months or years, and in the meantime, people with Lyme disease need to be able to function. When I discovered that I could no longer write without great difficulty, I began to research nutrients that would restore my cognitive abilities, because, as a writer, I couldn’t afford for my brain to not work. It took me years to find real solutions, but as I healed, I slowly began to recover many of the functions that I had lost, including my ability to read and write.
Today, twelve years after I first became ill, I still suffer from short-term memory loss and struggle at times to focus, organize and concentrate, but my symptoms have greatly improved. I can read and write at least twice as fast as I did a decade ago, and have since written and published eleven medical and/or health-related books, including the recently-released New Paradigms in Lyme Disease Treatment: 10 Top Doctors Reveal Healing Strategies that Work (October, 2016). I get things done a lot more efficiently and effectively and no longer wander around in a fog most of the time. I don’t have to labor to stay engaged in conversations, and I get lost less frequently whenever I drive or park my car. My mind still wanders if people launch into detailed stories about subjects that I know little about, but then again, I have never been a great listener, anyway!
I, as well as many others with Lyme disease have found all of the following nutrients and nutritional supplements to be instrumental for restoring cognitive function. Perhaps you or your clients will find them to be useful, too.
This is a phospholipid that supports the function of many organs, such as the pancreas and liver, and which plays a major role in the transport and metabolism of fats; cell membrane synthesis and inflammation reduction. It contains choline, which is used to make acetylcholine, a neurotransmitter that is largely responsible for learning, focus, decision-making, memory, comprehension, and creativity. It can also elevate mood.
Studies have linked acetylcholine deficiency with Alzheimer’s disease and research suggests that supplementing with choline can prevent Alzheimer’s and other neurological conditions associated with toxicity, such as Lyme disease, by preserving neurological function.[ii] Choline’s metabolites are important for the structural integrity of cell membranes and for cholinergic transmission and signaling during the development of neuron cells.[iii] I have personally found it to be the single most powerful nutrient for improving my memory, focus, concentration and other cognitive functions.
Taking over-the-counter phosphatidylcholine supplements can be beneficial for restoring cognitive function, but I have found transdermal phosphatidylcholine in the form of a cream that’s applied to the skin to be even more effective and to produce greater symptom reduction. (Transdermal phosphatidylcholine can be obtained at some compounding pharmacies). The transdermal form of this nutrient may be especially beneficial for those who have gastrointestional problems and/or who can’t absorb capsules or powders.
Datis Kharrazian, DHSc, DC, MS, author of Why Isn’t My Brain Working? also recommends alpha GPC (L-alpha-glycerylphosphorylcholine).[iv] GPC is a phospholipid metabolite that comes from lecithin and which also increases acetylcholine levels in the brain. GPC can be purchased at online retailers and at some health food stores.
The body makes the neurotransmitter serotonin from the amino acid 5-HTP. Serotonin has typically been known to enhance mood, energy, sleep and digestion, but a lesser-known fact is that it also assists with memory and cognitive function. Serotonin levels are often low in people with chronic Lyme disease so supplementing the body with 5-HTP can mitigate some symptoms of Lyme, including the cognitive on
A few studies confirm the role of serotonin in improving cognitive function. For example, one study, published in 2006 in Current Pharmaceutical Design, concluded serotonin to be a potential target for pharmacological cognition enhancement, particularly for restoring impaired cognitive performance due to 5-HT (5-hydroxytryptamine) dysfunction.[v]
People that have methylation problems, which is many of those with chronic Lyme disease, may need to take a methyl donor, such as SAM-e, pyridoxyl phosphate (P5P, or the bio-active form of Vitamin B6), methyl-folate or methyl B-12 to be able to effectively synthesize and utilize serotonin from 5-HTP. Most doctors I know advise against taking random amounts of amino acids and methyl donors, which can be dangerous, as too little or too much of a supplement, as well as the wrong kinds, can exacerbate symptoms. For this reason, it’s best to do a complete amino acid and methylation lab panel to determine which supplements and amino acids the body needs, including 5-HTP.
L-tyrosine and L-dopa
The body uses L-tyrosine and L-dopa to make dopamine, another neurotransmitter that is used to treat low energy, depression and cognitive dysfunction. Dopamine is also commonly found to be low in people with chronic Lyme disease. Parkinson’s disease is also associated with dopamine deficiency, and L-dopa is often given to mitigate symptoms of Parkinson’s. Interestingly, some Lyme-literate experts believe some cases of Parkinson’s to be caused by Lyme disease, so it makes sense that L-tyrosine or L-dopa supplementation could also relieve cognitive symptoms caused by Lyme.
Many studies have also shown L-tyrosine and L-dopa to be useful for restoring cognitive function in general. For instance, one research study, the results of which were published in 2007 in the Journal of Psychiatry and Neuroscience showed that L-tyrosine prevents cognitive decline due to stress.[vi] I have also personally found both L-tyrosine and L-dopa to boost my mental function, and particularly, to help me to process information faster.
Both L-tyrosine and L-dopa can be stimulatory, so as with 5-HTP, testing is necessary to determine how much the body needs. L-dopa can be contraindicated in certain situations and cause detrimental side effects if overdosed and should therefore only be used under strict physician supervision. Some studies have suggested that L-dopa causes oxidative stress in the brain but more recent studies show that this stress can be counteracted by taking L-dopa with certain antioxidants, especially epigallocatechin gallate EGCG, which is a compound found in green tea.[vii]
According to Datis Kharrazian, DHSc, DC, MS in his book, Why Isn’t My Brain Working? the amino acid compound L-acetyl-carnitine binds and activates acetylcholine receptors, so that they more readily utilize acetylcholine,[viii] and studies have shown L-acetyl carnitine to improve cognition and delay Alzheimer’s progression.[ix] [x] According to Thomas Lewis, PhD and author of The End of Alzheimer’s- A Differential Diagnosis Toward a Cure,[xi] spirochetal infections such as Borrelia have been linked to Alzheimer’s, so L-acetyl carnitine may produce similar effects in Lyme disease patients as in Alzheimer’s patients.
This compound preserves acetylcholine in the brain by preventing its breakdown. Studies have shown it to aid in memory and cognition, and according to Dr. Kharrazian, it is one of the best supplements to use for symptoms of acetylcholine imbalance.[xii]
Vinpocetine increases oxygen and blood flow to the brain and protects it against the effects of glutamate, a neurotransmitter which is found in excess in people with chronic Lyme disease and which damages neurons and causes symptoms such as insomnia and cognitive dysfunction. An article that was published in Neurochemistry International in 2008, confirms the neuroprotective effects of vinpocetine against glutamate.[xiii] The authors of the study also report that glutamate toxicity leads to mitochondrial dysfunction and problems with neuronal metabolism. For this reason, vinpocetine may be a very helpful nutrient for restoring cognitive function in Lyme disease.
There are likely many other nutrients out there that support cognitive function in chronic Lyme disease, but I haven’t researched or tried them personally. Also, what works for one person may not work for another. People with Lyme disease and their doctors will need to experiment and test to find out what works best for them. Nonetheless, I highly recommend reading Dr. Kharrazian’s book, Why Isn’t My Brain Working? for more general information on improving brain function.
Finally, cognitive function in Lyme disease can be improved by balancing the hormones, since hormones, particularly the thyroid, play a crucial role in cognition. Restoring the health of the gastrointestinal tract is also important, as is oxygenating and increasing blood flow to the brain with exercise and other strategies such as EWOT (exercise with oxygen). In addition, stabilizing blood sugar levels in the brain by eating frequently and maintaining a high fat, moderate protein and low-carbohydrate diet can be beneficial, since studies have shown this type of diet to reduce symptoms of neurological illness.
People with chronic Lyme disease usually have many biochemical imbalances, and many doctors believe that an anti-inflammatory, blood-sugar stabilizing diet, along with supplements to support the health of the gut and brain are essential for proper brain function. Incorporating these strategies into a daily regimen can go a long way toward mitigating the symptoms of cognitive dysfunction in chronic Lyme disease, and in restoring optimal function to the mind and body.
Biswas S1, Giri S2. Importance of choline as essential nutrient and its role in prevention of various toxicities. Prague Med Rep. (2015);116(1):5-15. doi: 10.14712/23362936.2015.40.
[ii] Coreyann Poly, Joseph M Massaro, Sudha Seshadri, Philip A Wolf, Eunyoung Cho, Elizabeth Krall, Paul F Jacques, and Rhoda Au The relation of dietary choline to cognitive performance and white-matter hyperintensity in the Framingham Offspring Cohort 1,2,3,4. The American Journal of Clinical Nutrition. (2011, Dec.). Accessed on Feb. 19, 2016 from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3252552/
[iii] 57. Wurtman RJ. Choline metabolism as a basis for the selective vulnerability of cholinergic neurons.Trends Neurosci (1992);15:117–22 [PubMed]
[iv] Kharrazian, D. (2013) Why Isn’t My Brain Working? Carlsbad, CA: Elephant Press. p. 275
[v] Schmitt JA1, Wingen M, Ramaekers JG, Evers EA, Riedel WJ. Serotonin and human cognitive performance. Curr Pharm Des. (2006);12(20):2473-86.
[vi] Young, S. L-Tyrosine to alleviate the effects of stress? J Psychiatry Neurosci. (2007 May); 32(3): 224. Accessed on December 30, 2015 from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1863555/.
[vii] Lee MY1, Choi EJ, Lee MK, Lee JJ. Epigallocatechin gallate attenuates L-DOPA-induced apoptosis in rat PC12 cells. Nutr Res Pract. (2013 Aug);7(4):249-55. doi: 10.4162/nrp.2013.7.4.249. Epub 2013 Aug 7.
[viii] Kharrazian, D. (2013) Why Isn’t My Brain Working? Carlsbad, CA: Elephant Press. p. 271-274
[ix] Bowman, B. Acetylcholine and Alzheimer’s Disease. Nutr Rev (1992); 50:142-44.
[x] Careta A. et al. Acetyl-L-Carnitine and Alzheimer’s Disease. Pharmacological considerations beyond cholinergic sphere. Ann NY Acad Sci 1993;695:324-326.
[xi] Lewis, T. (2014, Dec. 22) The End of Alzheimer’s?- A Differential Diagnosis Toward a Cure.
[xii] Kharrazian, D. (2013) Why Isn’t My Brain Working? Carlsbad, CA: Elephant Press 174-175.
[xiii] Tárnok K, Kiss E, Luiten PG, Nyakas C, Tihanyi K, Schlett K, Eisel UL. Effects of Vinpocetine on mitochondrial function and neuroprotection in primary cortical neurons. Neurochem Int. (2008 Dec);53(6-8):289-95. doi: 10.1016/j.neuint.2008.08.003. Epub 2008 Aug 28.