If you asked around among your friends and colleagues, you’d be hard-pressed not to find someone who’s been affected by Lyme disease—the notorious infection caused by the bacterium Borrelia burgdorferi, which is transmitted to humans through the bite of a tiny infected black-legged or deer tick—or another tick-borne illness such as Babesia or bartonella.
That’s because an estimated 300,000 people are diagnosed with Lyme disease every year, according to the Centers for Disease Control and Prevention (CDC), and many experts believe that number is almost certainly underestimated. Since ticks are so tiny, many people don’t even notice when they’ve been bitten, and because symptoms often mimic other health conditions such as chronic fatigue syndrome, multiple sclerosis, dementia, and fibromyalgia, Lyme is often referred to as “The Great Imitator” and goes undiagnosed for years.
This leaves many people struggling to manage their unrelenting chronic Lyme (which can trigger fatigue, autoimmune conditions, and debilitating inflammation-spectrum symptoms affecting the nervous system, immune system, and digestion) with no answers in sight when treatments for these other diseases don’t end up working.
Why we’re hearing more about Lyme: our modern diet, for one.
So, why is there so much talk about Lyme right now? In part, it’s because we understand more about these infections and testing is being done more frequently. But in my opinion, and from functional medicine’s perspective as a whole, better diagnosis is only part of the reason.
Because our genetics as humans haven’t changed in over 10,000 years, we have to look at what has changed: the world around us. Epigenetic or lifestyle factors like the processed foods we eat, the depletion of nutrients from our soil, and the pollution of the air we breathe and water we drink are all likely amplifying and perpetuating the impact that chronic infections caused by viruses, mold, protozoa, and bacteria (like Lyme disease) have on the body. As our earth is groaning in the form of climate change, so, too, is the human immune system from the onslaught of modern stressors.
Typically, mainstream medicine will diagnose the presence of Lyme through lab work—that is, if you notice a bite or if you or your doctor recognize your symptoms as possible Lyme indicators—and then treat the infection with a round of antibiotics. But chronic Lyme that persists after antibiotic treatment (sometimes referred to as post-treatment Lyme disease syndrome) or that’s never diagnosed and treated to begin with goes largely unrecognized in conventional medicine. Thankfully, it’s gaining recognition among the functional medicine community with the support of organizations such as the International Lyme and Associated Diseases Society.
Lyme-literate functional medicine practitioners like me have a multipronged approach to chronic infections like Lyme. One of the tools we often use: food as medicine.
How a keto diet supports your ability to heal from Lyme.
The most effective food protocol for Lyme that I’ve found in my years of seeing patients around the world is a mostly plant-based ketogenic diet that I call Ketotarian (here’s a sample shopping list and meal plan). By avoiding the common pitfalls of the conventional keto diet (lots of meat and dairy and not enough veggies), we can leverage the benefits of nutritional ketosis in the clean, sustainable way that people with chronic infections need.
Here, I’ll explain how a clean keto diet can be a major piece of the healing puzzle for people struggling with Lyme disease and other chronic infections:
1. Improved mitochondrial functioning.
Studies suggest that oxidative stress can contribute to mitochondrial dysfunction in the immune cells of Lyme patients, which can lead to extreme fatigue and amplify a variety of other Lyme symptoms. A ketogenic diet is able to help counter this by increasing mitochondrial biogenesis, or the production of new mitochondria, through a process called autophagy. Literally translating as “self-eating,” autophagy is your body’s natural cleaning system and the primary process for removing damaged mitochondria. A ketogenic diet and intermittent fasting (which enhances ketosis) are two of the best ways to increase autophagy.
2. Reduced inflammation.
Long-term exposure to the Lyme pathogen has been suggested to trigger autoimmune diseases such as rheumatoid arthritis and other joint-related conditions through pro-inflammatory processes. This means reducing inflammation is crucial for managing Lyme disease and reducing these debilitating symptoms. Fortunately, this is something a plant-heavy ketogenic diet excels at.
Ketones, including beta-hydroxybutyrate, are not just a form of fuel for the body, they’re signaling molecules and epigenetic modulators, which work to activate anti-inflammatory pathways like AMPK and Nrf-2 while inhibiting inflammatory pathways like NFkB, COX2, and the NLRP-3 inflammasome.
Together, improved mitochondrial function, autophagy, and reduced inflammation levels are particularly important for improving the neurological symptoms (e.g., brain fog) that often occur with chronic Lyme disease.
3. Enhanced methylation pathways.
Certain genes can predispose certain people to chronic infections such as the MTHFR gene mutation, which affects up to 40 percent of the population and impairs a crucial biochemical process called methylation. Since methylation controls your body’s hormonal, detoxification, and inflammatory pathways, it is important to optimize this function to manage Lyme. A ketogenic diet, especially a plant-heavy one, is filled with dark leafy greens and cruciferous vegetables that are rich in folate and sulfur compounds, both of which are important for healthy methylation.
4. Rebalanced microbiome.
Since close to 80 percent of our immune system is in our GI tract, plenty of Lyme experts agree that the microbiome is a key player in strengthening the immune system to fight off Lyme infections. The fiber content of nonstarchy vegetables (which you can eat freely on a keto diet as they’re naturally low in carbohydrates) provides fuel for good gut bugs, while limiting sweets and processed foods helps starve bad gut bacteria and restore balance to the microbiome. Too much sugar has also been shown to promote inflammation and suppress immune function, so an ultra-low-sugar diet like keto would certainly help prevent that.
While more studies need to be done to truly determine the benefits of a ketogenic diet for managing Lyme disease and other chronic infections, we do know that many of the pathways implicated in Lyme disease are also modulated with a high-fat, low-carb keto diet. That’s why I feel confident that a properly formulated keto diet can be a safe and effective way to support your body through your Lyme healing process.
Depending on the severity of your Lyme disease, you may want to consider seeking out a functional medicine practitioner who’s familiar with Lyme and low-carb diets to help guide you through the process.
*Disclaimer: The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of LymeNow or the LymeNow community.