Nutrients for Improving Cognitive Function in Chronic Lyme Disease

by Connie Strasheim Townsendticle for July 2

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 story isn’t unusual. Many 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 the common Lyme disease coconditions 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, and I will share some of those 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 well, 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, 12 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 9 medical and/or health-related books (I’m currently working on the 10th, which is an updated doctor-interview book on Lyme disease that will be released in late 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 as much 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 have found all of the following nutrients and nutritional supplements to be instrumental for restoring my cognitive function. Perhaps you or your clients will find them useful, too.

Phosphatidylcholine.

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 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.^1,2 Choline’s metabolites are important for the structural integrity of cell membranes and for cholinergic transmission and signaling during the development of neuron cells.³ 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 applied to the skin to be far 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 gastrointestinal 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).⁴ GPC is a phospholipid metabolite that comes from lecithin and also increases acetylcholine levels in the brain. GPC can be purchased at online retailers and at some health food stores.

5-HTP.

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 many symptoms of Lyme, including the cognitive ones.

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.⁵

People who 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 bioactive form of vitamin B6), methylfolate, or methyl B12 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. For this reason, it makes sense that L-tyrosine or L-DOPA supplementation could also relieve cognitive symptoms of Lyme.

Many studies have also proved 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.⁶ 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. As with phosphatidylcholine, I have found powdered and transdermal forms of L-tyrosine and L-DOPA more effective than oral capsules. 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, a compound found in green tea.⁷

L-acetylcarnitine.

According to Kharrazian, the amino acid compound L-acetylcarnitine binds and activates acetylcholine receptors, so that they more readily utilize acetylcholine, and studies have shown L-acetylcarnitine to improve cognition and delay Alzheimer’s progression.^8–10 According to Thomas Lewis, PhD, and author of The End of Alzheimer’s? A Differential Diagnosis Toward a Cure, spirochetal infections such as Borrelia have been linked to Alzheimer’s, so L-acetylcarnitine may produce similar effects in Lyme disease patients as in Alzheimer’s patients.¹¹

L-Huperzine A.

This compound preserves acetylcholine in the brain by preventing its breakdown. Studies have shown it to aid in memory and cognition, and according to Kharrazian, it is one of the best supplements to use for symptoms of acetylcholine imbalance.¹²

Vinpocetine

. Vinpocetine increases oxygen and blood flow to the brain and protects it against the effects of glutamate, a neurotransmitter found in excess in people with chronic Lyme disease and which damages neurons and causes symptoms such as insomnia and cognitive dysfunction. An article published in Neurochemistry International in 2008 confirms the neuroprotective effects of vinpocetine against glutamate.¹³ 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 functions 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 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 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 brain cells require glucose as their primary fuel and hypoglycemia is common in chronic Lyme.

People with chronic Lyme disease usually have many imbalances in their bodies, and many doctors and patients whom I know believe an anti-inflammatory, blood–sugar stabilizing diet to be essential for proper brain function, along with supplements to support the health of the gut. Incorporating these nutrients and 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.

Notes

1. Biswas S, Giri S. 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.

2. Poly C, Massaro JM, Seshadri S, et al. The relation of dietary choline to cognitive performance and white-matter hyperintensity in the Framingham Offspring Cohort 1,2,3,4. Am J Clin Nutr. 2011 Dec. Accessed Feb. 19, 2016. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3252552.

3. 57. Wurtman RJ. Choline metabolism as a basis for the selective vulnerability of cholinergic neurons. Trends Neurosci. 1992;15:117–122. 

4. Kharrazian D. Why Isn’t My Brain Working? Carlsbad, CA: Elephant Press; 2013:275

5. Schmitt JA1, Wingen M, Ramaekers JG, Evers EA, Riedel WJ. Serotonin and human cognitive performance. Curr Pharm Des. 2006;12(20):2473–2486.

6. Young S. L-Tyrosine to alleviate the effects of stress? J Psychiatry Neurosci. 2007 May; 32(3):224. Accessed December 30, 2015. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1863555.

7. Lee MY, Choi EJ, Lee MK, Lee JJ. Epigallocatechin gallate attenuates L-DOPA-induced apoptosis in rat PC12 cells. Nutr Res Pract. 2013 Aug;7(4):249–255. doi:10.4162/nrp.2013.7.4.249. Epub 2013 Aug 7.

8. Kharrazian. Op. cit., 271–274.

9. Bowman B. Acetylcholine and Alzheimer’s disease. Nutr Rev. 1992;50:142–144.

10. Careta A et al. Acetyl-L-carnitine and Alzheimer’s disease. Pharmacological considerations beyond cholinergic sphere. Ann NY Acad Sci. 1993;695:324–326.

11. Lewis T. The End of Alzheimer’s? A Differential Diagnosis Toward a Cure. 2014.

12. Kharrazian. Op. cit., 174–175.

13. Tárnok K, Kiss E, Luiten PG, et al. Effects of Vinpocetine on mitochondrial function and neuroprotection in primary cortical neurons. Neurochem Int. 2008 Dec;53(6–8):289–295. doi:10.1016/j.neuint.2008.08.003. Epub 2008 Aug 28.

Connie Strasheim is a medical researcher and writer, and author, coauthor, and/or ghostwriter of 10 wellness books, including several on Lyme disease. She collaborates with some of the world’s top integrative doctors to write her books, articles, and other works. She is also an editor for the Alternative Cancer Research Institute and Pro Health’s Lyme disease research and patient advocacy site. She hosts a monthly prayer conference call for those with chronic health challenges, believing that prayer is powerful for healing. To learn more about Connie’s work, visit www.ConnieStrasheim.org.