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The prevalence of Lyme disease in the United States has skyrocketed in recent years. This insidious tickborne disease, caused by infection with bacteria of the genus Borrelia, has reached every state in this country, although concentrations are greatest in the Northeast, mid-Atlantic, and upper Midwest regions. The Centers for Disease Control and Prevention (CDC) reports that approximately 476,000 new cases were diagnosed annually in the United States from 2010 to 2018, and estimates based on clinical criteria indicate that there are over a million new cases each year.
Yet many of the people whose lives have been upended by this disease are failing to obtain effective treatment or even receive an accurate diagnosis. In addition, it has been estimated that anywhere from 10 to 53% of those diagnosed with acute Lyme disease go on to develop chronic illness, despite the fact that the very existence of “chronic Lyme disease” is controversial in allopathic medicine. All of this can leave patients in medical limbo, suffering from multisystemic ailments with no recognized cause.
While Lyme disease is a complex problem that can be notoriously difficult to treat, new paradigms for addressing it have been arising from the field of complementary and integrative medicine. These focus on optimizing immunity and balancing inflammation as well as fighting infection, and take into account patient individuality. They support the body’s innate capacity for healing through modalities such as diet, nutritional supplementation, lifestyle habits, and herbal medicines. For many people, they are providing very positive results, opening the way for improved health and even recovery.
Rise of an epidemic
In the 1970s, researchers from Yale University investigated an unusual cluster of patients in the area of Lyme, Connecticut, who had been diagnosed with arthritis. These people – both children and adults – had symptoms such as swollen knees, fever, fatigue, headaches, and, in some cases, a bull’s-eye rash. The researchers called this “new” disease Lyme arthritis (later renamed Lyme disease). Then, in 1981,Willy Burgdorfer, PhD, MD, a medical entomologist, determined the cause of the Connecticut outbreak to be infection by a spirochete – a spiral-shaped bacterium – acquired from the bite of a blacklegged (Ixodes) tick, and the pathogen was named Borrelia burgdorferi in his honor.
Lyme disease was not entirely a new phenomenon, however. In Europe, descriptions of its dermatologic effects date back to 1883, and neurological disorders associated with Ixodes tick bites were recorded by the 1930s. Although presentation of the disease may differ somewhat between patients in the United States and those in Europe, probably due to variations in Borrelia strains, Lyme disease was eventually recognized as a form of the tickborne infection already known in Europe.
Contact between Borrelia bacteria and humans has actually been taking place for millennia. Genetic evidence of B. burgdorferi was discovered in a 5,300-year-old mummy that had been frozen in an Alpine glacier near the Italian-Austrian border. A 2017 study found that this bacteria was already present in the forests of North America 60,000 years ago. Why then has Lyme disease only recently emerged as a rapidly growing epidemic?
The rise of Lyme disease seems to be due in part to ecological changes – from global warming to deforestation and suburbanization of the landscape – that have allowed blacklegged ticks to spread and flourish in areas that were previously inhospitable to them. In addition, as human habitation and other activities increasingly encroach on animal habitats, we come in greater and greater contact with wildlife, such as deer and mice, that harbor these ticks. Migrating birds spread infected ticks and other insects worldwide, even into the cities, and our companion animals carry them into our homes.
However, it is not just the external landscape and climate that have changed. Our own internal ecology has been altered as well, due to dietary changes, inadequate nutrition, exposure to environmental toxins, chronic stress, and other factors. This, in turn, has impacted the functioning of our immune systems, making us more vulnerable to infection. Not everyone who is bitten with an infected tick will develop a debilitating case of Lyme disease; our immune status also plays an important role. It is the combination of pathogenic exposure with immune system impairment that is most likely to lead to serious illness.
Acute Lyme disease
The initial symptoms of acute Lyme disease may begin anywhere from hours to weeks after a bite from a tick carrying one of the pathogenic forms of Borrelia – most often, in this country, B. burgdorferi. At this point, the infection is localized to the skin; it has not yet spread throughout the bloodstream. The most common initial symptoms include:
- Fever and chills
- Stiff neck
- Muscle aches
- Rash known as erythema migrans
The initial erythema migrans (EM) rash, which occurs at the site of the tick bite, can be highly variable in appearance. Contrary to popular opinion, it is generally solid colored (red or pink). Less than 20% of EM rashes have the “classic” bull’s-eye appearance generally associated with Lyme disease. If there is no rash or if it is overlooked, acute Lyme disease is often misdiagnosed as a cold or flu.
Some people initially experience no symptoms whatsoever after infection with B. burgdorferi. This asymptomatic state may persist indefinitely until a dip in immune status increases the individual’s vulnerability. This delay, however, is not necessarily a good thing, as it precludes early treatment and allows the bacteria to more thoroughly colonize the body.
The most common allopathic treatment for Lyme disease is a two- to four-week course of oral antibiotics, often doxycycline or amoxicillin. However, some physicians are now prescribing more aggressive treatment with multiple drugs, and longer courses of antibiotics. (As with many aspects of Lyme disease, there is controversy as to whether or not these longer courses yield better results.) Antibiotics are often effective against Borrelia if initiated soon after the tick bite occurs. In fact, despite their potential side effects, such as gut dysbiosis and suppression of the immune system, many integrative health practitioners support their use – along with complementary therapies, such as immune support and herbal microbials – due to the critical importance of eliminating the microbe before it can settle in and wreak havoc on the body. However, both treatment failures and relapses after treatment are common.
If the disease is not treated successfully (or at all) in the first few weeks after infection, the Borrelia bacteria can start to spread through the bloodstream. This stage of the disease, known as early disseminated Lyme, may result in health issues such as:
- Multiple EM rashes in different areas of the body
- Facial palsy
- Joint pain and swelling
- Nerve pain
- Inflammation of the heart, brain, or spinal cord
As the bacteria begin moving into tissues and organs throughout the body, such as the joints, central nervous system, and heart, they can hide more easily from the immune system – and from antibiotic drugs. This can lead to late disseminated Lyme disease, also called chronic Lyme disease, months or years later. (Some health experts group early and late disseminated Lyme disease together under the classification of chronic Lyme disease. Others make a distinction between late disseminated Lyme and chronic Lyme. As you may begin to realize, there is very little about this disease that is not controversial.)
Chronic Lyme disease
No one knows precisely how many people suffer from chronic Lyme disease, but there are estimates that the number is in the millions. That’s millions of people with often-debilitating symptoms from a disease that their physician and health insurance company may not recognize as real. The standard allopathic view has long been that Borrelia will be eradicated – and thus Lyme disease cured – by a few weeks of antibiotic therapy. (According to this viewpoint, any symptoms persisting after treatment are not caused by Lyme disease.) However, this cannot be proven with current testing methods, and a wealth of case studies and animal research indicates otherwise.
In fact, the CDC now acknowledges a condition called post-treatment Lyme disease syndrome (PTLDS), which some experts consider a form of chronic Lyme disease. This term refers to “symptoms of pain, fatigue, or difficulty thinking that lasts for more than six months after [the patient] finishes treatment.” According to the CDC, the cause of this syndrome is not known, although their website cites various theories, such as an autoimmune response that outlives the bacteria, or a hard-to-detect persistent infection.
From a broader perspective, chronic Lyme disease includes a much larger pool of people than would meet the CDC’s definition of PTLDS. Some of these did not experience symptoms from the acute stage of the disease but came down with multisystemic problems months or years later. Others completed antibiotic therapy during the acute phase of their illness but either remained significantly symptomatic afterward or relapsed later. Their symptoms can be highly individualized, persistent, and devastating. In general terms, these symptoms often include:
- Extreme fatigue
- Sleep disorders
- Moderate to severe headache
- Neuropathic pain
- Musculoskeletal problems
- Cognitive dysfunction
- Mood disorders
- Dermatological conditions
- Balance or movement disorders
- Impaired vision
- Cardiac conditions (e.g., pericarditis)
Many of these problems appear to result from systemic inflammation brought on by the infection. This inflammation disrupts hormonal balance, weakens the immune system, and dysregulates the nervous system. It is increasingly accepted by Lyme-literate healthcare providers that chronic Lyme disease has a strong autoimmune component.
Because its symptoms can be so varied, chronic Lyme disease is often called the “great imitator” or “great pretender.” It can affect virtually any part of the body and resemble any systemic health condition, from chronic fatigue syndrome and fibromyalgia to multiple sclerosis, Parkinson’s disease, Alzheimer’s, psychiatric disorders, and more – complicating diagnosis and condemning patients to years or even decades of incorrect treatment.
Difficulties in diagnosis
The importance of diagnosing Lyme disease early in the process is clear. Yet this diagnosis is often not considered by physicians, even when symptoms are present. Sometimes, this happens because the tick bite was never noticed, either because it was in a hard-to-see area (think armpits, groin, or scalp) or because the tick was immature (a nymph). These tiny nymphs, less than 2 mm in size, which feed in the spring and summer, are much less likely to be detected than adult ticks and are responsible for transmitting the majority of Borrelia infections. In other cases, there is the misconception that a tick must remain attached to the body for at least 24-36 hours in order for the disease to be transmitted; however, this is not always the case. It may only take 8 to 16 hours – or, under certain circumstances, as little as 10 minutes – for the tick to transmit Lyme organisms. Sometimes, the possibility of Lyme disease is dismissed simply because the patient did not have – or was not aware of having had – the classic bull’s-eye rash.
Testing for Lyme disease is also extremely problematic. The CDC currently recommends a two-step testing protocol: administration of an enzyme-linked immunosorbent assay (ELISA), followed by a Western blot only if the ELISA results are positive or indeterminate. Unfortunately, this protocol has a low degree of sensitivity, particularly in the early stage of the disease, resulting in a large number of false negatives. For one thing, these tests are designed to measure the patient’s antibody response to B. burgdorferi, which can take four to six weeks to develop. For another, many ELISA and Western blot tests detect only one specific strain of the bacteria, causing many infections to be missed. In fact, the ELISA yields false negatives almost 50% of the time, and the Western blot, which is more reliable, is still only estimated to be 80% accurate at the best labs. In addition to false negatives, the presence of certain other health conditions, including some tickborne diseases, can result in false positives. For a variety of reasons, Lyme disease cannot be confirmed or ruled out solely on the basis of testing. Assessing clinical signs and symptoms, along with patient history, are the most important part of diagnosis, and this requires sufficient education and knowledge about the condition.
To complicate matters further, there are various species of Borrelia other than B. burgdorferi that can cause a form of Lyme disease, and there are many different subspecies and strains, each of which may give rise to a somewhat different pattern of symptoms. A typical person is likely to be infected with multiple subspecies or strains, which can target different areas of the body. Also, because ticks carry and transmit other pathogens in addition to Borrelia, many people with Lyme disease have coinfections, such as babesiosis, bartonellosis, ehrlichiosis, and spotted fever rickettsiosis, which can make both diagnosis and treatment more challenging.
Stealth pathogens and immune function
Why is treatment of Lyme disease so much more difficult than that of many other bacterial infections? Primarily because Borrelia is what is known as a stealth pathogen, a microbe that employs specific strategies to hide from the immune system. Remember, these bacteria have coexisted with us for many thousands of years and have learned to adapt to our bodies in ways that boost their likelihood of survival.
I have already mentioned that these bacteria can colonize areas of the body where our immune defenses (and antibiotics) have trouble reaching them; these include fibroblasts, tendons, ligaments, joints, and the central nervous system. They can also hide in the extracellular matrix – the spaces between our cells.
Beyond this, however, Borrelia is a shape shifter that can change its form under stress to evade attackers, either physiological or pharmaceutical. When stressed, the corkscrew-shaped organism can curl itself into an outer membrane and morph into a round form called a cyst, in which it can stay for prolonged periods of time, waiting until the threat has passed. As more and more of the spirochetes take an encysted, inactive form, symptoms can decrease. However, these may recur later when the threat has passed and the microbes regain their original, active form.
Borrelia has other defense mechanisms as well. It can evade recognition by the immune system by changing a major lipoprotein on its surface. It can even wrap itself in one of the host’s own proteins, so the immune system doesn’t detect any threat. To top things off, it can join with other bacteria to form a biofilm, a community of organisms embedded in a protective matrix.
Moreover, at the very time that we need a strong, well-balanced immune system to overcome these challenges, B. burgdorferi actually alters our immune response, stopping dendritic cells from communicating properly with T cells, which may cause the immune system to mistakenly perceive our healthy cells as invaders and attack them. In other words, it provokes autoimmunity. In fact, it is believed that many of the symptoms of chronic Lyme disease can be attributed to autoimmune responses.
Treatment of Lyme disease, particularly in its chronic form, is thus more complicated than simply utilizing antibacterial agents, whether pharmaceutical or complementary. In addition to eliminating the pathogen, it’s important to support the immune system, reduce inflammation, and address imbalances in all the bodily systems impacted by the disease. Because Lyme disease affects people in different ways, based on their unique physiologies, epigenetic influences, and coinfections, different treatment regimens are required. There is no one-size-fits-all protocol for chronic Lyme disease.
Numerous treatment approaches are being used today by alternative and complementary healthcare practitioners within a variety of specialties. These approaches encompass everything from diet and nutrition to herbal medicine, detoxification, mold remediation, hyperthermia, hydrotherapy, hyperbaric oxygen, ozone treatment, and much more. There are many excellent books exploring the wide range of treatment modalities available; a few examples are included in the Recommended Reading list below.
The remainder of this article will summarize some basic guidelines for supporting immunity and reducing inflammation for those with Lyme disease, and will discuss some of the nutritional supplements and herbs that can promote recovery. Due to the complexities and potentially disabling effects of this illness, treatment should be done under the guidance of a Lyme-literate physician or other healthcare professional. One way to find a knowledgeable doctor is to visit the International Lyme and Associated Diseases Society (ILADS) website at www.ilads.org/patient-care/provider-search/.
Diet and lifestyle
Some of the most basic ways to support your immune system and reduce excess inflammation if you have Lyme disease are also things that can help you maintain optimal health if you are disease free. The difference is that, in the case of Lyme disease, these guidelines are more critical and should be followed more strictly. Instead of limiting refined sugars, for example, it is best to eliminate them completely. Abstain completely from alcohol, and limit refined carbohydrates, processed foods, and industrial seed and vegetable oils (such as soy, corn, canola, and safflower oils). Some people with Lyme disease do best when also eliminating gluten and dairy from their diets.
Instead, select nutrient-dense foods such as grassfed meats (rich in amino acids, iron, and vitamin B12); wild-caught, low-mercury seafood (a good source of omega-3 fatty acids); and a variety of colorful, nonstarchy vegetables, containing dietary fiber as well as phytonutrients. Choose healthy fats, such as those found in olive and coconut oils, avocados, nuts, and seeds. Eat foods that are probiotic (e.g., yogurt, kefir, sauerkraut, and kimchi) and prebiotic (e.g., dandelion greens, garlic, onions, asparagus, and bananas) to help protect and restore your gut microbiome during and after antibiotic use. Add anti-inflammatory and antioxidant herbs, such as turmeric and ginger, to your meals. A healthy, anti-inflammatory diet can play an important role in reducing Lyme disease symptoms and promoting healing.
The best dietary approach is the one that works best for you. Some people with neurological Lyme disease find a ketogenic diet, which reduces neuroinflammation, to be beneficial; people with autoimmune disease may find the Autoimmune Protocol (AIP) diet, which removes dietary immune triggers, to be helpful. Working with a Lyme-literate healthcare provider can help you determine the most beneficial diet for your unique needs.
Quality sleep is critical to support immunity and limit excess inflammation, but this can be a particular problem for people with Lyme disease. They may experience sleep impairment from a variety of causes, from pain (which, in turn, can be worsened by poor sleep) to neurological disturbance caused by the Borrelia spirochete crossing into the central nervous system. Excess inflammation can reduce restorative sleep, further increasing inflammation and lowering immunity – a vicious cycle indeed. While it’s important to practice good sleep hygiene – going to bed at the same time each night, sleeping in a darkened room, avoiding electronic devices before bedtime, and so forth – this may not be sufficient to overcome Lyme-related sleep disorders. Therapies such as neurofeedback, which can balance erratic brainwave patterns, or sleep-promoting supplements – e.g., melatonin, phosphatidylserine, L-theanine, passionflower, valerian, or CBD oil- may be helpful.
A light to moderate exercise or movement program will also be beneficial for most people with chronic Lyme disease. Physical activity, such as yoga, tai chi, or walking, can support the immune system, help the lymphatic system drain toxins, reduce muscle and joint pain, improve mood, and aid sleep. Exactly how much exercise is optimal will depend on your health status. Too much (or too strenuous) exercise can worsen fatigue, increase muscle or joint pain, or exacerbate other symptoms. Before beginning an exercise program, check with your healthcare provider to make sure it’s safe for you. If you have a condition such as Lyme carditis, a disruption in the heart’s electrical signaling that can occur when the spirochetes enter the heart, this will have to be addressed first.
As with all nutritional protocols, supplementation must be tailored to the individual’s specific needs. Any nutrient deficiencies or imbalances must be addressed to allow the body to heal. Following are just a few of the nutrients that can promote recovery from chronic Lyme disease.
Omega-3 fatty acids: These have significant anti-inflammatory properties, enhance cognitive function, and have shown benefit in the treatment of rheumatoid arthritis, as well as decrease the risk of cardiovascular disease. Supplementing with the omega-3s EPA and DHA can help address the systemic inflammation associated with chronic Lyme disease. In the diet, EPA and DHA can be obtained from wild-caught oily fish and shellfish; two to three servings per week can boost omega-3 levels. Make sure to select varieties that are low in mercury, such as salmon, anchovies, herring, oysters, sardines, and trout.
Vitamin C: Among its many roles in the body, vitamin C is essential for collagen synthesis, which is of particular importance in Lyme disease because Borrelia bacteria can colonize and break down collagen fibers. A powerful antioxidant, this vitamin can help with recovery from chronic disease and can inhibit pathogenic bacteria and biofilms. Working in concert with vitamin E, another antioxidant, it can restore oxidized glutathione to a functional state. Some healthcare practitioners recommend high-dose vitamin C, either in liposomal or intravenous form, for treating Lyme disease.
Vitamin D: This fat-soluble hormone is critical for proper immune function and has anti-inflammatory effects. Levels are often low among those with Lyme disease, and B. burgdorferi may impede the activity of vitamin D receptors, increasing the need for the nutrient. Supplementation to bring low serum vitamin D up to a healthy level is generally recommended, as getting enough of the vitamin via sun exposure or food can be challenging, especially for those with health issues. For raising blood levels, vitamin D3 is the preferred supplement form; this is also the form found in cod liver oil and animal-based foods such as salmon, egg yolks, and beef liver. However, those with persistent Lyme disease may wish to have their 1,25-dihydroxyvitamin D level checked before supplementing. This active form of the vitamin can sometimes be high in people with chronic inflammation, even when the storage form, 25-hydroxyvitamin D, is low – in which case, supplementation may not be the best course.
Glutathione: A powerful antioxidant, glutathione is made within our cells and protects our mitochondria from oxidative damage. It is also involved in phase II liver detoxification and immune function. Research suggests that glutathione may play an important role in the body’s immune response to B. burgdorferi. While oral glutathione supplements have traditionally not been well absorbed systemically, some formulations of the active form, called reduced glutathione, show greater effectiveness. There are also ways to support glutathione production dietarily. For example, you can eat foods rich in sulfur, a critical building block of glutathione. These include eggs, beef, fish, poultry, cruciferous vegetables, and alliums. To increase your intake of selenium, a glutathione cofactor, eat foods such as Brazil nuts, seafood, and organ meats. Although dietary sources of glutathione are not well absorbed, foods with the highest levels include spinach, avocados, asparagus, and okra.
According to Lyme disease expert William Rawls, MD, raising glutathione levels inside the cells can be done more effectively by combining therapeutic doses of alpha-lipoic acid, N-acetyl cysteine, and vitamin C than by supplementing with glutathione. Alpha-lipoic acid is a potent antioxidant that regenerates glutathione, protects the liver and nerve tissue, and enhances immune function. N-acetyl cysteine, another antioxidant, is necessary for the formation of glutathione. It can inhibit the inflammatory response and the breakdown of collagen, protect the liver and nerve function, decrease biofilm formation, and disrupt existing biofilms.
Medicinal herbs have been the first line of defense against illness for as long as people and plants have coexisted on this planet. Today, the combined body of traditional knowledge, clinical experience, and scientific research reveals the value and effectiveness of herbs in addressing the most serious diseases of our time. Unlike pharmaceuticals, which are generally designed to act in a targeted way to produce a narrow, specific outcome, herbs are complex, natural medicines with multisystemic effects. They are well suited to address complex chronic diseases, and may often complement (or mitigate) the effects of drugs with which they are sometimes used. Among their many properties, herbs can have antimicrobial, anti-inflammatory, and immune-supportive properties.
A recent study published in Frontiers in Medicine bears mention here. The researchers found that seven individual plant extracts – Ghanaian quinine, Japanese knotweed, black walnut, cat’s claw, sweet wormwood, Mediterranean rockrose, and Chinese skullcap – all outperformed the antibiotics doxycycline and cefuroxime in killing B. burgdorferi in vitro, even when the bacteria had formed microcolonies, the first stage in the development of biofilms.
In recent years, Lyme-literate physicians and clinical herbalists have been developing core protocols that use plant medicines to help their patients recover from Lyme disease, and reporting great success. One protocol that particularly bears mention here is that of Stephen Harrod Buhner, whose comprehensive work on Lyme disease and its coinfections has influenced numerous practitioners and helped many people to heal. I highly recommend his book Healing Lyme (second edition) to anyone with Lyme disease.
As previously stated, treatment of Lyme disease should be done under the direction of an informed healthcare practitioner – and that includes herbal treatment, if at all possible. Clinical herbalists and other knowledgeable practitioners have a vast body of plants (and knowledge) to draw upon, and so can take the unique needs of each patient into account, treating the whole person rather than simply the disease. The herbs briefly discussed below are only a few of those being used to help people with Lyme disease.
Japanese knotweed (Polygonum cuspidatum): This herb has broadly systemic actions, including immune system enhancement and anti-inflammatory effects, as well as antimicrobial activity. It is heart protective and can help with symptoms of Lyme carditis. As its constituents cross the blood-brain barrier, Japanese knotweed can reduce inflammation in the central nervous system, which is of particular use in neuroborreliosis. It also stimulates microcirculation, improving blood flow to hard-to-reach places in the body, and facilitating movement of other herbal constituents and drugs to those areas. In the study mentioned above, it was found to be one of the two most effective herbs tested against the Borrelia spirochete. In addition, it is active against many other stealth microbes and can disrupt biofilms. Japanese knotweed is a rich source of polyphenols, including resveratrol. However, it does elicit side effects in a small number of people, including loss of taste and gastrointestinal upset, and it is contraindicated during pregnancy.
Andrographis (Andrographis paniculata): Another widely systemic herb, native to India, andrographis has immune-modulating, heart and liver protective, and anti-inflammatory properties. It specifically enhances natural killer cell activity. Andrographis also has antispirochetal actions against Borrelia bacteria, including in the central nervous system, as it crosses the blood-brain barrier. Although it is widely used in the treatment of Lyme disease, approximately 1% of the people who take it develop an allergic reaction in the form of an itchy, whole-body rash with hives that can take several weeks to resolve after use of the herb is stopped.
Cat’s claw (Uncaria tomentosa): Native to the Amazon, this herb is an immunomodulator that can boost the number of white blood cells, including a type of natural killer cell known as CD57 that is generally suppressed in long-term or chronic Lyme disease. It also has potent anti-inflammatory properties and can be particularly helpful in treating Lyme arthritis. (A related species, Uncaria rhychophylla, which is also considered cat’s claw, has different chemical constituents and is more effective in cases of neuroborreliosis.) This herb is generally safe and is commonly used in Lyme disease protocols. However, it may potentiate the action of pharmaceutical blood thinners.
Many other medicinal plants are useful in the treatment of Lyme disease and its various coinfections, such as Chinese skullcap, which acts as a synergist to increase the action of other supplements; and sarsaparilla, thought to bind endotoxins (toxic debris left behind when pathogenic bacteria are destroyed). There are also many powerful adaptogens (herbs that modulate the immune system), including cordyceps, reishi, and eleuthero. In addition, there are all the herbs that specifically address the various organ systems that Lyme disease and its associated inflammation may have compromised.
In conclusion, there are indeed effective ways to address the potentially devasting impact of chronic Lyme disease and its related coinfections beyond standard pharmaceutical interventions. Only some of these modalities have been discussed here. However, recently published books and increased media attention are bringing increased awareness of the treatment possibilities to those in need of them. More healthcare practitioners are becoming versed in the realities of Lyme disease, and more individuals are being empowered to find the care they need. Moreover, we can achieve much, in terms of both disease prevention and treatment, by supporting our body’s natural immunity and innate healing capabilities through healthy dietary and lifestyle practices.
About the Author
Roberta Louis is managing editor of the Price-Pottenger Journal of Health and Healing. Formerly editor of Well Being Journal and managing editor of Shaman’s Drum, she is the founder of the nonprofit Shaman’s Drum Foundation. Roberta is also a freelance writer and editor.
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Published in the Price-Pottenger Journal of Health and Healing
Fall 2021 | Volume 45, Number 3
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