By Bill Rawls, MD

Nearly 20 years ago, my life was completely disrupted by chronic Lyme disease. After multiple courses of antibiotics made me worse instead of better, I turned to herbal therapy.

By using herbs as my primary form of treatment, I was able to completely transform my health. Even more remarkably, I’ve enjoyed my restored wellness and increased vitality for over a decade.

People with chronic Lyme often turn to antibiotics because they’re the standard treatment for bacterial infections. However, once you understand the nature of the Lyme bacteria, you will realize why antibiotics aren’t always the right choice.

The nature of Borrelia

I’ve observed that people with chronic Lyme disease often don’t recall becoming ill around the time of a tick bite. In fact, many don’t remember being bitten by a tick at all.

Borrelia, the bacteria that causes Lyme disease, is very stealthy. When these spirochetes invade the body, they use sophisticated mechanisms to bypass the immune system’s defenses and spread throughout the body. These bacteria don’t need to cause illness to be successful, they just need to establish a presence inside the body. One way they gain a foothold is by becoming dormant inside cells.

After bypassing the immune system and penetrating tissues, Borrelia invades various cells in the body, including brain, joint, and heart cells. Once inside a cell, the bacteria gain protection from both the immune system and antibiotics. However, healthy cells aren’t defenseless—they have mechanisms to expel or destroy invasive bacteria. But, the ever-evasive Borrelia bacteria have one last trick: if the conditions are hostile for growth, they can simply go dormant.

Going dormant

The ability of Borrelia to go dormant inside cells has been well documented. The bacteria can remain dormant for long periods without affecting the functions of the cells they inhabit. While biofilms are often implicated as a primary mechanism of persistence, intracellular dormancy as a mechanism of persistence offers a compelling explanation for the symptoms of chronic Lyme disease.

In a dormant or quiescent state, the bacteria quietly wait for an opportunity. That opportunity arises when cells containing dormant bacteria are weakened by stress. When these cells are weakened, the bacteria reactivate and invade surrounding cells and tissues. Symptoms reflect the types of cells and tissues damaged by the reactivated bacteria.

In contrast, biofilms cause symptoms by damaging the surfaces where they form. While biofilms may be present in chronic Lyme, they don’t fully explain the diversity of symptoms that occur.

Intracellular (inside a cell)

Intracellular dormancy or quiescence is not unique to Borrelia. It has been described in many common infections, including Bartonella, Babesia, other tick-borne microbes, Chlamydia, Mycoplasma, Streptococcus, and a wide range of other bacteria and viruses.

Moreover, this phenomenon is not limited to just a few unlucky individuals. Mounting evidence suggests that everyone harbors dormant intracellular pathogens—some more concerning than others.

These microbes remain dormant and harmless until the cells containing them become stressed. This makes cellular stress a key factor in the occurrence of chronic symptoms.

It also explains why people often become symptomatic years after the initial infection, whether or not they received antibiotics early on, and why individuals with chronic Lyme test positive for a wide range of microbes, both tick-borne and otherwise.

The limitations of antibiotics

People often turn to antibiotics first because they are familiar with them, but antibiotics aren’t necessarily the best “first” choice for treating chronic conditions associated with reactivated microbes.

Antibiotics work by suppressing bacterial growth. The faster the bacteria grow, the more effective antibiotics are. For aggressive, fast-growing bacteria, such as those causing pneumococcal pneumonia, which doubles every twenty minutes, antibiotic treatment can be effective, and even lifesaving.

In contrast, Borrelia, the bacteria responsible for Lyme disease, has a much slower doubling time of 12-24 hours in a non-dormant state. This makes Borrelia more resistant to antibiotics than fast-growing bacteria, especially when it is in a dormant state inside cells. This alone explains why at least 20% of people treated with antibiotics after a tick bite develop chronic symptoms later on (sometimes called post-treatment Lyme disease syndrome).

Possibly the largest group of people identifying with Lyme disease, however, were not treated with antibiotics early on. This could be due to a provider’s refusal to prescribe treatment, but more often it is because the person didn’t recognize a tick bite or didn’t become symptomatic after the bite. These individuals identify as having chronic Lyme disease.

In chronic Lyme disease, bacteria and other microbes are constantly emerging from cells in different tissues throughout the body, driving symptoms. This only happens when cells containing dormant microbes are chronically stressed.

The boiling point

Microbe reactivation is always triggered by stress, which is generally a combination of factors such as poor diet, exposure to toxic substances (like mold), mental stress with poor sleep, emotional and physical trauma, or a new infection. The process becomes self-sustaining when widespread microbe reactivation leads to ongoing cellular destruction—a stage I call the “boiling point.” Once this boiling point is reached, eliminating the initial cellular stress will not solve the problem.

Overcoming chronic Lyme disease requires a two-pronged approach: reducing the microbe load while simultaneously restoring cellular integrity.

Because it’s impossible to eradicate all dormant intracellular microbes in the body—and because microbes will continue to emerge as long as cells remain weakened by stress—treatment must provide continuous, long-term suppression of microbe activity (broad-spectrum action against bacteria, viruses, protozoa, and yeasts) without adding to cellular stress.

For this purpose, conventional antibiotics have significant limitations. Within as little as ten days, their use disrupts normal flora in the gut and skin, allowing pathogens in those areas to flourish. While probiotics can help mitigate this problem, they don’t eliminate it.

Antibiotic resistance

Additionally, antibiotic-resistant pathogens can start to emerge in as little as ten days. Antibiotic resistance has become a major global concern, leading medical science to strongly caution against the long-term use of antibiotics for any purpose.

Also, in as little as ten days, antibiotic-resistance pathogens start to emerge. Antibiotic resistance has become a major concern worldwide. For this reason, medical science strongly cautions against long-term use of antibiotics for any purpose.

Moreover, antibiotics are toxic to cells. Studies have documented their toxicity to cellular structures and mitochondria. A 2019 study even found an increase in all-cause mortality with chronic use of antibiotics (over two months), especially in older adults (over age 60).

These three factors—disruption of friendly flora, antibiotic resistance, and cellular toxicity—severely limit the long-term use (over two months) of any antibiotic.

Herbal therapy for Lyme disease

Interestingly, all synthetic antibiotics were originally derived from natural sources—whether fungi, bacteria, or plants. It’s easier to borrow from another organism’s defense system than to create one from scratch. However, an antibiotic is just a single chemical agent extracted from that system.

It’s impossible to replicate and mass-produce the entire chemical defense system of another organism. Isolating a single chemical allows for large-scale production. This extracted chemical is then chemically altered, making it a novel agent that can be patented, which is economically viable since naturally occurring chemicals cannot be patented.

Despite the increased potency from chemical alteration, single chemical agents have distinct limitations. Unlike a natural defense system, antibiotics lose the selectivity of targeting harmful microbes while sparing beneficial ones. Bacteria can develop resistance to a single chemical agent much faster than they can to an entire defense system. Additionally, altering the chemical from its natural form typically increases cellular toxicity.

In contrast, herbs and medicinal mushrooms provide the full defense system of the organism, offering distinct advantages.

The antimicrobial properties of herbs and medicinal mushrooms are selective for pathogens and do not disrupt the normal flora in the gut and other areas of the body. In my experience, antimicrobial herbs restore the gut microbiome’s natural balance more effectively than probiotics.

Resistance to herbs or medicinal mushrooms is much less of a problem than with antibiotics. It’s harder for microbes to circumvent a defense system made up of a complex spectrum of powerful phytochemical agents than it is to overcome a single chemical agent.

Broad spectrum

The antimicrobial properties of herbs and medicinal mushrooms are broad-spectrum, providing activity against a wide range of pathogenic bacteria, viruses, protozoa, and yeasts. Because herbal therapy covers such a wide range of possibilities—both known and unknown—extensive microbe testing becomes less necessary and, in some respects, even irrelevant.

The final benefit is cellular protection. The complex chemistry of herbs and medicinal mushrooms safeguards cells from various toxic threats, including free radicals, foreign substances, and harmful radiation.

Summary of Herbal Benefits

• Broad-spectrum coverage against a wide range of pathogenic bacteria, viruses, protozoa, and yeasts
• Do not disrupt the balance of normal flora in the gut and other areas of the body
• Low potential to generate resistant pathogens
• Protect cells from various stress factors

Because of these beneficial properties, herbal therapy can be used long-term—potentially for months or even years—without causing harm, making it applicable to all stages of Lyme disease.

At least 20%of people treated with antibiotics for acute Lyme disease develop ongoing symptoms, indicating that antibiotics don’t fully eradicate the bacteria. A 1-3 month course of herbal therapy, in addition to antibiotics, could potentially reduce the likelihood of chronic symptoms later on. While no study has yet proven this, the low toxicity of the most commonly used herbs for Lyme disease suggests that the risk of using this strategy is also low.

Low-toxicity option

In areas where Lyme disease is endemic and tick bites are common, individuals at risk could benefit from taking herbal therapy as a preventative measure throughout tick season. Herbal therapy is also a low-toxicity option for someone bitten by a tick who doesn’t develop symptoms and therefore doesn’t receive antibiotics (as the absence of symptoms doesn’t necessarily mean bacteria haven’t entered the body).

Over the past decade, herbal therapy has proven to be an effective treatment for chronic Lyme disease. While many herbs could be considered for Lyme disease treatment, certain ones have emerged as the best choices. Selecting the right herbs and herbal preparations is essential for achieving the best results.

Choosing the “right” herbs for chronic Lyme

All herbs have antimicrobial properties, but some have stronger antimicrobial properties than others. The strength of these properties depends on the level of microbial stress in the herb’s natural environment—the greater the stress, the stronger the antimicrobial properties.

When considering herbs and medicinal mushrooms for treating chronic Lyme disease, the best options meet the following criteria:

• Efficacy
• Low toxicity
• Potency
• Synergy
• Immunomodulation

Efficacy

Efficacy refers to evidence that something actually works. While scientific studies are the most reputable form of evidence, anecdotal evidence can also be valuable. For over two decades, people have successfully used herbal therapy to treat chronic Lyme disease. Their stories and accounts, shared on the internet and social media, strongly support herbal therapy as a viable option for overcoming chronic Lyme disease.

For academic evidence on using herbal therapy to treat Lyme disease, Stephen Buhner is a key source of information. A certified herbalist and prolific author, Buhner has written a series of books detailing the mechanisms of action of a wide range of herbs commonly used to treat Lyme disease and its most recognized co-infections.

The growing popularity of herbs for Lyme disease even attracted the attention of researchers at Johns Hopkins University. In a study published in 2020, twelve herbs commonly used to treat chronic Lyme disease were evaluated for their activity against Borrelia burgdorferi. Of these, seven herbal extracts were found to have greater activity against both the motile and cyst (dormant) forms of the bacteria than commonly used antibiotics.

Though herbal therapy had been gaining traction for some time, this breakthrough study put herbal therapy on the map for chronic Lyme disease. The herbs highlighted by the study included:

• Polygonum cuspidatum (Japanese knotweed)
• Uncaria tomentosa (Cat’s claw)
• Scutellaria baicalensis (Chinese skullcap)
• Cryptolepis sanguinolenta
• Cistus incanus
• Artemisia annua (Sweet wormwood)
• Juglans nigra (Black walnut)

This study was followed by two similar studies that found Japanese knotweed, Chinese skullcap, and cryptolepis were also effective against Bartonella and Babesia, two of the most common chronic Lyme co-infections. Additionally, Andrographis paniculata, another herb commonly used in Lyme protocols, was found to have good activity against these pathogens. Notably, these same herbs were also found to be effective against SARS-CoV-2, the virus associated with COVID-19, highlighting their broad-spectrum potential.

Toxicity concerns

The best choices for chronic Lyme disease are influenced by the potential for toxicity. While antimicrobial herbs generally have lower toxicity than antibiotics, the lowest possible toxicity is crucial for long-term use. Some herbs are more toxic than others.

For example, Artemisia and black walnut have a higher potential for both short-term and long-term side effects and toxicity. Although these herbs are valuable for certain conditions, I typically recommend restricting their use to less than two months and avoid including them in primary protocols.

One product marketed to chronic Lyme sufferers that I reviewed contains lomatium, which can cause skin rashes, and stillingia, which has a higher potential for a variety of side effects compared to many other herbs.

While these herbs may have value for short-term use or managing specific issues, I don’t consider them good choices for long-term management of chronic Lyme disease. Another product contains a phytochemical called huperzine A, which has strong drug-like properties.

Making herbal products seem “drug-like” is a common practice among many herbal product companies. I assume this is done to meet people’s expectations of wanting something as potent as drugs. However, this approach contradicts the goal of using natural therapy.

The primary goal of herbs is to reduce microbial load while simultaneously restoring cellular integrity. Side effects or drug-like effects indicate cellular toxicity, which is highly undesirable for long-term use.

Some herbs are stimulating

I also try to avoid herbs that are stimulating. Ginseng, for instance, may be great for healthy individuals looking for a boost, but it isn’t ideal for those overcoming chronic illness. One product I reviewed contains several varieties of ginseng, which are highly stimulating adaptogens that can inhibit sleep and exacerbate sympathetic overactivity.

Purity and quality are also important considerations. Chemical or biological contaminants are common in low-quality ingredients. A person struggling with chronic illness has a compromised ability to purge toxic substances, and taking products with contaminants can increase their toxic load.

The only way to ensure a product’s safety is through testing. Reputable companies conduct multiple levels of testing to ensure the lowest potential for toxic contamination. It should be noted that in the modern world, achieving zero contamination is impossible.

All foods and natural products, even organic ones, contain low levels of heavy metals and organic toxicants due to their prevalence in the air and water. The goal is to achieve the lowest possible levels. Quality herbal products contain much lower levels of these substances than most commonly consumed foods.

Synergy

Combining multiple herbs into formulas is a standard practice in herbology. When compatible herbs with restorative properties are blended together, the benefits of the individual herbs are enhanced.

There is no absolute number of herbs required for a formula, but most contain anywhere from three to a dozen herbs. My rule of thumb is around 4-5 herbs—this is enough to achieve positive synergy without diluting the benefits of any one herb. That said, some effective formulas in Traditional Chinese Medicine contain up to a dozen herbs.

Immunomodulation

It’s crucial to use herbs that don’t overstimulate the immune system. In chronic Lyme disease, the immune system is already overly revved up and overtaxed, making it ineffective at containing the microbial threat.

This overstimulation is often driven by the microbes, which invade white blood cells and manipulate chemical messengers (called cytokines) to overstimulate certain parts of the immune system that react to foreign substances (leading to conditions like mast cell activation syndrome), while suppressing parts of the immune system responsible for destroying intracellular pathogens.

Herbs like echinacea and elderberry, which stimulate the immune system, can exacerbate this problem and may also increase autoimmunity. While these herbs are great for short-term use to reduce the severity of an acute viral illness, they are not ideal for long-term use. Some researchers believe that astragalus may also fall into this category, which is why I generally avoid using it long-term in herbal regimens for people overcoming chronic conditions.

The other herbs mentioned above are classified as immunomodulators. These herbs help by upregulating underactive parts of the immune system and downregulating overactive portions, making them ideal for long-term use. Some of the best immunomodulators are reishi and cordyceps, two medicinal mushrooms also classified as adaptogens. I often include these in herbal protocols for chronic Lyme disease.

Using herbs to treat chronic Lyme disease

If you’re considering herbal therapy on your Lyme disease healing journey, or incorporating it into your current Lyme or chronic illness treatment protocol, my advice is to shift your mindset away from the drug treatment paradigm that guides traditional Western medicine. Many people approach herbal therapy with the idea of replacing a drug or using the herb like a drug to kill off a specific microbe, expecting to feel better as a result.

However, comparing drugs to herbs is like comparing apples to oranges. Drugs are designed to block the manifestation of illness in the body by suppressing specific chemical processes. While they can effectively reduce symptoms, this relief only lasts as long as the drug is taken. Drugs don’t address the root cause of the illness, so people don’t achieve true wellness with them; they must continue taking the drug to keep symptoms at bay.

When you take an herb, you’re enhancing the body’s natural ability to heal itself. You benefit from the plant’s entire system of hundreds, or even thousands, of phytochemicals, which work synergistically to fight off microbes, support the immune system, balance hormones, and restore cellular integrity. These holistic processes are what lead to true wellness.

With over 30 years of medical experience, Dr. Bill Rawls specializes in the holistic treatment of chronic illnesses, particularly Lyme disease. His personal journey with Lyme disease inspired his mission to empower others with the knowledge and tools needed to regain their health naturally. Learn more about Dr. Rawls’ approach to treating chronic illness with herbal therapy at RawlsMD.com.

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