Homeopathy and the

Microbiome
The key to Lyme and other chronic diseases

Ronald D. Whitmont, MD, President,

The American Institute of Homeopathy
Clinical Assistant Professor,
Family and Community Medicine
New York Medical College
 Discussion Goals
• Human Microbiome
• Chronic Inflammatory Disease
• An Example of Chronic Lyme Disease
• Homeopathy
The Human Microbiome
 Microbiome

• Ecology and symbiosis

• Fundamental to health
• Dysbiosis associated inflammation
 Ecological Complexity
Metagenomic studies reveal that the
human microbiome is comprised of
an exceedingly complex group of
different ecological niches existing
throughout the body

Nature. 2007 Oct 18; 449(7164): 804–810. The human

microbiome project: exploring the microbial part of ourselves in
a changing world. Turnbaugh PJ, Ley RE, Hamady M, et al.
DOI: 10.1038/nature06244
 Supra-Organism

– A symbiosis between human and

microbial organisms
– Collective Interdependency

Medical Hypotheses. 74(2),2010:214215. The human

superorganism – Of microbes and men. Sleator RD. (Ed)
DOI: 10.1016/j.mehy.2009.08.047
 Supra-Organism
A continuous spectrum of different
ecosystems dependent on:
– Diversity
– Ecology
– Symbiosis

Genome Biology 201314:R1. Biogeography of the

ecosystems of the healthy human body. Zhou Y, Gao
H, Mihindukulasuriya KA, et al.
DOI: 10.1186/gb-2013-14-1-r1
 The Human Microbiome
• Complementary to the human
genome

• Neither functions independently

Nature. 2007 Oct 18; 449(7164): 804–810. The human

microbiome project: exploring the microbial part of ourselves in
a changing world. Turnbaugh PJ, Ley RE, Hamady M, et al.
DOI: 10.1038/nature06244
 1 Gram of Healthy Human
Stool
• 100 Billion Bacteria
• 100 Million Viruses
• 100 Million Archaea
• 10 Million Human Cells
• 1 Million Fungal Spores

PLOS Biology.
http://dx.doi.org/10.1371/journal.pbio.1002503 Fecal
Transplants: What Is Being Transferred? Bojanova DP,
Bordenstein SR.
 The Human Microbiome
Function integral to:
• Nutrition
• Development
• Immunity
• Mental and Physical Health

PLOS/One: June 13, 2012. Analyses of the Microbial Diversity

across the Human Microbiome. Li K, Bihan M, Yooseph S, et
al.
DOI: 10.1371/journal.pone.0032118
 The Human Microbiome
Regulates development and
function of the immune system

Cell Host & Microbe. Control of Brain Development, Function,

and Behavior by the Microbiome. Sampson TR, Mazmanian
SK.
DOI: 10.1016/j.chom.2015.04.011
 Colonization

Begins before birth in the placenta

Science Translational Med 21 May 2014;6(237): 237ra65

The Placenta Harbors a Unique Microbiome. Aagaard K, Ma
J, Antony KM, et al.
DOI: 10.1126/scitranslmed.3008599.
 Most Critical Period

Before birth
until two
years of life

Nutr.Reviews;65(6):259-
299. Perinatal and Neonatal
Manipulation of the Intestinal
Microbiome: a Note of
Caution. Neu J.
DOI: 10.1111/j.1753-
4887.2007.tb00305.x
 Diversity of Microbiome
Determined by Environment:

• Maternal Microbiome
• Birth Process
• Medication History
 Medication Damage

• Antibiotics, antifungals, antivirals

• PPI’s
• Glucocorticosteroids? Antihistamines?
• SSRI’s? HRT? Chemotherapy?
• Immunosuppressant's? Vaccines?
 Antibiotics
• Disrupt ecology of microbiome
– Overgrowth of resistant organisms
– Inhibition and elimination of sensitive
organisms

Science 2012; 336(6086):1255-1262. The Application of Ecological Theory

Toward an Understanding of the Human Microbiome. Costello EK,
Stagaman K, Dethlefsen L.
DOI: 10.1126/science.1224203
 Antibiotics
Promote fungal (viral?) overgrowth

Infect Immune 2004;72(9): 4996–5003. Role of Antibiotics

and Fungal Microbiota in Driving Pulmonary Allergic
Responses. Noverr MC, Noggle RM, Toews GB, et al.
DOI: 10.1128/IAI.72.9.4996-5003.2004
 Antibiotics and Asthma

Maternal antibiotic use in pregnancy

associated with 89% increased risk
of childhood asthma (p<0.0001)

Medscape Ob/Gyn Women’s Health November 27, 2016

Coverage from the American College of Allergy, Asthma &
Immunology (ACAAI) 2016 Annual Scientific Meeting.
http://www.medscape.com/viewarticle/872028?nlid=110951_25
81&src=WNL_mdplsnews_161202_mscpedit_obgy&uac=2427
86PX&spon=16&impID=1245995&faf=1
Asthma and Antibiotics in the First
Year of Life
• 1-2 Courses  20% increased risk
• 3-4 Courses  30% increased risk
• > 4 Courses  50% increased risk

Chest 2007;131(6):1753-9. Increased risk of childhood asthma

from antibiotic use in early life. Kozyrskyj AL, Ernst P, Becker
AB.
DOI: 10.1378/chest.06-3008
 Asthma and Antibiotics in the First
Year of Life
• Risk of asthma was highest in children receiving
more than four courses of antibiotics
• Broad-spectrum cephalosporin use was more
common in these subpopulations of children

Chest. 2007;131(6):1753-9. Increased risk of childhood asthma from antibiotic use in

early life. Kozyrskyj AL, Ernst P, Becker AB
DOI: 10.1378/chest.06-3008
 Antibiotics and Asthma
• Adjusted odds ratio of 4.05 if ABX used in 1st year
of life
• Adjusted odds ratio of 1.64 if ABX used after 1st
year of life

Clinical & Experimental Allergy;29,(6)1999:766–771. Antibiotic use in early childhood

and the development of asthma. Wickens, Pearce, Crane, et al.
DOI: 10.1046/j.1365-2222.1999.00536.x
“Over the past four decades, there
has been a significant increase in
allergy and asthma in westernized
countries, which correlates with
alterations in fecal microbiota
(microflora) and widespread use of
antibiotics”
Infect Immune 2004;72(9): 4996–5003. Role of Antibiotics
and Fungal Microbiota in Driving Pulmonary Allergic
Responses. Noverr MC, Noggle RM, Toews GB, et al.
DOI: 10.1128/IAI.72.9.4996-5003.2004
 Pediatrics
Prevalence of many chronic
diseases, including Asthma has
tripled since 1980

MMWR Surveillance for Asthma -- United States, 1960-1995

Mannino DM, Homa DM, Pertowski CA.
https://www.cdc.gov/mmwr/preview/mmwrhtml/00052262.htm
 Asthma
• The leading cause of chronic
illness in U.S. children
• One of the fastest growing chronic
conditions in developed nations

Population Reference Bureau. Childhood Asthma: A Growing

American Epidemic
Carlson JE, Stroebel C.
http://www.prb.org/Publications/Articles/2001/ChildhoodAsthm
aAGrowingAmericanEpidemic.aspx
 Asthma
Between 1980-1994:
• The total number of affected children
increased by 75%
• In children younger than 4 years, it increased
by 160%

Population Reference Bureau. Childhood Asthma: A Growing American

Epidemic. Carlson JE, Stroebel C.
http://www.prb.org/Publications/Articles/2001/ChildhoodAsthmaAGrowingAmerica
nEpidemic.aspx
 Asthma

A chronic dysbiosis of the respiratory tract

Lancet. 2014; 384 (9944):691–702. The role of the microbiome in exacerbations

of chronic lung diseases. Dickson RP, Martinez FJ, Huffnagle GB.
DOI: http://dx.doi.org/10.1016/S0140-6736(14)61136-3
 Asthma
“Respiratory tract dysbiosis provokes a
dysregulated host immune response, which in
turn alters growth conditions for microbes in
airways, promoting further dysbiosis and
perpetuating a cycle of inflammation and
disordered microbiota”

Lancet. 2014; 384 (9944):691–702. The role of the microbiome in exacerbations

of chronic lung diseases. Dickson RP, Martinez FJ, Huffnagle GB.
DOI: http://dx.doi.org/10.1016/S0140-6736(14)61136-3
 Dysbiosis
• The opposite of Symbiosis
• An ecological imbalance between
organisms within the ecology of
the microbiome
• Inversely proportional to diversity

Altern Med Rev 2004;9(2):180-197. The Causes of Intestinal

Dysbiosis: A Review. Hawrelak JA, Myers SP.
 Dysbiosis
• Can occur anywhere on body
• Directly proportional to
inflammation

Therapeutic Advances in Gastroenterology May 2013;

6(3):215-229. Microbial dysbiosis and colon carcinogenesis:
could colon cancer be considered a bacteria-related disease?
Sobhani I, Amiot A, Le Baleur Y.
 Dysbiosis
• Acute: Triggers an adaptive
immune inflammatory response
(UTI, URI, Sinusitis, etc)

• Chronic: Drives chronic

inflammatory diseases (IBD,
Asthma, CAD, DM, etc)

Gastroenterol Int. 1998;11:29-30. Antibiotic impact on

intestinal microflora. Gismondo MR.
 Diversity

“Dictates the stability of

ecosystems”

• Microbiome is an ecosystem

Science 06 July 2007. Stability and Diversity of Ecosystems.

Ives AR, Carpenter SR.
 Diversity in the Gut
“Rich, balanced and diverse bacterial
communities seem to be perceived as “self”
and induce a quick maturation of the immune
system and gut responses”

Immunity; 41(1) 2014:152–165. Foxp3+ T Cells Regulate Immunoglobulin A

Selection and Facilitate Diversification of Bacterial Species Responsible for
Immune Homeostasis Kawamoto S, Maruya M, Kato LM.
DOI: 10.1016/j.immuni.2014.05.016
 Diversity in the Gut

“Poor and unbalanced bacterial communities

are apparently perceived as “non-self” and
induce inflammatory responses aimed at
eliminating it”

Immunity; 41(1), 2014:152–165. Foxp3+ T Cells Regulate Immunoglobulin A

Selection and Facilitate Diversification of Bacterial Species Responsible for
Immune Homeostasis Kawamoto S, Maruya M, Kato LM.
DOI: 10.1016/j.immuni.2014.05.016
 Diversity

• Diversity inversely related to inflammation

• Lack of diversity (dysbiosis) associated
with high levels of inflammation

Immunity; 41(1), 2014:152–165. Foxp3+ T Cells Regulate Immunoglobulin

A Selection and Facilitate Diversification of Bacterial Species Responsible
for Immune Homeostasis Kawamoto S, Maruya M, Kato LM.
DOI: 10.1016/j.immuni.2014.05.016
There is growing evidence that dysbiosis of the
gut microbiota is associated with the
pathogenesis of both intestinal and extra-
intestinal disorders.

Microbial Ecology in Health & Disease 2015, 26:26191

Dysbiosis of the gut microbiota in disease. Carding S, Verbeke K, Vipond DT, et
al.
DOI: 10.3402/mehd.v26.26191
Intestinal disorders include
inflammatory bowel disease, irritable
bowel syndrome (IBS), and coeliac
disease

Microbial Ecology in Health & Disease 2015, 26:26191

Dysbiosis of the gut microbiota in disease. Carding S, Verbeke K,
Vipond DT, et al.
DOI: 10.3402/mehd.v26.26191
Extra-intestinal disorders include
allergy, asthma, metabolic syndrome,
chronic fatigue, cardiovascular disease,
autoimmune disorders, and obesity

Microbial Ecology in Health & Disease 2015, 26:26191

Dysbiosis of the gut microbiota in disease. Carding S, Verbeke K,
Vipond DT, et al.
DOI: 10.3402/mehd.v26.26191
 Diversity

Diversity of the microbiome depends on an

integrated ecology of bacteria, viruses,
archaea, fungi and “parasites”
Parasites and Inflammation
Eradication of malaria in an
otherwise stable population induces
the emergence of autoimmunity

Emerg Infect Dis. Program to eradicate malaria in Sardinia,

1946–1950. Tognotti E. 2009 Sep.
http://wwwnc.cdc.gov/eid/article/15/9/08-1317
DOI: 10.3201/eid1509.081317.
 Sardinia, Italy
Between 1946–1950, the Rockefeller
Foundation conducted a large-scale
Malaria eradication Project

Emerg Infect Dis. Program to eradicate malaria in Sardinia,

1946–1950. Tognotti E. 2009 Sep.
http://wwwnc.cdc.gov/eid/article/15/9/08-1317
DOI: 10.3201/eid1509.081317.
 Sardinia, Italy
267 metric tons of DDT were spread
over the island which entirely
eliminated Malaria

Emerg Infect Dis. Program to eradicate malaria in Sardinia,

1946–1950. Tognotti E. 2009 Sep.
http://wwwnc.cdc.gov/eid/article/15/9/08-1317
DOI: 10.3201/eid1509.081317.
Cases of malaria, by year, Sardinia, 1946–1952

Malaria Cases in Sardinia

Year No. cases (relapses)

1946 74,641

1947 39,303

1948 15,121

1949 1,314

1950 0 (44)

1951 9 (8)

1952 0
Incidence of Multiple Sclerosis,
Sardinia, Italy

• 0 before 1950
• 1.1/100,000 in 1965-69
• 5.8/100,000 in 1995-99

Neuroepidemiology. 2005;25(3):129-34. Increasing incidence

of multiple sclerosis in the province of Sassari, northern
Sardinia. Pugliatti M, Riise T, Sotgiu MA, et al.
DOI: 10.1159/000086677
Incidence of Multiple Sclerosis,
Sardinia, Italy

• 9.7/100,000 in 2003-07

Mult Scler 2011;17(11):1282-9. Epidemiology of multiple

sclerosis in south-western Sardinia. Cocco E, Sardu C, Massa
R, et al.
DOI: 10.1177/1352458511408754
Current Prevalence of Multiple
Sclerosis

• 224/100,000 in Sardinia
• 90/100,000 in U.S.

PLOS One 2012; Population Based Study of 12 Autoimmune

Diseases in Sardinia, Italy: Prevalence and Comorbidity.
Sardu C, Cocco E, Mereu A.
DOI: 10.1371/journal.pone.0032487
 Sardinia, Italy
“A dramatically rapid change of the environment
after the eradication of malaria has led the Sardinian
immune system to abnormal responses… favoring
increased MS incidence over the last four decades
in Sardinia because of the eradication of malaria, 50
years ago.”

Medical Hypotheses 2008; 70(4):819-25. Hygiene hypothesis: Innate immunity, malaria

and multiple sclerosis. Sotgiu S, Angius A, Embry A, et al.
DOI: 10.1016/j.mehy.2006.10.069
 Sardinia, Italy
Eliminating a stable/commensal
parasite from the environment alters
the microbiome (and the immune
system) and allows the phenotypic
penetration of a disease of immune
dysfunction

Medical Hypotheses 2008; 70(4):819-25. Hygiene

hypothesis: Innate immunity, malaria and multiple sclerosis.
Sotgiu S, Angius A, Embry A, et al.
DOI: 10.1016/j.mehy.2006.10.069
 Microbiome and Environment
Rapid environmental changes destabilize the
microbiome, triggering dysbiosis and altering
inflammatory patterns

EMBO Rep. 2012 Nov; 13(11): 968–970. The inflammation theory of Immunity;
41(1) 2014:152–165. Foxp3+ T Cells Regulate Immunoglobulin A Selection and
Facilitate Diversification of Bacterial Species Responsible for Immune
Homeostasis Kawamoto S, Maruya M, Kato LM.
DOI: 10.1016/j.immuni.2014.05.016
 Implications

The functioning of both the innate and

adaptive immune systems are dependent on and
programmed by the diversity the microbiome

Cell 2005;122(1):107-18. An immunomodulatory molecule of symbiotic bacteria

directs maturation of the host immune system. Mazmanian SK, Liu
CH, Tzianabos AO.
DOI: 10.1016/j.cell.2005.05.007.
Alterations of microbiome (bacteria, viruses,
fungi, archaea and parasites) have profound
effects on immune system:
• Risk of allergies, inflammation, autoimmunity
and neoplasm

Cell 2005;122(1):107-18. An immunomodulatory molecule of symbiotic bacteria

directs maturation of the host immune system. Mazmanian SK, Liu
CH, Tzianabos AO.
DOI: 10.1016/j.cell.2005.05.007.
One of the Most Important
Causes of Dysbiosis
“We’ve just spent the better part of a century
doing our unwitting best to wreck the human-
associated microbiota with a multifronted war
on bacteria and a diet notably detrimental to its
well-being.”

Gastroenterol Int. 1998;11:29-30. Antibiotic impact on intestinal microflora.

Gismondo MR.

NYTimes Magazine. May 19, 2013:36-43,50,58-59. Some of My Best Friends

are Bacteria. Pollan M.
“We have to stop looking at medicine
as a war between invading
pathogens and our bodies.”

New Yorker Magazine. Oct 22, 2012:39-39. Germs are Us.

Interview with David A. Relman, Chief of Infectious Diseases
VA Hospital Palo Alto, CA. Specter M.
The germ theory of disease… is a gross
“oversimplification”

The Lancet; 291(7551):1077-1081. Limitations of the Germ Theory.

Stewart T, Path FC.
DOI: 10.1016/S0140-6736(68)91425-6
 Germ Theory

Disrupts Ecology of Supraorganism:

Trends Ecol Evol 2011;26(4):202-9. New paradigms for the evolution of beneficial
infections. Sachs JL, Essenberg CJ, Turcotte MM.
DOI: 10.1016/j.tree.2011.01.010
 Germ Theory

Ignores Role of Immune System:

– In resolving infection
– In utilizing inflammation

Trends Ecol Evol 2011;26(4):202-9. New paradigms for the evolution of beneficial
infections. Sachs JL, Essenberg CJ, Turcotte MM.
DOI: 10.1016/j.tree.2011.01.010
 Germ Theory

Neglects Role of Microbiome:

– Evolutionary basis of Supraorganism
– Complement to immune system

Trends Ecol Evol 2011;26(4):202-9. New paradigms for the evolution of beneficial
infections. Sachs JL, Essenberg CJ, Turcotte MM.
DOI: 10.1016/j.tree.2011.01.010
“It goes against dogma to think that bacteria
would make our immune systems function
better... But the picture is getting very clear:
the driving force behind the immune system
are commensals.”

Scientific American. June 2012:37-43. The Ultimate Social Network.

Ackerman J.
 Infections
Play an important role in:
• Immune system development
• Microbiome diversity
 Modulation of inflammation

Annu Rev Immunol. 2012; 30: 759–795. The Microbiome in

Infectious Disease and Inflammation. Honda K, Littman DR
DOI: 10.1146/annurev-immunol-020711-074937.
 -Review-
The Human Microbiome

• The Microbiome is made up of a continuous

interconnected geography of ecological niches
covering the entire human organism

• Vital to growth, development and immune system

functioning
Dysbiosis equals inflammation

Cell 2005;122(1):107-18. An immunomodulatory molecule of symbiotic

bacteria directs maturation of the host immune system. Mazmanian SK, Liu
CH, Tzianabos AO.
DOI: 10.1016/j.cell.2005.05.007.
One of the most important causes of dysbiosis and
inflammation results from the application of modern
Germ Theory in medicine
Chronic Disease
 Chronic Disease

The Leading Cause of Death and

Disability in the US

http://www.cdc.gov/chronicdisease/overview/
 Chronic Disease
“The great epidemic of our times,
responsible for 75% of total health
care costs and the majority of deaths
in the US.”

Am J Med, 2015; 128(4):337–343 Health Care 2020:

Reengineering Health Care Delivery to Combat Chronic
Disease. Milani, RV, Lavie CJ.
DOI: http://dx.doi.org/10.1016/j.amjmed.2014.10.047
 Chronic Disease
• About half of all adults—117 million
people—had one or more chronic
health conditions in 2012
• 25% had two or more chronic
health conditions

Prev Chronic Dis 2014;11:130389. Multiple chronic conditions

among US adults: a 2012 update. Ward BW, Schiller JS,
Goodman RA.
DOI: 10.5888/pcd11.130389
 Chronic Diseases
• Hypertension
• coronary heart disease
• Stroke
• Diabetes
• Cancer
• Arthritis
• Hepatitis
• Kidneys disease
• Asthma
• COPD
 “Causes” of Chronic
Disease
-Lack of Physical Exercise
-Hypertension
-Hyperlipidemia
-Poor Nutrition
-Tobacco Use
-Excessive Alcohol Use
www.cdc.gov/chronicdisease/overview/
 Chronic Disease

Common denominator:

Chronic Inflammation-Dysbiosis
The Human Microbiome

EMBO Rep. 2012 Nov; 13(11): 968–970. The inflammation

theory of disease. The growing realization that chronic
inflammation is crucial in many diseases opens new avenues
for treatment. Hunter P.
DOI: 10.1038/embor.2012.142
 Chronic Disease
“Inflammation has long been a well-known symptom
of many infectious diseases, but molecular and
epidemiological research increasingly suggests that
it is also intimately linked with a broad range of non-
infectious diseases, perhaps even all of them.”

EMBO Rep. 2012 Nov; 13(11): 968–970. The inflammation theory of disease. The
growing realization that chronic inflammation is crucial in many diseases opens new
avenues for treatment. Hunter P.
DOI: 10.1038/embor.2012.142
 Chronic Disease
“It is becoming increasingly evident that the lack of
exposure to a variety of microorganisms, especially
during early life, may result in the development of
diseases such as type 1 diabetes, asthma, allergies,
celiac disease, inflammatory bowel disease and
obesity.”

J Perinatology (2011) 31, S29–S34; The developing intestinal microbiome and its
relationship to health and disease in the neonate. Torrazza RM, Neu J.
DOI:10.1038/jp.2010.172.
 Chronic Disease
According to the ‘hygiene hypothesis’, the
decreasing incidence of infections in western
countries and more recently in developing countries
is at the origin of the increasing incidence of both
autoimmune and allergic diseases.

Clin Exp Immunol. 2010 Apr; 160(1): 1–9. The ‘hygiene hypothesis’ for autoimmune
and allergic diseases: an update. Okada H, Kuhn C, Feillet H, et al.
DOI: 10.1111/j.1365-2249.2010.04139.x
 Chronic Disease

Inversely related to the incidence of infectious

disease

Clin Exp Immunol. 2010 Apr; 160(1): 1–9. The ‘hygiene hypothesis’ for autoimmune
and allergic diseases: an update. Okada H, Kuhn C, Feillet H, et al.
DOI: 10.1111/j.1365-2249.2010.04139.x
 Chronic Disease

• Epidemic and Increasing

• Related to Dysbiosis and Microbiome
damage
• A result of chronic inflammation
Chronic Lyme Disease
 Chronic Lyme Disease

A chronic inflammatory condition, a dysbiosis

 Chronic Lyme Disease
• A diagnosis often based solely on clinical
judgment rather than on well-defined clinical
criteria and validated laboratory studies
• AKA: Post Lyme Disease Syndrome

N Engl J Med 2007;357:1422-1430. A Critical Appraisal of “Chronic Lyme

Disease”. Feder HM, Johnson BJB, O'Connell S.
DOI: 10.1056/NEJMra072023
 Chronic Lyme Disease
A diagnostic term used in North America and
Europe for patients with persistent pain,
neurocognitive symptoms, fatigue, or all of
these symptoms, with or without clinical or
serologic evidence of previous early or late
Lyme disease

N Engl J Med 2007;357:1422-1430. A Critical Appraisal of “Chronic Lyme

Disease”. Feder HM, Johnson BJB, O'Connell S.
DOI: 10.1056/NEJMra072023
 Chronic Lyme Disease
Despite resolution of the objective
manifestations of infection after antibiotic
treatment of Lyme, a minority of patients
develop fatigue, musculoskeletal pain,
difficulties with concentration or short-term
memory, or all of these symptoms.

N Engl J Med 2007;357:1422-1430. A Critical Appraisal of “Chronic Lyme

Disease”. Feder HM, Johnson BJB, O'Connell S.
DOI: 10.1056/NEJMra072023
 Chronic Lyme Disease

Once the diagnosis is

made, patients are
commonly treated for
months to years with
multiple antimicrobial
agents

N Engl J Med 2007;357:1422-1430. A Critical Appraisal of

“Chronic Lyme Disease”. Feder HM, Johnson BJB,
O'Connell S.
DOI: 10.1056/NEJMra072023
 Chronic Lyme Disease
No significant difference in clinical responses
between those who received intravenous and
oral antibiotics for 90 days and those who
received placebo

N Engl J Med 2001; 345:85-92. Two Controlled Trials of Antibiotic Treatment in

Patients with Persistent Symptoms and a History of Lyme Disease. Klempner
MS, Hu LT, Evans J, et al.
DOI: 10.1056/NEJM200107123450202
 Chronic Lyme Disease
IV ceftriaxone therapy results in short-term
cognitive improvement for patients with post-
treatment Lyme encephalopathy, but relapse in
cognition occurs after the antibiotic is
discontinued

Neurology 2008; 70(13): 992-1003. A randomized, placebo-controlled trial of

repeated IV antibiotic therapy for Lyme encephalopathy. Fallon BA, Keilp JG,
Corbera KM,et al.
DOI: 10.​1212/​01.​WNL.​0000284604.​61160.​2d
 Chronic Lyme Disease
There is substantial risk, with little or no
benefit, associated with additional antibiotic
treatment for patients who have long-standing
subjective symptoms after appropriate initial
treatment for an episode of Lyme disease

N Engl J Med 2007;357:1422-1430. A Critical Appraisal of “Chronic Lyme

Disease”. Feder HM, Johnson BJB, O'Connell S.
DOI: 10.1056/NEJMra072023
 Chronic Lyme Disease
Antibiotic therapy causes considerable harm to
patients treated for chronic Lyme disease or
post–Lyme disease symptoms

Clin Infect Dis 2006;43:1089-1134. The clinical assessment, treatment, and

prevention of Lyme disease, human granulocytic anaplasmosis, and
babesiosis: clinical practice guidelines by the Infectious Diseases Society of
America. Wormser GP, Dattwyler RJ, Shapiro ED, et al.
 Antibiotics

Impair immune system

Trends in Immunology;33(9), September 2012:459–466. Antibiotics,

microbiota, and immune defense. Ubeda C, Pamer EG.
 Antibiotics
“Affect various host immune responses
adversely… including leukocyte chemotaxis,
lymphocyte and monocyte transformation,
antibody production, phagocytosis, and the
microbicidal action of polymorphonuclear
leukocytes.”

Goodman and Gilman's The Pharmacological Basis of Therapeutics, 7th

Edition. Gilman AG, Goodman LS, Rall TW, et al. MacMillan Publishing Co,
N.Y.1985:1084.
 Antibiotics

Temporarily suppress acute inflammation via non-

antimicrobial effects

Europ J Pharmacol.. Anti-inflammatory effects of macrolide antibiotics. Čulić

O, Eraković V, Parnham MJ
DOI: 10.1016/S0014-2999(01)01321-8
 Antibiotics

• Worsen dysbiosis
• Favor chronic inflammation

Gastroenterol Int. 1998;11:29-30. Antibiotic impact on intestinal microflora. Gismondo

MR.
 Chronic Lyme
Most cases of are remarkable for
histories of repeated and prolonged
overuse of antibiotics anteceding the
acquisition of Lyme by many years,
often beginning in early childhood

Clinical Observation: Whitmont, RD

 Chronic Lyme
Most cases demonstrate a downward
spiral of worsening clinical
symptomatology, directly
proportional to the frequency (and
length) of antibiotic therapy

Clinical Observation: Whitmont, RD

 Chronic Lyme
Risk of co-infections increases
proportionally with duration of
antibiotic use

Clinical Observation: Whitmont, RD

 Etiology?

Chronic Inflammation
Chronic dysbiosis
Microbiome
 “Solutions?”
• Long-term antibiotics
• Probiotics
• Suppression of inflammation
• Dump Germ Theory-Shift Paradigm
Homeopathy
 Homeopathy
• A 200 year old form of alternative
Medicine
• Currently used by more than 500
million worldwide
• A form of Nanomedicine

Frontiers in Bioscience 2013;5(2):685-708. Adaptive network

nanomedicine: an integrated model for homeopathic medicine.
Bell I.
“Ironically, one of the most
controversial systems of alternative
medicine, homeopathy, could turn out to
be one of the oldest and demonstrably
safest forms of nanoparticle based
treatment already used worldwide for
infectious diseases.”

Eur J Integr Med 2013;5(2):126-40. Advances in Integrative

Nanomedicine for Improving Infectious Disease Treatment in
Public Health. Bell IR, Schwartz GE, Boyer NN, et al.
DOI: 10.1016/j.eujim.2012.11.002
 Homeopathy

Historically interpreted within a

vitalistic and spiritual conceptual
framework common in the 18th
Century

The Organon of Medicine, 6th Ed. 1842. Hahnemann SC,

 Homeopathy

A form of:

Adaptive Network Nanomedicine

Frontiers in Bioscience. Adaptive network nanomedicine: an

integrated model for homeopathic medicine. 2013;5(2):685-
708. Bell I, Schwartz GE.
 Homeopathy
Using Transmission Electron Microscopy (TEM),
electron diffraction and chemical analysis by
Inductively Coupled Plasma-Atomic Emission
Spectroscopy (ICP-AES), the presence of physical
entities in extreme homeopathic dilutions, in the
form of nanoparticles of the starting metals and their
aggregates, has been confirmed

Homeopathy 2010;99(4):231-242. Extreme homeopathic dilutions retain starting

materials: A nanoparticulate perspective. Chikramane PS, Suresh AK, Bellare JR, et al.
DOI: 10.1016/j.homp.2010.05.006
 Homeopathy
Medicines in high potencies (30c and 200c)
involving huge dilution factors (1060 and
10400 respectively) are many orders of magnitude
greater than Avogadro’s number, and theoretically
should not contain measurable remnants of the
starting materials

Homeopathy 2010;99(4):231-242. Extreme homeopathic dilutions retain starting

materials: A nanoparticulate perspective. Chikramane PS, Suresh AK, Bellare JR, et al.
DOI: 10.1016/j.homp.2010.05.006
 Homeopathy

Observable nanoparticle forms of

source material (and silica) exist in
all homeopathic potencies

Int J High Dilution Res. 2011;10:299-310. Homeopathy

emerging as nanomedicine. Upadhyay RP, Nayak C.
 Nanoparticles
• Measure from 1-100 nm in diameter
• Formed by:
– Top-down milling from source
material
– Bottom-up self-assembly

Advanced Drug Delivery Rev 2011;63:427-40. Nanosizing for

oral and parenteral drug delivery: a perspective on formulating
poorly-water soluble compounds using wet media milling
technology. Merisko-Liversidge E, Liversidge GG.
 Nanoparticles

Exhibit superior antioxidant

properties than their respective bulk
forms

J Agricult Food Chem 2012;60(21):5388-99. Antioxidant

activities of curcumin and ascorbyl dipalmitate nanoparticles
and their activities after incorporation into cellulose-based
packaging films. Sonkaew P, Sane A, Suppakul P.
 Nanoparticles
More effective drug delivery vehicles
than conventional bulk form drugs
• Reach selective targets more
efficiently
• Reduce total dosage needed
• Cross Blood-Brain Barrier

Current Drug Deliv 2010;7:303-11. Nanoparticles: a

promising therapeutic approach in atherosclerosis. Antoniades
C, Psarros C, Tousoulis D, et al.
 Nanomedicine
Distinct advantages:
• Targets specific cells
• Doses last longer
• Therapeutic effects are magnified
(up to 1000 times)

Autoimmunity 2009;42:368-72. Imaging inflammation in real

time- future of nanoparticles. Hueber AJ, Stevenson R, Stokes
RJ, et al.
 Nanoparticles
Multiple selective effects:
• Apoptosis
• Anti-inflammatory
• Antioxidant
• Immunomodulatory
• Bacterial, viral, fungal infectivity

PLoS ONE 2011 ;6e26684. PLGA, PLGA-TMC and TMC-TPP

nanoparticles differentially modulate the outcome of nasal
vaccination by inducing tolerance or enhancing humor
immunity. Keijzer C, Slutter B, van der Zee R, et al.
 Nanoparticles

• Reduce side effects

• Greater efficacy
• Lower costs

Methods in Enzymology 2012;508:271-94. Nanotechnology

as a promising strategy for alternative routes of insulin
delivery. Reis CP, Damge C.
 Nanoparticles
• At high doses:
– Trigger stronger
pharmacological effects
• At low doses:
– Mobilize non-pharmacological,
biological adaptation, hormesis
and endogenous amplification
mechanisms
Homeopathy, 99 (2010), pp. 231–242. Extreme homeopathic
dilutions retain starting materials: a nanoparticulate
perspective. Chikramane PS, Suresh AK, Bellare JR, et al.
 Nanomedicine
• Supports the patient's adaptive
networks leading to functional self
reorganization as a biological
network
• Host expression of a more robust
cellular defense system against
infections and other stressors
European Journal of Integrative Medicine; 5(2):126–140.
Advances in integrative nanomedicine for improving infectious
disease treatment in public health. Bell IR, Schwartz GE,
Boyer NN.
DOI: 10.1016/j.eujim.2012.11.002.
 Homeopathy
• The world’s oldest form of
clinical nanomedicine
• Thousands of published case
studies in worldwide database
• Demonstrated effectiveness in a
wide range of acute, chronic and
infectious conditions
 Plasmodium Malaria

Significant inhibitory effects on

parasite multiplication in vivo

Homeopathy 2006;95:223-228. Effects of homeopathic

medications Eupatorium perfoliatum and Arsenicum alabum on
parasitemia of Plasmodium berghei-infected mice. Lira-Salazar
G, Marines-Montiel E, Torres-Monzon J, et al.
DOI: 10.1016/j.homp.2006.06.003
 Antiviral Effects
Significant reductions of infectivity
in:
– Human herpesvirus 1, Human
adenovirus C serotype 5, Influenza A
virus, Human respiratory syncytial
virus, Human parainfluenza virus 3,
Human rhinovirus B serotype 14, and
Human coxsackievirus serotype A9

Can J Physiol Pharmacol 2007;85:1084-90. In vitro evaluation

of the antiviral effects of the homeopathic preparation Gripp-Heel
on selected respiratory viruses. Glatthaar-Saalmuller B.
DOI: 10.1139/Y07-100
 HIV/AIDS
Significant improvement in specific physical,
immunologic, neurologic, metabolic, and
quality-of-life benefits, including:
• Lymphocyte counts and functions
• HIV viral loads in HIV/AIDS

J Alternat Complement Med 2003;9:133-41. Controlled clinical trials

evaluating the homeopathic treatment of people with human
immunodeficiency virus or acquired immune deficiency syndrome. Ullman D.
DOI: 10.1089/107555303321223008
 Homeoprophylaxis of
Leptospirosis

• N=2.3 million in high risk epidemic

region

Homeopathy 2010;99:156-66. Large-scale application of

highly-diluted bacteria for Leptospirosis epidemic control.
Bracho G, Varela E, Fernandez R, et al.
DOI: 10.1016/j.homp.2010.05.009
 Leptospirosis
• Significantly reduced incidence
in intervention regions
• Increased incidence in non-
intervention regions
• Incidence fell below historic
median
Homeopathy 2010;99:156-66. Large-scale application of
highly-diluted bacteria for Leptospirosis epidemic control.
Bracho G, Varela E, Fernandez R, et al.
DOI: 10.1016/j.homp.2010.05.009
 Chronic Disease
• 8 year follow-up cohort study
• N=3709
• 97% Chronic Disease

BMC Public Health 2008;8:413-421. How healthy are

chronically ill patients after eight years of homeopathic
treatment? – Results from a long term observational study.
Witt CM, Lüdtke R, Mengler N, et al.
DOI:10.1186/1471-2458-8-413
Most frequent diagnoses:

– migraine, tension type headache,

sleep disorders, depression,
anxiety disorders, multiple
eczemas, psoriasis, allergic
dermatitis, allergic rhinitis,
allergies, dysmenorrhea,
multiple infections,
hypertension, low back pain,
asthma
BMC Public Health 2008;8:413-421. How healthy are
chronically ill patients after eight years of homeopathic
treatment? – Results from a long term observational study.
Witt CM, Lüdtke R, Mengler N, et al.
DOI:10.1186/1471-2458-8-413
 Chronic Disease
• Significant decreased severity
(p < 0.001)
• Physical and mental Quality of Life
scores increased
• Younger age, female gender and
more severe disease at baseline
were most predictive factors of
therapeutic success

BMC Public Health 2008;8:413-421. How healthy are chronically ill patients
after eight years of homeopathic treatment? – Results from a long term
observational study. Witt CM, Lüdtke R, Mengler N, et al.
DOI:10.1186/1471-2458-8-413
 Homeopathy

• Adaptive Network Nanomedicine

• Directly impacts microbiome
 Homeopathy and the
Microbiome

“Homeopathic potencies are capable

of completely altering the bacterial
flora of the bowel, and this fact has
been demonstrated in many
hundreds of cases”

Br Hom J 1936;26:163-188. The Potentised Drug and its

Action on the Bowel Flora. Paterson J.
 Homeopathy and Lyme
Disease

“The judicious use of the classical

homeopathic method has proven
itself clinically effective in preventing
and treating illnesses like Lyme
disease in all its clinical stages.”

J Am Inst Homeopathy 1997;90(4) :186-198 Homeopathy

and Lyme Disease. Whitmont RD.
 A Case Report:
Chronic Lyme Disease
Dysbiosis
Initial Consultation:

A 92-year-old Caucasian male retired

physician presented with complaints of
“Chronic Lyme Disease”
 Main Symptoms
• Multiple tick bites over previous
year
• Living in Lyme endemic region
 Treatment History
• Initial Rx: Doxycycline 100mg POBID for 28 days,
followed by Cefdinir 600mg POQD for an
additional 26 days

• Initial improvement while being treated, followed

by relapse and worsening symptoms shortly after
discontinuing antibiotics
 Organon
“These [treatments] likewise do nothing but
debilitate, and only suppress or suspend the
malady for a short time without being able to
cure it, and when used for a long time always
add a new morbid state to the old disease.”

Organon of Medicine, 6th Ed. 1842; Aphorism 39:123. Hahnemann SC,

 Main Symptoms
• Brain fog
• Depression
• Vertigo: Worse after rising in the morning
• Nausea with intolerance of spices and fatty foods
• Prefers warm environments, fresh air
• “Clicking” in neck
• Night sweats
• Fatigue: “great effort” to do deskwork. Has not gone
outdoors in previous 2 months
• Generalized Weakness with lack of energy
 Medical History
• Multiple urinary complaints including
chronic urinary retention, hesitancy,
incontinence, nocturia
• Recent UTI treated with Ciprofloxacin
• Life-long history of frequent recurrent
antibiotic use (at “any sign” of cold or
infection)
• IBS
• Gastroparesis
 Medical History
• Chronic recurrent sinusitis treated
repeatedly with antibiotics
• Hiatal hernia
• Osteopenia
 Medical History
• Degenerative Disc Disease (DDD)
of Spine
• Prostate cancer s/p radiation and
chemotherapy
• Abdominal Aortic Aneurism (AAA)
 Physical Examination
• Tall, thin, frail Caucasian male
• Appeared older than stated age
• Pectus excavatum
• Pale skin
• No apparent distress
• Vital signs and physical
examination otherwise
unremarkable and noncontributory
 Diagnostic Assessment
Antibiotic overuse and abuse with evidence
of chronic dysbiosis manifesting as:
• IBS
• Chronic sinusitis
• Chronic Lyme/Post Lyme Syndrome

Dysbiosis leading to chronic malabsorbtion

and malnutrition contributing to:
• Osteopenia
• Fatigue
 Therapeutic Intervention

• Classically Prescribed Homeopathic

Medicine, 200c
• One Single Dry Dose By Mouth
 Classical Homeopathic
Prescribing
• Depends on the total clinical pattern of
biopsychosocial symptoms
• Relies on:
– Individual salience
– State dependency in the host to elicit
beneficial rather than adverse effects

Global Advan Health Med 2014;3(1):36-53. Integrative

Nanomedicine: Treating Cancer with nanoscale natural products.
Bell I, Sarter B, Koithan M, et al.
 1 Month Follow-up
• “Doing much better”
• Nausea is “mild”, worse in morning after rising,
better by noon
• Vertigo only “once in a while”, usually with
nausea.
• Still Feels head isn’t “level”, not “even-keeled”
• Nocturia “improved”
 Therapeutic Intervention
• Classically Prescribed
Homeopathic Medicine, 200c
• One Single Dry Dose By Mouth
 3 Month Follow-up

• “Very pleased over last 6 weeks”

• Gradual improvement in energy
• No nausea
• No GI distension
• No recurrent sinusitis or UTI
 3 Month Follow-up

• No vertigo
• No Brain fog
• No more urinary incontinence
• Asks: “How do you discourage old
friends from staying too long?”
 1 Year Follow-up
• No recurrence of symptoms
• No repetition of medicine
• Feels strong and fit
 1 Year Follow-up
Patient Perspective:

“I’m doing very well for 94. I have no

complaints. If I continue how I am I
will be very satisfied.”
 -Review-
Homeopathy

The oldest continuously utilized form

of nanomedicine worldwide
 Homeopathy

A paradigm shift away from the

“Germ Theory”
 Organon
“It was high time… to put a stop to these
abominations, to command a cessation of
these tortures… in place of curing patients,
render them incurable by the addition of new,
chronic medicinal maladies by means of the
prolonged use of wrong, powerful medicines”

Organon of Medicine, 6th Ed. 1842: 79. Hahnemann SC.

 Homeopathy

Promotes:
• Resolution of inflammation
• Resolution of dysbiosis
• Integration of immune system and
microbiome
• Restoration of health
 Homeopathy
Effective in a wide range of clinical
conditions including:
– Acute and Chronic illness
– Infections
– Chronic Lyme Disease
– Autoimmune Disease
– Cancer
 Homeopathy
Advantages:
– Ecologically sustainable
– Holistic
– Compatible with microbiome
– Compatible with immune system
– Inexpensive
 Conclusion…

The Human Microbiome:

• The ecological foundation of
healthy growth, development and
functioning
The Epidemic of Chronic Illness:
• An Iatrogenic side-effect of
conventional medicine
• A result of the Germ Theory
The Germ Theory:
• Promotes microbiome and immune
system damage, resulting in
inflammation, dysbiosis
• Should be 2nd line
Chronic Lyme Disease
• A example of a chronic dysbiosis -
inflammatory disease
Homeopathy:
• A form of adaptive network
nanomedicine
• Demonstrated efficacy in treating
(and preventing) acute, chronic
and infectious diseases
Homeopathy:
• Worldwide use
• Well established time-honored
methodology
• Safe and effective
Data from the Human Microbiome
Project provides a scientific
imperative to utilize and further
investigate homeopathy as
nanomedicine
“Rather than rejecting the entire filed of homeopathy
for its originally vitalistic interpretations, it is time
for modern scientists to examine seriously the
nanomedicine implications of Hahnemann’s
empirical findings for integrative health care.”
European Journal of Integrative Medicine; 5(2):126–140. Advances in integrative
nanomedicine for improving infectious disease treatment in public health. Bell IR,
Schwartz GE, Boyer NN.
DOI: 10.1016/j.eujim.2012.11.002.