25 | id == 25
25 | category_id == 5
25 | category_order == 3
25 | category_name == Inflammation
25 | category_color == #C47AC0
25 | slug == chronic-lyme-ABCB1
25 | title == Are You Genetically Susceptible to Post-Treatment Lyme? (ABCB1)
25 | meta_description == Personalized genetics blog article
25 | summary == <p><strong>For most people, a bout of Lyme disease is easily curable with a simple course of antibiotics. For some, however, the infection is just the beginning. Are you susceptible to post-treatment Lyme disease syndrome? If so, what can you do about it?</strong></p>
25 | overall_score_text == Your PTLDS Score (based on ABCB1)
25 | image == https://sd-selfdecode-assets-prod.s3.amazonaws.com/blog/background/How-to-Combat-Chronic-Lyme-Disease-Through-Genetics_JPG.jpg
25 | author_id == 1
25 | author_name == Jasmine Foster
25 | author_title == BSc, BEd
25 | author_order == 36
25 | author_photo == https://sd-selfdecode-assets-prod.s3.amazonaws.com/blog/author-photo/Jasmine.jpg
25 | author_intro == <p><strong>Jasmine received her BS from McGill University and her BEd from Vancouver Island University.</strong></p>    <p>Jasmine loves helping people understand their brains and bodies, a passion that grew out of her dual background in biology and education. From the chem lab to the classroom, everyone has the right to learn and make informed decisions about their health.</p>
25 | reviewer_id == 2
25 | reviewer_name == Joe Cohen
25 | reviewer_title == BS
25 | medical_reviewer_id == 11
25 | medical_reviewer_name == Puya Yazdi
25 | medical_reviewer_title == MD
25 | publish_date == 2019
25 | publish_date == 8
25 | publish_date == 26
25 | avg_rating == 4.0
25 | tags_id == 77
25 | tags_name == ABCB1 Gene
25 | tags_id == 34
25 | tags_name == Brain Fog
25 | tags_id == 67
25 | tags_name == Chronic Disease
25 | tags_id == 68
25 | tags_name == Fatigue
25 | tags_id == 69
25 | tags_name == Headache
25 | tags_id == 70
25 | tags_name == Lyme
25 | tags_id == 71
25 | tags_name == Pain
25 | permissions_favorite == False
25 | permissions_rate == False
25 | content_article == <h2><span style="font-weight: 400;">What is Post-Treatment Lyme Disease?</span></h2> <p><a href="https://selfhacked.com/blog/borrelia-lyme-disease-natural-treatment/"><span style="font-weight: 400;">Lyme disease</span></a><span style="font-weight: 400;"> is a debilitating illness caused by an infection of </span><em><span style="font-weight: 400;">Borrelia burgdorferi</span></em><span style="font-weight: 400;"> bacteria, typically transmitted to humans by tick bites. In most cases, Lyme can be successfully treated with a course of antibiotics, after which the patient returns to full health. Mysteriously, however, some people suffer from fatigue, </span><a href="https://selfhacked.com/blog/23-ways-to-combat-pain-naturally-by-increasing-your-opioids/"><span style="font-weight: 400;">pain</span></a><span style="font-weight: 400;">, and difficulty thinking (</span><a href="http://selfhacked.com/blog/the-cause-of-brain-fog/"><span style="font-weight: 400;">brain fog</span></a><span style="font-weight: 400;">) for months or years after the infection [</span><a href="https://www.niaid.nih.gov/diseases-conditions/chronic-lyme-disease"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5735370/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">This is post-treatment Lyme disease syndrome (PTLDS): a condition that extends and persists after the normal course of Lyme [</span><a href="https://www.niaid.nih.gov/diseases-conditions/chronic-lyme-disease"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Researchers have long been baffled about why some people suffer post-treatment Lyme symptoms and others don&rsquo;t. Recently, some have begun to suspect that our DNA plays a role.</span></p> <p><span style="background-color: #e8ebfc; border-left: 2px solid #4569fa; display: block; padding: 20px;"><span style="font-weight: 400;">Post-treatment Lyme disease syndrome is a condition that develops after an acute </span><em><span style="font-weight: 400;">Borrelia burgdorferi </span></em><span style="font-weight: 400;">infection is resolved. It causes fatigue, pain, and brain fog, and it may have a genetic component.</span></span></p> <h2><span style="font-weight: 400;">P-glycoprotein: a Troublesome Transporter</span></h2> <p><em><span style="font-weight: 400;">ABCB1</span></em><span style="font-weight: 400;">, sometimes called </span><a href="https://selfdecode.com/blog/gene/mdr1/?utm_source=seo&amp;#38;utm_medium=selfhacked&amp;#38;utm_campaign=id00002"><span style="font-weight: 400;">MDR1</span></a><span style="font-weight: 400;"> (for multi-drug resistance gene 1) codes for a protein called P-glycoprotein (P-gp) [</span><a href="https://ghr.nlm.nih.gov/gene/ABCB1"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/gene/5243"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">This troublesome little protein has been the subject of study because of its involvement in drug resistance; people with certain variants in </span><em><span style="font-weight: 400;">ABCB1</span></em><span style="font-weight: 400;"> have higher P-gp activity and require more of a given drug (like antidepressants or HIV medications) or may not respond to some treatments at all [</span><a href="https://www.cell.com/neuron/fulltext/S0896-6273(07)00975-0"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3098758/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">People with low P-gp activity may also be at risk of cancers that don&rsquo;t respond to conventional chemotherapy treatment [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/11475537"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <h3><span style="font-weight: 400;">Can a Transport Protein Prevent Post-Treatment Lyme?</span></h3> <p><span style="font-weight: 400;">Like so many things, however, P-glycoprotein is a double-edged sword: higher P-gp activity increases drug resistance (which can make it difficult to treat </span><a href="https://selfhacked.com/blog/natural-treatments-depression/"><span style="font-weight: 400;">depression</span></a><span style="font-weight: 400;">, cancer, and other conditions), but it may also protect against post-treatment Lyme disease syndrome[</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2599947/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.sciencedirect.com/science/article/pii/S2214540019300489"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Here&rsquo;s how researchers think it could work:</span></p> <h3><span style="font-weight: 400;">Inducing Autoimmunity</span></h3> <p><span style="font-weight: 400;">A tick bites a human host, and </span><em><span style="font-weight: 400;">Borrelia burgdorferi </span></em><span style="font-weight: 400;">is transmitted into the skin. It multiplies and spreads, and the immune system mounts an inflammatory defense. This inflammatory response creates the symptoms of Lyme: fever, </span><a href="https://selfhacked.com/blog/natural-treatment-migraines/"><span style="font-weight: 400;">headache</span></a><span style="font-weight: 400;">, fatigue, and rash. Doctors prescribe a course of antibiotics, and the bacteria die off in a few weeks [</span><a href="https://www.ncbi.nlm.nih.gov/books/NBK57011/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://nccih.nih.gov/health/Lyme-Disease"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">During the immune response, however, </span><a href="https://selfhacked.com/blog/how-to-increase-and-decrease-white-blood-cells/"><span style="font-weight: 400;">white blood cells</span></a><span style="font-weight: 400;"> are exposed to bacterial proteins, which may be similar enough to human enzymes to induce autoimmunity [</span><a href="https://www.sciencedirect.com/science/article/pii/S2214540019300489"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/29317049"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">One possible target is an enzyme called enolase, which is needed to release energy from glucose during glycolysis. Humans and bacteria both have a version of enolase, and if the immune system produces antibodies against bacterial enolase, those antibodies risk attacking human enolase as well [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/29317049"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">The autoimmune theory gets further support from the fact that most people who suffer from post-treatment lyme don&rsquo;t have any detectable </span><em><span style="font-weight: 400;">Borrelia</span></em><span style="font-weight: 400;"> bacteria left in their bodies after antibiotic treatment. Plus, </span><em><span style="font-weight: 400;">Borrelia</span></em><span style="font-weight: 400;"> doesn&rsquo;t produce toxins, so the illness must be coming from something else&mdash;like autoantibodies [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3952603"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/26593255"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <h3><span style="font-weight: 400;">Flushing the Threat</span></h3> <p><span style="font-weight: 400;">P-glycoprotein&rsquo;s job is to remove xenobiotics&mdash;compounds produced by bacteria and other potential pathogens&mdash;that make their way into our cells [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/12489979"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">P-gp may therefore protect against post-treatment Lyme symptoms by flushing </span><em><span style="font-weight: 400;">Borrelia</span></em><span style="font-weight: 400;"> proteins, thereby preventing your body from producing antibodies that react to both bacterial and human enzymes [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/12489979"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/20857089"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.sciencedirect.com/science/article/pii/S2214540019300489"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/29317049"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="background-color: #e8ebfc; border-left: 2px solid #4569fa; display: block; padding: 20px;"><span style="font-weight: 400;">ABCB1 codes for P-glycoprotein, a transporter that flushes foreign compounds like drugs and bacterial proteins out of our cells. If P-gp isn&rsquo;t working well and </span><em><span style="font-weight: 400;">Borrelia </span></em><span style="font-weight: 400;">enzymes remain in the cell, some people may develop autoimmune reactions.</span></span></p> <h2><span style="font-weight: 400;">More SNPs, More Problems</span></h2> <p><span style="font-weight: 400;">According to a recent study, the more P-gp-reducing variations someone has in their <em>ABCB1</em> gene, the more likely they are to suffer from post-treatment Lyme disease syndrome after an acute </span><em><span style="font-weight: 400;">Borrelia</span></em><span style="font-weight: 400;"> infection [</span><a href="https://www.sciencedirect.com/science/article/pii/S2214540019300489"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">The single SNP with the greatest impact is rs1128503, which has a significant effect on post-treatment Lyme predisposition on its own. The risk increases when combined with the &lsquo;C&rsquo; allele at rs2235067; meanwhile, the rare &lsquo;G&rsquo; allele at rs4148740 seems to improve the MDR1 transporter and decrease the risk of post-treatment Lyme [</span><a href="https://www.sciencedirect.com/science/article/pii/S2214540019300489"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">*6621503804900186*</span></p> <h2><span style="font-weight: 400;">Your ABCB1 Results for Post-Treatment Lyme</span></h2> <p><strong>Primary SNP: ABCB1 rs1128503</strong></p> <ul> <li style="font-weight: 400;"><span style="font-weight: 400;">&lsquo;AG&rsquo; = Increased risk of PTLDS,&nbsp;decreased MDR1 protein activity</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">&lsquo;AA&rsquo; = Somewhat increased risk of PTLDS</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">&lsquo;GG&rsquo; = Normal risk of PTLDS</span></li> </ul> <p><strong>Other Important SNPs:</strong></p> <p><strong>ABCB1 rs2235067</strong></p> <ul> <li style="font-weight: 400;"><span style="font-weight: 400;">&lsquo;C&rsquo; = Increased risk of PTLDS, decreased MDR1 protein activity&nbsp;</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">&lsquo;T&rsquo; = Decreased risk of PTLDS, increased MDR1 protein activity</span></li> </ul> <p><strong>ABCB1 rs4148740</strong></p> <ul> <li style="font-weight: 400;"><span style="font-weight: 400;">&lsquo;A&rsquo; = Increased risk of PTLDS&nbsp;when combined with other risk alleles&nbsp;</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">&lsquo;G&rsquo; = Decreased risk of PTLDS</span></li> </ul> <p>*7846485894338404*</p> <h2><span style="font-weight: 400;">Recommendations to Prevent Post-Treatment Lyme</span></h2> <p><span style="font-weight: 400;">Keep in mind that if post-treatment Lyme disease syndrome is an autoimmune condition, prevention is by far the best cure: if you live in an area with a lot of ticks and you&rsquo;re at risk of developing post-treatment Lyme, talk to your doctor about these recommendations as soon as you notice a tick bite.</span></p> <p><span style="font-weight: 400;">If you are already struggling with post-treatment Lyme symptoms, the suggestions in Joe&rsquo;s posts on </span><a href="https://selfhacked.com/blog/oral-tolerance/"><span style="font-weight: 400;">developing oral tolerance</span></a><span style="font-weight: 400;"> or </span><a href="https://selfhacked.com/blog/supplements-people-th1-dominant/"><span style="font-weight: 400;">suppressing </span></a><span style="font-weight: 400;"><a href="http://selfhacked.com/blog/supplements-foods-exercise-right-type-th1-vs-th2-dominance/">Th1 dominance</a> may be of interest.</span></p> <p><span style="font-weight: 400;">*7426743149916859*</span></p> <h3><span style="font-weight: 400;">Diet</span></h3> <p><span style="font-weight: 400;">Several plant flavonoids induce or stimulate P-gp; eating the fruits and vegetables that contain them may help prevent or improve post-treatment Lyme. They include [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/12631407"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">]:</span></p> <ul> <li style="font-weight: 400;"><span style="font-weight: 400;">Rhoifolin (lemons)</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Kaempferol (onions, grapes, tomatoes, apples, broccoli, spinach&hellip;)</span></li> <li style="font-weight: 400;"><a href="https://www.selfhacked.com/blog/quercetin-22-scientifically-proven-benefits-quercetin/"><span style="font-weight: 400;">Quercetin</span></a><span style="font-weight: 400;"> (</span><a href="https://www.selfhacked.com/blog/capers/"><span style="font-weight: 400;">capers</span></a><span style="font-weight: 400;">, dill, cilantro, red onion&hellip;)</span></li> </ul> <p><span style="font-weight: 400;">Kaempferol and quercetin had what&rsquo;s called a biphasic effect on P-gp in cell studies: at low concentrations, they stimulated P-gp, and at high concentrations, they blocked it. As such, you probably don&rsquo;t want to supplement with these polyphenols; stick to eating the foods that naturally contain them [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/12631407"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <h3><span style="font-weight: 400;">Supplements</span></h3> <p><span style="font-weight: 400;">Since there's limited research on post-treatment Lyme disease syndrome, it's unclear if these therapies would help, but if you research them and find that they fit with your overall health goals, then they might be worth discussing with a medical professional and maybe trying out.</span></p> <p><a href="https://selfhacked.com/blog/saint-johns-wort/"><span style="font-weight: 400;">Saint John&rsquo;s wort</span></a><span style="font-weight: 400;"> has been used as an herbal remedy for centuries; modern science has both reinforced its value as a natural antidepressant and cast light on its many drug interactions. One reason for these interactions is that Saint John&rsquo;s wort increases the activity of P-glycoprotein. Thus, Saint John&rsquo;s wort may help your cells dump any harmful components left behind by </span><em><span style="font-weight: 400;">Borrelia</span></em><span style="font-weight: 400;"> infection [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1874544/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Likewise, an extract of </span><a href="https://selfhacked.com/blog/health-benefits-cats-claw/"><span style="font-weight: 400;">cat&rsquo;s claw</span></a><span style="font-weight: 400;"> (</span><em><span style="font-weight: 400;">Uncaria tomentosa</span></em><span style="font-weight: 400;">) induced P-gp in a cell study. Cat&rsquo;s claw is sometimes used as a supportive measure&mdash;along with conventional antibiotics&mdash;to boost the immune system and fight Lyme; it may help prevent post-treatment Lyme symptoms from developing as well [</span><a href="https://www.mdpi.com/1420-3049/24/1/137/htm"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4971593/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Be careful, though: changing P-gp expression alters your body&rsquo;s drug metabolism. If you are on any prescription medications, talk to your doctor before using either Saint John&rsquo;s wort or cat&rsquo;s claw [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1874544/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p>
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25 | content_learn_more_6621503804900186_text == Based on the variants we looked at, your ABCB1 gene makes you somewhat more susceptible to post-treatment Lyme disease syndrome. Take extra precautions to avoid being bitten by ticks; if you do get Lyme, you’ll need to stimulate your P-glycoprotein transporter. Keep scrolling to find out how.
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rsIDs = rs2235067,rs4148740,rs1128503
rsStatus = rs2235067,ABCB1,chr7,87520606,C,T,,,30,0,Normal
rsStatus = rs4148740,ABCB1,chr7,87522787,A,G,,,27,0,Normal
rsStatus = rs1128503,ABCB1,chr7,87550285,A,G,,,18,15,HET
