 The Buhner Protocol Stephen Buhner, experienced herbalist and award-winning author, is one of the most prominent and well-respected leaders in the application of traditional herbal medicine to the treatment of Lyme disease.    Stephen Buhner’s therapeutic approach consists of several key elements:
Additionally, he discusses the importance of symptom management for stabilisation of the patient, an important factor in the patient's reclaiming control over their own healing process. I have been self-administering a Buhner-inspired herbal protocol, tailored to my own symptomatology, for two months now. There is rarely one solution to a very complex problem, and in researching various therapies, I have found the development of a multi-pronged toolkit to be the most promising approach. Herbs have proved to be one critical component of this personalised toolkit. As I learned more about the Buhner protocol, it became apparent that there were various layers to the healing method, each of which calls upon specific herbal formulations. 1. Protection of endothelial structures  Japanese Knotweed (Polygonum cuspidatum) Borrelia assault endothelial cells and junctions, thereby penetrating deeper into the body and causing damage more specifically to the brain and heart. Protection of endothelial cells renders access to organs and tissues more difficult, effectively denying the bacteria the nutrients they require to survive. Japanese knotweed is arguably the most important of all Buhner herbs, as it is not localised to one particular organ system but acts systemically to protect the integrity of the endothelial cells. I take Japanese knotweed in the form of a liquid extract or tincture. The herbs are typically extracted into ethanol or vegetable glycerin; this form is of higher potency relative to the dried herb and hence only a few drops daily is required to achieve effect. 2. i.) Cytokine remodulation Buhner promotes several herbs for the disruption of the so-called cytokine cascade initiated by borrelia. There is an increase in the secretion of cytokines, chemicals which comprise a key part of the immune response, during borrelial infection, leading to tissue destruction at the sites of inflammation to which the cytokines migrate. The bacteria benefit from this erosion, exploiting it in order to gain key nutrients for their own survival and replication. Thus, certain herbs lead to suppression of borrelia indirectly via cytokine disruption, or as Buhner labels it, remodulation. The most important of these include:
In my daily use of these so-called cytokine remodulators, I have noticed reductions in chronic fatigue and muscular pain, and an increase in stamina. While I am far from remission, the severity of my symptoms has been reduced to a much more manageable level, something which I failed to achieve through the use of conventional pharmaceuticals. ii.) Immune support It is known that asymptomatic individuals may also express antibodies against borrelia, indicating their exposure in the past to an infected tick. On the other hand, many receive tick bites from infected tick populations and develop symptoms of acute infection which, without early intervention and antibiotic treatment, may culminate in late-disseminated Lyme disease (so-called chronic Lyme). What distinguishes one set of individuals from the other? It has been proposed that the key difference is immune competency. The immunocompetent set are capable of combatting the infection, while the immunocompromised group remain vulnerable. From this perspective, it might be said that the key to symptom reduction for Lyme sufferers is restoration of immune function. Prior to the receipt of a tick bite, immune dysfunction in an individual may be the result of numerous overlooked lifestyle factors, including consumption of a highly processed, nutrient poor diet, chronic physical and/or emotional stress, and exposure to high levels of environmental toxins. Most Lyme specialists, irrespective of whether they promote pharmaceutical-based or natural herbal therapies, emphasise the need for immune restoration. Many herbs are beautifully adapted for this purpose: redirecting or remodulating the immune response so that it is no longer being hijacked by the bacteria. Buhner calls this "pathogen-initiated restructuring" of the immune system, something which must be systemically counteracted in order to regain immunocompetence. Immunomodulatory herbs which have proven to be highly effective if taken consistently and for the long-term, include: cordyceps, eleutherococcus, rhodiola, sculletaria baicalensis and ashwagandha (withania somnifera). In particular, I observed an increase in my energy levels within days of ingesting eleutherococcus. This herb has been instrumental in reducing my chronic fatigue, one of my most debilitating symptoms. Additionally, sculletaria baicalensis, which contains melatonin, has had a profound effect on regulating my sleep cycle, something which is characteristically disrupted by Lyme disease. Moreover, Buhner recommends taking astragalus, an immunostimulatory herb of particular use for populations which reside in Lyme-endemic areas. The state of the immune system at the time of the tick bite may be a crucial determinant in the individual’s susceptibility to symptomatic infection. However, the herb is contraindicated in the presence of an autoimmune condition due to the risk of overstimulation. Personally, I avoided Astragalus for this reason, availing instead of the other immunomodulatory herbs mentioned. An excellent article, written by Lyme specialist Dr Bill Rawls on the risks associated with stealth microbes in the presence of chronic immune disfunction:  3. Restoration of collagenous structures The physiological damage which results from chronic borreliosis occurs primarily due to erosion of collagenous tissue, which supplies the bacteria with a source of nutrition. “Lyme arthritis”, or the painful swollen joints characteristic of chronic Lyme, is a manifestation of this breakdown. In order to alleviate the symptoms, replenishment of the collagen at a rate faster than that at which it is being destroyed is necessary. Buhner recommends supplementation with gelatin, selenium, and the regular consumption of bone broth. Joint pain and inflammation, particularly in the hips and knees, has been one of my main obstacles to restoring full mobility. These symptoms can significantly restrict one’s ability to walk, rendering any form of even moderate exercise difficult. While this remains one of my most intractable symptoms, I have observed a reduction in my joint pain through the daily consumption of bone broth, supplementation with Great Lakes collagen, regular stretching, and the inclusion of teasel root tincture in my herbal protocol.   4. Restoration of damaged physiological structures Late-disseminated Lyme disease can cause substantial damage to every organ in the body, particularly the heart, the brain, the joints, and the lymph system. Symptoms of this damage have been effectively treated within the Lyme community using specific herbs. For example, hawthorn is administered to patients experiencing arrhythmias, palpitations and other manifestations of cardiac damage. Personally, I have experienced an improvement in cognitive function, which was affected significantly during the height of infection, using Chinese cat’s claw (Uncaria rhyncophylla or Gou Teng), an herb which Buhner propounds to be involved in the regeneration of neural structures.  Symptom management Lyme disease is a multi-systemic disease which affects the musculoskeletal, immune and cardiovascular systems, giving rise to a multitude of symptoms. Additionally, the disease manifests itself differently in each individual’s unique bioenvironment, rendering definitive diagnosis and treatment highly complex. There is no one treatment fits all and rigid diagnostic criteria cannot be applied very effectively due to this high degree of heterogeneity. While Buhner has developed a core protocol, which has proven highly effective for thousands of Lyme patients, he encourages its expansion to include additional herbs tailored to the individual’s unique symptomatology. Herbs which I have successfully introduced into my personalised protocol for symptom management include: curcumin, teasel root, poke root, motherwort, elecampane, and pasque flower. Coinfections Lyme disease typically occurs in the presence of a range of coinfections, both viral and bacterial, the most prominent of which include: babesia, anaplasma, ehrlichia, bartonella and mycoplasma. Many others exist however, with an apparent correlation between the type of coinfection and the Lyme-endemic region in which the patient was bitten. An individual’s unique symptom picture is further complicated by the coexistence of these infections, which depress the immune function to an even greater extent. Late-disseminated Lyme disease, in the presence of multiple coinfections, typically results in chronic immune suppression, a state which itself leads to the development of further stealth infections. While different herbal protocols exist which are specific for each coinfection, the treatment of each separately can become a very costly and overwhelming task. It is for this reason that I have focused solely on the treatment of chronic Lyme disease and babesia, as I am highly symptomatic of the latter. Babesia, a protozoan infection which shares a striking similarity to malaria, is characterised by fatigue, air hunger, and drenching night sweats. To my core Lyme protocol, I have added three herbs which Buhner has demonstrated to be effective in the treatment of babesia: sida acuta, cryptolepis sanguinolenta, and boneset. In conclusion, I believe herbal therapy to be an excellent tool in the treatment of late-disseminated Lyme disease, whether used as primary therapy or as an adjunct to allopathic treatment. If you are interested in sourcing any of the Buhner herbs from within the UK, I have found the products of the following herbalists to be of good quality: Napiers Bristol Botanicals
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