There is almost no research done on the effects of alcohol consumption on Lyme disease, mainly because it is considered unimportant whilst the view prevails that the infection is easily treated with a short course of antibiotics. However, anecdotal evidence from patient groups suggest a complicated relationship between chronic Lyme disease and alcohol and fleeting mentions of neuroborreliosis, psychiatric symptoms, and alcoholism provide further material supporting this connection.
Lyme Disease, Candida, and Alcohol
There are unsubstantiated accounts of alcohol increasing the risk of neurological symptoms of Lyme disease as the bacteria hitch a ride on alcohol’s sugars to cross the blood-brain barrier. No evidence exists to support this theory but it may be regarded as rather academic when considering the other potential drawbacks to consuming alcohol whilst sick with Lyme disease. Antibiotic treatment for borreliosis predisposes patients to bacterial imbalance in the gut and conditions such as Candida which are also fuelled by alcohol (through the sugar and yeast it contains). Patients taking Lyme disease antibiotics are often advised to adopt an anti-candida Lyme disease diet during recovery to attempt to stave off treatment complications and symptoms such as nausea, fatigue, and mental fog.
Flagyl and Alcohol in Lyme Disease Treatment
Some medications used to treat Lyme disease, such as Flagyl, can make patients extremely sick if taken with alcohol. Combining alcohol and Flagyl can cause severe nausea, vomiting, flushing, fast heartbeat (tachycardia), and shortness of breath and is thought similar to the effects of medications used in aversion therapy for alcohol abuse. When taking Flagyl it may even be necessary to avoid trace amounts of alcohol in things such as mouthwash or at religious services.
Lyme Disease Medications and Alcohol
Other medications may have a less overt reaction to being mixed with alcohol but do more subtle damage to the liver and other organs of elimination that have to process both substances simultaneously using cytochrome P-450 detoxification pathways. Lyme disease bacteria sometimes settle in the liver and even the kidneys and lead to tissue damage that compromise the processing of antibiotics. Adding alcohol to the existing burden can cause sickness, poor processing of the Lyme disease medications, and resulting long-term liver damage, especially if NSAIDs and other analgesics are used to manage Lyme disease symptoms.
Alcohol and Stress
Many patients turn to alcohol as a way of coping with the stress of Lyme disease, especially where the medical establishment is resistant to their being diagnosed with the infection and where money becomes an issue as test costs and treatment costs mount up. Lyme disease symptoms may also cause people to take time away from work, or even become unemployed and this kind of stress and potential isolation can precipitate an increase in drinking.
Inflammation and Lyme Disease
Where patients with Lyme disease use alcohol in small amounts as stress relief it may be considered to have an overall beneficial effect in reducing psychological symptoms such as the panic and frustration Lyme disease can induce in some, despite having some adverse physical consequences. Reduced stress can lower cortisol levels and reduce inflammation and, subsequently, Lyme disease symptoms such as joint pain. However, alcohol itself is pro-inflammatory and so the balance is difficult to achieve and largely dependent on individual tolerance for alcohol.
Alcohol and Immunity
Alcohol also inhibits natural immune function and so further compromises recovery from Lyme disease. This may mean that symptoms are initially ameliorated whilst drinking, only to return with a vengeance later that day or the next day. Some patients report a reaction similar to herxing which could come from a renewed attempt by the temporarily compromised immune system to fight the infection.
Lyme Risk Increased with Alcohol
Studies by Pavia, et al (1991, 2002), involved feeding rats with excessive amounts of ethanol and infecting them with borrelia to monitor the effects of alcohol on immunity. Perhaps unsurprisingly, the rats did not fare well and suffered significant changes in the expression of the cell-mediated immune functions from poor white blood cell activity and count. The rats also developed little to no antibody response to exposure to Borrelia burgdorferi, suggesting that those who are bitten whilst drinking alcohol are less likely to respond effectively in fighting off bacterial invasion. Arguably, alcohol increases Lyme disease risk although this research in rats only looked at acute excessive ethanol ingestion at the time of exposure rather than assessing the longer-term effects of alcohol when already infected with Lyme disease. It may not be too much of a stretch to suggest that any amount of alcohol whilst suffering from Lyme disease can compromise the ability to fight the infection.
Alcohol Tolerance and Lyme Disease
Some find that infection with Lyme disease and the subsequent development of candida during treatment with antibiotics can lower their alcohol tolerance and cause more severe hangovers then experienced prior to Lyme disease. Caution is certainly warranted in this regard as patients may find their blood alcohol level is higher than they would normally expect and lead to the added stress of drink-driving charges (as well as increasing the risk of an accident, of course). An elevated blood alcohol level without alcohol consumption can indicate the production of ethanol through bacterial imbalance in the gut, as well as suggesting that the liver may not be functioning optimally and eliminating alcohol effectively.
Nutrition and Alcohol
Other effects of alcohol that can play a part in exacerbating Lyme disease symptoms include its impact on levels of B vitamins in the system. Alcohol depletes B vitamins, particularly vitamin B12 which can, over time, create neurological problems. Indeed, chronic alcoholism may share some symptoms with neuroborreliosis, including memory deficits, confusion, loss of refined motor function, and even abnormalities of gait (walking). One case report noted that a patient being treated for alcoholism turned out to be infected with Lyme disease, possibly confusing diagnosis and treatment progression.
Gluten and Lyme Diseease
Patients who have managed to eradicate Lyme disease infection but are left with candida may find that alcohol leads to bloating, stomach pains, sluggishness, and even increased joint pain and inflammation. As candida, Lyme disease, and antibiotics all have the effect of altering gut immunity it may be that reactions to the sugars and yeast in the beer are compounded by a new intolerance to gluten. Trying gluten-free beer, in moderation, may produce different results but it is advisable to restore gut health prior to resuming any degree of alcohol consumption.
Drinking with Lyme Disease
It is unlikely that much research will be done into the effects of drinking alcohol whilst recovering from Lyme disease infection as the general guidance is to optimise recovery by avoiding stressors such as alcohol at such times. The research that does exist into ethanol and Lyme disease resistance could have you reconsidering that beer whilst camping, however, as acute excess of alcohol decreases the body’s ability to fight off initial infection. So, although there is a paucity of research it appears that Lyme disease and alcohol are not great bed-fellows, especially when certain medications are being used.
Gheorghiev C, De Montleau F, Defuentes G., Alcohol and epilepsy: a case report between alcohol withdrawal seizures and neuroborreliosis, Encephale. 2011 Jun;37(3):231-7. Epub 2010 Dec 3.
Pavia CS, Bittker S, Cooper D., Immune response to the Lyme spirochete Borrelia burgdorferi affected by ethanol consumption. Immunopharmacology. 1991 Nov-Dec;22(3):165-73.
Pavia CS, Harris CM, Kavanagh M., Impaired bactericidal activity and host resistance to Listeria monocytogenes and Borrelia burgdorferi in rats administered an acute oral regimen of ethanol. Clin Diagn Lab Immunol. 2002 Mar;9(2):282-6.