33. Diagnosing and treating Lyme disease, with Dr. Joseph Jemsek

In this episode, Sarah is joined by Dr. Joseph Jemsek, an infectious disease physician who runs the Jemsek Specialty Clinic in Washington, DC. Dr. Jemsek has been on the leading edge of both the HIV and Lyme disease epidemics. He became intrigued by reports of a small cluster of patients with outbreaks of Kaposi Sarcoma and Pneumocystis pneumonia in New York and San Francisco. He intuitively felt that this was an indication of something much bigger.

He recalls diagnosing the first HIV patient in North Carolina in 1983, before the disease was even called HIV. In the years that followed, the virus was identified, tests were created and treatments were researched, including an early study for azidothymidine (AZT) which Dr. Jemsek co-authored. This pioneering research study allowed patients access to this early treatment, clinical trial involvement and medical follow up. 

“I became a fierce advocate for the HIV population…I just hated the prejudice and I stayed steadfastly behind them.”

Dr. Joseph Jemsek

The tale of twin epidemics

Sarah points out that Dr. Jemsek’s early work with HIV, along with his curiosity, intrigue and open-minded approach lends well to working with Lyme disease patients. Along with taking the time to really listen to patients and to consistently do physical exams, Dr. Jemsek has developed a comprehensive approach that addresses the many facets of tick-borne illnesses. His early commitment to HIV patients has developed into a fierce advocacy for Lyme patients. He emphasizes that it is critical for physicians to not only listen to, but to learn from their patients.

“Today in medicine we have a situation where a lot of it’s programmed and visits are very short. If you have complex issues, you have no chance, and in fact a lot of doctors say, ‘ok you have time for one complaint’, as we all know with Lyme borreliosis, there are literally dozens and dozens and dozens of complex and evolving issues.”

Dr. Joseph Jemsek

The Jemsek protocol

Dr. Jemsek provides insight into how and why he created the Jemsek Protocol for treating Lyme patients. He notes that chronic inflammation is a key factor in Lyme disease, and he points out some of the ways it affects different body systems. He explains the acronym POEMS, which he uses to guide care for Lyme patients, with P standing for pain. Dr. Jemsek describes three types of pain he sees in Lyme patients: neuropathic, musculoskeletal and regional. He explains why it is so important to first address the POEMS issues which are pain, other (social support, access to care), endocrine/metabolic imbalance, mood and sleep. 

“We need our deep sleep. If we don’t get our deep sleep, we have trouble detoxing our brain…the vascular channels open up and…a lot of the toxins are swept away during deep sleep.”

Dr. Joseph Jemsek

After addressing these fundamentals, treatment is continued using a multi-dimensional approach. He explains how the unique nature of the Borrelia bacteria requires a very specific approach to treatment which includes ongoing detoxification, lymphatic movement, dietary concerns, and addressing biofilms. He also emphasizes the importance of treating co-infections such as Babesia. Dr. Jemsek highlights several underlying issues that he believes are under-recognized or misunderstood, including properly addressing Babesia infections, biofilms, congenital and sexual transmission, as well as the myriad of underlying opportunistic infections that often occur along with Lyme disease. 

Deep sleep detox

What role does deep sleep play? Dr. Jemsek explains that deep sleep is critically important in the brain detoxification process. During that time, vascular channels open to allow toxins to leave the brain. He looks at some of the many reasons Lyme patients experience sleep disturbances, and by investigating these causes he is able to recommend a multi-level approach to helping patients get the deep sleep they need for healing to occur. He also explains the importance of the limbic system and describes some of the symptoms that patients experience related to activation of that part of our nervous system. He also describes some of the symptoms patients experience due to inflammation and dysfunction of various parts of the brain and nervous system.

Tackling biofilm

Another important issue that Dr. Jemsek considers throughout treatment is that of biofilm. For treatment, the pathogen needs to be shifted from a dormant state (protected by biofilm) to a planktonic “free living” state where they can be killed more easily. Only a few antibiotics can get in through the biofilm…some antimalarials and antifungals can disrupt biofilm. He reiterates the need for a cautious and well monitored approach so that patients are not overwhelmed and circles back to the importance of detoxification practices to address the toxins released during treatment. 

“The pathogens (in biofilm) are in a dormant state, so we want them in a planktonic state…they’re much easier to kill…we want to break down biofilm in a progressive, selective and smart way and not overwhelm the body, but we have to release these things, otherwise we could do several months of work for naught.”

Dr. Joseph Jemsek

New research and the COVID-19 connection

Although early research on the pathophysiology of Lyme disease gave us some insight into Lyme disease, Dr. Jemsek notes that there aren’t many recent controlled trials on Lyme disease treatment. A pilot study of his treatment protocol was in the works, but had to be paused due to the COVID-19 pandemic. Dr. Jemsek points out the similarities between Lyme disease and the lingering symptoms of COVID-19, and believes that Lyme patients who become infected with COVID-19 experience a reactivation and clinical expression of their Lyme symptoms.

How can physicians learn more about treating patients with tick-borne illnesses? Dr. Jemsek mentors other physicians and firmly believes tick-borne illness should be designated as a specialty, with its own education and accreditation program. He refers listeners to his website for numerous videos, livestreams and a booklet he has written to help guide patients and physicians.

 “Something is going on, why can’t people wake up and see that the human condition is in another paradigm with a set infections that the immune system’s not had to deal with, in an environment where we can’t quantify or identify what new toxins are in our environment and what they do to our bodies.”

Dr. Joseph Jemsek

Thank you Dr. Jemsek for your pioneering work with both HIV and Lyme disease and for sharing your knowledge and professional lived experience with us!

Related resources

• Jemsek Specialty Clinic
• Self-help tools
• Jemsek Specialty Clinic videos
• Lymphatic system in brain
• Lymphatic research
• Dr. Daniel Reich, Reich Lab, Translational Neuroradiology