Parenteral - the two standard choices here are
As well as the Ilads recommendations, here is a US Government treatment guidelines document which is basically in agreement with the above http://www.guidelines.gov/content.aspx?id=9537&search=lyme+disease
Here is a Dutch paper emphasisizing the problem with the cyst form. It also proposes that penicillin and ceftriaxone drive the germ into the cyst form thus emphasisng again teh need to treat all forms http://www.lymemed.nl/wetenschap/312-Margulis-final.pdf
Combating the Neurotoxin
Hepatic clearance of the toxin is very high, as the raw toxin in bile. it is then reabsorbed 100% in small intestine. What a clever liver, what a clever toxin. However it can be sequestrated by cholestyramine very effectively. It is said that the toxin load can be virtually eradicated in 2 to 3 months at a dosage of 1 sachet bd. this however has not been my clinical experience with patients still having some symptomatology at 6 months
Expert opinion reinforces the need for adequate dietary supplementation
I am going to refer you to page 27 of the 2008 Burruscano document for a full listing
I find many of my patients just simply cant afford these. For these people I give the following advice.
Proper nutrition is gained by sourcing food fresh and in a large variety. This is not gained on the supermarket restaurant and take away food merry go round because the food is highly processed, pre prepared and packaged and people tend to buy and eat the same things all the time, over and over again.
Best nutritional advice is selecting 30 or more food substances in a day. Some will be in trace quantity in the meal. Then if you can be selecting a large range and differing 30's as much as possible each day you are getting the right variety.
There is a fuller treatise on nutrition the patient pages
Please Google this in association with Lyme for several treatises on the subject
My understanding is that any well versed practitioner
in this field will advise that antibiotics are essential.