The Mysterious Correlation

​​When a full moon makes its monthly appearance, many, if not most, with chronic Lyme disease, tend to feel relatively worse than the worse they’ve come to know every day. But why? While no one has yet brought forth a concrete scientific finding for this strange phenomenon, there does exist a lot of interesting information, reasonable postulations, and professional opinions on the mysterious correlation between a full moon and people with chronic Lyme feeling worse.

​As we know, correlation doesn’t always equal causation. A rise in ice cream sales at the beach in the Summer correlates to a rise in shark attacks, but it doesn’t necessarily mean each ice cream sale causes a shark attack. There's clearly a correlation between a full moon and people with chronic Lyme feeling worse, but is the full moon actually causing people with chronic Lyme to feel worse?

​We as humans understand how a full moon works, and we also have a great deal of knowledge on microorganisms -- specifically the Lyme spirochete, Borrelia burgdorferi -- and how they make us feel bad. Let’s pull together the information we know on both subjects and see if some type of reasonable causation can be drawn between the two’s irrefutably mysterious correlation.

​How Does Lyme Make Us Feel Worse?

​To understand how a full moon could cause people with chronic Lyme to feel worse, we should probably make an effort to understand how Lyme actually makes us feel worse in the first place. Knowing the mechanisms at play here allow us to better find a potential causation.

​While pathogens are inside of us, they release foreign material our bodies deem as a threat. In response, the immune system releases chemical messengers known as cytokines to call the correct clean up crew, and the bigger the mess, the greater the amount of cytokines (i.e., inflammation). These cytokines are what primarily cause you to feel worse with chronic Lyme (i.e., your symptoms). So, the more pathogens, the more inflammation, the more symptoms. Simple.

​If people with chronic Lyme are feeling worse during a full moon, then during a full moon, there has to be either a greater number of spirochetes, a greater number of foreign material (i.e., antigens) they release, or both. And whichever of these factors is at play here, how could these factors be caused by a full moon? Since we now know how Lyme makes us feel bad, let’s move on to the mechanisms of a full moon.

​What’s Going On With A Full Moon?

​A full moon occurs roughly every 29.53 days and it is when the Earth sits directly between the moon and the Sun. Think of it as a cosmic “monkey in the middle”. When you see a full moon, you’re seeing the Sun’s light -- coming from behind you (the other side of Earth) -- projected on the moon (in front of you).

Full Moon Alignment

New Moon Alignment

​Now, how many times throughout your life have you heard others say it’s the full moon that causes people to behave weirdly? You’ve also likely heard that since the gravitational pull of the full moon causes the tides, the tides are made of water, the human body is made of water, therefore the moon affects us.

​The gravitational pull of the moon on our bodies definitely has some merit to explain why people with chronic Lyme feel worse during a full moon, but then why do people without chronic Lyme tend to not feel bad during a full moon? Could it be that the gravitational pull of the moon is nearly the same regardless of it lunar phase? Yes, according to astrophysicist Neil DeGrasse Tyson. In fact, Neil takes it a fact further and notes that the force a pillow has on our head when we sleep, “is a trillion times greater than the tidal force of the moon across your cranium”.

​If it isn’t the moon itself that causes people with chronic Lyme to feel worse during a full moon, then it must be the Lyme alone. But if the Lyme bacteria is the one responsible for making people with chronic Lyme feel worse during a full moon, what is the Lyme bacteria doing and why is it doing it during a full moon?

​What Do The Professionals Tell Us?

​If you have chronic Lyme disease, you’ve likely heard of Dr. Joseph Burrascano, M.D. If you haven’t, just know he’s an innovator in chronic Lyme treatment and has helped establish chronic Lyme treatment guidelines for ILADS.

​During his professional career as a treating physician, Dr. Burrascano observed that many of his chronic Lyme patients’ symptoms would “flare” or worsen every 4 weeks while being treated. He postulated the Lyme bacteria’s reproduction cycle was at play here since antibiotics will only kill bacteria during their growth phase.

​Dr. Burrascano also observed that the worse of a reaction a person with chronic Lyme had during the 4 week flare, the higher that person’s germ load, and the more ill they were. In fact, Dr. Burrascano went so far as to suggest a person still has an active Lyme infection if they feel worse every 4 weeks, and that their treatment should continue.

​What Do We Make Of This?

​Dr. Burrascano postulates the Lyme bacteria’s reproduction cycle caused his patients to feel worse every 4 weeks, which is nearly exactly how often a full moon occurs. However, he doesn’t mention if these 4 week cycles of feeling worse align with the 4 week cycle of a full moon.

​Could it be that Dr. Burrascano simply failed to notice if the moon was full during the flare up of his patients’ symptoms? Possibly. Would he really have any reason to look at the moon’s current phase while his patients’ were feeling worse during their 4 week cycle? No, not really, or at all. Or maybe he did notice the moon was full when his Lyme patients felt worse, made a connection, but simply didn’t include it in his writing for reasons of reputation.

​While the professional account Dr. Burrascano has provided is certainly helpful in explaining why people with chronic Lyme feel worse every 4 weeks, we don’t need his observation to know that people with chronic feel worse every 4 weeks with a full moon present. Though it would be interesting to know if he accounted for the moon’s phase.

​What We’re Left With

​Dr. Burrascano wasn’t able to tell us if a full moon was present when his patients’ symptoms flared every 4 weeks, but he did hint that the Lyme bacteria’s replication cycle could explain why his patients felt worse every 4 weeks. Let’s work with that!

​The Lyme bacteria reproduces asexually through a process known as binary fission. This means that only a single Lyme bacterium is necessary for reproduction, and it does this by splitting itself into two.

​During the process of splitting itself into two, the spirochete must break its cell wall. When it does this, the ribosomes inside, which are normally protected by the cell wall, are exposed and vulnerable. Since antibiotics kill bacteria by binding to their ribosomes to disrupt the formation of cell wall proteins, any antibiotics in the area do so, not allowing the spirochete’s cell wall to be repaired, thus it dies.

​When the spirochete dies, it releases endotoxins, which causes the immune system to release those cytokines we mentioned earlier, thus you feel worse (i.e., the herxheimer reaction). If Dr. Burrascano is right that the Lyme bacteria’s reproduction cycle is causing people with chronic Lyme to feel worse every 4 weeks, then they’re just experiencing a big herxheimer reaction.

​So, where does the full moon fit in? Good question and your guess is as good as ours, but based on this information, it appears as though the full moon triggers the Lyme bacteria to reproduce. This, of course, is conjecture, but it’s not that far fetched to conceive of living things using the moon as a cue, even for mating rituals. For fish, lunar cycles influence reproduction with hypothalamus involvement. In birds, their melatonin levels don’t vary during the days surrounding a full moon. And with lab rats, the lunar cycle can affect the sensitivity of their taste buds.

What Do We Conclude?

We can conclude that the moon itself is not responsible for making not only people with chronic Lyme feel worse, but even people without the condition. We can also conclude that most people with chronic Lyme have an exacerbation in symptoms during a full moon.

While it's a credible start by Dr. Burrascano, we're not 100% certain that the Lyme bacteria's replication cycle is responsible for making people with chronic Lyme feel worse every 4 weeks. Though it likely is. We also can't conclude that if the Lyme bacteria's replication cycle is to blame for making people with chronic Lyme feel worse every 4 weeks, that those 4 weeks align with a full moon's 4 week cycle, nor that Lyme is triggered to replicate by the full moon.

​We know that the Lyme spirochete begins to replicate in the gut of a tick once it senses the tick has begun feeding via temperature changes. From the gut, it then makes its way to the tick’s salivary glands and into the bloodstream of the host the tick is feeding on. Are there temperature changes within the human body during a full moon or some other type of change the ticks are picking up on?

​Also, people with chronic Lyme who feel worse during a full moon don’t feel worse during every full moon. This of course could be explained by varying load numbers of the Lyme bacteria within the body, varying immune system strength, and even presence of antibiotics in the bloodstream.

​Additionally, this could also be explained by cyst forms of the Lyme bacteria. When the Lyme bacteria senses undesirable living conditions, it transforms into a hardy cyst form, of which it can stay in for many months, completely elusive from antibiotics.

​Some have also mentioned that they feel worse during a new moon as well, which if this is the case, then it could explain why it never occured to Dr. Burrascano to account for the moon’s phase. This is further supported by Dr. Burrascano never mentioning if his Lyme patients, who felt worse every 4 weeks, were all feeling worse at the exact same time.

​Blaming the full moon for why people with chronic Lyme feel worse could be primal. If things are unusual and a bit chaotic, without a clear reason why, we tend to blame the rare big bright object in the night sky. When it comes to werewolves and erratic human behavior, the moon was always innocent in the court of science. While there’s no denying that people with chronic Lyme tend to repeatedly feel worse during a full moon, whether the moon is actually causing people with chronic Lyme to feel worse is yet to be determined.

Resources

• Zimecki, M. “The Lunar Cycle: Effects on Human and Animal Behavior and Physiology.” PubMed, U.S. National Library of Medicine, 2006, www.ncbi.nlm.nih.gov/pubmed/16407788.
• ​Grier, Thomas M. “The Complexities of Lyme Disease.” Stowarzyszenie Chorych Na Borelioze (Association of Patients with Borreliosis), 2000, www.borelioza.org/.
• Grier, Thomas M. “The Complexities of Lyme Disease A Microbiology Tutorial: Part 1.” LymeNet Europe, 1997, www.lymeneteurope.org/info/the-complexities-of-lyme-disease.
• Savery, R.N., Virginia. “Controversy Continues to Fuel the ‘Lyme War.’” Clinical Advisor, 18 May 2007, www.clinicaladvisor.com/features/controversy-continues-to-fuel-the-lyme-war/article/117160/.
• Burrascano, M.D., Dr. Joseph. “Advanced Topics in Lyme Disease.” LymeNET, Oct. 2008, www.lymenet.org/BurrGuide200810.pdf.
• Tyson, Neil deGrasse, director. Neil DeGrasse Tyson Explains the Tides. StarTalk, YouTube, 10 Apr. 2018, www.youtube.com/watch?v=dBwNadry-TU.
• Tyson, Neil deGrasse, director. Neil DeGrasse Tyson Full Moon Effects. AmazingMeetingVideos, YouTube, 3 Mar. 2009, www.youtube.com/watch?v=bVk-2XAd-kI.
• Brisson, Dustin, et al. “Genetics of Borrelia Burgdorferi.” PubMed, US National Library of Medicine, 4 Sept. 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3856702/.