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Summary: Fasting-induced ketogenesis can shift host metabolism to increase bacterial susceptibility to antibiotics and to modulate immune and inflammatory responses.

These effects could, in principle, enhance standard Lyme disease therapy by improving antibiotic potency and supporting host immune function.

Because Borrelia burgdorferi is an obligate glycolytic organism (no TCA/ETC), the mechanistic rationale for applying this approach to Lyme management may be particularly strong

β-hydroxybutyrate inhibits Plasmodium falciparum development and confers protection against malaria in mice

Summary: Although focused on malaria rather than Lyme disease, this study shows that ketosis can impair pathogen development while altering host immune and inflammatory pathways, creating an environment less favorable to the pathogen and promoting host immune and mitochondrial resilience