Lyme Disease

Lyme Disease: Overview

Also known as tick-borne borreliosis or Lyme arthritis, Lyme disease is caused by the bacteria Borrelia burgdorferi, which is transmitted by the Ixodes tick.  Lyme disease may cause symptoms affecting the skin, nervous system, heart and/or joints.  Lyme disease is most common in the Northeast and mid-Atlantic states.

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Causes and Development; Contributing Risk Factors

Not all deer ticks are infected with the bacteria that causes Lyme disease.  Ticks can become infected if they feed on small animals that are infected.  The disease can be spread when a tick infected with the bacteria bites a person and stays attached for a period of time.  Person-to-person spread of Lyme disease does not occur.

Lyme disease can affect people of any age.  People who spend time in grassy and wooded environments are at an increased risk of exposure.  The chances of being bitten by a deer tick are greater during times of the year when ticks are most active.  Deer ticks in the nymphal stage are active from mid-May to mid-August, and are about the size of poppy seeds.  Adult ticks, which are approximately the size of sesame seeds, are most active in mid to late fall.  The risk of exposure to infected deer ticks may be statewide.

Signs and Symptoms

Early symptoms may develop within a week to a few months of the tick bite.  In about half of these cases a large, reddish rash about 2 inches in diameter appears and expands around or near the site of the bite.  Sometimes multiple rash sites appear.  Other symptoms, such as fever, headache, fatigue, stiff neck, muscle and/or joint pain, may develop.  If left untreated, within a few weeks to months, complications, such as meningitis, facial palsy, or heart abnormalities may occur.  Later symptoms may develop in people who did not have early symptoms or did not recognize them.  Swelling and pain in the large joints may recur over many years.  It is believed that re-infection is possible i.e. having it once does not provide full immunity.

Diagnosis and Tests

Laboratory testing for Lyme disease is under continuing development, but is still the best method to confirm the diagnosis.  The Lyme Disease Foundation (LDF), in their brochure entitled "LDF Frequently Asked Questions About Lyme Disease" (1999), lists nine reasons for false negative Lyme disease tests results.  This means that even though tests indicate you don't have the disease, you still could.

Nine reasons for false negative Lyme disease tests results:
A.  Antibodies against Borrelia burgdorferi (Bb) are present, but the laboratory is unable to detect them.

B.  Antibodies against Bb may not be present in detectable levels in patients with Lyme disease.  Possible reasons for this are listed below.

  1. The patient is currently on, or has recently taken, antibiotics.  The antibacterial effect of antibiotics can reduce the body's production of antibodies.
  2. The patient is currently on or has previously taken anti-inflammatory steroidal drugs (such as those taken to treat
    rheumatoid arthritis) or certain anticancer drugs.  These can suppress a person's immune system, thus reducing or preventing an antibody response.
  3. The patient's antibodies may be bound with the bacteria with not enough free antibodies available for testing.  This reason is very important and prevalent.  Some of the worst cases of Lyme disease test negative – too much bacteria for the immune system to handle.
  4. The patient could be immunosuppressed for a number of other reasons and the immune system is not reacting to the bacterium.
  5. The bacterium has changed its makeup (antigenic shift) limiting recognition by the patient's immune system.
  6. The patient's immune response has not been stimulated to produce antibodies, i.e., the blood test is taken too soon after the tick-bite (2-6 weeks).  Please do not interpret this statement as implying that you should wait for a positive test to begin treatment.
  7. The laboratory has raised its cutoff so high that a patient's previously positive test is now borderline or negative.
  8. The patient is reacting to the Lyme bacterium, but is not producing the "right" bands to be considered positive.

Treatment and Prevention

What can be done to prevent it? When in tick-infested areas (i.e. tall grass, overgrown brush, etc.), special precautions should be taken.  Wear light-colored clothing, tuck pants legs into socks, and wear closed toe shoes.  Use commercial insect repellents (particularly those containing DEET) sparingly and with care, as they may cause side-effects, especially in young children.  Avoid application to damaged skin.  When returning from outdoors it is important to check yourself, your children and your pets for ticks.  Look for ticks in all joint areas, the navel, behind ears, in the hairline, and in other skin folds.  Wash all skin treated with insect repellent thoroughly.  Keep your lawn mowed and cut overgrown brush.

Prognosis

Prognosis is improved with prompt diagnosis and appropriate, early treatment.

Signs, symptoms & indicators of Lyme Disease:

Symptoms - General

Symptoms - Head - Mouth/Oral

Symptoms - Metabolic

Symptoms - Mind - Emotional

Symptoms - Nervous

Symptoms - Skeletal

Conditions that suggest Lyme Disease:

Circulation

Hypercoagulation (Thickened Blood)

It is estimated that at least 90% of Lyme disease patients have had hypercoagulation issues, compared to only 5% of those unaffected by Lyme disease.

Metabolic

Musculo-Skeletal

Symptoms - Immune System

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Lyme Disease could instead be:

Aging

Alzheimer's Disease

Spirochetes, such as those found in Lyme disease, may be one of the causes of Alzheimer's disease and may also be the source of beta amyloid deposited in the brains of such infected patients.

Parkinson's Disease

Differentiating neuropsychiatric Lyme disease from a primary psychiatric disorder can be a daunting task.  Functional brain imaging and neuropsychological testing can be particularly valuable in helping to make diagnostic distinctions.

Autoimmune

Lupus, SLE (Systemic Lupus Erythematosus)

Lyme arthritis is often mistaken clinically for systemic lupus erythematosus.

Amyotrophic Lateral Sclerosis

Many different neurological conditions may be seen in the later stages of Lyme's Disease, such as blindness, epileptic crises, CVA, extrapyramidal disorders, amyotrophic lateral sclerosis, and dementia.

Multiple Sclerosis

Lyme Disease has been called "The New Great Imitator", a replacement for that old "great imitator" neurosyphilis.  The two diseases share so many symptoms that Lyme disease should be ruled out if multiple sclerosis diagnosis is in question.

Immunity

Chronic Fatigue / Fibromyalgia Syndrome

Lyme disease should be a differential diagnosis for all fibromyalgia patients who could have been exposed to a tick bite.

Musculo-Skeletal

Juvenile Rheumatoid Arthritis

Lyme disease was "discovered" in Lyme, Connecticut in 1975 because of the perseverance of Polly Murray, a homemaker who thought that too much Juvenile Rheumatoid Arthritis (JRA) was being diagnosed in her community.  Putting aside the issue of whether Lyme disease does or does not cause some cases of JRA, the two diseases share so many symptoms that Lyme disease is often mistaken for JRA.

Gout / Hyperuricemia

Lyme disease is similar to gout and is sometimes misdiagnosed as such.

Rheumatoid Arthritis

The symptoms of Lyme disease have frequently been misdiagnosed as rheumatoid arthritis and subsequently mistreated.

Nervous System

Guillain-Barre Syndrome

Putting aside the issue of whether Lyme disease does or does not cause some cases of Guillain-Barre syndrome, the two diseases share so many symptoms that Lyme disease can be mistaken for Guillain-Barre syndrome.

Trigeminal Neuralgia / Facial Pain

The rheumatoid-related condition, Lyme disease, can cause head and neck pain which could be mistaken for trigeminal neuralgia.

Recommendations for Lyme Disease:

Botanical

Garlic

Include garlic in your diet.  It is a natural antibiotic and immune-booster.

Echinacea (Coneflower)

Echinacea boosts the immune system and fights viral and bacterial infections.

Evening Primrose Oil

This may help combat the pain and inflammation.  1000mg 2-3 times daily.

Kelp

Helps in the treatment of the disorder by strengthening the immune system.  It also contains essential vitamins and minerals and aids in detoxifying the body.

Diet

Drug

Antibiotics

Current therapy involves the use of antibiotics, such as doxycycline or amoxicillin.

Lab Tests/Rule-Outs

Bacteria / Pathogen Testing by PCR

A Lyme/Tick Panel (Blood or Tissue Biopsy) can test for the presence of Borrelia burgdorferi (Lyme Disease), Babesia microti (Babesiosis), Ehrlichia chaffeensis (Ehrlichiosis) and Rickettsia rickettsii (Rocky Mountain Spotted Fever).

Mineral

Nutrient

Essential Fatty Acids

May reduce inflammation and joint stiffness.

Vitamins

Vitamin A

Vitamin A deficiency appears to be both a consequence of Lyme disease (Borrelia burgdorferi infection) and a factor in the resulting arthritis susceptibility.

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