Lyme disease is caused by an infection, commonly transferred by the common deer tick. In 1982, Dr. Willy Borgdorfer (gotta love that name) was a PhD researcher who discovered Borrelia Burgdorferi but this is not the only strain of Borrelia that causes Lyme. There are in fact over 100 strains of Borrelia in the US alone and more than 300 worldwide. At least 12 of these strains are known to cause disease. This is partly why testing is so difficult as the test has to attempt to identify all of these variables. The Western Blot test can NOT rule out Lyme disease. A negative Western Blot is nearly useless. The test only has value when it shows positive. There are a host of tests such as Igenex, DNA Connexion, and others that we can rely on and these will be discussed later but there is no ONE test that is perfect and reliable.
How do you diagnose Lyme disease?
Great question and the short answer according to the experts at ILADS (International Lyme and Associated Disease Society) is that Lyme is a “clinical” diagnosis not a laboratory diagnosis. What that means is that we rely more strongly on the presentation of symptoms and the patient history, and don’t rely on the lab to prove its presence. Go to ILADS.org for more information from the group that currently offers the only recognized national guideline for diagnosis and treatment. Exercise caution if following IDSA, the Infectious Disease Society of America, as they have not been very slow to recognize current literature on Lyme diagnosis and treatment.
The Dreaded Tick
Lyme is most commonly spread by the very small deer tick. It is the young offspring of ticks in the spring, known as “nymphs” that represent the biggest threat. Nymph is <2mm in size and is most active and threatening in the spring and summer. Adult ticks more active in cooler fall and less likely to infect. They hang out in tall grasses waiting for passer-by and then grab hold. Once infected it is possible for a mother to pass this infection to her unborn fetus in utero but it is felt that transmission from one person to another is not possible. You also can’t get it from your dog or cat or from eating deer meat.
Coinfection with Lyme disease
Borrelia as the cause of Lyme is a sneaky spirochete that in fact disables your normal immune defense. So as an infection it weakens the very system you use to kill it. This opens the door to other infections that enter with Borrelia. Common coinfections include Babesia, Bartonella, and Ehrlichia. Beyond this we also see opportunistic yeast, mold, virus and parasites jump on the bandwagon making treatment more difficult. A “Lyme literate” clinician will understand this and broaden the focus of treatment.
What are the symptoms of Lyme disease?
The symptoms are very broad and also very strange. Patients often feel self-conscious explaining what they feel as they fear being judged or labeled as “crazy”. You aren’t crazy and if you have been marginalized by a doctor for sharing the symptoms you have then you simply need to find a better educated clinician. This is a tough diagnosis and not every doctor is prepared to find or mange it. Some doctors are specifically educated through ILADS courses to stay abreast of current knowledge and approaches.
The symptoms can broadly be grouped into 3 systems: gut, musculoskeletal and neurologic. This article is not going to explain in great detail each of these but briefly here are some common findings:
- Fatigue
- Headache
- Neck pain or stiffness & chest pain
- Joint & Muscle pain & swelling – especially “migratory” joint pain
- Tingling, numbness, burning in extremities
- Pain syndromes that “migrate” or “come & go”
- Poor focus, difficulty reading
- Forgetful, memory issues, or even confusion
- Disturbed sleep – too much or too little
- Difficulty with speech or writing
- Psych changes: depression, anxiety, OCD
Note that many of these are quite vague or broad. To help organize and score these symptoms, go to the questionnaire developed by Lyme expert Dr. Horowitz.
Misdiagnosed
If you doctor is unfamiliar with how Lyme disease presents itself, you may have been diagnosed with another disease that actually has its origins in Lyme. If you have been diagnosed with Fibromyalgia, Chronic fatigue syndrome, Rheumatoid arthritis, Multiple sclerosis, Autoimmune disorder, ALS, or Myositis then you may in fact have Lyme. If your diagnosis is not supported by lab evidence or if it has had an usual course or abnormal response to treatment then perhaps you should explore Lyme or mold toxicity (discussed next) as a possibility.
The Mythical Lyme Rash
The classic description of the rash that can accompany Lyme disease, erythema migrans, looks like a red bullseye. The problem is the classic rash happens far less than 50% of the time. In fact the rash can look like hives, or a linear scratch, or speckled or quite often NOT at all.
What to do if bitten by a tick
If bitten by an infected tick the incubation period from time of bite is 3 to 30 days before symptoms appear. In my opinion I would advise that you NOT wait for symptoms – take action. There are natural treatments or prescription drugs that should be engaged based on your preference and recommendations from your doctor. Collecting the tick and sending it off for analysis has traditionally not been productive but that technology continues to emerge and will hopefully yield a useful tool in the future.
How to Treat Lyme Disease
The Borrelia spirochete is sneaky and can hide. It can bury itself in biofilms, live inside your cells or circulate in the blood so often it requires a multipronged approach. The first mistake often made is hitting someone hard with an antibiotic before opening the pathways for toxic removal. The complexity of a Lyme infection requires a step wise approach that ILADS and Lyme literate doctors understand well. The gut, liver, lymph and all detoxification pathways need to be supported before overwhelming the body with aggressive antibiotic treatment.
There are a host of antimicrobial options, some natural and some pharmaceutical. Often these elements work best when overlapped or used together. This is a very individualized issue and needs to be orchestrated with your treating physician. Don’t get locked into one idea or one approach. Stay flexible and open to ideas and avenues that may be foreign to you. The articles within this section will highlight with great detail some of the more useful tools and approaches.
Mold
Mold and Lyme often overlap and share many similarities. The greatest similarity is that these are both elements within nature that naturally produce a toxin that can make you sick. Mold may or may not be living inside you yet in your home or in your body it can produce a toxic element called mycotoxin that affects you in many of the same ways as Lyme toxin. Roughly 24% of the population own an abnormal version of the HLA gene that greatly impacts their individual ability to excrete or remove these mold and Lyme toxins. This is critical to know as it strongly predicts those that will struggle to get well and dictate to their doctor what needs to be done to facilitate toxin removal.
Mold is everywhere in nature. It is found in your gardens mulch bed, in the wet leaves of the forest and anywhere standing water collects. Light and air are the enemies of mold growth. If you have a crawl space under your house this is perfect breeding ground for mold as this is typically moist, dark and without proper ventilation. If you have had a leaky roof, a wet bathroom, a basement flooding issue then the odds rise that mold may be growing behind the drywall, under the carpet or maybe in plain sight but you don't identify it as mold. The mold emits spores and these spores carry the toxin that you inhale. Maybe the mold is in the basement and you never go into the basement but your furnace is circulating air throughout the house and thus circulating mycotoxins right into your bedroom. Finding the source of your mold toxicity can be very challenging. Your car? Your place of business?
There are several issues to address. Are you allergic to mold, infested with mold growing inside you, or simply inhaling mold mycotoxin and cant excrete the toxin? This can typically be resolved with some testing of blood and urine. You can measure the mycotoxins in your urine as a test of your current status. Other tests for metabolites of mold and yeast found in he urine can be a great resource showing the source of the problem. We are also able to measure blood labs to aid understanding of detox status and immune irritation. The tools for diagnosing and understanding mold are somewhat more reliable than the tools we use to see Lyme.
Binders are compounds such as charcoal and chlorella that can be used to help pull mycotoxins out of the body but finding the right mix and dose can be tricky. A skilled integrative physician will be very valuable in assembling the right treatment program. The challenge is that aggressive binders may stir the mycotoxins up without actually pulling them out of your body. Inappropriate treatment can cause a worsening of symptoms. This is where your integrative practitioner is skilled in finding the best path for you.
The important thing to remember is that there is an answer and you will get better. You can engage the labs found here on the HippEvo site to begin your journey of understanding and use products that pull the toxins out to start the process of recovery but engage the educational articles in this section to help avoid taking bad turns or ill-advised steps. There is a process to doing this correctly that avoids making a bad situation worse. Be patient and move slowly. When in doubt reach out to an expert. This is tricky turf.
