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Leo Galland, M.D.

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Lyme Disease Symptoms: Key Facts About This Mysterious Illness

Posted: 06/18/2011 12:32 am

Summer is peak season for transmission of Lyme disease.

The only known transporter of Lyme bacteria -- the deer tick -- goes through the most infectious stage of its life cycle in the summer.

But you don't need to be in contact with a deer to get a deer tick bite. Deer ticks can hitch a ride on small animals and land right in your backyard.

Here is a case study that highlights why Lyme disease is a mystery illness:

Anne had been diagnosed with three different autoimmune diseases, each by a top specialist:

  1. Crohn's disease, an inflammatory disorder of the intestinal tract that causes abdominal pain and diarrhea.
  2. Iritis, an inflammatory disorder of the eyes that causes eye pain and blurred vision.
  3. Spondyloarthritis, an inflammatory disease that attacks the spine and other joints.

Two of the specialists wanted to treat her with immune suppressive drugs, a decision that would have been counterproductive, given the fact that her real diagnosis was Lyme disease -- an infection spread by a tick bite.

Anne had suffered a tick bite five years ago, about six months before the onset of her arthritis, and had been treated with an antibiotic, doxycycline, for three weeks. Subsequent testing of her blood for antibodies to the Lyme bacteria were negative on four separate occasions. Her doctors, therefore, discounted the idea that Lyme disease could be causing her chronic illness.

Two Key Points About Lyme Disease

  • Active Lyme disease can persist after antibiotic therapy.
  • Active Lyme disease may occur in the absence of positive blood antibody tests. This condition, called false negative serology, may be more likely in people who received antibiotics very early in the course of infection, as had Anne.

Learn more about the source of Lyme from a new book: Lyme Disease -- Risk of Lyme Disease Expands

The Infectious Diseases Society of America has stated that three weeks of antibiotics will cure "over 95 percent" of people with Lyme disease. But many experts have challenged these treatment guidelines as being inaccurate. As I see it, even if the Infectious Diseases Society of America's guidelines are accurate, they are grossly inadequate: a failure rate approaching five percent for a curable disease is unacceptable.

New Cases of Lyme Disease

Let's check the math: At present there are about 30,000 new cases of Lyme disease reported to state health departments each year. Everyone acknowledges that under-reporting is the rule, so that there are undoubtedly many more cases of Lyme disease acquired in the U.S. every year. The annual incidence is probably more than 100,000 new cases each year.

Lyme disease has been with us for at least 30 years. So, even if the failure rate of the IDSA guidelines is only 1 to 4 percent, as claimed, there are tens of thousands of Americans living with incompletely treated Lyme disease. Anne was one of these and, like so many others, saw many competent physicians for her complaints without the correct diagnosis being made.

Anne Sought Evaluation for a Different Condition

She came to see me not for evaluating Lyme disease, but to find a nutritional therapy for Crohn's disease because she did not want to take the medication her gastroenterologist was recommending. Although her digestive complaints were controlled by a special diet and her iritis could be prevented by supplements of curcumin, an herbal extract, the cycles of joint and muscle pain and fatigue that she had experienced for the past five years continued.

I ordered some detailed blood tests to evaluate the possibility that she may still be suffering from active Lyme disease. The evidence was inconclusive, but strong enough that she and I agreed that further antibiotic therapy was warranted.

Like many other patients with Lyme disease who start antibiotic therapy, Anne originally felt worse with antibiotics. Fortunately, this reaction, called a "Herxheimer response," only lasted for about a week. Within a month, it had become clear that antibiotics, not immune suppressant drugs, were the right therapy for her. Although not totally well, Anne no longer has any evidence of Crohn's disease, iritis or spondyloarthritis. What appeared to be autoimmune diseases were the deceptive manifestations of a chronic infection of Lyme disease.

To Watch: Under Our Skin: Lyme Disease Film

Essential Facts About Lyme Disease

  • It is an infection with a bacteria called Borrelia burgdorferi, transmitted by the bite of a deer tick.
  • The tick is so small -- sometimes as small as a poppy seed -- that you may not be aware of a tick bite.
  • Symptoms of Lyme disease may occur within days or may not occur for many weeks after infection.
  • Lyme disease may involve any part of your body: skin, joints, muscles, the nervous system, the heart or the intestinal tract.
  • Laboratory tests for Lyme disease are imperfect and can be misleading.
  • Prompt treatment of early infection improves the likelihood of cure, but persistent chronic infection may occur and can take many forms. It is important to note though, that some people with chronic symptoms confuse them for chronic Lyme disease. It's ultimately important to explore all possible explanations for these sorts of symptoms.
  • The possibility of Lyme disease should be carefully considered in anyone with unexplained fatigue, fever or muscle pain, in people with an acute unexplained change in emotional or cognitive function, and in everyone given a diagnosis of autoimmune or degenerative neurological disease.

Many people feel that their thoughts or feelings about their condition, particularly with Lyme, have been brushed off by conventional medicine. Get my take on treating the whole person, and how to talk with your doctor in my article Is Conventional Medicine Ignoring You?

Now I'd like to hear from you:

Do you have unexplained symptoms? Has your doctor considered Lyme Disease?

Have you had any treatments? Did they help?

Please let me know your thoughts by posting a comment below.

Best Health,
Leo Galland, M.D.

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Leo Galland, M.D. is a board-certified internist, author and internationally recognized leader in integrated medicine. Dr. Galland is the founder of Pill Advised, a web application for learning about medications, supplements and food. Sign up for FREE to discover how your medications and vitamins interact. Watch his videos on YouTube and join the Pill Advised Facebook page.

References and Further Reading

Dr. Joseph Burrascano's Diagnostic Criteria on the California Lyme Disease Association Website

N Engl J Med. 1988 Dec 1;319(22):1441-6. "Seronegative Lyme disease. Dissociation of specific T- and B-lymphocyte responses to Borrelia burgdorferi." Dattwyler RJ, Volkman DJ, Luft BJ, Halperin JJ, Thomas J, Golightly MG.

Infection. 1989 Nov-Dec;17(6):355-9. "Survival of Borrelia burgdorferi in antibiotically treated patients with Lyme borreliosis." Preac-Mursic V, Weber K, Pfister HW, Wilske B, Gross B, Baumann A, Prokop J.

Am J Clin Pathol. 1996 May;105(5):647-54. "Polymerase chain reaction detection of Lyme disease: correlation with clinical manifestations and serologic responses." Mouritsen CL, Wittwer CT, Litwin CM, Yang L, Weis JJ, Martins TB, Jaskowski TD, Hill HR.

Expert Rev Anti Infect Ther. 2004;2(1 Suppl):S1-13. "Evidence-based guidelines for the management of Lyme disease." Cameron D, Gaito A, Harris N, Bach G, Bellovin S, Bock K, Bock S, Burrascano J, Dickey C, Horowitz R, Phillips S, Meer-Scherrer L, Raxlen B, Sherr V, Smith H, Smith P, Stricker R; ILADS Working Group.

Interdiscip Perspect Infect Dis. 2010; 2010: 876450. "Proof That Chronic Lyme Disease Exists."
Daniel J. Cameron.

"Chronic Lyme An Evidence-Based Review", Steven Phillips, MD. ILADS 2008

This information is provided for general educational purposes only and is not intended to constitute (i) medical advice or counseling, (ii) the practice of medicine or the provision of health care diagnosis or treatment, (iii) or the creation of a physician-patient relationship. If you have or suspect that you have a medical problem, contact your doctor promptly.

 
 
 

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