Lyme Disease

 

Dr. Amanda Hegnauer, ND

Lyme disease is often referred to as the ‘great imitator’ because it mimics other conditions, often causing patients to suffer a complicated maze of doctors in search of appropriate treatment. It is a disease whose diagnosis is synonymous with anxiety, fear and frustration. As with any chronic disease, Lyme disease ebbs and flows; three steps forward and four steps back. I find that it is important to keep this in mind as we begin our journey to beat back the symptoms of this bacterial menace.

Some Basic Information

Lyme disease is transmitted by the bite of a tick. Ticks lack respect and know no boundaries. People travel, pets travel and ticks travel and therefore residence does not accurately reflect his or her disease risk. The disease is caused by a spiral-shaped bacteria (spirochete) called Borrelia burgdorferi. The Lyme spirochete can cause infection of multiple organs and produce a wide range of symptoms.
Symptoms can include…

• Bull’s eye rash
• Flu-like symptoms
• Joint pain
• Numbness or weakness of limbs
• Paralysis of one side of the face
• Impaired muscle movement
• Meningitis-like symptoms
• Irregular heart beat
• Eye inflammation
• Severe fatigue

It is very important to note that fewer than 50% of patients with Lyme disease recall a tick bite. In some studies this number is as low as 15% in the culture-proven infection of the Lyme spirochete. Fewer than 50% of patients with Lyme disease recall any rash. Although the erythema migrans (EM) or ‘bull’s-eye’ rash is considered classic, it is not the most common dermatologic manifestation of early-localized Lyme infection. Atypical forms of this rash are seen far more commonly.
Not only are we to combat Borrelia burgdorferi but there are 5 subspecies, over 100 strains in the US and 300 strains worldwide. This diversity may contribute to the ability to evade the immune system and antibiotic therapy, leading to chronic infection. Not only should we test for Borrelia but also its co-infectors including Babesia, Anaplasma, Ehrlichia and Bartonella. The presence of the co-infection with these organisms leads to infection with the Lyme spirochete as well.  If these co-infections are left untreated, their continued presence increases morbidity and prevents the successful treatment of Lyme disease.

Testing

The accuracy and reliability of testing for Lyme disease is surrounded by a great deal of controversy and opinion. It has been shown that the elisa screening test is unreliable. The test misses 35% of culture proven Lyme disease (only 65% sensitivity) and is unacceptable as the first step of a two-step screening protocol. By definition, a screening test should have at least 95% sensitivity.  The next test to consider is the western blot blood test. Of patients with acute culture-proven Lyme disease, 20–30% remain seronegative on serial western blot sampling. Antibody titers also appear to decline over time; thus while the western blot may remain positive for months, it may not always be sensitive enough to detect chronic infection with the Lyme spirochete.  And since these bands are so specific to Borrelia borgdorferi (Bb), the CDC chose them for vaccine development. If a patient has formed an antibody (a protein against a foreign substance) to a specific Bb protein, a ‘band’ will form at a specific place on the immunoblot (the process when proteins are identified by their reaction with antibodies).  By looking at the band pattern of patient’s results, the lab can determine if the patient’s immune response is specific for Bb.

Treatment

Most cases of chronic Lyme disease require an extended course of antibiotic therapy to achieve symptomatic relief. The return of symptoms and evidence of the continued presence of Borrelia burgdorferi indicates the need for further treatment. The very real consequences of untreated chronic persistent Lyme infection far outweigh the potential consequences of long-term antibiotic therapy. Many patients with chronic Lyme disease require prolonged treatment until the patient is symptom-free. Relapses occur and retreatment may be required. There are no tests currently available to prove that the organism is eradicated or that the patient with chronic Lyme disease is cured.

High dose antibiotic treatment is overwhelming and speculative. Benefits versus risks must be taken into serious consideration.  Consider the extensive therapy options that a Naturopathic doctor utilizes in order to determine the root cause of a disease. This has been done for us in the case of Lyme disease. Now study each individual system and treat accordingly.  Support the immune system, balance hormones and the adrenal glands, eliminate toxins, and eat a whole foods diet by eliminating food sensitivies. Always focus on the center of our universe, the gut.   High dose antibiotics have a propensity to eat away at the gut disrupting the natural course of healthy bacteria. Consider scientifically based nutritional supplementation, botanical medicine, homeopathy and the other proven therapies that a Naturopathic doctor has to offer.
As we tackle individual symptoms it is important to step back, breathe and consider the body as a whole. Ask yourself, how is this chronic illness affecting me emotionally? Are my symptoms exacerbated by other factors? Keep in mind that an illness not only affects you but reaches others as well. Lyme disease is a serious diagnosis and not to be taken lightly.

Quick Facts

International Lyme and Associated Diseases Society (ILADS)
Note: all positive test results MUST be reported to the Center for Disease Control (CDC)

According to the CDC, Lyme disease is the fastest growing vector-borne, infectious disease in the United States.
The number of cases reported annually has increased nearly 25-fold since national surveillance began in 1982.
CDC Reports: Lyme disease infects 300,000 people a year. Ten times more Americans than previously reported.
CDC estimate New Lyme disease cases in the United States:

• Cases per month: 25,000
• Cases per week: 5,770
• Cases per day: 822
• Cases per hour: 34