What is Lyme Disease?
Lyme disease is an infectious disease caused by a spirochete (spiral shaped bacterium) known as Borrelia burgdorferi (Bb). Lyme disease is most often spread by ticks, but can also be transmitted by fleas, mosquito's, and mites. Evidence has suggested that these insects don't actually need to bite you for you to become infected. Worryingly, there is also evidence that Lyme disease can be spread by a number of other non-insect methods including from person to person through sex, or from mother to baby in the womb. Researchers at the University of Wisconsin have found dairy cattle and other animals can acquire the disease and pass it on to humans through the food chain. The Centers for Disease Control (CDC) in Atlanta, believe that Borrelia burgdorferi can even survive the blood purification processes that donated blood is subjected to, and the disease can thus be acquired through receiving a blood transfusion.
Although it currently has a low profile, Lyme Disease is considered to be one of the fastest growing illnesses in the world. Lyme disease is said to be rampant in the US with an estimated 200,000 new cases every year and and estimated 1.8 million Americans infected, according to the CDC. With awareness of the disease and appropriate testing methods still low, actual infection numbers may be higher still. One Lyme disease expert, Dan Kinderleher, MD has publicly stated that the actual number of Americans infected may even be 10 times the 1.8 million reported by the CDC. Doctors in Europe are currently less likely to look for Lyme, but positive samples have been detected in European countries including England, Scotland, Ireland, France, Germany, Spain, Switzerland and Denmark.
The Symptoms of Lyme Disease
It is well known that a large proportion of individuals infected with the Borrelia burgdorferi spirochete, do not show any signs of Lyme disease at all. In a 1998 study conducted in Switzerland, it was found that only 12.5% of those infected with Bb had any clinical symptoms. All carriers of Bb are at risk of developing Lyme disease at some time however. The bacteria may lie dormant for many years but be activated by events such as increased stress or another infection which alter immune activity.
When symptoms are present, Lyme disease is a master of disguise. Lee Cowden, MD states that there are very few symptoms or unexplained illnesses (or even already diagnosed illnesses!) where Lyme should not be considered a factor. The Sierra Integrative Medicine Clinic in Reno, Nevada, states that "Authorities estimate that up to 90% of the (US) population could be carrying the Lyme spirochete and that Lyme is a factor in over 50% of chronic illnesses."
Dr. Atanas Tzonkov, director of Bulgaria's largest private medical clinic, has successfully treated thousands of patients for Lyme infection. He says that these patients had been diagnosed with over 100 different conditions before he treated them. A possible explanation for this is that most of these patients were actually suffering from misdiagnosed Lyme disease, or, that Lyme infection is actually a component of these many different illnesses.
Lyme disease can obviously mimic a large number of illnesses through the production of a wide range of symptoms. Some tell-tale signs of Lyme disease however, include:
Direct tick bite related symptoms:
- A red spot around the location of the tick's bite. Spots gradually grow bigger, often with a pale area in the middle. This is known as erythema migrans.
- Erythema migrans may sometimes appear at other places on the body where you have not been bitten. Some people develop many red spots.
- Usually one to four weeks will pass between the bite and when erythema migrans appears.
Initial Systemic Lyme disease symptoms:
- Joint and muscle pains
- Mild fever
- Swollen lymph glands
The Canadian Lyme Disease Foundation lists a total of 75 symptoms in multiple body systems that infection with Bb may cause. Some of these include:
Head, Face & Neck
- Unexplained hair loss
- Headache, mild or severe, Seizures
- Pressure in Head, White Matter Lesions in Head (MRI)
- Twitching of facial or other muscles
- Jaw pain or stiffness
Eyes & Vision
- Double or blurry vision
- Pain in eyes, or swelling around eyes
- Light Sensitivity
- Bone pain, joint pain or swelling, carpal tunnel syndrome
- Stiffness of joints, back, neck, tennis elbow
- Muscle pain or cramps, (Fibromyalgia)
- Tremors or unexplained shaking
- Burning or stabbing sensations in the body
- Fatigue, Chronic Fatigue Syndrome, Weakness, peripheral neuropathy or partial paralysis
- Pressure in the head
- Numbness in body, tingling, pinpricks
- Mood swings, irritability, bi-polar disorder
- Unusual depression
- Disorientation (getting or feeling lost)
- Feeling as if you are losing your mind
- Over-emotional reactions, crying easily
- Memory loss (short or long term)
- Confusion, difficulty in thinking
- Difficulty with concentration or reading
- Going to the wrong place
- Unexplained fevers (high or low grade)
- Continual infections (sinus, throat, chest, etc.)
- Low body temperature
- Allergies & Chemical Sensitivities
- Increased affect from alcohol and possible worse hangover
For the full list see here
How Lyme Infection Causes Disease - Bio-Toxins Induced Illness
Over the years, a large body of research has been developed on microbial toxins and their clinical effects and ability to damage various tissues and organs, on both cellular and molecular levels. Microbial toxins can damage the body through both directly damaging tissues and indirectly through toxemia (the presence of toxins in the blood stream). With the Lyme disease causing bacterium Borrelia burgdorferi being implicated in so many chronic illnesses, the study of it's toxins is currently a highly relevant research subject in terms of both the way these toxins cause disease and identifying targets for potential treatments.
The term "Bio-toxins induced illnesses" has recently been introduced in light of this research into microbial toxins, and Lyme disease is considered as the most important in this category.
On the subject of molecular toxicology, Dr. C. Shoemaker, MD and H Kenneth Hudnell, PhD state that "Borrelia burgdorferi produces a large suite of bio-toxins that have tissue affinity, mainly neurotoxins with high molecular tropism for lipid structures (i.e., central nervous system, peripheral nervous system), muscles, joints, lungs and many others." These statements are backed up by research data identifying specific neurotoxins from Bb (1).
What this means is that Borrelia burgdorferi toxins are strongly attracted to fatty cells (such as those of the nervous system), and exert effects that disrupt normal functioning of these cells. These bio-toxins are thought to alter various specific sites in the brain on molecular, structural and chemical levels, interfering with all the major neurotransmitters (dopamine, serotonin, norepinephrine, acetylcholine, GABA). In this way they can cause all manner of neurological and psychiatric symptoms that mimic (or cause) many illnesses, from degenerative diseases such as Parkinson's Disease and Alzheimer's (2), to depression (3) and autistic disorders. Indeed, Dr. Paul Fink, a former president of the American Psychiatric Association, has acknowledged that Lyme disease can contribute to every single psychiatric disorder in the Diagnostic Symptoms Manual IV (DSM-IV), the manual used to diagnose psychiatric disorders.
Lyme bio-toxins are also known to interfere with many hormones, enzymes and their receptors, interfering with their usual functioning. One symptom that is prevalent in Lyme disease and related illnesses (chronic fatigue syndrome, fibromyalgia, autism, depression etc), is chronic fatigue. This can be explained by molecular toxicology research that shows that the calcium channel's normal functioning may be altered by Bb's bio-toxins. This results in the impairment of enzymes and other cellular chemicals involved in cellular energy production.
The same may be true for muscle and joint tissues, resulting in the aches and pains associated with Lyme disease. In fact there is a type of arthritis associated with Borrelia burgdorferi, known as Lyme Arthritis. This condition is officially reported as being rare, but as with all Lyme associated illnesses, accurate diagnosis and reporting may be well below actual numbers.
Diagnosing Lyme Disease
Diagnosing Lyme disease can be a very difficult task, which is why so many cases are missed, or patients are diagnosed with another illness entirely. For starters, only about 30% of people infected develop the tell-tale 'bulls-eye' rash (erythema migrans) from a tick bite, and even then, physicians often miss it. Sometimes the rash may not present as a 'bulls-eye' but will be more generalized. Patients often don't even remember being bitten by a tick as they often, especially in the nymph phase, are able to feed and drop off unnoticed. The incubation period from infection to onset of erythema migrans, is typically 7 to 14 days, but may be as short as 3 days or as long as many years.
The Canadian Lyme Disease Foundation reports that "Time and again this office receives phone calls from patients who have a rash, and in some cases had had a tick attached at the site, only to be told by their physician to come back a month later for a test. It is imperative that clinicians understand that the presence of a homogenous or "bull's eye" rash caused by a tick-bite is indicative of infection, and treatment should be started immediately. Do not look at this as simply an allergic reaction to the bite. Err on the side of caution. Most blood tests do not work until 4-6 weeks after infection has occurred, and any delay may cause complications at a later date"
There are a number of laboratory tests that doctors may use to try to detect Lyme disease but they are notoriously inaccurate, often producing "false negative" results, i.e. showing that a patient does not have Lyme disease when in fact they do. The reasons for this are due to the fact that the Borrelia burgdorferi spirochete is so adept at evading both our immune cells and conventional bacterial detection methods.
Like other tick-borne organisms, Borrelia burgdorferi, does not have one single, static appearance or chemical signature, but is able to alter these in order to evade detection. It is thought to have a number of genes whose purpose it is to randomly alter the organisms outer surface proteins (OSP's) so as to evade the immune system's fighters. In this way, Borrelia burgdorferi also often evades standard laboratory testing procedures. Add to this ability, the fact that there are 300+ known strains of Bb, and it becomes obvious that this is one elusive bug. It is not uncommon for a patient to display the bulls-eye rash of erythema migrans, and all the other core symptoms of recent Bb infection, only to repeatedly produce negative lab test results.
The Laboratory Tests:
EIA, ELISA, IFA or PCR-DNA probe - According to Dr. Charles. L. Crist, an experienced Lyme disease expert, one of these tests will be the first line of testing used by the average doctor who suspects Lyme. Unfortunately, these tests are not very accurate when it comes to detecting Borrelia burgdorferi infection, but many physicians will tell their patients they do not have Lyme disease based solely upon results from these tests. Of these, the PCR is considered the most reliable
Western Blot - Dr. Crist explains that the Western blot test is usually used as a 'confirmation test' when a patient has already tested positive on one of the above screening tests. He has presented research however (at the 1994 International Lyme Borreliosis Conference held in Bologna, Italy) that shows the Western blot to be much more accurate, detecting Bb infection when a patient has tested negative on previous screening tests. The Western blot test is a sensitive method of detecting antibodies to Bb in a patients blood by forcing them through a gel containing Bb fragments.
Bowen Q-RiBb (Quantitative Rapid Identification of Borrelia Burgdorferi) - A new testing method, that potentially represents a major breakthrough, is the Q-RiBb test, which has now been approved a US patent. Developed by Jo Anne Whitaker, M.D., a prominent international medical researcher, and Lyme disease patient, the Q-RiBb test is unique in its approach and potentially offers much greater accuracy than conventional testing. The method uses a fluorescent antibody technique on whole blood. As it is "quantative", the test can determine the extent of infection and may therefore be able to distinguish the carriers from the patients with serious disease. Another advantage is the brief time required to complete the test. A preliminary report of the findings is provided within 24 hours of receiving the specimen and the final report includes digital photographs of the findings. Finally, the Q-RiBb is the only test that is unaffected by whether the patient is currently (or recently has been) taking antibiotics.
Flow Cytometry - This is the test that Central Florida Research Inc is now using to test for Borrelia burgdorferi infection and Lyme disease. It is considered by many to be the "gold standard" of diagnostic testing at present. The test is essentially a refinement of the Q-RiBb and is such is much more accurate than the Western Blot, and of course the other screening methods. The Central Florida Research Inc website states that a "A Borrelia burgdorferi fluorescent antibody is used to detect the antigen in whole blood. The test is set up manually and read by Flow Cytometry. The Flow Cytometer can count the number of organisms in 100,000 events in 2 minutes and 50,000 in 1 minute. To visually count the organisms in 100,000 events or 50,000 events using a microscope would be almost an impossibility. The Flow Cytometer counts the number of all events passing through the aperture and enumerates the organisms that react with the antibody. The test result will be reported as a percent of the counted events." Essentially this statement is explaining that the Flow Cytometry test is quantitative and is able to detect the severity of infection rather than simply giving a positive or negative result for the presence of Bb. For more information visit the Central Florida Research Inc website.
Erythema Migrans Biopsy
If erythema migrans rash is present then a biopsy should be carried out as soon as possible. If Borrelia burgdorferi is present then it can be cultured from a tissue biopsy. This procedure can give a crucial early diagnosis of Lyme disease many weeks before antibodies will show up on many of the commonly used laboratory tests.
Most Lyme experts agree that current testing methods (with the possible exception of the Q-RiBb) are less than precise and should not be the sole tool used for diagnosing Lyme disease. Instead, a thorough review of possible exposure to ticks, patient symptoms, biopsy, and then the more accurate diagnostic tests, PCR and Western blot, should be used in combination to make a Lyme disease diagnosis.
If Lyme disease is diagnosed in its early stages (erythema migrans), it can often be treated quickly and successfully with oral antibiotic treatment. If there are other symptoms, the patient may be admitted to hospital for further investigation and possible further treatment with antibiotics. In cases of chronic Lyme disease a more holistic approach is often required to restore the patients health. In these cases functional/integrative and alternative medicine approaches are arguably more successful.
Standard Antibiotic Drug Therapy
Medicines used against Lyme disease include:
Oral: doxycycline (eg Vibramycin) (except in children), amoxicillin (eg Amoxil) or cephalosporin antibiotics are the usual first choices.
Studies have demonstrated that when Lyme disease is caught early, 4-6 weeks of oral antibiotics results in remission and apparent cure in most but not all cases. Several months is not uncommon and may be necessary in many instances before a cure is achieved. It is particularly important in this instance to regularly test blood levels on the antibiotic to make sure the level required to eradicate the Bb infection is maintained.
Injection: benzylpenicillin (eg Crystapen), cefotaxime (Claforan) and ceftriaxone (Rocephin) are the usual choices.
Used mainly when severe localized infection is present, especially when there is brain or heart involvement.
Although physicians practicing integrative/functional medicine try to avoid the use of antibiotic drugs because of their potential side-effects, when it comes to treating Lyme disease they often resort to these medicines. The difference is that they will also use other therapies concurrently in an effort bolster resistance to the infection naturally.
Steven J. Bock, MD speaks about the integrative treatment of Lyme disease in the International Journal of Integrative Medicine (May/June 1999):
"Patients with Lyme disease are placed on a nutritional regimen that includes anti-inflammatory eicosanoids, such as fish oil and borage seed oil. A high potency multivitamin/mineral formula is also used. Since muscle pain and spasm are present in many cases, a calcium/magnesium supplement is usually prescribed. Extra magnesium is recommended if symptoms are predominantly of a fibromyalgia symptoms are secondary to the underlying disease. CoQ10 and other mitochondrial nutrients (e.g., carnitine and lipoic acid) promote energy production. Intravenous nutrients, such as vitamin C and B vitamins, are often utilized for immune function enhancement.
When a patient is placed on antibiotic therapy, it is imperative to give him or her probiotics (e.g., Lactobacillus, acidophilus or bifidum) and Saccharomyces boulardii. this prevents imbalance in the intestinal flora, which could lead to intestinal dysbiosis and/or C.dificile infection.
Chronic candidiasis and intestinal dysbiosis are frequently encountered in the treatment of Lyme patients. In some cases, natural anti-fungal therapy is utilized. Nystatin or fluconazole can also be used. Occasionally, intestinal cleansing is necessary. milk thistle extract can help prevent potential dysfunction of liver enzymes from antibiotic therapy."
Other alternative treatments that may benefit the Lyme disease patient include acupuncture, stress reduction techniques and nutritional support for cognitive dysfunction, such as Gingko Biloba, L-Acetyl-Carnitine and pregnenolone.
Dr. Whitaker, who developed the Q-RiBb test, has also developed a treatment called the Bowen Technique. According to www.bowen.org " The Bowen- ANS (Autonomic Nervous System ) technique uses a series of simple gentle moves across muscle and connective tissue. This process is very effective in helping balance many muscular, skeletal nerve or chronic conditions. By balancing the parasympathetic and sympathetic portions of the Autonomic Nervous System, the body begins to heal itself and to be relieved of toxins.
Bowen Therapy is covered by Medicare and many insurances."
Samento - An exciting new natural antibacterial for the treatment of Lyme disease. Samento is also known as TOA-free Cat's Claw or Pentacyclic Alkaloid Chemotype Uncaria tomentosa, to give it it's scientific name. This rare form of the Cat's Claw plant contains pentacyclic oxindole alkaloids (POAs) that have powerful immune system modulating properties, especially relating to non-specific and cellular immunity. What makes Samento special is that it does not contain tetracyclic oxindole alkaloids (TOAs) that, even in very small amounts, inhibit this immune modulating action. Samento also contains generous amounts of acid glycosides, the antimicrobial chemicals found in the latest quinolone antibiotic drugs, the standard treatment for Lyme disease. The combination of POAs and acid glycosides appears to be highly effective in treating Lyme disease by directly killing off the Borrelia burgdorferi spirochete, and increasing the patients immune response and hence resistance, to the pathogen. In an 8 month pilot study, 28 patients suffering from chronic Lyme disease, who had all tested positive for Borrelia burgdorferi on the Western blot test, were split into 2 groups. The control group received standard antibiotic therapy and the experimental group was given Samento. At the end of the study, of the 14 patients in the control group, 3 improved slightly, 3 got worse and the rest had no change. In the Samento group, 85% tested negative for Borrelia burgdorferi when the Western blot was repeated, and all the patients reported a large improvement in their condition (4).
Visit our 'Lyme Disease and Environmental Illness' page to learn about the connections between Lyme disease and chronic fatigue syndrome, fibromyalgia, Gulf war syndrome, autism, mental and emotional problems, and candida.