Information » Diseases » Lyme Disease
A few decades ago, a large cluster of patients were identified as having a new illness. They complained of joint pains, fatigue and a wide range of neurologic symptoms. Eventually, they were found to have an infection with an organism later identified by a doctor named Burgdorfer. It was named Borrelia burgdorferi and we now know that it was transmitted by a tick bite – the Ixodes tick, to be specific. The people lived in Lyme, Connecticut and the disease was named after this town – a dubious honour.
Lyme disease is an escalating health problem that is very under-recognized and very controversial. Classically, it is defined by a specific kind of rash named erythema migrans that looks like a bull’s eye in a person with a history of a tick bite. Early Lyme disease can cause arthritis, cardiac arrhythmias and palpitations, and neurologic symptoms, including headaches, numbness or tingling, problems with vision or hearing, memory or concentration, depression or fatigue.
There are several reasons why it is so controversial. More than half of people with proven Lyme disease do not recall ever being bitten by a tick. More than half of people with proven Lyme disease do not remember having a rash, or developed a rash different from the typical one. Many people have proven Lyme disease even though they have never been to an area where the ticks are known to be; this may be because they can be carried by migratory birds. The long list of symptoms that people with proven Lyme disease present with has much in common with other under-recognized and misunderstood health problems, such as yeast overgrowth, chronic mercury toxicity, adrenal fatigue and psychiatric illnesses.
Even worse, there is no reliable diagnostic test to confirm infection with Borrelia burgdorferi. Blood tests that measure antibodies are negative in about 30% of people with culture-proven Lyme disease, and it becomes less accurate over time as the immune system is less able to react to the infection. Testing for DNA of the organism is positive in only about 35% of cases; this may be because it lives in the connective tissue and not the bloodstream.
The International Lyme and Associated Diseases Society (ILADS), a group expert physicians who treat patients and teach other doctors about Lyme disease, insists that the diagnosis should be made based on symptoms and history of infection – and that blood tests should only be used to support the diagnosis. The most reliable Western blot tests aim to identify a handful of antibodies referred to by their molecular size measured in kilodaltons. They are identified by names such as 31 or 34 kDa. In addition, a specific immune cell named CD57 is suppressed in Lyme disease, so low levels are very suggestive of infection.
The subject of the most controversy is the treatment of Chronic Lyme Disease. ILADS has strong objections to the guidelines published by the societies of mainstream Infectious Diseases specialists. This is because there is fairly strong evidence that a standard 30-day treatment regimen is associated with a failure rate of up to 40 percent. Many ILADS experts recommend a minimum of 4-6 months of treatment with oral or IV antibiotics until patients are without symptoms and/or their CD57 blood levels normalize. They sometimes use two or more antibiotic drugs concurrently. In most cases, oral and IV nutritional supplementation are also required, including magnesium, B vitamins, essential fats, probiotics and many other products.
There are many physicians who treat Lyme in the US, and Dr Jozef Krop in Toronto is probably the person with the most experience in Canada. We do not specialize in the treatment of Chronic Lyme Disease. If you think you may have Lyme, we can help you sort through your symptoms and history to help determine whether infection is likely – or whether you may be suffering from something else. We can also conduct the specialized testing that may support the diagnosis of Lyme. We are willing to treat patients with long-term antibiotics, as we have seen very encouraging results with many patients, but we also recommend that you seek consultation with an expert.