Lyme Disease and its Co-Infections

Lyme Disease

Lyme Syndrome was first discovered and named in 1977. It was named in the United States when an inflammatory arthritis was observed in a cluster of children in and around Old Lyme, Connecticut. About 20,000 cases are reported per year, but underreporting is a major issue. Only 10% of the cases are reported to the CDC, making the annual incidence at least 180,000 cases per year. The total number of cases are estimated in the millions.

Lyme Disease

Lyme Disease is known as the great imposter or great masquerader. It mimics over 350 different medical conditions including but not limited to: Rheumatoid arthritis, fibromyalgia, chronic fatigue syndrome, Lupus, vasculitis, chronic neck pain, chronic back pain, multiple sclerosis, Lou Gehrig’s disease, dementia, Alzheimer’s, chronic headache, migraines, irritable bowel, ulcerative colitis, Crohn’s, interstitial cystitis, chronic sinusitis, chronic bronchitis, and asthma. Also noted are depression and other hormonal imbalances.

The tick geographic penetration which transmits Lyme is most common in northeastern states, but at the present time its prevalence is nationwide and worldwide, reported from every state.

Borrelia, which is Lyme, and the other tick-born pathogens such as Babesia and Bartonella are transmitted principally through the bite of a tick. The infection rate in tick populations varies by location and from year to year. Many new varieties and genospecies of Borrelia have arisen in recent years due to the organism adapting to its local environment. That is, there are many new emergent species of tick-borne infections, and tests do not exist for all these pathogens. It must also be noted that in addition to ticks, 22% of horseflies, deerflies, and mosquito infection is also a carrier with Lyme and its co-infection in endemic areas. A tick, flea or mosquito caused the bite, but the bite is only remembered in 17% of patient cases.

Inflammation causes most of the symptoms found in people with Lyme disease. If you can lower the inflammation in the body, it is possible to become symptom free from Lyme, even if tick-borne microbes are still present.

The Lyme spirochetes spread along the matrix both intracellularly and extracellularly. They invade the skin, heart, brain, blood vessels, lymphatics, muscles, tendons, joints, synovial fluid, spleen, liver and kidneys. Lyme has a predilection for articular, vascular, muscular and nervous system, and can penetrate almost any tissue and reside in there for months or years extracellularly, as well as intracellularly.

Favorite sites include the endothelial wall of the cerebral arterioles and capillaries, and peripheral nerves and synovial cells and joints. They also invade the immune system. At the present time, there are about 300 different strains of Lyme existing. They express different organ specificity as well as variable degrees of antibiotic resistance. In addition, they induce variable disease manifestations as well as variable antibody responses.

LYME DISSEMINATION:

Early localized disease at 3 to 30 days after infected tick bite is the time to catch it, at or before the onset of symptoms. This phase is curable if treated promptly with oral antibiotics. The next phase includes the early disseminated disease, one to 12 weeks after an infected tick bite. There is multi-system disease, although there is good response to antibiotics. In the late dissemination phase, more than 3 months after a bite, there is complex multi-system, multi-organ progressive, disabling syndrome present.

So, when you see an early, localized disease, do not wait to treat! Remember, the Bullseye rash is only seen in approximately 36% of cases. It can last a few hours or longer than 6 weeks. It is usually small or very large, round, ovoid and can imitate skin problems like hives, eczema, tinea, or sunburn poison ivy. Also note the rash can reappear several weeks, months or years after initial presentation.

GENERAL FEATURES OF EARLY DISSEMINATED LYME DISEASE:

These include the gradual onset of fatigue, muscle aches with neck stiffness, neck pain, headache, memory flow. There is joint pain and stiffness, knee effusion, and progressive brain and nerve involvements.

The neurologic manifestations of late disseminated disease include sleep disturbances, severe insomnia, sensory loss, loss of smell, taste, hearing, visual disturbances, and touch, peripheral neuropathy, searing pain, numbness, tingling, pins-and-needles, burning, crawling, and a stinging sensation. Memory loss with diminished visual working verbal memory and processing speed can also be seen. There is decreased concentration, recall, retrieval of words and word substitution with confusion and disorientation.

In the later stages, there are multiple cranial neuropathies.

  • Facial paralysis (called Bell’s palsy),
  • Diplopia
  • Vertigo
  • Dysphasia
  • Hoarseness
  • Intractable nausea
  • Vomiting
  • Diarrhea
  • Tachy- or bradyarrhythmias
  • Chest pain

Other symptoms seen are spinal radicular pain, migraine headaches, tension, and sinus pain. Late manifestations of disseminated disease include demyelinating-like symptoms similar to multiple sclerosis or amyotrophic lateral sclerosis (otherwise known as Lou Gehrig’s Disease).

Ascending paralysis as in Guillain-Barré is also seen. Limb paralysis with peroneal nerve paralysis, footdrop and mononeuritis multiplex can also be seen.

Neurologic testing of latent Lyme is associated with measurable EEG (that is brain wave) abnormalities in temporal lobe spikes. Of interest are delta wave hyperactivity of the posterior cortex and beta wave hyperactivity which depends on psychiatric co-morbidity.

NEUROLOGIC IMAGING AND TESTING FOR ENCEPHALITIS

SPECT, CT and PET scans are dynamic pictures of brain function, metabolism, brain flow and chemistry. These patients note hypometabolism, and associated decrease in local blood flow both in the cortex and subcortical white matter. Serial testing suggests change.

Brain CT scanning findings are also normal, but there may be hypodense areas corresponding to ischemic lesions in portions of the patient with Lyme encephalopathy.

Lyme MRI Findings

they are normal in most cases of acute and early disseminated stages, but are abnormal in 20 to 40% of patients with Lyme encephalopathy. Punctate white matter demyelinization lesions are noted on T2-weighting. Also noted are multiple sclerosis-like lesions that are also heightened in distributions.

Cerebrospinal fluid typically is low-yield, less than 10% PCR-positive. There is increased intracranial pressure, mildly elevated protein, and usual normal glucose.

Neuropsychiatric manifestations include:

Prolonged panic attack, mood swings, irritability, low frustration tolerance, rage response, violence, mania, OCD, eating disorders, depression, and self-destructive behavior. Additionally, there is cognitive overload with memory loss, confusion, loss of focus, brain-thought pursuance with lack of clarity, depersonalization and loss of self and space. Patients sometimes have disturbed spatial orientation with altered speech and fluency, that is, word searching and stutter.

Chronic arthritis of late disseminated Lyme.

This includes a mono, oligo, or polyarticular septic arthritis involving the large joints, mainly the knees, hips or shoulders. These are seen in 60% of untreated Lyme. Please note that persistent intraarticular infection stimulates both inflammation and autoimmune responses. Treatment includes both traditional prescription medications and nutritionals.

Multi-hormonal dysregulation.

This usually presents as lack of stamina, fatigue wand exhaustion. There is loss of libido and encephalopathy despite treatment, intolerance to stress, irritability, and weight gain is seen in the majority with a minority showing weight loss. Also, there appears to be disturbances of the hypothalamic pituitary access with hypoparathyroidism, hypogonadism, ovarian failure, hypothyroidism, adrenal fatigue, diabetes insipidus and diminished growth hormone.

Neuro-mediated hypotension.

This is often seen with symptoms of dehydration and hypotension in a supine or orthostatic position. There is autonomic neuropathy present with pituitary insufficiency. The patient exhibits a paradoxic response to adrenalin with profound fatigue and adrenalin rushes with palpitations and the unavoidable need to lie down.

Autonomic neuropathy. There is decreased or increased sweating, anorexia, nausea, vomiting, diarrhea, constipation, esophageal dysmotility, urinary or fecal incontinence, sleep apnea, sleep movement disorders, and altered heart rate and arrhythmias.

No organ is spared.

Ear: There is pain, hearing loss, ringing, and noise sensitivity. Eyes: Pain, conjunctivitis, blurred vision.

Throat: Sore throat, swollen glands, chronic cough, hoarseness.

Jaw: Jaw pain, difficulty chewing.

Lungs: Cough, asthma, respiratory infections, shortness of breath.

Esophagus: Difficulty swallowing, choking on food. Liver or stomach: Pain, nausea, vomiting, abdominal cramps.

Heart: Weakness, palpitations, irregular heart beat, fainting, chest pain, shortness of breath, heart blockage.

Bladder: Frequency, repeated urinary tract infections.

WHY IS CHRONIC, PERSISTENT LYME SO SEVERE?

There appears to be a high spirochete load either through multiple tick bites or long duration of unrecognized infection. There are the creation of Bio-films or protected niches made up of mucopolysaccharides in which the infections hide. There are also alternative forms of Lyme such as the cyst, the L and the modal form. In addition to all of this, there is immune suppression of the host.

SO WHY IS IT SO SEVERE?

I think it is the presence of co-infections and premorbid states such as steroids, immuno-suppressive drugs, diabetes, heart failure, autoimmune disease, other chronic infection states like Epstein-Barré, HHV-6, Cytomegalovirus, salmonella, Brucella, etc. The complex causality is a genetic predisposition for detox dysfunction. There is evidence of heavy metals and toxic overload as well as influence of EMS and radiation.

HEAVY METAL OVERLOAD:

Heavy metal overload magnifies overlying symptoms. Its presence significantly weakens immune response, causes inflammation, and triggers autoimmunity through Hapten’s mechanism. There is also increased susceptibility to a wide variety of infections and unmasking latent infections. Heavy metals accelerate all types of degenerative disease and increase the risk of cancer. It leads to a sicker patient and slower recovery. You should suspect it if slow clinical response or in the presence of intractable neurologic symptoms.

Sources of free radicals must be eliminated. These sources include radiation, heavy metals like mercury, lead, arsenic, silver, gold, cadmium, cigarette smoke, cellulite, cooked-oriented fats, and neurotoxins of mold, Strep, Lyme, etc. Excess iron and copper must also be removed. Solvents such as benzene, xylene, toluene and methylene chloride are absolutely bad for the system, and gases such as carbon monoxide, formaldehyde and plastics should be removed.

DIAGNOSTIC TESTING:

There is no Gold Standard laboratory test at the present time, since the testing of Lyme’s Disease and its associated co-infections is in its infancy. Be aware that the Lyme number is sparse in number, and it is found in the tissues and not in the blood except briefly when it initially disseminates.

Serologic tests such as ELISA have a low sensitivity of approximately __%. They are a poor screening tool. Lumbar puncture, in addition, has a very low yield. PCRs have about a 30% sensitivity. They can be done on whole blood, serum, urine, bone marrow, or biopsy material such as gallbladder, tonsils, duodenal, colon and synovial fluid.

Lyme Western Blot test. This test measures antibody to a specific Lyme antigen or protein reported as a numbered band. Some highly specific bands are indicative of Lyme.

The Western Blot test is another commonly recommended way to test for Borrelia. Its sensitivity is somewhat higher than that of ELISA. About half of the people with Borrelia infection will test positive for infection using this test. As with the ELISA, the more ill a person is, the less likely he or she will test positive with this test.

IgeneX provides the most accurate Western Blot test results in the United States, and possibly worldwide. But remember, people may have false-positive Western Blot tests if the Borrelia is hiding in their cells in a cystic form or if they have been suppressed, or if they have suppressed antibody response. Also, if the antibodies for Borrelia are hiding within the immune complexes or the Borrelia level in the body are too low to create immune response.

A new test called the Urine Antigen Capture test detects Borrelia DNA in the urine.

The only problem with this type of test is that bacteria are uniformly present in body tissues or fluids, false-negative results may be common. Like the PCR test, sensitivity of this testing may be increased by taking antibiotics for several days prior.

Another new test called the T-Cell Stimulation Assay may also be useful for detecting Borrelia infections.

It looks for the presence of proteins from inside certain immune cells called T-cells. As with all tests, however, it has its limitations. Not everyone with Borrelia tests positive for infection. This test may also only detect the presence of exposure to Borrelia organisms rather than their current infection status.

New tests that are available, include a new PCR test called Spiro Stat Technologies.

They test for a large number of tick-borne infections including multiple species.

Its frequency of human versus nonhuman genes in the sequence information is then compared to the genomic sequences of all known vector-borne pathology.

This powerful technology allows Spiro Stat to detect and identify virtually all vector-borne pathogens.

Finally, another new promising type of tests involve culturing Borrelia in the laboratory.

Typically in a female this has been difficult to do, but new methods are now making it easy. Because culturing is a direct way to measure the presence of Lyme organism within a tissue sample, sensitivity culture testing could be as high as 80% according to some estimates, and maybe even higher. People with Borrelia who ordinarily would test negative with another type of test would be likely to test positive via culture testing.

Advanced Lab Services now offers these. Another benefit to culture testing is that all species of Borrelia that a person is affected with can be tested for. Currently, most labs can only detect a few species, but more than 20 are known to affect humans. Other testing includes C4a as well as low CD57 counts.

LYME: SO, HOW DO YOU MAKE THE DIAGNOSIS?

Lyme is a clinical diagnosis, and tests are only an adjunct. Remember, negative tests do not rule out Lyme. Lyme can be present with negative blood tests in all stages of Lyme. At the present time, there is currently no cost-efficient or simple mechanism to positively test for Lyme. There is no test of cure. But remember, I think a combination of testing or culture might be appropriate for most individuals.

TREATMENT OF LYME AND ASSOCIATED CO-INFECTIONS:

Lyme treatment is controversial at the present time. Depending on the stage and severity of the patient, either oral or intravenous antibiotics are used along with natural therapies.

Tick-borne common infections include Bartonella, Babesia, Ehrlichia, Q Fever, Rocky Mountain Spotted Fever, Colorado Tick Fever, mycoplasma and Chlamydia. Each tick-borne co-infection has similar but different symptoms. Lyme and its co-infections is a syndrome not just an infection. There are multiple imbalances.

There is immune imbalance, communication dysregulation, neurologic impairment, endocrine malfunction, gastrointestinal damage and dysbiosis; there is toxic-mediated impairment, end-organ damage, and neurophysiologic damage.

Doctors treat Lyme in different ways.

At one extreme, there may be the administration of multiple high doses of toxic antibiotics at the onset of treatment. At the other extreme, they may start their patients off on a low-dose of one or two antibiotics along with natural substances. Other doctors avoid antibiotics and use a more natural, gentler approach. Herbal remedies can be used as a stand-alone treatment for Lyme or as a complement to antibiotics. Herbs can, in some cases, be just as effective as antibiotics for treating infections, if not more so.

LYME DISEASE TREATMENT CONSIDERATIONS:

Herxheimer reaction is a detoxification reaction that increases inflammation. This inflammation can further upset homeostasis and can be harmful if not adequately treated. Over-aggressive treatment causes the Herxheimer, and slow-as-you-go is the best way. If this occurs, you may even temporarily stop your treatment.

Challenges to effective Lyme treatment include a compromised immune system, a genetic inability to detoxify, inflammation, lack of enzyme activity in the gut, nutritional deficiencies, and emotional trauma. The fact that most people have many infections including virus, mycoplasma, protozoa, parasites, Bio-films, Chlamydia, and others, must be stressed.

Heavy metals, mitochondrial dysfunction and adrenal fatigue, as well as low thyroid also suppress the immune system and render treatments for Lyme infections less effective or ineffective.

They must be corrected. Additionally, intravenous glutathione as well as PHOSPHYTIDYL CHOLINE lowers the inflammatory cytokines and may be helpful. The other Lyme co-infections include mycoplasma and Ehrlichia. These involve specific antibiotics or herbal remedies.

WHEN ARE HERBAL REMEDIES THE MOST EFFECTIVE AND USEFUL?

I feel that they should be used when the patient relapses on antibiotic treatment or the patient has a weak, depleted vitality, and the illness is slow and smoldering.

Antibiotics tend to be a better choice in people with rapidly escalating symptoms who have heavy neurological involvement in their overall symptoms picture. They are useful in people who are in the early stages of Lyme such as acute Lyme, children, and the elderly. Also, they appear necessary in people with co-infections, and those with good preexisting vitality.

But remember, people have various responses to pharmaceutical antibiotics; in some cases they can be life-threatening, but not in others. I use both therapies, but start with repairing the body. I employ remedies that include immune function detoxification, enzyme activity and Bio-films. Of course, mold toxicity is also ruled out.

SUMMARY

According to the Infectious Diseases Society of America (IDSA), most Lyme disease does not exist.

They do acknowledge the existence of acute Lyme disease, however, and believe that taking 10 to 20 days of antibiotic treatment is sufficient for treating it.

Unfortunately, the IDSA recommendations are based on flawed guidelines that were established by the National Institute of Health. IDSA dismissed extensive studies and clinical evidence of scientists and clinicians that proves the existence of chronic Lyme disease and the effectiveness of prolonged treatment.

If you have any of the symptoms in this article, you might have Lyme or a co-infection. Lyme is very similar to tertiary syphilis; that is, it is a spirochete. The treatment is based on an extensive History and Physical, along with relevant blood testing, by Western Blot, PCR, and/or culture.

Other co-infections are ruled out along with the possibility of toxic heavy metals, EMS in the environment, parasites, and virus. Detoxification of the patient is evaluated along with extensive immunologic testing. Therapies – either natural or prescription – are instituted when indicated.

Remember, the causes of Lyme are multifactorial and patients are different. Early detection, evaluation and treatment are the key.

If after reading this article, you feel I can help, please feel free to call me for consultation.