Lyme disease can cause devastating effects on your health. Symptoms of Lyme disease can mimic many other diseases and, unless you get the obvious bullseye rash, it may be extremely difficult to pinpoint the cause of your symptoms, leading to a misdiagnosis.
30,000 cases a year are reported to the Centers for Disease Control, but many more are not reported. The CDC estimates that “approximately 300,000 people may get Lyme disease each year in the United States.” Since Lyme disease is not simple to diagnose after it has progressed, the total number of Americans infected each year may be even higher than CDC estimates.
What is Lyme Disease?
Lyme disease originates from a bacterium that is transmitted through the bite of certain types of ticks. Fortunately for humanity, we are not able to transmit it to each other. As a tick goes through its life cycle, it feeds on blood once in each stage. Larva, ticks in the baby stage, do not begin to carry the bacteria until they feed on an animal which carries the organism. However, the nymph and adult may carry it before feeding and transmit it through their bite.
The good news is that normally the tick does not transmit the bacteria until it has been attached for 36-48 hours. So, if you inspect your body for ticks and are able to remove them shortly after they have attached, you are probably safe from developing Lyme disease. The bad news is that this is harder than it seems. Adult ticks are relatively easy to spot but the nymphal stage tick is much more difficult to see or identify. To minimize your chances of developing Lyme disease, be aware of what a tick nymph looks like, and thoroughly check your body after being in areas where ticks thrive.
The first few weeks are called acute Lyme disease. During this stage, symptoms are easily mistaken for the flu and are sometimes accompanied by a rash, called erythema migrans (EM). Somewhere between three and thirty days after being infected, up to 70 or 80 percent of people will develop this rash. It usually grows until it reaches around six inches across but can spread to over a foot in diameter and will last for three to five weeks. It often has a distinct bullseye pattern but may not. Further confusing the issue, some people will develop the rash in multiple places on their body. Luckily, it is rarely painful or itchy.
Other common early symptoms include headache, chills, mild fever, achiness, joint pain, fatigue, and swollen lymph glands. After the first few weeks, it progresses to late Lyme disease. At this point, the bacteria have reproduced and spread enough to cause more severe symptoms.
Joint pains begin to migrate, and the headache, fever, and fatigue worsen. Depending on how the disease affects you, you could have a sore throat, stiff, aching neck, changes in vision, facial palsy, nerve pain, numbness or tingling in your extremities, or shortness of breath.
Some of the more extreme symptoms of Lyme disease include arthritis in one or more large joints with severe pain and swelling, and heart problems, called Lyme carditis. Neurological disorders are also common if your central nervous system is involved, and may result in dizziness, short-term memory loss, difficulty concentrating, mental fog, and confusion.
As you can see, Lyme disease can impact you in a wide variety of ways. While this list seems diverse, it is not exhaustive, and there are many other symptoms observed in those with Lyme disease.
More About the Bacteria Which Cause Lyme Disease
Borrelia burgdorferi is the bacteria commonly known to cause Lyme disease. There are many strains of this bacterium, and at least 16 cause Lyme disease. Once you are exposed to a strain, your body begins creating antibodies, which are Y shaped proteins, that find the intruder and stick to it, so your immune system knows to destroy the antigen. Unfortunately, your body only creates antigens for the specific strain you were exposed to, so it is possible to be infected by multiple different strains of Borrelia that can cause Lyme disease. Researchers also have not determined how long immunity lasts after exposure so it may be possible to be infected by the same strain years later.
In 2016, researchers at the Mayo Clinic found that another Borrelia species called Borrelia mayonii also causes Lyme disease. In addition to the diverse symptoms of Lyme disease caused by Borrelia burgdorferi, when you are infected with B. mayonii you may have additional symptoms of nausea, vomiting and neurological symptoms. Currently, the only way to identify Lyme disease caused by this strain is to identify the bacterium in a blood smear from an infected person or with a different Lyme disease PCR test, which you can only get through the Mayo Clinic.
Another species of Borrelia, known as Borrelia miyamotoi, also causes Relapsing Fever, which humans can get through the bites of ticks and lice. Common symptoms of relapsing fever include a severe headache, nausea, vomiting, high fever, chills, muscle and joint pain, a rash, and delirium. Other, more severe and dangerous symptoms may also occur. The symptoms last three to five days, abruptly clear up, then return a week or two later. Untreated patients may relapse 2 to 10 times.
Testing and Diagnosing Lyme Disease
One of the biggest problems with diagnosing Lyme disease is in recognizing symptoms if the rash is not present. Many patients do not remember getting bitten by a tick or developing the erythema migrans rash. Since Lyme disease mimics so many other diseases, it is easily misdiagnosed. If Lyme disease is suspected, your doctor will diagnose you based on your symptoms, and whether you have been exposed to black-legged ticks. If you have the rash, you can start treatment without any testing. To correctly diagnose Lyme disease, the CDC recommends a two-step process of blood testing.
The first test is an enzyme-linked immunosorbent assay (ELISA or EIA). This test detects whether your body has created antibodies to specific antigens, in this case to Borrelia burgdorferi. The ELISA works by taking a blood sample and introducing a specific antigen to the blood. If antibodies to that antigen are present, the antigens will attach to the antibodies, giving a positive result. However, you can receive a false positive if you have a few other diseases, so if the test is positive or equivocal you then move to step two, a Western Blot test.
The Western Blot Test works similarly to the ELISA but is much more sensitive. There are two Western Blot tests that can detect antibodies indicating you have Lyme disease. The Lyme IgM detects antibodies present as early as one week after the infection. The Lyme IgG shows antibodies that appear a few months after exposure.
If the Western Blot is more sensitive, why bother with the first step? Unfortunately, patients with similar infections can also test positive for Lyme. Additionally, according to IGeneX, the maker of the Western Blot, “A negative Western Blot does not exclude the possibility of infection with B. burgdorferi.” Therefore, an accurate diagnosis is much more likely if both tests are conducted together.
Why would you go on to further testing if both recommended tests are either negative or inconclusive?
There are quite a few reasons for further testing. Borrelia burgdorferi reproduces far more slowly than other bacteria, so it takes longer for you to produce enough antibodies to get a positive result on conventional tests. If you have a suppressed immune system, it will also take far longer than usual to get a positive Western Blot. Early treatment prevents the bacteria from spreading as much, which may help your symptoms to be less severe and allow you to have a complete recovery. Other tests may help us diagnose you with Lyme Disease earlier than with conventional tests.
As mentioned earlier, another Borrelia species, B mayonii, also causes Lyme Disease. This is problematic because there are more than 30 Borrelia species, and current FDA approved testing only identifies antibodies for one specific species. We do not yet know which of the other species and strains also cause Lyme Disease or similar diseases such as Relapsing Fever. Other tests may show if you have an infection from additional strains.
For these reasons, if the ELISA and Western Blot tests are not positive but your clinical history points to Lyme disease, we will consider a few extra tests that are also proven to help diagnose Lyme disease. The recommended Western Blot test is produced by IGeneX and, at Temecula Center for Integrative Medicine, we utilize additional tests they and a few other reputable companies offer for determining if you suffer from Lyme disease. The Lyme Immunoblot is more sensitive and specific than ELISA or Western Blot and is useful when antibody levels are very low. The Lyme IGXSpot detects specific T-cell responses when they are reacting to B. burgdorferi before antibodies are able to be detected. A PCR test determines whether gene fragments specific to B. burgdorferi DNA sequences are present. The GLD test reduces false positives by eliminating proteins from other infections and minimizes false negatives by targeting a wider range of Lyme causing bacteria. Using one or more of these tests may help us determine if you have Lyme disease when conventional tests cannot.
The first few weeks after infection are considered to be the acute stage of Lyme disease, and treatment in this stage is often relatively simple with a course of oral antibiotics. If you are treated in the first few weeks, you will probably recover quickly and completely.
After the first few weeks, the disease enters later stages. At this point, symptoms begin to worsen, and treatment becomes more complicated. Antibiotics will still be essential, but you will probably need additional therapies for recovery since antibiotics may be less effective against certain symptoms. A study by John J. Halperin states “In contrast to the overwhelming evidence that Borrelia infections are readily cured with antimicrobial therapy, there is abundant evidence that antibiotic treatment is ineffective in patients with persistent fatigue and cognitive symptoms following appropriately diagnosed and treated Lyme disease.”
At any stage, but especially when antibiotic treatment is begun later in the disease, you may continue to have fatigue, pain, joint or muscle aches, or long-term damage to joints or the nervous system, long after completing the antibiotics. This has led many to use the term chronic Lyme disease although it is not currently recognized. Chronic LD can refer to untreated late Lyme disease, post-treatment Lyme disease syndrome, and other similar diseases from tick bites.
Treatment at any stage may also be more difficult because Borrelia have the ability to suppress the immune system and also to make themselves invisible to it. Studies suggest that Borrelia can go dormant when being attacked and may even be able to mutate its own genes to become antibiotic resistant. Complicating the issue, coinfections are common with Lyme disease. Therefore, your treatment regimen will need to address coinfections and support your immune system in a variety of ways to help you gain a more thorough recovery from Lyme Disease in any stage.
How can Functional Medicine help you recover from Lyme Disease?
Functional medicine treats your whole body, not merely the symptoms of your disease. This allows functional medicine practitioners the ability to more completely heal your body from the ravages of Lyme disease. At Temecula Center for Integrative Medicine, we use this approach to heal your Lyme disease and any co-infections.
First, we look at your detailed health history to identify the cause of your symptoms. In addition to testing for Lyme disease, we look for any co-infections and environmental toxin exposure complicating the picture. Before treating with antibiotics, we will analyze your gut function and prepare the gut to tolerate the barrage of antibiotics necessary to treat borreliosis or Lyme disease.
After healing and strengthening the gut and confirming the diagnosis, we work to remove or reduce the bacterial load on your body. This is where antibiotics come into play. Some people respond well to the usual antibiotics. Others, especially those with compromised immune systems, may tolerate botanical antibiotics better than those commonly used in conventional medicine.
Lyme disease impairs the immune system which therefore needs to be strengthened. This is done through a variety of ways. Probiotics, botanicals, and nutraceutical supplements are common therapies for strengthening your immune system. We may also utilize IV Nutritional therapy to expedite the healing, which could include oxidative IV treatments like IV ozone or high dose vitamin C. Nutrition is FOUNDATIONAL to the health of your immune system so we will probably modify your diet. You may need to be on a low-carb diet for a while since sugars not only feed bacteria but may also suppress your immune system for up to 16 hours every time you consume them.
In some cases, we may need to treat your immune system for a while before beginning antibiotics to combat Lyme disease. If you have chronic Lyme disease, your treatment could take three to seven years and will likely involve many cycles of strengthening your gut and immune system as well as intervals of triple antibiotic therapies. We will also address any co-infections, as well as help you make lifestyle changes.
Lastly, a continual focus on detoxification processes and lymphatic drainage will aid in the healing process as biological and environmental toxins, such as pesticides, heavy metals, and plastics are eliminated, reducing their compromising capabilities to your health and impeding your progress toward wellness.
Many people suffer from persistent Lyme disease because they are not properly diagnosed, are treated with an insufficient course of antibiotics not allowing for proper eradication of the bacteria from their bodies, or have a weakened immune system or damaged gut lining that needs support to fully heal. The doctors at Temecula Center for Integrative Medicine have experience identifying Lyme Disease, and helping those who have suffered for years heal and return to health. If you think Lyme disease may be the root of your problems, please call us to schedule an appointment!
Dr. Lundquist is Board Certified in Family Medicine with ABFM and he is sub-specialized with the American Board of Integrative Medicine (ABoIM). He has also has received a certification from the American Board of Integrative and Holistic Medicine (ABIHM).
Dr. Lundquist has a special interest in Integrative and Holistic medicine. He is currently the founder and medical director for the Temecula Center for Integrative Medicine specializing in all aspects of Functional Medicine. He is a member of the American Holistic Medical Association as well as the Institute of Functional Medicine. He specializes in endocrine disorders especially thyroid and adrenal dysfunction, chronic fatigue, migraine headaches, cardio metabolic disorders, and chronic pain.