Tuesday, May 27, 2014

Lyme Disease: The Great Imitator

Guest post by by Dr. Amanda Hegnauer, N.D., Naturopathic Doctor & Co-op Wellness Educator

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; therefore, residence does not accurately reflect a person’s 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 percent of patients with Lyme disease recall a tick bite. In some studies this number is as low as 15 percent in the culture-proven infection of the Lyme spirochete. Fewer than 50 percent 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 more commonly seen.

Not only are we to combat Borrelia burgdorferi but there are five subspecies and more than 100 strains in the United States and 300 strains worldwide. This diversity may contribute to its ability to evade the immune system and antibiotic therapy, leading to chronic infection. Not only should we test for Borrelia but also Lyme co-infectors including Babesia, Anaplasma, Ehrlichia, and Bartonella. The presence of a 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.

Click here for more on what to do in the event of a tick bite.

The Difficulty of Testing

The accuracy and reliability of testing for Lyme disease is surrounded by a great deal of controversy and opinion. The ELISA screening test is unreliable; it misses 35 percent of culture-proven Lyme disease (only 65 percent sensitivity) and is unacceptable as the first step of a two-step screening protocol. By definition, a screening test should have at least 95 percent sensitivity. The next test to consider is the Western Blot Blood test. Of patients with acute culture-proven Lyme disease, 20 to 30 percent remain seronegative on serial western blot sampling. Antibody titers also appear to decline over time. So, 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.

According to a recent alert from the NH Divisions of Public Health Services, recent reports of sudden cardiac death attributed to Lyme disease carditis highlights the importance of prompt diagnosis and treatment of Lyme disease. New Hampshire has the highest reported incidence of Lyme Disease per capita than any other state in the nation, according to the Centers for Disease Control and Prevention.

Lyme Treatment

Antibiotic TreatmentMost 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 re-treatment 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.

Naturopathic medicine offers a unique approach in which the doctor can determine the root cause of disease and individualize a treatment plan that may or may not include antibiotics as well as natural therapies. We often support the immune system, balance hormones and the adrenal glands, eliminate toxins, focus on a whole foods diet, and eliminate food sensitivity. We always focus on the center of the body’s universe: the gut. High-dose antibiotics have a propensity to eat away at the gut, disrupting the natural course of healthy bacteria.

Natural TherapiesSelf-treatment of Lyme with natural remedies is tricky because it is so individualized. Treatment is based on fighting the disease intra- and/or extra-cellularly and per symptoms. Self-treatment – even with natural therapies – can be challenging because a patient may start to utilize a therapy that is not appropriate for his/her needs.

We always treat the immune system because Lyme disease can initiate an underlying autoimmune concern. It takes a real toll on the immune system even if there is no underlying pathology.  It is important to note that any treatment may exacerbate a Herxheimer Response.  Therefore, please consult your health care provider prior to initiating treatment.  However it is always valuable for patients to educate themselves about possible therapies! These include....

Immune system support:
  • Citrus bioflavonoids
  • Cordyceps mushroom
  • Maitake mushroom
  • Reishi mushroom
  • Shiitake mushroom
  • Gingko
  • Vitamins: Vitamins C & D-3, B Vitamins
Herbs specific to Lyme disease and general symptoms of inflammation:
  • Andrographis
  • Cats Claw
  • Eleuthero
  • Pau D’Arco
  • Teasel Root

Homeopathy, hydrotherapy, acupuncture, reiki and massage therapy can also help in a natural approach.

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.


Dr. Hegnauer practices naturopathic medicine at Whole Health Concord. Her specialties include autoimmune disease, chronic fatigue, endocrinology, gastroenterology, and women’s health. Learn more at www.naturalmedicinenh.com.

The statements made on this blog have not been evaluated by the FDA and are not intended to diagnose, prescribe, recommend, or offer medical advice. Please see your health care practitioner for help regarding choices and to avoid herb-drug interactions.

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