Lyme disease & co-infections

Lyme disease and related co-infections are becoming more prevalent.

All over the United States we have people getting sick from Lyme, many have never had a tick bite, some know of someone with Lyme disease, few had the typical tick bite, fever, bulls eye rash, stiff neck with joint pain.

Lyme-complex illness is the name given to many tick borne illnesses due to the fact that most of the time these infections occur together. This is likely because a single organism may not be virulent enough to have a significant impact on health and evade or overpower the defence mechanisms. Pathological synergism is a twelve dollar word describing this phenomenon.

Multiple causative factors: our current understanding is that there are usually a combination of factors involved in the causation of Lyme-complex illness, including multiple infections, various toxicities like mold, mercury and whole trainload of other chemicals, blood clotting issues, digestive and nutritional status issues, food and environmental allergies, inflammation, energy production problems, hormonal problems, nervous system degeneration, emotional and psychiatric orders, sleep issues, deconditioning due to lack of exercise to name only a few components of the average lyme complex case we successfully help.

One of the giants that shaped the character of science and bacteriology as it relates to human health and disease was Claude Bernard [1813-1878] who said these famous and foundational words, especially relevant to Lyme complex:

“The terrain is everything; the germ is nothing,”

His contemporary, Louis Pasteur, considered the father of vaccination and pasteurization, said these [disputed] words on his deathbed:

Bernard was right; the pathogen is nothing; the terrain is everything.”

 The above is intended to bring your attention to the importance of the homeostatic and healing mechanisms of the body in which the infections are to get a foothold and cause their characteristic imprint.

The character sketches of the infections is intended to give you a glimpse of what we look at as medical detectives, as far as the  footprints we look for when we assess patients.

Lyme Screening tool: use Dr Horowitz’s lyme screening questionnaire if you think you have symptoms of Lyme Complex Illness

Lyme disease  (Borrelia bergdorferi, B. afzelii and B.garinii)  

Lyme is a bacterium that looks like a coiled hair or spring. They are very active and uses a sophisticated rotor like tail to propel themselves into the tissues and literally thrash their way through cell membranes.

Lyme and its common co-infections share many similar mechanisms and can produce similar general symptoms, with frequent overlap in is general and also specific presentation. This makes the work of the medical detective a bit more challenging and also interesting. We therefore use a combination of symptomatic “evidence”, thorough laboratory test investigations and therapeutic trials of preferably natural organism-specific natural medicines.

Lyme bacteria are very “intelligent” and can survive in a various hosts due to flexibly rearranging their gene structure and expression of outer surface proteins. They are really parasites and use nutrients and resources from the host, which makes the illness more difficult to treat as they strip your defence system, making it easy to evade your immune system.

Lyme borrelia bacteria has been found in human breast milk, tears, semen and urine. Babies can be infected via the placenta or birth if the mother has Lyme.

Lyme disease EM or bulls eye rash – it does not happen with the first inoculation, if you get a rash from a tick bite, you already had Lyme bacteria in your body.

Clinically there are three Lyme Disease stages: acute, early disseminated and late, chronic disseminated lyme.

We mostly see people in the chronic, later disseminated phase where many body systems, including the nervous system is affected.

Symptoms are mostly neurological, muscle pain, joint pain and arthritis, fevers, stiff neck, fatigue, brain fog, problems with memory and thinking, fibromyalgia with pain and fatigue, chronic fatigue syndrome with more fatigue and less pain, heart disease and neurodegenerative problems like MS, autoimmune conditions are also very common. Many patients have had MS, lupus and other scary diagnosis given and taken away by various well meaning specialists – but the symptoms remain in their waxing and waning periodicity. There is usually a monthly cycle of symptoms intensification, in females it is usually linked to their menstrual cycles.

The self-help home Lyme Screening Questionnaire by Dr Horowitz is a helpful tool to consider if you need further workup or a visit with a lyme literate doctor.

Fun review of the Borrelia species.

Links for more descriptions of lyme symptoms:

http://www.cdc.gov/lyme/

http://www.cdc.gov/lyme/signs_symptoms/index.html

http://www.ilads.org/lyme/about-lyme.php

 

Rickettsial illness, Rocky mountain spotted fever, Q fever
(Rickettsia typhi, C. burnetti, R. africa, R. conorii, R. prowazekii)

The most common Rickettsial illness in the US is Rocky Mountain Spotted Fever caused by Rickettsia rickettsii.

We do not see many acute cases here in Oregon and rarely find titers representing chronic infections in patients. The acute illness has a characteristic rash in about half of patients, low white blood cells, low platelet counts, elevated liver enzymes and other nonspecific symptoms like fatigue.

Q-fever from Coxiella burnetti shares similar to RMSF, but has a great affinity for the heart and blood vessels, just like their African cousins, see link to informative video by Dr Jardin.

Q-fever can persist chronically intracellularly for many decades and cause problems many years after the initial exposure, with endocarditis being the most important.

Here is a very informative video, by a Rickettsial expert from South Africa, Dr Cecil Jadin MD (MBCHB) who has very clearly linked Rickettsial infections with Chronic Fatigue, heart and blood vessel disease amongst other things.

Specific observations for Rickettsia:
– History of being outdoors, tick or other insect bites, contact with farm or wild animals or dust in areas with livestock
– Acute/early symptoms are non-specific with flu-like syndrome: fevers, nausea, vomiting, high fever, severe headache and muscle pains.
– skin rash with specific red spotted rash from micro-bleeding under the skin is present in 50-80% of acute cases
– longer term frequent involvement of heart and heart valves eg. endocarditis as pronounced and concerning symptom
– brain and spinal inflammation with many symptoms in the nervous system, esp confusion
– combination of lower WBC’s, elevated liver enzymes and endocarditis must be checked for Rickettsial illness especially Q fever.

 

Babesia and Babesia like organisms
(Babesia microti, B. duncani and about 100 other organisms known as Piroplasms)

Babesia is very commonly found all over the US and also globally and causes both human and animal pathology. Babesia infections often occur together with other infections, with as much as 60% of cases in certain areas of Lyme being a combined Lyme + Babesia infection. Do the math – currently the CDC numbers for new Lyme cases in the US is 300,000, this makes the approximate maximum new Babesia cases 180,000 per year.