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Lyme Disease

Lyme Disease –A Hidden Cause of Multiple Symptoms

Lyme borreliosis is a tick-borne infection caused by the spirochete (spiral-shaped bacterium) Borrelia burgdorferi sensu lato and is the most prevalent tick-borne infectious disease in the United States. The spirochete B. burgdorferi is transmitted to humans primarily by the deer tick on the east coast. On the west coast, the primary vector is the western black-legged tick of a different breed

According to the Centers for Disease Control and Prevention’s (CDC) 2007 data, 27,444 cases of Lyme disease were reported that year, with a national average of 9.1 cases per 100,000 persons. Residents of the coastal Northeast, Northwest California, and the Great Lakes region are at highest risk.

In the 10 states where Lyme disease is most common, the average was 34.7 cases per 100,000 persons. The incidence of Lyme disease is on the rise; the CDC reported that the number of cases of Lyme disease has doubled in the United States since 1991 and stated that these numbers are probably underestimated.

Pathology

Typically, the tick must feed for at least 36 hours for transmission of the bacterium to occur. B. burgdorferi enters the skin at the site of the tick bite, and then may spread through the lymph or blood. In fact, the latest research suggests Lyme disease can spread through sexual contact as well. Tick bites often go unnoticed because of the small size of the tick in its early stage. Some individuals infected with this bacteria may not show any signs of Lyme disease. Generally, there are 3 distinct stages of the disease process, with unique symptoms associated with each phase.

Stage 1: Early Localized Infection

Approximately 75% of infected patients develop a circular rash known as erythema migrans. The rash begins at the site of the tick bite, usually within 3–30 days, and gradually expands. The center of the rash may clear as it enlarges, resulting in a “bull’s-eye” appearance. Some patients develop additional lesions in other areas of the body after several days. The circular rash does not occur in all patients with Lyme disease. In patients who do not get the rash, the first sign of bacterial infection are symptoms of the second or third stage of Lyme disease.

Stage 2: Early Disseminated Infection

The second stage occurs days to weeks after the tick bite as the bacteria spreads throughout the body. Infected individuals may experience symptoms of fatigue, chills, fever, headache, swollen lymph nodes, muscle pain, and joint pain. Neurologic, musculoskeletal, or cardiovascular symptoms and multiple circular lesions may also develop. More specifically, individuals may experience facial muscle paralysis (Bell’s palsy), nerve damage, meningitis with severe headaches and neck stiffness, and abnormal heartbeat. Arthritis may begin with swelling, stiffness, and pain. Usually, only one or a few joints become affected, most commonly the knees.

The rash generally resolves in about 1 month without treatment.

Stage 3: Late Disseminated Infection

The late stage can occur weeks, months, or even years after initial infection in patients who did not receive antibiotic treatment for early Lyme disease or in individuals whose treatment did not eliminate the bacteria completely. Approximately 60% of patients with untreated infections will begin to have intermittent arthritis, with severe joint pain and swelling, with the large joints most often affected. Chronic arthritis develops in 10%–20% of untreated infected individuals.3 In addition, up to 5% of untreated patients may develop chronic neurologic complaints featuring motor and sensory nerve damage and brain inflammation months to years after infection. Entry of spirochetes into the central nervous system (CNS) may result in a severe inflammatory reaction and produce proinflammatory cytokines. Symptoms of neuropathy or encephalopathy may include shooting pains, numbness or tingling in the hands or feet, and problems with concentration and short-term memory loss. Lyme disease may become chronic with involvement of the central and peripheral nervous systems, and ophthalmic, cardiac, and musculoskeletal defects. Patients may even present with rheumatoid arthritis (RA); neurologic impairment with memory and cognitive loss, anxiety, and depression; cardiac disease such as myocarditis and endocarditis causing palpitations, pain, and bradycardia(slow pulse); and severe chronic fatigue and sleep disturbance.

Currently, the exact cause of these chronic symptoms is unknown. There is some evidence that the chronic symptoms may result from an autoimmune response.

Lyme and Autism

One theory suggests there may be an association between Lyme disease and autism. This theory is supported by numerous clinical findings such as case reports of mothers with Lyme disease whose children develop autism spectrum disorders; fetal neurologic abnormalities associated with tick-borne diseases; and symptom similarities between tick-borne diseases and autism spectrum disorders, with similar immune reactivity, temporal-lobe pathology, and brain imaging data.

Lyme Disease and Alzheimer’s Disease

There is some evidence linking B. burgdorferi infection with Alzheimer’s disease. The researchers who conducted a study on this concluded that spirochetes may contribute to dementia and brain degeneration,  which are both seen in Alzheimer’s disease.

The symptoms of the late chronic phase of Lyme disease have considerable overlap with other chronic conditions, often making diagnosis difficult. Chronic conditions such as chronic fatigue syndrome (CFS), fibromyalgia, and rheumatoid arthritis present similarly. In addition, co-infection frequently occurs, complicating the diagnosis.

Co-Infections

Co-infections are common with Lyme disease and complicate its diagnosis and presentation.

The intracellular protozoan Babesia microti is a tick-transmitted infection that may also be seen in Lyme disease infections.

Babesia co-infection generally increases the severity of presenting symptoms, including: high fever; chills; generalized weakness; gastrointestinal (GI) symptoms such as anorexia, nausea, abdominal pain, vomiting, and diarrhea; anemia; muscle and joint pain; respiratory problems; and dark urine. Babesia infection may produce mild-to-severe anemia and normal to slightly depressed white blood cell count. These may progress to blood clots, acute respiratory distress syndrome (ARDS), and heart failure.

Another co-infection seen with Lyme disease is another tick-borne infection, Ehrlichia, such as E. chaffeensis and E.phagocytophila. Patients who have thisinfection may present with fever, shaking chills, headache, muscle pain and tenderness, nausea, vomiting, abdominal pain, diarrhea, cough, and confusion. Ehrlichia infection may also cause mild to moderate anemia, decreases in white blood cell count, and increased liver enzymes.

Chronic Lyme Disease

Chronic Lyme disease is a controversial issue, as many doctors and scientists disagree on whether it is a true medical condition. The term chronic Lyme disease is used to describe patients presenting with symptoms associated with post-Lyme disease but without objective signs of previous or current infection with B. burgdorferi, as well as patients who are classified as having post-Lyme disease syndrome. Post-Lyme disease syndrome is defined as continuing or relapsing generalized symptoms, including fatigue, musculoskeletal pain, and cognitive complaints in patients previously treated for Lyme disease. Currently, there isn’t consistent data showing that post-Lyme disease syndrome is caused by persistent infection with B. burgdorferi.

Conventional Treatment

For most patients with Lyme disease, antibiotic therapy is curative. Typically, doxycycline for adults and children over age 8 or amoxicillin is given for 2–4 weeks for patients with early stage Lyme disease. Patients with chronic symptoms that are unresponsive to antibiotics may be treated with non-steroid anti-inflammatory drugs (NSAIDs) or corticosteroids.

Natural Treatments

Research regarding natural therapies for Lyme disease is scarce. However, there is anecdotal evidence supporting the use of Uncaria tomentosa (cat’s claw) for Lyme disease. In addition, clinicians have reported benefit from supportive measures to complement antibiotic therapy.

Cat’s Claw

Cat’s claw is used medicinally for antioxidant, anti-inflammatory, immune stimulating activity, and antiviral activity.

Samento, also known as TOA-Free Cat’s Claw, (Nutra-Medix LLC, Jupiter, Florida), is a commercially available in the form of an herb and has been used for treating Lyme disease. C-Med™ (M.W. International, Inc., Hillside, New Jersey), another proprietary extract of cat’s claw, has been shown to increase white blood cells.23 In addition, the constituents known as quinovic acid glycosides, have produced antibacterial and immune stimulating activity.

Cat’s claw has anti-inflammatory properties. It is believed that this activity is due to the ability of the herb to inhibit the production of the proinflammatory cytokine TNF-a, which is elevated in patients with Lyme disease.

Cat’s claw has also been studied as a treatment for rheumatoid arthritis (RA) and osteoarthritis (OA).

At the end of the study, 24 weeks of treatment with the cat’s claw extract resulted in a significant reduction of the number of painful and swollen joints compared with placebo. This anti-inflammatory activity may be beneficial for patients with Lyme-associated arthritis

Conclusion

The incidence of Lyme disease is rapidly increasing in the United States. Although many patients are cured with standard antibiotic treatment, there are countless patients that are not and are in need of additional treatment. Long-term conditions including severe fatigue and neurologic deficits make an impact on the quality of life of these patients. Clearly, research is needed to optimize diagnosis and treatment for this condition. In addition, the debate regarding the existence of chronic Lyme disease continues.  It is important to note that though natural medicines hold great promise to support the body, Lyme disease is a very serious condition, and working with a skilled medical provider is essential, as I have worked with patients with advancing cases and the symptoms and risk to health and life is great. A special thanks to Alternative and Complementary Therapies, where I have co-authored a more extensive article that I have excerpted for this summary.

 

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