I recently did a presentation on Lyme disease in my Functional Medicine class based on a book the professor recommended (The Beginner’s Guide to Lyme Disease), and I have a paper to write on Lyme disease epidemiology for my Environmental Medicine class. These two classes gave me the motivation to dive in deeper and learn more about treating Lyme disease so that I’m more prepared when I start seeing patients. Lyme disease is becoming more and more common, and those who have it are seeking out Lyme-literate doctors to get better.
I was surprised to learn that the Centers for Disease Control & Prevention’s (CDC) surveillance criteria for Lyme disease designed for national reporting isn’t appropriate for making a clinical diagnosis; however, it’s misused as the standard of care for health care reimbursement. This contributes to under-diagnosis and prolonged suffering for patients with Lyme disease.
Diagnosing Lyme disease can be tricky for several reasons:
- Lyme disease is a great imitator of many other diseases.
- People may not remember or notice tick bites because the ticks that carry the Borrelia bacteria are the size of a poppy seed.
- The classical erythema migrans (bull’s eye rash) only appears in about 50% of infections.
- Symptoms may not appear for several months after becoming infected.
- And additionally, there are several lab tests available, and a negative lab finding doesn’t necessarily rule out the disease!
The book recommends that three tests be run as a panel (Western Blot, Immunofluorescence Assay, and Polymerase Chain Reaction) through a specialized Lyme-literate laboratory for a laboratory diagnosis that is accurate 95% of the time.
Treating Lyme disease is a long-term battle that often takes several months to years. Since the Borrelia bacteria can be in different stages inside the body (spirochete, cyst, and cell-wall deficient forms), it’s important to treat all forms concurrently. Bacterial resistance is another complicating factor, so it’s recommended to rotate antibiotics and botanicals every six weeks.
Now that I have some basic information on the diagnosis and treatment of Lyme disease, I’m going to start researching the epidemiology of Lyme disease for my Environmental Medicine paper. There is so much to learn, and Lyme-literate doctors are needed!