Lyme disease on the rise

By Alison Rose Levy

The fastest growing insect-borne infectious disease globally, Lyme disease is conveyed into humans via a Lyme-infected tick bite that delivers the Lyme spirochete (Borrelia burgdorferi) and other co-infections into the blood stream. Although deer are the most common tick hosts, other animals such as mice, squirrels, and more can also carry ticks.  When Lyme enters humans, it sometimes (but not always) produces the bull’s eye rash, called erythema migrans. Classic Lyme disease symptoms include fever, joint pain, chills, memory issues, brain fog, and numbing and tingling in the hands and feet. According to Darin Ingels, ND, FAAEM, author of The Lyme Solution, Lyme disease is called the “Great Imitator,” because there are a hundred different symptoms, and it mimics other diseases.

Ingels, a naturopathic doctor, who has treated thousands of patients in his practices in Connecticut and California, points out that the symptoms of such ailments as fibromyalgia, chronic fatigue syndrome, Alzheimer’s disease, multiple sclerosis, and Parkinson’s disease, also overlap with Lyme disease and must often be ruled out to arrive a correct diagnosis. That can be tricky since, unlike Ingels and fellow practitioners of functional and integrative medicine, many doctors may not know either how to diagnose Lyme, nor treat it effectively.

The Centers of Disease Control and Prevention (CDC) assess that there are 300,000 Lyme sufferers per year in the U.S. What’s more, due to planetary warming, Lyme disease incidence is increasing. The challenge for both people and practitioners is that Lyme is not easily diagnosed or treated through conventional methods.

If the person recognizes the bull’s eye rash within the first 72 hours following a bite, and gets immediate treatment, antibiotics (usually doxycycline) can be effective. Without a visible bite, (which only occur in 40 percent of cases), many don’t realize that they have been bitten, and unknowingly harbor the disease.

As time passes, Lyme lurks within the body a-symptomatically. Weeks, months, or years later, it makes itself known through a mysterious parade of apparently unrelated symptoms, like those mentioned above—which many don’t recognize as Lyme disease-related.

Although conventional doctors consider antibiotics the “gold standard” in treatment, outside of the 72-hour window, they are only effective in a minority of cases, making treatment failure common.

What’s more, the longer it takes to recognize the spirochetes’ presence and begin treatment, the lower the likelihood of successful and complete recovery. A major obstacle to detecting the disease early are the standard tests used by conventional doctors and recommended by the CDC. The CDC approved testing protocol consists of a two-stage testing process. First, The ELISA (enzyme-linked immunosorbent assay), a Lyme antibody blood test. Next, doctors follow up with a different antibody test, the Lyme Western Blot test (commonly referred to as the Western Blot.)

Even though patients are accustomed to relying on test results, Ingels, who is networked with other practitioners addressing Lyme, says many reports that the tests produce unreliable and contradictory results. One study found that in 55 people with known Lyme disease, less than 46 percent of them had either IgG or IgM antibodies when first tested. Moreover, in the widely used Western blot test, a negative result does not exclude the possibility of having Lyme, says Ingels. Nor does a positive result guarantee that people do have it.

“The test measures the immune reaction, which means that you’ve been exposed to it at some point in time,” he says.

Ingels says a good blood test should be “sensitive and specific,” identify 95 percent of those who are positive for the specific item tested. For Lyme disease, most labs detect 4 percent.

“They’re not picking up those who have the illness,” he said.

In the absence of an accurate blood test, functional medicine doctors like Ingels rely on a clinical diagnosis. Ingels’ book features a questionnaire that practitioners can use to undertake a clinical assessment. A patient’s symptoms and history are a more reliable basis for diagnosis than the standard blood test, provided that the doctor is Lyme-literate, says Ingels. In some parts of the world, local doctors don’t admit that Lyme disease even exists in their country, despite air travel that increases the bug’s scope. Ingels reports that many Australians come to the U.S to consult with him.

Once the diagnosis is made, treatment can begin. For adults, the conventional treatment is 21 – 28 days of antibiotics, typically doxycycline. When people don’t recover, conventional doctors often prescribe additional courses. Despite standard treatment, research shows that the disease persists in what is called “post-Lyme disease syndrome.”  According to researchers, “The best estimates of the prevalence of post-Lyme disease syndrome come from studies of patients with erythema migrans who received appropriate antibiotic treatment. From 10–20 percent of such patients have persistent or intermittent subjective symptoms of mild to moderate intensity 12 months after completion of therapy.”

“[Doxycycline has] been the standard treatment for forty-one years,” says Ingels, though he says functional medicine doctors feel it’s inadequate.

Since Lyme is a slow growing organism, it replicates every 16 days. Doxycycline is only effective in the replication phase, not when the bugs lie dormant.

“It doesn’t make biological sense,” says Ingels. “People get a bite, go into the acute phase, get their doxy, feel well again. And then somewhere down the line it becomes active again.”

Ingels maintains that antibiotics are not the solution. If otherwise healthy people catch it and use antibiotics early, the likelihood of having a long-term problem is small. But for those with chronic Lyme, the research corroborates that antibiotics are not that helpful, says Ingels.

Ingels recommends that patients follow an alkaline diet, free of allergens such as gluten and dairy. The five-step program he uses with patients is detailed in his book. It also features supports for the gut and immune system, and a variety of effective herbal protocols that people can use and rotate through until they find the one that works best for them. He recommends patients begin with Chang’s herbs, and next try Lee Cowden’s formulas, proceeding if necessary with protocols by Stephen Buhner. Different herbal formulas can be effective, depending on the person. He has also used immunotherapy successfully with chronic Lyme patients.

Unfortunately, thanks to increasing temperatures from global warming, Lyme is becoming more prevalent. It has been spreading from its first habitat, the northeastern United States, to other parts of the country and the world.  

“The data show each month of the year being hotter than prior months in other years on record,” says journalist Mary-Beth Pfeiffer, author of Lyme: The First Epidemic of Climate Change. “Eight of the last ten years are the hottest on record. This situation has abetted Lyme. Ticks are moving to new latitudes. They are now able to live where they have not been able to live before.”

Also, as human kind has built on lands that were once wild, forested, or grassy, this has interfered with longstanding ecological systems, Pfeiffer learned in the research for her book. These disruptions have reduced certain animal populations, like foxes, which traditionally controlled the mice— which are the spirochetes’ first hosts. Simultaneously, the tick’s carrier— the deer population— is growing. Fewer enemies, more friends. Pfeiffer says all of it means “a perfect storm of tick-borne disease and especially Lyme.”

Researchers at Northeastern University, John Hopkins, and Tulane have studied Lyme disease hosts, such as mice, monkeys, and gerbils—after treating them with antibiotics. “They are finding even months later that Lyme disease persister cells remain in the hosts,” reports Pfeiffer. The takeaway? It’s not that no one can ever be cured, but that a core group of people stay sick. “We need to do research on these people,” Pfeiffer says. 

With Lyme on the increase, people can lower their odds of getting the disease by being mindful in the summer to fall transition, a time of year when the tick population is on the move. Pfeiffer recommends avoiding tick habitats, not brushing up against tall grasses, and treating clothing with tick sprays.

Doctors should recommend that their patients regularly check themselves and their animals for ticks upon coming in from outdoors. If a bite or rash is detected, it’s important to get acute treatment promptly, if indicated. The best long-term prevention strategy is maintaining a strong immune system.

References:

1. Qiu, W.-G., Bruno, J. F., McCaig, W. D., Xu, Y., Livey, I., Schriefer, M. E., & Luft, B. J. (2008). Wide Distribution of a High-Virulence Borrelia burgdorferi Clone in Europe and North America. Emerging Infectious Diseases, 14(7), 1097–1104. http://doi.org/10.3201/eid1407.070880. Geographic Distribution and Expansion of Human
2. Ingels, Darin. The Lyme Solution, Avery 2018
3. https://www.cdc.gov/lyme/stats/humancases.html
4. Berger, Stephen (2014). Lyme disease: Global Status 2014 Edition. GIDEON Informatics Inc. p. 7. ISBN 9781498803434.
5. www.nejm.org/doi/full/10.1056/NEJM200107123450201#t=article
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7. Interview with Darin Ingels, Connect the Dots, April 25, 2018 http://connectthedots.podbean.com/e/connect-the-dots-the-new-lyme-epidemic-042518/
8. https://www.ncbi.nlm.nih.gov/pubmed/18452806
9. Ingels, Darin, The Lyme Solution, Avery 2018
10. World Health Organization (2016). All about climate change and vector borne diseases. Retrieved from www.wpro.who.int/mvp/climate_change/en/. And McIver, L., Kim, R., Woodward, A., Hales, S., Spickett, J., Katscherian, D., … Ebi, K. L. (2016). Health Impacts of Climate Change in Pacific Island Countries: A Regional Assessment of Vulnerabilities and Adaptation Priorities. Environmental Health Perspectives, 124(11), 1707–1714. http://doi.org/10.1289/ehp.1509756
11. https://www.lymediseaseassociation.org/about-lyme/cases-stats-maps-a-graphs/940-lyme-in-more-than-80-countries-worldwide
12. Interview with Mary-Pfeiffer, Connect the Dots, August 15, 2018 https://connectthedots.podbean.com/e/connect-the-dots-environmental-causes-of-lyme-disease/