Chronic Lyme Disease Treatment – Diagnosis is Everything
In labelling a patient as having chronic Lyme disease there may be some physicians, and patients themselves, who are worried that their infection has not been cleared and that long-term antibiotic treatment is necessary. Many go to desperate lengths to acquire such treatment for symptoms which may not be caused by an active infection at all.
Improvements in diagnosis of Lyme disease, consideration of the real meaning of ELISA and Western blot tests for Lyme disease, and better regulation of laboratories offering such tests may all help such patients. Long-term treatment with either oral or intravenous antibiotics for post-Lyme disease syndrome has not been found effective and has resulted in serious side-effects for many patients. Such treatments are also often not covered by medical insurance as they contravene official guidelines. As such, many patients face difficulties in financing such treatments which are considered unlikely to be effective.
Lyme Disease Recurrent Infection
A number of patients who have been labelled with chronic Lyme disease will actually live in areas where the infection is endemic. These patients may be successfully treated for the infection following an initial tick bite only to be bitten again and reinfected. The continuing symptoms of Lyme disease may, therefore, be due to recurrent, not continued, infection, for which antibiotic treatment would be indicated. Patients who have not been reinfected may be led to believe that they have developed an autoimmune response due to the propensity of the Borrelia bacteria to hide in plain sight in the human body by mimicking our own cells. There is currently no evidence supporting this theory, which does not make it impossible, but does cast doubt on the safety of using immunosuppressant drugs for treating a theoretical autoimmune condition induced by Lyme disease.
Lyme Disease Treatment and Misdiagnosis
Some patients may be labelled as having chronic Lyme disease despite there being no evidence of either current or past infection with Borrelia burgdorferi sensu lato. These patients may have, in earlier years, been diagnosed with chronic fatigue syndrome, fibromyalgia, or even a psychological disorder but their nonspecific symptoms can now be diagnosed as chronic Lyme disease simply for the sake of a diagnosis being made. This does the patient few favors as the real cause of their symptoms remains unknown and, therefore, untreatable. It may even be dangerous in that it can convince the patient to undergo costly and risky treatments for a condition they do not even have, all the while delaying appropriate treatment for a genuine condition. Patients diagnosed with Lyme arthritis that persists after antibiotic treatment, for example, may be treated with hydroxychloroquinone or methotrexate, with corticosteroid injections avoided due to concerns about infection (Massarotti, 2002). If the diagnosis of Lyme disease was incorrect however, then patients may have alternative treatment programmes, including corticosteroids, and their prognosis may be brighter.
Lyme Disease Treatment, MS, ALS, and Neurological Disease
Patients suffering from chronic neuropathic pain after antibiotic therapy for Lyme disease appear to respond well to gabapentin treatment in one study although gabapentin’s use for other neurological conditions may confound the results should initial diagnosis be incorrect (Weissenbacher , et al, 2005). Similarly, some of the antibiotics used to treat Lyme disease, such as minocycline and doxycycline, are also used in neurological and inflammatory diseases such as multiple sclerosis, amyotrophic lateral sclerosis, Parkinson’s disease, and rheumatoid arthritis due to their anti-inflammatory effects (Bernardino, et al, 2009). Some of the symptoms of these diseases which are also symptoms of Lyme disease may be expected to improve during such treatments which could, again, cause an initial incorrect diagnosis to be considered confirmed by the response to the treatment.
Lyme Disease Treatment – Antibodies and Borrelia Bacteria
Establishing the exact causative agent of Lyme disease in an individual is also of importance as one study (Kraiczy, et al, 2002) has shown that whilst B. garinii is effectively eradicated by complement (part of the body’s innate immune system), B. afzelii is largely serum-resistant and other B. burgdorferi s.l isolates vary in serum-resistant. As such, an infection with highly resistant B afzelii is less likely to be fought off successfully by the body. The production of antibodies is clearly affected by this serum-resistance and may therefore obstruct accurate diagnosis using antibody detection tests for Lyme disease such as ELISA and Western blot. Testing for bacterial presence, using PCR for example, may then explain the absence of significant antibodies in a patient infected with B. afzelii. Concluding from an antibody test alone that the patient does not have a significant infection becomes questionable in light of such research.
While tests for Lyme disease continue to be improved, patients are then left in somewhat of a quandary, with no definitive answer regarding the cause(s) of their symptoms or the appropriate treatment. Those advocating long-term antibiotics and alternative therapies for chronic Lyme disease may be railing against the official guidance due to genuine concern for their patients but many may simply be taking advantage of the vulnerability of patients with a genuine chronic illness, just not chronic Lyme disease.
Continue Reading –> Herxing – Is it Necessary for A Lyme Disease Cure?
Weissenbacher S, Ring J, Hofmann H (2005). “Gabapentin for the symptomatic treatment of chronic neuropathic pain in patients with late-stage lyme borreliosis: a pilot study”. Dermatology (Basel)211 (2): 123–127.
Bernardino AL, Kaushal D, Philipp MT. (2009). “The antibiotics doxycycline and minocycline inhibit the inflammatory responses to the Lyme disease spirochete Borrelia burgdorferi.”. J. Infect. Dis.199 (9): 1379–88
Massarotti EM (2002). “Lyme arthritis”. Med. Clin. North Am. 86(2): 297–309.
Kraiczy P, Skerka C, Kirschfink M, Zipfel PF, Brade V. Immune evasion of Borrelia burgdorferi: insufficient killing of the pathogens by complement and antibody. Int J Med Microbiol. 2002 Jun;291 Suppl 33:141-6.