Q:I would like some more information on Lyme disease. Why is it handed out so often as a diagnosis does it really exist? If so, what can be done about it? HY, Freehold, NJ, USA.......
!ALyme disease is common throughout most of the world. There are now more than 10,000 medical papers on Lyme. But even as the knowledge surrounding this infection by the Borrelia burgdorferi spirochete (one of a family of corkscrew shaped bacterium) increases, there remain many unanswered questions about this disease. Lyme is spread by the bite of infected ticks of the genus Ixodes. Host animals include deer, mice and other mammals as well as birds.
The symptoms of Lyme mimic over 200 other conditions and it is often misdiagnosed as rheumatoid arthritis, fibromyalgia, lupus, chronic fatigue syndrome (CFS) and even some psychiatric disorders.
Blood tests for Lyme are notoriously unreliable (JAMA, 1992; 268: 891-5; Ann Intern Med, 1991; 115: 533-9), and a negative test cannot fully rule out infection. A better diagnosis can probably be made on the basis of careful assessment of symptoms and patient history (Arch Intern Med, 1990; 150: 761-3; Clin Courier, 1991; 9: 5-8). But even here you should not necessarily let yourself be satisfied by an "all clear" or an alternative diagnosis. In a small, informal study by the American Lyme Disease Alliance, 90 per cent of those diagnosed with CFS actually had Lyme disease.
Initially, it was thought that 75 per cent or more of those with Lyme would initially produce a round red rash. Now we know that the rash neither has to be red nor round and that the figure is closer to 50 per cent. In one study in Finland, only 16 per cent had the rash (Ann Med, 1993, 25: 349-52).
The most common and disturbing symptoms are those which affect the nervous system. Hands, fingers, feet and toes may twitch or go numb again and again, even though they may appear to be normal on examination. Vision can become blurred, and sharp electric pains may suddenly rip through the body.
The most common treatment, with long term antibiotics, has other implications for an already compromised immune system (WDDTY vol 8, no 1) and is unreliable. The FDA has not approved any drug for the treatment of Lyme disease and the dose and type of antibiotic which you are likely to receive varies wildly from physician to physician.
Several studies have shown that the Lyme disease bacteria can be present, without producing symptoms, in the spinal fluid of individuals who have been "cured" by aggressive antibiotic treatment (Infection, 1989; 17: 355-8; J Clin Microbiol, 1993; Aug: 61-63) and that symptoms can persist even after therapy (Ann Intern Med, 1994; 121: 560-7; Antimicrob Agents Chemother, 1995; 39: 1127-33; Clin Infect Dis, 1995; 21: 380-9; J Am Acad Dermatol, 1993; 28: 312-4; Eur Neurol, 1995; 35: 113-7).
Another problem with antibiotic treatment is that a two week course of oral antibiotics, given for instance on a just in case basis, is thought to be enough to cause a Lyme positive patient to test false negative for the rest of his or her life.
One question which has not been asked is why some become symptom free even if the spirochete remains in their bodies and others don't. It seems reasonable that genetic factors and the overall health of the immune system play an important part. So while there are no specific alternative remedies for Lyme disease, you can help yourself greatly by supporting your immune system, especially with supplements of copper, evening primrose oil, vitamin C and pycnogenol and by increasing your garlic intake. Herbal remedies which enhance immunity include echinacea, golden seal, alfalfa, dandelion root, Oregon grape and milk thistle.
WDDTY panellist Patrick Kingsley also recommends that a homeopathic treatment with Borrellia burgdorferi may be of benefit but cautions that, as with antibiotics treatment, improvement will often be slow and treatment may need to last for 40-60 days. In addition, aconite is indicated when your symptoms include fever; rhus tox for rheumatic symptoms; and ledum for joint and muscular pain