Biorepositories And Research Cohorts
Well-characterized samples are an essential tool to help researchers develop and validate new diagnostic tests and to better understand the complexities of LD. Well-characterized sample sets can benefit medical providers, test developers, and the public at risk for LD . It is critical that sample users understand the criteria used to enroll participants, how samples were collected and stored, and what additional clinical and testing data may be available. Additional benefits can be realized when multiple sample users are using the same well-characterized sample sets. Current sample sets available for researchers include the CDC Lyme Serum Repository , the Lyme Disease Biobank , and samples from the Studies of Lyme Immunology and Clinical Events at Johns Hopkins University School of Medicine. Additionally, some investigators also have their own sample collections with, in some cases, blood samples, skin biopsy specimens and synovial fluid which form the basis for collaborative studies .
Lyme Disease Biobank
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How Is Lyme Disease Diagnosed
It can be difficult to diagnose Lyme disease. The ticks that carry it are very small and the bites dont hurt. Many patients dont remember being bitten. In addition, most of the symptoms are common with other illnesses.
If you find a tick in your skin, use tweezers to remove it immediately. Then wait a few days to see if you develop any symptoms. If you do, call your family doctor. Your doctor will ask you about your symptoms. They will look at the bite and check for a rash. They may order a blood test. But those arent always necessary to make the diagnosis. They can often give false results, especially in early-stage Lyme disease.
People who have joint swelling or nervous system problems may need to have special tests. Your doctor may need to take some fluid from the swollen joint or the spine to check for clues to your condition.
If you have been sick for 4 weeks or more, call your doctor. They can give you a blood test at this stage. It will tell you if you have Lyme disease.
The Best Testing For Lyme Disease
If you find a tick attached to you, youll want to remove it and send it off to be tested for Lyme and the common co-infections. Use a pair of tweezers or the OTom Tick Twister to gently lift and remove the tick. Squeezing it too hard can cause it to regurgitate more pathogen-carrying saliva. Once removed, send the tick off using TickReport.com and youll receive your results in 72 hours.
As I mentioned earlier, conventional Lyme testing, which includes an ELISA and Western Blot blood test, is less than 50% accurate. Obviously, that is not very reliable and leaves a lot of patients with undetected cases that go on to become chronic Lyme with serious symptom involvement. In our clinic, we use a test called the Lyme ImmunoBlot from IgeneX that has a 90% sensitivity rating for Lyme.
It is rather expensive, so we make the decision with the patient after taking a close look at their symptoms and overall health picture to weigh the pros and cons of testing.
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What Are The Symptoms
One sign of Lyme disease is a round, red rash that spreads at the site of a tick bite. This rash can get very large.
Flu-like symptoms are also common. People in the early stages of Lyme disease may feel very tired and have headaches, sore muscles and joints, and a fever.
These symptoms can start at any time, from 3 days to up to a month after you have been bitten. Some people don’t have any symptoms when they are in the early stages of Lyme disease. And they may not even remember getting a tick bite.
If Lyme disease goes untreated, you can have more serious symptoms over time. These include:
- Swelling and joint pain .
- Tingling and numbness in your hands, feet, and back.
- A lack of energy that does not get better.
- Trouble focusing your thoughts.
- Weakness or paralysis in your face muscles.
Defining Patient Subgroups: Post
Patients with persistent symptoms related to Lyme disease likely represent a heterogeneous population, which includes previously untreated patients, as well as those treated patients who remain symptomatic. As a result, some will manifest primarily patient-reported symptoms while others will present with symptoms in conjunction with objective, physical findings. This heterogeneity is further complicated by variation in terminology and the definitions used by different groups in the field.
Figure 3. A schematic of clinical- and research-defined patient subgroups among those with persistent symptoms associated with Lyme disease . The size of each patient subgroup is not meant to represent actual population frequency, as prevalence data is extremely limited. IDSA, Infectious Diseases Society of America ILADS, International Lyme and Associated Diseases Society CLD-PT, Chronic Lyme Disease-Previously Treated CLD-U, Chronic Lyme Disease-Untreated IgG, Immunoglobulin G CFS, Chronic Fatigue Syndrome FM, Fibromyalgia.
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How Do My Top Picks Compete On Price
The Lyme disease tests on this list are relatively close on price. The test from Personalabsis the cheapest, but for the low cost, you need to visit a testing location to provide your samples.
If you have existing DNA data to upload, SelfDecodeoffers low-cost and free DNA wellness reports on much more than your predisposition to chronic Lyme disease for active subscribers. If youre interested in learning more about your genetic predispositions, SelfDecode provides excellent value-for-money.
Current Challenges And Future Priorities
Patients with PTLD represent a substantial burden to the United States health care system. In a large, health insurance claims analysis of 47 million members, estimated total direct medical costs from Lyme disease were between $712 million and $1.3 billion per year, with a significant portion of these specifically due to PTLD-related costs . The same study found that the adjusted odds of any PTLD-related symptom diagnosis following Lyme disease was 4.77 higher than age-, sex-, enrollment year-, region- and payer type-matched controls without Lyme disease, and that those patients with Lyme disease who went on to have at least one PTLD symptom had over twice the average total health care costs as those who did not . These cost estimates do not reflect additional indirect, non-medical, and lost productivity costs to patients, which may be substantial in a population with a chronic and significant illness impact on quality of life . Novel preventative approaches to reduce incidence of new Lyme disease cases, as well as physician and community educational interventions to increase awareness and reduce diagnostic delays and misdiagnosis, are needed to reduce costs and improve patient outcomes.
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How Can You Prevent Lyme Disease
- Avoid ticks.
- Learn where ticks are found in your community. Stay away from those areas if possible.
- Cover as much of your body as possible when you work or play in grassy or wooded areas. Wear a hat, a long-sleeved shirt, and long pants with the legs tucked into your socks. And keep in mind that it’s easier to see ticks on light-colored clothes.
- Use insect repellents, such as products containing DEET. You can spray them on your skin.
- Use products that contain 0.5% permethrin on your clothing and outdoor gear, such as your tent. You can also buy clothing already treated with permethrin.
- Take steps to control ticks on your property if you live in an area where Lyme disease occurs. Clear leaves, brush, tall grasses, woodpiles, and stone fences from around your house and the edges of your yard or garden. This may help get rid of ticks.
Getting An Accurate Diagnosis During A Pandemic
If you suspect you may have this tick-borne disease, its more critical than ever to seek help in light of the coronavirus pandemic. But Lyme disease can be challenging to diagnose. Seeing an integrative or functional medicine physician is a good place to start.
In addition, brain imaging can help. On brain SPECT scans, infections in the brain tend to show an overall pattern of significantly low blood flow and may appear toxic. When these abnormal brain patterns are visible, it calls for additional testing to determine the type of infection that may be causing cerebral blood flow issues. Lab tests for Lyme disease include the Western Blot , Immunoblot, and C6 Lyme ELISA, and although they offer critical data, Filidei cautions that they are only part of a comprehensive diagnostic process. Diving into a persons clinical history helps complete the picture.
With a precise diagnosis, you are better able toaddress underlying infections and related symptoms. And that makes you betterable to fend off other infections and to cope with the mental strain associatedwith quarantine.
At Amen Clinics, our integrative and functional medicine physicians have seen hundreds of patients with resistant complex psychiatric symptoms or cognitive problems who tested positive for Lyme disease. When the underlying infection is addressed as part of a comprehensive treatment plan, symptoms improve significantly.
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A Reasonable Approach To Post
If you are being treated for PTLD, there is no magic bullet to treat this problem, but here are some important steps to consider:
- Choose a doctor you trust and who can work closely with you.
- If your doctor agrees to start antibiotics for several months, make sure you talk about the risks and cost, as this can be dangerous and expensive.
- Make sure not to rely solely on antibiotics. The evidence for a benefit from antibiotics is weak, and we rely mostly on physicians clinical experience and interest in the disease to design a personalized therapeutic plan. For some, a more holistic approach may be the way to go.
- If you try supplements, ask about their source and purity, as they are not FDA-regulated.
- Consider looking for services in medical school hospitals or clinics where they may have programs with ongoing research on how to diagnose and treat Lyme.
About the Author
What Is The Best Medication For Lyme Disease
Treatments for Lyme disease are not universal. There is no singular treatment thats best for everyone. The range of symptoms and responses to treatment vary. A doctor can determine the best medication for Lyme disease based on an individuals symptoms, medical history, and response to treatments. Heres an overview of popular Lyme disease medications that a doctor may prescribe.
|Best medications for Lyme disease|
|500 mg tablet taken as directed by a doctor||Diarrhea, dizziness, or stomach pain|
A doctor determines the best dosage based on medical conditions, response to treatment, age, and weight.
Other possible side effects exist. This is not a complete list.
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Should I Call My Doctor Right Away Or Wait To See If I Develop Symptoms
ILADS recommends immediately contacting your health care provider. There are steps you can take to prevent a Lyme infection, as explained below. The onset of Lyme disease symptoms can be overlooked or mistaken for other illnesses. Once symptoms are more evident, the disease may have already entered the central nervous system, and could be hard to cure. Immediate care may prevent this from happening.
A Functional Medicine Approach To Treating Lyme Disease
Lyme is not like other bacterial infections, it causes systemic inflammatory effects throughout the body and immune dysfunction that makes it difficult to eradicate. This is why a simple course of antibiotics is often unsuccessful in completely resolving Lyme.
In functional medicine, we take a whole-body approach that addresses all of the dysfunction caused by Lyme and supports your bodys natural ability to fight off the disease and restore balance. The protocol is highly personalized to each patient, but heres a high-level overview.
Support the Immune System
First and foremost, you want to bolster your defense. Lyme raises inflammation and suppresses immune function, so your immune system needs extra support in the form of a nutrient-rich, anti-inflammatory diet, a low-tox environment, and possibly immune-supporting supplements.
Repair Your Gut
Your GI tract is home to nearly 80% of your immune system and many tick-borne co-infections can disrupt your microbiome. Take steps to repair your gut through diet and lifestyle and consider implementing supplements to restore your microbiome.
Pharmaceutical and herbal antimicrobials are still valuable tools to kill off the bacteria, they just arent our only tool.
Consider Low-Dose Immunotherapy
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Different Types Of Medication For Lyme Disease
Doctors prescribe different medications for children and adults and for women who are pregnant or breastfeeding. You’ll take antibiotics for 10 to 21 days, depending on your doctor’s advice.Medication treatment is more intense if the bacteria show signs of progressing into your central nervous system. This is what happens with time when Lyme disease is left untreated. Instead of taking pills, you’ll be given an antibiotic through a needle. This is called intravenous treatment. The medicine will work faster by going straight into your bloodstream. People are given IV treatment for two to three weeks.
Pain Treatment Of Active Disease
Pain may be severe enough to require specific analgesic therapy at any stage of LD. The first line of pain treatment is anti-inflammatory agents, because inflammation is always present with LD.4-6 The agents can be delivered topically or systemically. Topical anesthetics such as lidocaine also are helpful for managing joint pain . In addition to anti-inflammatory agents, standard, step-wise multimodal pain treatment is recommendedstarting with agents such as acetaminophen, muscle relaxants , various neuropathic drugs, and complementary therapies. Opioid analgesics may be required for severe pain if non-opioid measures are ineffective. Hypnotic agents may be necessary for insomnia, and anxiolytics often are required as well.
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Other Natural Treatments For Lyme Disease
The treatments discussed above are only some of the natural treatments that claim to treat Lyme disease. According to a 2015 study looking at the alternative treatments found during an Internet search, other natural treatments people use for Lyme disease include:
- saunas and steam rooms
- bee venom
The investigators noted that theres no research backing up these treatments, any many dont have a logical rationale behind them.
How Do I Treat Lyme Disease Naturally
Some people may choose home remedies and natural treatments to help treat Lyme disease. Certain lifestyle changes may help symptoms from worsening or recurring. Many natural supplements are not approved by the FDA. Here are some popular home and natural remedies for Lyme disease:
- Taking a natural supplement Many supplements are thought to have immune-boosting qualities. Top supplements for Lyme disease include vitamin B-1, vitamin C, and chlorella. The FDA doesnt regulate supplements as drugs to treat Lyme disease, so speak with a doctor about them before starting treatment.
- Using essential oils Some essential oils are known for their antibacterial properties. Oregano and cinnamon bark essential oils are highly antibacterial they would have to be mixed with a carrier oil and applied topically. However, more evidence is needed on the use of essential oils for Lyme disease in humans.
- Eating an anti-inflammatory diet Lyme disease symptoms are often rooted from inflammation in the body. Avoiding foods that can cause more inflammation, such as sugar, coffee, or processed foods, may help. Fresh fruits and vegetables are believed to have anti-inflammatory benefits.
- Seeking acupuncture treatmentAcupuncture can potentially relieve symptoms associated with Lyme disease such as pain, sleeplessness, and stress.
- Reducing stressYou can reduce stress by exercising, sleeping more, meditating, or spending time with friends and family.
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How Herbal Supplements Can Help
The best way to gain the level of phytochemical protection you need to help your immune system win the internal battle against invasive microbes is to take herbal supplements specifically, standardized botanical extracts.
Standardized botanical extracts take herbal supplements to the next level. Theyre made with wild plants or plants that have been cultivated to enhance their phytochemical content and are grown in an environment that doesnt introduce unwanted chemical toxins. The extraction process also yields the greatest concentration and the widest spectrum of phytochemicals in the plant. And the final product is standardized to a concentration of one or several key phytochemicals in the plant, so you know what youre getting.
Below are a few of my favorite herbs for mitigating the systemic chronic inflammation associated with chronic Lyme disease. Though all of the herbs have value in suppressing microbes and reducing inflammation, three of the herbs mentioned below Japanese knotweed, cats claw, and Chinese skullcap were found in a 2020 study from Johns Hopkins University to have greater activity against Borrelia burgdorferi than the antibiotics, doxycycline and azithromycin.