Chronic Lyme Disease Complex Is Not A Diagnosis
Chronic Lyme Disease Complex is not an official diagnosis but is a term Envita Medical Centers uses to categorize patients who suffer from a wide variety of vector-borne diseases and primary and secondary infections. We have been treating Lyme disease for nearly 20 years at Envita and have found that Lyme is often associated with a myriad of different infections that must be addressed to facilitate the patient’s progression to a better life.
Common primary co-infections that have been linked with Chronic Lyme Disease Complex include anaplasmosis, coltivirus, ehrlichiosis, mycoplasma pneumoniae, Powassan virus, Q Fever, chlamydia pneumoniae, and many more . We use the term Chronic Lyme Disease Complex because we feel it more accurately represents the wide range of infections patients can experience and better illustrates the complexity and uniqueness of the condition every singular patient is burdened with. Often these patients will have a resistant borrelia infection which is almost always followed by multiple other infections.
Study Shows Evidence Of Severe And Lingering Symptoms In Some After Treatment For Lyme Disease
In a study of 61 people treated for the bacteria that causes Lyme disease, Johns Hopkins researchers conclude that fatigue…
In a study of 61 people treated for the bacteria that causes Lyme disease, Johns Hopkins researchers conclude that fatigue, pain, insomnia and depression do indeed persist over long periods of time for some people, despite largely normal physical exams and clinical laboratory testing.
Post-treatment Lyme disease syndrome is a real disorder that causes severe symptoms in the absence of clinically detectable infection, says John N. Aucott, M.D., associate professor of medicine at the Johns Hopkins University School of Medicine and director of the Johns Hopkins Lyme Disease Clinical Research Center.
The findings, published in the December issue of Frontiers in Medicine, could spur further investigation into the cause of persistent symptoms, a source of medical controversy. As Lyme disease rates have steadily climbed in the United States since it was first recognized in the mid-1970s, so have reports of a collection of symptoms that patients commonly refer to as chronic Lyme disease. Experts in the field have questioned the validity of this term because of the lack of direct evidence in this group of patients of ongoing infection with Borrelia burgdorferi, the bacterium that causes Lyme disease.
Other Johns Hopkins researchers who participated in this study include Alison W. Rebman, Ting Yang, Erica A. Mihm, Mark J. Soloski and Cheryl Novak.
The Cortisol Connection: Are You Addicted To Your Pain
Cortisol, the stress hormone secreted by the adrenal glands, connects the limbic system to the rest of the body via the HPA axis. Chronic stress in the form of Lyme co-infections keeps the HPA axis functioning over time leading to cortisol addiction .
An autopilot cortisol addiction forces the body to remain in an eternal state of survival mode with unceasing PTLDS inflammation and chronic pain.
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Lyme Light A New Integrative Healing Modality For Lyme Disease
Contrary to the conventional antibiotic-based strategy, Innovative Medicines approach is aimed at restoring complete health by taking into consideration the physical, mental, emotional, and spiritual dysfunction of the patient suffering from Lyme.
Read our article, A new integrative approach to Lyme disease, to see what sets us apart.
Chronic Lyme Disease Vs Post
Patients typically use the term chronic Lyme disease to describe the cluster of symptoms that started after getting Lyme disease and that persist despite having received a course of antibiotic treatment which has been deemed curative by the Infectious Diseases Society of America. Patients say, “I’m not cured. I have symptoms now that I never had before Lyme disease. I’m fatigued 90% of the day. My muscles ache. My brain is in a fog. I can’t think clearly any more. I’m super sensitive to light and sound. What is going on? Chronic Lyme disease does exist – I’m a living example of it!”
Whatever one calls it, the experience is the same. Most often these patients experience profound fatigue, pain, and/or cognitive impairment. Mild to moderate levels of depression and anxiety may also accompany these symptoms, as the functional limitations can lead to social isolation, inability to work, and loss of sense of one’s identity as a provider, caretaker, or friend. Sometimes patients find themselves identifying with Job – the just and good man in the Bible whose life was wrecked by illness, death of loved ones, and economic disaster he felt tormented by God.
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Chronic Lyme Disease Complex Vs Post
While Chronic Lyme Disease Complex and Post-Lyme Disease Syndrome may seem similar, they are very different from each other and knowing the difference may be essential for achieving symptom remission for a Lyme disease patient. Post-Lyme Disease Syndrome is a diagnosis given to patients who continue to experience symptoms like depression, fatigue, and muscle/joint aches after being diagnosed and treated for Lyme disease with the recommended antibiotic regimen .
Envita Medical Centers doesn’t make any guarantee of outcomes. Results are not typical and will vary from person to person and should not be expected.
Post-Lyme Disease Syndrome is always characterized by a Lyme borreliosis infection and while it may involve many other infections including viral, bacterial, and fungal, those infections are controversially not recognized as part of PLDS and frankly are rarely tested for properly.
You may have heard of Chronic Lyme Disease or even Chronic Lyme Syndrome. It is important to know that Post-Lyme Disease Syndrome was previously recognized as Chronic Lyme Syndrome, but the medical community no longer recognizes that diagnosis and it is now considered an outdated term.
Can Lyme Borreliosis Become Chronic
Whether PTLDS is a specific disease remains controversial because of the lack of objective evidence of an ongoing immunological or infectious process in patients with correctly treated Lyme disease. Furthermore, identical symptoms appear to be equally prevalent in individuals without a history of Lyme borreliosis . Also, original data on PTLDS are scarce and heterogeneous, and no standardised, validated and widely accepted case definition is available. Moreover, the debate on PTLDS is confused by the discussion on whether Borrelia infection can persist and become chronic after adequate treatment .
Indeed, there is no scientific evidence of chronic Lyme borreliosis be it due to either microbiological failure of appropriate antibiotic treatment, antibiotic resistance , or pathogen persistence after correct treatment . B. burgdorferi culture results from erythema migrans skin lesion biopsies following adequate antibiotic treatment have been negative in almost all patients, including those with persisting symptoms after treatment . Furthermore, there are also no records of a reactivation of hypothetically latently persisting B. burgdorferi among immunocompromised hosts, as can be observed in latent infections due to intracellularly persisting pathogens.
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How Was This Study Done
We evaluated and followed seventy-six participants with physician-documented erythema migrans, the classic bulls-eye rash associated with Lyme disease, and 26 healthy controls with no history of Lyme disease. Sixty-four inflammatory markers were measured in blood samples taken at each visit for a total of 6 visits over 1 year. Levels of inflammatory markers in patients with and without persistent post-treatment symptoms were compared to those in healthy controls.
Treatment Data On Ptlds
The best available evidence on the natural history of PTLDS and the effect of antibiotic treatment can be obtained from randomised, controlled, prospective clinical trials comparing antibiotic treatment with placebo in patients with persisting symptoms following proven acute Lyme borreliosis .
Klempner et al. included 115 patients in two double-blind placebo-controlled clinical trials . Patients were eligible if they had a documented clinical history, laboratory findings of Lyme borreliosis, and documented adequate antibiotic treatment. Symptoms attributed to PTLDS had to have begun within 6 months after infection and to have persisted for at least 6 months. Patients with negative serology for borreliosis were included only if an erythema migrans was clearly documented by an experienced physician. Patients were randomly assigned in a 1:1 ratio to receive either antibiotics or placebo. The antibiotic treatment consisted of 1 month of intravenous ceftriaxone followed by 2 months of oral doxycycline clinical response rates were documented after 3 months. The overall status improved in roughly one third of patients, remained unchanged in another one third, and deteriorated in one third of patients, and did not differ between the intervention and the placebo group.
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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.
What Is Post Treatment Lyme Disease
The term PTLDS was first proposed in 2006 by the IDSA in its Lyme guidelines. It specifically incorporates the CDC surveillance case definition, meaning that a patient must satisfy the CDC surveillance criteria to be included in the term PTLDS.
The guidelines state, Inclusion criteria: An adult or child with a documented episode of early or late Lyme disease fulfilling the case definition of the Centers for Disease Control and Prevention.
When the IDSA proposed the term, the authors said it was an attempt to provide a framework for future research on this subject and to reduce diagnostic ambiguity in study populations.
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Update Of The Swiss Guidelines On Post
Publication Date: 04.12.2016 Swiss Med Wkly. 2016 146:w14353
Johannes Nemeth, Enos Bernasconi, Ulrich Heininger, Mohamed Abbas, David Nadal, Carol Strahm, Stefan Erb, Stefan Zimmerli, Hansjakob Furrer, Julie Delaloye, Thierry Kuntzer, Ekkehard Altpeter, Mathias Sturzenegger, Rainer Weber, for the Swiss Society for Infectious Diseases and the Swiss Society for Neurology
What Is Chronic Lyme Disease
Lyme disease is an infection caused by the bacterium Borrelia burgdorferi. In the majority of cases, it is successfully treated with oral antibiotics. In some patients, symptoms, such as fatigue, pain and joint and muscle aches, persist even after treatment, a condition termed Post Treatment Lyme Disease Syndrome .
The term chronic Lyme disease has been used to describe people with different illnesses. While the term is sometimes used to describe illness in patients with Lyme disease, it has also been used to describe symptoms in people who have no clinical or diagnostic evidence of a current or past infection with B. burgdorferi . Because of the confusion in how the term CLD is employed, and the lack of a clearly defined clinical definition, many experts in this field do not support its use.
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Lyme Disease Prevention And Treatment In Greater Houston
Internal Healing and Wellness MD has already helped thousands of people in Spring, The Woodlands, and other cities in Greater Houston deal with their Lyme disease diagnosis and make a comprehensive plan for recovery. We can also educate the public on how to minimize interactions with ticks and other disease-carrying animals.
How To Treat Post Lyme Disease Syndrome
This article was medically reviewed by Erik Kramer, DO, MPH. Dr. Erik Kramer is a Primary Care Physician at the University of Colorado, specializing in internal medicine, diabetes, and weight management. He received his Doctorate in Osteopathic Medicine from the Touro University Nevada College of Osteopathic Medicine in 2012. Dr. Kramer is a Diplomate of the American Board of Obesity Medicine and is board certified.There are 13 references cited in this article, which can be found at the bottom of the page. This article has been viewed 2,170 times.
Most people who contract Lyme disease are cured after a single round of antibiotics. However, some develop symptoms that last months, if not years, after that initial treatment. This condition is called post Lyme disease syndrome, or post-treatment Lyme disease syndrome , and doctors have struggled to understand and treat it.XTrustworthy SourceCenters for Disease Control and PreventionMain public health institute for the US, run by the Dept. of Health and Human ServicesGo to source If you were treated for Lyme disease and are still experiencing symptoms, find a doctor you trust who will listen to you and take you seriously. They can work with you to design a course of treatment that helps control or alleviate your symptoms.XTrustworthy SourceHarvard Medical SchoolHarvard Medical School’s Educational Site for the PublicGo to source
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The Conflict On Posttreatment Lyme Disease Syndrome: A Clinical Mini Review
4375650Manos Bogdos1 Sotirios Giannopoulos1,2
1Department of Neurology, School of Medicine, University of Ioannina, 45110 Ioannina, Greece.
2Neurosurgical Research Institute, School of Medicine, University of Ioannina, 45110 Ioannina, Greece.
31st Division of Internal Medicine, School of Medicine, University of Ioannina, 45110 Ioannina, Greece.
Received: Accepted:
This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License , which allows others to remix, tweak and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
What Were The Major Findings
Post-treatment levels of the blood protein CCL19 greater than 111.67 pg/mL one month after completion of antibiotic therapy was associated with symptoms that persisted 6 or 12 months later. The level of CCL19 also continued to be elevated in the blood of these patients, above the level of 79.28 observed in healthy controls, even 1 year after treatment with antibiotics. On the other hand, CCL19 levels returned to normal in Lyme disease patients who returned to health after treatment.
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Elisa And Western Blot Tests Are Outdated And Inadequate
The current standards for Lyme disease testing, the Elisa and Western Blot, are outdated and inadequate for definitively diagnosing and quantifying Lyme borreliosis additionally, these tests fail in detecting and accurately quantifying the presence of any co-infections that may be present. To make matters worse conventional testing often provides false negatives when diagnosing Lyme borreliosis, resulting in a monumental failure to provide critical early detection and treatment to patients .
Fortunately, Envita supports newer and much more accurate technologies including DNA sequencing to replace the archaic Western Blot and Elisa for a more sensitive diagnosis that relies on the latest genetic information. While this technology is still in research and development, DNA sequencing is an incredibly powerful tool in the battle against Chronic Lyme Disease Complex that can not only conclusively diagnose Lyme borreliosis and its many co-infections but can also give quantified data on these infections. The combination of tick-borne infections, and secondary infections such as viral, fungal, and parasitic co-infections can lead to resistance to treatment and other difficulties in providing care . DNA sequencing provides conclusive and quantifiable data on a patient’s total infectious load leading to a better diagnosis and treatment for patients suffering from Chronic Lyme Disease Complex while providing a more accurate way to track the progress of the patient’s treatment.
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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Association Of Small Fiber Neuropathy And Post Treatment Lyme Disease Syndrome
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* E-mail:
Affiliation Department of Neurology, Brigham and Womens Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
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Roles Data curation, Formal analysis, Writing original draft, Writing review & editing
Affiliation Department of Infectious Disease, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
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Roles Formal analysis, Methodology, Validation, Writing original draft, Writing review & editing
Affiliation Dean Center for Tick Borne Illness, Spaulding Rehabilitation Hospital, Boston, Massachusetts, United States of America
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Roles Methodology, Project administration, Resources, Writing original draft, Writing review & editing
Affiliation Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts, United States of America
Differences And Similarities Between Chronic Fatigue Fibromyalgia And Ptlds
Many patients complaining about increased fatigue or generalised pain associate their condition with a preceding infection . Symptoms of PTLDS may have an aetiological and phenomenological overlap with chronic fatigue syndrome, fibromyalgia and other chronic pain syndromes.
As shown in table 7, the diagnostic criteria of chronic fatigue and fibromyalgia do substantially overlap with PTLDS, and the clinical differentiation between fibromyalgia, chronic fatigue and PTLDS may, by definition, be blurred. However, the diagnosis of PTLDS requires a previously documented infection with B. burgdorferi and a plausible association between Lyme borreliosis and the beginning of persisting symptoms that were not present before the onset of B. burgdorferi infection.
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