The Truth About Antibiotic Treatments
Until recently, many doctors in Canada tended to prescribe only one round of antibiotics, irrespective of the stage of infection. However, current research suggests that a single course of antibiotics is often insufficient for treating Lyme disease, especially if the infection has been untreated for several months.
Key Points To Remember
- Most Lyme disease tests are designed to detect antibodies made by the body in response to infection.
- Antibodies can take several weeks to develop, so patients may test negative if infected only recently.
- Antibodies normally persist in the blood for months or even years after the infection is gone therefore, the test cannot be used to determine cure.
- Infection with other diseases, including some tickborne diseases, or some viral, bacterial, or autoimmune diseases, can result in false positive test results.
- Some tests give results for two types of antibody, IgM and IgG. Positive IgM results should be disregarded if the patient has been ill for more than 30 days.
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Healthsee The Full Today Series On How Women Are Treated Or Mistreated At The Doctor’s Office
For women who have Lyme disease, the struggle can be especially difficult, given the complicated nature of the disease.
“The problem with Lyme disease is that there are so many different strains,” said Dr. Andrea Gaito, a New Jersey-based rheumatologist who specializes in treating Lyme disease. “One person can have it and have headaches, someone else can have joint pain, someone else can have palpitations. And none of these are specific to Lyme. There’s no Lyme test that’s 100% accurate. Unless you have a tick in a baggie, literally, and a bulls-eye rash, there’s sometimes a delay in diagnosis.”
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In this blog, you will learn:
- What the signs and symptoms of Lyme Disease are
- How Lyme Disease is diagnosed
- Why it is important to get a correct diagnosis so that treatment can be targeted and effective
Do your clients suffer from fatigue, headaches or muscle or joint pain? Do they have Lyme Disease and do you know how to treat it? Then this blog on Lyme Disease is for you. Please read on for the details!
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What is Lyme Disease ?
Lyme Disease is a bacterial infection, caused by Borrelia burgdorferi. Borrelia is a bacterium that is transmitted by an infected black-legged tick. It is most commonly spread by a tick bite. The disease is named after Lyme, Connecticut, where it was first identified in 1975 in the US.
Cdc Supports The Development Of New Tests
New tests may be developed as alternatives to one or both steps of the two-step process. Before CDC will recommend new tests, they must be cleared by the Food and Drug Administration . For more details, see: Recommendations for Test Performance and Interpretation from the Second National Conference on Serologic Diagnosis of Lyme Disease.
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Why Is Lyme Disease So Difficult To Diagnose
Lyme disease is a bacterial infection transmitted through the bite of infected deer ticks. One common symptom of Lyme is a red rash on the skin , that appears at the site of a tick bite usually within a week, but up to a month later. Some people may not experience a rash, or may mistake it for a spider bite. Other symptoms like fever, chills, headache, fatigue, joint aches and swollen lymph nodes may occur in the absence of a rash, according to the Centers for Disease Control and Prevention.
If Lyme is not diagnosed immediately, the bacteria start to spread to other parts of the body the joints, the nervous system and the heart. Eventually, arthritis sets in, along with extreme fatigue and general aches and pains. These can also be symptoms of other conditions, which is part of the reason why Lyme is difficult to diagnose. Aside from the initial rash, there are no symptoms that are specifically indicative of Lyme disease.
Theres also no definitive way to test for Lyme disease. There is no direct blood test for the bacteria that causes Lyme. Doctors have to rely on antibody tests, which merely measure the immune systems response to the bacteria. Further complicating matters, studies have shown that those tests arent always accurate and can have poor sensitivity and false results in some cases.
Until a foolproof test exists, diagnosing Lyme disease, especially late-stage Lyme, is an imperfect science.
Chronic Lyme Disease Patients Profoundly Debilitated
Many patients with chronic Lyme disease are profoundly debilitated. Investigators of the four NIH-sponsored retreatment trials documented that the patients quality of life was consistently worse than that of control populations and equivalent to that of patients with congestive heart failure. Pain levels were similar to those of post-surgical patients, and fatigue was on par with that seen in multiple sclerosis.
An LDo published survey of over 3,000 patients with chronic Lyme disease found that patients suffer a worse quality of life than most other chronic illnesses, including congestive heart failure, diabetes, multiple sclerosis and arthritis. Over 70% of patients with chronic Lyme disease reported fair or poor health. Similar results have been found in other studies. Many of the symptoms associated with Lyme disease are common in other diseases. The CDC surveillance criteria for confirmed cases specifically exclude most of the symptoms that patients report, including fatigue, sleep impairment, joint pain, muscle aches, other pain, depression, cognitive impairment, neuropathy, and headaches. However, these common symptoms can be severe and may seriously affect quality of life.
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Dont Be Fooled By The Repeat Test
People with Lyme want to know if treatment is working especially if they are not feeling better. The truth is, there are no biologic markers or immune system tests that show if you have recovered or are recovering from Lyme and coinfections. Repeating elispot tests like those offered by Armin Labs, or western blot tests and immunoblot tests offered by IGenex do not have any scientific proof to show they can predict the end of treatment or where you are in your treatment.
Simply put, retesting is not scientifically valid.
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Treatment Of Lyme Disease
Early diagnosis and proper antibiotic treatment of Lyme disease is important and can help prevent late Lyme disease. The following treatment regimens reflect CDCs interpretation of the most current data for four important manifestations of Lyme disease. These regimens are consistent with guidanceexternal icon published by the by the Infectious Disease Society of America, American Academy of Neurology, and American College of Rheumatology.
Some patients report persistent symptoms of pain, fatigue, or difficulty thinking even after treatment for Lyme disease. The state of the science relating to persistent symptoms associated with Lyme disease is limited, emerging, and unsettled.
Additional researchexternal icon is needed to better understand how to treat, manage, and support people with persistent symptoms associated with Lyme disease. In light of these research gaps, recommendations for treatment of persistent symptoms in people previously treated for Lyme disease are not provided here.
If you are interested in information on chronic Lyme diseaseexternal icon, see NIHs website.
Links with this icon indicate that you are leaving the CDC website.
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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.
Stage : Late Disseminated Lyme Disease
Stage 3 or late disseminated Lyme disease is the final stage of the disease. A person may enter this stage if they did not receive treatment for Lyme disease in the early stages, or if their symptoms persisted despite treatment. As such, doctors sometimes refer to this stage as chronic or post-treatment Lyme disease .
Stage 3 Lyme disease can occur after an infected tick bites a person.
A person with stage 3 Lyme disease may experience additional symptoms, including:
- severe joint pain and swelling, known as chronic Lyme arthritis
- heart palpitations or irregular heartbeat, due to Lyme carditis
- inflammation of the brain and spinal cord
- mental fogginess
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Alternative Diagnostic Tests Not Available At Ripl
Tests used in the NHS and PHE to identify Lyme disease are well characterised, standardised, and are highly reproducible between laboratories. They are the methods of choice recommended in the 2018 NICE Lyme disease guideline, following an extensive review of the evidence and literature. International external quality assurance schemes are in place to ensure consistency between different centres offering these tests.
Several private laboratories in Europe and the USA offer an alternative type of test called an ELISpot to diagnose Lyme disease. This looks for different markers in blood samples compared to conventional validated Lyme disease serology tests. The laboratories using these tests in the diagnosis of Lyme disease do not publish their methods, and have not produced any peer reviewed publications on their clinical value.
This makes it very difficult to verify their results, especially as there are no national or international EQA schemes for Lyme disease ELISpot tests and therefore no independent verification of performance between laboratories. Without independent evidence it is impossible to determine the validity of results produced using these alternative tests.
RIPL cannot interpret the results of alternative diagnostic tests.
The Numbers On Chronic Lyme
Because Lyme disease is commonly missed or misdiagnosed, statistics vary on how many Lyme patients go on to experience chronic symptoms. The following research nonetheless paints a basic picture of the problem.
- An estimated 5-20% of patients may have chronic symptoms after getting Lyme disease, according to the Columbia University Irving Medical Center.
- The treatment failure rate for chronic Lyme disease patients was estimated at 26-50% in 2004, compared to 16-39% for early Lyme patients, according to Lymedisease.org.
- Up to 15-40% of late-stage Lyme patients develop neurological disorders, which are responsible for many common symptoms of chronic Lyme disease.
Experts dont know for sure why some people experience persistent symptoms, even with treatment. However, some believe the Lyme infection may trigger an auto-immune response that manifests in the chronic symptoms detailed below.
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What Are The Symptoms Of Lyme Disease
Signs and symptoms of early Lyme disease typically include:
- A reddish rash or skin lesion known as erythema migraines . The rash starts as a small red spot at the site of the tick bite anywhere from one week after to four weeks after the bite. The spot expands over a period of days or weeks, forming a circular, triangular or oval-shaped rash. The rash may look like a bulls eye because it appears as a red ring that surrounds a clear center area. The rash can range in size from that of a dime to the entire width of a person’s back. As infection spreads, several EM rashes can appear at different sites on your body.
Signs and symptoms of the second stage of Lyme disease may include:
- Multiple areas of rash.
- Paralysis of facial muscles .
- Heart block or an interruption of the electrical system of the heart.
- Areas of numbness or abnormal feelings .
Signs and symptoms of untreated late Lyme disease, which may happen from months to a year after infection, may include:
- Recurring episodes of swollen joints . This typically affects large joints like the knee.
- Difficulty concentrating, known as brain fog. This is a form of encephalopathy or damage to the brain.
- Damage to nerves all over your body, including your skin, muscles and organs .
Original Manifestations Of Lyme Disease
Demographic data and initial clinical picture and treatment of the patient groups.
The 25 patients in the erythema migrans group, by definition, had erythema migrans without objective manifestations of acute neuroborreliosis or Lyme arthritis. In addition to this skin lesion, they sometimes had signs and symptoms suggestive of hematogenous dissemination of the spirochete, including secondary annular skin lesions, migratory arthralgias, or transient headache and neck pain . Nineteen of 25 patients in this group were treated for erythema migrans with 1014-day courses of oral penicillin, tetracycline, or erythromycin. Thus, although hematogenous dissemination of the spirochete was probably common in this group, they did not develop acute neuroborreliosis, carditis, or subsequent Lyme arthritis.
By definition, the 28 patients in the Lyme arthritis group had intermittent or chronic arthritis, usually in one or a few joints, especially the knee. Early in the infection, these patients sometimes had signs and symptoms of dissemination of the spirochete, including secondary annular skin lesions or transient headache and neck stiffness . These 28 patients did not receive antibiotic therapy for early Lyme disease, and only 6 were treated with oral or parenteral penicillin when they had active arthritis. Thus, most patients in this group had active B. burgdorferi infection for at least several years, but none had objective findings of acute neuroborreliosis.
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When To See A Healthcare Provider
Since Lyme disease can take different forms, and since its often confused with other conditions, its important to be proactive if you suspect the condition. What signs prompt medical help? Call the healthcare provider if:
- You have a bullseye rashor any kind of rashfollowing a tick bite.
- You experience flu-like symptoms after a tick bite.
- You experience symptoms of more advanced Lyme disease: arthritis, heart palpitations, facial paralysis, dizziness, and others.
Selection Of Study Subjects
From 1976 through 1983, 582 subjects with facial palsy, erythema migrans, or Lyme arthritis were entered into the initial studies of Lyme disease at Yale . All these patients were evaluated by one of us . Details of the patients clinical pictures were recorded, and serum samples were frozen at 70°C for any subsequent determinations. Of 582 subjects, 126 had moved from the area, were lost to follow-up, or had died. In 1994, in an effort to obtain as many patients as possible who had had facial palsy for the current study, all 44 patients who had this manifestation and still lived in the area were contacted, and 31 agreed to participate. Of the 412 patients who had erythema migrans or Lyme arthritis without neuroborreliosis, a random sample was selected by random number table to obtain similar numbers in each of the patient groups. Of the 52 patients in the erythema migrans group who were contacted, 26 agreed to participate and 26 declined. Of the 56 patients in the Lyme arthritis group who were contacted, 30 agreed and 26 declined.
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When To See A Doctor
A person should see a doctor if they have recently received a tick bite. It is not possible to know whether a tick is carrying Lyme disease, and the symptoms may take weeks to appear.
The earlier a person receives a diagnosis and treatment, the higher the likelihood of a quick and complete recovery.
It is not always possible for a person to tell if a tick has bitten them. As such, people should also see a doctor if they experience any Lyme disease symptoms. A doctor will ask about the persons symptoms and duration and whether the person has spent time in tick-infested areas.
Chronic Lyme Disease Vs Ptlds
The terms chronic Lyme disease and Post-Treatment Lyme Disease Syndrome are sometimes used interchangeably. However, PTLDS is slightly more restrictive, referring to patients who have received treatment for Lyme disease but go on to experience Lyme disease symptoms. It does not include those who received a misdiagnosis or delayed diagnosis and have developed chronic symptoms of Lyme disease before receiving any kind of treatment.
The CDC defines PTLDS as generalized and/or recurring pain, fatigue, and cognitive difficulties that last for more than 6 months after treatment. These mirror symptoms associated with chronic Lyme disease, with or without treatment.
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