Chronic Fatigue Syndrome Or Lyme Disease?

The symptoms of Lyme Disease are almost indistinguishable from Chronic Fatigue Syndrome (CFS) and Fibromyalgia.  They share the same pathophysiology of total immune dyregulation with out of control cytokine production and inflammation.

 

This two series post will look at the approaches of two of the most knowledgeable physicians on CFS/Fibromyalgia and Lyme Disease, Dr Jacob Teitelbaum and Dr Neil Nathan.

 

Let’s look first at chronic Lyme Disease.  In the next post, I will explore Chronic Fatigue Syndrome and Fibromyalgia.

 

 

Most patients are told by their doctors that there is no such things as chronic Lyme Disease, but according to Dr. Neil Nathan MD, a medical doctor who specializes in the treatment of Lyme, chronic Lyme does exist and can be treated and cured.  Dr. Nathan believes that Lyme is the Great Masquerader, meaning that it can look like anything, and reminds us that we must also consider mold toxicity, as this has been discovered to be equally as deceptive in patients with chronic illnesses with no explanation.

 

Interpretation of the Western Blot

 

Many clinicians are unable to properly interpret a western blot.  The bands on a western blot represent pieces of protein to which the immune system may react with antibody production.  Not all bands are specific for Lyme Disease, while others are highly specific.

 

• Highly specific bands 23, 24, 25, 31, 34
• Specific bands 18, 22, 37, 39, 83, 93
• Non-specific bands 41, 45, 66, 73

 

Why are patients so sick?

 

This is a question many clinicians are plagued by as they encounter patients who are increasingly ill and resistant to many of their treatments.  These patients often have

• A higher spirochete load
• The development of alternate shapes and forms of Lyme bacteria
• Immune suppression and invasion
• Bacteria that have formed protective niches
• Presence of co-infections

 

Alternate Morphological Forms of Lyme Bacteria

 

Depending on host conditions, the Lyme bacteria can morph between three different forms, each of which requires a different type of treatment approach.  The spirochette form has a cell wall and is best treated with Penicillins and Cephalosporins.  The L Form has no cell wall and can be treated with Tetracyclines, erythromycins.  The third form is a Cyst form which is best treated with drugs like Flagyl, Tindamax, Rifampin.  Lyme bacteria replicate and divide every 21 days and are the slowest growing bacteria known in the world.  This makes treatment very difficult because antibiotic treatment must be initiated during a dividing period.  Since the replication period is so lengthy, antibiotic treatment for acute Lyme infection should last at least 6 weeks to make sure to catch the bacteria when it is in its replication period (chronic Lyme treatment must last much longer than 6 weeks).

 

Protective Niches

 

Lyme bacteria can hide within cells (intracellularly), within ligaments and tendons, in the central nervous system, and the eyes.  These spaces provide protection so that the bacteria can invade the immune system and make treatment much more difficult.

 

Basics of Treating Lyme Disease

 

1. Identify the organism(s) and treat them
2. Detoxification
3. Identify and treat weakened systems (immune, endocrine, nervous)

 

It is not enough to simply identify and kill off or eradicate the Lyme bacteria.  In addition to lowering the bacterial load until the immune system can recover, we must ensure that patients can detoxify all of the toxins that are released from the bacteria when they are killed off.  These toxins cause inflammation in the brain and the pituitary, which interferes with hormone production, the immune system, and the nervous system.  The hormonal imbalances can affect adrenal, thyroid and sex hormones and are a major cause of debility in patients with chronic Lyme.  We must simultaneously support all these systems and repair any damaged tissues and organ systems. Because of this complicated process to treating Lyme Disease, a great deal of patience, knowledge and compassion is required from both the physician and the patient.

 

Symptoms of Lyme Disease

 

Many patients have a long list of symptoms that no doctor has ever been able to figure out.  The many symptoms of Lyme Disease include:

 

• Fatigue
• Low grade fevers
• Hot flashes/chills
• Sore throat
• Swollen glands
• Stiff neck
• Myalgia
• Chest pain
• Diarrhea
• Depression
• Back pain
• Jaw pain
• Tinnitus
• Polyarthalgias
• Abdominal pain
• Arthritis/Rheumatoid arthritis
• Sleep disturbance
• Poor concentration
• Memory loss
• Stiffness
• Vertigo
• Headaches
• Palpitations
• Dizziness
• Mood swings
• Irritability
• Blurred vision
• Testicular pain
• Cranial nerve disturbances
• Parasthesias (numbness and tingling), especially if they do not correlate with the dermatomes
• Nerve palsies
• Bell’s Palsy
• Lightheadedness
• Eye pain
• Pelvic pain
• Atypical neurological presentations that look like MS, Parkinsons, Alzheimers (ie. atypical meaning the patient does not quite fit the typical definition and presentation of these conditions)