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Diagnostics
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Lyme Disease Tests:
ELISA IgG/IgM
Western Blot IgG/IgM
C6 Peptide
PCR
LDA
PCR-CSF
CFR Antigen
Co-Infection Tests:
Bartonella IgG/IgM
Babesia IgG/IgM
Ehrlichia IgG/IgM
Aanaplsma IgG/IgM
Bartonella
PCR
Tomography:
MRI
SPECT
PET
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Lyme disease can present itself in a wide variety of symptoms. The classic indicator of Lyme disease is a red rash
that cirulates outward in a form of a 'bulls eye' known medically as Erythema migrans (EM). Not all patients develope
the rash and the percentage of people that do is statistically varied across medical literature as well as opinion.
It is at this point, where Lyme disease can be left untreated and compliations from the disease can present later
on to the patient. These complications are multisystem disorders and can manifest into three stages of the disease:
early localized infection, early disseminated infection and late disseminated or persistent infection. A new stage
that is not medically confirmed is called chronic lyme disease or post-lyme disease syndrome. It is important to
realize that all of these stages can overlap each other and the timeline occurance is different for each patient.
It may take months to years to pass from one stage to another.
Local infection is the clinical signature of the EM rash and ranges from 3-30 days. A fllu-like illness occurs
in many patients with fever, chills, headache and muscle pain (myalgia). Early disseminated stage presents a host
of symptoms that again can be variable for each patient: fatigue, headache, muscle and joint pain, Bell's palsey,
disorientation, cardiac or neurologic problems. Late disseminated stage can include many of the symptoms of early
disseminated stage but with a strong emphasis on musculoskelete complaints, neurologic, optic neuritis, cognitive
and skin disease. Doctor Brian A. Fallon of Columbia Univeristy, N.Y. has reseached in partnership with the National
Institute of Health (NIH) presentations of late-state neruopyschiatric disorders in Lyme disease cases; "It
is less well known that psychiatric disorders may also arise as a result of borrelail infection. Depression, panic
attacks, schizoprenia-like states, bipolor disorder and dementia have been attributed to Lyme borreliosis".
Chronic or post-lyme stage mimics many of the symtpoms of Chronic Fatigue Syndrome and Fibromyaliga. The core complaints
of this stage are severe headaches, cognitive, muscle and joint pain, fatigue, weakness, light sensitivity and
sleep disturbance. Medical research is looking at the possiblity of Lyme disease as the cause or contributing cofactor
in other degenerative diseases, including ALS, Alzheimer's, multiple sclerosis and Parkinson's disease. Spirochetes
have been found in spinal fluid and tissues samples of MS patients, blood cultures of ALS and Parkinson's disease.
Accordingly to the Centers of Disease and Control, the diagnosis of Lyme disease is a clinical diagnosis. Supportive
evdience includes the history of possible tick exposure in an endemic area combined with serologic testing. Opinions
by medical doctors and some purported experts on the subject of Lyme disease blood testing is in conflict and discord.
In addition, some physicians disagree on certain laboratories that perform Lyme disease tests and consider them
unreliable. Technical issues within the tests such as the ELISA and Western Blot exist as well as what tests to
run in what order. The Centers of Disease and Control recommend a "two-tier" approach, first by performing
the sensitive ELISA and if positive, a Western Blot is performed for bacterial confirmation specificity (outer
protein markers that spirochetes exhibit).
The testing phenomena is almost as complex as the disease itself. The first problem is the human body. Antibodies
are produced by our bodies to fight off infection. One type of antibody called IgM is produced only on the first
encounter of an antigen (foreign invader such as bacteria). These are produced usually within weeks or longer during
infection. Some patients do not always produce this antibody and others produce the antibody months later. The
ELISA as well as the Western Blot test could show a false negative. Cross reactive bacteria or past exposure to
infection in our body could cause a false positive during Western Blot detection. However, most of these cross
reactive protein markers have been identified and are excluded from the test. Another problem with testing is there
is no gold standard that laboratories follow in regards to sensitivity and specificity. In addition, many labs
do not show all bands of the Western Blot test due to stringent epidemiology guidelines set forth by the CDC. Some
labs go beyond that type of "band reporting" allowing the medical doctor or Lyme specialist to see the
full picture as well as important bands they believe have been left out.
Lyme disease has more then one type of bacteria or strain. One major argument is with the various Lyme bacterial
strains, the ELISA may not use the correct strain in the detection process and miss the directed antibody response.
Various medical research has reported lyme borrelia as a stealth pathogen that can hide in immune cells and/or
changes to pleomorphic forms with no cell wall making it undetectable by our immune system.
Other testing suites for Lyme disease include the PCR which is specific for borrelia DNA, cerebrospinal fluid analysis
using PCR and ELISA, urinary antigen testing and the C6 peptide test. The CFR (Central Floriday Research) antigen
test is direct detection of the actual bacteria rather then antibodies. Again, there is debate in the medical community
on these tests as well for a definitive diagnosis of Lyme disease.
The current generation of Lyme disease testing has many problems. Medical doctors are confronted with unreliable
testing, differential diagnosis, objective evidence for a clinical diagnosis and confusing information. Dr. Bernard
Raxlen, a neuropsyschistrist strongly feels a sub-specialty of medicine should be created called tick-borne disease.
This specialty would include Lyme disease and all other tick-borne diseases (co-infections).
Stages and Symptoms of Lyme Disease
| Early Localized |
Disseminated
E a r l y
L a t e |
Chronic |
| EM Rash |
| Headache |
Severe headaches/migraines |
| Joint pain |
Crippling arthritis |
| Body aches |
Swollen joints |
| Night sweats |
Heart blockage |
| Sensitivity to light, and sound, touch |
Hypersensitivity to light, sound and touch. |
| Migratory pains |
Crippling migratory |
| Bell's palsy |
pains |
| Fatigue |
Severe fatigue |
| Heart palpitations |
Optic neuritis and increased eye complications |
| Swollen gland |
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| Stiff neck |
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Worsening of asthmatic
symptoms |
Seizures
Nosebleeds |
| Disorientation |
Memory loss |
| Lyme fog |
Lyme fog |
| Conjunctivitis |
Dyslexic reversals |
| Sleep disturbances |
Sleep disturbances |
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Abnormal MRI, CAT scan, EEG, CSF |
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Migraines
Arthritis
Loss of libido
Fatigue
Muscle weakness
Lyme fog
Dyslexia |
Stages and Symptoms of Lyme Disease from Denise
Lang, Coping with Lyme Disease,
14:171, 2004. With permission. |
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