Lyme disease is one of the most misunderstood, yet widely growing illnesses in Canada. One of the major challenges and why it eludes many doctors is that Lyme can mimic and produce symptoms similar to over 300 diseases. For example, a high percentage of people diagnosed with chronic fatigue are actually suffering from Lyme. The muscle joint and tendon pain seen in fibromyalgia and arthritis have also been linked to Lyme disease. Neurological symptoms are easily confused with multiple sclerosis or can present as psychiatric symptoms. An extremely high number of Parkinson’s and Alzheimer’s cases have been connected to Lyme.
Lyme can cause, mimic, manifest as, or is a contributing factor to many conditions. This is why it is called the Great Imitator, because its symptoms are so similar to other conditions. Common misdiagnoses include heart conditions, Attention Deficit Hyperactive Disorder (ADHD), amyotrophic lateral sclerosis (ALS - Lou Gehrig’s disease), Alzheimer’s, anxiety, arthritis, bipolar, interstitial cystitis, Bell’s palsy, acrodermatitis chronica atrophicans (ACA), chronic fatigue, depression, encephalitis, fibromyalgia, lupus, Meniere’s syndrome, multiple sclerosis (MS), Parkinson’s, rheumatoid arthritis and schizophrenia. It is estimated that up to 50% of chronically ill patients are infected with Lyme.
Lyme disease is a clinical diagnosis based on patient history and clinical symptoms. Blood testing can help to confirm a clinical suspicion, but a positive lab test is not a requirement to make a diagnosis. Diagnosis is very challenging due to a number of factors:
When people come into the office with a bull’s eye rash and flu-like symptoms, the diagnosis is crystal clear. In fact, at this stage, lab tests are not even necessary because it takes 3-4 weeks for antibodies to develop. Patients with early stage Lyme may complain of fever, fatigue, swollen glands, headache, stiff neck, backache and joint aches.
The biggest challenge with acute Lyme is the process that many patients have to go through when they access the public health system. If the person does not display the classic rash (only 10% of people have it) and is not living in an endemic area, testing is usually not ordered. If they do present with a rash, the blood tests at this point can be unreliable because it can take weeks for antibodies to show up in the blood. The additional problem is that the testing is only about 35% accurate for acute Lyme.
If there is a positive blood test for Lyme, the treatment protocol is a few weeks of low dose antibiotics. Studies have shown conclusively that the antibiotic dose is too low and the course of treatment is too short to successfully treat Lyme. There may be some temporary relief, but the acute Lyme becomes chronic Lyme.
Despite the complexity, to a Lyme-literate doctor, chronic Lyme is readily diagnosed, even in the absence of a positive laboratory result. The patient has been sick for a long time, months, years, sometimes even decades. Most patients have seen many doctors and received an assortment of diagnoses over the years, yet have not been treated successfully. About 30% would have been treated unsuccessfully for acute Lyme and now it is past the three months to one year mark. Some can recall when they were infected, but many have no idea when or where they may have contracted Lyme. The common symptoms, brain fog, loss of memory, numbness, tingling, spasms, fatigue, pain in joints and muscles (often burning pain), anxiety and depression, tend to cycle from low to extreme. It is usually not until the symptoms become significant that Lyme is diagnosed.