Lyme Disease: Symptoms, Causes, and Treatment in Charleston SC
Lyme disease is an infection that happens when an infected tick bites a human. The condition can cause joint pain. Visit The Center for Occupational and Environmental Medicine (COEM) today to get comprehensive and specialized care. For more information, contact us today or book an appointment online. We are conveniently located at 7510 North Forest Drive North Charleston, SC 29420.
Table of Contents:
Lyme disease: An overview
What are ticks?
Significant causes of Lyme disease
What are the symptoms of Lyme disease in humans?
Can Lyme disease completely be cured?
Lyme disease: Could a little tick be causing big problems?
Symptom checklist for Lyme-associated disease
Lyme disease (LD) is an infection caused by Borrelia Burgdorferi, a type of bacterium called a spirochete that is carried by deer ticks. An infected tick can transmit the spirochete to the humans and animals it bites. If left untreated, the bacterium travels through the bloodstream, establishes itself in various body tissues, and can cause a number of symptoms, some of which are severe. Lyme disease acts as a multi-system inflammatory disease and affects the skin in its early stage, and later, spreads onto the joints, and nervous system in severe cases, it also affects other organs of the body.
Ticks are closely related to spiders. They are typically small when unfed, (1 to 5 mm in length), and all active stages feed on blood. They are small and can be hard to see. Immature ticks, or nymphs, are about the size of a poppy seed; adult ticks are about the size of a sesame seed. They cannot fly and they move quite slowly. Ticks usually come in contact with people or animals by positioning themselves on tall grass and bushes. They may take several hours to find a suitable place on the host to attach to feed. Most tick bites are painless. The majority of bites will not result in disease because most ticks are not infected with the agent of Lyme disease.
LD is the most common illness in the U.S., more than 150,000 cases have been reported till date since the year 1982.
Infected black-legged ticks can spread Lyme disease to humans through their bite. Ticks are very small and as their bites are usually painless, you may not know you have been bitten.
Blacklegged ticks are most often found in forests and the overgrown areas between woods and open spaces. Current locations where populations of ticks and Lyme disease can be found, and where surveillance and research studies suggest ticks and possible Lyme disease risk have begun to become established are detailed on this map. But remember, it is possible to acquire Lyme disease outside of these areas as tick populations are expanding.
There is no agreed-upon scientific evidence that people can spread Lyme disease to each other. Pets, particularly dogs, can get Lyme disease, but there is no evidence that they can spread the infection to humans. Pets can carry infected ticks into your home and your yard.
The early symptoms of LD can be mild and easily overlooked. People who are aware of the risk of LD in their communities and who do not ignore the sometimes subtle early symptoms are most likely to seek medical attention and treatment early enough to be assured of a full recovery.
The first symptom is usually an expanding rash (called erythema migrans, or EM, in medical terms) which is thought to occur in 80% to 90% of all LD cases. An EM rash generally has the following characteristics:
• Usually (but not always) radiates from the site of the tickbite
• Appears either as a solid red expanding rash or blotch, OR a central spot surrounded by clear skin that is in turn ringed by an expanding red rash (looks like a bull’s-eye)
• Appears an average of 1 to 2 weeks (range = 3 to 30 days) after disease transmission
• Has an average diameter of 5 to 6 inches
• (range = 2 inches to 2 feet)
• Persists for about 3 to 5 weeks
• May or may not be warm to the touch
• Is usually not painful or itchy
EM rashes appearing on brown-skinned or sun-tanned patients may be more difficult to identify because of decreased contrast between light-skinned tones and the red rash. A dark, bruise-like appearance is more common on dark-skinned patients.
Other symptoms such as joint pains, chills, fever, and fatigue are common, but they may not seem serious enough. As the LD spirochete continues spreading through the body, a number of other symptoms including severe fatigue, a stiff, aching neck, and peripheral nervous systems (PNS) involvement such as tingling or numbness in the extremities or facial palsy (paralysis) can occur.
LD has 3 stages. Following are the symptoms according to the stages of LD-
Localized Early (Acute) Stage:
• Solid red or bull’s-eye rash, usually at site of bite
• Swelling of lymph glands near the tick bite
• Generalized achiness
Early Disseminated Stage:
• Two or more rashes not at site of the bite
• Migrating pains in joints/tendons
• Stiff, aching neck
• Facial palsy (facial paralysis similar to Bell’s palsy)
• Tingling or numbness in extremities
• Multiple enlarged lymph glands
• Abnormal pulse
• Sore throat
• Changes in vision
• Fever of 100 to 102 F
• Severe fatigue
• Arthritis (pain/swelling) of one or two large joints
• Disabling neurological disorders (disorientation; confusion; dizziness; short-term memory loss; inability to concentrate, finish sentences or follow conversations; mental “fog”)
• Numbness in arms/hands or legs/feet
Complications Associated with Lyme Disease
• Meningitis is characterized by headaches that fluctuate in intensity from mild to severe with or without associated nausea, vomiting, light sensitivity, neck stiffness, or pain on eye movement.
• Encephalitis is commonly accompanied by sleepiness, mood swings and irritability, atypical spontaneous tearfulness or personality change, cognitive problems (typically with word-finding problems, memory loss, slowed mental speed), balance problems, and sensory hyperarousal (e.g., vision, hearing).
• Cranial neuritis – CN VII Palsy (facial nerve weakness) is a form of cranial neuritis that is thought by many physicians to be common, however, studies suggest that it may be seen in as few as 10% of patients with neurologic Lyme disease. However, in a patient from a Lyme endemic area or in an individual who has previously visited a Lyme endemic area, a presentation of a facial nerve palsy should lead the physician to test for Lyme disease.
• Radiculoneuritis – When the infection in Lyme disease affects the nerve roots, it is called radiculoneuropathy.
• Encephalopathy – Patients may develop cognitive problems from Lyme disease either early or many months or years after the initial infection. The cognitive problems most commonly include problems with short- term memory, problems with verbal fluency such as in name or word retrieval, and problems with slower speed of thinking.
• Neuropsychiatric Lyme Disease – Neuropsychiatric symptoms can emerge either early or late in the disseminated phase of infection. These symptoms commonly appear as cognitive symptoms and as irritability, easy tearfulness, anxiety, and depression. Rarely, patients with undetected Lyme disease may present with obsessive-compulsive disorder, paranoia, auditory/visual hallucinations, or full-blown mania.
There are accepted pharmaceutical treatments that have been found to be effective for LD, but with possible side effects.
• Doxycycline (Vibramycin, Avidoxy, Monodox, Doxy 100, Doryx, Oracea, Adoxa)
Doxycycline inhibits protein synthesis and thus bacterial growth by binding to the 30S and possibly the 50S ribosomal subunits of susceptible bacteria. This agent interferes with bacterial cell wall synthesis during active multiplication, causing cell wall death and resultant bactericidal activity against susceptible bacteria.
• Tetracycline – Tetracycline is used to treat gram-positive and gram-negative organisms, as well as mycoplasmal, chlamydial, and rickettsial infections. This agent inhibits bacterial protein synthesis.
• Penicillins provide effective treatment of Lyme disease. These agents are used in patients who are intolerant of doxycycline and in pregnant women and children under the age of 8 years, in whom doxycycline is contraindicated.
• Intravenous antibiotics. If the disease involves the central nervous system, your doctor might recommend treatment with an intravenous antibiotic for 14 to 28 days. This is effective in eliminating infection, although it may take you some time to recover from your symptoms. Intravenous antibiotics can cause various side effects, including a lower white blood cell count, mild to severe diarrhea, or colonization or infection with other antibiotic-resistant organisms unrelated to Lyme.
• NSAIDS – Like ibuprofen (Advil, Motrin), naproxen (Aleve), to relieve pain and inflammation.
Nutrition and Supplements
• Probiotic supplement (containing Lactobacillus acidophilus – Probiotics, or “friendly” bacteria, help maintain intestinal health. If the patient takes antibiotics to treat Lyme disease, the antibiotics will kill the “good” bacteria along with the bad. That can cause diarrhea or yeast infections. Taking probiotics may reduce these side effects. People with weakened immune systems, or those who take drugs to suppress their immune systems, should ask their doctors before taking probiotics.
• Beta-glucan – This is a kind of fiber, is sometimes used to help fight Lyme disease. Beta-glucan is thought to stimulate the immune system, so people with weakened immune systems, or those who take drugs to suppress their immune systems, should ask their doctors before taking it.
• Garlic (Allium sativum) – This has antibacterial effects, and one study suggested it may help prevent tick bites. In that study, people who took garlic reported fewer bites than those who took a placebo. Garlic may increase the risk of bleeding, especially if the person also takes blood thinners such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin. Garlic can potentially interfere with several medications, including drugs used to treat HIV/AIDS, and even some birth control medications. Speak to your doctor.
• Essaic – Burdock root (Arctium lappa), sheep sorrel (Rumex acetosella), slippery elm (Ulmus fulva), rhubarb (Rheum palmate). It helps to treat Lyme disease. Essaic is a formula that contains several different herbs and may interact with many medications and potentially cause some dangerous side effects.
Schedule an Appointment with our Experts at COEM and get the most comprehensive treatment for Lyme Disease.
Your story might go something like this, “I have been to several doctors, had numerous blood tests and X-rays, but they can’t seem to find what’s wrong.” You complain of many symptoms that seem unrelated and involve multiple systems and organs of the body. Perhaps you have some fatigue, neurological, orthopedic, cardiac, gastrointestinal, endocrine, or psychiatric symptoms. Your doctor concludes that with so many “vague” complaints and “normal” testing results, it must be all in your head. He says, ”There is no condition that could explain all of these complaints.”
But wait, beware of the great imitator! Lyme disease is on the rise. This tick-borne disease, although originally identified in outbreaks in Lyme, Connecticut, has now been reported in all 48 states. Borrelia burgdorferi is the spirochete that causes Lyme disease. It gets transmitted by the bite of a variety of ticks and can be accompanied by numerous other infectious agents. Unfortunately, Borrelia is capable of causing terrible problems in humans if not diagnosed and treated. Borrelia can even be transferred through the placenta to the unborn baby. Some authorities think mosquitoes or other vectors may also carry and transmit Borrelia through their bites.
But you say, “I don’t remember a tick bite or the classic ‘bull’s eye’ rash.” Less than 50 percent of patients can recall these events. And if you do suspect a tick bite and ask your doctor for diagnostic testing, he will typically use first an Elisa test and secondarily the Western Blot.
The Elisa test misses 35 percent of culture-proven Lyme disease and tests for none of the co-infections. The Western Blot often misses 20 to 30 percent of culture-proven Lyme disease.
According to Tom Grier, Executive Director of the Minnesota Insect-Borne Education Council, these tests look for antibodies that the human host has formed against the invading Borrelia organism. But he points out four common reasons why, even with such laboratory testing, the organism can be missed:
1. Borrelia can escape detection by turning into a cyst. Therefore, the immune system cannot see it and does not form antibodies against it.
2. The antibodies necessary for detection are bound up into immune complexes.
3. Antibodies may not be present due to the early use of antibiotics or steroids that interfere with the immune system forming antibodies.
4. Antibody levels drop to very low levels often late into the disease.
So how would you know if Lyme disease is the real cause of your symptoms? Since Lyme is difficult to diagnose, it requires a physician skilled in recognizing the patterns of the disease and using the most accurate tests. The symptoms vary greatly. Some people start with a flu-like pattern of headache, fatigue, muscle and joint pains, numbness, tingling, and fever, which may last hours or days, disappear and then reappear. Some victims initially have no symptoms at all–while the Borrelia stays in the body, gradually causing a variety of symptoms.
There are other testing options, which are used by physicians skilled in working with Lyme disease. Three specialty laboratories have designed tests that can increase the likelihood of detection up to 90 percent. Some of the labs utilize a specially designed Western Blot test that looks for multiple sub-species of Borrelia, not just the one species in the standard test. These labs also use more of the “bands” that could reveal the presence of the disease and interpret the results in a different manner, allowing more people to get diagnosed and treated. There are also other laboratories with special tests that may detect the presence of Lyme.
Despite the more accurate testing available, it is critical to realize that no current tests are yet considered completely accurate, and the physician may have to rely on his clinical judgment to help diagnose Lyme. The Center for Disease Control says, “The diagnosis of Lyme disease is based primarily on clinical findings, and it is often appropriate to treat patients solely on the basis of objective signs of known exposure.”
Typically, treatment for Lyme disease has entailed a regimen of multiple antibiotics for lengthy periods of time, since the Borrelia organism is very difficult to eradicate. However, we at the Center for Occupational and Environmental Medicine have also found the Cowden comprehensive program using powerful, sequentially applied herbal remedies to be highly effective. This program eliminates not only the Borrelia organism but also the equally troublesome co-infections from other organisms. Although both the antibiotic approach and the Cowden herbal regimen are effective, our environmentally sensitive patients are better able to tolerate and benefit from the non-drug program.
If you know that you have been or could have been exposed to the Borrelia spirochete and would like more information about Lyme-associated Disease, contact The Center at (843) 572-1600.
This checklist by Joseph Burrascano, M.D. (reprinted with permission from the author), is not intended for diagnosis but only to show how easily we can be exposed to tick bites and what a broad range of symptoms can be associated with Lyme Disease.
Did you know that:
• Only 17% of people with a diagnosis of Lyme Disease ever remember getting a tick bite.
• Only 36% of people with a diagnosis of Lyme Disease ever recall having a bull’s eye rash or other warning signs of having been bitten by a tick.
• Only proper laboratory testing can help determine if multiple symptoms are due to Lyme Disease.
These factors increase the risk of tick bites:
• Visiting the tick-infested area
• Frequent outdoor activities
• Ticks noted on pets
The risk of Lyme increases if you:
• Remember being bitten by a tick
• Have or have had a bull’s eye rash
• Have any other suspect rash
• Have other household members
• who developed Lyme Disease
Have you had any of the following symptoms?
1. Unexplained fevers, sweats, chills, flushing
2. Unexplained weight change (loss or gain)
3. Fatigue, tiredness, poor stamina
4. Unexplained hair loss
5. Swollen glands
6. Sore throat
7. Testicular pain / pelvic pain
8. Unexplained menstrual irregularity
9. Unexplained milk production or breast pain
10. Irritable bladder or bladder dysfunction
11. Sexual dysfunction or loss of libido
12. Upset stomach or abdominal pain
13. Change in bowels (constipation or diarrhea)
14. Chest pain or rib soreness
15. Shortness of breath, cough
16. Heart palpitations or pulse skips
17. History of a heart murmur or prolapsed valve
18. Joint pain or swelling of joints
19. Stiffness of joints or back
20. Muscle pain or cramps
21. Twitching of the face or other muscles
23. Neck creaks and cracks, neck stiffness or pain
24. Tingling and numbness, burning/stabbing pain
25. Skin hypersensitivity
26. Facial paralysis (Bell’s Palsy)
27. Ears buzzing, ear pain, sound sensitivity
28. Double vision, blurry vision, light sensitivity
29. Motion sickness, vertigo, poor balance
30. Lightheadedness, unavoidable need to sit or lie
32. Confusion, difficulty thinking
33. Difficulty with concentration and reading
34. Forgetfulness, poor short-term memory
35. Disorientation and getting lost
36. Difficulty with speech or writing
37. Mood swings, irritability, depression
38. Disturbed sleep (too much or too little)
39. Fractionated sleep, early awakening
40. Exaggerated symptoms from drinking alcohol
For more information, contact us today or book an appointment online. We are conveniently located at 7510 North Forest Drive North Charleston, SC 29420. We serve patients from Charleston, Mt. Pleasant, Summerville, North Charleston SC, Ladson SC, Hanahan SC, James Island SC, John’s Island SC, all of South Carolina, Nationally, and Internationally. Patients routinely fly into Charleston to be evaluated by COEM and to enjoy this beautiful city which is a Condé Nast and Travel and Leisure Top Domestic and International Tourist Destination.
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