Spring is here, and naturally, after our long harsh winter, we can’t
wait to get outside and enjoy the outdoors. However, my patients who suffer from
Chronic Fatigue Syndrome and
Fibromyalgia are not quite as happy because their symptoms prevent them from enjoying
being active and outside.
When treating patients with both of these conditions, I am extremely vigilant
in looking for an underlying infection, which may have brought on these
illnesses. The diseases that are becoming the most prevalent and in some
ways the most difficult to diagnose are tick borne diseases.
TICK BORNE DISEASES
Almost everyone has heard of Lyme disease. The Lyme epidemic seems to have
exploded from a little known illness that was discovered in Lyme, Connecticut
to a country-wide problem.
The big problem in the past decade was the hot debate over what symptoms
caused Lyme disease. Rashes, arthritis and neurologic symptoms were well-documented
in the scientific literature. However, the medical literature seemed to
indicate that with appropriate treatment the symptoms would be resolved.
Other symptoms, such as fatigue and chronic generalized pain were not as
widely accepted by the medical community or insurance companies that were
contesting the concept of a Chronic Lyme disease state.
Insurance companies refused to pay for long courses of antibiotics to try
and cure the disease. To further complicate matters, the laboratory tests
to diagnose Lyme disease were not easy to interpret and there was a significant
variation from one lab to another.
THE LYME CONUNDRUM
The big medical question was to treat or not to treat? The medical world
did not know whether they should treat Lyme disease.
Also, patients with
Chronic fatigue syndrome and
Fibromyalgia were usually told that if they didn’t show any evidence of a Lyme
infection, they didn’t have the tick and had no hope of getting
better with antibiotics. This may have been a big mistake!!
While Chronic Fatigue Syndrome and
Fibromyalgia are completely separate to Lyme disease, it does not mean a tick borne
infection cannot cause any of these conditions.
My own frustration in diagnosing tick borne diseases was that I could not
seem to find a lab that did consistently good testing. However, my luck
and the luck of my patients has changed. I recently discovered the company
Imugen, that specializes in Lyme and other tick borne infections.
Imugen has several types of laboratory testing that utilizes the latest
advances in diagnostic testing for ticks – Polymerase Chain Reaction,
or PCR. PCR tests DNA for the presence of the tick, not the antibody.
I know this seems very scientific, but the bottom line is that like in
criminal investigations, nothing trumps DNA evidence. An antibody test
can miss an infection or give a false positive test due to a cross reaction,
but DNA does not lie.
While talking to the head nurse epidemiologist in Suffolk county, Long
Island she informed me that they frequently see many patients who are
co-infected with multiple tick infections at the same time.
IT MAKES SENSE…
If you go into the woods and get exposed to various ticks, some may carry
the Lyme infection and others may carry not so famous infections such
as Borrelia Miyamotoi, Babesia Microti, Anaplasmosis, Ehrlichiosis. These
infections can cause even nastier illnesses than Lyme disease.
Realistically, until we find a more specific cause for Chronic Fatigue
Syndrome and Fibromyalgia, I believe any patient has the right to be tested
for all of these very important tick illnesses that happen more frequent
than most of us realize!
- Dr. Dean Mitchell
Mitchell Medical Group, NYC