Lyme Disease Diagnostics: The Intersection of Infection and Chronic Illness
More Programs and Publications Featuring Dr. Rodney Rohde
In this program:
Lyme disease can be a difficult medical condition to diagnose in patients. Medical laboratory scientist Dr. Rodney Rohde discusses Lyme disease symptoms and complications, conditions that can mimic Lyme disease, impact of comorbidities, and advice for tick removal.
Transcript
Interviewer:
What advice is there for people, Dr. Rohde, who cannot easily distinguish the early stages of Lyme disease from symptoms of chronic conditions such as arthritis or regular arrhythmias?
Dr. Rodney Rohde:
So Lyme disease, just as a reminder for the audience, it's caused by a bacterium known as Borrelia burgdorferi. That's from the individual that discovered it, but it's in the blood, it's in the tick. So this is typically something you get from a tick bite. But the diagnostic piece around Lyme disease is really still difficult. I've been talking about Lyme disease for decades, and there's still really great difficulty in an accurate diagnosis of Lyme disease, especially without classic symptoms, and without other chronic conditions that show up. Sometimes it's a light, almost asymptomatic type of infection you may not get the kind of the hallmark bullseye rash that you're supposed to get around the tick bite. That doesn't happen all the time. And so if a physician doesn't see that rash and you just report, eh, I'm just not feeling great, they may not think about Lyme disease.
So again, this has to do with good case history, where you live geographically because of where the ticks are, because this disease mimics so many things as your question alludes to. So it can mimic all sorts of chronic illnesses like juvenile idiopathic arthritis, fibromyalgia, even multiple sclerosis. Multiple sclerosis and arthritis can have symptoms that mimic Lyme disease. So an early diagnosis is critical. And if once you get that early diagnosis, this is typically going to take a particular type of molecular assay or perhaps you might get a culture or other type of identification depending on if you're looking for it 'cause that's part of the problem. And in proper early antibiotic treatment, it is really important, because it can help prevent further kind of long-term disease complications. This is a huge topic. There are full on resources for the public to check out around Lyme disease. We can hit some of these topics, but it is really even controversial in how you treat it. There are documentaries about this disease, there's all sorts of information around what some of the consequences are for it.
Interviewer:
And speaking of consequences, what consequences are there for having no treatment for a long-term? And can there be long-term effects even with treatment of Lyme disease?
Dr. Rodney Rohde:
Yeah, so if you don't treat this, one of the dangers is it can lead to serious, even fatal health conditions that can develop months…this is the headache. They can develop months or even years after the initial infection. And this is what's really problematic. And some of the conditions around that, untreated Lyme disease can be something known as Lyme arthritis. And that attacks about roughly 60 percent of the people who don't get early antibiotic treatment. They'll get reoccurring, sometimes debilitating arthritis in their large joints like their knees and their elbows. It's been associated with nerve damage, some numbness and tingling in your hands and feet, neurological actual kind of confusion and memory loss and hearing loss, or even speech impediments around some patients cardiac arrhythmia, so an irregular heartbeat. There's even something known as this sounds scary, and it is Lyme neuroborreliosis, which is an inflammation of the brain and spine that is one of those that can become fatal.
And then there's just this kind of how we talk about long COVID kind of these collection of symptoms. There's something with Lyme called brain fog. You might remember hearing that around COVID, where people are kind of cloudy and confused. They can't concentrate. So there's this whole kind of abstract collection of symptoms around brain fog for people that have not been treated from Lyme disease, and they come and go. And so they're really difficult. Sometimes people may not even realize they're dealing with it until they get a specific test that might identify that they've had it recently or in their past. And again, we really look at people. Although it's changed because of that geographic expansion and the changing weather patterns, but it has been, in fact, Lyme comes from Old Lyme, Connecticut. That's where the name comes from.
And so it's always been associated with the northeast and the Pacific, kind of North Pacific areas in the United States at least because of higher tick incidents in those areas. It's interesting, in Texas, we always talk to young children about rattlesnakes or skunks, staying away from animals or these types of things. In the northeast, they actually talk about ticks a lot because you should be checking for ticks and removing ticks the proper way. This comes from my zoonotic expertise. If you didn't know this, you really should remove ticks if you find them with a pair of tweezers. And you go in, if you can imagine my skin...you go in and try to get that forcep under the chelicerae, they're the mouth biting parts of the tick. They kind of look like this. You want to get that tweezer under it, and so you can kind of pull it out.
he idea is that you remove the biting mouth part so that it doesn't continue to pump Borrelia into your bloodstream. So those old wives’ tales of putting a burnt match on it are I've seen all kinds of things or covering it up with fingernail polish to kind of suffocate it, those actually induce more Borrelia bacteria into your bloodstream. The easiest and most effective way to remove a tick is a pair of tweezers or really clean, long fingernails if you have them to kind of get under it and pluck it out. And then if you're really good with this, which is not something most of us would do, you would save it. You would put that tick in a baggie or a little bottle or something and take it to somebody like a public health department where they could speciate it and perhaps test it to see if it was Lyme positive. That's probably above and beyond. In my world, I'm sensitive to that, right? But most people wouldn't be thinking of that. But it's something to think about. Anytime you get bitten by a mosquito, by an animal, by a tick, by a wasp, you can, if you can trap it, if it's there and you're able to do that safely, you can sometimes test the animal or the insect, and that can be really helpful to understand what happened.
Interviewer:
When you had mentioned Lyme arthritis and the neuropathy symptoms of Lyme disease, could those become permanent for patients? And as far as what Lyme disease does to the body, does it create neurological issues?
Dr. Rodney Rohde:
Yeah, it's kind of sporadic, but yes, in those individuals where it goes long-term and there's been no treatment, unfortunately, usually it develops into kind of these really severe neurological issues, including all the things we talked about with memory loss and kind of mimics dementia and things like that, even in their 40s, 50s and 60s so it's really unfortunate. It's really an interesting area. If you have some time to do some background reading on this, you can find this with a pretty easy Google search. There are institutions that are devoted to Lyme disease, and there's even kind of some controversial reading around what they used to call Lyme doctors who had a strong belief that you had to treat long-term with antibiotic therapy to kind of get rid of the Lyme spirochete. That is still up for debate in the medical world. There have been some reports that that works well, but as you know, Deandre, that's a really careful subject because using antibiotics long-term, that could really be problematic for so many things. So it's not something I would recommend without constant physician kind of interaction and knowing what's going on.
Interviewer:
And then it brings you back to patients that may have comorbidities and comorbidities that have immunosuppressant factors associated with them. And so being on long-term antibiotics just makes all of that even worse.
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