Did you know that there are two categories on how to recognize Lyme disease? Let’s watch Dr. Daniel Kinderlehrer talk about this and how to also consider Lyme Disease complex in all of your patients.
In general, we’re talking about two categories.
One is the people with a prior history of acute Lyme disease. So, they presented with, you know, maybe a known tick bite and a rash and they were diagnosed with Lyme disease, they were treated with a course of ten days to three weeks of antibiotics. And either they continued to be symptomatic, or after having gone into remission, now they have a recurrence of symptoms. And this recurrence can be weeks, months or even years after treatment. In other words, the infection goes dormant, but comes back later in the form of chronic symptoms. These people are referred to as having post treatment Lyme disease syndrome or PTLDS.
There’s another category, and that’s people who have no prior knowledge of acute Lyme disease. They never saw a tick, they never saw a rash, but they developed chronic symptoms. I can tell you that that category is much larger than the former category. These people just develop chronic symptoms and are labeled or mislabeled with numerous ICD code diagnoses that are simply misdiagnoses, and among them often are significant psychiatric diagnoses.
Four Central Points: Pattern recognition is essential in diagnosis
Lyme disease complex often presents as a psychiatric illness with major mood disorders, accompanied by physical symptoms. The pattern recognition is essential in diagnosis.
What is this onset of neuropsychiatric complaints and what is it accompanied by? Testing for Lyme disease? Not straightforward. The diagnosis of a chronic infection with Lyme is still not generally accepted by mainstream medicine despite overwhelming evidence.
Lyme endemic areas: Lyme disease has been reported in all 50 states
Lyme disease has been reported in all fifty states, there is no state immune from Lyme disease. But there are areas where it’s much more likely to get it than others. And these are basically states with higher humidity and/or doctors who are more aware and capable of making the diagnosis. So, the Northeast, but that includes the Mid-Atlantic states, and it doesn’t actually doesn’t stop at the Mason-Dixon line. You can keep on going south to Delaware, Maryland, Virginia, and so on. So, areas with high humidity, that includes the Great Lakes states, that includes the Pacific Northwest. At least 50% of my patients are actually from Colorado, and at least 5% of my patients got it in Colorado.
What’s the Pathophysiology?
This is quite interesting. It’s not what we normally think. When we normally think of infections, we think of microbes invading cells and tissue. These microbes in general do not attack our hardware, they don’t invade cells, but rather they attack software. They result in dysregulation of our systems that are supposed to keep us in homeostasis, like our nervous system.
Consider Lyme Disease Complex in all of your patients with:
Consider Lyme disease complex in your patients with anxiety, depression, perhaps a bipolar presentation, but often a lot of irritability, rage or ODD in kids, along with these other symptoms – fatigue, impaired cognition, pain syndromes, sleep problems. And then if you want to really start to narrow it, the likelihood if they have treatment resistance, why isn’t this person getting better?