Testing and initial therapy for Chronic Lyme disease and it’s co-infections
There is considerable controversy regarding the diagnosis and treatment of chronic Lyme disease.
Issues surround the current conventional testing performed here in the UK. The one test undertaken, the ELISA test for the organism that causes Lyme – Borrelia burgdorferi, is between 33%-50% sensitive depending on which study you read. That means that at best 1 in 2 results are accurate but at worst 2 out of 3 are wrong.
Two main laboratories in Europe are leading the way in diagnosis. BCA and Armin Laboratories consider it necessary to do 3 specific tests for Lyme and one for immune suppression. B.burgdorferi, and co-infections that travel with it, can supress immune response by blocking the activity of white blood cells. As two of the tests for Lyme are looking at immune response (antibodies) and one at actual particles of the infective organism, any suppression of immunity may mean that a borderline result is actually positive. Each test has the same level of sensitivity as the ELISA but when you combine them the results are considered to be over 90% accurate.
The tests combined, inclusive of phlebotomy, special overnight courier and my written summary report of these complex results, cost £630.
Conventional treatment tends to be focused only on acute infection at the time or just after a typical skin lesion appears following the story of tick bite. Chronic (long term) infection is rarely considered and generally only when several neurological or cardiac symptoms remain unexplained. The role of B. burgdorferi in Chronic Fatigue and persisting unexplained symptoms is not yet widely accepted in conventional medical circles despite research and published papers starting to appear.
Specialists in this field in Europe and the USA consider that chronic infection is not only associated with cardiovascular, neurological and other overt organ disease but can also have an effect on mitochondria (small parts of cells that make energy) thereby causing chronic fatigue syndromes. Furthermore, there is scant regard being paid by conventional medicine to co-infections which are caused by organisms that share the same host as Borrelia. - http://canlyme.com/just-diagnosed/co-infections/specific-co-infections/. Testing for co-infections is best done after going into detail in each individual case and using an algorithm to see which are most likely to be an issue. There are over a dozen possible co-infections and testing for any one can cost between £100 - £200 so doing all becomes expensive and mostly unnecessary without the use of the algorithm.
As a physician in integrated/functional medicine, I treat each case individually. At an initial consultation I discuss the accuracy of investigations to date as well as therapeutic options based on conventional studies of such chronic infections as well as naturopathic therapeutic avenues. At this time I'm tending to favour the Cowden Protocol and variations on the Klinghardt or Horowitz Lyme Disease protocols and those carried out by the BCA Clinic in Ausgburg, Germany. Here is an over view of the Klinghardt protocol from a presentation in 2018: http://www.klinghardtacademy.com/klinghardt_biological_treatment_of_lyme_disease_protocol.pdf Treatment is constantly updated.
At the initial consultation I will establish with any patient, whether they wish to 'dive into the deep end of the pool', which tends to involve investigations and a combination of conventional and non-orthodox/naturopathic therapies. The 'shallow end of the pool' is based on a). What has and has not worked for an individual patient to date and b). My experience. The deeper into the pool we go, the more likely we are to find the swiftest avenue to return you to good health. This includes discussion on the dissolving of infective ‘biofilm’ and also resurrecting an often supressed and sub-optimal immune system. Without focus on these areas, recurrence and other infections may occur.
Dr Sharma. April 2019
