# Lyme Disease - The great imitator of CFS and Fibro



## M&M

*Lyme DiseaseThe Great Imitator Of CFS And Fibro*​_by MM July, 2007_​Are you feeling exhausted? Are you stiff and achy, with a headache and swollen glands? Have you been feeling that way for a while, and has your doctor been unable to pinpoint the cause? It may be wise to investigate the possibility of Lyme disease. Lyme disease was identified in 1975, and has been reported in all 50 states in the US, and in China, Europe, Japan, Australia, and parts of the former Soviet Union.Lyme disease is one of the great CFS mimics. It also mimics many other diseases, and can easily be misdiagnosed as CFS, Fibromyalgia, rheumatoid arthritis, multiple sclerosis, the flu, or psychiatric illnesses, just to name a few. Lyme disease is a great imitator, and the symptoms can wax and wane for years, eluding diagnosis.Lyme disease is a bacterial infection that is introduced into your system by the bite of a tick carrying the bacteria. Ticks that can carry the bacteria are deer ticks and western black-legged ticks. These ticks are tiny, and often go unnoticed. The ticks carry the bacterium in their stomachs, and when they pierce the skin, the bacteria are introduced into the host. Generally, Lyme disease is considered to progress in three stages. Stage one is referred to as "Early Lyme disease", and typically will cause one or more of the following symptoms days to weeks after the initial infection: fatigue, chills, fever, headache, muscle and joint pain, swollen lymph glands, and a rash called Erythema Migrans. (This rash forms in a circle around the tick bite that continues to grow. As the red circle grows, the center often clears, giving it a "bull's eye" appearance.) Keep in mind that more then 1 in 4 patients do NOT develop the tell tale rash of Lyme disease. So while the rash can aid in diagnosis of the early stages of the disease, the lack of the typical rash is not definitive proof that you aren't infected. Many patients do not have any memory of a tick bite, as the ticks carrying Lyme disease can be as small and hard to see as the period at the end of this sentence. In patients who don't develop the rash, the first sign of the bacterial infection can often be symptoms of second or third stage Lyme disease. In any case, the rash typically clears on its own in about a month.The second stage of Lyme disease is called "early disseminated Lyme disease". At this stage, the bacteria are beginning to spread and to affect other body systems. This stage typically occurs weeks or months after the tick bite and initial infection. Some of the symptoms at this stage are: numbness or pain in the arms or legs, Bell's palsy or paralysis of facial muscles (typically affecting just one side of the face), meningitis - with fever, stiff neck, and severe headaches, or an abnormal heart rate.The third stage of Lyme disease is called "late Lyme disease" or "chronic Lyme disease". This third stage can occur anywhere from weeks, months, or even years after the initial infection. Some of the symptoms of this stage Lyme disease may be: recurring bouts of arthritis (often localized in a few or just one joint, most commonly the knees), problems in the nervous system, including memory loss and difficulty concentrating, generalized muscle pain, and non-restful sleep.So, if you think you might have Lyme disease, or a loved one might have it, what tests are there, and what treatment options are available?There are blood tests called "Lyme titers", but they cannot be used alone to diagnose the disease, and are not good indicators early in the disease. Another blood test called the "ELISA assay" is also used to find the antibodies in a patient's blood stream. Antibodies may take up to 2 to 6 weeks to form in the blood stream, and may remain in the blood for years after being cured of the infection. It is easy to get a false positive on such tests, or a false negative. So while they can be tools to help aid or confirm a diagnosis, they are neither fantastic nor 100% reliable, especial when done in the very early stages of infection.Currently, the most reliable test we have for Lyme disease is the Western Blot test. This test can be used 6 to 12 weeks after infection, and is recommended to confirm all abnormal ELISA assay results.More accurate tests are currently being developed, but the best defense remains to be an attentive, well-versed physician, and a reliable patient with good records. The best thing for a patient to do is keep a detailed log, or journal, of symptoms, so they can give their physician a thorough history. A thorough history, search for the tell-tale rash, and tests ruling out other diseases (like rheumatoid arthritis, heart disease, and nervous system disorders) will aid a doctor in diagnosis. A thorough history of this sort can actually be more reliable than the laboratory tests, and a doctor may easily decide to begin treatment without blood test confirmation.Lyme disease can be treated, and often cured, with antibiotics. The stage of the disease will normally dictate which antibiotic should be used. Usually the antibiotics will be given by mouth, but in some cases of severe, or late-stage, infection they may need to be given intravenously. The stage of disease a patient is in will greatly affect their outcome. When caught in its earliest stages, Lyme disease can usually be cured. Unfortunately, in late stages of the infection, symptoms may not go away completely, but they should improve with treatment. Even after being cured, a patient may test positive for Lyme disease antibodies for years; however that does not mean that the patient still has the disease.There is no reason to live in fear of Lyme disease. As patients, however, we do need to be on alert for any messages our body is sending us that something is just "not right". If you feel exhausted, sore and achy, or are running fevers, contact your physician. It may not be CFS or Fibromyalgia at all, and your cure may be just around the corner!


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