Joseph J. Burrascano Jr., M.D. has just published a critical update on Advanced Topics in Lyme disease, sixteenth edition (copyright October, 2008. He is one of the foremost experts on this condition, and has written a comprehensive and very helpful paper on “Diagnostic Hints and Treatment Guidelines for Lyme and other tick borne illnesses”. Anyone who has ever had Lyme disease or knows anyone with this illness or complex of illnesses, please keep reading. I will summarize some of the important findings for you.
• Dr. Burrascono subscribes to a broad view of the definition of Lyme disease. Traditionally Lyme was defined as an illness caused by the spirochete, Borrellia burgdorferi (Bb). Clinically it may be helpful to consider this specific disease may be manifesting with other tick borne infections (called co-infections) such as Babesia species, Bartonella-like organisms, Ehrlichia, Anaplasma, Mycoplasma and viruses. Yeast and nematodes may be tick-born as well. Co-infections may result in “more severe clinical presentations with more organ damage.”
• He sees three categories of Lyme disease: acute, early disseminated and chronic.
Taking a stand on the issue of Chronic Lyme Disease, based on clinical data he offers a working definition which include three criteria: 1. where the illness is present for at lease one year, 2. where there have been persistent major neurologic involvement and 3. still have active infection with (Bb) regardless of prior antibiotic therapy.
Key: if not treated early the immune system is compromised (Bb has been demonstrated in vitro to both inhibit and kill B- and T- cells and will decrease the count of CD-57 subset of the natural killer cells).
With a compromised immune system other pathogens which may have entered into the “host” at the same time may proliferate and the immune system is unable to fight off the other tick-transmitted microbes. Also, other infections which predated the tick bite may proliferate while the body is in a weakened state.
Severe stress, immunosuppressive medications like steroids and other illnesses worsen Lyme disease because they further weaken the immune system’s ability to defend and fight for health.
Damage can occur in virtually any bodily system.
• For treatment to be successful all of the active infections have to be treated in a thorough and systematic manner. “Only by addressing all of these issues and engineering treatments and solutions for all of them will we be able to restore full health to our patients.”
• For the majority of patients with chronic Lyme the nervous system has been affected. Thus neuropsychiatric testing, SPECT and MRI brain scans, CFS analysis at times and input from Lyme-aware neurologists, psychopharmacologists and other clinicians is critical.
The next installment will include information about collateral conditions which are associated with Lyme disease; these include
B 12 levels, magnesium levels, pituitary and other endocrine abnormalities, inflammatory cascade, and neurally mediated hypotention.
The third installment will include a review of the tests most helpful in the diagnosis of different tick-born infections.
The forth installment will include Dr. Burrascano’s check list of symptoms. The diagnostic checklist is used to aid the clinician with a workable set of criteria. The document has been refined over the years with input from many front-line physicians.
The fifth installment will make reference to treatment regimens developed for the specific infection/s identified. This part is extremely complex and I will be referring you to the original source for detailed information about this aspect.
The sixth installment will summarize nutritional supplements in disseminated Lyme disease and optional supplements for special circumstances.
The seventh, and last installment will refer to Dr. Burrascano’s Lyme disease rehabilitation recommendations.
Before closing, I would like to tell you that I have lived through chronic Lyme disease myself, have supported family members, friends and patients through the painful maze, and would be happy to offer my expertise and solace to you or your loved-ones as you seek health and wellness.
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