I don’t get it. I’m not talking about this piece written here—it’s thoroughly informative and concise. What I don’t understand is WHY is this the celebrity disease du jour. To me, Lyme Disease seems like one of the easiest to cross off the list because it has such specific conditions. Then again, I don’t understand why people take vaccine advice from a chiropractor. So maybe it’s just me…I just don’t get it.
Hi Dr Love . Primary doc since 1986 here. Working the whole time in central Maryland . Managed lots of Lyme. It is tricky and one does have to keep alert about it. But I sensed in the 90s that something was afoot about overuse or frank abuse of the diagnosis . Your writing on Lyme is why I subscribed. Thanks for this. Don’t get me started on “Lyme Literate “ docs. And you mentioned drivers of the problem - I cringe or sigh with every time I have to deal with a random IgM Lyme that someone has ordered - if not ordered in the first 6 weeks after a deer tick bite of significant duration , I believe the PPV is under 5%. Thanks again for your work .
I the late 90s my dad was having health issues and ended up taking our entire family to a "Lyme Literate" doctor in California. My entire family was diagnosed with chronic Lyme by said doctor, I as a pre-teen and was prescribed antibiotics for months at a time. I didn't realize that this was all a sham until recently (thanks to you!) and I'm also a microbiologist/epidemiologist. I'm so angry that this happened to me as a minor, and it worries me that the publicity celebrities are giving this pseudoscience is going to cause harm to children that definitely don't know any better.
What seems most tragic in this scenario is that an inaccurate DX prevents people from getting the care they need. When I developed random joint inflammation and excruciating pain in March, one of the many lab tests I had was for Lyme’s. I live in Wisconsin and I spend a lot of time outdoors. That test was negative. A number of other options were R/O before settling on reactive arthritis - a rare, post-infection response (I had an eye infection in February) in which the body loses its mind (not the medical term). I’m grateful to a PCP who has excellent diagnostic skills, while also referring out to specialists. Thanks to their perseverance, I am getting the treatment I need, slowly recovering from a condition that can linger for 6-12 months, and preparing to leave for a very ambitious bike tour in 3 weeks. I use this as an example of what responsible medical care can do. If I’d gone to a quack, I’d likely still be suffering, and would be wasting money on all kinds of treatments that aren’t backed by empirical data. Thanks for continuing to be a voice of sanity in an increasingly insane time.
Very interesting. I live in Asheville NC and unfortunately there are a lot of ticks around me. We have tall grasses and both deer and mice. I have to always check my dog because they attach to him constantly. However, your article actually put me more at ease. One thing I would like to understand better is there a definite diagnosis for Lyme? Does the specific bacteria show up on a blood test?
Sorry, another scary caution...Lone star tick a concern, but not for Lyme disease
The distribution, range and abundance of the lone star tick have increased over the past 20-30 years, and lone star ticks have been recorded in large numbers as far north as Maine and as far west as central Texas and Oklahoma.
A bite from the Lone Star tick can cause people to develop an allergy to red meat, including beef and pork.
Scott Commins, associate chief for allergy and immunology in the School of Medicine at the University of NC at Chapel Hill and a leading researcher in AGS...People with alpha-gal syndrome (AGS) may not only be allergic to red meat and dairy, but also cosmetics, medicines, and certain surgical devices that contain mammalian products.
Commins himself sees “8-10 new patients with AGS every week” at the UNC allergy clinic.
Rick Ostfeld, a senior scientist at the Cary Institute of Ecosystem Studies, says that “the expansion [of lone star ticks] has been well documented…it’s pretty unassailable.” Several tools that use climate factors to predict tick habitats “pretty much all predict a range expansion further up into New England, the Midwest, and into Canada,” he said. CBC News · Posted: Jul 28, 2023 6:36 PM EDT
Continued ..The standard test for Lyme disease used by Canadian public health laboratories consists of a two-step process performed according to recommendations from the Infectious Diseases Society of America (IDSA) & the U.S. CDC. This process uses enzyme immunoassay for initial screening and if the result is negative, no further testing is done. If the result is positive or equivocal, a Western blot is used to confirm the results. Antibiotics typically effective within 4 to 6 wk's of becoming infected with Borrelia burgdorferi, the bacterium that causes Lyme disease; at this point, the sensitivity of the two-step testing protocol is about 87% and the specificity is about 99%. False-negative results may occur in early stage Lyme disease, when the sensitivity of the two-step protocol is about 40%.
The Lyme disease write up is magnificent! From a diagnostic perspective, is there something that would help with the diagnosis, e.g., rapid, inexpensive point-of-care nucleic acid detection from blood or saliva; IgM/IgG assays; antigen assays?
I don’t get it. I’m not talking about this piece written here—it’s thoroughly informative and concise. What I don’t understand is WHY is this the celebrity disease du jour. To me, Lyme Disease seems like one of the easiest to cross off the list because it has such specific conditions. Then again, I don’t understand why people take vaccine advice from a chiropractor. So maybe it’s just me…I just don’t get it.
Hi Dr Love . Primary doc since 1986 here. Working the whole time in central Maryland . Managed lots of Lyme. It is tricky and one does have to keep alert about it. But I sensed in the 90s that something was afoot about overuse or frank abuse of the diagnosis . Your writing on Lyme is why I subscribed. Thanks for this. Don’t get me started on “Lyme Literate “ docs. And you mentioned drivers of the problem - I cringe or sigh with every time I have to deal with a random IgM Lyme that someone has ordered - if not ordered in the first 6 weeks after a deer tick bite of significant duration , I believe the PPV is under 5%. Thanks again for your work .
I the late 90s my dad was having health issues and ended up taking our entire family to a "Lyme Literate" doctor in California. My entire family was diagnosed with chronic Lyme by said doctor, I as a pre-teen and was prescribed antibiotics for months at a time. I didn't realize that this was all a sham until recently (thanks to you!) and I'm also a microbiologist/epidemiologist. I'm so angry that this happened to me as a minor, and it worries me that the publicity celebrities are giving this pseudoscience is going to cause harm to children that definitely don't know any better.
What seems most tragic in this scenario is that an inaccurate DX prevents people from getting the care they need. When I developed random joint inflammation and excruciating pain in March, one of the many lab tests I had was for Lyme’s. I live in Wisconsin and I spend a lot of time outdoors. That test was negative. A number of other options were R/O before settling on reactive arthritis - a rare, post-infection response (I had an eye infection in February) in which the body loses its mind (not the medical term). I’m grateful to a PCP who has excellent diagnostic skills, while also referring out to specialists. Thanks to their perseverance, I am getting the treatment I need, slowly recovering from a condition that can linger for 6-12 months, and preparing to leave for a very ambitious bike tour in 3 weeks. I use this as an example of what responsible medical care can do. If I’d gone to a quack, I’d likely still be suffering, and would be wasting money on all kinds of treatments that aren’t backed by empirical data. Thanks for continuing to be a voice of sanity in an increasingly insane time.
Very interesting. I live in Asheville NC and unfortunately there are a lot of ticks around me. We have tall grasses and both deer and mice. I have to always check my dog because they attach to him constantly. However, your article actually put me more at ease. One thing I would like to understand better is there a definite diagnosis for Lyme? Does the specific bacteria show up on a blood test?
Sorry, another scary caution...Lone star tick a concern, but not for Lyme disease
The distribution, range and abundance of the lone star tick have increased over the past 20-30 years, and lone star ticks have been recorded in large numbers as far north as Maine and as far west as central Texas and Oklahoma.
A bite from the Lone Star tick can cause people to develop an allergy to red meat, including beef and pork.
Scott Commins, associate chief for allergy and immunology in the School of Medicine at the University of NC at Chapel Hill and a leading researcher in AGS...People with alpha-gal syndrome (AGS) may not only be allergic to red meat and dairy, but also cosmetics, medicines, and certain surgical devices that contain mammalian products.
Commins himself sees “8-10 new patients with AGS every week” at the UNC allergy clinic.
Rick Ostfeld, a senior scientist at the Cary Institute of Ecosystem Studies, says that “the expansion [of lone star ticks] has been well documented…it’s pretty unassailable.” Several tools that use climate factors to predict tick habitats “pretty much all predict a range expansion further up into New England, the Midwest, and into Canada,” he said. CBC News · Posted: Jul 28, 2023 6:36 PM EDT
Continued ..The standard test for Lyme disease used by Canadian public health laboratories consists of a two-step process performed according to recommendations from the Infectious Diseases Society of America (IDSA) & the U.S. CDC. This process uses enzyme immunoassay for initial screening and if the result is negative, no further testing is done. If the result is positive or equivocal, a Western blot is used to confirm the results. Antibiotics typically effective within 4 to 6 wk's of becoming infected with Borrelia burgdorferi, the bacterium that causes Lyme disease; at this point, the sensitivity of the two-step testing protocol is about 87% and the specificity is about 99%. False-negative results may occur in early stage Lyme disease, when the sensitivity of the two-step protocol is about 40%.
Edited from previous information presented from Dr. Andrea...
If the person has the stereotypical bull’s-eye rash, that is diagnostic {pathognomonic} & Ab's would be prescribed.
If an irregular rash was present, then laboratory testing might be ordered if epidemiological risk factors existed.
FDA-approved Lyme testing is based on the immune response to infection, specifically, antibodies produced by B cells.
Antibody testing cannot differentiate between active or past infection.
Antibodies can last for years after you are infected, and they will remain even after a successful course of antibiotics!
This is why laboratory testing should be used only if there is reason to suspect Lyme disease at that moment.
FDA-approved Lyme tests assess antibodies using immunoassay.
JJF Phm 🇨🇦
The Lyme disease write up is magnificent! From a diagnostic perspective, is there something that would help with the diagnosis, e.g., rapid, inexpensive point-of-care nucleic acid detection from blood or saliva; IgM/IgG assays; antigen assays?