Lyme, Lyme Disease, Lyme Syndrome discussed on The Doctor's Farmacy with Mark Hyman, M.D.
He's someone who's found functional medicine even before I did backing the nearly ninety s we go way back at work together at Canyon ranch. He teaches around. The world is leading thought leader in the field of functional medicine. And he just an all around great guy and we are GonNa talk about lyme disease which we both have had by the way and are both doing pretty good. Yeah so that's the punchline. There is a way out. It's not through the traditional doorway of six weeks or three weeks of antibiotics and that's it and otherwise you're just complaining. Malinga over right which is what are typical approaches and Lime Disease. So welcomes the podcast. Thanks mark thanks for having me okay. So we both live in the country here. In fact I had when chronic the other day I was planning my garden was like a working my God housing like he attached you add but little coming off yeah so let's just talk about the elephant room. Is there something called chronic lyme disease and why does traditional medicine? Not Think there is an think. Everybody's just wind complainer. Was psychological issues. I think it's the concept of what is a disease really you know inject lands book the Disease Delusion how we look at Z's and most doctors are trained to think that when you have an infection you have a fever. You're sick you've got. You GotTa take an antibiotic Lower Fever. And then it's done and chronic. Lyme disease is a stealth infection. And it's you mentioned before it's really not lime disease. It's tick borne illness illness. And so you have to think not only could possibly be Borelli door fry but other species of the bacteria caused line in other co-infections launching bar BBC. Oh so Bartonella and the others. So you've got to really sort of think about what is it that may be driving this these chronic type symptoms and I have seen patients walk through my door with a fifteen year. History of quote unquote FIBROMYALGIA. Which is not a diagnosis. Like a call chronic fatigue. Chronic fatigue is a symptom not a Zach unexplained auto immune issues Parkinson's Alzheimer's multiple sclerosis so just like simplest which is also aspira keitel illness. Lyme disease is the Great Mimic Mimika. And Wow you if you know that. The history of medicine way back when when Syphilis was very prevalent it could mimic anything and everything in line is the same thing. That's a that's an incredible insight that people think you know lime disease you get the bull's eye rash maybe get arthritis lyme arthritis for lime heart disease. You know it's acute illness you know. Get neurologic lime. It's a thing you know. Said they'd give people IV antibiotics but there's very little appreciation that if someone comes with Parkinson's disease or ms that you should be thinking about a tick infection. It's not even on the radar now. Most doctors exactly in functional medicine. We do think differently. And if you actually go back into the history of understanding syphilis there used to be primary syphilis which is acute infection and then you would have secondary and tertiary civilization would appear years down the road as dementia and tables door. Saleh's and problems with balance and all kinds of things so you've got to have a broad a broad understanding of how these things affect the body and then the immune system maybe it's not chronic and acute maybe it's primary and secondary line. Exactly that's right. He's about how you WanNa word it exactly so you. What is a typical approach? Thinking about lyme disease and how traditional knockers diagnose it and treat it and what. What is the the general perspective the general perspective and I think this is the CDC criteria is basically? You go to your doctor and you get a what's called a two tiered testing. I was the Elisa screen test in the license. Just a screening on the anybody antibody enzyme linked immuno absorb an antibody. And if that's posit- then you're then re reflexively go to a Western blot test which is supposed to be more sensitive and and also it's more expensive and this standard of how you diagnose lime disease is this two tiered approach and the unfortunate thing is if that's negative which fifty percent of the time it is. You're going to be missing lime disease a lot of your patients so you might as well flip a coin so. I almost don't even do that if it's positive and you have a clinical history then it's helpful but fifty percent of the time it's not gonna be helpful the most acute disease. I mean I remember working in the. Tuck in the Er and I remember seeing so many patients with lyme disease but they had acute the a fever the joint pain they had. Arash you give me any botox three weeks or fine and the you. There's a lot of people will get lines you can get treated. And they're fine or get on an issue and I think that there's a subset of patients that are uniquely susceptible to adverse consequences of these tick infections are more resilient to absolutely and you bring up a really good point. In fact I just had a paper about people who have Manas binding Leptin deficiency. That's right so I'm actually a relatively new to me and there's a condition which is mantles binding Leptin deficiency which you can draw on routine lab test and people who have. This are more susceptible to developing infections. Urinary Tract Infections and upper respiratory infections and low behold chronic lyme disease so now. I'm starting to actually check for this. In my patients other pays. You'll absolutely yes absolutely the other thing. That is also. I don't Nice exactly sure the mechanism point but patients who have hypermobility source of a form of Ehlers Dan Law Syndrome and for whatever reason. Those patients tend to have a little bit more a more difficult to radically and that may be related to the fact. That lime is predisposed towards going towards connected. Tissue and connective tissue disease or a mild form of it was a typical alike approach traditional medicine they just give them through extending -biotics and you're done. I mean the traditional approach is anywhere between one week to a month of antibiotics. And then you're done in. It's the end of discussion. I can't tell you the number of times that I've gone to still sick afterwards. The doctor goes well. Can't be lime exit. They've call that post lyme syndrome. There's a there's a whole diagnosis called post lyme syndrome where you're testing may be negative. You still have symptoms. Despite the standard of Care Treatment and you fall into this nebulous category Is it a ongoing? Immune reaction is it the the body still trying to fight the infection. And you're not seeing it on the lab testing etc. Yeah and so. What does the approach to post lyme syndrome and traditional medicine There is none. There is not. It's the there really is no treatment. I mean that's sort of where you know patients fatigue. They make it provincial. Having problems sleeping they're gonNA throw ambient them if they're depressed. They'll get some PROZAC. Holly Pharmacy Poly Poly Pharmacy. And that's atherogenic imperfect one of my favorite terms so most of the time. What does that mean taught? Basically I after Genyk is the doctor. Does it so by right so a lot of times mark you and I've seen patients come into US and the problem? Is the doctors between them so number. One stay from doctors. True some of them. Some of them are exactly. Yeah so it's really a a very Problematic issue and I would say if there was one condition that I could erase from the planet. Yeah it would be tick borne. Illnesses is one of the biggest scourges on humanity ever absolutely causes so much suffering. Needless it's so under diagnosed. It's not a well appreciated by traditional medicine now and it's really real and does masquerade as all these other problems so you mentioned a few of them but it can cause. All sorts of autoimmune diseases can cause all sorts of gut issues can cause all sorts of neurologic issues and mood issues. It can cause like you said neurodegenerative diseases it can cause chronic fatigue syndrome fibromyalgia depression dementia. A guy come in with Cap Grass Syndrome. Was He kind of mistake? Your everybody for somebody else. You know your wife is and you hear like Neuro Lime nearline about three other code infections and we treat him with anybody and he got better patient all these. Ms Symptoms and she saw the best doctors that Cleveland Clinic and mess and she ended up having Erhlichia which is a tick. One of those tick-borne actions I gave doxycycline for six weeks and like all went away and I don't love anybody sometimes. You have to use them and you have to use them. I think I think having an open mind to those patients who are just not getting better. There's whole subclass of them. Who really struggle with these chronic issues? That are undiagnosed that nobody can figure out. And there's a lot of approaches to this so we do different kinds of diagnostics. Here and functional. Medicine has a very different approach. What how would you define the approach for functional medicine? The approach proposal messes actually. Listen to the patient I think the best thing you can do is take the time. And you can't do this five or ten minutes as you as you. Well know mark you have to really be astute to listen really well and yes the clinical experience where you've seen a lot of patients and you can sort of put the pieces of the puzzle together because this is like this is not a you know a fifteen piece jigsaw puzzle this a thousand piece. Jigsaw plus yeah often ran and it you know you're not gonNA you're not GonNa do a thousand piece jigsaw puzzle. Five minutes takes takes awhile can do happen. Yeah right so so. You've got to really listen well. And then a lot of the the confer. Confirmation of the line is in my opinion done by advanced testing like the tests that I really like. We use here is the Eli spot testing. Which basically is checking for the immune system's response to the bacteria causing an antibody tests which is traditional medicine. Right exactly so so. An antibody test is say for example you get a polio vaccination. You'RE GONNA develop polio antibodies. Okay if I test you right now for polio. Antibodies you have polio antibodies. Does that mean that you have polio? The disease no okay in chronic lyme. Some patients don't develop antibodies on those antibodies. Lexical way over time so. The antibody test is negative especially in chronic lyme and if somebody has had the disease and the antibodies are positive. Does that still mean they still have the disease or the disease away? So you're sort of up in the air you're in this nebulous area. And that's why I think combining The clinical history with some of the more advanced testing. Like the Eli spot test where you actually take the person's blood. Expose it to the antigens the proteins that the tick has or the other co-infections that are there and see the the live cells immune response to it. So this is based upon memory t cells in the production of compounds like Interferon. Gamma is your nate. Immune system urinate immune system. Your your primary. There's like two kinds of your in Cincinnati. There's one that's like the old ancient. Immune system reacts to everything in sort of like carpet bombing. And that's why maybe the symptoms with so bad with this and then there's the antibody which is more like the smart missile or call the active immunity that actually target specific bugs. So it's a memory cells so that you get a memory seldom measles when the measles vaccine so you don't get measles this is. This is just more of a widespread immune response and you can't measure tests. That's why this ally spot is so unusual helps us to determine what's going on and the other test which I also use it again. It's not really this test but diagnostic of line but the CD fifty seven. Which is the natural killer cell and we measure the overall level of the natural killer cells in patients. There are many conditions that can cause low natural killer cell function so things like Chronic Epstein Barr virus may do it HIV virus cancer etc. But lime is also one of those so if a patient comes in with symptoms consistent with chronic liar and they have a low CD fifty seven count that ups the threshold for their probability of having chronic lyme clinically and then we also do the natural killer cell function test which is not only the level of the natural killer cells but are these cells actually able to do their thing. Are they kill pathogens as a really important? I think I have a theory after seeing so many hundreds and hundreds of these patients is that lime in these chronic infections are kind of like AIDS in a way they suppress the immune system absolutely and they're sort of sort of hijack it and it makes your body unable to fight it so what I've and find out if you see this time but so many of these patients don't just have chronic line but they haven't all host of other things that destabilizer system and maybe things at the body could handle when they're normally everything else okay. There's heavy metals gut issues. There may be mold issues maybe nutritional factors so they're all these things that are complex web of causative factors that don't get with traditional medicine.