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What if I told you that as a clinician, you were potentially misdiagnosing a large percentage of your autoimmune patients? What if the arthritis, Alzheimer's, cancer, or Grave's disease was actually caused by an infection? The research is starting to show that perhaps our bodies are not flawed or simply have bad luck but rather sabotaged by chronic and hidden infections. Our treatment plans would be different, and our outcomes more positive. This is the beginning of a whole new understanding of chronic disease, and the potential is hugely exciting.
Lyme disease has been gaining a lot of attention in the media lately. Doctors are becoming more aware of the symptoms, but why just look at Lyme disease? There are multiple bacterial, viral, and other parasitic infections that can sabotage our clinical outcomes and have been ignored or assumed to be benign. This article is going to help you to identify those key symptoms to look for, how to test for the infections, and familiarize you with the most common hidden infections that we are not taught about in medical school.
Lyme is the ultimate mimicker. Sometimes it looks like arthritis, sometimes like MS or rheumatoid arthritis, and other times like chronic fatigue.1-3 A patient may present with adrenal fatigue or weird facial or muscle tics, unusual skin sensations, and periods of feeling okay and other times struggling to get out of bed. On top of this, all diagnostic testing comes back mostly normal: no indication of autoimmunity, normal organ function testing, and no nutritional deficiencies.
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My experience over the last few years has taught me to throw out the "facts" that I have been taught about chronic infections:
- The bullseye lesion is rare, incredibly rare, and often can look like a bruise or present as a rash on a different part of the body than the bite location.
- There is no season to Lyme disease or co-infections. Ticks have two main peaks in their life cycle; and when you take into account global warming, increased songbird migration range, and the international travel of our clients, never rule out an infection based on time of year.
- It was thought that the tick needs to be attached for 24 hours, that bites need to be seen; but this is not the case.4 In fact, many of my patients rarely remember a tick being on them. Many of these infections can also be transmitted by fleas and mites and intimate contact with someone already infected.
- Definitive diagnosis based on lab work is not always possible. Lab tests can be accurate and flawed. Does the lab you use test for one of the more than 52 strains identified? It is believed that four to six of the strains are the disease causative ones, but a few years ago we believed it was only one or two. Did the lab test occur before the one month mark or after the three month mark? Was the lab test performed after antibiotics had been initiated? Did the lab also test for co-infections? Many tests are performed improperly, at the wrong time, or are inherently flawed.
- Autoimmune disease doesn't usually "just happen." Sometimes, we do have a fluke in nature, and the body short circuits; but it is becoming more and more apparent that the body does not intend to start destroying itself. Often the immune system is hunting something inside the cells of the tissue itself and destroys healthy cells in the friendly fire. A great example of this is the link between Epstein-Barr virus (EBV) and thyroiditis/Graves' disease.5,6
I find it shocking to think that the medical profession believes that something as simple as herpes virus 1 or 2 can come out as a lesion on our skin yet not create a lesion inside the body and produce symptoms that are hard to understand, while diagnostic imaging would be negative and blood tests all show normal.
The World Health Organization in 1997 estimated that some cancers are 84% attributable to viruses, bacteria, and parasites and estimate that 15% of all cancer cases could be prevented by preventing the infection in the first place. They also went on to state that treating the bacterial, viral, or parasitic infection could result in the remission of cancer.7
One of my first patients was a gentleman with chronic debilitating testicular pain. He had every test in the book done on him, and everything was fine; yet he was in excruciating pain. I questioned him extensively and discovered that despite having no obvious trauma to the testicles, his pain started shortly after a couple weeks of extreme stress, sleep deprivation, and poor diet. My mind immediately thinks "immune suppression," and what occurs when the immune system is weak is these hibernating viruses come out to play. I asked his doctor to test him for chickenpox and herpes, and sure enough, it was internal shingles. We were not taught about these abnormal and internal presentations of the disease in school, but if you look in the literature, it exists. Antiviral therapy, B12 injections, nutraceuticals supporting the immune system and suddenly the pain subsided.
Anytime a patient presents with abnormal symptoms and no obvious event or cause, you need to think infection. I have had patients with chronic migraines, sudden onset, no history and nothing abnormal in conventional medical investigation; yet their labs come back as positive for a secondary occurrence of Cytomegalovirus.
We have to add in the fact that patients might have acquired an infection, but Lyme is not the only possibility.
Ehrlichia/Anaplasma often presents with symptoms similar to Lyme, but there are a few distinguishing differences. Often patients will have sharp, knife-like headaches, muscle pain (not joint), sudden onset of psychiatric symptoms, and possibly a diffuse rash over large parts of their body. The treatment is often the same as Lyme, but this infection is often missed by simply not testing for it. In the area where I live, rate of co-infection with Lyme and Ehrlichia is 50%, meaning if you get Lyme, there is a 50% chance you also contracted Ehrlichia/Anaplasma. The published data shows much less with rates closer to 10% in Manitoba,8 but infectious disease doctors have confided that their experience shows that it is much higher.
Bartonella has some very unique and confusing symptoms. Being that all of these infections can theoretically infect the brain and spinal cord, we need to look for mood disorders and psychiatric changes of sudden onset. Patients may experience morning fevers, muscle twitching/seizures, striae across their backs that look like stretch marks, and extreme fatigue. In addition, Bartonella can lead to endocarditis, retinitis, epilepsy, aseptic meningitis, and liver and spleen enlargement. Patients that are hospitalized with these conditions would not be typically tested for infection. There are even associations with pediatric and blood borne cancers.9,10
Babesia is similar to malaria in many ways, which perhaps is the reason why it responds so well to artesunate IV's or oral artemisia medications. Patients will often have issues with sweating, temperature control, stiff neck, air hunger, stomach pains, rapid onset of fever, and feel mentally dull and tired. This infection can often be confused with menopausal symptoms, adrenal fatigue, and simply being stressed out and run down. Malarone, Plaquenil, or quinine are the drugs of choice; but it does respond well to natural medications and often requires multiple supports and medications.
Rickettsia has a similar presentation to Babesia with fevers, headaches, swollen lymph nodes, and nausea/vomiting; but it can also simply present as a rash.
Chlamydia pneumoniae is not the STD that most patients assume it is. It is usually contracted through human contact and results in an upper respiratory infection. However, in those with a compromised immune system, it can develop into arthritis, brain fog, ear/nose/throat chronic concerns, and tendovaginitis. There have even been papers published showing a connection to multiple sclerosis, rheumatoid arthritis, depression, Alzheimer's, autism, and other neurological pathologies.11-13
Mycoplasma pneumonia is also an acute, usually self-limiting, upper respiratory infection. However, it can set up shop in a run-down individual and create symptoms that mimic so many other diseases. Fatigue, joint pain, swelling, headache, insomnia, anxiety, memory loss are all symptoms I have seen in patients with this infection. The literature also shows an association with ALS, Gulf War syndrome, esophageal cancer, and encephalitis.14
Yersinia is associated with short-term but acute bowel symptoms, but it can be much more complicated. In my practice, I had a gentleman presented with acute bowel pain, just above the umbilicus, no precipitating event. Eating relieves it for five minutes but increases the pain after. Pain killers have little effect, and lab work/scopes all show normal. My first thoughts were to try an elimination diet and do a complete digestive stool analysis to see what was reacting and what was growing in him. He displayed some food sensitivities, and the stool analysis showed some overgrowth but no parasites. I decided to run an infection panel through a German lab, and we discovered his immune system was fighting Yersinia. Upon further investigation, I learned that Yersinia usually is self-limiting but, on rare occasions, can burrow into the muscular tissue of the bowel and create chronic symptoms.15 In the end, we ended up treating with antibiotics and natural supportive agents. This was another perfect example of a hidden infection.
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