You May Not Have Lyme Disease: Possible Alternatives

Have you met LLMDs who quickly hop on board with the idea that you have Lyme disease? They seem to think everyone with chronic fatigue is a Lymie.

Fact: Lyme can masquerade as other ailments. For example, it causes false positive ANAs and rheumatoid factor (RF) tests by over-stimulating the immune system (read this article on Lyme vs RA, Lupus and other autoimmune disorders).

Fact: BUT… other ailments may give you false positive Lyme tests.

Below is a list of conditions that could be Lyme and coinfections. So, let’s see what ELSE they could be. I will recommend testing for each issue, and you can bring this up to your doctors for discussion. I encourage you to do online research as well. I must also warn you, I have crammed a lot of information into this post, so brace yourself.

Rule things out

For instance, rule out autoimmune diseases by using the erythrocyte sedimentation rate (ESR) and C reactive protein (CRP). You can also rule out nerve damage with a somatosensory evoke potential. Heavy metals mimic a lot of the same ailments as Lyme so rule them out, too.

The book that confuses everyone

This information was gathered from the book Why Can’t I Get Better?

Fevers, night sweats, chills, flushing

Could be:

  • Hyperthyroid
  • Menopause
  • Tuberculosis
  • Non-Hodgkins Lymphoma
  • Panic disorders
  • Autoimmune disorders (so many possibilities)
  • Inflammation

Bloodwork:

  • CBC with a white cell count
  • CMP with liver functions
  • Giemsa stain and malarial smears
  • Babesia IFA
  • Babesia Wa-1
  • Babesia FISH
  • Babesia PCR
  • Thyroid panel
  • Hormone panel
  • ANA
  • RF
  • ESR
  • CRP
  • Cytokine panel

 

Weight changes

Conditions:

  • Hormonal issues
  • Metabolic syndrome with increased insulin
  • Malignancy

Bloodwork:

  • TFTs
  • Sex hormones
  • DHEA/cortisol
  • HbA1c with insulin levels
  • Lipid profile

Fatigue

Conditions:

  • Oh, everything (who isn’t tired?)
  • Immune dysfunction
  • Inflammation
  • Mold and toxins
  • Nutritional deficiencies
  • Mitochondrial dysfunction
  • Thyroid dysfunction
  • Neurodegenerative disorders
  • Lack of sleep
  • ANS dysfunction and POTS
  • Gastrointestinal problems
  • Liver dysfunction
  • Lack of exercise
  • Stress, of course!

Blood work:

  • CBC
  • CMP
  • ANA
  • RF
  • ESR
  • CRP
  • Ganglioside antibodies
  • Complement studies
  • CPK
  • HLA testing (DR2, DR4, B27)
  • GM1AB IgM/IgG
  • Mag IgM/IgG
  • Immunoglobulin levels (IgM, IgG, IgA)
  • DMSA urine challenge
  • Serum magnesium, RBC mag++, iodine, zinc
  • Parasitology
  • Food allergy panel (IgE, IgG)
  • Antigliadin AB.TTG
  • Hormone panel
  • Glucose
  • B12, folate
  • MMA and HC levels
  • MTHFR genetic test
  • Mold – Stachybotrys titers, mold plates, ERMI testing
  • TBARS assay for lipid oxidation, and lipid peroxides
  • DNA oxidation (8-OhdG, autoantibodies to oxidized DNA, modified Comet assay)
  • Protein oxidation (protein carbonyls)
  • IgM/IgG Western Blot
  • Lyme specific bands 23, 31, 34, 39, 83-93
  • Babesia microti IFA, Babesia duncani/WA1, Babesia FISH, Babesia PCR
  • Borrelia Hermsii
  • Ehrlichia and Anaplasma titers
  • Bartonella IFA, PCR, FISH
  • Mycoplasma
  • Chlamydia
  • RMSP, Q-fever, typhus
  • Tularemia
  • Brucella
  • HHV6, EBV, CMV, West Nile or any virus

 

Hair loss

Conditions:

  • Stress
  • Inflammation
  • Dermatological issues
  • Autoimmune disorders
  • Pregnancy
  • Mineral deficiencies
  • Hormonal disorders

Bloodwork:

  • Minerals
  • Iron panel
  • Thyroid panel
  • ANA
  • ESR
  • CRP
  • Cytokine panel
  • Dermatological evaluation

Swollen glands

Conditions:

  • Lyme Disease, Bartonella, tularemia
  • Mono, Epstein Barr
  • Malignancy

Bloodwork:

  • Appropriate cancer screening
  • Lyme and co-infections
  • Epstein Barr

Sore throat

Conditions:

  • Lyme (if chronic)
  • Strep
  • Viruses
  • Allergies

Bloodwork:

  • Throat swab for strep
  • Tests for viruses
  • Allergy testing
  • Lyme and coinfections

 

Abdominal pain

Conditions:

  • Lyme
  • Epididymitis
  • Testicular torsion
  • Endometriosis, ovarian cysts
  • UTIs

Bloodwork:

  • Physical exam with urethral swabs
  • Abdominal ultrasounds
  • Urinalysis and culture

 

Bladder dysfunction

Conditions:

  • Interstitial cystitis with or without Lyme and Bartonella
  • Dropped bladder
  • BPH
  • UTI
  • Fungal infections
  • MS or other diseases that affect nerve function

Bloodwork:

  • Urinalysis
  • Culture and sensitivity (C+S)
  • Urological exam with scope and cystometric studies
  • Testing for MS (VEP, AEP, MRI, spinal tap, MBP)

 

Stomach issues

Conditions:

  • GERD with reflux
  • H pylori
  • Gallbladder dysfunction
  • Food allergies
  • Stress
  • Medications
  • IBS
  • SIBO
  • IBD
  • Celiac
  • Dehydration
  • Infections, parasites, viruses, Candida

Bloodwork:

  • GI testing: serum antibodies for H pylori
  • Upper endoscopy
  • Food allergy testing
  • CBC
  • CMP with electrolytes
  • BUN/creatinine, liver functions (LFTs)
  • Antigliadin and TTG levels
  • Breast test for SIBO
  • Parasitology
  • Stool CDSA
  • Colonoscopy

Shortness of breath

Conditions:

  • Allergies
  • GERD with reflux
  • COPD
  • Interstitial lung disease
  • Malignancy in smokes
  • Inflammation

Bloodwork:

  • Allergy testing
  • Pulmonary function tests (PFTs)
  • Arterial Blood Gas (ABG)
  • Diffusing capacity (DIco)
  • Chest x-ray
  • Rapid CT scan chest
  • Cytokine panel

Heart palpitations and valve prolapses

Conditions:

  • Inflammation
  • Stress
  • Hypoglycemia
  • POTS
  • Caffeine
  • Meds
  • Heart disease with arrhythmias
  • History of rheumatic fevers
  • PFO
  • Heart valve abnormalties

Bloodwork:

  • Cytokine panel
  • EKG
  • GTT with insulin levels
  • ANS evaluation
  • Keep an eye on medications
  • Echocardiogram

Joint and muscle pain

Conditions:

  • Autoimmune
  • Inflammation
  • Osteoarthritis
  • Gout
  • Joint sepsis
  • Acute trauma
  • Muscle strain
  • Myositis
  • Trichinosis
  • Mineral deficiencies
  • Dehydration
  • With neck cracks and stiffness: rule out bacterial and viral meningitis

Bloodwork:

  • Cytokine panel
  • CPK
  • Aldolase and LDH levels
  • Eosinophil count with Trichinella ELISA
  • Serum and RBC magnesium levels
  • K+ level
  • BUN/creatinine on CMP
  • Autoimmune markers

Twitching

Conditions:

  • Magnesium deficiency
  • Stress
  • Caffeine
  • Sleep deprivation
  • Motor neuron diseases like ALS

Bloodwork:

  • RBC and serum magnesium
  • EMG to rule out ALS

Headaches

Conditions:

  • Food allergies
  • Mineral deficiencies
  • Migraines
  • Hypoglycemia
  • Mold and toxins
  • Stress
  • Inflammation
  • Meds
  • Trauma
  • CNS infections

Bloodwork:

  • Food allergy testing
  • Glucose with insulin levels
  • Serum and RBC magnesium
  • DMSA urine challenge
  • Cytokine panel
  • CT scan

Tingling numbness, burning or stabbing sensations

Conditions:

  • Autoimmune
  • Carpal tunnel or other nerve entrapment syndromes
  • Diabetes
  • Hypothyroid
  • Pregnancy
  • Metal toxicity
  • Vitamin deficiencies
  • Mitochondrial dysfunction
  • MS
  • Strokes or TIAs
  • Anxiety

Bloodwork:

  • EMG
  • Small fiber nervy biopsy
  • Thyroid panel
  • B-HCG
  • Blood sugar and HbA1c levels
  • B12 and folate
  • MMA and HC levels
  • Immunoglobulin levels with subclasses
  • DMSA urine challenge
  • Lipid peroxide levels and other markers of oxidative stress
  • MRI, VEP, AEP, oligoclonal bands if suspecting MS
  • CT head or MRI if suspecting TIA
  • Move your head forward and touch your chin to your chest: do you notice an increase in numbness? MS will give you a tingling or electrical sensation down the spine known as a Lhermitte’s sign.

Bell’s palsy

Conditions:

  • CNS viral infections
  • Stroke
  • Sarcoidosis
  • Trauma

Bloodwork:

  • Brain CT or MRI
  • Spinal tap to rule out meningitis
  • Viral titers
  • Kveim test with ACE level and chest x-ray, if ruling out sarcoid

 

Vertigo and poor balance

Conditions:

  • Viral infections
  • Toxins, heavy metals
  • Eighth nerve of cerebellar disorders
  • Metabolic disorders
  • Hypoglycemia
  • Neurological disease (MS, ALS)
  • Strokes

Bloodwork:

  • DMSA urine challenge
  • ENT evaluation with ENG
  • Blood alcohol and ammonia levels
  • GTT with insulin levels
  • Cytokine panel
  • Brain scan

 

Severe forgetfulness and speech problems

Conditions:

  • Viral encephalitis
  • Metabolic abnormalities
  • Stroke
  • Hypothyroid
  • Heavy metals and mold
  • Alzheimer’s
  • Jacob-Creuzfeldt disease

Bloodwork:

  • Cytokine panel
  • Blood and alcohol ammonia levels
  • Thyroid panel
  • DMSA urine challenge
  • Mold titers
  • Lumbar puncture with CT or MRI with severe cases
  • Apo E genetic testing
  • GTT with insulin levels

 

I love bloodwork. It is a great indicator of my progress. It also gives me an idea of the whole picture. I may be tired because of Lyme, or because of estrogen dominance, low thyroid, anemia, etc. Whatever has been abnormal is what I like to retest again after tweaking my  life or meds. It also gives me a list of things to work on and reminds me not to blame all my problems on Lyme. It’s only when every aspect of my body, mind and spirit feel optimal that I will consider retesting for Lyme.

Check out more Horowitz notes here, here, here, here, here and here.

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