Great kick-off day at the “ILADS DC 2014 Fundamentals of Diagnosing and Treating Tick-Borne Illness”!

Did lots of note taking today, but only enough mental energy right now to share some sound bites!

From Daniel Kinderlehrer, MD:

“Based on restricted criteria, the CDC estimates 300,000 new cases of Lyme each year. However Boltri and Hash believe that is closer to 1.2 million cases each year, almost 500,000 of which will end up being Chronic Lyme.”

“Remember, first the truth is ridiculed. Then it becomes outrage. Then…it is said to have been obvious all along. Folks, this ILADS movement will become mainstream, it will.”

“Syphilis is the original Great Imitator. This bacteria has 30 genes. Borrelia is the new Great Imitator. It has 132 genes. Syphilis is Lyme’s dumb cousin.”

“Twenty-nine percent of ticks in the arctic circle are infected with Borrelia.”

“Lyme has been reported in 50 states.”

“How does Lyme present? Any way that you can think of.”

“Have a high Suspicion Index when it comes to Lyme. Even when the tests are negative, look for the symptoms that present.”

“Morning sweats? Bartonella. Night sweats? Babesia.”

“50% of my patients became gluten sensitive after being diagnosed with Lyme.”

“Doxycycline is the new morning after pill. Morning after a tick bite.”

“After treatment, 42% of Lyme patients are still not well. After three years, 12%.”

“Only 14-16% of the thousands of IDSA guidelines are supported by at least one properly designed trial.”

“301 studies cite evidence of persistent infection even after treatment. Borrelia burgdorferi can withstand antibiotic treatment.”

Joe Burrascano, MD

“Biofilm has a 1,000 fold increased tolerance to antibiotics. Clorox does not even kill biofilm.”

“Borrelia is rapidly transmitted. The 24-36 hour window is a fallacy. A study at reference labs shows that Borrelia can be transmitted from a tick within two hours.”

“Only 17% of those with Lyme recall a tick bite and 36% a rash. Meanwhile, serotologic diagnostics only diagnose half of the cases…that’s a coin toss!”

“Some believe that the most sick will have the most positive Western blot results. The opposite is true. Over time, Lyme forms immune complexes, immune dysfunction and immune suppression. Lyme is either hidden in their bodies unable to be found or they are so sick they don’t produce antibodies anymore. They are actually most likely to have a negative result.”

“Doxycycline 400 mg daily. Not 100 mg. Not 200 mg. That’s not strong enough.”

“Can we cure Lyme Disease? Right now there is no fool proof way to cure it and relapses can occur. Most docs need to treat the patient until they are asymptomatic for 6 weeks.”

“Should you treat a tick bite prophylactically? Should you treat it or wait? There is no single answer. A number of factors need to be considered. The type of tick, how deep it is embedded, whether it is engorged or not, the patient’s health and history (immunocompromised?). If treating, I’d recommend Doxy for the 1st two weeks to target lyme and then switch to a cell wall busting antibiotic to target erhlichia/anaplasma. But treat for 4 weeks.”

“They type of exercise that is beneficial to boost T-cell function is whole body exercise. Like resistance training and weights. Not aerobics. Then best to take a hot shower/bath and lie down or sleep after a workout.”

Ginger Savely, DNP

“Regular commerical Western blots (Quest, LabCorb) are only 46% sensitive. IgeneX Western blot is 90% sensitive.”

“There are 7 bands you need to know: 18, 23, 31, 34, 39, 83, 93”

“Blood culture is a direct way to test for Borrelia, but there is usually such a small amount of bacteria found in the blood, could take up to 5 months to culture, and can cost as much as $700.”

“Other tests that assist in putting the Lyme puzzle together diagnostically are CD57, C4a, C3a, and SPECT scans of the brain.”

“Don’t use the ELISA test. Go straight to the Western Blot. It is not appropriate for you to rule out Lyme just because a test (Western Blot) is negative. Remember the 7 bands we talked about? Any one of them being positive should cause you to be suspicious.”

“Treat the patient, not the lab test.”

Dr. Richard Horowitz, MD

“In my Hudson valley in NY, 71% of ticks had 1 co-infection, 30% had 2 or more co-infections, and 5% had 3 or more.”

“There are over 100 species of Babesia. When testing for Babesia, a full Babesia panel must be done. Otherwise, it is easy to test negative for Babesia on tests that are only sensitive for one strain. Symptoms include fever, chills, flushing, air hunger, flares every 4 weeks, mood disturbances. Treatment includes mepron and zithromax, possibly made more effective with Bactrium. I also use grapefruit seed, artemesia, neem, cryptolepis.”

“There are over 30 species of Bartonella. Bartonella testing is inadequate Symptoms include irritability, rage, insomnia, seizures, red papular eruptions, stretch mark like streaks, subcutaneous nodules, a creepy crawly sensation under the sking, gastritis, constipation, nausea/vomiting, burning pain, burning soles in feet, paresthesias, electric like sensations, inflammation in/around the eyes. Treatment includes doxy and rifampin. Or tetracylcine and macrolides. If using quinolones, take 600 mg alpha lipoic acid 2x per day and 500-1000 mg magnesium to protect tendons.”

Thank you speakers, thank you!

Dr. Horowitz and I at ILADS 15th Annual Symposium

Dr. Horowitz and I at ILADS 15th Annual Symposium