Chronic Lyme Disease May Be A Misdiagnosis Of Chronic Fatigue Syndrome
A tick bite can cause treatable Lyme disease, while long-term symptoms may be due to chronic fatigue syndrome
Most people who think they have a long-lasting form of Lyme disease, triggered by a tick bite, may really have chronic fatigue syndrome, a panel of UK infectious disease experts said today.
Some people who mistakenly believe they have Lyme disease are endangering their health by taking long courses of antibiotics, leading to other infections such as sepsis, the doctors warned.
Lyme disease is a potentially serious infection that first came to attention in the 1970s, after an outbreak of cases in New England. It is caused by bacteria, passed on by bites from ticks, and often triggers a circular red rash initially.
Untreated Lyme disease can lead to a range of health problems, including joint pain, and heart damage. But if diagnosed in time, the infection can be quashed with a short course of antibiotics.
However, some people who have persistent symptoms believe they have a long-term infection, known as chronic Lyme disease, which needs treating with long courses of antibiotics or other alternative therapies such as supplements. This idea has spread from the US to the UK and some other countries.
CFS, also sometimes known as myalgic encephalomyelitis, is itself a controversial condition: some think it involves immune system problems, perhaps triggered by an infection, while others believe psychological factors may contribute.
More on these topics:
Key Points About Chronic Fatigue Syndrome
- Chronic fatigue syndrome is characterized by profound tiredness.
- Symptoms often worsen with physical or mental activity.
- In addition to severe fatigue, symptoms include light sensitivity, headache, muscle and joint pain, difficulty concentrating, mood swings, and depression.
- Treatments may include medicines, exercise, supplements, and counseling.
Other Commonly Observed Symptoms In Cfs
There are a number of secondary symptoms that are also associated with chronic fatigue syndrome. Up to half of people with CFS may experience symptoms including abdominal pain, alcohol intolerance, bloating, chest pain, chronic cough, diarrhea, dizziness, dry eyes or mouth, earaches, irregular heartbeat, jaw pain, morning stiffness, nausea, night sweats, psychological problems , shortness of breath, skin sensations, tingling sensations, and weight loss.
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Criterion #: Other Symptoms
In addition to prolonged fatigue, a person must have four or more of the following symptoms to be diagnosed with chronic fatigue syndrome:
- impairment in short-term memory or concentration
- sore throat
- joint pain without swelling or redness
- headaches of a new type, pattern, or severity
- unrefreshing sleep
- post-exertional malaise lasting more than 24 hours.
Symptoms Of Chronic Fatigue Syndrome
Chronic fatigue syndrome is a common condition which is triggered by long-lasting exhaustion or fatigue which does not fade away with rest or sleep.1 Chronic fatigue syndrome can greatly reduce the quality of life. However, children and young people affected by this condition generally find it difficult as they grow up. Let us look at the top 10 symptoms of chronic fatigue syndrome .
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Solid Basis For A Diagnostic Blood Test
Theres been a great deal of controversy and confusion surrounding ME/CFS even whether it is an actual disease, said Davis. Our findings show clearly that its an inflammatory disease and provide a solid basis for a diagnostic blood test.
any, but not all, ME/CFS patients experience flulike symptoms common in inflammation-driven diseases, Montoya said. But because its symptoms are so diffuse sometimes manifesting as heart problems, sometimes as mental impairment nicknamed brain fog, other times as indigestion, diarrhea, constipation, muscle pain, tender lymph nodes and so forth it often goes undiagnosed, even among patients whove visited a half-dozen or more different specialists in an effort to determine whats wrong with them.
I have seen the horrors of this disease, multiplied by hundreds of patients, he said. Its been observed and talked about for 35 years now, sometimes with the onus of being described as a psychological condition. But chronic fatigue syndrome is by no means a figment of the imagination. This is real.
Antivirals, anti-inflammatories and immune-modulating drugs have led to symptomatic improvement in some cases, Montoya said. But no single pathogenic agent that can be fingered as the ultimate ME/CFS trigger has yet been isolated, while previous efforts to identify immunological abnormalities behind the disease have met with conflicting and confusing results.
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Will I Still Be Able To Work With Me/cfs
Research shows that about half of people with ME/CFS work part-time or full-time jobs. For some people with ME/CFS, the ability to work is possible thanks to a supportive employer and certain workplace accommodations, including a flexible schedule, a quiet comfortable place to rest, and memory aids.
But, if you can’t work because of ME/CFS, you may be eligible for Social Security benefits. Learn more about applying for disability through the Social Security Administration.
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Other Symptoms Of Leukemia
The bone marrow in our bodies creates cells that develop into white blood cells, red blood cells, and platelets. With leukemia, the bone marrow produces too many abnormal white blood cells. These faulty cells crowd out the healthy ones and make it hard for them to function properly.
Unlike other types of cancer, leukemia usually doesnt form into a tumor that can be seen on imaging tests. There are several types of leukemia, which are categorized by the blood cells they affect and how quickly they grow.
Sometimes, leukemia doesnt show any warning signs or symptoms at all.
If you do experience symptoms, they may include:
- Fatigue
- A feeling of fullness or pain below the ribs on the left side
- Swollen lumps in the neck, underarm, groin, or stomach
- Stomach or bone pain
- Shortness of breath
Different types of rashes can also present as a sign of leukemia or develop as a side effect of cancer treatment.
Children Young People And Me/cfs
ME/CFS can affect people of all ages, including the very young. Young people with ME/CFS, especially children under the age of ten, might have trouble knowing or articulating that something is wrong. They may not realise that their loss of stamina, or other symptoms they are experiencing, are not normal. Alternatively, they may not have the words to describe what they are feeling.
For both younger children and teenagers, schooling can be affected but ME/CFS is not school refusal. While school refusal can often be accompanied by physical complaints , and these complaints may tend to disappear when the young person stays home, the pattern is different with ME/CFS. In a young person with ME/CFS, some symptoms never ease and symptom exacerbation is triggered by activity. In ME/CFS, symptoms are likely to be worse after school attendance, and can reduce with pacing and rest, which includes time away from school or during holidays.
Some young people with ME/CFS can continue to attend school, and others may be too unwell for regular classroom attendance. Parents, healthcare providers, schools and the child or teenager need to work together to come up with a plan for the young persons continued education. This plan needs to take into account the energy limits of ME/CFS. Being creative and flexible is key and might include things like fewer subjects or school from home.
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Supportive And Symptomatic Treatment
Educating patients about CFS and validating their illness experience in addition to establishing a working alliance are the initial steps in the treatment.1,65 Direct the treatment toward the most problematic symptoms, as prioritized by the patient,1 and other illness-perpetuating factors.65 Encourage a well-balanced diet, and discuss with patients their nutritional habits. Advice about preventing over- and under-activity is essential. Start low and go slow is the correct advice for activities and exercise, the same as for using medications. Gear activities toward improving function in areas that are of greatest importance in achieving activities of daily living and remain open-minded about alternative therapies and discuss them with your patients when appropriate.1 Consider referring or asking for consults and discuss that with patients early in the treatment.
Caring For Someone With Me/cfs
Having a supportive community of family, friends, school, work, employers and health workers, who understand the potential seriousness of ME/CFS, can also help improve the quality of life of people living with ME/CFS.
Everyone involved in supporting someone with ME/CFS needs to understand Post Exertional Malaise, which is an abnormal, biological response to exercise or activity. This means the patient will not be able to do all of the activities they used to be able to do, and will benefit from practical and emotional support. People with ME/CFS will each have different needs and preferences, so it is important to talk with them about how best to provide support. This may include help with daily routines, family life, accessing healthcare and other personal priorities.
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Has Niaid Looked At The Potential Benefits Of Long
Yes. NIAID has funded three placebo-controlled clinical trials on the efficacy of prolonged antibiotic therapy for treating PTLDS. The published results were subjected to rigorous statistical, editorial, and scientific peer review.
These trials were designed to ensure that several key parameters were addressed:
- The susceptibility of B.burgdorferi to the antibiotics used
- The ability of the antibiotics to both cross the blood-brain barrier and access the central nervous system and to persist at effective levels throughout the course of therapy
- The ability of the antibiotics to kill bacteria living both outside and inside mammalian cells
- The safety and welfare of patients enrolled in the trials
The first clinical trial, which included two multicenter studies, provided no evidence that extended antibiotic treatment is beneficial. In those studies, physicians examined long-term antibiotic therapy in patients with a well-documented history of previous Lyme disease but who reported persistent pain, fatigue, impaired cognitive function, or unexplained numbness. Those symptoms are common among people reporting PTLDS. Patients were treated with 30 days of an intravenous antibiotic followed by 60 days of an oral antibiotic.
In 2016, a clinical trial conducted in the Netherlands also concluded that in patients with persistent symptoms attributed to Lyme disease, longer term treatment with antibiotics did not provide additional benefits compared with shorter term regimens.
When To See A Healthcare Professional About Rashes
If you dont already have a physician, you can use the Healthline FindCare tool to find a professional near you.
Go to the hospital immediately if you experience a rash along with any of the following symptoms:
- increasing pain or discoloration in the rash area
- tightness or itchiness in the throat
- difficulty breathing
- swelling of the face or limbs
- fever of 100.4°F or higher
- confusion
- severe head or neck pain
- repeated vomiting or diarrhea
Your healthcare professional may also:
- take your temperature
- order tests, such as an allergy test or complete blood count
- perform a skin biopsy, which involves taking a small sample of skin tissue for analysis
- refer you to a specialist, such as a dermatologist, for further evaluation
Your healthcare professional may also prescribe medication or medicated lotion to relieve your rash. Most people can treat their rashes effectively with medical treatments and home care.
Follow these tips if you have a rash:
- Use home remedies to soothe mild contact rashes.
- Identify potential triggers for the rash and avoid them as much as possible.
- Carefully follow any treatments your doctor prescribes. Speak with a healthcare professional if your rash persists or gets worse despite treatment.
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How Is Chronic Fatigue Syndrome Diagnosed
CFS diagnosis depends on two criteria:
A specific treatment for CFS has yet to be proven effective. Vitamin supplements and medicines have some benefit. Many treatments just relieve the symptoms of CFS.
Why Is Chronic Lyme Disease Chronic
Several factors may account for persistent symptoms. These include low grade persistent infection which either causes damage directly or indirectly through the inflammatory and toxic effects of an activated immune response, permanent damage as may occur in brain injured patients, or a Lyme-triggered autoimmune reaction.
The post-infectious inflammatory hypothesis also is supported by several lines of evidence. For example, patients with Lyme arthritis who carry the HLA-DR4 or DR2 allele are more vulnerable to developing a chronic antibiotic-resistant arthritis. Indirect evidence exists to support molecular mimicry as at least one possible explanation for persistent symptoms. For example, the flagellin protein can generate antibodies that cross-react with myelin basic protein, thereby contributing to axonal dysfunction. Finally, remnants of pieces of the spirochete may result in a persistent activation of the immune system, causing the production of interleukin-6, tumor necrosis factor, and nitric oxide. These cytokines produce fatigue and malaise, two of the more prominent symptoms experienced by patients with chronic Lyme disease.
© 2021 Lyme education & research fundraising in Canada. KWD
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Fibromyalgia Chronic Fatigue Syndrome And Lyme Disease
Dr Sam Donta presented a comprehensive, compassionate, cutting-edge lecture to Mass. CFIDS/FM Association members on November 3rd, 2002. His topic was The Interface of Lyme Disease with CFS and FM: Diagnostic and Treatment Issues. Dr. Donta is a nationally recognized expert on Lyme disease. He is the Director of the Lyme Disease Unit at Boston Medical Center and a Professor of Medicine at BU Medical School. He is a bacteriologist and an infectious disease specialist, who views CFS and FM from that vantage point. He is also a consultant to the National Institutes of Health , and presented at NIHs scientific meetings on CFS research.What does Lyme disease have to do with CFS and FM you might be asking? Some people believe that Lyme disease may be one of the causative factors in both CFS and FM. Others believe that some CFS and FM patients are really misdiagnosed chronic Lyme disease patients and vice versa. Some believe that there is no such thing as chronic Lyme disease, instead these patients actually have CFS or FM. We asked Dr. Donta to help sort all this out.
Parallel Symptom Patterns
Flu-like illness, fever, malaise, fatigue, headache, muscle aches , and joint aches , intermittent swelling and pain of one or a few joints, bulls-eye rash, early neurologic manifestations include cognitive disorders, sleep disturbance, pain, paresthesias , as well as cognitive difficulties and mood changes.
Etiology
Clinical Diagnosis
New Proof Offered For Cfs
Researchers say their study, which appears in the August issue of the International Journal of Psychophysiology, is the first to use electrodermal activity and skin temperature to look at differences between people with chronic fatigue syndrome, those with major depression, and healthy individuals.
Electrodermal activity is a measure of electrical activity within the skin and was measured by placing electrodes on each hand.
The study showed that people with CFS scored much lower on measures of how well electricity passes through the skin compared with those with depression or healthy individuals.
Skin temperatures were also much higher among those with chronic fatigue syndrome than in the other two groups.
Researchers say the results suggest that despite sharing similar symptoms with depression, people with CFS can be identified by physiological measures: skin temperature and electrical activity within the skin.
They also say the study adds to the growing body of evidence that demonstrates that CFS and depression are distinct disorders with different disease profiles.
Show Sources
International Journal of Psychophysiology
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What Are The Signs & Symptoms Of Chronic Fatigue Syndrome
Someone with chronic fatigue syndrome can have many possible symptoms. The most common ones include:
- severe fatigue, which can make it hard to get out of bed and do normal daily activities
- sleep problems, such as trouble falling or staying asleep, or not having a refreshing sleep
- symptoms getting worse after physical or mental effort
- symptoms or dizziness that get worse after standing up or sitting upright from a lying down position
- problems with concentration and memory
- headaches and stomachaches
What Can I Do To Cope With Me/cfs
Talking about your feelings with a friend or family member can help. Sometimes it also helps to talk with people who are going through the same thing. Consider joining an ME/CFS support group. See the “ME/CFS Organizations” section at the end of this fact sheet for a list of organizations that offer additional information on ME/CFS and can help you find ME/CFS support groups.
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Chronic Fatigue Syndrome In Patients With Lyme Borreliosis
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So What Stresses Cells
The factors that stress or threaten cells are intimately tied to the fact that we must interact with the surrounding environment to survive. The nutrients, water, and oxygen that cells need to thrive must come from outside the body. This mandatory interaction with the outside environment poses a variety of different risks to cells of the body.
All totaled, there are five categories of factors that can stress cells of the body and lead to chronic illness.
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