Lyme Symptoms: Neurological, Psychological, and Cardiac

Author Ken Singleton, M.D.

Excerpts from the Lyme Disease Solution:

Table of Contents

Introduction

Chapter 1

Chapter 2

Chapter 3

Chapter 4

Chapter 5

Chapter 6

Chapter 7

Chapter 8

Chapter 9

Index

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Patients and doctors alike face an enormous challenge regarding the diagnosis and treatment of Lyme and other tick-borne illnesses. In this chapter, I want to discuss one very important aspect of this challenge—the recognition of symptoms of Lyme and of the co-infections (other organisms) that may accompany Lyme at the time of Lyme infection.

First of all, let me define two terms. “Symptoms” are subjective feelings as a patient experiences them. For example, knee pain is a symptom of discomfort in the knee as a person experiences it. “Signs” are objective evidences that a doctor examines, observes, or tests for, that allow the doctor to reliably make a diagnosis. For example, a swollen and red knee is a sign of joint inflammation that is called arthritis.

One of the most challenging problems with Lyme disease is that very often neither a patient’s subjective symptoms nor a doctor’s objective signs are specific enough to reliably diagnose Lyme or the co-infections. Unfortunately, when a patient comes to a doctor’s office, there are very few symptoms that are absolutely specific for Lyme. Likewise, there are very few objective signs that a doctor can examine or test for that are so specific that no one disputes the diagnosis of Lyme disease.

The only indisputable Lyme symptom and sign is the presence of a rash that is diagnosed as the erythema migrans (EM) rash. Therefore, if a person does not have a diagnosed EM rash, there is a good possibility that the Lyme diagnosis will be missed. Consequently, those patients can become chronically ill with Lyme disease.

The symptoms of chronic Lyme are often non-specific symptoms that look like a wide variety of other medical conditions. A good example would be the symptom of chronic fatigue. While fatigue is a universal chronic Lyme disease symptom, it is also a major symptom of literally hundreds of other medical conditions, including depression, cancer, heart disease, hypothyroidism (low thyroid function), and chronic stress to name just a few.

In this chapter, I will discuss the symptom patterns of Lyme disease and the major co-infections that often accompany Lyme. The symptoms presented below should not be considered a complete or exhaustive list.

Lyme and Neurological Disease

Lyme disease is also frequently the cause or a significant contributing co-factor in a number of chronic degenerative and neurological diseases, such as Parkinson’s, Lou Gehrig’s disease (ALS), Alzheimer’s disease, and multiple sclerosis (MS). In addition, these same conditions can also be misdiagnosed as a result of Lyme disease, meaning that physicians can fail to detect that Lyme is the underlying cause. Susan’s case illustrates what can result when this happens.

Susan came to our office because of neurological symptoms that began six years previously. An avid gardener living in rural Delaware, she recalled feeling tired and unmotivated during that summer six years ago. She recalled no tick bite or rash. In addition to ongoing severe fatigue, a few months later she began having vision problems and strange electrical sensations involving her back, legs, and feet. Next, her knees and leg muscles began to ache, and she began to have night sweats. This was followed by balance and walking problems shortly afterwards.

Susan’s doctor appropriately referred her to a neurologist. She underwent extensive testing—including MRIs, a Lyme screening test, and lumbar puncture (spinal tap)—all of which were normal. The conclusion was that she had “atypical multiple sclerosis.” However, the treatment Susan was prescribed caused her symptoms to become even worse. One of her friends who had been diagnosed and treated for Lyme convinced her to get a second opinion concerning Lyme disease. Our laboratory tests confirmed that Susan had both disseminated Lyme disease and the co-infection, Babesia. (I will discuss this organism below.)

We treated the Babesia first, using atovaquone and azithromycin. This was followed by treatment for Lyme disease with intravenous ceftriaxone, along with oral clarithromycin and metronidazole. (This combination is used to attack Lyme in its three different structures: spirochete form, “L” form, and “cystic” form.) After a total of several months of antibiotic treatment, combined with the natural therapies you will learn about later in this book, Susan’s symptoms completely resolved.

Lyme and Psychological Disease

A variety of mental and emotional (psychiatric) conditions can also be caused or severely exacerbated by Lyme disease. It is estimated that 50 percent of Lyme patients have psychiatric manifestations. These include behavioral disorders (including impulsive acts of aggression and violence), bipolar disorder (manic depression), chronic depression, dementia, eating disorders, hallucinations, mood swings, panic attacks, paranoia, schizophrenia, and other personality disorders and even suicide. Jill was one patient who suffered serious psychological problems because of Lyme.

Before she came to me for treatment, Jill had been in and out of psychiatric hospitals, where she was treated unsuccessfully for suicidal depression. Her deteriorating mental and emotional state first began shortly after she gave birth to her child. Initially, she experienced what she thought were symptoms of the flu. But soon thereafter, she began her mental and emotional decline. She was told she had severe post-partum depression, but her doctors were unable to help her. After she was properly diagnosed with Lyme disease and was treated with intravenous and oral antibiotics, she made a remarkable recovery and received her life back.

Dr. Virginia Sherr is a psychiatrist practicing in Holland, Pennsylvania. She has published numerous articles in medical journals on Lyme disease and is an authority on the psychological manifestations of Lyme disease. She recently reported in the Journal of Psychiatric Practice three cases of panic disorder that were actually psychiatric manifestations of Lyme disease. In each of the cases, the patients presented to her with body symptoms that were not typical of primary panic disorder alone. These symptoms included foggy thinking and memory loss; joint pains; light and sound sensitivity; and bizarre, shifting, and even excruciating nerve pain. She was able to recognize that some other systemic disorder was occurring in each of these patients. After the appropriate diagnoses of Lyme disease (and co-infections) were made and treatment completed, the panic symptoms of each of the patients were totally eliminated.

Lyme and Heart Disease

One of the little known facts about Lyme disease is that it can cause a number of serious cardiovascular problems that can lead to or worsen heart disease. The reason for this is that, as Lyme disease spreads through the body, weakening other body systems, it can create an ongoing strain on the heart and overall cardiovascular system. Left unchecked, Lyme disease can also cause permanent damage to the heart and even death by heart attack.

Dr. Phillip W. Paparone, an infectious diseases specialist in New Jersey, is an expert on heart problems as they relate to Lyme disease. According to Dr. Paparone, “The potentially fatal cardiac involvement of Lyme disease remains the least well-documented complication of this multi-system illness.” Medical research published in 1990 indicates that between 8 and 10 percent of all Lyme disease patients have symptoms that indicate heart involvement. He believes that the percentage of heart disease patients with Lyme disease may actually be higher due to how easily Lyme disease can escape detection or be misdiagnosed. For this reason, Dr. Paparone recommends that all patients suffering from symptoms of heart disease who live in geographic regions where Lyme disease is most prevalent be screened for the Bb bacteria. Frederick’s case dramatically illustrates what can happen when Lyme screening does not take place.

Frederick began noticing peculiar symptoms at the age of thirty-eight. His feet began swelling, he suffered from shortness of breath with minimal exertion, and at times he would awaken in the middle of the night gasping for air. His worsening symptoms motivated him to visit his family doctor. The doctor sent him for a chest X-ray and immediately recognized that Frederick was having serious heart problems.

He was referred to a cardiologist (heart specialist) who discovered that he had “congestive heart failure.” This is a condition in which the heart muscle becomes weakened to the point that it cannot pump out enough blood to meet the demands of the body. The problem was that the doctor could not figure out why Frederick had this fairly sudden onset of poor heart muscle function. At that time, he underwent heart catheterization. It showed normal coronary arteries, but a very poor heart muscle function. His “ejection fraction” was 21 percent, meaning his heart was able to pump out only 21 percent of the blood that was arriving to it. A normal ejection fraction is 50–75 percent.

Frederick underwent a heart biopsy and was told that he had “idiopathic cardiomyopathy.” His condition was deemed to be so serious that he was placed on a heart transplant list. Frederick had acquired some other symptoms around the same time that his heart problems began. These symptoms included knee pains, numbness in his feet, and foggy thinking. Interestingly, Frederick’s next-door neighbor had just moved into the neighborhood recently, and Frederick had told him his story. The neighbor asked if he had ever been tested for Lyme disease. At that point Frederick had not.

He requested a Lyme test from his cardiologist, but was refused. His neighbor then referred him to the Lyme Disease Association’s Web site. (See the resources section at the end of this book.) He was able to get the names of several doctors who are able to evaluate and treat patients with chronic Lyme disease. He decided to travel to Maryland to visit our office.

From his history, Frederick did not have any tick bites or strange rashes. However, his symptoms certainly fit a possible Lyme disease pattern. We tested him for Lyme and a host of other problems. He had a very strongly abnormal Lyme Western Blot test. He was started on intravenous ceftriaxone as well as oral azithromycin and metronidazole.

Within two weeks of treatment, he began to feel hopeful that he might be able to get his heart functioning normally again. After three months of treatment, his heart symptoms and systemic Lyme symptoms were nearly resolved. Meanwhile, he had found a new cardiologist (one who was more open-minded) and had a repeat of his ejection fraction. His new ejection fraction was now 46 percent. After Frederick completed the intravenous therapy, he was continued on oral antibiotics for several more months, after which time his repeat ejection fraction improved to 58 percent. Eventually, the antibiotics were discontinued and he was released from my care. A year later he sent a letter stating that he was doing fine and was back to normal and no longer needed a heart transplant.

Heart conditions caused by Lyme disease are collectively known as Lyme “carditis.” Any of the following problems can result from Lyme carditis: atrial fibrillation, cardiac failure, cardiomegaly, cardiomyopathy, chest pain, exertional dyspnea, irregular heartbeat (arrhythmia), myocarditis, palpitations, pancarditis, pericarditis, syncope, and tachycardia. Lyme carditis can also cause serious “blockages” in the electrical impulse transmission between the atrial and ventricular sections of the heart. These heart blockages may require that a heart pacemaker be placed inside of the patient. Without such a pacemaker, the patient may experience sudden cardiac death.

If you have been diagnosed with any of the above heart conditions for reasons that neither you nor your physician can explain, ask your physician to refer you to a physician who specializes in Lyme disease so that you can be screened for it. Given how potentially serious, and even fatal, Lyme carditis can be, when it comes to screening for Lyme, it’s always better to be safe than sorry.

If you would like to learn more about the book before ordering it, feel free to browse these excerpts, which are available online, free of charge:

Table of Contents • Introduction • Controversy and Background

Symptoms • Testing and Diagnosis • Natural Killer (NK) Cells

Anti-Inflammation Diet • Medical History and Physical Exam

Low Dose Naltrexone (LDN) • Food, Diet, and Omega Fatty Acids

Hope and Positive Outlook • Index

"What I have accomplished with this 500+ page book, The Lyme Disease Solution, is to share my everyday knowledge and practical experience of 10 years as a Lyme-enlightened practitioner (who also is himself a Lyme-survivor). Although I hesitate to use the “cure” word in relation to chronic Lyme, the principles in this book have resulted in a greater than 90% response rate in my patients. At least 60% of my patients achieve long-term improvement that allows them to get off of antibiotics completely."

— Ken Singleton, M.D.

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