Lyme disease - How to diagnose it
From DoctorMyhill
07 August 2007
The key point to remember about Chronic Fatigue Syndrome is that it is a symptom, which may have many causes. There is no question that infection can be a trigger, the difficulty is finding out which infection and whether it is clinically relevant.
The body is constantly assailed by bacteria, viruses, fungi and other micro-organisms who wish to make it their home! Throughout evolution the body has evolved excellent mechanisms for keeping these organisms at bay. My view is increasingly that we have to put the body in as fit a state as possible and let the immune system deal with any bugs which should or should not be there.
See Chronic infections in CFS See The general approach to maintaining and restoring good health
Extra interventions to improve immune function
In addition to the above, immune function can be substantially improved by attention to the following, is used, all of which have a separate information sheet or web page to explain them.
- Mitochondrial function
- Antioxidant status
- Methylation cycle
- Correct thyroid and adrenal status
- Detoxing regimes with far infrared saunas
- Also see handout on avoiding viral infections
ie - all teh standard workups to treating CFS.
If all the above fail and Lyme disease is suspected
There is no single test to diagnose Lyme disease. Diagnosis is made on the basis of:
- A typical history, possibly with clinical signs - see Diagnostic Hints and Treatment Guidelines for Lyme and Other Tick Borne Illnesses by Joseph J. Burrascano Jr., M.D.September, 2005
- Positive test - tests for Lyme Borreliosis are evolving all the time, but the current two favourites are LTT MELISA and Western blot.
- Response to treatment.
Western blot
This is a laboratory diagnosis, which identified antibodies to borrelia. The problem with this test is that it may be negative because borrelia can hide inside cells and not elicit an antibody response.
LTT (Lymphocyte Transformation Test) MELISA
This looks at how white cells behave in the presence of borrelia specific antigens. So if this is positive, it suggests that these white cells have learned how to react against borrelia, i.e. that patient has active infection. This test can also be useful after patients have started treatment. One of the problems with drug treatment for borrelia is that sometimes people get worse initially. One can use MELISA test to see if treatment is working. If therapy is effective, then the test should come back negative. However, if the treatment is ineffective, then it should remain positive.
Having the tests for Lyme Disease
The tests are performed on three blood samples in a laboratory in Bremen, Germany. There is a London based company handling the paperwork for these tests for the German lab called MELISA Diagnostics. However, they do not handle arrangements for transporting the samples to Germany - this is the responsibility of each test user.
Transport of the test samples from the patient's address to the lab in Germany is arranged with FedEx. FedEx charges MELISA Diagnostics, who in turn invoice the patient directly.
The prices as at January 2008
£150 for LTT Melisa £80 for Western Blot
£210 for the two tests done at the same time
plus in either case approx ?30-35 for transport to Germany with FedEx. This is invoiced from MELISA Diagnostics directly to the patient.
JULY 2008 UPDATE
I have to say I am disappointed with the results of the MELISA test for Lyme disease and have decided to stop referring patients for it. The overwhelming majority of the results have come back negative, leaving me and the patient wondering whether this is a false negative or cause for celebration. The high cost of the tests (the prices have recently been increased several times) and the effort of arranging sample transport to Germany are not, in my opinion, justified by the inconclusive results.
At present (Jan 2010) I really do not know how to best to tackle the problem of Lyme disease!
Related Tests
Related Articles
References
Sarah Myhill Limited :: Registered in England and Wales :: Registration No. 4545198
Registered Office: Upper Weston, Llangunllo, Knighton, Powys, Wales LD7 1SL, UK.
Tel 01547 550331 | Fax 01547 550339
