You may have seen singer Avril Lavigne’s recent media appearances discussing her experience with Lyme disease. What is this mysterious illness, and how can you tell if you have it?
In recent years, Lyme disease has almost become another one of those fad medical conditions that tends to catch headlines (and audiences), similar to Vitamin D, supplemental testosterone, and gluten sensitivity. I’m not saying these things are not real … they are very real for some. But they are overly-used and abused in order to gain media attention (sorry again, Dr. Oz).
With Lyme disease being so over-hyped in the media, and with it being such a mysterious illness with common symptoms, it's challenging to decipher fact from fiction. And that’s my goal for today’s episode—to explain what we do know about Lyme disease, and what may be over-sensationalization.
What Is Lyme Disease?
Lyme disease stems from the bite of a tick, of all things. And in the Unites States, it is associated with one blood-sucking species that transfers a bacteria called “Borrelia burgdorferi.”
After that nasty (and sometimes not noticeable) tick bite carrying the illness, there are three phases of the condition in adults:
1. Early Localized: In about 80% of patients with Lyme disease, a particular skin lesion typically develops at the site of the tick bite, referred to as “Erythema Migrans,” within a month after the bite. This one skin lesion itself often expands over the next few days or weeks, and appears as a “bulls-eye” (think “Target,” no pun intended). This stage may also include very non-specific viral-like symptoms (but without the upper respiratory or stomach symptoms), such as fevers, body aches, fatigue, headaches, lymph node enlargements, neck stiffness, etc. Not very unique or distinguishable without that rash, huh?
2. Early Disseminated: Within days to weeks after the infection, the rash tends to spread. And within weeks to months after, Lyme can spread to the nervous system, heart, or eyes and produce more specific Lyme symptoms:
- Nervous System: Numbness/tingling in the hands or feet, symptoms of meningitis, or abnormalities of the nerves on the face
- Heart: Inflammation or weakness of the heart muscles and palpitations caused by heart block on an EKG that resolves in days to weeks
- Eyes: Inflammation of the eyes or acute vision changes
3. Late: This later stage (typically months to a few years after the initial stages) often includes joint pain or arthritis in one or multiple larger joints, most commonly the knee. Also, if it attacks the nervous system, further neurologic symptoms can also develop, including subtle difficulty concentrating. These neurologic symptoms are often also non-specific and attributable to numerous other conditions as well. So, it can be challenging to pinpoint.
Some patients may “miss” or skip the early stages altogether and instead initially present in the late stages. That’s what makes this rare disease so tricky to diagnose. So, how do you diagnose Lyme disease?