Testing of Lyme Disease and photo of Tick

Testing of Lyme Disease and Problems with It

Lyme disease is an infectious disease spread by ticks. It is a growing problem with hundreds of thousands being diagnosed each year. However, Lyme disease is possibly the most misunderstood and controversial health issue. Many people go misdiagnosed and silently suffer from chronic and serious symptoms of chronic Lyme disease without receiving proper treatment. Unfortunately, current testing for Lyme disease is highly unreliable, and many doctors are not versed enough in Lyme disease to provide an accurate diagnosis and treatment.
In this article, you will learn what Lyme disease is, the difference between acute and chronic Lyme disease, and their symptoms. You will learn about current testing methods for Lyme and the problems with these tests. You will learn what tests may further help accurate diagnosis, and why you need a Lyme-literate health practitioner for proper diagnosis and successful treatment.

What Is Lyme Disease?

Lyme disease is an infectious disease. It is caused by the Borrelia burgdorferi bacteria found in ticks.
Lyme is more common in wooded areas or in nature. It is transmitted to the human body by the bite of an infected black-legged or deer tick. Based on the old standards, in order to transmit the disease, the tick usually has to stay in the body for 24 to 48 hours or longer. However, the new studies show that even 15 min from tick attachment it may transmit the variety of microbes into the victim.

Acute vs Chronic Lyme Disease

Acute Lyme disease refers to a short-term or recent infection, whereas chronic Lyme refers to a long-term infection with ongoing health problems. After getting infected with Borrelia burgdorferi, you may develop symptoms of acute Lyme disease. When caught early, within the first few days to weeks, acute Lyme disease is usually treated with a course of 1-2 antibiotics.
However, chronic Lyme disease is increasingly prevalent as well. Some people, unfortunately, are simply resistant to treatment. In other cases, Borrelia burgdorferi simply lingers in the body even after adequate treatment. While in other situations, acute Lyme disease symptoms may be too mild to take seriously, and the infection becomes chronic. In other cases, acute Lyme gets misdiagnosed and confused with the summer flu or another short-term illness and patients never get adequate treatment. Unfortunately, when the bacteria has fully integrated itself into your system, it leads to chronic health issues, and it is much harder to identify and shift.

symptoms from lyme disease include rash

Symptoms of Acute Lyme Disease:

  • Flat, circular rash with a bull’s eye
  • Joint pain, including neck and back pain
  • Fatigue
  • Muscle pains
  • Headaches
  • Sleep issues
  • Fever
  • Swollen lymph nodes
  • Concentration problems

Not all people with acute Lyme have a bull’s eye rash, actually, those who do are minority. Many people miss the tick bite altogether. Not all people with acute Lyme disease experience severe symptoms. Some may not visit the doctor. In some cases it may be confused with the flu or due to inaccurate Lyme testing, may get tested for autoimmune or other health conditions instead of Lymes. In some cases, symptoms may be written up as symptoms of stress, fatigue, or psychosomatic symptoms.

Symptoms of Chronic Lyme Disease:

  • Fatigue
  • Pain
  • Migrating and intermittent joints and muscle pains
  • Migrating pains or swelling in elbows, knees, and shoulders
  • Sleep troubles
  • Memory and concentration problems
  • Speech problems
  • Neurological issues — migrating numbness, tingling or burning pains
  • Fibromyalgia-like pain
  • Other chronic health issues

Chronic Lyme disease is often confused with fibromyalgia, autoimmune conditions, mental health issues, and psychosomatic illness. Without proper diagnosis and treatment, people with chronic Lyme disease may get worse over time and never recover.

Lyme Disease from Ticks

Conventional Testing for Lyme Disease

Conventional testing for acute Lyme disease usually starts with a health story. Your doctor will look for tick bites and rashes. They will perform a physical exam looking for symptoms of Lyme disease.
If your doctor believes that you have Lyme disease, they may order the following “standard-of-care” tests:

  • Enzyme-linked immunosorbent assay (ELISA) may be ordered to detect antibodies against B. burgdorferi.
  • Western blot may be used to confirm a positive ELISA test result. It is only used if your ELISA test is positive and checks for the presence of antibodies specific to B. burgdorferi proteins.
  • Polymerase chain reaction (PCR) may be used to evaluate people with Lyme arthritis or nervous system symptoms. This test is not routinely used as it has a very low sensitivity.

If a patient tests positive for both ELISA and Western blot tests the conventional diagnosis of Lyme disease can be established.

Problems with Testing for Lyme Disease

The problem is that Lyme disease is critically misunderstood by many people in the medical profession. Most doctors are not very well-versed in Lyme disease. Testing is not reliable. Many medical professionals are simply not educated about chronic Lyme disease to recognize and treat it. Conventional doctors often have a difficult time diagnosing, understanding, or treating something that they cannot see or isolate. Hence, Lyme disease diagnosis and treatment may be one of the most controversial and difficult issues in medicine. There are a lot of grey areas, a lot of misunderstandings, and unreliable testing, so going to a Lyme-literate practitioner is critical.

Lyme Testing Is Not Designed to Detect the Lyme-Causing Bacteria

It is important to know that there are many types of Borrelia, not just B. burgdorferi, that also cause Lyme-like illnesses. Despite of the variety of bacterias, the conventional tests only look for one species of Borrelia, B. burgdorferi. There are actually 16 known strains of Borrelia. Another example of Lyme-related infection, for example, is caused by B. mayonii. If it is not that you are infected with B. burgdorferi, conventional testing may not pick up on your Lyme diagnosis and may be misdiagnosed and left without treatment.

Inaccurate Results and False Negative Due to Lower Test Sensitivity

Most non-Lyme literate doctors and labs stick to the two-step test for Lyme that is recommended by the CDC and approved by the FDA. These tests include the ELISA followed by a Western blot test. Both tests are only designed to detect B. burgdorferi and no other Lyme-related bacteria or co-infection.

One of the problems with testing for Lyme disease is that the ELISA tests are not always accurate. False negatives may occur. For example, if you get tested too soon after getting bitten and infected, it’s possible that your body hasn’t developed enough antibodies for the test to detect the bacteria. If your ELISA test is negative, many labs will not move onto the Western blot. Many doctors don’t retest, even if your symptoms persist and are in correspondence with the symptoms of Lyme disease. Research has shown that the two-step testing of ELISA and Western blot may miss up to 60 percent of Lyme cases.

The ELISA and Western blot are also not accurate when it comes to chronic Lyme disease, and are more helpful when it comes to acute Lyme disease.

False-Negatives May Also Occur

While false negatives may occur, false positives also commonly occur. After getting infected with B. burgdorferi, your immune system may not show a positive response with positive IgM (young antibodies), however, neither convert or mount an immune response with IgG (old antibodies). One study, for example, has found that over 50 percent of test participants showed false positive for Lyme disease. This may happen because of early antibiotic use or because the B. burgdorferi destroys the specific part of your lymph nodes that are responsible for IgG antibodies.

Some patients simply will not ‘convert’ to a classic immune response that most conventional healthcare professionals and testing are looking for. If you are working with a health practitioner who is not Lyme-literate, they may have a false-positive interpretation as positive for Lyme disease, when you don’t have Lyme disease.

Indirect vs Direct Testing: More False-Negatives

The two-step testing process used by most doctors is indirect diagnostic methods that do not look for or detect the bacteria that are causing the infection but measuring your body’s immune system response when the bacteria is present. There are several problems with this method:

  • Timing: During the early stages of the disease, your body may not have created enough antibodies yet to show up on the ELISA test. Most doctors don’t retest even if symptoms persist.
  • Immune suppression: Tick bites are tricky. The saliva of Lyme-causing ticks has an immune-suppressing component that may prevent or delay your body’s immune response, hence, your body won’t respond to the two-step test.
  • Antibiotics: Taking antibiotics around the time of the infection may also prevent your body from making enough antibodies to show up on your test.
  • Modified form of Borrelia: In some cases, the bacteria will turn into a cyst and prevent the production of antibodies.
  • Weakened immune system: If you have a weak or compromised immune system due to an illness, co-infection, or poor diet, false negatives may occur.
  • Seronegative patients: Some patients’ bodies simply do not produce antibodies at all.

More Reliable Diagnosis

In order to get the right diagnosis and the right treatment, you need to find a Lyme-literate functional or integrative medicine practitioner who understands Lyme disease.

Direct Testing

Direct testing methods are better than indirect testing. They don’t simply rely on your body’s response to bacteria. Instead, they are looking for specific disease-causing bacteria. This can help to determine if you have Lyme, what exact bacteria is causing it and what co-infections you may have.

More Lab Testing

Lab testing only provides a glimpse of what’s going on in your body. There is certainly more needed than simple Lyme blood testing. Other blood tests, besides the standard Lyme tests, may help to evaluate the state of your health and get a better understanding of what is going on in your body. It is crucial that you find a Lyme-literate functional doctor who listens to your symptoms and is able to make an accurate Lyme diagnosis based on your symptoms, health history, and other tests.

Some further blood tests that may help accurate diagnosis include:

  • Complete blood count (CBC): white blood cells count (WBC), differential (diff), hemoglobin (HB)
  • Blood chemistries: electrolytes, liver function, kidney function
  • Glucose metabolism: fasting blood glucose, fasting insulin hemoglobin A1c (HbA1c)
  • Minerals: magnesium and calcium
  • Thyroid function: complete thyroid
  • Lipid panel
  • Autoimmune testing rheumatoid factor, ANA titer
  • C-reactive protein (CRP)
  • Vitamins: vitamin D and B12
  • Iron: ferritin
  • Urinalysis: pH, WBCs, nitrites, protein, bilirubin
  • Mold and mycotoxins
  • Food sensitivities
  • Omega-3/omega-6 ratio
  • Cytokine testing (Th1/Th2)
  • Adrenal hormone testing
  • Reproductive hormone testing: estrogen, progesterone, testosterone
  • Testing for toxins
  • Comprehensive stool analysis: yeast, parasites, viruses, and bacteria
  • Microbes testing
  • Genetic testing, like methylation ( MTHFR gene mutation)
  • Testing for neurological, cardiac, and GI symptoms
  • Testing for Lyme co-infections

Find a Lyme-Literate Integrative or Functional Health Practitioner

If you know or suspect that you have a Lyme disease (acute or chronic), it is important that you find a Lyme-literate functional medicine practitioner to help you received the right diagnosis, identify the root cause of your condition, and prescribe a personalized treatment.

As a Lyme-literate functional and integrative doctor, I can help you to receive the right diagnosis, address the underlying causes of all your health issues, and get the right treatment using a system-oriented approach, engaging both patient and practitioner in a therapeutic partnership. As an experienced functional medicine doctor with an integrated expertise of both Western medicine and traditional Eastern practice, I can assess all the factors, including diet, lifestyle, stress, toxicity, allergies, sleep habits and medication that may affect your immune system in order to accurately diagnose Lyme disease and/or other health issues or co-infections and provide a personalized and effective plan to improve other organs function like the thyroid condition, repair your body and regain your health and well-being.

If you would like to get more information about Lyme disease and other tick-borne illnesses or to schedule a functional medicine consultation, please call my office at 212-696-4325.

References:

  1. Wormser GP, Nowakowski J, Nadelman RB, Visinainer P, Levin A, Aguero-Rosenfld ME Impact of clinical variables on Borrelia burgdorferi-specific antibody seropositivity in acute-phase sera from patients in North America with culture-confirmed early Lyme disease.Clin Vaccine Immunol 2008 Oct;15(10):1519-22.
  2. Engstrom SM, Shoop E, Johnson RC Immunoblot interpretation criteria for serodiagnosis of early Lyme disease. J Clin Microbiol 1995 Feb;33(2):419-27.
  3. Ledue TB, Collins MF, Craig WY New laboratory guidelines for serologic diagnosis of Lyme disease: evaluation of the two-test protocol. J Clin Microbiol 1996 Oct;34(10):2343-50.
  4. Bacon RM, Biggerstaff BJ, Schrfiefer ME, Gilmore RD Jr., Philipp MT, Steere AC, Wormser GP, Marques AR, Johnson BJ Serodiagnosis of Lyme disease by kinetic enzyme-linked immunosorbent assay using recombinant VlsE1 or peptide antigens of Borrelia burgdorferi compared with 2-tiered testing using whole-cell lysates. JID 2003:187 (15 April) • 1187
  5. Bakken LL, Callister SM, Wand PJ, Schell RF Interlaboratory comparison of test results for detection of Lyme disease by 516 participants in the Wisconsin State Laboratory of Hygiene/College of American Pathologists Proficiency Testing Program. J Clin Microbiol 1997 Mar;35(3):537-43.
  6. Trevejo RT, Krause PJ, Sikand VK, Schriefer ME, Ryan R, Lepore T, Porter W, Dennis DT Evaluation of two-test serodiagnostic method for early Lyme disease in clinical practice. J Infect Dis 1999 Apr;179(4):931-8
  7. Nowakowski J et al Laboratory diagnostic techniques for patients with early Lyme disease associated with erythema migrans: a comparison of different techniques. Clin Infect Dis 2001 Dec 15;33(12):2023-7. Epub 2001 Nov7.
  8. Wojciechowska-Koszko I et al Seroidiagnosis of Borreliosis: Indirect Immunofluorescence Assay, Enzyme-Linked Immunosorbent Assay and Immunoblotting Arch. Immunol. Ther. Exp. (2011) 59:69– 77
  9. Chmielewska-Badora J, Cisak E, Wo´jcik-Fatla A et al Correlation of tests for detection of Borrelia burgdorferi sensu lato infection in patients with diagnosed borreliosis. Ann Agric Environ Med (2006) 13:307–311
  10. Coulter P et al Two-Year Evaluation of Borrelia burgdorferi Culture and Supplemental Tests for Definitive Diagnosis of Lyme Disease Journal of Clinical Microbiology Oct 2005 Vol 43, No. 10 5080- 5084
  11. Craft J, Fischer DK, Shimamoto GT, Steere AC. (1986) Antigens of Borrella burgdorferi Recognized during Lyme Disease appearance of a new Immunoglobulin M response and expansion of the immunoglobulin G response late in the illness. J. Clin.Invest.1978, 934-39
  12. Hilton E, Tramontano A, DeVoti J, and Sood SK. (1997) Temporal study of immunoglobulin M seroreactivity to Borrelia burgdorferi in patients treated for Lyme borreliosis. J Clin Microbiol 35(3), 774-776.Kalish RA, McHugh G, Granquist J, Shea B, Ruthazer R, Steere AC (2001) Persistence of IgM or IgG antibody responses to Borrelia burgdorferi 10 to 20 years after active Lyme disease. Clin Infect Dis 33, 780-5. Abstract/FREE Full Text
  13. http://cid.oxfordjournals.org/content/33/6/780.full
  14. Racine R., McLaughlin M. Jonesa DD. et al. (2011) IgM Production by Bone Marrow Plasmablasts Contributes to Long-Term Protection against Intracellular Bacterial Infection. J Immunol 186, 1011-1021 Prepublished online 8 http://www.jimmunol.org/content/186/2/1011
  15. Seriburi V, Ndukwe N, Chang Z, Cox ME, Wormser GP (2012) High frequency of false positive IgM immunoblots for Borrelia burgdorferi in clinical practice. Clin. Microbiol. Infect 18, 1236-1240.
  16. Elsner RA, Hastey CJ, Baumgarth N (2014) CD4+ T cells promote antibody production but not sustained affinity maturation during Borrelia burgdorferi infection. doi:10.1128/IAI. http://iai.asm.org/content/early/2014/10/08/IAI.02471- 14.abstract
  17. https://www.healthline.com/health/lyme-disease#symptoms
  18. https://www.webmd.com/rheumatoid-arthritis/arthritis-lyme-disease
  19. https://www.cdc.gov/lyme/index.html
  20. https://www.healthline.com/health/lyme-disease-chronic-persistent
  21. https://www.healthline.com/health/lyme-disease
  22. https://neuro.psychiatryonline.org/doi/full/10.1176/jnp.2008.20.1.iv
  23. https://www.ncbi.nlm.nih.gov/probe/docs/techpcr/
  24. https://www.sciencedaily.com/releases/2014/04/140402110029.htm
  25. https://www.health.harvard.edu/blog/lyme-disease-resolving-the-lyme-wars-2018061814071
  26. https://danielcameronmd.com/relying-on-a-negative-lyme-disease-test-can-prove-deadly/
  27. https://danielcameronmd.com/lyme-diagnosis-tests/
  28. https://www.tiredoflyme.com/4-reasons-a-lyme-test-will-come-back-negative-even-if-a-person-truly-has-lyme-disease.html
  29. https://www.lymedisease.org/lyme-sci-testing/
  30. https://www.cdc.gov
  31. https://www.mayoclinic.org/diseases-conditions/lyme-disease/diagnosis-treatment/drc-20374655
MAKING SENSE OF LYME DISEASE

Making Sense of Lyme Disease – the Great Imitator

To say that Lyme disease is difficult to diagnose, would be like saying that McDonald’s has sold a few hamburgers over the years. Besides being called the great imitator, it has also been called an “invisible illness” as those who have it can still appear healthy, and so can their bloodwork.

Consider the shocking difference between these two statistics. In 2013, federal health departments reported that there were 27, 203 confirmed cases of Lyme disease. While the CDC that same year reported that there were 300,000 cases of the disease. What may be even more problematic, is that it appears to be on the rise.

What is Lyme Disease?

Lyme disease is the most common tick-borne infectious disease in the U.S., according to the National Institute of Allergies and Infectious Diseases. The disease was first identified in Lyme, Connecticut in 1975, which is how Lyme disease got its name.

It’s actually a bacterial disease. The corkscrew shape of the bacteria responsible allows them to burrow into body tissues and even cells, where the bacteria can then hide. This is why different parts of the body can be affected and why those who are infected can exhibit a wide range of symptoms.

What Causes Lyme Disease?

Of the four bacteria responsible for causing Lyme disease, Borrellia burgdorferi and Borrelliamiyamotoiare the two most common in the U.S., while Borrelliagarinii and Borrelliaafzelii are common in Asia and Europe.

The bacteria enter the body through the bite of a tick. However, according to Dr. Dietrich Klinghardt, one of the top Lyme disease experts, other blood-sucking insects can also spread the disease.

A tick will usually attach itself to areas of the body where it will go unnoticed, like the scalp, groin, and armpits. It must be attached for around 24 hours before the bacteria are transmitted. And it’s usually the immature ticks that are most responsible, as adult ticks are bigger and easier to notice.

Research shows that within the first 15 minutes, as the tick attaches itself to the host, it injects a salivary content with numbing substances, so we don’t feel the invader as it feeds on our blood for hours. Up to 75 percent of a tick’s salivary secretion has a “soup” of pathogens, including Borrelia and other co-infections.

What are the Symptoms of Lyme Disease?

The biggest problem with Lyme disease is that, for your best chances of a complete recovery, early detection is both critical and difficult.

Common symptoms of Lyme disease mirror those of several other conditions including:

• Multiple sclerosis
• Chronic fatigue syndrome
• Arthritis
• Fibromyalgia
• ADHD
• Alzheimer’s disease

symptoms from lyme disease include rash
First Warning Signs

In about half of all Lyme disease cases, the infected person will notice a growing red rash at the site of the bite that can grow up to 12 inches in diameter. The rash isn’t itchy or painful and is usually accompanied by other symptoms that may include:

• Chills
• Fever
• Headaches
• Body aches
• Fatigue

Chronic Symptoms

The longer the disease goes untreated, other signs and symptoms may come and go, such as brain fog, severe fatigue, muscle and joint problems, and an irregular heartbeat. The longer it persists, the more difficult it is to treat. And if left untreated long enough, it can cause problems with many organs and systems in the body, including the heart, digestive system, nervous system, brain, and reproductive system.

How is Lyme Disease Diagnosed?

Blood tests are the most common method to detect Lyme disease. However, it may take a few weeks after infection for detection to be possible.

The tests are looking to confirm the presence of antibodies to the Lyme-causing bacteria. Antibodies are created by the immune system to combat pathogens, but the body needs a certain amount of time to make them.

The CDC recommends a two-step process when attempting to diagnose Lyme disease. The first test is an enzyme immunosorbent assay which checks for any and all antibodies. If results are positive, the second test – an immunoblot test – will check for two specific antibodies that the body produces due to the presence of the Lyme bacteria.

If both tests are positive, the presence of Lyme disease is a practical certainty. But again, problems persist. Proper results of these testing methods rely on the proper functioning of the body’s white blood cells. So, there is still a chance that tests can be negative and Lyme disease present.

There is some good news, though. A brand-new testing method has been developed that can detect Lyme DNA, rather than the antibodies the body produces to combat the Lyme bacteria. This should allow for detection weeks sooner. And since time is the most critical factor in treating Lyme disease, this early detection is a very positive development.

It should be noted that diagnosing and treating Lyme disease can become quite pricey and that a patient will often see five to seven physicians before the disease is even properly diagnosed.

How to Treat Lyme Disease?

Unfortunately, the conventional treatment for Lyme disease – short courses of antibiotics – is often unsuccessful, particularly if the disease has been present for a longer time. For most patients, symptoms continue, and the disease worsens.

A natural health approach may be the better option, as in a rotation of herbal antimicrobials. The advantages are two-fold. There’s no chance of a resistance developing, the way it might with antibiotics. And there are no adverse side effects, such as the disturbance to your delicate microbiome that antibiotics use can cause.

Renowned natural health expert, Dr. Joseph Mercola, recommends taking a functional nutrition approach by using a number of herbs, foods, and other supplements to fight the Lyme infection, including astaxanthin, curcumin, krill oil, probiotics, resveratrol, grapefruit seed extract, and others.

Don’t underestimate the role of diet and functional nutrition when it comes to fighting Lyme disease. Naturopath and author of “The Lyme Diet: Nutritional Strategies for Healing from Lyme Disease”, Dr. Nicola McFadzean, has this to say on the subject:

“The role of nutrition is central not so much in the actual bug-killing, but in the underlying strength and resilience of your health. Immune support, inflammation management, hormone regulation, and detoxification functions can all be vitally influenced by your nutritional intake.”

If you’re concerned that you may have Lyme disease, the first step is to find a functional medicine practitioner who can properly diagnose and treat the disease.  Remember that with Lyme disease, time is critical. As is getting the proper treatment.

Call our office and learn about an affordable way to get care from Lyme-literate practitioners certified in integrative medicine and natural therapies with our Access Membership plan. Call today – (212)-696-HEAL(4325).

References:

http://cid.oxfordjournals.org/content/33/6/780.full

https://www.healthline.com/health/lyme-disease#symptoms

https://www.webmd.com/rheumatoid-arthritis/arthritis-lyme-disease

https://www.cdc.gov/lyme/index.html

https://www.healthline.com/health/lyme-disease-chronic-persistent

https://www.healthline.com/health/lyme-disease

https://www.sciencedaily.com/releases/2014/04/140402110029.htm

What is CIRS - Chronic Inflammatory Response Syndrome

How to Know if You Have Chronic Inflammatory Response Syndrome?

Illnesses caused by biotoxins are on the rise. Since I’ve begun testing my patients for Chronic Inflammatory Response Syndrome (CIRS) markers in my practice, I’m surprised at just how prevalent this condition is turning out to be.

Up to 25 percent of the population is thought to have the gene HLA, which makes them more susceptible to biotoxins. Though anyone can be impacted by biotoxins, these people are much more sensitive and therefore more likely to have symptoms strong enough to send them to the doctor.

Part of this apparent uptick in biotoxin illness is also due to the improvement in diagnostics. We are realizing the body’s reaction to mold, Lyme, and other biotoxins are unique in each person, which is partly why strategies for identifying and correcting these problems have remained largely underdeveloped until recently.

If you’ve been struggling with chronic health issues, you may want to consider getting yourself checked for Chronic Inflammatory Response Syndrome.

What is CIRS?

So what is CIRS? Chronic Inflammatory Response Syndrome or CIRS is a condition with a wide range of symptoms which are triggered by a biotoxin – usually mold. The term CIRS was coined by Dr. Ritchie Shoemaker to describe when a body’s immune system is out of whack. In some people this could mean the immune system is simply weakened, while in others it’s running rampant.

You can also get CIRS from common chronic sinus infections with MARCONS and tick borne illnesses like Lyme disease ticks, fish that’s been contaminated with ciguatera, and infections from a brown recluse spider bite. Essentially, CIRS is a dysfunctional reaction of the body’s immune system in response to a biotoxin. In my practice, I’ve seen the symptoms range from manageable to debilitating.

The different markers that we can test for, and the differences in how symptoms present, make CIRS a difficult condition to diagnose. Though diagnostics are improving, there still needs to be a cluster of symptoms and an improvement in treatment response for a CIRS diagnosis to be made.

Unfortunately, it’s not unusual for a person with CIRS to go years, even decades, without a proper diagnosis. However, if we can pool our knowledge and spread the word about the differences in this condition, I believe we can make a major difference in awareness and treatment of CIRS. This is part of the reason I’ve begun testing most of my patients for biotoxins and CIRS markers.

Waiting For A Diagnosis Might Not Be The Answer

There are numerous symptoms of CIRS, different biomarkers, and the toxins also differ. This complicates the diagnostic process and is part of the reason CIRS has gone largely ignored by conventional medicine. But just because an illness is complex and not fully understood, it doesn’t mean we should shy away from helping people heal – we just need to adjust our approach accordingly.

Testing and treatment often have to happen side by side when tackling CIRS. Sometimes the response to different treatments actually help in achieving a complete diagnosis. Symptoms, biomarkers, and testing must be used to correctly diagnose CIRS.

Some common symptoms of CIRS include:

  • Cognitive difficulties such as brain fog and trouble concentrating
  • Fatigue and weakness or chronic fatigue syndrome
  • Unexplained weight gain
  • Frequent urination, excessive thirst, dehydration
  • Fibromyalgia
  • Visual insensitivity
  • Post nasal drip and sore throat
  • Numbness and tingling
  • Digestive issues
  • Mood swings
  • Tinnitus
  • Static shocks
  • Vertigo
  • Metallic taste in mouth

If you have some of the symptoms associated with CIRS, you should make an appointment with a doctor who is experienced in dealing with this condition. If you’re in need of a New York certified functional medicine doctor, you can request a consultation here.

Testing for Chronic Inflammatory Response Syndrome Due to Mold

Some of the biomarkers for the different underlying causes of CIRS overlap, some are different. These are some of the biomarkers seen in mold patients which have been the most common forms of CIRS I’ve found in my practice.

CIRS due to mold exposure has a couple of characteristic markers, including high levels of

  • C4a – An activation protein that can cause inflammation, free radical production, and damage to tissues if too high.
  • TGF–beta1 – A cytokine in the immune system that has both anti– and proinflammatory effects.
  • MMP–9 – An enzyme that helps with tissue repair and is a significant marker of CIRS.
  • ACTH / Cortisol – A hormone that can be elevated and lead to weight gain in CIRS patients.
  • VEGF – A protein that causes blood vessel formation.

CIRS due to mold exposure is characterized by low levels of:

  • MSH – A hormone that is anti-inflammatory and typically low in CIRS patients.
  • ADH – This hormone regulates the amount of water your body removes and is associated with dehydration, frequent urination, and excessive thirst.
  • VIP – A neuroregulatory hormone that is associated with inflammation
  • Visual contrast ability – You can take the VCS test, which is simple and can be done at home.

There are several tests that can help you identify if mold is the cause of your inflammation, and therefore your symptoms. These tests are useful If you suspect you have CIRS, I recommend the following:

  • The Visual Contrast Sensitivity (VCS) test checks for neuroinflammation, which is often caused by mold exposure. The VCS test checks your ability to see differences in colors, a common symptom of CIRS. It’s also only $10 and can be done at home, so it’s a good place to start.
  • There is a Mold CIRS Panel laboratory markers that you can test in the conventional laboratory. This panel tests for MMP9, TGF-beta1, MSH, ADH, and osmolality.

If you believe your symptoms might be caused by chronic inflammatory response syndrome, it’s so important that you make an appointment with a doctor familiar with this condition. I can’t tell you the number of times I‘ve seen patients who have gone from doctor to doctor trying to find the cause of their symptoms.

When CIRS is the suspected culprit of your symptoms, there are a number of things that can be done right away to ease your struggles. Intervention and remedies like eating specialized diets, taking supplements that support natural detoxification, sauna therapy, and mold remediation can help those with CIRS.

If you are in need of a New York functional medicine doctor who is experienced in CIRS, you can request a consultation here. Don’t wait until this condition becomes worse, you can begin the path to relief today.

Resources:

http://www.survivingmold.com/news/2014/12/what-is-cirs/
https://selfhacked.com/blog/dr-ritchie-shoemaker-pioneer-in-cirs-mold-with-guest-host-dana-howell/#Dr_ShoemakersBiotoxin_Discovery
http://www.survivingmold.com/diagnosis/lab-tests
https://www.vcstest.com/

 

Diagnosing CIRS: Your Complete Guide to Testing

Diagnosing CIRS: Your Complete Guide to Testing

CIRS or Chronic Inflammatory Response Syndrome is really an umbrella term for symptoms with a few different causes. It can be caused by tick borne illnesses, mold exposure, and more. Characterized by extreme exhaustion, weakness, and cognitive difficulties, CIRS is a debilitating condition that’s inherently complex.

The nature of CIRS makes it difficult to diagnose. Sometimes patients go years, even decades before a full diagnosis is made. Fortunately, our understanding of this disease and its diagnostic testing has gotten much better.

I’ve found that because the functional medicine approach examines the body as a whole, it’s better at diagnosing complex conditions such as CIRS. In my article How to Know if You Have Chronic Inflammatory Response Syndrome, I explored:

  • What is Chronic Inflammatory Response Syndrome?
  • Why waiting for a diagnosis might not be the answer.
  • Testing for mold exposure.

If you need more of an introductory to CIRS, I recommend you start there. In this article, you will find a comprehensive approach to diagnostic testing for CIRS. This is a guide you can use before you see a doctor, to help you determine if you possibly have CIRS – and what testing you can ask your doctor for to achieve a proper diagnosis.

Do You Have CIRS? Testing Before The Doctor’s Office

Before you even make an appointment with your doctor there are a couple things you can do.

First, see how many symptoms you have in the CIRS symptoms clusters below. This system was developed by Dr. Ritchie Shoemaker through the analysis of thousands of patients. People with Chronic Inflammatory Response Syndrome will have symptoms in eight or more clusters.

For example, if you are experiencing night sweats that counts as a positive result for the entire cluster of symptoms in the red box on the right. Even if you don’t have red eyes, blurred vision, mood swings or ice pick pain, because you’re experiencing night sweats that counts as a positive result for the entire cluster. You only need one symptom in a cluster for it to count. You may have symptoms that aren’t on this chart, but if you have CIRS you’ll have at least eight symptom clusters. You can see how many clusters you have right now.

Diagnosing CIRS: Your Complete Guide to Testing

Next, you can take the Multiple Systemic Infectious Diseases Syndrome (MSIDS) Horowitz questionnaire. This questionnaire allows you to assign 0-3 in severity on a number of symptoms that are commonly associated with CIRS that’s been triggered by Lyme disease. At the end, you’ll have a total score which will tell you how likely it is you have a tick-borne illness.

Finally, you can take a Visual Contrast Sensitivity (VCS) test. This is a simple test that costs $10. It checks your ability to distinguish between very similar colors. Those with CIRS often are unable to differentiate between similar shades due to neuroinflammation.

If any of these tests result in a trip to the doctor’s office, be sure to bring your results with you to your appointment. These tools are excellent resources for beginning your CIRS diagnosis.

Testing for CIRS

Remember, because there are numerous underlying causes of CIRS, there are also various tactics in tackling these diagnostics. You’ll need to go through these with a doctor who’s experienced in chronic conditions. You might not need every single test listed here. Your symptoms will tell your doctor where to start.

Testing should include:

  • Mycotoxin testing – These tests can identify biotoxins in your blood created by mold.
  • Human Leukocyte Antigen (HLA) genetic test – An estimated 25 percent of the population have a genetic variation that makes their immune system bad at identifying and ridding the body of biotoxins. Sometimes when mold is an issue in a home,  the rest of the family only notices the problem after a person with the HLA gene becomes sick.
  • MARCoNS – Multiple Antibiotic Resistant Coagulase Negative Staphylococci (MARCoNS) live inside the nasal cavity. These can contribute to CIRS and need to be identified and treated.    
  • Mold CIRS Panel of laboratory markers. This panel tests for MMP9, TGF-beta1, MSH, ADH, and osmolality.

The following are biomarkers commonly associated with CIRS and should be tested:

  • Vasoactive Intestinal Polypeptide (VIP) – Normal range is 23-63 pg/mL. CIRS patients usually have lower levels.
  • Melanocyte Stimulating Hormone (MSH) – Normal range is 35-81 pg/mL. CIRS patients usually have lower levels.
  • Transforming Growth Factor Beta–1 (TGF Beta-1) – Normal range is <2380 pg/ml.
  • C4a – Normal range is 0-2830 ng/ml.
  • Antigliadin (AGA IgA/IgG) – Normal range is 0-19.
  • Adrenocorticotropic hormone (ACTH)/Cortisol – Normal range is ACTH 8-37 pg/mL. Cortisol in the a.m. 4.3-22.4 and p.m. 3.1-16.7 ug/dL. CIRS patients usually have higher levels.
  • Vascular Endothelial Growth Factor (VEGF) – Normal range is 31-86 pg/mL. CIRS patients usually have lower levels.
  • Antidiuretic hormone (ADH)/Osmolality – Normal range is ADH 1-13.3 pg/ml and Osmolality 280-300 mosmol.
  • Matrix Metallopeptidase 9 (MMP-9) – Normal range is 85-332 ng/mL.
  • Leptin – Normal range is 0.5-13.8 ng/mL for men and 1.1-27.5 ng/mL for women.

You should also have an Environmental Relative Moldiness Index (ERMI) test done. The ERMI test is a DNA-based test that’s used to identify specific species living in your home. This is beneficial because it helps identify potential mycotoxins that could be making you sick. Furthermore, it will help you know if you should have any mold remediation done in your home. Removing the cause of CIRS (in this case mold) from your life is the number one step in recovering your health.

Finding a Functional Medicine Doctor for CIRS

If you suspect you have Chronic Inflammatory Response Syndrome, it’s important you make an appointment with a functional medicine doctor who has experience in working with CIRS. If you don’t start with a doctor who’s knowledgeable in complex, chronic conditions it could end up costing you a lot more time, money, and energy down the road.

When potential CIRS patients come to me, not only do we begin diagnostics to completely identify the condition, we also start taking steps to alleviate the symptoms. Together we come up with a treatment plan that reduces any exposures, heals any outstanding infections, reduces inflammation, and supports natural detoxification.

As a certified New York functional medicine doctor with CIRS experience, I’ve helped thousands of patients get their life back from chronic, debilitating conditions. If you are struggling with your health, you don’t have to go through this alone – you can request an appointment here or call 212-696-HEAL (4325). When you catch chronic conditions early, the treatment is often easier, faster, and cheaper – don’t wait any longer, start today.

Resources:

http://www.lymeactionnetwork.org/wp-content/uploads/2015/06/MSIDS.pdf
https://www.vcstest.com/
http://www.survivingmold.com/diagnosis/lab-tests