Lyme Disease Diagnosis is Clinical, Not Laboratory Based

tickI see it time and time again. “My doctor said my Lyme antibody test was negative, so my symptoms can’t be due to Lyme disease.” This is unfortunate, because many people in this area are becoming infected with Lyme disease, without being properly diagnosed. Even worse, they give up searching for answers, because their doctors tell them everything is “normal”, allowing Lyme disease to progress into the more chronic stages, potentially causing serious, irreversible health consequences.

On their website, the Centers for Disease Control and Prevention (CDC) state that “Lyme disease is diagnosed based on signs and symptoms” and “a history of possible exposure to blacklegged ticks”.  They go on to say that “laboratory blood tests are helpful if used correctly . . .”  In my experience, most doctors don’t appear to be following these recommendations.  In fact, they seem to be completely ignoring symptoms and history, relying solely on laboratory evaluation.  Another problem is the reliance upon the characteristic “bull’s eye” rash, or the history of a known tick bite.  Have you ever seen how small a deer tick is in size?  The likelihood of knowing you’ve ever been bitten is quite low.  Plus, a 2010 study in the Journal of Emergency Medicine found that only a minority of cases (as little as 9%) exhibited the classic “bull’s eye” rash!  No wonder we’re dropping the ball when it comes to diagnosing this debilitating disease!  Adding to the confusion is the classic example of people visiting so-called Lyme “specialists” who will perform spinal taps or PCR tests on patients, telling them that a negative test is definitive for not having Lyme disease.  Quite frankly, these tests are like looking for a needle in a haystack.  The organisms responsible for Lyme burrow deeply into tissues, so the likelihood of identifying them in serum or cerebrospinal fluid is slim at best.

This doesn’t even take into account the co-infections that go along with Lyme disease, which can cause their own set of symptoms independently.  As a medical community, we need to put politics aside, and start paying more attention to what our patients are telling us.  Of course, you’ll have the occasional patient who swears that everything wrong with them is the result of Lyme, when it’s really not, but let’s not let that ruin for the people who truly are suffering from this disease!

We live in an area where Lyme is endemic, yet the number of healthcare providers who tend to recognize and treat this disease without relying solely on laboratory criteria are few and far between.  If you believe that you’ve been affected by Lyme or related tick-borne infections, don’t let doctors convince you that “everything is normal.”  Seek out a practitioner who has experience with diagnosing and treating this potentially chronic condition, as the sooner you can get help, the better!

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