Dr. Aaron Hartman argues Lyme disease is diagnosed clinically, not by blood test alone. Up to 7 million Americans may contract it yearly, far more than CDC reports. Standard tests miss cases, so he recommends sensitive immunoblot assays and symptom questionnaires, sharing stories of patients whose sciatica and Bell's palsy resolved with doxycycline.
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Why aren't you getting better? Your body's stuck. You're not healing. You're sensitive to a whole bunch of things: chemicals, perfumes, supplements, whatnot, foods. You can't eat a lot of things. What else could be going on? What could be overlooked that your body— why aren't you getting better? And I want to talk about the next thing in our series as we talk about this, which is Lyme disease. That's finally getting some headway in our country. I said actually for our podcast, I'm not sure when it'll be aired. But this past week, had a great conversation with Richard Horowitz, who's the top Lyme expert in the country. Has a new book coming out. Really interesting conversation. But potentially 7 million Americans getting Lyme disease every year. That is a crazy number to think about. The most recent number I looked at before having a conversation with him, he's a top researcher in this field in the country, was that from the CDC, maybe There are 30,000 or 40,000 new cases a year, but there are about 400,000 undiagnosed cases. So more acute, more new cases of Lyme disease in our country than breast cancer. Interesting statistic. Talking with Dr. Horowitz, and it's interesting, like, how do you diagnose Lyme disease? Because if you diagnose it only based on standard testing, then you're— yeah, it makes sense, you're going to underestimate, you know, the cases. If you get more advanced testing, you'll pick up more. But according to Infectious Disease Society of America, IDSA, Lyme disease is a clinical diagnosis, meaning you diagnose it based on symptoms, not based on lab testing. And all of a sudden, oh, okay, the infectious disease experts in America, not ILADS, which is international, but they say, hmm, it's clinically diagnosed. Okay, got that. You know, what could that mean? That means it's the summertime, you get the flu without respiratory symptoms. Yeah. Fever, body aches, pains, joint aches and pains. Summer flu in my book is Lyme until proven otherwise. You have migrating pain. There's only like six things that cause migrating pain: lupus, rheumatoid arthritis, gonorrhea, syphilis, and Lyme disease. So I don't see a whole lot of syphilis in my clinic. I do see a I don't see a lot of gonorrhea. I do see a fair amount of lupus and a fair amount of rheumatoid arthritis. But Lyme disease is what I see way more of. So all of a sudden. You know what's being overlooked that's making to these specialty doctors that's being overlooked, and that could be Lyme. And so when I see new patients with chronic fatigue, fibro, migrating pain, or just not getting better body aches, you know it's it's interesting how many of my fibro pain, my chronic fatigue, fibro patients are diagnosed with Lyme disease. But it's something if you're having weird autoimmune diseases, you know I'm one of my patients who um who's a veterinarian came to me one day with like. Really bad sciatica, foot drop. She'd already seen an orthopedic surgeon, and she was scheduled to get a disc surgery like six or eight weeks later. And for some reason, we have these we have an interesting conversation because I can't I don't know why I did Lyme testing on her, to be honest with you. There's something about it that just felt off. Something she said that I don't recall triggered me to do this testing, which is you know why having clinical having a a good clinical expertise, a good a good a good guesser maybe you know intuition. Dr. Jensky calls it his Spidey sense. But the ability to pick on something that you know in your gut or your subconscious that you don't necessarily know why you did it. But I did that testing, and she had horrible Lyme disease, and her sciatica and foot drop went away after four to six weeks of doxycycline. Crazy! I remember early in my career seeing a patient with with with Bell's palsy, which is you know it's a little nerve thing. Your face looks kind of like you have a stroke, but it's not. And she actually had Lyme disease, and it got better with With um with doxycycline again, so it's interesting how many weird things could be Lyme disease. And the testing we never do just the Western blot testing. I'm sorry, so we never do just antibody testing, which you're supposed to do the antibody testing if it's positive, then it reflexes to the Western blot. The problem is half of people later diagnosed have Lyme disease have a normal have a normal antibody test. So I'll go straight to the Western blot test with Quest over LabCorp. But even that's not the best test. The best testing in that field is probably an immunoblot with someplace like Igenex. And that is telling you, did your immune system get exposed to and respond to Lyme? Doesn't mean you have Lyme per se, but the reality is if someone comes to my body with a lot of weird things, a lot of weird symptoms, and it's— the testing is positive, it's probably Lyme disease. And then using Dr. Horowitz's IMSIDS, he's— it's actually a validated questionnaire that if you have over a certain score on it, That means you, based on symptoms, which is again what the Infectious Disease Society of America says, then you have Lyme disease. So again, you know, what are things that are often overlooked that could be the cause of lots of weird things? Why are you stuck? Why are you still sick? Think Lyme disease. Don't overlook it. It's getting more becoming more commonly known about these days, but it's been around forever. It's been around. You know, I'll you know tell patients how long has Lyme disease been around. You know, I think it's Itzu Itzi. It was like the cave ice man they found in. I think it was the Swiss Alps. Frozen there from 5,000 BC had the DNA of Lyme Borrelia in his body. So it's been around for 7,000 years, but it's getting worse. It's getting more common, getting more aggressive. That's a different conversation altogether. But if you're stuck, you're not getting better. Why are you still sick? It could be Lyme disease. Get checked out. And this and the basic testing can be done by any any provider in the country through your basic labs. But even if that's negative, you still you really probably should take a deeper dive and do. Do a hygienics or a better quality test because the typical labs overlook it. On a side note, recently I was working with a patient who comes to me from out of state and saw me, had hygienics done by someone, another provider, blatantly positive, came to see me to start treating it. Wasn't getting better because other things are going on, hence the purpose of our podcast series. She wanted— she got a second opinion from a different Lyme specialist who ordered a standard Quest lab on her, not standard. The white Western blot came back 100% negative. So I saw them back. I'm like, this is kind of weird. Like blatantly positive, blatantly negative. So I repeated the iGenics testing and still had you know seven or eight bands for Lyme. Point being is the standard testing trust providers trust your gut providers doctors nurse practitioners PAs watching this right now trust your gut intuition if it doesn't feel quite right. Do the MCIDS questionnaire if they have the symptoms that make them high risk. Again, Lyme disease is a clinical diagnosis. Do the more advanced testing. Don't ignore it because that's how we overlook and miss a lot of stuff. Yes, it is does cost money. Yes, it's not covered by insurance, but you just gotta use the right tools, the best tools available. Hopefully, this information is helpful, and we'll keep on going through why are you not getting better? Why are you stuck? What else might be going on? We'll talk about the what else next.
