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Lyme Disease Symptoms in Cats
Veterinarians have known for years that dogs get full-blown Lyme at least as often as humans do, and are well aware of the canine Lyme Disease symptoms they need to look for. Cats are a horse of different color (so to speak). Until recently, most vets didn't take the possibility of feline Lyme Disease seriously.
But recent discoveries (partly driven by sharp-eyed human sufferers of the disease) have opened their eyes to the reality of Lyme Disease in cats, and vets have developed the appropriate diagnostic and treatment protocols. Let's take a look at those.
While the worse Lyme Disease symptoms most often present in humans and dogs, cats can be hard-hit as well.
The Basic Symptomology
Sometimes, Lyme Disease seems like a plague intended to strike at the heart of humanity. Not only does it infect human beings, it also strikes our most beloved companion animals: dogs and cats. And interestingly, the symptoms are quite similar in all three species.
Lyme arthritis is a huge problem in cats, causing lameness and often becoming so acute that even picking up an affected cat causes excruciating pain. If your cat suffers from unexplained joint pain and swelling, consider the possibility of Lyme.
There are blood tests that can confirm such a diagnosis, so don't hesitate to ask your vet to conduct one, especially if you live in an area where LD is common in any form. Vets tend to be more willing to do Lyme tests on animals than medical doctors are to do them on humans.
As in dogs and (to some extent) humans, cats infected with LD may also present with swollen lymph nodes, fever, and lethargy, as well as loss of appetite and dehydration. A common symptom they share with dogs is unexplained kidney disease or failure.
It's harder to recognize neurological insults in cats than in humans or even dogs, since humans can directly communicate confusion, and loss of cognitive ability (to do tricks, for example) is more easily observable in dogs. However, loss of motor skills not caused by arthritis may also indicate neurological damage.
What's more, feline LD can cause heart problems, and breathing may become labored or odd-sounding in affected cats. Many cats also develop severe eye infections when the Borrelia spirochetes infect the vitreous and aqueous humors, as well as the corneas.
Causes and Prevention
Deer ticks cause LD in cats, just as they do in humans and dogs. There may be other potential vectors of the illness, but thus far the research remains limited on that front. Clearly, outdoor cats can easily pick up infected ticks from the great outdoors.
Needless to say, you should remove any ticks you find on your cat as soon as possible; infection can occur very rapidly. A good way to avoid tick bites altogether is to apply a topical flea and tick killer like Frontline. A good flea and tick collar can't hurt, either; nor can regular baths with tick shampoo.
Finally, there are LD vaccinations for cats, just as there are for dogs. We recommend that you look into them if you live in a Lyme-ridden area.
If your cat comes down with LD anyway, realize that most feline LD infections are mild, and can easily be cured. A four-week course of doxycycline or amoxicillin, which can be added to your kitty's food, is usually enough to kill the infection.
In some cases, more intense treatment is necessary; but be aware that there's only so much that your vet can do if your cat has chronic Lyme. So it's best to move as quickly as you can if your cat begins showing obvious Lyme Disease symptoms.
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An Introduction to the Tests Used for Lyme Disease Diagnosis
Doctors use three primary tests to confirm a Lyme Disease diagnosis.
One of the reasons that it's so difficult to get a Lyme Disease diagnosis, at least in the United States, is because most doctors require positive results from blood and serum tests in the absence of an erythema migrans (EM) rash -- the single diagnostic symptom accepted by almost everyone.
There are three common tests for LD: ELISA, Western Blot, and PCR. All look for evidence of Borrelia spirochetes in the bloodstream, though the type of evidence varies from test to test. All three tests have their issues, which we'll explore briefly in this article.
The ELISA Test
ELISA is an acronym for Enzyme-Linked Immunosorbent Assay, which is more of a category than an individual test. Doctors also use ELISAs to identify HIV and other immunodeficiency ailments. The LD version is only a first-round check for infection, and it's not a good idea to use it as the sole basis for diagnosis.
Basically, an ELISA test looks for antibodies that your system creates to fight the LD spirochetes. Unfortunately, this test tends to return a lot of false positives, and doesn't always detect Borrelia antibodies even when they're present. Also, the low levels of antibodies present early in the disease makes it less useful then.
A Western Blot test should follow any Lyme ELISA test, positive or negative, if the patient remains symptomatic. However, many doctors refuse to go forward with LD testing if an ELISA comes back negative, despite the well-known problems with the test.
The Western Blot Test
Like ELISA, the Western Blot searches for Borrelia-related antibodies; in this case, those antibodies are specific to certain proteins. Most doctors consider an individual who tests positive on the Western Blot as well as the ELISA to have full-fledged LD, and will treat accordingly.
This testing method produces a series of bands on a strip of paper, like the lines on a barcode, which correspond to specific antibody strains. As mentioned earlier, the Western Blot also has significant problems, partly based on the definition of which bands comprise a positive result.
The current standardized guidelines, signed off on by the Centers for Disease Control, are very controversial. They ignore some antibody bands altogether, while dismissing others as minor.
Indeed, the current guidelines often categorize people who lack the proper bands as uninfected, even if other symptoms prove otherwise. Some doctors will even ignore an obvious EM rash if the Western Blot comes back negative.
The PCR Test
PCR is short for "polymerase chain reaction." This test actually finds pieces of spirochetal DNA, if they're present, and makes enough copies to proper test them. A PCR test can work even with very low levels of infection, and often comes back positive even when ELISA and Western Blot are negative.
The problem here is that the PCR test works best with fluids drawn from an infected joint or spine; it doesn't work well at all with blood or even urine. In other words, by the time you get a PCR test, the LD is usually well advanced and more difficult to treat.
And even the PCR test doesn't work well when DNA levels are very low in joint or cerebrospinal fluids, which can occur when the spirochetes have either burrowed into hard tissues or have encysted themselves.
That said, the PCR method is currently the most accurate test for confirming a Lyme Disease diagnosis, at least within its limited purview.
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Lyme Disease Symptoms: The Psychological Effects, Part I
Most of us in the LD community are aware of neuroborreliosis, which causes many of the most frightening Lyme Disease symptoms. This syndrome occurs when Borrelia spirochetes -- or at least their neurotoxins -- get through the normal system defenses to infect the central nervous system, including the brain.
Full-blown neuroborreliosis results in physical damage that can cause everything from insomnia to Bell's Palsy to loss of the ability to speak or concentrate -- and so much more. It can even cause severe personality changes, as I'll describe in Part II of this article.
But before we get to that point, I'd like to talk about something that's less damaging physically, but can be just as painful emotionally: the psychological effects that just knowing, or even suspecting, that you have LD can cause... even before neuroborreliosis strikes.
There's no doubt that LD has reached epidemic proportions in the United States. It's hard to say whether this is because more people are getting new cases as we allow our deer populations (and thus deer tick populations) to grow out of control, or because doctors are simply more likely to recognize LD for what it is.
It seems likely that both factors have contributed to the consistent rise in LD cases through the years.
The lay public -- that's you and me -- now has more access to information on LD than ever before, given the widespread availability of the Internet. That's a good thing, in most senses; but it can have bad effects.
It's a sad fact that not everyone responds to LD treatment, whether of the traditional or unconventional kinds. Needless to say, the sickest patients are the most likely to reach out for help on message boards, forums, and websites, describing their suite of symptoms and how LD has destroyed their lives.
This is not to belittle their pain. Lyme is a horrible disease, and by no means is it always curable. But there is hope.
But those recently diagnosed with Lyme often see the horror stories over and over, and something like that can make you think that's all there is to treatment -- that you're doomed to a life of pain and illness. This is not necessarily the case!
Beyond the purely physical Lyme Disease symptoms, the disease can have terrible effects on the mind... in several different ways.
The Reality of Lyme
Most people do respond to LD treatment, at least to some extent; many recover completely after a short course of antibiotics. It's true that in some cases LD may relapse, but repeated treatment (especially the aggressive kind performed by Lyme literate doctors) may kill the infection for good.
This may be one reason that some doctors are so vehement in their denial that any further symptoms aren't attributable to LD at all -- and that chronic Lyme doesn't exist as such.
Be that as it may, don't let the bad news depress you; you'll never beat Lyme if you give up before you start. Too much worry that you're one of the rare incurable individuals will just make everything worse and more difficult to handle.
So please: if you have Lyme Disease, try to stay optimistic. That's one of the best ways to beat the disease!
Beyond Mere Worry
Optimism can be strong medicine, but you must also realize that chronic Lyme can have measurable organic effects on your personality, if allowed to worsen to neuroborreliosis.
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Lyme Disease Symptoms: The Psychological Effects, Part II
Psychological Lyme Disease symptoms are sadly common, and can have two different bases: emotional distress and actual damage due to neuroborreliosis.
The former can lead to despair and depression, often fed by the disturbing true stories of those who've faced difficult courses of treatment, as outlined in Part I of this article. In this installment, we'll take a look at the personality changes sometimes associated with Lyme cases that advance to neuroborreliosis.
A Depressing Reality
You may be aware that Lyme Disease has reached epidemic proportions in recent years. While it’s hard to say exactly why, evidence points toward two culprits, as outlined in Part I.
First of all, greater acceptance and recognition of the disease on the part of doctors and medical researchers has likely played a huge role in ripping the mask off this "Great Pretender" disease. Second, an increase in deer populations in the U.S. is exposing more and more people to the ticks that carry Lyme.
A Surprising Statistic
Did you know that in Europe, psychiatric in-patients are twice as likely to test positive for Lyme Disease as the general public? Other studies have also revealed severe personality disorders that may be associated with the illness.
We already know that Lyme Disease infections that invade the central nervous system, becoming neuroborreliosis, can cause learning disabilities, mood swings, sudden rage, obsessive behavior, and other organic neurological affects not attributable to emotional disturbances.
On a lesser but still damaging scale, lack of impulse control, loss of concentration, forgetfulness, and an inability to process information are also common side effects of neuroborreliosis infections. Microedemas, tiny swellings in the brain tissue, may cause some of these problems.
All that's frightening enough... but there's also evidence that the damage caused by neuroborreliosis can lead to other mental ailments that the influential psychiatric sourcebook, the Diagnostic & Statistical Manual, defines as discrete conditions, including bipolar (manic depressive) disorder and schizophrenia.
Researchers are also beginning to suspect that neuroborreliosis may be the root cause of many other psychiatric illnesses, from Attention Deficit/Hyperactivity Disorder (ADHD) to obsessive compulsive disorder to an extreme sensitivity to sound or light.
And as we've outlined in other articles on this site, a number of researchers have even implicated Lyme in various forms of degenerative neurological diseases and dementia, including Lou Gehrig's Disease, multiple sclerosis, and Alzheimer's Disease.
None of the evidence for these claims is conclusive at the moment, but it's certainly compelling.
Recognizing Lyme's Effects
Personality changes can represent the most frightening of Lyme Disease symptoms.
Changes in personality that we know to be associated with Lyme can result in everything from minor financial troubles to family dysfunction, increased levels of marital strife, and domestic violence. So we recommend that you be very wary of, and very responsive to, any personality changes you observe if you have Lyme.
Even if you don't have a Lyme diagnosis, but have never had a history of these psychological problems before, you should have yourself tested for Lyme Disease by a sympathetic doctor—especially if you live in an area where the disease is endemic. Don't take chances!
The testing is worth the cost and effort, especially if you experience other telltale symptoms: fatigue, muscle and joint pain, headache, fever, and especially the bull's-eye rash. If nothing else, you can eliminate Lyme Disease symptoms as a possibility, and start working toward a more accurate diagnosis.
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Two Uncommon Lyme Disease Symptoms You Should Recognize
While few Lyme Disease symptoms are as slam-dunk diagnostic as an erythema migrans (EM) rash, there are a couple that should tip any doctor off when they appear: acrodermatitis chronica atrophicans (or ACA), which was one of the earliest recognized symptoms in Europe, and borrelial lymphocytoma (BL).
Like EM, both issues affect the skin, though the results are quite different. Now, admittedly, these particular Lyme symptoms mostly appear in European patients; but that's not always the case. And besides, it's not impossible to acquire LD during a European visit, so it's worth knowing the symptomology.
In addition to the infamous Borrelia burgdorferi spirochetes that cause almost all American Lyme Disease cases (as well as many in Europe and elsewhere), the Borrelia genus includes about three dozen other member species, at least 11 of which cause LD in some form or another.
The species implicated in causing both ACA and BL is almost exclusively B. afzerii, though B. garinii may also be involved, and it's possible that other Borrelia species can contribute to both conditions as well.
A number of European physicians described ACA in the medical literature as early as the 1880s. It's a chronic Lyme symptom, presenting first as a bluish-red discoloration and swelling that persists for months. It causes the skin to permanently wrinkle as it progresses.
ACA is most common in the elderly. Infected skin comes to resemble thin, crumpled tissue or cigarette paper. The skin basically wastes away as the disease progresses, becoming dry and hairless, and often developing stiff (sclerotic) plaques in which connective tissue replaces the dermis.
Usually, ACA first appears on the backs of the hands or feet, although it can appear elsewhere and may spread to other parts of the body if left untreated. In extreme cases, the patient loses some mobility in their joints. ACA may also affect the peripheral nervous system, causing nerves to misfire painfully.
ACA requires treatment with intravenous antibiotics such as ceftriaxone, cefotaxime, or penicillin G for 12-28 days.
This condition results in the appearance of an ugly red or purplish lump somewhere on the body, most often on a sensitive area such as the earlobe, scrotum, or nipple. The condition is benign, in that it causes no direct damage to the body, unlike ACA.
BL is a form of cutaneous lymphoid hyperplasia, of which there are several types; most are not indicative of a Borrelia infection. However, if you suspect you have LD, you should take the sudden appearance of a lymphocytoma very seriously. It certainly warrants further testing.
A quick response may, in fact, be sufficient to destroy the actual Borrelia infection, since BL appears during the early disseminated stage of Lyme Disease. Most Lyme-literate doctors treat BL with an ordinary course of an antibiotic such as doxycycline.
Are You At Risk?
The Borrelia genus includes about three dozen other member species, at least 11 of which cause lyme disease symptoms in some form or another.
Yes, though the risk may be minimal. American strains of Borrelia usually don't produce either ACA or BL as symptoms; however, you should never forget that Lyme is an international disease.
Not only is LD also common in Europe (where medical science first recognized it, actually), it's starting to appear in Australia and elsewhere. The explanation for that is simple: when we humans shuffle ourselves and our goods around the globe, we take our pests and diseases with us.
Borrelia burgdorferi is already beginning to appear more often in Europe, possibly because of the accidental importation of infected ticks. B. afzerii and B. garinii may very well someday hitch a ride here and start spreading... in which case these unusual Lyme Disease symptoms won't be unusual anymore.
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The Bitter Reality of Lyme Disease Coinfections
Researchers have discovered that coinfection rates for Lyme and its companion diseases can be quite high in ticks.
There was a time when many researchers just didn't believe in Lyme Disease coinfections -- not too surprising, given how politically charged and hidebound this medical subspecialty can be. It's not that these people can't learn; it's just that they constantly underestimate LD and everything about it.
Most medical methods require a simplified definition of a disease and its symptoms, so researchers can create vaccines and draft easily-followed treatment guidelines. Lyme doesn't play fair that way, and some researchers find that hard to accept...so the coinfection reality has been a real blow to them.
Nonetheless, most of the doctors working with LD now accept that other diseases often enter the bloodstream along with Lyme, deriving from the very same vector. They may not like it, because it makes their jobs even harder, but to ignore this reality is foolish.
Leaving aside all the other possible vectors of LD, common tick-borne coinfectuous diseases include babesiosis (probably the most common LD coinfection, and one of the first recognized), bartonellosis, anaplasmosis, ehrlichiosis, Q fever, Rocky Mountain Spotted Fever, and more.
Most of these coinfections are bacterial, though those bacteria tend to be rod- or sphere-shaped, rather than corkscrew-shaped like the Borrelia spirochetes that cause Lyme. Confections can also be protozoan or rickettsial -- that is, caused by types of microscopic parasites that aren't bacterial in nature.
A Huge Problem
Don't assume that Lyme coinfection is a problem only in America. It's common anywhere in the world where LD is a problem, especially in Europe, and physicians there tend to recognized it more readily.
In the U.S., Lyme-literate doctors are starting to recommend that in addition to LD, patients have themselves tested for babesiosis and ehrlichiosis at the very least; along with LD, these diseases form the so-called "Tick Triad." Bartonellosis is another disease of significant concern.
A protozoan causes babesiosis, while bacteria cause bartonellosis and ehrlichiosis. Ehrlichiosis occurs in two distinct varieties. And, of course, LD occurs in a wide variety of strains -- several of which can apparently occur at once in the same patient, as some doctors are just beginning to realize.
How Bad Is It?
Researchers have discovered that coinfection rates for Lyme and its companion diseases can be quite high in ticks. On average, as many as 26% of ticks infected with Borrelia may also be infected with Babesia protozoans. The Lyme/ehrlichiosis coinfection rate runs slightly less, at about 25%.
Rates are similar for bartonellosis and other common tick-borne diseases. But remember, these are averages; in some areas, the coinfection numbers can run much lower or much higher -- as high as 80%.
Here's the kicker: in some cases, ticks can carry more than two coinfections; three are common, hence the Tick Triad concept. If an infected tick bites you, you may end up with everything it's carrying, not just LD.
There's a possibility that other critters beside ticks may carry LD and its coinfections. Recent evidence suggests that biting flies and mosquitoes are good candidates... despite the fact that many researchers are finding it hard to accept that possibility.
Of course, they found it hard to accept the possibility of coinfections in the first place. That's understandable: coinfections complicate treatment immensely, since medications that might work for one microbe might not work for the other, and multiple medications can conflict and cause dangerous interactions.
That said, the growing acceptance of Lyme disease coinfections in the medical field is a brightening light in the darkness -- because like so many other recent breakthroughs in our understanding of Lyme, it offers tremendous hope for future treatment.
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Chronic Lyme Disease Symptoms: A Focus on Lyme Arthritis
Lyme arthritis is one of the most recognizable of the many chronic Lyme Disease symptoms. Age doesn't seem to matter, and neither does species: the arthritis occurs in children and adults alike, and in both humans and dogs -- the other species that bears the brunt of LD.
Let's take a closer look at this painful problem, from a purely human perspective.
Lyme arthritis is one of the most diagnostic LD symptoms, and was instrumental in identifying the disease in the first place.
Back in the 1970s, a Yale University group led by Dr. Allen Steere (who, ironically, is best known for his dismissal of chronic Lyme as a real medical problem) identified an unusual cluster of pediatric arthritis cases in the vicinity of Lyme, Connecticut.
Steere's group eventually recognized the disease as an American expression of a type of tick-borne meningoencephalitis (a swelling of the brain and brain lining) already known to occur in Europe. They named it Lyme Disease, after the town, and their research triggered a flurry of further work.
Eventually, Dr. Willy Burgdorfer, a Swiss-American scientist, isolated the causative agent that bears his name: the corkscrew-shaped bacterium known as Borrelia burgdorferi. But it all started with the arthritis.
Lyme Arthritis Defined
Lyme arthritis is very similar to standard osteoarthritis, and is sometimes mistaken for rheumatoid arthritis.
Lyme arthritis is very similar to standard osteoarthritis, and is sometimes mistaken for rheumatoid arthritis. It typically doesn't strike until the late disseminated stage of LD, when the patient has had the disease for months or years, and may occur even after the patient has undergone antibiotic treatment.
The result is a stiff, swollen joint -- often the knee, but not always. Sometimes the joint turns red, and there may be fluid build-up. The episode is usually brief, and limited to one joint; occasionally it occurs in corresponding joints on both sides of the body, but this is rare. It may also switch sides suddenly.
In addition to the knees, the hips, ankles, elbows, and wrists can also by stricken by Lyme arthritis. The arthritis comes and goes, sometimes accompanied by a fever. If left untreated, the infection can permanently damage the joint cartilage.
What's Happening Here?
Most physicians agree that Lyme arthritis results when Borrelia spirochetes enter the cartilaginous tissue of a joint. With their tough corkscrew shape, they're uniquely suited to bore into the cartilage. The resulting inflammation (as with other symptoms) is most due to the toxic waste products they produce.
Some doctors blame the arthritis on autoimmune reactions in the post-infection phase, especially when it occurs after standard antibiotic treatment. As discussed in an earlier article, a Borrelia infection may be able to short circuit the body's immune system so that it later attacks its own cells, thinking they're Borrelia.
That said, some researchers have photographed Borrelia spirochetes in cartilage cells, and others have cultured them from cartilaginous tissues.
What's the Treatment?
Lyme arthritis usually responds well to aggressive antibiotic treatment. In most cases, oral antibiotics, especially doxycycline, are sufficient. In extreme cases, you may need an intravenous course of ceftriaxone or penicillin to effectively treat the infection.
For the pain, expect to receive prescription non-steroidal inflammatory drugs (NSAIDs) such as Tylenol, backed up with ibuprofen and aspirin. Other palliative treatments may include a draining of joint fluid called a "joint aspiration," and even the surgical removal of the inflamed joint lining.
Lyme arthritis episodes typically pass within a few weeks -- but don't expect the arthritis to go away completely until you completely kick your LD infection. As one of the chief chronic Lyme Disease symptoms, it's not going to give up without a heck of a fight.
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Cat's Claw, A Potent Natural Lyme Disease Treatment
Cat's claw is a popular natural Lyme Disease treatment.
For those who are either averse to standard Lyme Disease treatment or have enjoyed no relief from such treatment, cat's claw offers hope. This all-natural medication is a core component of many natural treatments, along with herbs like Japanese knotweed and andrographis.
Please note that cat's claw currently has no conventional medical standing as a Lyme treatment. But herbal practitioners swear by it, so it's worth educating yourself on the possibilities it offers.
A Little Background
Uncaria tomentosa (cat's claw, uña de gato, or vilcarora) is a vine with nasty claw-shaped thorns that grows in Central and South American jungles. It produces a variety of alkaloids, some of which have anti-inflammatory and antioxidant properties.
Native Americans used cat's claw to treat a wide variety of ailments, including dengue fever, acne, diabetes, and urinary tract infections. In modern medicine, it contributes to HIV drugs and memory enhancers. Herbal healers use it to treat chronic fatigue syndrome, diabetes, arthritis, and rheumatism in addition to LD.
Warnings About Cat's Claw
Some cat's claw plants produce pentacyclic alkaloids, which can strength the immune system. This is the vine's greatest value in LD treatment protocols.
Ironically, however, some cat's claw plants don't produce pentacyclic alkaloids at all; in fact, they produce chemicals that counteract the effects of said alkaloids, while slowing the heart and causing loss of physical coordination. These alkaloids can also have a sedative effect.
It's impossible to tell which plant produces which type of alkaloid without chemical testing, so we recommend that you purchase only cat's claw guaranteed to contain pentacyclic alkaloids. Otherwise, it can have no positive effect at all and, at high doses, may actually be damaging.
Also, be aware that cat's claw can cause allergic reactions in those allergic to related plants. Finally, there are other plants from Central and South America called cat's claw that are not related to this particular herb, and some can be toxic. Be absolutely certain that your cat's claw is Uncaria.
Cat's Claw and Lyme Disease
The inner bark of the Uncaria vine yields the alkaloids used to treat Lyme Disease. These alkaloids act primarily as an immune system stimulant, though as noted, there are also analgesic and anti-inflammatory effects.
According to supporters, cat's claw increases the CD57 white blood cell count. The CD57 cells are apparently the ones that target Borrelia spirochetes.
Herbal healers use cat's claw specifically for late stage and chronic Lyme symptoms, including Lyme arthritis, neuroborreliosis, and Lyme fatigue, particularly in patients whose symptoms have not responded to standard antibiotic treatment.
Although cat's claw isn't currently an accepted part of the standard medical protocol for LD, scientists have actually tested it in a study, and so it has attracted at least a little medical attention.
In the study in question, cat's claw did appear to ameliorate most LD symptoms in most of the 28 patients tested, and the researchers later discovered that 85% of the test subjects were negative for Borrelia infection.
However, the study was tiny and flawed, and even some natural healers view the results skeptically. Among other things, it turns out that the patients also resorted to a variety of other healing methods, and the researchers failed to specify the cat's claw dose administered. It's hard to determine how well it worked, if at all.
Despite the problems cited above, cat's claw does seem to offer a good, all-natural alternative to antibiotics. While we recommend that you try antibiotics first, since we know they can work, it can't hurt to keep cat's claw in the wings as an alternate or supplemental Lyme Disease treatment.
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The Lyme Wars
The Lyme-disease infection rate is growing. So is the battle over how to treat it.
KeywordsLyme Disease;Kaleigh Ahern;Ticks;Health;Saratoga Springs, New York;Alternative Medicine;Centers for Disease Control (C.D.C.)
Kaleigh Ahern was twelve years old when a tick bit her. She noticed it “perched” on her shoulder when she was taking a shower one morning. “I thought it was your average, everyday bug,” Ahern told me recently. But, when she tried to brush it off, the tick wouldn’t budge. “The legs wiggled but it was embedded in my skin. I freaked out and started screaming.” Kaleigh’s mother, Holly Ahern, came running and removed it. “I took the kid and the tick to the doctor,” she said. “I told him, Here is my kid, here is the tick, and there is the place where it was attached to her.” That was in 2002. The Aherns live near Saratoga Springs, New York, where Lyme disease has been endemic for years. The infection is transmitted by tick bites, so Ahern assumed that the doctor would prescribe a prophylactic dose of antibiotics. But he said that he wasn’t going to treat it. “If a rash develops or she starts to have flulike symptoms, bring her back,” he told her. At the time, Ahern, an associate professor of microbiology at SUNY Adirondack, didn’t know much about tick-borne illnesses. She took Kaleigh home and watched for the signature symptom of Lyme disease: a rash that begins with a bright-red bull’s-eye around the tick bite.
No rash developed, and Kaleigh was fine—strong enough to become an all-American swimmer both in high school and at Union College. There were times during high school when she felt mentally hazy and not quite right physically, which she attributed to allergies or a teen-age bout of mononucleosis. But at the end of her freshman year in college she found herself crippled by anxiety, depression, and insomnia. She was beset by searing headaches, her muscles often felt as though they were on fire, and her brain seemed wrapped in a dense fog. Kaleigh tested positive for Lyme disease. Like most physicians, her doctor followed the standard medical practice, endorsed by public-health officials throughout the United States, and prescribed a three-week course of antibiotics. “I was so happy to know what was wrong with me,” Kaleigh said. “For a while, I didn’t mind the pain.”
The drugs didn’t work, though. At her mother’s insistence, the doctor extended the prescription three more weeks, but Kaleigh only got sicker. This brought the Aherns to a clinical impasse. The Centers for Disease Control and Prevention has established highly specific criteria for the diagnosis of Lyme disease: an acknowledged tick bite, the appearance of a bull’s-eye rash, and, for those who don’t live in a region where Lyme is common, laboratory evidence of infection. Most people who fit the profile respond well to antibiotics, even months or years after the initial infection. Many Lyme specialists, however, believe that short-term antibiotic therapy may suppress symptoms but rarely cures the disease. Kaleigh switched doctors and began a course of antibiotics that lasted eight more months.
There was no change. Furthermore, there is no evidence that prolonged antibiotic therapy helps patients with Lyme disease, so insurance companies almost never pay for it. “I realized that my parents were shovelling thousands of dollars into these antibiotics,” she said. “After the oral approach failed, I was recommended to go onto I.V. treatment, but I had had enough.” Kaleigh’s condition had become so grave that she withdrew from school. “I would have episodes where I would just lie on the ground writhing. And my parents could do nothing but watch. I wish they had taken videos and put them online, so people would know.”
Kaleigh turned to alternative treatments often recommended by Lyme patients with similar experiences. She took herbs—turmeric and ginger, which are thought by some to strengthen the immune system—and she gave up gluten, grains, refined foods, and sugar. The goal was to reduce inflammation caused by her body’s production of insulin and to inhibit the growth of the bacterium that causes Lyme. She also began treatments with a Rife machine, an electromagnetic device invented in the nineteen-twenties which emits radio signals that, some researchers suggest, can destroy harmful bacteria. Although thousands of people are convinced that Rife therapy has helped them with Lyme and other diseases, little empirical evidence exists to demonstrate that it works. Nonetheless, Kaleigh began to feel better. She still has headaches and severe muscular pain at times, but she returned to Union a year ago and graduated this spring. She knows that her approach to Lyme disease is controversial and acknowledges that the improvements might be due to her dietary regimen or to Rife treatments or to a placebo effect. She doesn’t mind; after enduring such pain, she has found that fine points don’t matter.
Lyme disease is the most commonly reported tick-borne illness in the United States, and the incidence is growing rapidly. In 2009, the C.D.C. reported thirty-eight thousand cases, three times more than in 1991. Most researchers agree that the true number of infections is five to ten times higher. Although some of that increase is due to heightened awareness, transmission is rising in areas, like New England, where the disease is well established, and is spreading to regions as far south as Florida, through changes in climate and the movements of infected animals.
The disease is caused by the bacterium Borrelia burgdorferi. In the Northeast and the Midwest, B. burgdorferi is transmitted by the bite of a black-legged tick, Ixodes scapularis. (In the Western United States, a related tick, Ixodes pacificus, prevails, and in Europe the main vector is Ixodes ricinus.) Lyme was all but unknown until 1977, when Allen Steere, a rheumatologist at Yale, produced the first definitive account of the infection. The condition was initially thought to have been an outbreak of juvenile rheumatoid arthritis in and around Lyme, Connecticut. In 1982, Willy Burgdorfer, a medical entomologist at the National Institutes of Health’s Rocky Mountain Laboratories, determined that the infection was caused by the previously unknown spirochete borrelia. As is common in scientific practice, the bacterium was named for him: Borrelia burgdorferi.