Tuesday, January 8, 2013

The Great Chronic Lyme Mirage – Herx Edition

Halperin / ALDF:
… Early work indicated that patients with acute, active early Lyme disease, as indicated by the presence of an erythema migrans (EM) skin lesion (when large numbers of spirochaetes are presumably present), sometimes exhibited a Jarisch–Herxheimer-like reaction within 24 h after initiation of treatment (Weber et al., 1988; Maloy et al., 1998).

This led to the notion that any worsening of symptoms during treatment constituted ‘Herxing’, regardless of the duration of symptoms or treatment at the time of the worsening.

The logical in-consistency of postulating that treatment-resistant disease was due to a small number of undetectable bacteria, while at the same time concluding that symptoms arising or worsening during antibiotic therapy were due to the release of large amounts of pharmacologically active bacterial products, was either discounted or never considered.

However, this then completed the very tidy but circular conceptual model.

If patients improved, even transiently, after treatment, this validated the diagnosis and justified further treatment; the possibility of a placebo effect or natural fluctuation in symptom severity was either never considered or completely rejected.

If patients worsened, this was considered to be due to a Jarisch–Herxheimer reaction, similarly validating the diagnosis.

If there were no response to therapy, this validated the assumption that this infection is highly resistant to standard antimicrobial therapy. …
The more I see of these "LLMD" quacks, the more I am sure that "Chronic Lyme" is a quack diagnosis.

The people who are misdiagnosed with "Chronic Lyme" have a disease, no question – and in most if not all cases it is an organic disease – but I am rather sure that it is not a active/persistent/latent ("chronic") lyme infection.

At the same time I believe that a very very small number of people who are misdiagnosed with "Chronic Lyme" might have "Post Lyme", where the bug is gone but the organic damage stays, same as there are Postviral Fatigue Syndromes and other postviral CFS-like diseases.

However, I am certain that no "LLMD" quack would be able to differentiate Post Lyme from Post Mono. These LLMDs see a patient and can only diagnose "Chronic Lyme", it seems …

As Tom Waits once sang:
LLMD always try so hard to look like real doctors
They couldn't catch a cold,
baby don't waste what's left of your health
So unless you have an acute infection and take short term antibiotics for it (for a couple of weeks) stay the hell away from antibiotics if they are given long-term, especially when they give you a long time supposed "Herx" reaction – because a "long-time Herx reaction" is not Herxheimer (due to Lyme "die off"), but the side-effects of antibiotics that are destroying your health.

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