Lyme disease: Myths, treatment and overtreatment
With summer hiking and camping in full swing, Lyme disease is more of a threat to our health. We've all heard that you need to check yourself for ticks after being in the woods in fear of developing Lyme disease. But the real facts about Lyme disease are hard to find, and some medical professionals are saying that Lyme disease is overdiagnosed and overtreated. We talked with Dr. Steven Soloway, board-certified rheumatologist in Vineland, New Jersey, about the myths, misdiagnoses and treatments for Lyme disease. Don’t go into the woods until you read this.
What is Lyme disease?
According to Dr. Soloway, Lyme disease is a tick-borne infectious disease caused by Borrelia burgdorferi, an organism that lives on deerticks and can be spread to humans from the bite of an infected tick.
Lyme disease: Lots of hype and contradictory info
Dr. Soloway warns that people who live in areas where Lyme disease is prevalent should do all they can to prevent getting tick bites. However, he believes there is too much hype about the disease and an overwhelming amount of contradictory information.
"For example, one study indicated that individuals have 25 percent chance of infection if they miss a tick, yet other research suggests the tick has to be attached to the skin for at least two days to transmit the Lyme bacteria," the doctor explains.
Most common Lyme disease myth
"The most common myth is that Lyme is a chronic illness," Dr. Soloway says. "When you hear someone use the phrase 'chronic Lyme disease' they are probably talking about a patient whose arthritis or other symptoms such as headache, fatigue, loss of sleep and joint pain are due to the Lyme infection that was properly treated. " The rheumatologist explains that true chronic Lyme's disease is a life-threatening neurologic illness.
Post-Lyme disease syndromes
Dr. Soloway says there are cases in which people end up with post-Lyme syndromes, which typically fall into two categories.
"People can develop post-Lyme synovitis, in which a patient develops arthritic symptoms after being properly treated for Lyme disease," the doctor explains. He says he treats these patients similarly to how he treats other patients with inflammatory arthritis, such as for rheumatoid arthritis.
Some patients develop post-Lyme fibromyalgia, where they suffer from persistent body aches, sleep loss and depression, according to Dr. Soloway. "Many patients with fibromyalgia feel better with antidepressants and sleep medicine," he adds.
Lyme disease often over-medicated
Dr. Soloway is concerned about the common practice of treating Lyme disease with long-term antibiotics. "The reality is that most patients should only receive a three-week course of oral antibiotics," he explains. "In rare later stage cases or in chronic arthritis, patients may require one or two months of antibiotics. There is no evidence based on data to support a long-term course of antibiotics."
Find a Lyme disease specialist for proper treatment
Physicians who don't specialize in Lyme disease may misdiagnose Lyme disease and prescribe an ineffective treatment. Dr. Soloway suggests, "Go to a specialist like a rheumatologist or infectious disease specialist who has experience in testing for and treating Lyme disease." He also explains that your specialist should conduct a Western blot test to confirm the infection.
If you're going out for a hike or plan to spend time in the woods, wear clothing that protects your skin -- but don't just rely on your clothing to keep you from getting bit. "The single most important thing someone can do is to check their body for ticks after being in an area where they may be present," says Dr. Soloway. "An infected tick must be on the body for 48 hours in order to transmit the infection; so early removal of ticks is essential to Lyme disease prevention. It is also important to use insect repellents with DEET prior to entering areas where ticks may be present."
How to remove a tick
Follow these steps to safely remove a tick.