Bacterial infections: Lyme disease and thyroid disease

By Cristiano Antonino Last updated Sep 13, 2023

Lyme disease is an infection caused by the spirochete bacterium – Borrelia burgdorferi – which is transmitted to people and animals through the bite of an infected deer tick, known as a black-legged tick

According to the Centres for Disease Control and Prevention (CDC), Lyme disease is the most common arthropod-borne illness in the United States.

Bacteria introduced by the tick bite travel through the bloodstream and settle in various tissues and organs.

Over time, it can cause significant symptoms.

The American Lyme Disease Foundation (ALDF) describes Lyme disease as a ‘multisystem inflammatory disease that affects the skin in its early, localised phase and spreads to the joints, nervous system and, to a lesser extent, other organ systems in its later, disseminated phases’.

Prevalence of Lyme disease

The US CDC states that age, gender and outdoor exposure are risk factors for those who get Lyme disease.

The disease is more common in boys under the age of 15 and men between the ages of 40 and 60, groups that are more likely to play outdoors and engage in outdoor activities.

“If you have been diagnosed with hypothyroidism but do not seem to respond to thyroid hormone replacement treatment, familiarise yourself with the signs and symptoms of Lyme disease.”

Symptoms of Lyme disease

Within the first month of exposure, Lyme disease symptoms can be similar to the onset of influenza, and include:

fever
Chills
Headaches
Fatigue
General pain
Swollen lymph nodes
Joint and muscle pain

The most characteristic symptom of Lyme disease, however, is a rash called erythema migrans

This rash usually has a characteristic bull’s-eye appearance around the site where the tick was bitten.

It is estimated that erythema migrans occurs in up to 80% of Lyme disease infections and may start as early as three days after the bite or as late as 30 days, but usually occurs within a week.

The rash is usually about 15 centimetres wide, but can be up to 20 centimetres wide or more.

It appears on any part of the body and usually lasts three to five weeks.

On dark skin, the rash may resemble a bruise.

In the first weeks and months after the initial tick bite, other symptoms may appear.

These include:

severe headaches
Neck stiffness
Further erythema migrans rash on other sites
arthritis, joint pain and swelling, often in the knees and other larger joints
Muscle pain
Paralysis or facial palsy, with drooping appearance and/or loss of facial muscle tone
Heart palpitations, irregular heartbeat
Periodic dizziness or shortness of breath
Inflammation of the brain and spinal cord
Nerve pain
Pain, numbness and tingling in the hands and feet
Brain fog and short-term memory problems
Changes in vision
Continuous fever
Severe tiredness
Months or even years after the initial tick bite, untreated Lyme disease can cause
severe headaches
Arthritis, with pain and swelling of joints
Heart abnormalities
Mental disorders, including depression
Cognitive and neurological disorders, such as confusion, short-term memory loss and severe brain fog
Numbness of the extremities

Diagnosis of the disease

New-onset Lyme disease is usually diagnosed based on symptoms, the presence of erythema migrans and possible exposure to infected ticks.

In addition, a blood test known as the ‘two-step’ process is recommended.

The US CDC describes this testing process in its guidelines: ‘Recommendations for Performing and Interpreting the Test from the Second National Conference on Serological Diagnosis of Lyme Disease’.

Specifically, the two phases include:

Stage 1: the ‘EIA’ (enzyme immunoassay) test or, less commonly, the immunofluorescence assay (IFA) is performed.
Stage 2: if the EIA or IFA are positive or inconclusive, the second test performed is an immunoblot test, also known as a ‘Western blot’. If the symptoms are new onset (less than 30 days), the IgM Western blot is performed.

If symptoms have been present for more than 30 days, a positive or inconclusive EIA or IFA test is followed by the Western Blot IgG test.

Lyme disease treatment

Two basic antibiotics are used to treat Lyme disease: amoxicillin and tetracycline.

Typically, a course of 10-21 days is prescribed.

In some cases, the antibiotics cefuroxime or doxycycline are used.

In cases of long-term Lyme disease, intravenous (IV) antibiotics are sometimes used, in some cases for a longer period.

According to research by the National Institutes of Health (NIH), most people recover from Lyme disease after one course of antibiotics.

Post-treatment Lyme disease syndrome

In some cases, Lyme disease symptoms such as fatigue, muscle pain and cognitive problems persist for more than six months.

This is known as ‘post-treatment Lyme disease syndrome’ (PTLDS), or post-Lyme disease syndrome (PLDS).

It is also sometimes referred to as ‘persistent Lyme disease’ or ‘chronic Lyme disease’.

Researchers estimate that about 10-20% of patients have PTLDS, with continued joint inflammation and other Lyme symptoms for months or years after treatment.

Some experts recommend the long-term use of antibiotics – including intravenous antibiotic therapy – to help resolve PTLDS.

Lyme disease, autoimmunity and the thyroid

The reason why some people develop PTLDS is not known, but antibiotic resistance and an autoimmune reaction are thought to play a role.

Some experts theorise that an autoimmune response is triggered by Lyme disease infection, causing increased levels of antibodies that attack the joints.

Some research has also shown that, in the presence of a genetic predisposition to autoimmunity, Lyme disease can give rise to a range of autoimmune diseases that attack other tissues, organs or glands, including Hashimoto’s thyroiditis.

New treatments for Lyme disease and PTLDS are also being investigated, especially in conjunction with autoimmune thyroid disease.

As part of his defence of Lyme disease patients, Dr Holtorf drew attention to cutting-edge research on disulfiram (Antabuse), a drug usually used to treat people with alcohol abuse problems.

Disulfiram is showing promise as a possible treatment for PTLDS and further research is underway.

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