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  • Do I Have Lyme, CFS/ME, or Both?

Do I Have Lyme, CFS/ME, or Both?

June 28, 2014 / Charles W. Lapp, MD / Ask The Doctor

On a regular basis PWCs return to me with a new diagnosis of Lyme Disease.  My main concern in such a situation is whether the diagnosis is accurate and treatment appropriate.

Lyme Disease can be a trigger for CFS/ME just as can EBV, HHV6, and other infections [Steere AC, JAMA 1993].  That’s why we request Lyme titers on all new patients with classical CFS/ME symptoms.

How do you know if you really have Lyme Disease ( LD)?  LD is a clinical diagnosis based on exposure in an endemic area, a history of embedded tick, or a tick bite followed by a typical rash or symptoms.  Ninety percent of persons with LD will have a positive screening test, which should be followed by a more specific test, the Westrern Blot test  [www.arupconsult.com/Topics/LymeDisease.html ].  If the diagnosis is confirmed by the Western Blot test, then 21 to 28 days of antibiotic therapy is indicated to kill off the causative organism,  Borrelia burgdorferi.

Untreated Lyme Disease may lead to symptoms almost identical to CFS/ME [Gaudino EA, Arch Neurol 1997], so most CFS and Lyme experts consider Borrelia to be one of many triggers for CFS/ME.  There is no convincing evidence that long term antibiotic therapy or alternative therapies are effective in treating late Lyme Disease [ Feder HM, NEJM 2007].

When patients are desperate or slow to improve from CFS/ME they frequently seek second opinions, which may lead to consideration of LD.   Sadly, many “experts” disregard venerable institutions such as the Centers for Disease Control, National Institutes of Health, the World Health Organization, and others, relying instead on unreliable or unvalidated testing to make a diagnosis of LD.  There are labs that tout their Lyme testing as superior or more accurate than FDA- and CDC-approved testing.  In fact, they may produce many false positive results [Klempner MS, Amer J Med 2001, Hurely D, NY Times, 8/23/2005, forbes.com/forbes/2007/0312/096, www.cdc.gov/mmwr/preview/mmwrhtml/mm5405a6.htm ].  Patients frequently cling to these erroneous results and submit themselves to unnecessary, costly, and sometimes dangerous treatments.  Perhaps even worse, when these treatments do not work patients again feel discouraged, deceived, and disappointed.

For these reasons we, at Hunter-Hopkins Center, implore our patients to provide medical notes and lab results to us or a reputable infectious disease specialist for review before accepting a Lyme Disease diagnosis and embarking on therapy.

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Dr. Hillman

Dr. Hillman

Dr. Hillman was born and reared in Utica, New York. He attended college at Clarkson University where he earned a bachelor’s degree in engineering, and then spent two years toward a master’s degree in biochemistry/oncology at the University of Buffalo’s Roswell Park Division, where he did research in leukemia. Dr. Hillman attended St. George’s University School of Medicine, and completed his clinical years at the Maimonides Medical Center in Brooklyn, New York, graduating in 1996. During the Summer of 1994 he also did research at the University of Buffalo Dental School using PCR technology on RNA subtyping of gram negative oral bacteria. Following medical school, Hillman went on to a Family Practice Residency at North Shore / Long Island Jewish Hospital in Bay Shore, NY.

After his residency, Dr. Hillman worked for the US Army at the West Point Military Academy (Keller Army Hospital family practice unit), worked in the Emergency Room and hospital admitting areas, and ran a private practice as well. From 2005-2006 he also worked at the Winn Army Hospital at Fort Stewart, GA, before setting up a private Family Practice in Huntersville, NC in 2007. In addition to his private practice Dr. Hillman also has an interest in helping clients with disabilities. He has worked for ProMed Urgent Care in Occupational Medicine and performed over 13,000 examinations for Social Security Disability.

Dr. Hillman has a family member with Chronic Fatigue Syndrome, so he has a long standing interest and empathy with the disorder! He is married and has two sons and a daughter. The family lives in Huntersville.

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