Lyme Disease Retreatment Guidance From IDSA May be Flawed

August 30, 2012  |  Contact: David Orenstein |  401-863-1862
Ixodes tick

Accepted medical practice discourages antibiotic retreatment in cases where Lyme disease symptoms persist. A new review of studies behind current medical advice says those studies prove nothing. Photo courtesy of the Centers for Disease Control and Prevention (CDC)

PROVIDENCE, R.I. [Brown University] — A new statistical review calls into question studies that have been taken as proof that antibiotic retreatment for chronic Lyme disease is futile. That misunderstanding has led to medical guidance that discourages retreatment and insurance coverage for it. Instead, the authors of the review suggest, the proper reading of the studies and their data is that they prove nothing. (emphasis added)

Most doctors treat Lyme disease with antibiotics for two to four weeks after diagnosis, but if symptoms persist after that, medical guidelines recommend against antibiotic retreatment. That recommendation may not be warranted. A newly published statistical review of the four studies upon which those guidelines are based reports flaws in design, analysis, and interpretation that call into question the strength of the evidence against retreatment.

Allison DeLong, a biostatistician at Brown University’s Center for Statistical Sciences and lead author of the study published online Aug. 19, 2012, in Contemporary Clinical Trials, said the four studies do not prove that retreatment does not work. That questionable interpretation, however, has led doctors to forgo treatment and insurance companies to withhold reimbursement.

[Read more…]


Antiinflammatories, Antibiotics Boost Treatment of Depression

treament imageInternational Congress of the Royal College of Psychiatrists (RCP) 2011.

June 30, 2011 (Brighton, United Kingdom) — Adding an anti-inflammatory medication to an antidepressant may augment efficacy and enhance depression treatment, researchers said here at the International Congress of the Royal College of Psychiatrists 2011.

Carmine Pariante, MD, PhD, from the Institute of Psychiatry, Kings College, London, United Kingdom, told delegates attending the International Congress of the Royal College of Psychiatrists 2011 that a series of studies published during the last 5 years offers clear evidence to support the combination therapy with anti-inflammatory drugs and antidepressant medication.

“Inflammation is a key element in the pathogenesis of depression, and using anti-inflammatory drugs is a novel strategy that uses a completely new antidepressant approach, finally, after 20 years of me-too drugs,” Dr. Pariante told Medscape Medical News.

Speaking on behalf of the Psychiatric Research into Inflammation, Immunity and Mood Effects (PRIME), a consortium of UK researchers in biological psychiatry, Dr. Pariante said that it is well known that long-term illness is a trigger for depression and that people with chronic disorders also have high levels of inflammatory markers or cytokines. [Read more…]


Treatment: Antibiotics or Herbs?


Is it possible to effectively treat Lyme disease and co-infections without antibiotics?  Is the immune system able to wipe it out if given the right support?

Dr. Eric GordonAnswer from Dr. Eric Gordon:

I would say unequivocally, maybe. The difficulty goes to the heart of the Lyme war between ILADS  and the IDSA. Since active Lyme is a clinical diagnosis, which means it is determined by the patient’s history and current symptoms, we can’t really say how many people diagnosed with Lyme have Lyme, or other infectious or toxin caused diseases.  If you look at symptom lists, the overlap with other illnesses is huge.

My answer is yes, I have read reports of people treated with herbs, and their symptoms and their CD57 tests have normalized. In my practice,  I often start with herbal treatments, but almost always use antibiotics at some point in the therapy. The biggest issue is not drugs vs. herbs, but rather the underlying toxicity of the person, and whether or not their immune system can manage inflammation.  I have had several patients who had severe “Herx’s” to herbs and yet did well on antibiotics. [Read more…]


Can Treatment Damage Hearing?


Could you speak to Ototoxicity (toxicity to the auditory nerves) of the antibiotics used to treat Lyme?  My neurologist cannot tell if hearing loss is caused by Lyme or antibiotic use.

Dr. Eric GordonAnswer from Dr. Eric Gordon:

If ototoxicity is present, I do not know how to be sure if it is due to antibiotics versus infection of the 8th cranial nerve.  Not all antibiotics are considered ototoxic, and even those that are will not cause problems for every patient. The toxicity from antibiotics is probably mediated by oxidant stress, and this may also be the cause of some of the damage by infection, as well.  Individuals have varying ability to manage oxidative stress. With that in mind, checking glutathione adequacy, methylation pathway tests  from Vitamin Diagnostics Labs (special testing, have your physician contact the lab), as well as evaluating the other detox pathways and your heavy metal burden would be helpful.  All of these problems will make ototoxicity more likely whatever the stressor of the system.  Treatment of these metabolic problems will often improve ototoxicity.

I would also get a good evaluation by a cranial osteopath.  Occasionally osteopathic cranial manipulation will mitigate some of the tinnitus.

Consult your physician for a more complete workup of your toxic load in order to support your ability to deal with any toxicity, as well as the infection.

Dr. Eric Gordon is the founder of  Gordon Medical Associates. What Dr. Gordon emphasizes is listening to his patients. “I believe my patients. Their description of what is going on in their body is the most accurate way we have to assess what is going on with them. I interpret the information they present, and blend it with laboratory results and imaging and other tests to determine a protocol that is customized to their condition.”