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Conversation with Eric Gordon, M.D. on Transmission and Treatment Issues

Dr. Gordon spent some time in conversation to cover some of the remaining patient questions from the conference with Dr. Burrascano. The following is a transcript from that conversation. The second part of the talk will be posted later this week.

Initial questions:

Can Lyme or co-infections be transmitted thru sex or kissing?

 Please address whether Lyme is an STD?

 Can it be transmitted from an adult to young children during normal care giving?

 What do you think about the possibility of sexual transmission or other TBD?

DR. GORDON: 

Can Lyme disease be transmitted through sex or kissing? The answer is through sex, probably; through kissing is much harder. I don’t believe anybody has found Lyme bugs in saliva. Usually you don’t get it from saliva. You might be able get it because there is a cut, there is a little bleeding….

INTERVIEWER:

An opening to the bloodstream.

DR. GORDON:

….gums that bleed or something.

INTERVIEWER:

Eric, have you heard anything in any of the conferences about what it takes to actually be able to transmit the infection. For example, with sexual transmission, men’s sperm actually suppress women’s immune system so they can impregnate the egg.

So they think that’s why, or it’s part of why, it might be easier to transmit Lyme disease from males to females, but is there anything else that you’ve heard in terms of what it takes to transmit the bacteria, like if it got on your arm could it crawl through the skin….?

DR. GORDON:

No, I wouldn’t believe so. I mean, most bugs don’t do that very effectively.

It takes usually a broken area…. The skin has to be broken. If you had an open cut or an open sore, that would be theoretically possible. But so far, there is no evidence to show that it happens in reality.

INTERVIEWER:

Yes.

DR. GORDON:

These are just guesses. I mean, yes, I’m sure it can happen, but if you look at something like Hepatitis C and AIDS, they are good examples. Hepatitis C is definitely contagious and transmissible through sexual contact, but it still happens to be relatively difficult to do so, and does not happen often.

INTERVIEWER:

Yes. Well that’s what I keep trying to say to people when they say, “Well I can get Lyme from mosquitoes,” or “I can get it this way.” Ticks have a very unique transmission process, that suppresses the immune system enough to allow the bacteria a chance to be established.

DR. GORDON:

Yes. Lyme, you probably cannot get from mosquitoes. You can probably get Ehrlichia and any of the Rickettsial things from mosquito bites. And Bartonella may be transmitted through other vectors, but Lyme, I don’t know if it is possible, I don’t think so.

INTERVIEWER:

They haven’t been able to prove it yet in transmission studies, so, you know, it seems like when they ask, “Can it be transmitted from an adult to a young child in your daily care taking?” Again, it seems unlikely except….

DR. GORDON:

With Lyme it would be very, very unlikely.

INTERVIEWER:

Except, you know that there is a possibility with breastfeeding. Borrelia has been found in breast milk.

DR. GORDON:

Yes, again, could be, but unlikely, because the mother should have some immune globulins going at the same time. So if the breastfeeding is passing the infection, it is also passing protection from the infection. Other than that, you just have to say, what people don’t understand, is that this disease has not been studied.

And people are making these statements based on evidence that could have other interpretations. Like, we know in utero transmission has happened, but we really only have maybe one or two documented cases. Everything else is a guess.

So I have always been uncomfortable about this whole thing. I think you just have to say that it is possible, yes, but likelihood is very low, yes; just like yes, it is possible to win the lottery.

INTERVIEWER:

Right, right. But I think the thing that people are asking you, Eric, is do they need to do anything different? Do they need to be concerned in their sexual relationships? Do they need to be concerned when taking care of their children? That’s of course the bottom line about these questions.

DR. GORDON:

The bottom line is that we don’t know, and I think there’s probably a better chance that you can do more harm to your child by worrying about it than by doing it.

INTERVIEWER:

Well, there you go.

DR. GORDON:

And as far as relationship, it is the same thing. If you’re in a committed relationship, it’s not something I would worry about. If you are really worried then, get yourself tested! Because you have to remind people that most people who get Lyme can be treated relatively easily.

They’re not all going to be chronically infected. The IDSA is not all wrong.

INTERVIEWER:

So talk a little bit more about that, Eric…

DR. GORDON:

Back to my statement—my basic statement to the world is that the reason we’re in this terrible political battle is because the IDSA (Infectious Disease Society of America) people really do see folks respond to short-term antibiotics, and get well, and they don’t go on to get recurrent illness. I forget…. The rate in Connecticut is like, what, 10% or 15% of the people have had Lyme disease?

INTERVIEWER:

Yes, something like that.

DR. GORDON:

It’s some huge number, and they are not all having chronic joint pain and brain fog and difficulty functioning.

INTERVIEWER:

Right. Ten percent of their population is not disabled.

DR. GORDON:

Exactly! This is a disease that does disable people and do terrible things, but it takes a combination of events, and a combination of genetics, and other infections before this will lay you low, and that’s why it has been so difficult to convince so many doctors that chronic Lyme does exist. Because the IDSA looks at their regular patient population, and then they have somebody who thinks they have chronic Lyme come in. They have people come to them who have diagnosed themselves on the internet, because they read about what Lyme symptoms are, and the problem with that is if you read the symptoms, they fit multiple diseases.

So yes, this is a clinical diagnosis, but it is a clinical diagnosis where you have to listen to lots of people to make it. When patients have the symptoms, and read a lot about Lyme, they don’t always know the difference between the achiness that might come from something else, and the level of disability that Lyme can bring, unless they have seen a lot of patients. So sometimes the IDSA doctors can be right when they tell a patient they don’t have Lyme disease, or that it is not the cause of their symptoms.

Another big part is that the IDSA usually doesn’t pay any attention to the kind of symptoms that those of us who treat Lyme recognize as more Lyme-specific symptoms. So they miss some of the people who do have Lyme.

INTERVIEWER:

Okay.

DR. GORDON:

So, a lot of what are really neuropathic pain symptoms, like the deep burning pain that moves around, the joint pains, like one day your shoulder hurts; the next day your knee hurts…. Those are the things that they tend to just  ignore.

INTERVIEWER:

Or they think it’s something psychological.

DR. GORDON:

Exactly, when you have symptoms that move around they think you’re kind of crazy, so that just adds to their impression that what they’re dealing with is a psychologically over-stimulated population who has some minor illness that a little therapy would help.

INTERVIEWER:

Exactly. Are there some other symptoms that you feel like you look at carefully that they disregard?

DR. GORDON:

Well, it would be…. The type of pains, I guess: It’s burning pains, the sense of muscle fasciculations, a sense of what they call not fasciculation but formication – the sense that ants are crawling on your skin. That’s a common Lyme symptom, but not common in regular medical practice. People in medicine think it’s a psychological problem.

Also, sharp, stabbing pain that once they work you up, they don’t find anything really wrong on the regular tests, that also goes into the realm of probably psychological.

INTERVIEWER:

Right, because they can’t find a physiological cause.

DR. GORDON:

Right, right. So if  you’re an average Lyme patient who does not have a swollen joint, but merely achy joints, okay, and painful, tender muscles, has brain fog and has lots of muscle fasciculations and the joint pain moves around, has headaches and sleep disturbance, they go to an infectious disease doctor, that doesn’t add up to any infectious disease they recognize. The symptoms have been there for a year or two and their tests show you are normal.

Those guys, they see this person who they think is no big deal, and then they get that same kind of patient show up who has been on IV antibiotics for two years, and isn’t getting better, and they just go, “Oh my God, this is malpractice! This is terrible medicine. So they rightfully decide that the doctors who treat chronic Lyme disease are really just enablers, and dangerous enablers.

Because that’s what they see. And on top of that, all they need to see is one patient once a month, or once every 6 months who comes in with these kind of symptoms, and had been diagnosed with Lyme disease, and it turns out that they actually have sleep apnea.

INTERVIEWER:

Right, something that was missed.

DR. GORDON:

Right. And they think, oh, let’s treat the sleep apnea, and the body pain gets a lot better, and the doctor ignores the parts that don’t get better, and they think, “Oh my God, well it was just sloppy diagnosis.”

Or the patient sees somebody like Richie Shoemaker, who notices that they’ve got mold toxicity, and so therefore all their Babesia symptoms are meaningless, because they can both look the same as far as symptoms. Not all doctors think about whether you might have both, and need to be treated for both.

INTERVIEWER:

So, Eric, what other kinds of things do you see? This is another thing that I feel like people with Lyme, they have this tendency to think everything they have is Lyme. They are always asking, “Do Lyme patients have this? Is this because of Lyme?” And it’s so possible to have multiple issues going on.

DR. GORDON:

Well, what I think we have to say is that the other good example is  celiac disease, but you don’t have to have celiac disease in the classic sense. You could just have milder forms of gluten intolerance or GI inflammation.

INTERVIEWER:

Yes, yes. And do you find that in people with Lyme that because of the inflammation levels that they are more likely to have that?

DR. GORDON:

Absolutely. Any inflammatory process makes the others easier. Because if you’re stuck in inflammation, your body’s ability to modulate inflammation goes down because if it didn’t you would not be stuck there. Usually the ongoing inflammatory response is no longer effectively killing the bug, okay? It’s no longer self regulating.

INTERVIEWER:

So what besides celiac or gluten intolerance, or sleep apnea, what other kinds of things do you see most often are missed?

DR. GORDON:

Oh,  the chronic biotoxin issues Dr. Shoemaker talks about. Insulin resistance, which increases the inflammation in the body. Shoemaker’s Actos treatment helps a lot of people by lowering the constant inflammation from insulin and leptin resistance.

If you also put them on a high protein, low glycemic diet, their inflammation might go down also. Because insulin is very pro-inflammatory, and so if you have insulin resistance and you eat, but you’re sick and you’re tired and the only thing that lets you get through the day is a little bit of ice cream now and then, or just peanut butter and jelly, or whatever high carb snack works for you, and if you have the genetics, which a lot of people do, or just start to gain a little weight without the genetics, you begin to have higher and higher levels of insulin being released all the time, and that drives inflammation. That turns on a lot of the inflammatory cascades. It also will suppress your adrenals.

This goes back to the whole naturopathic concept….and why a lot of naturopaths have been late to the game of treating Lyme is because they, in their training, they think that if they fix the gut and balance the hormones and supplement the hormones, help resuscitate the adrenals and the hypothalamus and pituitary gland, get that functioning better, get the ovaries and testicles working better, restore basic nutrition and deal with some of the allergic foods, you’re going to get people well. And you will help them. But if their main trigger is a Lyme or Bartonella or Babesia or Chlamydia or Mycoplasma infection, you’re not going to get them well. You might improve them, but if they’re really sick you don’t even do much for them—until you begin to remove the bug. And you don’t have to necessarily cure the infection. Suppression of the infection and allowing the immune system’s self regulatory pathways to function again,  will then keep the bug in a dormant state. Similar to having a chronic herpes virus which stays dormant as long as the immune system is healthy. And the problem is that  the  Lyme world has been so focused on killing the bug, and that does work with some people. But what I would love to know with some of the Lyme doctors is, they talk about the number of patients that they treated and claim are well. I wonder what was their dropout rate, though? One of the problems with the use of long tern antibiotics by many physicians is that they may be seeing their successes and forgetting about those people who had to drop out because they couldn’t tolerate the long term antibiotics. This doesn’y invalidate long term antibiotic therapy, it just means that we have to remember to tailor the therapy to the patients.

…and I think again we need a common denominator to use, because to be fair to the doctors who only use antibiotics, you know, they help a lot of people by just keeping them on antibiotics forever, but they don’t stop to go back and go, okay, what else do people need? Maybe the infection has been knocked down but the patients are still sick and look the same.

INTERVIEWER:

It’s unfortunate because some don’t tend to look very much in sort of the more conventional issues other than Lyme.

DR. GORDON:

Right. You know, what makes this difficult and I think we have to emphasize is why this is so individual because,  I have one patient who sticks in my mind. She was somebody who saw a doctor for like 5 years, and he did a good job, he really did; she was a very, very sick young lady. She came to see me—I was lucky. I had just started supervising one of his patients, okay, and she had some severe headaches and was so sick and had been on tons of Rocephin for a year and all kinds of antibiotics, you know, and she has been on a ton of Mepron. And it hadn’t helped. She still had positive Babesia tests.

So I put her on  IV clindamycin? But not in the way Dr. Jemsek uses.  Rather, I put her on it daily for one month.  I was only going to do it for a month, but she improved so much she stayed on it for a few months, and then we did vancomycin. She eventually lost about a hundred pounds that she had gained and is  now symptom free.

INTERVIEWER:

Oh my gosh!

DR. GORDON:

And she’s now back to functioning normally. I mean she really got well after being totally disabled and on high doses of narcotics for six years.

INTERVIEWER:

Wow!

DR. GORDON:

I mean, she’s young. She’s only in her mid 30s, but she got well. This is somebody who when you found the right antibiotic and the right antibiotic combinations, it worked.  We have to remember is that we don’t want to say never do that, but we need some parameters while we’re treating to make sure that the thyroid and the adrenals are being looked at, sort of like checking, sort of like cooking, like, “Is it done?”

INTERVIEWER:

Yes. And what else does it need now?

DR. GORDON:

Yes.

.……… This interview will continue later this week.

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.”