Archive for the ‘Psychological Aspects’ Category

Lyme, Alzheimer’s, Enbrel – New Potential Treatment

http://lymemd.blogspot.com/2019/06/lyme-alzheimers-enbrel-new-potential.html

Thursday, June 6, 2019

By Dr. Jaller

Lyme, Alzheimer’s, Enbrel — New Potential Treatment

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I have learned that most people want a simple sound bite answer or conclusion. The edges of medicine always operate in the grey and nuanced.

It has long been dogma in Lyme circles that immune suppressing drugs, e.g. Enbrel are very dangerous and should not be used.  The same is true with prednisone.

I have patients who get the occasional injection by their rheumatologist; joint pain gets better and they are no worse for the wear.

The drug is used for psoriasis amongst other many other conditions. The drug has serious side effects: its use should not be taken lightly.

A study suppressed by Pfizer, brought to light by the Washington Post, was based on insurance company data considering outcomes of  hundreds of thousands of patients and found those taking Enbrel had a 64% decrease in the incidence of Alzheimer’s disease. 

Enbrel impairs the function of TNF alpha, a master cytokine responsible for trafficking immune cells.

Pfizer did not make the disclosure because: a generic version will be  available.  A shiny new, me-too drug promoted heavily by pharm reps costing obscene amounts of money will take its place. Doctors will be given shiny data, along with lunch, proving equivalency? with the old drug.

The myth that generics are poor (dangerous) and lack quality control may be resurrected.

Watch out for first year generic prices: cute trick. For the first year a single company is given a monopoly and only required to reduce the price by 20%.  “See, the generic is almost as cheap as the brand,” the rep will inform a doctor. This is a bad pro big-pharma rule passed by Congress decades ago I’m sure) by the way. Cheap is a relative term.

The pharmaceutical giant, Pizer has excuses, reasons why it withheld the data, for example, they  claimed the data is wrong because of biological plausibility: the molecule is too large to cross the blood brain barrier.

Really? I care if the molecule gets into the brain; maybe it’s an advantage.  The brain has its own immune system which needs to be tweaked lightly. Ask anyone who has had a brain Herxheimer reaction knows. The Cytokine storm which may make you crazy results from peripheral cytokine reactions/overproduction primarily.  And there is no data the molecule cannot get into the brain. Cytokines get in the brain.

Alzheimer’s is in part motivated by inflammation. Other major factors are: production of amyloid beta protein (AB) (plaques and tangles), genetic factors and multiple external factors.

It is thought that AB protein is a naturally occurring antibiotic which responds to inflammation. Discussed elsewhere. Lyme resides in the brain along with many  bacteria, viruses, protozoans. It is true that spirochetes have been reported to aid in the transportation of AB into the brain.  Infection (or colonization) may be omnipresent and therefore not the whole story — or the most critical piece.

The vast majority of my patients present with cognitive complaints. Many or most Lyme patients, at one time or another fit the criteria for a disorder call MCI, minimal cognitive impairment. The mainstream medical community considers this a pre-Alzheimer’s condition, often.

What’s a Lyme patient to do?

First off, if symptoms completely resolve with usual therapy do nothing.

If you are a patient who has had very aggressive therapy, e.g. months of IV antibiotics and cognitive symptoms persist, look up MCI and consider the following:

Get an AB PET. The tests measures metabolic activity in the brain and the presence of early AB protein deposition. IF the test is positive you are at very high risk for developing Alzheimer’s.

Prednisone and Enbrel have largely been seen as dangerous because patients are misdiagnosed and not also treated for Lyme. Enbrel is likely tolerably safe, in many cases, considering benefit to risk ratio.

A lot of money has been spent searching for an Alzheimer’s cure. To no avail. Nothing very promising in the literature.

I for one am very angry with Pfizer. I suppose it is typical behavior in the industry. We still need big pharma. Don’t throw out the baby with bathwater. Hold them accountable. But, do not  conclude big pharma is corrupt therefore all drugs developed through the system are fruit of a poisoned tree and are therefore inherently untrustworthy and dangerous — in addition to being immorally overpriced.

It’s a bad syllogism. Drug companies are a very necessary evil.

Getting back to Enbrel.  Is this a silver bullet?.  More comment, biostatistics and analysis are required as well as prospective RCT medical studies. Since the drug will be generic soon big pharma will not finance the research. Fortunately, Alzheimer’s, a burgeoning epidemic as our population ages, is well funded through private sources.

Ideal prospective studies, which will likely be done make observations moving forward starting with a baseline current population. The process is slow.

Retrospective, population studies, primarily manipulation of data already there will not take long. These studies are never as good as prospective studies but perhaps good enough.

If you want my  bottom line: don’t run out and get Enbrel– YET.

I am not endorsing the use of the drug for any medical condition, including Alzheimer’s. This site is for informational purposes only. Medical care can only be delivered by a certified medical practioner who properly evaluates your particular issues. Please don’t diagnose or treat yourself. 

http://www.drjaller.com Dr. Jaller’s practice is in Maryland
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Regarding immune suppressants, many LLMD’s use them IF the patient is also on antimicrobial therapy at the same time. This tandem usage will protect the patient from a worsening infection(s), be it Lyme or any of the coinfections or even a latent infection.
Talk with your doctor about all treatments.

Category:

Alzheimer's, Lyme, Psychological Aspects, Treatment

Chronic Inflammation Removes Motivation By Reducing Dopamine in the Brain

https://www.news-medical.net/news/20190605/Chronic-inflammation-removes-motivation-by-reducing-dopamine-in-the-brain.aspx

Chronic inflammation removes motivation by reducing dopamine in the brain

June 5, 2109

Written by Dr. Liji Thomas

Why do we feel listless when we are recovering from an illness? The answer is, apparently, that low-grade chronic inflammation interferes with the dopaminergic signaling system in the brain that motivates us to do things.

This was reported in a new paper published in the journal Trends in Cognitive Sciences.

The research carried out at Emory University explains the links between the reduced release of dopamine in the brain, the motivation to do things, and the presence of an inflammatory reaction in the body. It also presents the possibility that this is part of the body’s effort to optimize its energy expenditure during such inflammatory episodes, citing evidence gathered during their study.

The authors also published an experimental framework based on computational tools, devised to test the theory.

The underlying hypothesis is that the body needs more energy to heal a wound or overcome an infection, for instance, both of which are associated with low-grade inflammation. To ensure that energy is available, the brain uses an adaptive technique to reduce the natural drive to perform other tasks which could potentially drain away the energy needed for healing. This is essentially a recalibration of the specialized reward neurons in the motivation center of the brain, so that ordinary tasks no longer feel like they’re worth doing.

According to the new study, the mechanism of this recalibration is immune-mediated disruption of the dopamine pathway, reducing dopamine release.

The computational technique published by the scientists is designed to allow experimental measurements of the extent to which low-grade inflammation affects the amount of energy available, and the decision to do something based on the effort needed. This could allow us to better understand why and how chronic inflammatory states cause a lack of motivation in other disease conditions as well, including schizophrenia and depression.

Andrew Miller, co-author of the study, says,

“If our theory is correct, then it could have a tremendous impact on treating cases of depression and other behavioral disorders that may be driven by inflammation. It would open up opportunities for the development of therapies that target energy utilization by immune cells, which would be something completely new in our field.”

It is already known that immune cells release cellular signaling molecules called cytokines, which affect the functioning of the dopamine-releasing neurons in the area of the brain called the mesolimbic system. This area enhances our willingness to work hard for the sake of a reward.

Dopamine

Image Copyright: Meletios, Image ID: 71648629 via shutterstock.com
Recently, it was discovered that immune cells also enjoy a unique capability to shift between various metabolic states, unlike other cells. This could affect cytokine release patterns in such a way as to signal the brain to conserve available energy for the use of the immune system.
These facts were the foundation of the new hypothesis, which explains it in terms of evolutionary adaptation. In the hypothetical early environment, the immune system, faced with abundant microbial and predatory challenges, needed tremendous amounts of energy. It therefore had its own mechanism to signal other body systems, via the mesolimbic dopamine system, to control the use of energy resources during periods when the organism was undergoing severe or sudden stress.
Modern life is relatively soft and less challenging. With less physical activity, low-grade inflammation is chiefly due to factors such as obesity, chronic stress, metabolic syndrome, aging and other lifestyle illnesses. This could mistakenly cause the mesolimbic dopamine neurons to produce less dopamine. Lower dopamine levels in turn decrease the motivation for work, by reducing the perception of reward while increasing the perception of effort involved. This ultimately conserves energy for use by the immune system.
Previous studies by Miller as well as other scientists have shown that a high level of immune functioning in association with low levels of dopamine and reduced motivation characterizes some cases of schizophrenia, depression and certain other mental health conditions.
The scientists do not think these disorders are caused by the low-grade inflammation, but that some people who have these illnesses are hypersensitive to immune cytokines. This could in turn cause them to lose motivation for daily living.
The scientists are currently performing a clinical trial on people with depression, to test the theory using the computational framework.

 

Source: Treadway M. T. et al., (2019). Can’t or Won’t? Immunometabolic Constraints on Dopaminergic Drive. Trends in Cognitive Sciences. https://doi.org/10.1016/j.tics.2019.03.003

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**Comment**
Interestingly,
2017 May;3(3). doi: 10.15761/JSIN.1000163. Epub 2017 May 11.

Lyme and Dopaminergic Function: Hypothesizing Reduced Reward Deficiency Symptomatology by Regulating Dopamine Transmission.

Blum K1,2,3,4,5,6,7, Modestino EJ8, Febo M1, Steinberg B8, McLaughlin T9, Fried L2, Baron D5, Siwicki D7, Badgaiyan RD6.

Abstract

The principal vector of Lyme disease in the United States is Ixodes scapularis: black legged or deer ticks. There is increased evidence that those infected may be plagued by anxiety or depression as well. Researchers have identified transcripts coding for two putative cytosolic sulfotransferases in these ticks, which recognized phenolic monoamines as their substrates. It is hypothesized that protracted Lyme disease sequelae may be due to impairment of dopaminergic function of the brain reward circuitry. The subsequent recombinant proteins exhibited sulfotransferase function against two neurotransmitters: dopamine and octopamine. This, in itself, can reduce dopamine function leading to many Reward Deficiency Syndrome behaviors, including depression and possibly, anxiety. In fact, it was shown that activity of Ixosc Sult 1 and Sult 2 in the Ixodid tick salivary glands might contain inactivation of the salivation signal through sulfonation of either dopamine or octopamine. This infraction results in a number of clinically observed mood changes, such as anxiety and depression. In fact, there are common symptoms observed for both Parkinson and Lyme diseases. The importance of understanding the mechanistic and neurobiological effects of Lyme on the central nervous system (CNS) provides the basis for pro-dopamine regulation as a treatment. WC 195.

Great article on dopamine:  https://suzycohen.com/articles/depression_low_dopamine/ Excerpt:

Dopamine deficiency will cause you to wake up sluggish in the morning, usually with brain fog, but you might feel happier and suddenly more enthusiastic with a “hit” of some sort, perhaps a cup of coffee.  Low dopamine (as opposed to low serotonin) causes a different kind of depression, one that is hallmarked by a lack of pleasure.

 

 

 

 

Category:

Inflammation, Lyme, Psychological Aspects, research

Are Lyme Disease & Anxiety Connected? Dr. Rawls

https://rawlsmd.com/health-articles/lyme-disease-anxiety-connected?

Are Lyme Disease and Anxiety Connected?

by Dr. Bill Rawls
Posted 6/21/19

Can Lyme disease cause anxiety? In this video, Dr. Bill Rawls explains how the stress of chronic illness impacts adrenaline levels and mood. Plus, he shares natural remedies for anxiety and lifestyle tips for short-circuiting an overactive flight-or-fight response. Read all about Dr. Rawls’ natural approach to overcoming Lyme disease here.

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Video Transcript

Question: Are Lyme disease and anxiety connected?

Hello, I’m Dr. Bill Rawls. A question: How is Lyme disease related to anxiety?

Most people are really struggling with anxiety and sleep disturbances who have chronic Lyme disease. And the reason is that Lyme disease — the stress of Lyme disease — makes you less resistant to any kind of stress. It lowers your reserves.

So your body is stressed, and whenever your body is stressed, you activate your sympathetic nervous system, your fight-or-flight nervous system. And that’s really designed to use intermittently when there’s a real emergency, like somebody breaking into your house at 3:00 in the morning. You want that surge of adrenalinethat wakes you up, gets you going, and helps you deal with that emergency.

But when your body is stressed, when the chronic illness is generating inflammation, and the microbes are disrupting everything in your body, your body becomes less stress-resistant, and it activates your fight-or-flight response chronically. If you’ve got adrenaline pushing through your system all the time, it makes your system very, very fragile.

Anything that would cause anxiety is very apt to generate that kind of response — you feel anxious, you feel revved up all the time. You’ve got that adrenaline surging through your system.

It affects your sleep, and then not getting sleep actually affects the immune disruption that would generate that. So the whole thing becomes this vicious cycle that’s never-ending.

Breaking that cycle: The first step is controlling those microbes, restoring normal immune system functions, but also bringing down your adrenaline levels, and I think that’s really, really important. When I was going through my recovery, something I became very conscious of is when my adrenaline levels were starting to raise.

I could feel the energy just building in the upper part of my body, and my body became tense. That anxiety response was very prevalent, especially as I went through the day of just dealing with stress factors. As you go through the day, it tends to make it worse. So you raise your adrenaline levels as you go through the day. That affects your cortisol, and it can really make you miserable.

Being aware of your adrenaline levels, being aware of tension is really important. When I was recovering from Lyme, I was really careful about any kind of input that was coming into my brain.

I didn’t listen to the radio. I was very careful about reading the newspaper or reading what was on the Internet. I tried to make my world small by not worrying about things in the outside world that maybe were significant, but were also things that I couldn’t really control.

You like to bring your world down to the things that you have control over, and you like to minimize that as much as you can. You’re looking to reduce factors that raise your adrenaline levels during the day.

Getting regular exercise of any kind, whether that’s just walking or doing qigong or yoga, can help diffuse that adrenaline surge that you have, that adrenaline buildup during the day. Just taking a meditation or what a lot of people call a power nap.

I used to call it touching sleep. I would take 15 to 30 minutes in the middle of the day at lunchtime and lie down, and I would try to relax myself to the point that I could just barely get to sleep, even if it was a minute or two.

If I reached that point, I know that I brought my adrenaline levels down to zero. And if you can do that once or twice during the day, that can short-circuit that adrenaline buildup and help you deal with that anxiety, that excessive overactive fight-or-flight response that’s driving this whole situation.

There are also plenty of calming herbs that can help. Ashwagandha, bacopa, passionflower — many of our calming and balancing herbs are very good for short-circuiting that sympathetic response.

So yes, Lyme disease is very, very much tied to anxiety. It does increase your propensity to become anxious, and decreases your stress resistance. The solution to that is reducing stress by using herbs to calm and normalize and balance your hormones, trying to move, trying to get exercise during the day.

Keep doing that and keep doing that and keep working at it until you become an expert at keeping those adrenaline levels down through the day.

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**Comment**

I never had anxiety, but my husband did. It would come and go like the wind – hitting him at the most unexpected times leaving him feeling completely helpless. Proper treatment completely ameliorated this symptom.

Here’s a story of patients misdiagnosed with anxiety when the culprit was Lyme:  https://madisonarealymesupportgroup.com/2018/10/03/lyme-patient-misdiagnosed-with-anxiety-depression/

 

 

 

Category:

Herbs, Lyme, Psychological Aspects, Treatment

On the Lyme War Path – Chick2Chick

 Approx. 14 Min

PennWatch

Published on Jun 30, 2019

Watch out!!! Carrie Perry from @Chick2Chick is on a warpath. She now has 2 daughters diagnosed with Lyme Disease, both missed by her primary care doctor.
Carrie and Flora Posteraro chirp about that and the many ways to protect you and your family against tick bites. #podcast #letschirp #realtalk #womensvoices
You can also listen to this as a podcast at your convenience through your favorite online podcast directory – iTunes, Stitcher, Spotify, TuneIn, Podbean or Google Play.
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Wisconsin desperately needs FREE tick testing.  Call your reps and tell them.

You have to remember that tick testing isn’t perfect and can miss things but it’s a place to start & that it only follows that since ticks are filled with many pathogens, people will be too.

Category:

Activism, Lyme, Prevention, Psychological Aspects, Ticks

OPINION: How Many Cases of Lyme Disease Are We Missing?

https://www.thechronicleherald.ca/opinion/opinion-how-many-cases-of-lyme-disease-are-we-missing-327404/

OPINION: How many cases of Lyme disease are we missing?

Published: June 27, 2019

Black-legged, or deer ticks are not the only kind of tick that can transmit disease, dog ticks like the one shown here and have been found to carry a number of things, writes Donna Lugar. - 123RF
Black-legged, or deer ticks are not the only kind of tick that can transmit disease, dog ticks like the one shown here and have been found to carry a number of things, writes Donna Lugar. – 123RF

DONNA LUGAR

I participated in a “Tick Talk” in Bedford with Lisa Ali Learning of AtlanTick on June 25. One takeaway from that meeting, for me anyway, is that we are not doing enough to ensure Nova Scotians are adequately aware of the risks associated with tick bites. One family, new to the country, had never even heard of ticks before one recently attached to their child.

Although there has been a steady increase in awareness initiatives over the past few years, we need to continue to do more to reduce the number of new cases of Lyme and tick-borne diseases. One way to do this is through more “in your face” awareness, such as signage, print media and radio/TV alerts. Nova Scotians need to reach out to all three levels of government to request that more is done.

Nova Scotians need to know that any tick that bites them could potentially transmit an illness. Black-legged (deer) ticks are not the only kind of tick that can transmit disease, and Lyme is not the only thing we need to worry about. Dog (wood) ticks have been found to carry a number of things, and Lone Star ticks have been found sporadically within the province. As well, migratory birds could be dropping other types of ticks within the province that we haven’t even discovered yet. Any tick that bites a human could potentially be carrying disease — sometimes multiple illnesses.

Symptoms can vary from person to person, with some not showing any outward, visible signs, so medical professionals need to listen to their patients and start to put two and two together.

Please learn what preventative measures to take and how to properly remove attached ticks. This document, which I prepared, provides a lot of information, including how to remove a tick, what to do to prevent tick bites, as well as outlining a number of potential co-infections.

We also need to do more to ensure that those bitten receive a quick diagnosis and appropriate treatment. It’s time our doctors learn that, according to the Canadian Adverse Reaction Newsletter, Volume 22, Issue 4, October, 2012, there are at least three possible reasons for a false negative ELISA/Western Blot.

  • The fact that the test is performed too early (which most are aware of)
  • It could be a different strain of the Borrelia bacteria not picked up by the test (we also have Borrelia miyamotoi in the province, which can cause a Lyme-like illness and doesn’t generally present with a rash)
  • Antibiotic use. If you were put on antibiotics for something between the bite and the test, or only received a one-day prophylactic treatment upon the bite, you could always test false-negative.

According to Conquering Lyme Disease, a book by doctors at the Columbia University Medical Center, “false negative rates on the ELISA have been reported as high as 67 per cent in early Lyme disease and 21 per cent in early neurologic Lyme disease.” The potential for people to not form enough antibodies to be picked up by the test is also possible.

If your test is negative, it doesn’t mean you do not have Lyme!

There is a proviso in Guidance for Primary Care and Emergency Medicine Providers in the Management of Lyme Disease in Nova Scotia that states, on page five, No: 3, under IDEG Recommends: “Patients presenting with a non-specific febrile illness, but no EM–like rash, AND a recent, clear exposure in an area at moderate or higher risk for Lyme disease (https://novascotia.ca/dhw/CDPC/lyme.asp) should be tested and monitored for other symptoms suggestive of Lyme disease. Repeat testing in 4-6 weeks is suggested if there are still concerns that the patient has Lyme disease.” I have only heard from a few people who received repeat testing and that was usually at their own insistence.

Also very important to note is that Lyme is supposed to be a clinical diagnosis, with testing supplementary. Unfortunately, doctors may recognize the better-known bull’s-eye rash, but that is only seen in 20-30 per cent of cases (if that). Other types of erythema migrans rashes are more common. About 20 per cent do not get any rash (Borrelia miyamotoi, perhaps?), while many that do don’t see it because it is tucked away somewhere not easily visible, just like the ticks like to be.

Symptoms can vary from person to person, with some not showing any outward, visible signs (such as an erythema migrans rash, Bell’s palsy, or swollen, hot knees), so medical professionals need to listen to their patients and start to put two and two together. That includes changes in mental health, new digestive issues, new sensitivities to scents, sounds, light and food, migrating pain, more frequent headaches, changes to heartbeats, and so much more that can be suggestive of Lyme and tick-borne diseases.

Rather than immediately dismissing Lyme and tick-borne diseases, as many doctors are still doing to this day, they need to realize that this issue is not rare, hard to get or easy to treat.

In other words, it is very hard to get a diagnosis if you do not see the tick, get the bull’s eye rash version of the erythema migrans rash, and/or test positive on both the ELISA and confirmatory Western Blot.

How many are we missing?

Donna Lugar is Nova Scotia representative of the Canadian Lyme Disease Foundation and founder of the N.S. Lyme Support Group. She lives in Bedford.

 

Category:

Activism, Lyme, Psychological Aspects, Testing, Ticks, Transmission