Science-based medicine conference, part 5: chronic lyme disease
Wednesday, July 15, 2009
Lyme from the IDSA to the ILADS to the ABA."
http://lippard.blogspot.com/2009/07/sci ... rt_15.html
He started his talk with a description of Lyme disease. It's caused by a spirochete related to syphilis, that comes in three varieties, European, Asian, and North American...
Dr. Crislip identified two groups that have radically different views about Lyme disease:
1. The Infectious Diseases Society of America (IDSA).
2. The International Lme and Associated Diseases Society (ILADS)
The latter says that Lyme is common, hard to diagnose, and "requires infinite antibiotic treatment." The former says nearly the opposite.
Dr. Crislip then stated that the two camps present a false dichotomy, but that the truth is closer to the IDSA position. He asked, "is there asymptomatic Lyme?", and answered "yes." 7% of test subjects have asymptomatic seroconversion (show B. Bergdorferi antibodies) in vaccine trial placebo groups. He asked, "can [Lyme be] persistent due to antibiotic resistance?", and answered that there is no good data of that.
He pointed out that Borellia can exist in three forms, the spirochete, a cyst, and an L-shaped form with no cell wall. The cysts appear when the organism is stressed (in < 25 PubMed references) but has not been found in humans. The L-shaped form can be made in the lab, but doesn't survive in the human body.
..."there is genotypic variation in Lyme that could potentially make the two-step test less sensitive..."
There are also labs which perform their own unvalidated tests, such as a lab in Texas that he says "almost always yield positive results." These labs with unvalidated diagnostic tests have caused the CDC and FDA to issue warnings about non-valid Lyme tests.
Dr. Crislip posted a list of alleged symptoms of chronic Lyme disease, which was a very long list including "unexplained hair loss" and "feeling as if you are losing your mind," along with another list of alleged symptoms of chronic candida, and noted that they were quite similar. Using such lists, virtually any symptom is an indicator of these alleged chronic conditions.
The ILADS guidelines go even further, and say such things as:
•The labs are all unreliable, so treat for Lyme even if the test is negative.
•The primary symptom is that the patient thinks they have the condition.
•Physical findings are nonspecific and often normal.
•If the Western blot result is ambiguous, treat it as positive (the opposite of what you do with HIV).
•A comparison to tuberculosis and leprosy provides justification for long-term antibiotic treatment (even though those diseases are biologically dissimilar to Lyme).
In short, the ILADS guidelines provide a nonfalsifiable definition of Lyme disease.
Dr. Crislip concluded by pointing out that the cause of this unsubstantiated syndrome will be promoted by a new film coming out, called "Under Our Skin," which has the tag line "There's no medicine for someone like you."
Crislip noted that of the two doctors in the film promoting this illness, one lost his license for diagnosing Lyme disease over the telephone.