by Barry Keate
Lyme disease is an infectious disease caused by one of three species of bacteria. The primary bacteria in North America is Borreli burgdorferi. The bacteria reside in a natural reservoir among mammals, such as mice and deer, and are carried by ticks that feed on the animals then transmit the bacteria to humans. It is the most common tick-borne disease in the Northern Hemisphere.
Left untreated, as many as 48% of patients with late-stage Lyme disease may develop hyperacusis, tinnitus and/or sensorineural hearing loss.1 More on this will be discussed later in this article.
Symptoms of Lyme disease vary among infected people and some demonstrate no symptoms for months or years. Others display symptoms similar to chronic fatigue syndrome and fibromyalgia. Because of this, Lyme disease is often misdiagnosed and left untreated until it develops worsening neurological symptoms. It is important to know at this point that Lyme disease does not appear to be destructive, as with cancer, nor is it fatal. However it can be very debilitating.
The disease is named after the village of Lyme, Connecticut, where a number of cases were identified in 1975. It was recognized as a tick-borne disease in 1978 but the cause of the disease remained a mystery until 1982 when B. burgdorferi was identified.
The larvae and nymphs of ticks become infected when they feed on infected small animals, particularly the white-footed mouse. Ticks transmit Lyme disease to humans primarily during the nymph phase, when they measure less than 2 mm (less than 0.08”). Adult ticks can carry and transmit the disease but they are much larger and are more likely to be noticed and removed from a person’s body. Also, adult ticks are more active during the cooler months of the year when human outdoor activity is limited.
Ticks are most likely to transmit infection after approximately two or more days of feeding on a person. Therefore, the most effective means of preventing infection is to bathe and wash clothes after outdoor activities in a tick-prone area. Ticks are not able to tolerate high temperatures so drying clothes in a heated dryer will remove them.
Lyme disease can affect multiple body systems and produce a wide range of symptoms. There are three stages of infection.
Stage 1: Early localized infection The classic sign of early local infection is a circular, outwardly expanding rash called erythema migrans, or EM. Generally, the innermost portion remains dark red, the outer edge remains red, and the portion in between clears, giving the appearance of a bull’s eye. This rash occurs at the site of the tick bite 3 to 30 days after contact.
Erythema migrans is thought to occur in about 80% of infected patients however, Lyme disease can progress to later stages even in patients who do not develop a rash.2
Stage 2: Early disseminated infection Approximately 4-6 weeks following the tick bite, the first systemic symptoms occur in some patients, usually in the form of the “flu”. These symptoms include sore throat, severe headaches and neck aches, and severe fatigue. Inflammation of the nose, sinus, and coughing, are not present, distinguishing these flu-like symptoms from true influenza.3
Soon after the onset of flu-like symptoms, fatigue, joint and muscle pain may begin. The joint pain primarily involves the large joints (knees, elbows, hips, shoulders). Neck stiffness is common.
Acute neurological problems, which appear in 15% of untreated patients, encompass a spectrum of disorders. These include Bell’s palsy, which is the loss of muscle tone in the face, as well as severe headaches, neck stiffness and sensitivity to light. Shooting pains may interfere with sleep. Mild encephalitis (brain inflammation) may lead to memory loss, sleep disturbances, and mood changes.4
Stage 3: Late persistent infection After several months, untreated or inadequately treated patients may go on to develop severe and chronic symptoms that affect many parts of the body. Lyme disease affects each of its victims in a unique and personal way. Symptoms can include one or more of the following, in no predictable combination:
- Jaw pain and difficulty swallowing,
- Frequent or painful urination,
- Respiratory infection,
- Ear pain, hearing loss, tinnitus, hyperacusis,
- Eye pain and inflammation, light sensitivity, blurred vision, dropping eyelids,
- Severe headache, paralysis of facial muscles, seizures, stiff neck, loss of coordination and a syndrome that closely mimics multiple sclerosis,
- Mood swings, irritability, poor concentration, memory loss, depression,
- Abdominal pain, diarrhea, nausea, vomiting, loss of appetite,
- Dizziness, fainting, weakness, irregular heartbeat,
- Muscle pain and inflammation,
- Joint pain, arthritis.
Diagnosis Because of the difficulty in culturing the bacteria in the laboratory, there is not yet a reliable blood test for Lyme disease. Routine laboratory tests usually appear normal. Lyme disease is typically diagnosed based on symptoms and a history of exposure to endemic Lyme areas.
Diagnosis of late-stage Lyme disease is further complicated because of the multi-faceted appearance, which can mimic symptoms of many other diseases. For this reason, a reviewer called Lyme the new “great imitator”.5 Lyme disease may be misdiagnosed as multiple sclerosis, rheumatoid arthritis, fibromyalgia, chronic fatigue syndrome (CFS), lupus, or other autoimmune and neurodegenerative diseases.
Antibiotics are the primary treatment for Lyme disease. The antibiotics are typically given for periods of 4 to 6 weeks. Symptoms usually decrease then disappear before the medicine is gone but discontinuing early allows the bacteria to become antibiotic resistant and return stronger with increased potency.
If early diagnosis and treatment is not begun in the beginning stages of the disease, treatment becomes more intense. This can mean several weeks where the patient is hospitalized, receiving intravenous antibiotics until the patient responds well enough to be discharged on oral medications.
Hearing Loss, Hyperacusis and Tinnitus
As mentioned earlier, these hearing-related symptoms can occur in up to 48% of late stage Lyme disease patients. Highly variable response rates of hearing loss and tinnitus to Lyme disease treatment have been reported. Sometimes these symptoms are resolved with treatment and sometimes they are not and other treatments may be necessary.
Hyperacusis is a condition where patients can experience an extreme sensitivity to sound. In some patients it is limited to louder sounds, but in more severe cases ordinary sounds can be very debilitating. One small clinical study showed improvement in hyperacusis using carbamazepine (Tegretol), an anticonvulsant and mood-stabilizing drug used primarily in the treatment of epilepsy and bipolar disorder.6.
Hearing loss and tinnitus will not be helped by carbamazepine or therapies aimed at controlling hyperacusis. However, treatments for hearing loss and tinnitus will also help reduce hyperacusis.
Arches Tinnitus Formula (ATF) contains pharmaceutical-grade Ginkgo biloba extract, zinc picolinate and odorless garlic. There is significant scientific support and clinical evidence for its use in lowering tinnitus and supporting hearing health. An overview of 19 clinical studies investigating Ginkgo biloba for tinnitus stated “The investigations showed a clinical efficacy of EGb 761 (Ginkgo biloba) in cases of acute and chronic tinnitus. Two large-scale studies, however, established that in cases of shorter durations of the disease a better prognosis and treatment success are to be expected in general. The clinically relevant conclusion to be drawn from this is to start treatment as early as possible.”7 Another relevant study on the importance of zinc in treating tinnitus found “...the severity of subjective tinnitus decreased in 82% of the patients receiving zinc.” 8
Individuals suffering from Lyme disease, fibromyalgia or Chronic Fatigue Syndrome and who have experienced hearing loss, tinnitus and hyperacusis can receive help for these side effects by using Arches Tinnitus Formula.
- Fallon BA, Nields JA, Burrascano JJ, et al: The Neuropsychiatric manifestations of Lyme borreliosis. Psychiatr Q 1992; 63: 95-117.
- Fauci, Anthony S. (2008). Harrison's Principles of Internal Medicine: Editors, Anthony S. Fauci ... [Et Al.]. McGraw-Hill Medical Publishing. pp. Chapter 166.
- Feder HM Jr, Gerber M, Krause PJ. Early Lyme disease: a flu-like illness without erythema migrans. Pediatrics 91:456-9, 1993.
- Auwaerter PG, Aucott J, Dumler JS (January 2004). "Lyme borreliosis (Lyme disease): molecular and cellular pathobiology and prospects for prevention, diagnosis and treatment". Expert Rev Mol Med 6 (2): 1–22.
- Pachner AR (1989). "Neurologic manifestations of Lyme disease, the new "great imitator"". Rev. Infect. Dis. 11 Suppl 6: S1482–1486.
- Nields JA, Fallon BA, Jastreboff PJ. Carbamazepine in the Treatment of Lyme Disease-Induced Hyperacusis. J. Neuropsychiatry and Clinical Neurosciences 1999; 11:97-99.
- Fortschr. Med. 118 (2000), p.157-164.
- Otol Neurotol 2003 Jan;24(1):86-89.