Lyme disease and its relationship to Intracellular Hypothyroidism: origin, symptoms, diagnosis and treatment.
An old friend, who is an avid and successful vegetable gardener, is passionate about mushrooms, especially chanterelles (Fig. 2), which abound in the woods of Ontario and are easily found, if you know what to look for. So successful is he in the chanterelle hunt, that he is able to augment his income (a bit) by selling them to knowledgeable restaurants. 2023 was a bumper year, for chanterelles and my friend, while keeping himself amply supplied, sold his surplus for more than $1,000.
In July however he found a small red spot, which began just above his elbow and spread around the arm.
Soon he became ill and progressively, so weak that he was admitted to a hospital. Eventually, a blood test showed Lyme Disease and he was started on a course of antibiotics. He is now improving, though very slowly.
My friend’s experience led me to a web search on Lyme disease and being me, I began the search by entering “Lyme disease T3” into Google. Lo and behold, the following appeared on my handheld screen: “The inflammatory cytokines that are produced in Lyme disease impact thyroid hormone signalling. This means thyroid stimulating hormone (TSH) may decline. The conversion of T4 to T3 (the active thyroid hormone) can be reduced, leading to fatigue and low energy levels. Additionally, reverse T3 can become elevated. June 2. 2023.”
I almost fell off my chair: that such a perspicacious (if slightly inaccurate) statement would appear as a first response from Google is mind-boggling! It means that someone, somewhere, is beginning to think about peripheral thyroid hormone metabolism and if we are lucky, the medical establishment will finally begin to consider it seriously.
So let’s discuss Lyme disease
Lyme disease is caused by a germ called Borrelia Burgdorferi (Fig 2), which looks like the syphilis germ, Treponema pallidum, in that it is a “spirochete”. It is long and narrow, for a bacterium (20 – 30 µm long and 0.2 – 0.3 µm wide), “curly and wiggly” and completely colourless – to see it under a microscope, you have to view it on a “dark field”, as shown in the graphic from Wikipedia, in figure 1. Worldwide, there are 15 species of Borrelia, of which 5 cause Lyme Disease.
Borrelia Burgdorferi is passed to humans by the bite of ticks and lice (Fig. 3). Its presence in our blood can be identified in the laboratory by immunity testing (not by looking for it under a microscope).
Usually, the tick bite is painless and isn’t noticed by the unfortunate recipient until a red spot appears somewhere on the skin, 3 days to a week (or more) after the bite. Classically, the area around the bite looks like a “bull’s-eye” (Fig. 4), with a red spot in the middle, a surrounding circle of normal -looking skin and a red circle of 6 inches or more, outside of that (figure 4). However it isn’t always that obvious: there might be a simple, small red spot such as one would get from any insect bite, or maybe a rash, or an irregular red area. The inflamed area usually lasts between 3 and 5 weeks and other red spots may develop.
Symptoms
Symptoms begin sometime later, usually with headaches and neck stiffness, other rashes, odd aches and pains, fever, fatigue, numb and tingly areas and even “brain fog”. The affected person may become really ill and the problem can last a long time: years, in some cases.
The symptom lists below comes partly from the two references, mentioned below:
In the acute phase, there is some combination of:
Headache, fever, fatigue and neck stiffness, in the acute phase
Additional “erythema migrans” rashes in other locations
Muscle pain and joint pain, often affecting the large joints (e.g. knees)
Nerve pain, numbness, and tingling in the hands or feet
Facial paralysis, with a drooping appearance and loss of muscle tone in the face
Heart palpitations, irregular heartbeat, dizziness, shortness of breath
Brain fog, short-term memory problems and changes in vision
In chronic cases, the history may include:
Severe headaches
Arthritis, with pain and swelling of joints
Heart abnormalities
Mental disorders, including depression
Cognitive impairment: confusion, short-term memory loss, and brain fog
Numbness in the extremities, from Peripheral Neuropathy.
Caveat
(1) A discussion of Lyme disease itself is not my main purpose here: for greater detail about the illness, please see an excellent “layman’s” dissertation on the subject, by Mary Shomon, at health central, https://www.healthcentral.com/article/lyme-disease-and-your-thyroid .
(2) Lyme disease is like long Covid in two ways – the fatigue is similar and its effects can persist for an extraordinarily long time. Lyme disease doesn’t become chronic in every case, but for those who are affected, it represents a major problem. So much so that, like “Long Covid”, there is a name for it. The term is “Post–Treatment Lyme Disease Syndrome,“or “PTLDS” (I’m tempted to call it “Long Lyme”, a nickname which my Trinidadian friends would find amusing, because in Trinidad, “Lyme” means “hang-out, drink rum, and chat”).
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