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Common Misdiagnosis?


Have You Been Diagnosed with Multiple Sclerosis? You May Want to be Assessed for Lyme Disease as well

The pacific northwest has one of the highest incidences of multiple sclerosis (MS) anywhere in the United States. Doesn't this seem a little peculiar? Yes, we do suffer from a chronic lack of vitamin D due to such few sunny days, but even still, don't you find this rather odd? Perhaps your diagnosis of MS is a masquerade. Have you considered Lyme Disease?

Multiple sclerosis is an autoimmune disorder characterized by numbness and tingling in the hands and feet coupled with white matter lesions in the brain noted on an MRI of the brain. It is typically seen in women ages 25-55 and can be of a progressive nature. It is a demyelinating disease where an autoimmune reaction causes degradation of the myelin sheath around neurons and subsequently causes sensory and motor disturbances and loss of function. Variable treatment may be applied to this disease including the use of steroid hormones to reduce inflammation caused by the autoimmune reaction.


Lyme Disease (Neuroborreliosis) can also a demyelinating disease but it is not an autoimmune disease. Lyme Disease is caused by a bacteria known as a spirochete, Borrelia burgdorferi. Borrelia are typically carried in ticks which are the primary vector for this disease. However, other arthropods may be implicated in transmission as well. Ticks seek a host for attachment and a blood born meal, and subsequently release their contents including Borrelia into the bloodstream of a host causing infection.

Borrelia are an ancient bacteria inhabiting the earth some 400 billion years ago and probably evolved as parasites. They cannot manufacture their own nutrients and require a host to sustain life. They are unable to manufacture their own fatty acids and therefore gravitate to places in a host where high density fatty acids occur. In humans, this is the brain. Neurons are coated with myelin known to be mostly comprised of fatty acids. When Borrelia "nest" in the brain, they feed off of the fatty acids in the myelin sheath and leave "lesions" in the brain. On an MRI, these lesions appear as "white matter lesions" and look identical to white matter lesions associated with MS. In effect, these lesions are indistinguishable, however they result from very different etiologies.

The Correct Etiology of a Brain Lesion 

It's important to determine the correct etiology of a brain lesion because one responds well to antibiotics and the other does not. In fact, this is one of the ways to determine if a diagnosis of MS is real. White matter lesions caused by Borrelia diminish over time when the bacteria is exposed to certain antibiotics. This can be demonstrated on an MRI by examining the brain before and after antibiotic application.

White matter lesions caused by a true autoimmune disease do not respond to antibiotics and therefore a true diagnosis of MS is achieved. Given that an identical symptom can be caused by two very different etiologies, it is important to rule out Lyme Disease before undergoing treatment for MS.

The danger in misdiagnosis of white matter lesions is that the application of steroids which is used in MS is actually very harmful to Lyme Disease patients and may make their condition much worse. Therefore, a consultation with a Lyme literate physician would be beneficial to anyone who has a diagnosis of Multiple Sclerosis. Many people have been bitten by nymph ticks (the size of poppy seeds) and did not know it. A characteristic Bull's Eye Rash did not occur and therefore suspicion of Lyme Disease was never entertained. This may be why Lyme Disease can go undiagnosed. Consider seeking a second opinion for your Multiple Sclerosis diagnosis.

Dr. Susan L. Marra is a Bastyr graduate Naturopathic physician and a Lyme literate physician with 10 years of experience treating Tick Borne Diseases. She was trained on the east coast in Connecticut (ground zero for Lyme Disease) and is currently practicing in Seattle now. For more information, please visit her website at or phone her office at 206-299-2676.


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