Revolution Health & Wellness

Episode 78 – How to Properly Test for Lyme Disease

Episode 78 - How to Properly Test for Lyme Disease

Lyme disease testing in Tulsa, OKTesting for Lyme disease can be VERY tricky! Why? There are a lot of reasons and it is important to understand the process.

The IDSA recommends a 2-tier testing process but we know that this is insufficient. There are good reasons for this but you have to understand why. Knowing this information can make all the difference for the right people.

 

Speaker 1: 00:00 Welcome to against the grain podcast with Dr Chad Edwards, where he challenges the status quo when it comes to medicine. We get into hot topics in the medical field with real stories from real patients to help you on your way to a healthy lifestyle. Get ready because we’re about to go. Go against

Speaker 2: 00:19 the gray,

Speaker 3: 00:25 right? This is the wonderful Nathan Arnold. I’m here with Dr Chad Edwards, revolution health and wellness. He is a physician in the Tulsa area and he was a former US military member and served many overseas tours, Iraq, Iraq, Afghanistan. No, no. Okay. He did not serve in Afghanistan, but anyways, he is a physician. And what are we going to be talking about today? Dr Edwards

Speaker 4: 00:54 talking about a very, very controversial topic. Um, and you know, for, I’ve seen many cases of this, I’ve seen a lot of issues with this. So today we’re going to talk about lyme disease and why, uh, why this is so tumultuous and why it’s just so controversial. So basically we’re gonna talk about the testing for lyme disease and I think that this is going to be the beginning of a multipart series on lyme disease. So there’ll be several podcasts that we’re going to talk about lyme disease and why some patients feel so bad. Um, you know, for example, I had a patient that came in this last week and I would have missed this patient having lyme disease if I didn’t have the appropriate training and questionnaires and tools and you know, I had recently went to work with or I got a chance to meet Dr Richard Horowitz.

Speaker 4: 01:51 Arguably one of the world’s leaders in lyme disease, literally has traveled the world discussing lyme disease, was recruited by the Chinese government to evaluate lyme disease in China. And they estimate that six percent of the Chinese population has lyme disease. Six percent, six percent of the idea how many Chinese people there are. There’s a lot. I mean, that six percent have a whole lot. That’s still a whole lot. Still a whole lot. So, uh, so anyway, this guy is just phenomenal and it was a life changing working with him. And he gave me some tools that I had a patient this week that felt bad, thought it was kind of testosterone, unrelated, started some testosterone, and then they came into see me and I said, you know what, we need to look at ways to look at something, fill out this questionnaire. And the questionnaire was double the high end of this tick Bourne illness, lyme disease being a possibility for his, for his problem.

Speaker 4: 02:47 We did confirmatory testing and sure enough he has lyme disease and I never would have caught it had I not had the proper, uh, the proper training exposures kind of things. So today what I wanted to go into the detail about specifically the lyme disease is how we test for it. And why is it such a rocky topic? You ask any physician in Oklahoma, do we have lyme disease in Oklahoma? And they’ll say, no, no, no, no, we don’t. We don’t see lyme disease in Oklahoma. Was it? And Yeah. So, and that’s what we’re going to get into. Great. Cool. Great. All right. So basically the, there are in order to understand why this is kind of a rocky topic, you got to understand that there’s two different primary societies, you know, we have in medicine, we have a lot of societies, you know, the, and memberships in certain clubs, but just these, these groups.

Speaker 4: 03:43 And so one group that looks at lyme disease is the IDSA, which is Infectious Diseases Society of America, and they have certain criteria for how they diagnose and evaluate lyme disease. The other side of the coin though, is another group called I lads, which is the international lyme and associated diseases society. Now, both of these groups are, you know, they’re um, comprised of physicians, nurse practitioners, you know, medical professionals, very intelligent, smart people, yet they see two different sides of the same problem and come to two different conclusions. And so, you know, we’re going to talk about why that is. Sounds good. So the, the testing for lyme disease, there’s other, when it comes to medical problems, you can have all different kinds of testing and I think, well before we get into the testing, let me just kind of convey, um, there’s, there are criteria for diagnosis and there are criteria for epidemiology and the CDC Centers for Disease Control does epidemiologic data, they evaluate epidemiologic data for lyme disease because they’re trying to track where in the country do we find lyme disease.

Speaker 4: 05:03 And so they use epidemiologic criteria, meaning that if a, let’s say you had cancer and your cancer falls into a certain category and they’re gonna say, well, we’re going to look for this specific tumor marker so that we can follow all the people with this tumor marker and see what happens or where are they or what’s going on. And those kinds of things. Now if you have that tumor marker, you’re lumped into their group. If you’re a, if you don’t have that tumor marker, you’re not lumped into that group. It doesn’t mean that you don’t have cancer. It means that your cancer doesn’t express that, that tumor marker. And you know that basically they’re saying we have to draw the line somewhere, so where are we going to draw that line so that we can follow this particular group of patients and the epidemiologic data is different than diagnostic criteria and the criteria that the CDC uses for epidemiologic data was never intended to be diagnostic. Now the problem is is it has become diagnostic and that is part of the problem. So we’re going to dig a little bit

Speaker 3: 06:04 because it seems very general, like do you feel that it’s too general the way that they would do the EPA? The immunologic epidemiologic? Yeah. Okay. Do you feel that in general to conclude that, like if you show the certain characteristic, then we put you over here and if you don’t have this tumor marker

Speaker 4: 06:22 Oscar or

Speaker 3: 06:25 this, like you said, this tumor marker, do you feel that it’s too general just to say, okay, you don’t exhibit this specific characteristics so we’re not going to put you over here with this group? Or do you think that’s the right way to do it? Doesn’t matter.

Speaker 4: 06:37 Well I don’t. I don’t fault the CDC for, for having this epidemiologic data. They’re using it for tracking. The problem that I have is when it has come down to its diagnostic criteria, it was never intended to be diagnostic criteria. It’s not diagnostic criteria. The problem is not, you know, with the cancer and the tumor marker, the, the problem is not, you know, are they following these people with these tumor markers? That’s not the problem. The problem is when we say, oh, the CDC is using this to follow this group of patients, but if you don’t have that, you don’t have cancer. That’s the problem. Right? So in the case of lyme disease, they’re using the wrong criteria to say that you do or don’t have a. let me rephrase that. It’s not, they’re using the wrong criteria. Were using incomplete data to say you do or do not have a disease specifically in this case, lyme disease.

Speaker 4: 07:34 Uh, so when it, when it comes to the testing, you can do direct testing and you can do indirect testing. Drugs testing means things like a blood culture, a DNA amplification, what we call a PCR. You can test antigens and urine, uh, you can do dark field microscopy. That’s where we take the blood and put it out. You know, for syphilis we used to use what’s called dark field microscopy, and you can do the same thing for lyme disease because they’re both spiral [inaudible]. They’re the same, the same kind, same type of bacteria. The interesting thing about lyme disease or Borrelia Burgdorferi or Borrelia species or genesis, I shouldn’t say, is that the genome, the genetic makeup of that bacteria is orders of magnitude greater than that of other bacteria. It think about it as a smart bacteria. It has, I want to say tenfold the amount of DNA that your standard bacteria has.

Speaker 4: 08:28 So I don’t wanna, I don’t wanna say it’s more intelligent, but it’s much more. It has much greater complexity, which means that it can do things very differently than standard bacteria. We can’t put it in that same, in that same model. Now there’s problems with some of the direct testing. For example, blood culture. If, if I draw your blood and I cultured Borrelia Bacteria, the spare keys out of blood, that means you had that spare key in your blood, you know, so that’s, that’s a direct test. There’s a problem with it though, because there is a very small number of Borrelia Burgdorferi in the blood. So the bacteria that causes lyme disease, it’s not primarily a blood pathogen, it’s, it’s, it’s a, it’s a facultative anaerobe, meaning that it prefers an, uh, a low oxygen environment. So it doesn’t really want to be in the blood because you got more angst.

Speaker 4: 09:25 Exactly. So, um, it, there’s not a lot of this bacteria in the blood, so I can get your blood and I can culture it out, but there may not be anything growing out on it because there’s not a whole lot in the blood. Anyway, I got to get a large volume of blood and to make sure I catch it. Secondly, it, the bacteria are very slow growing. Think about tuberculosis. It takes a long time to treat someone with tuberculosis. It can take awhile to diagnose them, you know, or a culture of them because the bacteria grow very, very slowly. In fact, the cultures for Borrelia can take 10 and a half months. Wow. That’s a long time. And so you’re waiting for diagnosis for 10 that month. So it’s almost like time it takes to give birth to a baby a month and a half short.

Speaker 4: 10:05 But yeah, generally it’s similar. Yeah, exactly. And it takes, it’s a long, long time. Then things like with DNA amplification of the PCR technology, great technology, again, it’s considered experimental PCR is considered experimental by the Idsa for diagnosing lyme disease. And again, we’re looking for this complex, more complex genome bacteria in the blood. So we’ll pull the blood out or, or spinal fluid or anything else and we’ll do a PCR technology to try and get the DNA from Borrelia, from that tissue specimen. That concept is considered experimental by the Idsa. Now if you find it, you find it, why that would be experimental. I don’t know. But, uh, I mean if you find it, it’s there, but the problem is just like what the fact that there’s limited numbers of bacteria in the blood. There’s also limited numbers of these DNA in the blood. Your immune system may do a good job of keeping that out, you know, I’m not sure, but it’s like trying to find the needle in a haystack.

Speaker 4: 11:07 It’s if you, if you get the right club, a, hey, it’s in there, you just got to dig through it. But if you get the wrong Columbia, hey, it’s not there. You can look all day long. Doesn’t mean like the test is, is bad necessarily. It’s just, it’s difficult to find this stuff. And then you know, the antigens in urine, dark field microscope, again, we talked about some of that stuff. So direct testing while while beneficial and if you find it’s great, does not mean if you don’t find these things that you don’t have it. So it gets a little more rocky. Then you can do direct testing. And this is where the, uh, it’s called the dearborn criteria. The dearborn guidelines or some people call it the CDC guidelines, uh, kind of starts to come in and there’s basically, there’s a number of tests, but the primary ones that we’re going to talk about here are the Eliza, which is an enzyme linked immunosorbent assay.

Speaker 4: 11:57 And the other one is a western blot. They both have a little bit different, uh, technology and we look for things a little bit different ways. So the first part of the, um, the dearborn guidelines is that it is, they, they recommend a two tier test and this is similar to how, you know, back old school, when HIV first came out and you wanted to get tested for HIV, they would do an antibody test and if you found the antibodies then they would do a confirmatory western blot, a confirmatory test. So what does all that mean? Well, the antibodies, in order for a test to, to have, we want to start with a screening test. With a screening test, you want to have something that has a high sensitivity. In other words, it’s going to pick up. You want it to pick up everybody you know if you’re going to do a test and you want to know how many people have green eyes, then you set up a test so that everyone with green eyes as lumped into the category, but you might get a couple of people with Hazel eyes, which means you might get a couple of people with Brown eyes.

Speaker 4: 13:04 So the sensitivity means you catch all of them. You want some screening with a screening test. You want a very, very high sensitivity. Now that doesn’t mean that they do have it. You have to do confirmation. So in this screening process, we want to catch everybody. So an antibody test, or in this case the Alyssa should be a very, very sensitive test. So once we, we say, okay, we see antibodies or we did the Elisa test and we think you’re positive for lyme disease because the test is sensitive, but it’s not very specific. Specific means that the test only picks up the people with lyme disease. They’re looking for eyeballs. Only the people with green eyes get picked up and everybody else’s is thrown to the side. So the uh, the more sensitive, the better the screening test, the more specific, the better the confirmatory test goes up.

Speaker 4: 14:00 Does that make sense? Okay. So the western blot is supposed to be the very specific tests. So we get the sensitivity with the screening test and we confirm it with the confirmation test. So the license test is supposed to be the screening test and by that dearborn criteria or guidelines we’ll do the Eliza and if that is positive then we’ll do the confirmation test. If it’s not positive then you’re done testing the if you are positive, then we do the western blot and the western blot is basically a test that looks at certain size proteins and how they migrate through this, you know, we apply electricity to in how are they migrate through these, these tissues and these different sizes of proteins will yield these bands and it’s a little stripe on the, on the medium where you’ll have this little highlighted mark so to speak.

Speaker 4: 14:58 And then they, they use a scale basically to tell us where these things are and the proteins are scaled in kilodaltons a kd and that’s the size of the protein. And so like a 31 kilodalton protein will migrate through that, that medium at a certain rate and but a, you know, an, a 93 Mike is going to migrate at a different rate because it’s a bigger protein. So the western blot is looking for a certain bands of proteins and if you have these specific bands then they’ll say, okay, that’s the confirmatory test. So we associate these proteins with, in this case the Barilla Burgdorferi. There are some on a western blot and we’ll definitely get more into this after the break, but there are some that are very specific to a certain bacteria or a certain structure and there are some that are not but may still be a little bit helpful.

Speaker 4: 15:58 So on the western blot, the dearborn guidelines, there’s a couple of different tests that we do. The first one is an igm. There’s different kinds of antibodies. Igm is the first antibody that will show up in response to exposure to an antigen. If you get, you know, you were. You’re a military, so you’ve got immunizations, right? Yeah, exactly. Now we like to be a pin cushions for those things, so we will do a. When you get a vaccine, the very first thing to respond is an igm. That’s an antibody that responds in a very short period of time within a couple of few days and you start getting elevated ige levels, and then the other way to look at this as Igg, it’s the, it’s the second antibody. Again, you get that vaccine. Edgeum levels come up over a matter of a few weeks. The IGM levels begin to decline. Igg levels, which are much more specific to that antigen begin to rise.

Speaker 4: 16:55 Normally we will convert igm to Igg within six weeks. So you get an a, a, an immunization and the IGM levels go up, they’ll begin to decline. IGG levels come up and so six months later you don’t really have any igm, but you do have Igg, right? So the thought is we can determine if something’s an acute infection or a chronic infection or exposure. So on the IGM immunoglobulin a western blot by the dearborn criteria, they’re looking for three different bands and you have to have two of the three bands. You have bands 23, 39 and 41 of those three. You’ve got to have two of them that are positive in order for that to be a western blot or on the igg looking at that other antibody, um, five of the following, you have to be positive. And there’s 18, 23, 28, 30, 39, 41, 45, 58, 66 and 93.

Speaker 4: 17:58 So you gotta have you gotTa have a, um, a five of any of those bands. And by the Dearborn or CDC criteria, the Western blot can be, uh, can be positive. So you have to have either two of the, three or five of, of the rest of those in order to have a confirmation and thus a diagnosis of Borrelia Burgdorferi. Um, so will, there’s, there’s a whole litany of problems with this criteria and we’ll talk about those parents submitted, right? Well, we’re gonna take a break and we will discuss why does the CDC is crap? Why, why the criteria for, for their, for their guidelines. A while I believe it is crap. The CDC is not crap. They’re just using a different standard and it’s not diagnostic. Are you tired and fatigued? Are you frustrated with doctors because they just don’t seem to listen. Do you want to fix your pain without surgery?

Speaker 4: 19:03 If you answered yes to any of these questions than we are the clinic for you, we offer prolotherapy prp or platelet rich plasma therapy and stem cell injections, ivy nutritional therapies, bioidentical hormone replacement therapy and functional medicine to get you back on track to optimal health. Call our clinic at nine one eight, nine three, five, three, six, three, six. Or visit our website@wwwdotrevolutionhealth.org to schedule your appointment today. Okay. And we’re back. So before we left, we were just about to talk about why the CDC criteria is not where you believe the standard should be. And why is that? Yeah. So again, we talked about that too to tear process of the, uh, Eliza test. So if you think you have lyme disease or I think you had lyme disease, you come into the clinic and we’re going to run this through a lab and I want to know if you have lyme disease.

Speaker 4: 19:55 Now I’ve done this well and patients before and one patient, I was fortunate enough to get back a positive Eliza test. And so then they went on to do a western blot, which they said was negative, which is going to happen most of the time based on the criteria that, uh, that my experience most of the time based on these criteria and through a traditional standard lab, it’s going to go through this to steer two tier process because that’s what the Idsa guidelines or what it’s called, so called the Dearborn CDC guidelines say to do. But the first thing we talked about, the sensitivity and the specificity of a test. A screening test is supposed to be very, very sensitive, needs to pick up everybody. The problem is, as the Eliza test for Borrelia Burgdorferi is, is just not sensitive at all. It doesn’t, it does not meet to be a screening test.

Speaker 4: 20:50 The sensitivity of it is crap. There are two studies that validate what I’m saying. So it’s not just me saying this, uh, and, and the, the overall gist of this, the point of this is that if, you know, as we said, if you get antibodies or if I want to know if you have lyme disease and I get antibodies on you and they’re negative, that’s supposed to say you don’t have it in this case. That’s not what it does. And you know, unfortunately, the Idsa, uh, and most physicians don’t recognize that that’s the case. Uh, so there again, two studies validating what I’m saying. The first one, uh, this one is a two year study done at Johns Johns Hopkins showed that the Eliza test for Birla Burgdorferi had a 45 percent sensitivity, only 45 percent of the time. It was positive when it should have been positive 95 or 99 percent of the time, so much less than, um, than, than what we’d expect.

Speaker 4: 21:48 Another study just their conclusion was they realized it just doesn’t have adequate sensitivity to be used as a screening test so that, that first concept of we need this two tier test that if this is positive then we’ll go on, but it’s only positive 40, 45 percent of the time when it should be positive 100 percent. So we’re missing a lot of people and you just got to understand that part as the initial piece. Then, you know, like I mentioned before, the break I think, or maybe just to save me that I had done a lab and was fortunate enough to get a test back, positive antibodies. In fact I had, I had one this week that positive antibodies. Um, so now we’ve got to do the confirmatory test, which is the western blot. Now we talked about those three bands that have to be positive by the dearborn criteria, which is Benz 2139 and 41 for the IGM.

Speaker 4: 22:46 Now part, there’s a, there’s a couple of problems. The first is that this western blot by the dearborn criteria only includes one strain or of Borrelia Burgdorferi. There are different strains and when you look at bacteriology, even with a probiotics, so people will take probiotics and they think that lactobacillus acidophilus is, is lactobacillus Acidophilus, and that’s just not the case. You can have lack of bacillus acidophilus, that doesn’t interact with the human gut and it may not be that beneficial for you. When you look for probiotics, and I think I’ve said this before, on the podcast, you want to look for specific strains of these probiotics and they’re going to be identified usually with a letter and a number, you know, like La Dash five or something to that effect. So with the western blot test, it was only developed for the B, 31 strain of Barellia Burgdorferi.

Speaker 4: 23:41 So that, I mean, that’s an important strain, but it’s not the only one out there. Right? So the second piece is that it, the, uh, the western blot by the Dearborn, IDSA CDC criteria specifically excluded to very specific a barellia specific bands. On the western blot and they are 31 and 34, those proteins are also called a and [inaudible] B r s Osp stands for outer surface protein and a is is the 31 on the western blot and the B, b is 34 on the western blot. They specifically excluded both of those, both on the IGM and Igg Igg. Now why would they do that? Those are very specific bands for Barellia Burgdorferi. Lyme disease. Why would they eliminate those? The reason they did it is because the, uh, the vaccine for lyme disease, which will have another podcast about w was targeting those two proteins. So if I gave you an immunization for lyme disease, which they did in the late nineties, I believe, um, if I gave you an immunization for lyme disease, it would give you antibodies against 31 and 34. So if I did a western blot, you will be positive for 31 and 34. So they say, well we can’t use that because the line or the, uh, the vaccine covered that. Now, how many people do you know of that got the lyme disease vaccine?

Speaker 4: 25:22 I can’t think of any in my, uh, over 20 years of experience in the medical world, I’ve seen one patient that got the lyme disease vaccine. It was only out for about two years. Really? Not many people got it and it went off the market, not because it was a bad idea, not because it didn’t work, but because there wasn’t a market interest for it. And that’ll be in the next [inaudible], the podcast on the lyme disease vaccine. So we eliminated two very specific protein bands that are very specific for Borrelia because the vaccine would cover for it and we don’t want to get confused. Wow. So it just added to the confusion. And then the next piece is that, um, the I, I use, I genics, which is a lab that does a Western blot. And what’s different is that they include 31 and 34, but they also include another strain of Borrelia, uh, specifically, uh, straighten to 97.

Speaker 4: 26:18 Now when you include what you only do a western blot for the [inaudible] strain and you exclude the, the I’m 31 and 34, the A and B, then the sensitivity of that test is only 46 percent. That’s not very good. Exactly. So when you include strange to 97, along with 31 as well as include the A and b are the the 31 and 34, I’m your sensitive. Your sensitivity goes up to greater than 90 percent, so we had a much better test for lyme disease with a different lab. Now some doctors would say, oh, well everyone that tests you, all those tests were positive when they. When they send a lab to ign x, well, I can tell you that the only people that use [inaudible] are the physicians that are used to dealing with lyme disease. You get physicians that are used to dealing with lyme disease and they do a better job of sorting out who does and doesn’t have lyme disease before they even send a test.

Speaker 4: 27:22 I’m only going to send the test if I think there’s a chance. It might be positive if I send 100 percent to the lab, then I’m going to get a lot of them that are negative. If I only get the ones that I think I think this might be lyme disease, of course I’m going to have a higher incidence that is positive. So to say that, oh, it’s all positive. That’s you’re not using sites and that’s where I just get fired up because this is using science. It is a good lab, it is a good test and you have to understand where the bands come from and the strains that are being tested for lyme disease that you have to understand the testing. And that’s why I think this podcast in particular, so important because the testing matters and you have to understand why, uh, so on the western blot, those are some of the issues with it.

Speaker 4: 28:07 Now there are seven bands on this western blot that are very specific to Borrelia Burgdorferi. The bacteria that causes lyme disease, seven of them that are very specific band 18. And there is a physician, I believe is, I forget his name, Dr Roberts maybe, but he saw tens of thousands of lyme disease patients, probably saw more lyme disease patients than, than anyone else. And he felt this is not, there’s no study proving it. This was just his words. Uh, but he felt that if you had the 18 band positive, that that was diagnostic for lyme disease. So, you know, is that proof? No, but that’s good. Clinical Acumen. I’m the band 23 also called see outer surface protein seat is very specific to Borrelia Burgdorferi. A band 31 and 34. We’ve talked about those. They’re 34 is very borrelia burgdorferi specific band. Thirty nine is specific to the flagella. It’s like a little tale, you know, like sperm flagella this little tail.

Speaker 4: 29:08 So the, uh, the, the flagella on Borrelia Burgdorferi, is that his band? Thirty nine a band, 83, maybe a cytoplasmic membrane and band 93 is also specific. Now, if you look at what the CDC or the Wellbore, the dearborn criteria use on their igm 23, 39 and 41 band 41 is only 50 percent specific. So that means if it comes back positive only half the time as it Barilla, half the time it’s something else, but the ones that are lyme disease specific on the igm, there’s only one row and that’s bands 23. Oh, I’m sorry. Thirty nine is also specific, but so we were looking at fuzzy data. Excuse me. When you’re talking about, uh, what, what specific to Borrelia, how, what is going to give me the best test? Now, another issue is that, you know, we talked about the IGM and the Igg and normally it converts in six weeks with Igm and lyme disease.

Speaker 4: 30:14 Remember we talked about the, the genome of Borrelia, and it’s much more complex than your standard bacteria. So it actually has the ability to change some of its protein expression. The way our immune system works, we recognize protein expressions. We’d been developed antibodies against specific proteins generally against specific epitopes. And the Borrelia has a, the ability to turn some of them on and some of them off so it express it and not expressing those kinds of things. Um, and so because of that, it stays in this active form. Your immune system doesn’t really get a chance to convert the igm to the Igg, uh, you know, because of this multifaceted way in which it presents. And there are three studies that validate this as well. The first one was done by steer in 1979 and it showed that igm increases during exacerbations but decreases during remission.

Speaker 4: 31:12 And it can do that for up to 18 months. That was one of the conclusion from that study. Another study done in 1984 by craft showed that persistent igm antibody is associated with more severe disease. So again, it doesn’t really fall into the traditional, uh, immunologic process of IGM converts to Igg. And then the next study is by Maserati in 1992 show that 50 percent, 56 percent of early lyme disease had a positive igm after six months. And that’s just not the way the rest of, you know, the, the immunologic evaluation goes, so it can get very complex in evaluating for lyme disease. And you’ll get a lot of very intelligent physicians that will argue the point where we’ve got studies showing it’s not as black and white as they think. And the last piece, and then I’ll wrap it up, is that another component of this is lyme disease patients, chronic lyme disease patients are sick patients.

Speaker 4: 32:11 The, the bacteria evades the immune system. Their immune system becomes dysfunctional. They, uh, the, these antibodies will interact with antigens and so they’re not available for the test so they don’t often show up. And so what we find is the sicker patients often have fewer antibodies, um, because the Barilla is immune suppressive. And so the more often they have actually negative tests, but you get healthier patients with chronic lyme disease and they are much more likely to have a positive test. So you get these people that you’re like, oh, it’s probably not. And they have a raging positive test. You get these really sick as stink patients and it’s like, holy cow, they had nothing was positive on it. So it’s a very interesting disease process. Um, and you know, the more I learned about this and certainly the more I’ve interacted with patients, the more I’ve been able to identify the more I found and the more patients that we’ve been able to help.

Speaker 4: 33:06 So it’s just a fascinating disease. Uh, and I’ve, I’ve seen patients for several years with, with lyme disease, chronic lyme disease and I wouldn’t wish that on anybody but you know, stay tuned to our next podcast and we’re going to talk more about the history of lyme disease, what we can do about it, how do we treat it? And in talking with Dr Horowitz, he thinks he’s really close to a cure for chronic lyme disease. So very hopeful for patients and to think you might have something like this. Certainly come see us, come see someone specific that knows a lyme disease and all of its ins and outs and uh, uh, you know, hopefully we can get you feeling better.

Speaker 3: 33:45 Sounds great. Thank you so much for spreading the knowledge about lyme disease. I’m sitting on the edge of my seat for the next segment. I want to know more about it now, every time I walk outside I’m going to have a hat on because I’m going to be worried that a tick might drop on my head and give me lyme disease, but if I do get it, then I know who I can come talk to you and I’m sure you’ll do a great diagnosis, but until next time, thank you so much Dr Edwards.

Speaker 4: 34:10 Matt, thanks for being here with me. Thanks for helping me out and stay tuned for a lot more on lyme disease.

Speaker 1: 34:16 Thanks for listening to this week’s podcast with Dr Chad Edwards. Tune in next week where we’ll be going against the grain.