Dr. Gary Kaplan was recently interviewed on The Health Fix podcast, hosted by Dr. Jannine Krause, aka “Dr. J”.
Episode #397: How chronic illnesses provoke the body to attack you vs. the bug
The effects of bacteria, viruses, parasites, molds, and other infections can linger in the body long after the infection. These molecules of invaders can trigger your body to attack itself. This is a common phenomenon that has been going on for a long time but has been gaining publicity with long-haul symptoms since the pandemic. Turns out viruses aren’t the only bugs causing long-haul syndromes. In this episode of The Health Fix, Dr. J interviews Dr. Kaplan on how to identify if your chronic symptoms are related to lingering effects of previous infections.
You can access the podcast via any podcast streaming website/app (Apple Podcast link below).
What You’ll Learn:
Why chronic fatigue is a sign of brain inflammation
20-50% of people do not make enzymes to neutralize mold toxins
How pieces of the bugs that you get infections from cause inflammation in your body
Why mold, Lyme, strep, viral infections, and parasites could be keeping you sick
How mental health issues can be related to chronic infections, especially in kids
Tests commonly used to sleuth out chronic infections
The connection between sleep apnea and chronic illness
How to test yourself for the autoimmune condition POTS by taking your blood pressure
There are over 20 million Americans suffering from a group of chronic disabling disorders who are diagnosed without a clear elucidation of pathophysiologic mechanisms. Fibromyalgia, Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome (ME/CFS), Neuropsychiatric illnesses, Posttreatment Lyme Syndrome, Pediatric Acute on Neuropsychiatric Syndrome (PANDAS/PANS).
Adding to this massive disease burden the CDC now estimates that of the 40% of Americans who were infected with COVID-19 1 in 5 continue to suffer with what is now referred to as Post-acute sequelae of COVID (PASC). Research has demonstrated that common to all of these conditions is dysregulation of the immune system resulting from an infectious insult. Dramatic advances have occurred in our understanding of all of these conditions as a result of COVID. We are entering an incredibly exciting period in medicine where these diseases are beginning to coalesce around an understanding of shared pathophysiology. We are entering a period of true hope for those millions who are suffering where we will finally be able to provide comprehensive solutions for their illness.
This conference will bring together some of the leading researchers and clinicians from around the world to discuss the advances in our understanding of these conditions and breakthroughs in diagnostic and treatment options.
Characterized by widespread pain, fatigue, and cognitive difficulties, fibromyalgia (FM) is a complex disorder of the central nervous system (CNS). It affects the brain’s messaging system causing those who have it to experience heightened sensitivity to pain. A fibromyalgia flare-up can last for months at a time and cause debilitating physical and emotional distress. Symptoms can vary from person to person and often suggest other conditions, making it a very difficult diagnosis. Despite all that has been learned about fibromyalgia over the last two decades, people with FM can go years without a proper diagnosis.
Fibromyalgia is associated with many other conditions like Chronic Fatigue Syndrome (also known as Myalgic Encephalomyelitis), sleep dysfunction, infections like Lyme disease or E-BV (Epstein-Barr Virus), digestive problems such as SIBO (Small Intestinal Bacterial Overgrowth), or Celiac Disease and other food allergies that can cause leaky gut. It can lead to autoimmune disorders like Hashimoto’s thyroiditis or autoimmune arthropathies. People suffering from FM may also exhibit reactions to environmental toxin exposure, like mold or heavy metals, which can be diagnosed through specialty labs looking at stool, urine, breath, and bloodwork.
Once you receive a fibromyalgia diagnosis, there are various treatment options and lifestyle habits to consider. My approach to treating fibromyalgia is multifaceted; I look at digestion and diet, sleep, hormone imbalances, injuries (psychological and physical), infections, environmental exposures, genetics, and more.
For example, I often find that fibromyalgia is related to a deficiency in delta-wave deep sleep; medications like Xywav, which promotes deep-wave sleep have been helpful in reducing chronic pain. If you don’t get enough deep delta wave sleep your body can’t recover, and chronic pain can be an issue. (We find that this is common in those with fibromyalgia.)
A common area of pain is the cervical spine. Treatments like physical therapy, acupuncture, or injection therapies like prolotherapy, perineural injection therapy (PIT), or PRP (platelet-rich plasma) therapy may be helpful. You may also consider having your jaw evaluated for TMJ by a dentist specializing in temporomandibular joint problems, which can often cause referred pain in the head, neck, and shoulders.
If you have leaky gut from a food allergy, then inflammation of the intestinal tract leads to nutritional deficiencies and toxicity; I’ll want to look at dietary changes and supplementation. Supplements that may be helpful include D- ribose, fish oil, glutathione, and IV magnesium with B complex and Vitamin C (also known as Myers cocktail).
Because FM affects the CNS, it can influence your experience of pain and emotional sensations; therefore it’s very important to consider my patients’ emotional health which is often not addressed in chronic pain. There are many stress-reduction therapies that can be done from the comfort of your own home including yoga, mindfulness-based meditation, breathing exercises, and even a therapy called Emotional Freedom Technique which involves tapping acupressure points and utilizing positive affirmations. However, if you feel overwhelmed by symptoms, look for a psychotherapist who specializes in working with people with chronic pain. Dealing with chronic pain is emotionally exhausting; seeking help can be a vital lifeline for many.
As with other chronic illnesses, treating fibromyalgia is not a straightforward process; it requires a multifaceted treatment approach with close collaboration in order to help you recover or better manage your illness.
We are here for you, and we want to help.
Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2
Wednesday, November 8, 2023, 10:00 AM – Friday, November 10, 2023, 3:00 PM
Marriott Marquis, Washington, DC
Overview
There are over 20 million Americans suffering from a group of chronic disabling disorders analogous to the confused interplay of language described in the biblical Tower of Babel, who are diagnosed without a clear elucidation of pathophysiologic mechanisms. Fibromyalgia, Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome (ME/CFS), Neuropsychiatric illnesses, Post-treatment Lyme Syndrome, Pediatric Acute on Neuropsychiatric Syndrome (PANDAS/PANS).
Adding to this massive disease burden the CDC now estimates that of the 40% of Americans who were infected with COVID-19 1 in 5 continue to suffer with what is now referred to as Post-acute sequalae of COVID (PACAL). Research has demonstrated that common to all of these conditions is dysregulation of the immune system resulting from an infectious insult. Dramatic advances have occurred in our understanding of all of these conditions as a result of COVID. We are entering an incredibly exciting period in medicine where our current Tower of Babel of diseases is beginning to coalesce around an understanding of shared pathophysiology. We are entering a period of true hope for those millions who are suffering where we will finally be able to provide comprehensive solutions for their illness.
This conference will bring together some of the leading researches and clinicians from around the world to discuss the advances in our understanding of these conditions and breakthroughs in diagnostic and treatment options.
If left undiagnosed and untreated, Lyme disease and other tickborne illnesses can have detrimental long-term effects on the body.
Lyme disease is the most reported vector-borne illness (diseases transmitted through mosquitoes, tick, and flea bites) in the United States. The latest numbers from the CDC estimate that approximately 476,000 patients are diagnosed and treated for Lyme each year.* People who are diagnosed early and receive proper treatment consisting of 28-30 day antibiotic therapy usually recover rapidly and completely. However, others who are correctly diagnosed and treated sometimes fail to fully recover, and, for a variety of reasons, still others go undiagnosed and untreated.
This article explores 4 reasons why Lyme disease may go undetected and/or become a chronic illness.
1) It is not always possible to confirm a tick bite
A key component of early diagnosis is recognition of the characteristic “bulls-eye” rash. Courtesy of the CDC/PHIL.
The only way you can contract Lyme disease is through the bite of an infected tick. If you develop the telltale bull’s eye rash (medically referred to as erythema migrans), there is no disputing the fact that you have Lyme disease, but not all patients have a rash and sometimes the rash does not have a bull’s eye appearance.
Ticks vary from the size of a poppy seed to a sesame seed, which makes them hard to see; and they prefer latching onto hard-to-see areas of the body such as armpits, groin, or scalp, so it’s likely you won’t notice their presence. This means, more often than not, you won’t know if you’ve been bitten, and by the time you start feeling sick – the incubation period for Lyme ranges from a few days to a few weeks – the tick will be long gone.
2) Lyme disease symptoms are very similar to other non-tickborne chronic illnesses.
Another factor that can make it difficult to obtain an accurate diagnosis is the similarity of symptoms that present with Lyme and other tickborne diseases (fever, chills, fatigue, headache, and joint aches) with those of many other non-tickborne illnesses, such as flu and other viral or bacterial infections.
If left undiagnosed and untreated, there can be detrimental effects on the body’s musculoskeletal and nervous systems. Symptoms such as chronic joint pain & headaches, extreme fatigue, and mood disorders can subsequently be misdiagnosed as fibromyalgia, chronic fatigue syndrome, or depression. This similarity of symptoms can cause delays in getting tested, and in turn causing delays in treatment.
There is also evidence indicating that chronic cases of Lyme disease (when symptoms persist after taking the typical short-term dose of antibiotics – also called Post Treatment Lyme Disease) contribute to a sustained inflammatory condition throughout the body that interferes with the healthy functioning of the nervous system. Known as Central Sensitization Syndrome, CSS has been implicated in several chronic illnesses and pain conditions, including fibromyalgia, chronic fatigue syndrome, depression, and Lyme disease.
3) The patient may also be co-infected with another tickborne disease.
Ticks can carry multiple bacteria and parasites, including Babesiosis, Ehrlichiosis, Anaplasmosis, Bartonella, and Rocky Mountain Spotted Fever (also called Spotted Fever Rickettsiosis), and it’s not uncommon to see patients with multiple tickborne infections, but you won’t find them if you don’t look. In fact, some studies suggest that as much as 30 percent of ticks that carry Lyme also carry another infectious agent that produces similar symptoms to those of Lyme disease, but requires completely different antibiotics and lengths of treatment. Because of this, it is extremely important for physicians to test for all forms of tickborne diseases and not just for Lyme.
4) Laboratory tests, while important, have room for improvement
Unless you’re among the small percentage of people who present the classic bulls-eye rash, a confirmed diagnosis is a little trickier. Blood tests, can get you another step closer to a diagnosis – and more importantly – a treatment. But before deciding to run diagnostic testing, a doctor must consider a patient’s physical symptoms and obtain a comprehensive history that assesses their personal exposure risk. For example, if an individual is experiencing some suspicious symptoms and often hikes or horseback rides, and/or owns a pet that spends time outdoors, a Lyme test is in order.
Unfortunately, the tests aren’t perfectly reliable, especially if the order includes testing for Lyme and other tickborne diseases. Different labs have varying levels of sensitivity, and some testing can miss some cases of infection. To accurately interpret test results your physician needs to understand the sensitivity and specificity – or, in other words, the limitations — of the lab testing they are ordering.
So what’s the takeaway?
Be your own healthcare advocate. The best medicine is prevention. Before recreating outdoors, cover your body in light-colored clothing. Use an insect repellant on yourself and make sure to treat your pet. Take the time to check yourself and your pet for ticks after spending time outdoors. If you do find a tick, do not throw it away. It can be sent to a lab, such as tickreport.com, and tested for multiple tickborne diseases. Having this information will allow you to request the proper treatment faster.
If you do notice Lyme-like symptoms, a helpful first step is the Horowitz Lyme Questionnaire. Developed by Lyme expert, Dr. Richard Horowitz, this test should not replace medical advice from your physician but can be a useful tool to determine the likelihood of Lyme or other tickborne illnesses. The only way to confirm or rule out a Lyme diagnosis is with a blood test.
Every individual is unique in their genetic makeup, medical history, and environmental exposures. Each of these factors can affect how Lyme disease manifests itself in your body. If some of your symptoms persist, even after you have been treated — don’t give up! Be your own advocate; keep asking questions and seeking answers until you find the right treatment options for you.
Dr. Kaplan delves into the very controversial topic of identifying and treating chronic Lyme disease, a tick-borne illness that lingers past standard courses of treatment. This presentation by Dr. Gary Kaplan was recorded on Sept. 26, 2019.
Dr. Kaplan discussed the difficulties in correctly diagnosing chronic Lyme as well as new research and treatments that are currently available.
To download any of the handouts that were provided, click on the links below. You can also download a pdf copy of Dr. Kaplan’s PowerPoint presentation.
According to the Centers for Disease Control, almost 1 out of 3 people in the United States will develop shingles during their lifetime. Shingles is a painful viral infection caused by the varicella-zoster virus, the very same virus that causes chickenpox. The reason for this is that the virus never completely leaves the body, instead, it remains inactive in nerve tissue near your spinal cord and brain and years later it may reactivate as shingles.
What do you need to know?
Most cases of shingles occur in people who are over 50 and the risk continues to increase as you get older.
A weakened immune system may also put you at higher risk.
Shingles can cause severe pain. The most common symptom is a painful skin rash that usually appears on either side of your torso or can affect the trigeminal nerve around and over the eye. The rash and accompanying symptoms can last anywhere from 2 to 4 weeks and unfortunately for some, the pain can last for months, or even years, after the rash goes away. Postherpetic neuralgia (PHN) is the most common complication of shingles, affecting approximately 10-15% of shingles cases. Integrative treatments that can help ease the pain of PHN include acupuncture, medications, stress reduction techniques, and IV therapy.
In 2017, the Food & Drug Administration approved a new, more effective vaccine called Shingrix. This new vaccine is reported to be more than 90% effective when taken as recommended according to the Centers for Disease Control (CDC). This is a far higher effectiveness rate than the old vaccine, Zostavax. For maximum effectiveness, the vaccine is given in two shots, 2-6 months apart.
Who should get the vaccine?
Adults over 50 years old who:
have had chickenpox or can’t remember if they have had chickenpox
have already had shingles
have already been vaccinated with the Zostavax vaccine
If you meet the criteria above or have questions about the vaccine, talk to your primary care physician right away.
Getting vaccinated will significantly reduce your risk of getting shingles and the complications that it may cause.
If you have questions about the Shingrix vaccine or if you are not sure if you are a good candidate, ask them if it’s right for you. You can also visit https://www.cdc.gov/shingles/index.html for more information from the CDC.
If you currently have shingles and would like to talk to a nurse about our treatment protocol, call us today at 703-532-4892.
Vector-borne diseases (diseases transmitted by insects) in the United States are steadily – and in some cases, rapidly – increasing, according to this 2018 report by the Centers for Disease Control (CDC).
An analysis of data collected over the span of a decade showed that disease cases from tick, flea, and mosquito bites more than tripled nationwide between 2004 and 2016. While this increase is evidence enough of a serious public health concern, some estimate that the actual number of infections (including unreported or undiagnosed cases) far surpass the reported numbers. The CDC report also confirmed that since 2004, 9 new germs have been discovered or introduced in the United States, including Zika virus and West Nile Virus.
If you have been diagnosed with Lyme disease, you are already well aware of how detrimental its effects can be on the body. Vector-borne diseases can cause serious disability and neurological harm if left undiagnosed and untreated and can have serious effects on the body’s musculoskeletal and nervous systems. Symptoms can linger for months, and sometimes are permanent. In older populations and with young children the risks can be far more serious and can even result in death.
With the risk of infection steadily rising, taking precautions to reduce the number of bites you get is more important than ever before. Along with wearing clothing that covers exposed skin during peak hours, an effective repellent is a must. We recommend that you choose a repellent that contains one of the following: Picaridin (20%), IR3535 (20%), DEET (20-30%) or Oil of Lemon Eucalyptus (30-40%).
But for those who are more inclined to try DIY repellents or natural bug sprays due to concerns over chemical additives, most important is to know that what you’re using actually works. Finding a repellent that is both safe and effective can be difficult, so Dr. Jane Marke has analyzed some homemade remedies and natural bug sprays to see what works best.
For those who are interested in natural solutions to treat lawn and garden, Arbico Organics offers a wide array of pesticide-free products.
After spending time outdoors, always check for ticks! If you find one, watch this video to see how to remove it safely.
Talk to your provider right away if you experience symptoms such as fever, joint aches, headaches or other flu-like symptoms, as these are also common to vector-borne illnesses.
You don’t have to sacrifice enjoying the outdoors, but you do have to be diligent in protecting yourself.
We are here for you, and we want to help.
Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2