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Activists Force Review of Lyme
Disease Guidelines + Natural Treatment 7-11-08
Ardent proponents of the much-disputed notion of chronic Lyme disease, backed
by this state's attorney general, have won a concession by the Infectious
Diseases Society of America, which has agreed to reevaluate its guidelines that
cover the issue.
The agreement to reevaluate the 2006 IDSA guidelines by a new society committee
came after the Connecticut attorney general, Richard Blumenthal, an ally of the
chronic disease enthusiasts, raised questions about conflicts of interest
involving the IDSA panel that developed the group's position.
Blumenthal said he was not taking a position in the scientific debate, but in
the past he has supported efforts by chronic-Lyme enthusiasts to get insurance
companies to cover long-term antibiotic treatment. He initiated the IDSA
investigation after meeting with chronic-Lyme activists.
Essentially, the IDSA guidelines disputed the very existence of chronic Lyme
disease. The new committee will determine whether the guidelines should be
revised or updated.
The new committee, which has not yet been recruited, will also take testimony in
an open public hearing, in response to allegations that the earlier panel
members refused to consider evidence conflicting with their views.
It's the latest skirmish in a 20-year-old war over whether persistent infection
with the Lyme pathogen, Borrelia burgdorferi, is responsible for long-term
symptoms resembling fibromyalgia.
A small but vocal group of physicians and patients insists that the symptoms are
a chronic form of Lyme infection, treatable with long-term or repeated courses
of antibiotics, or both.
For their part, the IDSA panelists and other mainstream researchers have pointed
to a dearth of hard evidence that the Lyme pathogen can exist undetected. They
also argued that antibiotic therapy beyond the conventional two- to four-week
course for new acute infection has not been shown to have benefit, but does pose
significant risks to patients and to public health. This view is shared by the
CDC and NIH.
At first, attorney general Blumenthal opened an antitrust investigation of IDSA
after the society issued the 2006 guidelines. Later that was revised to
conflict-of-interest allegations.
Lyme disease was first identified in the Connecticut town of Old Lyme, and it
remains a hot-button issue in the state.
Blumenthal, first elected in 1990, has long been active on behalf of
chronic-Lyme proponents, holding a hearing in 1999 on whether health insurance
companies were improperly denying coverage for Lyme treatment. He has also
criticized the state's health department for underreporting Lyme infections.
IDSA's guidelines recognized that some patients who have had Lyme disease have
persistent symptoms, including musculoskeletal pain, chronic fatigue, and
cognitive problems sometimes called "brain fog."
But panel members agreed that there was no convincing evidence that persistent
B. burgdorferi infection causes the symptoms. It proposed calling the symptoms
"post-Lyme disease syndrome" and suggested a definition.
In a 2007 review article in the New England Journal of Medicine, Gary Wormser,
M.D., of New York Medical College in Valhalla, N.Y., and colleagues -- several
of whom, including Dr. Wormser, were part of the IDSA guideline panel -- went
further.
They compared chronic Lyme disease to such now-discredited conditions as chronic
Epstein-Barr virus infection.
"Chronic Lyme disease, which is equated with chronic B. burgdorferi infection,
is a misnomer, and the use of prolonged, dangerous, and expensive antibiotic
treatments for it is not warranted," they wrote.
After the guidelines were published, Dr. Wormser, a reviled figure in the
chronic-Lyme activist community, was the target of a street demonstration.
Activists also went to their ally Blumenthal to suggest an investigation of IDSA.
Initially the antitrust inquiry focused on whether IDSA's guidelines were an
illegal attempt to monopolize medical treatment of patients with potentially
Lyme-related symptoms.
But the Federal Trade Commission and Department of Justice had previously stated
a policy that medical-society guidelines do not inhibit competition.
Blumenthal's target subsequently shifted to what he said were conflicts of
interest among many members of the expert panel IDSA had appointed to develop
the new guidelines.
Blumenthal also criticized what he called "improper links" between IDSA's panel
and one convened by the American Academy of Neurology. The AAN also publishes
guidelines on Lyme disease treatment because the infection can penetrate the
central nervous system and cause neurological symptoms.
Dr. Wormser chaired both panels, and two other researchers served on both.
Blumenthal, through a spokesman, would not specify the conflicts or which panel
members had them.
In publishing the guidelines, five of the 14 members had disclosed outside
financial relationships, with drug and diagnostics companies as well as having
served as expert witnesses in malpractice cases involving Lyme disease.
One member of both panels -- Eugene D. Shapiro, M.D., of Yale University --
reported elsewhere having been paid to review disability claims for Metropolitan
Life Insurance. No other panelists indicated relationships with insurance firms.
On Internet blogs and forums, chronic-Lyme activists suggested that ties to the
insurance industry were common in the panel and accounted for the recommendation
against extended antibiotic therapy.
Their reasoning was that insurance companies want to avoid paying for such
treatments, which often involve daily doses of intravenous antibiotics for
months at a time. The cost frequently runs into the thousands of dollars.
However, Blumenthal's spokesman would not confirm that insurance-industry ties
were ever an issue in the investigation.
In its statement, IDSA denied that any of these relationships were relevant to
the guidelines.
"Panel members had no financial interests that would have affected, or been
affected by, recommendations in the guidelines," the statement said. "The
guidelines recommend generic drugs and generic diagnostic tests. Panel members
do not stand to profit from any recommendation in the guidelines. In fact, the
panel members denied themselves and their colleagues an opportunity to generate
a significant amount of revenue when they recommended against expensive,
repeated, long-term antibiotic therapy."
IDSA spokesman Steven Baragona said the conflict-of-interest allegation "has
been puzzling to us from the get-go."
The organization agreed to the review of the guidelines in order to "put to rest
any questions about them," according its statement.
It pointed out that the organization is not required to alter or retract the
2006 guidelines.
Although IDSA will incur some costs in conducting the re-evaluation, it is not
paying any fines or penalties.
The agreement also stipulates that it may not be construed as an admission of
wrongdoing.
The AAN guideline is not affected by the IDSA review, according to its general
counsel, Murray Sagsveen.
Blumenthal subpoenaed documents from AAN last year but no additional substantive
contact has taken place, Sagsveen said in an email.
Blumenthal's spokesman would not comment on whether AAN is actively being
investigated.
Under the agreement with Blumenthal, the new IDSA committee will have eight to
12 members with minimal conflicts of interest. Its chairman must be trained in
infectious diseases but may not have published a viewpoint on Lyme disease
diagnosis or treatment, nor have financial interests related to Lyme disease
exceeding $10,000.
Committee members are to represent "a balanced variety of perspectives" and must
include one physician who treats Lyme disease patients. They may not include
anyone who served on earlier Lyme guideline panels.
The agreement also stipulates that any committee recommendation will require a
75% "supermajority" vote.
The process includes what the agreement calls an "ombudsman" to oversee the
conflict-of-interest review.
IDSA and Blumenthal jointly selected Howard Brody, M.D., Ph.D., of the
University of Texas Medical Branch in Galveston, for the post.
Dr. Brody stressed that his role is relatively narrow -- primarily to help in
drafting disclosure forms and other procedures for evaluating conflicts of
interest. The final decision on the appointment of committee members remains
with IDSA, he said.
He said it would be important that the conflict-of-interest review not be
limited to corporate ties, which have recently occupied so much attention in
journal publishing.
Many of the physician proponents of chronic Lyme disease earn significant income
from treating it, he said. Consequently, the review will include "conflicts of
interest based on their personal practice patterns and practice incomes," he
said.
One well-known proponent of chronic Lyme infection, Sam Donta, M.D., of Falmouth
Hospital in Falmouth, Mass., said he was concerned that the new committee may
nevertheless end up stacked with those who deny its existence.
Dr. Donta, a former Boston University professor who has published papers
claiming that tetracycline and macrolide antibiotics relieved symptoms in
"several thousand" patients he has diagnosed with chronic Lyme, served for a
time on an earlier IDSA Lyme guideline panel, which published a report in 2000.
He said he left the panel after he refused to sign on to language about chronic
Lyme written by Dr. Wormser, who also chaired that panel.
Dr. Wormser could not be reached for comment.
Both the 2000 and 2006 guidelines "were not reviewed in good faith," Dr. Donta
said. Their membership was entirely composed of those "with like mind," and he
feared the new committee would be similar.
He said he planned to apply for a seat on the new committee, despite his
apparent disqualification, and will encourage other researchers with favorable
views of chronic Lyme disease to do likewise.
Sagsveen, the AAN attorney, said the academy had no plan to re-evaluate its Lyme
guidelines.
He also rejected Blumenthal's allegation of "improper links" between the AAN and
IDSA panels.
"Each organization submitted the draft guidelines to a gauntlet of professional
reviewers -- from the subcommittee level through the boards of directors to the
editors of the respective journals," he said.
The similarity between the two sets of guidelines is a good thing, he said,
insofar as it "avoided conflicting and potentially confusing professional
guidance."
Comment:
If you draw a patients blood and the B. burgdorferi shows up than you
have Lyme disease. If that still show up after repeated treatment months or
years later, you have Chronic Lyme Disease! To say that is impossible is medical
malpractice!
However repeated use of iv antibiotics is not only irresponsible. This will
cause a patient with an already compromised immune system to further compromise
themselves. This will cause worsening symptoms and possibly new ones to show up.
I have never seen antibiotics fully remove the Lyme infection.
Natural Treatment For Lyme's Disease:
Familiarize yourself with the real tics that cause Lyme's disease and how it
is spread, visit
Tick 101!
If you have been bitten and attached by a tick and it is the kind that could
carry Lyme's Disease than start treatment right away. Start taking Silver
Biotics right away 1 Tbsp 3times a day. Treat the bite area with Purifying
essential oil blend. If this is done as soon as you remove the tick it is all
that is necessary. Do this with any tick just in case. Continue this for 1 week.
If there are no symptoms of Lyme Disease than your done.
Natural Treatments For Chronic Lyme Disease:
Do the above treatment and have a friend, massage therapist or chiropractor
use the Rejuvenation Technique with Bella Mira ,
Artemisinin,
Niaouli, Marauder,
Fortitude and
Purifying. If
they need instructions they can
contact
Dr. Beth Dupree.
This next paragraph is very technical but it outlays the actual makeup of the
spirochete and why it is so hard to kill.
THE MAIN COMPONENT of the Gram-negative cell wall is lipopolysaccharide.
Additionally there is present phospholipid, protein, lipoprotein and a small
amount of peptidoglycan. The lipopolysaccharide consists of a core region to
which are attached repeating units of polysaccharide moieties. A component of
the cell wall of most Gram-negative bacteria is associated with endotoxic
activity, with which are associated the pyrogenic effects of Gram-negative
infections.
So in laymen terms it is protein in a cellulose shell, just like yeast. The
best way to defeat permanently is an easy one. It's the same way we take care of
candida, mycoplasm diseases (Lou Gherig etc), many chronic illness. You have to
take digestive enzymes on an empty stomach to digest them right out of your
body. This combined with strongly antibacterial essential oils and Silver
Biotics in a 1-2-3 knockout punch to Lyme's Disease.
Bella Mira Perfect Enzymes contains high amounts of protease which digests
protein, cellulase that digest cellulose and some sugars, sucrase for other
sugars, and lipase for the lipid proteins and fats. Take 2 on an empty stomach
(30 mins before or 2 hours after eating) 3 times a day for 30 days. Bella Mira
Perfect Enzymes also contain complementary essential oils to reduce stomach
discomfort and assist in killing the organism.
Along with Bella Mira Perfect Enzymes continue taking Silver Biotics right
away 1 Tbsp 3times a day.
At the end of the month get retested. If it is still positive you need to
schedule a phone consultation with me and well get it figured out.
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