May 21, 2014 at 1:00 am

To Your Health

Conflicting Parkinson's, Lyme diagnoses require follow-up

Dear Dr. Roach: Would you please explain the difference between Parkinsonís disease and Lyme disease?

My husband has been told by a neurologist he has Parkinsonís. A regular medical doctor who also works in the field of alternative medications has told him that he has Lyme disease. This doctor uses the Meridian Stress Assessment test, and has been treating my husband with many supplements for his condition.

We have been told that there isnít a test to determine Parkinsonís. All supplements and testing for Lyme disease are out-of-pocket costs. We would appreciate your opinion or thoughts on his condition.

P.L.

Dear P.I.: Lyme disease and Parkinsonís are very different conditions. Lyme disease is caused by a bacteria spread by the deer tick. Often, the tick bite is not noticed at the time. In most cases, a characteristic target-shaped skin rash appears within a month of the tick bite. Some people may have fever, fatigue, headache or just not feel right.

Without treatment, Lyme can progress to a second stage, where it can affect the heart, joints and other organs. During this time, Lyme disease can affect the nervous system, but the common symptoms of nerve palsies of the face and head, meningitis and peripheral neuropathy are very unlike the usual symptoms of Parkinsonís disease.

However, there have been a very few reported cases of advanced Lyme disease with symptoms that looked like Parkinsonís.

Parkinsonís disease is a progressive neurologic condition that causes tremors, slowed movements, stiffness and balance problems. Much later in the course of Parkinsonís disease, some people may not think clearly and can have hallucinations. Parkinsonís disease is diagnosed by a neurologist based on the symptoms and a detailed physical exam.

Meridian stress assessments have not been proven to be effective as a diagnostic test. I would highly suspect the efficacy of the supplements chosen by this method. I am not against alternative treatments if they donít interfere with effective treatment, but if it is Lyme disease, it shouldnít be treated with supplements. Further, if he really has Parkinsonís, he is not getting treatments that may help him.

I would recommend a visit with an infectious-disease specialist whoís familiar with Lyme disease to confirm or refute the diagnosis of Lyme disease. Current blood tests are nearly 100 percent sensitive for late-stage Lyme disease. I also would recommend that you discuss with the neurologist (or obtain a second opinion if you prefer) whether the Parkinsonís disease is in need of treatment.

Dear Dr. Roach: It was recommended I get my blood cobalt and chromium levels checked, because I have several joint replacements.

Why do I need these? Are high levels dangerous?

O.G.

Dear O.G.: Some types of joint replacements (those that involve metal-on-metal surfaces) will cause higher-than-normal levels of chromium and cobalt in the blood. The blood levels correlate with the degree of wear within the artificial joint, in a person with symptoms of joint wear, such as joint pain. Once the blood levels are above a certain level, they indicate a high likelihood of wear and can influence a surgeonís decision to revise the joint.

There remains debate about whether these elevated levels of metals in the blood are toxic. There is no definitive proof one way or the other, although most authors have suggested a low likelihood of toxicity. There have certainly been court cases about it, but I am unable to find definitively how toxic these levels might be.

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