By Dr. Kyle Warren

Edited by Meghan Feir Walker

In today’s article, I (Dr. Warren) am going to try to clear up a few of the common Lyme myths surrounding not only Lyme disease but other chronic infections as well. I’m going to point out a few ways doctors have been misguided in their thinking and practices and try to answer some questions about chronic Lyme, why doctors get confused, and why testing can be leading doctors and patients astray in the case of chronic illnesses. I’m especially going to explain the IgM vs. IgG testing “past infection” Lyme myth and how false information leads doctors and patients astray.

To watch the correlating video to this article, click here.

The IgM vs. IgG testing “past infection” Lyme myth

Chronic Lyme IS real

I’m happy to inform everyone that the days of arguing about whether or not chronic Lyme is real with standard medical doctors, with that neighbor across the street, or with your brother-in-law can finally be over. 

For 40 years, the CDC taught that chronic Lyme was not real, but in April of 2022, they finally changed their stance. 

Although this is fantastic news for every doctor and patient in the Lyme community who has been waiting decades for them to finally admit it’s real, there’s still a problem at hand. Since they have been educating doctors for 40 years that it’s not real, it’s going to take a long time for doctors to realize they’ve been wrong. 

Don’t be surprised when you run into a medical professional who doesn’t think it’s real. Most doctors have been taught and believed for decades that chronic Lyme doesn’t exist. However, now you can inform them that the CDC believes it is real and that chronic Lyme is called post-treatment Lyme disease syndrome

Over the years, I’ve even run into infectious disease doctors who don’t believe chronic Lyme is real, and when I inform them the CDC now believes in chronic Lyme, they’re shocked. The re-education of doctors across the world needs to start happening, for the sake of everyone in the Lyme community. 

Now all the energy spent on arguing and defending whether chronic Lyme is real or not can be redirected toward finding help for people suffering from this debilitating disease, prevention, and reeducation.

The IgM vs. IgG testing “past infection” Lyme myth

IgM vs. IgG testing: The “past infection” Lyme myth

Another matter related to chronic infections is the classic IgM vs. IgG model. The IgM vs. IgG testing “past infection” Lyme myth is closely tied to whether people get accurately diagnosed with chronic Lyme or other chronic infections. 

Most doctors tend to believe that immunoglobulin M (IgM) indicates a current infection and that immunoglobulin G (IgG) indicates a past infection, but it’s not as simple as that, particularly when you’re dealing with patients who are chronically ill. 

If you are currently suffering from an acute infection, it should appear through a rise in your IgM level.

If you had an infection, got over it, and are feeling well now, you may still have it appear on an IgG test, even though it’s not currently affecting your health negatively. That’s how the model is supposed to work. 

However, what’s to be said about the patients who got infected and have never felt better after months or years have passed? It may only show up on the IgG, but since getting infected, they’ve never returned to their baseline level of health. 

There’s acute Lyme disease that can produce the classic (but often not present) bulls-eye rash and joint pain which happens within about a week or so of getting a bite from an infected tick. But chronic Lyme can cause long-term, debilitating symptoms that, in the vast majority of cases, do not resolve on their own. 

Acute infections can be life-threatening. Chronic infections can be debilitating. 

Keep in mind with chronic conditions that while the chronic Lyme infection itself might not kill you, it can lead to other bodily problems, serious mental health issues, and exacerbate other conditions, which can lead to life-threatening results. Just because it isn’t acute doesn’t mean it’s not just as dangerous in other ways.

IgM vs. IgG

Getting into the weeds comparing IgM and IgG: The oversimplified lie

To illustrate what doctors are taught about current and past infections, take a look at the chart below. 

Lyme myths and the IgM vs. IgG debate.

This chart is supposed to illustrate an acute infection. These lines are the normal immunoglobulin curves illnesses are supposed to take and doctors have to study and familiarize themselves with this process.

If we start at the upper left, there’s an incubation period. This is when you get exposed to sickness. There’s a period of time when it’s in your body, but it’s probably not causing any symptoms at this point. 

Next, we start developing symptoms and realize we’re getting sick. This is when our body first creates immunoglobulin M which your body can make relatively quickly. 

Notice the purple arc of immunoglobulin M. It comes up in about a week before it goes back down. It’s pretty much gone by about the three-to-four-week mark. Most doctors will say an IgM is an active, acute infection. 

Now notice the IgG curve. Immunoglobin G is Y-shaped and comes up later. It spikes at about three to four weeks after the first onset of an infection. 

You’ll keep some IgG around long-term. Notice it spikes up and then comes down; it does not stay up at the peak. You will keep your low amount of immunoglobulin present so that if your body ever sees this infection again you have some immunity toward it in the future. Doctors will also say that if you have an IgG but the IgM is gone, it’s a past infection that no longer can cause symptoms. 

Along with the IgM and IgG curves on this chart, it also shows C-reactive proteins (CRP). In the middle of the test, there’s a green bar that indicates the CRP going up during acute infections. 

Because acute infections are the focus of most doctors, they completely ignore chronic infections…

For acute infections, doctors are looking at the CRP and IgM indications. The issue is when we deal with chronic infections, you don’t usually have elevated IgM or C-reactive proteins. Because of this, most doctors will say it’s no longer there. This can be incredibly frustrating for patients who are experiencing chronic symptoms; for patients who caught an infection and never recovered. Doctors tell them it’s no longer active because of their rigidity in following this chart and from what they were taught in medical school. 

It’s not a safe assumption for doctors to assume that because IgM is no longer elevated after a month that the patient is completely better. Unfortunately, many patients don’t get better and continue having symptoms after 30 days and even after a round of treatment. 

This chart illustrates what is supposed to happen, but what happens when you continue feeling sick 3, 6, 12 months, or even years later? What happens when your acute illness turns into a long-term problem? 

Just because your immune system is supposed to work like the chart example displayed, it doesn’t mean it will. Too many factors can throw it off. You’re also supposed to be sick for a couple of days to a couple of weeks and then get better. 

Chronic illness is like a check engine light appearing on the dash of your car. Your car may still be running, but something is wrong with the engine and needs to be addressed immediately. 

The medical community needs to find ways to help people who are chronically sick for months and years at a time. 

The IgM vs. IgG testing “past infection” Lyme myth

Lyme myths debunked: Other infections become chronic 

Although many doctors deny the reality of infections becoming chronic after the acute phase, there are actually several examples of known chronic infections. This reminds me a little bit of the doublespeak mentioned in the famous George Orwell novel “1984.” Chronic infections aren’t real… until you start asking doctors about well-known chronic infections. It just doesn’t make sense. 

Syphilis is a perfect example. Just like Lyme, syphilis confused doctors because it goes through phases of being active and dormant. 

Leprosy is an example of a slow-growing, chronic bacterial infection, and the fact that you can develop shingles after having chickenpox is another illustration of how infections can stay in your body and reemerge. 

HIV, malaria, tuberculosis, and polio can all become chronic infections. In other words, this isn’t anything new. The existence of chronic infections has been around forever, so why was it and is it so difficult to admit that other infections can go from acute to chronic stages? 

One similarity between long-haul COVID and Lyme

Our most recent example of acute infections that can become chronic has been long-haul COVID.

At a recent seminar, we were looking at some of these long-haul/chronic/post-COVID numbers. It’s hard to get much data on long-haul COVID, but the latest numbers report that about 7 percent of people who have had COVID haven’t returned to their baseline level of health and have developed chronic symptoms. This correlates well with Lyme disease. 

While many people who get acute Lyme disease are able to treat it and prevent it from becoming a chronic problem when treated swiftly, not everyone is as fortunate. There are many people who don’t realize they’ve been bitten or who weren’t able to completely eradicate the infection after taking a round of antibiotics (though taking antibiotics within the first three months is highly effective). 

The similarities between long-haul COVID and Lyme don’t end there with many symptoms of long-haul COVID shared with that of chronic Lyme. However, from what we can observe so far, the majority of the time, Lyme and other chronic tickborne illnesses still seem to debilitate even more extensively than long-haul COVID. The daily impact of any chronic illness can be devastating for both the one suffering and their family. 

Many who contract Lyme don’t recover (without continued, proper treatment) and it becomes a chronic issue, leaving them debilitated or disabled. What is happening to them, and what do their tests look like? Their immune response doesn’t look like the normal test chart shown earlier, and that’s the whole point.

This is another reason why everyone in the medical community should stop making simplistic assumptions and listen to their patients’ experiences with an open mind.

What we do in our clinic: Good, thorough testing and listening to symptoms

This is why we like testing IgM, IgG, PCR testing, and immune system markers to try to get a better, more thorough look at what the state of your immune system is like and why it’s having difficulties getting over chronic infections. The IgM vs. IgG testing “past infection” Lyme myth needs to be exposed.

In order to help you fight back and recover your health, we want to know how your immune system is stuck and why it got stuck in the first place. Patients can’t be put on a one-size-fits-all plan for healing. 

Summary

  • After 40 years of being taught that chronic Lyme isn’t real, doctors are slowly becoming more aware that chronic Lyme (aka, PTLDS) exists and is a very real problem for many patients who are chronically ill.
  • The IgM/IgG/CRP chart illustrating how the immune system is supposed to react to acute infections is what doctors are taught. Unfortunately, this doesn’t illustrate what happens when people develop chronic infections.
  • Doctors are also becoming more aware of the presence of other chronic infections. This has been the silver lining of the COVID-19 pandemic.
  • With about 7 percent of the population of those who have had COVID developing long-haul COVID, more research is starting to be done on chronic infections. This will help us all gain more knowledge and understanding about what the immune system is doing when people are chronically sick.
  • Doctors will still stand by this chart because it’s what they learned in medical school. In its simplicity, this model doesn’t explain chronic illness well, only acute infections where the person recovers after a few days or weeks.
  • It’s cognitive dissonance when we teach how something is supposed to work when we’re surrounded by examples of how it doesn’t work that way much of the time.
  • Understanding your unique situation and the state of your immune system is vital to getting better. 

I am hopeful that the CDC’s recent acknowledgment of chronic Lyme (PTLDS) and the research coming out of COVID will also help a myriad of other chronic debilitating diseases, as opposed to only the acute phases of illnesses.

We hope this article has been useful for you in your journey toward healing. Follow us on Instagram and Facebook for more information, and share with friends and family on social media if a post has been helpful for you.

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