What's the difference between Lyme Disease and CIRS/Biotoxin illness?
There's so much confusion over this question, I felt it was important to blog about. Even at conferences I frequently hear my fellow physicians misspeak on the subject. The short answer is that there IS no difference, they are the same thing. Lyme disease and mold toxin illness and Babesia infection and ciguatoxin poison and so many others cause the same type of inflammation that lead to system-wide symptoms.
Let me explain. CIRS stands for Chronic Inflammatory Response Syndrome. “Biotoxin illness” is another name for CIRS, because CIRS is caused by biotoxins. Biotoxins are teeny-tiny chemicals that are released by certain living organisms, and when ingested or absorbed or injected, as through a bite, has the potential to cause illness through a cascade of unfortunate events that lead to system-wide inflammation.
Now, many critters on this planet contain “toxins” that they use as self defense. Tuberculosis bacteria release a toxin that kill cells (and was only recently discovered in 2015, believe it or not!). Bee stings and snake bites also contain toxins that harm cells, and can even be specific to certain types of cells, like nerve cells in the case of snake venom. Plants can also release toxins: think of poison ivy, and its obnoxious impact on your skin!
The difference between those types of toxins and what we call “biotoxins” is that biotoxins are much smaller than other types, which means they can cross over between cell membranes into places that larger toxins can't, such as the brain, or across intestinal cell walls. Larger toxins are simply too big to accomplish this. When tiny biotoxins get into places they shouldn't, they create all kinds of trouble. Your immune system doesn't like it one bit. It tries to attack the “foreigners”, which results in all kinds of inflammation, and pain and suffering for you.
Now, it's important to understand that biotoxin illnesses can come from several different types of living organisms. Tick bites containing bacteria or parasites are one kind. Lyme bacteria are the most well-known type of biotoxin-producing organism in the world. But ticks also transmit Babesia infection, which is not a bacteria at all but a red-cell parasite similar to malaria. Even though they both affect the red blood cells of their host, the difference is that Babesia parasites give off tiny biotoxins that cause body-wide disease one way, while malaria (transmitted by mosquitoes) causes disease in a completely different way.
Mycotoxins from indoor mold growth, mixed with other bacteria, fungi, dust mite debris, and other junk found in a water-damaged building creates an air-born tiny biotoxin that people absorb mostly through breathing in the air or absorbing through direct contact with their skin. Strangely enough, these types of biotoxins cause the same type of inflammation that tick-born infections cause. This means that the symptoms and many of the inflammation-specific lab tests we do are the same for both conditions. It also means that a lot of the treatments we use can be used for both!
Other types of biotoxin-containing organisms:
Dinoflagellates (these come from oceans or estuaries, and can infect fish): Pfisteria, Ciguatera, Chattonella)
Apicomplaxans: including Lyme bacteria, Babesia parasite, Sarcocystis, Eimeria
Cyanobacteria (from fresh water sources): Microcystis, Lyngbya, Cylindrospermopsis
Other tick-born bacteria and viruses: Ehrlichia, Anaplasma, Powassan virus, Bartonella
And many more!
When we do our “biotoxin tests” at our clinic through LabCorp and Quest (and other labs) at a first visit we are testing for inflammatory pathways that are common to ALL of these types of biotoxins. Other tests are used to differentiate the source of the inflammation; is it virus, bacteria, a poison, or due to water-damaged building biotoxins? This helps us get the person away from the cause of their inflammation, so that we can get it to die down and they feel better. (See next week's blog post on how this step works).
So although it makes a difference for treatment (especially at the beginning) to figure out what type of biotoxin is responsible for creating the inflammatory problem, many of the treatment steps are EXACTLY the same no matter what biotoxin you have floating around in your system.
One other thing that's important to know: many people have more than one type of biotoxin illness. For example, a person can have Lyme disease and some of the co-infections (Babesia, Bartonella, etc.). Or they can get a tick-born infection and then start reacting to their water-damaged basement that never bothered them before (inflammation begets inflammation). The various combinations are endless.