Lyme disease may be a far more extensive cause of chronic fatigue and disability than previously recognized. It can mimic every disease process including Chronic Fatigue Syndrome, Fibromyalgia, autoimmune conditions like MS, psychiatric conditions like depression and anxiety, and cause significant memory and concentration problems, mimicking early dementia. It is called the "Great Imitator," and inaccurate testing-combined with debate and denial of this chronic infection-makes it difficult for sufferers to find effective care.
Dr. Nicholas Anhorn, BSc, ND of the Moncton Naturopathic Medical Clinic has training through ILADS (International Lyme and Associated Diseases Society) to test and treat patients with Lyme Disease.
Have 7 mins to spare? If so, check out Dr. Anhorn's interview with CBC's Jonna Brewer on Naturopathic care of Lyme Disease.
There is no perfect test for Lyme disease. Dr. Anhorn, ND uses IGeneX Laboratory testing out of California and Armin Labs out of Germany, which are widely considered as the best that is currently available. However, regardless of the test results, experienced doctors recommend that Lyme disease be diagnosed clinically, meaning diagnosis is based on an evaluation of your risk and your symptoms. The Horowitz Lyme - MSIDS Questionnaire is one tool that can be used to determine your likelihood of having Lyme and associated tick-borne disorders. is found in Dr. Richard Horowitz's book "Why Can't I Get Better? Solving the Mystery of Lyme and Chronic Disease."
Horowitz Lyme-MSIDS Questionnaire
The Horowitz Lyme-MSIDS Questionnaire is not intended to replace the advice of your own physician or other medical professional. You should consult a medical professional in matters relating to health, and individuals are solely responsible for their own health care decisions regarding the use of this questionnaire. It is intended for informational purposes only and not for self-treatment or diagnosis.
© 2014 Richard I. Horowitz, M.D.
SECTION 1: SYMPTOM FREQUENCY SCORE
None = 0 Mild = 1 Moderate = 2 Severe = 3
1. Unexplained fevers, sweats, chills, or flushing
2. Unexplained weight change; loss or gain
3. Fatigue, tiredness
4. Unexplained hair loss
5. Swollen glands
6. Sore throat
7. Testicular or pelvic pain
8. Unexplained menstrual irregularity
9. Unexplained breast milk production; breast pain
10. Irritable bladder or bladder dysfunction
11. Sexual dysfunction or loss of libido
12. Upset stomach
13. Change in bowel function (constipation or diarrhea)
14. Chest pain or rib soreness
15. Shortness of breath or cough
16. Heart palpitations, pulse skips, heart block
17. History of a heart murmur or valve prolapse
18. Joint pain or swelling
19. Stiffness of the neck or back
20. Muscle pain or cramps
21. Twitching of the face or other muscles
22. Headaches
23. Neck cracks or neck stiffness
24. Tingling, numbness, burning, or stabbing sensations
25. Facial paralysis (Bell’s palsy)
26. Eyes/vision: double, blurry
27. Ears/hearing: buzzing, ringing, ear pain
28. Increased motion sickness, vertigo
29. Light-headedness, poor balance, difficulty walking
30. Tremors
31. Confusion, difficulty thinking
32. Difficulty with concentration or reading
33. Forgetfulness, poor short-term memory
34. Disorientation: getting lost; going to wrong places
35. Difficulty with speech or writing
36. Mood swings, irritability, depression
37. Disturbed sleep: too much, too little, early awakening
38. Exaggerated symptoms or worse hangover from alcohol
SECTION 2: MOST COMMON LYME SYMPTOMS SCORE
If you rated a 3 for each of the following in section 1, give yourself 5 additional points:
39. Fatigue
40. Forgetfulness, poor short-term memory
41. Joint pain or swelling
42. Tingling, numbness, burning, or stabbing sensations
43. Disturbed sleep: too much, too little, early awakening
SECTION 3: LYME INCIDENCE SCORE
Now please circle the points for each of the following statements you can agree with:
44. You have had a tick bite with no rash or flulike symptoms. 3 points
45. You have had a tick bite, an erythema migrans, or an undefined rash, followed by flulike symptoms. 5 points
46. You live in what is considered a Lyme-endemic area. 2 points
47. You have a family member who has been diagnosed with Lyme and/or other tick-borne infections. 1 point
48. You experience migratory muscle pain. 4 points
49. You experience migratory joint pain. 4 points
50. You experience tingling/burning/numbness that migrates and/or comes and goes. 4 points
51. You have received a prior diagnosis of chronic fatigue syndrome or fibromyalgia. 3 points
52. You have received a prior diagnosis of a specific autoimmune disorder (lupus, MS, or rheumatoid arthritis), or of a nonspecific autoimmune disorder. 3 points
53. You have had a positive Lyme test (IFA, ELISA, Western blot, PCR, and/or borrelia culture). 5 points
54. Thinking about your overall physical health, for how many of the past thirty days was your physical health not good?________ days
Award yourself the following points based on the total number of days:
0–5 days = 1 point
6–12 days = 2 points
13–20 days = 3 points
21–30 days = 4 points
55. Thinking about your overall mental health, for how many days during the past thirty days was your mental health not good?________ days
Award yourself the following points based on the total number of days:
0–5 days = 1 point
6–12 days = 2 points
13–20 days = 3 points
21–30 days = 4 points
SCORING:
Record your total scores for each section below and add them together to achieve your final score:
Section 1 Total:
Section 2 total:
Section 3 total:
Section 4 total:
FINAL SCORE
If you scored 46 or more, you have a high probability of a tick-borne disorder and should see a health-care provider for further evaluation.
If you scored between 21 and 45, you possibly have a tick-borne disorder and should see a health-care provider for further evaluation.
If you scored under 21, you are not likely to have a tick-borne disorder.
Interpreting the Results
We see a high frequency of Section 1 symptoms in our patients, including fatigue, joint and muscle pain that often migrates, sleep disorders, as well as memory and concentration problems, and a high frequency of Section 3 symptoms, especially neuropathic pain that comes and goes and migrates (tingling, numbness, burning, etc.). These form a cluster of presenting symptoms that are characteristic of those with a high probability of having Lyme-MSIDS.
In one recent study conducted in our office of 100 consecutive patients, we found that more than 25 percent reported that the following symptoms were present most or all of the time in the month preceding their office visit. Many of these patients reported that these symptoms affected their quality of life: 71 percent reported that their physical health was not good and 47 percent reported that their mental health was not good on at least fifteen days in the previous month.
Disclaimer: The Horowitz Lyme-MSIDS Questionnaire is not intended to replace the advice of your own physician or other medical professional. You should consult a medical professional in matters relating to health, and individuals are solely responsible for their own health care decisions regarding the use of this questionnaire. It is intended for informational purposes only and not for self-treatment or diagnosis.