Are You Confusing Mono and Lyme?

Have you or your children been diagnosed with Mono? Maybe you had an onset in your teens and still feel plagued by fatigue, joint pain, and a low functioning immune system. Many of the symptoms associated with the onset of Mononucleosis (or Epstein Barr Virus) can often be misdiagnosed and could actually be the onset of Lyme Disease. Learn more in this episode of Integrative Wellness Radio with Dr. Nicole Rivera and Brooke Scheller!


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Hey everyone, welcome back to another episode of Integrative Wellness Radio, the place to be for all of your wellness needs. I am Dr. Nicole Rivera, and I am here with Brooke Scheller. We work side by side at Integrative Wellness Group in Belmar, New Jersey. We are going to be talking to you about the different between mono and Lyme disease, and how they can be confused quite often.

I think that most people when they first hear that, they're probably like, "What the heck?" We think of mono as being something so common. I even think back to when I was in high school, and I'm sure you shared a similar experience, that I had a ton of friends that got all the symptoms, and they were on bed-rest, and had the sore throat, the fatigue.

I remember it being something that was so common when I was in high school. I'm sure you shared a similar experience, but we wanted to talk to you a little bit today about how maybe the two might be overlapping, and really how you can find out which is present in the system. One of the big things we wanted to talk about is the symptoms can be very similar of the onset of mono and also the onset of Lyme. I want to have Dr. Nicole just give a really good explanation of both mono and Lyme so that we can get some more clarification on that.

Dr. Nicole:
Definitely. When it comes to mono, technically what mono is, is it is caused by the Epstein-Barr virus. When you are infected with the Epstein-Barr virus, and it's in its acute phase, meaning the new phase because you've just been recently exposed, you can develop what you call mononucleosis, and that is typically going to manifest as symptoms like you mentioned, Brooke. Anything from a fever to a sore throat, swollen glands, and I would say the biggest thing is major fatigue, which is why many people end up being out on bed-rest or getting homeschooled for a period of time just because they're really so tired that they can't function in their day to day classes.

When it comes to Lyme, Lyme has very similar onset symptoms, but it actually has very different chronic symptoms. In the beginning of getting exposed to Lyme, and this is not necessarily immediately after a tick bite, because unfortunately a lot of us are getting exposed to Lyme, not necessarily from ticks anymore. It can be from fleas and mosquitos, and some scientists are actually exploring the idea that it could be airborne, which is actually kind of terrifying. That's not the point of this, but I think that we are getting exposed to it a lot more than we realize.

Technically Lyme is something that comes from a spirochete infection. A spirochete is technically ... it's classified as a bacteria, but honestly, we find through our clinical practice that it acts more like a parasite. I think that's a really important takeaway, because when it comes down to the treatment of Lyme, you really need to treat it more like a parasite, and not a bacteria.

It is caused by the spirochetes which will manifest in the body. The interesting thing is the spirochetes will primarily affect the connective tissue of the body. Connective tissue is the tissue that connects your joints. It's also tissue that can surround your organs. With the spirochete affecting those areas, that's why in the long term, most people will experience joint pain. In the short term, you can experience maybe moderate joint issues, but more than likely, you're going to experience fever, and swollen glands. This is really because your immune system is trying to fight it.

I think one of the biggest miscommunications here is the actual diagnosis, or the actual testing. I think that maybe it's quite common that mono is present in a young adult, and so they are experiencing some of these symptoms and they head over to their primary care physician, and the primary care physician may or may not do the correct testing to find out if mono is present or not. They might have the patient come in and they say, "Oh, you're exhibiting all of the symptoms of mono. You have mono. Go home, rest, and follow these recommendations." But maybe they aren't testing properly to find out which is actually present.

I want to clarify a little bit what the difference is, in the actual diagnostic process with these.

Dr. Nicole:
Well, I'm glad that you brought that up because the whole reason we're doing this podcast in the first place is because of an experience that we just had. This was a young girl, she is about 17. She came to me because apparently, this past April was her second time getting mono. When her mom told me that, because her mom is one of my current clients, I was like, "That's not really possible. When you get mono, it's not something that you necessarily get again."

I was like, "That sounds odd, and it sounds like there might be something more going on." We proceeded with doing testing on her, and I ran a pretty comprehensive blood work. What I did find, was that the Epstein-Barr virus was actually absent within her system, which is honestly kind of rare. She did not have the Epstein-Barr virus in her system, and she did not have mono come up positive either.

We immediately ruled out that either one of those are part of the puzzle. But what did show up, was Lyme. Really only two of her bands on her Western blot were lit up, which technically your average physician would say that that is not positive, but there is another test that you can do to back up those findings called the CD57 panel. That is something that will give you a little bit more information about how the immune system is reacting to Lyme. You also can run something else called the C4a, which will also give you information about the body fighting Lyme disease.

Interesting enough, her CD57 panel was completely out of range, and her C4a was also completely out of range. She had about two bands lit up on her Western blot. For her, this was a clear depiction that mono was not part of the problem for her, and it wasn't four years ago when she technically had her first bout of it, but when I did inquire about a lot of her symptoms, she was experiencing extreme joint pain. She was having a lot of problems with her hips, a lot of problems with her knees, a lot of problems with her ankles, which is the large joints of the body and that is the tell-tale symptoms of Lyme as well.

It's very very interesting how she went in to the doctor with those specific symptoms, the fever, the fatigue, she went in with the swollen glands, sore throat ... and she was told immediately, like you said, Brooke, "Oh you have mono, go home, you need to be out of school, just rest, it will pass within the next month to three months depending on how well your immune system works."

She never really felt 100%, and it wasn't until a couple months later that she really started to have the joint pain. Because her immune system has just been so taxed out, because the Lyme is something that is pretty over-abundant in her body, that she then manifested symptoms four years later, that almost looked like the mono was coming back, but it was actually a relapse, and she was having a major flare with the Lyme again.

It was definitely a very interesting scenario, and I thought that this could be very good information for other people, because mono, Epstein-Barr ... these are things that people are diagnosed with left and right. I know just offhand out of my close friends five people when I was in high school that were homeschooled for a consecutive amount of months because they technically had mono. And who knows what it really was? Maybe some people it truly was that.

Doing the blood work is absolutely essential, so if you, or your daughter or your son is having those types of symptoms or has been diagnosed with mono at some point, just get the testing done to rule out if it is truly Epstein-Barr or if it is the Lyme.

It'd definitely something that you want to have clarity about because the last thing that you want is later down the line for your child to start developing a lot of joint pain, and then we maybe say, "Oh, it's growing pains," or we say, "Oh, it's because they play sports," and we're totally missing the boat on the idea that it could potentially be something more.

I think it's interesting that you mentioned your own story, because for me, I had never had mono. I had never had any symptoms of it come on, I never went to the doctor, but years later I had testing for the Epstein-Barr virus, and they had told me that I did have an exposure. Somebody like me, who, I did have an exposure, but also never had any symptoms ... I think that that's another thing to be said about it is not everybody's going to have those classic mononucleosis type of symptoms. The testing is really important in gaining clarity.

Dr. Nicole:
Yeah, because later in life, the Epstein-Barr virus which causes the mono, it manifests as chronic fatigue. How many of us are tired? A lot of us. The way that I always explain it to people, because when I tell them that Epstein-Barr showed up in their blood, they're like, "What? No, I didn't have mono." And the way I explain it is, if you go on vacation and then you come back from your vacation and you say, "I need a vacation to recover from my vacation," it's normally because you go on vacation and you're out and you're about, and maybe you're eating more dessert than normal, you're having more drinks, and cocktails than normal ... so you kind of run down your immune system. When you get back from your vacation, your Epstein-Barr kind of peaks, so your fatigue symptoms will kick in. Then you get back into your normal lifestyle, and what you'll find is the symptoms will go away, primarily just because your immune system is getting strong again.

Yeah, and I wanted to jump back on how we talked about, I know you were talking about this particular case, but we mentioned something like the Western blot test. This is something that is kind of commonly run for Lyme, but it is actually very difficult to diagnose Lyme because it doesn't necessarily live in the blood. As you mentioned it kind of lives in the connective tissue. It will come out in the blood maybe if your immune system is down, if you're having some more extreme reactions. I want to talk a little bit more about the limitations with that testing also.

Dr. Nicole:
Yeah, definitely. A really, really important takeaway is when you talk about Lyme, it does not live in the blood, it lives in the connective tissue. In a perfect world, we would biopsy the connective tissue in order to figure out if Lyme is in the body. Nobody is doing that. We kind of base our testing off of blood when it comes to Lyme disease, but truly you actually need to treat the Lyme with anti-parasitics and anti-microbials before you would actually do the blood test.

If you start a treatment process which would technically push out the Lyme, push it out of the connective tissue, six weeks into treatment you could actually re-run that same panel, and you'll find out if the Lyme is truly positive. That's actually honestly not the most convenient thing, because if you say, "Oh, I'm going to put you on a treatment for the next six weeks and we're just going to do that just in case you do have Lyme," doesn't really always make the most sense to the patient. That is one of the reasons why I run the CD57 panel and I also will run the C4a, so that I can get some more information about how the immune system is working in conjunction to Lyme being in the body.

The other thing that you might see is somebody's white blood cell count is pretty low. When I say low, I mean below 3.5, that is definitely an indicator that your immune system is pretty taxed out, and has been fighting a serious infection. Lyme technically does fall under that category.

That is some of the labs that we do, but one of the other things that we do in conjunction is a form of muscle testing that's somewhat similar to applied kinesiology. It's called autonomic response testing. It was founded by Dr. Dietrich Klinghardt who is a physician out of Germany. He does practice in the Seattle area now.

He is someone who really understood the limitations of laboratory testing and how so many of these different infections will hide within either our neurological system, so like our brain tissue or nerve tissue, or these infections that will hide within connective tissue. He has found a way to do muscle testing using different vials of these different types of infections that will actually allow us to use a different modality to diagnose if these infections are in the body. We will usually use that in conjunction with our laboratory results, and that will give us the most accurate picture as to what's happening in that person's body.

Great. With regard to ... for anyone who's listening ... I know that Lyme can be something that's a little scary, too ... One of the biggest things to understand is that it's definitely manageable, there's definitely a lot of things that can be done to help rid your body of some of these offenders, and then replace some of the things that it's missing and improve your immune system.

I want to talk a little bit about management and what we would do for somebody in either of these cases.

Dr. Nicole:
I mentioned earlier when I was talking specifically about that case of the young woman who technically had those quote unquote, "mono symptoms" four years prior, and then it was this past April that all of those symptoms remanifested and she was told she had mono again. Regardless of mono or Lyme, that is not necessarily the most typical thing that would happen.

One of the really important things to understand is that the amount of wireless radiation that we are exposed to on a day to day basis can really affect different types of bugs in our body. So Lyme, being one of those because it's technically a spirochete. Someone of her age group, which was a teenager, they're typically on their cellphones all the time, they're using a lot of wireless devices, wearing Fitbits, maybe Apple watches, they are in school where they're constantly immersed in WiFi, typically coming home, hopping on their laptop, getting their homework done ... Literally, it's just never ending.

They're constantly, constantly exposed to tons and tons of wireless radiation. With that being said, that is something that will actually cause different types of infections in our bodies, including Lyme disease, to act more aggressively. It will cause it to affect and latch onto the host, aka us, more aggressively as well.

If you are a person who has been wearing a Fitbit, or you're wearing an Apple watch, and you're finding that you're progressively feeling like crap, take it off. Because it is very very important. If you have a router in your bedroom, get it out. These are really important things. They might sound completely ridiculous and silly, but I promise you that they are very, very important. The more experiments that are done, they're finding that different types of infections are multiplying by up to 600% in one week if that infection on a petri dish is exposed to tons of wireless radiation.

That's number one. Really start taking some inventory on how much are you being exposed to. Are you sleeping with tons of stuff plugged in around your bed? Are you sleeping with a router in your bedroom? Or do you have three or four routers in your house?

Or do you have your cellphone right next to your bed?

Dr. Nicole:
Yeah. And I know, my sister is young and she sleeps with that cellphone literally it is practically on her cheek when she sleeps. I'm like, "Please stop."

I know that the younger age demographic, they are just constantly using their phones and attached to social media. It's really important to give your body a little break. If that can be at night while you're sleeping, just putting that phone on airplane mode is huge.

That's a really just great takeaway to start implementing right away. Then when it really comes to diet and supplements, obviously those things need to be customized to the person, but when you're coming down to the idea of helping your body to fight infections and you want to help to get your immune system up, you really need to be cautious of the things that are creating inflammation and feeding these different types of infections. Sugar and crappy carbs ... they really need to go. In a perfect world, I wouldn't say you have to be sugar free, but you need to be considering the amount of sugar you're consuming and you need to be using better alternatives.

If your sugar is coming from fruit, not the end of the world. If your sugar is coming from something like a natural honey, not a big deal. But when we think of sugar and carbs, we kind of think of pasta and bread and soda, and things like that ... honestly milk has a ton of sugar in it.

Every vegetable is technically a carbohydrate, even if it's a leafy green. If you're eating that, but in addition you're making sure that you have a big hefty portion of pasta or rice or bread, you're just overloading yourself, so you need to be very conservative with the amount that you're consuming. Following a paleo diet is really optimal. My recent cookbook is called "Eat for Your Gut", but a whole chapter in there is about anti-inflammatory diet. That is what I recommend when somebody is trying to fight infections.

The last thing with supplements is, again, these have to customized. When you talk about something like Lyme disease, you absolutely need to treat it like a parasite, and stop treating it like a bacteria. If you treat it like a parasite, you will be successful with ridding it from your body. Don't get me wrong, it's not that easy, it's not like you go get some type of anti-parasitic and you just take that by itself and you're good to go. Depending on who you are, you might have other co-infections. You may have yeast, you may have bacteria, you might also have a really poorly functioning immune system, so you might need immune boosters.

You really need to work with a physician when you're talking about Lyme. Trying to manage it on your own is not easy, there's a lot of bad information out there, so you really need to work with somebody who is Lyme literate. I would say that that is really the most important takeaway is working with the right physician, and do your research. Not many physicians understand Lyme. It's a tricky condition, and you really need to work with somebody who knows their stuff.

Yeah, so with that being said, one of the things that we offer on all of our podcasts is a free 15 minute strategy call with myself, just to get a little bit better of an idea of what you're experiencing and how we can best guide you to the best type of care for you.