1. 1. Institut fr SymptomforschungGunnar Torbohm (Institute for Symptom Research) E-mail: g.torbohm@web.de E-mail: i.f.symptomforschung@web.de G. Torbohm 2007 Attachment 2List of 100+ symptoms that are possibly linked to chronic ilnesses Updated 23/10/10Still nowadays laboratory diagnostics have fatal deficiencies in evidencing pathogens that are carried by sufferers! Therefore the clinical evidence is of much importance. E.g. the CDC codifies that the diagnos- is of Lyme disease is based on clinical evidence and that the laboratory diagnostics only support the clin- ical evidence. But often the GP deals with the patient contrarily. The clinical evidence is often disputed or not taken seriously and the laboratory diagnostics is constituted as the Gold Standard.But how does the sufferer get to his clinical evidence anyway? At first the GP collects the number of symptoms during the anamnesis. These symptoms are based on the statements of the sufferer and the ob- servations of the GP. They allow coming to a thesis about the possible cause of the symptoms. Unfortu- nately the anamnesis is often carried out inadequately and incomplete which leads to false diagnosis and medical malpractice.The following list is just another incomplete catalogue of possible symptoms that can be triggered by a number of pathogenic germs. The person concerned usually suffers from several of these symptoms. The sum of the single symptoms represents the severity of the illness. Only few of these symptoms are visually detectable and if they are, this is some times for a very short period of time and therefore hard to catch for an observation through the GP. Most of the symptoms have a deep impact on the every day life of the suf- ferer for he perceives them with all his senses. The existence of neurones and receptors in higher de- veloped organisms enables sensitive and differentiated sensory perception. During the course of chronic infection often the neurotransmission between the neurones becomes more or less seriously damaged by the pathogenic organisms.The resulting pains are signals of the body. Therefore chronic pains are only in very rare cases caused just by the sufferers imagination. Normally the person concerned does not suffer hypersensitivity or a too low tolerance of pain. In many cases the sufferers have learned to bear severe pains for months and even years. On the one hand it is a fact that there are people who get benefit out of imagined syndromes of illness. On the contrary there is the tendency of many GPs to explain to an increasing number of symptom sufferers that their symptoms are caused by psychological/mental disorders or are incurable which clearly is related to economic/commercial aspects inside the Public Health System.Not every symptom can be fully understood. Not every little ache needs a therapy or gives reason for concern. Life is finite and feelings of well-being as well as of paraesthesia up to a certain level are just a natural part of this life. A person who possibly suffers a chronic infection should therefore ease his GPs diagnosis by providing him with a preferably detailed and exact description of his symptoms. It is not necessary to describe every single symptom in all its details. Experience shows that only the sufferer himself can fully understand the degree of his impairment. Every person concerned feels individually and describes his symptoms in his own words. In addition the intensity of the symptoms can swing and change in an hourly rate.
2. 2. The following list of 100 possible symptoms will help you to approach the symptoms that are ap- propriate for you and to use them for the documentation of your condition and progress relating to therapies you have undergone or will be undergoing. The course of the emerging documentation includes the answers to most of your questions regarding your symptoms. What therapy helps decrease my symptoms? What pathogen/s cause/s my symptoms? For how long should I carry on with a therapy? What additional treatment would be of benefit? Without documentation the Therapy of your Borreliosis is like a blind flight through fog. Following logical discretion and experience from symptom research the symptoms on the list, in the next column to the last on the right which are marked with an X are adequate for documentation. Symptoms like diarrhoea, loss of libido, alcohol intolerance, fears and depression are not adequate for the docu- mentation.The aim of this symptom documentation is the creation of a fever curve with which you and your GP or alternative practitioner will be able to quickly visualise the progress of your symptoms in relation to absolved therapies.Symptom research is epistemology in the sense of philosophy of science. Therefore a central evaluation of a number of people who suffer from one of the below named syndromes is the main aim of symptom research. Gunnar. Torbohm 2007
3. 3. Brief descriptions and explanatory notes of symptoms Name: Medical diagnosis: Age: Tel:E-mail:Date:Current SymptomP Detailed Description intern- alAcrodermatitis chronica Swelling with reddish-violet skin rash, initially puffy swelling, bluey-red X atrophicans coloured, later atrophied (shrunken) paper-thin, transparent in appear- ance earlobes, hands, scrotum, calves, feet. Alcohol intolerance Often reported, tending to lead to abstinence.Allergic maxillary sinusit- Non-healing infections, formation of cysts. isAmnesic aphasia (diffi- Speech problems, sufferer struggles to find the appropriate words to ex- x culty to find the correct press himself or cannot remember what he wanted to say, names slip word(s))ones mind etc. Friends may distance themselves increasingly with time which potentially leads to social isolation. Anxiety Belief in ones abilities drops with increase in symptoms. General state of anxiousness or due to extreme pain and/or heart arrhythmia a fear of death.ApathyLoss of interest and initiative, loss of interest in hobbies and career, X simple decisions become difficult, urgent tasks are put to one side, de- manding situations are avoided, social isolation due to lethargy.Bladder dysfunction Permanent urgency, bladder infections, urinary tract infections includingx incomplete urination.Bloodshot eyesBlood vessels stand out unnaturally, making the eyes swell and appear inflamed. Combined with other symptoms third parties can believe the sufferer is depressed or in grief.Blurred/hazy vision Thousands of moving spots like snow; tunnel vision. Borreliosis psychosis The delusive idea to suffer from a chronic Lyme Disease infection after proper antibiotic treatments, no medical confirmation by a medical doc- tor. Brain fog, numbness On waking, feeling of excessive alcohol consumption on previousx evening. Clear thoughts are difficult and structured actions are diffi- cult. Breast pain Specific to women: pressure, touch sensitivity. Karl Hsing listed this symptom in 2004.Burning, stinging, crawl- Sensory disturbance, so-called paraesthesia feeling of pins andx ing sensationsneedles, stroking of forearm provokes pain, stabbing pain in torso, heart, lungs, stomach, spleen, liver, Candida infections of the Susceptibility to Candida infections. Particularly likely to occur duringx skinantibiotic therapy and may require additional treatment. Compare: Fluc- onazole and the Fluconazole-Study. Circulatory disorders Generally unspecific, resulting in weakening of the whole organism; shortness of breath, increased need for rest, slowness in carrying out daily activities. At the same time the heart beat rate is very high. Meas- urable as beats per minute. Responds to therapy.
4. 4. Cognitive problems Decision making ability greatly reduced, inability to follow conversa-xtions leading to reduced involvement, reduced driving ability, normalstraightforward logical problem solving becomes difficult/impossible,avoidance taking on additional responsibilities. Unspecificsymptomatology but using specific testing techniques measurable. Comprehension problems Failure to understand the content of a sentence, resulting in one sentencex when reading being read repeatedly. The heavier the symptoms the more reduced theability to concentrate.ConfusionBrain fog; the feeling that ones head is full of cotton wool.xCoughKarl Hsing listed this symptom in 2004. Creeping sensationsCreeping sensations in the extremities, as if (part of) limb has gone toxsleep. This symptom often occurs at night time.Delusive parasitosis The delusive idea to suffer from a chronic microbiotic infection with nomedical confirmation by a medical doctor. Depression Inability to carry on with profession; social isolation, breakdown of rela-tionships, lack of positive medical prognosis.DiarrhoeaKarl Hsing listed this symptom in 2004.Concentration problems Inability to concentrate leading to unemployability. Even easy tasks be-xcome a challenge e.g. writing a letter, reading a book, having a conver-sation on the phone, tidying a room. It takes a much extended length oftime to get started, carry out and finish even small tasks and often theyare too much and are just left. Difficulty swallowingThis symptom occurs together with a sore throat and neck pain. Thexsufferer has difficulties swallowing this symptom is located on aclearly defined area. Swallowing raises the level of pain. Also reflux. Disorientation Getting lost, walking the wrong way, no overview of important appoint-ments or where one left their keys or wallet etc. Ear/hearingBuzzing, whistling, pain, sensitivity to noise, tinnitus, inflammation ofthe middle ear.Emotional instabilityThe sufferer tends to become upset and cries easily, gets annoyedquickly, tantrums are possible etc. Energy during the dayLack of or no motivation - cant see things through, no stamina, no drive xto straightforward carry out essential tasks like e.g. brushing teeth. In ex-treme cases leading to a bed-bound life. Energy upon waking Extreme feeling of tiredness directly after getting up which forces the xsufferer to sit or lie down immediately or even to return to bed.Erythema migrans (EM)EM is the typical pathognomonic symptom of an initiating Borrelia-in-fection. Focal, red dermatological reaction/phenomenon which seems tomove, also known as bulls eye rash. Exhaustion An unnatural level of exhaustion can already be experienced directlyxafter an extended period of rest. E.g. awaking in the morning and feelingthe need to go straight back to bed, when possible. Fever, extremely highNightly fever attacks which include extremely high temperatures, heavy and frequent sweating and exhaustion. Days are more regenerative than nights. This isa typical pathognomonic symptom of a recent Borrelia-infection and is anatural immune reaction. Fever, inability to pro- The immune system is not able to create a high temperature purging duce satisfactorilyfever anymore. Harming bacteria are suspected of blocking the bodysnatural ability to create fevers in order to protect themselves.
5. 5. Eyes, glaucomaKarl Hsing listed this symptom in 2004. Facial palsyNumbness of cheeks, forehead and/or temples; swelling, loss of con- x trol over facial-muscles, distorted facial expression etc.Fatigue Unbearable fatigue during the daytime that can lead e.g. to the suffererx falling asleep whilst reading or watching a film. Fatigue morningsThe documentation of the fatigue perception in the mornings, afternoons x Fatigue afternoonsand evenings can be useful in making a diagnosis. Additionally the suf- Fatigue eveningsferer can document times of awakening and dormancy. A lack of sleep weakens the immune system. The sleep/wake cycle is controlled by hor- mones. These hormones are produced in the epiphysis. As the brain is in- fected the hormone production becomes out of sync. Food intoleranceSudden intolerance to certain foods which were well tolerated before. Occurrence of various digestive problems e.g. nausea, vomiting, diarrhoea, constipation etc. Foot pain Pain and swelling of the toes, ball of the foot and ankle.xForgetfulness, which canParticularly a restriction in short term memory; the sufferer forgets im- x be noticed by those portant appointments, cannot remember names, loses things etc. around one Hair loss Extreme loss of hair, which is always accompanied by other symptoms. Headaches Unexpected attacks which can remain for hours or even days; from per- x manent light to extreme pressure, leaving the sufferer absolutely incapa- citated. On top of that the sufferer generally has to endure more than just this one symptom. Hearing loss, (acute) Karl Hsing listed this symptom in 2004.Heart pains See PericarditisxHeart rhythm disturbanceIrregular heart-beat, quick short beats followed by extremely long (arrhythmia)pauses. Loss of a stable rhythm.Hiatus hernia Karl Hsing listed this symptom in 2004.HormonesKarl Hsing, Borreliose Krank nach Zeckenbiss Wege zur Heilung, 2004, 3. Auflage, S.33 (Borreliosis Ill After Tick Bite Ways To Recover, 2004, 3. edition, p. 33) Inappropriate aggressionPerson can psychologically or physically overreact to demanding situ- ations. Indigestion Constipation, diarrhoea, cramps, bleedings, permanent paraesthesia be-x cause of blocked defecation, chronic cramping of the gastrointestinal tract. Inflammation of jointsArthritis-like symptoms including suspicion of rheumatism in hands, el- x bows, knees etcInternet BorreliosisThe delusive idea to suffer from a chronic Borreliosis infection with no medical confirmation by a medical doctor as a result of the patients in- ternet research. Intestinal pain Diffuse, difficult to locate pains. xIrregular menstrual cycle The cycle is not regular making it difficult to be prepared. Joint pain / elbows Pains of inflammation partly including overheating and reddening of x the elbow.
6. 6. Joint pain / hands Hands are stiff in the mornings, swollen, immobile and unusable. The xnormal function of the hands returns only after specific exercise.Joint pain / hipsWalking becomes painful and difficult, sitting upright becomes rapidly xunbearable, - trying to find a comfortable position leads to ridiculouspostures, driving or sitting in a car can become a torture.Joint pain / knees The pain can jump to and fro between the knees in just an hour, butxalso inflammation, overheating, reddening and swelling can occur andstay for days, weeks and even months. Joint pain / neckExtreme pains which can often be comparable to the pain of a herniated xdisc. This neck pain is a typical symptom of a chronic/persistent Borreliainfection but cannot be medically verified and sedated like a herniateddisc. Joint pain / shoulderRacking pains in the shoulders which severely restrict the ability tomove the arms or even the upper part of the body. Joint pain / spine The spine feels stiff, grates and clicks in particular the cervical spine, xthe lower part of the spine and the lumbar region.Lack of staminaWalking, cycling, team sports, work, even brushing ones teeth isxavoided. The more severe the symptoms the greater the immobility.Light sensitivityDirect sunlight can be very aggravating and leads to the sufferer retreat-ing from outdoor activities. Liver pain Can occur as light prickling below the rips on the right and can increasexto stabbing sensations with every breath causing the sufferer to takeshort sniffs rather than breathing normally.Loss/lack of libidoRelated to other hormone regulated systems like sleep rhythm.Weight loss/gain Weight loss or gain can occur e.g. because of a change in diet or becauseof hormonal changes. Low blood sugarHypoglycaemia, Karl Hsing listed this symptom in 2004. Lymph nodesSwollen and painful. xMCS -Multiple Chemical Karl Hsing listed this symptom in 2004. Sensitivity Meningitis The meninges appear to be a convenient milieu for the Borrelia bac-xteria. The consequences are typically concentration problems, forgetful-ness, headaches, migraine-like symptoms, nausea etc.Migraine Occurs in attacks lasting hours, days or even weeks extremexheadaches including sensations of inflammation and overpressure.Every heartbeat causes throbbing inside the head. Total inability tocarry on normally resulting in retreat from all daily activities. Mood swingsMood can vary extremely. Manic-depressive disorders, suddenly chan-ging expressions of aggression, grief or lethargy. This symptom dependson many factors and on the persons character. It is not a typicalpathognomonic symptom for a Borrelia infection. Muscular pains Muscle cramps which can occur everywhere at the same time or in spe- xcific locations in the calves, compressor, shoulders, hands etc.Neck painSee joint pain/neckx
7. 7. Sleep disturbancesThe sleep/wake cycle, which is hormone controlled, becomes disturbedx so that the sufferer may wake up in the middle of the night feeling wide awake and not able to fall asleep again for hours. This is followed by fa- tigue attacks during the day. Night sweatsSweat attacks that occur during the night and are not explainable, - see also fever.Pain in meningesPermanent shooting sensations of pain under the scalp.xPalpitationsPalpitations and abnormal heartbeat can be so pronounced that they dis- x turb sleep. It can take hours till the heartbeat eventually slows down to a normal rate.ParaesthesiaParticularly concerning the skin: being touched or stroked (sensitively)x can be a painful torture, as can warmth or chilliness. Numbness of face, arms or legs.Paralysis With similarities to MS, the sufferer might even end up in a wheel- x chair. E.g. facial palsy and numbness of hands are very common and often accompanied by creeping sensations.Pelvic pain Accompanied by hip pain, difficulty walking, sitting upright quickly be- comes unbearable, - trying to find a comfortable position leads to ridicu- lous postures. PericarditisInexplicable cardiac pains, heart aches (tachycardia) and palpitations oc- curring most often at night can even cause fear of death. May feel similar to a weak heart. This association plus any underlying causes have to be taken into account. TetchinessPermanent exposure to pain can lead to a lack of tolerance and a tend- ency to overreact. During an episode of severe pain the sufferer prefers to withdraw from any demanding or difficult situations. Symptom too unspecific. Pins and needles in the Extremities go numb loss of the sense of touch. Can occur more or x extremities less severely, only for a few minutes or even having a long term im- pact, leaving the sufferer wheelchair bound. No official figures known.PleurisyStabbing pain in the chest, ribs feel sore, shortness of breath.xProblems with the cranial x nerves, facial nerve pares- is Production of milkNot explainable Prostate, bladder prob- Pain, dull or stinging like suffering an inflammation of the bladder or x lemsthe ureter. Permanent and useable as pathognomonic symptom for a Borrelia infection. Restricted agilityIncreased level of symptoms lead directly to restricted movement. Ex- x ample: neck, knee, hip, hand etc. Tying shoe laces or weeding difficult.Sensitivity to smells Either overreaction to certain smells or the opposite a total loss of the sense of smell. Sexual dysfunctionShortness of breath Dyspnoea, even undemanding tasks like walking up a few stairs can lead to the feeling that one is not able to get enough air.Sleep/wake cycleGreat fatigue possible at all times of the day; uncontrollable wakefulnessx during the night. See also: Hormones, impact of therapy, thistle.
8. 8. Sore throatThe throat hurts in general and the sufferer has difficulties swallowingx this symptom is related to the neck pain and located on a clearlydefined area. Swallowing provokes even more pain.Stiffness of neckFeels like a pulled muscle in the area around the neck. The sufferer mayxonly turn his head a tiny bit because the turning of the head causes painand is mechanically restricted. Cracking and shooting pains.Stomach ache Regular stomach aches despite a healthy diet. xStomach complaints See stomach achexTachycardia at night Abnormally fast heartbeat which can be felt so strongly and also so xloudly that it disturbs the sleep. It can take hours till the heartbeat even-tually slows down to a normal rate.Tantrums Increased potential for aggression; sometimes the sufferer literally ex-plodes due to some minor thing, gets annoyed easily. Also see moodswings. TeethTeeth can die; the sufferer regularly gets increased maxillary sinusitismore frequent treatment. But the sufferer tends to be lethargic and for-gets about necessary dental care and hygiene. Testicular pains Tremor Involuntary shivering or shaking of hands or legs.x Tunnel visionThe view gets restricted and narrower until the sufferer can only seewhat happens right in front of them. The swollen face and the brainsymptomatology act negatively together during an attack.Twitches Facial muscles and other body parts start twitching uncontrollably xwithout leading to pain. Twitching musclesUncontrollable twitching and wincing of muscles, possible in the facialareas like the eyelid.VertigoSudden giddiness, the feeling of being about to pass out, which increases xthe concern of losing control.Weak immuneFrequent occurring infections e.g. with Herpes virus, intestinal para- system sites and/or Candida infections.Name and describe your individual symptoms that are missing!