Lyme

Decode Lyme With The Horowitz MSIDS Questionnaire

Healing Lyme Summit

https://drive.google.com/file/d/18B3F-w83QfKuTDCnPCIWEUXhuBDx2EYy/view?usp=drive_link

We validated this questionnaire. Empirical validation of the Horowitz/MSIDS Questionnaire that was published in 2017 in the International Journal of General Medicine with state university researchers Dr. Mary Ellis Cetera and Phyllis Freeman, a very good friend of mine. The purpose of the study was to evaluate the HMQ design as a screening tool to see if it was reliable and valid. Data were collected from two independent samples. We have 1600 patients from three medical practices specializing in treating Lyme, as well as healthy individuals who were recruited through email and social media to complete an online survey. 
The HMQ has four sections. The first is a 38-symptom questionnaire, which rates from zero, I don&#8217;t have the symptoms. To three; extremely frequent or zero severity. It&#8217;s not present, or one, it&#8217;s mild, two, it&#8217;s moderate, and three, it&#8217;s severe. Both forms of the HMQ are accurate. The Lyme incidence scales give an idea of your likelihood of having Lyme. Do you live in a Lyme-endemic area? Have you had any rashes? Do you have migratory symptoms? Section three comes from the CDC. It&#8217;s the Healthy Days Scale. This is about items about the individual&#8217;s overall health and physical and mental health over the last 30 days. Finally, section four is the common Lyme score, which is a point for the most common Lyme symptoms. The way we score the questionnaire, a score of more than 63 is a very high likelihood of exposure to Lyme, especially if migratory pain is present. Now, there are only seven diseases in medicine that cause migratory pain, and your doctor should be able to help you know which of these you have. The only seven diseases. When we researched it, it was acute rheumatic fever, Crohn&#8217;s disease, inflammatory bowel, gynecological arthritis, different forms of hepatitis, reactive arthritis, or something that&#8217;s called Ryder syndrome, which can be due to infections with Salmonella, Yersinia, and Chlamydia species, or lupus and finally Lyme disease. 
But Lyme disease is the only one that has migratory nerve pain. When we looked at the HMC factors, the most significant factor, neuropathy was one of the most significant. If you had migratory, neuropathic pain, tingling, numbness, stabbing, or burning pains around your body, it was highly significant for Lyme cognitive dysfunction, memory concentration problems, and brain fog, followed by musculoskeletal pain, which can also be migratory. Anywhere between mild to severe fatigue disorder and dysautonomia, POTS, meaning again, low blood pressure problems standing, getting dizzy, and feeling like you&#8217;re going to pass out also contribute to chronic fatigue and brain fog. Finally, cardiorespiratory problems such as chest pain, shortness of breath, and palpitations. The five factors consistent with Lyme in our questionnaire were fatigue, flu-like symptoms, joint stiffness, tingling, neuropathy, and memory concentration problems. But migratory pain was significant—very significant for chronic Lyme. The questionnaire demonstrated what&#8217;s called convergent and divergent construct validity, as well as predictive validity. What does this mean? It means that the two-tier testing is roughly going to have a 50% chance of picking up whether you have Lyme. But if we did the discriminant analysis using the HMQ, we showed we could accurately classify your Lyme status with 87% accuracy. It&#8217;s even better than the two-tier testing. 
If your score is greater than 63, you have a high probability of Lyme between 45 and 62. Probable Lyme between 25 and 40. Possible Lyme and healthy individuals scored below 24, and questions one and 22 on the HMQ indicated a possible co-infection with the Babesia. Question one was about unexplained fever, sweats, chills, or flushing, classic malaria-like symptoms. Question 22 was whether we had unexplained shortness of breath or an unexplained cough. 
Once we have done the HMQ and looked at the MSIDS model, as you&#8217;ll hear about during our summit, the treatment options we are finding extremely effective are short-term oral protocols or using Short-term Pulsed Dapsone Combination Therapy and Double-dose Dapsone Combination Therapy for the treatment of Lyme disease and associated co-infections like Bartonella. You can read about these in our journal articles and microorganisms, in September 2023 and our newest one, which just came out in April 2024. Please let everyone know that help is on the way. Wisdom is the age of knowledge and experience bound by compassion. During our summit, you are going to gather the tools to help empower you to get better. I look forward to seeing you during the next summit. Thank you so much for paying attention.

<h6>Richard Horowitz, MD</h6>
Hello, everyone. My name is Dr. Richard Horowitz, and I am one of the co-hosts of the Healing from Lyme Disease Summit, sponsored by DrTalks. June 4th to 10th, 2024. I&#8217;d like to now present to you a mini talk on the use of the Horowitz/MSIDS Questionnaire, or HMQ, for helping to diagnose Lyme disease and a quick overview of the 16-point MSIDS model, which is very helpful in diagnosing and treating those with chronic, persistent symptoms. The advantage of using the MSIDS model questionnaire is that the blood tests for Lyme disease are highly unreliable. We need a clinical way to tell if someone suffers from Lyme disease. That&#8217;s what we&#8217;re going to see during this presentation. 
Are your symptoms due to Lyme disease? You can take the Horowitz Lyme/MSIDS Questionnaire or HMQ. This is a validated screening tool to determine the probability of having Lyme and associated tick-borne illnesses without an EM rash. If you do have any EM rash, it means you automatically have Lyme disease. You don&#8217;t need a blood test. Patients can have up to 16 different reasons why they stay ill. I call this a multifactorial diagnostic and treatment model of MSIDS. The 16-point MSIDS map evaluates all the sources of inflammation and downstream effects. Inflammation is what gives people symptoms of fatigue, headaches, joint muscle, nerve pain, brain fog, and sleep problems. One of the sources of inflammation is usually chronic infections like the three Bs: Borrelia, Bartonella, and Babesia. GI problems like dysbiosis of the intestinal bacteria, leaky gut with food allergies or mast cell disorder, sleep difficulties, environmental toxins like molds and heavy metals, and finally nutritional deficiencies. Any one or all of these six factors drive inflammation, which has downstream effects such as immune dysfunction, and auto-immunity. Endocrine issues such as low testosterone can lower adrenal function. Neurological problems. Psychological issues, POTS, dysautonomia, mitochondrial dysfunction, resistant pain syndromes, GI and liver dysfunction, and deconditioning.

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Dr. Richard Horowitz is a board-certified internist and the medical director of the Hudson Valley Healing Arts Center, an integrative medical center which combines both classical and complementary approaches in the treatment of Lyme disease and other tick-borne disorders. 
He has treated over 13,000 Lyme and tick-borne disease patients in the last 30 years, with patients coming from all over the US, Canada, and Europe to his clinic. 
He is one of the founding members and past president elect of ILADS, the International Lyme and Associated Diseases Society, and Dr Horowitz was previously awarded the Humanitarian of the Year award by the Turn the Corner Foundation as well as awards from Project Lyme for his treatment of Lyme Disease. He has dedicated his life to helping those stricken with this devastating illness.
He is also the author of two best-selling books on Lyme disease, Why Can’t I Get Better? Solving the Mystery of Lyme and Chronic Disease (2013, St Martin’s Press, NY Times Best Seller), and How Can I Get Better? An Action Plan for Treating Resistant Lyme and Chronic Disease (2017, St Martin’s Press, National bestseller). 
These books incorporate recent scientific advances and explain in detail how healthcare providers can effectively diagnose and treat resistant chronic illness.
In addition, he has co-authored peer-reviewed Lyme guidelines, and Dr Horowitz was a member of the HHS Tick-borne Disease Working Group and Co-chair of the “Other Tick-borne Diseases and Coinfections” subcommittee from 2017-2019 which provided recommendations to Congress to help the US improve the care of those suffering with tick-borne disorders. He recently served as a member of the HHS Babesia and Tick-borne Pathogen Subcommittee and was elected to serve as a member of the NYS DOH Tick-borne disease Working Group in 2021.
Finally, Dr Horowitz recently published several scientific articles on classical and integrative solutions for COVID-19 which have been effective in helping those with acute and chronic illness (see www.cangetbetter.com), and he released his first novel, Starseed R/evolution, ‘The Awakening’ a cli-fi (science fiction/climate change) novel in March of 2022, which will provide novel solutions to our present climate crisis. For more information, please see https://starseed-revolution.com/

Decode Lyme With The Horowitz MSIDS Questionnaire

Richard Horowitz, MD

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Richard Horowitz, MD