Are you or someone you love affected by tick-borne illness?

Here are some great resources and frequently asked questions about tick-borne illness. See the answers to these questions below:

The deer tick. Photo courtesy of iStockphoto.

The deer tick. Photo courtesy of iStockphoto.

What should I do if I find a tick???

What is tick-borne illness? Is it the same as Lyme Disease? 

If I am bitten by a tick, do I have Lyme Disease? 

What is all the controversy about?  

What is the best test to see if I have Lyme or any co-infections?  

What are the treatment options? Do I have to take antibiotics? 

How can I prevent Lyme Disease? 

Where can I find more resources and support? 

 

What Should I Do If I Find a Tick???

First off, don't panic. If it isn't embedded and doesn't look like a chocolate-covered raisin (full of blood), it hasn't likely bitten you yet. Just brush it off. If it is attached to you...again, DON'T PANIC and simply follow these recommendations:

  • DO NOT squeeze, smash, pinch, twist, burn or smother/try to drown the tick - this only increases the potential for it to infect you and/or have its mouth parts break off inside of you and cause infection
  • Grab the tick with tweezers as close to the skin as possible and pull straight up with firm, consistent pressure, without tugging or twisting - click here for a graphic 
  • Wash your hands and the bite site with soap and water and apply an antimicrobial salve or ointment
  • Put the tick in a zip-loc baggy with a small piece of paper towel or a cotton ball with a few drops of water on it. Make sure it is sealed. Send the tick to be tested if you can (I HIGHLY RECOMMEND THIS - it is much easier and cheaper than testing yourself later!)  - UMASS TICK TESTING or IgeneX
  • Keep an eye on the area, preferably writing down when you were bit, where and any symptoms in case you need this information later. If you get a red area that continues to grow over 7-10 days that MAY OR MAY NOT look like a bulls-eye, or has multiple red areas - call your doctor now. The rash is a positive test. Period. If you doctor tries to test you at that moment, or refuses treatment, find another doctor. Tests will not be effective until 4-6 weeks after the bite and are pointless if you have the rash.
  • If you don't get a rash, but get flu-like symptoms (fever, achy muscles/joints, fatigue, headache), a migraine or stomach upset - call you doctor now and begin treatment immediately - again, tests are not effective for 4-6 weeks, so do NOT wait. 
  • The recommended treatment for acute infection (with rash and/or symptoms) is now 6-8 weeks, some even dosing up to 3 months, NOT a single dose or 1-2 weeks. If your doctor recommends a single dose or refuses to do 30 days or more, find a Lyme literate doctor in your area immediately. Antibodies will not show up for 2-4 weeks minimum, so do not wait for testing. a couple months of antibiotics is a small price to pay for the potential long-term effects of this infection. 
  • If you just have a bit of inflammation right at the bite no bigger than a pencil eraser that does not spread and no flu-like symptoms, it is likely you were not infected. Still, let your doctor know next time you go in for an appointment and file the information on the bite (date, place, symptoms) with your medical records in case you need them later.

What is tick-borne illness? Is it the same as Lyme Disease?

Tick-borne illness is any illness that is transmitted to humans by ticks. This does include Lyme, which is when ticks are infected with the bacteria, Borrelia spp. Other illnesses that are transmitted to humans via ticks include Babesia, Bartonella, Erlichia and Anaplasma, which can be transmitted at the same time with the Borrelia. 

If I am bitten by a tick, do I have Lyme Disease?

Not necessarily. Not every tick is infected with the bacteria. And not every tick that is infected will transmit it to you. It depends on the area you live and what types of animals are the chosen host in that area. Ticks like to feed off of deer, ground rodents like mice, chipmunks and squirrels, and songbirds. It also depends on your immune status. As we say in naturopathic medicine, it's all about the terrain. A healthy body will not provide a good environment for infection to take over. 

What is all the controversy all about?

I wish I could answer that question, but I simply don't understand it myself. Acute (meaning right after the tick bite) Lyme is rarely disputed, but there is a lot of controversy in the medical community of whether or not chronic Lyme (having symptoms months or years after the exposure) in fact exists, or if it is the long-term damage done from the infection. Many doctors also do not believe the use of long-term antibiotics is appropriate. To this I ask - why do doctors prescribe long-term antibiotics (covered by insurance no less) for acne? Acne can be cured with diet modifications and hormone balancing and does not completely destroy someone's nervous system. Any physician who has treated the chronic effects of tick-borne illness cannot dispute its existence. Due to the lack of accurate testing available, many critics claim there is not enough evidence that it exists. But to me, and to many other physicians and healers treating this terrible condition, there is NO evidence that is does NOT exist. Laboratory tests should not be used to diagnose, but should support the clinician's opinion of what is going on. A blood test is just a snap-shot of a patient's blood at that very moment, in that very area from where it is taken. Good clinicians rely on the whole picture - history, physical exam and testing because tick-borne illness is a clinical diagnosis. And remember - the rash is a POSITIVE test and requires immediate treatment.

What is the best test to see if I have Lyme or any co-infections?

For acute Lyme (right after the bite), if you get a spreading, red or bulls-eye rash or multiple red areas, that is positive for the infection as the antibodies will not show up for a number of weeks after exposure and treatment should be started right away (though research now suggests more than 50% of people may not recall a rash). Chronic Lyme and other tick-borne illness however is a clinical diagnosis, meaning it is diagnosed by a Lyme literate physician based on history, physical exam and laboratory testing. Because there is no one perfect test for this condition and the tests currently available each have their own limitations and are only part of the picture. We have to put all of the information together - history, exam and testing - to get a clinical diagnosis.

The ELISA, or basic antibody/screening test run by most labs is unreliable, missing approximately 35% of positive cases (screening tests should have at least 95% accuracy, not 65%). The Western Blot can be positive for longer, but is again, only measuring exposure, not active infection, thus can still overlook about 20-30% of positive cases. Commercial labs also do not test enough of the bands in a Western blot to know if there is significant exposure. IgeneX is the preferred lab for Western Blots as they test more bands including bands 31 and 34, which are specific to Borrelia burgdorferi and are the actual bands the vaccine was made from. Igenex does not have more false positive tests as some doctors will try to elude, they simply test for more bands. They also offer various PCR testing (to find the DNA of the actual bugs) for Borrelia and its co-infections. Pharmasan Labs also offers a new test, which monitors the parts of the immune system that responds to active infection specific to Borrelia with much more accuracy and can also be useful in monitoring treatment (they are also developing this test for co-infections like Bartonella and Babesia). Other than those, the only other test with significant accuracy is a culture, which sees if the bacteria actually grows out of the blood or tissue. This lab has 100% accuracy, but only if you are able to get blood or tissue where the organisms are currently present, which can be difficult since Borrelia likes to hide in joints, organs and the nervous system.

What are the treatment options? Do I have to take antibiotics? 

There are various treatment options and they will likely include antibiotics at some point depending on the extent of symptoms and damage done by the infection. That being said, there have been cases where herbal and/or homeopathic treatments alone have been successful. The issue with tick-borne illness is that it's not just about killing the bugs. In order to get full recovery, you have to support the body's natural ability to heal by incorporating food and lifestyle changes, remedies to support the immune system and detoxification pathways (to help rid the body of the toxins created by the infection itself, the toxins released by the dying bugs and the dead bugs themselves), emotional support (which has a profound effect on treatment) and addressing any underlying conditions that could potentially prevent treatment from being successful. Many people suffering from tick-borne illness also suffer from other infections like yeast/mold/parasites, have significant sensitivities to certain foods and can have numerous other issues that, if gone unaddressed, could significantly slow treatment response. This is why it is imperative to have a doctor who addresses the whole person and not just the infection. One of the reasons these conditions are so difficult to treat is because there is no one treatment protocol. Each patient is different and will have different responses to treatment. I have never seen anyone return to health using antibiotics alone for chronic infection. 

How can I prevent Lyme Disease?

  • Educate yourself - just reading this is your first step! Since we live in an endemic area, it is likely we will be exposed to ticks and/or Lyme at some point. Now, you know what to do when that happens which is half the battle. Remember, there have to have been people who have fought this infection off naturally - again, it's all about the terrain. Staying healthy and keeping a strong immune system is the number one way to prevent Lyme (and any chronic illness for that matter).
  • Use protection - check out your options for bug repellant and landscaping - it can be a huge help!
  • Be cautious around brush, woodpiles or any areas frequented by deer, rodents or birds.  
  • Keep brush, wood piles and bird feeders away from the house, garden and play areas. 
  • Do nightly tick checks - ticks are prevalent in some form almost all year round here in Southern Maine. Your best bet is to do nightly tick checks which only take seconds. Use you fingertips and lightly feel all over your body as the nymph-stage ticks are tiny (the size of a poppy seed) and you are more likely to feel them rather than see them. Don't forget the hairy/warm areas as those are a favorite spot for ticks looking for a warm meal - scalp, pits and privates. 
  • Don't forget your furry family members - just because you use a flea/tick repellant on your animals doesn't mean they can't bring ticks inside your home. If they go outside, do a tick check on them as much as possible (at least every night), especially if they sleep with you. Again, use your fingertips and just pet/massage while trying to notice any poppy/sesame seed-sized ticks (dog ticks are larger and easier to feel/see). And don't forget to check those ears, eyes and snouts!
  • Don't assume that snow on the ground or going to the beach means no ticks. Ticks don't hibernate until it's been consistently under 40 degrees for a period of time. Even then, you still may find some hiding in warmer areas like wood piles, fire pits, compost piles, etc.  Snow means less of a chance, but it's not impossible. I have yet to get through a winter when I have not had a patient with a tick bite. Even the Maine CDC shows there is not one month where Lyme is NOT reported - and we now know that only represents about 10% of true cases. Similarly, a lot of people think there are no ticks at the beach. In my practice, this has been the most common area people have picked up ticks. With the seagrass and variety of water birds, the beaches here in Maine are still a viable place for ticks to thrive. 

Where can I find more resources and support?