You go hiking or playing in woods or fields – taking advantage of being outdoors. While this is great for overall health and wellness, there’s a risk lurking in the grass and under dried leaves. Ticks, or more precisely a bacterium they can pass along when they bite you, can turn a wonderful day at the park into a long-term health nightmare for some when it leads to Lyme disease.
“Lyme disease is the most common disease that results from tick bites in the United States,” says Dr. Sabina Rebis, an internal medicine and family medicine specialist with Yale New Haven Health Bridgeport Hospital. According to the Centers for Disease Control and Prevention, about 30,000 cases of Lyme disease are reported to the agency each year by state departments of health, but the number of infections is probably about 10 times higher or roughly 300,000 cases per year in the U.S.
Lyme disease is caused by the Borrelia burgdorferi bacterium that’s carried by deer, mice and other animals. The tick feeds on the blood of the infected animal and ingests the bacteria, which then lives in the tick’s gut, Rebis explains. Eventually, when the tick feeds on a new host, it can transmit the bacteria onward.
“If the tick latches on to a human host, it usually takes anywhere from 48 to 72 hours for the bacteria to travel from the tick’s gut to where it makes contact with human blood and results in transmission, and in turn causes Lyme disease,” Rebis says.
Increasing Prevalence and Co-Infections
Though not all ticks carry Lyme disease, they can also carry other tick-borne diseases. The CDC reports that other tick-borne diseases that have been detected in various locations across the United States include:
- Borrelia mayonii.
- Borrelia miyamotoi.
- Bourbon virus.
- Colorado tick fever.
- Heartland virus.
- Powassan disease.
- Rickettsia parkeri rickettsiosis.
- Southern tick-associated rash illness.
- Tickborne relapsing fever.
- 364D rickettsiosis.
All of these diseases can cause a range of different symptoms that may be similar to those caused by the Borrelia burgdorferi bacteria, and sometimes more than one disease can be passed along in a single tick bite. Therefore, in some people, diagnosing Lyme disease can become a tricky affair.
However, Lyme disease is on the rise in the U.S. The U.S. Environmental Protection Agency reports that the incidence of Lyme disease in the U.S. has roughly doubled since 1991, from 3.74 reported cases per 100,000 people to 7.95 reported cases per 100,000 people in 2014.
Climate change is just one factor the EPA cites as influencing this increase. As temperatures rise, that has increased habitat range for ticks. For example, deer ticks are most active when air temps exceed 45 degrees Fahrenheit, and they thrive in places where humidity hits 85%, so the hot sticky weather that the Northeast has been experiencing in recent summers makes for happy ticks. Shorter, warmer winters are also contributing to ticks’ ability to overwinter and come back in greater numbers in the spring.
New Hampshire, Maine and Vermont have seen the biggest increases in Lyme disease infection rates since 1991. Delaware and Massachusetts have also seen large rises in numbers, the EPA reports.
Acute Lyme Disease Infections
“Lyme disease can be generally divided into early and chronic categories,” says Dr. Matthew Cook, a board-certified anesthesiologist, regenerative medicine specialist and founder of BioReset Medical, an integrative medicine practice located in Silicon Valley that specializes in treating patients with Lyme disease. In acute cases, symptoms of Lyme disease usually develop one to six weeks after the tick bite.
Symptoms of Lyme typically include:
- Fevers and chills.
- A foggy or fuzzy feeling.
- Stiff neck.
- Joint pain that typically begins in a single joint but can affect multiple joints.
- Swollen lymph nodes.
- A telltale bull’s eye rash called erythema migrans, around the site of the bite or elsewhere in the body. Cook says this is “the most common early symptom,” and it “occurs in 70% to 80% of patients, typically at the tick bite location.” The CDC reports that this rash generally shows up between three and 30 days of the bite, with seven days being the typical time period.
For many people, infection with Lyme disease can feel a lot like the flu, and they might ignore it and assume it’ll clear up on its own. But if it is Lyme, that can have lasting consequences, Rebis says. “If left untreated, the infection can spread to major organ systems, affecting the heart and the nerves.”
Ongoing Problems from Lyme Disease
If Lyme is left untreated, or not diagnosed quickly, symptoms can become chronic. And even when treated in a timely manner, some people develop chronic symptoms.
While acute cases of Lyme disease are often curable with antibiotics when they’re identified early and treated appropriately, if Lyme is left untreated or not diagnosed quickly, symptoms can become chronic. Even with timely intervention, some people can still develop chronic symptoms. A 2016 editorial in the New England Journal of Medicine estimated that 10% to 20% of people with Lyme will experience chronic symptoms after completing antibiotic therapy.
“Some patients can have very long-term complications if the bacteria spreads in the body,” Cook says. “When that happens, it can spread to the nervous system where it can affect peripheral nerves or the brain. It can also affect the heart, gastrointestinal system and joints.”
Symptoms of chronic Lyme disease may include:
- Severe headaches and neck stiffness.
- Joint pain and swelling particularly in the knees and other large joints.
- Widespread inflammation that may center in the brain or spinal cord.
- A loss of muscle tone or a droop on one or both sides of the face called facial palsy.
- Shortness of breath.
- Dizziness or lightheadedness, especially when standing up.
- Nerve pain and numbness, tingling or shooting pains in the hands or feet.
- Heart palpitations or arrhythmias, also called Lyme carditis.
- Night sweats.
- Gastrointestinal problems, such a leaky gut and food allergies.
“Because it can affect so many areas in the body, it can cause symptoms that are diverse and difficult to diagnose,” Cook says. Therefore, “Lyme has been termed by some the ‘great masquerader.'”
Arriving at a definitive diagnosis of Lyme can be challenging, especially given that it can occur alongside other tick-borne illnesses that may produce similar symptoms.
“Often Lyme disease is diagnosed clinically based on the appearance of erythema migrans, or a classic bull’s eye rash, following a tick bite,” Rebis says. However, if you don’t have the hallmark rash and your symptoms are nonspecific, such as fatigue, joint pain, headaches, neck pain and fogginess, your doctor can order blood tests that may reveal the presence of the bacteria that causes Lyme disease.
But even the lab tests aren’t always definitive, Rebis adds. “In the first one to four weeks following a tick bite, blood tests can be falsely negative, because antibodies – the immune response the body makes to the bacteria – don’t become positive until at least two (weeks) and often as long as four to six weeks later.”
The good news, Rebis says, is that “Lyme disease in its acute form is very easily treatable. And in its chronic form, it’s manageable. New research shows that anti-inflammatory therapies used in autoimmune disease treatment may be a key component to managing those with chronic, intractable Lyme disease symptoms.”
In most acute cases, a two- to four-week course of antibiotics will clear up the infection. Antibiotics are also the first line of defense in treating most cases of chronic Lyme disease. Doxycycline, cefuroxime and amoxicillin are the three antibiotics usually used to treat Lyme infections.
Why exactly some people develop these post-treatment complications is not understood, but the CDC reports that some experts believe the infection can trigger an autoimmune response that causes chronic symptoms and widespread inflammation. Tamping down that inflammation is thought by some to be the key to resolving issues, Rebis says. “Reducing inflammation and calming down the immune system in those who have recovered from Lyme disease” may improve symptoms that don’t clear up after treatment with antibiotics.
Some people also reach for vitamins and minerals that support or improve immune system functioning, with the aim of reducing inflammation and supporting the immune system, Cook says.
While keeping your immune system running well is a key to good overall health, the downside with regard to Lyme disease is that it has also opened the door to some unscrupulous “cure” purveyors who peddle unproven herbs or supplements that claim to treat Lyme. Some of these products have little or no evidence backing them.
Still, studies into using herbs, vitamins and other supplements are ongoing. For example, a 2017 study conducted by researchers at Johns Hopkins University looked at the antimicrobial effects of 34 essential oils to see whether they could kill the B. burgdorferi bacteria in cultures.
Five essential oils seemed to offer promise:
- Cinnamon bark.
- Clove bud.
Other herbal medicines that have been evaluated and seem to have some efficacy in treating persistent Lyme infections include:
- Ghanaian quinine.
- Japanese knotweed.
- Black walnut.
- Cat’s claw.
- Sweet wormwood.
- Mediterranean rockrose.
- Chinese skullcap.
Currently, antibiotics are the only proven treatment for Lyme disease, so more work needs to be done before herbal remedies to treat chronic Lyme disease can be considered truly safe and effective. It should also be noted that herbal remedies and supplements are not risk-free. Some have powerful effects, may interact with other medications you’re taking or may cause potentially dangerous side effects. Therefore, you must consult with your doctor prior to starting any new treatment for chronic Lyme disease, even if it’s just a vitamin supplement you pick up at the grocery store.
Beyond using antibiotics or supplements, try these other ways to live better with Lyme disease:
- Ensuring you’ve got the right diagnosis. Because Lyme disease can be difficult to diagnose and may be confused with other tick-borne or autoimmune conditions, “the most important thing to keep in mind when treating Lyme is to make sure there’s an accurate diagnosis of infections and other issues and develop treatment for those,” Cook says. Other co-infections with bacteria, viruses or mold can compound and confuse the diagnosis and treatment of Lyme disease. Speak with your doctor to make sure you’ve got the correct and complete diagnosis for your situation.
- Reducing stress. Stress is a major contributor to inflammation throughout the body. While you can’t get rid of all of it, trying to control your response to stressful situations can help lower your body’s release of stress hormones that can increase inflammation and symptoms of Lyme disease.
- Changing your diet. Highly processed foods and those that are high on the glycemic index, meaning they increase your blood sugar levels more rapidly, may contribute to systemic inflammation in the body, Rebis says. Instead, focus on eating a healthy diet rich in vitamins, minerals and whole foods such as leafy greens, colorful fruits and vegetables, whole grains and lean proteins. Boosting your intake of anti-inflammatory foods such as ginger and garlic might also help, she says. Cook adds that avoiding dairy products and gluten, a protein found in some grains and products made from them such as bread and beer, may help with Lyme symptoms.
- Getting plenty of rest. When you’re coping with a chronic illness of any sort, making sure you’re getting adequate, high-quality sleep is critical to helping your body heal.
- Exercising regularly. Getting at least 30 minutes of exercise three or more times per week is helpful for keeping your joints moving better and reducing inflammation.
- Practicing yoga and meditation. Establishing a consistent yoga practice can help ease stress while also providing you with regular physical exercise that’s gentle on sore joints and may help you cope with Lyme disease better. In addition, adding a meditation practice – even just 5 or 10 minutes per day – can reduce overall stress and inflammation in the body.
- Getting out in nature. Although hiking in the woods can put you in contact with ticks that carry the bacteria that causes Lyme disease, getting out and moving in nature can help you reduce stress and feel better overall. Just be sure to cover up as much skin as you can and use insect repellant that contains DEET. Or treat your clothes and gear with the insecticide permethrin, to prevent another tick bite.
- Getting support. Living with Lyme disease can be challenging, Cook says: “Lyme can cause profound psychological stress and many patients have had chronic symptoms of depression, anxiety and PTSD.” These symptoms can feel overwhelming, but connecting with others who are coping with the same issues may provide support and a sense of connection. Plus, others may share helpful solutions that could also be beneficial to your situation.