Introduction:

Lyme disease is the most common tick-borne disease in the United States, with about 16,000 new cases reported each year. It was first identified in 1975 when a group of children in Old Lyme, Connecticut, had mysterious arthritis-like symptoms. Lyme disease is caused by the bacterium B. burgdorferi, which is carried by deer ticks. Not every bite from a deer tick causes Lyme disease. It is more likely to occur if the tick stays attached to your skin for 36 hours or more.

Cases have been reported in nearly all states, and the disease is also on the rise in large areas of Asia and Europe. It is very important to get early treatment for Lyme disease, so if you have any symptoms, you should call your doctor immediately. Although symptoms may disappear after a while, that does not mean the disease is gone. People who get early treatment with antibiotics usually recover without any complications.

Signs and Symptoms:

Lyme disease has three stages:

Localized Early Stage

Red rash that appears within a few weeks of a tick bite, starting as a small red spot at the site of the bite. The spot expands over time, forming a circle or oval and sometimes looking like a bull's eye. The rash can range in size from that of a dime to the entire width of a person's back. As the infection spreads, rashes can appear at different places on the body.

Early Disseminated Stage

Flu-like symptoms -- fever, headache, stiff neck, body and joint aches, and fatigue

Late Stage

• Arthritis -- 60% of people not treated with antibiotics develop recurring attacks of arthritis, most often in the knees, that last a few days to a few months. About 10 - 20% people who are not treated will develop chronic arthritis.
• Neurological symptoms -- stiff neck and severe headache (may indicate meningitis), temporary paralysis of muscles in the face (Bell's palsy), numbness, pain or weakness in the limbs, or poor motor coordination.
• Heart problems -- Palpitations, lightheadedness, fainting, chest pain, and shortness of breath may develop in fewer than 10% of people with Lyme disease. Symptoms may show up several weeks after infection and last a few days or weeks.

What Causes It?:

Deer ticks carrying the bacterium B. burgdorferi bite people. The bacteria enter the skin at the site of the bite, after the infected tick has been in place 36 - 48 hours.

Who's Most At Risk?:

Your risk of Lyme disease may be higher if you:

• Spend time in heavily wooded areas where there are ticks.
• Spend time outdoors in summer and fall.
• Are young -- children and young adults are more likely to get Lyme disease.
• Live in the coastal northeast, as well as in Wisconsin, Minnesota, California, and Oregon, where the majority of cases occur.

What to Expect at Your Provider's Office:

Lyme disease can be hard to diagnose because many of its symptoms mimic those of other illnesses, and there is no definitive lab test for Lyme disease. About 20% of people with Lyme disease do not develop a rash. Tell your doctor if you think you may have been bitten by a tick. Your doctor may order these tests:

• ELISA test -- detects antibodies to B. burgdorferi. Can result in false positives.
• Western blot test -- detects antibodies to proteins of B. burgdorferi
• Polymerase chain reaction (PCR) -- detects the presence of bacteria in synovial (joint) fluid and is used for people who may have Lyme arthritis.

Treatment Options:

Prevention

The best defense against Lyme disease is to guard against tick bites. Avoid heavily wooded areas, wear long-sleeved shirts and long pants, and apply tick repellant. Use an insect repellent with DEET or oil of lemon eucalyptus. Wear light-colored clothing (which makes ticks easier to see), and inspect your body carefully after you' ve been outdoors. If you find a tick, remove it with tweezers, making sure to remove the head as well as the body. Seeing your doctor and taking antibiotics within 3 days of a tick bite may prevent Lyme disease.

Drug Therapies

Your health care provider may prescribe the following medications:

• Antibiotics -- usually doxycycline (Vibramycin), amoxicillin, and cefuroxime (Ceftin) are prescribed. Later-stage Lyme disease may require intravenous (IV) antibiotics, either ceftriaxone (Rocephin) or penicillin.
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) or naproxen (Aleve), for relief of pain and inflammation.

Complementary and Alternative Therapies

You should never treat Lyme disease with complementary therapies alone. Antibiotics are needed to cure the disease and avoid complications. However, Lyme disease affects many systems in your body, so treatment that includes complementary therapies may help.

Always tell your doctor about the herbs and supplements you are using or considering using.

Nutrition and Supplements

Probiotic supplement (containing Lactobacillus acidophilus), 5 - 10 billion CFUs (colony forming units) a day. Probiotics, or “friendly” bacteria, help maintain intestinal health. If you take antibiotics to treat Lyme disease, the antibiotics will kill the “good” bacteria along with the bad. That can cause diarrhea or yeast infections. Taking probiotics may reduce these side effects.

Herbs

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a healthcare practitioner.

You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.

• Green tea (Camellia sinensis) standardized extract, 250 - 500 mg daily, for antioxidant, anti-inflammatory and heart health effects. Use caffeine-free products. You may also prepare teas from the leaf of this herb.
• Cat's claw (Uncaria tomentosa) standardized extract, 20 mg three times a day, for inflammation and antibacterial activity.
• Garlic (Allium sativum), standardized extract, 400 mg two to three times daily, for antibacterial effects and to boost the immune system.

Homeopathy

Few studies have examined the effectiveness of specific homeopathic remedies. Professional homeopaths, however, may recommend treatments for Lyme disease based on their knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person' s constitutional type -- your physical, emotional, and intellectual makeup. In some cases, such as Lyme disease, a professional homeopath may prescribe specific remedies without considering the individual's constitutional state. Such remedies for Lyme disease include:

• Arsenicum album
• Borrelia burgdorferi nosode
• Carcinosin
• Lac canimum
• Ledum
• Mercurius
• Syphilinum
• Thuja

Prognosis and Possible Complications:

Most people who are treated with antibiotics make a full recovery. Getting early treatment can help avoid complications.

Following Up:

If you have a severe and advanced case of Lyme disease with varied symptoms, your health care provider may want to see you regularly.