Lyme Disease

Lyme disease is the most common tick-borne disease in the United States, with approximately 16,000 new cases reported each year. The disorder was first identified in 1975 when a group of children in Lyme, Connecticut, experienced mysterious arthritis-like symptoms. The deer tick carrying the bacterium B. burgdorferi is responsible for the spread of the disease in the United States. Cases have been reported in nearly all states, and the disease is also on the rise in large areas of Asia and Europe.

Signs and Symptoms

Lyme disease is accompanied by the following signs and symptoms:

• Red rash that appears within a few weeks of a tick bite, initially as a small red spot at the site of the bite. The spot expands over time, forming a circle or oval and sometimes resembling 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.
• Flu-like symptoms—fever, headache, stiff neck, body aches, and fatigue.
• Arthritis—60 percent of people not treated with antibiotics develop recurring attacks of arthritis, most commonly in the knees, that last a few days to a few months. About 10 to 20 percent of untreated individuals will develop ongoing 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. Symptoms can develop weeks, months, or even years following an untreated infection, and can last for weeks or months. Symptoms usually resolve completely, but they may recur.
• Heart problems—heart abnormalities such as palpitations, lightheadedness, fainting, chest pain, and shortness of breath are uncommon. Symptoms may appear several weeks after infection and last a few days or weeks.

What Causes It?

Ixodes 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 to 48 hours. Symptoms are primarily due to the body's response to this invasion.

Who's Most At Risk?

The following factors increase the risk for developing Lyme disease.

• Environment: exposure to heavily wooded areas
• Season: infection is most likely during the summer and fall
• Age: most common in children and young adults
• Location: 90 percent of cases occur in the coastal northeast, as well as in Wisconsin, Minnesota, California, and Oregon

What to Expect at Your Provider's Office

Lyme disease can be difficult to diagnose because many of its symptoms mimic those of other disorders. About one quarter of people with Lyme disease do not develop a rash. Your healthcare provider will consider your risk factors and will check your blood for antibodies against B. burgdorferi to confirm the presence of the bacterium. A spinal tap may be performed to detect brain and spinal cord inflammation and to examine antibodies or genetic material of B. burgdorferi in the spinal fluid.

Treatment Options

Prevention

The best defense against Lyme disease is to guard against tick bites. Avoid heavily wooded areas, wear protective clothing, and apply tick repellant. Wear light-colored clothing (which makes ticks easier to detect), do a careful inspection of your body after outdoor activities in wooded or grassy areas, and, if ticks are found, remove them with tweezers. New evidence suggests that it may even be possible to prevent Lyme disease if antibiotics are administered within 3 days of a tick bite.

A vaccine against Lyme disease was approved by the FDA in December 1998. The vaccine is recommended for those who live, travel, or work in areas where Lyme disease is prevalent. Studies indicate that the vaccine is about 80% effective.

Drug Therapies

Your provider may prescribe the following medications:

• Antibiotics, such as amoxicillin, doxycycline, cefuroxime axetil, or erythromycin; in the case of neurological symptoms, ceftriaxone or penicillin is used
• Nonsteroidal anti-inflammatory drugs (NSAIDs) for relief of symptoms

Complementary and Alternative Therapies

Lyme disease affects many body systems, so treatment that includes complementary therapies, such as homeopathy and stress management, may have benefits. Chiropractic therapy may help relieve pain, make you more mobile, and improve range of motion.

Nutrition
These nutritional factors may help in treating Lyme disease; each of these should be discussed with your healthcare provider before using:

• Fatty acids that reduce inflammation (such as borage and fish oils)
• Mitochondrial nutrients (such as carnitine and alpha-lipoic acid), which boost energy; these supplements may also help with cognitive functions such as focused thinking and memory
• Cognitive enhancements, such as coenzyme Q10, used to increase blood flow to the brain
• Nutrients that support your adrenal gland (such as vitamin C, vitamin B6, and pantothenic acid)
• Calcium/magnesium supplements for muscle pain and spasm
• Extra magnesium (30 to 420 mg a day, depending on age and gender) and malic acid (found in apples, pears, and other fruits, and used as a food additive), when muscle pain is your primary symptom
• Low levels of vitamin A may increase arthritic inflammation caused by Lyme disease; although not known definitively, taking vitamin A may improve these symptoms
• Probiotics, such as Lactobacillus acidophilus; if antibiotics are taken, your healthcare provider may suggest this supplement to help maintain or restore normal levels of beneficial microorganisms in the intestines

Herbs

• Ginkgo (Ginkgo biloba) may help reduce cognition (thinking, learning, memory) problems, and valerian (Valeriana officinalis) may help with any accompanying anxiety.
• Case studies suggest that Chinese herbal formulas may be effective in people with Lyme disease who don't respond to antibiotics.

Homeopathy
There have been few studies examining the effectiveness of specific homeopathic remedies. Professional homeopaths, however, may recommend treatments for Lyme disease based on their knowledge and clinical experience. Typically, homeopaths take into account a person's constitutional type before prescribing a remedy. In homeopathic terms, a person's constitution is his or her 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
• Carcinosin
• Lac canimum
• Ledum
• Mercurius
• Syphilinum
• Thuja

Acupuncture
Acupuncture may help relieve pain, increase mobility, and reduce fatigue. Chinese herbal formulas, used by many acupuncturists, may help resolve joint, muscular, and neurological symptoms from B. burgdorferi infection after many courses of antibiotics.

Massage
Massage therapy may help relieve muscle pain and increase mobility as part of a physical therapy program.

Prognosis/Possible Complications

The long-term prognosis for most patients treated with antibiotics is excellent. Delay in treatment can result in complications.

Following Up

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

References

American College of Physicians. Guidelines for Laboratory Evaluation in the Diagnosis of Lyme Disease. Ann Intern Med. 1997;126:1106-1123.

Amoxicillin. NMIHI. Accessed at http://www.nmihi.com/a/amoxicillin.html on February 6, 2018.

Antibiotics. NMIHI. Accessed at http://drugs.nmihi.com/antibiotics.htm on February 6, 2018.

Anti-inflammatory drugs. NMIHI. Accessed at http://drugs.nmihi.com/anti-inflammatory.htm on February 6, 2018.

Beers MH, Berkow R, eds. The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck & Co.; 1999:1189-1191.

Bock SJ. Integrative treatment of Lyme disease. Int J Integrative Med. 1999;1(3):19-23.

Brier SR. Lyme disease. J Manipulative Physiol Ther. 1990;13(6):337-339.

Cantorna MT, Hayes CE, DeLuca HF. 1,25-Dihydroxycholecalciferol inhibits the progression of arthritis in murine models of human arthritis. J Nutr. 1998;128(1):68-72.

Cantorna MT, Hayes CE. Vitamin A deficiency exacerbates murine Lyme arthritis. J Infect Dis. 1996. 174(4):747-751.

Edlow J. Tick-borne diseases, Lyme. In: Adler J, et al. Emergency Medicine: An On-line Medical Reference. Accessed at www.emedicine.com on February 1, 2000.

Jonas WB. Do homeopathic nosodes protect against infection? An experimental test. Altern Ther Health Med. 1999;5(5):36-40.

Ibuprofen. NMIHI. Accessed at http://www.nmihi.com/i/ibuprofen.html on February 6, 2018.

Kacherski SE. The diagnosis and treatment of Lyme related TMJ utilizing the Bi-Digital O-Ring test, homeopathic dilutions of reference controlled substances and nutritional support. Acupunct Electrother Res. 1997;22(1):76.

Lyme Disease. Centers for Disease Control and Prevention. Accesssed August 18, 2018 at https://www.cdc.gov/lyme/index.html.

Lyme Disease. NMIHI. Accessed at http://www.nmihi.com/l/lyme-disease.htm on February 6, 2018.

Lyme Disease. MedlinePlus. Accessed at https://medlineplus.gov/lymedisease.html on February 6, 2018.

Lyme Disease Slideshow. WebMD. Accessed at https://www.webmd.com/ on February 6, 2018.

Minocycline. NMIHI. Accessed at http://www.nmihi.com/m/minocycline.html on February 6, 2018.

Scalzo R. Naturopathic Handbook of Herbal Formulas. 2nd ed. Kivaki Press, Durango, Colo; 1994:72-73, 94.

Seltzer EG, et al. Long-term outcomes of persons with Lyme disease. JAMA. 2000;283:609-616.

Ullman D. The Consumer's Guide to Homeopathy. New York, NY: Tarcher/Putnam; 1995.

Van Benschoten MM. Treatment of Lyme disease via Omura's test of acupoints and Chinese herbal formulas. Am J Acupunct. 1992;20(4):363-367.

Whitmont RD. Homeopathy and Lyme disease. J Am Inst Homeopath. Winter 1997-98;90(4):186-198.