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Chronic Disease

Preventing Lyme Disease: An Integrative Approach

In March, with snow still on the ground, and having not played outside in over 48 hours, my son felt a sharp pinch in his scalp and a knowing expression fell over his face, then mine. “Is this a tick in my head?” He asked the inevitable, and still in disbelief (I mean it was early March for heaven’s sake!), I parted his hair to find the infamous pest chewing on him with its noxious mandibles.Sadly, if you reside in one of the high risk areas, living with ticks from early spring to late fall is the new normal. In this series on how to prevent tick-borne infections, I will present an overview of how to prevent a tick bite, what to do after a tick has bitten you, how to treat an acute Lyme infection or co-infection, and how to treat chronic Lyme, all from an integrative medicine perspective.

Part I: Bite Prevention

Ticks and Lyme Disease have been a scourge for long enough that most of us know some of the basic prevention methods: stay on trails, wear light-colored clothing, pants instead of shorts, pant cuffs tucked into socks, and hair tucked into hats. Use some sort of repellant and check yourself daily and thoroughly.
But the rampant spread of ticks has garnered a collaboration among medical, entomological, and forestry experts, a collaboration that has brought us more knowledge on the subject of prevention. Ticks can live anywhere there is moisture, darkness, and organic matter, and can be carried anywhere on a host. Some ways to prevent tick infestation in your home environment are:
• Keep grass cut very short
• Reduce brush and invasive overgrowth close to your yard as much as possible
• Use a natural barrier spray such as garlic in your yard
• Consider cutting back trees to allow for more sunlight, as ticks do not live long in sunny, dry places
• Consider keeping and ranging chickens or guinea hens, which are known to efficiently eat ticks
• Reduce wood and debris piles that can harbor ticks or nesting material for rodents that carry them
• Consider a wide barrier of cedar mulch around the perimeter of your yard adjacent to any forested areas
• Use deer-repellant landscaping practices and surround vegetable gardens with deer fencing
• Check all pets daily, and consider using a systemic flea and tick treatment
• Keep pets out of bedrooms and off of furniture
• Vacuum rugs daily if possible

Tick bite prevention should be a part of any outdoor recreation plan, and should include the following:
• Use of chemical or natural repellant (a topic about which I will go into greater detail below)
• Consider short haircuts or “buzz cuts”, especially for dark or thick hair, or keep hair up and hidden in a hat that has been treated with repellant
• Remain on trails or mowed areas
• When coming inside, take all clothing, including underwear, off immediately and place in the dryer on high for ten minutes.
• Shoes can be placed outside and then dried the same way after the clothing cycle is done. If shoes are too dirty to place in dryer, examine them thoroughly.
• Shower and scrub scalp and body within two hours of coming inside
• If possible have another person check your scalp, ears, and back thoroughly
• Check all areas of your body, including between fingers and toes, under breasts, in the navel, on the genitals and anus
• Re-examine your body in the morning after waking up

Opinions among health professionals vary greatly regarding botanical versus synthetic repellants. There are pros and cons to both. What medical experts can agree on is that how thoroughly and frequently any repellant is applied will determine how effective it is, with a consensus that botanical repellants need to be applied more liberally and frequently. The preponderance of published research supports the use of Permethrin treated clothing in combination with application of DEET on skin as the most effective repellant. However, those of us who have studied natural medicine also have an understanding of how effective botanical repellants can be. Plants produce volatile compounds to protect themselves from pests, information that strongly suggests that there are many natural compounds that are effective tick repellents and are waiting for a large population-based study to validate their use.

Synthetic Repellant vs. Botanical Repellant Pro’s and Con’s:
• Synthetic repellants tend to require fewer applications than botanicals (but still require frequent reapplication)
• DEET specifically doesn’t last long and needs to be reapplied frequently
• Skin irritations have been reported by 1-10% of people using synthetic repellants, more than those using botanical repellants
• Synthetic repellants should not be used at all on newborns
• Products containing a sunscreen and DEET application can result in excessive exposure to DEET and therefore should not be used on children
• Picaridin, an organic compound, is another synthetic option that is less effective than DEET after the first hour but has a better safety profile and is often preferred because it is less greasy and does not stain. However, it is stronger smelling.
• Botanical repellants such as cedarwood, lemongrass, geranium, peppermint, and garlic all have a repellant mechanism of action and have been shown to be effective repellants through empirical data.
• BioUD (available in the United States as BiteBlocker) is a tomato-derived repellant that has proven effective in repelling ticks at a high concentrations, but it is only available in concentrations much lower than used in the study.

Stay tuned for parts two, three, and four of this series:

Part II: Tick Bite: Now what?
Part III: Treating Acute Lyme and Co-infections: An Integrative Approach
Part IV: Treating Chronic Lyme and Co-infections: An Integrative Approach

Common Sense Disclaimer: Systemic treatment of Lyme, acute or chronic, requires individual assessment and a customized treatment plan. Please contact our office for a consultation.