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Chronic Disease

Tick Bite, Now What? Lyme Disease Prevention: An Integrative Approach PART TWO

When we moved to the Vermont woods, we knew that it would only be a matter of time before each of us would be bitten by a tick. However, we assumed that with preventive measures and thorough tick checks, we would only be bitten once or twice a year. Certain that 1-2 doses of antibiotics a year, combined with a high quality probiotic, would not adversely affect us or our children, we proceeded to use prophylactic antibiotics to treat the first, and then the second tick bite. Diarrhea, nausea, vomiting, and low appetite are common side effects of antibiotics, but when our son’s digestion continued to suffer on and off for a year afterwards, we knew that even the two doses of antibiotics had caused some damage, and that we would have to weigh the pro’s and con’s of prophylactic treatment more carefully the next time.

If you live in an area that is heavily populated by ticks, it’s not a matter of IF but WHEN you or a loved one will be bitten. The number one Lyme Disease prevention recommendation is to get into the habit of doing daily, thorough tick checks spring, summer, and fall, because prompt tick removal can drastically lower the likelihood of a tick transmitting Lyme or a co-infection. If you have found a tick crawling but detached, simply grab it securely with your fingers and remove it, make sure to flush it down the toilet, and wash hands thoroughly. If you have found a tick attached to your body, the following recommendations will prove most effective in the majority of tick bite cases. However, because each of us brings our own unique medical history to the table, I highly encourage visiting your licensed naturopathic physician for individual assessment and care.

Another reason to visit your physician after a tick bite is that ticks carry many infectious organisms that a often fly under the radar because so little is known about them. Actually, there is a 60% chance that a tick will be a carrier of another disease such as Anaplasma, Babesia, or Ehrlichia, as opposed to a 40% chance that a tick will be a carrier of Lyme. Unfortunately, these co-infections are often misdiagnosed as another, more common condition such as anxiety, depression, chronic fatigue, and muscle and joint disorders like arthritis. A Lyme test alone does not test for co-infections. A Lyme-literate Naturopathic Physician would know when your symptoms indicate that testing for co-infections is necessary to either treat them or rule them out.

How to Remove a Tick Once Bitten:
• Always use fine-point tweezers and grab the tick as close to the skin as possible.
• Pull straight up gently but firmly, with an even, steady and slow motion.
• Do not jerk, twist, squeeze, crush, or puncture the tick, as you may irritate it and cause it to release infectious fluids
• Do not use topical applications, such as matches, oils, nail polish, or even soap and water, as this may also irritate the tick and cause it to release infectious fluids.
• While the goal is to remove the entire tick, including the head and mouth, if parts of the tick still remain in the skin, leave them there as the body will expel them naturally.
• Here is a brief and thorough tick-removal demonstration : https://youtu.be/0wotB38WrRY
• A health provider can also be called to remove the tick if an office visit can be made promptly upon finding the attached tick.
• Place the tick in a sealed container or baggy, label the container with the name of the bitten person, the date bitten, the location where the tick was likely picked up, and how long the tick was likely to be attached. Keep these sealed in a designated area out of reach of children, as they can be tested for infectious organisms if symptoms occur.
• Try your best to identify the type of tick on the container as well. Here is an interactive online identification guide: http://tickencounter.org/tick_identification/tickid_nonflash

Treating the Bitten Area:
• After removing the tick, clean the affected area with soap and water
• Dry thoroughly with a clean towel and apply an over the counter antibiotic ointment such as Bacitracin
• Wash your hands

Having the Tick Tested for Lyme and Co-infections:
• There is no need to test the tick right away if you have decided to treat with prophylaxis (explained below), but still save it for testing later in case symptoms occur
• If not treating with prophylaxis, consider sending the sealed tick with all the information to be tested for Lyme and co-infections. It is usually more expensive to test for co-infections, but well worth it, especially from a prevention standpoint.
• The three testing services we have used—tickreport.com, tickcheck.com, and tickcenter.org/tick-testing—are comparable in price and the tests they offer
• Having test results from a tick that has bitten you will give your physician another data point to consider when making treatment recommendations.
Homeopathic and Herbal Treatments:
• First, it is important to note that natural treatment of Lyme does not take the place of medically-supervised treatment. The best practitioners work in an integrative way, using both natural and conventional treatments to ensure the most comprehensive care.
• For a bite, the homeopathic remedy Ledum at a dosage of 1m can be taken under the tongue, 3 pellets, 3 times daily, for 3 days.
• If a rash appears, the homeopathic Apis at a dosage of 30c can be taken under the tongue, 3 pellets, 3 times daily, for 3 days.
• Take homeopathics 15 minutes away from any water or food, and timed as far as possible from peppermint and caffeine.
• An herbalist or Naturopathic Physician can apply a topical herbal poultice to the site as a prophylactic treatment, but herbs, like other nutritional supplements, must be individualized based on patient history, allergies, and possible contraindications to prescribed pharmaceuticals.

Medical Prophylaxis:
• Pharmaceutical prophylaxis is not recommended for children under 8 or pregnant women, both of whom cannot take doxycycline safely
• Amoxicillin can be used for children safely, although there is not enough data to support its efficacy against tick-borne illness
• For adults who are not pregnant and children over eight, your Naturopathic Physician can help you decide whether to use a single round of antibiotic treatment within the first 72 hours of tick removal
• For ticks that have been removed very promptly and are not engorged, you may choose to send the tick for testing before taking a course of antibiotics that might upset your digestive tract
• Choosing to have the tick tested without taking a single course of antibiotic treatment will remove that option since the testing service takes about 10 days to return results, so some people choose to do both
• Even one dose of antibiotics can cause a myriad of problems, including but not limited to digestive imbalances, which can lead to food sensitivities, compromised immunity, and more. This is why many people choose to wait until symptoms occur before treating with antibiotics.
• When treating with antibiotics prophylactically or acutely, always see a Naturopathic Physician for a high quality probiotic to help replenish the beneficial gut bacteria that are essential for optimal health.
Blood Testing at the Time of a Tick Bite:
• Testing the blood for Lyme and co-infections at the time of a tick bite will not yield an accurate result
• You must wait 2-6 weeks for accurate results

Stay tuned for Part THREE in this series: Treating Acute Lyme and Co-infections: An Integrative Approach