Preventing Lyme Disease: Best Practices and Tips for your Patients
By Dr. Emily Miller, ND
Lyme disease and other tick-borne illnesses are becoming more and more common around the country. While it has been concentrated in Northeastern and Northern Midwest states, ticks carrying Borrelia burgdorferi (the bacteria that causes Lyme disease) have been identified in all 50 states. It is rapidly increasing on the entire west coast from California to Washington, throughout western states and significantly in Texas. The black legged tick (aka deer tick) is the traditional vector for transmission and highly prevalent in the Northeast and in Texas, while the western black-legged tick transmits the disease along the Pacific Coast and in Utah, Nevada, and Arizona. If you have questions or fears about Lyme disease and ticks, then you are not alone. There is a lot of misinformation out there about Lyme disease so this article seeks to help clarify what we know to be true at present.
Lyme disease was the first identified illness resulting from an infection by a Borrelia species of bacteria (most commonly, Borrelia burgdorferi) The bacteria are typically transmitted to humans by ticks, and while the black-legged (deer) tick is the most recognized vector by the CDC to carry Borrelia, there is increasing evidence that other species of ticks may also be infected, as well as fleas and mosquitoes. While ticks have been known to prefer weather between 50 and 70 degrees and damp areas, they can still be found in the heat of August, clinging to tall grass, even beach grass, and can also survive the winter. There have been a variety of cases of people getting tick bites while there is still snow on the ground.
What are the symptoms of Lyme? Joint pain and swelling, muscle pain, unexplained rashes, fever, brain fog, forgetfulness and other cognitive decline, irritability, headaches, mood changes, muscle weakness, and especially fatigue are all common symptoms of Lyme sufferers. Less than 40% of people who contract the disease will see a bulls-eye rash. The bacteria have an incredible way of evading the immune system, and decreasing your immune responses over time. Because of this, patients with Lyme often experience a myriad of other infections.
Perhaps you know someone, have a family member or are personally experiencing the devastating effects of Lyme disease that has been untreated. How can we stay safe, help our patients stay safe and continue to enjoy the beauty of the outdoors? Prevention of tick bites is the most important thing to focus on and maintaining strict diligence to the proper prevention protocols will help preserve quality of life. If prevention fails then immediate treatment is the most important factor in prognosis.
So, what do we mean by “following strict prevention protocols”? While it may be a little inconvenient, it’s really not that hard. Ticks typically like to hide out of the sun and in damp places so keeping the yard free of debris, piles of leaves and undergrowth, as well as keeping a low-mowed lawn helps minimize ticks in the yard. A fence or even a barrier of bark mulch around the perimeter of the yard can also be helpful in keeping ticks in the surrounding woods and out of the grass where children or pets play. Chickens will eat ticks and can be great scavengers for ticks in the yard and in the surrounding woods and many people are now choosing that option! There is a new resurgence in popularity of backyard chickens, not just for the eggs!
Some Lyme specialists recommend using chemicals such as permethrin to repel ticks. Permethrin has been used by the army to repel insects for many years and is typically sprayed on clothing-NOT on the skin for this particular use. Permethrin is used to treat scabies and head lice and is neurotoxic to insects and animals in the wild. It’s important to understand the toxicity of anything that you might recommend for patients and their families, and provide information on how to use it properly. In addition, there are companies that specialize in spraying yards with a tick insecticide such as pyrethrin. There are both natural/organic and synthetic forms of pyrethrin. Look into which is best for your area and contact a professional for more details.
From a natural perspective, essential oils such as Lemon Eucalyptus, Thyme, Tea Tree, and Neem oil have been reported to repel ticks. While it can’t hurt much to use these home remedies on clothing and skin to help repel ticks there isn’t much research on how effective they are.
There are several companies making all natural tick repellents and I do recommend their use. However, natural and chemical repellents are no replacement for diligence in physical prevention practices such as frequent changing of clothes, frequent “tick checks” throughout the day and thorough showering before bed if you have engaged in outdoor activities where ticks may be present.
Ticks are at their height of activity throughout the spring, summer and fall seasons. When possible and practical, wear long pants and tuck them into your socks to prevent ticks from climbing up into your pants from your shoes. Wear long sleeve shirts and be sure to tuck long hair up into a hat, as ticks can grab on directly to your hair when walking through trees and shrubs.
When returning to the house from gardening or playing in the yard I recommend stripping clothes off outside and getting directly into the shower or tub. This is the best way to ensure ticks are not brought into the house and are washed out of hard to see areas like hair and groin. Remember to especially check groin, behind the ears, armpits, and hairline for ticks, as they are favorite areas for ticks to hide, and use a fine tooth comb to check for ticks on the scalp.
When going for a hike in the woods, I recommend bringing an extra change of clothing for the whole family for the ride home and bagging up outdoor clothing before getting into the car. Examine your gear, backpacks and coats. Store outdoor gear outside of the house. Ensure that clothing is washed promptly and not allowed to sit in a hamper as ticks will find their way out and into your living areas. Tumble dry clothing for 90 minutes on low heat or 60 minutes on high heat to kill ticks. Just tumble dry any items that cannot be washed.
On the topic of prevention, lastly, and unfortunately, we must acknowledge that pets significantly increase human exposure to Lyme disease, especially if they are free to roam in the brush or the woods. The ticks will grab hold of their fur and be carried into the yard and into the house. Brushing your pet daily is very important and can help prevent many ticks from coming into the house, but won’t prevent your pet from bringing them into your yard. Tick medications that are applied to pet’s skin, usually between the shoulder blades or at the base of the neck, are called “spot-ons.” Spot-on chemicals spread over the animal’s entire body, depositing into the sweat glands of the skin, where the active ingredient can be released over several weeks’ time. These popular products typically contain ingredients that may repel and kill fleas and ticks as well as mosquitoes. The ingredients commonly found in these products include fipronil, methoprene, imidacloprid, permethrin, pyriproxyfen, and moxidectin.
Unfortunately, there is some bad news about these products. First, they are usually toxic to humans and increase a family’s exposure to toxic chemicals. Second, they may not repel the ticks, which may still be crawling around on the pet for hours, and can be transferred to the carpet, furniture and (yikes) even the families bedding. Never allow pets in the bedrooms during tick season or the family risks tick bites during the night while they are sleeping which is very common. Finally, if you own a pet in a high-risk area, please talk to your veterinarian about products that will repel as well as kill ticks on your pet, but minimize your toxin exposure.
It’s very important to give information to patients on what to do if they find an embedded tick. First, tell them not to panic! You can give them a handout with a complementary set of fine tipped tweezers. Using a pair of fine tipped tweezers they should try to pull the tick off of the skin directly at the point in which it is connected, trying not to squeeze the tick, as they can squeeze the tick contents into the blood. Most important: SAVE THE TICK! Put the tick in a plastic sealed bag with a small piece of moist paper towel. Find out about tick testing centers in your area and contact a tick testing center yourself for information to give your patients. Many university cooperative extension services offer tick testing, such as UMass Extension Tick Diagnostic Lab at (413) 545-1055, website: www.umass.edu/tick.
Testing the tick for Lyme disease can be helpful in determining the course of treatment, especially in hard to treat populations such as pregnant and lactating women and children. Just because a tick has bitten does not necessarily mean a person will develop Lyme disease. Although Borrelia bacteria has spread to various species of ticks, it’s still true that not every tick may carry it. However, there are many other infectious bacteria ticks may carry either with or without “Lyme bacteria” so it’s good to know what you are up against and testing the tick can help. Although the CDC states that a tick must be attached for 24-48 hours to transmit Lyme disease, positive Lyme tests and clinical symptoms suggest otherwise and we will most likely see changes to this information in the future. Clinical results have shown herbal antimicrobials, immune support and/or pharmaceutical antibiotics can be preventative of chronic and disseminated Lyme disease and may be instituted immediately in exposed individuals who have no complicating factors. The sooner treatment is instituted after exposure the better chance it has of preventing Lyme disease from occurring. Practitioners who do not specialize in Lyme treatment should find and refer to a practitioner who does because Lyme is a very bad bug, with a unique ability to hide from the immune system, wreak havoc on many body systems and is very difficult to eradicate if left unchecked.
Experience has shown us that testing people for Lyme disease is difficult and not very accurate. Some testing centers are beginning to develop new and more advanced testing methods. Even with a proper diagnosis, many popular treatments have proven ineffective, so If you are concerned that a patient may have Lyme disease, referral for advanced testing and treatment by a top notch Lyme specialist is imperative.
Awareness of Lyme disease in the Northeast began about 30 years ago, and what has been learned is that prevention is key. Lyme disease is preventable if you are diligent, and usually treatable with a good combination of natural and conventional medicines if addressed immediately. For additional information check out http://www.ilads.org. In addition, many individual states have their own Lyme Disease Associations.
Dr. Emily Miller
Both an Emerson Ecologics and a wellevate customer, Dr. Emily Miller is a Naturopathic Doctor specializing in family health care, naturopathic pediatrics and women’s health. Her practice, The Luna Center for Natural Health in Dover, New Hampshire, serves families and individuals from New Hampshire, Maine, and Northern Massachusetts. To learn more about Dr. Miller, please visit her website at www.thelunacenter.com.