With my move from Los Angeles to Duluth, we have found a new challenge to fight in the practice, Lyme disease. We have discovered that this is a large problem in the Northland with few solid answers, especially for chronic patients. While I was able to consult with collegues who have experience with Lyme, I am finding that the answers are similiar to many other chronic health problems. While there are answers, there is not one answer that will help everyone.

First, lets talk about prevention. Lyme disease is caused by a bacteria in tick saliva that is transmitted when they bite our skin. To avoid ticks, wear long light colored pants and tuck them into your socks when walking or hiking in the woods or in tall grass. The light color will help you see the ticks when they do "hitch a ride" so you can get them off quickly. While I don't like to support the use of many chemicals, bug spray with DEET will help keep the ticks away. While the spray is harmful to the insects, it can also be harmful to us, so please be careful when using the sprays. There are also some natural tick repellents, although I have not tried them myself and do not know how well they work. Finally, when you come out of the woods check yourself thoroughly for ticks.   

If you do happen to get bitten by a tick, quick removal is a key to reducing the possibility of Lyme disease. The bacteria that causes Lyme is not transmitted at the time of the initial bite. It takes 6-24 hours before the bacteria moves from the tick into our body. Lyme disease is typically identified by the bulls-eye rash commonly seen after a tick bite that transfers the bacteria. Although many people infected with Lyme disease will not have the typical rash.

Symptoms of Lyme disease vary from person to person and some people won't have symptoms for quite some time after they have been infected. Common symptoms are joint aches and pains especially in the ankles and feet, flu-like symptoms, and severe headaches. Also symptoms of menopause in women who are not in the typical menopause age range can be caused by the Lyme disease bacteria. Fatigue, lethargy, and neurological, cardiac, and psychiatric problems can also show as symptoms. 

Lyme treatment is very controversial with some politics in the background that fuels the debate. Conventional treatment uses antibiotics to try to defeat the bacteria. Some say that when antibiotics are given at the time of the initial bite, Lyme can be defeated.  The controversy comes in with treating chronic, or ongoing, Lyme disease. Some doctors do not acknowledge that chronic Lyme disease exists, while others acknowledge it and use long-term antibiotics to treat it.  

What I have found is that there are many factors playing into this controversy other than the politics. First, previous testing for Lyme disease has had poor results with its accuracy of positive and negative results. Second, there are bacteria, similar to the one that causes Lyme, that can produce the same symptoms, but not respond to the same treatments. Third, the bacteria that causes Lyme is able to avoid our immune system by changing itself often enough that our immune system cannot keep up. Lastly, antibiotics push the bacteria into a "hibernation" type of form. I call it hibernation because the patient will not have symptoms and the antibiotics do not work, but when the antibiotics are finished the bacteria returns to its original form and the symptoms return.

The good news is that lab testing has evolved recently and there are now tests that can identify not only the bacteria that cause Lyme, but other bacteria that cause similar symptoms and do not respond to Lyme therapy. This test also can help to identify the life stage of the bacteria which was not possible before. Also, there are herbs that have been shown to reduce the number of both the bacteria and its hibernating form. By reducing both forms of the bacteria, we give our immune system a better chance of catching up and fighting the rest of the bacteria that are causing the symptoms.

While this just touches the basics of Lyme and how diagnosing and treatments are evolving, if you have more questions I would be glad to answer them further.  It is essential to have a proper diagnosis and treatment plan when dealing with Lyme as it can lead to neurological problems, autoimmune diseases, severe pain, and possibly contribute to Autistic Spectrum Disorders.  To dig into the details of this disease would make this a book more than a newsletter. Please give me a call and we can talk more about the complexity of Lyme and how to treat it. 

For your health, 

Dr. Herbert