Lyme & Tick-Borne Disease

Tick - JG NPThe treatment and diagnosis of Lyme disease continues to cause frustrations among patients and clinicians around the country.  Many providers are inclined to rule out Lyme disease based on  negative laboratory testing that is highly insensitive.  In the absence of reliable laboratory testing or adequate experience in recognizing the varied and complex presentations of Lyme and tick borne disease, most practitioners are ill-equipped to diagnose chronic Lyme disease.

Lyme disease is first and foremost a clinical diagnosis. This has been established by both the FDA and the CDC. A clinical diagnosis is made by considering the patient’s history of tick exposure as well as symptoms which are consistent with Lyme and tick borne disease.  Current laboratory testing can help confirm a diagnosis, but is outdated andnot reliable enough to diagnose or rule out Lyme disease.

Therefore, many Lyme patients suffer needlessly for years, and are shuffled through the health care system as they look for answers while enduring the skepticism of practitioners; often suffering long-term consequences of misdiagnoses.

Current ILADS Guidelines

The Great Imitator

Lyme disease is often referred to as “The Great Imitator” because it resembles numerous other illnesses.  As a result, most providers overlook a Lyme diagnoses and attribute symptoms to conditions such as Fibromyalgia, Chronic Fatigue Syndrome, MS, Parkinson’s disease, Alzheimers disease and many others.   Acute Lyme Disease, which generally occurs 3-30 days after a tick bite can cause symptoms such as fever, chills, muscle and joint pain, facial palsy, bullseye rash, swollen lymph nodes and profound fatigue.  However, Chronic Lyme Diseae can present very different clinically with symptoms such as abdominal pain, light or sound sensitivity, dizzyness or vertigo, burning sensation of skin, memory loss or brain fog, cardiac issues such as heart block, palpitations or chest pain and hormonal imbalances to name a few.


Conventional treatment of Lyme disease which follows the CDC guidelines typically consists of 3 weeks of antibiotic therapy.  Providers who are members of and follow the International Lyme and Associated Diseases Society (ILADS) protocols use longer courses of both oral and IV antibiotics when appropriate; often treating well beyond the 3 weeks recommended by the CDC.

Dr. Richard Horowitz, MD’s Lyme-MSIDS Questionnaire

Our practice follows ILADS protocols and after 6 years of treating both Acute and Chronic Lyme disease, I have found that a comprehensive,  integrative approach has provided the best outcomes for my patients.  Treatment is multi-faceted, individualized and often includes the following:

  • Diet – “Food is medicine…good food is good medicine…bad food is bad medicine”…dietary changes are focused on keeping inflammation under control, supporting a healthy immune system and a healthy gut flora.
  • Gut Health – Research shows that approximately 75% of our immune system is found in our intestinal tract. All patients are given individualized gut protocols which are designed to support gut repair and maintain a  healthy gut flora.  A healthy gut contains both “good bugs and bad bugs”.  Lyme disease as well as antibiotic use can disrupt the balance of bacteria in your gut creating a negative impact on your immune system and increasing the possibility of inflammation and  autoimmunity.
  • Lifestyle and Environment –  Identify and address lifestyle factors such as exposure to toxic chemicals, mold, metal toxicity and stress; all of which can negatively influence response to treatment as well as take an additional toll on your immune system.
  • Treat the infection with judicious use of antibiotics, herbs and supplements.  There is not a one size fits all protocol which works for everyone.  Patients will be evaluated on a regular basis whether or not they would benefit from a change of protocol or continue on their current protocol.

Awareness Is Key

Early detection and prevention are key.    Lyme disease is not the only pathogen carrried by ticks. A tick does not need to be attached for 24-48 hours in order to transmit disease.   Powassan virus can be transmitted from tick to host in as little as 15 minutes. Not enough research has been dedicated to the transmission times of co-infections such as such as Babesia, Bartonella, Anaplasma and Ehrlichia.

If you live in a Lyme endemic area and spend a lot of time outdoors gardening, hiking, walking your dog or hunting, it is important to get in the habit of perfoming tick checks on yourself, your family members and pets regularly.  If you do find a tick attached to your person, we recommend sending the tick fortesting of Lyme and co-infections.  We recommend or Medical Diagnositic Laboratories.  Both labs will have results available in a few days.