Lyme disease is the most common tick-borne disease in the United States, with
approximately 16,000 new cases reported each year. The disorder was first
identified in 1975 when a group of children in Lyme, Connecticut, experienced
mysterious arthritis-like symptoms. The deer tick carrying the bacterium B.
burgdorferi is responsible for the spread of the disease in the United
States. Cases have been reported in nearly all states, and the disease is also
on the rise in large areas of Asia and Europe.
|Signs and Symptoms|
Lyme disease is accompanied by the following signs and
- Red rash that appears within a few weeks of a tick bite, initially as
a small red spot at the site of the bite. The spot expands over time, forming a
circle or oval and sometimes resembling a bull's eye. The rash can range in size
from that of a dime to the entire width of a person's back. As the infection
spreads, rashes can appear at different places on the body.
- Flu-like symptoms—fever, headache, stiff
neck, body aches, and fatigue.
- Arthritis—60 percent of people not treated
with antibiotics develop recurring attacks of arthritis, most commonly in the
knees, that last a few days to a few months. About 10 to 20 percent of untreated
individuals will develop ongoing arthritis.
- Neurological symptoms—stiff neck and severe
headache (may indicate meningitis), temporary paralysis of muscles in the face
(Bell's palsy), numbness, pain or weakness in the limbs, or poor motor
coordination. Symptoms can develop weeks, months, or even years following an
untreated infection, and can last for weeks or months. Symptoms usually resolve
completely, but they may recur.
- Heart problems—heart abnormalities such as
palpitations, lightheadedness, fainting, chest pain, and shortness of breath are
uncommon. Symptoms may appear several weeks after infection and last a few days
|What Causes It?|
Ixodes ticks carrying the bacterium B. burgdorferi bite people.
The bacteria enter the skin at the site of the bite, after the infected tick has
been in place 36 to 48 hours. Symptoms are primarily due to the body's response
to this invasion.
|Who's Most At Risk?|
The following factors increase the risk for developing Lyme
- Environment: exposure to heavily wooded areas
- Season: infection is most likely during the summer and fall
- Age: most common in children and young adults
- Location: 90 percent of cases occur in the coastal northeast, as well
as in Wisconsin, Minnesota, California, and
|What to Expect at Your Provider's Office|
Lyme disease can be difficult to diagnose because many of its symptoms mimic
those of other disorders. About one quarter of people with Lyme disease do not
develop a rash. Your healthcare provider will consider your risk factors and
will check your blood for antibodies against B. burgdorferi to confirm
the presence of the bacterium. A spinal tap may be performed to detect brain and
spinal cord inflammation and to examine antibodies or genetic material of B.
burgdorferi in the spinal fluid.
The best defense against Lyme disease is to guard against tick bites. Avoid
heavily wooded areas, wear protective clothing, and apply tick repellant. Wear
light-colored clothing (which makes ticks easier to detect), do a careful
inspection of your body after outdoor activities in wooded or grassy areas, and,
if ticks are found, remove them with tweezers. New evidence suggests that it may
even be possible to prevent Lyme disease if antibiotics are administered within
3 days of a tick bite.
A vaccine against Lyme disease was approved by the FDA in December 1998. The
vaccine is recommended for those who live, travel, or work in areas where Lyme
disease is prevalent. Studies indicate that the vaccine is about 80% effective.
Your provider may prescribe the following medications:
- Antibiotics, such as amoxicillin, doxycycline, cefuroxime axetil, or
erythromycin; in the case of neurological symptoms, ceftriaxone or penicillin is
- Nonsteroidal anti-inflammatory drugs (NSAIDs) for relief of symptoms
|Complementary and Alternative Therapies|
Lyme disease affects many body systems, so treatment that includes
complementary therapies, such as homeopathy and stress management, may have
benefits. Chiropractic therapy may help relieve pain, make you more mobile, and
improve range of motion.
These nutritional factors may help in treating Lyme disease; each of these
should be discussed with your healthcare provider before using:
- Fatty acids that reduce inflammation (such as borage and fish
- Mitochondrial nutrients (such as carnitine and alpha-lipoic acid),
which boost energy; these supplements may also help with cognitive functions
such as focused thinking and memory
- Cognitive enhancements, such as coenzyme Q10, used to increase blood
flow to the brain
- Nutrients that support your adrenal gland (such as vitamin C, vitamin
B6, and pantothenic acid)
- Calcium/magnesium supplements for muscle pain and spasm
- Extra magnesium (30 to 420 mg a day, depending on age and gender) and
malic acid (found in apples, pears, and other fruits, and used as a food
additive), when muscle pain is your primary symptom
- Low levels of vitamin A may increase arthritic inflammation caused by
Lyme disease; although not known definitively, taking vitamin A may improve
- Probiotics, such as Lactobacillus acidophilus; if antibiotics
are taken, your healthcare provider may suggest this supplement to help maintain
or restore normal levels of beneficial microorganisms in the intestines
- Ginkgo (Ginkgo biloba) may help reduce cognition (thinking,
learning, memory) problems, and valerian (Valeriana officinalis) may help
with any accompanying anxiety.
- Case studies suggest that Chinese herbal formulas may be effective in
people with Lyme disease who don't respond to antibiotics.
There have been few studies examining the effectiveness of specific
homeopathic remedies. Professional homeopaths, however, may recommend treatments
for Lyme disease based on their knowledge and clinical experience. Typically,
homeopaths take into account a person's constitutional type before prescribing a
remedy. In homeopathic terms, a person's constitution is his or her physical,
emotional, and intellectual makeup. In some cases, such as Lyme disease, a
professional homeopath may prescribe specific remedies without considering the
individual's constitutional state. Such remedies for Lyme disease
- Arsenicum album
- Lac canimum
Acupuncture may help relieve pain, increase mobility, and reduce fatigue.
Chinese herbal formulas, used by many acupuncturists, may help resolve joint,
muscular, and neurological symptoms from B. burgdorferi infection after
many courses of antibiotics.
Massage therapy may help relieve muscle pain and increase mobility as part of
a physical therapy program.
The long-term prognosis for most patients treated with antibiotics is
excellent. Delay in treatment can result in complications.
If you have a severe and advanced case of Lyme disease with varied symptoms,
your provider may want to see you regularly.
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|Review Date: October 2000|
|Reviewed By: Participants in the review process include: Shiva Barton, ND, Wellspace,
Cambridge, MA; Jacqueline A. Hart, MD, Department of Internal Medicine,
Newton-Wellesley Hospital, Harvard University and Senior Medical Editor
Integrative Medicine, Boston, MA.|
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