Lyme Disease in Washington? YES.

American folklore may have led you to believe that Lyme Disease is only contracted by infected deer ticks from Northeast or Midwest. Unfortunately, it is spreading, and we are seeing more and more cases of Lyme here in Washington. I have quite a few patients who struggle with it chronically. According to the CDC, only 260 cases have been reported in Washington from 2000-2016, but diagnoses either go missed or unreported, so the University of Massachusetts estimates that the incidence is closer to 2600 cases and climbing. 

Lyme disease is a systemic inflammatory disorder caused by a spirochete/bacteria called Borrelia burgdorferai. It is transmitted to humans by ticks, but Lyme is not the only disease that ticks carry. We also have concern for “coinfections” like babesia or bartonella, and they can be just as difficult to diagnose and treat.

Lyme disease is clinically diagnosed by a medical professional and may be confirmed by running bloodwork a few weeks after tick bite. That said, bloodwork is not reliable and false negatives are common. Suspicion rises if a patient develops a bullseye rash called “erythema migrans” 1-14 days following a tick bite. Although the bullseye rash and flu-like symptoms (fever, headache, fatigue, joint pain) can be classic signs of early Acute Lyme disease, many people have no symptoms at all! If left untreated, an individual may experience disruptions in digestive health, cognitive impairment, numbness and tingling of extremities, wandering joint and muscle pains, heart problems, hormone and thyroid imbalances, etc. Chronic cases become much more relentless where symptoms may go into periods of remission, but they recur repeatedly. 

Both acute and chronic Lyme are misunderstood and we have a long way to go before medicine, both conventional and naturopathic, knows for certain how to address it efficiently. Lyme disease is also known as “The Great Mimic” because it can look like many other diseases, so it is often misdiagnosed or not even considered, especially in states like Washington. 

Preventing Lyme requires diligence and awareness of tick management.

1. Consider avoiding wooded or tall grassy areas. Ticks are more commonly picked up in areas of tall grass. I see them often in my forested neighborhood and hiking trails where we have lots of deer. 

2. Tuck pants into socks. Keep skin covered. Wear a hat.

3. Wear insect repellent. The Environmental Working Group (EWG) has found the following to work the best. Please refer to their website fore more information. www.EWG.org

1. Picaridin
2. DEET (at least 30%)- it is actually safer than most people assume. Toxicity may be possible if used in excess, but studies from 2003 and 2017 have found that it is unlikely that DEET causes neurotoxicity.
3. IR3535 (20%)
4. Oil of Lemon Eucalyptus and its synthetic cderivative PMD
5. 2-undecanone (from wild tomato plant)
6. Essential oils like rosemary, lemongrass, cedar, peppermint, thyme and geranium, grapefruit (nootkatone)
7. Permetherin-treated clothing 

4. Do frequent skin checks. 

5. Don’t forget to treat your pets and check their skin frequently as well. If the ticks do not bite your pet but are carried into your home, they could then potentially crawl onto you or your children and bite.

6. Prompt removal of tick. Some literature states that if ticks are removed within a certain window of time, disease will not be transmitted. This is not true, but the sooner the tick is removed, the better.

7. Do NOT apply anything topical for removal of a tick. Do not apply alcohol, tea tree oil, or light a match. Simply pull out gently and completely with a tweezers. 

8. Clean site with alcohol after removing.

9. SAVE THE TICK FOR TESTING. This is the best way to know if there is a possibility of Lyme disease or coinfection from another bacteria. Place in a baggie and send off to the University of Massachusetts laboratory for testing. First place an order online, then send in and expect results within 24-48 hours of their receiving the tick. https://www.tickcheck.com/

10. Make an appointment with your physician if you develop any symptoms including: rash, fever, joint pains, or a general feeling of being unwell. Bloodwork should be run within the first few weeks after a tick bite to evaluate for Lyme and coinfections. If someone is bitten by a tick, a 21 day course of antibiotics is often given as prophylaxis (a preventative measure). 

Consider seeing a naturopathic doctor (ND). NDs have access to specialized labs (Igenex) that are more specific and sensitive to Lyme and coinfections. We also address Lyme in a broader sense by treating the individual’s immune system and digestive system, supporting the detoxification process, and addressing the diet, lifestyle and environment because all of these things influence how we respond to disease. NDs also have endless therapeutic tools to meet the needs of each individual be it pharmaceuticals, herbs, homeopathy, nutrition, etc.