Lyme disease is often seen as a tick bite and rash, followed by a course of antibiotics. The reality is much more complex.
First, Lyme disease is a tick-borne disease, and the primary bacterial pathogen is spirochete, Borrelia burgdorferi. But since it is transmitted by ticks, there are often other pathogens present within the tick that can be a big problem.
These co-infections can be bacterial, parasitic, or viral, making Lyme disease more difficult to diagnose and treat than many of us would like to admit.
Why we often miss Lyme disease
One of the challenges with Lyme disease is that the tick itself is very small. Often times, when they bite someone, they are in the nymph stage, about the size of a poppy seed or the tip of a ballpoint pen. It also secretes an anesthetic substance in its saliva, so people usually do not feel the sting.
Even if one notices it, the reaction may appear as a small red dot. Sometimes people get a rash, but this is actually less common than many people think, and is often confused with something else.
In many cases, the most common symptom is no symptoms at all, at least at first. Lyme bacteria grow very slowly, so symptoms may take time to appear.
Many people believe that Lyme disease is difficult to catch, easy to diagnose and treat. In fact, all three of these concepts are wrong.
When symptoms appear, they may be caused by: for. burgdorferi itself, or through one of the infections associated with it. Anaplasma, or ehrlichia, can cause acute illness within days or weeks of the bite, with symptoms including high fever, extreme fatigue, and cognitive difficulties. Some people may experience flu-like symptoms, joint pain, or muscle pain.
Why do symptoms persist?
Clinically, we often treat Lyme disease as a fast-growing bacterial infection that usually responds quickly to a short course of antibiotics. But Lyme bacteria don’t behave this way. They grow very slowly, sometimes taking days or even weeks to reproduce. Antibiotics work best to actively reproduce bacteria, so short treatment periods may not be enough to completely eliminate the infection.
Another problem is if someone has a co-infection, but we’re just targeting them for. burgdorferiOther pathogens may be left to continue to spread and cause symptoms.
That’s why it’s so important that we get the test done correctly and do a thorough evaluation of symptoms. We need to specify everyone of contributing infections and takes into account the entire clinical picture, rather than focusing on a single pathogen or a narrow set of symptoms.
The great imitator
Lyme disease is often called the “great mimic” because it can mimic many different conditions. It can affect many systems, and can manifest in such a variety of ways that it is often confused with other conditions.
Testing for Lyme disease relies largely on the body’s immune response, not direct detection of disease-causing organisms. The problem is that the immune response may not appear until weeks after infection occurs, meaning the test can be negative even though pathogens are already present.
Joint pain is common in people with Lyme disease, but one of the things that makes Lyme disease different is that the pain is often migratory. It moves from one joint to another instead of staying in one place. Migrating joint pain can strongly suggest Lyme disease clinically, although it is necessary to look beyond the joints.
Lyme disease can affect multiple systems throughout the body. People may experience cognitive problems, including memory loss, that seem unusual for their age. Others may experience pelvic pain or abdominal pain due to nerve involvement. Some develop heart-related symptoms such as irregular heartbeat or fainting spells, which can become serious.
Muscle pain, cramping, fatigue, headache, sleep disturbances, and neurological symptoms are also common.
Look at the whole person
Our approach starts with comprehensive time and history.
For new patients, we spend approximately an hour and a half understanding their complete background because history remains the most important part of the diagnosis. The test is supportive, but does not replace a detailed clinical picture.
We look at risk factors such as outdoor exposure, occupation, pet ownership, and the environment in which a person lives.
From there, we evaluate other potential conditions using a broad diagnostic approach and comprehensive assessment of the biological terrain. This may include laboratory tests, imaging, and other evaluations to determine factors that may contribute to the disease.
The biggest difference in our practice is the time we devote to patients. It allows us to build rapport and gain a deeper understanding of what’s really going on.
Nutrition and lifestyle issue
Nutrition plays an important role in recovery from Lyme disease. Diet can have a huge impact on inflammation, causing many symptoms across different organ systems. Therefore, a comprehensive review of dietary patterns is a vital part of our evaluation, and our patients routinely work with a dietitian as part of their comprehensive care plan.
While dietary recommendations should be individually tailored, there are some near-universal guidelines. Processed foods, preservatives, refined carbohydrates, and excess sugar can negatively impact the gut microbiome, promote inflammation, and worsen inflammation. Therefore, we strongly encourage patients to reduce processed foods, sugars, and refined carbohydrates.
Mental health support is just as important. Chronic illness has a psychological impact. Counseling and emotional support can be essential components of recovery and overall health.
Lyme hyperbaric oxygen
Hyperbaric oxygen therapy (HBOT) has become an important component of our comprehensive approach to treating Lyme disease.
Hyperbaric oxygen therapy delivers oxygen under pressure, thus increasing blood oxygen levels and allowing oxygen to reach tissues where blood flow may be limited. This is essential for tissue repair and healing.
In Lyme disease, hyperbaric oxygen may also work as an antimicrobial treatment because Borrelia and some other common co-infections do not thrive in high-oxygen environments.
for. burgdorferi It protects itself by forming a biofilm to hide from the immune system. They can settle in tissues, cause inflammation, evade blood flow, and in some cases remain dormant for years. Often, antibiotic treatments fail to provide complete relief of symptoms because blood flow is insufficient to deliver sufficient amounts of medication to eliminate well-protected bacteria.
In Lyme disease, hyperbaric oxygen may also work as an antimicrobial treatment because Borrelia and some other common co-infections do not thrive in high-oxygen environments.
With compressed oxygen therapy, the plasma becomes saturated with oxygen at levels that are not possible under normal living conditions. This results in a significant increase in tissue oxygenation, bypassing the need for oxygen to be delivered solely through hemoglobin carried by red blood cells.
Bacteria may be able to hide from immune cells transported through the bloodstream, but they cannot hide from oxygen.
Increased oxygen levels can also enhance the activity of white blood cells and improve the bactericidal action of those cells. Hyperbaric oxygen therapy can also promote angiogenesis, creating new blood vessels that improve blood flow to affected tissue. Improving circulation may enhance the effectiveness of antibiotics and other treatments by improving tissue penetration.
We have also seen that pressurized oxygen therapy has a beneficial effect on many of the symptoms that patients experience every day. These may include a reduction in neuroinflammation, improvements in short-term memory, decreased chronic fatigue, reduced headaches, improved depression, better sleep, reduced inflammatory joint pain, reduced muscle discomfort, and improved energy levels.
When used as part of a comprehensive Lyme treatment plan, hyperbaric oxygen therapy makes a big difference, speeding up the recovery process and improving overall results.
Common misconceptions
Many people believe that Lyme disease is difficult to catch, easy to diagnose and treat.
In fact, all three of these beliefs are misconceptions. It is very easy to get Lyme disease, especially in endemic areas. The disease is much more difficult to diagnose than many people realize, and much more difficult to treat than we would like.
Testing for Lyme disease relies largely on the body’s immune response, not direct detection of disease-causing organisms. The problem is that the immune response may not appear until weeks after infection occurs, meaning the test can be negative even though pathogens are already present.
Another misconception is that a single dose of antibiotics is sufficient for treatment. Because Lyme bacteria grow slowly, short or simple courses of treatment may not always be effective.
There is also a misconception that Lyme disease exists in isolation. In fact, co-infections are common and must be identified and treated for patients to fully recover.
Finally, persistent symptoms after treatment are sometimes described simply as “post-treatment Lyme disease.” But often, those remaining symptoms reflect incomplete treatment or an incomplete understanding of the full scope of the disease.
If the initial test result is negative, but symptoms suggestive of Lyme disease persist, repeat testing may be appropriate because timing can affect accuracy. Testing too early or too late can lead to false negative results.
Importantly, treatment decisions should be based on clinical judgment, not just laboratory results.
If someone has a high likelihood of infection, and the pattern of symptoms is consistent with Lyme disease, you should consider Lyme treatment. Antibiotics, when used appropriately and accompanied by probiotics and supportive care, are generally safe and can be very effective.
The key is to realize that Lyme disease is often more complex than other simple infectious diseases. Successful treatment requires looking at the whole patient, not just test results.
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Ronald Stram, MDis the founder and medical director of the Stram Center for Integrative Medicine, in Delmar, New York. The Center is a collaboration of healing arts practitioners dedicated to serving the well-being of their patients, families and community by integrating the best therapeutic modalities in a safe, effective and respectful manner, with the goal of physical healing care and the promotion of balance and well-being. Dr. Strahm received his MD from the Icahn School of Medicine at Mount Sinai in New York City and is board certified in emergency medicine. His journey into integrative medicine began with his completion of an integrative medicine fellowship at the University of Arizona in 2003. He also completed his training at the International Lyme and Associated Diseases Society (ILADS).
