Lyme Disease: A summertime danger. How to prevent it. How to treat it. - July/August 2003
by Todd A. Hoover, MD
(from the website of The National Center of Homeopathy)
Lyme Disease is caused by the Borrelia burgdorferi bacterium (identified in the 1940s) and is passed to humans and animals via infected deer ticks. Like the bacterium that causes Syphilis, Borrelia burgdorferi is a spirochete (spiral-shaped bacterium), and like Syphilis, Lyme Disease can be difficult to diagnose, difficult to treat, and extremely invasive.
Lyme Disease got its name in 1977 when a high rate of the illness was observed in and around Lyme, Connecticut. The first case reports actually occurred in Europe in the early 1900s, however, and the first case of Lyme Disease successfully treated with Penicillin was in Wisconsin in 1969.
Facts and figures
- The Northeastern/Mid-Atlantic regions of the U.S. have the highest incidence of Lyme Disease in the world although some cases have been reported in the West Coast states as well.
- In 1999, 16,273 cases of Lyme Disease were reported to the U.S. Centers for Disease Control and Prevention. Ninety-two percent of these were from Connecticut, Rhode Island, New York, Pennsylvania, Delaware, New Jersey, Maryland, Massachusetts, and Wisconsin.
The most common time to contract Lyme Disease in the U.S. is between May and August.
Symptoms and Stages
Lyme Disease can result when a person is bitten by a deer tick (Ixodes species) that is infected with Borrelia burgdorferi bacteria. Infection can lead to a variety of symptoms from mild to severe.
First Stage: Typically, the first symptom of Lyme Disease is a rash that develops within a few weeks of the tick bite. The rash is usually red, flat, and ring-shaped and expands over several days. As many as 20--30% of patients never get a rash, but may have symptoms of fever, flu-like illness, and muscle or joint pains within 2 weeks of the tick bite. This first stage of the illness is called Primary Lyme Disease (or Borreliosis in Europe).
Second Stage: Secondary or Stage 2 Lyme Disease can affect the joints, heart, and nerves. Headache, muscle aches, joint inflammation, fatigue, blurred vision, heart palpitations, speech impairment, numbness and tingling, facial paralysis, awkwardness of motion, drooping eyelids, and confusion are all potential symptoms. In patients with untreated Lyme Disease, approximately 8% will develop heart involvement and 10% will develop nerve involvement.
Third Stage: Tertiary or Stage 3 Lyme Disease may occur months to years after the original tick bite. Symptoms include chronic joint inflammation in the knees or other large joints, chronic generalized arthritis, memory loss, mood changes, sleep disorders, numbness and tingling, confusion, and abnormal sensitivity to light.
Deer ticks are approximately the size of a sesame seed, and the females have a slightly reddish color. They are much smaller than common dog ticks, which generally do not carry Lyme Disease. Ticks feed by inserting their mouths into the skin and slowly taking in blood. They are most likely to transmit infection after feeding for 36 hours or more.
One of the most common questions I receive is how to handle a tick bite. Simply grasp the head of the tick with tweezers and firmly remove the tick. Remove all parts of the tick to avoid having a foreign body remain in the skin, which raises the possibility of a general infection. Don’t squeeze the body of the tick or you may increase the possibility of injecting potentially infectious material into your skin.
Diagnosis and testing
Because many of the symptoms of Lyme Disease are vague and the testing methods inaccurate, the actual diagnosis is very difficult. As a consequence, Lyme Disease is both under diagnosed and over diagnosed. Some combination of clinical findings from the history and exam, test results, and response to treatment is probably the best diagnostic methodology possible.
Testing for the bacteria in the tick is frequently not helpful because the presence of the bacteria only carries a small percentage risk of transmission. If the tick is believed to have been attached for more than 24 hours in high-risk regions of the country, this is considered reasonable grounds for treatment, although many physicians prefer to wait for the appearance of symptoms.
An initial screening for the presence of antibodies to the Lyme bacteria (Elisa and Western Blot tests) is most common and is performed at least 2--3 weeks after symptoms appear to allow for time to develop antibodies to the bacteria. Both false positive and false negative tests occur commonly. In Secondary and Tertiary Lyme Disease, it is much more likely that a larger amount of antibodies will be present, increasing the value of these tests.
Testing for the actual presence of bacteria can be performed through a blood test that looks for the genetic signature of the bacteria in the blood (Polymerase Chain Reaction test). A high level of skill and appropriate equipment are required to perform this test, and it is associated with a high rate of false positives. Skin biopsy of the rash with culture for the Borrelia bacteria is still considered the “gold standard” for confirming the presence of the bacteria, but it is done very rarely due to frequent false negatives and the long wait period to obtain results. Spinal fluid testing is also possible for those patients with neurological signs of the disease.
- Avoid ticks. The primary way to prevent Lyme Disease is by avoiding tick bites.
- Whenever possible, avoid areas likely to be infested with ticks, particularly in spring and summer: moist, shaded environments, especially those with leaf litter and low-lying vegetation in wooded, brushy, or overgrown grassy areas where both deer and rodent hosts are abundant.
- Wear long sleeves and pants in wooded or grassy areas. Tuck pants into socks or boot tops as ticks are usually located close to the ground.
- DEET insect repellent has been shown to discourage ticks from biting, but it is not 100% effective.
- After any potential exposure, visually check your body for ticks especially around the ears, in the hair, on the neck, and in the belly button.
- Pets should also be checked frequently for the presence of ticks.
A homeopathic “specific”? In an attempt to prevent Lyme Disease, many homeopaths suggest taking one dose of the homeopathic remedy Ledum palustre in a 30C potency at the time of the bite. [Some homeopaths recommend a higher potency, such as 200C or 1M.—Ed.] Ledum is indicated for insect bites in general, and the indications for Ledum match many of the symptoms of Primary and Secondary Lyme Disease. Although some evidence from other infectious diseases does seem to support a short-term preventative effect of specific homeopathic remedies for certain infectious diseases, there have been no studies to support the use of Ledum for Lyme Disease.
Vaccine? Lyme Disease vaccine was introduced in the U.S. in 1999. Although the vaccine had been deemed safe for use, no long-term studies of efficacy had been conducted. Many reports of persistent Lyme Disease-like symptoms have surfaced since the introduction of the vaccine. In February 2002, the manufacturer took the vaccine off the market. (Chronic symptoms that occur after many different types of vaccinations have been successfully treated by homeopaths, but treatment does require careful prescribing by a trained professional.)
Treatment for Primary Lyme Disease
In considering potential treatment options for Lyme Disease, one must first decide about the use of antibiotics. In many homeopathic circles, this might be tantamount to heresy, but in this matter I have my personal experience to rely on. Several years ago I contracted Primary Lyme Disease from a deer tick. A typical rash at the site of the bite, followed by muscle aches and a low-grade fever convinced me of the diagnosis. I decided to rely upon the standard antibiotic course, which resulted in complete resolution of the symptoms.
It is out of concern that Lyme Disease can progress to chronic rheumatic and neurological injuries, that we must employ the most consistently effective treatment early in the disease. Many homeopaths consider antibiotics to be suppressive to the immune system and the vital force, leading to long-term injury to the individual. In my opinion, however, antibiotics are similar to a surgical intervention. The drug goes into the body and removes the organisms causing the current acute pathology. While the antibiotics do nothing to strengthen the individual, they do remove the stress that the vital force is battling. If the individual is healthy, a natural balance can then be restored; if there are chronic underlying imbalances, some overall depression of the health might occur no matter what treatment is employed.
With many diseases, antibiotic use may be associated with recurring infections. This is commonly seen with ear infections and strep throat. Since Lyme Disease is spread by a vector (tick), however, recurrent infection is somewhat less of a problem than in diseases that are spread person-to-person.
Given the extremely invasive nature of the Borrelia burgdorferi bacteria and the relatively strong track record of early antibiotic treatment, I would strongly recommend antibiotic treatment for primary Lyme Disease in the acute stages. The typical drugs include Amoxicillin for children and Doxycycline for adults, each given for a three-week course (although recommended antibiotics and dosages change over time).
Antibiotics may have significant side effects including allergic reactions and destruction of the normal intestinal bacteria leading to diarrhea. With any antibiotic use, appropriate probiotic products including Lactobacillus acidophilus for adults, and combinations of Lactobacilli and Bifidobacterium for children should be administered one to three times per day for the duration of the antibiotics and then for three to six weeks afterwards to prevent imbalance in the natural bacteria of the intestinal tract. Refrigerated and potency-dated probiotic products are considered most effective.
Homeopathic care can be used alongside conventional medical treatment for all patients with Primary Lyme Disease. The strongest symptoms should be considered to select the appropriate homeopathic remedy. Possible remedies include:
Ledum palustre is thought by many to be the primary remedy for acute Lyme Disease. Ledum is useful in problems arising from insect bites, especially when there is a purplish area at the bite site. If a rash is present, the individual needing Ledum would typically report that it is better for cold compresses. Irritability and restlessness may be present. Of note, this remedy has often been used for arthritic conditions where the pain is better for cold applications and worse for heat.
Arnica montana would be considered after a tick bite where there is considerable soreness of either the bite site or the muscles in general. There may be bruising or purplish discoloration of the skin or the bright red rash typical of Primary Lyme Disease, but tenderness to the touch is the hallmark of this remedy. Fever and a generalized achiness, including a bruised sensation of the body, would also be good indications for the use of Arnica montana. These individuals may report that they think they will be just fine and that they do not need any help to get better.
Belladonna is a remedy for individuals with bright red rashes that may be warm or even hot to the touch. While most people who contract Lyme Disease will only have a low-grade fever, these individuals may have a very high temperature for a brief period. If they have a high fever, there is typically an associated throbbing headache, reddish face, and coolness of the feet or hands.
Mercurius solubilis would be considered for a specific type of rash: a patch of red, raised, and moist-appearing skin at the site of the bite. The typical symptoms of fatigue, muscle aches, and low-grade fever may be present, but in order to prescribe Mercurius, you would particularly look for perspiration (especially at night) and symptoms being worse at night.
Treatment for Advanced Lyme Disease
All patients with Secondary or Tertiary Lyme Disease should see a physician, preferably a specialist in Lyme Disease. Most, if not all, of these individuals will be prescribed powerful intravenous antibiotics for varying durations. Some of these patients will recover completely from their symptoms, but many will go on to develop a chronically ill state, their overall health having been undermined by the impact of the Lyme Disease, the antibiotics, or both.
When considering the homeopathic treatment of advanced Lyme Disease, one must first sort out the nature of the disease process within the individual. Some chronically ill Lyme patients have cleared the bacteria from the body, but the stress of the infection may have negatively altered their overall level of health. They will continue to have chronic symptoms as a result, but these symptoms are not due to an ongoing infection. A well-prescribed constitutional homeopathic remedy will be helpful to many of these individuals, and it is possible that they may then experience complete resolution of their symptoms.
Many patients continue to be ill because the Lyme bacteria remains in the body. These people report that each time antibiotics are used, there is a dramatic improvement in symptoms, but when the antibiotics are stopped, the symptoms tend to recur. Although many of these individuals will respond to appropriately prescribed homeopathic remedies and experience some symptom relief, a complete cure may be unlikely.
Lastly, some chronically ill Lyme patients may have continued symptoms purely as a result of the heavy use of antibiotics. Supportive care using probiotics as described earlier, nutritional and herbal therapies designed to help support the body’s recovery process, and appropriately prescribed homeopathic remedies will help many of these patients resolve their symptoms.
A multifaceted approach
Lyme Disease is an extremely complex, invasive disease that can deeply disturb one’s health. By far the most effective strategy in managing Lyme Disease is to avoid contracting it through practical preventative measures. Unlike many diseases, prior infection with Lyme Disease does not generate future immunity.
Diagnosis is often difficult and response to treatment is not always easy to quantify. Many patients treated in the early stage with antibiotics will proceed to a complete cure of the disease and a restoration of health. Using antibiotics in conjunction with an acute homeopathic remedy and/or the addition of a more accurately prescribed remedy by a trained homeopath probably yields the greatest chance of recovery.
For more advanced disease, coordination of treatment using conventional medical approaches combined with classical homeopathy and other alternative modalities may yield the best chance for recovery and restoration of health.
Twice bitten: A case of advanced Lyme Disease
Mary, a previously very healthy 30-year-old, came to see me with a history of chronic and recurring Lyme Disease. Her initial symptoms began five years earlier with fatigue, muscle aches, and joint pains. There was no known history of either a tick bite or rash. Blood testing for Lyme antibodies was positive, and at that time she was treated with one month of antibiotics.
Over the next several years Mary developed recurring respiratory infections and progressive fatigue, muscle twitching, numbness in the extremities, and ringing in the ears. She was eventually diagnosed with Chronic Lyme Disease. Antibiotics were prescribed in oral and intravenous forms over the next year. With each course of antibiotics, she would improve for a short while and then relapse, but her energy levels did eventually improve to the point where she was able to exercise and be more active.
The following year (one year before she came to see me) she was again infected with Lyme Disease and developed the typical rash. Antibiotics were prescribed for one month, but her symptoms became progressively worse. Allergic reactions and fungal infections eventually caused her to stop all antibiotics.
At the time of her homeopathic consultation, she was no longer taking antibiotics, and she reported the following symptoms: tingling and numbness throughout the body, fatigue, dizziness, difficulty concentrating, poor memory, depression, muscle aches, joint pains, ringing in the ears, and swelling of the face. While these symptoms are typical of advanced Lyme Disease, they were not specific enough to show how Mary as an individual was reacting to the stress of the infection. In order to appropriately select a homeopathic remedy, the individual reaction of the patient must be discerned and matched to the known description of a remedy.
Tremendous anxiety and fear
Upon further consultation, I was able to elicit the following characteristic symptoms. Mary showed tremendous anxiety about her health and was very concerned that her problems were getting worse and worse. No matter which symptom we discussed, she had more and more expansive fears leading to a fear of dying from the disease. Her mind raced with worry. She was concerned that her life was a failure.
Despite complaining of deep fatigue and depression, she appeared noticeably hurried and excitable, almost frantic in her presentation. She spoke quickly, loudly, and often. She filled the entire room with her presence.
Her sleep had become disturbed when she was receiving intravenous antibiotics. She would be concerned that the I.V. would fall out and the blood would come out. Her mind would continue to expand this scenario until she would feel panicky and develop heart palpitations.
Her concentration was most problematic when there were many things going on at the same time. She would be unable to focus her attention, and she described having a dizzy feeling in her mind.
Her pains were like knots and would wander from joint to joint, and she had itching throughout various areas of the body.
Analyzing the case
I included the following symptoms in my analysis and repertorization of Mary’s case:
Mind, Anxiety about her own health
Mind, Delusions she has an incurable disease
Mind, Hurry, haste
Mind, Fear something will happen
Extremities, Pain, wandering, shifting
Chest, Palpitation of heart
Chest, Palpitation of heart, with anxiety
Vertigo, Mental exertion
Mind, Mental exertion aggravates
Mind, Confusion of mind
These symptoms led me to consider Argentum nitricum, Phosphorus, Arsenicum album, and Calcarea carbonica among other possible remedies. Of these, Argentum nitricum is a remedy considered for individuals who experience a sensitivity of the mind to anxious thoughts. Once these thoughts enter, they expand until the individual begins to become overwhelmed. This can lead to intense fear of death, palpitations, confusion, and panic.
In this patient, although there were clear physical symptoms, the primary symptoms leading to impairment of overall health were actually on the mental-emotional level. Many late-stage Lyme Disease patients suffer greatly from a decline in their mental and emotional states in addition to the physical symptoms. Mary’s primary complaint at the time of consultation revolved around despair of recovery, and confusion that was almost like a swirling vertigo. Obviously, if the primary symptoms had been predominantly physical (e.g., joint swelling and paralysis of the face), the case analysis would have been much different.
A single dose
Argentum nitricum 200C was prescribed in a single dose. Six weeks after the remedy, Mary reported that her anxiety, depression, confusion, and insomnia had all improved significantly. Her headaches were worse, there was swelling in her back and pain in her shoulder, and the tingling and numbness were worse. Overall, however, she was feeling much improved.
Three months after the remedy, she reported that the fatigue had resolved and there were no symptoms of headache, numbness, or joint and muscle pains. She felt better than she had in years. The only new symptom was a rash that had appeared on her back. On examination, she was considerably more relaxed, and her speech was much less racy and pressured. Eventually, the rash cleared, and eight months after having received one dose of Argentum nitricum, Mary had no further signs of Lyme Disease. Six years later, she remains free of any Lyme Disease symptoms.
Mary’s case is typical of many patients with advanced Lyme Disease. With antibiotic treatment, symptoms temporarily abate, but the health is not restored. Over time, the general energy, mental functioning, and balance of the individual are more and more deeply disturbed. Eventually, the individual may become increasingly susceptible to injury from the antibiotics used in treatment, resulting in even greater weakening of the system.
Careful understanding of the precise imbalance in the patient can lead the experienced homeopath to a correct prescription for patients with advanced Lyme Disease. While the homeopathic prescription in this case was somewhat straightforward, many patients will require several remedies prescribed in the correct sequence to reestablish a balance of health. Adjunctive supportive nutritional and herbal therapy may be required and some patients may need antibiotics alongside homeopathic treatment.
About the author:
Todd A. Hoover, MD, is a board certified family physician and homeopath practicing in Narberth, Pennsylvania. He is a graduate of Jefferson Medical College and studied homeopathy at the New England School of Homeopathy, as well as with Ananda Zaren, Vassilis Ghegas, and others. He has been practicing homeopathy for nine years. He is also a yoga teacher, father, avid cyclist, and “full-time explorer of things unknown.”