As the temperatures get warmer and the outdoor world begins to awaken, it calls us to enjoy its beauty. It is without question that long strolls through the woods, lazy days by the beach, and endorphin-producing hikes give great gifts of health as they aid us in lowering stress, detoxing, and strengthening various organ systems. However, these same activities can also pose significant harm to our health, not so much because of the activity itself, but rather because of the tiny creatures that share the habitat with us during these activities.

Over the last decade or so, our awareness of the diseases carried by ticks has grown significantly, causing credible cautiousness toward these sneaky arachnids. Not only that, but concern about ticks continues to grow because their domain seems to be spreading like wildfire across the United States as they adapt to various climates. No longer are the threats of ticks isolated to wooded areas in the northeastern and western regions of the United States, but even city dwellers of the south and Midwest are at risk for being bitten while playing on the playground. As ticks adapt to different climates, they have been found actively seeking a meal in temperatures even as low as 33 degrees Fahrenheit, no longer making cold temperatures a safety zone for these predators.

Although ticks are now known to carry various diseases that can be transferred to humans by a single bite and result in lifelong health problems, Lyme disease remains at the forefront of the conversation surrounding ticks and their diseases. This transmittable tick-borne infection is caused by the spirochete Borrelia burgdorferi which is notorious for morphing into different forms and hiding in various body tissues in order to conceal its identity from conventional therapies such as antibiotics. Therefore, treatment is difficult and often ineffective.

The identification of symptoms, methods of testing, and criteria for diagnosis of Lyme disease has been hotly debated for the last decade – a debate riddled with political and economic provocations; however, as Lyme disease and its systemic complications continue to be researched and advocated for, newer studies are validating that Lyme disease is far more than a rare condition evidenced only by the classic “bullseye” rash. Finally, within the last few years, posttreatment Lyme disease syndrome (PTLDS) has been recognized by the Infectious Diseases Society of America (ISDA) as a systemic condition of nonspecific symptoms including fatigue, cognitive complaints and widespread pain that remains after conventional treatment.

Most individuals with PTLDS suffer from neurological manifestations such as mild cognitive difficulties, lymphocytic meningitis, cranial neuritis, radiculoneuritis, and mononeuropathy multiplex, which have collectively been termed Lyme neuroborreliosis or Lyme encephalopathy. The exact pathology of PTLDS is unclear, but purportedly arises from cytotoxicity by the spirochete, neuroinflammation or autoimmune reactions which cause damage to the central and peripheral nervous systems. To better understand PTLDS, a retrospective, single-center study was conducted that included consecutive patients with a history of PTLDS who underwent autonomic testing between 2016 and 2018 at the Brigham and Women’s Faulkner Hospital Autonomic laboratory. This study found evidence of sensory and severe small fiber neuropathy, autonomic dysfunction, and abnormal cerebral blood flow in all subjects. These results can explain the persistent pain, sensory, and cognitive symptoms commonly experienced by those with PTLDS.

As with many health concerns, an ounce of prevention is worth a pound of cure. The best way to avoid being an unsuspecting receiver of a tick bite is to create a barrier between you and the insect by covering up with clothing. Permethrin-treated clothing is now widely available to ward off insects and provide an alternative to putting insecticides directly on the skin. Diligently checking the body and clothing for any ticks following an outdoor adventure is crucial for prevention. Additionally, Fido may be a tick carrier so it is important to remind animal owners to check their pets before loving on them too much.

Prevention is crucial but for those who have already been attacked by the spirochete, Borrelia burgdorferi, specific botanicals and micronutrients can be helpful in managing the chronic effects which are often unresponsive to conventional therapies. Cat’s claw (Uncaria tomentosa) is a popular choice for its anti-borreliae efficacy on both active and dormant forms of Borrelia burgdorferi, reducing all its morphological forms as well as its biofilm. Stevia leaf (Stevia rebaudiana), which is well known as a natural sweetener, has also been shown to reduce the viability of spirochetes and biofilm attachment. Flavones such as baicalein and luteolin as well as fatty acids such as monolaurin (found in coconut oil) reduced biofilm-like colonies formed by Borrelia burgdorferi by 30–60 percent in in vitro studies. Various other botanicals and micronutrients are helpful in addressing the microbial load and systemic inflammation linked to the symptoms of Lyme disease and PTLDS.

Acute Lyme disease and chronic PTLDS are not easily treatable conditions, despite what mainstream media may suggest. Instead, one single tick bite can initiate a lifelong health battle. As the warmer weather entices us outdoors to enjoy its numerous benefits, it is important to remind ourselves and our patients to take adequate precautions against the organisms that share the beauty of the season with us.