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save your tick

An Important Reminder From Nurse Nan: Save Your Tick

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While avoiding contact with ticks is the only way to prevent contracting a tick-borne disease it is not a reason to avoid outdoor activities. Taking steps to protect yourself from being attractive to ticks is one of the first lines of defense.

  • Wear light-colored long pants, tucked into socks when outside. This makes seeing the ticks easier and prevents them from crawling up your legs.
  • Stay on clear paths when in the woods.
  • Change your clothes immediately when you get home and put the clothes you were wearing in the dryer for 30 minutes.
  • Most importantly, perform daily tick checks!

While ticks are most commonly found in wooded areas, they can breed and thrive around your home landscape as well. Being vigilant about the practices above will make a difference.

What should you do if you find a tick on you?

Save it!! Testing can be done on ticks to see if they are carriers of Lyme and other tick-borne illnesses (co-infections). If you’re not sure exactly how to remove it, this video shows very clearly how to remove a tick the right way.

Once you pull off the tick, place it inside a sealed zip-lock type plastic bag with a damp (not wet) paper towel. Do not soak in bleach, alcohol or preservative. The tick can be even months old and still be appropriate for testing.

Find a tick lab

There are a number of different labs that will perform tick testing. You can send the tick to a lab directly and do not need a doctor’s order. We use TickReport.com. You can place the order on their site by clicking the “Test A Tick” button. Complete the requested information, choose a test package (we recommend the comprehensive package), provide payment, and then send the tick as instructed. The prices range from $50 to $200.00 depending on the number of tests that you would like done. The results from this lab are received within 3 business days via secure email. Once you receive the results, you can share the information with your physician to guide your treatment.

If you have a known tick bite, do not wait for the results to contact your doctor; the sooner you are treated the better. Adjustments in treatment protocols can be changed if needed once you get the results back.

The importance of testing the tick

  • Early treatment can be key in preventing chronic Lyme disease;
  • Not everyone presents with the classic “bulls-eye rash” even though they have contracted Lyme or other co-infections;
  • Knowing the tick-borne illness that was contracted, instead of assuming, can guide the treatment; and,
  • Antibiotics are not benign, taking them when not needed or for extended periods can have long term consequences.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

Losing your mind or are you sick?

“I Think I’m Losing My Mind”: When Treating Tick-Borne Illness Feels Worse Before It Gets Better

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She’s 23. Bright, motivated, kind and always eager to smile. She came to our office after years of searching for answers to her fatigue, body aches, temperature swings, and lightheadedness that started without warning.

Testing eventually revealed she was dealing with Babesia, one of the lesser-known but highly impactful tick-borne co-infections. We started a targeted treatment plan that included antimicrobials, detox support, acupuncture and mitochondrial nutrients. In the first few weeks, she felt hopeful, after having an occipital nerve block done, her headaches were less frequent, she had less body pain and her energy had started to return.

But then something changed.

When she was weeks into her protocol, her mom called the office one Monday morning, worried. Her daughter had become withdrawn, anxious and couldn’t sleep.. She said she felt “like I’m going crazy”. Her heart raced at night. She had dark, intrusive thoughts that made no sense to her. And worst of all, she had stopped her medication without checking in because she felt like she just couldn’t swallow anymore pills—afraid that the treatment was making her worse.

It’s a story I hear often.

What Was Happening?

The medications to kill the parasitic Babesia caused an overall inflammatory response of the brain.

She wasn’t losing her mind. The process of die-off reaction can trigger a wave of inflammation and neurotoxicity—especially in sensitive patients or when infections like Babesia are involved.

Babesia in particular is a red blood cell parasite that releases pro-inflammatory molecules, affects oxygen delivery, and can trigger severe mood and neurologic symptoms. Inflammatory cytokines can cross the blood-brain barrier, activating microglia (the brain’s immune cells) and producing symptoms like:

  • Panic and paranoia
  • Intrusive or obsessive thoughts
  • Nightmares and air hunger
  • Brain fog, rage, or emotional volatility

These are not just mental health concerns—they’re signs of neuroinflammation. And they are treatable—with the right tools and support.

What Helped Her?

Luckily, her family saw changes and brought her back in. She cried when we explained what was happening—but this time, with relief. She wasn’t broken. Her brain was inflamed, and her nervous system was overwhelmed by the die-off. We sat down together and made a plan:

  • Paused medications for a few days to let the inflammation calm down
  • Restarted treatment at a lower dose, with pulsing to avoid overload
  • Burbur and pinella drops in water to help detox
  • Continuing her glutathione and binders to support detox
  • Doing an IV with glutathione in the clinic to help detox her body faster
  • Encouraged her to take her magnesium, L-theanine, and omega-3s to support her brain
  • Encouraged gentle movement, hydration with electrolyte drinks, acupuncture, salt baths and infrared sauna

But most importantly—we agreed that she would not stop treatment without calling us first. Because when you’re navigating a complex illness, especially one that hides in the nervous system, staying connected to your care team is as important as any prescription.

The Takeaway

Communication is the key to successful treatment…. Don’t assume it means you’re regressing—or broken. It may be a signal that your body is fighting hard—and just needs help navigating the process. Pause. Reach out. Let’s reassess and adjust the plan.

Tick-borne illnesses can affect every part of us—the body, the brain, the mood, and the spirit. But with the right support, healing is possible. And more often than not, you are far stronger and more resilient than you realize.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

The_Root_Cause_Medicine_Podcast

Listen Now: How Chronic Inflammation is Silently Destroying Your Brain and Body with Dr. Gary Kaplan

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Dr. Gary Kaplan was a recent guest on Rupa Health’s Root Cause Medicine Podcast hosted by Dr. Carrie Jones and Dr. Kate Henry.

Topics of discussion include

  1. Autoimmune diseases and chronic illnesses
  2. The impact of chronic inflammation on the brain and body
  3. The role of sleep in brain health
  4. PANS, PANDAS, and POTS
  5. How to find a doctor that listens to your symptoms

 

Episode: How Chronic Inflammation is Silently Destroying Your Brain and Body with Dr. Gary Kaplan

Labs mentioned

  • The Cunningham Panel
  • Lyme disease tests

Timestamps

00:00 – Intro
02:28 – Why are you still sick?
04:51 – Autoimmunity, infections, and chronic diseases
14:24 – Unveiling the inflammation mystery
24:15 – The Foundation for Total Recovery annual conference
25:43 – How brain inflammation shapes who we are
29:07 – Meditation, exercise, sleep, and brain health
34:08 – PANS, PANDAS, and POTS
36:49 – The Cunningham Panel
39:53 – Testing for tick-borne illnesses
44:56 – Holistic healing and the insurance dilemma
53:14 – Dr. Gary Kaplan’s key tip for well-being

lyme disease

Lyme Disease – Four Reasons It May Go Undetected

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If left undiagnosed and untreated, Lyme disease and other tickborne illnesses can have detrimental long-term effects on the body.

Lyme disease is the most reported vector-borne illness (diseases transmitted through mosquitoes, tick, and flea bites) in the United States. The latest numbers from the CDC estimate that approximately 476,000 patients are diagnosed and treated for Lyme each year.* People who are diagnosed early and receive proper treatment consisting of 28-30 day antibiotic therapy usually recover rapidly and completely. However, others who are correctly diagnosed and treated sometimes fail to fully recover, and, for a variety of reasons, still others go undiagnosed and untreated.

This article explores 4 reasons why Lyme disease may go undetected and/or become a chronic illness.

1) It is not always possible to confirm a tick bite

bullseye rash on arm from tick bite is a sign of Lyme disease

A key component of early diagnosis is recognition of the characteristic “bulls-eye” rash. Courtesy of the CDC/PHIL.

The only way you can contract Lyme disease is through the bite of an infected tick.  If you develop the telltale bull’s eye rash (medically referred to as erythema migrans), there is no disputing the fact that you have Lyme disease, but not all patients have a rash and sometimes the rash does not have a bull’s eye appearance.

Ticks vary from the size of a poppy seed to a sesame seed, which makes them hard to see; and they prefer latching onto hard-to-see areas of the body such as armpits, groin, or scalp, so it’s likely you won’t notice their presence. This means, more often than not, you won’t know if you’ve been bitten, and by the time you start feeling sick – the incubation period for Lyme ranges from a few days to a few weeks – the tick will be long gone.

2) Lyme disease symptoms are very similar to other non-tickborne chronic illnesses.

Another factor that can make it difficult to obtain an accurate diagnosis is the similarity of symptoms that present with Lyme and other tickborne diseases (fever, chills, fatigue, headache, and joint aches) with those of many other non-tickborne illnesses, such as flu and other viral or bacterial infections.

If left undiagnosed and untreated, there can be detrimental effects on the body’s musculoskeletal and nervous systems. Symptoms such as chronic joint pain & headaches, extreme fatigue, and mood disorders can subsequently be misdiagnosed as fibromyalgia, chronic fatigue syndrome, or depression. This similarity of symptoms can cause delays in getting tested, and in turn causing delays in treatment.

There is also evidence indicating that chronic cases of Lyme disease (when symptoms persist after taking the typical short-term dose of antibiotics – also called Post Treatment Lyme Disease) contribute to a sustained inflammatory condition throughout the body that interferes with the healthy functioning of the nervous system. Known as Central Sensitization Syndrome, CSS has been implicated in several chronic illnesses and pain conditions, including fibromyalgia, chronic fatigue syndrome, depression, and Lyme disease.

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3) The patient may also be co-infected with another tickborne disease.

Ticks can carry multiple bacteria and parasites, including Babesiosis, Ehrlichiosis, Anaplasmosis, Bartonella, and Rocky Mountain Spotted Fever (also called Spotted Fever Rickettsiosis), and it’s not uncommon to see patients with multiple tickborne infections, but you won’t find them if you don’t look.  In fact, some studies suggest that as much as 30 percent of ticks that carry Lyme also carry another infectious agent that produces similar symptoms to those of Lyme disease, but requires completely different antibiotics and lengths of treatment.  Because of this, it is extremely important for physicians to test for all forms of tickborne diseases and not just for Lyme.

4) Laboratory tests, while important, have room for improvement

Unless you’re among the small percentage of people who present the classic bulls-eye rash, a confirmed diagnosis is a little trickier. Blood tests, can get you another step closer to a diagnosis – and more importantly – a treatment. But before deciding to run diagnostic testing, a doctor must consider a patient’s physical symptoms and obtain a comprehensive history that assesses their personal exposure risk. For example, if an individual is experiencing some suspicious symptoms and often hikes or horseback rides, and/or owns a pet that spends time outdoors, a Lyme test is in order.

Unfortunately, the tests aren’t perfectly reliable, especially if the order includes testing for Lyme and other tickborne diseases. Different labs have varying levels of sensitivity, and some testing can miss some cases of infection. To accurately interpret test results your physician needs to understand the sensitivity and specificity – or, in other words, the limitations — of the lab testing they are ordering.

So what’s the takeaway?

Be your own healthcare advocate. The best medicine is prevention. Before recreating outdoors, cover your body in light-colored clothing. Use an insect repellant on yourself and make sure to treat your pet. Take the time to check yourself and your pet for ticks after spending time outdoors. If you do find a tick, do not throw it away. It can be sent to a lab, such as tickreport.com, and tested for multiple tickborne diseases. Having this information will allow you to request the proper treatment faster.

If you do notice Lyme-like symptoms, a helpful first step is the Horowitz Lyme Questionnaire. Developed by Lyme expert, Dr. Richard Horowitz, this test should not replace medical advice from your physician but can be a useful tool to determine the likelihood of Lyme or other tickborne illnesses. The only way to confirm or rule out a Lyme diagnosis is with a blood test.

Every individual is unique in their genetic makeup, medical history, and environmental exposures. Each of these factors can affect how Lyme disease manifests itself in your body. If some of your symptoms persist, even after you have been treated — don’t give up! Be your own advocate; keep asking questions and seeking answers until you find the right treatment options for you.

Looking for natural ways to protect yourself?

This Washington Post article outlines several non-toxic, protective measures against tick and mosquito bites that are also less harmful to the environment: Nontoxic methods to protect yourself against mosquitos and ticks.

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*This number includes both actual infections and patients that are treated presumptively but may not actually be infected.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

This article was originally published in July 2017. It was reviewed and updated on May 2023.

Dealing with Anxiety

8 Commonly Overlooked Causes Of Anxiety and Depression

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With the right treatment, people seeking relief from depression or anxiety can live happy, productive lives. But if you’re one of the many Americans seeking relief from depression or anxiety, you’re no doubt aware of just how elusive successful treatment can be. It is estimated that as many as 30% of depressed patients do not respond to treatment, raising an important question: could it be that we’re thinking about — and therefore treating — these conditions in the wrong way?

A growing body of research suggests that depression and anxiety might not be mental disorders in and of themselves, but rather symptoms of a physical inflammation stemming from increased microglial activity in the brain. Microglia are the immune cells of the Central Nervous System (CNS) and are responsible for producing inflammatory chemicals in response to infection or other CNS damage.

This gives the medical community and those living with these debilitating conditions new hope. In thinking about depression and anxiety as symptoms, we’re afforded new insights into potential root causes, as well as alternative methods of treatment.

Here are eight often-overlooked causes of depression and anxiety that you should consider:

1. Celiac disease or gluten intolerance.

About 1% of Americans have celiac disease, an autoimmune disorder caused by the body’s negative reaction to gluten, the protein found in wheat, barley and rye. And gluten intolerance — also called non-celiac gluten sensitivity — is estimated to impact six times as many Americans.

While we don’t yet understand the mechanism of gluten intolerance in the body, the impact can be very similar to that seen with celiac disease. While intestinal complaints are most common, research is showing that some people with these conditions may, in fact, present with anxiety and depression as the only symptoms.

You can test for celiac disease with a simple blood test. The only way to test for gluten intolerance is to go gluten-free for six weeks and watch for any improvement. (Before making any major dietary changes, make sure to consult your provider or a registered dietitian.)

2. Sleep apnea.

There are two types of sleep apnea. Obstructive sleep apnea is the more common form and occurs when the soft tissue in the back of the throat collapses, thereby blocking the airway during sleep. Central sleep apnea, although not as common, is a result of the brain forgetting to tell the body to breathe. Studies confirm the relationship between sleep apnea and depression.

If you get plenty of sleep but never feel quite rested, or you find yourself often nodding off, a first step you can take is to answer the 8 questions on the Epworth Sleepiness Scale. If your score is equal to or higher than 10, the results should be discussed with your provider.

3. Lyme disease.

Lyme and other tick-borne diseases are becoming increasingly prevalent. While the most common symptom is joint pain, these diseases can also be associated with depression and anxiety disorders (affective disorders).

This link between Lyme disease and neuropsychiatric disease was first documented in 1994 in the American Journal of Psychiatry and has been widely documented since, but the potential connection is frequently overlooked when diagnosing those with psychiatric illness. If you are suffering from chronic pain and a mental disorder, this diagnosis should be considered.

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4. Unhealthy diet.

A study published in PNAS (Proceedings of the National Academy of Sciences of the United States of America) confirmed that “…frequent fried food consumption is strongly associated with a higher risk of anxiety and depression.”

On the other hand, eating a diet high in omega-3 fatty acids (fish oils, walnuts, and flaxseed) and antioxidants (colorful fruits, berries, and greens including spinach, broccoli, and collards) can help provide the brain with the nutrients it needs to repair free radical damage and optimize function.

5. Thyroid disease.

Both an under-functioning thyroid (hypothyroidism) and an over-functioning thyroid (hyperthyroidism) can present as depression or anxiety — not to mention other symptoms like weight changes and exhaustion. If you suffer from depression or anxiety, you may wish to have your thyroid hormone levels checked to rule out any disorder.

6. Medications.

It’s also possible that regular medications may be causing or worsening your depression or anxiety. Beta-blockers used to treat high blood pressure are known to cause depression, and acne-fighting Accutane, birth control pills, and even statins all list depression as a possible side effect.

If you take medication regularly, I recommend talking with your provider about the chances that your medication is bringing you down or making you anxious.

7. Toxic mold exposure.

Exposure to certain indoor molds can result in a wide range of symptoms, including depression, ADHD, difficulty concentrating, fatigue, chronic sinus infections, and various pulmonary and neurologic issues. If you fear that you’ve been exposed to indoor molds, it’s critical that you speak with a physician who is familiar with mold toxicity disorder.

8. Coffee.

Several studies have demonstrated a link between coffee consumption and heightened anxiety. While most people can tolerate one to two cups of coffee per day without issue, if you are prone to anxiety, you may want to rethink your morning pick-me-up. Try cutting out coffee altogether for at least two months and observe whether or not your mental state changes as a result.

This article first appeared in Dr. Kaplan’s column on MindBodyGreen.com in September 2015. It was reviewed and updated in May 2023.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

Additional Resources

Harding CF, Pytte CL, Page KG, Ryberg KJ, Normand E, Remigio GJ, DeStefano RA, Morris DB, Voronina J, Lopez A, Stalbow LA, Williams EP, Abreu N. Mold inhalation causes innate immune activation, neural, cognitive and emotional dysfunction. Brain Behav Immun. 2020 Jul;87:218-228. doi: 10.1016/j.bbi.2019.11.006. Epub 2019 Nov 18. PMID: 31751617; PMCID: PMC7231651.

Temple JL, Bernard C, Lipshultz SE, Czachor JD, Westphal JA, Mestre MA. The Safety of Ingested Caffeine: A Comprehensive Review. Front Psychiatry. 2017 May 26;8:80. doi: 10.3389/fpsyt.2017.00080. PMID: 28603504; PMCID: PMC5445139.

depression_pain

Is Depression Ever Just Depression?

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A modified model for understanding depression and anxiety ought to involve a whole person, integrative approach.

Public acts of violence seem to fill the news media streams these days and are typically followed by outcries for greater access to mental health care for those that need it most. And although almost all individuals with serious mental illness are not dangerous, many of the perpetrators of these heinous crimes later turn out to have a documented history of depression or mental illness, which often went untreated.

So, what can we do to stop the anguish? What is it that we are missing?

The Cost of Failure

Unfortunately, the number of Americans affected by serious depression and anxiety disorders is enormous, as are the costs to society due to failure to treat and/or treatment failure. Tens of millions of Americans suffer from depression, including chronic, low-grade depression (dysthymia) and anxiety. 21 million of those Americans have been diagnosed with major depressive disorder (MDD), the leading cause of disability for people ages 15 to 44.

The cost of failing to effectively treat these conditions is not just the individual’s inability to complete college, hold a job or cultivate positive relationships; it also includes the toll taken on an entire family and community when a despairing person takes their own life. And in other cases, the costs of acts of public violence – in terms of suffering, municipal expenses, personal medical and legal expenses, and lost human potential – are immeasurable.

Michael, a 17-year-old high school student, came to see me with a long history of hospitalizations after attempting to take his own life. Despite undergoing intensive psychiatric treatment, he remained depressed and suicidal. Like 40 percent of those who suffer from major depressive disorder, Michael was not responding to treatment.

When contemplating a situation like Michael’s, the question “What am I missing?” is never far from my mind. Statistics show that only about one-third of patients with MDD respond to antidepressant medication, with about the same number responding to psychotherapy alone. If we combine the two approaches the numbers improve slightly, but the fact remains that most people with MDD respond only partially to medical interventions, with almost half remaining entirely unresponsive.

A Central Nervous System in Turmoil

There is a mountain of scientific research demonstrating that neuropsychiatric conditions such as depression, anxiety disorders, and possibly bipolar disease are, in a very high percentage of cases, the result of inflammation occurring in the brain.

There is a great deal of research linking generalized inflammation to heart disease, chronic pain, and obesity. Inflammation in the body takes many forms: When we have an allergic response to pollen or food, our bodies’ inflammatory response includes the release of histamine, which makes our eyes itch and noses run; we see the inflammation associated with a skin wound when the white cells of our immune system respond to a bacterial infection. Inflammation in our brains, however, is unique in that it is mediated by tiny cells called microglia.

Microglia are the innate immune system of the central nervous system (CNS). Their job is to respond to trauma and damage to the brain. In response to brain injury, the microglia release a virtual symphony of chemical mediators that orchestrate the destruction of bacterial invaders, the elimination of damaged neuronal tissue, and the initiation of the repair process.

After responding to an assault on the brain, microglia typically return to a resting state. But ongoing and cumulative assaults to the brain will cause the microglia to remain chronically up-regulated, causing them to continuously spew out inflammatory, tissue-destroying chemicals. Examples of ongoing assaults include fever, physical assault, and emotional trauma. It can also be infections like Lyme disease or COVID-19.

Since the beginning of the COVID-19 pandemic, researchers have been studying how the SARS-CoV-2 virus affects the CNS as well as other body systems. What they are finding out is that it too heightens the activity of microglia leading to the release of inflammatory cytokines and a sequence of damaging events that can affect the brain and have other long-term effects on health.

Brain inflammation can produce a wide range of symptoms including depression, anxiety, chronic pain, difficulty focusing and concentrating, fatigue, and sleep disturbances.

Further compounding the issue is the fact that a solid understanding of the role of microglia in brain health is sadly lacking among most medical professionals, with the result that they continue to treat what are in fact “symptoms” as separate and unique “diseases.”

Looking Beyond the Symptoms

A better framework, where physicians look beyond the symptoms, involves giving priority to the discovery of the root causes of an individual’s depression or anxiety. This primarily requires an understanding of what caused the microglia to up-regulate.

Research has shown that anything that can damage neuronal tissue can be a trigger. So, an exploration of a patient’s depression may include asking them about possible traumatic head injuries, psychological traumas (acute events and chronic stress), infections (as mentioned above, tick-borne diseases, other bacteria, and viruses like Covid-19), and even biotoxins that may have entered the body from exposure to toxic molds, celiac disease, and hypoxia (usually related to sleep apnea). The list of triggers is long, and as such, the process of identifying the possible underlying causes of the disease requires putting together a thorough medical health timeline for each patient. By using this approach, treatment options expand due to the greater understanding of the origin of the illness, thereby increasing prospects for recovery.

As for Michael, my 17-year-old patient who was depressed and suicidal, it turned out that he has celiac disease. But how could a food allergy be related to his depression? Celiac disease is far more than an allergy to gluten – it is a very serious autoimmune disorder that’s triggered when even the smallest amount of gluten is ingested. As we know, with autoimmune disorders the immune system mistakenly attacks the body’s normal cells. In the case of celiac disease, when gluten is consumed the immune system goes into attack mode and causes damage to the healthy villi of the gut lining. Villi are responsible for absorbing nutrients and keeping food particles and toxins from entering the bloodstream. When the gut lining is compromised and toxins enter the bloodstream, widespread inflammation can occur, and this inflammatory response can affect more than the digestive system – it can cause inflammation in the brain. Research shows that people with celiac disease are at greater risk of neurological damage and mental health issues in addition to other serious chronic health conditions.

Michael, now gluten-free, is no longer depressed and he has re-engaged in life. He continued with antidepressant medications for a period of time, but slowly weaned himself from them under medical supervision (it takes time for the brain to heal after the assault is removed). His life has been changed, for the better, forever.

It is my hope that, with a modified model for understanding depression and anxiety, involving a “whole” person, integrative approach, more patients will be correctly diagnosed and treated, as Michael was. In his case, and I suspect in many more, we’re learning that all too often, depression is not just depression.

This article originally appeared in US News and World Reports, May 12, 2015. It was reviewed and updated in May 2023.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

Additional references

InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Depression: How effective are antidepressants? [Updated 2020 Jun 18]. 

Mohammadkhanizadeh A, Nikbakht F. Investigating the potential mechanisms of depression induced-by COVID-19 infection in patients. J Clin Neurosci. 2021 Sep;91:283-287. doi: 10.1016/j.jocn.2021.07.023. Epub 2021 Jul 20. PMID: 34373041; PMCID: PMC8289699.

“Combating Chronic Lyme,” a Presentation by Dr. Gary Kaplan

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Dr. Kaplan delves into the very controversial topic of identifying and treating chronic Lyme disease, a tick-borne illness that lingers past standard courses of treatment.  This presentation by Dr. Gary Kaplan was recorded on Sept. 26, 2019.

Dr. Kaplan discussed the difficulties in correctly diagnosing chronic Lyme as well as new research and treatments that are currently available.

To download any of the handouts that were provided, click on the links below. You can also download a pdf copy of Dr. Kaplan’s PowerPoint presentation.

Questionnaire:
Horowitz Lyme-MSIDS Questionnaire

Research study:
“Disulfiram (Tetraethylthiuram Disulfide) in the Treatment of Lyme Disease and Babesiosis: Report of Experience in Three Cases“

Research study:
“The Use of Dapsone as a Novel “Persister” Drug in the Treatment of Chronic Lyme Disease/Post Treatment Lyme Disease Syndrome“

PowerPoint presentation:
Solving the Puzzle of PTLDS, a Presentation by Dr. Gary Kaplan, DO

To subscribe to the Kaplan Center’s YouTube channel visit http://bit.ly/1N4YqmA.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

save your tick

Tick Bites: What You Should (And Shouldn’t) Do If You Get One

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Lyme disease and other tick-borne illnesses shouldn’t prevent you from enjoying the outdoors, but you should absolutely be aware of how to best protect yourself and what to do if you think you may have been bitten by a tick.

Lyme disease and other tick-borne illnesses (babesoisis, ehrlichiosis, anaplasmosis, bartonella, and Rocky Mountain Spotted Fever) can cause skin, heart, joint and nervous system problems. Early symptoms may be fatigue, chills, fever, headache, muscle and joint aches and swollen lymph nodes. With the chances of getting a tick bite higher than usual this year, precautions should be taken to minimize your risk. This includes using an effective repellent*, wearing long pants and sleeves whenever possible, incorporating a tick-check into your evening routine, and most importantly, staying educated on signs, symptoms, and treatments.

* Choose a repellent that contains one of the following: Picaridin (20%), IR3535 (20%), DEET (20-30%) or Oil of Lemon Eucalyptus (30-40%)

Below you’ll find some myths and truths about tick bites, and what to do if you think you may have Lyme, by Jane Marke, M.D., Integrative and Holistic Psychiatry

Tick Bite Care

What to do if you get a tick bite? There are some myths, but there’s good science busting them.

  1. Tick attachment time is irrelevant. If a tick is sick enough, Lyme bugs are in their saliva, and they transmit the disease immediately. If the tick is less infected, they have to send bugs from their stomach to mouth, and that takes longer. But do you really want to count on how sick the tick is? Don’t let anybody tell you that because the tick wasn’t attached for 24-36 hours you’re ok.
  2. One double-dose of doxycycline is not sufficient. The guidelines that are on the government guideline website, www.guidelines.gov  advise 21 days.  (That’s a federal government Institute of Medicine website and it’s high quality). No other Lyme guidelines exist. (CDC is not in charge of guidelines; the Institute of Medicine is.) The problem with the study of one single-dose of doxy is that it looked for the bull’s eye rash; it did not look to see if people got sick later. It reduced the rash incidence by 87%. That’s something; but not enough, and it tells us nothing about whether those without rash got sick later. There is no reason to not follow the government guidelines and to risk your health or that of your child because somebody only wants to give you one “double dose” of doxy. There are mice studies of this treatment, and they look abysmal
  3. If you missed the tick bite and have the bull’s eye rash you are lucky inasmuch as you have incontrovertible evidence of being infected with Lyme. You HAVE Lyme. You can still get “early Lyme” treatment, but it’s not the same as treatment for a tick bite. You can find recommendations for treatment on the www.guidelines.gov website. Here’s a direct link to the Lyme Guidelines: http://bit.ly/2tqnaGU. These are government endorsed guidelines, the best we have at this point in time.
  4. Tick-testing is controversial. Don’t wait for the testing to get treated. Negative tick tests give you no useful information; we have no idea how reliable tick testing is vs human testing. But if a tick is positive for a co-infection, something other than Lyme, you might consider getting prophylactic treatment. That’s your call, made with your doctor, but it’s a real consideration. So if you send the tick for testing, make sure the lab tests for co-infections, as well as several species of Lyme.

Jane Marke, MD
Integrative and Holistic Psychiatry
Urgent Tickbite Care
80 East 11 Street, Suite 214
New York, NY 10003

 

Additional resources:

Horowitz Lyme-MSIDS Questionnaire

4 Simple Tips to Prevent Lyme Disease

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The best medicine is prevention so when recreating outdoors, take a moment to engage in a few simple steps to protect yourself, and even your pet, from Lyme disease-carrying ticks and other tick-borne illnesses.

  1. Cover your body in light-colored clothing.
  2. Use an insect repellant. Don’t forget the hard-to-see areas of the body such as your armpits, groin, and scalp.
  3. When you’re done with yourself, spray your pet too!
  4. Take the time to check yourself and your pet for ticks before going back inside.

Dr. Kaplan advises, “If you do notice Lyme-like symptoms, talk to your doctor immediately and ask to be tested. Remember: every individual is unique in their genetic makeup, medical history, and environmental exposures, and each of these factors can affect how Lyme disease manifests in your body. If some of your symptoms persist, even after you have been treated — don’t give up! Be your own advocate – keep asking questions and seeking answers until you find the right treatment options for you.”

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

Chronic Lyme Disease

The Controversy of Antibiotics for Lyme Disease Treatment and Alternative Treatment Options

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Scientists agree that Lyme disease appears in at least two forms in the human body – as a spirochete (a flexible spirally twisted bacterium ) and in “oval” form – and these two forms are sensitive to different antibiotics and to different lengths of treatment. There is also some debate about whether Lyme exists in a third “biofilm” (a thin, slimy film of bacteria) form that is especially resistant to antibiotic treatment, which may account for why Lyme disease becomes a chronic illness in some people.

In any event, there is extensive discussion within the medical community, about what constitutes the best protocol for treating patients suffering with Lyme disease. The root of the controversy is that physicians have a variety of opinions about how Lyme disease is expressed in the body.

One view is that, with proper antibiotic treatment, most people fully recover from Lyme disease, and only in a small subset of the population does Lyme present as a long-term intracellular illness.

The other view is that Lyme disease is always intracellular, and as such, never completely leaves the body. The implication of this perspective is that, even if a patient stops experiencing symptoms, his or her body still harbors the infection. Consequently, symptoms may reappear over time, either chronically or intermittently.

When a patient’s symptoms persist (Chronic Lyme Disease) despite treatment with a round of antibiotics, some doctors will prescribe a long-term course of antibiotics of up to 2 or 3 years. Dr. Gary Kaplan cautions patients about the risks with this approach, however, as high doses of strong antibiotics can cause imbalances in the digestive tract that can lead to diarrhea, yeast overgrowth, and nutritional deficiencies. There is also the theoretical risk of creating an antibiotic-resistant bacteria.

“We can’t just give a patient antibiotics and walk away. We must closely monitor each patient, and watch for and be ready to treat any side-effects that do appear. In fact, in some cases, the long-term use of antibiotics can cause more problems than the Lyme disease itself.” he says. Dr. Kaplan recommends probiotic nutritional supplementation during the antibiotic regimen. He also prescribes some Chinese and Western herbal remedies to alleviate some of the side effects of taking high doses of antibiotics over an extended period of time.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

Praise for Dr. Kaplan’s book – Why You Are Still Sick: How Infections Can Break Your Immune System & How You Can Recover

“Gary Kaplan is not only a pioneer in his field, he’s a badass who is changing the face of medicine. This book holds everything I wish I knew twenty years ago about autoimmunity. It’s an incredible resource for anyone with chronic pain and illness. It will bring hope and health to so many people.”

– Dave Asprey, founder, Bulletproof 360