“The Great Imitator” is making its way across the country. What you need to know now…

Your risk of getting Lyme disease is higher than you might think. Until recently, it was estimated that about 36,000 new cases occurred in the US each year. The newest report released by the Centers for Disease Control and Prevention (CDC) says that the number of Lyme cases is roughly 10 times higher—about 360,000 per year.

If you assume that you’re safe from Lyme, consider this—although many people think that this disease occurs in isolated pockets around the country, it’s actually now been reported in all 50 states.

“The great imitator”: Lyme, the most common disease that’s spread by ticks, causes dozens of symptoms that can easily be mistaken for other conditions such as chronic fatigue syndrome, fibromyalgia, unexplained neuropsychiatric disorders, dementia…and autoimmune diseases including rheumatoid arthritis and multiple sclerosis. Many patients with Lyme suffer unnecessarily because they never even know that they have the disease—and those who are diagnosed often are not given the best treatments.

Leading misconceptions about Lyme—and the facts…

MYTH #1: Lyme always causes a bull’s-eye rash. People who live in areas where Lyme disease is common are taught to look for a red, expanding rash called erythema migrans. It resembles a bull’s-eye and generally appears from three to 30 days after a bite from an infected tick.

Fact: About half of Lyme patients develop a rash. But even when the rash is present, it resembles a bull’s-eye in only about half of those cases. It’s just as likely to appear as a “simple” rash that’s easily mistaken for a spider bite or skin infection.

MYTH #2: Joint pain is the telltale symptom of Lyme.

Fact: Many Lyme patients will develop Lyme arthritis, severe joint pain and swelling that usually affects the knees or other large joints. But not every Lyme patient develops this symptom—so you can’t assume that the absence of joint pain and swelling means that you don’t have Lyme. In fact, most Lyme patients have at least a dozen different symptoms, but there is no one symptom that everyone with Lyme has. Among the most common symptoms are fatigue…migratory joint, muscle and/or nerve pain (tingling, numbness and burning sensations)…a stiff neck…headache…memory and concentration problems…and sleep disorders. These symptoms can range from mild to severe. The constellation of symptoms and ruling out other disorders point to Lyme.

MYTH #3: Lyme is fairly easy to diagnose with a blood test.

If you have Lyme symptoms, your doctor will probably recommend two-tiered blood testing—the ELISA test, which measures the total amount of antibodies produced by the body in response to the Lyme bacterium (Borrelia burgdorferi)…and if that test is positive, the Western blot, which looks for specific protein patterns that are characteristic of Lyme.

Fact: The tests are not very accurate. One study, conducted by the New York State Department of Health, looked at more than 1,500 patients who had been diagnosed with Lyme disease. Two-tiered testing missed 81% of the cases. If tests are done early in the course of the disease or if the patient has received an antibiotic, test results may indicate a false-negative.

Important: I recommend getting both the ELISA and Western blot tests, but a broader laboratory panel approach—including C6 ELISA, immunofluorescent antibody (IFA), lymphocyte transformation test (LTT or EliSpot, a type of LLT) and/or Nanotrap urine test—may be necessary if standard testing is negative. If your Western blot shows a 23, 31, 34, 39 and/or 83-93 band, this indicates Lyme or exposure to a similar borrelia species. Other tests, such as a DNA test called polymerase chain reaction (PCR) and antibody titers, to check for Lyme and other commonly associated infections, such as Babesia (a malaria-like parasite) and Bartonella (which causes cat scratch fever) also can be helpful in diagnosing resistant symptoms. A screening questionnaire for Lyme, such as my Multiple Systemic Infectious Disease Syndrome Questionnaire (HMQ), can help evaluate the probability of having Lyme and tick-borne disorders such as Babesiosis.

MYTH #4: Doxycycline cures Lyme and cures it quickly.

It’s true that when Lyme is diagnosed and treated within two to four weeks of the tick bite that transmitted the disease, about 75% of patients will be cured with tetracycline antibiotics such as doxycycline or other antibiotics such as penicillin or cephalosporin. But about one-quarter of these patients—and a higher percentage of those who don’t get quick treatment—will develop a chronic infection that doesn’t respond to simple antibiotic therapy. Although some doctors don’t think Lyme and other borrelia bacteria can survive after 30 days of antibiotic treatment, many studies have shown that they can.

MYTH #5: Medication is the only treatment.

Antibiotic therapy is the mainstay of Lyme treatment. But it’s usually not enough. Many Lyme symptoms—such as fatigue, muscle and joint pain, and memory loss—that persist despite antibiotics may be caused by more than one organism. Chinese herbs such as coptis, artemesia and cat’s claw may help treat Lyme and some of these coinfections.

I often advise patients also to take low-dose naltrexone, a medication that helps reduce inflammation. A combination of naltrexone, curcumin (an anti-inflammatory compound found in the spice turmeric) and antioxidants such as glutathione have helped relieve fatigue, pain and cognitive difficulty in my patients.

Also helpful: Diet is important as food sensitivities are common. Some people feel better avoiding sugar, gluten and dairy as well as histamine-releasing foods, and for others, an alkaline diet with lots of fruits and vegetables counteracts the acidity and inflammation caused by infection.


People can prevent some cases of Lyme by carefully checking their skin and removing ticks with tweezers after spending time outdoors—but don’t count on it. The black-legged tick that causes Lyme is about the size of a sesame seed. Most people never see the ticks that bite them.

My advice: Whenever possible, wear long pants and high socks when you go outdoors during tick season. Spraying your clothing with a product that contains permethrin, a flower-based insect repellent, can help not just repel ticks but kill them. If it’s just too hot and you prefer shorts or other summer clothes, you can apply the stronger insect repellent known as DEET to your skin, but wash it off as soon as you are out of the tick-infested area to reduce exposure to the chemical. Either of the repellents IR3535 (in Avon Skin Soft Bug Guard and other products) or picaridin can also be applied to the skin to repel ticks. Do a full-body check for ticks once you’re back indoors. Placing clothing in the dryer at high heat for at least six minutes will kill ticks.

For more from our report “Frightening Tick Alert—What You Need to Know Now,” please see the following stories…