Lyme and Tick-Borne Diseases
Lyme disease and other tick-borne infections are often misunderstood, underdiagnosed, or inadequately treated. Many people continue to experience symptoms despite standard testing or short courses of antibiotics.
As a Lyme-literate physician with over 16 years of experience treating complex tick-borne illness, I provide comprehensive evaluation, education, and individualized care for patients dealing with Lyme disease and associated infections via telehealth.
Lyme and tick-borne diseases (TBD) are preventable infectious diseases transmitted through a tick bite. Ticks can carry bacteria, viruses and parasites. Each tick-borne disease presents with distinct signs and symptoms and may sometimes cause changes in laboratory markers.
For a comprehensive, step-by-step education on Lyme disease and tick-borne illnesses from around the world, explore my Lyme & tick-borne disease online course.
For a comprehensive, step-by-step education on Lyme disease and tick-borne illnesses from around the world, explore my Lyme & tick-borne disease online course.
What Is Lyme Disease?
Lyme disease is the most commonly reported tick-borne illness in the United States. While approximately 63,000 cases were reported to the Centers for Disease Control and Prevention (CDC) in 2022, estimates using additional methods suggest that closer to 476,000 people may be diagnosed with Lyme disease each year.
A subset of individuals continues to experience ongoing symptoms following standard treatment, a condition often referred to as Post-Treatment Lyme Disease Syndrome (PTLDS). Lyme disease and other tick-borne infections can significantly affect physical, cognitive, emotional, and social well-being, underscoring the importance of prevention, early recognition, and individualized care.
Lyme disease is the most common tick-borne disease. It was first identified in 1975 in Lyme, Connecticut by Dr. Alan Steere, following an unusual number of juvenile arthritis cases. In 1982, Willy Burgdorfer discovered the bacteria in ticks on Long Island that causes Lyme disease.
Lyme disease is caused by an atypical bacterium called Borrelia. It is classified as a spirochete, meaning it has a helical, corkscrew-like shape. Spirochetes are unique among bacteria due to their arrangement of flagella, which gives them motility. The Borrelia bacterium can express a variety of lipoproteins on its outer membrane, known as outer membrane surface proteins (Osp), which change depending on its environment, such as within the tick or host, and in response to the host’s immune system. This variability enhances its ability to invade the host effectively.
While Borrelia burgdorferi and Borrelia mayonii are the species that cause Lyme disease in North America, the following species cause Lyme disease throughout the world: B. afzelii, B. garini, B. spielmanii, B. bavariensis, B. bissettii, B. lusitaniae, B. valaisiana.
Once in the human host, Borrelia can change forms into round bodies which evade the immune system and antibiotics when used to treat Lyme disease. Additionally, a community of Borrelia spirochetes can come together and create a structure around themselves called biofilm, which protects this "city" of pathogens.
After a tick bite (from a tick that may transmit Lyme disease, like the blacklegged tick or the Western blacklegged tick in North America), watch for the following signs and symptoms which may manifest from three to 30 days after the bite:
A subset of individuals continues to experience ongoing symptoms following standard treatment, a condition often referred to as Post-Treatment Lyme Disease Syndrome (PTLDS). Lyme disease and other tick-borne infections can significantly affect physical, cognitive, emotional, and social well-being, underscoring the importance of prevention, early recognition, and individualized care.
Lyme disease is the most common tick-borne disease. It was first identified in 1975 in Lyme, Connecticut by Dr. Alan Steere, following an unusual number of juvenile arthritis cases. In 1982, Willy Burgdorfer discovered the bacteria in ticks on Long Island that causes Lyme disease.
Lyme disease is caused by an atypical bacterium called Borrelia. It is classified as a spirochete, meaning it has a helical, corkscrew-like shape. Spirochetes are unique among bacteria due to their arrangement of flagella, which gives them motility. The Borrelia bacterium can express a variety of lipoproteins on its outer membrane, known as outer membrane surface proteins (Osp), which change depending on its environment, such as within the tick or host, and in response to the host’s immune system. This variability enhances its ability to invade the host effectively.
While Borrelia burgdorferi and Borrelia mayonii are the species that cause Lyme disease in North America, the following species cause Lyme disease throughout the world: B. afzelii, B. garini, B. spielmanii, B. bavariensis, B. bissettii, B. lusitaniae, B. valaisiana.
Once in the human host, Borrelia can change forms into round bodies which evade the immune system and antibiotics when used to treat Lyme disease. Additionally, a community of Borrelia spirochetes can come together and create a structure around themselves called biofilm, which protects this "city" of pathogens.
After a tick bite (from a tick that may transmit Lyme disease, like the blacklegged tick or the Western blacklegged tick in North America), watch for the following signs and symptoms which may manifest from three to 30 days after the bite:
Early Symptoms
- Rash (erythema migrans) (see below for photos): a pink or red rash surrounding the tick bite that:
- May or may not feel warm to the touch
- May or may not be circular with central clearing (bull’s eye)
- May be flat or raised
- Usually spreads in a centrifugal fashion from around the bite outward
- May manifest as multiple bull’s-eye rashes across the body (known as disseminated erythema migrans)
- Fever
- Flu-like symptoms (chills, sweats, unusual fatigue, headache)
- Swollen lymph nodes
- Joint pain and/or swelling
- Muscle pain
- Stiff neck
- Heart symptoms: chest pain, shortness of breath, palpitations, fainting
- Eye symptoms: redness of eyes, itchy or burning eyes, discharge, floaters
- Neurological symptoms: Bell’s palsy or facial nerve (cranial nerve VII) palsy ( the dropping of one or both sides of the face due to loss of muscle control), numbness, tingling, burning, shooting pain, weakness, cognitive changes, pain with eye movement, double vision, ringing in ears, vertigo
Photos courtesy of CDC.
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Persistent or Late Symptoms
- Flu-like symptoms
- Swollen lymph nodes
- Joint pain and/or swelling
- Muscle pain
- Fatigue
- Headache
- Heart symptoms: chest pain, shortness of breath, palpitations, fainting
- Eye symptoms: redness of eyes, itchy or burning eyes, discharge, floaters
- Neurological symptoms: numbness, tingling, burning, shooting pain, weakness, cognitive changes, memory loss, mood changes, personality changes, seizures, confusion, pain with eye movement, double vision, ringing in ears, hearing loss, vertigo, problems walking, difficulty with balance
Changes on laboratory testing may include: elevated erythrocyte sedimentation rate, mildly elevated hepatic transaminases, microscopic hematuria or proteinuria.
Early diagnosis and comprehensive treatment of Lyme disease offer numerous benefits, including preventing more serious disseminated symptoms, avoiding the development of chronic illness, facilitating a quicker recovery, and minimizing disruptions to work, school, and family life.
Learn more in this video on Lyme disease symptoms.
Tick-Borne Diseases Often Occur Together
Tick-borne diseases often occur together and may require different treatment approaches.
From Preventing Lyme and Tick-Borne Diseases Online Course by Alexis Chesney, 2024.
Tick-borne diseases include infections caused by bacteria, protozoa, viruses, and non-infectious immune reactions. These include:
Bacterial tick-borne diseases
- Lyme disease (Borrelia burgdorferi)
- Anaplasmosis (Anaplasma phagocytophilum)
- Ehrlichiosis (Ehrlichia chaffeensis, E. ewingii)
- Rocky Mountain spotted fever (Rickettsia rickettsii)
- Tularemia (Francisella tularensis)
- Tick-borne relapsing fever
- Babesiosis (Babesia microti, Babesia duncani)
- Powassan virus
- Heartland virus
- Bourbon virus
- Tick-borne encephalitis virus
- Alpha-gal syndrome
- Tick paralysis
While Lyme disease is the most common tick-borne illness, many other tick-borne diseases exist, and each may require a different approach to evaluation and care.
Why Lyme Disease Is Often Missed or Misdiagnosed
Lyme disease and other tick-borne infections are frequently missed or misdiagnosed, particularly in the early stages. Many patients seek care promptly after symptoms begin, yet still experience delays in diagnosis or are told their illness is unrelated to a tick bite.
One major reason for this is the limitations of standard laboratory testing. Antibody-based tests may be negative early in infection, before the immune system has produced a measurable response. In addition, some patients with persistent or complex illness may not mount a typical antibody response at all.
Another challenge is that Lyme disease often does not present with a classic bull’s-eye rash, and when rashes do occur, they can vary widely in appearance. Flu-like symptoms, fatigue, joint pain, neurological complaints, and heart symptoms are frequently attributed to other causes, leading to misdiagnosis.
Tick-borne diseases also commonly occur together, and co-infections such as Babesiosis, Bartonella, Anaplasmosis, or Ehrlichiosis can significantly alter symptoms and disease course. When these infections are not considered, treatment may be incomplete or ineffective.
Finally, Lyme disease is a clinical diagnosis, meaning it should be based on a thorough history, symptom pattern recognition, exposure risk, and thoughtful interpretation of laboratory data. When care relies solely on limited testing criteria, many patients are left without answers despite ongoing symptoms.
In some individuals, ongoing symptoms may also be influenced by other contributors, such as mycotoxicity (mold toxicity) or environmental exposures, which are not routinely evaluated in conventional care.
These complexities highlight the importance of working with a clinician experienced in the evaluation and management of Lyme disease and associated diseases.
One major reason for this is the limitations of standard laboratory testing. Antibody-based tests may be negative early in infection, before the immune system has produced a measurable response. In addition, some patients with persistent or complex illness may not mount a typical antibody response at all.
Another challenge is that Lyme disease often does not present with a classic bull’s-eye rash, and when rashes do occur, they can vary widely in appearance. Flu-like symptoms, fatigue, joint pain, neurological complaints, and heart symptoms are frequently attributed to other causes, leading to misdiagnosis.
Tick-borne diseases also commonly occur together, and co-infections such as Babesiosis, Bartonella, Anaplasmosis, or Ehrlichiosis can significantly alter symptoms and disease course. When these infections are not considered, treatment may be incomplete or ineffective.
Finally, Lyme disease is a clinical diagnosis, meaning it should be based on a thorough history, symptom pattern recognition, exposure risk, and thoughtful interpretation of laboratory data. When care relies solely on limited testing criteria, many patients are left without answers despite ongoing symptoms.
In some individuals, ongoing symptoms may also be influenced by other contributors, such as mycotoxicity (mold toxicity) or environmental exposures, which are not routinely evaluated in conventional care.
These complexities highlight the importance of working with a clinician experienced in the evaluation and management of Lyme disease and associated diseases.
What Is a Lyme-Literate Physician?
A Lyme-literate physician is a clinician with specialized training and experience in recognizing, evaluating, and managing Lyme disease and other tick-borne infections. This approach acknowledges the complexity of these illnesses and the limitations of relying solely on standard testing or rigid diagnostic criteria.
Lyme-literate care emphasizes clinical judgment, detailed patient history, symptom pattern recognition, and thoughtful interpretation of laboratory results. Because tick-borne diseases can affect multiple systems in the body—including the nervous, immune, musculoskeletal, and cardiovascular systems—care often requires a broader, more integrative perspective.
A Lyme-literate physician also understands that co-infections are common, that symptoms may evolve over time, and that patients may present very differently from one another. Factors such as immune function, inflammation, mast cell activation, environmental exposures, and overall health can all influence how illness develops and persists.
Importantly, Lyme-literate care prioritizes individualized treatment plans, ongoing assessment, and patient education. The goal is not only to address infection, but also to support the body’s ability to heal and recover while minimizing unnecessary risk.
As a naturopathic physician with extensive experience treating complex tick-borne illness, I work with patients who have early Lyme disease, persistent symptoms, or unclear diagnoses following tick exposure. My approach is grounded in education, careful evaluation, and collaborative, patient-centered care.
Lyme-literate care emphasizes clinical judgment, detailed patient history, symptom pattern recognition, and thoughtful interpretation of laboratory results. Because tick-borne diseases can affect multiple systems in the body—including the nervous, immune, musculoskeletal, and cardiovascular systems—care often requires a broader, more integrative perspective.
A Lyme-literate physician also understands that co-infections are common, that symptoms may evolve over time, and that patients may present very differently from one another. Factors such as immune function, inflammation, mast cell activation, environmental exposures, and overall health can all influence how illness develops and persists.
Importantly, Lyme-literate care prioritizes individualized treatment plans, ongoing assessment, and patient education. The goal is not only to address infection, but also to support the body’s ability to heal and recover while minimizing unnecessary risk.
As a naturopathic physician with extensive experience treating complex tick-borne illness, I work with patients who have early Lyme disease, persistent symptoms, or unclear diagnoses following tick exposure. My approach is grounded in education, careful evaluation, and collaborative, patient-centered care.
My Approach to Lyme & Tick-Borne Disease Care
My approach to Lyme disease and tick-borne illness is comprehensive, individualized, and patient-centered. Because these conditions can affect multiple systems in the body and present differently from person to person, care begins with a thorough evaluation rather than a one-size-fits-all protocol.
I take time to review a detailed health history, including symptom patterns, prior testing, treatments tried, environmental exposures, and potential tick encounters. This helps identify not only Lyme disease itself, but also possible co-infections, immune system dysregulation, inflammatory drivers, and other factors that may influence symptoms and recovery.
Evaluation is guided by clinical judgment, supported by appropriate laboratory testing when helpful. Testing is used thoughtfully and interpreted within the broader clinical picture, recognizing both the strengths and limitations of available diagnostics.
In my clinical approach, treatment may include an initial pharmaceutical antibiotic-inclusive phase, followed by a transition to targeted natural therapies. Botanical medicine offers additional mechanisms of action against Lyme disease, including both anti-spirochete and anti-round form activity (unlike most pharmaceutical antibiotics), immune modulation, anti-inflammatory effects, joint support, heart support and protection of the brain. One such formula is Lyme Plus, which combines several botanicals commonly used in integrative approaches to Lyme care and supported by research. Incorporating anti-biofilm interventions throughout the treatment plan is also essential.
Treatment decisions for Lyme disease are highly individualized and depend on factors such as symptom severity, duration of illness, co-infections, and response to prior therapies. Ongoing monitoring and clinical judgment are essential throughout the course of care.
Care for Lyme disease and tick-borne illness may involve collaboration with other healthcare providers. I encourage patients to maintain an ongoing relationship with a primary care provider and refer to medical specialists or other practitioners—such as physical therapists, massage therapists, acupuncturists, or eye care providers—when appropriate, with the goal of optimal healing.
Recommendations are tailored to the individual and may evolve over time. Education is a central part of the process, empowering patients to understand their condition, participate actively in care decisions, and recognize how lifestyle, stress, sleep, nutrition, and environmental factors can influence healing.
This approach allows for flexibility and continuity of care, including comprehensive support through telehealth.
I take time to review a detailed health history, including symptom patterns, prior testing, treatments tried, environmental exposures, and potential tick encounters. This helps identify not only Lyme disease itself, but also possible co-infections, immune system dysregulation, inflammatory drivers, and other factors that may influence symptoms and recovery.
Evaluation is guided by clinical judgment, supported by appropriate laboratory testing when helpful. Testing is used thoughtfully and interpreted within the broader clinical picture, recognizing both the strengths and limitations of available diagnostics.
In my clinical approach, treatment may include an initial pharmaceutical antibiotic-inclusive phase, followed by a transition to targeted natural therapies. Botanical medicine offers additional mechanisms of action against Lyme disease, including both anti-spirochete and anti-round form activity (unlike most pharmaceutical antibiotics), immune modulation, anti-inflammatory effects, joint support, heart support and protection of the brain. One such formula is Lyme Plus, which combines several botanicals commonly used in integrative approaches to Lyme care and supported by research. Incorporating anti-biofilm interventions throughout the treatment plan is also essential.
Treatment decisions for Lyme disease are highly individualized and depend on factors such as symptom severity, duration of illness, co-infections, and response to prior therapies. Ongoing monitoring and clinical judgment are essential throughout the course of care.
Care for Lyme disease and tick-borne illness may involve collaboration with other healthcare providers. I encourage patients to maintain an ongoing relationship with a primary care provider and refer to medical specialists or other practitioners—such as physical therapists, massage therapists, acupuncturists, or eye care providers—when appropriate, with the goal of optimal healing.
Recommendations are tailored to the individual and may evolve over time. Education is a central part of the process, empowering patients to understand their condition, participate actively in care decisions, and recognize how lifestyle, stress, sleep, nutrition, and environmental factors can influence healing.
This approach allows for flexibility and continuity of care, including comprehensive support through telehealth.
Telehealth Care for Lyme Disease
Telehealth consultations allow individuals affected by Lyme disease and other tick-borne illnesses to access specialized support regardless of location. This model is especially helpful for those who experience fatigue, neurological symptoms, or mobility limitations, as well as for individuals seeking guidance from a clinician experienced in complex tick-borne disease.
Through secure, HIPAA-compliant video visits, I offer comprehensive consultations that include detailed history-taking, symptom review, education, and collaborative care planning. These visits provide the time and space needed for thoughtful discussion and a deeper understanding of each individual’s health concerns.
Telehealth consultations support individuals at many stages of their health journey, including coordination with local healthcare providers when appropriate. Specific services available through telehealth depend on location and licensure, and are discussed in detail during the intake and consent process to ensure clarity and transparency.
Through secure, HIPAA-compliant video visits, I offer comprehensive consultations that include detailed history-taking, symptom review, education, and collaborative care planning. These visits provide the time and space needed for thoughtful discussion and a deeper understanding of each individual’s health concerns.
Telehealth consultations support individuals at many stages of their health journey, including coordination with local healthcare providers when appropriate. Specific services available through telehealth depend on location and licensure, and are discussed in detail during the intake and consent process to ensure clarity and transparency.
What to Do After a Tick Bite
Knowing what to do after a tick bite can help reduce the risk of Lyme disease and other tick-borne infections. Prompt, informed action is important, even if symptoms are absent at the time of the bite.
After removing a tick, it is helpful to note when and where the exposure occurred, how long the tick may have been attached, and whether any symptoms develop in the days or weeks that follow. Not all tick bites result in infection, but early awareness allows for timely evaluation if concerns arise.
It is also important to monitor for early signs and symptoms, which may include flu-like illness, fatigue, headache, fever, muscle or joint pain, or changes to the skin near the bite site. A rash does not always occur, and when it does, it may not resemble the classic bull’s-eye pattern commonly associated with Lyme disease.
Because ticks can transmit multiple infections, symptoms may vary widely and may not appear immediately. Education, observation, and individualized decision-making are key following a tick bite.
For a more detailed, step-by-step guide, including when to seek further evaluation, visit:
👉 What to Do After a Tick Bite
For the exact step-by-step process outlined in my book Preventing Lyme and Other Tick-Borne Diseases, I walk through what to do after a tick bite in more depth in this video:
👉 What to Do After a Tick Bite (Video)
After removing a tick, it is helpful to note when and where the exposure occurred, how long the tick may have been attached, and whether any symptoms develop in the days or weeks that follow. Not all tick bites result in infection, but early awareness allows for timely evaluation if concerns arise.
It is also important to monitor for early signs and symptoms, which may include flu-like illness, fatigue, headache, fever, muscle or joint pain, or changes to the skin near the bite site. A rash does not always occur, and when it does, it may not resemble the classic bull’s-eye pattern commonly associated with Lyme disease.
Because ticks can transmit multiple infections, symptoms may vary widely and may not appear immediately. Education, observation, and individualized decision-making are key following a tick bite.
For a more detailed, step-by-step guide, including when to seek further evaluation, visit:
👉 What to Do After a Tick Bite
For the exact step-by-step process outlined in my book Preventing Lyme and Other Tick-Borne Diseases, I walk through what to do after a tick bite in more depth in this video:
👉 What to Do After a Tick Bite (Video)
Education, Prevention, Resources
Education is a cornerstone of navigating Lyme disease and other tick-borne illnesses. Understanding how these conditions develop, recognizing potential signs and symptoms, learning about appropriate blood testing and treatment considerations, and knowing how to reduce future risk can help individuals make informed decisions and feel more confident moving forward.
In addition to clinical care, I provide a variety of educational resources designed to support prevention, early recognition, and thoughtful decision-making. These resources are intended to complement—not replace—individualized medical guidance.
Available resources include:
Whether you are seeking foundational information or deeper education, these resources are designed to support awareness, prevention, and informed next steps.
In addition to clinical care, I provide a variety of educational resources designed to support prevention, early recognition, and thoughtful decision-making. These resources are intended to complement—not replace—individualized medical guidance.
Available resources include:
- Educational videos on Lyme disease, tick bites, and common symptoms
- Written guides focused on tick bite prevention and what to do after a tick bite, including a highly valuable prevention handout available through my newsletter
- My book, Preventing Lyme and Other Tick-Borne Diseases, which outlines practical strategies for tick bite prevention and early decision-making
- An online educational program, Preventing and Treating Lyme and Tick-Borne Diseases, offering in-depth instruction on ticks from around the world, the diseases they carry, prevention strategies, and early treatment considerations
Whether you are seeking foundational information or deeper education, these resources are designed to support awareness, prevention, and informed next steps.
Schedule an Appointment
If you are seeking individualized guidance related to Lyme disease or other tick-borne illnesses, appointments are available to support education, evaluation, and next steps. Care is tailored to each individual’s circumstances and may include an in-depth discussion, review of symptoms and history, recommendations and coordination with other healthcare providers when appropriate.
Telehealth consultations are available and allow individuals to access support from home, which can be especially helpful for those experiencing fatigue, neurological symptoms, or limited access to specialized care. Specific services available through telehealth depend on location and licensure and are reviewed in detail during the intake and consent process to ensure clarity and transparency.
To learn more about scheduling options or to request an appointment, please visit:
👉 Schedule an Appointment
Taking the next step begins with understanding your options and determining what support may be most appropriate for you.
Telehealth consultations are available and allow individuals to access support from home, which can be especially helpful for those experiencing fatigue, neurological symptoms, or limited access to specialized care. Specific services available through telehealth depend on location and licensure and are reviewed in detail during the intake and consent process to ensure clarity and transparency.
To learn more about scheduling options or to request an appointment, please visit:
👉 Schedule an Appointment
Taking the next step begins with understanding your options and determining what support may be most appropriate for you.