• Lyme Disease, An Overview

    by Steven Bock, MD
    on Mar 16th, 2017

Lyme disease, or rather Tick Borne disease or Lyme disease complex, de-

notes an illness of an infectious nature that can manifest as a simple rash (bulls eye),

flu symptoms and joint pain, to a myriad of symptoms ranging from fatigue, joint

and muscle pain, cardiac, neurologic and ocular problems, all the way to cognitive

dysfunction. It has be-come endemic in the United States and Canada, stretching

from the northeast to the Midwest and extending to northern and southern


Lyme disease, and co-infections which will be discussed later, are known to

be caused by the bite of a tick. In the classic case, where a tick bite is found, a bull’s

eye rash can develop within 3 to 30 days. A bull’s eye, called erythema migraines, is

a rash with a red ring around a clear center, which may have evidence of a bite in

the center.

The tick has to bite someone, and then take a blood meal. The microbe that

causes Lyme disease is a class of bacteria called a spirochete. It resides in the mid-

gut or belly of the tick. The blood meal, the tick takes with the bite, has to travel to

the mid-gut and mix with the bacteria. and then is injected into the person it has

bitten. It then spreads in the skin, causing the rash. The infection then can

disseminate or spread to different parts of the body.

The Center for Disease Control states that the tick has to be attached for 36 –

48 hours for the process to transmit the bacteria, and thus contract the disease. I

feel, and this is supported by ILADS, a professional society of like-minded Lyme

literate physicians, that this is understated. In over 30 years of practice, I have seen

over 12,000 patients with tick borne disease, and have found that transmission of

the illness can occur, in many cases in 6-12 hours. There are reports in the

literature, documenting spread of Lyme disease after only 6 hours of tick


Less than 50% of patients contracting Lyme disease; ever see or remember a

tick bite. They may just get a bull’s eye rash, or just present with symptoms of Lyme

disease. To make things more complicated and confusing in diagnosing Lyme

disease, less than 50% of patients getting Lyme disease present with the typical

bull’s eye rash. For another curve in the road, the bacteria are being found in other

insects, such as mosquitoes and fleas. A recent article reported that the spirochete

that causes Lyme disease can be found in semen and vaginal fluid. It has been shown

that the bacteria can be transmitted from a mother to her child, through the

placenta and through breast milk.

When I talk about “Lyme disease”, I am discussing the field of what we

recognize as “Tick borne disease”. Yet, there are other microbes that can be involved

with blood borne diseases. Some of these are listed below:

• Bartonella, a ubiquitous gram-negative bacteria, which has a predilection

for the cells lining the blood vessels. It can affect the nervous system, joints,

heart, eyes and GI tract to name a few.

• Babesia, an intracellular malaria like parasite

• Erhlichia and Anaplasmosis, organisms called Rickettsia

• Borrelia myiamotoi, relapsing fever, Q fever are other spirochetal diseases

• Chlamydia, Mycoplasma, Brucella

• Viruses like Powassen, etc.

Each of these organisms can present with their own individual set of

symptoms and some symptoms overlap. If there are multiple infections, which are

being seen more and more, there can be effects on the immune system. If one

bacterium or infection suppresses the immune system, that could make the other

infection more difficult to treat. This would have to be considered during drafting a

treatment plan.

Tick Borne disease is becoming a major problem in the United States. In

2013, the CDC, the Center for Disease Control, upgraded their reporting from 30,000

cases a year to 300,000 cases a year, a 10-fold revision. And considering that

approximately 1 in 10 cases are reported, this would constitute epidemic


In cases where a person is having: multiple symptoms, they live in an

endemic area, and they have been worked up for a myriad of symptoms with no

diagnosis; they need to consider the possibility of Lyme disease. I can’t say how

many times a patient, in exploring their health, has told me that their physician

would not order a Lyme test, saying that they “can’t have Lyme disease.” Not to be

too confusing, in the scenario just mentioned, merely getting a Lyme test may not be

enough. The testing available for both Lyme disease and coinfections is not very

sensitive. The take home...a negative test, in the context of Lyme symptoms, does

not rule out Lyme disease. In the words of an MD, who treated Lyme disease in

Missouri, “Absence of proof is not proof of absence.”

So far in this article, when it comes to the possibility that tick borne disease is

an issue, the surface has only been scratched as to the problems that a concerned

health person might encounter. Information is power – and informed use of

information, when it comes to one’s health, is imperative.  These issues, and those 

outlined above, will be the focus of future articles.  

Author Steven Bock, MD Steven J. Bock, M.D. has been practicing integrative medicine for over 35 years. He attended New York Medical College and received his M.D. in 1971. He was Board Certified in Family Practice in 1977 and is certified in Acupuncture. Dr. Bock was the Co-Founder and Co-Director of the Rhinebeck Health Center. He is a Diplomate of the American College of Family Practice, a Diplomate of the American Academy of Acupuncture and a Diplomate of the American Academy of Anti-Aging Medicine, Secretary of The International Lyme and Associated Diseases Society. His expertise is in the treatment of complex lyme disease and other tick borne illnesses. Dr. Bock’s medical practice merges traditional medicine with alternative and complementary medicine, combining the modalities of acupuncture, functional and nutritional medicine, homeopathy, herbal medicine and environmental medicine into an integrated medical model for optimal wellness.

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