Acute Tick Bite: What Do You Do?

Acute Antibiotic Therapy for Lyme Disease

The official CDC (Center for Disease Control) recommendation for managing an acute tick bite includes antibiotic therapy only if symptoms are present (fever, fatigue, joint pain, muscle pain, malaise, rash, bull’s eye rash). The concern is that treating too early could delay the onset of Lyme disease and interfere with adequate treatment.

This stance, however, is controversial. All ticks carry microbes, and asymptomatic individuals can initially develop chronic disease or become chronic illness carriers and develop relapsing illness later if immune function falters. At-risk individuals (absence of robust health) may want to consider a course of antibiotics and herbal therapy after an acute tick bite. For frequent tick bites, continuous herbal therapy may be the best option.

What’s the Standard Treatment for Tick Bite?

The standard treatment for acute symptomatic tick bite is doxycycline 100 mg started at the onset of symptoms and taken twice daily for 21 days or until three days after symptoms subside (or 4 mg / kg in children >8 years, but no doxycycline in children < 8 years). If symptoms indicating early Lyme disease are present, including EM rash (bull’s eye rash), amoxicillin 500 mg three times daily (or 50 mg / kg in children < 8 years) or cefuroxime 500 mg twice daily for 14-21 days ( or 30 mg / kg in children < 8 years) should be added. Severe illness, including neurologic or cardiac symptoms, should be managed more aggressively, potentially with IV antibiotics (see CDC website for complete recommendations).

Immediate prophylaxis for acute tick bite is less well defined. Even though antibiotic therapy is not recommended unless symptoms are present, a single dose of doxycycline, 200 mg orally, can be given under the following circumstances:

• The tick has been identified as a black-footed tick (Ixodes scapularis, Ixodes pacificus) and has been attached for >36 hours
• Less than 72 hours have elapsed since the tick bite
• The tick bite occurred in an endemic area for Lyme disease
• There are no contraindications to doxycycline.

Whether this is truly valuable or not is still being determined.

Covering for Lyme Disease Coinfections

Rocky Mountain Spotted Fever, caused by Rickettsia rickettsii, has the highest potential to cause severe illness. Other common coinfections, including ehrlichia, anaplasma, and babesia, also have the potential to cause acute severe illness. Even these microbes, however, often infect without causing symptoms but can become dormant inside cells of the body and then re-emerge later in life. Recognizing Symptoms of Severe Acute Infection

The tipoff for severe acute infection with these microbes is high fever. If a high fever occurs with a history of tick bites, antibiotic therapy should be started immediately to prevent long-term complications. Herbal therapy alone should never be the primary therapy for these potentially life-threatening conditions.

Fortunately, doxycycline covers borrelia and the known coinfections, with the exception of babesia. Therapy should be continued for at least 21 days or until three days after symptoms subside. Failure to respond to antibiotic therapy indicates that babesia or an antibiotic-resistant microbe is present.

Addressing Babesia Infections

Babesia is known for relapsing high fevers. Again, fever is the tipoff for severe disease. Severe babesia infection should be treated aggressively, usually with two to three babesia-specific drugs. Most people exposed to babesia, however, will not develop symptoms or will only have mild disease. The babesia-specific drugs are associated with significant side effects.

Alternative Treatments for Tick Bite

In veterinary medicine, an antibiotic called metronidazole is commonly used with doxycycline to treat canine babesiosis. Metronidazole may provide a safe and well-tolerated alternative for covering the possibility of early mild infection with babesia in humans (metronidazole is commonly used for protozoa and intestinal bacterial overgrowth in humans). The dose of metronidazole is 500 mg, taken twice daily for 7 to 14 days.

Clindamycin, an antibiotic commonly prescribed for Lyme disease coinfections, should be avoided when administered orally. Clindamycin is commonly associated with overgrowth of Clostridium difficile in the gut. Overgrowth of C. diff. causes severe bloody diarrhea, often requiring hospitalization. Clindamycin should only be used topically or intravenously.

It should be noted that antibiotic therapy will not eliminate all of the microbes; it just helps to give the immune system the upper hand. After the microbes have disseminated into tissues, antibiotic therapy is less likely to eradicate the infection. Studies have repeatedly shown that long-term use of antibiotic therapy offers no benefit.

Introducing Post-Lyme Syndrome

At least 20% of people with an infected tick bite will develop fatigue and migrating arthritis within weeks to months after completing antibiotic therapy (so-called post-Lyme syndrome). Repeat antibiotics generally provide a transient benefit or no benefit at all.

All of the recommended protocols depend on developing symptoms to initiate therapy. At least half of people who are never exposed to a tick-borne microbe from a tick bite never develop symptoms. Many of these people will become active carriers for borrelia and/or coinfections. They can become ill at a later time if immune function falters for any reason.

You can (and should) hedge your bets.

Natural Herbal Therapy and Acute Lyme Disease

Herbs can safely be taken concurrently with antibiotic therapy. They are also a good option for asymptomatic tick bites (all ticks carry something, whether you develop symptoms or not).

Herbal therapy has the advantage of both suppressing microbes and enhancing immune function at the same time. Herbal therapy is most beneficial when high doses of herbs with different medicinal and antimicrobial properties are taken simultaneously. Herbs can be safely continued for an indefinite period of time beyond antibiotics without concerns for causing harm. The reason is that herbs do not disrupt gut flora, do not cause resistance, and are not toxic to cells of the body. 

Recommended Herbs:

Japenese Knotweed

Japanese knotweed offers broad-spectrum activity against a wide range of bacteria, viruses, protozoa, and yeasts. Featured in a 2020 study from Johns Hopkins University, Japanese knotweed was one of several herbs found to have greater activity against active motile and nonmotile (dormant) forms of borrelia than doxycycline. Japanese knotweed is also an excellent source of resveratrol, a phytochemical known for protecting cells and mitochondria.  

Chinese Skullcap

Chinese skullcap, another herb featured in the John Hopkins study, also provides broadspectrum antimicrobial properties. In addition to protecting cells and tissues from free radicals and other stress factors, it is an excellent herb for balancing immune system functions (immunomodulator).

Cat’s Claw

Cat’s Claw, one of the most widely used herbs for Lyme disease, has traditionally been used to treat microbial illnesses. It was also featured in the Johns Hopkins study. Cat’s claw offers antiviral, antiparasitic, anti-inflammatory, and antioxidant properties. It also reduces inflammation and is beneficial for stomach ulcers.

Andrographis

Andrographis offers antiviral, antibacterial, and parasitic properties. Numerous clinical trials have demonstrated its ability to reduce the length and severity of common viral illness. Other benefits include liver protection, immune enhancement, and cardioprotective effects.

Reishi Mushroom

Reishi is a medicinal mushroom offering adaptogenic properties. It balances stress hormones and is an exceptional immunomodulator (balances immune system functions). It also protects cells and tissues from inflammation and has anti-inflammatory and antiviral properties.  

Cordyceps

Cordyceps is also an adaptogenic medicinal mushroom that pairs well with reishi and the other herbs on the list to provide exceptional protection of the body’s tissues and immunomodulation. 

Sarsparilla
Sarsparilla offers anti-inflammatory, antioxidant, and antibacterial properties against gram-negative bacteria. Sarsaparilla also binds up endotoxins produced by microbial die-off, which lessens the severity of Herxheimer reactions.

To gain the maximum benefit from taking essential herbs, it’s important to use high-grade standardized botanical extracts from a reputable source that includes testing for chemical and biological contaminants. My company Vital Plan creates products set to these high-quality standards. The Vital Plan Resore Kit can help you get your life back, as an individual suffering from Lyme disease or chronic illness. Let us help you get well and stay well.

For more information on natural herbal therapy options, see Unlocking Lyme »

Final Words from Dr. Bill Rawls on Acute Tick Bites

Ten years of clinical practice have shown that people who take herbal therapy (with or without antibiotics) after tick bites are less likely to develop symptoms later. Herbal therapy is also effective for controlling post-Lyme syndrome symptoms. Of course, acute and/or severe symptoms should always be treated with antibiotics.

Dr. Bill Rawls is a physician who overcame Lyme disease through natural herbal therapy. You can learn more about Lyme disease in Dr. Bill Rawls’ best-selling book, Unlocking Lyme.

You can also learn about Dr. Rawls’ personal journey in overcoming Lyme disease and fibromyalgia in his popular blog post, My Chronic Lyme Journey.

REFERENCES 1. https://www.cdc.gov/lyme/treatment/index.html 2. Wormser et al, The Clinical Assessment, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis: Clinical Practice Guidelines by the Infectious Diseases Society of America, Clinical Infectious Diseases, 2006, 43(9), p.1089-1134. 3. Buhner S, Healing Lyme, Raven Press, 2005