Help! I've been bitten by a tick. What do I do?
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Help!
I've been bitten by a tick. What do I do?
The official IDSA answer to this question is:1: Identify the tick type, but do not test the tick for infectious organisms2: If the period of time is within 72 hours than take 200 mg of Doxycycline one dose once and you will have no problems. 3: Watch and wait
I’ve discussed this treatment strategy on the LYME DISEASE PAGE. For this blog I’ll recap with this piece of info. The study that looked at doxycycline 200 mg one dose once STOPS THE RASH. That's what the study was designed to figure out.
During this study, a few people may have even gotten Lyme Disease.Doxycycline single dose may alter antibody production, making diagnosis more difficult using a 2 tier antibody testing methodDoxycycline may cause some of the borrelia organism to transition into persister cells and grow again when the doxy is gone.Doxycycline can stop the rash, which is a way to diagnose the onset of the Lyme Disease, but some people that contract Lyme Disease never get a rash.
My answer to the question “Help I've been been by a tick, what do I do” is not the same as the IDSA guidelines. I believe more in a proactive solution. Acute Borrelia is much easier to treat than chronic Borrelia, and the tick may have transmitted other organisms that have severe health consequences like anaplasma, ehrlichia, Babesia or Bartonella...even other types of Borrelia that are harder to test for. These infections can be fatal and you wouldn't be able to test for them in a human until long after the infection set in. Therefore...TEST THE TICK! (for infectious organisms)
Deer ticks may or may not contain Borrelia burgdorferi, which is the causative agent of Lyme disease. Knowing what infectious organisms the tick had informs what symptoms to monitor for and what tests to use. Onset of symptoms can be confusing, may has well know what to be looking for!
There is always risks in taking antibiotics. There is also risks in not treating acute infections.
It takes weeks to test for antibody production in a person. The onset of a severe or fatal infection happens before antibody production. If you know what organisms the tick had, and then see a rapid onset of severe symptoms, you know how to treat those symptoms. Otherwise, you're treating blind.
If the tick didn’t have any infections then undertaking the risk of treatment isn't necessary and any new symptoms could be evaluated better
The IDSA guidelines state no treatment if the tick has been attached for less than 36 hours. One dose of doxy 200 mg once if the tick is attached for 36+ hours, in an endemic area. Sadly, Borrelia can be transferred faster than 36 hours from a nymph or an adult tick that was feeding on something else first. Other infectious organisms in a tick can transmit much faster!TEST THE TICK!
Please take these steps with the tick that bit you.1. Check what kind of tick it is. A deer tick can transfer Borrelia and other infections. Other types of ticks can still transfer certain infections.2. Figure out how long it’s been on.
I suggest following this protocol if it's well attached especially if you aren't sure:
3. Get the tick off you as quickly as possible, using a method that gets the whole tick out without much trauma to you or squeezing tick's body. READ UP ON HOW TO REMOVE A TICK.4. Put the deer tick in a zip lock bag.5. Test the tick. I suggest Tickreport.com in my area because the time is three to five days. It may even be fast enough that you have a result before you have any symptoms... the ideal scenario. See below for Tickreport.com and other tick testing options.6. If you have symptom that indicate you got an infection, I suggest you take antibiotics while you wait for the test results. The longer the tick is on you, the more likely I will suggest being on antibiotics while you wait. I tend to put people on doxycycline or minocycline while waiting for the tick test to return if I suspect onset of anaplasma or Ehrlichia. If the infection appears to be cellulitis Cephalexin may be indicated. *These antibiotics are suggestions and not a definitive treatment guidelines . A patient, the symptoms and antibiotic sensitives are always considered based on the individual.The infection could be a virus and then antibiotics are not indicatedSeeing a doctor to evaluate rapid onset symptoms is suggested. Borrelia (Lyme Disease) is slow growing, so rapid onset symptoms near the time of the bite tend to be other organisms.7. If the tick is positive for Borrelia and there is any indication of infection, then I test and treat the person as if there is an acute Borrelia infection (Borreliosis). Antibiotics should start sooner the better. Waiting for the tick results is reasonable if you use a lab with fast turn around and you don't have symptoms.8. Baseline antibody production in a patient would be indicated if the tick has pathogenic bacteria. Ie if the tick had Borrelia, I would do baseline Lyme Disease antibody testing, so I could to the same test a month later and determine if the antibody levels change.9. If you are an established patient and are aware of my Lyme treatment style, you can get in touch with me to start treatment. I will charge a short appointment charge and initiate the treatment. If you aren't an established patient, test the tick and get in touch with my office to set up an appointment. Please let us know the tick testing is in progress or done. We will try to fit you in. In that case, reading my LYME DISEASE WEB PAGE ahead of your first appointment, please.
You could use an alternative to antibiotics while waiting for the test results. I generally use a mixture of herbs and grapefruit seed extract. I still suggest adding antibiotics if the test came back positive for Borrelia or other infection in the tick AND there are indications of an infection.
Tick testing companieshttps://www.tickreport.com (Massachusetts)https://www.ticklab.org (Pennsylvania)
https://ticktests.com (Massachusetts)
This list is not comprehensive. I have personal experience with tickreport.com and use it frequently. You may find other options online..and I encourage that as long as they test for infectious organisms and not just tell you the type of tick. Feel free to email me other tick testing companies, I'll add them. Use the contact us link.
I strongly insist that you do tick testing instead of guessing or waiting for symptoms. Not everyone gets the rash. The bacteria is very slow growing so symptom lag time could be months! Testing the tick is often easier and faster than testing a person. Cell mediated immunity reaction testing may be positive within a few days, but it's expensive compared to testing the tick. Antibody testing for Lyme can take weeks to turn positive.
At the very least. SAVE THE TICK. Keep the tick in a zip lock bag, in your freezer and label it with 1) Who it bit2) When it bit3) How long you guess it attached4) Where it attachedThat way you can pull that tick out of the freezer if you are having difficult to explain symptom. You can test that frozen tick for quite a long time
Do NOT stick it in tape (not testable anymore)Do NOT put it in alcohol (not testable anymore)
Hope this help you decide what to do.Dr. Steve Clark, N.D.
I've been bitten by a tick. What do I do?
The official IDSA answer to this question is:1: Identify the tick type, but do not test the tick for infectious organisms2: If the period of time is within 72 hours than take 200 mg of Doxycycline one dose once and you will have no problems. 3: Watch and wait
I’ve discussed this treatment strategy on the LYME DISEASE PAGE. For this blog I’ll recap with this piece of info. The study that looked at doxycycline 200 mg one dose once STOPS THE RASH. That's what the study was designed to figure out.
During this study, a few people may have even gotten Lyme Disease.Doxycycline single dose may alter antibody production, making diagnosis more difficult using a 2 tier antibody testing methodDoxycycline may cause some of the borrelia organism to transition into persister cells and grow again when the doxy is gone.Doxycycline can stop the rash, which is a way to diagnose the onset of the Lyme Disease, but some people that contract Lyme Disease never get a rash.
My answer to the question “Help I've been been by a tick, what do I do” is not the same as the IDSA guidelines. I believe more in a proactive solution. Acute Borrelia is much easier to treat than chronic Borrelia, and the tick may have transmitted other organisms that have severe health consequences like anaplasma, ehrlichia, Babesia or Bartonella...even other types of Borrelia that are harder to test for. These infections can be fatal and you wouldn't be able to test for them in a human until long after the infection set in. Therefore...TEST THE TICK! (for infectious organisms)
Deer ticks may or may not contain Borrelia burgdorferi, which is the causative agent of Lyme disease. Knowing what infectious organisms the tick had informs what symptoms to monitor for and what tests to use. Onset of symptoms can be confusing, may has well know what to be looking for!
There is always risks in taking antibiotics. There is also risks in not treating acute infections.
It takes weeks to test for antibody production in a person. The onset of a severe or fatal infection happens before antibody production. If you know what organisms the tick had, and then see a rapid onset of severe symptoms, you know how to treat those symptoms. Otherwise, you're treating blind.
If the tick didn’t have any infections then undertaking the risk of treatment isn't necessary and any new symptoms could be evaluated better
The IDSA guidelines state no treatment if the tick has been attached for less than 36 hours. One dose of doxy 200 mg once if the tick is attached for 36+ hours, in an endemic area. Sadly, Borrelia can be transferred faster than 36 hours from a nymph or an adult tick that was feeding on something else first. Other infectious organisms in a tick can transmit much faster!TEST THE TICK!
Please take these steps with the tick that bit you.1. Check what kind of tick it is. A deer tick can transfer Borrelia and other infections. Other types of ticks can still transfer certain infections.2. Figure out how long it’s been on.
I suggest following this protocol if it's well attached especially if you aren't sure:
3. Get the tick off you as quickly as possible, using a method that gets the whole tick out without much trauma to you or squeezing tick's body. READ UP ON HOW TO REMOVE A TICK.4. Put the deer tick in a zip lock bag.5. Test the tick. I suggest Tickreport.com in my area because the time is three to five days. It may even be fast enough that you have a result before you have any symptoms... the ideal scenario. See below for Tickreport.com and other tick testing options.6. If you have symptom that indicate you got an infection, I suggest you take antibiotics while you wait for the test results. The longer the tick is on you, the more likely I will suggest being on antibiotics while you wait. I tend to put people on doxycycline or minocycline while waiting for the tick test to return if I suspect onset of anaplasma or Ehrlichia. If the infection appears to be cellulitis Cephalexin may be indicated. *These antibiotics are suggestions and not a definitive treatment guidelines . A patient, the symptoms and antibiotic sensitives are always considered based on the individual.The infection could be a virus and then antibiotics are not indicatedSeeing a doctor to evaluate rapid onset symptoms is suggested. Borrelia (Lyme Disease) is slow growing, so rapid onset symptoms near the time of the bite tend to be other organisms.7. If the tick is positive for Borrelia and there is any indication of infection, then I test and treat the person as if there is an acute Borrelia infection (Borreliosis). Antibiotics should start sooner the better. Waiting for the tick results is reasonable if you use a lab with fast turn around and you don't have symptoms.8. Baseline antibody production in a patient would be indicated if the tick has pathogenic bacteria. Ie if the tick had Borrelia, I would do baseline Lyme Disease antibody testing, so I could to the same test a month later and determine if the antibody levels change.9. If you are an established patient and are aware of my Lyme treatment style, you can get in touch with me to start treatment. I will charge a short appointment charge and initiate the treatment. If you aren't an established patient, test the tick and get in touch with my office to set up an appointment. Please let us know the tick testing is in progress or done. We will try to fit you in. In that case, reading my LYME DISEASE WEB PAGE ahead of your first appointment, please.
You could use an alternative to antibiotics while waiting for the test results. I generally use a mixture of herbs and grapefruit seed extract. I still suggest adding antibiotics if the test came back positive for Borrelia or other infection in the tick AND there are indications of an infection.
Tick testing companieshttps://www.tickreport.com (Massachusetts)https://www.ticklab.org (Pennsylvania)
https://ticktests.com (Massachusetts)
This list is not comprehensive. I have personal experience with tickreport.com and use it frequently. You may find other options online..and I encourage that as long as they test for infectious organisms and not just tell you the type of tick. Feel free to email me other tick testing companies, I'll add them. Use the contact us link.
I strongly insist that you do tick testing instead of guessing or waiting for symptoms. Not everyone gets the rash. The bacteria is very slow growing so symptom lag time could be months! Testing the tick is often easier and faster than testing a person. Cell mediated immunity reaction testing may be positive within a few days, but it's expensive compared to testing the tick. Antibody testing for Lyme can take weeks to turn positive.
At the very least. SAVE THE TICK. Keep the tick in a zip lock bag, in your freezer and label it with 1) Who it bit2) When it bit3) How long you guess it attached4) Where it attachedThat way you can pull that tick out of the freezer if you are having difficult to explain symptom. You can test that frozen tick for quite a long time
Do NOT stick it in tape (not testable anymore)Do NOT put it in alcohol (not testable anymore)
Hope this help you decide what to do.Dr. Steve Clark, N.D.