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In this episode, you will learn strategies for Preventing Lyme and Other Tick-Borne Diseases.
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About My Guest
My guest for this episode is Dr. Alexis Chesney. Alexis Chesney, MS, ND, LAc is a naturopathic physician and acupuncturist specializing in Lyme and other tick-borne diseases. Originally from New York, Dr. Chesney received a BA from Holy Cross College in Worcester, Massachusetts. She earned a Masters in Science in acupuncture from the University of Bridgeport Acupuncture Institute and a doctorate in naturopathic medicine from the University of Bridgeport College of Naturopathic Medicine in Connecticut. She is one of the first naturopathic students to complete a hospital-based medical rotation. With five of her colleagues from across the nation, she founded the Naturopathic Medical Student Association, which is a recipient of the AANP President's Award. Naturopathic residency brought her to Vermont, where she has continued to work with a team of integrative practitioners at Sojourns Community Health Clinic in Westminster. She also has a private practice in Northampton, Massachusetts. She has dedicated her practices to the treatment of Lyme and tick-borne diseases. She is a member of the American Association of Naturopathic Physicians (AANP), Vermont Association of Naturopathic Physicians (VANP), the International Lyme and Associated Diseases Society (ILADS) and a founding full member of International Society for Environmentally Acquired Illness (ISEAI). Dr. Chesney serves on the Board of Directors and as the Naturopathic Medicine Committee Chair for ILADS. She has been featured as an expert on tick-borne illness at an ILADS conference, at other professional and patient-focused conferences, on local talk radio, and in various news publications.
- Why does the incidence of Lyme disease continue to rise?
- Are co-infections the rule or the exception?
- What is the difference between hard and soft ticks?
- What times of year have the highest risk for tick exposures?
- How common is a bulls-eye rash?
- What is the role of Tick-Borne Relapsing Fever in Lyme-like illnesses?
- What is alpha-gal?
- How can tick populations be reduced?
- What should be considered when spending time in nature to reduce the possibility of a tick bite?
- What treatment options might be considered for prophylaxis?
- When should one contact a doctor to discuss acute treatment strategies?
- What testing options may be helpful early on?
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April 27, 2020
Transcript Disclaimer: Transcripts are intended to provide optimized access to information contained in the podcast. They are not a full replacement for the discussion. Timestamps are provided to facilitate finding portions of the conversation. Errors and omissions may be present as the transcript is not created by someone familiar with the topics being discussed. Please Contact Me with any corrections.
[00:00:01.12] Welcome to Better HealthGuyBlogcasts, empowering your better health. And now, here's Scott, your Better Health Guy.
[00:00:14.03] The content of this show is for informational purposes only and is not intended to diagnose, treat, or cure any illness or medical condition. Nothing in today's discussion is meant to serve as medical advice, or as information to facilitate self-treatment. As always, please discuss any potential health-related decisions with your own personal medical authority.
[00:00:34.18] Scott: Hello everyone, and welcome to episode number 118 of the BetterHealthGuy Blogcasts series. Today's guest is Dr. Alexis Chesney, and the topic of the show is Preventing Lyme. Dr. Alexis Chesney is a naturopathic physician and acupuncturist specializing in Lyme and other tick-borne diseases. Originally from New York, Dr. Chesney received a BA from Holy Cross College in Worcester, Massachusetts.
She earned a Master's in Science in Acupuncture from the University of Bridgeport Acupuncture Institute, and a Doctorate in Naturopathic Medicine from the University of Bridgeport College of Naturopathic Medicine in Connecticut. She is one of the first naturopathic students to complete a hospital-based medical rotation. With five of her colleagues from across the nation, she founded the Naturopathic Medical Student Association, which is a recipient of the AANP President's Award. Naturopathic residency brought her to Vermont, where she's continued to work with the team of integrative practitioners at Sojourns Community Health Clinic in Westminster.
She also has a private practice in Northampton, Massachusetts and has dedicated both of her practices to the treatment of Lyme and tick-borne diseases. She is a member of the American Association of Naturopathic Physicians, Vermont Association of Naturopathic Physicians, the International Lyme and Associated Diseases Society, and a founding full member of the International Society for Environmentally Acquired Illness. Dr. Chesney serves on the board of directors and as the naturopathic medicine committee chair for ILADS. She's been featured as an expert on tick-borne illness at an ILADS conference, at other professional and patient-focused conferences, on local talk radio, and in various news publications. And now my interview with Dr. Alexis Chesney.
[00:02:27.00] Scott: As most of our listeners know, my own health journey was significantly impacted by Lyme disease after a tick bite over 20 years ago. So many people's lives are impacted by Lyme disease, and our guest today has authored a new book on Preventing Lyme and Other Tick-Borne Diseases. If our talk today can help even one person to avoid acquiring Lyme disease, that would be a beautiful thing. Thanks so much for being here, Dr. Chesney.
[00:02:49.16] Dr. Chesney: Thank you for having me.
[00:02:51.06] Scott: Tell us a little about how you became interested in Lyme disease. Did you have some type of personal experience that led you to doing the work you're doing today?
[00:02:59.20] Dr. Chesney: Well, in naturopathic medical school, a friend of mine came down with what we didn't know was Lyme at the time. And so being very close and seeing each other studying, I would see this sort of downturn that she took. Both physically; very bizarre symptoms like the neuralgia, the nerve pains that happen to people; pains that would come and go things that just didn't really make sense. One day they would be okay, the next they would not.
And so I actually took her to a Lyme literate doctor, someone at the clinic suggested this, and she got the IGeneX test done, it was positive. She received treatment and did very well. So just seeing that and being in medical school at the time, and then thinking about it more medically as well as having that personal relationship really got me thinking about wow, this is so interesting and different than other diseases.
[00:03:57.14] Scott: Why does the incidence of Lyme disease seem to be continuing to rise? Is it that testing is getting better? Is it that ticks are more prevalent or more multiply infected? Or maybe a combination of several of these things?
[00:04:10.28] Dr. Chesney: I think a combination of that, Scott, definitely. I moved up to Vermont about ten plus years ago, just ten to eleven years ago, and unfortunately we hear this a lot, but being from New York and then being in school in Connecticut, in Massachusetts. I've worked my way up north and so has Lyme.
So people were saying oh there's no Lyme here, there are no ticks here. And I think the warming of the climate has certainly had its effect on tick survival. They're not dying off over the winters up here anymore. So I think Vermont, New Hampshire, and Maine have been really hard hit in recent years. And we're seeing that all over. The spread, there's bird migration, there's a warming climate also that ticks can carry more than one species of Borrelia or other tick-borne diseases, all these are factors, yes.
[00:05:05.22] Scott: So talk to us a little bit about ticks, would we think of a tick as a parasite, and then for people that aren't familiar with the word vector, what do we mean when we say vector in reference to a tick?
[00:05:15.16] Dr. Chesney: Right. So a vector-borne illness like Lyme disease means that a vector-like a tick can carry a pathogen like Borrelia burgdorferi that it has gotten from a reservoir which should be something like a mouse or another animal. But for instance, say a mouse is where a tick can first get infected. And then it could carry that and transmit it to a human for instance, when it bites a human and transmits it. So that's the idea of vector and vector-borne illnesses.
[00:05:48.08] Scott: And would you consider a tick to be a parasite?
[00:05:51.05] Dr. Chesney: Yes. So it requires three blood meals in order to then, female tick, requires three blood meals to then be able to lay eggs and hatch out that next generation. So if they do not find a host they are not going to survive, they need that blood meal from a host. So they're dependent on that.
[00:06:09.10] Scott: There's such a focus on ticks, we talk about tick-borne diseases. But other biting or stinging insects potentially carry these organisms potentially transmitted Borrelia and co-infections. What are your thoughts on people acquiring Lyme disease maybe from a vector other than a tick bite?
[00:06:27.18] Dr. Chesney: I think it's possible. I don't have a lot of background in this issue, but there's certainly research out there showing that other insects can carry Borrelia. I do not think at this time we have anything proving that it can then transmit to humans, I could be wrong about that.
But last time I looked into it because patients have asked me this. I think that's a great question, and I think we need more research in this area. Certainly, it's very hard to avoid tick bites, but I think it's even harder in some areas to avoid mosquito bites or other insects coming into contact with them. So that would be really important knowledge to have.
[00:07:05.04] Scott: And what are your thoughts about the potential for congenital transmission of Lyme and co-infections?
[00:07:10.11] Dr. Chesney: Yes, I think that definitely can happen. So yes I've done some phone consults with Charles Ray Jones, and he's a pediatrician that treats Lyme. So learning from him, 50% of those who are not treated can transmit Lyme to the fetus. And so I've worked with a lot of pregnant women, and we do the cord blood testing, and they've all come back negative, thank goodness.
But I've also met people that have not been diagnosed until they've already had children, and sometimes we see certain symptoms in the children, and we may test them, we may do a clinical look at the symptoms and do a trial treatment with the child, and it looks like they have Lyme too. So I think I see that, even if we can't prove it all the time with lab testing at the time of the pregnancy.
[00:08:06.07] Scott: In your experience, how common is it that someone gets a tick bite and acquires only Borrelia? So if we're thinking from a co-infection perspective, are they the rule? Are they the exception? And then are there some tick bites that carry only co-infections, but no Borrelias?
[00:08:22.09] Dr. Chesney: Yes. So there was an interesting study in 2019 out of Connecticut looking at deer ticks and how many different pathogens they carry. So 56% had Borrelia burgdorferi, 10% had Anaplasma, and you can certainly read about the details. But there were so many pathogens found in these ticks, and about 10% of them had to two different pathogens at the same time, and so there were even some that had three pathogens at once.
So we know these ticks are definitely carrying multiple pathogens. And sometimes I think about is it another tick bite someone had that they didn't notice? Did they have travel to areas where there are other types of ticks? I live in the Northeast, so I deal with a lot of deer tick bites. But some people have traveled to other areas of the country, of the world, and of course, you could be infected by other transmissions of other pathogens from different ticks.
[00:09:26.27] Scott: It's interesting to hear that number 56%, because I know years ago studies would suggest maybe 1%, 2% of ticks that were tested carried these types of Lyme associated pathogens. And so maybe the testing is getting better, maybe there's just more prevalence in ticks themselves.
But I mean that's shocking to hear that more than one out of two of the ticks tested had Borrelia in them.
People often say that Lyme can only be acquired from the bite of a deer tick; you just referenced a deer tick. At the other end of the spectrum, some suggest that any tick can carry Lyme or Lyme associated pathogens. So what's the reality? What do you think is happening here?
[00:10:05.11] Dr. Chesney: Well, it was really interesting writing this book, I didn't know much about the Gulf Coast tick for instance. Even the Lone Star tick we don't have those at this point. At least no one's brought them into my office or spotted a Lone Star tick, but they're making their way up to Vermont in the Northeast.
So I think all of these ticks actually carry different pathogens So for Lyme disease, Borrelia burgdorferi it's really the Ixodes scapularis which is the deer tick, the black-legged tick and then the Western black-legged tick. But that covers basically almost the entire United States and provinces of Canada, so that's the big one. But even those ticks carry Anaplasma, Babesia; they're discovered not too long ago in the north-central States in Minnesota and in that area, that the deer ticks are carrying a type of Ehrlichia murus like pathogen.
So really the deer ticks do carry, can carry, many things and as we're seeing recent research more and more often that's the case. But then there are all these other ticks and the Lone Star tick carries, well they don't know what it carries there causes STARI. So that's really a point of interest, and I look forward to seeing more research because I feel like there is probably an epidemic of this Lyme-like illness called STARI but there's no data; going through writing my book I was looking at maps, trying to help people find tick ranges and also the areas in which these diseases are found.
And there's no data on STARI because there's a debate going on about well what kind of pathogen is this? And it was pretty confusing actually to read about that. Some have called it Borrelia lonestari, but this is not readily discussed, there are no tests for it. So I wonder if there is going to be a lot coming in the future about that.
[00:12:12.08] Scott: I learned a new word reading your book and that was Scutum, which I didn't know before this. So talk to us about what is a tick scutum, and how does that potentially help identify the type of tick that bit us? And then from a transmission of disease perspective, is there a difference between hard ticks and soft ticks in terms of their potential to cause human disease?
[00:12:33.07] Dr. Chesney: Right, so the scutum or the dorsal shield is the area of the tick where it really helps us identify a tick basically, so it's a nice tool to be able to, it's kind of its torso, its upper body. And it doesn't change during the blood meal, because some people identify, it's pretty easy to find an adult deer tick because there are a little bit reddish-tan in their body.
But that changes once they've had a blood meal or a partial blood meal, so if somebody were to remove that from their body, that part if it's no longer this tannish-red that's getting our attention, they might have trouble identifying it. So we really want to look at that dorsal shield or the scutum in order to like for instance the black-legged tick, the deer tick is just a black circle, really dark circle, solid color. Ticks up here that we have that people could bring in would be the wood tick or the dog tick, and that one has a very different dorsal shield as many of them do.
And so that one is very mottled, that is larger, is a little harder. But if you compare those two, scutums you can really, which you may need to get a magnifying glass to do, but you could really tell the difference that way no matter where they are in their blood meal process or not.
[00:14:01.24] Scott: And then is there a difference in terms of transmission of disease in terms of hard versus soft ticks?
[00:14:07.20] Dr. Chesney: Listen, the soft ticks are so interesting. Really, it's incidental that humans get infected through a soft tick because unfortunately, it's such a quick nighttime feeding that happens. And usually, it's in places like caves or cabins or structures that are in certain areas of the United States where they have these soft ticks. And so you might be somebody who is either working outdoors, who is camping, hiker in the backcountry or caving, these very particular types of landscapes and then usually they feed on mice or some kind of small animal quickly overnight.
So with that type of a tick bite, you may not even feel it at all. They're not going to attach, they don't attach for a period of time like a hard tick that attaches generally three to five days. Do they detach sometimes sooner than that? Yes, about 10% of hard ticks actually detach, and about 10% of them attach much sooner than that. Which is interesting because then when they go for another feed, the process of transmission might be hurried along. But anyway, the soft ticks can carry a different Borrelia that causes Tick-Borne Relapsing Disease.
And so it's for a different Borrelia, Borrelia hermsii, Borrelia turicatae these are all named after the more the Ornithodoros soft tick that is carrying them. And basically, it's a Lyme like illness, but usually, there's this fever that comes and goes, this undulating fever and that's a hallmark sign of it. But it would be also treated similarly to Lyme, as well as Borrelia as well.
[00:16:08.25] Scott: Talk to us about the times of year that we need to be more aware, have heightened awareness of the potential for tick bites. Are there times where we don't really need to be concerned, versus those where we really should be watching out?
[00:16:21.00] Dr. Chesney: Well, it's really all based on temperature. So above 28 degrees Fahrenheit is when ticks are active, and we had a very mild winter here, so people did get tick bites during the winter in February, March.
Often people think that oh somewhere in May, somewhere around October that's the main time for tick bites. But it really depends on the temperature and where you're located. So yes, I think it's more about the temperature and thinking about your outdoor activities and being safe no matter what month it is.
[00:17:01.28] Scott: So where I am in Northern California where it never gets below 28 degrees, it sounds like it's pretty much any time you need to be concerned.
[00:17:09.02] Dr. Chesney: Exactly, yes.
[00:17:10.13] Scott: Talk to us a little about the life cycle of Borrelia in terms of ticks and deer and the white-footed mouse, and humans. And then does Borrelia cause illness in non-human hosts?
[00:17:22.20] Dr. Chesney: So looking at the life cycle, it's a two-year life cycle of the tick. And so usually the tick will feed on a small animal. So first they're hatched out from eggs usually in someplace like leaf litter, and then they're larvae at that point. And so they're not going to go far, right? They're babies, they're not crawling up a piece of grass at this point.
So they're just going to hang out and wait for somebody to come really close to them, like a white-footed mouse. So that's usually where they first get infected with Borrelia. And then so in the tick, they're going to then have that blood meal, the tick is going to have the blood meal digest that, Borrelia is there.
And then it will go out seeking another meal at some point as a nymph, and a little more energy might go a little farther, right? So they might get another small animal or a dog or even a human at that point. And at that point they could transmit Borrelia, they could also absorb whatever pathogens are in whatever that host is that they're feeding on. And then they've become adults, and adult male does not need to feed. And then the adult female does in order to then lay those eggs, and the cycle moves on.
[00:18:52.18] Scott: And would you say that Borrelia can cause illness in these other hosts as well? So I mean do we have white-footed mice that have trouble with their feet for example? Or what happens to them when they're carrying these Borrelias?
[00:19:06.23] Dr. Chesney: That's a good question; I don't know I mean we know that dogs and horses definitely get sick and exhibit symptoms. I don't know if the white-footed mice exhibit any symptoms. I saw a study somewhere through my research that it was something like this very low number, where they decided that there was a fatality due to two Borrelia. So it does not seem likely.
[00:19:33.10] Scott: Lots of deer running around with anxiety and depression from Borrelia. What are some of the mechanisms that Borrelia has acquired that allow it to evade our immune system, and then to persist a long term in a human host?
[00:19:48.11] Dr. Chesney: Yes, so it's really interesting. They're just so smart and they've got all these mechanisms. These OSPs, these outer surface proteins. And so depending on the environment the Borrelia is in, it will express these different proteins on its surface, right? So first it's in the midgut of the tick and it's expressing OspA, and it binds to this …, binds to this place on the midgut of the tick. And then okay, maybe there's some change, there's a feeding going on.
So the tick is attached to a host and that Borrelia is noticing this different temperature may be change in pH, and then it's going to be moving toward the salivary glands, and the OspC will be expressed at that point. It's really interesting how it changes and adapts all because it's moving toward that host, it wants to then proliferate out and it can change forms.
The Borrelia we know can change into the round form or cysts form. It creates these little blebs that also spread the genetics of the Borrelia. So they're doing everything they can in all these creative ways to move through our body. They adapt when they go into the joints, into the brain it's really amazing.
[00:21:30.25] Scott: Is there a difference between a Borrelia cyst and what we now call a persister form? Or is that just a new word for what we've been talking about for many years?
[00:21:40.21] Dr. Chesney: I think scientifically the persister form is just meaning they're still finding despite some antibiotic treatment, they're still finding the Borrelia there, right?
And then the question of well, why is the Borrelia is still there is regarding okay, they make biofilm which is the shell that they create around themselves to hide out in that way in little communities, and all the research around bats and how complex these communities are, and that they can change into the ground for when antibiotics come their way.
They change from that spirochete form into that round form or cyst. So they're doing all these different things, right? They're changing their genetics; they're changing their protein on the surface, all these ways that they're adapting and therefore persisting.
[00:22:31.12] Scott: And we thought we were the smarter ones.
[00:22:34.10] Dr. Chesney: They've been here a lot longer.
[00:22:36.08] Scott: Many people say that if you don't see a bull's eye rash particularly conventional medicine if you don't see an EM or erythema migrans rash that you don't have Lyme disease. So in your practice, how often would you say that someone with confirmed Lyme disease actually saw a bull's-eye or erythema migrans rash?
[00:22:54.20] Dr. Chesney: Not that often, definitely less than 50 percent probably less than that. I do see a lot of new cases, and in a way, it's great when the erythema migrans happens because then we know it's there and that we can treat Lyme.
So I treat a lot of folks that have chronic illness, but then I do see people with acute illness. So I think those are the people more so that might change my statistics in showing that I do see people with bull’s eye rashes or Lyme rashes that may not be perfect bull's eyes which is really important to know. But my chronic case is more often than not; definitely, people don't remember rashes, yes.
[00:23:43.05] Scott: One of the really cool things that you do in the book is look at many different types of ticks geographically, and then the potential pathogens they carry. I mean I've seen lots of books on Lyme disease, but this is really interesting the way that you looked at it.
And really helpful for people to consider where they live and what are some of the potential pathogens they could be exposed to if they have a tick bite in a certain area. So tell us a little bit about this, and then how did you compile all of that information Was it from tick testing? Or was it from lab positive cases of people with Lyme disease and co-infections?
[00:24:19.10] Dr. Chesney: Thank you. Yes, I really want people to really stop getting Lyme disease. I've had so many patients that they've gotten to the point where they're feeling well, that maybe they were chronically ill and they're doing well and then, unfortunately, they get a tick bite. So that's what really put me on this journey because my hand out to be involved would get longer and longer.
It'll please take these measures, preventive measures in order not to get a tick bite again, in order not to get Lyme again, etc. So I really wanted people to get as much knowledge as they can throughout the country and Canada because there are so many different ticks. And so I was looking mostly at PubMed a Medline database, and first starting with the CDC information, but then some of that is pretty outdated.
I wanted to get as up-to-date as I could, and then as we're speaking this is becoming outdated as well. So I wanted to be as updated as possible, and create a map regarding tick range. Where could I find this tick? We don't necessarily know like we can't claim that we know those tips have pathogens or not. But just so people are aware of how widespread these ticks are. And in their backyard, or when they go on vacation, what they should be looking for so that they're prepared.
[00:25:39.26] Scott: In doing this analysis, how different are the exposure potentials geographically to different pathogens? Do we find overtime let's say that the soup of microbes in nature's dirty needle becomes more homogeneous?
I'm thinking back years ago where we used to talk about the Babesia WA-1 for example, or Babesia duncani which was more of a Washington state, California, West Coast kind of thing and now we see it pretty much anywhere in the U.S. And so how different are the pathogens we might encounter geographically in your experience?
[00:26:15.05] Dr. Chesney: Well certainly because the deer tick and the Western deer tick or the black-legged ticks are so widespread, and they transmit Lyme. I think that's the biggest problem, right? So when you get into areas where you see that there are more ticks than that, there are many different ticks like down south.
We're in the Midwest sort of the Rocky Mountain area then; you have the potential to have this transmittance of more than one pathogen, many different pathogens if you've had a collection of different tick bites and that sort of thing.
Yes, I think there are pockets where you might see certainly and we do see more of one type of tick-borne illness in another. But more and more, even after Lyme I mean Babesia, Babesiosis, and Bartonellosis which is another story, they're just so common now in my practice. So I think it's a good question, where are we in our clinical experience versus where the research is.
[00:27:24.14] Scott: You mentioned in the book that in some areas, more than half the ticks, you mentioned 56% in one study carried Borrelia.
Let's say we've been exposed to a tick bite, do we think that more often than not people do acquire these infections even if they don't end up with a disease process? And is it possible that there are more healthy people walking around carrying these microbes than unhealthy people?
[00:27:50.17] Dr. Chesney: Oh, I think so. I've had people who are asymptomatic, who really wanted to get a Lyme test because their entire family has had Lyme. And they may come up positive and be asymptomatic; we may do a trial treatment.
Sometimes we may find some symptoms, like one of my approaches is to do a certain type of treatment to elucidate whether there might be Herx reaction, kind of bringing out symptoms. And so we can use that type of a strategy to assess for whether or not someone has Lyme disease.
And I've had plenty of people not have any symptoms, so we think okay well what does this test mean? Most of the antibodies test means that at some point we're exposed, they don't tell us if you have it right now anyway.
If we finally get that culture test back, then we can do that which would be great. But with that information, then it's just looking at symptoms and trying to decipher whether or not they currently have it. And I have had, it was not the most common the part of my practice, but I've had cases like that it is interesting. So I think who hasn't been exposed.
[00:29:05.05] Scott: Yes, hopefully, we'll get that culture back soon. My understanding is that IGeneX is working on it and that it should be available sometime in the near future, I don't know how near. But I do think that that's a work in progress.
One of the hot topics in Lyme disease circles more recently is the impact of Tick-Borne Relapsing Fever Borrelias that can cause diseases similar to Lyme disease. But can be entirely missed by most labs that are looking for traditional Lyme Borrelia burgdorferi for example. So how important are these non-Lyme Borrellias in terms of people's clinical presentations?
[00:29:43.08] Dr. Chesney: Yes. I mean the regular tests, especially if you were to just get an ELISA at a hospital lab is not going to pick up those Borrelia. I do use the IGeneX testing for that, I think looking at symptoms as usual tell us so much. And so if it's suspected I might treat. And if one is treating for Lyme or suspecting Lyme and Tick-Borne Relapsing Fever, it's basically the same treatment, so that's helpful.
And looking at, well so the one thing is that Borrelia miyamotoi is a Tick-Borne Relapsing Fever. So that one kind of throws it off a little bit, because that one is transmitted by a hard tick versus the others that are transmitted by soft ticks.
Where at least at this point, I think about what we discussed earlier in location. But for Borrelia miyamotoi which is in the Northeast and out near you as well, that's going to be difficult to determine is this Lyme, which is one type of Borrelia versus this other, and at the end of the day I feel like the treatment in my perspective is going to be the same.
[00:31:00.18] Scott: And it's interesting even with the IGeneX ImmunoBlot, there are two different tests, right? There's the more traditional Lyme Borrelias and then there's a Relapsing Fever Borrelia panel that is separate.
And so if practitioners are looking just at the ImmunoBlot for more Lyme associated Borrelias, that they have to be aware that there is this other Relapsing Fever Borrelia panel. And my understanding is that the percentages of positives in that Relapsing Fever ImmunoBlot are actually pretty significant.
[00:31:30.27] Dr. Chesney: Yes, we're seeing more of it, and sometimes it isn't supported by that travel or something like that.
[00:31:41.03] Scott: So besides Borrelia and Bartonella and Babesia, which seem to be fairly universal and Lyme disease very common. What are some of the co-infections that you see in your patient populations? Where do things like Ehrlichia or Anaplasma or Rickettsia fall in your clinical practice?
[00:31:59.01] Dr. Chesney: Well, I see those. I feel like viruses, I mean viruses seem to be the most common after the pathogens you've named. So I'm usually thinking about that, I'm often asking about history of mononucleosis, testing for that isn't that helpful, but can you at least support the picture of it. I've had some people with acute IgM, where certain testing results that led me to feel that there was an acute Epstein-Barr virus for instance.
And we do herbal treatments for that and see that people do respond to that which is helpful. So thinking about viruses I think is really important in general Epstein-Barr virus, Cytomegalovirus, herpesviruses and then seeing how many of these might somebody be carrying around with them. And when your immune system is down maybe because of Lyme or other co-infections, and you do have perhaps viruses that are dormant earlier in life, now this comes out.
So a lot of times there are so many layers, and we have to go after many different things over time as things unfold. And as treatments occur and people get better in certain ways, other things can pop up and so okay, look at that that's probably more of a viral load and now we need to go after that. So I'd say in general that's very common yes.
[00:33:33.20] Scott: And would you say that most of the viruses that you see are acquired from the tick exposure? Or are they more opportunistic in that the immune system dysregulation and suppression from Lyme and co-infections allow them to re-emerge where the immune system was managing them fine for years or decades prior to that?
[00:33:55.26] Dr. Chesney: Right, more opportunistic, absolutely. Yes, not tick-borne.
[00:34:00.17] Scott: In one of your talks, I heard you talk about Ehrlichia and Anaplasma being fairly common. I think people don't really think about those as much as Bartonella and Babesia for example.
So I wonder if you could just share with us a little bit about Ehrlichia and Anaplasma, and then is that also one that tends to persist in the system? Or do you believe that Ehrlichia and Anaplasma are pathogens that we can fully eradicate with appropriate treatments?
[00:34:28.10] Dr. Chesney: Usually I see that they're eradicated. You know I would say if I was going to have to get a tick-borne disease, I would probably choose Anaplasma, which I should not say these things. But usually, when I hear patient reports back, it's after they've gone to the ER because they have that very high fever 104, 105.
They feel absolutely horrendous, and they test it's positive for Anaplasmosis; they get treatment and they feel great. And I don't see that with Lyme disease, they may get some treatment, they may feel a little better, they may not. They may feel great, but then they feel worse months later. So it seems at least in this area we have Anaplasmosis not much Ehrlichiosis, and I don't really see Rocky Mountain Spotted Fever.
So those all being related it seems like the Doxycycline seems to work very well. But if the tick had something else like what I have seen and what I feel has been more Lyme-related, is when somebody comes back from the hospital to see me, and they've only been diagnosed with Anaplasmosis and then they're telling me about their symptoms and I'm thinking well, okay.
Certain things are better, but certain things are not so I think maybe you have Lyme as well, and there was some treatment that happened, but they're not getting to the round form, to the biofilm, etc. So we need to do some more treatment, and often I'll move on to herbal treatments, and there's not much overlap herbally with Anaplasmosis and Lyme. So it leads me to believe that it's more of the Lyme, that's the issue at that point or something else if we need to look at others.
[00:36:23.00] Scott: Another topic that you brought up in the book is this idea of alpha-gal that people are hearing more and more about just in the last couple of years I would say. So talk to us a little about what ticks potentially lead to alpha-gal in humans.
Share with us what it is for those people who haven't heard of it, and then for those that do have alpha-gal, what are the implications? What are the treatment approaches, and is it something that can be resolved?
[00:36:49.03] Dr. Chesney: Yes. So alpha-gal syndrome is basically an allergic reaction to a carbohydrate that's transmitted by a Lone Star tick from its saliva, right? So it's a tick-borne illness. But often I think of tick-borne illnesses as infections. So just to make that clear to people, it's not an infection, it's from this carbohydrate carried by the saliva of a tick.
So it's a separate issue you could get all these pathogens from a Lone Star tick bite which we've talked about, and then you could also, unfortunately, get the alpha-gal syndrome. And so it's basically this odd reaction that happens to meat.
So mainly beef, pork, lamb people will get hives, anaphylaxis, very clear symptoms. Immediate hypersensitivity symptoms. And so basically you just need to not eat those foods, which can be difficult depending on who you are. But that would be the only treatment that we have at this point is the avoidance of the foods, the allergens. that become hypersensitive to.
[00:38:03.05] Scott: Does it improve or lessen over time? Or is it still too early for us to really know long-term what the outcomes might be?
[00:38:10.09] Dr. Chesney: Oh it can, it can get better over time as well. I think we need more research in that area. Some people have been able to tolerate some of the foods, while others have not say in a few years after this happens to them.
[00:38:26.24] Scott: And alpha-gal just for people listening, so alpha-gal is named after the carbohydrate that you mentioned which I believe is alpha galactose, is that right?
[00:38:40.15] Dr. Chesney: Oh yes.
[00:38:42.12] Scott: Are there Borrelia species that do not seem to cause any human disease?
[00:38:48.28] Dr. Chesney: Sure. There are nineteen known Borrelia species at this point, and really just four of them can cause Lyme disease. So the others as far as we know do not cause any illness in humans.
[00:39:05.17] Scott: Interesting, cool. Another really cool feature of the book is that you review the potential microbes with the maps with symptoms that those microbes can produce. I think you did such a fantastic job putting it all together. I love at the back even the pull-out card where you can look at the different ticks and types of ticks and those types of things.
In the book, you talk about Rickettsia and Bartonella, and those appear to be the only two that are identified in all states in the continental United States. I know Kris Newby; she wrote a book recently called ''Bitten'' that talks about Rickettsia and this “Swiss Agent” as she terms it as potentially playing a very major role in Lyme disease, maybe even more so than Borrelia. And so I'm curious where do you think Rickettsias fit in terms of the Lyme soup that lead to disease?
[00:39:56.07] Dr. Chesney: That's a great question. Through my research and thinking about this and thinking about STARI, I just really wonder; they still haven't really figured out and agreed upon what is the pathogen. So I think that leads us to wonder about what you're bringing up, and in the area that we see STARI.
So is it Rickettsia that's basically what I was thinking, is this in Borrelia or is this a Rickettsia illness or some kind of hybrid, who knows? So that was interesting. But most of the people that I see, and I think mine is still the top disease certainly with the statistics we have and my clinical experience, and that of colleagues, I think Rickettsia needs a lot of attention as well.
[00:40:50.18] Scott: In the book, you talk about the reduction of the tick populations as one of the key strategies for preventing Lyme disease. So how do we reduce tick populations? What are some of the key strategies that you think people should prioritize in this realm?
[00:41:06.01] Dr. Chesney: Yes. Well something I'm passionate about is the tick tubes, you probably know about that. So just thinking about that mouse population that we were talking about, how ticks first get Borrelia or whatever pathogen from a mouse most likely.
So there's a study done and it showed that when you use tick tubes, that it reduced the tick population by 93 percent, it's huge. So basically what they are is you can make them yourself or you can buy them, you can save, it's a great project with kids during those schooling times we're in. You can save your paper towel tubes or toilet tissue tubes and then get some permethrin.
[00:41:56.16] Scott: That's why everybody's buying all the toilet paper.
[00:41:59.01] Dr. Chesney: Yes, that's it, that's what it is. They're thinking about not getting Lyme. So you can save your lint from your dryer, or you can get cotton or some kind of material like that, that will absorb this permethrin. You treat that, you put it in the tubes and you put the tubes out in mouse habitat, and then the mice can bring that back to their nests and it kills the ticks on the mice.
So it's really effective, I've had patients do this and report back from one year to the next and this year we don't even see ticks, and they can't believe it, because they were getting tick bites all the time. So it's really effective great, pretty easy to do. So I highly recommend that. And then so other things like thinking about just landscaping, some basic things that most people know about how ticks love moisture and darkness.
So thinking about if you have a yard, the landscape, what you can do in your landscape. So trying not to have a lot of debris or if you have leaves rake them up and take care of that. If you have wood be, really careful with wood stoves, like bringing in wood to the house. And thinking about just all these things with your property basically, and trying to make it a tick-free space.
[00:43:29.08] Scott: One of the other things I learned from the book was the impact of barberry on tick populations. I never realized that there was actually a substance that the ticks liked and then come into your yard because they want this particular plant. Am I understanding it correctly?
[00:43:46.25] Dr. Chesney: Yes, well they just love it, it's a great habitat for the ticks because it's moist, it's really moist under there. And so it's funny there's a map that I included in the book, it's really not funny but interesting that there's this coincidence that the barberry map of the United States is almost identical to the Lyme disease map of the United States. So that really hit me when I was researching.
[00:44:14.07] Scott: The other thing that you pointed out that resonated with me personally because my tick exposure actually came from a dog that had gone outside and brought it into the guest bedroom of a home I was staying at for a work project many years ago. And so you also talk about how important it is to keep ticks off of pets so that they're not bringing it back into the home.
[00:44:35.19] Dr. Chesney: Right, yes. So pet owners are two times as likely to get a tick crawling on them, and one-and-a-half times as likely to get a bite, so that's really important to note. So many of my patients that have had tick bites have dogs, cats; as well as just thinking about activities that you do and where you live. Horses, certainly this increases the possibility for tick bites.
So thinking about things you can do, of course, you can talk to your vet and do some treatments for your pets. And even thinking about something like a permethrin-treated bandanna around dogs necks works really well. Thinking about using one of those rollers on the lint rollers on the dog when it comes in to see if you pick up some; combination.
I always encourage people to think about a combination of strategies in order to prevent the bites, right? So there's looking at the landscape, okay, do I have pets, what am I going to do about that? How about tick repellents, probably talk about that a little bit. How do I treat my person, make sure to do tick check, put the clothes in the dryer. So there are all these different steps that we can take and make more of a habit in our everyday lives to really cut down the chances of a tick bite.
[00:45:59.10] Scott: So let's talk about that a little bit. When we go out hiking or spending time in nature. What are the most important considerations to avoid those few hours of fun turning into a lifetime of misery?
[00:46:12.06] Dr. Chesney: Yes, definitely. So thinking about repellents, so of course, there's DEET if you want an alternative I like to use Cedarcide. Cedar essential oil has been shown to repel ticks very well. You do need to apply it more often, so every one to two hours I recommend that. And then thinking of that for your skin that would be safe for your skin with the Cedarcide.
And then thinking about clothing, permethrin again like we're using in the tick tubes, we can treat our clothes with that, treat our shoes with that, and basically just to make sure to be careful with the permethrin. Wear gloves if you're treating something, because it is toxic to our skin, so that's really important. But once it's dried, it's no longer toxic to us.
So just when you when you do it go outside, don't have kids or animals that you care about near it, and then let it dry. It only takes an hour or so to dry, depending on how humid it is, and then that would be safe for use. And if you do it yourself like I always get the shoes out every six weeks. It's every six weeks; put it on the calendar, spray them down, and then you know you're protected in that way.
Because really the shoes and the socks, that's huge and actually you're 73 times less likely to get a tick bite if you treat both shoes and socks. So that's huge. So you may want to do more than that, but if you think about walking through grass sometimes we think oh if the grass is short, there are no ticks there it's okay, that's not true. So it makes it less likely for ticks to be there.
So like I'm saying all these things in combination are going to put you in a better place, but walking through grass or having a shrub rub against your shoe or your lower leg, then you'd be protected against that, which is more often where they come, these ticks are low to the ground and so they're going to be coming. Looking for somebody lower to the ground, unless they come in on a dog or something.
[00:48:24.12] Scott: Another really cool option that you shared in the book as a resource is a service where I can send my pants and shoes and socks, and actually have them apply an insect shield to them, which seemed like a really cool service. Tell us a little about that.
[00:48:41.13] Dr. Chesney: Yes, it's great. Actually, I just had a few things that arrived in the mail yesterday. So you can actually send your own clothing in or a sheet. Like I have my permethrin sheet that is in the car so that for some reason I'm somewhere, planned or unplanned, and want to be on the grass, I put it down, have a picnic, great. So it's great to be able to actually just send your clothes or materials so that they get treated because it lasts longer. So I was saying before if you treat your own shoes or clothes, it's only going to last six weeks. But insect shield, for instance, guarantees it lasting 70 washes.
[00:49:27.29] Scott: That's pretty cool. Yes, so for people listening InsectShield.com if you're interested in that service, I loved it. I mean it's just one of so many resources that you packed into this book, so people definitely get, this is a book you want to have before you get a tick bite, so that you know what to do and have all the resources.
Let's say we're out and we do get a bite, what then are the next steps? How do we properly remove a tick? And I'm a little embarrassed to say that when I got my tick bite, I immediately went and found a match and tried to burn it out, and this is 23 years ago, but completely the wrong thing. So if I do see a tick, what should I do?
[00:50:06.15] Dr. Chesney: Yes, well avoid the match definitely. And what I love are tick twisters, so it's funny somebody brought in one and they thought they had an O’Tom the Tick Twister, which is actually from France that I happened upon that work really well. But they had an imitation, and so they couldn't get their tick off.
And I was disappointed thinking oh, I was really trusting this product. But it was a different product, and the tick went right through the times. So this O’Tom the Tick Twisters, sort of this little handle with the sliding device that goes right under the tick. So that's the tick, it would go right under there and you twist it and it comes right off. And actually, it comes off really easily most of the time. So it kept missing it and missing it, so then I got mine out and it worked.
The O’Tom works really well. And tweezers, I mean in the beginning I uses to use tweezers, and it's so easy to mangle the body of the tick. And if you're thinking about well the tick is feeding basically, you're trying to get it off. So anything you can do not to agitate it like vaseline or a match or the tweezers, oh it's hard, it's taking us a long time to get it off; the tick twister does it really gently and easily. So I highly recommend that, yes.
[00:51:34.04] Scott: Plus that's an option that actually gets the head or the stinging pieces out as well, right? Sometimes with tweezers, it seems like it'll break off and then you're still stuck with part of it left in the body, very cool.
How do we determine after a tick bite when prophylactic treatment is appropriate to minimize potential longer-term consequences? Should we test the tick first, or should we start doing some herbal therapies right after a bite for example?
[00:52:01.01] Dr. Chesney: Yes, so there are a few ways to go, I do recommend the tick testing, TickReport.com is amazing. They're in Amherst, Massachusetts at UMass. It's really interesting if anyone's interested, they have a whole database they've been collecting this since 2006, collecting tick data from people who have sent them in.
So you can actually look that up and see where you are, and look at the area and what ticks are carrying there. But so there are different tiers of testing, well for a deer tick in this area where I am in the Northeast, the first tier is just fine. But it all depends on what you're wondering, what tick it is and what pathogens you're wondering about.
So that first level is $50, so tests for all Borrelia species and then the particular Lyme, Borrelia, burgdorferi and mayoni, Anaplasma, Ehrlichia, Babesia so that's really pretty comprehensive. It does not test for Powassan that would be the next year, the hundred dollars one. So Powassan virus I think it's important to know about, but it is pretty rare. So you think sometimes it becomes a financial decision for people.
So if you can test the tick financially, I would definitely recommend that. Although I've had some people say well I saved this one tick, but two weeks ago I had this other tick bite and I didn't save it. So if we're talking about multiple tick bite, just knowing that it's only going to give us information about that one that you see which is important to note.
If you think you've had other bites, then this information is less relevant, and I would probably just go for the prophylaxis or test it so you know what it was caring, knowing there are other ticks that you've had that you did not save. This is actually come up a lot lately this month in practice. So then starting with prophylaxis would be important. But you can also use what the tick is carrying to guide your treatment.
So if we knew that the tick was just carrying Lyme, then we might do something more targeted to Lyme. So for instance, the Deer Tick Bite formula or Black-Legged Tick bite formula would treat all the pathogens that are carried in that type of tick. But if you know that your tick was only carrying one or two of those pathogens, then you could certainly gear that, focus that treatment which I do with people.
So it sort of depends on at least when I meet the person on their journey of the tick bite, and if they're symptomatic then we're in a whole different category. So you could always start the prophylaxis as well and send the tick out. The tick takes about three days to get back for that company anyway. So three days I think early in after a tick bite is not too long to wait if you'd rather find out. Maybe the tick isn't carrying anything that would be great.
[00:55:05.18] Scott: So if I lived in an area that has lots of ticks, is it potentially wise to use herbs throughout the entire high point of tick season? Or is it better to wait until you think you might have had an exposure?
[00:55:20.11] Dr. Chesney: You can also use it that way, absolutely. So I work with people who are at high risk for tick bites: farmers, loggers, linesman. I think if you're at high risk it is something to consider. You can take a Deer Tick Bite formula or whichever tick formula is appropriate for you during tick season, which again we talked about whenever it's warm enough for the ticks to be out.
And you can stop and start that's fine if you're farming at a certain time of year, you're only working outdoors or highly recreational for a week. You go on this trip and you want to take it during that week, you can do it like that.
[00:56:00.16] Scott: If I am considering starting something for prophylaxis, would that generally be herbal? Or is there a place for antibiotics in a prophylactic strategy before I know whether the tick had anything, before I have any symptoms?
[00:56:15.07] Dr. Chesney: I don't use antibiotics as pure prophylaxis. If somebody develops symptoms, then we're in a whole other camp and then we talk about that. I do use antibiotics early on in treatment. But for prophylaxis, I stick to the herbal regimen. Which I must say these herbs are first of all getting to the round form of Lyme which say like the one or two-dose doxycycline does not get to that round form.
And to the biofilm some degree, I also add a biofilm buster onto that as well sometimes, and especially if there are symptoms. And then it gets to all these different pathogens, but then it's also helping your immune system work better. So in the face of Lyme, antibiotics as far as we know are not helping immune modulation like say knotweed, Japanese knotweed, or Cat's claw.
And they do for concern over neurological symptoms, andrographis and knotweed; these are herbs that can go through the blood-brain barrier. And so I mean there's so many different properties of herbs which is so wonderful because they do more than one thing; they're not just engineered to kill this one bacteria in a certain way. So I think that's really helpful to have all those strategies on board early on, whether you're symptomatic or not.
[00:57:47.28] Scott: Yes, a hundred percent agree. I think herbs are amazing and have a fantastic potential here to really save lots of suffering and misery later after an exposure to a vector-borne pathogen.
After a tick bite, would we generally be thinking of only oral interventions? Or are there any topical tools that one might use at the actual site of the tick exposure?
[00:58:12.29] Dr. Chesney: Yes, I recommend andrographis to the tick bite wound, that is specific to killing Lyme. So you could also use the tick bite formula that's appropriate to the tick bite, and just put two drops right on the wound. I've had good feedback talking about people feeling like they've been healing better, which is interesting and aside to the actual infection piece.
Because some people find the bites are itchy or they heard or they take a while to heal and sometimes people have reported that. I tend to get tick bites that then itch me, and when I put the andrographis on, its healed up and I actually didn't have that itchiness. And I don't think we know why some people have the itching or the extra inflammation just locally around the tick bite compared to other people, but it’s seemed to help in that way.
And I mean the point of putting that on is more so about how when a tick attaches, it can release feces onto the skin, and in that feces can be these tick-borne diseases. So if you have a bite and then you remove the tick and it's itchy, and then you bring in the feces there can be another exposure to the tick-borne disease. Lovely image, I know.
[00:59:38.16] Scott: It's interesting, yes.
[00:59:41.07] Dr. Chesney: So I always think about quick removal, quick gentle removal with the O’Tom Twister, and then put the andrographis right on, don't touch it, don't scratch it that sort of thing.
[00:59:53.14] Scott: Do you find that those people that have that exacerbated itching type response, are they also then the patients that are more likely to have mast cell activation syndrome and histamine intolerance? Or have you not necessarily seen a correlation?
[01:00:06.06] Dr. Chesney: Oh, that's a good question. I don't think so, yes I haven't, I haven't noticed that.
[01:00:11.22] Scott: One of the things that you so use in your prophylaxis approach our homeopathic remedies, and so as a naturopath in the work that you do. I love naturopaths; I mean I think that everyone with a tick-borne infection should have a naturopath on their team because we need to look really holistically. And so talk to us a little bit, what are the homeopathic like Ledum and Apis doing in these prophylactic protocols.
[01:00:34.21] Dr. Chesney: Yes. So the next step after putting the andrographis on, you could take Ledum for a tick bite, and so homeopathy is a entire branch of medicine unto itself, that's fascinating, but basically, it's this energetic medicine. The Ledum can help basically in an energetic way also in a way to help the immune system deal with this tick bite. So it would be three pellets under your tongue, three times a day for three days.
And then Apis, basically the profile of when to use Apis in that world would be for something that's swollen and red and hot and that sort of thing. So if you did get a Lyme rash, a bulls-eye rash or otherwise that's red or swollen, hot to touch.
Or if it's really just locally, even if the bite itself, if you are somebody who feels like there's a lot of itching sometimes that comes with this redness and burning or heat that would be a sign that Apis would be helpful. And you can do both of them together three pellets, three times a day for three days.
[01:01:46.09] Scott: In the book, you talked about so many different herbal formulations like the Deer Tick Bite formula, the American Dog Tick Bite formula, the Lone Star Tick Bite formula, I mean on and on there's a whole list of these things that have been put together.
So talk to us a little about some of these herbs that are potentially helpful for people that are dealing with tick-borne infections that are in these formulas. How might they target specific pathogens that are observed in various types of ticks, and then are these formulas something that people can purchase pre-made, or do they have to make them themselves?
[01:02:21.18] Dr. Chesney: Yes. So I first started with, well I just called the Tick Bite formula several years ago with patients who were getting tick bites. And I was thinking about this idea of prophylaxis and being proactive, I certainly would be. And some people may or may not choose to be and that's okay. But if people want it to be to start doing that and we have tick bite clinics at the Sojourns Community Health Clinic where I work in the Vermont and became really passionate about really bringing attention to the acute illness and the tick bite, versus most of my time being spent with those with chronic illness.
So trying to really make time and a schedule to also see during tick season, which we see more all the time, but certainly more during the warmer weather starting around this time. So that we can really get to that infection early so that we can prevent the chronic illness later. So yes, so I work with the herbalist Bonnie Bloom, who’s wonderful. She's got so much knowledge and passion for treating Lyme as well.
So through research a lot of Stephen Buhner's reading and other information that I picked out the specific, and also thinking about side effects and making as safe as possible. All these different components to come up with this formula. So basically you know thinking about it's interesting, Cryptolepis there was a study showing that is used, so Cryptolepis treats malaria, there's a lot of research on that.
And then there's even the study showing that it is used in prophylaxis. So, people who are on Cryptolepis this herb from Africa, they would be less likely to get malaria. So it was actually used in that way, so I thought well this is this is great having that after I've already been using with people. So I'm kind of applying that idea I think, the idea of prophylaxis but using herbs. And so Cryptolepis more recently, there's an article out which is amazing that it actually treats Lyme. So I usually use it in Babesia treatment, a malaria-like a tick-borne disease.
So it's also showing that it kills Lyme which is great. So I think that's a real powerful piece probably of this Deer Tick Bite formula, and then there's knotweed which I mentioned earlier. So it crosses the blood-brain barrier, has a lot of immune modulation.
I use it a lot as a support some people, not just thinking about that antimicrobial piece, but also just how supportive it is for the neurological system, for joints, for endothelial cells, and all these different pieces. Japanese knotweed is pretty amazing, yes. So we started with Deer Tick Bite formula, and then as I was writing this book I was thinking well, I definitely want to give other people and other areas with different ticks the ability to do the same thing. So I started drawing up these different formulas, so that would be applicable per tick.
[01:05:48.08] Scott: So can people get those directly from Bonnie? Or do they have to get them through a health care provider?
[01:05:55.19] Dr. Chesney: They can get it through Bonnie Bloom, who's at Blue Crow Botanicals in Massachusetts. They could get it from the Sojourns Community Health Clinic, or they can buy like in the book, in the back they're different companies like Woodland Essence or Herbie’s Herbs, there are these different companies that you can buy one tincture from and then make your own.
Or you can also; I mean you can also buy the raw material, right? If you really wanted some homework and so I include with gratitude to Bonnie Bloom her process in making the medicine. And really it's not just a generic kind of medicine making approach, it's very particular to how each of these herbs needs to be treated and what constituents were looking for.
And so it's not that easy really getting into the details with her brought even more gratitude for all the hard work that it takes to make these formulas. So if you're a herbalist already or if you're into learning something new like this, you can totally do it yourself and so there are instructions how to do that. But it might be hard for a lot of us.
[01:07:20.18] Scott: If we look at something like the Deer Tick Bite formula, it makes a lot of sense that if you just had an exposure that that's very broad in its coverage.
Let's say someone has had chronic Lyme disease for 15 or 20 years, would you necessarily then use something like the Deer Tick Bite formula? Or would you use things that were more specific to Bartonella or Anaplasma for example and unlayer things? In other words, would people with chronic microbial burdens be able to tolerate these broad-spectrum formulas?
[01:07:52.21] Dr. Chesney: Yes. With a chronically ill patient that I am treating for tick-borne disease already, we may not need to even do deer tick bite formula. So I would look at what they're taking, and maybe we would add something like yes if they're not being treated for Anaplasma, maybe we'll have that conversation. So he had this tick bite, we tested it, it was positive for Anaplasma. We could then do one month prophylaxis with Anaplasma formula, which has a host of herbs in it for Anaplasma, so that would be an option.
But if they're already being treated for Lyme, we may just boost in that treatment or we may just leave it alone and see and watch and wait if anything comes new from the bite. But I've also had plenty of people, want to do that extra now, let's just do the tick bite formula. I got a tick I didn't save it; I definitely want to do everything I can right now.
And they've Herxed, right? Because we're adding treatment. So if they already had Lyme, Babesia or Bartonella, knotweed treats Bartonella so they might have a Herx on that. And so we know that we have this conversation we know what to expect, and we might have to pull back if it's just too much for them.
[01:09:13.17] Scott: So let's say we had a tick bite, we've started the herbal prophylaxis program. What do we then watch for to determine when a doctor should be contacted and things might have gone beyond this prophylaxis and potentially into the need for personalized treatment or therapeutic interventions?
[01:09:30.19] Dr. Chesney: Right. So I think once symptoms come, I mean if somebody does not have a practitioner on board at all, I would encourage you to reach out to a Lyme literate practitioner if possible, or at least your primary care practitioner or somebody in the medical field if you start developing symptoms after a tick bite.
[01:09:59.00] Scott: So let's say I do develop some symptoms, how does the treatment then shift from prophylaxis to more of an acute treatment strategy? Are there different things then that you're considering in that acute treatment strategy phase?
[01:10:12.03] Dr. Chesney: Right. So then I want to try and get as clear as we can about the symptoms. I want to evaluate whether or not we need to do some testing, which depends on how long after the bite it is. Like say with Anaplasma again, it's often pretty straightforward. There's a PCR test that you can take in the first week of Anaplasmosis, and it's pretty accurate and after that, you can do antibodies testing.
But between their acute symptoms, I don't know it's like high fever, headaches and yes it can also be either joint and muscle pain, flu-like symptoms, then that's a little more Anaplasmosis. And so we can talk about testing, and then Lyme, of course, we wouldn't test until three or four weeks later.
So if they're already sick, it's all about trying to see with this individual, like where are you on this journey, do you have symptoms? Does it make sense the test, is it too early? All of that. So we would think about that. And if we had a positive or if we had a Lyme rash, then we know it's Lyme, or if you had a positive Anaplasma or something like that, then we would definitely talk about incorporating antibiotics at that point and making sure there's a biofilm buster as well.
[01:11:34.25] Scott: So then in terms of testing, what are some of the tests that you find most helpful in your clinical practice? Are you generally looking at direct tests or indirect tests? And then maybe you can elaborate a little bit more around how much time after the bite do we potentially need to wait for certain tests to be even valid? So could I run any of these tests a week later, or do you need time for the immune system to create antibodies for an indirect test to potentially show a positive result?
[01:12:05.02] Dr. Chesney: Right. So with the Lyme, you need three to four weeks, Anaplasma, the PCR is fine in the first week and then after that, it would be antibodies IFA, IgG, IgM.
And so looking at different companies for the Borrelia burgdorferi would be the most common discussion that I would have, for Anaplasmosis or Ehrlichiosis, Rickettsia, the regular labs are just fine with accuracy. But it's more about the Lyme disease or Tick-Borne Relapsing Fever, where I look at using a lab like IGeneX for a better accuracy.
[01:12:52.20] Scott: And how about Bartonella and Babesia?
[01:12:55.27] Dr. Chesney: Yes, and the same, yes. I like to use IGeneX the FISH technology, the fluorescent institute hybridization which tags RNA. And so basically from Babesia and Bartonella, we use the FISH technology, we can find out whether somebody has a current active infection. So that's also really helpful anyway whether somebody's acute or chronic. Lyme disease is a little trickier, but the ImmunoBlot has been really helpful.
[01:13:32.02] Scott: The book doesn't really go into a lot of the chronic Lyme treatment strategies, it's focused on prophylaxis and acute treatment and ticks and prevention. I mean the title of the book is really focused on prevention which is fantastic.
But you as a top clinician in this realm, I'm interested when you're in the chronic Lyme realm and someone's dealt with this for fifteen or twenty years, what are some of the top interventions right now that really excites you as the practitioner?
[01:13:59.19] Dr. Chesney: Well, I use a lot of herbal medicine and as a naturopath, I look holistically at people. So I'm always looking at well what else could be going on, what are we missing, mold illness is huge, mast cell-like you mentioned before. I mean even just you have a thyroid, the low thyroid function. There are so many pieces looking at the whole person making sure they're not missing anything.
You know are you sleeping how is your stress, how are your relationships? Looking at diet, there are all these different pieces that are so important. For treatments, we're a non-profit clinic; I don't do anything too fancy, we don't have the means to do a lot of expensive treatments.
So I don't have a lot of experience beyond oral treatments, except for hyperbaric oxygen which I've seen great things with. So also yes, I've had people do really well with hyperbaric. And now I'm using Disulfiram, although it's been hard to get. So I've had to pause a little bit on getting new people onto it, but I've seen really great things. So that's been great.
[01:15:17.29] Scott: Yes, it's exciting having myself observed the Lyme realm now for 15 years. It's really the first time that it feels very hopeful that we have new tools and strategies like Disulfiram that are really making a difference. I mean not that people didn't get well in the past, but that there was some degree of managing chronic Lyme longer-term and that maybe we didn't actually eradicate it completely.
But with Disulfiram, it sounds like that's potentially different that people do have these very long-term remissions. And so I think for people that are just finding out that they maybe have chronic Lyme disease, I think it's a very hopeful time in the timeline of Lyme disease to be hopeful about having the real possibility of getting well.
[01:16:10.05] Dr. Chesney: Yes, it's exciting. It really is.
[01:16:12.09] Scott: Yes. Where do you recommend people go to find practitioners that treat Lyme disease in a similar manner to what you do, or that are really skilled in treating Lyme disease?
[01:16:21.08] Dr. Chesney: ILADS is a wonderful resource, so ILADS.org. There's also the Global Lyme Alliance and LymeDisease.org as well. So those are three great resources where you could just ask for a referral of a person in your area or a list of practitioners in your area to link you to Lyme literate practitioners.
[01:16:46.23] Scott: And I know you're also involved with ISEAI or the International Society for Environmentally Acquired Illness, which lots of the practitioners there are also are familiar with Lyme. But to your point also really exploring the potential for mold illness and the environmental aspect of all of this.
So I think ISEAI.org, ISEAI.org, there's also a list of practitioners there that could potentially be helpful for people.
I really want to urge people to get this book as a resource, so that you have it on hand when you need it. There's just so much good information in the book. We couldn't even begin to cover it in this conversation, yes fantastic. Tell us how people can find the book, and any other resources that you want to share that might be helpful for that.
[01:17:35.06] Dr. Chesney: Yes. So you can get the book at your local bookseller, your library. You can go online to Amazon or Barnes & Noble or Indie booksellers. So it's readily available if you ask. You can also if you'd like a signed copy, you can go to my website DrAlexisChesney.com click on book, and then there'll be a link that if you so desire, you could purchase a book that is signed.
Sojourns Community Health Clinic is also carrying the book. And if you would like to carry the book, you can contact the publisher which is Storey Publishing. So that in your office or in your community space, if you wanted to do that you could.
[01:18:24.29] Scott: And if for some reason you didn't get the book, and you got a tick bite and then you need the book, you can go on to Amazon and buy the Kindle edition and have it available in just a couple of minutes which is what I did. So yes, it's really a great resource.
The last question that I ask is the same for every guest, and that's what are some of the key things that you do on a daily basis in support of your own health?
[01:18:47.28] Dr. Chesney: Well, my new addition is I just got this little mini trampoline, because of all the telemedicine I'm doing. The first week of that I realized I was not moving much at all. So in-between visits, most of the time if I have even 30 seconds, I'll just be on that which has really improved I think my circulation and my mood, my focus; so that's been awesome this past week. But other things that I do, exercise is really important to me.
I happen to enjoy it, and I'm glad for that. Also, just spiritual health is really important to me, so I have a meditation practice, I do yoga every morning. So it gives me a little of that exercise but also that grounding I need in myself, in order to them hold space for other people. And yes, I take a list of supplements, of course. Reading this great book the Energy Codes really fascinating, Sue Morter; so that's a little bit of intellectual interest, but also self-care so.
[01:20:05.05] Scott: Beautiful. This has been a really fun conversation. Again, I'm really excited about the book, I do hope people will go out and get it. There's just so much good information in it, and looking at things from a slightly different perspective that I've seen them before with the maps and charts and all of that, I mean it's just a fantastic resource.
It's obvious to me from our conversation that you have a lot of passion for really helping your patients, and minimizing their struggle and giving them resources. And so I just want to thank you and honor you and I appreciate you taking the time to share with all of us today, so thank you, Dr. Chesney.
[01:20:38.23] Dr. Chesney: Thank you, thank you so much for having me. Thank you for your work.
[01:20:42.18] Scott: To learn more about today's guests visit DrAlexisChesney.com That's DrAlexisChesney.com, DrAlexisChesney.com.
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