Office Hours: That Tick Bite You Forgot Could Be Destroying Your Health

Mark Hyman, MD

Dr. Mark Hyman is leading a health revolution—one focused on using food as medicine to support longevity, energy, mental clarity, happiness, and so much more. Mark Hyman, MD is a practicing family physician and an internationally recognized leader, speaker, educator, and advocate in the field of Functional Medicine. He is the founder and director of The UltraWellness Center, Founder and Senior Advisor for the Cleveland Clinic Center for Functional Medicine, a sixteen-time New York Times best-selling author, and Board President for Clinical Affairs for The Institute for Functional Medicine. He is the founder and chairman of the Food Fix Campaign, dedicated to transforming our food and agriculture system through policy.

He is a co-founder and the Chief Medical Officer of Function Health. He is the host of one of the leading health podcasts, The Dr. Hyman Show with 150+ million downloads. Dr. Hyman is a regular medical contributor to several television shows and networks, including CBS This Morning, Today, Good Morning America, The View, Fox, and CNN.

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Full Transcript

Automatically generated. Please forgive any typos or errors in the following transcript. It was generated by a third party and has not been subsequently reviewed by our team.

Dr. Mark Hyman
What if the fatigue, the brain fog, joint pain, or these mysterious symptoms you've been chasing for years don't chase back to stress, aging, or burnout, but to a tick bite you don't even remember? Nearly half a million Americans are diagnosed and treated for Lyme disease every year, and it remains one of the most misunderstood illnesses in medicine. And many people never see the bull's eye rash. Others are told it's all in their head. And for some, the symptoms persist long after treatment ends.

Today, we're going deep on what Lyme is and what its co infections are and why they're so often missed, and most importantly, how we diagnose and treat them comprehensively from a functional medicine perspective. We're going to cover herbs, supplements, the roles and the limits of antibiotics, and a few innovative therapies that are generating real interest that I think need a lot more research, but that are, I think, hopeful and promising. And I've used a number of patients who've been successful, including things like ozone, hyperbaric oxygen therapy, and hyperthermia, which is inducing the temperature of fever, with honest caveats that each one deserves. Now, if you're worried about prevention, you're newly diagnosed, or you're still searching for answers after years, this one's for you. So let's dive in.

What is Lyme disease really? And why it's rarely just a thing by itself. It's usually a part of a complex dysfunction in your body. Lyme disease is an infection that's primarily caused by a corkscrew type bacteria or bacterium called Borrelia burgdorferi. It's transmitted through the bite of an infected blackleg or deer tick.

Now, part of what makes it so tricky is that the bite usually goes unnoticed. These ticks can be the size of a poppy seed and most people never remember being bitten. Early on, Lyme can look just like the flu. Fatigue, chills, fever, headaches, muscle and joint aches. And I saw a lot of these people in Nantucket when I used to work in the emergency room there and they'd come in with acute It's pretty classic, but most people never get that.

Some people get a classic presentation, but many people don't. Some people get the classic bull's eye rash, but here's a big myth I want to bust. Most people don't get that rash and not every rash looks textbook. No rash does not mean no Lyme disease. As it spreads, Lyme can reach everywhere in the body.

The joints, nervous system, the heart, your immune system. You can get migrating joint pain, brain fog, sleep disruption, nerve pain, palpitations, and a bone deep fatigue that sleep doesn't touch. I personally had Lyme disease and I've had one of the co infections called Babesia, it's awful. And I had most of those symptoms and they're not fun. Now here's the part conventional medicine often misses, and it certainly missed it in me.

I often use my own healing as a way of helping others because I learn what works and what doesn't. Conventional medicine often misses that the ticks rarely carry just one organism. A single bite can deliver lots of co infections. So doctors, I'll check for Lyme, but that's fine, but they missed all these other infections. You might actually not have Lyme.

You might have Babesia or Bartonella or Ehrlichia or Anaplasma or Mycoplasma. These can dominate the picture. Babesia, which is a malaria like parasite, I have that one. It brings air hunger, night sweats, chills, and a heavy, can't catch my breath fatigue. I mean, just so deep fatigue.

Bartonella, another one, often shows up as anxiety, or rage, or mood swings, or other weird neuropsychiatric symptoms. It can have foot pain. It's worse in the morning. It can cause stretch mark like skin striae or skin lesions. Ehrlichia and Anaplasma can look more like a severe flu, sometimes with low blood counts.

That's why two people with tick borne illnesses can look completely different, and why so many people get passed from specialist to specialist without a clear answer. Now their symptoms don't fit in one box. So how do we diagnose this? Well this is where functional medicine thinks differently. Chronic Lyme is almost never just Borrelia or Lyme.

It's a web of overlapping drivers, multiple infections, immune dysfunction, inflammation, environmental toxins, mold, I had that, food sensitivities, nutritional deficiencies, mitochondrial dysfunction, hormonal imbalances, sleep and autonomic problems, and gut dysfunction. Pretty much everything. I always think of syphilis as a diagnosis we learned in medical school that caused everything. Lyme disease is like that. It just causes everything.

It's also a spirochete. It's also this curly, squirrelly, kind of curly bacterium, which is like syphilis. But it's not sexually transmitted. Well, although sometimes people say it can't be, but that's another topic. Now these infections rarely travel low, which is exactly why a single cause, single drug model often falls short and fails to get these people better.

A careful symptom inventory is really important across all these symptoms. It often tells me more than any one test. Now in testing, I'll be honest about the limitations. The standard two tier approach was something called an ELISA test followed by Western Blot. It's designed for surveillance.

It's not for catching every case. It misses early infection. It misses patients who don't actually mount an antibiotic response. So I read it carefully. The IgM and IgE bands, including species specific bands that strict CDC criteria about, I I pay attention to all of that.

And when the picture warrants it, I use specialty labs like Hygenx or Infecto Labs or Galaxy Diagnostics that test more broadly, and I test specifically for co infections. Like Babesia, I use a smear, I use something called PCR, measures for the actual organism DNA, for antibodies as well. And I remember also that there are different species. For example, Babesia has Babesia duncani and Babesia micrati. So you've got to check for all the species.

There's lots of Borrelia species. It gets quite complicated. So you really need a doctor who knows what they're doing. Barnella, very hard to capture on antibody testing. Anaplasma and lichi are important, but again, the tests are not perfect.

Test result is only the beginning. From a functional medicine lens, I'm also assessing the whole terrain. Inflammatory markers, cytokines, immune function, looking for mold, mycotoxic exposures, looking for heavy metals, looking for nutrient status, hormones, mitochondrial function. Because the real question isn't only is Borrelia present or Lyme, it's why is this person's body unable to recover? Treating Lyme and co infections is important.

Now there's a comprehensive approach I wanna go through here. And it's not the same for everybody, so it's very personalized. I want to be far more thorough than we'd go to in the usual conversation about Lyme because Lyme is really one drug for a few weeks, which is what traditional medicine believes, right? Just take doxycycline for three weeks, you're done, that's it. Doesn't work usually unless you have acute Lyme.

Then it usually works. Conventional medicine asks the essential first question, how do we eliminate the infection? And it's right to do that, okay, but functional medicine adds a second question. Why are two people exposed to the same organism having such different outcomes? One recovers in weeks, the other is struggling for years.

The answer usually lives in the whole system. So we treat on several fronts at once. We reduce the infectious burden, right? For early localized Lyme, that's conventional antibiotics, doxycycline, amoxicillin, cefuroxime, they're generally effective and well worth using. I mean, I'm definitely down on antibiotics for this if you get early.

Caught early, a focused course is often curative. I never want anyone to skip appropriate treatment for acute Lyme. Really important. Don't go, I'm going take herbs for that. Don't do that.

It's too serious on the other end. And this is this is now this is where I part ways with a purely conventional approach. It's when we deal with chronic persistent illnesses, which people, many people in traditional medicine don't even believe exists. Chronic Lyme disease doesn't even exist. It does.

I had it. Trust me, I know it does. And I've treated hundreds, if not thousands of patients with But here, I lean far less on long escalating rounds of antibiotics and far more on a broad integrative strategy. And part of the reason is biology. Borrelia doesn't only live as the familiar spiral.

Under stress, it shifts into a dormant round body form, and it hides inside biofilms where antibiotics really struggle to reach it. And where repeated prolonged courses of antibiotics often disappoint while disrupting your gut, your microbiome in the process. So they cause side effects and they don't really work. So for persistent disease, I think in terms of a layered arsenal with antibiotics as one tool among many rather than the whole plant. Co infections still need targeted treatment because while clearing the Borrelia is important, while ignoring the B.

C. Or Barnella, that's gonna stall your treatment. You've got to deal with all the infections. Here, both worlds have something to offer. Babesia, prescription antibiotics like atovacrone with erythromycin, which is what I took, alongside herbal antiparasitics like cryptoleptis or artemisin, which I also took, did help.

Bartonella, also antibiotics can be helpful, such as antibiotics like rifampin and azithromycin, and botanicals like Ceta, Acuda, and other ones that are very helpful we can use. Ehrlichia and enoplasma, they're the clearest case for a short course of targeted antibiotic therapy, usually doxycycline. Then I lean on ERVOS, herbal antimicrobial therapies. This is often the backbone of persistent Lyme care and it's earned its place. It really can help.

Several botanicals have real anti Borrelia data. Johns Hopkins lab tested herbs against the persistent phase of Borrelia and found some outperformed standard antibiotics in the dish. Now most strikingly, cryptoleptis alongside with Japanese knotweed, which is a source of resveratrol, cat's claw, Chinese skullcap, sweet wormwood or artemisia, which is actually used for malaria in Africa, and black walnut. All these are very helpful and they're well known anchors in herbal anti tick borne infection protocols. And they usually shine for people who can't tolerate antibiotics or who need gentler, a longer arc with far less collateral damage to the gut.

I also use biofilm disruptors because these these bugs hide in your cells. You've to break through the biofilms in your system. Lumbar kinase, serrapeptase, nattokinase, monolaurin, and acetylcysteine. These crack open the bacteria's hiding places, so these antimicrobials and the herbal ones or the regular ones can actually reach these bugs. There's often other therapies which I've used myself and I'm often used in patients successfully, but I use them with caution.

They need a lot more research. There's three things that come up. These are oxidative therapies. Oxidation is what actually your body use to kill infections. So your body makes hydrogen peroxide in your cells.

Your body makes ozone inside your cells. It's how it kills infections. That's what your body does naturally. Fever, your body has fever. That's how your body works.

It's sort of amplifying these natural processes in your body. And three of these therapies are I think worth considering. They come up a lot in the Lyme world. They just want to talk about them because people are talking about them and you should know at least my perspective. They have a promise, but they also have some caveats about them, the warnings.

First is ozone therapy. This is medical ozone. If you read the FDA's website, says ozone's dangerous. Yes, it's deadly if you breathe it in, so don't do that. Medical ozone is delivered by drawing blood, mixing with ozone, and returning it to the body.

And it basically is an oxygen therapy. It's used by a lot of integrated practitioners for its effect on infections, pathogens, supports immune function, helps oxygen utilization. And some patients report meaningful improvement. I certainly found it helpful. But I'll be straight with you.

There's no rigorous clinical trial evidence on this for Lyme disease, really. It isn't the standard of care and it must be done if you're going to do it with a properly trained practitioner and if it's done wrong, it can be quite harmful. So I view it as something reasonable to explore with an experienced clinician but not a proven cure. And then there's hyperbaric oxygen therapy. This is used in traditional medicine to deal with resistant infections and wound healing.

It is a traditional medical therapy and this is a situation where you breathe in high concentration oxygen under increased pressure. The rationale is kind of appealing. Borrelia prefers a low oxygen environment, so and also the tick infections. So saturating the tissues with oxygen may make the environment inhospitable to the tick infections. It also can calm inflammation.

It can support healing, especially for a lot of neurological symptoms. The research in Lyme is limited, mostly small, so I hold it loosely, but that said, hyperbaric oxygen therapy, or HBOT, is well established and generally safe for other conditions. The main risks are being ear and sinus barotrauma from the pressure, just like scuba diving. For some patients, it's a helpful piece of the puzzle. The next big one is hyperthermia.

This is the oldest idea in the book. The fever is one of the body's own antimicrobial strategies and Borrelia is heat sensitive. Approaches range from gentle infrared sauna, which I use comfortably for circulation, detox support, overall resilience, and medical whole body hypothermia in specialized clinics, which raises core temperature substantially. The gentle end of it is low risk and supportive. The aggressive end carries real cardiovascular risk.

It demands close medical supervision, has limited controlled evidence, so I would approach it with caution and expert oversight, never casually. But if you are quite sick and you're not getting better from anything else, it is a Hail Mary. The threat connecting all these three is that they're adjuncts, not magic bullets, and used thoughtfully inside a comprehensive plan under skilled care, they may help. Used as a standalone shortcut, probably not a good idea. The next thing to think about is what we call a die off reaction or the Herxheimer reaction.

This is not uncommon when you're killing bacteria. We saw this first with syphilis when we would give antibiotics like penicillin. We'd see the body go into a kind of a terrible inflammatory reaction. People would get quite sick from the treatment. This happened to me.

I kill the bugs with antibiotics. I often feel quite ill, and there's a way to manage that. So how do you manage that? Microbes die, their breakdown products flood the system, the symptoms can temporarily flare. It's called the Herxheimer reaction.

Not a sign to push harder, it's a sign to support drainage and detoxification. And the fundamentals do most of the work. Stay hydrated, have regular bowel movements, lots of fiber, labor support, foods, herbs, movement, sweating through general exercise, sauna. On top of that, I lean on something called glutathione, which is either oral or liposomal, sometimes IV or nebulized for neurologic symptoms. That's an important molecule of detoxification in your body.

N acetylcysteine also supports glutathione, alpha lipoic acid, milk thistle, other binders like charcoal when mold or heavy toxins are in play. That can be helpful. Just remember, going low and slow beats going fast and crashing every time. The next thing you want to focus on is restoring the gut. Roughly 70% of the immune system lives in and around the gut.

Most Lyme patients arrive with it in disarray from the infection, from chronic inflammation, from all the antibiotics they might have taken, or any antibiotics they've taken in their past. And when the gut's leaky and the microbiome is depleted, the immune system gets more reactive. Inflammation climbs, nutrient absorption falls, recovery stalls. So it's important to rebuild the gut. Targeted probiotics, saccharomyces is especially important.

They call saccharomyces boulardii, especially important when antibiotics are being taken because it helps reduce the yeast overgrowth. Prebiotic fibers, glutamine, lots of other things that can help the gut barrier repair of leaky gut, removing foods that drive inflammation, gluten, dairy, things like that. Healing the gut, really important. When you do that, other symptoms can quietly start to improve. The next thing we want to do is calm inflammation.

Inflammation is supposed to be the immune system response, that's okay. The problem is when it won't switch off. Even after when the infection is addressed, a stuck inflammatory response can keep generating fatigue, joint pain, brain fog, and poor sleep. Nutrition is the most powerful lever. A whole foods anti inflammatory pattern rich in vegetables, quality protein, healthy fats, phytonutrients with plenty of omega-3s, and stable blood sugar is really important.

And then there's there's other supplements that can be helpful. Curcumin, resveratrol, these are anti inflammatory, special things called specialized proresolvent mediators are really great. They can help the body actively resolve inflammation rather than just suppress it. Also rebuilding cellular energy is really important. This is mitochondria.

The complaint I hear most isn't tiredness, it's exhaustion. The kind that sleep doesn't fix. That makes thinking, working, exercising just feel impossible. Now under prolonged immune stress, the mitochondria, these tiny little engines inside your cell, well they falter. So I support them directly with things like CoQ10 or Ubiquinol, NAD plus precursors like NR or NMN, acetylcarnitine, D ribose, magnesium, D vitamins, something called PQQ, alongside deeper work on sleep, stress physiology, and inflammation.

If you don't restore the body's ability to make energy, recovery stays incomplete. The next thing you want to do is modulate the immune system and the nervous system. Two pieces I never skip. First, immune system support and modulation. It's like vitamin D, vitamin C, zinc, medicinal mushrooms like maitake and reishi and so forth.

And increasingly low dose naltrexone, which can gently recalibrate an immune system that's either overwhelmed or stuck. And second, you want to work on the nervous system. Chronic infection holds the body in a sustained danger state. And a dysregulated threat sensing nervous system perpetuates inflammation and the symptoms long after the bugs are handled. Things like vagal toning, breath work, limbic retraining, sleep, and stress work aren't extras.

They're part of the medicine. And that's what comprehensive looks like. We're not just killing a bug, we're rebuilding a person. And as far as ticks go, prevention is still the best medicine. With all that said, all the things we just talked about, the best treatment for Lyme is never getting it.

And tick exposure isn't just for deep woods. People get bitten in their own backyards, gardening, walking the dog at the park. There's a few high yield habits. Wear long sleeves and pants in brushy areas. Tuck your pants and your socks.

No. I know it's unfashionable, but it's very effective. Stay on cleared trails. Use an EPA approved repellent. And then do a tick check after any time outdoors.

Check your scalp, your underarms, your waistline, behind your knees, your groin, anywhere clothing fits snug because they like to hide there. Check your kids and your dogs too. If you find one attached, don't panic. Transmission usually takes hours, so proper removal matters. Grasp it with a fine tip tweezers right at the skin, pull straight up with steady pressure, don't twist or squeeze, and then clean the area with alcohol.

And here's the functional medicine layer. You can't control every exposure, but you can improve the host. Sleep, a nutrient dense anti inflammatory diet, regular movement, stress management, and a healthy microbiome won't make you immune, but they build the strongest possible terrain for your body to meet a challenge and to recover from it. Now where is the science heading? What's life after treatment?

Well, there's reason for real optimism here. The federal government is now investing heavily in tick borne disease research, and public private efforts like Limex are pulling scientists, clinicians, technologists, and patients together to push on better diagnostics, including AI tools that can spot the subtle overlapping patterns Lyme is famous for hiding behind. The goal isn't to replace clinicians. It's to give us sharper tools for earlier, more accurate diagnosis. And then there's the hardest group, The people who do everything right and still don't fully recover.

Persistent fatigue, cognitive trouble, pain, sleep problems, we still don't fully understand why, although immune changes, lingering inflammation, unaddressed co infections, nervous system dysfunction, and metabolic disruption all appear to play a role. The bottom line, when it comes to Lyme, prevent what you can and diagnose early when you can't. But recovery is rarely just about killing the infection. A functional medicine approach treats the whole person. Clearing the infections and co infections, calming inflammation, restoring the gut, rebuilding energy, supporting detoxification, and steadying the immune and the nervous systems.

And reaching for antibiotics when they fit and for herbs and well chosen integrative therapies when they serve the bigger goal. Now if you spend time outdoors, take prevention seriously. If you're struggling with unexplained symptoms, get a comprehensive evaluation from someone who knows tick borne illness. And remember, you are the CEO of your own health. Healing means looking past the diagnosis to understand and work with your own unique biology.

If you enjoyed today's episode, don't miss my upcoming conversation with Lyme disease expert Doctor. Richard Horowitz. We dive into why so many people stay sick and we look at the hidden drivers of chronic illness and a whole new way of thinking about inflammation and recovery and healing. It drops this Wednesday, and until then, here's a preview of what's to come.

Dr. Richard Horowitz
In fact, you know, I recently published an article in the Journal of Alzheimer's Disease Reports, we can get to this just briefly about

Dr. Mark Hyman
Yeah, I wanna get it.

Dr. Richard Horowitz
I reversed for the first time ever in the world, the most sensitive and specific biomarker for Alzheimer's, p tau two seventeen. So again, we're dealing with neuroinflammation, where did it come from? In my patient, it was coming from multiple M SIDS factors. It was Lyme, she had exposure to Babesia Bartonella, she had heavy metals, she had metabolic syndrome, she had food allergies. We need to treat it all, but interestingly enough, we were finding that when we treated the Lyme disease with the nine weeks of dapsone combination therapy, and she was sick for fifteen years by the way, with positive rheumatoid factors with joint pain, some cognitive issues, which she didn't think were bad, completely reversed p tau two seventeen.

Now what's interesting is that the Cochrane report, which came out about one week before my article got released said, hey, we have no good things to treat Alzheimer's at this point. The article comes out one week later, and what I did is I proved the hypothesis. Right? We're in the middle of an Alzheimer's epidemic where the NIH said that forty two percent of people over 55 years old are now gonna become demented. Right.

I mean, it is really frightening, especially when they say we don't have answers. So there was always they looked at autopsy studies of Alzheimer's patients and they would find biofilms, amyloid, and phosphorylated tau in the brains. So there was an association, but they couldn't say causation. This is the first time I proved causation by completely reversing this biomarker p tau two seventeen with this nine week pro and this woman was, by the way, was sick for fifteen years.

Dr. Mark Hyman
And the symptoms got better.

Dr. Richard Horowitz
Her symptoms her joint pain got better, rheumatoid factor reversed, because it wasn't rheumatoid arthritis. It was from the Lyme bacteria driving rheumatoid factors.

Dr. Mark Hyman
What was her memory? Did it get better?

Dr. Richard Horowitz
It also improved. She thought it was her meditation that was keeping her stable, and she noticed after she was done, it's like, Oh my God, I'm so much clearer. By the way, I have a second patient, I just did the same, I haven't published it yet. We reversed his beta amyloid ratios with dapsone. Here we have an Alzheimer's epidemic where I found that all 16 M SIDS factors are associated with it, the Cochrane report is saying, hey, we don't have anything good out there to treat, And the drugs that are used for it, lucanumab, dananemab, they lowered phosphorylated tau by 23% in almost seven years.

I lowered it by 63% in nine weeks. Yeah. And that was because it was the infection driving the amyloid and the phosphorylated tau. And unfortunately, you go to a neurologist, they're not even gonna check you for Lyme disease or Bartonella or mold when you have Alzheimer's disease.

Dr. Mark Hyman
Right? But it's important to find out.

Dr. Mark Hyman
I mean, people people think,

Dr. Mark Hyman
you know, Alzheimer's is one of those things with nothing to do for it because of the bad drug, you know, debacle we have in terms of poor drugs and and drugs that don't really work based on billions of dollars of research and hundreds and hundreds of studies. But but what you're saying is using this approach, which is looking at root causes, looking at treating the whole system, peeling all the layers of the onion, you can actually start to see changes in these people. And I've I've seen the same thing in my practice, and Dale Bredesen, who's quoting a quote on your book also, has done this. And, you know, for for us out there doing it, we we sound a little bit like quacks because, well, why? We're reversing Alzheimer's.

Well, it isn't really Alzheimer's is just a a symptom.

Dr. Richard Horowitz
It's a neuroinflammation.

Dr. Mark Hyman
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Thank you so much again for tuning in. We'll see you next time on the doctor Hyman show. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic, and Function Health where I am chief medical officer. This podcast represents my opinions and my guests' opinions. Neither myself nor the podcast endorses the views or statements of my guests.

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