There is a lot of misinformation being propagated regarding tick bites and diseases that you can catch from them. Being educated is key. The most common question I am asked is, “A tick bit me. Should I do anything or wait until Lyme disease symptoms show up?” If a tick bites you, here is what I suggest doing.



First, if you find a tick on you or a loved one, remove it carefully with fine tweezers as close to the skin as possible. Alternatively, you can use a tick removal tool. Once you remove the tick, put it in a plastic bag or even a medicine bottle to save the tick for testing. Be sure to clean the affected skin with alcohol and wash your hands afterwards. Observing the tick for whether it is engorged or not can be helpful but can give a false sense of security. We now understand that some ticks transmit diseases quickly before it becomes engorged.



The 24-hour rule that the tick needs to be attached for 24 hour to transmit lyme disease has been disputed. It could be as little as 4 hours based on some recent research. Different infections can get transmitted during different periods of time of tick attachment. For instance, the Powassan virus can be transmitted in less than 15 minutes. Since you cannot rely on tick engorgement or how long it was attached, ideally, you should send the tick for testing. It actually doesn’t matter if the tick is alive or dead. Some labs test only for the bacteria that causes Lyme disease, but I prefer labs that also test many of the different infections that ticks transmit.



Research has found that close to half of all ticks carrying Lyme Disease also carry co-infections. IGeneX is one laboratory that can test up to 6 different tick-borne infections, including Lyme, Babesia, Bartonella, Rickettsia, Ehrlichia, and Relapsing Fever. TickReport is a not-for-profit organization through UMass Amherst that can test the tick for up to 23 different organisms depending on the panel you order. You can also contact your local health department, as many of them offer limited tick testing usually for Lyme Disease and sometimes for a few other co-infections.



Turnaround times vary depending on the lab, so what should you do while you wait? There is, unfortunately, quite a bit of controversy in this area. Some physicians feel comfortable with the watch and wait approach. In other words, you watch for the development of a bull’s eye rash within 3 to 30 days and then when present you get treated for Lyme disease. There are serious concerns regarding this approach. The development of the bull’s eye means that the infection could already be systemic and many patients will have associated symptoms, such as fever, fatigue, headaches and joint pain. A recent study has shown that even at this early stage of diagnosis, it is possible that the antibiotics might not work effectively.

Another concern is that many patients will get Lyme Disease but will not have a bull’s eye rash. Some will have atypical rashes but others will not have any and so Lyme disease can go unnoticed. In addition, the tick could transmit a different disease that is not associated with a rash, so waiting for a rash to develop could be futile.



The approach that many Lyme literate doctors recommend is to treat for Lyme and tick-borne infections with antibiotics while waiting for results from the tick analysis. There are, of course, issues regarding this approach as well, including side effects from antibiotics and the unnecessary use of antibiotics. There are also some herbal protocols with decent data that they can kill Lyme and other infections and can help boost the immune system. These might be considered alone or with antibiotics, depending on the patient. This is where a personalized approach is imperative. Doctors need to consider the risk factors of the patient and how closely they can be monitored. Until more research is available on the right course of action after a tick bite, doctors and patients need to work together to determine the best course of action: antibiotics vs. herbs (or both) vs. watch and wait.