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Dr. Susan Marra with JuJu.

Lyme Disease in Dogs

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What You Need to Know for Prevention and Treatment

As an avid pet lover, hearing “Lyme disease in dogs” may raise your concerns. Don’t worry, Dr. Marra is here to educate you on prevention, teach you to recognize the symptoms, and understand the treatment options available.

“As most of you know, I am an avid dog lover and have had a dog in my office for most of my career, both for emotional support and mental health. Dogs can be excellent office companions on your health care journey. So you can imagine, I am very aware and concerned for dogs that get Lyme disease. I’m here to help.” 

Medical Minutes with Dr Marra; Episode 51: Lyme Disease in Dogs

What is Lyme Disease in Dogs?

Lyme disease affects over 300,000 people annually in the United States and it CAN also affect dogs when they are bitten by an infected tick. The bacteria Borrelia burgdorferi, which causes Lyme disease, is transmitted through tick bites and can have significant effects on your dog’s health if not treated properly.

Symptoms of Lyme Disease in Dogs

Canine Lyme disease symptoms can vary, but they often include:

  • Generalized body pain
  • Limping
  • Swollen joints
  • Fever
  • Vomiting
  • Lethargy
  • Anorexia
  • Weight loss
  • Lameness

Unfortunately, it typically takes 2-5 months after the tick bite for dogs to show symptoms of Lyme disease, and by then, the bacterial infection has usually become systemic.

Diagnosing Lyme Disease in Dogs

Lyme disease can be diagnosed using blood tests for the bacteria antibodies (IgM and IgG) or a PCR test on blood or joint fluids. General blood work and a urinalysis can also help. The vet will look for signs of kidney damage, such as a loss of protein in the urine, which can indicate that the infection has affected the kidneys.

Treatment for Lyme Disease in Dogs

Treatment for Lyme disease in dogs is readily available and effective. Common medications include:

  • Doxycycline (the best choice)
  • Amoxicillin
  • Zithromax

Generally, your dog will need to stay on antibiotics for at least 4 weeks to completely eliminate the infection. This treatment is much more effective in dogs compared to humans, where treatment can be more challenging.

Lyme Disease Vaccine for Dogs

There is a vaccine available for dogs to help prevent Lyme disease. While it is safe and can reduce the risk of infection, it is NOT 100% effective. If you live in a Lyme-endemic area, discuss the pros and cons with your vet to determine whether this vaccine is appropriate for your dog. If you do not live in a Lyme-endemic area, your dog likely does not need this vaccine.

Tick Prevention for Dogs

Tick prevention is absolutely critical in Lyme-endemic areas. However, tick repellents for dogs can have side effects, so it’s important to discuss options with your vet. Some commonly used tick prevention products include:

  • Frontline
  • Advantix
  • Bravecto (topical)
  • Nexgard (chewable)
  • Simparica

Speak to your vet about which product would be best suited for your dog breed.

Be a Responsible Fur Parent: How to Protect Your Dog from Lyme Disease

Part of being an excellent fur parent is ensuring that your dog is protected from health dangers like Lyme disease, especially in endemic areas. It’s important to be aware of where ticks are common in your state/area, so you can take proactive steps to prevent Lyme disease.

Dogs are our dearest friends and allies, but they cannot protect themselves from Lyme disease. When they play outside, they are just being goofy dogs—but this is when they can be vulnerable to Lyme disease. To protect your canine companion, be sure to:

  • Discuss the prevalence of Lyme disease in your area with your vet
  • Use tick prevention medication
  • Stay vigilant in tick-prone areas

Your dog will love you for taking such great care of them!

FYI, NONE of my dogs have ever had Lyme disease because when I am in an endemic area, I generally use Frontline. I have never even found a tick on them. Thank goodness! I hope you take these precautions seriously to protect your beloved dog(s) from Lyme disease. Here’s to keeping both you and your furry friend healthy and happy!

About Dr. Susan Marra & Juju

Dr. Susan Marra is a world-leading Lyme Literate Naturopathic doctor specializing in the treatment of Lyme disease, vector-borne diseases, Neurodegenerative Diseases (Alzheimer’s, Parkinson’s disease), Post Covid, Long Covid, red light therapy, and environmental illness (mold).

Having trained with Dr. Richard Horowitz and Dr. Charles Ray Jones, Lyme disease experts on the East Coast, Dr. Marra is well qualified to manage and heal tick-borne disease. Take the first step toward a better quality of life with expert care tailored to your needs.

Juju (Juliette Pearl) is Dr. Marra’s cream french bulldog and the inspiration for understanding Lyme disease in dogs. Juju has wonderful healing energy and properties just because she is lovable and friendly and wants belly rubs all the time. If you join us in the office, you can find her treats at the front counter but please ONLY give her one.  We have to watch her weight because she is a true “bon bon” girl.

To learn more about Dr. Marra’s approach or to schedule a consultation, contact or call us to book an appointment. 


Disclaimer The information, including but not limited to, text, graphics, images and other material contained in these videos is for informational purposes only.  It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician before undertaking a new healthcare regimen, and never disregard professional medical advice or delay in seeking it because of something you have seen, read, or heard in these videos.

Oxalates and Kidney Stones

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Oxalates are molecules found in certain foods such as spinach and cashews that are formed as the combination end product of several amino acids such as serine, glycine, and ascorbic acid, that can combine with calcium (a naturally occur ion in the blood also from food) in the blood to form calcium oxalate crystals.  Foods that contain more than 100g of oxalates per serving include (but this IS NOT an exhaustive list):

  • Beets
  • Rhubarb
  • Brussel Sprouts
  • Carrots
  • Spinach
  • Tofu
  • Rice Bran
  • Almonds
  • Snap Beans
  • Cashews
  • Soybeans
  • Quinoa
  • Blackberries
  • Blueberries
  • Figs
  • Plum
  • Raspberry
  • Tangerine
  • Sweet Potatoes
  • Eggplant
  • Kale

These oxalate crystals are needle shaped crystals called raphides.  They are readily absorbed after ingestion, cannot be metabolized by mammals, and are largely eliminated through renal excretion.  Calcium oxalate crystals get filtered by the glomeruli in the kidney unless they are large, and then they become “stuck” in the nephrons and form kidney stones, especially if you have the genetic propensity.  Oxalates are toxic to the renal epithelial cells and can cause membrane injury.  The common upper limit of normal for oxalate excretion is 45mg/day (0.5mmol/day).  Chronic vitamin C oral use can also cause hyperoxaluria and kidney stones. 

Kidney stones are EXTREMELY painful, and the symptoms associated with them are as following:

SEVERE and sudden onset pain on the abdomen sides or low back

  • Nausea
  • Vomiting
  • Fever
  • Chills
  • Blood in the urine
  • Cloudy urine

Small kidney stones can be passed in the urine, but larger ones greater than 9mm must be treated with lithotripsy (a procedure where a skilled physician blasts the  stones into pieces for excretion, or surgery).  The pain associated with kidney stones is very significant and usually requires pain management by the ER.

To check for oxalate crystals in the urine, you can have your doctor order a 24 hour urine oxalate test through Labcorp or Quest, and this will reveal urinary levels and the presence of toxicity.

Treatment for calcium oxalate crystals is largely dietary.  You’ll need to go on a low oxalate diet, and read the book “Toxic Superfoods” by Sally Norton, MPH.  She has some excellent information on how to change your diet if you are prone to kidney stones.

I was plagued by kidney stones 10 years ago from over eating spinach and cashews and the urologist NEVER told me to change my diet.  After researching the subject, I found that you can lead a very normal life IF you curb your diet from high oxalate foods, and drink at least 64oz of water with electrolytes every day.

Professional Health Products has two supplements, Oxalate Scavenger, and Oxalate Balancer that contain nutrients such as: Calcium citrate, Magnesium oratate, vitamin B6 (P5P) or Calcium, Magnesium, and Zinc citrate with P5P which will bind the oxalate crystals.

Kidney stones are no fun and you can avoid them simply by being mindful with your diet.  Find a list with high oxalate containing foods, and remove the top 10-15 of them completely from your diet and that should do the trick.  Make sure you drink plenty of fresh water to cleanse the kidneys daily and you should be just fine.

Of note, it is my observation that patients with Bartonella are much more likely to develop kidney stones although to date, this is an anecdotal observation.  I happen to be one of these patients.

The Importance of Probiotics

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The importance of probiotics while undergoing Lyme Disease treatment cannot be underestimated. The human microbiome is composed of trillions of different bacteria that live harmoniously and perform various necessary physiological functions, especially in the intestines. These bacteria have specific nutritional needs just as we do to sustain life. Additionally, endigenous bacteria generally do not cause disease, unless the bio-terrain is altered by other infectious organisms, antibiotics, or poor diet. In this case, your “garden” becomes a “garden of weeds.”

While antibiotics are necessary to eradicate Lyme Disease and co-infections in most patients, great care should be taken to maintain a healthy microbiome while undergoing treatment. A plant-based diet low in carbohydrates and plenty of water keeps inflammation at a minimum so that the antibiotics can work optimally to kill pathogenic organisms.

But make no mistake…this is risky business because antibiotics not only kill the bad organisms, they also kill the good ones. Therefore, high-dose, diverse, probiotics should be taken alongside antibiotic therapy without question. Some of these can include:

Lactobacillus acidophilus

Lactobacillus brevis

Lactobacillus plantarum

Bifidobacterium lactis

Bifidobacterium longum

Saccharomyces boulardii

Additionally, pre-biotics in the form of FOS (fructooligosaccharides) may be necessary to balance the gut flora.

As you age, your gut microbiome becomes increasingly less able to optimally function. This gets exacerbated when you have multiple infections affecting the mucos.

Herxheimer Reaction

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The Herxheimer reaction (HERX) was originally noted in 1895 by Dr. Jarisch who worked with Syphyllis (a spirochete) patients.  In the 21st century, we observe Herxheimer reactions in tick-borne illnesses such as Lyme Disease, also caused by a spirochete.  A Herxheimer reaction (Herx) typically occurs hours to days after antimicrobial administration and is thought to be the result of endotoxins released into the bloodstream by dying spirochetes.  The body’s immune system then responds to the endotoxins and the concurrent release of cytokines (i.e., tumor necrosis factor, interleukin 6, and interleukin 8) which are chemical messenger molecules of the immune system producing exaggerated symptoms lasting 3 days up to several weeks.

Dr. Marra doses antibiotics specifically for the individual patient so that the Herxheimer reaction on a scale of 1-10, is about a 5.  This is her own technique, and she feels that severe Herxheimer reactions over prolonged periods of time may cause tissue damage from the excessive release of endotoxins and cytokines.  Tissues become friable as a result of chronic inflammation, not unlike what happens when a sponge is repeatedly used and the surface area becomes frayed.  Dr. Marra is not convinced that this kind of tissue damage is reversible which is why she chooses to take the route of treatment that she does.  However, many other physicians choose to treat more aggressively and seem to have good results. This is simply her own treatment preference.

The general description of a Herxheimer reaction is a temporary increase in symptoms but may also include the development of completely new symptoms.  More specifically, the most common complaints of a Herx reaction are increased joint and muscle pain, headaches, chills, night sweats, fever (usually low grade), extreme fatigue, brain fog or lack of mental clarity, drop in blood pressure, hives, or a rash of some sort.  Worth noting here is that a rash or hives can sometimes be mistaken for an allergic reaction.  It is up to the treating physician to determine this, but with close, experienced observation and the use of Benadryl, Alka Seltzer Gold, Quercitin, warm lemon water, and vitamin C (see Herx management), unnecessary premature cessation of antibiotics may be prevented.  In more severe cases of Herxheimer reactions, a reduction in the antibiotic dosage or cessation of the antimicrobials may be required.

The timing of a Herx reaction is very individualistic and can occur within days to weeks after the onset of antibiotic treatment.  In some patients, a Herxheimer reaction occurs only once or twice, or not at all throughout treatment.  It is clear, however, that as you move through the treatment and the spirochetal load becomes decreased, the Herx reactions become less and less severe.  Herxheimer reactions can also occur in cycles (usually 4-week cycles) and may be affected by the lunar cycle.  This is anecdotal but it is an interesting observation in some people.

About 70-80% of people undergoing Lyme Disease treatment with antibiotics experience some sort of Herxheimer reaction.  It is thought by a number of physicians and scientists that these people have difficulty in detoxification processes and that perhaps there may be a defect in one of the detox pathways in the liver.  This may be genetic, environmental, or a combination of both.  But without question, maintaining an alkaline diet and an  “alkaline bio terrain” helps lessen the effects of a Herx reaction.  The 20% of patients who do not experience a Herx reaction should not feel like they are getting nowhere by taking antibiotics.  Discussion of this issue should be left to the patient and their treating physician.

Check out our page about alkalizing foods.

Dyslipidemia and Lyme Disease

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Dyslipidemia is abnormal lipid metabolism. Patients who have had or have Lyme Disease often have significant abnormalities in their lipid metabolism.  This results from chronic inflammation and prolonged activation of the proinflammatory cytokines such as IL-1, IL-6, and tumor necrosis factor-alpha (TNF alpha).  Elevated cholesterol, triglycerides, VLDL, and LDL are commonly seen, while HDL (the good cholesterol) is decreased.  Dr. Jones and I believe that these elevations in cholesterol are not only related to diet and genetic predisposition but may be a compensatory response of the body in an attempt to repair cell membranes (that are composed of lipids) that have been damaged by infection. The piercing of the cell membrane by organisms such as Borrelia, Bartonella, and Mycoplasma on their way to the intracellular compartment where they prefer to reside, can render changes in lipid metabolism and increase lipid peroxidation.  Lipid peroxidation is a biochemical reaction resulting from damaged lipid-containing cells that increases the concentration of free radicals in the body and contributes to a state of overall oxidative stress.  Oxidative stress affects not only cells but the vascular endothelium which can lead to increased stroke and myocardial infarction.  The presence of biofilm created by spirochetes and other organisms also contributes to plaque formation in the arteries, which affects blood flow to peripheral tissues and the overall health of the cardiovascular system.

Optimizing lipid metabolism may require diet and lifestyle modifications as well as nutritional intervention.  Dr. Marra’s extensive knowledge and experience in Lyme Disease and Functional Medicine will help you to regain optimal health in a reasonable amount of time.

For more detailed information about the glycemic index of foods (how much sugar they contain), please visit www.Mendosa.com and go to the food tab. You can search through the various options. This website is a phenomenal resource for everyone who wants to change their diet and needs help understanding what foods they can and can’t eat to improve their metabolic condition.

Gestational Lyme Disease

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Unfortunately, there is great debate within the medical community regarding the existence and prevalence of the transmission of Lyme disease, co-infections, and parasites to the unborn fetus.

The medical community already recognizes that certain infections cross the placental barrier and they are known as “TORCH Syndrome” infections which include: Toxoplasmosis, Other (i.e., Syphilis), Rubella, Cytomegalovirus, and Herpes Simplex Virus. These infections become of great concern to the physician when unexplained birth defects occur in newborn babies. Antibody titer blood tests for “TORCH” infections in these babies yield insights into the cause of the birth defects, and this phenomenon is well established in the infectious disease medical community.

Operating purely from a perspective of common sense, if Syphilis crosses the placental barrier and can cause birth defects, why wouldn’t Borrelia, since they are both spirochetes and share similar gene sequences? During the 1980s, Dr. Alan MacDonald, a pathologist in Long Island, New York, wrote several scientific case studies documenting the presence of spirochetes in the tissues of both aborted fetal births, and children born with significant birth defects. Unfortunately, his research was largely ignored by the mainstream medical community for reasons that remain elusive to this day. Most likely, his work was ahead of its time.

Tessa Gardner, MD, an infectious disease specialist at the University of Washington, St. Louis, MO also wrote an entire chapter in a book devoted to infections of the unborn and newborn child, titled “Infectious Diseases of the Fetus and Newborn Infant” Philadelphia, Saunders, 2001. In this chapter, she discusses the possibility of Lyme Disease transmission from mother to child in utero.

Therefore, it is important to recognize that women who intend on becoming pregnant or who are pregnant and have Lyme disease, take the necessary precautions to prevent the transfer of Borrelia to their unborn child. This entails using appropriate antibiotics before, during, and after pregnancy, as it is also likely that Borrelia is transmitted through the mother’s milk (personal communication with Dr. Charles Ray Jones) to a developing infant.

Although there is sparse scientific evidence regarding congenital and gestational Lyme disease, the concept falls easily within the parameters of common sense and can be prevented, simply by appropriate antibiotic use during pregnancy.

Additionally, there is good reason to believe that certain cases of autism are in fact the result of congenital Lyme disease. Since Borrelia is known to be involved in a myriad of neurological disorders including ALS, Parkinson’s Disease, Alzheimer’s Disease, and Multiple Sclerosis, logic follows that we might suspect similar involvement in childhood neurological disorders such as autism, ADHD, sensory integration, and processing difficulties, learning differences, dyslexia, Asperger’s Syndrome, and a host of other unexplained disorders. Here is a website that might be helpful for more information: Mothers Against Lyme.

For those of you who have Lyme disease and wish to become pregnant or who are pregnant, please consider consulting a “Lyme Literate Doctor” during your pregnancy to avoid unwanted complications that can be circumvented by the administration of antibiotics throughout pregnancy.

If you do have Lyme disease, it is also a good idea to do PCR (Polymerase Chain Reaction) testing on the cord blood and placenta for Borrelia, at the time of birth. You can contact Igenex at 800-832-3200 and order a test kit which can be available at the time of birth, so that blood and tissue samples can be assayed for spirochetal DNA.

As for the co-infections of Lyme disease, there is currently sparse evidence regarding the transmission of Babesia, Ehrlichia, Anaplasma, Bartonella, Tularemia, Mycoplasma, and other zoonotic diseases to the unborn fetus and newborn infant. However, yet again, the application of common sense would suggest that these diseases are quite likely to cross the placental barrier just as Syphilis does, which has been extensively scientifically documented.

The Importance of Probiotics

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The importance of probiotics while undergoing Lyme Disease treatment cannot be under estimated. The human microbiome is composed of trillions of different bacteria that live harmoniously and perform various necessary physiological functions, especially in the intestines. These bacteria have specific nutritional needs just as we do to sustain life. Additionally, endigenous bacteria generally do not cause disease, unless the bio-terrain is altered by other infectious organisms, antibiotics, or poor diet. In this case, your “garden” becomes a “garden of weeds.”

While antibiotics are necessary to eradicate Lyme Disease and co-infections in most patients, great care should be taken to maintain a healthy microbiome while undergoing treatment. A plant based diet low in carbohydrates and plenty of water keeps inflammation at a minimum so that the antibiotics can work optimally to kill the pathogenic organisms.

But make no mistake…this is risky business because antibiotics not only kill the bad organisms, they also kill the good ones. Therefore, high dose, diverse, probiotics should be taken along side antibiotic therapy without question. Some of these can include:

Lactobacillus acidophilus

Lactobacillus brevis

Lactobacillus plantarum

Bifidobacterium lactis

Bifidobacterium longum

Saccharomyces boulardii

Additionally, pre-biotics in the form of FOS (fructooligosaccharides) may be necessary to balance the gut flora.

As you age, your gut microbiome becomes increasingly less able to optimally function. This gets exacerbated when you have multiple infections affecting the mucos

Recommendations for Infected Patients with Tick-Borne Disease

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  1. DO NOT donate blood.  You have been infected with a bacteria that can live in the blood, and therefore can be passed onto someone else.
  2. Carry a card in your wallet indicating that you have Lyme Disease (and co-infections if applicable) and the drugs that you are taking.  This is important to alert health professionals in the case of an accident.
  3. If you have having elective surgery, let your surgeon(s) know so that they can be aware.  If you need blood, I would suggest auto-transfusion (you receive your own blood for a transfusion, instead of a separate donor) if necessary.
  4. DO NOT have unprotected sex with your partner.  These infections are thought to be sexually transmitted.  Although there is little data to support this, we do know that syphilis is sexually transmitted, and therefore by deduction, Borrelia and the other tick-borne infections are likely as well.
  5. If you are pregnant with Lyme Disease, you SHOULD be on safe antibiotics throughout the pregnancy in order to protect the developing fetus from contracting the disease.
  6. At birth, have the newborn tested for Lyme Disease through cord blood, placenta, and foreskin if the baby is a boy.  Three samples of cord blood are suggested. Ask for a test kit to be sent to you prior through Igenex (800) 832-3200.
  7. If your infant tests PCR positive for Lyme Disease, you should consider antibiotics in order to prevent the development of full blown disease.
  8. Nursing mothers SHOULD use caution.  Lyme Disease is known to be transmitted through breast milk, and therefore, antibiotics during the nursing period is highly recommended.
  9. If you are an outdoors person, it is highly recommended that you use some form of tick and insect repellant.  Deet is recommended.
beach stones pile

Autoimmune Disease

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Frequently we see autoimmune diseases associated with Lyme Disease and coinfections such as Multiple Sclerosis, Lupus, Hashimoto’s Thyroiditis, Scleroderma, Graves Disease, Celiac Disease, etc. Essentially any tissue in the body can fall prey to autoimmune disease if the autoimmunity is driven by infection.

When pathogenic infections invade tissues, the bacteria produce LPS (lipopolysaccharides) which are found on their outer cell membrane and promote inflammation. These molecules are produced and fool the host’s immune system into thinking that there is a foreign invader. The body naturally mounts an immune response, but the response is against its own tissue, yielding autoimmune disease.

In 18 years of practice, most of my patients’ autoimmune conditions are completely eradicated with proper long-term antibiotic use as well as targeted nutraceuticals. If you decrease the infection in the tissue, the concentration of LPS decreases, inflammation decreases, and tissues can return to their healthy state. If the infection is allowed to persist, autoimmune disease simply gets worse.

It is my belief that most if not all autoimmune diseases are infection-driven. The challenge becomes to identify the exact pathogen and then treat it accordingly.

Systemic Inflammation and Cytokines

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Historically, the defining features of inflammation include rubor (redness), calor (warmth), tumor (swelling), and dolor (pain), and there is a distinction between acute and chronic inflammation.  Acute inflammation compromises the early response to an injurious agent and is a defensive response that fosters repair of the damaged site.  Chronic inflammation results from stimuli that are persistently damaging to tissues.  Inflammation is a way that the body reacts to infection, irritation, or other injury and is considered a nonspecific immune response.  The inflammatory response directs immune cells to the site of injury or infection and is manifested by an increased blood supply coupled with vascular permeability.  Microorganisms (i.e., bacteria, viruses, fungi) are then engulfed by neutrophils and macrophages (types of white blood cells)  in an attempt to contain the infection to a smaller tissue space.

Systemic Inflammation and Cytokines

However, Lyme Disease can involve multi-organ systems rendering an inflammatory state that is a more generalized condition.  Proinflammatory cytokines (chemical messenger molecules) are released by immune cells in response to a pathogen which in turn causes inflammation in the joints, muscles, heart, brain, gastrointestinal system, and urinary system.  Spirochetes have an affinity for both collagen tissue and tissues that contain fatty acids (i.e., the brain), and bury deep within these substrates to avoid detection by the hosts’ immune system.  This is one of the reasons why capturing the DNA (PCR test) of these microorganisms remains difficult because they simply don’t dwell in the blood.  Hence, measuring the immune system’s antibody response to the pathogen(s) is the best choice for demonstrating pathogen exposure and infection.

Inflammation becomes particularly concerning when the brain is involved.  Microglial cells (immune cells of the brain) become activated in response to an insult or injury and cause localized inflammation.  When spirochetes reach the brain, an immune response is activated and inflammation occurs.  Patients experience the feeling of swelling in their head or eyes or pressure in their head.  This may also be the result of increased intracranial pressure secondary to infection and inflammation.

When the microglial cells of the brain become activated, a particular brain biochemical pathway known as the “kynurenine pathway” becomes involved and the production of a highly toxic molecule known as “quinolinic acid’ results from the metabolism of the amino acid tryptophan.  Quinolinic acid can be thought of as equivalent to “battery acid” in the brain where it literally causes neuronal destruction through increased free radical production as is observed in Multiple Sclerosis, Parkinson’s Disease, Alzheimer’s Disease, and ALS.

There are many natural therapies to combat inflammation and help minimize the effects of quinolinic acid in the brain.  This will result in less brain fog, confusion, a recovery of memory and function, and greater mood stability.  I have been working with this paradigm for quite some time with great success.  The general idea is to DECREASE inflammation so that tissue damage is minimized and nutritive healing takes place.  An analogy here is the following: when a person becomes heated and angered, they are less likely to receive the opinion of an opponent.  Likewise, when tissues are inflamed, they are less likely to properly receive and utilize nutrients, water, and metabolize medications.  In essence, inflamed tissues are unable to perform adequate metabolic functions for optimal organ health.

Tick Removal

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Instructions for Tick Removal.

Any tick that is attached to the skin should be removed carefully and quickly using the following guidelines:

  • Using small tweezers, grasp the head of the tick at the skin and hold firmly without squishing it, and pull STRAIGHT OUT without twisting or turning it.  There may be some resistance as ticks secrete a cement-like substance that allows them a tight hold on the skin site of attachment.
  • Place the tick in a small jar and save it to send to Igenex, Inc. for PCR/DNA testing of the tick for Lyme Disease.
  • NEVER squeeze or burn a tick.
  • NEVER use any ointments at the site of the tick bite.
  • Clean the tick bite site thoroughly with alcohol.
  • Phone your physician and make an appointment immediately.
  • Monitor the site of the tick bite and note any strange rashes.
  • Take a magic marker and draw an outline around the edge of the rash so the Lyme Literate physician can see the extent of the rash. The marker won’t wear off in a shower if you have to wait to see the physician.
  • Take a picture of the rash, and bring the picture with you to the doctor’s office so that if the rash fades, the physician can still assess it.
  • Rashes can also occur on the body other than at the site of the tick bite so make note of these as well.
  • Fleas, mosquitoes, sand flies, and probably any biting insect may also transmit Lyme Disease, so if you have suspicious swelling after an insect bite, take a picture of it and bring that picture to a Lyme Literate doctor’s office.

Pediatric & Adolescent Lyme Disease

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Tick-borne diseases are a 21st-century epidemic in most geographical areas of the United States and Europe, China, Japan, Australia, South America, and Africa.  Greater awareness regarding the spread of these diseases is gaining momentum as we enter the “Decade of the Microbe.”  However, the multidimensional impact of Lyme disease in particular on our most vulnerable population, children, is still under substantial scrutiny by the medical establishment despite numerous scientific articles demonstrating clear and contrary evidence.,

Children are among the most vulnerable to tick-borne illness simply because they spend time outdoors, play low to the ground where ticks often reside, and are more likely to come into physical contact with these arthropods. At the same time, they show affection to family pets.

The northeast United States was where Lyme disease was first noted in 1975, among a population of children who demonstrated swollen sore knees, sore throats, fever, malaise, and debilitating fatigue.  This observation was made by a housewife, Polly Murray, who, to this day, is mainly responsible for recognizing the first outbreak of Lyme disease in Lyme, Connecticut.  At the same time, Dr. Charles Ray Jones, located in New Haven, Connecticut, not far from Lyme, Connecticut, who is now the world’s leading pediatric Lyme disease specialist, agreed with Mrs. Murray’s observations and began successfully treating many of these children with long term multiple antibiotics.

Dr. Jones was the first pediatrician to recognize the widespread prevalence of Lyme disease in Connecticut, Rhode Island, Massachusetts, New York, New Hampshire, and Maine.  As of December 2010, Delong-Termas treated over 20,000 children with various tick-borne diseases using long-term antibiotics.  Notably, most of these children recover and move on to do great things in the world.  At the age of 85, Dr. Jones continues to commit his life’s work to the healing and well-being of children who have Lyme disease. For a more detailed description of his contributions to pediatric Lyme disease, please see his website at Dr. Jones Kids. To view an in-depth interview with Dr. Jones, please watch the documentary “Under Our Skin,” which can be purchased at www.openeyepictures.com.

As a mentor to Dr. Marra for six years, Dr. Jones taught her the detailed intricacies of diagnosing and treating multiple tick-borne infections in children.  He encouraged her to look for the “subtle” nuances and the effects of tick-borne disease on developing bodies and brains.  His unrelenting perseverance for the truth about the prevalence of Lyme disease in children has made him an international treasure. Dr. Marra is grateful to have had the opportunity to work with him.

As a result of working with Dr. Jones,  she is well-trained in pediatric Lyme disease and co-infection treatment.  She fosters her interest in this medical niche by attending annual ILADS (International Lyme and Associated Diseases Society) conferences while discussing complex cases with Dr. Jones and maintaining frequent professional dialogue with other Lyme-literate doctors.

Dr. Marra feels privileged to know Dr. Jones and is thankful for his willingness to mentor her.   She is fortunate enough to know someone with experience in the medical management of pediatric and adolescent Lyme disease.  Dr. Marra utilizes his wisdom and insights daily in her practice, and Pediatric/Adolescent Lyme disease remains one of her greatest professional strengths.  Dr. Marra intends to continue practicing medicine for tick-borne illness with the skills she has obtained in 22 years of training and over 7,300 patients with Dr. Jones’ principles at the core of her treatment plans. She remains a colleague and a friend of Dr. Jones and hopes to continue his legacy with as much commitment to healing children as he does throughout his more significant 60-year medical career.  Dr. Jones is without question an honorable man who dedicated his life to a most worthy cause. For that, the world is no doubt a better place, despite the continued controversy over antibiotic treatment for chronic Lyme disease.

Adult Lyme Disease

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Living with Adult Lyme Disease: What You Need to Know About Symptoms and Treatment

Adult Lyme disease is a complex and often misunderstood illness that has surged in recent years due to factors like climate change, urban development, and a growing deer population. These conditions have led to increased tick exposure year-round. Accurate testing tools are crucial for detecting Borrelia bacteria in blood and urine, which causes the fluctuating symptoms of Lyme disease.

What is Adult Lyme Disease?

Adult Lyme disease refers to the manifestation of Lyme disease in individuals over the age of 18. While Lyme disease is commonly associated with children and adolescents, adults can be just as susceptible. In adults, Lyme disease can be more difficult to detect because its symptoms can mimic those of other chronic conditions, making diagnosis tricky.

The bacteria responsible for adult Lyme disease, Borrelia burgdorferi, are typically transmitted by the black-legged tick, also known as the deer tick. It is important to remember that not everyone who contracts Lyme disease develops the hallmark “bull’s-eye” rash, especially in adults. Without the rash, the infection can go unnoticed until it becomes more severe.

Common Symptoms of Adult Lyme Disease

The symptoms of adult Lyme disease can vary greatly depending on how long the infection has been present and whether it has spread throughout the body. Lyme disease is typically classified into early-stage (localized) and late-stage (disseminated) disease, and the symptoms can differ significantly between the two stages.

Early-Stage Symptoms of Adult Lyme Disease

In the early stages of adult Lyme disease, symptoms often resemble the flu or other viral infections, making it difficult to identify without a proper examination. Some common early-stage symptoms include:

  • Fever and chills
  • Fatigue and malaise
  • Headaches
  • Muscle and joint aches
  • Swollen lymph nodes
  • Erythema migrans (EM) rash – a circular, red rash that appears around the bite site in some cases, though not always

If you notice any of these early symptoms, especially after being outdoors in tick-prone areas, it’s crucial to see a healthcare provider for further testing.

Late-Stage Symptoms of Adult Lyme Disease

If left untreated, adult Lyme disease can progress to more severe symptoms, which may affect multiple organs in the body. Late-stage symptoms can include:

  • Chronic joint pain or Lyme arthritis, often affecting the knees
  • Neurological symptoms, including cognitive impairment, memory loss, and difficulty concentrating (often referred to as “brain fog”)
  • Heart palpitations or irregular heartbeat (known as Lyme carditis)
  • Chronic fatigue and weakness

These symptoms can be debilitating, making early diagnosis and treatment critical for adults diagnosed with Lyme disease.

Diagnosing Adult Lyme Disease

Diagnosing adult Lyme disease can be challenging because its symptoms overlap with many other conditions. Lyme disease and mold toxicity, also known as the “Great Imitators,” can mimic many other diseases, especially in adults, where a proper diagnosis can be difficult. They are diseases that affect multi-organ systems, causing local and systemic inflammation while rendering tissues, cells, and organelles unable to cope with the daily demands of everyday life.

Having trained as an ILADS preceptor under the tutelage of Dr. Richard Horowitz in Hyde Park, NY, a leading Lyme disease expert, it is Dr. Marra’s belief that an integrated approach to Lyme disease and co-infection treatment is the most effective way to eradicate tick-borne illness. Depending on the patient and severity of the disease, she uses rotating combinations, peptides, botanical medicines, and nutrition to maximize the healing from this all too often debilitating disease.

Without question, the sooner you receive proper diagnosis and treatment, the more likely you will fully recover.

Some patients struggle with detoxifying endotoxins released into the bloodstream from dying spirochetes. These individuals often require a careful combination of antibiotics and herbal treatments to facilitate healing. 

With over 22 years of experience in naturopathic medicine treating adults with chronic Lyme disease and co-infections, Dr. Marra emphasizes that successful healing relies heavily on a strong doctor-patient relationship built on honest communication. This trust allows for informed treatment decisions. Dr. Marra collaborates closely with other Lyme-literate doctors, sharing insights and innovative therapeutic approaches to enhance patient care.

Adult Lyme Disease Treatment with Dr. Marra

At Dr. Susan Marra’s office, we specialize in diagnosing and treating adult Lyme disease with a comprehensive, patient-centered approach. Schedule an appointment or learn more about Lyme disease treatment, call us at 206-299-2676. Dr. Marra is here to help you regain your health and well-being.

Resources for Lyme Disease and Chronic Illness

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When dealing with chronic illness, the more information, and support that you have the better. Below, you will find some resources for Lyme disease, chronic illness, and more that may be helpful and provide a lot of additional information.

The Bacterial Biofilm

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The Bacterial Biofilm is a sticky, viscous negatively charged substance similar to “bacterial slime”, composed of mucopolysaccharides and DNA, and stabilized by minerals and probably heavy metal molecules.  Plaque found on teeth surfaces is an example of a biofilm.  Biofilm adheres to aqueous environmental surfaces like vascular endothelium and proliferates.  Most types of bacteria secrete some form of this substance which allows them to dwell in the vasculature and extracellular matrix of tissues while also living in a community.  By utilizing cell adhesion molecules, the bacteria bind to surfaces, “seed”, and form new colonies allowing for continued proliferation.

A biofilm community can be comprised of more than one bacterial species (and viral species) that cohabitate and engage in “quorum sensing”, an evolutionarily old form of bacterial communication.  This is important as we begin to unravel the mysteries encased within the complicated architecture of biofilm.  Biofilm resembles “cheesecloth” where it is negatively charged,  loose, fluid, and anchored at certain places by positively charged ions including calcium, magnesium, mercury, lead, etc…  This may be why when a Borreliosis/Lyme disease patient undergoes heavy metal chelation, they often experience an exacerbation of symptoms.  Chelation of minerals and metals essentially destabilizes the biofilm, rendering the inhabiting bacteria more vulnerable to the hosts’ immune system and antimicrobials.  Additionally, a recent study demonstrated that bacteria actually sense the presence of ammonia which ultimately regulates the social behavior of species contained within the biofilm community.  The ability to sense ammonia leads the microorganisms to nutritional sources such as proteins which are nitrogen-containing molecules so that feeding can take place.

Dr. Alan MacDonald, a highly regarded Borreliosis/Lyme disease researcher in New York, demonstrated that Borrelia species not only produce biofilm, but can live in the community in any form (i.e., spirochete, L form, spheroplast, and cyst).  Additionally, other zoonotic bacteria such as Babesia, Bartonella, Ehrlichia, Anaplasma, and Mycoplasma species inhabit these communities as well.  The bacterial biofilm is used to both protect the bacteria from the hosts’ immune system, while also serving as a nutritional reservoir in times of harsh environmental conditions.  It’s a very evolutionarily old and efficient way to ensure that many bacteria of a certain species survive, thrive, and replicate.  Essentially, it is “bacterial commune living.”

The biofilm can adequately prevent antibiotics from reaching pathogenic bacteria and this may account for some people developing chronic Borreliosis/Lyme symptoms.  The film is effectively protecting many bacterial species that can later escape the community, reproduce and move on to inhabit other tissues.

Currently, it is not scientifically known how to permanently degrade the biofilm, however, it is known that proteolytic enzymes are very effective at dissolving mucopolysaccharides.  Typically, biofilm is degraded by enzymes including:

  • Bromelain
  • Lactoferrin
  • Lumbrokinase
  • N-Acetylcystein
  • Nattokinase
  • Serrapeptase
  • Wobenzym
  • Xylitol

Also, the peptide, KPV is great at degrading bacterial biofilm.