The Root of Wellness®

Georganne Backman Garfinkel, FMCHC, NBC-HWC / Functional Medicine Certified Health Coach, National Board Certified-Health & Wellness Coach

Ticks, Lyme & What Your Doctor Might Be Missing

Most people put away their tick worries at the end of summer, but in the Northeast ticks remain active well into fall and may appear in winter when temperatures are above about 40°F. Symptoms can begin days to weeks after a bite, and some appear months later. If you develop a new rash, fever, facial weakness, palpitations, joint swelling, or unexplained fatigue after possible tick exposure, talk with a clinician.1

LYME DISEASE AND OTHER TICK-BORNE ILLNESSES

Lyme disease is common in the Northeast and can be missed when the bite or rash goes unnoticed.

A few things to know:

You may never see the tick. People with Lyme disease are often unaware of the bite because nymphs can be as small as a poppy seed. Up to 80% of infected people develop an erythema migrans (EM) rash, but it is not always the classic bull's-eye. It may be uniformly red, oval, or otherwise atypical and can be mistaken for another skin reaction.1

Lyme testing has a window period. CDC recommends a two-step antibody test, with the second test done only if the first is positive or equivocal. Tests can be falsely negative during the first few weeks, so a characteristic EM rash with likely exposure is diagnosed clinically rather than by waiting for a positive blood test. Testing becomes more reliable after 4 to 6 weeks. If symptoms persist, ask your medical practitioner whether repeat testing or evaluation for another tick-borne illness is appropriate.2

An integrative perspective: In the functional and integrative medicine world, there are additional nuances around Lyme and other tick-borne illnesses, particularly when symptoms persist despite negative standard testing or after initial treatment. Some practitioners use broader testing and clinical criteria and take a more individualized approach. These areas remain debated, so work with a knowledgeable medical practitioner who can help you evaluate the evidence and your individual situation.

Different tick species in our region can transmit other infections, including babesiosis, anaplasmosis, ehrlichiosis, Borrelia miyamotoi disease, Powassan virus disease, and tularemia. Bartonella is also sometimes discussed as a tick co-infection.3

A recent Long Island alert: On August 6, Suffolk County health officials confirmed a fourth tularemia case on Long Island in 2026. Tularemia, or 'rabbit fever,' can be spread by infected ticks or deer flies and may cause sudden fever, a skin ulcer, and swollen lymph nodes.4

Why diagnosis can be difficult

Lyme can affect the skin, joints, nervous system, and heart, and symptoms such as fatigue, pain, and brain fog overlap with many other conditions. That does not mean every case of fibromyalgia, autoimmune disease, anxiety, depression, or Long COVID is undiagnosed Lyme. If symptoms remain unexplained, ask your medical clinician to consider Lyme and other tick-borne illnesses among the possible causes.

Dr. Richard Horowitz

Dr. Horowitz is a board-certified internist in New York's Hudson Valley and the developer of the MSIDS (Multiple Systemic Infectious Disease Syndrome) framework. 5

His new book, Ending Chronic Illness: A Revolutionary New Program to Reverse Inflammation and Heal Persistent Disease, will be released in October, and applies his MSIDS framework to a broad range of chronic illnesses.6

In this recent episode, Dr. Hyman talks with Dr. Horowitz about infection, immune dysfunction, inflammation, and chronic illness. I highly recommend it.7

Listen: Undiagnosed Infections Are Silently Causing Chronic Disease (Episode 1164)

THREE THINGS TO TRY

1. Do a tick check — and know what to look for

After time outdoors, check your entire body, especially behind the knees, between the legs, under the arms, around the waist, and in and around the hair and ears. Shower within two hours; this may wash off unattached ticks and gives you another chance to check.8

Use an EPA-registered repellent on exposed skin and wear long sleeves and pants in grassy, brushy, or wooded areas. Clothing, boots, and gear can be treated with 0.5% permethrin or purchased pretreated; never apply permethrin directly to skin.8 If you find an attached tick, remove it promptly as per the CDC: What to Do After a Tick Bite. Seek medical advice if concerning symptoms develop.

2. Make a Golden Immune Latte

Turmeric contains curcumin, a compound widely studied for anti-inflammatory effects. Black pepper contains piperine, which can substantially increase curcumin absorption.

A pinch of black pepper increases curcumin absorption by up to 2,000%.

IIngredients: 1 cup unsweetened almond, oat, or coconut milk; 1 teaspoon ground turmeric; ½ teaspoon ground ginger; ¼ teaspoon cinnamon; a pinch of black pepper; 1 teaspoon raw honey or maple syrup, or stevia to taste; optional: 1 shot espresso or strong brewed coffee, regular or decaf.

Whisk the spices with a splash of milk until smooth. Add the sweetener, remaining milk, and coffee if desired. Warm gently, or serve over ice. Finish with cinnamon.

3. Take a relaxing Epsom salt bath

A warm Epsom salt bath can be a simple relaxation ritual and may help ease temporary muscle soreness.

Add 1 to 2 cups to a comfortably warm bath and soak for 15 to 20 minutes. Check with your clinician first if you have kidney or significant heart disease, open wounds, or another serious medical condition.

SUPPORTING NORMAL IMMUNE FUNCTION

A strong immune system won't prevent a tick bite, but it gives your body a much better chance of fighting off infection and recovering fully. It may be the difference between a short acute illness and a long chronic one.

A few things that matter most: Vitamin D deficiency is linked to higher susceptibility to infection, and nearly 42% of American adults are clinically deficient, so get your levels tested.¹³ Rhonda Patrick, PhD, of FoundMyFitness has written extensively on this, calling vitamin D "a steroid hormone that serves as a major regulator of immune function." She recommends aiming for a blood level of 40–60 ng/mL, which is significantly higher than what many conventional doctors consider normal.¹⁴ Vitamin C, zinc, and selenium all support your body's ability to fight bacterial and viral threats. Glutathione, your master antioxidant, is best supported through cruciferous vegetables like broccoli and cauliflower, or supplements like NAC.¹⁵ Gut health is foundational to immune function; fermented foods, fiber, and cutting back on sugar all help. And no supplement overcomes poor sleep or unmanaged stress, both of which directly suppress immune function.

REFERENCES

1. CDC: Signs and Symptoms of Untreated Lyme Disease
2. CDC: Clinical Testing and Diagnosis for Lyme Disease
3. CDC: About Bartonella
4. ABC7 New York: Fourth Case of 'Rabbit Fever' Reported in New York (August 6, 2026)
5. ILADS Fellowship Program: Richard Horowitz, MD
6. Simon & Schuster: Ending Chronic Illness, Official Publisher Page
7. The Doctor's Farmacy: Episode 1164 with Richard Horowitz (July 29, 2026)
8. CDC: Preventing Tick Bites
9. FoundMyFitness: Q&A #6 with Dr. Rhonda Patrick - Vitamin D blood levels (40–60 ng/mL)

Until Next Time

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Please note: This newsletter is for educational purposes only and is not a substitute for individualized medical advice, diagnosis, or treatment. Seek prompt medical care for concerning symptoms after a tick bite or possible tick exposure. Do not change medications or supplements except under the guidance of your medical practitioner.

Be well,

Georganne