Avoiding Tick Bites and Lyme Disease this Summer and All Year, with Alexis Chesney, ND

Editor’s Note: INM is grateful to have this guest column on Lyme Disease and prevention from Alexis Chesney MS, ND, LAc is a naturopathic physician, acupuncturist, author and educator. Dr. Chesney is author of the book, Preventing Lyme and Other Tick Borne Diseases.


There are more than 300,000 new cases of Lyme disease diagnosed each year. And while most think of the disease as a summer issue, Lyme disease can occur at any time of the year, which is why being diligent is important year- round, so says the Global Lyme Alliance

What is Lyme Disease? It is a preventable infectious disease transmitted through a tick bite, although fewer than half of people with Lyme disease actually recall a tick bite. Ticks are biting arachnids that can transmit disease-causing pathogens like the bacteria  Borrelia Burgdorferi, which causes Lyme disease, protozoa, or viruses. Prevention is the key

Prevention is one of the six foundational principles of naturopathic medicine. Evaluating and addressing environmental and other external impacts on health is a key component of a naturopathic doctor’s toolkit. To prevent Lyme and tick-borne disease (TBD), there are many proactive strategies to take, including the following:

Addressing tick habitat is paramount. Grass, low-lying shrubs, and leaf litter are common places ticks can thrive. Ticks love high-humidity environments, between grassy and forested areas, wood piles, stone walls, and around the perimeter of buildings surrounded by grass.

Take the following steps to make your land less tick friendly and to address the wildlife, like mice and birds that are common tick hosts: 

  1. Rake and remove leaves. 
  2. Clear brush and debris from grass and gardens. 
  3. Keep grass short. 
  4. Trim shrubs and low branches. 
  5. Create wide, grass-free paths made of wood chips or stone. 
  6. Remove bird feeders or place them on the perimeter of the land. 
  7. Demarcate border areas, where ticks seem to thrive. Consider adding a 3-foot-wide strip of stone or wood chips in places where your lawn meets high-plant growth or any kind of structure, areas that are prime mouse habitat.
  8. Eliminate or limit wood piles, brush piles, compost piles, stone walls, and rotting wood, places that both capture moisture and are prime mouse habitat.

More on Controlling the Habitat Environment for Ticks

Beyond what is listed above, consider tick control treatment options for the land. The natural fungal spray Metarhizium anisopliae strain F52 (Met52) causes a decrease of nymphal deer ticks by 55 percent on lawns and 85 percent on woodland plots.1 Fungus spores attach and penetrate the outer surface of the tick, then grow inside the tick, causing the tick to die. 

This spray does not harm birds, mammals, bees, or aquatic wildlife and is nontoxic to humans. Certain essential oils have also been shown to repel or be toxic to ticks.2 Cedar, rosemary, peppermint, and wintergreen essential oils are among those showing good results. Studies of a commercially available essential oil formulation suggest that high-pressure spray is more effective than a low-pressure spray.

Tick tubes are an excellent intervention to target ticks in areas where mice nest. As Richard Ostfeld who has studied and written extensively on the biology of Lyme Disease explains, “White footed mice are consistently shown to be the most efficient wildlife reservoirs of Borrelia burgdorferi, infecting between 75 and 95 percent of larval blacklegged ticks that feed on them.”3

Place these biodegradable tick tubes filled with permethrin-treated cotton in areas where mice are found. The mice will take the permethrin-treated cotton to build their nests. The permethrin will not harm the mice or other animals, but it will importantly kill ticks at the larval stage. It is the larvae that most often feed on mice, and the permethrin kills them before they have a chance to acquire pathogens from the mice and before they reach the nymph and adult stages, when they might use humans as hosts. Research shows that over an 8-year period, there was on average a 93.6 percent reduction in exposure per hour to infected ticks in treated areas of the Fire Island Pines, New York.4 

Here are effective strategies when in tick territory: 

  • Use personal tick repellent. 
  • Wear permethrin-treated clothing. 
  • Wear light-colored clothing. 
  • Tuck pants into socks and shirts into pants. 
  • Avoid walking through grass and leaf litter. 
  • Treat pets with tick-control products, and check them for ticks every few hours while outdoors and when they come indoors. 
  • When coming in from the outdoors, place clothes directly in the dryer on high heat for 6 minutes to kill ticks.5 
  • Shower soon after coming indoors. Showering will not wash off attached ticks, but it will aid in spotting them and may wash off crawling ticks.     
  • Conduct a full-body tick check. Use sight and touch to sense for any ticks crawling on or attached to the body. Ticks are attracted to warmth and moisture, so make sure to search under the arms, behind the knees, between the legs, inside the belly button, between the buttocks, in the genitals, under the bra, around the waist, around and in the ears, on the head, and between the toes. Use a mirror or another set of eyes to check hard-to-see places. 

Should One Use Pyrethroids? 

The most effective way to kill and repel ticks is to use pyrethroid acaricide, however using pyrethroids on the land has serious environmental consequences because when wet they are toxic to bumble bees, butterflies, and aquatic life, and moderately toxic to birds. To prevent this, the careful use of permethrin (a type of pyrethroid) in treating materials is recommended as an environmentally safe alternative.

Permethrin-treated clothing and gear is highly effective against tick bites and safe for use. In one study, researchers reported that “subjects wearing permethrin-treated sneakers and socks were 73.6 times less likely to have a tick bite than subjects wearing untreated footwear.”6 When treating clothing with permethrin, efficacy lasts for six weeks before requiring further treatment. 

One can buy clothes that have already been treated with permethrin and there are companies that will treat clothing for people. There are factory-based techniques for long-lasting permethrin impregnation of clothing that allows for clothes to hold pesticidal activity against Ixodes scapularis (deer ticks) for 70 washes.7 A study conducted on workers from the North Carolina Division of Water Quality wearing clothing treated by this technique found a 99 percent decrease in the rate of tick bites acquired during work hours and a 93 percent decrease in the total incidence of tick bites.8 

While Lyme and other tick-borne diseases are on the rise, one can be well-equipped with these environmental tick control and personal tick bite prevention tactics. Prevention is the best medicine. Implementing strategies to protect oneself from tick bites and therefore from Lyme disease instills confidence in safely enjoying the outdoors .

More on the topic of Lyme Disease and ticks from Dr. Chesney.


Alexis Chesney MS, ND, LAc is a naturopathic physician, acupuncturist, author and educator. She works full-time at Sojourns Community Health Clinic and has a small part-time private practice. She enjoys getting to the root cause of complex chronic illness and partnering with patients to find wellness and balance in their lives. Her book Preventing Lyme and Other Tick-Borne Diseases, published by Storey Publishing, was released in March 2020. Dr. Chesney is passionate about education and speaks on the topics of prevention, diagnosis and treatment of Lyme and tick-borne diseases at medical conferences and to the general public. She also enjoys mentoring other medical practitioners.


This article is provided by the Institute for Natural Medicine, a non-profit 501(c)(3) organization, partnered with the American Association of Naturopathic Physicians. INM’s mission is to transform healthcare in America by increasing both public awareness of naturopathic medicine and access to naturopathic doctors for patients. INM believes that naturopathic medicine, with its unique principles and practices, has the potential to reverse the tide of chronic illness that overwhelms existing health care systems and to empower people to achieve and maintain their optimal lifelong health. INM strives to achieve this mission through the following  initiatives:

  • Education – Reveal the unique benefits and outcomes of naturopathic medicine
  • Access – Connect patients to licensed naturopathic doctors
  • Research – Expand quality research of this complex and comprehensive system of medicine

References:

  1. Kirby C. Stafford and Sandra A. Allan, “Field Applications of Entomopathogenic Fungi Beauveria bassiana and Metarhizium anisopliae F52 (Hypocreales: Clavicipitaceae) for the Control of Ixodes scapularis (Acari: Ixodidae),” Journal of Medical Entomology 47, no. 6 (November 2010): 1107–15, doi:10.1603/me10019
  1. Catherine Regnault-Roger, “The Potential of Botanical Essential Oils for Insect Pest Control,” Integrated Pest Management Reviews 2, no. 1 (February 1997): 25–34, doi:10.1016/j. jep.2016.11.002
  1. Richard S. Ostfeld, Lyme Disease: The Ecology of a Complex System (New York: Oxford University Press, 2012).
  1. “Damminix Tick Tubes Test Results on Fire Island, N.Y.,” Ecohealth Inc., www.ticktubes .com/downloads/ticktubes_fire_island_study.pdf. Accessed March 11, 2018. 
  1. Christina A. Nelson, et al., “The Heat Is On: Killing Blacklegged Ticks in Residential Washers and Dryers to Prevent Tickborne Diseases,” Ticks and Tick-Borne Diseases 7, no. 5 (2016): 958–63, doi:10.1016/j.ttbdis.2016.04.016
  1. Nathan J. Miller, Erin E. Rainone, Megan C. Dyer, and Liliana Gonzalez, “Tick Bite Protection with Permethrin-Treated Summer-Weight Clothing,” Journal of Medical Entomology 48, no. 2 (January 2011): 327–33, doi:10.1603/me10158.
  1. Meagan F. Vaughn and Steven R. Meshnick, “Pilot Study Assessing the Effectiveness of Long- Lasting Permethrin-Impregnated Clothing for the Prevention of Tick Bites,” Vector-Borne and Zoonotic Diseases 11, no. 7 (July 2011): 869–75, doi:10.1089/vbz.2010.0158
  1. Sullivan, Kristin M. Sullivan, Alison Poffley, Sheana Funkhouser, et al., “Bioabsorption and Effectiveness of Long-Lasting Permethrin-Treated Uniforms over Three Months among North Carolina Outdoor Workers,” Parasites & Vectors 12, no. 1 (January 23, 2019): 52, doi:10.1186/ s13071-019-3314-1
  1. Chesney, Alexes, ND, Lac, Excerpted from Preventing Lyme and Other Tick-Borne Diseases. Used with permission from Storey Publishing (2020).

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Deb Hubers

Debra Hubers is a serial entrepreneur and has started seven businesses; ranging from an advanced genomics to an employer health care purchasing cooperative. Deb has over 35 years of experience in healthcare finance, education, technology, and pharmacogenomics.

Ms. Hubers has dedicated her career to measuring and improving healthcare outcomes. Her expertise is leveraging technology to deliver personalized, preventative medicine. Ms. Hubers co-founded La Vita Compounding Pharmacy in 2007. Collaborating with her business partner, physicians and strategic partners, Deb has grown La Vita to be one of the most respected and sought-after personalized medicine providers on the west coast. She is also Co-Founder of EpigeneticsRx, a leading provider of precise, personalized, prevention which positively impacts genetic expression.

Alex Keller, ND

Dr. Alex Keller, ND, AFMCP is a graduate of the University of Ottawa with an Honours Bachelor in Health Sciences and Psychology. Although originally intending to attend conventional medical school, following a three-month volunteer internship at a rural Kenyan hospital where he observed how doctors used local food to treat patients, he shifted his career goals and pursued a degree in naturopathic medicine at the Canadian College of Naturopathic Medicine in Toronto.

After one year of practicing with the esteemed Dr. Chris Pickrell, ND, RH in a community acupuncture setting, in 2015 he and his wife Dr. Jenn Keller, ND moved to rural Ottawa, Canada where they started an organic farm and retreat center. In the same year, Alex and his athletic therapist sister Jess Keller combined their practices to form Keller Active Health, an integrative physical therapy clinic.

Ever curious and passionate about the education of evidence-based natural medicine, in 2017, Dr. Keller joined a fledgling Ottawa-based health tech startup named Fullscript. He serves as its Medical Director and oversees the development of medical education content for practitioners across North America.

Prior to medicine, Alex worked in the renewable energy sector, where he developed a deep passion for sustainable agriculture and environmental stewardship. This connection between medicine and agriculture now drives Alex to focus much of his energy on bringing awareness to the quality and sourcing standards in the supplement and organic agriculture supply chains.

Today, he splits his professional time practicing as a clinician, working for Fullscript, and expanding the farming operation while chasing his kids with Jenn and occasionally running ultra-marathon trail races. He is also currently completing an Executive MBA through the Quantic School of Business & Technology with a focus on supply chain innovation.

Pamela Snider, ND

Pamela Snider, ND, is Executive and Senior Editor for the Foundations of Naturopathic Medicine Project, producing a first of its kind international textbook of Naturopathic medicine through a series of international retreats and symposia. A nationally recognized integrative health and policy leader, she is active in both national and regional integrative health initiatives. Dr. Snider serves on the Board of Directors, was founding Executive Director and co-founder of the Academic Consortium for Integrative Health (ACIH/ACCAHCa consortium of the councils of schools, accrediting agencies and certifying bodies of the licensed, traditional and emerging integrative health professions, and is currently Vice Chair and co-founder of the Integrative Health Policy Consortium (IHPC).  Dr. Snider served as a founding Board Member of the Academy of Integrative Health & Medicine from 2014-2016. Her public policy work includes completing a two year appointment to the DHHS Center For Medicaid and Medicare Services (CMS) Medicare Coverage Advisory Committee (MCAC); serving as a Steering Committee Member for  the HRSA funded American College of Preventive Medicine NCCIM Integrative Medicine in Preventive Medicine Residency program, co-directing in USPHS Region X the Building Bridges Between Provider Communities Group, an exploration of interdisciplinary collaboration and common ground between public health and CAM; serving for 22 years on Washington State’s Health Professional Loan Repayment and Scholarship Program Advisory Committee (HPLRSP); providing technical assistance to and developing key language for the enabling legislation for NIH Center for Complementary and Alternative Medicine (NCCIH/NCCAM); and staffing Joseph Pizzorno ND during his appointment as Commissioner on the White House Commission on CAM Policy.

From 1994-2003, Dr. Snider served as Associate Dean for Public and Professional Affairs and Naturopathic Medicine at Bastyr University, dividing her work between academic and public affairs activities, including chairing the Naturopathic Medicine Program Curriculum Review Committee.  Dr. Snider has been teaching, publishing and lecturing widely on Naturopathic philosophy, theory integrative health, public policy, and other topics for over 30 years. Currently, an Associate Professor at National University of Natural Medicine (NUNM) in Portland, OR, Dr. Snider also continues at Bastyr University in her 22nd year as a faculty member teaching naturopathic medicine history, clinical theory, and global context. Among her Naturopathic medicine professional roles she serves on the Institute for Natural Medicine’s Leadership Council.  In 1989, she co-led the naturopathic profession with Dr. Jared Zeff, in developing a unifying definition of naturopathic medicine and its principles of practice adopted unanimously by the American Association of Naturopathic Physicians (AANP) House of Delegates. She was a co-investigator in the 2004 NIH NCCAM research study, the North American Naturopathic Medical Research Agenda and CAM Advisor in NIHCCAM’s Financing Integrative Health Care (University of Washington).  Her areas of experience include healthcare education; naturopathic and interdisciplinary clinical theory, curriculum development; clinical practice; government and legislative affairs, public policy, interdisciplinary collaboration, and community organizing.  Dr. Snider has received the Ontario Naturopathic Physician of the Year Award, the Physician of the Year Award from the AANP, the President’s Outstanding Vision Award and Distinguished Alumnus Award at Bastyr University, AANP’s President’s Award, an honorary Doctorate of Naturopathic Philosophy from the Canadian College of Naturopathic Medicine (CCNM), the William A Mitchell Vis Award from the AANP and The Gathering – NMSA’s Beacon Award. She received her ND degree in 1982 from Bastyr University of Natural Health Sciences and is a licensed naturopathic physician in the State of Washington. She lives with her husband and children at their homestead in North Bend Washington, in the beautiful mountain to sea landscape and home of The Revival – Restore the Vis, an annual student-led community gathering.

Susan Haeger

Susan Haeger is Founder/Principal of Transformative Health Solutions Inc. She has applied her twenty plus years in executive leadership to help shape and drive adoption of progressive health policy for whole person healthcare. She was a section contributor to the 2021 INM/AANP published professional white paper, Naturopathic Physicians as Whole Health Specialists: The Future is Whole Person Health Care that provides supporting evidence for the profession’s significant and unique contributions to preventive, whole person care and models of integrative clinical practice.

Bruce Barlean

Bruce Barlean is an owner and founder of Barlean’s, a global dietary supplement manufacturer located in the Pacific Northwest in Ferndale, WA. Bruce has been actively involved in the Natural Products industry since 1989 and is passionate about making a difference in the world and positively impacting the lives of others.

Bruce believes that people can make a difference in the world through ordinary purchases. He is committed to improving the quality of life for every person on the planet by making the best products and by using the profits to support outreach programs. Bruce summarizes it simply, “We make good stuff to do good stuff”.

In the late 1980’s Bruce became passionate about how health could be dramatically improved with Flax Oil Supplementation. Bruce along with his entrepreneurial parents saw the potential to improve the lives of many people and in 1989 they began selling Flax Oil under the Barlean’s name. From 1989 – 2000 the business grew an average of 40% year over year. While most companies saw a decline in business in the 2001 recession, Barlean’s continued to grow and soon became America’s #1 selling flaxseed oil and continues to be to the present. The brand has since expanded to include additional oils, green food concentrates and other premium supplements. Bruce continues to drive innovation and over the years his products and company have won countless awards including: Eight consecutive Vity Awards for #1 EFA, Six consecutive Vity Awards for #1 Greens Food Supplement, Natural Choice Award for Best Specialty Supplement, Best Product of the Year, Best New Product, Gold Medal Taster’s Choice Award, Gold Medal American Masters of Taste Award, #1 Health Food Store Brand for Consumer Satisfaction by Consumer Lab, and Manufacturer of the Year.

In 2013 as the company was on the eve of celebrating the 25th year in business Bruce and his parents decided to take their desire to help people to a new level that they call Pathway to a Better Life – which is now seen in the Barlean’s logo. Bruce and his parents had always been generous in their giving and support of charities, but as part of the Pathway to a Better Life they decided to increased partnership with charitable organizations such as: Vitamin Angels, Compassion International, KidsTown International, Autism Hope Alliance, Engedi Refuge, Project 92, and others. And because so many people are unable to meet basic nutritional needs, Bruce created a comprehensive Omega-3 and multivitamin formula that he distributes free-of-charge to local food banks. In addition, Bruce decided the company would supply food banks with organic coconut oil to provide people with a health alternative to standard cooking oils.

Always generous with his time Bruce has served as a youth leader for his local church for several years and continues to mentor youth. He has been on several not for profit boards including; Whatcom County Pregnancy Center (2003-2006), Natural Products Association (dates?), and the Institute for Natural Medicine Leadership Council (presently).

The Barlean family have been avid supporters of Bastyr University since the 1990’s and in 2013 were given Bastyr’s most prestigious honor, the Mission Award, which recognizes their leadership over time in improving the health and well-being of the human community.

Bruce currently resides in Ferndale, WA with his wife Lisa and their two dogs: Heinz & Shadow. When he’s not helping others he can be found fishing (catch & release).

Get Involved!

Michelle Simon, PHD, ND

President & CEO

As president and CEO of INM, Dr. Simon brings her passion for working with organizations dedicated to improving the quality and delivery of healthcare. This desire stems from her years of practice as a licensed naturopathic physician. In addition to holding a Naturopathic Doctorate from Bastyr University she also holds a PhD in Biomedical Engineering from the University of North Carolina at Chapel Hill.

She has served on boards for the American Association of Naturopathic Physicians (AANP), the Naturopathic Physicians Research Institute (NPRI), and several advisory boards. Dr. Simon served nine years on the Washington State Health Technology Clinical Committee, as Ambassador to the Academy of Integrative Health and Medicine (AIHM) and was recognized as 2018 AANP Physician of the Year. Dr. Simon shares with her husband a passion for adventure travel, preferably by boat or motorcycle. She also enjoys teaching a women’s off-road motorcycling class.