People who have been told that they have Alzheimer’s disease or another form of dementia owe it to themselves to ask their doctors one important question—“Could it be Lyme disease?”

Case in point: Singer Kris Kristofferson struggled for years with memory problems. His doctors suspected Alzheimer’s disease or brain damage from sports-related head injuries. Just last year, he got some surprising news: What he really had was Lyme disease, which often causes cognitive problems that can be misdiagnosed as Alzheimer’s disease.

What most people don’t realize: While doctors routinely look for the physical symptoms of Lyme disease, such as a rash, fatigue, joint and muscle pain and unexplained fevers, many don’t realize that psychological and cognitive impairments, including depression, anxiety, short- and long-term memory loss and other symptoms often confused with Alzheimer’s disease, are also important clues.

THE BRAIN AT RISK

Lyme disease is a bacterial infection transmitted by tick bites. The organisms that can cause human infection readily travel from the place where a tick bite occurred into the brain, the sac surrounding the brain (the meninges) or the spinal cord as well as to the muscles, joints, heart and other parts of the body.

What happens next: Infection and inflammation of brain tissue can lead to memory and concentration problems and may also cause psychiatric problems, such as visual and auditory hallucinations that resemble schizophrenia. Infection of nerves in the spinal cord can cause numbness, tingling, burning or stabbing sensations in the arms and legs and/or across the trunk, which can come and go and even migrate to other parts of the body.

Shocking fact: About a quarter of all people diagnosed and treated early for Lyme disease go on to develop a chronic and hard-to-treat infection that often leads to some of the neurological symptoms described earlier, as well as headaches, neck stiffness, light and sound sensitivity and sleep disorders. The percentage is much higher among Lyme patients who aren’t given early antibiotic treatment, who are undertreated or who remain undiagnosed.

WHY IT’S MISSED

Doctors should suspect Lyme disease when patients complain about problems with memory, concentration or other cognitive functions—particularly in parts of the country where Lyme and other tick-borne diseases are rampant (mainly the Northeast and upper Midwest). But Lyme is spreading. Doctors should consider it in dementia work-ups.

Experts advise Americans who live in tick-infested areas to be alert for the earliest sign of Lyme infection—a bull’s-eye–shaped rash surrounding the site of the tick bite. However, only about 50% of Lyme patients ever develop a rash…or they confuse the rash with a spider bite, skin infection or bruise. Unless they know for a fact that they were bitten by a tick—and most don’t—they don’t even consider that Lyme might be the culprit.

More worrisome are the cognitive/psychological symptoms that affect more than 90% of the Lyme patients I’ve treated. These include memory loss and concentration problems, depression and psychiatric disorders…as well as symptoms easily mistaken for those caused by Alzheimer’s disease and other neurodegenerative disorders.

Diagnostic complication: Even when Lyme is suspected, it’s often difficult to diagnose. That’s why doctors should start with a clinical diagnosis that is supported by lab testing. Hallmarks of Lyme include pain that migrates around the body and symptoms that come and go. When used together, the two main blood tests for Lyme disease—the Western blot and the ELISA test—miss about half of all infected patients. To improve accuracy, newer tests such as the C6 ELISA and EliSpot, which show higher sensitivity in detecting evidence of Lyme disease, can also be done. Other options (such as DNA and RNA tests, Nanotrap, etc.) are available, and spinal taps and PET scans may also be helpful.

Best advice: When outdoors, wear protective clothing treated with permethrin (an insect repellent), use tick sprays (those containing IR3535 and picaridin are safer) and do frequent tick checks. Remove any ticks immediately using fine-tipped tweezers and grasping the tick as close to the skin as possible, pulling upward without squeezing. Save the tick so it can be tested and examined by your health-care provider.

Suspect Lyme disease if you experience sudden concentration or memory problems, anxiety and mood swings, headaches, migratory joint or muscle pain, dizziness or other symptoms—especially if you have no history of these problems. Such symptoms can occur within days to months of the bite.

TREATMENT CHALLENGES

People who aren’t treated quickly for Lyme (or those who have Lyme disease along with another tick-borne disease, such as babesiosis or bartonellosis) might not improve when they’re given the standard antibiotic therapy—usually oral doxycycline (Oracea), amoxicillin (Moxatag) or cefuroxime (Zinacef). Because Lyme is more curable when treated early, your doctor might begin medication if you have symptoms (such as migratory joint pain) even before test results are confirmed or if you’ve had a tick bite but are not displaying symptoms of illness. About three-quarters of Lyme patients who take antibiotics within a month of the infection won’t develop long-term symptoms and can be cured.

Important: If you’ve had antibiotic treatment for Lyme but continue to have neurological symptoms, the infection has likely spread to the nervous system. This may require different combinations of antibiotics for a longer treatment period. There are many treatment options, depending on specific symptoms, your medical history, the type of infection(s) and other considerations, such as allergies and the state of your immune and gastrointestinal systems.

How I have treated Lyme patients with persistent neurological symptoms: During the first month of treatment, I might prescribe doxycycline with hydroxychloroquine (Plaquenil), an antimalarial drug that helps to increase effectiveness, with or without the antibiotics metronidazole (Flagyl) or tinidazole (Tindamax) to kill cystic (dormant) forms of bacteria. I find that two or three drug regimens work best for chronically ill patients. Important: Treatment must be tailored to the individual.

ANTI-INFLAMMATORY SUPPORT

The presence of cognitive/psychological symptoms with Lyme disease always means that inflammation is affecting the brain and/or surrounding tissue. When you’re infected, microglial cells in the brain secrete inflammatory substances that cause fatigue, mood changes and problems with memory and concentration. It’s critical to shut down the infection and accompanying inflammation. What helps…*

• Anti-inflammatory supplements, such as curcumin, broccoli seed extract, resveratrol and green tea extract. Take them one at a time or all together. Also consider an antioxidant such as glutathione.

• Stevia, available in supplement form (the Nutramedix brand is effective), has been shown to kill the Lyme bacterium, and it reduces and breaks up Lyme biofilms, “sheets” of bacteria that resist the effects of antibiotics. Gradually work up to 15 drops, twice a day. (Note: This is not the same stevia found in the sweetener section of the grocery store.)

• A good night’s sleep is critical during Lyme treatments. Sleep deprivation increases inflammation…impairs immunity…and increases cognitive/psychological symptoms.

• An anti-inflammatory diet, including lots of healthy, low-carbohydrate fruits and vegetables…no sugar…and little or no red meat. I often recommend a mercury-free fish oil supplement as well.

For more from our report “Frightening Tick Alert—What You Need to Know Now,” please see the following stories…

*If you use prescription medication, have a chronic medical condition or are pregnant or nursing, consult your doctor before taking any supplements.