Will There be Cake?

I have Lyme. I’d like to not have it anymore. I also just want cake.

You Can Get Bit and Not Immediately Sick – Here’s How.

It is well known in the Lyme community that a very large percentage of us never recall getting bit. But does the general population really understand this phenomenon? Before Lyme so rudely interrupted my life, it was the furthest thing from my radar. ranges-of-tick-sizesI thought ticks were these big gross bugs that would be impossible to miss, and frankly, I’d never seen one so… out of sight out of mind, right? Besides, you’re supposed to get like, immediately sick from a bite if you have Lyme so, totes hard to miss, I was sure of it. Unfortunately, this is deadly thinking. And I’m paying for it. If I could scream from the mountain top one thing to the people, it would be that TICK BITES ARE MORE ELUSIVE THAN OTHER INSECT BITES, AND YA’LL CAN BE INFECTED WITH A DEVASTATING AND USUALLY INCURABLE DISEASE AND NOT EVEN KNOW IT! I would scream it. I would. See that little guy under the dime? The one second from the right? It is a nymph tick (adolescent stage if you will), and they are ever just as hungry, pathogen-filled, and dangerous as their bigger, more adult form that we always picture in our heads when someone says “tick”. You’re more likely to notice a mosquito bite. You are. This should frighten you.

giphy

 Now that my fear-mongering opening PSA is out of the way…

Let’s get sciency. Let’s talk biological things. Let’s get down and dirty with spirochetes. Let’s understand how this vicious little bacteria can go from tick belly to human brain without you ever knowing (okay so maybe a little fear mongering left in me still). This stuff is important guys. Getting a tick bite (or two or twelve or who can really say) as a child and never knowing was the single most defining act of my future destiny. It carved in stone a future illness with no cure. It started the silent ticking of a timer on a countdown to collapse.

So like, let’s say there is a human. This human likes doing some of the following normal human things that put him at risk for a vector borne illness like Lyme:output_lCr5VY

I mean, I ain’t sayin hide yo kids, hide yo wife…  I won’t say don’t live your life. But live it with awareness. I know of someone who got a tick bite in a movie theater. Movie theater guys. Movie theater. Okay so back to our hypothetical human. Some teeny little nymph tick the size of a sharpie dot bites him. If only he saw it… but most don’t. If only he felt it… but most won’t…

The infection process is complex. This is where we take off the gloves and just start using a ton of big words. Que science!

To: You, With Love, From: Tick

Borrelia just chills out in the stomach of a tick by attaching itself to receptor sites ticks have in their gut for the borrelia outer surface protein A (OspA). This alone blew my mind. Ticks and borrelia are made for each other. As the tick begins to feed on our little human guy, the influx of his blood signals the Lyme bacteria to multiply and prepare to disseminate to the tick’s saliva glands. They begin to arm themselves with a big bag of tricks to avoid our immune system. To understand his tricks, you should know some basics about the immune system. There are two components: (this graphic is poor I know it’s poor)chapter-21-the-immune-system-1-4-638In a nutshell, your innate immune system is designed to roam the body looking for things that shouldn’t be there (whether viruses, bacteria, parasites, or even our own damaged or dead cells) and kills and/or cleans them up as best it can. It does this through inflammatory, often symptomatic processes. However, the innate immune system can not make antibodies. It’s only purpose is to “stave off the invaders” long enough to give the adaptive immune system time to be exposed to pathogen antigens (their surface proteins) and begin forming antibodies that match them. The adaptive immune system is the real key to beating infections and forming lasting resistance to those infections in the future. Those symptoms you feel when you get the flu? That’s your innate immune system throwing out inflammation bombs in action. Your symptoms subside as your adaptive system shows up and is all like “guys chill, we’re ready now we got this”. Seasonal allergies? Food allergies? Mast cell activation? These are all symptoms of a chronically over-active innate immune system. These first responders are programmed to fight until relieved by the backup. It is believed many chronic conditions are the result of a breakdown in communication between these two immune systems, i.e. the adaptive just doesn’t show up whether due to weakening, low cells counts, disease, or immune suppression…. and thus chronic innate-mediated inflammation perpetuate.  All hallmark conditions associated with Lyme disease.

Now that we know that, borrelia has different tricks to evade both. Before it even leaves the tick it is preparing evasion from the innate immune system and a take-down of the adaptive system. If borrelia can successfully weaken the adaptive system enough, it knows it is home free as the innate system alone can never eliminate it. Three main stages of trickery have been discovered, and certainly there may be more. Let’s discuss them stages in order.

  1. Downregulation of surface proteins – Before entering the human body, Lyme will begin to hide their surface proteins known to make some of our innate immune cells go absolutely Up. The. Wall. For example, outer surface protein A (OspA), the one that fit receptors in the tick guts, is a particularly potent stimulator of our neutrophils and will cause the body to release pro-inflammatory cytokines (small proteins that are released by cells to signal and direct the behavior of other cells). Borrelia will downregulate OspA incredibly quickly as soon as host blood begins flowing into the tick’s belly. This not only prepares them to evade our detection systems, but also allows them to detach from the receptors in the gut of the tick so they can begin flowing towards our human. lyme_pathology1Another borrelia surface protein, (OspC), on the contrast, will rapidly upregulate. OspC will bind a specific protein (Salp15 but others have also been identified) in the saliva of a tick to itself and will wear it for weeks. This protein will, among many things, downregulate human T cell activation (a vital component of the adaptive immune system). Basically, these bacterias be stealin war tactics from even the ticks themselves. *Sidenote, the ticks use this protein found in their saliva to prevent your immune system from fighting the tick itself during its feeding. Hence, you can go days without feeling pain or an itch or what have youseethisisscaryyoushouldbeconcerned. Thus borrelia slips into the body past our first responders and simultaneously weakens the response of our second responders, buying itself plenty of time to spread. Finally, it has been proven that borrelia will also release decoys of themselves (via a protein that our antibodies will attach to). These decoys will not only bind to our antibodies and decrease their concentration in the body, but will also send the immune system chasing after them instead of borrelia. Seriously like, so rude. The ability to shapeshift, wear invisibility cloaks made from their own or other life form’s proteins, make decoys, and change their own surfaces at will tell me this bacteria is basically, honestly, terrifying. giphy (2)
  2. Hiding in difficult-to-reach parts of the body – Borrelia has niche hot-spots in the body it likes to migrate to once it has found itself some prime human real estate, most notably joint and nervous system tissue. These areas are blood-poor, difficult for immune cells to reach, and give Lyme a chance to put up their feet. They use flagella (a little tail like appendage that help them “swim”, so to speak) to spread through extracellular matrix which they dissolve pathways through with the help of a specific protein. From there, any organ is at risk. It is important to note that Lyme prefers not to raft around lazy river style in the bloodstream, it’s too smart for that. Extracellular matrix (the matrix of molecules secreted by cells that provide biochemical and structural support to those cells) is considered an immunologically challenged area. This is why your blood tests fail, you get false negatives, or nothing ever seems to show up and doctors call you ca-razay. Blood tests for Lyme is like looking for an elephant in the arctic – they just don’t hang out there.
  3. Central nervous system takedown – Lyme’s ultimate end game. There are two thought patterns for how borrelia gets into the CNS. One states that Lyme can reach it simply through the skin at their point of entry by traveling structures like peripheral nerves. The more commonly accepted belief is that Lyme will briefly enter the bloodstream where they can arrive at cerebral or spinal vessels. But to play devil’s advocate, studies have shown the presences of highly inflammatory substances in CSF fluid of patients while simultaneously finding very little in the circulatory system. Would this not suggest a route other than blood was used? There are likely many routes of CNS infection, we just don’t know it yet. As for how borrelia passes through the blood brain barrier, it is still not well known. I mean, they drill through it right? But, how? Again, two patterns of thought: one is they pierce through the endothelial cells or two, they use their ability to enter our cells directly for transport across the blood brain barrier. Like a little ferry boat of hell. Either way, our hypothetical human has bacteria in his brain now. And still, he can very well be asymptomatic and doesn’t know it. mol14_3p0205f4

Borrelia (squiglies) attached to neuronal cells. 

Once in the brain, however, human’s carefree and healthy days are numbered. Eventually the infection manifests and will illicit a symptomatic and damaging inflammatory response within the central nervous system. These symptoms are caused by potentially several mechanisms – direct cytotoxicity, neurotoxic mediators, or triggered autoimmune reactions.

  1. Direct cytotoxicity (quality of being toxic to cells) – We often talk about how Lyme secretes its own toxins which injure cells. However some studies are uncovering possible additional reasons for toxicity such as friendly fire and cellular debri.
  2. Neurotoxic mediators – Borrelia can adhere to certain cells in the CNS and as a response those cells will release their own toxic substances or induce cell death. Schwann cells (which keep nerve fibers alive and produces myelin sheaths to protect them), appear to secrete nitric oxide in monkeys infected with borrelia. This would certainly damage surrounding cells and myelin.
  3. Triggered autoimmune reactions – Borrelia also appears to provoke autoimmune reactions by inducing inflammatory cytokines in our glial cells (major player in the brain’s immune system). Not only this, it has been found that certain antibodies to borrelia can cross-react with neural antigens. Which in layman’s terms means that your body’s own antibodies meant to fit surface proteins on borrelia like delicate puzzle pieces will also fit on and attach to the surface proteins of some neural cells. This kills the cell. It is not a far cry to link Lyme with Neurodegenerative diseases (or other autoimmune disorders) at this point. Anybody with such an illness should explore deeply a Lyme possibility. This isn’t just anectodal, this is like I’ve said, science.

 

Now finally, our human is sick. Very sick. It may be months after his bite it may be decades. There is no time frame for symptom development for Lyme. In fact, there are no rules at all. And because it’s likely he didn’t notice his bite, and his blood tests will be normal or inconclusive, and his symptoms can be any set of random things, it’s likely Lyme won’t be the first thing considered. Or the second, or seventh. Unless our human knows the facts. This is why I’m spreading the facts. I didn’t sit down today with the intention of inducing a panic attack in you, but one would be warranted, if you like. I mean… no way to notice every tick bite, no way to always know when infected, no way to prove infected, nothing but just waiting for the timer to stop and the bomb to detonate. Go on, panic, I’ll give you a minute.

Okay, time to wrap this up. I’m on a wooden chair and I just can’t.

giphy (3)

In our world we currently have two popular opinions of bacteria, namely, 1) infections in the modern world are killed with ease using short courses of antibiotics, and 2) the really dangerous bacteria make you immediately, umistakeabley ill, and kill quickly. Lyme behaves like neither (or if it does, it’s opinion #2). And since Lyme is currently the most prevalent vector born disease in the northern hemisphere, people should take note.

To summarize, I wrote this post to establish credible scientific evidence for the following Lyme FACTS:

  1. Ticks can be tiny and most may never notice a bite.
  2. A large majority will NOT GET SICK RIGHT AWAY.
  3. Borrelia infections can persist for years or even decades while you are UNAWARE.
  4. Testing is not accurate.
  5.  A borrelia infection IS a ticking time bomb.
  6. A disseminated infection destroys lives and is UNCURABLE.

I didn’t talk about that last one but, I mean, it’s true and you should know it. I am living all six facts today. Check your kids after they play outside. Dress appropriately. Wear repellent. Don’t just look for the big ticks, be aware of just how tiny they can be. Don’t accept the first negative Lyme test you receive if you are mysteriously ill. Don’t “sit and see what develops” if you or your child does get a tick bite. Demand a course of antibiotics even if you need to go to several doctors to get it. Demand it!

There, I shouted from my mountain. And I’m now getting off this chair. Peace.

 

*Sources:

How Lyme Evades the Immune System from Tick to CNS

Tick Spit helps Borrelia

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13 comments on “You Can Get Bit and Not Immediately Sick – Here’s How.

  1. Michael
    February 25, 2017

    Have you ever noticed a reduction in symptoms after having the flu or some other transient illness?

    Like

    • tarathackeray
      February 25, 2017

      No I haven’t… flus only exacerbated symptoms for a time.

      Like

      • Michael
        February 25, 2017

        Ok thanks. It’s something I have noticed in my situation. I have wondered if the spike in my immune system brought on by the flu big had an effect on whatever I caught from the tick

        Like

  2. Lucia
    July 10, 2016

    Thank you❤️

    Like

  3. Carole
    May 22, 2016

    Thank you for all you do 💜

    Liked by 1 person

  4. Lauren
    May 19, 2016

    Hey! I Just wanted to let you know that i really love your blog and all that you do and so bravely share. I am of close age and have had such a similar story, symptoms, and diagnosis (lyme, babesia) and i randomly started developing a mysterious and scary autoimmune disease called scleroderma before i knew it was lyme. I am in the thick of my treatment now and you’re blog is fantastic, keep going! All the best and healing wishes.

    Liked by 1 person

    • tarathackeray
      May 19, 2016

      Thank you so much! Best wishes for you too as you get better and can get on with life ❤️

      Like

  5. Das Nathan
    May 12, 2016

    Found it of great interest as we try and get our daughter well. However, would appreciate a bit more info on note 6 – that the disease is incurable. Any thoughts or further clarification would be much appreciated. Are we just hoping for something that is not achievable? Would love to get more info on this and what you feel are the issues ref a full recovery. Thanks again!

    Liked by 1 person

    • tarathackeray
      May 12, 2016

      It’s generally accepted that late-stage Lyme is incurable as far as being impossible to kill every last spirochete, as well as it being impossible to prove such. However a complete remission of symptoms is. I will look into this further with studies and see what I can find.

      Like

      • Das Nathan
        May 12, 2016

        Hi, Thanks for the clarification. At this moment, just getting her back to good health is all that we want. Any further details would be greatly appreciated. I have found your blogs of great interest as it actually gives us some details which we are unable to get from other sources e.g. the success rate study. So thanks again and greatly appreciate your time and energy!

        Like

      • tarathackeray
        May 12, 2016

        Thank you!

        Like

  6. Heather
    May 10, 2016

    This post is so informative, terrifying, and humorous all at the same time 🙂
    I stumbled across your blog a few weeks ago, and I am so happy to have found it. I’ve poured over your older posts over the last few weeks. Some posts had me in tears b/c they were so funny, others b/c they were so moving. How you are able to put all of what Lyme brings to the table (and doesn’t) is beyond me. You have such a beautiful gift. Thank you for sharing it.
    Best regards😊

    Liked by 1 person

    • tarathackeray
      May 10, 2016

      Aw thanks Heather. I needed to hear this today! Many blessings! 😊

      Like

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