Newsletter August 2026: Ticks don't follow guidelines...
- PCNM
- Aug 4
- 6 min read
Dr. Tapp's Thought's
My garden is going to be incredibly generous this year! It started off with some questionable leggy seedlings, but I am now growing some impressive tomatoes, peppers, cucumbers, carrots, celery, lettuce, and potatoes!! Not only is it giving me a bounty, it's also giving me a renewed appreciation for why tick checks should become part of everyone's evening routine!
As tick populations grow across Ontario, and they will continue to do so into the fall, it's worth separating fact from fiction. I'm continually surprised by how much misinformation is still floating around, even amongst regulated health care providers!
Here are four of the biggest myths I hear in practice, and the truth, so you can help me share the knowledge.
Myth #1: "The tick had to be attached for at least 24 hours."
Maybe... maybe not. The risk of Lyme disease certainly increases the longer a tick is attached, but there is no magical clock that suddenly starts transmission at the 24-hour mark. If you find a tick attached to you, remove it properly and don't assume you're "safe" simply because you think it wasn't attached very long.
Myth #2: "One dose of doxycycline is enough to treat the infection."
A single dose of doxycycline is recommended after a tick bite, pharmacists in Ontario can even dispense it to you without a prescription from your doctor … but it's intended as post-exposure prophylaxis, not treatment for an active infection.
It may reduce the risk of Lyme disease in certain circumstances, but it doesn't guarantee prevention; you can still develop Lyme disease, even after a single dose of Doxy. It also doesn't address many of the other organisms ticks can carry, including, but not limited to:
Babesia: acutely presents as fever, fatigue, malaise, drenching sweats, air hunger (feeling breathless)
Bartonella: acutely can present with fever, sweating, deep joint pain especially in the feet and shins, swollen lymph nodes, stretch mark like rash, feelings of rage
Anaplasma phagocytophilum: acutely can present as fever, chills, intense migraine, nausea, malaise
The recommendation for a single 200 mg dose of doxycycline is based primarily on one human clinical trial, and even that study reported a very wide confidence interval (25-98%), making it difficult to know its true effectiveness. In animal studies, a single dose prevented Lyme disease in less than 50% of cases. When researchers looked at patients who had already developed the classic bull's-eye (erythema migrans) rash, 20 days or less of antibiotics achieved success rates as low as 52.2%, meaning many patients remained symptomatic or required additional treatment.
Because of these findings, the International Lyme and Associated Diseases Society (ILADS) recommends against relying on a single dose of doxycycline. Instead, ILADS recommends 20 days of doxycycline after a known high-risk blacklegged tick bite (barring any contraindications) and 4-6 weeks of treatment for patients who develop an erythema migrans rash, with reassessment to ensure symptoms have fully resolved.
Myth #3: "Get tested right away."
Testing immediately after a tick bite is actually one of the quickest ways to get a false negative. The Lyme disease testing performed through Public Health Ontario looks for your immune system's response to the infection, not the bacteria itself. Your immune system needs time to recognize the infection and produce detectable antibodies.
Testing is best performed 4 to 6 weeks after a tick bite. Testing earlier than that may simply be too soon for the laboratory to detect your immune response.
Once you've been bitten, start paying attention to how you feel over the next month. Early Lyme disease commonly causes flu-like symptoms such as fatigue, fever, headache, muscle aches, joint pain, swollen lymph nodes, and sometimes neurological symptoms. Not everyone develops the classic bull's-eye rash, so don't rely on the presence or absence of a rash alone.
Unfortunately, the two-tier testing for Lyme disease used by Public Health Ontario misses approximately one-half of actual cases. While that is a discussion for another day, one thing you can also do is consider having the tick itself tested.
Although Public Health Ontario no longer routinely tests ticks submitted by the public, several private laboratories do. One Canadian company is Geneticks, which offers:
Lyme disease panel: approximately $50
Lyme disease plus common co-infections: approximately $150
Comprehensive tick panel: approximately $300
Other laboratories, such as IGeneX and ArminLabs, also offer tick testing. But remember, tick testing isn't perfect either. A positive tick doesn't necessarily mean transmission occurred. It's simply another piece of information that can help guide decision-making.
Myth #4: "Two weeks of doxycycline cures Lyme disease."
If only medicine were that simple. There remains considerable debate about the optimal duration of antibiotic therapy. Different medical organizations interpret the evidence differently and recommend different treatment durations depending on the patient's presentation. The most important thing is that treatment should be individualized. Clinical judgment will always be more valuable than blindly following a guideline.
The bottom line … don't panic. Remove the tick promptly with fine-tipped tweezers or your tick key. Save it if possible.
Contact your healthcare provider to discuss whether antibiotics or other treatments are appropriate for you. Monitor yourself for symptoms over the following weeks, and don't rush into blood work before your immune system has had enough time to respond.
For those of you without an OHIP-covered physician or NP, please know that NDs can order Public Health Ontario Lyme testing; while not perfect, it is a reasonable place to start.
Happy harvesting! May your gardens be plentiful and your tick checks uneventful.
Clinic News
Surgery Is Coming…Are You Ready For It? Webinar Replay
Most people spend more time planning a vacation than preparing for surgery. But what if the weeks before surgery could influence complications, healing time, hospital stay, pain, recovery, and even long-term outcomes?
In this replay, Dr. Brenda Tapp Leonard, ND offers an evidence-informed deep dive into perioperative care and prehabilitation: the science of preparing your body before surgery to improve recovery after surgery.
Whether you’re preparing for surgery yourself, supporting someone who is, or you’re a healthcare provider who wants to better support patients through recovery, this webinar will change the way you think about surgical outcomes. Because surgery starts long before the first incision. Come learn how to stack the deck in your favour.
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Exciting News From Dr. Kori Macarthur, ND
We’re so excited to share with you that Dr. Kori Macarthur's family is expanding!
Her last day for in-clinic appointments is expected to be Tuesday, September 29. After this date, she will shift to virtual video and phone appointments until her maternity leave starts on Tuesday, October 6.
She will begin her return to practice on Wednesday, December 16 with phone appointments available for both follow ups and new patient initial consultations available each Wednesday. Virtual video calls can be accommodated where needed.
Starting in the new year, Dr. Macarthur will begin a gradual return to seeing patients in-clinic with one in-clinic shift available per week and expanded virtual/phone availability becoming available in January 2027.
Throughout her maternity leave, our team will be here to facilitate your continued care. Whether you have questions, need treatment plan clarifications or an urgent consultation, please reach out to our reception team directly for ongoing support. If you’d like to get in to see Dr. Macarthur before October 5, please reach out to us right away to reserve your spot.
A Few Friendly Reminders Regarding Insurance Submissions
First and foremost, if your provider or insurance details have changed, or it has been greater than 1 year since your last appointment, we kindly ask that you bring your card or digital insurance details to your appointment with you so that we can ensure your file is current and accurate moving forward.
For insurance submissions, we wanted to remind you that we only offer direct billing for your primary insurance provider. If you're covered by two plans, we will submit to your primary provider on your behalf and provide you with a detailed receipt for you to self-submit to your secondary coverage once any outstanding balance has been paid. If you've hit your coverage maximums for your primary provider, you will need to self-submit for all appointments and testing until your coverage renews.
If you're booking an appointment for your child and both parents have extended health coverage, coordination of benefits (COB) rules state that the parent whose birthday falls first in the calendar year is the primary insurance provider. In special circumstances or for blended families, COB rules may vary slightly, and we ask that you confirm who the primary provider is with your respective insurance plans.
Having accurate, up-to-date primary insurance on file helps to make your post-appointment billing run smoothly and limits any confusion around claims submissions.
As we enter the month of August, despite the fact that summer is still in full swing, parents may often begin thinking about our children going back to school, and how we can best prepare them to thrive throughout the school year.
Which is why I wanted to talk about an important mineral that is commonly depleted in children.
Iron deficiency* is one of the most common nutritional deficiencies in children and can have a significant impact on growth, development, and learning. Because symptoms often develop gradually, it can be easy to overlook. It’s important to recognize the signs early and seek appropriate treatment to help children thrive both at home and at school.
In this post, we'll explore why iron matters for learning and development, signs and symptoms of iron deficiency in children and what causes it, as well as different options for treatment and prevention.
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