Dr. Steven Bock Answers Questions from the Lyme Disease Patient Community
Last Updated: March 2026
Lyme Advise recently asked our community a simple but powerful question on social media:
“If you could ask a Lyme-literate doctor any question, what would it be?”
The response was overwhelming. Patients living with Lyme disease often have questions about diagnosis, treatment options, coinfections, and how to navigate the complexities of long-term illness.
To help address some of these concerns, we shared the community’s questions with Dr. Steven Bock, an integrative physician based in Rhinebeck, New York, who has spent decades treating patients with Lyme disease and other complex chronic conditions. Dr. Bock is also a two-time past president of the International Lyme and Associated Diseases Society (ILADS), a professional medical organization dedicated to advancing the understanding, diagnosis, and treatment of Lyme disease and other tick-borne illnesses through physician education, research, and clinical collaboration.
Dr. Bock generously agreed to provide his insights and perspectives for the Lyme Advise community.
A Thank You to Dr. Steven Bock
We extend our sincere thanks to Dr. Steven Bock for taking the time to answer these questions and for continuing to support the Lyme community through his clinical work and patient education.
If you would like to learn more about Dr. Bock and his integrative approach to treating Lyme disease and complex chronic illness, you can explore his practice here.
Q: Are you ILADS trained? Could you also please elaborate and tell us more about your training, experience working with Lyme patients, and any continued work you do with ILADS?
A: I am one of the founders of ILADS and am currently on the board. I started learning about and treating Lyme disease 29 years ago. Currently, approximately 75 percent of my practice revolves around treating Lyme disease and tick-borne illnesses.
Q: What do you do to stay on top of the latest findings and research?
A: I attend and teach at conferences multiple times a year and am involved with collaborative conferencing with other Lyme specialists where we work together to share information. I also learn a lot from patients, I listen to what is working for them, research new therapies and treatments they’re interested in, and spend personal time learning about up and coming alternative treatments and products that they’ve brought to my attention.
Q: Do You Treat Biofilms And Cyst Forms Of Lyme Disease?
A: Yes
Q: Do you jump on the bandwagon for new options or stand back and observe for a bit to evaluate efficacy, etc? Neither is necessarily bad in my opinion, but it can help determine whether or not the practitioner's philosophy is in alignment with our own.
A: It depends entirely upon the treatment in question. Let’s take UVL for example. A colleague of mine called and suggested I give it a try so I did my research, liked what I learned, and began treating patients shortly thereafter. We have had great results and now have 4 machines between our Albany and Rhinebeck offices.
Q: Do you think this is an AIDS-like disease that targets the B cells?
A: No. AIDS kills B cells whereas Lyme decreases the B cells ability to duplicate, affecting the number and quality but doesn’t specifically target and kill B cells.
Q: What is your opinion on the drug Rituxan for treatment?
A: I don’t use Rituxan as a treatment. I have many things that I prefer to use, for example, Nutritional and Herbal, or Ozone Therapy for the treatment of Autoimmune disease.
Q: What do you do if you’ve been told you have Fibromyalgia and neuropathy, you’ve been bitten by a tick years prior, you never took antibiotics, and you have tests for Lyme that are of course negative?
A: If you have symptoms compatible with lyme and negative test you still might need treatment. Lyme is a clinical diagnosis and a negative test DOES NOT RULE OUT DISEASE! You need to be properly evaluated by an LLMD. Be sure to have your medical records and a written chronological order of all symptoms and medical history prepared to present to your Lyme specialist as they help assist with clinical diagnoses.
Q: If you have intense and aggravated symptoms in the beginning--does that mean you are more likely to continue to have problems and flair ups throughout your life?
A: No. Your immune system could have been weakened due to other extenuating factors. There is no way to answer this without a patient’s detailed medical history.
Q: Why does it clear up and go away in some people and in other people it is a persistent and never ending battle? Does it have to do with the person's genes, or is it the amount of time before treatment was started, or the type of treatment that was initially given? Is it predetermined who will have problems before the tick even bites?
A: It depend on the person, how many tick-borne related infections and the health of the individual's immune system.
Q: Are intense/aggravated symptoms a sign of repeat infection? What causes a dormant infection to become active?
A: Lyme is a spirochete that has the ability to hide and lie dormant for months or years. It absolutely can be aggravated and activated. Things such as a new bite, stress, deep tissue massage, flu shot, too much sugar or stress can all trigger dormant Lyme.
Q: Is transmission of co-infections in utero, not just Lyme disease, possible? If yes, which co-infections are transmitted in utero?
Related research: A 2019 review, Babesiosis in Pregnancy: An Imitator of HELLP Syndrome, highlights that babesiosis may be spread by ticks, transfusions, or congenitally.
The authors also note that recognizing and treating this infection during pregnancy is important to help optimize maternal and fetal outcomes.
Khangura RK, Williams N, Cooper S, Prabulos AM. Babesiosis in Pregnancy: An Imitator of HELLP Syndrome. AJP Rep. 2019 Apr;9(2):e147-e152. doi: 10.1055/s-0039-1687873. PMID: 31041119.
A: Yes, all of the co-infections can be transmitted through the placenta.
Q: Will I ever be able to have a family?
A: Yes, if you are treating or have previously treated and you have no symptoms. Having a good doctor is crucial so seek out an LLMD and a good fetal maternal doctor who can work together to benefit the mother and baby. It’s equally important to eat well, avoid sugar and rest as much as possible. This year, I have had 5 patients with chronic Lyme have babies and everyone is doing very well. Dr. Charles Jones, a pediatric Lyme specialist, did a study giving antibiotic treatment to pregnant mothers and 95 percent were healthy and fine.
Lyme disease is a complex and often misunderstood condition, and many patients spend years searching for answers. Conversations like this one help bridge the gap between patients and physicians by addressing real questions that arise in the Lyme community. By sharing insights from experienced clinicians like Dr. Steven Bock, we hope to provide patients with additional perspective as they navigate diagnosis, treatment options, and long-term health decisions.
Dr. Bock has spent decades working with individuals facing complex chronic illnesses, including Lyme disease and associated tick-borne infections. His integrative approach reflects a growing effort among clinicians to better understand and manage these multifaceted conditions through patient-centered care and ongoing medical education. Physicians involved with organizations like the International Lyme and Associated Diseases Society contribute to professional collaboration and research aimed at improving the diagnosis and treatment of Lyme disease and related infections.
Key Takeaways
Lyme disease treatment often requires an individualized approach.
Lyme-literate physicians stay informed through ongoing education, conferences, and collaboration.
Patients often benefit from preparing questions before their medical appointments.
Understanding co-infections and symptom patterns can help guide discussions with a Lyme-literate physician.
Below, we’ve also compiled answers to some frequently asked questions about Lyme disease and Lyme-literate physicians to further support patients and families seeking reliable information.
FAQs
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A Lyme-literate doctor (often referred to as an LLMD) is a physician who has additional experience diagnosing and treating Lyme disease and other tick-borne infections. Because Lyme disease can affect multiple systems in the body and present with a wide range of symptoms, many physicians pursue additional education to better understand complex cases. Organizations such as the International Lyme and Associated Diseases Society (ILADS) provide training, conferences, and clinical guidelines to help doctors stay informed about evolving research and treatment approaches.
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Lyme disease can affect the nervous system, joints, immune system, heart, and other organs. Symptoms may overlap with many other conditions, including autoimmune diseases, chronic fatigue syndrome, fibromyalgia, and neurological disorders. In addition, current laboratory tests have limitations and may not detect every case of Lyme disease. Because of this complexity, many physicians consider a combination of clinical history, symptoms, and laboratory results when evaluating patients.
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Lyme disease symptoms can vary widely from person to person. Some individuals develop early symptoms such as fatigue, fever, headaches, joint pain, or the well-known “bullseye” rash. Others may experience neurological symptoms, migrating joint pain, sleep disturbances, cognitive issues, or persistent fatigue. Because Lyme disease can affect multiple body systems, symptom patterns may change over time.
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Ticks can carry and transmit more than one infection during a single bite. These additional infections are commonly referred to as co-infections. Examples include Babesia, Bartonella, Ehrlichia, and Anaplasma. Co-infections may influence symptoms and can sometimes make diagnosis and treatment more complex.
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Several laboratory tests are used to detect Lyme disease, most commonly antibody-based blood tests. However, no single test is considered perfect, and results may vary depending on the stage of infection and the patient’s immune response. Some physicians may use multiple tests, review clinical symptoms, and consider tick exposure history when evaluating a patient.
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Because Lyme disease can affect many different systems in the body, patients may experience neurological symptoms, joint pain, cardiac issues, digestive symptoms, or immune dysregulation. As a result, individuals may consult neurologists, rheumatologists, infectious disease specialists, or integrative physicians while trying to understand their symptoms and determine the best course of care.
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Preparing questions before a medical appointment can help patients make the most of their visit. Common questions include:
• How do you evaluate patients for Lyme disease and co-infections?
• What testing options do you use?
• How do you monitor treatment progress?
• What supportive therapies may help during treatment?
• How long have you worked with Lyme disease patients?Every case is unique, so open communication between patients and physicians is an important part of the care process.
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Many patients find it helpful to bring a timeline of symptoms, previous laboratory tests, imaging results, and a list of current medications or supplements. Documenting symptom patterns and potential tick exposures can also help physicians better understand the clinical picture during an initial evaluation.
Suggested Articles for Further Reading
If you would like to continue to learn about Lyme disease and how it is diagnosed and managed, the following articles from Lyme Advise may also be helpful:
Start Here: Lyme Foundations & Core Understanding: If you're new to Lyme disease or trying to better understand the basics, this guide provides an overview of how Lyme disease affects the body and why symptoms can vary so widely from one person to another.
Why Lyme Disease Is Often a Clinical Diagnosis: Many patients are surprised to learn that Lyme disease is not always confirmed by a single laboratory test. This article explains why physicians often rely on clinical judgment, symptoms, and medical history when evaluating possible Lyme disease.
Lyme Disease in School-Aged Children: Symptoms to Watch For and How to Support Students: Lyme disease can present differently in children than in adults. This article explores common symptoms in school-aged children and offers guidance for parents, teachers, and caregivers supporting students with Lyme disease.