Archive for April, 2021

PANS, A Misdirected Immune Response, Can Hijack a Child’s Life

https://www.lymedisease.org/brandi-dean-pans-immune/

PANS, a misdirected immune response, can hijack a child’s life

Brandi Dean

Pediatric Acute-onset Neuropsychiatric Syndrome–or PANS–is a misdirected immune response that can result in profound changes in a child’s brain.

It can be caused by different factors, including Lyme disease, and can result in terrifying symptoms. 

By Brandi Dean

This is a difficult post to write and one I have been thinking about for a while now. I have always been very open about my own experience recovering from tick-borne illness. While I am usually a private person, it came easy to open up because my goal was always to help someone else in need of guidance or support.

But this is a harder story to tell because it involves our 10-year-old son, Finn. It is a story that has caused a tremendous amount of pain as a mother. I have watched our beautiful boy’s vibrant and energetic personality literally wither away, just like the muscle tone he developed over several years of playing hockey and soccer.

Before PANS, Finn was known for his sense of humor, his love for fast cars, and his Terriers hockey team. Rides to school and games were often filled with laughter as Finn would put on his British or Australian accent and share stories about searching for wallabies in the outback or eating biscuits in London.

If he wasn’t talking, he was singing. I loved his voice and would turn down the music just enough so that I could hear him sing. And then he knew when it was time to prepare for battle.  Before every hockey game, he would turn on rap music and do planks and sit-ups in the car in anticipation of soon taking the ice.

Then everything changed

Our vibrant, healthy, and energetic child changed overnight. It started gradually with fatigue and weakness in his extremities.  Then one evening he started to scream, “make it stop!”

He held his hands to his head while pacing back and forth screaming over and over again. I tried holding him and he pushed me away while screaming, “I need help! Leave me alone! I need help! LEAVE. ME. ALOOOONE!”

I was terrified as I had no idea what Finn was experiencing and did not know how to help him. Things seemed to escalate every day as the old Finn withered away. His eyes drew sullen and surrounded with dark circles. His beautiful smile was now tight as he nervously chewed his fingernails and refused to go outside.

Very soon after, he gave up hockey and soccer and filled the many hours he used to spend on the practice field or practice ice nestled away in a fort he built in our living room. The few times I tried to get him to attend practice, he screamed in the car while punching the back of my seat. “I hate you. You are so annoying! I HATE YOU! BRING ME HOME Noooooow!”

I was heartbroken and felt helpless as I watched Finn cry himself to sleep while begging for help.

A Diagnosis

In late October, Finn was diagnosed with PANS (Pediatric Acute-onset Neuropsychiatric Syndrome). PANS is a clinical diagnosis given to children who have a dramatic-sometimes overnight – onset of neuropsychiatric symptoms triggered by an underlying infection. In Finn’s case, Lyme, Bartonellosis, and Mycoplasma are all infections identified by his doctors as potentially causing PANS and its associated symptoms of obsessive-compulsive disorder (OCD), depression, irritability, and anxiety.

The Heartbreak

I feel very fortunate that Finn was diagnosed quickly and started treatment within days of his diagnosis. I wasn’t prepared for the heartache and depression that followed. I feel lost and alone again. I can’t describe the deep sorrow I feel when I look at photos of Finn, before PANS.

I am mourning the loss of the child he was and I am desperate to get him back. Our rides to school are now quiet as he no longer likes listening to music and no longer chooses to sing along. There are no more pre-game workouts to rap songs before hockey and no more “Cowboy Cellys” after scoring a goal. He is quiet and withdrawn.

On Easter morning, he was triggered after being told to take a shower before we headed out for Easter brunch. His screams fill the house with tension and our bodies stiffen as we prepare ourselves for one of Finn’s many meltdowns.

“I hate this! I just want to be normal again! Everyone hates me! I just want to be normal!”

“You don’t know what this feels like! I hate this! Everyone is mad at me! No one understands what this is like! I just want to be NORMAL!”

Conversations no mother should have

I have had conversations with Finn that no mother should ever have. Every time, I take him into my arms and hope that he is absorbing everything I share with him.

“Finn, I need you to remember something. This is temporary. OK? This is temporary and you WILL get better. And, Finn, you need to give yourself some grace when these moments of rage happen. You know why? Because you are fighting a BIG battle, hon. And, when you have these moments of rage, you need to know that this is not you. It’s your brain. Your brain is on fire. So when you are able to calm down, please don’t be so hard on yourself. There are not too many people that could go through what you are going through right now. You are strong, you are RESILIENT and you are LOVED. Please don’t forget this, Finn. You are so brave and you are not alone. You WILL get better.”

Finn always collapses in my arms in tears while nodding his head to let me know that he’s heard me. He is exhausted and desperate for some sense of normalcy again and we are all learning to cope the best we can.

Moments of grace

It’s been almost six months since his diagnosis with very little improvement. We continue to trudge along and pray fervently for the sun to shine again. We have been blessed with moments of grace that have lifted our spirits and helped get us through the unimaginable. The motivational message from Boston Bruin’s Charlie Coyle gave Finn the strength to keep fighting. The videos from his Terrier’s hockey team showing them chanting Finn’s name “on three” and doing Finn’s signature “Cowboy Celly” after a goal showed Finn how much he’s cared for. His daily game-night chats with classmates have given him something to look forward to.

He knows he has people rooting for him. He knows he has “triggers” from an illness that is preventing him from doing the things he loves. But, he still wakes up every morning, determined to get better so that he can play for his team again. He still has hope and he still has an enormous amount of support from his friends and family. He’s a fighter. He’s brave. He’s #FinnStrong.

Young Finn

Brandi Dean is the founder of the Dean Center for Tick Borne Illness and Ride Out Lyme, Inc. She is also an integrative wellness coach. This blog first appeared on her website.

For more information about PANS:

ASPIRE: The Alliance to Solve PANS and Immune-Related Encephalopathies

New England PANS/PANDAS Association

Northwest PANDAS/PANS Network

PANDAS Network

Moleculera Labs

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For more:  

Category:

Activism, Bartonella, Lyme, Mycoplasma, PANS

Lyme Disease: ‘Beating Back Death’

https://spindigit.com/2020/08/17/lyme-disease-beating-back-death/

Lyme Disease: Beating Back Death

Sara White

With multiple television and movie projects, 2019 was a busy year for southwest Georgia native Stacy Johnson.

That nearly wasn’t the case for the budding young actress because a chance encounter with a tick 14 years ago nearly ended her career — and life.

“When I saw her in 2017, she couldn’t hardly verbalize, couldn’t concentrate, had dizziness,” said Dr. Jeffrey Lawson, the rheumatologist and founder of Piedmont Arthritis Clinic in Greenville, S.C., who diagnosed and treated Johnson. “She had shooting pain in her extremities.”

Before seeing Lawson, the actress had been to a number of specialists who were unable to identify the cause of her symptoms. Johnson was performing in a sideshow at a circus when her crisis hit.

“Her family owns Barnum & Bailey Circus,” Lawson said. “She had a show in Chicago. She died in McDonald’s. Her heart stopped.”

Johnson was resuscitated and hospitalized, but she was no closer to learning the underlying issue.  (See link for article)

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For more:  https://www.imdb.com/title/tt12919858/?ref_=ttrel_rel_tt

Storyline

“Lyme Disease: Beating Back Death” is a tell-all documentary about a decade’s long battle against Lyme disease. Following the story of Stacy Johnson, a critically acclaimed actress, the documentary, in vivid, personal detail, chronicles the struggles of this horrific disease mentally, physically, and emotionally, and serves as a dire warning to the public.Written by Stacy Johnson

Looks like the release date was Feb, 2021.  Facebook page

Category:

Activism, Lyme

Lyme Disease Has the Potential to Emerge in a Wider Range of Habitats Than Previously Thought

https://medicalxpress.com/news/2021-03-lyme-disease-potential-emerge-wider

Lyme disease has the potential to emerge in a wider range of habitats than previously thought

by Ali Howard, University of Glasgow

March 21, 2021

scotland
Lyme disease has the potential to emerge in a wider range of habitats than previously thought, suggests University of Liverpool and University of Glasgow research.

A new study, published in Emerging Infectious Diseases found that open, treeless habitats can support similar densities of infected ticks as woodland in the UK, challenging established knowledge of which habitats present the most risk.

Lyme disease—an infection contracted from the bite of an infected – is growing in incidence in people in the UK and large parts of Europe and North America. It is usually associated with forested habitats but over the past decade has, somewhat surprisingly, emerged on treeless islands in the Western Isles of Scotland.

Researchers from the Universities of Liverpool and Glasgow, in collaboration with NHS Western Isles and NatureScot, examined the different human and environmental factors which could have contributed to the rise of Lyme disease in the Western Isles.

Co-lead researcher Dr. Caroline Millins, a research fellow at the University of Liverpool, said: “Superficially, the habitats and the climate of these islands look very similar, yet the incidence of Lyme disease on some islands is 40 times higher than the national average for Scotland, while other nearby islands are relatively less affected. This is really intriguing from an ecological and public health perspective so we wanted to try and understand what could be causing this difference.”

For the study, the researchers sampled ticks from different habitats on islands with high Lyme disease incidence and on islands with low incidence to determine tick numbers and infection rates. None of these islands had any forests. They also analyzed survey responses from 522 local adult residents to understand the social and behavioral factors that influence when and where people are exposed to tick bites.

The proportion of infected ticks was found to be around 6% on islands with high numbers of Lyme disease cases, compared to less than 1% on islands with low numbers of cases.

On islands with a high incidence of Lyme disease, the researchers found that open habitats, including grassland and domestic gardens, had similar tick density and prevalence of infected ticks as forested mainland sites in Scotland.

Co-lead researcher Dr. Roman Biek, from the University of Glasgow, said: “This is a striking finding and suggests that microclimatic conditions in these open habitats, possibly driven by the milder oceanic climate on the Western Isles, can be as conducive to tick survival as conditions in woodlands.

“Our study highlights the potential for Lyme disease to emerge in habitats with a suitable climate other than forests so we should be looking at non-forested habitats more broadly both in the UK and globally.”

The survey results found that residents on islands with a high incidence of Lyme disease were more likely to be bitten by ticks, with most people being bitten close to their home or in their gardens. Residents also reported increasing problems with ticks, with many suggesting increasing numbers of deer, and deer coming closer to people’s homes, as a potential driver.

“When we visited the and attended community meetings, there were significant concerns raised by residents about frequent tick bites in their gardens.”

Dr. Millins said: “Our surveys support residents’ concerns and show that spillover of infected ticks into people’s gardens is very common. These findings can suggest ways we might be able to reduce exposure risk, for example by managing garden environments to reduce tick numbers. We have also started to investigate how deer move across the landscape and how that might affect where ticks are found.”

NatureScot’s Outer Hebrides Operations Manager Johanne Ferguson said: “This important piece of research confirms what many in the Uist community have been reporting for some time—that infected ticks are being found much closer to home. The Lyme Disease Research project is carrying out ongoing research into this, which will inform NatureScot’s work with the Uist community, the Uist Deer Management Group and others to find ways to reduce the tick burden in and around villages.”

Isabell MacInnes, a public health nurse specialist with NHS Western Isles said: “We are aware of the increasing numbers of cases of Lyme disease being reported in people living in the Western Isles, and we welcome the evidence provided through this research, which we will use to guide future public health actions.”

Explore further:  Tick behavior and host choice explains geographical patterns of Lyme disease prevalence

More information: Caroline Millins et al. Emergence of Lyme Disease on Treeless Islands, Scotland, United Kingdom, Emerging Infectious Diseases (2021). DOI: 10.3201/eid2702.203862
Journal information: Emerging Infectious Diseases
Provided by University of Glasgow

Category:

Lyme, research, Ticks

Volleyball Player ‘The Phoenix’ Rises From the Ashes of Lyme Disease

https://www.washingtonpost.com/sports/2021/03/26/after-years-battling-lyme-disease-this-volleyball-player-is-back-has-loudoun-county-undefeated/

After years battling Lyme disease, this volleyball player is back and has Loudoun County undefeated

By Ryan McFadden
March 26, 2021

For the past three years, Loudoun County’s volleyball team has had a tradition in which players assume call signs that represent their personality or story. Each player’s navy blue warmup shirt has that word scrawled on the back.

For senior Ella Solomon, Coach John Senchak chose the phoenix — a mythological bird known for ascending from its ashes. It is fitting, given Solomon’s journey from being bedridden with chronic Lyme disease to becoming a key contributor for the Captains.

“She’s our motivation to keep going because of what she’s been through,” senior teammate Alicia McCandless said.

Neither Solomon nor her parents recall a particular moment she started to feel sick or remember seeing a tick, which causes Lyme disease. But the symptoms certainly presented.

Solomon had nagging headaches daily for more than six years, prompting her parents to go to Johns Hopkins Children’s Center in Baltimore for answers. When Solomon received Lyme tests from doctors, the results were negative.

“The tests aren’t super accurate,” said her mother, Regina. “It may not be in your bloodwork at the moment, but it is still in your body.” (See link for article)

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**Comment**

Keep fighting – there is hope!

Category:

Activism, Lyme

Lyme Disease & Biofilms: What You Need to Know

https://rawlsmd.com/health-articles/understanding-biofilm?

Lyme Disease + Biofilms: What You Need to Know

by Dr. Bill Rawls
Updated 3/30/21

If you’ve tried everything to get well to no avail, chances are you’re feeling frustrated, confused, and exhausted. After all, which stone could you possibly have left unturned? Many people blame their persistent symptoms of chronic Lyme disease on the slimy collections of microorganisms known as biofilms, as suggested in the recent review article in Frontiers in Neurology.

But are biofilms really what’s stopping you from getting better? Here, we’ll take a closer look at these micro-communities to understand what they are and how they contribute to certain chronic illnesses. Though biofilms are interesting, the role they actually play in chronic Lyme disease may be minor.

What Are Biofilms?

Biofilms are colonies of microbes. They chiefly contain bacteria, but biofilms can also include protozoa and fungi. Biofilms form anywhere there is moisture and a surface. In other words, everywhere — including many surfaces inside the human body. The ring inside your toilet bowl and plaque on your teeth are examples of biofilm.

Certain types of bacteria initiate biofilms that can attach to a moist surface with specialized adhesion structures called pili. Once adhered to the surface, bacteria stick together and produce a matrix of slime called extracellular polymeric substance (EPS). After the matrix has been established, other kinds of microbes can join, creating a structured community. To get a sense of how a biofilm operates, imagine a crowded dance floor with bodies squeezed together, forming a uniform mass, swaying to the rhythm of the music.

A polysaccharide shell on the biofilms’ surface protects the organisms inside from starvation, drying out, the immune system, and antibiotics. The surface can include minerals, such as calcium, and blood products, including fibrin. Safe inside the biofilm, microbes are free to mingle and exchange information. Communication between bacteria, called quorum sensing, is accomplished by signaling molecules. Once a community is formed, particular groups of microbes take on specialized roles of performing metabolic functions for the entire unit. For example, water channels develop within the biofilm for moving nutrients and signaling molecules. The biofilm grows by cell division and recruitment of new individuals.

Reasons Microbes Form Biofilms

  • Conserve nutrients and energy and avoid starvation
  • Bypass the host’s immune system
  • Avoid antibiotics
  • Join forces with other microbes and increase the chances of long-term survival

In essence, the biofilm becomes an organism unto itself. Biofilms are as ancient as any lifeform. They were likely the bridge between single-cell organisms and higher multi-cell organisms.

How Biofilms Work

Biofilms cause illness by damaging the surfaces to which they attach. Additionally, if a biofilm matures and becomes massive enough, it can cause obstructions in organs or impede the function of medical equipment such as stents or catheters. Once a biofilm reaches a certain size (maturation II stage), it disperses, allowing inhabitants to spread and colonize other surfaces. As a means of survival, bacteria in the body are always trying to form new biofilms, and the immune system is constantly working to break them down.

The following graphic illustrates the 5 stages of biofilm development:
circle map with arrows connecting five circles. 1. Initial attachment 2. Irreversible attachment 3. Maturation I 4. Maturation II 5. Dispersion

Common Biofilm Diseases

Typical biofilm diseases occur where there are surfaces and moisture present for the biofilm to form. Examples of biofilm diseases include:

  • Bacterial vaginosis: Associated with biofilm in the vaginal wall.
  • Chronic urinary tract infections: Biofilm on the bladder wall is a contributing factor.
  • Middle-ear infections: Biofilms are linked to chronic middle-ear infections.
  • Heart valve infections: Microbes may attach and form biofilms on heart valves or tissues surrounding the heart.
  • Chronic vertigo: Caused by calcium deposits in the inner ear and may be a form of biofilm.
  • Dental plaque and gingivitis: Classic examples of biofilm found in the mouth.
  • Chronic sinusitis and chronic bronchitis: Associated with biofilm in sinuses and bronchial tubes.
  • Arterial plaque buildup: Responsible for heart attacks and stroke, arterial plaques have many characteristics of biofilm and are often found to harbor bacteria.
  • Hospital infections: Indwelling devices such as catheters are associated with biofilms.

Biofilms readily occur in the intestinal tract. In fact, the formation of biofilms in the colon and appendix is quite normal and supported by the immune system.

Is There a Link Between Lyme Disease and Biofilms?

There has been a lot of talk on Lyme forums about Lyme disease being a biofilm disease. This idea stems primarily from a study done in a lab showing Borrelia, the bacteria associated with Lyme disease, could participate in forming a biofilm.

No doubt, Borrelia can form a biofilm inside a test tube. Forming and participating in biofilm is a natural trait for almost any bacteria. Indeed, if you can’t join in on a biofilm, you’re not much of a bacteria. But most of the symptoms associated with chronic Lyme disease aren’t consistent with biofilm diseases. Biofilms cause localized symptoms primarily by damaging the surface they adhere to. Symptoms of chronic Lyme disease are systemic.

White blood cells, red blood cells, and in blood stream, borrelia disrupting immune system communication.

The symptoms of chronic Lyme disease and persistence against antibiotics are best explained by the fact that Borrelia is an intracellular bacteria. When the Borrelia spirochetes enter the bloodstream, they hitch a ride inside white blood cells and travel to tissues throughout the body, including the brain. Once they arrive at targeted tissue sites — heart, brain, joints, muscles — they emerge and infect other cells. Inside the cell, they can lose their wall and become an l-form bacteria. This, and being shielded inside the cell, provide protection from antibiotics and immune system functions.

The bacteria cannibalize the cell to generate new microbes and then emerge to infect other cells.

Symptoms of chronic Lyme disease are caused not only by bacterial activity invading cells, but also by the immune system’s efforts to eliminate cells that have been infected with bacteria.

The concentrations of cells that have been infected with bacteria, compared to normal cells, is not great. Considering the bacteria are a hundred times smaller than our cells, even millions of bacteria spread out among the trillions of cells in the body isn’t a high concentration of bacteria — tissues are only lightly peppered with infected cells. To take out infected cells nestled among normal cells, the immune system targets the abnormal cells with antibodies, but in the process, there is collateral damage to normal cells. In other words, autoimmunity. Research suggests that the autoimmune phenomenon may be a significant driver of symptoms of chronic Lyme disease.

In addition, bacteria manipulating the immune system to generate cytokines and inflammation may be another contributing factor to Lyme disease symptoms. Inflammation breaks down tissues and allows the bacteria to access vital nutrients from our cells.

The fact that chronic Lyme symptoms are most consistent with Borrelia existing as an intracellular bacteria suggests that this is the primary reason as to why Borrelia is persistent in the body. Participation in biofilm and being able to form an antibiotic resistant cyst form likely also contribute to antibiotic resistance, but these may not be primary factors.

Biofilms may be most relevant to intestinal symptoms that usually accompany Lyme disease and skin diseases like Morgellons that’s sometimes associated with the tick-borne infection. Calcium deposits in the inner ear causing dizziness may also be related to biofilm.

Dealing with Biofilms

Though Lyme disease is not a standard biofilm disease per se, there’s nothing wrong with supporting the body’s ability to deal with biofilms during any illness. A healthy immune system is the best way to slow the formation of biofilm in the body. The immune system is always breaking down new biofilms that start to form — it’s part of the everyday struggle of life.

The following are my preferred herbs and supplements to supports the body’s efforts to break down biofilms:

zoomed in pineapple skin

1. Proteases

Proteases are enzymes that break down proteins. It is thought that proteases may be beneficial for breaking down the outer coating of a biofilm, especially in the gut. Common natural proteases that are available in supplement form include bromelain (from pineapple), nattokinase, and serrapeptidase. Proteases also break down immune complexes in the blood and reduce inflammation.

cell diagram of N-Acetyl Cysteine (NAC)

2. N-Acetyl Cysteine (NAC)

A potent antioxidant and anti-inflammatory, n-acetyl cysteine (NAC)is known to break up mucus and may also play a role in dissolving biofilms. It also protects nerve tissue and liver function.

three overlapping image circles. cats claw, japanese knotweed, and chinese skullcap

3. Antimicrobial Herbs

The best way to overcome chronic Lyme disease, including the possibility of biofilm formation, is persistent use of herbs with antimicrobial properties. The herbal advantage is that herbs suppress pathogens without disrupting normal flora and therefore can be used for prolonged periods of time (years) without adverse side effects. Herbs also protect cells from free radical damage and other stressors, modulate immune system functions, reduce inflammation, and erode away at biofilms. Common herbs with documented activity against Borrelia include Japanese knotweed, cat’s claw, and Chinese skullcap.

The Bottom Line

Ultimately, the idea that patients must aggressively hammer away at biofilms with harsh drugs and treatments to see improvements in symptoms may not be a sustainable or beneficial approach for most people. Blasting biofilms with strong chemicals and potent antibiotics has the potential to backfire because it can disrupt the balance of normal flora in the body and inadvertently suppress immune system functions.

In contrast, by supporting a healthy immune system with herbal therapy and a few select supplements, you can etch away at biofilms that may be present, while addressing other more significant underlying causes of your symptomsuntil they’re gone without setting yourself back for days or weeks at a time.

Dr. Rawls is a physician who overcame Lyme disease through natural herbal therapy. You can learn more about Lyme disease in Dr. Rawls’ new best selling book, Unlocking Lyme.

You can also learn about Dr. Rawls’ personal journey in overcoming Lyme disease and fibromyalgia in his popular blog post, My Chronic Lyme Journey.

Learn About Dr. Rawls’ Herbal Protocol »
REFERENCES
1. Supi et al, Characterization of Biofilm Formation by Borrelia burgdorferi, In Vitro, PLOS-one, Oct 24, 2012
2. Karatan E, Watnick P, Signals, Regulatory Networks, and Materials That Build and Break Bacterial Biofilms, Microbiology and Molecular Biology Reviews, June 2009, Vol 73 (2), P. 310-347
3. Lennox J, Biofilm Development, Biofilms: The Hypertextbook, Web, May 2011
4. Costerton, Stewart, Greenburg, Bacterial Biofilms: A Common Cause of Persistent Infections, Science, May 1999, Vol 284 (5418) p. 1318-1322
5. Sapi, MacDonald, Biofilms of Borrelia burgdorferi in chronic cutaneous borreliosis, Am J Clin Pathol, 2008, 129, p. 988-989
6. Hoyle, Costerton, Bacterial resistance to antibiotics: the role of biofilms, Prog Drug Res, 1991, 37, p. 91-105
7. Kurti, Munderloh, Ashstrand, Colony formation and morphology in Borrelia burgdorferi, J Clin Microbiol, 1987, 25, p. 2054-2058
8. Figure copyright 2006 Keith Kasnot, MA, CMI, FAMI
9. Image source: http://nutritionreview.org/2014/08/gingivitis-gum-health/
10. Di Domenico EG, Cavallo I, Bordignon V, et al. The Emerging Role of Microbial Biofilm in Lyme Neuroborreliosis. Front Neurol. 2018;9:1048. Published 2018 Dec 3. doi: 10.3389/fneur.2018.01048
11. Datar A, Kaur N, Patel S, Luecke D, Sapi E. In Vitro Effectiveness of Samento and Banderol Herbal Extracts on the Different Morphological Forms of Borrelia Burgdorferi. Townsend Letter, the Examiner of Alternative Medicine. July 27, 2010.
12. Rudenko N, Golovchenko M, Kybicova K, Vancova M. Metamorphoses of Lyme disease spirochetes: phenomenon of Borrelia persisters. Parasit Vectors. 2019;12(1):237. Published 2019 May 16. doi: 10.1186/s13071-019-3495-7
13. Markova ND. L-form bacteria cohabitants in human blood: significance for health and diseases. Discov Med. 2017 May;23(128):305-313. PMID: 28715646.
14. Rivera OJ, Nookala V. Lyme Carditis. 2020 Oct 3. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. PMID: 31536195.
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**Comment**
Patients often struggle with whether they should go after biofilms or not.  I had this same struggle myself and still do not have a definitive answer.  I know patients who didn’t notice a thing after treating biofilms and others who had great progress.  Herein lies the challenge: what works for one, doesn’t work for another.  We are a conundrum to treat for sure.
I’ve taken everything mentioned in Dr. Rawl’s article for various reasons throughout my journey.  The ones I’ve stuck with are NAC and proteases as both supplements do a myriad of things simultaneously.
I’ll never forget Master Herbalist Stephen Buhner’s advice in the need to find a sophisticated treatment that does many things simultaneously.  I believe he’s absolutely correct.  This saves time and money.
For more on NAC:

For more on Systemic Enzymes (proteases):

Category:

Biofilm, Herbs, Inflammation, Lyme, Treatment