Archive for the ‘Babesia’ Category

Lyme Questions Answered and Mighty Methylene Blue

https://mailchi.mp/3e52484072a9/4i7vbuaut5-4797205

Conversations with Marty Ross MD: 1/9/25

Good Morning,

I enjoyed answering your questions on Wednesday night.

We discussed:

  1. Introduction and Webinar Format. Dr. Marty Ross explained the structure of his Lyme disease webinar, outlining guidelines for participation, including the use of the chat box for submitting questions, and detailed plans to provide session recordings and summaries.
  2. Addressing Sleep Jerks and Neurological Symptoms. Severe sleep jerks occurring when falling asleep were attributed to neurological irritation caused by infections like Bartonella, Borrelia, or mold toxicity, and potential remedies including curcumin, glutathione, and GABA-boosting supplements were discussed.
  3. Managing Nervous System Agitation. Strategies to calm the nervous system included treating infections, detoxifying mold, using anti-inflammatory supplements like curcumin and glutathione, and calming nerves directly via GABA enhancers such as L-theanine.
  4. Ozone and IV Vitamin C may Cause Nerve Damage. The use of oxidizing agents like IV vitamin C and UV ozone can worsen oxidation injury in tick-borne infection patients, with Dr. Ross warning against their potential nerve-damaging effects.
  5. Role of Hyperbaric Oxygen Therapy. While hyperbaric oxygen therapy (HBOT) may aid in neurological healing and support mitochondria, it is often ineffective for directly killing infections based on clinical experiences.
  6. Exploring White Blood Cell Counts in Tick-Borne Infections. Chronic infections like Borrelia, Bartonella, or Babesia often cause reduced neutrophil counts, which may normalize over time with effective treatment.
  7. Pregnancy Considerations and Tick-Borne Disease Testing. Pregnancy planning was addressed with recommendations for comprehensive infection testing, symptom-tracking, and considerations for treatment strategies that align with maternal and fetal health.
  8. Re-testing for Infections to See Where Your Are Is Not Accurate. Retesting for tick-borne infections was deemed unreliable as antibodies can fluctuate; instead, tracking symptoms was suggested as a better measure of disease progression.
  9. Indirect vs Direct Testing for Borrelia. Dr. Ross explained the differences in sensitivity between indirect (antibody-based) and direct (PCR or culture) testing methods, emphasizing the limitations of direct tests in chronic infections.
  10. Babesia Treatment Length before Pregnancy. Recommendations for treating Babesia included maintaining a five-month treatment course, balanced with probiotics and potential yeast management, to optimize health before pregnancy.
  11. Addressing Gastrointestinal Symptoms during Treatment. GI symptoms during antimicrobial treatment were linked to gut flora disturbance and potential yeast overgrowth, calling for probiotics and antifungal options like Nystatin or CapriPlus.
  12. Management of Cytokines and Herx Reactions. Elevated cytokines causing inflammation and herx reactions were addressed with anti-inflammatory interventions, including quercetin or curcumin, and glutathione supplementation.
  13. Best Ways to Lower Cytokines and to Control Herx. Suggestions to lessen herx reactions included increasing glutathione levels and using quercetin for both anti-inflammatory and mast cell-stabilizing effects.
  14. Meaning of a Single White Brain Lesion on MRI. A single white lesion on MRI is typically attributed to aging or limited blood flow rather than Lyme disease, which usually exhibits diffuse demyelination patterns.
  15. You Don’t Have to Herx to Make Progress. Not all patients experience herx reactions during treatment, yet progress is still possible, particularly as the germ load decreases over time.
  16. Methylene Blue and Its Uses. Methylene blue was recognized as a therapy for both Borrelia and Bartonella due to its efficacy against persister cells, as well as for its FDA-approved use in addressing methemoglobinemia. Go here for a sound warning of methylene blue, which is a man-made monoamine oxidase inhibitor.  Animal and human studies have shown that when monoamine neurotransmitters are over-activated it eventually makes those taking it subdued, apathetic and disengaged from their own feelings, those around them, and life itself.
  17. Methylene Blue for Improved Thinking and Mitochondria Function. Beyond pathogen-killing properties, methylene blue improves mitochondrial function, aids ATP production, and has shown promise for reducing brain fog and increasing energy.
  18. Potential Risks and Side Effects of Methylene Blue. Risks of methylene blue include bladder irritation, intestinal discomfort, and staining issues, though real-world human risks are minimal when dosed properly.
  19. Mitochondrial Function and Repair. Recommendations for repairing mitochondrial damage included supplements like glutathione and ATP 360 to enhance cellular energy production.
  20. Exploring Histamine Reactions. Unusual reactions like hives or hyperactive histamine levels during treatment were linked to mast cell activation, which can be managed with stabilizers and antihistamines.
  21. Taking Enzymes and EDTA. Potential interactions between enzymes and EDTA supplements were addressed, with Dr. Ross advising additional research to confirm compatibility.
  22. Impact of Biocidin on Direct Testing Results. Biocidin, containing antimicrobial ingredients like oregano oil and garlic, may reduce the accuracy of direct tests like PCR by lowering pathogen levels in the blood.
  23. Causes of Visual Issues. Neuropathic visual challenges like light sensitivity and convergence insufficiency were discussed as possible symptoms of Bartonella, Borrelia, or mold toxicity.
  24. Causes of Air Hunger. Air hunger, frequently caused by Babesia or Bartonella, results from disrupted oxygen delivery due to inflamed red blood cells or reduced red blood cell quantity.
  25. Muscle Contractions and Spasms. Severe muscle spasms were linked to magnesium deficiency or neurological irritation, with treatment approaches including supplements and anti-inflammatory support.
  26. Thoughts on Steps if You Are Not Getting Better. Persistent illness despite treatment prompted considerations for comprehensive reviews of treatment history and potential alternative strategies like addressing limbic system dysregulation.
  27. Role of Limbic System Retraining for Chronic Symptoms. Limbic system retraining methods such as dynamic neural retraining (DNRS) were recommended for addressing chronic illness patterns after addressing active infections.
  28. Senescent Cells may Cause Ongoing Inflammation and Chronic Symptoms. Cell senescence caused by infections may perpetuate inflammation, with solutions including senolytics, fasting mimicking diets, and autophagy-promoting supplements.
  29. Timing of Limbic System Retraining and Physical Medicine. Brain retraining exercises and somatic therapies are best initiated after active infections are controlled to avoid exacerbating symptoms.
  30. Evaluating ZenMen for Bartonella. The herbal formula ZenMen showed promise in addressing Bartonella but lacked sufficient evidence on effectiveness or ingredient concentrations for strong recommendations.
  31. Role of Ketotifen for Mast Cell Activation. Ketotifen was highlighted as an effective option for calming histamine-driven nervous system agitation by blocking histamines and stabilizing mast cells

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In Health,

Marty Ross MD

*Comment*

I’ve never heard of ozone and IV C causing nerve damage.  Ever.  My LLMD uses this as a mainstay in treatment and would never use them if they in fact caused nerve damage. Of course the toxin is always in the dose.

Herbs For Bartonella & Babesia

https://iladef.org/herbs-for-bartonella-and-babesia/?

The International Lyme and Associated Diseases Society (ILADS) is a nonprofit, international, multidisciplinary medical society dedicated to the diagnosis and treatment of Lyme and other complex inflammatory diseases. With these educational blog posts from experts and members of our board, ILADS aims to promote awareness and understanding of health and wellness, especially as it relates to complex inflammatory diseases, so that we can all learn and grow together. If you have any questions or want more information, you can email us at contact@ilads.org. 

Disclaimer: Every patient is an individual with unique characteristics. This blog article is not medical advice. It does not constitute a physician-patient relationship. It is for educational purposes only. Do not try out what is in this article without medical advice, working with your licensed physician and licensed healthcare providers

For people grappling with chronic Lyme disease, Bartonella and Babesia are increasingly in the spotlight. These stealthy microbes are often linked to some of the most debilitating symptoms, yet there’s a puzzling twist: they rarely cause severe acute illness in otherwise healthy individuals. This paradox may hold the key to understanding why traditional antibiotics often fall short—and why herbs, with their complex and synergistic properties, might offer a more promising path to lasting relief.

Babesia

Babesia is a protozoan. It shares characteristics with Plasmodium, the protozoa that cause malaria, but its potential to make people acutely ill is much lower. Instead of mosquitoes, it’s spread primarily by ticks. The most common species of Babesia are Babesia microtiBabesia divergins, and Babesia duncani, but about a dozen species have been associated with human illness.

Like Plasmodium, Babesia invades erythrocytes (red blood cells). Symptoms associated with an acute infection of Babesia, however, tend to be mild and may not appear at all: About 1 in 4 cases are asymptomatic. Symptomatic cases in immunocompetent (healthy) individuals generally resolve without treatment. Significant acute illness is mostly isolated to immunocompromised individuals and those lacking a spleen. Because most cases resolve without treatment, only about 2,000 cases are reported in the U.S. each year.

Bartonella

Bartonella is a slow-growing, gram-negative bacterium. The most common species include Bartonella quintana (trench fever) and Bartonella henselae (cat scratch fever), but a variety of Bartonella species infect humans; in fact, every mammalian species on earth (including whales!) harbors some species of Bartonella. Bartonella is spread primarily by insect and other arthropod vectors, including fleas, lice, and ticks.

Bartonella is a facultative intracellular bacterium, meaning it can live either inside or outside cells. It has a preference for invading endothelial cells lining small blood vessels. Like a tiger waiting for prey, this places the bacteria at an ideal location to invade and scavenge nutrients from erythrocytes.

As with Babesia, symptoms of acute infection with Bartonella are generally mild, and asymptomatic infections are not uncommon. Most infections in immunocompetent individuals resolve without treatment and go unreported.

A Balanced Relationship is a Natural State

Their main survival strategy is persistence, not aggression. (This is true of Borrelia and all the Lyme coinfections as well). Overwhelming a host with infection doesn’t work in the microbes’ favor. An equilibrium in which the host isn’t severely affected but the microbes can persist offers a stable environment for the microbes and — importantly — allows ongoing opportunities to spread to new hosts.

Of course, the host’s immune system would rather not have them there at all and makes every effort to root them out. The microbes, however, match that effort with sophisticated moves that allow them to persist. It’s a chess game that’s been going on between hosts and microbes for millions of years. In the end, a balanced host-microbe relationship is a natural outcome.

Mechanisms of Persistence

A key strategy used by all the Lyme microbes is invading and surviving inside cells. The internal environment of a living cell offers isolation from both the immune system and antibiotics. Different microbes invade different cells. Babesia and Bartonella have a preference for invading erythrocytes (red blood cells).

Another key strategy is the ability to slow their growth or even go dormant. Slowed growth or dormancy (quiescence) allows microbes to remain inside a cell without affecting the cell’s functions or alerting the immune system that the cell has been compromised.

Babesia parasites are cleared primarily by macrophages in the spleen (which is why not having a spleen is a big risk factor for severe acute illness). When red blood cells become swollen with parasites, the swollen red blood cells become trapped and then eliminated. By slowing their growth rate, red blood cells infected with parasites don’t swell, which allows infected red blood cells to pass through the spleen undetected.

Persistence of Babesia for greater than two years has been documented in asymptomatic individuals. Transmission of Babesia by blood transfusion is a leading risk to the blood supply in the United States, suggesting that individuals harboring Babesia asymptomatically are not uncommon.

The same strategy is used by Bartonella. It has been documented that the bacteria can achieve a slow enough growth rate to survive undetected for the lifespan of infected erythrocytes. In addition to lodging within erythrocytes, these bacteria may exist within lymphocytes and other cells in the body. Numerous studies have documented an asymptomatic carrier state for Bartonella in healthy individuals.

That isn’t to say that Babesia and Bartonella aren’t pathogens. They most certainly are. But they wait until they have the advantage. And they can wait — quietly residing inside cells — for a long time.

And it isn’t just Babesia and Bartonella. All the Lyme microbes use intracellular persistence as a strategy, though each microbe goes about it in a different way and has preference for different cell types. Together they form a silent reservoir of pathogens hiding out in blood and tissues — all waiting for an opportunity.

Reaching the Boiling Point

That opportunity comes if the host’s health is compromised. 

Sometimes it’s a sudden event — like a severe trauma or infection with a more virulent microbe, such as SARS-CoV-2 (COVID-19) — that tips the balance. But more often it’s multiple factors adding up over time: years of eating a poor diet, inadequate sleep, chronic exposure to toxic substances, or a sedentary lifestyle. All of those factors may weaken cells.

Once infected cells are weakened by stress, the microbes are free to grow unchecked. Unchecked microbes destroy cells. The types of symptoms that result correspond to the types of cells that are damaged.

Destruction of erythrocytes by Babesia results in symptoms including anemia, headache, muscle and joint aches, air hunger, an enlarged spleen and liver, brain fog, jaundice, bruising, petechiae, and dark urine.

Invasion of endothelial cells (cells that line blood vessels) by Bartonella bacteria can cause constriction of blood flow, which can result in symptoms including bone pain, pain in the soles of feet, endocarditis, and liver or spleen enlargement. Damage to red blood cells can result in anemia. Entry into the central nervous system can cause a range of neurological symptoms.

Babesia and Bartonella, of course, don’t account for all the symptoms that occur with chronic Lyme disease. Compromised host status allows the unchecked growth of not only Babesia and Bartonella but also Borrelia and any other pathogens that might be lurking in the host’s blood and tissues. Because different microbes invade and damage different cells in the body, a wide range of symptoms is possible.

It’s like a pot boiling over on the stove. Increased microbial activity compounds stress on the host, which unleashes greater microbe activity. It becomes a vicious cycle with cellular destruction caused by a frenzy of unleashed microbes throughout tissues.

Where Treatments Fall Short

Whereas, antibiotics might seem like the logical solution, antibiotics only kill active microbes, but have minimal impact on the total reservoir of slow-growing or dormant intracellular microbes in tissues. As soon as the antibiotics are discontinued, new microbes emerge and the patient relapses.

What’s more, antibiotics don’t restore the body’s ability to contain the microbes. In fact, prolonged use of antibiotics further compromise this ability by:

  • Disrupting normal flora in the gut and skin, which are a key part of the body’s natural defenses
  • Generating antibiotic-resistant pathogens, which has become a major health hazard worldwide
  • Being toxic to cells and mitochondria in the body

Winning the battle requires long-term suppression of microbe activity — without causing further stress to the body. In other words, you have to counter the microbes with the same strategy they use — with persistence instead of aggression.

The best suited option to achieve that goal is herbal therapy.

The Herbal Advantage

Herbs are plants. Like all living organisms, plants must maintain defenses against invasive microorganisms. They accomplish that task with a sophisticated defense system made up of hundreds of chemical substances known as phytochemicals.

It’s not a random collection of chemicals, however. The plant phytochemical defense system functions somewhat like an immune system. It’s selective for a wide range of pathogenic bacteria, viruses, protozoa, fungi, and parasites — but doesn’t adversely affect normal flora.

This gives herbs a distinct advantage over synthetic antibiotics. The regular use of herbs actually balances the microbiome of the gut and skin, instead of disrupting it. Though well recognized, this phenomenon has been documented by science.

The advantages don’t stop there.

Antimicrobial resistance occurs most rapidly with the use of synthetic antibiotics. This creates antibiotic-resistant “superbugs.” In contrast, the same type of resistance doesn’t occur to herbs. In a world where antibiotic-resistant pathogens have become a major problem, herbs may be our best hope.

Instead of being toxic to cells (like antibiotics and many therapies), the phytochemical defense provided by herbs protects cells throughout the body from a wide range of stress factors by neutralizing free radicals, harmful radiation and toxic substances. This provides a high level of protection to cells.

Herbs are plants that humans have selectively consumed for hundreds or even thousands of years as both food and medicines. Not surprisingly, the most commonly used herbs have a very low potential for toxicity.

While all herbs provide broad-spectrum antimicrobial properties, some herbs are more potent than others — and many of these herbs have found their way to treatment of chronic Lyme disease.

People have been using herbal therapy to treat chronic Lyme disease with good results for over two decades. Their stories and accounts, posted on the internet and social media, provide strong support for herbal therapy as a viable option for overcoming chronic Lyme disease.

The popularity of herbs for Lyme disease caught the attention of researchers at Johns Hopkins University. In a study published in 2020, a dozen herbs commonly used for treatment of chronic Lyme disease were evaluated for activity against Borrelia burgdorferi. Of the twelve, seven herbal extracts were found to have greater activity against both motile and cyst (dormant) forms of the bacteria than commonly used antibiotics.

The list included

  • Cryptolepis sanguinolenta
  • Juglans nigra (Black walnut)
  • Polygonum cuspidatum (Japanese knotweed)
  • Artemisia annua (Sweet wormwood)
  • Uncaria tomentosa (Cat’s claw)
  • Cistus incanus
  • Scutellaria baicalensis (Chinese skullcap)

In the same year, two other studies were published using some of these same herbs against Babesia and Bartonella.  In one study published in Frontiers in Cellular and Infection MicrobiologyCryptolepis sanguinolentaArtemisia annuaScutellaria baicalensis, Alchornea cordifolia, and Polygonum cuspidatum were found to have good in vitro inhibitory activity against Babesia duncani in the hamster erythrocyte model.

In a second study done at Cold Springs Harbor Laboratory, Cryptolepis sanguinolentaJuglans nigra, and Polygonum cuspidatum were able to eradicate all stationary phase Bartonella henselae cells within 7 days.

The fact that several of the herbs — Polygonum cuspidatum (Japanese knotweed), Scutellaria baicalensis (Chinese skullcap), and Cryptolepis sanguinolenta — had good activity against more than one of the microbes shows the wide range of activity found in herbs. When herbs with strong broad-spectrum antimicrobial properties are combined with immunomodulating and adaptogenic herbs and medicinal mushrooms, the results can be phenomenal.

Rebuilding the Body Back Better

The low potential for toxicity associated with these herbs allows you to do something that isn’t possible or practical with most chronic Lyme therapies — never let up. Herbal therapy can be continued until all symptoms are resolved, even if that takes years. Instead of being in a perpetual war, however, you can think of it as rebuilding your body from the ground up.

Learn more about Dr. Rawls’ approach to treating chronic illness with herbal therapy on RawlsMD.

References

An X, Bao Q, Di S, et al. The interaction between the gut Microbiota and herbal medicines. Biomed Pharmacother. 2019;118:109252.

Akel T, Mobarakai N. Hematologic manifestations of babesiosis. Ann Clin Microbiol Antimicrob. 2017;16(1):6.

Bloch EM, Kumar S, Krause PJ. Persistence of Babesia microti Infection in Humans. Pathogens. 2019;8(3):102.

Bush JC, Robveille C, Maggi RG, Breitschwerdt EB. Neurobartonelloses: emerging from obscurity!. Parasit Vectors. 2024;17(1):416.

Cheslock MA, Embers ME. Human Bartonellosis: An Underappreciated Public Health Problem?. Trop Med Infect Dis. 2019;4(2):69.

Deng H, Pang Q, Zhao B, Vayssier-Taussat M. Molecular Mechanisms of Bartonella and Mammalian Erythrocyte Interactions: A Review. Front Cell Infect Microbiol. 2018;8:431.

Eicher SC, Dehio C. Bartonella entry mechanisms into mammalian host cells. Cell Microbiol. 2012;14(8):1166-1173.

Feng J et al. Evaluation of Natural and Botanical Medicines for Activity Against Growing and Non-growing Forms of B. burgdorferi. Front Med (Lausanne). 2020 Feb 21;7:6.

Goc A, Niedzwiecki A, Rath M. In vitro evaluation of antibacterial activity of phytochemicals and micronutrients against Borrelia burgdorferi and Borrelia garinii. J Appl Microbiol. 2015;119(6):1561-1572.

Goc A, Rath M. The anti-borreliae efficacy of phytochemicals and micronutrients: an update. Ther Adv Infect Dis. 2016;3(3-4):75-82.

Jalovecka M, Sojka D, Ascencio M, Schnittger L. Babesia Life Cycle – When Phylogeny Meets Biology. Trends Parasitol. 2019;35(5):356-368.

Jin X, Gou Y, Xin Y, et al. Advancements in understanding the molecular and immune mechanisms of Bartonella pathogenicity. Front Microbiol. 2023;14:1196700.

Ma X, Leone J, Schweig S, Zhang Y. Botanical Medicines with Activity against Stationary Phase Bartonella henselae. Cold Spring Harbor Laboratory.

Scherler A, Jacquier N, Greub G. Chlamydiales, Anaplasma and Bartonella: persistence and immune escape of intracellular bacteria. Microbes Infect. 2018;20(7-8):416-423.

Vannier EG, Diuk-Wasser MA, Ben Mamoun C, Krause PJ. Babesiosis. Infect Dis Clin North Am. 2015;29(2):357-370.

Xi Y, Li X, Liu L, et al. Sneaky tactics: Ingenious immune evasion mechanisms of BartonellaVirulence. 2024;15(1):2322961.

Zhang Y, Alvarez-Manzo H, Leone J, Schweig S, Zhang Y. Botanical Medicines Cryptolepis sanguinolenta, Artemisia annua, Scutellaria baicalensis, Polygonum cuspidatum, and Alchornea cordifolia Demonstrate Inhibitory Activity Against Babesia duncani. Front Cell Infect Microbiol. 2021;11:624745.

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**Comment**

Please keep in mind this is one doctor’s opinion who just happens to make money off the very thing he promotes, so there’s a definite conflict of interest.

Also, since treating over a long period of time is often required, keep an open mind, and be willing to experiment.  It is common knowledge that people respond quite differently to treatment.  Wisdom and finesse is required for this journey.  Your best bet is to see an experienced Lyme literate doctor.

Personally, I can say I’ve used nearly everything out there – and some things definitely worked better than others, but again, what worked for me may not work for you.  Also, it’s important to understand dosages, pulsing, and cycling of treatments as these issues can make all the difference.

For more:

Advances in Lyme & Babesiosis Research

https://www.globallymealliance.org/news/from-diagnostics-to-disease-mechanisms-advances-in-lyme-and-babesiosis-research?

Cutting-edge research funded by GLA advances diagnostics and insights into Lyme disease and babesiosis, identifying key biomarkers and genetic risk factors.

Three GLA-funded investigators have been making exciting progress. Dr. Rafal Tokarz’s team has been uncovering key insights into the immune response to specific proteins of Lyme bacteria, paving the way for more accurate diagnostics. Dr. Ben Mamoun has achieved an important milestone by developing the first diagnostic tests for detecting active Babesia duncani infections.  Dr. Klemen Strle’s research suggests that specific genetic factors may increase the risk of developing chronic Lyme arthritis. Meanwhile, Dr. Strle’s new findings are shedding light on how certain genetic factors may heighten the risk of developing chronic Lyme arthritis. 

Summary: 

GLA-funded research continues to shed light on key aspects of Lyme and tick-borne diseases, from diagnostic biomarkers to genetic factors influencing disease outcomes. 

Dr. Rafal Tokarz and his team at Columbia University used peptide arrays and machine learning to identify immune reactive proteins in Borrelia burgdorferi to differentiate between phases of Lyme disease. These insights could enhance the accuracy of antibody-based diagnostic tests by improving their sensitivity and specificity (Tokarz et al., 2024). 

At Yale University, Dr. Choukri Ben Mamoun and his team developed the first antigen detection tests for Babesia duncani, a parasite often responsible for severe babesiosis. These assays, validated with over 1,700 samples, can detect active infections with high sensitivity and specificity, paving the way for early diagnosis, reservoir animal screening, and improved blood safety (Chand et al., 2024).  

Research by Dr. Klemen Strle and his group at Tufts University identified genetic variations associated with chronic Lyme arthritis. These variations are linked to increased inflammation and autoantibody responses, suggesting that some patients may have a genetic predisposition to persistent arthritis in Lyme disease. These findings may guide future biomarker development to predict disease risk (Ehrbar et al., 2024). 

These studies reflect GLA’s unwavering commitment to support research that addresses critical challenges in diagnosing and managing tick-borne diseases. 

Publications: 

Tokarz, R., Guo, C., Sanchez-Vicente, S., Horn, E., Eschman, A., Turk, S. P., Lipkin, W. I., & Marques, A. (2024). Identification of reactive Borrelia burgdorferi peptides associated with Lyme disease. mBio, 15(10). https://doi.org/10.1128/mbio.02360-24   

Chand, M., Vydyam, P., Pal, A. C., Thekkiniath, J., Darif, D., Li, Z., Choi, J. Y., Magni, R., Luchini, A., Tonnetti, L., Horn, E. J., Tufts, D. M., & Ben Mamoun, C. (2024). A set of diagnostic tests for detection of active Babesia duncani infection. International Journal of Infectious Diseases, 147, 107178. https://doi.org/10.1016/j.ijid.2024.107178  

Ehrbar, D., Arvikar, S. L., Sulka, K. B., Chiumento, G., Nelson, N. L. J., Hernandez, S. A., Williams, M. A., Strle, F., Steere, A. C., & Strle, K. (2024). Variants in the late cornified envelope gene locus are associated with elevated T-helper 17 responses in patients with postinfectious Lyme arthritis. The Journal of Infectious Diseases, 230(Supplement_1), S40–S50. https://doi.org/10.1093/infdis/jiae164  

https://www.globallymealliance.org/news/decoding-chronic-lyme-investigating-epigenetic-signatures?

Pictured: Tanja Petnicki-Ocwieja, PhD, courtesy of Tufts University School of Medicine
Tufts University, with support from GLA, is leading research to uncover epigenetic mechanisms behind chronic Lyme disease. Dr. Tanja Petnicki-Ocwieja’s work could improve treatments and reveal commonalities with other post-infectious syndromes like long COVID.

By Mase Peterson

In the fight against Lyme disease, cutting-edge research is essential for advancing treatment and prevention strategies. Tanja Petnicki-Ocwieja, PhD, a research assistant professor at Tufts University School of Medicine, is a key contributor to this effort through her work with the Tufts Lyme Disease Initiative. This collaborative group of faculty, staff, and students is dedicated to eliminating the public health threat of Lyme disease by 2030.

Tufts is home to one of the world’s most comprehensive groups of tick-borne disease researchers. Led by co-directors Linden Hu, Paul and Elaine Chervinsky Professor of Immunology, and Robert P. Smith, a physician at Maine Medical Center and professor of medicine, the team recently secured a $20.7 million federal grant, further solidifying Tufts’ position as a global leader in Lyme disease research.

In this Q&A, part of a feature series spotlighting members of the Initiative, Professor Petnicki-Ocwieja discusses her research on the immunological and epigenetic mechanisms underlying chronic Lyme disease and its potential to transform patient outcomes…

Read the rest from Tufts School of Medicine

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**Comment**

I’d love to be hopeful, but when the moniker PTLDS continues to be used it shows an inherent bias that ongoing infections aren’t to blame for people’s ongoing symptoms.  This must change.

For more:

Medical Detective: An Overview of Lyme Disease Signs and Symptoms

https://www.lymedisease.org/overview-lyme-signs-symptoms/

MEDICAL DETECTIVE: An overview of Lyme disease signs and symptoms

This article was originally posted on Dr. Richard Horowitz’s Medical Detective Substack. You can find more helpful content by subscribing to it here.

Now that you know that Lyme disease presents a regular risk for you and your family due to its worldwide spread, rapidly increasing tick populations due to a warming climate (ticks reproduce faster at higher temperatures), and lack of accurate testing, what are the most common Lyme symptoms, aside from the telltale rash, that you should be looking for to suspect an infection?

Signs and Symptoms of Lyme Disease

There are six major signs and symptoms that allow the Medical Detective to suspect an infection with Borrelia burgdorferi, the agent of Lyme disease:

(1) It is a multisystemic illness. Although it is possible to just have one joint that hurts and may be swollen as your primary symptom, this is not the usual manifestation that I have seen among the 13,000 chronically ill individuals I have diagnosed and treated. A broad range of body systems is usually affected, including the heart, musculoskeletal system, along with neurological, psychological, hormonal, and even immunological consequences, including immune deficiency.

So if you have a multisystemic illness, with many of the symptoms listed below, and your doctor has sent you to specialist after specialist looking for answers, that is a telltale sign Lyme disease may be present.

(2) Symptoms of Lyme disease tend to come and go with good and bad days. In many other chronic illnesses, symptoms tend to be daily without huge variations in intensity or frequency.

(3) The hallmark symptom of Lyme disease is migratory pain. Migratory joint pain, migratory muscle pain and/or migratory nerve pain (neuropathy, which is usually experienced as a burning, tingling, numbness or stabbing sensation) lets the Medical Detective know that a diagnosis of Lyme is likely. (There are only seven diseases that cause migratory pain.)

(4) Symptoms of Lyme disease usually get better or worse with antibiotics. This would not be the case with a chronic fatiguing, musculoskeletal, cardiac, neuropsychiatric illness due to a pure viral infection (which can be the case in CFS/ME, FM, and/or long Covid). Symptoms that can get better (lowering the load of the bacteria) or worse (known as a Herxheimer reaction, which is an inflammatory reaction due to killing off of the bacteria) include the following:

*Muscle and joint pain (which can be migratory in nature)

*Severe fatigue

*Tingling and/or numbness/and/or burning and/or stabbing sensations (neuropathy, which can be migratory in nature)

*A stiff neck

*Headaches

*Light and sound sensitivity

*Dizziness

*Memory and concentration problems

*Mood disorders such as depression and/or anxiety

*Difficulty falling asleep and staying asleep

*Fever and/or chills

*Gastrointestinal issues

*Chest pain with palpitations

*Shortness of breath…and more.

*(I’ll have more details about symptoms in my next article.)

(5) Women usually have a worsening of Lyme disease symptoms around their menstrual cycle: before, during or right afterwards. This is because when estrogen levels drop, the bacteria can become more active.

(6) Finally, there are clues on blood tests that you have been exposed to Lyme disease and associated tick-borne infections, but it is important to know that standard two-tiered testing (STTT), using an ELISA followed by a Western blot–one of the primary ways doctors try to diagnose Lyme disease–is highly insensitive, with the accuracy of about a coin flip.

Insensitive testing

For early Lyme disease, doctors may use a version of the STTT, called “Modified two-tiered testing (MTTT),” where two enzyme immunoassays (EIAs) are used instead of the traditional Immunoblot. (Although in one Canadian study it was 25% better at diagnosing some early cases, it is still an imperfect test, and other studies have found the MTTT to be more or less equivalent to the STTT.)

Which means that, ultimately, Lyme disease is a clinical diagnosis. An EM rash, the classic rash of Lyme disease, is proof of exposure and does not require a positive blood test. But if you did not see the rash, you need to know that negative testing with a STTT and/or a MTTT does not rule out exposure.

Clues that you have been exposed are Borrelia specific bands in your blood, such as the 23 kDa (Outer surface protein C, i.e., Osp C), 31 kDa (Osp A), 34 kDa (Osp B), 39 kDa and the 83/93 kDa bands. The exception is the 31 kDa band on a Western blot may cross react with viral proteins or reflect an autoimmune process. The 31 kDa band on an Immunoblot, a test that uses recombinant DNA, is however specific, which is why we prefer using Immunoblots as our first line test.

Standard treatment for Lyme disease

Because testing and treatment can be so complicated, there’s much more info to come….

For now, know that if caught early, the standard treatment for Lyme by some infectious disease doctors is a 14-day course of antibiotics, usually doxycycline or amoxicillin. For an EM rash, some doctors will prescribe antibiotics for up to 30 days.

However, if you have multiple EM rashes, or an EM rash with peripheral nervous system (PNS) involvement (tingling, numbness, burning, and/or stabbing sensations of the arms and legs) and/or central nervous system (CNS) involvement with nerve palsy like Bell’s palsy (where your facial muscles don’t work properly) with associated neuropathy, cognitive difficulties with memory/concentration problems, light or sound sensitivity, dizziness, sleep disorders, new or exacerbated psychological symptoms–short courses of antibiotics will not clear the infection, and you will go on to the chronic form of the disease.

When symptoms persist–Stephen’s story 

If symptoms persist, brace yourself! You could find yourself at the mercy of the bacteria that will make your life a misery. Like Stephen.

When Stephen came to see me in March 2020, he told me he’d had to drop out of his first semester at college because he couldn’t function anymore. He’d been suffering for 10 years—no, that is not a typo!–from a strange disease that had brought his life to a halt, going from one doctor to another trying to find a cure.

When I asked him to describe his symptoms, he took a deep breath. The list was long. “Well, I’m tired all the time, no matter what I do,” he told me. “My joints and muscles always ache. I get these sharp stabbing pain in my hands or legs or chest. Sometimes it’s a burning pain.” He shook his head, confused. After all these years, he still couldn’t understand why this was happening. It didn’t make sense.

Working on a theory, I asked if he experienced shortness of breath or night sweats. He did. But then, carefully avoiding my eyes, he confessed to the worst symptom of all. “Sometimes —not always—I see or hear things that aren’t really there.”

My heart went out to him. This bright young man with such a promising future had suddenly developed auditory and visual hallucinations when he was 18 for no apparent reason. A psychiatrist decided he was schizophrenic, and prescribed an antipsychotic that came with serious side effects. Once Stephen had this diagnosis, no doctor had ever listened to him the same way again. Until now.

An important piece of the puzzle

“Have you ever been around cats?” I asked him.

“Not lately,” he said. Then he remembered that, growing up in rural Pennsylvania, he’d had a cat. Inevitably, she had scratched and bitten him more times than he could remember.

“How about tick bites?”

“Sure,” he said. “But that was years ago…”

As I questioned him, the pieces of the medical puzzle started to fall into place. I’d seen the same series of infectious and environmental assaults in patients with this illness for decades. I thought it might also stem from the same infections.

When I asked Stephen to stand up for the physical exam, he felt dizzy. I checked his pulse. It had jumped more than 30 beat per minute and stayed high for several more minutes.

That was a clear sign of POTS (Postural Orthostatic Tachycardia Syndrome), a dysregulation in areas of the nervous system that controls our blood pressure and pulse rate. I see this problem regularly in my chronic Lyme disease patients, those suffering from long Covid, as well as those with problems due to environmental toxins like mold.

When he lifted his shirt so I could listen to his lungs, Stephen muttered, apologetically, “Oh, I have a rash…” That was an understatement. Spreading across his entire middle and upper back was a distinctive purple rash that looked like horizontal stretch marks.

I smiled. “I need to confirm it with blood tests, but I think I know what’s causing your symptoms.”

Stephen was stunned. “What is it?”

“A parasite,” I told him. “It’s called Babesia. It’s a protozoan, like malaria, that can cause sweats, chills, shortness of breath. And I also strongly suspect you have contracted a bacterial infection called Bartonella, often transmitted through cat bites and scratches.”

When we got his laboratory results back, they confirmed my suspicions. “Bartonella could’ve caused all of your neuropsychiatric symptoms—and the rash!” I told him.

Other factors

That said, a condition as extreme as Stephen’s is not just about parasites and little-known bacterial infections. There were a lot of contributing factors. He’d been exposed to environmental toxins like mold, along with vitamin and mineral deficiencies, and this had exacerbated and compounded his symptoms, preventing his immune system from clearing away any lingering infections and making it difficult for him to detoxify and improve.

With so many things going on, it was clear that Stephen didn’t just have Lyme disease. He had Multiple Systemic Infectious Disease Syndrome (MSIDS). He had multiple overlapping sources of inflammation with downstream effects making him ill.

When I started Stephen’s treatment, using dapsone combination therapy for chronic Lyme disease and Bartonella, he soon felt like a completely different person. For the first time in over a decade, his pain was gone. His joint and muscles didn’t ache. The stabbing, burning nerve pains had disappeared. No more night sweats (we will devote an entire article to Babesia in the future). No fatigue.

Even the hallucinations were almost gone. After struggling to regain his health for so long that he had nearly given up hope, Stephen was almost completely back to normal — in months — after finally getting the right treatment.

And you can get the right treatment too.

More to come

In upcoming articles, I’m going to talk much, much more about MSIDS, and the 16-point treatment plan that I used my Medical Detective skills to develop. It’s a treatment plan that works for not only chronic Lyme disease, but many other chronic illnesses which share overlapping biological processes with the three I’s: multiple infections, inflammation, and immune dysfunction.

Coming up next, I’m going to share the Lyme questionnaire, taken from my book. How Can I Get Better? and published in the International Journal of General Medicine. We validated this questionnaire in 1,600 individuals, both healthy and sick, with help from researchers at the State University of New Paltz. I know it’s going to help if you worry at all that you or someone you know might have Lyme disease. Then, in future articles, we are going to dive into the broad range of testing available to help diagnose early and late disease.

This article was originally published on Substack by Dr. Richard Horowitz. 

Dr. Richard Horowitz has treated 13,000 Lyme and tick-borne disease patients over the last 40 years and is the best-selling author of  How Can I Get Better? and Why Can’t I Get Better? You can subscribe to read more of his work on Substack or join his Lyme-based newsletter for regular insights, tips, and advice.

For more:

Healing After Four Decades of Lyme Misery

https://www.lymedisease.org/four-decades-lyme-misery/

Finding healing after four decades of Lyme-related misery

By Christian Scarborough

Nov. 5, 2024

I grew up on a little farm in Northern Virginia, just outside Washington DC, in what was then a very rural, middle-class community. That part of Fairfax County is now one of the wealthiest in the nation.

In addition to being around livestock, grass fields and woodlands, my brothers and I liked to hike, camp, hunt and fish. In Virginia, that meant encountering ticks! We routinely pulled them off our bodies, thinking nothing of it. We also dealt with plenty of fleas from barn cats and house dogs.

As a teenager, I began experiencing severe pain in my hands and other joints. An orthopedic surgeon prescribed me the first NSAID – Clinoril – which was later pulled due to its dangerous side effects. He said he felt strange giving a 16-year-old arthritis medication, but that I clearly had it systemically. This was also around the time I started struggling with anger issues, depression and anxiety. I was given prescription sleeping medication by an internist.

I have always been an adventure athlete and health/fitness geek, which as it turns out has saved me many times. People look at me and say you look amazing at 62, but they have no idea of the battle I’m fighting and why so many health issues I’ve had most of my life now make sense.

Severe GI issues

It all came to a head in May 2023, when I began to have severe GI issues and lost 27 pounds. After eight months and several false diagnoses ranging from pancreatic cancer to SIBO, the top GI practice in Austin punted. They said, “You have irritable bowel syndrome. Don’t eat anything and take these horrible meds forever.”

Well, the meds were awful. My gut would spasm so violently that it tore up my insides, but the antispasmodic they gave me had terrible side-effects, too. Another medication swung things to the opposite extreme, leaving me constantly balancing between diarrhea and constipation. And along with this I had severe shin and foot pain at night, no energy, blurry vision, an overall feeling I was falling apart.

A new doctor

I finally went to an integrative physician who specializes in treating complicated illnesses. Unlike other doctors, she spent close to two hours with me, asking detailed questions about my medical history. I told her everything.

Even before I had the very expensive, cash-only blood tests, she said, “I’d bet my medical license that you have Lyme.” And boy was she right! It turns out I also have Babesia and Bartonella.

The first thing she did was address my severe GI pain, spasms and diarrhea – and in a way not one GI doctor had ever suggested. She put me on a nightly microdose of naltrexone, and within a week I was much better. At normal doses, naltrexone is used to treat opiate addicts and alcoholics, but you have to think outside the box in order to effectively treat Lyme.

As anyone who is being comprehensively treated for chronic Lyme disease will tell you – treatments aren’t fast, easy, painless or cheap. The months of oral antibiotics made my already fragile gut worse. Then, they switched me to six weeks of intramuscular Rocephin shots, four days a week rotating between my glutes and thighs. It was as brutal as it gets.

Rocephin is so painful it’s mixed with straight lidocaine, and it still feels like someone hit you with a hammer. I am a tough man. But those shots made me want to cry. The volume is so large it has to be split into two syringes of material with the viscosity of motor oil. I sit in an infusion center every week surrounded by very sick people, many with Lyme, mold, cancer or a combination.

Sleeping through the night

I have been getting weekly procaine IVs with vitamin B12. The results have been amazing! I am sleeping through the night for the first time I can remember – albeit I am still taking Clonazepam before bed. And I find myself in a calmer, more relaxed state in general.

Procaine helps reset the central nervous system. In combination with the daily microdose of ketamine I take per my psychiatrist, it has greatly improved my quality of life and my outlook on fighting Lyme. And at least now I can make sense of why I’ve had three total joint replacements, a foot of colon removed, shin pains, foot tumors, insomnia, anxiety, overall fatigue and brain fog, etc.

I am convinced there are many people like me who are suffering from vector-borne illness and have tried everything with no results. They need to know there is hope.

This week the 25th annual conference of the International Lyme and Associated Diseases Society is being held in San Antonio, Texas, and my doctor is one of the featured speakers. I hope healthcare professionals in the audience listen and learn from her.

Christian Scarborough lives in Texas.