Archive for the ‘Babesia’ Category

The Three Bs – Borrelia, What, and What? Co-infections & Chronic Illness

https://www.lymedisease.org/the-three-bs-borrelia-what/

The three Bs – Borrelia, What, and What? Co-infections and chronic illness

By Nicole Bell, Galaxy Diagnostics CEO

3/10/25

While many people in the Lyme community are familiar with the three Bs – Borrelia, Bartonella, and Babesia – most people outside the community look confused when I mention these top flea and tick-borne pathogens. I understand their puzzled looks because back in 2017, I was confused too.

Even after my husband, Russ, was diagnosed with these three stealthy invaders, I focused all my research on Borrelia, the bacteria causing Lyme disease.

It ended up taking a tragic journey followed by years of studying the research to gain an appreciation for the complexities of all three pathogens – and that research is still unfolding.

In complex cases, co-infections are the rule, not the exception.

The first thing to understand when considering the three Bs, is that in complex cases, co-infections are common. In a survey of over 3,000 chronic Lyme disease patients published by LymeDisease.org, over 50% had co-infections, and 30% had two or more co-infections. Babesia and Bartonella top the co-infection list, each presenting in about 30% of chronic Lyme cases.

Source: About Lyme Disease Co-infections, LymeDisease.org

The second thing to understand about these pathogens is that calling them “Lyme co-infections” is misleading. All these pathogens – the other Bs and beyond – can be present without a Borrelia  infection (past or present).

The problem is that many doctors don’t have these invaders on their differential – and it’s easy for a pathogen to be considered rare if you never test for it. 

Rare disease? Or inadequate testing and data?

To understand the true prevalence of these pathogens, we need to dig into the details of each pathogen and how we count and test for them. For example, before 2013, Lyme incidence in the U.S. was estimated to be approximately 30,000 cases per year. Then, in 2013, the CDC looked at clinical records, laboratory reports, and public surveys and increased this estimate 10-fold.

In 2021, an analysis of insurance records increased the estimates again, and current data shows that approximately 500,000 Americans are diagnosed and treated annually. And since the standard of care test for Lyme leading to diagnosis and treatment is 40-60% accurate, even this number is likely underestimating the extent of the problem.

So, the question looms – what is the prevalence of the other two Bs? Are they destined for a similar exponential increase as we dig into the data? Emerging research points to yes.

Bartonella – The Hidden Pandemic

Bartonella is a genus of gram-negative bacteria that can infect humans and a wide range of animals. Googling the bacteria shows that it is the pathogen causing cat scratch disease or CSD, an acute form of the infection. But like Lyme, this pathogen has been associated with complex chronic conditions spanning multiple body systems, including the joints, eyes, heart, and brain.

Lyme disease has made people fearful of ticks, but Bartonella can be transmitted by a long list of biting insects – or vectors – including fleas, body lice, sand flies, and even spiders. Also, an underappreciated risk factor for bartonellosis is animal exposure, particularly exposure to cats, which are natural reservoirs of the bacteria.

In a study of veterinary workers, 44% were positive for Bartonella antibodies, and 28% had DNA of the pathogen detected directly from their blood. With approximately 66% of U.S. households owning at least one pet, the pathogen has the potential to be more widespread than generally thought.

Dr. Ed Breitschwerdt from North Carolina State University’s veterinary school has studied Bartonella since the 1990s. The advanced testing methods developed in his lab by collaborator Dr. Ricardo Maggi have uncovered key links between the pathogen and complex illnesses, such as arthritis, chronic fatigue, and fibromyalgia.

Neuropsychiatric conditions

Recently, using innovations in advanced PCR technology, the lab has made groundbreaking discoveries linking Bartonella and neuropsychiatric conditions, such as schizophrenia.

The investigation into schizophrenia started the way many discoveries in medicine do, with one case. A 14-year-old boy – who we will call Michael – suffered from sudden onset psychosis and received a formal diagnosis of schizophrenia. Michael was referred to Dr. B’s lab because he had marks on his skin, called striae, consistent with a Bartonella infection.

Dr. B and his team used their advanced test methods to confirm that Michael was infected with Bartonella. Upon treatment with the appropriate antibiotics, his symptoms evaporated.

The case inspired Dr. Breitschwerdt to consider a hypothesis – what if other patients were experiencing psychosis because of a Bartonella infection? Bartonella can cross the blood-brain barrier and infect endothelial cells, contributing to neuroinflammation.

The hypothesis had merit. His lab partnered with the University of North Carolina to test 17 schizophrenia patients. Sixty-five percent of those patients tested PCR positive for the pathogen, compared to 8% in healthy controls.

A subsequent study with Columbia University on over 100 patients found that people affected with psychosis were over three times more likely to have direct evidence of Bartonella in their blood than unaffected controls.

PANS

And schizophrenia isn’t the only neuropsychiatric condition linked to the pathogen. Pediatric patients with Bartonella infections have been reported to develop Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and symptoms like anxiety, obsessive-compulsive disorder, and cognitive dysfunction. Case studies have shown improvement in neuropsychiatric symptoms following treatment of the underlying infections.

With over 3 million Americans battling schizophrenia and 1 in 200 children in the U.S. affected by PANS, Bartonella may emerge as the great hidden pandemic.

Babesia – the tip of the iceberg

Babesia is a tick-borne parasitic infection, often touted as similar to malaria, because both parasites infect and replicate within red blood cells and can cause fever, chills, sweats, headache, muscle aches, fatigue, and hemolytic anemia.

Researching Babesia on the CDC Website shows that under 2000 cases were reported nationwide in 2020. The CDC notes that most Babesia cases in the U.S. are caused by Babesia microti, with occasional cases caused by other Babesia species.

Using the same advanced PCR technology that drove clinical discovery in Bartonella, Dr. B and his team turned their attention to Babesia. They found that what we “know” about Babesia may only be the tip of the iceberg.

In 82 individuals the lab was studying for Bartonella infection, 22 (27%) were also infected with Babesia. Furthermore, the top Babesia species identified was not Babesia microti, as expected from CDC data, but rather Babesia divergens (considered rare in the U.S.) and then Babesia odocoilei (considered rare in humans).

Before Dr. B’s work, only a handful of case reports in the U.S. have ever been reported for Babesia divergens. Their best-in-class assay turned up 12 new cases in a group that wasn’t even targeted for Babesia studies.

Dr. B’s team also recently published a paper where an entire family – all five members and one of their dogs – tested positive for a Babesia-divergens-like species. Similar new case discoveries have been made for Babesia odocoilei. His work poses the question – are the pathogens really rare, or are we just not testing for them properly?

Genus versus species – why it matters

Genus and species are terms commonly used by microbiologists, but when I first entered the world of tick-borne disease, I didn’t fully understand their significance. The “genus” is akin to a family name, grouping related individuals – think Hatfields and McCoys. The “species” is like the first name, identifying a specific individual in the family.

Translating this to Lyme disease, Borrelia is the genus or family name, and Borrelia burgdorferi is the species name identifying the particular pathogen.

So why does it matter? The current commercial test methods for all three Bs generally use serology or antibody testing. These assays measure antibodies created by the host’s immune response to the pathogen. The problem is that antibodies react to proteins on the surface of the pathogen, and these proteins can vary depending on the particular species.

In other words, the patriarch of the Hatfield family, Anderson Hatfield, looked and dressed differently than his son Cap Hatfield. Thus, sending out a warrant and a picture of Anderson is unlikely to lead to Cap’s arrest.

Antibody testing is similar, and testing for Babesia microti, may not accurately diagnose a case of Babesia odocoilei or Babesia divergens. There are over 100 known Babesia species, with 15 of those confirmed in human cases.

There are over 50 species of Bartonella, at least 20 of which have been documented to infect humans and other mammalian hosts. Dr. B’s research and testing technology is redefining what we know about these pathogens. And until these tests are launched commercially, millions have the potential to be misdiagnosed.

Direct Detection for BBB is Launching at Galaxy Diagnostics

Fortunately, Galaxy Diagnostics was founded by Dr. Breitschwerdt, Dr. Maggi, and Dr. Amanda Elam to bring these diagnostic advancements to market. This month, Galaxy is launching its digital PCR, direct detection assay for BBB.

This assay has been instrumental in driving clinical discovery in Dr. B’s lab and will now be commercially available to practitioners. Top features of the assay include:

  • Genus level detection, detecting each pathogen regardless of species.
  • Ultra-sensitive, digital PCR, which increases detectability for low abundance pathogens.
  • Multiplexed detection to provide three results in a single test.

The BBB assay is a blood-based assay that detects the DNA of each pathogen. The approach has previously been used only in a research setting, but the team at Galaxy has now validated the assay for commercial use.

Bartonella and Babesia – but what about Borrelia?

The BBB assay is a blood-based approach, and it is essential to note that blood is NOT the best matrix for Lyme Borrelia, as I have discussed previously.

Galaxy recommends its urine antigen test for Lyme since the concentrations of Lyme Borrelia are so low in the blood that a blood draw is unlikely to capture the pathogen in the test tube. And no matter how sensitive the technique is, if the pathogen isn’t in the tube, there is no way to detect it.

So then, why is Borrelia included in the BBB assay? The answer goes back to the genus versus species issue. While the species associated with Lyme Borrelia often hide in tissues and don’t free-circulate in high copy numbers in blood, the species associated with Relapsing Fever Borrelia do replicate to high numbers in the blood.

As a result, combining the BBB assay with Galaxy’s Nanotrap urine antigen test for Lyme provides optimal coverage for the top flea and tick-borne infections at the genus level.

Coming Full Circle – Avoiding Cases like Russ

After my husband Russ passed, the engineer in me knew there had to be better options. I immersed myself in the research and found Dr. B’s published peer-reviewed results. I introduced myself to the Galaxy team, and as I dug in, I became even more convinced that their technology would provide the clarity I craved as a caregiver.

In June 2024, I became Galaxy’s CEO to bring these advanced testing techniques to a broader market. We crystallized our mission to provide a new standard of care for diagnosing these devastating flea and tick-borne diseases. With the commercial launch of the BBB assay, we are one step closer to that goal. I know that Russ is watching – and smiling.

Nicole Bell, CEO of Galaxy Diagnostics, is also the author of What Lurks in the Woods and The State of Lyme Disease Research. 

For more:

Category:

Babesia, Bartonella, Lyme, PANS, Testing, Ticks, Treatment

Complex Role of Bartonella in Chronic Illness #1

https://www.lymedisease.org/med-detective-bartonella-part-1/

MEDICAL DETECTIVE: The complex role of Bartonella in chronic illness, part 1

This article was originally posted on Dr. Richard Horowitz’s Medical Detective Substack. It is Part 1 of a 5-part series. You can find more helpful content by subscribing here. 

Bartonella is the third “B” of the triad found in the vast majority of my chronically ill patients who suffer from chronic Lyme disease/PTLDS, along with Borrelia and Babesia.

A gram-negative intracellular bacteria, it’s controversial and misunderstood and has been throwing a monkey wrench into my treatments for decades.

I barely remember learning about it in medical school, except when they were teaching me about cat scratch fever in children that would cause small, localized rashes (papules) at the site of the scratch with swollen lymph nodes and fevers.

It would be treated with a short course of antibiotics like azithromycin. These images show classical cat scratch disease before and after treatment when the lesions are starting to crust up.

[From: Mazur-Melewska K, Mania A, Kemnitz P, Figlerowicz M, Służewski W. Cat-scratch disease: a wide spectrum of clinical pictures. Postepy Dermatol Alergol. 2015 Jun;32(3):216-20. doi: 10.5114/pdia.2014.44014. Epub 2015 Jun 15. PMID: 26161064; PMCID: PMC4495109.]

Unfortunately, Bartonella infections rarely resemble this one particular manifestation, or the general medical community would be diagnosing and treating it a lot more often.

It is a very tricky bacteria, and, like Lyme disease, has found a way to not only avoid immune recognition, but change its clinical characteristics so it resembles a broad range of other diseases.

Immune Evasion by Bartonella

Bartonella is referred to as a “stealth bacteria” because it evades the immune system by living inside red blood cells (intraerythrocytic persistence), blood vessel walls (inflaming them, causing vasculitis), endothelial cells, fibroblasts, epithelial cells of the skin (causing the classic Bartonella rashes described below), macrophages (immune cells that play a critical role of initiating and maintaining an inflammatory response, as well as potentially resolving inflammation) and bone marrow cells.

So it can hide throughout the body in areas where the immune system doesn’t easily penetrate and recognize the bacteria, not to mention, it can exist under biofilms in persister forms like Borrelia. Biofilms protect the bacteria from immune recognition and the effects of antibiotics.

[From: Okaro, U.; George, S.; Anderson, B. What Is in a Cat Scratch? Growth of Bartonella henselae in a Biofilm. Microorganisms 2021, 9, 835. https://doi.org/10.3390/microorganisms9040835%5D

Bartonella can manipulate host cell interactions to hide from immune detection by altering its surface proteins to avoid recognition (like Lyme disease), and possesses unique fat and sugar molecules (lipopolysaccharides) that minimize immune response activation; this often leads to prolonged, asymptomatic infections that can be difficult to diagnose with standard tests (it can hide in the body for years in some patients without symptoms), and then reactivate under certain conditions.

The patient below was in remission for one year after doing an 8-week course of double dose dapsone combination therapy (DDDCT), and then reactivated after being treated with antibiotics for a skin infection. This skin rash emerged when he got treated for cellulitis, which had nothing to do with his initial Lyme infection. You can see the classical Bartonella “stretch marks.”

[From: Horowitz, R.I.; Fallon, J.; Freeman, P.R. Comparison of the Efficacy of Longer versus Shorter Pulsed High Dose Dapsone Combination Therapy in the Treatment of Chronic Lyme Disease/Post Treatment Lyme Disease Syndrome with Bartonellosis and Associated Coinfections. Microorganisms 2023, 11, 2301. https://doi.org/10.3390/microorganisms11092301%5D

Reactivation often happens when the immune system is unable to control the infection, due in part to the immunosuppressive nature of the bacteria.

I’ve found multiple species of Bartonella in our sickest patients leading to chronic variable immune deficiency (CVID), just as I’ve found Borrelia causing immune suppression, along with mold toxicity and Long Covid affecting immune functioning.

The multisystemic nature of Bartonella infections

When we see patients with Bartonella, as I mentioned, it has no resemblance whatsoever with the classical cat-scratch disease I learned about in medical school. Bacteria like Bartonella cause similar symptoms to those seen in chronic Lyme disease, presenting as a “great imitator.”

It can result in chronic fatiguing, musculoskeletal, cardiopulmonary, neuropsychiatric illness and can cause fevers, chills, fatigue, headaches, muscle/joint and nerve pain, cognitive difficulties, insomnia, depression, anxiety, and cause inflammation in every body system imaginable, just like Lyme disease, Borrelia burgdorferi, does.

There can also be inflammation in the eyes (optic neuritis, conjunctivitis, uveitis, arterial and venous occlusions); the brain, surrounding structures and spinal cord (meningitis, encephalitis, transverse myelitis, seizure disorders), with associated Bartonella “rage” and psychosis (Bartonella, like Lyme disease, can cause a broad range of psychiatric manifestations, including but not limited to severe depression, anxiety, Obsessive Compulsive Disorder, Bipolar disorder and schizophrenia with psychosis).

It also can cause inflammation in the muscles (myalgias), joints (arthritis, osteomyelitis), nerves (neuropathy) and blood vessels (vasculitis), as well as the heart valves (endocarditis, including culture negative endocarditis), heart muscle (myocarditis), and sac surrounding the heart (pericarditis) causing chest pain with masses in the chest (mediastinum) and lymph nodes resembling non-Hodgkins lymphoma.

Even the gastrointestinal tract can be affected (nausea, vomiting, weight loss, bleeding), as can the liver (hepatitis), spleen (splenitis, enlargement), and skin, which oftentimes shows signs of inflammation (stretch marks, i.e. striae; granulomas, hard fibrous areas over the knuckles, elbows, and Bacillary angiomatosis, which are tumor-like masses, raised dark areas, papules, nodules, and lesions in the skin, bones, and organs).

Bartonella is a frequently found infection in those suffering from chronic Lyme disease—I’ve seen it in up to 80-90% of all of my chronically ill patients these days and should be considered in any and all cases of FUO (fever of unknown origin).

[From: Cheslock, M.A.; Embers, M.E. Human Bartonellosis: An Underappreciated Public Health Problem? Trop. Med. Infect. Dis. 2019, 4, 69. https://doi.org/10.3390/tropicalmed4020069%5D

Transmission of Bartonella

Part of the reason Bartonella has been a controversial topic in the Lyme community–at least among certain physicians and researchers–is because there has only been one study to date regarding tick transmission of the bacteria, and this was in European species of deer ticks (Ixodes ricinus) with one species, called Bartonella birtlesii.

The bacteria is, however, being found in ticks throughout the world, and other studies have shown the bacteria in different ticks and in chronic Lyme disease patients.

When I was co-chair of the HHS Tick-borne Disease Working Group (TBDWG) back in 2018, I had to fight to get Bartonella included as a co-infection of importance; whether all species are able to be transmitted by ticks or not, makes no difference.

Why? To date, the number of species able to transmit Bartonella keeps increasing over the years, and most of us are exposed to these vectors on a regular basis. The most common vectors transmitting the bacteria are fleas, mites, lice, keds (not the sneakers!), spiders, red ants, ticks (probable), sand flies, black and yellow flies, and mosquitoes.

Bartonella is showing up in a broad range of vectors, so it’s possible to get exposed from many different sources. That is why the vast majority of my sick patients are testing positive for it. In fact, for most of us living on this planet, I daresay we’ll all likely be exposed to Bartonella at some point during our lives. How we handle it, and whether we get symptoms, will depend on how our immune system is functioning.

Testing for multiple Bartonella species

The table below shows some of the most common species of Bartonella seen in human disease. This is not comprehensive, as there are now at least 45 species of Bartonella, and 18 of them or more are pathogenic [capable of causing disease].

Some of the most common ones are: B. henselae (Cat scratch disease, CSD; endocarditis, neuroretinitis, lymphadenopathy), B. quintana (Trench fever, endocarditis, bacillary angiomatosis [BA]), B. clarridgeiae (bacteremia, endocarditis, CSD, chest wall abscess), B. elizabethae (endocarditis, neuroretinitis),  B. bacilliformis (Carrion’s disease), B. koehlerae (endocarditis, including culture negative endocarditis), B. vinsonii subsp (bacteremia, endocarditis, fevers, neurological symptoms), B. berkhoffi (endocarditis, bacteremia, neurological symptoms), and B. grahamii  (neuroretinitis).

[From: Rebekah L. Bullard, Emily L. Olsen, Mercedes A. Cheslock, Monica E. Embers, Evaluation of the available animal models for Bartonella infections, One Health, Volume 18, 2024,100665, ISSN 2352-7714, https://doi.org/10.1016/j.onehlt.2023.100665.%5D

How do we test for Bartonella?

As you can see from the above table, testing for just one species makes no sense, because we can be exposed to a broad range of Bartonella species during our lifetime. I started to test for Bartonella over two decades ago. This is from an abstract I presented at the 16th International Scientific Conference on Lyme disease in 2003:

You can see from this abstract, even 22 years ago, by just testing for Bartonella henselae, one of the most common species, we found that using an ELISA and IFA (Immunofluorescent Assay) was positive in less than 50% of patients–but using DNA analysis with a PCR (Polymerase Chain Reaction) in the blood, we found 53% were positive when standard antibody assays were negative.

Which means the rule of thumb when testing for Bartonella is go as broad as you can. It is fine to start with local lab testing.

Level 1 testing

Using local labs like Quest, Labcorp, or Bioreference, you can send off antibody titers to B. henselae, B. quintana and B. bacilliformis, as well as PCRs and even a VEGF (vascular endothelial growth factor), an indirect marker of Bartonella exposure, indicating inflammation in the blood vessels (vasculitis). Often, however, you’ll want to use several specialty labs to prove infection.

Level 2 testing

If the above testing is negative, as it usually is, but you clinically suspect Bartonella, move on to the next level of tests. The three specialty labs include IgeneX laboratory (Bartonella IgM/IgG Immunoblots, Bartonella FISH [Fluorescent In-Situ-Hybridization test, an RNA test], T Labs (Bartonella FISH) with confocal microscopy, and Galaxy Laboratories, using their 4 species IFA antibody panel (for the most common species), and their ddPCR (direct droplet PCR) tests. The Bartonella Digital ePCR™ platform combines highly sensitive ddPCR technology with culture enrichment (BAPGM™).

I usually start with IgeneX laboratory and find that most of my patients have indeterminate or positive Immunoblots. Many times a negative Bartonella FISH test will turn positive later on during treatment, after the bacteria has been flushed out from the intracellular compartments where it’s been hiding.

I follow VEGF levels over time, as an indirect marker of Bartonella, when reactivation of infection is suspected. Keep in mind VEGF can be positive for other reasons (including Long Covid or cancer with metastases).

Level 3 testing

Skin biopsies can be done of the classical Bartonella rashes. Dr. Marna Ericson from T Labs has done this for me several times, and she found positive Bartonella in the skin, under biofilms, when it couldn’t be found through other methods.

I suspected Bartonella in two of my patients, but despite all classical testing, couldn’t prove exposure. The Bartonella fluoresces red under the microscope with this technique. I don’t suggest it as first level testing, but it can be very useful if you have looked for Bartonella using any and all of the above laboratories and methodologies.

Stay tuned for parts 2, 3, 4 and 5

In Part 2, I’ll discuss more about establishing a diagnosis as well as an overview of how other co-infections may overlap and affect Bartonella symptoms. Part 3 will discuss effective treatments, and Parts 4 and 5 go into more detail about these treatments.

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:

Category:

Babesia, Bartonella, Lyme, Psychological Aspects, research, Testing, Ticks, Treatment

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.

Category:

Activism, Babesia, Bartonella, Eye Issues, Gut Health, Inflammation, Lyme, Testing, Treatment

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 microti, Babesia 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 Microbiology, Cryptolepis sanguinolenta, Artemisia annua, Scutellaria 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 sanguinolenta,  Juglans 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 Bartonella. Virulence. 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:

Category:

Babesia, Bartonella, Treatment

Advances in Lyme & Babesiosis Research

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

From Diagnostics to Disease Mechanisms: Advances in Lyme and Babesiosis Research

by Cara DeAngelis, Ph.D. on January 3, 2025

<span id="hs_cos_wrapper_name" class="hs_cos_wrapper hs_cos_wrapper_meta_field hs_cos_wrapper_type_text" style="" data-hs-cos-general-type="meta_field" data-hs-cos-type="text" >From Diagnostics to Disease Mechanisms: Advances in Lyme and Babesiosis Research</span>
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?

Decoding Chronic Lyme: Investigating Epigenetic Signatures

by Admin at Global Lyme Alliance on January 3, 2025

<span id="hs_cos_wrapper_name" class="hs_cos_wrapper hs_cos_wrapper_meta_field hs_cos_wrapper_type_text" style="" data-hs-cos-general-type="meta_field" data-hs-cos-type="text" >Decoding Chronic Lyme: Investigating Epigenetic Signatures</span>
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

_____________

**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:

Category:

Babesia, Lyme, research, Uncategorized