Archive for the ‘diet and nutrition’ Category

How About Health As a COVID Exit Strategy?

Opinion: How about health as a COVID exit strategy?

Frank Edelblut
Frank Edelblut


What is common among many of these health conditions are the significant influence lifestyle choices have in controlling them. This is particularly true for the top three causes of severe COVID-19. Of course, hereditary factors play a role in these conditions for some people, but for many people, these health conditions can be controlled with lifestyle choices.

The lesson we might take from this is health and wellness should be a key strategy in the avoidance of severe COVID-19 effects.  (See link for article)

The article points out that anxiety and fear-related disorders increased the chance of death from COVID-19 by 28%, which is the second-highest health condition accompanying death from COVID-19.

The author then astutely points out that for over 18 months the media has done nothing but emphasize and focus on risks, dangers, and tragic outcomes with little coverage on making healthy choices as a strategy.  To demonstrate this, a German paper finally came clean and apologized for its fear-mongering.

The media should be reporting on the complete censorship of doctors who are trying to truly help patients with effective, safe treatments and saving lives.  Instead, they are complicitly spreading the government’s misinformation.

For more:

There are also many, many success stories of people who have survived COVID. You never read about these cases – only fear, gloom, doom, and more fear.  The healthiest thing you can do for your mental health is turn off mainstream media.  Just turn it off. 

A NY Times reporter just got caught lying about a COVID surge in schools that didn’t actually happen.

Mold & Chronic Inflammatory Response Syndrome

**UPDATE** Register Here

Lyme and Mold: Guiding the Complex Patient
Join us Wednesday, Sept. 8, at 11 am PT and listen in as Dr. Jocelyn Strand, Biocidin’s Director of Clinical Education, talks with Tom Moorcroft, DO.Dr. Tom is a member of the ILADS Evidence-Based Lyme and Coinfections Fundamentals Program working group and a trainer of healthcare providers.

He will share proven strategies gleaned from over a decade of supporting some of the most sensitive patients with Lyme and other chronic issues. These include:

• Investigating and addressing physical triggers
• Patient-centered treatment of mind, body, and spirit
• Combining conventional therapies with simple, natural interventions

Don’t miss this discussion as Dr. Tom shares his experience and wisdom for supporting the healing journey for even our most complex patients!

Time:  Sep 8, 2021 11:00 AM in Pacific Time (US and Canada)

Mold + Chronic Inflammatory Response Syndrome (CIRS): What is It + Ways to Get Relief

Mold + Chronic Inflammatory Response Syndrome (CIRS): What is It + Ways to Get Relief

by Jenny Lelwica Buttaccio
Updated 7/20/21

If your recovery from Lyme disease has been fraught with many twists and turns despite multiple trips to doctors, numerous treatments, and your best efforts — you might feel yourself becoming increasingly more frustrated. Thankfully, there are always new avenues to explore for finding relief, including a lesser-known condition you might not yet have heard of: Chronic Inflammatory Response Syndrome (CIRS).

Named by Dr. Richie Shoemaker, MD, a researcher and retired family physician from Pocomoke City, MD, CIRS is a biotoxin illness — meaning, an illness caused by chemical toxins released by certain living organisms — and it could play a critical role in why some patients remain ill despite months or years of treatment for chronic Lyme disease.

But because the symptoms associated with CIRS overlap with many other health conditions, including Lyme disease and other tick-borne diseases, it makes identifying the illness challenging for healthcare providers and adds layers to the problems that most patients already face when trying to obtain an accurate diagnosis.

Learn more about CIRS below, including its history, symptoms, testing, and treatment, to determine if this condition might be impeding your recovery and what to do about it.

The History of CIRS

The majority of our understanding of CIRS comes to the medical community by way of Dr. Shoemaker. He began his foray into the world of biotoxin illness in 1997 near an unincorporated community in Shelltown, MD. There, he linked a group of acutely ill individuals to water contaminated with a bacterial exotoxin (a biotoxin that damages cells in the body) from Pfiesteria, a dinoflagellate or single-cell aquatic organism.

Young black woman suffering from headache or migraine after waking up in morning. Stressed lady sitting in bed with painful face expression feeling terrible hangover, unpleasant weakness, dizziness

The affected individuals exhibited symptoms like headaches, memory loss, digestive disturbances, and skin lesions, according to a case report in the Maryland Medical Journal. The toxins produced by the dinoflagellate had been responsible for killing billions of fish in North Carolina’s estuaries, but whether or not it had contributed to illness in humans had largely remained controversial prior to Dr. Shoemaker’s findings.

Through his practice-based studies, a clinical picture of illness emerged, with the affected patients having a reduced capacity to clear biotoxins from their bodies, a heightened inflammatory response, and multi-systemic involvement. Dr. Shoemaker named the constellation of symptoms Chronic Inflammatory Response Syndrome. Through the years, he discovered other biotoxin illness in people who have had exposure to the following:

  1. Water-damaged buildings (WDB): WDBs are often hotspots for mold, even if you can’t see it or smell it. Though the exact prevalence of mold-infested buildings isn’t known, approximately 50% of homes and 85% of commercial buildings have sustained some water damage and mold.
  2. Organisms in the water: We already mentioned the discovery of the toxic dinoflagellate Pfiesteria, which laid the foundation for CIRS. However, another compound produced by dinoflagellates called ciguatera, as well as toxins from blue-green algae known as cyanobacteria, may be problematic for some people, too.
  3. Spiders: The poisonous venom from recluse spider bites, namely Mediterranean and brown, have been known to cause CIRS.

Of the above, mold is the most well-known biotoxin discussed in the chronic illness community. “Approximately, 25% of Americans carry a gene called HLA-DR (human leukocyte antigen) that makes it more difficult for them to excrete the toxic metabolites produced by a variety of different molds or other biotoxins,” says Dr. Bill Rawls, MD, Medical Director of RawlsMD and Vital Plan. Furthermore, the population of people with the genetic variant is more likely to develop CIRS because their bodies are unable to recognize toxins as foreign invaders, so they don’t produce the antibodies needed to remove these toxic substances.

But CIRS isn’t usually caused by one event alone, such as mold. Like many complex health conditions, there may be several components that overwhelm the body, such as multiple biotoxin exposures, untreated or stealth microbes, environmental toxins, and genetic variants.

<img class=”lazyload” src=”data:;base64,” alt=”Molecular level representation of virus, bacteria or disease.” data-orig-src=”; />

For instance, if you’re already battling Lyme disease, your body is inundated with other kinds of toxins called endotoxins, which are pieces of dead bacteria that also cause an immune response, systemic inflammation, and can lead to a Herxheimer reaction. But unlike the exotoxin from Pfiesteria, endotoxins don’t damage cells directly.

Both exotoxins and endotoxins often get lumped together under the biotoxin umbrella, but they are quite different, notes Dr. Rawls, and they aren’t cleared from the body in the same manner. But ultimately, a body that is overrun with a multitude of toxins from various sources can reach a tipping point, and a person may encounter symptoms that don’t resolve with treatment.

The Primary Symptoms of CIRS

The symptoms of CIRS exist on a spectrum. Some individuals experience mild illness, while others are debilitated — which, as mentioned, is more likely to happen when Lyme disease is in the mix, burdening the immune system and stressing your cells.

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CIRS can affect several systems of the body, including neuroimmune, vascular, and endocrine systems. In addition to Lyme disease, the syndrome may mimic or overlap with other conditions, such as ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome), ulcerative colitis, fibromyalgia, and multiple sclerosis.

There are dozens of symptoms associated with CIRS, many of which will likely sound familiar to you. The most common ones include:

  • Cognitive problems with memory, concentration, and focus
  • Brain fog
  • Confusion
  • Headaches
  • Vertigo and dizziness
  • Fatigue and post-exertional malaise (PEM)
  • Muscle aches and joint pain
  • Abdominal cramping
  • Diarrhea
  • Shortness of breath
  • Sensitivity to light
  • Changes in mood
  • Sinus problems
  • Cough

How to Test for CIRS

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Because the symptoms of CIRS are similar to those of other illnesses, your doctor will likely gather a detailed history of your potential exposure to mold or other biotoxins and perform a physical exam, as well as order tests to evaluate biomarkers that correlate with a mold and biotoxin illness.

Although many lab tests exist in the world of mold and biotoxin illness, is it a requirement to do all of them?

Not necessarily, says Dr. Rawls. It’s important to determine whether the information you might get from these labs will influence your decision-making. “Labs can provide valuable information, but in my opinion, about 75% of labs ordered by physicians probably won’t change the outcomes or management of the illness.”

Before allowing tests to be done, Dr. Rawls suggests always defining with your healthcare provider exactly how much a test will cost, whether it’s covered by insurance, and how the information obtained by a test will influence how you treat your condition. “Remember, you should always have the final say so.”

If you decide to move forward with testing, potential labs might include:

  1. HLA-DR: This genetic blood test determines whether a person has the genes that trigger the immune system to properly recognize and excrete mold and biotoxins from the body.
  2. VCS (Visual Contrast Sensitivity): A VCS test measures your ability to detect changes in visual contrast, a function that may be impaired in individuals who have been exposed to mold and biotoxins. The test is available online or can be completed in a doctor’s office.
  3. MSH (Melanocyte-Stimulating Hormone): The hormone MSH is produced in the hypothalamus and the pituitary gland. It regulates neuroimmune pathways, including melatonin, cortisol, cytokines, sex hormones, and the integrity of mucous membranes. Among CIRS-mold patients, 95% have decreased MSH functioning.
  4. TGF-beta-1 (Transforming Growth Factor Beta-1): TGF-beta-1 is an inflammatory cytokine marker that affects the functions of immune cells. It may be elevated in people with CIRS, causing a host of neurologic and autoimmune-type symptoms.
  5. VEGF (Vascular Endothelial Growth Factor): VEGF measures oxygen delivery capabilities throughout the body’s tissues. In the presence of CIRS, a state of low oxygen may ensue (hypoxia), resulting in increased fatigue, poor stamina, and PEM.
  6. C4a: C4a is a complement protein known as an anaphylatoxin, a substance that creates a response similar to an allergic reaction. It also executes tasks related to the immune system and inflammation. An elevated C4a may be present in individuals who have been exposed to mold or biotoxins. However, note that C4a levels aren’t exclusive to mold or biotoxins — levels may also be elevated in patients with Lyme disease and lupus.
  7. VIP (Vasoactive Intestinal Peptide): VIP is a peptide that regulates the immune response, inflammatory cytokines, and pulmonary arterial pressure. Low levels may be seen in people with mold and biotoxin illness. Symptoms of low VIP levels can include shortness of breath and exercise intolerance.
  8. MARCoNS (Multiple Antibiotic Resistant Coagulase Negative Staphylococcus): MARCoNs is a type of bacteria that resides deep in the nasal cavity and may pose a risk to people with mold and biotoxin illness. MARCoNs may suppress MSH levels, further hindering neuroimmune pathways. Testing for MARCoNs involves a nasal culture in the back of the nose.
  9. ADH (Antidiuretic Hormone): ADH manages the body’s fluid levels by balancing salt and water. ADH dysregulation may occur in people with mold and biotoxin illness, resulting in symptoms like excessive thirst, urinary frequency, fluid retention, and more.
  10. MMP-9 (Matrix Metalloproteinase-9): An enzyme, MMP-9, may increase in response to higher levels of cytokines in the body. A prolonged increase in MMP-9 may result in damage to certain tissues in the body.

Indeed, this is an expansive (and overwhelming) list of tests. “Labs can be extremely expensive,” says Dr. Rawls, “So your money might be better spent on therapies that have a high potential to help you feel better than labs that have a marginal impact on the outcomes or management of your illness.”

Thankfully, nowadays, most Lyme-literate medical doctors (LLMD) and many integrative physicians have at least a basic knowledge of mold and biotoxin illness and likely have established a set of biomarkers they prefer to use to evaluate for CIRS that might help trim the cost.

Top Treatment Options for CIRS

Treatment for CIRS requires an individualized, multi-faceted approach aimed at removing mold and biotoxins from the body, quieting inflammation, and assisting the body with cellular and tissue repair. Here are the best therapies to consider.

1. Remove or Remediate Biotoxins from Your Environment.

<img class=”lazyload” src=”data:;base64,” alt=”Woman holds ventilation grill with dust filter to clean it. Dirty and dusty white plastic, harmful for health. Cleaning lady with disguised expression, blurred, in protective rubber gloves and uniform” data-orig-src=”; />

If you’ve been diagnosed with CIRS, a first key step is eliminating troublesome mold and biotoxins in your environment to nip the trigger for your symptoms in the bud. “The solution to a mold problem is avoiding it as best you can,” advises Dr. Rawls.

The reason? If someone living in a dwelling with mold issues is chronically ill with Lyme disease or another illness, then the likelihood that person is mold sensitive is quite high. “Though there is a higher incidence of mycotoxin sensitivity in HLA-DR positive individuals, it still occurs in individuals who are HLA-DR negative,” explains Dr. Rawls. “Either way, the solution is the same: Eliminate exposure to mold.”

If you know or suspect you’re contending with mold, the best course of action is to consult with a professional to safely remove or remediate it — tackling it on your own increases your exposure and often leads to a worsening of symptoms. In addition to selecting a professional you can trust, here are some things you can try:

  1. Use a HEPA air purifier in the areas of your home where you spend the most time. The bedroom is a good place to start.
  2. Use dehumidifiers and air conditioners to maintain low humidity levels. Mold flourishes when humidity is greater than 50%, so aim to keep levels between 30% and 50%.
  3. Heating and air conditioning units can contain hidden sources of mold. Regularly inspect them, and if mold is present, have them cleaned.
  4. Remove rugs or carpets in rooms known to contain high levels of moisture, such as bathrooms or the basement.
  5. Keep your kitchen, bathroom, and laundry rooms well ventilated.
  6. If you have an attic, make sure the space is dry and doesn’t contain moisture.

2. Use Binding Agents to Remove Biotoxins from Your Body.

“I must reiterate that with mold issues and mycotoxin sensitivity, the most important aspect of management is mitigating your exposure,” says Dr. Rawls. “In my clinical experience, symptoms generally start resolving within weeks of exposure elimination. With that said, binding agents may be helpful in severe cases for those who are not getting well after the threat has been removed.”

For this, Dr. Shoemaker uses medications like cholestyramine (CSM) or Welchol (for sensitive individuals). Though CSM and Welchol are cholesterol-lowering medications, they have a unique structure that binds to biotoxins and removes them via the digestive tract.

<img class=”lazyload” src=”data:;base64,” alt=”image split into four sections. Okra pepsin, bentonite clay, activated charcoal, chlorella” data-orig-src=”; />

Some healthcare providers may also recommend gentler, natural binders like okra pepsin, bentonite clay, activated charcoal, and chlorella, depending on the type of mold or biotoxin you’ve come in contact with. But it’s important to know that binders absorb more than biotoxins — they’ll also mop up supplements, medications, and herbal therapies. To avoid this, you’ll generally want to take binders two hours before or after the other elements of your treatment protocol.

Typically, binders are taken until you have an improvement in test results like VCS, MSH, or a negative MARCoNS culture. Note that some people may experience constipation when taking activated charcoal or other toxin binders. If this happens to you, increasing your intake of magnesium, especially magnesium glycinate or citrate, can be useful to keep the digestive tract moving.

3. Eat a Healthy Diet

A nutritious diet is a mainstay of any smart recovery plan, but knowing what to eat can be a challenge. One simple rule of thumb: “The majority of your diet should be plant-based foods, especially vegetables,” says Dr. Rawls. “Vegetables contain nutrients and antioxidants to feed the beneficial flora of your gut and reduce inflammation, as well as crucial fiber to aid in toxin removal.”

<img class=”lazyload” src=”data:;base64,” alt=”Healthy food background, spinach, quinoa, apple, blueberry, asparagus, turmeric, red currant, broccoli, mung bean, walnuts, grapefruit, ginger, avocado, almond, green peas and goji, top view” data-orig-src=”; />

To combat runaway inflammation, be sure to eliminate sugar, gluten, processed carbohydrates, or foods you have a known allergy to. Instead, you’ll want to stock up on healthy fats and proteins — foods like eggs, wild-caught salmon, chicken, olive oil, avocados, and ghee. In general, “If you pick up a food package and can’t pronounce the ingredients listed on the label, that product is better left on the shelf,” says Dr. Rawls.

Finally, if you’re taking certain binders, they may come with specific dietary requirements for maximum effectiveness. For instance, a low-amylose diet is recommended when taking CSM or Welchol; amylose is a digestion-resistant polysaccharide found in legumes, starchy fruits and vegetables, and whole grains.

4. Include Beneficial Adjunct Therapies.

<img class=”lazyload” src=”data:;base64,” alt=”CIRS therapy sauna yoga supplements outside” data-orig-src=”; />

Various therapies can support the body’s efforts to eliminate biotoxins and reduce symptoms. There’s no one-size-fits-all approach to healing, but options that are often beneficial to patients include:

  • Herbal therapy: Herbal remedies like allicin (from garlic), curcumin, and glutathione help to lessen inflammation and normalize immune function. Antimicrobial herbs like cat’s clawandrographis, and Japanese knotweed can help suppress stealth microbes that might be overtaxing your immune system.
  • Heat therapy: Infrared sauna use increases circulation, quells inflammation, and oxygenates tissues.
  • Time outdoors: Going outside offers breaks from continuous exposure to indoor mold and access to some fresh air. Some patients with mold or biotoxin illness practice extreme mold avoidance where they live or spend a substantial amount of time in drier climates such as the desert. For many people, this may not be a viable option, but spending extra time outside whenever possible can greatly benefit you as you heal.
  • Mind-body exercises: Yoga, Pilates, and tai chi can dial down an overactive sympathetic nervous system. These therapeutic movements help set the stage for more healing without pushing yourself to the max — which can leave your body more vulnerable to illness, not less.

The Bottom Line

Healing from CIRS takes time because, like Lyme disease, there are many layers to peel away. The good news is that as you sort through the different areas of dysfunction and take a comprehensive approach to recovery, you’ll begin to notice an increase in energy, clearer thinking, less pain, and a reduction in other debilitating symptoms. With time and patience, most people reach a state of better health — and that’s worth waiting for!

Dr. Rawls is a physician who overcame Lyme disease through natural herbal therapy. You can learn more about Lyme disease in Dr. Rawls’ new best selling book, Unlocking Lyme.  You can also learn about Dr. Rawls’ personal journey in overcoming Lyme disease and fibromyalgia in his popular blog post, My Chronic Lyme Journey.

1. Berndtson K. Chronic Inflammatory Response Syndrome: Overview, Diagnosis, and Treatment. 2013. Available at
2. Gunn SR, Gunn GG, Mueller FW. Reversal of Refractory Ulcerative Colitis and Severe Chronic Fatigue Syndrome Symptoms Arising from Immune Disturbance in an HLA-DR/DQ Genetically Susceptible Individual with Multiple Biotoxin Exposures. Am J Case Rep. 2016;17:320-325. Published 2016 May 11. doi: 10.12659/ajcr.896949
3. Prevalence of Building Dampness. Indoor Air Quality Scientific Findings Resource Bank website.
4. Shoemaker RC. Diagnosis of Pfiesteria-human illness syndrome. Md Med J. 1997;46(10):521-523.
5. Shoemaker RC. Surviving Mold: Life in the Era of Dangerous Buildings. Otter Bay Books; 2011.
6. Stricker RB, Savely VR, Motanya NC, Giclas PC. Complement split products c3a and c4a in chronic lyme disease. Scand J Immunol. 2009;69(1):64-69. doi: 10.1111/j.1365-3083.2008.02191.x
For more:

GI Issues With Lyme Disease

When patients consider taking long-term antibiotics for persistent Lyme disease, they need to weigh risks and benefits of treatment. Gastrointestinal risks can include the possibility of a C.diff infection, or candidaovergrowth, which is a yeast infection that occurs not just in typical places you imagine but also in the gut. A good Lyme Literate Medical Doctor (LLMD) will put a patient on probiotics and a specific diet to mediate these risks, or may decide to go the intravenous route to take pressure off the gut.

Medication is not the only way that the gut can be impacted by Lyme disease; the infection itself can cause gastrointestinal issues. In his book How Can I Get Better? An Action Plan for Treating Resistant Lyme & Chronic Disease, Richard I. Horowitz, MD notes that Lyme and co-infections can cause inflammation leading to issues such as abdominal pain, nausea, gas, bloating, constipation, diarrhea, or reflux disease, with occasional vomiting. He writes, “…a review of gastrointestinal and liver problems associated with tick-borne diseases found that in 5 percent to 23 percent of those with early Lyme borreliosis, patients presented with varied gastrointestinal symptoms, such as nausea, vomiting, abdominal pain, anorexia with loss of appetite, and hepatitis, and some even had symptoms of an enlarged spleen and liver.”[i] And that’s just in early Lyme—in later stages of the disease, spirochetes(Lyme bacteria) can burrow deeper into the gastrointestinal tract, causing more damage. Other tick-borne diseases can also cause their own gastrointestinal issues, often overlapping with Lyme symptoms when the patient is co-infected.

Because every case of tick-borne illness is different, some Lyme patients may not experience any gastrointestinal symptoms. When I was at my sickest with Lyme disease, babesiosis, ehrlichiosis, possible bartonella, and chronic active Epstein-Barr virus, I used to joke, “Well, at least my stomach feels okay.” Because I wasn’t experiencing abdominal pain or vomiting, I figured my stomach was the one part of my body that had gotten off easy.

In fact, many of the symptoms I experienced in other parts of my body, including joint and muscle pain, migraine headaches, fever, and fatigue, were directly related to weakness in my gut caused by disease. Unbeknownst to many people—myself included before I got sick—the gut is a major player in the immune system. Dr. Horowitz writes that the “GI tract houses 80 percent of our immune system and 70 percent of our lymphocytes, making it the first line of defense against infections.” He goes on to explain that “…the gut can hold as many as 100 trillion microbes, referred to as the microbiome.” The bacteria in each person’s unique microbiome “help to supply essential vitamins; fight dangerous pathogens; keep the immune system in balance and modulate autoimmune disease (like MS and rheumatoid arthritis); modulate hormones, appetite, weight, glucose metabolism, and diabetes; modulate cardiovascular risk, neurological and psychiatric diseases (like Parkinson’s and schizophrenia); affect epigenetics, modulate cancer risk and affect inflammatory reactions in the body, including allergies, asthma, Crohn’s disease, and colitis.”i

An imbalanced microbiome can lead to intestinal permeability, commonly called “leaky gut syndrome.” This can allow toxins pass into the gut, causing inflammation and changes in flora; it’s similar to what happens when the blood-brain barrier is compromised. A 2020 study done by researchers at Johns Hopkins University School of Medicine, Northeastern University, and University of California San Diego found that the gut microbiome of post treatment Lyme disease patients was distinctly different than the gut microbiome of healthy subjects.

Whether Lyme patients experience gastrointestinal symptoms or not, their microbiome is impacted by their infection(s), their medications, and their diet. A weakened microbiome means a weakened ability to heal. As Lyme patients, we can help strengthen our microbiome by taking probiotics to replace good bacteria that are killed by antibiotics (some patients also take an anti-fungal medication, which can have anti-spirochetal effects, too), and by sticking to “The Lyme Diet.” Gluten and sugar are particular menaces to the microbiome, and your doctor may also recommend other dietary changes or nutritional supplements to help you maintain gut health. As I’ve come to learn, it is central to overall health!

[i] Horowitz, Richard I., MD. How Can I Get Better? An Action Plan for Treating Resistant Lyme & Chronic Disease. New York: St. Martin’s Griffin, 2017 (327, 328-9).

Lyme & Fibromyalgia & Chronic Fatigue Connection

Boiling Point: The Lyme + Fibromyalgia + Chronic Fatigue Connection

Boiling Point: The Lyme + Fibromyalgia + Chronic Fatigue Connection

by Dr. Bill Rawls
Updated 6/11/21

The misery of chronic illness is very real. But if you’re the one who’s suffering, you know that those around you typically can’t see it or understand it — not family, friends, or even medical providers.

They don’t know what it’s like:

…to push through oppressive fatigue day after day.
…to be tired beyond exhaustion but unable to sleep.
…to ache all over so badly that all you want to do is curl up in a ball inside a dark closet.
…to feel like you have the flu every day of your life but still have to go to work.
…to be isolated, both socially and professionally.
…to have bizarre symptoms that no one can put a finger on.
…to be told that all your lab tests are normal, even though something is obviously wrong.
…to become dependent on symptom-suppressing drugs prescribed by well-meaning doctors who didn’t know enough to know better.

I can relate better than most doctors because I’ve lived it. I am part of a growing epidemic of people suffering from chronic ailments that the modern medical system is at a loss to help.

An unexpected twist during my late 40s changed my life and career path forever. Unrelenting stress from a too-busy medical practice combined with an entanglement of unpredicted life stressors plunged me into chronic misery that took me 10 years to escape.

After countless hours sitting in doctors’ offices and a myriad of tests that provided no answers, my only available choices for diagnoses were fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) — neither being diagnoses that anyone really wants.

For one, they carry a stigma. Many Americans believe fibromyalgia and chronic fatigue are made-up excuses for getting out of work and other life obligations. This would help explain why people with fibromyalgia suffer for nearly a year on average before seeking treatment.

Close up of patient and doctor in doctor's office

What’s worse, both of these conditions are considered disorders and not true diseases. Why is that significant? Because a disease is considered treatable, whereas a disorder is a label given to a collection of symptoms for which there is no known cause or treatment.

Doctors prefer treating illnesses that are easy to define and have known solutions. If you have something that’s difficult to define and has no known treatment, they don’t want to mess with it. I admit, I know the feeling: I’ve been confronted with patients who have a long list of seemingly unrelated symptoms, and when no tests pointed to a specific diagnosis, it was frustrating.

Then, I became the patient — I could almost sense my doctors roll their eyes the minute I came through the door.

To be honest, I didn’t completely fit the strict criteria for either fibromyalgia or ME/CFS — I had more muscular pain than you’re supposed to have for chronic fatigue, but I also didn’t have all the specific trigger points of fibromyalgia. I now know that’s the norm. Studies have shown that greater than 70% of people given the label of fibromyalgia don’t fit the strict criteria for the diagnosis, and similar for ME/CFS.

Diagnosis Break Down

The concept of “diagnosis” is artificial by nature — it’s simply a way to categorize an illness to define a treatment plan. It works well for acute illnesses, such as a broken leg, acute appendicitis, heart attack, stroke, acute pneumonia, or kidney stones, where the cause is well defined, and interventions exist specifically to address it.

However, the concept of diagnosis is often less functional when applied to chronic illnesses. The signs and symptoms of many chronic illnesses overlap, and the underlying causes are not straightforward. All too often, patients are left endlessly searching for the “right” diagnosis or end up with a diagnosis like fibromyalgia or ME/CFS.

Unfortunately, for most chronic illnesses, medical therapies are designed to artificially block symptoms or the progression of the condition. Patients end up in a state of managed illness and never get well. This is true not only for fibromyalgia and chronic fatigue but also for a range of other chronic illnesses, including autoimmune diseases, chronic Lyme disease, multiple sclerosis, Parkinson’s disease, and ALS.

Close up of unrecognizable scientist holding test tube with blood sample while working on research in laboratory, copy space

Dissatisfied with symptom management alone, I decided to aggressively pursue healing. Along the way, I discovered I was carrying the bacteria associated with Lyme disease, Borrelia burgdorferi. At first, I was relieved. Finally, a “real” diagnosis! But after several rounds of antibiotics left me sicker than when I started, my presumptive diagnosis of Lyme disease generated more questions than answers. If I had Lyme, why didn’t antibiotics help?

The reason: Once the bacteria are buried deeply in tissues, testing is often inaccurate, and the bacteria are extremely resistant to antibiotic therapy. What’s more, there are many other bacteria that can cause Lyme disease-like symptoms, equally as resistant to antibiotics. And like me, many patients diagnosed with fibromyalgia and ME/CFS often end up finding out they are carrying the bacteria associated with Lyme disease.

After antibiotics failed and otherwise getting nowhere with the medical system, I decided to take things into my own hands. Somehow I knew that I was destined to figure this thing out — and if I was successful, I could help others who were suffering like I was.

But first, I had to rethink the concept of chronic illness as I was taught in medical school. Instead of studying how to label and inhibit disease (mostly with drugs), I was searching for answers as to why chronic illness happens in the first place. Deep down, I felt that chronic Lyme disease, fibromyalgia, and ME/CFS were somehow related, and these and many other chronic illnesses shared common root causes.

It wasn’t an overnight revelation; it took years of intense research and deep introspection. My search began with an extensive review of human biochemistry, physiology, and pathology.

“Many patients diagnosed with fibromyalgia and ME/CFS often end up finding out they are carrying the bacteria associated with Lyme disease.”My conclusion?

Wellness boils down to one thing: the health of the cells of your body.

Healthy Cells Equal a Healthy Body

The human body is a complex collection of living cells. When all the cells in the body are healthy and working in unison, you feel well. Symptoms occur when cells are stressed. Sometimes the symptom points to the source of stress: for example, joint pain indicates that cells in the joints have been taxed or injured. Symptoms like fatigue, however, suggest that cells throughout the body are overburdened, and communications that unify cellular functions have been compromised.

Fortunately, cells can recover from being stressed; it’s what healing is all about. Cells can repair internal damage, and even when they’re injured beyond repair, other cells in the body can divide to make replacements (some cells do this better than others: skin cells have the highest potential in the body to regenerate and nerve cells have the lowest potential). That is, if the stress resolves or is relieved.

Chronic illness occurs when stress never resolves, and our cells don’t get a chance to recover from being overworked. There are many different chronic illnesses because different cells in the body can become chronically stressed in different ways.

The immune system plays an enormous role in the healing process. It’s responsible for removing old and abnormal cells, cleaning up cellular debris and dead microbes, clearing foreign substances from the bloodstream, and purging toxins from the body. During chronic illness, cellular turnover is increased to the point that the immune system becomes overtaxed. When the immune system can’t do its job, all cells in the body suffer.

It becomes a vicious cycle that increases cellular stress throughout the body and intensifies the process of chronic illness.

So, What Stresses Cells?

The factors that stress or threaten cells are intimately tied to the fact that we must interact with the surrounding environment to survive. The nutrients, water, and oxygen that cells need to thrive must come from outside the body. This mandatory interaction with the outside environment poses a variety of different risks to cells of the body.

All totaled, there are five categories of factors that can stress cells of the body and lead to chronic illness.

5 Cellular Stress Factors

#1 Unnatural diet: To function properly, cells require carbohydrates and fats to generate energy, amino acids to make proteins, and a wide spectrum of nutrients, including vitamins and minerals, all of which must be extracted from food by the intestinal tract. Though humans can tolerate a wide variety of foods, if the right balance of nutrients isn’t present, then cells suffer. It’s not just deficiencies of nutrients that cause problems; the gross excess of carbohydrates and refined fats that have become signatures of the modern diet is extremely damaging to cells.

The type of food you eat also influences how well the digestive system works; the intestinal tract requires dietary fiber and a healthy balance of bacteria to function properly. Carb-loaded processed food causes overgrowth of bacteria, which compromises the intestine’s protective barrier. This allows foreign proteins and bacteria to leak across the gut-blood barrier, which sends the immune system into overdrive, causing fatigue, brain fog, flu-like symptoms, and other symptoms.

#2 Toxic environment: Though toxic substances have always been present in the earth’s atmosphere, our modern environment has become inundated with unnatural chemicals that are toxic to all lifeforms. Toxic substances in water, food, and air, or those that come in contact with skin, have the potential to disrupt biological processes of cells directly or impede communications (hormones, neurotransmitters), which interferes with all cells in the body.

Beyond toxic chemicals, the modern sea of artificial radiation generated by cell phones, computers, microwave transmission towers, and hundreds of other sources can disrupt cellular functions.

#3 Chronic mental stress: The complexities of 21st-century life cause a certain level of pervasive, low-grade tension. Continually remaining in high-alert mode hampers all communication systems in the body. Eventually, the body and cells begin to break down. Chronic stress also disrupts normal sleep — a necessity if cells are to have downtime to recover from being stressed. Normal health is not possible without adequate sleep.

#4 Sedentary lifestyle: Until about 100 years ago, physical stress would have been characterized by excessive physical labor. Today, the opposite is true. Modern life, however, requires little in the way of physical effort. Increased blood flow associated with physical activity flushes debris and metabolic waste that has collected around cells. It’s such an integral part of cellular health that being sedentary is extremely detrimental. Without regular movement, everything in the body stagnates, toxic substances accumulate, muscles turn to mush, arteries become clogged, and cell loss is increased.

#5 Microbes: We share our bodies with trillions of microorganisms known as the microbiome; by numbers alone, they outnumber our cells 10:1. The list includes 20-40 thousand different species of bacteria but also protozoa, fungi, multicellular parasites, and an untold number of different viruses. Though we have a mutually beneficial relationship with most of our microbes, some aren’t so friendly. Beyond that, foreign microbes from the outside are constantly trying to get inside the body.

They all want food — the carbohydrates, fats, proteins, vitamins, and minerals that make up our cells provide everything that microbes need to make more microbes. Therefore, infection is simply microbes trying to get inside your body to consume your cells.

Microbes: A Key to Chronic Illness

The vast majority of microbes that inhabit the body are confined to the gut, skin, and body openings. Technically, however, these microbes are outside the tissues of the body. Because all microbes have the potential to consume our cells, the body maintains barriers to keep them out. The primary barriers include:

  • Skin
  • Mucous membranes lining the mouth and nasal passages
  • Bronchial passageways in the lungs
  • Linings of the stomach and intestinal tract

In other words, even though our microbes are part of us, they are kept apart from the cells that make up our tissues because of the potential to do us harm. Of course, certain microbes have a higher potential to cause harm than others.

The microbes with the lowest potential for harm are defined as normal flora. Normal flora are microbes that your immune system knows better than any others — it’s a relationship that has been honed over millions of years. Because the immune system is able to keep these microbes completely in check, the partnership is mutually beneficial.

We depend on our normal flora to keep other, more aggressive microbes in the gut and on the skin suppressed. Intestinal and skin diseases result when the balance of normal flora is disrupted by poor diet, chronic stress, or antibiotic therapy.

Because the barriers of the body aren’t nearly as secure as you might hope, you rely on your immune system to protect your cells from pathogens that get through. Without protection from the immune system, your cells are defenseless.

Studies over the past decade, however, have shown that microbes regularly trickle across barriers. This means the immune system must constantly stay on guard to protect cells. Beyond that, microbes from the outside are constantly trying to cross barriers to get inside the body.

Case in point: Every time you get bitten by a tick, mosquito, or flea, are nipped or scratched by a dog or cat, scrape or cut your skin, put your fingers in your mouth or your nose, hug or kiss another person, have sex, use a public toilet just after someone else has been there, take a breath just after someone sneezes, swim in a natural pond, lake, or river, or consume any food or beverage — foreign microbes enter your body.

A microbe that can do us harm is called a pathogen. The potential of a pathogen to do harm is more about the relationship our immune system has with a particular microbe than the microbe itself.

Of course, there are varying degrees of pathogens; some are more threatening than others. A microbe like the Ebola virus is so dangerous because humans have rarely been exposed to it. Therefore, we don’t have built-in immunity to it. When Ebola crosses barriers into tissues, it’s able to ravage cells of the body.

Fortunately, most of the foreign microbes you will be exposed to during your lifetime are low-grade pathogens. They are well known to your immune system, and, if your immune system is healthy, they have a low potential to cause you harm.

Borrelia infection in the blood. Borrelia bacteria cause borreliose, transmitted by ticks and by lice.

But if your immune system becomes compromised, low-grade pathogens can also be problematic to you. Certain microbes have adopted stealth as a primary strategy for evading immune functions. First, they enter your bloodstream. Then, they hitch a ride inside white blood cells to all tissues throughout the body — muscles, joints, heart, organs, intestines, and even the brain and nervous system. Termed intracellular microbes, they’ve adopted the ability to live inside cells by cannibalizing them for nutrients to survive and make new microbes. When that cell is used up, they emerge to infect other cells.

Beyond borrelia, there are many known microbes that fit the description of being intracellular, and many more yet to be discovered. Mycoplasma, bartonella, chlamydia, and babesia are a few well-known examples, and coinfections with these microbes are common in people with Lyme, fibromyalgia, chronic fatigue, and other chronic illnesses.

Despite intracellular microbes’ manipulative ways, your immune system is well versed in all of their tricks. It evolved over millions of years from repetitive exposure to many thousands of microbes, and each encounter was recorded in your genes for future reference. The better your immune system “knows” a microbe, the better it is able to slow its growth rate and maintain ultra-low concentrations in tissues.

Notice I didn’t say the microbes are eradicated. They are very good at persisting. A much more common outcome is a stalemate in which the stealth microbes are marginalized, and their potential for harm is minimized (their natural aggressiveness is kept in check). But they can stay alive and dormant deep in tissues for a lifetime without you ever knowing they are there.

Though science is just starting to understand the role that stealth microbes and other opportunistic pathogens play in the microbiome, one fact is quite clear: Everyone, even the healthiest of us, harbors a variety of intracellular microbes that are low-grade pathogens. As long as your immune system is healthy, you’ll never hear from them.

But cells overwhelmed by poor nutrition, toxic environment, chronic mental stress, and sedentary lifestyle become more vulnerable to invasion by intracellular pathogens. Increased cellular turnover and increased microbe activity overtaxes the immune system. At a certain point, a threshold is crossed, such that symptoms occur.

Impaired immune function allows the microbiome to shift off balance and pathogens in your tissues and gut to flourish. It’s not just one microbe that becomes activated, but all the questionable suspects — stealth microbes that have been dormant in tissues, pathogens in the gut and on the skin, and viruses in tissues such as Epstein-Barr virus(EBV) and cytomegalovirus (CMV), setting the stage for chronic illness. The associated symptoms result from the immune system’s reaction to the microbes and the damage the microbes inflict upon the cells directly.

text overlay of boiling pot, listing the causes of chronic immune dysfunction: microbes, weak immune system, poor diet, toxins, stress, and sedentary life

When Symptoms Boil Up

You can think of it as a pot of water on the stove that starts out over a low simmer. As the simmer increases, minor discomforts start showing up — general body aches and joint stiffness; bloating, gas, and digestive issues; lack of energy; and simply not feeling well. Often, these kinds of changes become accepted as part of aging or life in general.

It’s not until the pot is fully boiling over that things become noticeably uncomfortable. Sometimes it’s a specific event that causes the pot to bubble over — severe emotional stress, an accident or trauma, an acute viral illness, or even a tick bite. But most often, it’s a perfect storm of cellular stress factors accumulating over time until a tipping point is reached.

At that point, the immune system can no longer keep a lid on things, and life becomes miserable. I refer to this as Chronic Immune Dysfunction.

What Chronic Immune Dysfunction Looks Like

Typical Chronic Immune Dysfunction (CID) symptoms include fatigue, decreased stamina, stress intolerance, feeling flu-like, muscle pain, joint pain, and sleep disturbances. Also common are temperature fluctuations, digestive dysfunction, mood changes, brain fog, skin rashes, a range of neurologic symptoms, and allergic-type reactions.

flow chart showing the cycle of chronic immune dysfunction, containing cellular stress factors, imbalance microbiome, inflammation, gut problems, neurological problems, and more

If you hadn’t already guessed, the default diagnosis for this morass of symptoms is fibromyalgia, when pain is the primary symptom. Or, if fatigue predominates, it’s labeled myalgic encephalomyelitis/chronic fatigue syndrome. Both are conditions, not diseases, and thus, are considered to have no known cause or treatment by the conventional medical community.

If a patient presenting with CID symptoms has any history of tick exposure, some providers may consider the possibility of Lyme disease. On the surface, this might seem like a much more attractive diagnosis than fibromyalgia or chronic fatigue because it has a recognized cause (infection with a microbe), which implies a condition is treatable with antibiotics.

Unfortunately, this only applies to acute Lyme infection. Chronic Lyme disease is actually another consequence of CID, in which immune reaction is dysfunctional, and the entire microbiome is disrupted. Concentrations of borrelia are low and embedded deep in tissues where antibiotics can’t reach them. As a result, treating chronic Lyme isn’t much different from treating fibromyalgia or ME/CFS.

When you consider the cause of all three of these chronic illnesses, the concept of diagnosis becomes practically irrelevant. Instead of being entirely separate illnesses, they are all very likely just different variations of the pot boiling over.

Indeed, all chronic illnesses — fibromyalgia, ME/CFS, chronic Lyme disease, and even more definitive diagnoses such as Parkinson’s disease, multiple sclerosis, ALS, and autoimmune diseases — share an association with Chronic Immune Dysfunction.

overlapping circle chart of chronic fatigue, fibromyalgia, and lyme disease. Related disease being alzheimers, multiple sclerosis, arthritis, Parkinsons, and ALS

What types of illness you end up with during your life is dependent on three factors:

  • Genetics: Your genes define your risk of different illnesses, but not whether you will actually get those illnesses.
  • How cellular stress factors come together to disrupt immune system functions.
  • Which intracellular microbes you pick up through life. Because intracellular microbes have a preference for certain cells of the body, the various combinations of these microbes give rise to different chronic illnesses. In other words, when it comes to defining the spectrum of chronic illnesses, microbes are the wild card.

When chronic illness is considered as a “pot boiling over” problem, the best solutions are directed toward decreasing cellular stress factors to restore normal immune system functions and balance in the microbiome, instead of treating symptoms alone. Take this route, and wellness becomes a reachable endpoint, as opposed to living in a chronic state of managed illness. Here’s how to get from here to there.

Real Solutions for Chronic Immune Dysfunction

I divide options for overcoming illnesses associated with Chronic Immune Dysfunction and stealth microbes into two categories: Heroic Therapies and Restorative Therapies.

A third category of solutions, Symptomatic Therapies, is best reserved for acute relief. Specifically directed at controlling symptoms, Symptomatic Therapies come mostly in the form of prescription drugs and contribute only minimally to healing and wellness.

three level pyramid, from top: heroic, symptomatic, restorative therapies

Heroic Therapies

Heroic Therapies have significant limitations. They include single-agent chemical warfare (antibiotics), oxidative therapies (ozone, hyperbaric oxygen), rife machines, and any other therapies directed specifically at killing pathogens. But stealth microbes hide in protected niches in the body, occur in low concentrations, and typically grow very slowly, so they are extremely hard to eradicate with antibiotics.

In fact, keeping stealth microbes at bay is just about impossible without restoring normal immune function. When people do get better with heroic therapies, it’s only because microbes are suppressed enough to allow rebound of immune function to get a handle on things, not because the heroic therapy eradicated the microbes completely. And sometimes, heroic therapies can suppress immune function further and actually make the person more ill.

Ultimately, where you want to be is with a healthy immune system keeping all stealth microbes well marginalized, so harm is minimized and you can enjoy a normal, vibrant life. Restorative Therapies are the best way to get you there. They focus on minimizing Cellular Stress Factors to optimize immune function and restore homeostasis (natural balance in hormone and healing systems in the body), as well as killing or suppressing microbes.

Restorative Therapies

With Restorative Therapies, the ability of the body to heal itself is restored, along with the ability of the immune system to control any threatening microbes in the margins. This approach takes time and patience, but because it has such low potential for harm, it can be followed for a lifetime.

A comprehensive restorative program includes the following essential components:

Balance your microbiome with herbal therapy. Take synergistic herbal therapy to suppress microbes, promote microbiome balance, and help counter the other cellular stress factors.

Herbal therapy is the cornerstone of any restorative approach. Over millions of years of evolution, plants have developed an impressive array of phytochemicals that offer very sophisticated biochemical solutions to the same stress factors that threaten our health, including every variety of microbe, free radicals, toxins, radiation, physical stress, and maybe even emotional stress.

Medicinal herbs are plants that mesh particularly well with human biochemistry. Evidence supporting herbal therapy includes historical information from traditional use by every culture on earth, population studies of current use, lab-based studies, animal studies, and human studies. All totaled, we know more about medicinal herbs than any other therapy currently available, including all drugs.

Here are just some of the benefits of natural herbal therapy for overcoming all sorts of chronic illness:

  • Balances the microbiome by suppressing intracellular microbes and supporting normal flora
  • Supports normal immune function
  • Reduces immune messengers stimulated by stealth microbes that cause inflammation
  • Restores homeostasis (balances hormones and supports healing systems in the body)

Nourish your body. A healthy diet for immune system support should focus on whole foods, ample vegetables that are rich in phytochemicals (beneficial plant chemicals that support your body’s systems and functions), and healthy fats. Keep processed foods, grain-fed meats, excess carbohydrates, and unhealthy fats to a minimum, and fill at least 50% of your plate with veggies.

Purify your environment. Reduce your exposure to environmental toxins whenever you can. Opt for organic foods when feasible, filter your water and air, and choose non-toxic cleaning supplies and beauty products.

Calm your mind. Adopt some daily stress reduction and management techniques such as practicing meditation, doing yoga, walking outdoors, or even napping.

Activate your body. Doing gentle, restorative exercise every day helps keep the body moving and counters the modern-day pitfall of being too sedentary.

The Bottom Line

Natural herbal therapy combined with the other Restorative Therapies — healthy diet, detox, stress management, and regular exercise — is the best countermeasure for the cellular stress factors that impair immune function and make us vulnerable to chronic illness. It wasn’t until I embraced them that I was able to begin crawling out of the deep dark well of chronic illness.

Since then, I’ve used everything I learned on my journey back to health to create a holistic and herbal protocol that simplifies the process of reversing Chronic Immune Dysfunction. I also chronicled the exact steps I took to recover in my book, Unlocking Lyme.

I hope these resources can serve as a guiding light to those who need them. But none of it works unless you remember this: Your body is naturally powerful. It possesses the inherent ability to overcome chronic illness and fend off future illness. Clear the path of obstacles, and you will empower your body to find its own way to optimal wellness.

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

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

1. Potgieter M, Bester J, Kell DB, Pretorius E. The dormant blood microbiome in chronic, inflammatory diseases. FEMS Microbiol Rev. 2015;39(4):567-591. doi: 10.1093/femsre/fuv013
2. Walitt B, Katz RS, Bergman MJ, Wolfe F. Three-Quarters of Persons in the US Population Reporting a Clinical Diagnosis of Fibromyalgia Do Not Satisfy Fibromyalgia Criteria: The 2012 National Health Interview Survey. PLoS One. 2016;11(6):e0157235. Published 2016 Jun 9. doi: 10.1371/journal.pone.0157235

What Helps Improve Cognitive Function for Lyme Patients?

When Lyme disease bacteria (spirochetes) cross the blood-brain barrier, they can cause myriad neurological impairments and nervous system inflammation. Neurological Lyme disease can manifest as brain fog, memory loss, word and song iteration, confusion, anxiety and depression, sleep disturbancesand more. “Lyme brain” is terribly frustrating for patients who could once multitask, but now lose their train of thought mid-sentence, or can’t find their way to the store. Many have written to me to ask what helped me improve cognitive function. Here’s what helped the most:

  • Pharmaceutical treatment: Lyme is a bacterial infection, and you can’t improve cognitive function without killing the bacteria that’s causing it. Sometimes symptoms can get worse as bacteria die off faster than your body can eliminate them (a Herxheimer reaction), but in my experience, the payoff is worth the temporary increase in discomfort and decrease in capabilities. Your doctor may want you to pulse antibiotics in order to give your body time to recover. There are particular antibiotics that work best to penetrate the blood-brain barrier and improve cognitive symptoms. Because every single case of tick-borne illness is unique, there is no set protocol, but your Lyme Literate Medical Doctor (LLMD) can tailor one to your needs.
  • Supplements: Certain supplements can help reduce inflammation and neurotoxins. Glutathione and Essential Fatty Acids are two that are commonly used (but again, I can’t give specific medical advice; you need to check with your LLMD about which supplements, and what dosage, would be appropriate for you). I’m wary of doctors who sell supplements themselves (you want to make sure your health, not their financial gain, is their top priority). Though supplements may seem good because they’re “natural,” they can have side effects and contraindications, so don’t always assume that natural is better. For me, I’ve needed a combination of both pharmaceutical treatment and supplements to improve all of my symptoms of Lyme disease, babesiosis, and ehrlichiosis.
  • Rest: Your body needs adequate sleep to heal. This can be really hard to come by for Lyme patients, and it also can be aggravating and downright boring to be in bed all the time. But your body is working really hard to fight infection, and it needs all the rest it can get in order to do so. Even now, a decade into remission, I still can get neurologically overstimulated and experience a flare-up of cognitive symptoms. When that happens, I need to wind down, give myself some quiet time, and get extra sleep.
  • Anti-inflammatory foods: In my post “The Lyme Diet,” I discuss foods that help with reducing inflammation. There are good foods to avoid, like gluten and processed sugar, and good foods to include, like fruits, vegetables, and proteins. Certain foods have antioxidant properties. Whether eating them has helped my cognitive function, I can’t say for sure, but I know it hasn’t hurt, and I’ll take any excuse to have a piece of dark chocolate!
  • Pacing: It can be enticing to keep reading a book that you’re really into, or to binge watch a show, but doing either can be taxing on a Lyme-riddled brain. Often, I don’t know I’m overstimulated until it’s too late. I feel fine reading one page, and then another, and then all of a sudden, my head feels like it’s full of molasses. I’ve learned to stop while I’m ahead. You might tell yourself, “I have to stop reading after two pages, even if I feel fine, and rest for twenty minutes.” Eventually, as your infections get better, you’ll be able to do more, but you have to think of improving cognitive function as a marathon, not a sprint.
  • Making lists: Because memory can be so impacted by tick-borne illness, it can help to make to-do lists for each day. You can literally write down tasks like “shower” and “eat lunch,” and check them off when you’ve done them (it’s especially helpful to set reminders, either in writing or on your phone, to take your medications). Write out only what you can handle for one day at a time, and put other items on lists for later in the week. Remember to include self-care items, too, like “rest” or “take a bath.”
  • Neurofeedback: This non-invasive brain training program helps your brain to work optimally (the system I use is called Neuroptimal). I use it to help quiet my brain down; others use it to sharpen their thinking. The process uses your brain’s own information to figure out what it needs. It’s a relaxing process that involves watching kaleidoscope images on a screen (you can close your eyes if those feel overstimulating) and listening to gentle music while sensors are attached to your head. You’ll hear occasional skips in the music, which are signals that help your brain get back to its optimal state. Neuroptimal is great because it works on the whole brain at once. The neurofeedback practitioners I’ve worked with have cautioned against doing neurofeedback that only works on one section of the brain at once, saying this can actually worsen Lyme brain. I first got connected with my practitioner through a sleep clinic (which meant that sessions were covered by insurance). Your LLMD may want to do a sleep study, or refer you to a practitioner; you can also find one through the Neuroptimal site.
  • Body work/cranial sacral massage: I do a type of hands-on therapy called Integrative Manual Therapy, which encompasses cranial sacral therapy and neurofascial processing. This gentle, light touch helps lymphatic drainage, and often calms my limbic system Easing these symptoms reduces my brain fog, allowing for better cognitive function. Some physical therapists offer this type of therapy (which again means that insurance can cover it).
  • Play word and memory games: To help sharpen my brain (and keep me busy), a friend used to play writing games with me over email. He’d set rules such as, “Tell a story about a dog using only three syllable words” or “Tell me the name of someone we went to school with, and then come up with another using the first letter of that person’s last name.” I think these games helped improve my memory. It was nice to do them over email because I could take as long as I needed to complete them.
  • Recall the music or games of healthier times: Memory care units for the elderly sometimes use music therapy to help prompt long-term memory. People struggling with short-term memory are often able to recall and sing entire songs from their youth. In the midst of convalescence, I played an old card game, “Scrooge.” This elaborate version of double solitaire requires memory, quick thinking, and strategy. These were not functions that I could generally execute well in those darkest days of illness, but while playing that card game, I suddenly could. When I won handily, my opponent quipped, “There’s nothing wrong with that brain of yours!”
  • Limit stimulation: I quickly learned that loud noises, crowded rooms, and flashing screens would stimulate my brain to the point of shut down, and then brain fog would settle in. By limiting the amount of time I spent on screens, and avoiding particularly fast-paced shows, I was able to keep my brain calm so I could engage in other activities like writing and reading.
  • Accept that there will be setbacks: Healing from tick-borne illness is not linear. You will regain some cognitive function, and then have periods of brain fog, and then start improving again. Eventually, if you follow your doctor’s protocol and stick to some of these tips, you should start to see more good days than bad. I still sometimes struggle with cognitive issues, but they are slight now. When I was at my sickest, I couldn’t read or watch TV. I mixed up my words. My head ached. Now, I can write, teach, read and watch TV in short segments, and generally carry on with good cognitive functioning, so long as I work to maintain my health.

Jennifer Crystal


Opinions expressed by contributors are their own. Jennifer Crystal is a writer and educator in Boston. Her memoir about her medical journey is forthcoming. Contact her using her email.