Archive for the ‘Psychological Aspects’ Category

The Explosive Lyme Symptom That Can Destroy Relationships

https://www.lymedisease.org/lyme-rage-explosive-symptom/

Lyme rage: the explosive symptom that can destroy relationships

By Fred Diamond

6/17/25

We often focus on the physical symptoms of Lyme disease such as joint pain, neuropathy, and fatigue. But there’s another symptom that hides in the shadows, misunderstood even by some healthcare professionals: Lyme rage.

This intense, sometimes explosive emotional reaction can alienate friends, damage families, and leave survivors questioning who they are.

On this week’s episode of the Love, Hope, Lyme podcast, I spoke with Dr. Darin Ingels, a Lyme-literate naturopathic doctor, author of The Lyme Solution, and a Lyme survivor himself. We devoted the entire episode to Lyme rage—what it is, why it happens, and how to heal from it.

“These are typically people who aren’t angry people,” says Dr. Ingels. “They’ll tell me, ‘I’ve been a happy-go-lucky person,’ and now they’re having meltdowns over nothing.”

What is Lyme rage?

Lyme rage is not just general irritability. It’s a sudden, often uncharacteristic burst of anger or emotional volatility. Dr. Ingels explained that while it doesn’t affect every Lyme survivor, it’s common enough—and deeply disruptive.

“It’s this ability to flip the switch so quickly,” he says. “You go from fine to furious in a heartbeat. And it often doesn’t feel like you.”

Many people with Lyme report that these emotional outbursts damage relationships and lead to overwhelming feelings of guilt and shame.

“I don’t know that I experienced ‘rage’ per se,” Dr. Ingels says, “but I definitely had personality changes. I felt indifferent to life. I had meltdowns that felt like I was five years old.”

It’s these personality shifts—especially when they seem to come from nowhere—that serve as red flags.

What causes Lyme rage?

Dr. Ingels describes three core mechanisms behind Lyme rage, all of which involve inflammation in the brain:

  1. Direct Infection of the Brain:
    “We have postmortem studies showing Borrelia in and around brain tissue,” Dr. Ingels notes. The immune system’s response to the presence of these pathogens creates neuroinflammation that affects emotional regulation.
  2. Autoimmune Response:
    The immune system, to eliminate Borrelia or Bartonella, sometimes turns on the brain itself. “We start seeing antibodies that attack gray and white matter,” he says.
  3. Mast Cell Activation:
    Mast cells, typically associated with allergies, also play a role in Lyme. “They dump histamine and other chemicals around the brain, which leads to more inflammation and emotional instability.”

Many survivors describe Lyme rage as a complete departure from their typical personality. Some feel dissociated or emotionally numb. Others feel like they’re watching themselves explode and are powerless to stop it.

“Things that used to spark joy no longer do,” Dr. Ingels says. “You don’t want to go to dinner. You avoid friends. Even people who were very social become isolated. It’s overwhelming.”

He notes that these changes are often abrupt, especially in children or teens, where a diagnosis like PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) may apply. But adults can experience the same kind of inflammation-driven behavioral shifts, even if we don’t label it the same way.

“It’s almost like the effort to participate in life becomes too much,” he says.

Does Lyme rage build gradually or strike without warning?

“Some people feel it coming and can intervene,” he says. “But for many, it just hits like a lightning bolt. They’re fine, and then boom—they’re yelling, crying, or throwing things.”

When survivors do sense it building, Dr. Ingels suggests quick interventions that reduce inflammation—both pharmaceutical and herbal.

“Ibuprofen can help. Curcumin, Boswellia, Harpagophytum all have strong anti-inflammatory effects,” he said. “The key is to calm the inflammation in the brain.”

But for many with Lyme, the rage is sudden and uncontrollable, which means that long-term healing strategies become essential.

The long-term path to healing

How can survivors begin to heal from the neurological and emotional wreckage left by Lyme rage?

For Dr. Ingels, the answer lies in a combination of approaches:

  • Herbs and Botanicals:
    “I’m living proof that herbs work,” he says, recounting how Chinese herbal formulas from Dr. Zhang helped him feel 85% better after months of failed antibiotic treatments. “There’s a lot of power in plants.”
  • Immune System Support and Modulation:
    The goal isn’t just to kill the bug, but to restore balance to the immune system. “We have to clean up the mess Lyme leaves behind,” he said. “That includes food sensitivities, chemical sensitivities, and even environmental triggers like mold.”
  • Low Dose Immunotherapy (LDI):
    One of the most promising tools in Dr. Ingels’ clinic is LDI, which uses homeopathic dilutions of dead pathogens to retrain the immune system and reduce overreaction. “It’s like telling your immune system, ‘You don’t have to go to war anymore.’”
  • Oxygen and Energy-Based Therapies:
    For those who have access, hyperbaric oxygen therapy and PEMF (pulsed electromagnetic field therapy) can help calm brain inflammation without medication.

“Anything we can do to keep inflammation in the brain down will reduce the likelihood of those rage episodes.”

The emotional toll 

Lyme rage doesn’t just hurt the person who is ill. It often creates lasting pain within families and relationships. Many of the people listening to this podcast—and reading this article—carry guilt about the way they’ve lashed out at partners, children, or friends.

I ask Dr. Ingels what he would say to someone who’s struggling with that guilt.

“Have grace for yourself,” he says. “Much of this is reflexive. It’s not who you are. It’s something that’s happening to you because of the inflammation in your brain.”

He speaks candidly about how Lyme changed his own personality and may have contributed to the end of his marriage.

“I didn’t have the words at the time to explain what I was feeling. But I’ve since realized, this wasn’t really me—it was the disease.”

That recognition—while painful—is also liberating. It can offer survivors a starting point for healing, not just their bodies, but their sense of identity and self-worth.

What to tell Lyme patients who feel like giving up?

“You have to be your own best advocate,” he says. “The reality is, we are built to heal. Just because something hasn’t worked doesn’t mean there’s nothing out there that will. Keep going. This is your one life. Don’t give up.”

Click here to listen to all episodes of the Love, Hope, Lyme Podcast or on YouTube.

Fred Diamond is based in Fairfax, Virginia. His popular book, “Love, Hope, Lyme: What Family Members, Partners, and Friends Who Love a Chronic Lyme Survivor Need to Know” is available on Amazon. The e-version (pdf) of the book is always free to Lyme survivors. PM Fred on Facebook or LinkedIn for your copy.

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**Comment**

So thankful this information is becoming available.

It’s the stuff patients have to share in support group because nobody believes them.

For more:

Category:

Lyme, Psychological Aspects

Lyme Disease Was Behind Her Seizures

https://danielcameronmd.com/lyme-disease-seizures-children/

Lyme disease was behind her seizures
Jul01

Lyme disease was behind her seizures

Posted By: Dr. Daniel Cameron

It’s one of the most emotional stories parents share.

They tell me their child was once full of energy and curiosity—but suddenly began struggling.

Fatigue, brain fog, dizzy spells, and even seizure-like episodes.

Brain scans? Normal. EEGs? Clear. Yet the worry remained.

“We were told they were functional seizures—just stress-related. No one believed our child was in pain.”

In more cases than you’d expect, Lyme disease or a tick-borne co-infection was the missing piece.

What Are Functional Seizures?

Functional seizures, also called psychogenic non-epileptic seizures (PNES), look like epileptic seizures on the outside—but don’t show abnormal electrical activity in the brain. They’re often thought to stem from psychological stress or trauma.

But here’s the issue:

Many children with tick-borne illness also have seizure-like episodes without abnormal brain scans or EEGs. And when they receive antibiotic treatment for Lyme disease, these episodes often improve or resolve.

So, the question becomes:

What if it wasn’t “just stress”? What if it was an infection affecting the nervous system?

What the Research Confirms

In a 1998 study led by Dr. Barbara J. Bloom, five children with Lyme disease were followed over time. Two of them had seizure-like episodes—but their EEGs and MRIs were normal. After receiving appropriate antibiotics, both improved.¹

A broader review by Dr. Brian A. Fallon and colleagues in the American Journal of Psychiatry found that Lyme disease can mimic seizures, anxiety, depression, and other neurologic disorders—even when imaging looks normal.²

These studies validate what many parents already sense: The symptoms are real. The child isn’t faking. And treatment can help.

How Lyme Affects the Brain

Lyme disease is caused by the bacterium Borrelia burgdorferi, which can invade the central nervous system—called neuroborreliosis.

In children, it may not look like arthritis. Instead, it may show up as:

    1. Seizure-like episodes
    2. Dizziness or fainting
    3. Brain fog and cognitive slowdown
    4. Mood changes
    5. Sensory sensitivities
    6. Trouble sleeping

When test results are “normal,” these symptoms can be misdiagnosed as:

    1. Anxiety or panic disorder
    2. ADHD
    3. Conversion disorder (functional neurologic disorder)

But Lyme and co-infections—like Babesia or Bartonella—can trigger these symptoms in ways that standard tests miss.

A Real-Life Story: Not Epilepsy, But Lyme

A 12-year-old patient of mine developed:

    1. Non-epileptic seizure-like episodes
    2. Dizziness
    3. Brain fog
    4. Light sensitivity
    5. Severe fatigue

Her brain MRI and EEG were normal. She was diagnosed with functional seizures.

But her mother remembered a camping trip. We tested her for tick-borne illness—results came back positive for Lyme disease and Babesia.

With the right treatment:

    1. The episodes stopped
    2. Her thinking cleared
    3. Her laughter returned

Her mother said, “She laughed like herself again.”

What Every Parent Should Know

  • If your child has unexplained seizure-like episodes, trust your instincts.
  • Lyme disease can trigger neurologic symptoms—even when scans are normal.
  • Don’t stop at “normal EEG” or “it’s just stress.” Ask about tick-borne testing.
  • Treatment for Lyme and co-infections has helped many children reclaim their health.
Key Research
  1. Bloom BJ, Wyckoff PM, Meissner HC, Steere AC. Neurocognitive abnormalities in children after Lyme disease. Pediatr Infect Dis J. 1998;17(3):189–196.
  2. Fallon BA, Nields JA. Lyme neuroborreliosis: neurologic and psychiatric manifestations. Am J Psychiatry. 1994;151(11):1571–1583.

Category:

Lyme, Psychological Aspects, research

Microbes & Mental Health Webinar Q & A

https://rawlsmd.com/webinars/microbesmentalhealth/?

Chronic Lyme Connection

Reserve My Seat

LIVE WEBINAR + Q&A

Let’s change the way we talk about Lyme and mental health—together.

Tuesday, May 27th, 4:00pm EDT

Have your questions ready for a LIVE Q&A with Dr. Bransfield & Dr. Rawls.

PLUS: Webinar attendees will have the opportunity to get Dr. Rawls’ bestselling book, Unlocking Lyme for free.

Reserve My Seat

JOIN US: Tuesday, May 27 4:00PM EDT
A Special Event for Lyme Awareness & Mental Health Awareness Month

Chronic Lyme Isn’t Just Physical.
It Affects the Mind, Too

If you’ve struggled with anxiety, depression, OCD, or cognitive challenges as part of your chronic Lyme experience, you’re not alone—and you’re not imagining it.

For too long, the emotional and neurological symptoms of chronic Lyme disease have gone unrecognized or misdiagnosed. But emerging science—and the lived experience of thousands—makes it clear: stealth microbes can impact the brain, nervous system, and mental health.

Join Us for a Groundbreaking Conversation

In this live event, two leading experts—Dr. Bill Rawls and Dr. Robert Bransfield—will explore the often-overlooked connection between chronic infections and mental health symptoms.

Together, they’ll unpack how microbes like borrelia and bartonella may contribute to mood changes, psychiatric conditions, and feelings of isolation—and what you can do to begin healing. You’ll learn:

How chronic Lyme and co-infections can influence brain function and mood
Why anxiety, OCD, and depression are common in Lyme patients

What a more complete approach to healing really looks lik

The role of stealth microbes in triggering neuroinflammation

Dr. Robert Bransfield

Neuropsychiatrist and internationally recognized expert on the psychiatric impacts of chronic infections. Known for pioneering work on how tick-borne illnesses influence mental health.

Meet the Experts:

Dr. Bill Rawls

Author of Unlocking Lyme and The Cellular Wellness Solution, Dr. Rawls is a physician, herbalist, and creator of RESTORE180™. He is a wellness educator who brings lived experience and integrative insight to chronic illness recovery.

Why This Conversation Matters

Mental health challenges are one of the most isolating aspects of chronic illness. They often get overlooked—by providers, by loved ones, even by ourselves.

This event is about validation, education, and community. Whether you’re living with chronic Lyme, supporting someone who is, or seeking better answers—you deserve to be part of this conversation.

Presented by Dr. Robert Bransfield & Dr. Bill Rawls. Moderated by Liza Blas.

For more:

Category:

Activism, Lyme, Psychological Aspects

Data & Intel’s Here: Time to Cancel mRNA

https://www.thefocalpoints.com/p/we-have-the-dataits-time-to-cancel?

We Have the Data—It’s Time to Cancel mRNA

http://

Epidemiologist Nicolas Hulscher reveals alarming new data on mRNA-driven mass harm and death on Ask Dr. Drew
Nicolas Hulscher, MPH
Apr 30, 2025

In my interview with Dr. Drew, I walk through the latest data linking COVID-19 mRNA shots to global surges in death and serious harm:

Among 184 Million Test Subjects, The Verdict Is Clear

The two largest COVID-19 vaccine safety studies ever conducted, involving 99 million (Faksova et al) and 85 million people (Raheleh et al), found that mRNA injections are not safe for human use. The shots significantly increase risks of the following serious adverse events:

  1. Myocarditis (+510% after second dose)
  2. Acute Disseminated Encephalomyelitis (+278% after first dose)
  3. Cerebral Venous Sinus Thrombosis (+223% after first dose)
  4. Guillain-Barré Syndrome (+149% after first dose)
  5. Heart Attack (+286% after second dose)
  6. Stroke (+240% after first dose)
  7. Coronary Artery Disease (+244% after second dose)
  8. Cardiac Arrhythmia (+199% after first dose)

Emergency Room Visits Surge 20% Among mRNA Vaccinated Teens, Study Finds

Higher rates of emergency room and doctor visits were observed among 105,726 Pfizer mRNA vaccinated 12–18-year-olds compared to unvaccinated controls — lasting for at least 6 months after injection. If we are serious about reversing the chronic disease epidemic—now affecting over 60% of Americans—the most obvious and urgent step is to remove chronic disease-inducing injections from the market. These products are still being administered to millions of children, adolescents, adults, and the elderly every year.

COVID-19 mRNA Injection Spike Protein Expressed in Cerebral Arteries of Stroke Patients for Up to 17 Months

Vaccine mRNA and Spike protein found in hemorrhagic stroke patients’ brains — confirming human biodistribution to vital organs.

WHO Data Reveals Global COVID-19 Deaths Skyrocketed After Mass Vaccination

New study finds that mass COVID-19 vaccination not only failed, but made things worse — with the highest death surges in the most heavily vaccinated populations.

Catastrophic Neurological and Psychiatric Damage from COVID-19 Vaccines

Based on multiple studies, COVID-19 vaccines seriously damage the neurological system and devastate mental health. They increase your risk of:

  1. Alzheimer’s (+22.5%)
  2. Cognitive impairment (+137.7%)
  3. Ischemic stroke (+44%)
  4. Hemorrhagic stroke (+50%)
  5. Transient ischemic attack (+67%)
  6. Myelitis (+165%)
  7. Myasthenia gravis (+71%)
  8. Depression (+68.3%)
  9. Anxiety disorders (+43.9%)
  10. Sleep disorders (+93.4%)

(See link for article, studies, and video)

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https://usawatchdog.com/government-admits-it-knew-covid-vax-shots-were-fraud-president-trump-pull-them-off-the-market-karen-kingston/

Government Admits it Knew Covid Shots Were Fraud

By  On May 7, 2025 
Article Excerpts:

Karen Kingston is a biotech analyst and former Pfizer employee who is back with some grotesque news about what the US government knew about the CV19 bioweapon vax.  They knew it was not safe at all, and the FDA also knew Pfizer committed fraud to get the CV19 injections approved.  Kingston says, “This is the government’s words exactly:  ‘The FDA was aware of the protocol violations.’  So, the FDA was aware of the fraud that was reported . . . before it granted emergency use authorization (EUA) for its vaccine.  They were aware of the fraud.  Second, the government said it ‘had continued access’ to the Pfizer vaccine clinical data, and ‘in the FDA’s view, Pfizer’s vaccine is effective.’  Notice they dropped the word ‘safe.’  The minimum bar is safe before effective, but they intentionally dropped the word safe. . . . They ignored safety.

Kingston says, “In 2020, they met and listed out Myocarditis. Pericarditis, neurological malfunctions, respiratory failure, multiple system inflammatory disease, Guillain-Barré syndrome, and they listed everything out except for cancer.  So, they knew the CV19 vax would cause all those debilitating injuries, infertility and death.

Kingston points out they want to put so-called mRNA in everything to fight cancer, but all the studies for the past several decades on mRNA say it causes cancer.  Kingston says:

“Pfizer is telling us we are putting in faulty genes.  We are debilitating you.  We are disabling you.  We are sterilizing you, and we are killing you.  We are directing the evolution of human beings to become more weak and more dependent on us. . . . To survive, you will need us.  It’s on their website.  It’s called ‘directed evolution.’  They are directing the extinction of our species.  That is what this is.  They are playing God. . . .You can call it eugenics.  You can call it depopulation, but the new word is ‘directed evolution.’  It’s mRNA technology or personalized medicine, it’s all the same thing.”

(Go to link for article and interview)

_______________

**Comment**

Kingston came out early that the COVD clot shots are bioweapons.  She hasn’t changed her tune but has in fact been continuously outspoken. The attorney for another whistleblower, Brook Jackson, revealed that Pfizer argued the court should dismiss her lawsuit alleging fraud in Pfizer’s COVID clinical trials because the government knew about the fraud but continued to do business with them.  

None of this matters to the hopelessly irredeemable CDC (and government) which is set to recommend MORE mRNA shots this year despite  a minimum 35% increase in 1-year all-cause mortality (at least for the Pfizer shot), and FIVE recent papers showing the COVID shot harms outweigh any supposed benefits.

Oh AND……

Covid mRNA ‘Vaccines’ Caused ‘Alarming’ Surge in Violent Behavior, Homicidal    Ideation

https://www.preprints.org/manuscript/202504.1099/v1

Association between COVID-19 Vaccination and Neuropsychiatric Conditions

This version is not peer-reviewed.

James Thorp ,Claire Rogers*,Kirstin Cosgrove,Steven Hatfill,Peter Breggin,Drew Pinsky ,Peter McCullough

Submitted:  11 April 2025

Posted: 14 April 2025

Abstract
Introduction: COVID-19 mRNA vaccines are known to penetrate the blood-brain barrier and could potentially cause a myriad of unintended adverse effects. The purpose of this study is to explore potential associations between vaccination and neuropsychiatric conditions. Methods: Data were collected from the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA). The CDC/FDA Vaccine Adverse Event Reporting System (VAERS) was queried from January 1, 1990, to December 27, 2024, for adverse events (AEs) involving neuropsychiatric complications following COVID-19 vaccination. The timeframe included 420 months for all vaccines except COVID-19 vaccines which have been available to the public for only 48 of the 420 months (from January 1, 2021, to December 27, 2024). Proportional reporting ratios (PRRs) were calculated by time comparing AEs after COVID-19 vaccination to those after influenza vaccination and to those after all other vaccines. The CDC/FDA stipulates a safety concern if a PRR is ≥ 2. Results: Comparing COVID-19 vaccination to influenza vaccinations, the CDC/FDA’s safety signals (PRR, 95% confidence interval, p-value, Z-score) were breached for the following combinations: 47 AEs associated with cognitive impairment (PRR: 118, 95% CI: 87.2-160, p < 0.0001, Z-score: 30.9); 28 AEs associated with general psychiatric illness (PRR: 115, 95% CI: 85.1-156, p < 0.0001, Z-score: 30.8); and 11 AEs associated with suicide/homicide (PRR: 80.1, 95% CI: 57.3-112, p < 0.0001, Z-score: 25.7). Likewise, when comparing COVID-19 vaccination to all other vaccines except COVID-19, the safety signals were also breached for the following: 47 AEs associated with cognitive impairment (PRR: 26.8, 95% CI: 19.8-36.1, p < 0.0001, Z-score: 21.5); 28 AEs associated with general psychiatric illness (PRR: 28.6, 95% CI: 21.2-38.6, p < 0.0001, Z-score: 21.9); and 11 AEs associated with suicide/homicide (PRR: 14.0, 95% CI: 10.3-19.0, p < 0.0001, Z-score: 16.8). Conclusions: There are alarming safety signals regarding neuropsychiatric conditions following COVID-19 vaccination, compared to the influenza vaccinations alone and to all other vaccinations combined. These data raise concerns about long-term consequences, including continued cognitive decline, dementia, and neuropsychiatric morbidity and mortality. An immediate global moratorium on COVID-19 vaccination is warranted.
_______________

Big Pharma Throws Fit

May 6, 20205

Dr. Dhand reports that Big Pharma and researchers obtaining government grants are panicking due to fears of HHS daring to collect information about funding for research into mRNA technology.

Any research utilizing public funds should have oversight about funding information!

But, true to form Big Pharma and these deluded researchers are making this political by stating that Trump-appointed officials are being driven by misinformation and conspiracy theories.

Demonstrating the complete lunacy, these researchers completely ignore the body of mRNA research which was originally abandoned by its creator (Robert Malone) due to being a dead end as well as for health concerns, which now include:  infertility, fetal loss, maternal death rates, excess deaths, organ damage, autoimmunity, myocarditis, and cancer.  

Please remember that the CDC changed the definition of a ‘vaccine’ so mRNA would fit in the category.  It is asinine to expect an mRNA platform to work like a traditional vaccine, and it’s purposely called a platform for drug delivery because new drugs are needed for variants, creating a endless market.

Dr. Dhand states that one of the best things he ever did for his health was to refuse the clot shots.  He states he will continue refuse any mRNA product.  He’s not alone:

 “I Have Absolute Faith That mRNA Vaccines Will Kill You” ~ Dr. Sucharit Bhakdi:

For more:

Category:

Activism, Psychological Aspects, research, vaccines

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

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