Archive for the ‘research’ Category

Tularemia in Minnesotan Ticks

https://www.liebertpub.com/doi/abs/10.1089/vbz.2018.2388

Prevalence of Francisella tularensis in Dermacentor variabilis Ticks, Minnesota, 2017

Tory Whitten, Courtney Demontigny, Jenna Bjork, Mandy Foss, Molly Peterson, Joni Scheftel, Dave Neitzel, Maureen Sullivan, and Kirk Smith
Published Online:https://doi.org/10.1089/vbz.2018.2388

Introduction: The prevalence of Francisella tularensis in Minnesota ticks is unknown. Ticks collected at seven sites were tested to determine the infection prevalence of F. tularensis in Dermacentor variabilis in Minnesota.

Materials and Methods: Ticks were collected from two properties at an epizootic site and at five long-term tick research sites. Ticks were pooled by species, sex, date, and site with a maximum of 10 ticks per pool. Ticks were bisected and homogenized; DNA from supernatant was extracted and tested by real-time PCR (RT-PCR). Twice, additional ticks were collected for bacterial culture and isolation of F. tularensis. Proportion of positive pools and minimum infection rate (MIR) were calculated.

Results: A total of 3527 ticks were tested for F. tularensis including 1601 male D. variabilis and 1926 female D. variabilis. Across all sites, 128 (34%) of 378 pools were RT-PCR positive for F. tularensis. Of 128 positive pools, F. tularensis from 96 (75%) was identified as type A; F. tularensis from 32 pools was unable to be subtyped. The overall MIR was 3.6%. The MIR was significantly lower at the epizootic site compared with Morrison County 1 (3.9% vs. 7.2%; p = 0.02) but did not differ between the epizootic site and Pine County 1 (3.9% vs. 2.1%; p = 0.49). Within the epizootic site, the MIR was significantly higher at Washington County 2 compared with the adjacent property (5.7% vs. 2.3%; p < 0.001). F. tularensis was cultured from 6 (15%) of 40 pools.

Conclusions: F. tularensis was found in ticks at a majority of sites tested. The MIR of F. tularensis in D. variabilis ticks in Minnesota varied geographically. Our findings support the hypothesis that D. variabilis plays an important role in the natural history of tularemia in Minnesota. Further ecologic studies are needed to fully understand the importance of tick species in the maintenance and transmission of F. tularensis in Minnesota.

_______________

**Comment**

The Dermacentor variabilis tick is a hard bodied tick, also known as the American Dog tick or Wood tick and is widely known.  It transmits Rocky Mountain spotted fever (RMSF) and tularemia to humans as well as canine tick paralysis to dogs.  http://edis.ifas.ufl.edu/in781

LyraEDISServlet-2

Dorsal view of American dog ticks, Dermacentor variabilis (Say), with male on left, and female on right.  Credit: J.F. Butler, University of Florida

It was been suggested that adult ticks move to the edge of the roads and trails in an attempt to find a host, or “quest.” Some have hypothesized that because many animals typically follow trails, they leave an odor that attracts these ticks causing them to move toward and quest alongside trails in attempts to find a host (Mcnemee et al. 2003).

More on Tularemia:  https://madisonarealymesupportgroup.com/2016/10/25/of-rabbits-and-men/ 

https://madisonarealymesupportgroup.com/2018/09/28/after-tularemia-death-experts-stress-education/

https://madisonarealymesupportgroup.com/2018/08/07/tularemia-hunting-dogs-as-possible-vectors/

https://madisonarealymesupportgroup.com/2018/02/27/tularemia-infected-ticks-found-on-sorrento-valley-trail-in-ca/

https://madisonarealymesupportgroup.com/2018/03/07/hantavirus-tularemia-warnings-issued-in-san-diego-county/

https://madisonarealymesupportgroup.com/2018/09/19/glandular-tularemia/

Normally thought of as inhabiting areas east of the Rocky Mountains, the Wood tick is obviously defying entomology maps and traipsing all over – from Minnesota to Missouri, California, and most probably everywhere in-between.

I remember hearing Timothy Lepore, MD, FACS, surgeon at Nantucket Cottage Hospital, at a Lyme conference.  He explained that Tularemia is also a disease of those who work with the land such as landscapers and farmers, as well as those who get bit by a tick. There are cases reported in every state but Hawaii, and many other wild and domestic animals can be infected. The highest rates of infection are in Arkansas.  Please see this link for more details but know that this is a bioweaponized pathogen:  https://madisonarealymesupportgroup.com/2016/10/25/of-rabbits-and-men/  The WHO estimates that an aerosol dispersal of 50 kg of F. tularensis over an area with 5 million people would result in 25,000 incapacitating casualties including 19,000 deaths.

Transmission: Transmission can occur through the skin or mucous membranes when handling infected animals as well as through tick bite, contact with fluids from infected deer flies, mosquitoes or ticks, handling or eating undercooked rabbit, drinking contaminated water, inhaling dust from contaminated soil, and handling contaminated pelts or paws of animals. It can also be inhaled from infected hay, grain, or soil. Dr. Lepore had patients who contracted it from their pet dog who shook rain water on them after chewing on a dead rabbit, as well as from folks eating road kill, a person who held sick animals, and a gentleman who slept with his pet bunny.

Another reminder – don’t sleep with pets!
The fact that 35% of Minnesotan ticks are infected with Tularemia is concerning.  Spread the word.

 

 

 

 

Impact of Pre-operative Antimicrobial Treatment on Microbiological Findings From Endocardial Specimens in Infective Endocarditis

https://www.ncbi.nlm.nih.gov/pubmed/30680557

2019 Jan 24. doi: 10.1007/s10096-018-03451-5. [Epub ahead of print]

Impact of pre-operative antimicrobial treatment on microbiological findings from endocardial specimens in infective endocarditis.

Abstract

Treatment of infective endocarditis (IE) should be initiated promptly. This might hamper the chances to identify the causative organism in blood cultures. Microbiological sampling of infected valve in patients undergoing surgery might identify the causative organism. The impact of pre-operative antimicrobial treatment on the yield of valve samples is not known. This study evaluated the impact of the duration of the pre-operative antibiotic treatment on valve culture and 16S rRNA PCR findings from resected endocardial samples. Patients meeting the modified Duke criteria of definite or possible IE and undergoing valve surgery due to IE during 2011-2016 were included from Southern Finland. Eighty-seven patients were included.

In patients with shorter than 2 weeks of pre-operative antimicrobial treatment, PCR was positive in 91% (n = 42/46) and valve culture in 41% (n = 19/46) of cases. However, in patients who had 2 weeks or longer therapy before operation, PCR was positive in 53% (n = 18/34) and all valve cultures were negative. In 14% of patients, PCR had a diagnostic impact. In blood-culture negative cases (n = 13), PCR could detect the causative organism in ten patients (77%). These included five cases of Bartonella quintana, one Tropheryma whipplei, and one Coxiella burnetii. Long pre-operative antimicrobial treatment was shown to have a negative impact on microbiological tests done on resected endocardial material. After 2 weeks of therapy, all valve cultures were negative, but PCR was positive in half of the cases. PCR aided in diagnostic work-up, especially in blood culture negative cases.

____________________________

**Comment**

The dilemma “to treat or not to treat” because of hampered ability to subsequently test for organisms is real; however, the risk for not treating is potentially death.

The big point for Lyme/MSIDS patients; however, is the fact they found Bartonella and Coxiella burnettii, also known as Q-fever in patients with infective carditis.

https://www.columbia-lyme.org/q-fever  Those working with farm animals are at greater risk through inhalation or ingestion of soil or animal waste particles; however, ticks do transmit it.

Signs and Symptoms

Symptoms include high fever, headache, sore throat, malaise, nausea, diarrhea, chest pain, nonproductive cough, pneumonia, and hepatitis. Neurological manifestations occur in about one percent of patients and could develop into meningitis, encephalitis, myelitis and/or peripheral neuropathy. Endocarditis, infection of the heart valves, is the most serious manifestation. However, it is usually found in patients with preexisting valvular disease. Unfortunately, the mortality rate is increasingly high, currently at 65 percent.

Go here for a nifty table with the various coinfections, vectors, causative agent, endemic area, and symptoms: https://www.lymedisease.org/lyme-basics/co-infections/other-co-infections/

You will note that the brown dog tick, Rocky Mountain Wood tick, and the Lone Star Tick are all vectors and Q-fever is endemic throughout the U.S.  Treatment is doxycycline.

https://www.wrair.army.mil/Documents/TropMed/(18)%20Lyme%20and%20Rickettsial%20Disease_LTC%20Waterman.pdf  This document states endocarditis caused by Q fever may be chronic.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88923/  Interestingly, even as far back as the 30’s, Q fever was noted to have properties of both viruses and rickettsiae. This document states Q fever may occur in patients without any animal contact due to it’s ability to be spread by wind.  The same document states human Q fever cases have occurred in the following:

  • An OB after an abortion on an infected woman
  • transplacental transmission
  • autopsies
  • intradermal inoculation
  • blood transfusion
  • tick bite
  • sexually in infected mice
  • possibly from infected dogs
  • infected cats

The real kicker on that last one was the 1984 report of 13 people who developed febrile respiratory disease by playing poker in a room where a cat had delivered kittens.  Abstract here:

Kosatsky T. Household outbreak of Q-fever pneumonia related to a parturient cat. Lancet. 1984;ii:1447–1449. [PubMed]

Symptoms were:

  • bradycardia (slow heart rate)
  • fever
  • palatal petechiae (red or purple spots on mouth palate)
  • rapidly enlarging bilateral pulmonary infiltrates (fluid in both lungs)

 

 

 

 

 

Study Shows Ticks PCR Positive for Bartonella and Two Strains of Borrelia

https://www.sciencedirect.com/science/article/abs/pii/S1877959X18302942

Regional prevalences of Borrelia burgdorferi, Borrelia bissettiae, and Bartonella henselae in Ixodes affinis, Ixodes pacificus and Ixodes scapularis in the USA

Abstract

The objective of this work was to determine the prevalence of Borrelia and Bartonella species in Ixodes spp. ticks collected from 16 USA states. Genus PCR amplification and sequence analysis of Bartonella and Borrelia16SsRNA-23SsRNA intergenic regions were performed on DNA extracted from 929 questing adult ticks (671 Ixodes scapularis, 155 Ixodes affinis, and 103 Ixodes pacificus).

Overall, 129/929 (13.9%) Ixodes ticks were PCR positive for Borrelia burgdorferi sensu stricto, 48/929 (5.1%) for B. bissettiae whereas 23/929 (2.5%) were PCR positive for a Bartonella henselae. Borrelia bissettiae or B. burgdorferi s.s. and B. henselae co-infections were found in I. affinis from North Carolina at a rate of 4.5%; in a single I. scapularis from Minnesota, but not in I. pacificus. For both bacterial genera, PCR positive rates were highly variable depending on geographic location and tick species, with Ixodes affinis (n = 155) collected from North Carolina, being the tick species with the highest prevalence’s for both Borrelia spp. (63.2%) and B. henselae (10.3%). Based on the results of this and other published studies, improved understanding of the enzootic cycle, transmission dynamics, and vector competence of Ixodes species (especially I. affinis) for transmission of Borrelia spp. and B. henselae should be a public health research priority.

________________

**Comment**

One of the most understated studies yet.  Research on transmission and vector competence is screaming to be done – especially for Bartonella as mainstream medicine still thinks it’s a simple disease caused by the scratch of a cat that only affects immunocompromised people.  They also insist the black-legged tick is the sole perp for Lyme.  Both of these tenets are being shattered on a daily basis.

https://madisonarealymesupportgroup.com/2018/07/10/bartonella-henselae-neuroretinitis-in-patients-without-cat-scratch/

https://madisonarealymesupportgroup.com/2019/01/23/chest-imaging-of-cat-scratch-disease-in-2-year-old-immunocompetent-baby-with-no-history-of-cat-contact/

https://madisonarealymesupportgroup.com/2018/07/05/cat-scratch-disease-in-a-1-5-year-old-girl-case-report/  A 1.5-year-old girl who was seen in hospital for the sparing use of her left arm when crawling.  Tested positively for Bartonella henselae.

https://madisonarealymesupportgroup.com/2018/04/03/encephalopathy-in-adult-with-cat-scratch-disease/  Case of a 53-year-old healthy man, presenting with confusion.  Serology confirmed Bartonella henselae infection.

https://madisonarealymesupportgroup.com/2019/01/09/transverse-myelitis-guillain-barre-associated-with-bartonella/  Healthy 10 year old girl had coexisting transverse myelitis and Guillain-Barré syndrome (GBS) related to infection with Bartonella henselae.

https://madisonarealymesupportgroup.com/2018/11/05/skull-infection-due-to-bartonella/  A 3-year-old female with a recent history of typical CSD involving lymph nodes who developed osteomyelitis of the skull.

https://madisonarealymesupportgroup.com/2019/01/02/bartonella-langerhans-cell-histiocytosis-cancer/

 

https://madisonarealymesupportgroup.com/2018/11/16/study-shows-lyme-in-15-species-of-canadian-ticks-6-of-which-bite-humans-numerous-new-bird-species-acting-as-hosts/  Overall, 1,265 ticks consisting of 27 tick species belonging to four genera were collected.  Of the 18 tick species tested, 15 species (83%) were positive for Bbsl and, of these infected ticks, 6 species bite humans.

Two ticks species known to be transmitters of disease (I. affinis and I. minor) were transported into Canada and are actually more important vectors of Bbsl in the southeastern U.S. than the blacklegged tick.

THESE FINDINGS UNDERSCORE THE FACT PEOPLE DO NOT HAVE TO GO AN ENDEMIC AREA TO CONTRACT LYME DISEASE AND ASSOCIATED TICK-BORNE DISEASES. 

 

 

 

 

Mitral Valve Endocarditis: A Supposed Rare Manifestation of Lyme Disease

https://www.ncbi.nlm.nih.gov/m/pubmed/30690018/

Mitral Valve Endocarditis: A rare Manifestation of Lyme Disease.

Haddad O, et al. Ann Thorac Surg. 2019.

Abstract

Valvular involvement in Lyme disease is rare. Confirmation of Borrelia species as the causative agent by Polymerase Chain Reaction (PCR) was done in a few cases in Europe and the US. We describe a case of mitral regurgitation with a preoperative diagnosis of myxomatous mitral valve degeneration. During surgery, the surgeon suspected infective rather than degenerative; etiology; tissue cultures were negative. However, universal bacterial PCR on explanted valve tissue detected Borrelia burgdorferiDeoxyribonucleic Acid(DNA). If a surgeon suspects infective endocarditis at the time surgery, appropriate specimens should be sent for histopathology, culture, and PCR.

____________________

**Comment**

If I’ve said it once, I’ve said it 1,000 times:  researchers need to obstain from using the word “rare” in anything they write about MSIDS.  Nobody has a clue about numbers.  Testing misses over half of all cases and this study is a perfect example in that it proves tissue cultures can be negative yet a person can still be infected with Lyme.  Lyme experts have talked about seronegativity for decades yet mainstream medicine continues to deny it exists.  This must change.

Lyme/MSIDS causes all sorts of heart issues:  

https://madisonarealymesupportgroup.com/2018/08/14/vermont-resident-dies-of-rare-lyme-disease-complication-that-isnt-rare/

https://madisonarealymesupportgroup.com/2018/09/17/lyme-carditis-heart-block-other-complications-of-ld/

https://madisonarealymesupportgroup.com/2018/11/16/advanced-heart-block-in-children-with-lyme-disease-2/

https://madisonarealymesupportgroup.com/2017/08/23/video-dr-neil-spector/

https://madisonarealymesupportgroup.com/2018/06/03/heart-problems-tick-borne-disease/

https://madisonarealymesupportgroup.com/2018/10/10/lyme-carditis-presenting-with-atrial-fibrillation/

https://madisonarealymesupportgroup.com/2017/06/10/lyme-carditis-with-complete-heart-block/

https://madisonarealymesupportgroup.com/2018/04/04/correlation-of-natural-autoantibodies-heart-disease-related-antibacterial-antibodies-in-pericardial-fluid-mycoplasma-bb-chlamydia/

https://madisonarealymesupportgroup.com/2019/01/30/13-common-infections-that-can-raise-your-heart-attack-risk-including-lyme-msids/

https://madisonarealymesupportgroup.com/2018/09/28/bartonella-infective-endocarditis-with-dissemination-a-case-report-literature-review/

https://madisonarealymesupportgroup.com/2017/01/04/endocarditis-consider-bartonella/

https://madisonarealymesupportgroup.com/2018/02/20/babesia-and-heart-issues/

Does this look rare to you?

Industry-Sponsored Doctors: New Study Shows Depth of Commercial Influence

http://www.greenmedinfo.com/blog/industry-sponsored-doctors-new-study-shows-depth-commercial-influence?

Industry-Sponsored Doctors: New Study Shows Depth of Commercial Influence

“© [2/7/19] GreenMedInfo LLC. This work is reproduced and distributed with the permission of GreenMedInfo LLC. Want to learn more from GreenMedInfo? Sign up for the newsletter here http://www.greenmedinfo.com/greenmed/newsletter.”

Professional education events are heavily sponsored by drug companies promoting their products as the solution. This widely used coercive and misinformation technique where drug risks are exaggerated and side effects minimized was exposed in a recent BMJ Open study. 

The online medical journal BMJ Open recently published a retrospective cohort study titled Does industry-sponsored education foster overdiagnosis and overtreatment of depression, osteoporosis and over­active bladder syndrome? An Australian cohort study. Looking at publicly reported industry-sponsored events in Australia from October 2011 to September 2015, the researchers focused on three conditions subject to over diagnosis and over treatment: depression, osteoporosis and overactive bladder.

Over the 4-year study period 3,132 events were identified consisting of approximately 96,660 attendees. These events were attended by primary care doctors more often than sponsored events without a focus on the three conditions identified in the study. The researchers found a strong concentration of sponsorship among just a few companies. Two companies sponsored over 70% of depression events; another two companies over 80% of overactive bladder events.

The researchers concluded the following:

“…primary care clinicians were often targeted, dinner was often provided and that a few companies sponsored most events. In most cases, sponsors’ products are not cost-effective choices for the specified condition.

The researchers initially hypothesized that company’s marketing treatments for each condition would sponsor related events and that target audiences would mainly work in primary care, reflecting a broad patient population. What they found was in alignment with their hypothesis. The results from the study showed the following:

“Servier, which markets agomelatine and AstraZeneca (quetiapine) sponsored 51.2% and 23.0% of depression events, respectively. Amgen and GlaxoSmithKline, which co-market denosumab, sponsored 49.5% of osteoporosis events and Astellas and Commonwealth Serum Laboratories (CSL) (mirabegron and solifenacin) sponsored 80.5% of overactive bladder events.

The study highlights the need for professional education to be free of commercial sponsorship. Medical professionals are continually influenced, both directly and indirectly, by pharmaceutical and commercial interests which can have negative, real-world consequences for their patients.

While the recent Australian study highlights the problem of industry-sponsored influence, another more insidious method may be just as alarming. The fraudulent and selective nature of industry-sponsored research often captures the intellectual and regulatory pillars of medicine. For example, in 2015 the BMJ published Restoring Study 329, a decade-long effort by researchers to uncover the truth about the health risks and treatment value of an antidepressant approved for use by adolescents. Using the same data GlaxoSmithKline used to market their blockbuster antidepressant Paxil, researchers doing the restorative study 14 years later found that,

 Neither paroxetine nor high-dose imipramine demonstrated efficacy for major depression in adolescents, and there was an increase in harms with both drugs.

Meanwhile, a 2012 Cochrane systematic review found that AstraZeneca’s antipsychotic quetiapine, highlighted in the recent BMJ Australian study, had limited efficacy evidence for depression.

Industry influence upon the knowledge base, prescribing habits and beliefs of medical professionals often renders natural remedies and true healing solutions to depression, osteoporosis and overactive bladder invisible. Modalities with less potential for serious side effects too often become the casualties with the net effect seeing the patient shouldering the burdens of risk and substandard results.

How bad can it get? A look back at the past twenty-years reveals a cautionary tale of a racing American opioid epidemic caused in part by the combination of both industry-sponsored education and fraudulent research.

Dr. David Kessler, U.S. Food and Drug Administration (FDA) commissioner when Purdue Pharma’s opioid OxyContin, the drug that kicked off the American epidemic, won the agency’s green light in 1995 acknowledged,

No doubt it was a mistake. It was certainly one of the worst medical mistakes, a major mistake.

It was the first opioid to win the stamp of approval from the FDA, despite the lack of testing and demonstrated proof of the drugs safety and efficacy. Purdue then went on to sent a promotional video to approximately 15,000 doctors who were told OxyContin was “less than 1 percent addictive” — a figure subsequent studies proved false.

Once the overwhelming evidence of devastation from the opioid crisis began to be spotlighted by the media, then-president Richard Sackler of Purdue wrote in a confidential email,

“…we have to hammer on the abusers in every way possible. They are the culprits and the problem. They are reckless criminals.

Established medicine appears to be at the beginning stages of confronting its industry-sponsored blindspots. As more in the profession began escaping their myopic pharmaceutical shackles in search of true healing, it is essential for patients to empower themselves alongside this awakening become active participants in their individual healing journeys. Please use the GreenMedInfo research dashboard to access over 10,000+ evidence-based topics related to natural and integrative medicine. And share the resource, and this article and others to friends and family, who can subscribe to our complimentary newsletter here.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of GreenMedInfo or its staff.

Bias #8. News Media Blackout: Blackout on Ebola when White House asked the AP to stop reporting on it. It took De Niro’s pulling “VAXXED” from a film festival for the media to report on vaccines even though it was produced by a reputable producer, had two celebrity doctors who did a 180 on their stance on vaccines as well as a vaccine whistleblower who showed the CDC “sanitized” results. Weiler also shows how Andrew Wakefield’s study was retracted after a reporter, not a scientist, alleged impropriety in the study design approval.The CDC whistleblower states this is what the CDC does all the time.

https://madisonarealymesupportgroup.com/2017/12/11/levels-of-evidence-media-liability-double-standards-zika-vs-aluminum/

https://madisonarealymesupportgroup.com/2018/11/09/cochrane-no-longer-a-collaboration/

 

Wormser’s Worthless Study & Waste of Taxpayer Money

https://www.change.org/p/the-us-senate-calling-for-a-congressional-investigation-of-the-cdc-idsa-and-aldf/u/24149441?

Wormser’s waste of your taxpayer dollars!

FEB 10, 2019 — 

Yet another useless study out of New York Medical College funded by the US Centers for Disease Control. Please see the following letter of disgust sent to Wormser with carbon copy to the TBD Working Group, Assistant Secretary for Health and Mark Holodniy Editor-in-Chief, Diagnostic Microbiology and Infectious Disease.

——— Original Message ———-
From: CARL TUTTLE <runagain@comcast.net>
To: gwormser@nymc.edu, tickbornedisease@hhs.gov, brett.giroir@hhs.gov
Cc: (82 Undisclosed recipients)
Date: February 9, 2019 at 9:42 AM
Subject: Efficacy of a 14-day course of amoxicillin for patients with erythema migrans

ScienceDirect

Diagnostic Microbiology and Infectious Disease

Efficacy of a 14-day course of amoxicillin for patients with erythema migrans.

https://www.sciencedirect.com/science/article/pii/S0732889318303304

Wormser GP1, Brady KC2, Cho MS2, Scavarda CA2, McKenna D2.

Excerpt:

“….findings provide additional evidence that a 14-day course of 500 mg amoxicillin given 3 times per day is highly effective therapy for patients with early Lyme disease.”

Feb 9, 2019

Division of Infectious Diseases,
New York Medical College,
Valhalla, NY 10595
Attn: Gary P. Wormser, MD

Dr. Wormser,

Once again, as previously stated in the email below; “Your fixation on the acute stage of disease [with bulls-eye rash] after early treatment has done nothing to advance our understanding of how Lyme disease disables its victim.”

Early treatment of strep throat prevents patients from advancing to rheumatic fever which as you know causes irreversible heart damage. If we focused on the acute stage of strep we would never have realized that missed early treatment caused serious life-altering/life-threatening health consequences.

Ignoring the late stage horribly disabled Lyme population which could total in the millions worldwide is the equivalent of denying the Holocaust.

I noticed that your manuscript did not include the following reference:

July 2017- In Vitro Susceptibility of the Relapsing-Fever Spirochete Borrelia miyamotoi to Antimicrobial Agents.

https://www.ncbi.nlm.nih.gov/pubmed/28674060

Excerpt:

“We were able to show that both B. miyamotoi strains and B. hermsii demonstrated greater susceptibility to doxycycline and azithromycin, equal susceptibility to ceftriaxone and proved to be resistant to amoxicillin in vitro as compared to the B. burgdorferi s.l. isolates.”

Your retirement Dr. Wormser is highly, highly anticipated.

Carl Tuttle

Lyme Endemic Hudson, NH

NOTE: Wormser’s study was funded directly from the US Centers for Disease Control

Funding: RO1 CK 000152 which appears to be an open checkbook for his junk science.  (Wasteful taxpayer spending)

Cc: Tick Borne Disease Working Group
Assistant Secretary for Health, ADM Brett P. Giroir, M.D.
Mark Holodniy Editor-in-Chief, Diagnostic Microbiology and Infectious Disease.

_________________________________________________________

Previous email sent to Wormser on Jan 4, 2019:
On January 4, 2019 at 10:48 AM CARL TUTTLE <runagain@comcast.net> wrote:

JAMAShapiro ED, Wormser GP. Lyme disease in 2018: what is new (and what is not).
https://jamanetwork.com/journals/jama/article-abstract/2696480

Jan 4, 2019

Division of Infectious Diseases,
New York Medical College,
Valhalla, NY 10595
Attn: Gary P. Wormser, MD

Dr. Wormser,

In reference to your response to my letter to the Editor published in the December 18th  issue of JAMA, it would appear that you and your coauthor Dr. Shapiro conveniently ignored my question highlighted below: 

Excerpt from my letter to the editor:

Controversies About Lyme Disease
https://jamanetwork.com/journals/jama/article-abstract/2718786

-Carl Tuttle

“It is well known that untreated streptococcal pharyngitis can progress to rheumatic fever, causing irreversible heart damage. Untreated syphilis leads to progressive disability and dementia, and untreated HIV infection progresses to AIDS with significant disability and death. What happens to the patient with Lyme disease who goes months, years or decades before diagnosis because of a false negative serological test?”

___________________________

Untreated Lyme is destroying lives, ending careers while leaving the patient in financial ruin as reported by the disabled Lyme community for the past three decades. The absence of a bulls-eye rash after tick bite allows patients to progress to severe neurological disease instead of obtaining a prompt diagnosis and early treatment.

I would like to call attention to the following quote taken from an interview with Professor Willy Burgdorfer, the discoverer of the Lyme disease spirochete:

“The controversy in Lyme disease research is a shameful affair. I say that because the whole thing is politically tainted. Money goes to people that have for the past thirty years produced the same thing. Nothing.”  – Willy Burgdorfer

Source: (Live interview)

Prof. Willy Burgdorfer Talks About Lyme Disease
https://www.youtube.com/watch?v=dCnrUmAPcOE

Your fixation on the acute stage of disease after early treatment Dr. Wormser has done nothing to advance our understanding of how Lyme disease disables its victim.

For example:

Subjective symptoms after treatment of early Lyme disease.
https://www.ncbi.nlm.nih.gov/pubmed/20102996

Gary Wormser, New York Medical College

(Financed by the U.S. Centers for Disease Control)

RESULTS:

“At 12 months after enrollment, only 5 (2.2%) of 230 evaluable patients reported new or increased symptoms, and in none of the patients were these symptoms of sufficient severity to be functionally disabling”

_____________________________

Summary of Wormser’s study: Anyone experiencing symptoms after the one-size-fits-all treatment approach is just experiencing nothing more than the “aches and pains of daily living.”

So basically Wormser’s results are then assumed to apply to the entire patient population; in other words, Lyme is no big deal which has wrongly influenced our nation’s response to this serious life-altering health threat. The research into how Lyme disables should have been completed by now but the misclassification of Lyme as a simple nuisance disease (hard to catch and easily treated) has paralyzed the response to this runaway plague.

Many infections as I continue to point out evolve into an entirely different and serious life-altering/life-threatening disease when left untreated.

Post Treatment Lyme Disease Syndrome (PTLDS) after early treatment and untreated Lyme of months, years or decades are two entirely different disease states; the latter being ignored for three decades. Patients who have had a prolonged exposure to the pathogen are almost always incapacitated.

Purposely avoiding the advanced stage of disease hides the horribly disabled and anyone unable to see this is somewhat naive.

So I ask the question Dr. Wormser, What is the motivation for downplaying the severity of Lyme disease while ignoring patient outcry for thirty years?

A prompt response to this inquiry is requested.

Please hit Reply-All as I have carbon copied the Tick Borne Disease Working Group and Assistant Secretary for Health, ADM Brett P. Giroir, M.D.

Carl Tuttle

Lyme Endemic Hudson, NH

___________________

Study found here:  https://www.sciencedirect.com/science/article/pii/S0732889318303304

Efficacy of a 14-day course of amoxicillin for patients with erythema migrans

Abstract

Although a 14-day treatment course with amoxicillin is in wide clinical usage to treat early Lyme disease, only a few published studies exist to validate its efficacy and safety, with none in the United States. In this study, we reviewed the records of 24 prospectively followed adult patients with erythema migrans who were prescribed a 14-day course of amoxicillin, 500 mg 3 times daily. Treatment with amoxicillin was well tolerated and uniformly successful in resolving the erythema migrans skin lesion and in preventing the development of an objective neurologic, cardiac, or rheumatologic manifestation. Although the study was relatively small and only involved a single center, the findings provide additional evidence that a 14-day course of 500 mg amoxicillin given 3 times per day is highly effective therapy for patients with early Lyme disease.

__________________

For appropriate treatment, see:  https://madisonarealymesupportgroup.com/2016/02/13/lyme-disease-treatment/

For a fantastic overview listen to Dr. Burrascano on the history of Lyme, and important considerations in treatment:  https://madisonarealymesupportgroup.com/2018/12/28/the-history-of-lyme-disease-dr-burrascano/  

In brief:

  • Treat ALL forms of Bb
  • Treat coinfections
  • Treat long enough (Bb is slow-growing and persistent)
  • Make sure blood levels of antibiotics are high enough as people vary.  He discusses amoxicillin and how they found that increasing the dosage to 1,000mg 3X/day and adding probenecid to increase the antibiotic in the blood, people did even better.  He goes on to tell of an unpublished study with Stoneybook where there was a failure rate of 100% of patients taking 300mg of doxycycline a day for 21 days. Yet, how many people are given this exact treatment?
  • Cycle treatment.  This means, once you are symptom-free for 2-4 months, stop treatment.  If symptoms return, treat again.  Burrascano has found that it typically takes 3-4 Cycles before a person remains symptom-free.  The 3rd cycle often yields the worst herx in his experience.

https://madisonarealymesupportgroup.com/2018/04/13/chronic-lyme-post-mortem-study-needed-to-end-the-lyme-wars/  In this astute editorial, Microbiologist Tom Greer states:

From the very beginning, treatment failures were seen in virtually every antibiotic study done. The longer the patient follow up, the higher the incidence of treatment failure. The medical community blamed early treatment failures on the older antibiotics erythromycin, tetracycline, and penicillin, and determined that these antibiotics were not very effective at curing Lyme disease. Ignored was the fact that the newer antibiotics were also consistently failing to prevent relapses of active infection. Since these early treatment studies, the concept that two weeks of antibiotic therapy is adequate treatment for Lyme disease has remained ingrained in the medical community’s collective consciousness. [The Long-Term Follow-up of Lyme Disease: A Population-Based Retrospective Cohort Study. Authors: Shadick NA; Phillips CB; Sangha O et al. Ann Intern Med 1999 Dec 21;131(12):919-26]

*Data presented by Dr. Nancy Shadick at an International Lyme Symposia showed that patients in the Nantucket Island study followed for up to 5.2 years after initial antibiotic treatment had ever-climbing relapse rates. Relapse rates in patients receiving two weeks of IV Rocephin (ceftriaxone) could expect a relapse rate to exceed 50% after five years.

There is a smart way to treat this, yet few are nuanced in this skill.  We desperately need post-mortem studies to determine what is keeping people ill.  We need current transmission studies.  We need doctor education on the polymicrobial aspect of this disease. And, we need the stigma & polarization to go away so insurance companies will cover Lyme/MSIDS medical expenses, patients will be believed and supported and the bullying will end.

The Endocannabinoid System and the Important Role It Plays in Human Health

https://articles.mercola.com/sites/articles/archive/2019/02/10/endocannabinoid-system-role-in-human-health.aspx?

Published on Feb 5, 2019

Natural health expert and Mercola.com founder Dr. Joseph Mercola interviews Carl Germano, a board-certified nutritionist and phytocannabiniods expert, on how the endocannabinoid system influences human health.
February 10, 2019
By Dr. Mercola

STORY AT-A-GLANCE

  • Cannabinoid receptors in the human body were discovered in the 1990s, which in turn led to the realization that we make compounds in our body — endogenous cannabinoids — that influence these receptors
  • Endocannabinoid deficiency has been identified in people who have migraines, fibromyalgia, irritable bowel syndrome, inflammatory and neurological conditions and a variety of treatment-resistant conditions
  • While CBD has gained the most attention, CBD alone cannot fully support your body’s endocannabinoid system (ECS). You need the other phytocannabinoids and terpenes as well
  • Hemp has been outlawed in the U.S. since 1938. The latest Farm Bill, signed into law at the end of 2018, makes it legal again; hemp oil with full-spectrum phytocannabinoids may benefit a wide range of health problems
  • There’s an intimate relationship between your ECS and your omega-3 status. Omega-3 fats make your cannabinoid receptors more active, and are used as backbone structures to produce cannabinoids in your body

Hemp has been outlawed in the U.S. since 1938. Thankfully, the latest Farm Bill signed into law at the end of 2018 makes it legal. In this interview, board-certified clinical nutritionist and expert on phytocannabinoids, Carl Germano, discusses the exciting implications of this change.

Now, there’s a difference between cannabidiol (CBD) products made from hemp and those made from marijuana. While many mistakenly believe hemp and marijuana are interchangeable, they’re actually two different plants.

“Both are considered Cannabis sativa by genus and species, but that’s where the similarity ends,” Germano explains. “Hemp has been cultivated for many reasons for the past few thousand years — food, clothing, fiber and fuel. The plant itself contains naturally occurring active compounds called phytocannabinoids, of which CBD is just one of them.

Marijuana, on the other hand, has been cultivated for its primary phytocannabinoid, tetrahydrocannabinol (THC). While it has recreational value at small levels, it does have medicinal value.

Nevertheless, many decades ago, hemp got dumped into the definition of marijuana. Hemp was unjustly placed into the Controlled Substances Act (CSA), which kind of hampered its access, its ability to have U.S. farmers grow it, or to have even medical or academic institutions study it.

We’ve been in the Dark Ages for decades. Thanks to Israel and Europe, who’ve championed all the research, we’ve [discovered] the cannabinoid system in the body called the Endocannabinoid System (ECS).

Trump did sign a Farm Bill that finally deregulates hemp. It takes it out of the CSA … It gives the rights of farmers to grow it. It will open up the doors for academic and medical institutions to study it. It will give consumers access to [what is] probably the most important botanical we have on this planet.”

Why Whole Hemp May Be Better Than Isolated CBD

The hemp plant contains over 100 different phytocannabinoids, of which CBD is one. And while hemp has now been taken off the CSA, CBD is still under the jurisdiction of the U.S. Food and Drug Administration (FDA), which is responsible for the labeling of supplements and enforcing the Dietary Supplement Health and Education Act (DSHEA).

“With the passage of the Dietary Supplement Health and Education Act (DSHEA), you have several things against CBD. First, CBD was not in commerce prior to 1994, so it could not be grandfathered as a dietary supplement, yet hemp oil has been in commerce prior to 1994, so we’re OK there.

Secondly, DSHEA states that if you want to submit a new dietary ingredient application, you can do so and petition the FDA for an ingredient to be classified as a dietary supplement.

Well, if you were to do that today, you would get rejected immediately because the other part of DSHEA states that if Big Pharma takes a natural ingredient and makes a drug that gets approved, it’s hands-off to the dietary supplement industry.

GW Pharmaceuticals has two drugs using isolated purified CBD in it. Therefore, we’ve got several strikes against putting CBD on the front panel, calling it a dietary supplement, and I say, why bother? Because the story is much bigger than CBD, both clinically, scientifically and legally.”

Hemp oil is a food that happens to have CBD in it. But while CBD may not be legally advertised on the label, CBD-containing hemp products can be labeled as having phytocannabinoids — the class of compounds to which CBD belongs. While CBD has gained the most attention, CBD alone cannot fully support your body’s endocannabinoid system (ECS). You need the other phytocannabinoids and terpenes, which are very complementary to the phytocannabinoids, as well.

“Those of us in botanical medicine understand that the sum of all the parts of the plant is greater than any one single ingredient,”Germano says. “Let’s face it. There’s more than one ginsenoside in ginseng. There’s more than one curcuminoid in curcumin. There’s more than one isobutylamide in Echinacea. There’s more than one ginkgolide in ginkgo.

Well, there’s more than just one phytocannabinoid in hemp. Back in 2011, Dr. Ethan Russo in the British Journal of Pharmacology1 … wrote about the entourage effect of all the phytocannabinoids and terpenes needing to be present to give rise to full clinical, meaningful benefit …

While CBD may be the most dominant phytocannabinoid in hemp, the others are there in minor in number, but they are not minor in the body as they all participate in nourishing, supporting the ECS, which is the bigger story.”

Understanding Your ECS

While the discovery of the ECS is fairly recent, genetically it dates back over 600 million years.2Cannabinoid receptors in the human body were discovered in the 1990s, which in turn led to the realization that we make compounds in our body — endogenous cannabinoids — that influence these receptors.

It was also discovered that the ECS orchestrates communication between other bodily systems, such as your respiratory, digestive, immune and cardiovascular systems. The ECS does this via receptors found in every organ, including your skin.

“Your ECS is like the conductor of the orchestra. The orchestra are our organ systems. We cannot be healthy, we cannot be well if our ECS does not function well,” Germano says.

“Your body produces cannabinoids similar structurally to the cannabinoids found in cannabis. Your body feeds off of them. If you don’t produce enough to feed every single receptor, various conditions and various illnesses will ensue.”

Two Types of Endocannabinoid Receptors Have Been Identified

There are two primary ECS receptors: cannabinoid receptor type 1 (CB1) and cannabinoid receptor type 2 (CB2). While CB1 is typically thought of as being primarily in the brain and CB2 primarily in the immune system, both types of receptors are in fact found throughout your body.

One of the two cannabinoids your body produces is called anandamide — a nod to the word “ananda,” the Sanskrit word for “bliss,” as it attaches to the same CB1 receptors that THC attaches to. The other, 2-arachidonoylglycerol (2-AG), is found throughout your body.

“The ECS has been the subject of many scholarly textbooks … Quite frankly, this is something that should be taught from high school to college to medical school. Unfortunately, because of the stigma attached to cannabinoids … less than 13 percent [of medical schools in the U.S.] are teaching the ECS.

I say, ‘Are you insane? This is like saying that for the next 70 years we will not teach the cardiovascular system, as if it never existed.’ We now have to dismantle this medical travesty … The whole thing is about education. This is critical and crucial to our health and well-being.

We have to dismantle the stigma, and we have to start educating ourselves to understand that the ECS is probably one of the most important medical discoveries in quite some time. Understanding the enormity of this system and what it does and what it influences throughout the entire human body.”

Low Endocannabinoid Levels Result in Ill Health

With age, our bodies tend to become less efficient in creating the compounds needed for optimal health, and this holds true for anandamide and 2-AG as well. According to Germano, these two cannabinoids can actually be used as biological markers for certain illnesses and conditions.

Endocannabinoid deficiency has been identified in people who have migraines, fibromyalgia, irritable bowel syndrome, inflammatory and neurological conditions and a variety of treatment-resistant conditions. Germano also cites a paper3 in Translational Psychiatry, which found low anandamide levels are a statistically positive indicator for stress-induced anxiety.

They’ve also discovered there’s an intimate relationship between your ECS and your omega-3 status.4As it turns out, omega-3 fats make your cannabinoid receptors more active, and are used as backbone structures to produce cannabinoids in your body.

What do we see in people who have low omega-3 status? We see the same things we see in people who are endocannabinoid deficient: pain, inflammation, stress, anxiety, depression and so on. It is a perfect marriage between omega-3s and phytocannabinoids, which act like a multivitamin for the ECS.

But it doesn’t stop there. Look at bones … the reason we give post-menopausal women estrogen is because it influences the cells that build up bone, osteoblasts, and the cells that break down bone, osteoclasts. What does this have to do with the ECS?

We now know that if you stimulate the CB1 receptors, you start to stimulate the brain-to-bone communication by slowing down the brain from releasing bone-breaking compounds, like norepinephrine. Then when you stimulate the CB2 receptors, it increases osteoblasts, the bone makers, and decreases osteoclasts, the bone breakers.”

Top conditions associated with low cannabinoid levels include:
  • Pain, inflammation and inflammatory conditions
  • Stress, anxiety and insomnia
  • Ocular health
  • Bone health
  • Neurological conditions

“These are all conditions that can be suitably treated with phytocannabinoids,” Germano says. “These are conditions that we see in people who are endocannabinoid-deficient.”

Running Dramatically Boosts Anandamide Level

While runner’s high is typically attributed to the release of endorphins, running also dramatically increases anandamide in the body, and anandamide not only targets the CB1 receptor, but it also influences opioid and endorphin receptors. Not surprisingly then, the higher an individual’s anandamide level, the better they report feeling.

“That makes sense, because anandamide hits the receptors in the brain that are involved in reward and mood,” Germano says. “We also understand that the cannabinoids we produce are quite promiscuous.

They certainly touch the CB1 and CB2 receptors, but they [affect] other receptors as well, [such as] the 5-hydroxytryptamine (5-HT3) receptors, peroxisome proliferator-activated receptors (PPAR), gamma-aminobutyric acid (GABA) receptors, and receptors that control inflammation, pain, reward, anxiety and things of that nature.”

A paper5 published in PLOS ONE also details how various nutrients (such as omega-3 fats), drugs, exercise, chiropractic care, massage and acupuncture influence the function of your ECS.

Your Endocannabinoid System — A Key Player in Inflammation

Curcumin, boswellia, fish oil and quercetin are all well-recognized anti-inflammatory nutrients, but none can compare to what cannabinoids can do, Germano says, especially when the full spectrum is used.

As noted in a 2014 paper6 in Current Opinions in Clinical Nutrition and Metabolic Care, the ECS is an emerging key player in inflammation, because it’s intertwined with all of the inflammatory pathways, including the eicosanoid ones that omega-3 fish oils influence.

Germano also cites other research showing that targeting the ECS can ease both inflammatory and neuropathic pain, and describe how cannabinoids act as analgesics. According to Germano:

“You cannot contend with any inflammatory condition unless you’re supporting the ECS. They can be used interchangeably; phytocannabinoids along with curcumin and boswellia and fish oils would be remarkable, as they are complementary to each other by doing different things.

Again, we must address the ECS in any inflammatory condition, whether it be irritable bowel syndrome or injuries — even inflammation in the brain, which is one of the hallmarks of all neurological diseases. In 2003, the United States government got issued a patent on the neuroprotective effects of cannabinoids.

At that time, while the government has been telling us that phytocannabinoids are like lysergic acid diethylamide (LSD) and heroin — [meaning they] have no medical value — they go out and get a patent on the medical value.

But that was followed up, and there are many papers that talk all about the anti-inflammatory effects in the brain and in the nervous system, of these cannabinoids … There is nothing else like supporting the ECS with phytocannabinoids.”

Your Endocannabinoid System Also Plays a Key Role in Your Gut Health

You’re probably familiar with the fact that there’s a strong connection between not only your brain and your gut, but also your immune system. The importance of this triad in health and disease prevention cannot be overstated. Your gut not only is your largest immune organ, it’s also your second brain, containing hundreds of millions of neurons.

“We now understand how the gut is involved with communicating with the brain and the immune system, because it has brain cells and immune cells in it,” Germano says. In the middle of this trio is your ECS. It is actually the orchestrator of this tri-directional communication. According to Germano, researchers have also discovered the ECS controls:

  • Motility in the gut
  • Intestinal inflammation
  • Abdominal pain
  • Gut permeability
  • Tolerance to antigens

The ECS also reduces the activity of the stress pathways, including the hypothalamic-pituitary-adrenal (HPA) pathways. Anandamide, specifically, participates in the immunological response in the gut. What’s more, there’s also communication occurring between your endocannabinoid system and your gut microbiome (the bacteria in your gut).

Clinical Applications for Hemp Products

Again, a full-spectrum oil is actually far preferable to product in which CBD has been isolated. Germano cites a 2015 Israeli paper, which compared full-spectrum oil against isolated CBD, and found the full-spectrum oil was in fact clinically superior.

As for dosing, most of the literature demonstrates efficacy of CBD in the several hundred milligram range — but that is for “single magic bullet” isolated CBD. Preclinical studies and any clinicians are reporting that efficacy can be achieved with much lower doses when using a ful spectrum oil — some in the 10 to 25mg CBD range.

“Since CBD is the most dominant cannabinoid in hemp, when you extract oil from hemp, you do have much, much higher levels of CBD naturally in the oil as compared to the rest of the phytocannabinoid family. Providing 10 to 25 mg of CBD is the sweet spot for most conditions in the trade — especially when used with other synergistic ingredients …

People are responding quite remarkably, which [suggests] you don’t need a lot to jump-start the body’s ECS. Quite frankly, when we look at the bell-shaped curve with the isolates, the higher the dose, sometimes you decrease the effectiveness … When you use a full-spectrum oil and you’re getting the other important phytocannabinoid and terpene components, this is superior, and I’ll tell you why.

People have been focusing on CBD, which is the wrong message. It’s the myopic message. Think about it, CBD does not attach to the CB1 or CB2 receptors. If anything, CBD supports the CB1 receptors by preventing the breakdown of anandamide in our bodies and anandamide hits the CB1 receptor.

What about the CB2 receptor that controls inflammatory cycling, pain signaling, insulin sensitivity and bone building? CBD does nothing for that, so we need something of a CB2 agonist. A perfect partner to CBD would be another phytocannabinoid called beta caryophyllene. Luckily, the family of other phytocannabinoids in a full-spectrum oil contains other phytocannabinoids that complement to what CBD is not doing as well.

We must get off this single magic bullet bandwagon. We must appreciate the full gamut of all these phytocannabinoids as a whole, and that they complement each other, because CBD is not the answer to support the ECS as a whole.”

As with most things, too much can backfire. While CBD cannot kill you, using CBD isolate in too high amounts can reduce its effectiveness. Such problems are far less likely when using a full-spectrum oil.

“I don’t foresee anybody really overdosing on the standard dosages that we’re recommending,” Germano says. “Nor when we look at the data that’s been published, up to 1,500 mg of CBD chronically administered over time show that it was well-tolerated, minimal to no adverse reactions on physiological function, psychological functioning and other parameters in the body, including blood pressure. So, CBD is quite well-tolerated in humans.”

Hemp Oil for Sleep

Aside from inflammation and pain, another area where a full-spectrum hemp oil can be beneficial is to improve sleep and treat insomnia. Germano recommends using a full-spectrum oil in a dose that provides 25 mg of CBD.

“CBD at that range does a number of things. No. 1, it reduces excitability in the brain. It can reduce glutamate toxicity and any excitatory conditioning. Secondly, CBD is involved in various neurotransmitters that are involved with a normal sleep cycle.

While it has a calming effect and helps to establish a normal sleep cycle, it’s not necessarily a sedative. You can use it with melatonin. You can use it with lavender. You can use it with chamomile and passionflower, what have you. I would do that towards the latter part of the day, at least an hour or two before bedtime. Lower doses of CBD are more stimulating, so to speak, and more upregulating.”

How the New Law Can Improve Quality of Hemp Products

In the past, prior to the signing of the new Farm Bill, the leaf, flower and bud of the hemp plant could not be used in the production of CBD-rich hemp oil. The oil had to be pulled from the stalk and stem of the plant only — the less concentrated part. With the new law, all parts of the plant can be used, which will make processing easier and more economical, as the cannabinoids are more concentrated in the leaves, flowers and buds.

The law also makes it legal to grow hemp in in every state, so if you wanted to, you could grow it in your backyard. This is something I’m definitely considering, as you can easily juice the whole plant or add it to smoothies.

“Growing it for yourself would be wonderful,” Germano says. “It is a weed. It has a short period of harvest. It grows very rapidly — July, August and September. Yes, the whole plant can be used rather than just extracting the oils from it. All the phytocannabinoids and lipids are found in the oils, but the leaf can be juiced and put into smoothies as well …

In terms of growing and processing it, it’s a rather easy plant to grow, because it is a weed. When we talk about the raw plant, a lot of these cannabinoids are in their acidic form. CBD is in CBDA, cannabidiol acid, form. To convert it to its useable form, the acid has to be decarboxylated.

So, while you may benefit from a lot of the phytocannabinoids [in the raw plant], it’s going to be reliant on your body’s ability to process it from the acidic forms that are in there. Exposure to heat, light, moisture and air will decarboxylate a lot of them as well. The more you process it yourself, the more useable some of those phytocannabinoids will be.

[To process it], you can take the leaf, flower and bud. You can blend it and store it in the refrigerator. Over a day or two of exposure to heat, air, light and moisture, it’ll decarboxylate to some extent and you’ll benefit more from that. How much do you get? Appreciable amounts of CBD may be difficult with just juicing alone …

I don’t want to misquote myself and say the wrong thing, but probably an ounce or two [of raw plant] would do the trick as a healthy plant beverage. Again, you don’t need a lot to jump-start your body’s ECS. It’s not a numbers game. Small doses, you would definitely respond to.”

How to Identify a High-Quality Hemp Product

If you’re not growing your own, attributes to look for when shopping for a hemp product include:

Organic Kosher-certified
Non-GMO Verified pesticide and herbicide free
Full-spectrum phytocannabinoids Grown from certified seeds and not hybrids with marijuana

“I look for companies that are doing the right thing also. That is, they don’t mention CBD on the front panel or quantify it in the Supplement Fact box. Responsible companies talk about phytocannabinoids,” Germano says.

They talk about hemp oil. They talk about nourishing the endocannabinoid system. This is a superior story to just CBD. Those are the more reputable companies that are telling the right story, [and not just talking about] isolated CBD.”

More Information About Endocannabinoid System

Germano has written a book about the endocannabinoid system called, “Road to Ananda: The Simple Guide to the Endocannabinoid System, Phytocannabinoids and Hemp,” (www.roadtoananda.com) which is due out shortly. I am very proud to have written the forward to this book as it is a great resource. Definitely pick up a copy if you want to learn more about this fascinating topic.

“I’m ecstatic to announce that the person who wrote the introduction to the book is Raphael Mechoulam, the father of cannabinoid research and who was involved in the discovery of the endocannabinoid system.

He is well-known in the scholarly circles. There are certainly plenty of scholarly work out there, but we need to get this message, this story, which is enormous, out to the layman and practitioner out there who is really unaware still,” Germano says.

“I’ve been in this industry for over 35 years. I’m a clinical nutritionist by trade. I have not seen any natural compounds this clinically relevant since the inception of this industry. I can tell you that targeting the endocannabinoid system, supporting it, will dominate medicine and nutrition of the next couple of decades.

There are also topical applications for phytocannabinoids, because, again, our skin is one of our largest organs. It also has five to 10 times more cannabinoids in it than we have in our brain. The CB1 and CB2 receptors are there as well.

There are three targeted areas for topical applications. One, obviously, is pain and inflammation, because the CB2 receptors are there that control that. That is something that will blow away any of these compounds in the marketplace today for topical pain relief.

Then we know that certain cannabinoids strangle the sebaceous gland for acne. Certain cannabinoids also influence age spot development and antiaging. [There are] some very interesting things going on in the topical application area.

When we look at the global picture of what is the subcutaneous endocannabinoid system doing, it’s helping to maintain normal cell proliferation, differentiation and immune competence. Oncologists are going to be interested in that aspect.”

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**Comment**

If you are a Lyme/MSIDS patient you should see yourself ALL over this article.  We struggle with pain, inflammation, gut issues (motility, permeability, antigen tolerance, pain/inflammation), neurological issues, & insomnia.  Many experience ocular & bone issues as well.  It will be interesting to observe the topical applications of this since so many have pain.

It’s quite amazing that our government has gotten away with pigeon-holing this wonderful plant into the same category as heroin and marijuana for decades.  Hopefully, we will see pricing begin to fall as currently, cost is high.

The article, and indeed everything I’ve read, stresses that full-spectrum CBD is crucial.

For more:  https://madisonarealymesupportgroup.com/2019/02/09/webinar-cbd-craze-health-or-hype/

My entire family has found CBD oil to help with both sleep and pain.  I give the brand we’ve had success with here:  https://madisonarealymesupportgroup.com/2019/01/16/ldn-cbd/  (I am not affiliated with ANY companies).  It is potent.  The company has other strengths as well.