Archive for the ‘Treatment’ Category

Oregano, Cinnamon, and Clove Found to Have High Anti-Persister Activity for Bb


Front. Med., 11 October 2017 |

Selective Essential Oils from Spice or Culinary Herbs Have High Activity against Stationary Phase and Biofilm Borrelia burgdorferi

imageJie Feng1imageShuo Zhang1imageWanliang Shi1imageNevena Zubcevik2,imageJudith Miklossy3 and imageYing Zhang1*
  • 1Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
  • 2Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Charlestown, MA, United States
  • 3International Alzheimer Research Centre, Prevention Alzheimer International Foundation, Martigny-Croix, Switzerland

Although the majority of patients with acute Lyme disease can be cured with the standard 2–4 week antibiotic treatment, about 10–20% of patients continue suffering from chronic symptoms described as posttreatment Lyme disease syndrome. While the cause for this is debated, one possibility is that persister bacteria are not killed by the current Lyme antibiotics and remain active in the system. It has been reported that essential oils have antimicrobial activities and some have been used by patients with persisting Lyme disease symptoms. However, the activity of essential oils against the causative agent Borrelia burgdorferi (B. burgdorferi) has not been well studied. Here, we evaluated the activity of 34 essential oils against B. burgdorferi stationary phase culture as a model for persister bacteria. We found that not all essential oils had activity against the B. burgdorferi stationary phase culture, with top five essential oils (oregano, cinnamon bark, clove bud, citronella, and wintergreen) at a low concentration of 0.25% showing high anti-persister activity that is more active than the known persister drug daptomycin. Interestingly, some highly active essential oils were found to have excellent anti-biofilm ability as shown by their ability to dissolve the aggregated biofilm-like structures. The top three hits, oregano, cinnamon bark, and clove bud completely eradicated all viable cells without any regrowth in subculture in fresh medium, whereas but not citronella and wintergreen did not have this effect. Carvacrol was found to be the most active ingredient of oregano oil showing excellent activity against B. burgdorferi stationary phase cells, while other ingredients of oregano oil p-cymene and α-terpinene had no apparent activity. Future studies are needed to characterize and optimize the active essential oils in drug combination studies in vitro and in vivo and to address their safety and pharmacokinetic properties before they can be considered as a novel treatment of persistent Lyme disease.


Lyme disease or Borreliosis is the most common vector borne illness in the United States with an estimated 300,000 cases per year (1). The illness is transmitted by a tick bite and in some endemic areas, where more than 40% of the ticks are infected with the causative agent of Borreliosis, Borrelia burgdorferi sensu lato complex species, which increases the risk of transmission to human host (2).

The difficulty in the clinical management of Borreliosis is that the current treatment regimen recommended for acute stage of illness of 21 days of Doxycycline (Dox) (3) leaves over 20% of patients with chronic symptoms that can last over 6 months (4). These chronic symptoms can be debilitating fatigue, muscular and joint pain, and cognitive and neurologic impairment. While we do not yet understand the full spectrum of etiologies, research evidence in animal studies illuminates that persistence of infection is one of them. The persistence of the organism after antibiotic treatment is seen in dogs (5), mice (67), monkeys (8), as well as humans (9), but viable organisms are very difficult to be cultured from the host after antibiotic treatment.

Once the disease has been acquired, it can spread from the skin to various secondary organs throughout the body, including heart, joints, peripheral and central nervous system (10). The early stage of the illness tends to be easier to cure, but it can become more difficult to treat when the disease has progressed to late stage (11). This further challenges conventional antibiotic monotherpy such as intravenous ceftriaxone, which has not been proven successful with a subset of patients presenting with complex chronic symptoms (12).

One of the reasons for this failure, clinically relatable, would be that the host is infected with organisms that are enriched in variant persister forms or the disease when not treated in early stage can progress allowing persisters to further develop (round bodies and biofilm-like microcolonies and larger aggregated biofilm structures). Analogous variant atypical persister forms can be found in stationary phase cultures and under stress conditions such as starvation and antibiotic exposures (1315). It is worth noting that the current antibiotics used to treat Lyme disease such as Dox, amoxicillin, and cefuroxime (CefU) are highly active against the growing spirochetal form of B. burgdorferi but have poor activity against the atypical persister forms (round bodies, microcolonies, and biofilm) enriched in stationary phase cultures (1417). These persister forms that are not killed by the current Lyme antibiotics may underlie the persistent symptoms in patients despite the standard antibiotic treatment.

To identify drugs that target the persister forms, we screened FDA-approved drug library and NCI compound libraries (1418) against stationary phase cultures enriched in round bodies and microcolonies as well as antibiotic-induced round body persisters (19). Using these models, we identified a range of drugs such as daptomycin (Dap), clofazimine, anthracycline antibiotics, and sulfa drugs, etc., which have good activity against the Borrelia persister forms. However, some of these persister-active agents are either very expensive, difficult to administer, and have to be given intravenously, or have significant side effects.

Essential oils are concentrated volatile liquids that are extracted from plants, most of which are used as spices and culinary herbs. It has been reported in the literature that essential oils have antimicrobial activities (20), and anecdotal patient reports from the internet suggest that some essential oils may improve symptoms of patients with persistent Lyme disease ( However, only one study has been done, which assessed the activity of essential oils on B. burgdorferi, where it showed that volatile oil from Cistus creticus has growth inhibiting activity on growing B. burgdorferi (21). Because the current Lyme antibiotics (e.g., Dox, amoxicillin, CefU) are already very good at killing the log phase B. burgdorferi but have poor activity against stationary phase B. burgdorferi (141617). In addition, it is the dormant persister forms enriched in stationary phase cultures (often in variant morphological forms such as round bodies and microcolonies and biofilm) that may be involved in persistent infection that is not cured by the current Lyme antibiotics. Moreover, no study has been performed to evaluate the activity of essential oils on non-growing stationary phase B. burgdorferipersisters. Thus, the purpose of this study is to comprehensively evaluate the activity of essential oils for activity against the more difficult to kill persister forms of B. burgdorferi that are enriched in the stationary phase culture (22). To achieve this goal, we screened a panel of essential oils from common commercial sources for activities against B. burgdorferi stationary phase cells and found that not all essential oils have activity against B. burgdorferi, with oregano, cinnamon bark, and clove bud having among the highest anti-persister activity in vitro.

Materials and Methods

Strain, Media, and Culture Techniques

Low passaged (less than eight passages) B. burgdorferi strain B31 5A19 was kindly provided by Dr. Monica Embers (16). The B. burgdorferi B31 strain was grown in BSK-H medium (HiMedia Laboratories Pvt. Ltd.) and supplemented with 6% rabbit serum (Sigma-Aldrich, St. Louis, MO, USA). All culture medium was filter-sterilized by 0.2 µm filter. Cultures were incubated in sterile 50 ml conical tubes (BD Biosciences, CA, USA) in microaerophilic incubator (33°C, 5% CO2) without antibiotics. After incubation for 7 days, 1 ml stationary-phase B. burgdorferi culture (~107spirochetes per milliliter) was transferred into a 96-well plate for evaluation of potential anti-persister activity of essential oils (see below).

Essential Oils and Drugs

A panel of commercially available essential oils was purchased from Plant Therapy (ID, USA), Natural Acres (MO, USA), or Plant Guru (NJ, USA). Carvacrol, p-cymene, and α-terpinene were purchased from Sigma-Aldrich (USA). Essential oils were added to BSK-H medium or B. burgdorferi cultures to form aqueous emulsion suspensions by vigorous vortexing, followed immediately by serially diluting the essential oil suspensions to desired concentrations into B. burgdorferi cultures. Essential oils were also dissolved in organic solvent dimethyl sulfoxide (DMSO) at 20%, followed by dilution at 1:20 into 7-day-old stationary phase culture to 1% final concentration. To make further dilutions for evaluating anti-Borrelia activity, the 1% essential oils were further diluted with the stationary phase culture to achieve desired dilutions. Dox, CefU (Sigma-Aldrich, USA), and (Dap) (AK Scientific, Inc., USA) were dissolved in suitable solvents (2324) to form 5 mg/ml stock solutions. The antibiotic stocks were filter-sterilized by 0.2 µm filter and stored at −20°C.


The B. burgdorferi cultures were examined using BZ-X710 All-in-One fluorescence microscope (KEYENCE, Inc.). The SYBR Green I/PI viability assay was performed to assess the bacterial viability using the ratio of green/red fluorescence to determine the live:dead cell ratio, respectively, as described previously (1422). This residual cell viability reading was confirmed by analyzing three representative images of the bacterial culture using epifluorescence microscopy. BZ-X Analyzer and Image Pro-Plus software were used to quantitatively determine the fluorescence intensity.

Evaluation of Essential Oils for Their Activities against B. burgdorferi Stationary Phase Cultures

To evaluate the activity of essential oils, aliquots of the essential oils or drugs were added to 96-well plate containing 100 µL of the 7-day-old stationary phase B. burgdorferi culture to obtain the desired concentrations. In the primary essential oil screen, each essential oil was assayed in four concentrations, 1, 0.5, 0.25, and 0.125% (v/v) in 96-well plate. Dap, Dox, and CefU were used as control drugs at 40, 20, 10, and 5 µM, respectively, since this drug combination has been shown to completely eradicate B. burgdorferi persisters in our previous studies (1525). The active hits were further confirmed with lower 0.1 and 0.05% concentration; all tests were run in triplicate. All the plates were incubated at 33°C and 5% CO2 without shaking for 7 days when the residual viable cells remaining were measured using the SYBR Green I/PI viability assay and epifluorescence microscopy as described (1422).

Antibiotic Susceptibility Testing

To qualitatively determine the effect of essential oils in a high-throughput manner, 10 µl of each essential oil from the prediluted stock was added to 7-day-old stationary phase B. burgdorferi culture in the 96-well plate. Plates were sealed and placed in 33°C incubator for 7 days when the SYBR Green I/PI viability assay was used to assess the live and dead cells as described (14). Briefly, 10 µl of SYBR Green I (10,000× stock, Invitrogen) was mixed with 30 µl propidium iodide (PI, 20 mM, Sigma) into 1.0 ml of sterile dH2O. Then 10 µl staining mixture was added to each well and mixed thoroughly. The plates were incubated at room temperature in the dark for 15 min followed by plate reading at excitation wavelength at 485 nm and the fluorescence intensity at 535 nm (green emission) and 635 nm (red emission) in microplate reader (HTS 7000 plus Bio Assay Reader, PerkinElmer Inc., USA). With least-square fitting analysis, the regression equation and regression curve of the relationship between percentage of live and dead bacteria as shown in green/red fluorescence ratios was obtained. The regression equation was used to calculate the percentage of live cells in each well of the 96-well plate.

The standard microdilution method was used to determine the MIC of carvacrol, based on inhibition of visible growth of B. burgdorferi by microscopy. Carvacrol was added to B. burgdorferi cultures (1 × 104spirochetes per milliliters) to form aqueous suspension by vortex. The carvacrol suspension was twofold diluted from 0.5% (equivalent to 4.88 µg/ml) to 0.008% (equivalent to 0.08 µg/ml). All experiments were run in triplicate. B. burgdorferi culture was incubated in 96-well microplate at 33°C for 7 days. Cell proliferation was assessed using the SYBR Green I/PI assay and BZ-X710 All-in-One fluorescence microscope (KEYENCE, Inc.).

Subculture Studies to Assess Viability of the Essential Oil-Treated B. burgdorferi Organisms

A 7-day-old B. burgdorferi stationary phase culture (500 µl) was treated with essential oils or control drugs for 7 days in 1.5 ml Eppendorf tubes as described previously (15). After incubation at 33°C for 7 days without shaking, the cells were collected by centrifugation and rinsed with 1 ml fresh BSK-H medium followed by resuspension in 500 µl fresh BSK-H medium without antibiotics. Then 50 µl of cell suspension was transferred to 1 ml fresh BSK-H medium for subculture at 33°C for 20 days. Cell proliferation was assessed using SYBR Green I/PI assay and epifluorescence microscopy as described above.


Evaluation of Essential Oils for Activity against Stationary Phase B. burgdorferi

We evaluated a panel of 34 essential oils at four different concentrations (1, 0.5, 0.25, and 0.125%) for activity against a 7-day-old B. burgdorferistationary phase culture in the 96-well plates with control drugs for 7 days. Consistent with our previous studies (1425), Dap included as a persister drug control was shown to have higher activity against the B. burgdorferi stationary phase culture than the currently used antibiotics such as Dox and CefU for treating Lyme disease (Table 1), with a dose-dependent increase in killing activity. We used 40 µM Dap (64.8 µg/ml) as a positive persister drug control because this is a clinically achievable concentration that could cause near complete clearance of B. burgdorferistationary phase cells while the current Lyme antibiotics could not (1415) (Figure 1). Five essential oils (bandit, oregano, clove bud, geranium bourbon, and cinnamon bark) at 1% concentration showed more activity against the stationary phase B. burgdorferi culture than 40 µM Dap with the plate reader SYBR green I/PI assay (Table 1). We found some essential oils have autofluorescence, which interfered with the SYBR Green I/PI plate reader assay; however, we were able to resolve this issue present in some samples by fluorescence microscopy. As we previously described (18), we directly calculated the green (live) cell ratio of microscope images using Image Pro-Plus software, which could eliminate the background autofluorescence. Using the SYBR Green I/PI assay and fluorescence microscopy, we additionally found 18 essential oils that showed more or similar activity against the stationary phase B. burgdorferi at 1% concentration compared to the 40 µM Dap, included as a positive persister drug control (14), which could eradicate all live cells as shown by red (dead) aggregated cells (Table 1; Figure 1A). At 0.5% concentration, seven essential oils (oregano, cinnamon bark, clove bud, citronella, wintergreen, geranium bourbon, and patchouli dark) were found to have higher or similar activity against the stationary phase B. burgdorferi than 40 µM Dap by fluorescence microscope counting after SYBR Green I/PI assay (Table 1; Figure 1B). However, bandit thieves oil, while having good activity at 1%, had significantly less activity at 0.5% and lower concentrations (Table 1). Among the effective hits, five essential oils (oregano, cinnamon bark, clove bud, citronella, and wintergreen) still showed better activity than 40 µM Dap at 0.25% concentration (Table 1; Figure 1C). Eventually, oregano, cinnamon bark, and clove bud were identified as the most active essential oils because of their remarkable activity even at the lowest concentration of 0.125%, which showed similar or better activity than 40 µM Dap (Table 1; Figure 1D).

www.frontiersin.orgTable 1. Effect of essential oils on a 7-day-old stationary phase Borrelia Burgdorferi.a

www.frontiersin.orgFigure 1. Effect of essential oils on the viability of stationary phase Borrelia burgdorferi. A 7-day-old B. burgdorferistationary phase culture was treated with essential oils at different concentrations (v/v), 1% (A), 0.5% (B), 0.25% (C), and 0.125% (D) for 7 days followed by staining with SYBR Green I/PI viability assay and fluorescence microscopy. Daptomycin was included as a persister-active positive control drug at 40, 20, and 10 µM in panels (A–C), respectively.

To further compare the activity of these active essential oils and find whether they could eradicate stationary phase B. burgdorferi at lower concentrations, we evaluated six essential oils (oregano, cinnamon bark, clove bud, citronella, geranium bourbon, and wintergreen) at even lower concentrations at 0.1 and 0.05%. We noticed that oregano could not wipe out stationary phase B. burgdorferi at 0.05% concentration as shown by some residual green aggregated cells (Table 2; Figure 2), despite oregano showing strong activity sterilizing all the stationary phase B. burgdorfericells at and above 0.1% concentration (Tables 1 and 2).

www.frontiersin.orgTable 2. Comparison of essential oil activity against stationary phase Borrelia burgdorferi at 0.1 and 0.05% (v/v).a

www.frontiersin.orgFigure 2. Effect of active essential oils or their ingredients on stationary phase Borrelia burgdorferi. A B. burgdorferi stationary phase culture (7 days old) was treated with 0.1% (A) or 0.05% (B) essential oils (labeled on the image) or the ingredients (carvacrol, α-terpinene, or p-cymene) of oregano for 7 days followed by staining with SYBR Green I/PI viability assay and fluorescence microscopy.

To address potential concern that the essential oils may not dissolve in culture medium well and may affect the above results, we diluted all the 34 essential oils in DMSO and found 19 could be dissolved and 15 could not be dissolved in DMSO (see Table 1, Superscript c). For essential oils that can be dissolved in DMSO, we simultaneously dissolved them in DMSO and also in aqueous culture medium at the same dilutions of 0.5, 0.1, 0.05% and evaluated their activity against the 7-day-old stationary phase B. burgdorferi. However, we found that there was no significant difference in their anti-borrelial activity when dissolved in DMSO or in aqueous culture medium (p = 0.138–0.975) (see Table S1 in Supplementary Material).

Carvacrol As a Highly Potent Active Ingredient of Oregano Oil against Stationary Phase B. burgdorferi

To identify active ingredients of the oregano essential oil, we tested three major constituents (26), carvacrol, p-cymene, and α-terpinene on the stationary phase B. burgdorferi. Interestingly, carvacrol showed similar high activity against B. burgdorferi as oregano essential oil either at 0.1% (6.5 µM) or 0.05% (3.2 µM) concentration (Table 2; Figure 2, h). Meanwhile, we also found that carvacrol was very active against replicating B. burgdorferi, as shown with a very low MIC of 0.16–0.31 µg/ml. By contrast, p-cymene and α-terpinene did not have activity against the stationary phase B. burgdorferi (Table 2; Figure 2, i,j). Thus, carvacrol could be one of the most active ingredients in oregano oil that kill stationary phase B. burgdorferi.

Subculture Studies to Evaluate the Activity of Essential Oils against Stationary Phase B. burgdorferi

To confirm the activity of the essential oils in killing stationary phase B. burgdorferi, we performed subculture studies in BSK-H medium as described previously (15). To validate the activity of these essential oils, samples of essential oil-treated cultures were subjected to subculture after removal of the drugs by washing followed by incubation in fresh BSK medium for 21 days. According to the essential oil drug exposure experiments (Table 2), we used subculture to further confirm whether the top six active essential oils (oregano, cinnamon bark, clove bud, citronella, geranium bourbon, and wintergreen) could eradicate the stationary phase B. burgdorferi cells at 0.1 or 0.05% concentration. At 0.1% concentration, the subculture results were consistent with the above drug exposure results, and no regrowth in samples of three top hits, oregano, cinnamon bark, and clove bud was observed (Figure 3A, b–d). However, citronella, geranium bourbon, and wintergreen could not completely kill the stationary phase B. burgdorferi with many spirochetes being visible after 21-day subculture (Figure 3A, e–g). Subculture also confirmed the activity of carvacrol by showing no spirochetal regrowth in the 0.1% carvacrol-treated samples. However, in the p-cymene and α-terpinene subculture samples, growth in 0.1% concentration samples was observed. At 0.05% concentration, we observed no spirochetal regrowth after 21-day subculture in the oregano and cinnamon bark-treated samples (Figure 3B, b,c), even though some very tiny aggregated microcolonies were found after treatment (Figure 2B, b,c). Although the clove bud showed better activity than the cinnamon bark at 0.05% concentration (Table 2), it could not sterilize the B. burgdorferi stationary phase culture, as they all had visible spirochetes growing after 21-day subculture (Figure 3B, c,d). Additionally, 0.05% citronella, geranium bourbon, and wintergreen could not kill all stationary phase B. burgdorferi since many viable spirochetes were observed in the 21-day subculture (Figure 3B, e–g). Remarkably, 0.05% carvacrol sterilized the B. burgdorferi stationary phase culture as shown by no regrowth after 21-day subculture (Figure 3B, h).

www.frontiersin.orgFigure 3. Subculture of Borrelia burgdorferi after treatment with essential oils. A B. burgdorferi stationary phase culture (7 days old) was treated with the indicated essential oils at 0.1% (A) or 0.05% (B) for 7 days followed by washing and resuspension in fresh BSK-H medium and subculture for 21 days. The viability of the subculture was examined by SYBR Green I/PI stain and fluorescence microscopy.


Previous in vitro studies showed that certain essential oils have antibacterial activity against multidrug resistant Gram-negative clinical isolates (27). In this study, we tested 34 essential oils from different plants on non-growing stationary phase B. burgdorferi as a model of persister drug screens. We were able to identify 23 essential oils at 1% concentration that are more active than the control persister drug Dap (40 µM or 64.8 µg/ml) 3 of which, oregano, clove bud, and cinnamon bark, highlighted themselves as having a remarkable activity even at a very low concentration of 0.125% (Table 1). Among them, oregano and cinnamon bark essential oils demonstrated the best activity as shown by complete eradication of stationary phase B. burgdorferi even at 0.05% concentration. In a previous study, oregano oil was found to have antibacterial activity against Gram-positive and Gram-negative bacteria (26). Here, for the first time, we identified oregano oil as having a highly potent activity against stationary phase B. burgdorferi. We tested three major ingredients of oregano oil (carvacrol, p-cymene, and α-terpinene) on B. burgdorferi, and found carvacrol is the major active component, which showed similar activity as the complete oregano oil (Figures 2 and 3). We could not rule out the possibility that other components may also have activity against B. burgdorferi. We plan to use GC/MS to identify components of the active essential oils and test them on B. burgdorferi in the future.

In addition to the above findings, we noted that oregano oil can dramatically reduce the size of aggregated biofilm-like microcolonies compared to the antibiotic controls (Figure 1). After treatment with 0.25% oregano essential oil, only some dispersed tiny red aggregated cells were left in the culture (Figure 1C). Interestingly, we observed that amount and size of aggregated biofilm-like microcolonies of B. burgdorferi dramatically reduced with increasing concentrations of oregano oil, as aggregated biofilm-like structures vanished after treatment with 0.5 or 1% oregano essential oil. When we reduced the concentration of oregano essential oil to 0.05%, it could not eradicate stationary phase B. burgdorferi (residual viability 56%, Figure 2B, b) but the size of aggregated microcolonies decreased significantly. By contrast, Dap could kill the aggregated biofilm-like microcolonies of B. burgdorferi as shown by red aggregated microcolonies but could not break up the aggregated microcolonies even at the highest concentration of 40 µM (Figure 1A). It has been shown that carvacrol and other active compositions of oregano oil could disrupt microbial cell membranes (20). Future studies are needed to determine whether oregano oil and other active essential oils have similar membrane disruption activity and could destroy the aggregated biofilm-like structures of B. burgdorferi.

We also noted that some essential oils such as oregano and cinnamon bark had relatively high residual viability percentage (Table 2) at a low concentration of 0.05%, but the treated B. burgdorferi cells did not grow in the subculture experiment (Table 2; Figure 3B, b,c). We speculate that these essential oils could dissolve the dead B. burgdorferi cells presumably due to their high lipophilicity. The reduction of the number of dead red cells by the essential oil made the residual viability percentage increase, although the number of live cells obviously decreased as well (Figure 2A, b–d and Figure 2B, b,c). In addition, these essential oils may also permanently damage B. burgdorferi during the treatment, such that even in the fresh medium, the residual B. burgdorferi cells still could not regrow.

Meanwhile, we found that, at a high concentration (above 1%), lemongrass or oregano essential oil showed apparent high residual viability percentage by the SYBR Green I/PI plate assay, compared with the microscopy counting data (Table 1; Figure 1A). This may be caused by strong autofluorescence of these essential oils that severely interfere with the SYBR Green I/PI assay. We studied the emission spectra of lemongrass essential oil using Synergy H1 multi-mode reader and found lemongrass essential oil emits the strongest autofluorescence. The peak fluorescence of lemongrass essential oil is at 520 nm that overlaps with the green fluorescence of SYBR Green I dye (peak is at 535 nm). The strong autofluorescence caused the abnormal residual viability percentage (above 100% in Table 1) using SYBR Green I/PI plate assay. We also found that the oregano essential oil emits autofluorescence at 535 nm, which pushed the green/red fluorescence ratio higher than their true values (Table 1). We were able to solve this problem by using fluorescence microscopy as a more reliable measure to confirm the results of SYBR Green I/PI plate reader assay (1418).

Additionally, we found cinnamon bark and clove bud essential oils showed excellent activity against stationary phase B. burgdorferi. Cinnamon bark essential oil eradicated the stationary phase B. burgdorferi cells even at 0.05% concentration (Table 2) while clove bud essential oil showed sterilization at 0.1% or above concentration. Extractions of cinnamon bark and clove bud have been used as flavors for food processing. Based on this discovery, effective oral regimens with low side effect may be developed to fight against Lyme disease in future studies.

In a previous study, it has been found that volatile oil from C. creticusshowed growth inhibiting activity against growing B. burgdorferi in vitro(21), but its activity against stationary phase bacteria enriched in persisters was not evaluated. In this study, we tested six Citrus plants (Citrus bergamia, Citrus sinensis, Citrus limonum, Citrus aurantifolia, Citrus racemosa, Citrus reticulata) on the stationary phase B. burgdorferi culture and found bergamot (C. bergamia) had high activity (residual viability 12%) at 1% concentration. The other Citrus essential oils did not show good activity against B. burgdorferi compared with clinically used Dox, CefU, or Dap (Table 1).

Although we found several essential oils (oregano, cinnamon bark, clove bud) that have excellent activity against B. burgdorferi stationary phase cells in vitro (Table 1), the effective dose that will show equivalent activity in vivo is unknown at this time largely because the active ingredients in the active essential oils and the pharmacokinetic profile of the active ingredients are not all known. Future studies are needed to identify the active ingredients of the active essential oils and determine their effective dosage in vivo. Identification of active components or active component combinations from essential oils may help to eliminate the quality difference of natural products such that MICs and MBCs of the active compounds could be tested on growing bacteria in future studies. We were able to identify carvacrol as the most active ingredient in oregano essential oil, and its pharmacokinetics has been studied as a feed addition in pigs (28) and topical oil in cattle (29). In the rat model, the calculated LD50 of carvacrol is 471.2 mg/kg (30). We noticed that the 0.05% of carvacrol used here, which is equivalent to 0.48 µg/ml or 3.2 µM and completely eradicated B. burgdorferi stationary phase cells in subculture (Figure 3), is lower than the peak plasma concentration (3.65 µg/ml) in the swine study (28). Clinically, an antimicrobial agent that penetrates the blood–brain barrier as well as the persistent Borreliaorganisms do, would be an ideal candidate for further study (31). Oil of Oregano is a good candidate for this consideration given that its main active ingredient—carvacrol is a phenolic monoterpenoid that is fat-soluble and found in animal studies to have blood–brain barrier penetration (32). These findings favor the application of carvacrol in future treatment studies. Importantly, carvacrol seems to be more active than Dap, the most active persister drug against B. burgdorferi (1415). In this study, 0.1% carvacrol (6.4 µM) showed much higher activity (2% residual viability) than 5 µM Dap (45% residual viability) (Tables 1 and 2). In addition, 0.05% carvacrol (3.2 µM) could eradicate B. burgdorferistationary phase cells with no regrowth in subculture, by contrast, 10 µg/ml Dap (6.2 µM), could not completely kill B. burgdorferi stationary phase cells as shown by regrowth in subculture (15). Furthermore, we know that the drug’s activity against non-replicating bacteria is not always consistent with its activity against growing bacteria. With that in mind, we also tested carvacrol on the growing B. burgdorferi cells and found its MIC to be 0.16–0.31 µg/ml. This result showed that carvacrol is a good drug candidate active against not only stationary phase B. burgdorferi but also log phase replicating cells. For consideration in clinical applications, there is limited safety information on carvacrol and essential oils in humans. In mice, carvacrol has been given at 40 mg/kg daily for 20 days with no apparent toxicity (33). However, carvacrol and other active components of essential oils showed certain cytotoxicity (IC50 of carvacrol was 200–425 µM) (3435) on mammalian cells and genotoxic activity in vivo (10 mg/kg) (36). We found that few essential oils have been used in human studies. This is probably because these essential oils are natural products, which are mixtures of multiple active components, and little is known about their active ingredients or their mechanisms of antibacterial action. Thus, more work is needed to identify their active compounds of the effective essential oils. In addition, it is well known that some effective drugs identified in vitro may fail when tested in vivo. Thus, adequate animal studies are needed to confirm the safety and efficacy of the active essential oils in in vivosetting before human studies.

In summary, we found that essential oils had varying degrees of activity against stationary phase B. burgdorferi. The most active essential oils are oregano, cinnamon bark, and clove bud, which seem to have even higher activity than the persister drug Dap. A particularly interesting observation is that these highly active essential oils had remarkable biofilm-dissolving capability and completely eradicated all stationary phase cells with no regrowth in vitro. In addition, carvacrol was found to be the most active ingredient of oregano with high activity against B. burgdorferi stationary phase cells. Future studies are needed to test whether carvacrol could replace the persister drug Dap in drug combinations against more resistant biofilm-like structures and for treating persistent Borrelia infections in animal models and in patients.

Author Contributions

YZ and JM conceived the experiments; JF, WS, and SZ performed the experiments; JF, NZ, JM, and YZ analyzed the data; and JF, NZ, JM, and YZ wrote the paper.

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

The reviewer AN and handling editor declared their shared affiliations.


We acknowledge the support of this work by Global Lyme Alliance, Lyme Disease Association, NatCapLyme, and Steve Sim Fund. YZ was supported in part by NIH grants AI099512 and AI108535.

Supplementary Material

The Supplementary Material for this article can be found online at




While this is potentially great news for patients, please remember this was all done in vitro (in a test tube), similarly to the work on Stevia.  Also, we have no idea what dosage would be effective or safe for human consumption.

More on Stevia:



Lyme Or Fibromyalgia?  by Lonnie Marcum

LYME SCI: Is it fibromyalgia–or Lyme disease?

When Lady Gaga recently revealed a diagnosis of fibromyalgia—a set of symptoms characterized by widespread pain that is frequently accompanied by fatigue, sleep disturbances, memory issues and mood changes—I thought of another famous singer, Kris Kristofferson.

The Country Music Hall of Famer was also initially told he had fibromyalgia. As his symptoms worsened over the next 12 years, however, Kristofferson was eventually diagnosed with Alzheimer’s—until he was later found to actually have late-stage Lyme disease. 

Like others in the Lyme community, I couldn’t help wondering if Lady Gaga actually has Lyme disease. It turns out that Alfred Miller, MD, a retired doctor from San Antonio, Texas, has the exact same suspicion.

Mysterious Illness From The 70s
Dr. Miller practiced internal medicine and rheumatology for 40 years, and taught at the University of Texas Medical School in Houston.

He first learned about Lyme disease at a medical conference in 1977, when he heard Dr. Allan Steere describe an epidemic of arthritis-like symptoms in children near Lyme, Connecticut. Five years later, Dr. Wilhelm Burgdorfer would identify a tick-borne species of Borrelia as the causative agent of what came to be known as “Lyme disease.” (It’s named Borrelia burgdorferi in his honor.)

Years later, Lyme disease would tragically affect a member of Dr. Miller’s own family.

A Missed Diagnosis Of Lyme Disease
Shortly after Dr. Miller retired, his 43-year-old daughter-in-law, living in Boston, came down with a mysterious illness. She was evaluated by top doctors at three prestigious teaching hospitals, and given a terminal diagnosis of amyotrophic lateral sclerosis (ALS).

But, according to Dr. Miller, something didn’t line up. Although she had all the symptoms of ALS, he thought the lesions in her MRI looked more like multiple sclerosis.

ALS, also known as Lou Gehrig’s disease, is a progressive degenerative nerve disease with no cure. Not willing to accept this diagnosis for his daughter-in-law without being extra-sure, Dr. Miller did some research.

He states, “When I went to the medical literature, the only illness that could present the MRI of the brain of MS and the physical findings of ALS was neuroborreliosis” — late-stage Lyme disease which has spread to the central nervous system.

As a physician trained at the Mayo Clinic, Dr. Miller reached out to his colleagues there and asked that they look at the possibility that she might have Lyme. However, her ELISA test came back negative, as is the case in approximately 50% of patients who actually have Lyme disease.

From there, Dr. Miller did what many physicians experienced in Lyme disease do—he sent her blood to a specialty lab that reports all the bands on the Western blot. Lo and behold, her test came back positive for Lyme.

In this video, Dr. Miller explains how most standard tests for Lyme will miss the diagnosis and why the Western blot must include all bands: (This link contains the entire series by Miller)

Rheumatologist Turned Lyme Activist
Since his daughter-in-law’s diagnosis, Dr. Miller has made it his mission to educate others about the risks of Lyme disease being mis-diagnosed. He believes all patients who have been given a diagnosis of a neurodegenerative disease—including ALS, MS, lupus, and fibromyalgia—should be evaluated for Lyme disease.

While there are distinct differences in the later stages of these illnesses, they are almost all accompanied by pain, fatigue, sleep issues, cognitive issues, headache, numbness and tingling.

According to a survey of over 4000 patients with Lyme disease, “roughly 20% of those with chronic Lyme disease were initially misdiagnosed with a neurologic disease” including MS, ALS, Parkinson’s and multiple systems atrophy.

When To Suspect Lyme Disease
Unfortunately, fibromyalgia has no cure and a diagnosis may lead to a dead-end when looking for potential causes. Because there is overlap with the symptoms, many patients with Lyme disease are initially diagnosed with fibromyalgia. The good thing is Lyme disease is treatable and for many patients, treatment resolves their pain.

Women are twice as likely to be diagnosed with fibromyalgia, with the average patient going five years before getting a diagnosis. Interestingly, women are also more prone to false-negative testing for Lyme, leading to a delayed diagnosis of more than two years in over 60% of the cases.

Because so many patients with Lyme disease are frequently misdiagnosed, has created an easy to use checklist that you can fill out and take to your healthcare provider. Click here to check your symptoms:

LymeSci is written by Lonnie Marcum, a Licensed Physical Therapist and mother of a daughter with Lyme. Follow her on Twitter: @LonnieRhea Email her at: .


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Today is PANS/PANDAS Awareness Day  October 9, 2017

The following article is just one example of how children are affected by a hard to diagnose complex illness called PANDAS or PANS.  Infections such as Lyme/MSIDS can trigger it and one prominent Wisconsin LLMD states that 80% of his PANS patients have it.

carsonCarson Spears, 11, has PANS, a disorder where his body’s antibodies attack his brain instead of foreign pathogens. Homeopathic treatment has helped him, however. Kate Stevens

It started with strep throat. Then ‘it’s like your kid died but they’re still there’


SEPTEMBER 11, 2017 3:16 PM

Carson Spears was just like the other pupils in kindergarten. The bubbly little boy loved to play outside and had plenty of friends.

Then, Carson came down with his first case of strep throat.

He didn’t respond to antibiotics and his sore throat and fever worsened, said Carson’s mother, Melissa Spears.

After changing antibiotics three times over a two-week period, Carson seemed to improve.

But on Sept. 24, 2011 — his mother remembers the date — the Spears family’s only son came downstairs a changed boy.

Carson had developed an unusual and noticeable eye tic seemingly overnight.

Her son’s eyes were traveling back and forth as if to the 10 and two position on a clock over and over, said Melissa Spears, 37.

By the time she returned home from work that afternoon, she counted Carson’s eyes tics at about 80 per minute, she said.

Cory Spears said his son’s obsessive tics reminded him of an android in a science-fiction movie.

“You ask him a question and he can’t compute,” Cory Spears recalled. “That’s what I relate it to. Everything reset.”

This initial symptom of uncontrollable eye tics began the Spears’ journey into learning about Pediatric Acute-onset Neuropsychiatric Syndrome, or PANS, a disorder resulting from an infection or environmental trigger causing abnormal activation of the immune system.

The Spears family of Mooresville has fought for the past six years to bring back Carson from this disorder that nearly robbed him of his personality.

“It’s like your kid died but they’re still there,” said Cory Spears, 39.

The Spears family hopes to educate others about PANS on Sept. 16 when they will participate in the PRAI for 100K 5K fundraiser at Marvin Ridge High School in Waxhaw.

The fundraiser is held by the Pediatric Research & Advocacy Initiative, or PRAI, a nonprofit organization whose mission is to find answers for children affected with neuroimmune disorders.

The disorders could affect as many as one in 200 children, most of whom are misdiagnosed or undiagnosed, according to PRAI statistics.

Awareness events like these fundraisers help educate people who may not have even heard of PANS and helps those diagnosed with PANS to realize there are others like them.

“The biggest thing that worries me about families with PANS kids is they think they’re alone,” said Cory Spears.

Carson’s eye tics were the first symptoms that eventually led to an unofficial diagnosis of PANDAS six years ago by his eye specialist.

Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, or PANDAS, is a subset of PANS and is linked to a recent streptococcal infection, according to PRAI.

“We are very, very, very fortunate that we had an unofficial diagnosis within 24 hours of onset symptoms,” said Melissa Spears. “Some parents go years.”

‘It hurts worse than average’

PANS is related to other bacterial or viral infections, including strep but other co-diseases, as well, Melissa Spears said.

Antibodies in a healthy person will attack a foreign antigen like a virus or bacteria once it enters the body to prevent illness, said Melissa Spears. For a person with PANS or PANDAS, the antibodies will instead attack the person’s brain instead of the foreign antigen, she said.

The inflammation of the brain can cause symptoms including terrible headaches, obsessive compulsive disorder, anxiety, sleep disturbances and aggression in children with PANS or PANDAS, Melissa Spears said.

When Carson has a “flare,” as the Spears family calls it, he says it feels like “his brain is on fire,” Melissa Spears said.

“It sort of feels worse than other people would think it would,” said Carson, now 11. “Other people are like, they’re thinking that I’ll be OK over time but it hurts worse than average.”

After Carson’s unofficial diagnosis in 2011, the family was left on its own to discover who could treat their son.

Meanwhile, Carson’s symptoms multiplied. He became withdrawn and began having issues focusing and completing tasks. He would leave lights on all over the house and leave cabinet doors open. He developed a life-changing fear of anything that flew, including insects and birds.

Carson developed severe separation anxiety from his parents and refused to go into a room alone or sleep in his own bed.

“He didn’t leave the house one summer,” Melissa Spears said.

Treatment trail

Over the next two years, the family took Carson to five doctors from Greensboro to Charlotte to Matthews where the Spears experienced backlash from physicians.

Doctors didn’t believe the disorder was real or thought Carson’s problems were psychiatric, said Melissa Spears.

The family spent $17,000 seeking medical answers the first year after Carson was diagnosed, Melissa Spears said.

After trying different medicines and going to local doctors “that didn’t listen to us as parents,” Melissa Spears turned to Dr. Rosario Trifiletti, a New Jersey neurologist who, at the time, was one of the few in the world who specialized in PANS/PANDAS cases.

During a phone appointment, Trifiletti listened to the Spears’ story and ordered lab work for all the family members, including Carson’s younger sister, Braxtynn.

Lab technicians took 17 vials of blood from Carson, then just 7 years old.

Trifiletti officially diagnosed Carson with PANS, not PANDAS, due to the active co-infections found in his blood work: mycoplasma, the bacteria that causes pneumonia; coxsackie — the virus causing Hand, Foot and Mouth disease; streptococcus, the bacteria causing strep throat; bartonella and babesia — a bacteria and parasite related to Lyme disease; and yeast, Melissa Spears said.

Instead of attacking these infections, Carson’s antibodies were instead going after his brain.

Carson began taking antibiotics daily for two years, as well as Tylenol and Ibuprofen, but his symptoms, although better, persisted. His parents began worrying how the treatment was affecting his already fragile body.

They decided something new had to be done.

‘Changed our lives’

At a crossroad, Melissa and Cory Spears could either commit to a $25,000 intravenous immunoglobin treatment commonly used for cancer patients to reset their immune systems or try integrative medicine and homeopathy.

The family found Dr. Angelica Lemke, a naturopathic doctor or ND, online.

After a 3 1/2 hour initial Skype consultation, Lemke asked for 30 days to see if her remedies would make a difference in their lives.

“My experience is that for the rapidly growing group of kids like Carson who have been diagnosed with PANS, and who often tend to have significant sensitivity, damage or imbalance in their immune system, homeopathy is a very excellent tool because it is specific enough to be tailored to each individual, gentle enough to not cause more harm than good, and when used correctly is particularly well-suited for improving or balancing children’s immune response to infections,” said Lemke through an email interview.

Three weeks in, Lemke’s treatment “changed our lives,” Cory Spears said.

Carson stopped waking in the middle of the night and he would actually go into a room alone, Melissa Spears said.

Instead of antibiotics, Melissa Spears picks from a number of paper packets containing nosodes, a diluted form of a disease used to treat that same disease.

Carson then drinks the nosode after it is dissolved in a small amount of water.

The nosodes teach the body to recognize the disease and then push it out, said Melissa Spears.

The family also diffuses essential oils and applies them topically to aid Carson’s immune system as well as purifies the air inside the home since toxins can make him sick. No one wear shoes inside the house to keep germs from getting inside.

Carson also avoids cow’s milk, which affects his ability to focus.

The homeopathic treatments have worked miracles and for that they are grateful.

“Our goal is to heal his immune system so that he will no longer have to battle this disorder on a daily basis,” said Melissa Spears.

The homeopathic treatments cost less than $500 annually, substantially less than some western medical treatments, the Spears family said.

A new Carson

The family feels they pretty much got Carson back about two and a half years ago, thanks to Lemke’s homeopathic treatments.

Today, Carson is a sixth-grade student in the gifted program at Mooresville Intermediate School.

He communicates his needs with his teachers and will work in the hallway quietly if he needs a break from the noisy group work that comes with some of his lessons, Melissa Spears said.

He enjoys playing Xbox, collecting and sorting his Pokemon trading cards and playing basketball with friends down the street, he said.

“Over the years it will get better if you have it,” said Carson. “I’ve gone through hard times with it and I’ve been healed from it. I hope other people are able to heal from it too.”

Kate Stevens is a freelance writer:

For information about PANS/PANDAS, please contact Melissa Spears at or Cory Spears at


For more:





Some LLMD’s are using a treatment called LDA/LDI to treat immune dysfunction:  In short, it is transdermal injections every two months with substances that a person reacts to and can include anything from mold to dust, to Bartonella and Lyme.  The principle is somewhat like homeopathy as mentioned in the article.


Misdiagnosed: How Children With Treatable Medical Issues Are Mistakenly Labeled as Mentally Ill by A. Elizabeth Washington, Writer, Advocate, Mother

Misdiagnosed: How Children With Treatable Medical Issues Are Mistakenly Labeled as Mentally Ill


In the fall of 2015, eleven-year-old Sophia Cahill* began blinking her eyes. Though an eye doctor dismissed the blinking as a symptom of dry eyes, her parents would look back later and realize the blinking was a tic. Sophia was otherwise healthy and unbothered by the blinking so life carried on as usual. The simple tic would unfortunately foreshadow much darker days to come.

As Sophia entered seventh grade the following year, she enjoyed spending time with friends and family, performed well academically, and excelled in several sports. She played softball and skied black-diamond slopes with ease. With a love of horseback riding, she had spent two weeks the prior summer at an overnight riding camp. Independent and responsible, she had flown alone across the country to see her cousins and was a trustworthy babysitter for her siblings. Sophia was happy and healthy, with a precocious sense of humor and an easygoing demeanor. Sophia’s parents, both medical doctors, had no concerns about her behavior or health that could have predicted that her life would soon be dramatically and abruptly turned upside down.

Shortly after the school year started, Sophia became sick with a virus and then pneumonia. The illnesses would have been easily forgotten were it not for the troubling episodes that began the following month. Out of the blue and generally in the evenings, Sophia would become extremely distressed and inconsolable, crying for hours at a time. In a state of extreme anguish, she’d rip up boxes of Kleenex, pound her fists on the bed, and repeat bizarre and senseless phrases. Her pupils would dilate and with sheer terror in her eyes and panic on her face, she would scream “Mommy! Mommy, help me!” but no amount of consoling could ease her suffering. Eventually, her hysterical sobbing was punctuated with the disturbing sight and sound of the usually calm twelve-year-old banging her head against the wall. By the wee hours of the morning, she would collapse from utter exhaustion and fall sleep.

The morning after each episode, Sophia would awake in good spirits showing no signs of the turmoil that had transpired the night before. A few nights would pass before another episode would occur. Gradually the episodes became more frequent and began lasting longer. Within three months, she had racked up a number of mental health diagnoses from several different doctors and had started an SSRI, yet her mental health continued to deteriorate.

Shortly after the New Year, the distressing symptoms that Sophia had exhibited only intermittently in the prior months turned into an around-the-clock nightmare for her and her family. With the addition of peculiar involuntary movements and constant moaning that would later be recognized as a vocal tic, Sophia was admitted into the hospital.

While hospitalized, her mother received a call from the pediatrician. The strep titers that she had asked the pediatrician to order were positive. This indicated that Sophia had likely had a fairly recent strep infection. Coupled with her dramatic neuropsychiatric deterioration, the pediatrician believed her mother’s suggestion that Sophia might have pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, commonly referred to as PANDAS, was likely accurate. She asked that Sophia’s mother discuss the possibility with the doctors at the hospital. Because Sophia also had a virus and pneumonia in the month before her symptoms began, pediatric acute-onset neuropsychiatric syndrome, or PANS, was also a consideration. PANDAS, a subset of PANS, requires documentation of previous strep infection. Diagnosis of PANS does not require identification of a specific trigger.

Sophia’s parents shared the labs and their suspicions with the hospital, but the attending physicians were adamant that Sophia did not have PANS. Relentlessly symptomatic, Sophia was transferred to an inpatient child and adolescent unit at another hospital with a diagnosis of anxiety. Here too, her symptoms continued to worsen and she developed an extreme startle response, jerking violently at the slightest sound. One week passed and high doses of anti-psychotics, beta-blockers, and other medications as well as additional investigation into medical causes produced no relief. Desperate for help, Sophia’s parents brought her back to the first hospital.

An MRI, EEG, and lumbar puncture provided no insight into what might be wrong and a neurologist reported she could find nothing amiss neurologically. After seeing another psychiatrist, Sophia picked up yet another diagnosis. This time her parents were told she had a conversion disorder and that they were to bring her home and behave as though nothing was wrong with her. With that, Sophia was discharged from the hospital.

At home, she continued to moan around the clock, jerked her arms uncontrollably, screamed hysterically, and was frequently catatonic. Frantic for answers, Sophia’s parents took her to yet another psychiatrist. This time she was diagnosed with a panic disorder, and though the psychiatrist admitted he honestly was not sure what was wrong with her, he prescribed two different anti-psychotics in an effort to stabilize her.

The attempt failed and by February, Sophia had refused to eat or drink for a full week. Treated for dehydration and released by the hospital, she was sent to an in-patient psychiatric facility. She was initially placed on an eating disorder unit and then moved to the OCD and anxiety unit. The two psychiatrists who evaluated her quickly encouraged her parents to have Sophia evaluated by a doctor who specialized in PANS and PANDAS. Sophia and her parents traveled out of state to see a specialist. With a virus and pneumonia preceding her initial neuropsychiatric symptoms, as well as positive streptococcus titers, the specialist confidently diagnosed Sophia with PANS and its subset PANDAS. Returning to the psychiatric facility with a proper diagnosis and treatment plan in place, Sophia was discharged.

Still suffering horrifically, Sophia tried to end her own life two days later. She was rushed back to the same hospital that had encouraged her parents to take her home and behave as though nothing was wrong the month before.

Now open to the possibility of PANS, hospital physicians agreed to treat her with intravenous immunoglobulin, or IVIG. Derived from the plasma of over a thousand donors, IVIG is used to treat a number of serious and life threatening medical conditions, including PANS. Sophia also underwent plasmapheresis, a procedure in which the plasma is separated from the blood cells, treated to remove auto-antibodies that may be attacking the body, and then returned to the body. Next she received Rituximab, a medication that halts autoimmune disorders by targeting and destroying B-cells, a type of blood cell responsible for antibody production

Though patients receiving these treatments often wait eight or more weeks for relief, Sophia was well enough to leave the hospital by the end of the month. Just as she was beginning to resume a few normal activities, pharyngitis caused relapse and she was readmitted to the hospital for an additional six weeks of aggressive immunomodulatory therapies, antibiotics, tonsillectomy and adenoidectomy. This time, the treatment would provide complete remission.

Four months after her final release from the hospital, Sophia is functioning just as well today as she had been prior to the onset of PANS. She is content, doing well academically, and on the school volleyball team. Surrounded by friends to celebrate her thirteenth birthday last month, Sophia showed no evidence of the year-long nightmare she had endured.

To understand how the physicians of a highly regarded hospital system could repeatedly misdiagnose Sophia, it is helpful to understand the history of PANS and PANDAS. National Institute of Mental Health researcher, Dr. Susan Swedo, first recognized what would come to be called PANDAS more than 25 years ago. While researching Sydenham’s chorea and obsessive-compulsive disorder (OCD), the mother of a patient with severe OCD and tics mentioned that her son had strep throat less than two weeks before his onset of symptoms. She had also noticed her older son’s tics would worsen a couple days before the start of a sore throat and positive strep test. As Dr. Swedo investigated further, she became aware that other infections also triggered OCD, tics, psychiatric issues, and behavioral problems in certain children.

Focusing early research on strep-triggered cases of obsessive-compulsive and tic disorders, Dr. Swedo published a paper in 1998 that provided clinical description of the first 50 children she had observed with PANDAS. All cases were characterized by an abrupt onset of OCD or tics following a strep infection. Many of the children also suffered from emotional lability, changes in school performance, personality changes, bedtime fears, separation anxiety, irritability, sensory defensiveness, impulsivity, distractibility, deterioration in handwriting and math skills, oppositional defiant behaviors, and nightmares (1).

A small handful of neurologists were swift to criticize the research. Quickly labeled as controversial, Dr. Swedo and other researchers would find themselves defending the concept of PANS for decades to come. Ruthless in their attack of PANS and PANDAS, several critics published a paper in 2012 in the Journal of Pediatrics titled “Moving From PANDAS to CANS (2).” Despite a large body of evidence to the contrary, they again called into question the scientific evidence for its existence. They also criticized the use of antibiotics to treat children with abrupt onset OCD and tics despite evidence that the health of many children with PANS was restored with antibiotic treatment.

After the paper was published, it was revealed that three of the authors, Dr. Roger Kurlan, Dr. Harvey Singer, and Dr. Donald Gilbert, failed to disclose that they had received financial support from the pharmaceutical company Psyadon (3). The company manufactures a medication for tics, providing a possible motive for their persistent criticism of the concept of PANS and use of inexpensive antibiotics to treat it.

Despite the frequent negative publicity, significant progress has been made in the understanding and treatment of PANS. In 2012, Lucile Packard Children’s Hospital at Stanford started a program treating children with PANS. In 2013, they hosted a conference with a number of experts from prestigious medical institutions and published a paper with clear diagnostic guidelines (4). In February 2015, an entire edition of the Journal of Child and Adolescent Psychopharmacology (5) was dedicated to PANS and PANDAS and in 2017, the same journal published three articles detailing full treatment guidelines (6). The articles were co-authored by an incredible team of experts like Dr. James Leckman, Professor of Child Psychiatry at Yale University, who served as the Director of Research for the Yale Child Study Center for more than twenty years; Dr. Mark Pasternack, infectious disease doctor and Associate Professor of Pediatrics at Harvard University; Dr. Jennifer Frankovich, PANS rheumatologist and Director of the PANS Program at Stanford; and more than two dozen other experts from prominent institutions.

Though experts consider the controversy to be resolved, the vast majority of pediatricians, child psychiatrists, and neurologists are unapprised of the latest research and continue to misdiagnose children who have PANS with any number of mental health disorders. The PANDAS Physician Network, an organization that educates medical professionals and sponsors research of the disorder, lists only one or two physicians who treat PANS in many states. Considering that by National Institute of Mental Health estimates, at least 350,000 children in the United States have PANS, the number of doctors who recognize and treat it is woefully inadequate to meet the needs of suffering children.

For now, many children with PANS continue to wait for the medical community to catch up to what experts have known for decades. We can only hope they’ll be as lucky as Sophia and receive proper medical attention before it’s too late.


*Name has been changed to protect privacy.



1. Swedo, Susan E., et al. “Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: clinical description of the first 50 cases.” American Journal of Psychiatry 155.2 (1998): 264-271.

2. Singer, Harvey S., et al. “Moving from PANDAS to CANS.” The Journal of pediatrics 160.5 (2012): 725-731.

3. Singer, Harvey S., et al. “Moving from PANDAS to CANS.” The Journal of pediatrics 160.5 (2012): 725-731. (see correction)

4. Chang, Kiki, et al. “Clinical evaluation of youth with pediatric acute-onset neuropsychiatric syndrome (PANS): Recommendations from the 2013 PANS Consensus Conference.” Journal of Child and Adolescent Psychopharmacology 25.1 (2015): 3-13.

5. Chang, Kiki, Harold S. Koplewicz, and Ron Steingard. “Special issue on pediatric acute-onset neuropsychiatric syndrome.” Journal of child and adolescent psychopharmacology 25.1 (2015): 1-2.

Marijuana & Chronic Pain: Q & A With Dr. David Barton
Marijuana and Chronic Pain: Q&A with Dr. David Barton
Celeste Cooper, RN / @FibroCFSWarrior, Health Professional

marijuana         Credit:  Thinkstock

Dr. David J. Barton (AKA Dr. B), a conservative physician by personality and training, says it required an evolutionary process to arrive at his present clinical outlook on medical marijuana.

What is your medical background?**

Dr. B**: I was a double-boarded general surgery trained plastic surgeon until I became disabled and retrained in Pain Medicine at the University of Utah. I hold memberships in the American Academy of Pain Medicine, the International Cannabinoid Research Society and the Hawaii Medical Society.

How did your opinion on cannabis medicine evolve?**

Dr. B**: I was hindered from a career in surgery, causing a neck and arm condition that lead to chronic pain. That led me to where I am today. Much of my philosophy is guided by my personal experiences with severe pain and the failed treatments.

I became frustrated by poor treatment outcomes. For many pain conditions, traditional medicine included aggressive treatments and dangerous levels of medicines. Having no personal experience with marijuana use, I learned by listening to patients who found significant relief using cannabis. With further study, I realized the truth about cannabis and its potential to relieve suffering in a safe and effective manner.

What is cannabis medicine?**

Dr. B**: For the Pain Doc, cannabis medicine represents a naturopathic, legitimate alternative for treating chronic neuropathic pain and muscular conditions using a variety of cannabis based medicines.

The U.S. National Institutes of Health/National Cancer Institute states the known benefits include:

Antiemetic effects (effective against vomiting and nausea)
Appetite stimulation
Pain relief
Improved sleep
Symptom management
Direct antitumor effect
End of life care
Cannabis medicine focuses on treating a variety of medical conditions.

Are there risks?**

Dr. B**: There are risks to any treatment. Seldom headlined are the consequences of undertreated or untreated pain. According to the American Osteopathic Association, chronic pain “affects more Americans than cancer, diabetes, and heart disease combined.”

Patients and physicians should discuss potential negative effects. About 90 percent of my patients use very small amounts of cannabis, and learn quickly how to avoid problems. And like with any medication, I screen for the small minority of those who may be prone to misuse and addiction.

When an individual’s health problems are addressed by a qualified healthcare provider, risks, significantly less than traditional medications, are minimized.

Many say THC and CBD** transform pain signals between peripheral nerves, the spinal cord and brain. Do you agree?**

Dr. B**: Yes. At the 2013 American Academy of Pain Medicine meeting, Dr. Michael Moskowitz said, “preclinical studies, surveys, case studies and randomized double-blind placebo-controlled trials with cannabis have all shown its effectiveness in chronic pain conditions … Cannabis works to settle down the processing of wind-up (centralization) and is the only drug known to do so. It reduces inflammatory pain in the peripheral nerves, and has a unique mechanism for pain reduction unlike any other medicine.”

The complex interaction between innate opioid and cannabinoid systems is not well understood. But with effort and opportunity, we can unravel the mysteries of cannabis science.

How does MMJ stack up against other painkillers?**

Dr. B**: Studies show MMJ can be as effective as opioids. Many people are able to eliminate or significantly reduce their use of opioid pain pills. Cannabis also treats other problems associated with chronic pain, such as sleep, mood disorders, and myofascial spasms and pain, thereby reducing the need for additional medications that have potential side effects or drug interactions.

Is there a cultural transformation regarding MMJ?**

Dr. B**: Yes. This was most evident at a recent NIH symposium (Marijuana and Cannabinoids: A Neuroscience Research Summit) that took place in Bethesda this past spring, wherein, the medical use of cannabis was clearly discussed.

Over the past few years, we have all seen the direct medicinal effects of cannabis in the media by high profile people and entities. The most dramatic have been children with intractable seizures whose parents are directly challenging hostile politicians. The second group is our veterans with service-related conditions who find relief with medical cannabis use.

Patients, their love ones, and organizations have teamed up with activist physicians and political allies to challenge the status quo of government. The tsunami of change in every state has been accelerated by opioid related deaths.

How do you counsel patients?**

Dr. B**: The patient must have a qualifying condition according to the laws of Hawaii, where I practice. I expect patients to act responsibly and follow the laws that govern MMJ access and use. I discuss various delivery systems with my patients. The majority use inhalation delivery. Oils, edibles, and topical ointments are in strong demand. I have seen great results for autoimmune conditions using high CBD low THC cannabis based juice, which provides pain relieving, strong anti-inflammatory effects without psychogenic effects.

Our goal is to combine traditional multi-disciplinary therapies with our patient’s right to use medicinal cannabis to improve their outcome. (See An Elephant Called Pain.)

David J. Barton, MD is a clinician in Pain Medicine and a Medical Political Activist with more than 31 years of experience as a physician. He is fellowship trained in Pain Medicine, and became board certified in Pain Medicine by the American Board of Pain Medicine in 2005. Past board certifications include General Surgery (1992) and Plastic Surgery (1995). He is owner and founder of Hawaiian-Pacific Pain and Palliative Care and focuses his practice on chronic pain and end of life care. Dr. Barton has personally lived in the “Pain World” for nearly 20 years.

Celeste Cooper, RN, is a chronic pain patient, freelance writer, and contributor to the Health Central Community. She is also lead author of five published self-help books and enjoys writing and advocating for people living with chronic pain as a participant in a local patient leadership group and the PAINS Project. She is lead author of Integrative therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain and the Broken Body, Wounded Spirit: Balancing the See-Saw of Chronic Pain book series.  Connect with Celeste through her website, Twitter @FibroCFSWarrior, or follow her FB page:
Published On: Aug 1st 2016


For more on medical cannabis:

Dr. Steven Phillips Writing Book on Lyme and Bartonella Treatment


Dr. Phillips has closed his practice to new patients as the waiting list was 1.5 years long.  Wanting to focus on broader issues he hired a nurse practitioner and another doctor.

The important news for patients is he has come upon a treatment he feels is a durable remedy for late stage Lyme and bartonella and is raising money to study it in mice for proof.  After that he plans on writing a book about the process.

Dr. Phillips

He and Dana Parish have started a Q & A video series on Facebook to answer questions about Lyme, bartonella, and other co-infections.  Video 1

If you haven’t seen Dr. Phillips in action before, you are missing a real treat.  This man I can level the CDC in mere minutes.

Removing Parasites to Fix Lyme & Chronic Illnesses – Dr. Jay Davidson  Sept. 2017

by Dr. Jay Davidson

Article Summary

  • Parasites are more common than you might think. About 50% of the western world has parasites. Importantly, parasites can play a part in almost every common illness, and they can prevent the effective treatment of chronic disease.
  • Parasites can range from microscopic creatures, to huge tapeworms. Anyone can be affected by parasites, but there are some patients, such as those with poor immune systems and Lyme sufferers, who are more risk-prone.
  • The symptoms of parasites and Lyme are often very similar. It may be easy for many people to overlook the presence of a parasite in their body. Common symptoms range from insomnia and bruxism, to anemia, skin conditions, and more.
  • Parasites and Lyme disease go hand in hand. When parasites are within your system, it is impossible to remove Lyme. Some studies have even found that parasites can protect the bacteria of Lyme inside themselves.
  • Treating parasites can also mean treating chronic illness. Often, treatment for parasitic infections will begin with a careful consideration of diet. Make sure to remove grains, sugars, and pork from your diet. You should also consider adding substances like garlic, diatomaceous earth, and coconut oil.
  • One of the most powerful treatments for Lyme and parasites is Mimosa Pudica. This substance paralyzes parasites and flushes them from the system.
  • Management for parasite die-off will be necessary during a cleanse. Removing Lyme and parasites from your body can be an exhausting process.


It is difficult to think that there might be parasites crawling around inside you. The concept is nerve-wracking, and just plain disgusting. Experts believe that more than 50% of people in the Western world will suffer from a parasitic infection in their lifetime. It is easy to understand why this is the case when the human body is crawling with bacteria. The digestive tract holds more than three pounds of bacteria alone.

Although some bacteria can be good for your body, improving nutrient absorption and digestion, other bacteria can be devastating. When the bacteria in your system gets out of balance it creates a perfect place for parasites to thrive.

Parasites can enter your body in many ways and eating lot of fructose and glucose feeds the parasites helping them multiply. Pharmaceuticals, such as antibiotics, can also deplete the digestion system of bacteria and encourage parasitic growth.

For people with chronic Lyme, the problem is that they may not know they have a parasitic infection. This can mean that you are attempting to rid the body of disease while the parasites inside you are still acting as a host for Lyme disease itself. Researchers believe that parasites could play a part in every common illness. If you want to get rid of a chronic disease, you need to start by killing parasites.

The first step, of course, is recognizing that you have parasites in your body. The disturbing truth is that you probably do. Studies indicate that most people have parasites – especially those with chronic illnesses like Lyme.

The Symptoms of Parasites: What to Watch For


Parasites are complex creatures. Almost always associated with inflammatory diseases, including chronic Lyme, they actively prevent good health. A parasitic infection can range all the way from tiny microscopic organisms, to tapeworms that are several feet long. A parasite can enter your body through water, food, or even just skin contact.

The key thing to remember is that anyone can have a parasites. These creatures are not just common for impoverished countries and unhygienic environments. Parasites are a common all over the world, including the United States.There are factors that can mean you have a greater level of risk.

Factors that can increase your risk of parasite infection include:

  • You frequently swallow water from ponds, lakes, rivers, or other unhygienic sources.
  • Your immune system is compromised, perhaps because you’re suffering from chronic Lyme.
  • You work in a medical environment that might include direct contact with feces and bodily fluids
  • You travel frequently to tropical regions where parasitic infections are more common.

The symptoms involved with parasitic infections are varied. Many involve skin problems, such as hives, rashes, eczema, and psoriasis. According to Parasite expert, Dr. Todd Watts, one of the most common problems links back to trouble sleeping. Many of his patients suffer from insomnia and “bruxism”.

Bruxism, or the grinding of teeth, can happen because parasites are more active at night. Additionally, parasites can also be responsible for anemia and blood sugar problems. Before you begin treating your parasites, you may need to come to terms with some of the common symptoms. For chronic Lyme sufferers, pinpointing symptoms can be particularly difficult. Lyme symptoms and the signs of parasites are often very similar.

Some signs that you may have a parasitic problem include:

  • Insomnia, consistent fatigue, and poor sleeping habits
  • Lowered immune systems, the appearance of new allergies, and constant illness
  • Rashes, itching, and skin problems such as sores, or eczema and Psoriasis
  • Mental problems such as brain fog, anxiety, or depression
    Food cravings
  • Joint and muscle pains
  • Eye spots or difficulties with sight
  • Anemia, low blood sugar, or adrenal fatigue
    Parasites and Chronic Lyme Disease

It is an uncomfortable truth that the human body is crawling with hundreds of strains of bacteria. When properly balanced, the right bacteria can be beneficial. However, when bacteria falls out of balance, problems begin to occur. In chronic Lyme disease patients, imbalance is a significant problem. Ongoing inflammation within the body, and issues with the immune system can throw the entire system into chaos.

In many circumstances, parasites enter the body because we create the ideal environment for them. With a compromised immune system from Lyme disease, consistent gut problems, and exposure to various chemicals, we are welcoming parasites in. Experts, like Dr. Watts, believe that to overcome chronic infections such as Lyme, we need to first address parasites.

Interestingly, it is also worth noting that some parasites can house Lyme disease. In other words, if you do not remove the parasites from your system before treatment, you’ll still have protected Lyme bacteria in your system living inside of the parasites. One study, which examined the brain tissue of patients who died due to serious neurological conditions, revealed that Lyme can thrive within nematoid worms., and

Without a protocol that takes parasites into consideration, treatments for Lyme disease may be temporary, or completely ineffective. While it is possible that treatments that do not engage parasites might lead to some improvements in your symptoms, many problems will remain or return later on. This is because parasites allow Lyme disease to persist within the body, inside the parasites, even after treatment.

On top of the problems that parasites impose when it comes to Lyme, they also cause a range of problems in general with your health. Simply ignoring the presence of parasites in your body could mean overlooking solutions that could allow you to achieve optimum health.

Treating Parasitic Infections to Treat Chronic Illness

Treatment for parasitic infection can come in numerous forms. There are a range of natural treatments that can help to eliminate parasites and prepare the body for better health. Most of the time the best solutions for parasitic infections involve changing your diet and using the right supplement at the right time.

People suffering from parasitic problems in combination with Lyme can make the problem worse by consuming sugars. It is often recommended that you remove all sugars and grains from your diet during a parasitic removal so you are not feeding the parasites as you try to eliminate them. Dairy can also present problems for some patients, although you should seek out guidance from a professional.

Natural Solutions For Parasites:

Just as there are foods that can worsen parasitic infections, there are other foods that can help your circumstances. For instance, pumpkin seeds help to fight off parasitic infections. There are also a range of other solutions that are commonly recommended, including:

Garlic: Garlic can be a powerful solution when removing yeast and parasites. It is a natural source of health-boosting nutrients. To use garlic, simply mince two cloves into a glass of water.
Cinnamon: Cinnamon can be a fantastic remedy for a range of different illnesses. Cinnamon can break down a parasite infestation and kill fungus in the body.
Vitamin C: Vitamin C is wonderful for boosting your immune system. While fighting Lyme disease, Vitamin C can give your body the antioxidants it needs to thrive. For the purpose of parasite removal, it is best to take around 5,000mg per day.
Coconut oil: Coconut oil is a naturally nourishing anti-fungal substance. You can consume coconut oil throughout the day to support parasitic removal and soothe your gut.
Apple cider Vinegar: A rich source of B-vitamins, apple cider vinegar is useful for neutralizing the pH in your gut, which can help to make the intestines healthier. By boosting your microbiome health, you can improve digestion, and remove parasites at the same time.
Diatomaceous Earth: Effective at killing parasitic eggs, and parasites, Diatomaceous earth is great for improving your digestive tract.

Natural solutions

Foods To Avoid:
Banishing parasitic infections is a complicated process. Generally, you’ll need to focus on introducing positive substances into your diet, while removing dangerous substances. There are some foods that will naturally help parasites to thrive. Since your aim will be to remove parasites at all costs, stay away from:

Pork: Pork is one of the most common sources of parasites. Because pigs consume and process food differently to humans, there are toxins present within the flesh of the animal. It is crucial to avoid pork when cleansing your body of parasites.
Grains: Wheat and many other grains containing gluten can quickly break down into sugar. Sugar not only feeds parasites, but also leads to intestinal inflammation.
Processed foods: Processed foods are bad for your health because they contain a lack of nutrition. However, it is worth noting that these foods also contain a great deal of sugar.
Alcohol: Alcohol impairs the immune system and many other elements in the body. To improve your body functioning during a parasite cleanse, avoid alcohol.
Sugar: Sugar reduces the functioning of the immune system, and feeds parasites.

One of the best treatment solutions for removing parasites is a Mimosa Pudica (Para 1) protocol. The best supplier of premier, fat soluble, additive free Mimosa Pudica, is Microbe Formulas. Importantly, while there are other Mimosa Pudica options on the market, the Organic Mimosa Pudica offered by Microbe Formulas is the most pure form for treating parasitic infections.

Mimosa Pudica actively paralyzes parasites and forces them to fall away from their position on intestine walls. This means that parasites can be effectively flushed from your system.

With Mimosa Pudica, patients have seen huge improvements in their lives, thanks to the removal of parasitic infections. The good news about this substance, is that it is a powerful tool to include in any parasite protocol. This means that regardless of what your parasitic treatment includes, Mimosa Pudica (Para 1) could enhance your protocol.

The system fits into every GI and GAP protocol, because it helps to create a healthier gut microbiome. To make the gut system more effective, it is crucial to get all the mucus, parasites, and other dangerous substances out of your stomach and intestines. Whether mucoid plaque or parasites, you need to begin by clearing out your microbiome.

Mimosa Pudica supplements should be used for at least six months. The supplement mentioned above is particularly effective because it plays multiple parts in recovery. Not only does it bind the toxins in the body, but it also repairs cell membranes. On top of that, it delivers positive nutrients into the blood and digestive system.

Importantly, if you are considering using Mimosa Pudica, you will need to deal with issues of constipation first. If you’re struggling to pass bowel movements, this can be a serious problem for any parasite or detox program. Although the substance itself can cause a little constipation at first by releasing things throughout the body, it is important for patients to manage their bowel movements. Make sure that you use enemas, magnesium, and frequent water consumption to push your bowel movements through.

Managing Parasite Die-Off
As we bring this conversation about parasites and Lyme disease to a close, one important thing to mention is parasite die-off. Crucially, as you move forward with your parasite cleanse, you may notice that you begin to suffer from a range of symptoms caused by the death of parasites in your system.

Regardless of the cleanse you choose, the process of removing parasites and Lyme from your body is exhausting. It is crucial to make sure that you get plenty of rest. Sometimes its best to take some time off of work if possible to reduce stress and recover faster. On the other hand, you might consider using a gentler cleanse to help acclimatize your body. Some of the symptoms you might expect during die-off include:

Headaches: Pain and headaches are common with parasite die-off. Sometimes, these pains are a result of a change in your internal environment. In some cases, headaches can also be a result of parasites moving around in your head.
Crawling sensations: A parasite cleanse is an uncomfortable experience for your unwanted guests. This means that the parasites might begin to move around in your body. The truth is that many patients will not be able to feel this movement. However, you may convince yourself that you can notice a crawling sensation.
Issues with digestion: When parasites are living in your body, digestive problems are common. In some cases, as you begin to rid the parasites from your body, you might find that the symptoms appear to get worse. You may experience issues like diarrhea and bloating as your body eliminates toxins.
Skin sores: As mentioned above, skin problems are a symptom of parasites. However, sores can also occur when the body tries to remove toxins and parasites too fast. The skin can suffer from breakages and sores over time.
Problems with emotional stability: Parasites thrive on your nutritional income. A parasite can also steal away the nutrients and minerals that you need to enjoy good mental health. You might struggle from periods of anxiety and depression during die-off.
Cravings: As mentioned above, parasites thrive on sugars and other types of food. It is important to remove these foods from your diet during a parasite cleanse. However, doing so could leave you with specific cravings. Make sure that you do not give in to them!
Respiratory effects: Killing parasites in the body can mean that your system takes drastic measures to rid you of the infection. Increasing the flow of mucous is a common way to respond to contaminants. There’s a chance that you’ll experience respiratory symptoms similar to the common cold.
Frequent bruising: When parasites begin to feel threatened, they can move around. Sometimes, the restlessness of parasites in your body can cause them to move closer to the skin. When this happens, you might find that you see more bruises on your body.
Ultimately, it is fair to say that removing parasites from your body can be a difficult and uncomfortable process. However, if you want to overcome Lyme for good, it is essential to start by killing parasites.

If you leave parasites unattended in your body, they can contribute to a range of illnesses and diseases, including chronic Lyme. On top of that, it is simply impossible to live in good health with a buildup of parasites in your body.


More on Parasite treatment:

Dr. D. KLINGHARDT PROTOCOL – To be used only under the direct supervision of qualified medical practitioners.  
(systemic parasite medications)

The following represents only PART of Dr. K.’s protocol. Other herbs and therapies comprise the complete protocol. They can be found in the “A Deep Look Beyond Lyme” in the note book. That information is from 2011 and is being updated as Dr. K and other physicians learn more.

The following drugs are used for a year in rotation to kill parasites.

1. Biltricide 600 mg – twice daily (q. 12 hours) for two days
Absorption increases most when taken with a high carb meal. A high fat meal increases it almost as much. Take with grapefruit juice to increase absorption also.

2. Ivermectin 12 mg – one 12 mg (or four 3 mg) tablet(s) four times per day for fourteen days (take at the same time as Pyrantel Pamoate) on an EMPTY stomach.
Pyrantel pamoate (liquid – 4 teaspoons) 1000 mg per day at bedtime for fourteen days.

3. Albenza 400 mg – Two 200 mg tablets twice per day for fourteen days (after completing fourteen days on Ivermectin and Pyrantel). Take with food. (every 12 hours)

4. Alinia 1000 mg – Two 500 mg tablets twice per day for fourteen days (after completing Albenza) every 12 hours

(A’s addition from Dr. Clark’s Book – Levimasole 100 mg (3 times/day) before meals)


5. Mimosa Pudica (Biopure) – ½ teaspoon 2x/day for fourteen days mixed drink, milk or juice

6. Arteminisin (Biopure) – 200mgs 2x/day for fourteen days.
ALWAYS take with 4 oz. of grapefruit juice 30 minutes before meals.

REPEAT ENTIRE SEQUENCE 4 TIMES.  Nurse practitioner Rebecca Keith on Parasites and MCAS.

For another take please read this by Susan Luschas, PhD, and mom who has done a lot of footwork for her family:


“Dr. Klinghardt has suggested that when it comes to parasites, this is where some of the pharmaceutical options really shine and are often necessary.” –Quote from Better Health Our family had to learn this the very hard way (See 5 years and thousands of dollars in the previous section).

I no longer believe that you can get rid of parasites in humans without prescription medications. If I could do it all over again, here is a list of what I would do, in order from first to last:

Enemas to get a head start on worms
Kalcker Protocol for worms
Additional Parasite Medications for flukes, protozoans, and more worms
Gallbladder Liver Flush & Massage to flush out the dead ones
Suppositories if itchy bum  and  Excellent articles, both by Dr. Simon Yu, M.D.  Here we learn an inconvenient truth about nearly ALL coinfections including nematodes: Despite the prevalence of parasitic worms, anthelmintic drug discovery is the poor relation of the pharmaceutical industry. The simple reason is that the nations which suffer most from these tropical diseases have little money to invest in drug discovery or therapy. It comes as no surprise therefore that the drugs available for human treatment were first developed as veterinary medicines. There is thus a pitifully small repertoire of chemotherapeutic agents available for treatment (see Table 1). In some respects, this situation has been exacerbated by the remarkable success of ivermectin over the last twenty years (Geary, 2005), which has decreased motivation for anthelmintic drug discovery programmes (Geary, Sangster and Thompson, 1999). This prompts concern, as anthelmintic resistance has been widely reported in livestock and it may also only be a matter of time before this phenomenon occurs in parasites of humans.

The drug industry just isn’t attracted to these pathogens.  Frankly, treatment is in the stone ages on all things TBI.

For more on detoxing: