Archive for the ‘Treatment’ Category

How Are MS & Chronic Lyme Related?

Although this article is about MS, I wanted to post this information from Dr. Makis on fibromyalgia since both have many similar symptoms:  https://makismd.substack.com/p/ivermectin-and-fibromyalgia-testimonials?

In short, fibromyalgia patients are experiencing great relief, and even cure with ivermectin.  Many are stating their pain is entirely or nearly gone.  A few MS patients claim ivermectin cured their MS.

https://www.lymedisease.org/multiple-sclerosis-chronic-lyme/

How are multiple sclerosis and chronic Lyme related?

By Bill Rawls, MD

April 21, 2025

Multiple sclerosis (MS) is a disease where the immune system attacks the protective covering (called myelin) around nerves in the brain and spinal cord.

Myelin acts like an insulator to keep nerves from touching each other and shorting out, much like the plastic coating on a copper wire.

This damage disrupts nerve signals, leading to symptoms such as fatigue, muscle weakness, numbness, vision problems, and coordination difficulties.

Undoubtedly, plenty of people who identify as having chronic Lyme disease struggle with these same symptoms. And demyelination of nerves has been documented for Lyme disease. Beyond that, many people with MS test positive for Borrelia, the Lyme bacteria. So what distinguishes MS from chronic Lyme?

The answer: arbitrary cut-offs.

So how do we differentiate?

There is no single test that is specific for MS. The diagnosis of MS is made using a combination of clinical evaluation, imaging, such as MRI, and laboratory tests of blood and spinal fluid.

If all of the findings are deemed significant enough by the clinician evaluating the patient, then the diagnosis of MS is made and the patient qualifies for treatment.

This means that a person could have all of the symptoms, and some or all of the findings, but not to the degree that would qualify for a diagnosis of MS.

That person might end up being diagnosed with some other neurological condition, fibromyalgia, or maybe wouldn’t get a diagnosis at all. Chronic Lyme disease is unlikely because it isn’t a diagnosis recognized by the conventional medical community.

No diagnosis, no treatment. But maybe that’s not such a bad thing.

Getting to the root cause

There are numerous drugs for treatment of MS. They work by blocking inflammation or blocking the immune system’s assault on myelin. The benefits are marginal at best and they carry significant side effects.

What the drugs don’t do is address why the body is attacking myelin in the first place. Without getting to the root causes of the problem, patients typically don’t get well. They live in a compromised state of relying on medications to mask the symptoms of their illness.

When you start looking for underlying causes, you’ll find that MS is listed as multifactorial. In other words, it’s not one specific cause, but rather multiple variable causes. This is also true of other chronic illnesses, including chronic Lyme disease.

A review paper published in the 2023 edition of the journal, NeuroSci, cataloged some of the known risk factors for MS that may be causative. These risk factors can be grouped into five categories.

  • Diets rich in processed foods and saturated fat, but low in vegetables and fruit
  • Chronic mental stress with inadequate sleep
  • Smoking or chronic exposure to other toxic substances
  • Sedentary lifestyle
  • Certain myelin-scavenging microbes, including (but not limited to) Chlamydia pneumoniae, Epstein-Barr Virus (EBV), Human Herpesvirus-6 (HHV-6), Mycoplasma pneumoniae and other mycoplasma species, and Borrelia burgdorferi

While the review didn’t go as far as defining how these factors might come together to cause MS, it doesn’t take much imagination to figure out a possible scenario.

A plausible explanation for MS

Myelin is contained within specialized cells called oligodendrocytes, which wrap around the shaft of a nerve to insulate it. Each of these microbes are known to invade oligodendrocytes to scavenge myelin as a resource for replication. While this provides one possible link to MS, that’s not the end of the story.

Evidence shows that the microbes can go dormant inside an oligodendrocyte after they invade it. Intracellular dormancy is a common survival mechanism used by many host-dependent microbes. It has been documented for borrelia and all the Lyme coinfections. Dormancy allows microbes to survive when conditions aren’t favorable for growth — in other words, when the cells they’ve invaded are healthy.

When cells are weakened by chronic stress factors — poor diet, chronic exposure to toxic substances, unrelenting mental stress and poor sleep, being sedentary — dormant microbes are able to reactivate, consume the cell, and then emerge to infect adjacent cells.

The immune system reacts by attacking the oligodendrocytes where microbes are emerging, in the process compounding the damage.

This is also a plausible explanation for chronic Lyme disease. The question remains: Why do some people progress to more advanced symptoms that are ultimately defined as MS?

The answer may be genetics. A variety of genetic mutations are common among people diagnosed with MS. You can’t do anything about genetic mutations, of course, but you can do something about the root causes of the problem.

A natural solution for MS and chronic Lyme

One obvious part of the solution is minimizing stress factors that weaken cells. Not surprisingly, there are many documented cases of people who went into stable remission from MS after modifying their health habits.

Improved health habits alone, however, don’t completely address the microbe factor. Fortunately, there is one thing that does — and it’s not antibiotics or other drugs.

Certain medicinal herbs demonstrate antimicrobial and immunomodulating properties that offer the potential for an ideal solution to support recovery from MS. They are already used widely for chronic Lyme disease and supported by sound evidence.

Among numerous studies, a study from Johns Hopkins University showed that certain herbs — cryptolepis, Japanese knotweed, and Chinese skullcap — were more effective for killing Borrelia than antibiotics.

Unlike an antibiotic, however, which is a single chemical agent specific for only certain microbes, an herb contains hundreds of chemical substances that act as a chemical defense system against a wide range of microbes, including bacteria, viruses, protozoa, and yeasts.

Never just one

This is important because it’s never just one microbe possibility. People identifying as having chronic Lyme disease typically test positive for co-infections. Chronic Lyme co-infections associated with demyelination include Chlamydia pneumoniaeEpstein-Barr Virus (EBV), Human Herpesvirus-6 (HHV-6), Mycoplasma pneumoniae and other mycoplasma species.

But these are just the ones that have been identified so far — there are probably many others.

Combining multiple herbs extends the range of coverage. This is possible because the potential for toxicity of the most commonly used herbs in Lyme protocols is inherently low.

Medicinal herbs and mushrooms that are commonly included in chronic Lyme protocols that could also be beneficial for MS recovery include:

  • Japanese knotweed (Polygonum cuspidatum)
  • Cat’s claw (Uncaria tomentosa)
  • Chinese skullcap (Scutellaria baicalensis).
  • Cryptolepis (Cryptolepis sanguinolenta)
  • Andrographis (Andrographis paniculata)
  • Reishi (Ganoderma lucidum)
  • Cordyceps (Cordyceps sinensis)
  • Berberine or berberine-containing herbs
  • Red sage (Salvia miltiorrhiza)
  • Rehmannia (Rehmannia glutinosa)

Very importantly, the complex chemistry of herbs and medicinal mushrooms also protects cells from a wide range of toxic threats, including free radicals, foreign toxic substances, and harmful radiation. This applies to all cells in the body, including cells that make up the nervous system.

Immunomodulators

The medicinal herbs and mushrooms listed are classified as immunomodulators, meaning they upregulate underactive parts of the immune system and downregulate overactive portions of the immune system. This is important for reducing inflammation and calming the autoimmune response.

A final advantage of antimicrobial herbs is specificity for pathogens. The antimicrobial properties of herbs and medicinal mushrooms are selective for pathogens, but do not disrupt normal flora in the gut and other areas of the body.

Low toxicity and low potential to disrupt the gut microbiome means that herbal therapy can be used for extended durations, months or even years, which is often what it takes for complete recovery.

What this all means is that therapy — with a targeted endpoint of wellness, not managed illness — can be started with or without having a formal diagnosis.

With over 30 years of medical experience, Dr. Bill Rawls specializes in the holistic treatment of chronic illnesses, particularly Lyme disease. His personal journey with Lyme disease inspired his mission to empower others with the knowledge and tools needed to regain their health naturally. Learn more about Dr. Rawls’ approach to treating chronic illness with herbal therapy at RawlsMD.com.

References

An X, Bao Q, Di S, et al. The interaction between the gut microbiota and herbal medicines. Biomed Pharmacother. 2019;118:109252.

Anderson C, Brissette CA. The Brilliance of Borrelia: Mechanisms of Host Immune Evasion by Lyme Disease-Causing Spirochetes. Pathogens. 2021;10(3):281.

Berer K, Mues M, Koutrolos M, et al. Commensal microbiota and myelin autoantigen cooperate to trigger autoimmune demyelination. Nature. 2011;479(7374):538-541.

Bjornevik K, Münz C, Cohen JI, Ascherio A. Epstein-Barr virus as a leading cause of multiple sclerosis: mechanisms and implications. Nat Rev Neurol. 2023;19(3):160-171.

Branton WG, Lu JQ, Surette MG, et al. Brain microbiota disruption within inflammatory demyelinating lesions in multiple sclerosis. Sci Rep. 2016;6:37344.

Eisenreich W, Rudel T, Heesemann J, Goebel W. Persistence of Intracellular Bacterial Pathogens-With a Focus on the Metabolic Perspective. Front Cell Infect Microbiol.

Feng J, Leone J, Schweig S, Zhang Y. Evaluation of Natural and Botanical Medicines for Activity Against Growing and Non-growing Forms of B. burgdorferiFront Med (Lausanne). 2020;7:6.

Fritzsche M. Chronic Lyme borreliosis at the root of multiple sclerosis–is a cure with antibiotics attainable? Med Hypotheses. 2005;64(3):438-448.

Greening C, Grinter R, Chiri E. Uncovering the Metabolic Strategies of the Dormant Microbial Majority: towards Integrative Approaches. mSystems. 2019;4(3):e00107-19.

Ivanova MV, Kolkova NI, Morgunova EY, et al. Role of Chlamydia in multiple sclerosis. Bull Exp Biol Med. 2015;159(5):646-648.

Kriesel JD, et al. Spectrum of Microbial Sequences and a Bacterial Cell Wall Antigen in Primary Demyelination Brain Specimens Obtained from Living Patients. Sci Rep. 2019 Feb 4;9(1):1387.

Landry RL, Embers ME. The Probable Infectious Origin of Multiple Sclerosis. NeuroSci. 2023;4(3):211-234.

Libbey JE, Cusick MF, Fujinami RS. Role of pathogens in multiple sclerosis. Int Rev Immunol. 2014;33(4):266-283.

Livengood JA, Gilmore RD Jr. Invasion of human neuronal and glial cells by an infectious strain of Borrelia burgdorferi [published correction appears in Microbes Infect. 2015 Jun;17(6):e1]. Microbes Infect. 2006;8(14-15):2832-2840.

Pender M. The essential role of Epstein-Barr virus in the pathogenesis of multiple sclerosis. Neuroscientist. 2011;17(4):351-367.

Rittershaus ES, Baek SH, Sassetti CM. The normalcy of dormancy: common themes in microbial quiescence. Cell Host Microbe. 2013;13(6):643-651.

Thakur A, Mikkelsen H, Jungersen G. Intracellular Pathogens: Host Immunity and Microbial Persistence Strategies. J Immunol Res. 2019;2019:1356540.

Toledo A, Benach JL. Hijacking and Use of Host Lipids by Intracellular Pathogens. Microbiol Spectr. 2015;3(6):10.1128/microbiolspec.VMBF-0001-2014.

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**Comment**

A few points:

  • The Johns Hopkins study was in vitro, or the lab, which may not transfer over to the human body.
  • Antibiotics of daptomycin, doxycycline, and cefuroxime were used as controls at a final concentration of 5 μg/ml.  I’m not sure how this translates to oral dosages given patients, but according to Burrascano, dosages matter greatly.  It could be that these dosages were not high enough.
  • Doxy is a great front-line drug due to its action against many coinfections, but it is not the best and only drug to treat Lyme disease.
    • Eva Sapi found that while the use of doxy reduced spirochetal structures ~90%, round body forms increased about twofold.What this means is these round forms will simply lie and wait until conditions are better to reemerge. She found that tinidazole was the only antibiotic that reduced viable organisms by ~90%.  Recent research showed piperacillin effectively cured mice of Lyme at a dose 100 times smaller than doxycycline with virtually no impact on resident gut microbes.
So, for anyone paying attention, doxy has its limitations and all experienced Lyme literate doctors use multiple antibiotics in a combination therapy.

This, right here, is why mainstream medicine and research are worthless because this complex illness is treated as a one pathogen, one drug illness when typically more than one pathogen involved, and to complicate it further, the pathogens have multiple forms (pleomorphism) and strains that need to be addressed.

  • Daptomycin is an antibiotic that has been utilized recently in combination therapies. In a study through Johns Hopkins, when combined with doxycycline and ceftriaxone, daptomycin effectively cleared Lyme disease infection in vitro as well as in mice. However, daptomycin is relatively expensive and only available intravenously.  Notice it’s effectiveness is due to being used in a combo therapy.  I would say this is true of ALL antibiotics and why single antibiotics were not successful in the Johns Hopkins study Rawls refers to.
  • While cefuroxime has been found to have a minimum bactericidal concentration (MBC) similar to doxycycline; out of three borrelia species tested, two were susceptible while the third (borrelia hermsii) was less susceptible. The three antibiotics with similar MBCs in vitro, i.e., cefuroxime, doxycycline, and amoxicillin, demonstrated comparable activities in preventing borreliosis in B. burgdorferi-challenged hamsters (50% curative doses = 28.6, 36.5 and 45.0 mg/kg, respectively). So cefuroxime is far from perfect either when used alone.  Source

Using single antibiotics is really doing an injustice to what is known about successful treatment for Lyme since tindy is the most effective drug overall and combination drug protocols are by far the most effective.

Please remember too that Dr. Rawls manufactures and sells herbs and is financially compensated.

Don’t misunderstand – I’m not opposed to herbs.  I’ve used many myself and know of patients who have done well on them.  I just don’t want you to believe they are perfect or the only answer, either.  It takes everything AND the kitchen sink for this crap so keep an open mind.  And herbs are not harmless – there are interactions with other drugs as well as toxicity.

Nothing is ever simple.

For more:

Why Doctor Treated Patient for Lyme – Even When His Test Was Negative

https://danielcameronmd.com/treated-lyme-negative-test/

Why I Treated Him for Lyme—Even When His Test Was Negative

May 13, 2025

Patients Deserve an Explanation

One of the most common—and most important—questions I hear from patients is:
“If my Lyme test is negative, why are you still treating me?”

It’s a fair question. And if you’re asking it, you deserve a clear and compassionate answer. The truth is, when it comes to Lyme disease, test results don’t always tell the full story.

Let’s break down why.


Lyme Disease Testing Isn’t Always Reliable

The standard test used to diagnose Lyme disease is called the two-tier system. It includes an ELISA screening test followed by a Western blot if the first result is positive. But this system is far from perfect—especially when the infection is in its early or late stages.

Here’s what you should know:

  • Early in the infection, your body may not have produced enough antibodies yet to trigger a positive result
  • Some patients never produce detectable antibodies at all
  • Co-infections like Babesia or Bartonella are not picked up by this test
  • Many rashes don’t appear in the textbook “bulls-eye” pattern—or don’t appear at all
So yes—you can absolutely have Lyme disease, even if your test is negative. And unfortunately, this is more common than many realize.

In Medicine, We Don’t Wait for Disease to Get Worse

In most areas of healthcare, we don’t wait for a serious event before we start treatment.

  • We don’t wait for a stroke to treat high blood pressure
  • We don’t wait for vision loss to manage diabetes
  • We don’t wait for full organ failure to address chronic kidney disease

We act early—because we know that early treatment improves outcomes. So why does Lyme disease often get treated differently?

When it comes to Lyme, many patients are told to “wait and see”—even when the symptoms are clear and distressing.

Waiting Is Not a Neutral Decision

Here’s what I tell my patients:
Waiting is not harmless. It’s a medical decision with consequences.

Delaying treatment can allow symptoms to worsen. It can allow the infection to persist or spread. In some cases, patients who were told to wait eventually end up with a label: Post-Treatment Lyme Disease Syndrome (PTLDS)—a condition where symptoms linger long after the initial infection was treated, or in some cases, never properly treated at all.

What if we had treated earlier? Could we have prevented months—or even years—of suffering?

In many cases, the answer is yes.


Clinical Judgment Is Not Guesswork

When I decide to treat someone for Lyme disease despite a negative test, it’s not a random decision. It’s based on:

• The full pattern of your symptoms

• Your medical history

• Your response to prior treatments

• Known or likely tick exposure

• And experience with thousands of Lyme patients

This is called clinical judgment. It’s a core part of good medical practice. I don’t ignore science—I apply it in context. Because Lyme doesn’t always follow the rules, and neither should we when those rules are failing real people.


You Know When Something Feels Wrong

I’ve met patients who’ve been told their symptoms are “just stress” or “hormonal” or “all in their head.” But they know their bodies. They’ve tracked their fatigue, their joint pain, their cognitive changes. They’ve seen something shift—and they’re right to speak up about it.

Many of those patients improve once treatment begins, even if their test results never confirmed the diagnosis. That’s not luck. That’s Lyme disease showing up in real life—even when it doesn’t show up in the lab.


It’s Time to Rethink How We Treat Lyme

We’re in a new era of medicine. Patients are more informed, more proactive, and more in tune with their own health than ever before. But too often, our Lyme diagnostic standards are stuck in the past—waiting for certainty while people lose months or years of their lives to untreated illness.

We need to bring clinical judgment back into focus. We need to listen more, wait less, and treat Lyme disease with the urgency it deserves.


Final Thoughts

If you’ve been told your test is negative, but you’re still struggling with symptoms—please know this:
You’re not imagining it. You’re not overreacting. And you’re not alone.

In my practice, I treat the whole patient—not just the lab result. Because when it comes to Lyme, early treatment can change everything.


Want to learn more? Follow my blog series for more insights on Lyme disease diagnosis and care—or reach out to my office if you’re looking for answers.
You deserve to be heard.

Related Articles:

Relying on a negative Lyme disease test can prove deadly

Don’t wait for a positive Lyme disease test

Can’t trust single dose of doxycycline to prevent Lyme disease

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**Comment**

A very needed article with crucial information for all to understand.

Testing for Lyme/MSIDS is abysmal Clinical judgement is required; however, doctors receive little training for tick-borne infections and whatever training they do receive is antiquated and biased.  The fact the needle hasn’t budged in 40 years is proof of this fact.

Dr. Cameron is an example of an independent doctor who could save your life.  He’s also a Lyme-literate doctor who has studied under ILADS and who has years of experience treating this.  Like many of his colleagues, he’s been attacked by the state medical board – which is common for these doctors because they do not partake in the globalist idea for ‘consensus-based’ medicine – which turns doctors into robots who blindly follow dictates from bureaucrats who are profiting from conflicts of interests including patents, drugs, and other metabolomics. 

Due to the horrific lack of education on all things Lyme/MSIDS, there is a parallel group to the tyrannical IDSA (Infectious Diseases Society of America) called ILADS (International Lyme and Associated Diseases Society) which holds their own medical conferences to educate doctors on what is happening in reality with Lyme/MSIDS and through independent, global research that the IDSA simply ignores or maligns. Their next conference, “The Complexity of Lyme: Diagnosing and Treating Tick-Borne and Related Diseases,” is June 7-8 in Philadelphia.

Our conference will include:

  • Introduction to diagnosing and treating vector-borne diseases
  • Case discussions with experts
  • Advanced topics in clinical treatments such as PANS/PANDAS, Mold toxicity, MCAS, supportive natural therapies and more.
  • Exhibitors showcasing medical services
  • CME credit available

The conference is open to healthcare professionals. Students enrolled in a medical degree program and PhD candidates conducting Lyme-related research are also eligible to attend and qualify for discounted rates. Email conference@ilads.org for more information.

‘Must Hear’ Dr. Hatfill Interview

http://  Approx. 1 Hour

Dr. Steven Hatfill Blows Whistle on COVID Treatments, Gene Therapy Injections, and Research Fraud

“They lied!”

Podcast by Dana Parish

May, 2025

This is one of the most shocking interviews I’ve ever done. Dr. Steven Hatfill, renowned virologist, bioweapons expert, author, and senior scientific adviser to HHS, joins me to reveal the debacle behind COVID, the ‘vaccine,’ early treatments, and what really happened behind the scenes during the pandemic.

Hatfill was wrongfully accused of the anthrax attacks in the early 2000s and later exonerated, earning a multi-million dollar settlement from the US Government. But that didn’t stop him from stepping back into the fire. During the first Trump administration, he became a fierce advocate for early COVID treatment while the mainstream medical establishment tried to silence him.

In this episode, he lays out the evidence on how COVID was bioengineered, early treatments were suppressed, the vaccines were entirely misrepresented, and much more.

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**Comment**

No, you are not losing your mind.  I’ve posted this podcast before here:  https://madisonarealymesupportgroup.com/2025/05/14/study-confirms-covid-shots-laced-with-cancer-causing-dna/

I just felt it important enough to repost as some might have missed it.

And you don’t want to miss this one.

Dr. Hatfill answers all of Parish’s questions humbly and honestly.  I’m happy to report that everything posted on this website on the COVID chapter aligns with what Dr. Hatfill says in this interview.  I am indebted to doctors and researchers who shared prolifically on Linkedin early on.  Many of these experts are retired or not employed by the government and could speak freely.  Unfortunately, one by one, Linked in kicked these truth-tellers off the platform until one day I too was ‘disappeared.’  

Shame on platforms for censoring experts sharing information that could have saved lives.

The entire COVID chapter was mishandled from the start and there’s many people and organizations who need to be brought to justice over the fraud, deceit, and damage done in virtually every area.

And now, the IPAK-EDU White Paper 2025-ENDEUA states that when corrected efficacy curves and suppressed risks are taken into account, the mRNA covid shots fail the EUA standard.  The shots were based upon interim data from large-scale Phase III trials. The legal standard under §564 of the Federal Food, Drug, and Cosmetic Act requires that a product may be authorized for emergency use only if it is “reasonable to believe” that the product “may be effective” against a life-threatening condition, that the known and potential benefits outweigh the known and potential risks, and that no adequate alternatives are available. This report demonstrates, through a rigorous retrospective analysis, that these criteria were never met.

Trust me when I say, you need to hear this interview.  Please also share this widely, particularly to those who are still in the dark or need to hear it from an ‘expert.’  Hatfill knows his stuff.

For articles on the many topics Hatfill covers:

COVID is lab made:

Suppression of early, successful treatment:

How spike protein behaves in the body:

Is the shot gene therapyYES

Why was mRNA the government choice for COVID?

    • There are 9,613 patents licensed to giants in biotech and the US government
    • BARDA and DARPA have had a torrid love affair with mRNA for decades
    • retrospective cohort study found the US government invested at least $31.9B to develop, produce, and purchase mRNA covid-19 shots, including sizable investments in the three decades before the pandemic through March 2022. 
    • While the study claims “millions of lives were saved,” the truth is the experimental, COVID gene therapy injections saved ZERO lives.

Links between COVID shots & Cancer

Nasal sprays to prevent COVID:

Persecution of doctors & health professionals who defied the global narrative:

FDA’s War on America’s Health

https://www.midwesterndoctor.com/p/the-fdas-war-on-americas-health?

The FDA’s War On America’s Health

Why do so many innovative therapies never see the light of day

Story at a Glance:

The FDA was established in 1906 in response to public concern over unsafe food and drugs, such as spoiled food and counterfeit products. However, food industry lobbyists gradually gained influence, leading to the removal of the agency’s original leader. As a result, numerous harmful food additives were granted “generally recognized as safe” (GRAS) status and continue to be used today.

•In 1962, the FDA was given broad powers to oversee drug safety following the thalidomide incident. Unfortunately, the new regulations created strict standards for drug efficacy that were often selectively enforced, benefiting the pharmaceutical industry. Unfortunately, the FDA increasingly targeted natural therapies, which led to many being erased from history.

•Despite numerous attempts to reform the agency, issues of inefficiency and bias within the FDA persist. This article examines these challenges and suggests potential reforms to improve the agency’s role in safeguarding public health.

For most of my life, I’ve observed the FDA belligerently suppress natural treatments and any unorthodox therapy which threatens the medical monopoly while simultaneously railroading through a variety of unsafe and ineffective drugs regardless of how much public protest the agency meets.

(See link for article and videos)

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**Comment**

Please share and record this important history or it will be scrubbed and lost forever.

Like most government agencies, the FDA began well and good in the 1800’s due to unscrupulous food producers as well as medicines with secret ingredients like opium and alcohol.  But, even from the get-go, the food and pharmaceutical industries were powerful and fought as lobbyists using legal tactics. The first Director of the Bureau of Chemistry, and thus the fist head of the FDA, actually resigned realizing he could do more as a private citizen than within government.  

The article goes into life-saving treatments vilified by the FDA as well as ‘vaccine’ cover-ups, and disastrous drug approvals.

For more:

Lyme Disease With Decrease in Reflexes

https://danielcameronmd.com/lyme-disease-hyporeflexia/

Lyme Disease with Weakness and Hyporeflexia

April 22, 2025

This case involved a 25-year-old woman who experienced progressive numbness and tingling, beginning in her torso and eventually affecting her entire body. Over a four-week period, her neurological symptoms worsened, including a decrease in her reflexes (hyporeflexia), prompting her to seek care at a neurology clinic. Notably, she lacked the hallmark features typically associated with Lyme disease.

Instead, her clinical presentation was dominated by decreased reflexes (hyporeflexia) and sensory disturbances. Symptoms initially localized to the hypogastric region gradually radiated to her back and extremities.

“The numbness and tingling began on the right side of her stomach and radiated to her back and later spread to her entire body. The tingling was not associated with any burning or pins-and-needles sensation,” the authors wrote.¹


Alarming Progression of Symptoms

The symptoms significantly impaired her daily functioning, including her ability to care for her child.

“She especially became alarmed when she could not hold her toddler anymore and ended up dropping the child secondary to her numbness and tingling,” the authors reported.


Neurological Findings

A motor examination revealed:

  • Decreased muscle tone, more pronounced in the upper limbs (3/5 strength) than in the lower limbs (4/5 strength)
  • Hyporeflexia in the biceps, triceps, patellar, and Achilles tendons

Diagnostic Workup

A lumbar puncture revealed an elevated protein concentration in cerebrospinal fluid (148 mg/dL; normal range: 15–60 mg/dL), suggesting central nervous system involvement. The diagnosis of Lyme disease was confirmed via Western blot testing.


Comparison to Logigian and Steere’s Findings

This case contrasts with findings from the 1990 study by Logigian and Steere published in The New England Journal of Medicine, which evaluated 27 patients with chronic neurologic Lyme disease. In that study, 25 of 27 patients (93%) had normal CSF results, including normal protein levels and no pleocytosis.²

This discrepancy underscores a key point: while CSF abnormalities may support the diagnosis of neurologic Lyme disease, their absence does not rule it out. The variability in neurological presentations highlights the importance of clinical judgment.


Treatment and Outcome

The patient was initially treated with intravenous ceftriaxone for three days, followed by oral doxycycline. Her response to treatment was both rapid and substantial. Upon discharge:

• She regained full spontaneous movement in all extremities.

• Her gait had normalized.

“At the time of discharge, the patient was able to move all extremities spontaneously and ambulate with a normal gait,” the authors noted.


Four Key Discussion Points
1. Neurological Manifestations of Lyme Disease

This case reinforces the importance of recognizing the diverse neurological presentations of Lyme disease. As shown in the Logigian and Steere study, the absence of CSF abnormalities is not uncommon in chronic neurologic Lyme. Clinicians should consider Lyme disease even when classic signs are absent.

2. Role of Lumbar Puncture in Diagnosis

Although this patient had elevated CSF protein levels, many patients with neurologic Lyme disease may have normal CSF results. This highlights the need to use a combination of clinical history, physical exam, and serological testing to make the diagnosis.

3. Timely Diagnosis and Treatment

Despite a delay in diagnosis, the patient responded well to antibiotics. The treatment regimen—IV ceftriaxone followed by oral doxycycline—is effective in managing Lyme neuroborreliosis.

4. Impact on Quality of Life

The patient’s neurological symptoms significantly affected her ability to care for her child. Early recognition and treatment are vital to restoring function and preserving quality of life.


Conclusion

Timely diagnosis and treatment of Lyme neuroborreliosis can lead to excellent outcomes, even in patients with atypical presentations. This case emphasizes the importance of clinical awareness and early intervention in restoring function and providing reassurance.


References
  1. Semy R, et al. Lyme Disease Presenting With Interesting Neurological Features of Weakness and Hyporeflexia: A Case Report.
  2. Logigian EL, Kaplan RF, Steere AC. Chronic neurologic manifestations of Lyme diseaseN Engl J Med. 1990;323:1438–1444.