Archive for the ‘Treatment’ Category

The End of Compounded Hormones? Please Contact Your Representatives & Senators

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Have you benefited from Compounded Bioidentical Hormone Replacement Therapy (cBHRT)? If so, you won’t be happy with what the FDA is planning.

The FDA has never been a fan of pharmacy compounding, but now it is making a move that could keep millions of people like you from using this critical therapy.

Here’s the deal:
Last year, the agency commissioned the National Academies of Sciences, Engineering, and Medicine (NASEM) to conduct a study of cBHRT. The study ignored vast amounts of clinical evidence of its current effective use. But not surprising, NASEM recommended that cBHRT be severely restricted—which is exactly what the FDA paid it to say. The NASEM committee was composed of medical professionals with sterling credentials. However, none of the committee members has any clinical expertise or experience treating  women or men with compounded hormones, and no experts on compounding were on the committee!

Never mind that tens of thousands of providers prescribe, and millions of Americans use cBHRT every day and rely on it. Never mind that the study didn’t find any significant negative effects cBHRT. Oh, and never mind that the NASEM study didn’t even ask the basic question: Does cBHRT work for patients? (It does. Very well.)

And now:
The FDA is using that study—yes, the one it paid for—as an excuse to consider limiting compounded hormone therapy by adding the entire class of medication to its so-called “too-difficult-to-compound list. Under federal law, the FDA does have the authority to place individual medications but not entire classes of drugs to this list. And there must be clear evidence of safety issues.

You read that right: If you use cBHRT, these medications may no longer be available to you. 
A bi-partisan group of members of the U.S. House of Representatives, Mark Pocan (D-WI), Jaime Herrera-Beutler (R-WA), Henry Cuellar (D-TX), and Phil Roe (R-TN) have written a letter to the FDA commissioner, asking that the agency not limit cBHRT. 

You can help cBHRT by asking your member of Congress to sign this letter!

We’ve made it easy for you.

https://www.savemycompounds.com/take-action/?  Go here to take action.

We’ll match you with your House Representative and Senators and provide pre-written messages that you can customize. (If your Representative is a sponsor of the letter, you’ll be thanking him or her for doing so!) Please act right now.

Category:

Activism, Treatment

Anthony Fauci: 40 Years of Lies From AZT to Remdesivir

**UPDATE**

Adding insult to injury, Open the Books via a FOIA request exposed that for the past two years Dr. Fauci has received $15 MILLION in taxpayer-funded security detail despite having returned to private citizenship.  This contract could be extended, and it is unknown if it has already been extended.

https://off-guardian.org/2020/10/27/anthony-fauci-40-years-of-lies-from-azt-to-remdesivir/

Anthony Fauci: 40 Years of Lies From AZT to Remdesivir

October 27, 2020

As the planet’s “Virus Tsar” since 1984, he has spread misinformation and ignored critical questions. The consequences could hardly be more fatal.

By Torsten Engelbrecht & Konstantin Demeter

Last week, US president Donald Trump committed a kind of blasphemy by attacking Anthony Fauci, his pandemic consultant and practically the spokesperson for the White House regarding COVID-19, saying that:

People are tired of hearing Fauci and all these idiots. He’s been here for 500 years.  Fauci is a disaster. If I listened to him, we’d have 500,000 deaths.“

A remarkable statement of historical dimension, since Trump is the first American head of state to cast doubt on Fauci, who has acted as the virus tsar for no less than six presidencies: Reagan, Bush, Clinton, Bush Jr., Obama and Trump. (See link for article)

___________________

**Comment**

You probably recognize the name of Torsten Engelbrecht as I’ve posted numerous times on how his “must read” book, “Virus Mania:  How the Medical Industry Continually Invents Epidemics,  Making Billion-Dollar Profits at Our Expense,” prepared me for what we are going through today.  Engelbrecht has been onto the virus scam for a long, long time.  Explanation of book here:  https://www.torstenengelbrecht.com/en/virus-mania/  Highly recommended reading.  

The article might seem unduly rough, but you must understand COVID-19 is not Anthony Fauci’s first rodeo.  The singular big cahoona at NIAID for 7 presidencies, Fauci is the gatekeeper to research funding and has more power than one man should ever be given.  

Recently, the public has been shown the antics of Dr. Fauci, aka, Dr. Evil:

  • Fauci’s funding of AIDS drug trials in orphans which included forced feedings through nasal and gastric tubes which caused organ failure, deformities, brain damage, and killed 200 children.  Fauci demanded adherence at all costs, even the children’s’ well being.  No testing was used to even confirm if the children had HIV.  When parents withdrew consent, the child was removed and placed in a foster home that would comply. 
  • Fauci’s funding of beagle puppy experimentation which severed their vocal cords so they couldn’t bark, covered their heads in mesh boxes, and allowed flies to eat their faces off.
  • Fauci’s funding of experiments implanting aborted fetal scalps onto lab rats and hamsters.
  • Fauci’s funding of $2 Million to force feed puppies with experimental allergy drugs.
  • Fauci’s funding of $205,000 to create transgender monkeys.
  • Fauci’s funding of $2.5 Million injecting puppies with cocaine.
  • Fauci and his wife were worth $11M at the end of 2022, up from $7.9M in 2019.  
  • $350 Million in secret payments were given to Fauci, Collins, and NIH scientists.
  • Besides 
  • Go here for Dr. Evil’s historical playbook.

Here’s a bullet point summary of the article, although I highly recommend reading the entire article:

  1. Not wearing a face mask has not lead to a single, extra death:  https://madisonarealymesupportgroup.com/2020/11/12/fauci-states-covid-test-has-a-fatal-flaw-back-in-july-just-like-he-said-face-masks-were-useless-back-in-may/
  2. The COVID-19 death rate shows the viral cause for excess mortality is virtually impossible.
  3. Fauci has been telling one lie after another for decades with a complicit mass media regurgitating his lies:  https://madisonarealymesupportgroup.com/2020/08/29/every-breath-you-take-every-move-you-make-the-who-is-watching-you-the-media-is-bought-out-by-gates/
  4. Fauci has a long habit of silencing and ignoring critical questions.
  5. In order to understand the abundance of lies one has to understand that PCR tests are scientifically meaningless in detecting so-called SARS-CoV-2 infections, that according to orthodox researchers COVID-19 is not excessively dangerous, and those referred to as COVID-19 victims probably did not die of it, but of non-viral factors and serious underlying diseases.
  6. The viral narrative has become a fairy-tale:  https://madisonarealymesupportgroup.com/2020/12/07/ten-fatal-errors-scientists-attack-paper-that-establish-global-pcr-driven-lockdown/
  7. The beginning of the fairy-tale; however, started with AIDS when “virus hunters” enjoyed god-like status accomplished by lies and deceit:  https://madisonarealymesupportgroup.com/2020/03/16/does-the-coronavirus-exist/
  8. 50 million were persuaded to get vaccinated during the 1976 swine flu SCAM, which resulted in severe side-effects including paralysis and death in 20-40%:  https://madisonarealymesupportgroup.com/2020/08/22/the-2009-swine-flu-scam-murderous-anthony-fauci-betrays-public-trust-again/
  9. Due to “unsettled political waters” at the end of the 70’s, the NIH and CDC, “increasingly needed a major epidemic to justify its existence,” according to Red Cross office Paul Cumming.  The HIV/AIDS theory was just the ticket.
  10. According to Kary Mullis, the inventor of the PCR, “All the old virus hunters from the National Cancer Institute put new signs on their doors and become AIDS researchers.”  All of a sudden everyone was fully employed, including Robert Gallo who just happened to need a new career at the time.
  11. AIDS research started with big lies, specifically Gallo’s announcement that “the probable cause of AIDS has been found.”
  12. After he filed a patent application for an antibody test, Gallo’s papers were printed, so nobody was able to review his work for a time, which is a severe breach of professional scientific etiquette.
  13. Review later showed Gallo’s studies did NOT prove the virus thesis.
  14. Kary Mullis is quoted as stating Montagnier, Gallo, nor anyone else has published papers describing experiments which leads to the conclusion that HIV probably causes AIDS.  Mullis personally asked Montagnier for a reference proving HIV causes AIDS but he couldn’t name one.
  15. When Engelbrecht asked Fauci and NIAID several times for such a study, he was told, “Dr. Fauci respectfully declines to respond to the questions that you emailed.”
  16. This failure to respond to scientific questions is typical of misconduct cases and “runs like a golden thread through Fauci’s 36-year history as director of the NIAID.”  Please see original article for specific examples – and there are many.
  17. The approval of AZT, the 1st authorized AIDS medication, is a perfect example, as many labeled the study it was all based upon a “fraud,” “a gigantic botch-up,” and “seriously flawed.”  Even a FDA toxicologist analyst stated there was insufficient data to support approval of AZT.  Please refer to the original article for the study’s many flaws.  Stopped after four months, the study was financed by AZT manufacturer Wellcome, which is now GlaxoSmith Kline. (All of this is quite reminiscent of what is currently happening with Remdesivir which recently obtained EUA approval for COVID-19 despite lack of results)
  18. Fauci only appears in the media when critical questions are not asked. On the rare occasion when he was asked why AZT was the only drug available he stated numerous lies: “that it was safe”, “that there have been scientifically controlled trials”, and that “it’s effective”.  AZT is a highly toxic drug, the FDA trials were not scientifically controlled, and about the only thing AZT is effective for is destroying bone marrow.  Even the creator of AZT “dumped it on the junk pile, didn’t keep the notebooks, and didn’t even think it was worth patenting.”
  19. Despite Fauci’s promise of an AIDS vaccine 35 years ago – which has been given over a trillion US dollars so far, and an annual budget of around 35 billion dollars, it hasn’t happened yet.  
  20. Fauci predicted the so called “bird flu” would cause 2-7 million deaths. WHO estimated by May 2006 it had killed only 100 people.  He stated serious adverse events for the fast-tracked swine flu vaccine was “very, very, very rare,” yet cases of narcolepsy came pouring in.
  21. Fauci has pushed for preexposure prophylaxis of ART for HIV prevention in those that are HIV negative, i.e. giving highly toxic drugs to completely healthy people.  Engelbrecht sent Fauci a list of important question about this but was told again, “Dr. Fauci respectfully declines to respond to the questions that you emailed.”
  22. Regarding the anti-viral Remdesivir which recently obtained EUA status for COVID-19, the Alliance for Human Research and Protection (AHRF) brings up the fact Fauci has a vested interest the drug as he sponsored the clinical trial – which has not even been peer-reviewed. To date, he still has not made public his financial relations with Gilead the manufacturer.  Instead of using science, he made the promotional announcement sitting on a couch in the White House, without allowing for review of the data. At the time he also failed to disclose to the public that the primary outcomes of the study were changed, which the AHRF considers “dubious and suspicious”, of which the mainstream media ignored, but should raise serious red flags.  He then shrugged off a randomized, double-blind, placebo-controlled, multi-center peer-reviewed, published Chinese study that was stopped due to serious adverse events.  
  23. Remdesivir has caused serious kidney problems and the WHO “Solidarity” trial showed it did not produce any measurable benefit in mortality, the need for ventilators, or the length of hospital stay, but Fauci is silent on these findings.  In a bizarre twist, Gilead came out with a statement that conclusive findings can not be drawn from the trial because hadn’t been peer-reviewed or published yet, despite the WHO stating that the large, international study was designed to generate the robust data needed to show which treatment are most effective.  Gilead failed to mention that the study used to promote Remdesivir was not peer-reviewed or published before it was given EUA status.  When it was finally published it was in the New England Journal of Medicine, the same journal as the fraudulent pivotal trial of AZT. The study only stated that there was a shorter recovery time. Engelbrecht states this has no validity because of the flawed data and the fact participants did not receive a true placebo. FYI: we are talking about BIG money here.  According to this, the mediocre drug has already brought in $873 million:  https://www.nytimes.com/2020/10/29/health/covid-remdesivir-gilead
  24. Fauci maligns anything that competes with his lucrative products. In the case of COVID, this includes HCQ which had numerous studies stacked against it from the beginning, from giving patients high killer doses to poorly done studies which were eventually retracted.  Engelbrecht states that the Virology Journal study lacks validity because the science behind SARS-CoV-1 & 2 is totally unfounded and was a cell culture study, not a patient trial.
  25. Fauci is all about Big Pharma – not life-style factors. Robert F. Kennedy points out that while HCQ costs a measly 30 cents, it completes with Moderna’s vaccine which Fauci’s agency owns half the patent and has invested $500 million in taxpayer money.  He is aligned with numerous powerful industries and sits on the Bill and Melinda Gates Foundation Council, which in turn invests millions directly into Fauci’s NIAID. But Fauci maintains he is apolitical and neutral.
  26. Fauci, the highest paid employee in the U.S. Federal Government makes about $80K more than the president of the United States. In 2021, he released the book ‘Expect the Unexpected: Ten Lessons on Truth, Service, and the Way Forward,’ and recently  sold his memoir for nearly $5M to Penguin Random. He is also to appear in a Disney-backed documentary keeping him prominently in the public eye even after retirement. His replacement, Hugh Auchincloss is also an animal experimenter who has lobbied to build more risky biolabs and has been Fauci’s right-hand man for the last 16 years.
  27. There is a petition circulating titled #Fire Fauci.

Go here for a powerful video exposing Fauci.

A deadly new virus is discovered…there’s no treatment or cure…it’s highly contagious…everyone is a potential victim…the world is at risk from asymptomatic super spreaders…new clusters of cases reported daily…Everyone must get tested even though the tests are unreliable…positive antibody tests are called “infections” and “cases” even when the patient has no symptoms…every politician gets involved…media hysteria in high gear…activists demand salvation from government and Big Pharma…Billions of dollars are authorized for fast track drug and vaccine research…simple, effective remedies are rejected while expensive, dangerous ones are pushed……presumptive diagnoses…exaggerated death statistics…falsified death certificates…

Sound familiar?

It’s been done many times by Tony Fauci.
This is the first and only film to put Fauci where he belongs: squarely in the middle of the AIDS fraud story.

___________________

http://

JP Interviews Fauci

Comedian JP does a better job covering the news than the media.  I hope you enjoy this tongue-in-cheek interview as much as I did.

Fauci’s Pandemic: How He Caused It & Uses It

http://  Approx. 8 Min.

Oct. 22, 2020

By Dr. Breggin

Based on the in-depth scientific and historical report, “Fauci’s COVID-19 Treachery with Chilling Ties to the Chinese Military” on Breggin.com in the Coronavirus Resource Center. https://breggin.com/coronavirus-resou… The video and the scientific report that will change how you think about COVID-19.

STORY AT-A-GLANCE

Found here:  https://articles.mercola.com/sites/articles/archive/2020/10/30/dr-anthony-fauci-coronavirus-chinese-communist-party.aspx?

  • A report by Dr. Peter Breggin reveals Dr. Anthony Fauci’s ties to the Chinese Communist Party (CCP) and globalists who have profited from the pandemic measures promoted by him as the leader of the U.S. Coronavirus Task Force
  • Fauci has been the major force behind research activities that enabled the Chinese Communist Party to manufacture lethal SARS coronaviruses, which in turn led to the release — whether accidental or not — of SARS-CoV-2 from the Wuhan Institute of Virology
  • In collaboration with the CCP and the World Health Organization, Fauci initially suppressed the truth about the origins and dangers of the pandemic, thereby enabling the spread of the virus from China to the rest of the world
  • Fauci has supported and praised Director-General of the WHO, Tedros Adhanom Ghebreyesus, a member of a Marxist-Leninist Ethiopian political party with a corrupt past and terrorist ties who has also been accused of covering up cholera outbreaks in Ethiopia
  • Fauci recently published a paper in which he dismisses the possibility that SARS-CoV-2 was created in and released from the Wuhan Institute of Virology, arguing instead for natural mutation. He also uses the pandemic to justify the “green new deal” and the globalist movement known as “the Great Reset”  

For more:  

Category:

Activism, Testing, Treatment, Viruses

Illness-Related Fatigue: More Than Just Feeling Tired

https://www.health.harvard.edu/blog/illness-related-fatigue-more-than-just-feeling-tired-

Illness-related fatigue: More than just feeling tired


Contributor
woman who is feeling fatigue

A common refrain during the COVID-19 pandemic is, “I’m so tired.” After months of adjusted living and anxiety, people are understandably weary. Parents who haven’t had a break from their kids are worn out. Those trying to juggle working from home with homeschooling are stretched thin. Between concerns about health, finances, and isolation, everyone is feeling some level of additional stress during this unusual time, and that’s tiring. We all could use a good, long nap — or better yet, a vacation.

But while a break would be nice, most people — except those who are actually sick with COVID-19 or other illnesses — are able to push through their fatigue, precisely because they aren’t sick. “Tired” is a nebulous word that covers a broad spectrum of levels of fatigue. A crucial distinction, however, is between regular fatigue and illness-related fatigue.

Regular fatigue

Everyday fatigue that is not illness-related starts with a baseline of health. You may feel sleepy, you may in fact be sleep-deprived, or your body and mind may be worn out from long hours, exertion, or unrelenting stress — but you don’t feel sick. Your muscles and joints don’t ache like when you have the flu. You are capable of getting out of bed and powering through the day, even if you don’t want to. A cup of coffee or a nap might perk you up.

This type of fatigue is usually related to external factors: lack of sleep, stress, an extra-hard workout. But internally, your body is working well: your glands and organs are operating properly; infection is not depleting your body of energy; your nervous system may be overtaxed, but it’s not frayed from actual impairment.

Illness-related fatigue

When I was acutely ill with persistent Lyme, babesiosis, and ehrlichiosis (all tick-borne illnesses), as well as chronic Epstein-Barr virus, a good night’s sleep did nothing. Naps were staples of my day that helped me survive but didn’t improve my energy. Drinking a cup of coffee was akin to treating an ear infection with candy. No matter how much I rested, my exhaustion persisted.

I felt like I had the flu, except it lasted for years. My whole body ached. I suffered migraine headaches. I had hallucinogenic nightmares. Exercise was out of the question; at times, I was literally too tired to walk up a flight of stairs or sit at the dinner table. I couldn’t concentrate, unable to read or watch TV. Sometimes I was too tired to talk.

There was no pushing through this level of fatigue, because it was caused by internal factors: illnesses that were ravaging my body. Only when they were adequately treated did I start to get my energy back.

For me, the root causes were bacterial infections (Lyme, ehrlichiosis), a parasite (babesiosis), and a virus (Epstein-Barr). Profound fatigue may also result from a host of other diseases and conditions, including chronic fatigue syndrome, fibromyalgia, and multiple sclerosis.

Is it everyday fatigue or illness-related fatigue?

When determining whether your tiredness is everyday fatigue or illness-related, consider the following questions:

  • Do you feel worn out, or do you feel sick?
  • Have you experienced this before, or does it feel more extreme or unrelenting?
  • When you lessen the load of external factors (work, stress, long days) does the fatigue improve, or does it persist?
  • Do you feel refreshed after a good night’s sleep or a nap?
  • Can you go about your day, or is it impossible to get out of bed?
  • Has the fatigue persisted longer than you would expect?
  • Are you experiencing other symptoms that might point to illness?

The bottom line

No one knows your body better than you do. You know what feels normal, and you know what you feel like when you’re sick. If you are not responding to regular fatigue remedies, your fatigue has persisted over time, you have other symptoms, or you just don’t feel right, it’s probably time to call your doctor.

____________________

**Comment**

I had a Lyme/MSIDS patient state, “I could fall asleep standing up.”  Yep, that about describes it.

The author doesn’t mention it, but a large part of the problem is the unrelenting insomnia.  You would do anything to sleep at night.  But you can’t.

The great news is that appropriate tick-borne disease treatment fixes this or improves it greatly. There are also medications both natural and pharmaceutical that can help.

For more:  https://madisonarealymesupportgroup.com/2020/10/04/lyme-disease-is-associated-with-various-sleep-disorders/

https://madisonarealymesupportgroup.com/2018/08/23/sleep-sweet-sleep/

https://madisonarealymesupportgroup.com/2018/08/07/to-sleep-perchance-to-dream/

https://madisonarealymesupportgroup.com/2018/04/02/cant-sleep-18-plants-herbs-can-help/

https://madisonarealymesupportgroup.com/2016/12/18/ldn/

https://madisonarealymesupportgroup.com/2019/01/16/ldn-cbd/?

https://madisonarealymesupportgroup.com/2019/03/14/melatonin-benefits-uses/

Category:

Lyme, Sleep, Supplements, Treatment

Study Shows D, Magnesium, and B12 Reduces Clinical Deterioration in Older COVID-19 Patients

https://www.sciencedirect.com/science/article/pii/S0899900720303002

Cohort study to evaluate effect of vitamin D, magnesium, and vitamin B12 in combination on severe outcome progression in older patients with coronavirus (COVID-19)

 

Highlights

  • Use of a combination of vitamin D, magnesium, and vitamin B12 (DMB) in patients with coronavirus disease (COVID-19) was studied.
  • Fewer patients ≥50 y of age with COVID-19 on DMB suffered clinical deterioration.
  • Further studies are warranted to ascertain the full benefit of DMB in patients with COVID-19.

Abstract

Objectives

The aim of this study was to determine clinical outcomes of older patients with coronavirus (COVID-19) who received a combination of vitamin D, magnesium, and vitamin B12 (DMB) compared with those who did not. We hypothesized that fewer patients administered this combination would require oxygen therapy, intensive care support, or a combination of both than those who did not.

Methods

This was a cohort observational study of all consecutive hospitalized patients ≥50 y of age with COVID-19 in a tertiary academic hospital. Before April 6, 2020, no patients received the (DMB) combination. After this date, patients were administered 1000 IU/d oral vitamin D3, 150 mg/d oral magnesium, and 500 mcg/d oral vitamin B12 upon admission if they did not require oxygen therapy. Primary outcome was deterioration leading to any form of oxygen therapy, intensive care support, or both.

Results

Between January 15 and April 15, 2020, we identified 43 consecutive patients ≥50 y of age with COVID-19. Seventeen patients received DMB before onset of primary outcome and 26 patients did not. Baseline demographic characteristics between the two groups were significantly different by age. In univariate analysis, age and hypertension had a significant influence on outcome. After adjusting for age or hypertension separately in a multivariate analysis, the intervention group retained protective significance. Fewer treated patients than controls required initiation of oxygen therapy during hospitalization (17.6 vs 61.5%, P = 0.006). DMB exposure was associated with odds ratios of 0.13 (95% confidence interval [CI], 0.03–0.59) and 0.20 (95% CI, 0.04–0.93) for oxygen therapy, intensive care support, or both on univariate and multivariate analyses, respectively.

Conclusions

A vitamin D / magnesium / vitamin B12 combination in older COVID-19 patients was associated with a significant reduction in the proportion of patients with clinical deterioration requiring oxygen support, intensive care support, or both. This study supports further larger randomized controlled trials to ascertain the full benefit of this combination in ameliorating the severity of COVID-19.

__________________

**Comment**

Once again we see there are numerous things that can be used successfully against COVID-19, but don’t expect to hear about this in main stream media.  They are all about pushing products that our public ‘authorities’ have financial interests in.  One is a dangerous, experimental vaccine:  https://madisonarealymesupportgroup.com/2020/08/29/every-breath-you-take-every-move-you-make-the-who-is-watching-you-the-media-is-bought-out-by-gates/

We’ve been warned about this vaccine:  https://madisonarealymesupportgroup.com/2020/10/20/experts-issue-serious-warnings-about-a-covid-vaccine/

https://madisonarealymesupportgroup.com/2020/10/05/covid-19-vaccine-explained/

And another is the expensive anti-viral Remdesivir which has recently been given EUA status despite lack of results:  https://madisonarealymesupportgroup.com/2020/10/26/remdesivir-gets-fda-approval-but-who-says-drug-ineffective-for-covid/

https://madisonarealymesupportgroup.com/2020/07/02/remdesivir-for-covid-19-not-backed-by-results/

For more successful COVID-19 treatments that doctors have been using successfully:

 

 

Category:

research, Supplements, Treatment, Viruses

A Case of Borrelia Miyamotoi

https://www.nejm.org/doi/full/10.1056/NEJMcpc2004996?

Case 32-2020: A 63-Year-Old Man with Confusion, Fatigue, and Garbled Speech

Authors:  Shibani S. Mukerji, M.D., Ph.D., Kevin L. Ard, M.D., Pamela W. Schaefer, M.D., and John A. Branda, M.D.

The following was obtained from the case presented in the link above in the New England Journal of Medicine.A 63-year-old retired government employee who lived with his wife in northern New England had recently traveled to Florida and to rural Canada to hunt was evaluated at the hospital because of:

  • fever
  • confusion
  • headache
  • garbled speech
  • fatigue
  • vision changes & floaters
  • lymphocytic pleocytosis
  • elevated protein level in the cerebrospinal fluid (CSF)
  • worsening proteinuria and hypertension
  • flash of light accompanied by transient sharp pain in the left retro-orbital area and forehead, with monocular blurry vision
  • garbled and nonsensical speech with impaired comprehension
  • word-finding difficulty
  • photophobia
  • sonophobia
  • staring spells that lasted for 1 minute
  • low-grade fever 
  • somnolence
  • generalized weakness
  • unsteadiness
  • mild neck stiffness
  • unintentional weight loss of 10 kg in the past 6 months
  • nocturia
  • cachectic appearing
  • perseverative thoughts
  • unable to name days of the week backward
  • when asked to remember three words, he could recall only one word after 5 minutes
  • he reported that nine quarters equaled $4.25
  • dilated-eye examination revealed edema in both optic nerves

Interestingly, after IV acyclovir, ceftriaxone, ampicillin, vancomycin, and thiamine, he developed myoclonic jerks with marked lethargy, and the photophobia, and nonsensical speech persisted. He was intermittently impulsive and uncooperative. After 4 days of IV treatment he reported feeling better and having increased strength, allowing him to walk. On the fifth hospital day, he was calm and cooperative; oriented to person, place, and time; and able to follow complex commands.

Administration of broad-spectrum antimicrobial agents resulted in rapid improvement in his clinical condition within days despite increasing neurologic symptoms over the course of several months, findings that suggested meningoencephalitis.  Despite an extensive evaluation for likely causes of meningoencephalitis, a definitive diagnosis was not established. This patient’s presentation and clinical course are emblematic of challenges faced by clinicians, given that the causative agent in meningoencephalitis is identified in only 30 to 60% of cases, despite extensive and invasive testing.1,2

There are three important clinical features of this patient’s presentation:

  • uveitis associated with meningoencephalitis
  • subacute cognitive decline
  • clinical improvement after the administration of antimicrobial therapy

A unique feature of this patient’s presentation is his exposure to rituximab, a humanized chimeric anti-CD20 monoclonal antibody that causes B-cell depletion. The effects of rituximab should be considered when interpreting the results of IgG and IgM serologic tests. This concern is relevant to testing for West Nile virus infection and eastern equine encephalitis, both of which can cause neuroinvasive viral encephalitis and are endemic in the northeastern United States. The antibody response during these infections can be delayed or absent in patients with B-cell depletion.4,5 Such a response may also occur in Powassan virus infection, an emerging cause of viral meningoencephalitis in the United States that is transmitted by ticks.6

A key question remains: What pathogen can cause uveitis and meningoencephalitis and result in rapid clinical improvement after the administration of vancomycin, ampicillin, ceftriaxone, and acyclovir?

The authors point out that spirochete infections can cause uveitis and meningoencephalitis.

Due to the patient’s history of living in an endemic area for tick-borne diseases, is an avid hunter, whose condition improved dramatically after IV antibiotics, infection with borrelia species seemed a logical diagnosis.

The authors point out the problem with testing:

Testing for Lyme disease occurs as a part of a two-tiered algorithm and measures a person’s antibody response to the spirochete. Whether treatment with rituximab delays formation of antibodies in blood and CSF is unknown, thus complicating the interpretation of this patient’s serologic test results.

They further state that those with neurological Lyme infection often have abnormal imaging findings of the head or spine but that this patient had neither.

Then they state that B. miyamotoi, another borrelia species, causes a symptom complex that is consistent with this patient and that there are two case reports of meningoencephalitis in immunocompromised patients receiving rituximab, where B. miyamotoi was the causative agent.  These patients received rituximab for hematologic cancers, and in both, Wright-Giemsa staining of CSF showed spirochetes, and a definitive diagnosis of B. miyamotoi infection was made based on nucleic acid testing of the blood.

The authors state the patient’s recurrent fever but lack of rash also support a B. miyamotoi infection, but that the opthalmologic findings do not.  They admit; however, that there is limited understanding of B. miyamotoi but since other spirochetes can cause eye issues, B. miyamotoi is likely no different. ( I must add here that I know many Lyme disease patients who get recurrent fevers and have never seen a rash.  This is a perfect example of how researchers and doctors have falsely pigeon-holed Lyme symptoms into a box of their own making).  For more:  https://madisonarealymesupportgroup.com/2019/02/22/why-mainstream-lyme-msids-research-remains-in-the-dark-ages/

Regarding testing, a lumbar puncture targeting the glpQ gene of borrelia that causes relapsing fever, which is absent in Lyme disease, was positive. Serum showed strong reactivity on the ELISA that detects IgG antibodies directed against the GlpQ protein of B. miyamotoi.  Corresponding IgM ELISA was negative, consistent of B. miyamotoi infection of several months duration.

Unfortunately there are no randomized controlled trials and no formal treatment recommendations.  Patients typically receive Lyme disease treatment.  An in vitro study showed B. miyamotoi was susceptible to doxycycline, azithromycin, and ceftriaxone but not amoxicillin. (Again, I must add that current Lyme disease treatment advocated by the CDC/IDSA only works for a small percentage of patients and that studies from the beginning have shown treatment failures using their approach.  For more:  https://madisonarealymesupportgroup.com/2016/02/13/lyme-disease-treatment/)

The patient was sent home with 4 weeks of IV ceftriaxone but developed a facial rash and was switched to doxycycline.  After 3 weeks all symptoms had resolved but the blurry vision which improved slowly over 3 months.

This patient should be followed up for years, but won’t be.
And the question begging to be asked is: how many people with B. miyamotoi are falling through the cracks?  It isn’t even reportable to the CDC yet (which notoriously undercounts all things tick-borne-related).

For more:  https://igenex.com/tick-talk/what-you-need-to-know-about-borrelia-miyamotoi/

This article points out the confusion with B. miyamotoi: 

  • many separate it from other tick-borne relapsing fevers
  • while it can cause relapsing fevers, it sometimes doesn’t
  • it appears to be the only TBRF transmitted from a hard bodied tick, unlike TBRF which is mainly transmitted from a soft bodied tick (I remain skeptical of this as ticks have repeatedly been found to transmit things they shouldn’t – just like they are found in places they shouldn’t be.)
  • symptoms often resemble Lyme disease
  • you can be infected with BOTH B. miyamotoi AND Lyme disease (as well as numerous other coinfections) which will complicate symptom presentation
  • testing for B. miyamotoi is just as abysmal as it is for Lyme/MSIDS:  https://madisonarealymesupportgroup.com/2020/03/01/study-cdcs-2-tier-lyme-testing-inaccurate-in-more-than-70-of-cases/

Category:

Psychological Aspects, research, Tickborne Relapsing Fever, Treatment