Archive for the ‘Treatment’ Category

Complex Role of Bartonella in Chronic Illness #1

https://www.lymedisease.org/med-detective-bartonella-part-1/

MEDICAL DETECTIVE: The complex role of Bartonella in chronic illness, part 1

This article was originally posted on Dr. Richard Horowitz’s Medical Detective Substack. It is Part 1 of a 5-part series. You can find more helpful content by subscribing here. 

Bartonella is the third “B” of the triad found in the vast majority of my chronically ill patients who suffer from chronic Lyme disease/PTLDS, along with Borrelia and Babesia.

A gram-negative intracellular bacteria, it’s controversial and misunderstood and has been throwing a monkey wrench into my treatments for decades.

I barely remember learning about it in medical school, except when they were teaching me about cat scratch fever in children that would cause small, localized rashes (papules) at the site of the scratch with swollen lymph nodes and fevers.

It would be treated with a short course of antibiotics like azithromycin. These images show classical cat scratch disease before and after treatment when the lesions are starting to crust up.

[From: Mazur-Melewska K, Mania A, Kemnitz P, Figlerowicz M, Służewski W. Cat-scratch disease: a wide spectrum of clinical pictures. Postepy Dermatol Alergol. 2015 Jun;32(3):216-20. doi: 10.5114/pdia.2014.44014. Epub 2015 Jun 15. PMID: 26161064; PMCID: PMC4495109.]

Unfortunately, Bartonella infections rarely resemble this one particular manifestation, or the general medical community would be diagnosing and treating it a lot more often.

It is a very tricky bacteria, and, like Lyme disease, has found a way to not only avoid immune recognition, but change its clinical characteristics so it resembles a broad range of other diseases.

Immune Evasion by Bartonella

Bartonella is referred to as a “stealth bacteria” because it evades the immune system by living inside red blood cells (intraerythrocytic persistence), blood vessel walls (inflaming them, causing vasculitis), endothelial cells, fibroblasts, epithelial cells of the skin (causing the classic Bartonella rashes described below), macrophages (immune cells that play a critical role of initiating and maintaining an inflammatory response, as well as potentially resolving inflammation) and bone marrow cells.

So it can hide throughout the body in areas where the immune system doesn’t easily penetrate and recognize the bacteria, not to mention, it can exist under biofilms in persister forms like Borrelia. Biofilms protect the bacteria from immune recognition and the effects of antibiotics.

[From: Okaro, U.; George, S.; Anderson, B. What Is in a Cat Scratch? Growth of Bartonella henselae in a Biofilm. Microorganisms 2021, 9, 835. https://doi.org/10.3390/microorganisms9040835%5D

Bartonella can manipulate host cell interactions to hide from immune detection by altering its surface proteins to avoid recognition (like Lyme disease), and possesses unique fat and sugar molecules (lipopolysaccharides) that minimize immune response activation; this often leads to prolonged, asymptomatic infections that can be difficult to diagnose with standard tests (it can hide in the body for years in some patients without symptoms), and then reactivate under certain conditions.

The patient below was in remission for one year after doing an 8-week course of double dose dapsone combination therapy (DDDCT), and then reactivated after being treated with antibiotics for a skin infection. This skin rash emerged when he got treated for cellulitis, which had nothing to do with his initial Lyme infection. You can see the classical Bartonella “stretch marks.”

[From: Horowitz, R.I.; Fallon, J.; Freeman, P.R. Comparison of the Efficacy of Longer versus Shorter Pulsed High Dose Dapsone Combination Therapy in the Treatment of Chronic Lyme Disease/Post Treatment Lyme Disease Syndrome with Bartonellosis and Associated Coinfections. Microorganisms 2023, 11, 2301. https://doi.org/10.3390/microorganisms11092301%5D

Reactivation often happens when the immune system is unable to control the infection, due in part to the immunosuppressive nature of the bacteria.

I’ve found multiple species of Bartonella in our sickest patients leading to chronic variable immune deficiency (CVID), just as I’ve found Borrelia causing immune suppression, along with mold toxicity and Long Covid affecting immune functioning.

The multisystemic nature of Bartonella infections

When we see patients with Bartonella, as I mentioned, it has no resemblance whatsoever with the classical cat-scratch disease I learned about in medical school. Bacteria like Bartonella cause similar symptoms to those seen in chronic Lyme disease, presenting as a “great imitator.”

It can result in chronic fatiguing, musculoskeletal, cardiopulmonary, neuropsychiatric illness and can cause fevers, chills, fatigue, headaches, muscle/joint and nerve pain, cognitive difficulties, insomnia, depression, anxiety, and cause inflammation in every body system imaginable, just like Lyme disease, Borrelia burgdorferi, does.

There can also be inflammation in the eyes (optic neuritis, conjunctivitis, uveitis, arterial and venous occlusions); the brain, surrounding structures and spinal cord (meningitis, encephalitis, transverse myelitis, seizure disorders), with associated Bartonella “rage” and psychosis (Bartonella, like Lyme disease, can cause a broad range of psychiatric manifestations, including but not limited to severe depression, anxiety, Obsessive Compulsive Disorder, Bipolar disorder and schizophrenia with psychosis).

It also can cause inflammation in the muscles (myalgias), joints (arthritis, osteomyelitis), nerves (neuropathy) and blood vessels (vasculitis), as well as the heart valves (endocarditis, including culture negative endocarditis), heart muscle (myocarditis), and sac surrounding the heart (pericarditis) causing chest pain with masses in the chest (mediastinum) and lymph nodes resembling non-Hodgkins lymphoma.

Even the gastrointestinal tract can be affected (nausea, vomiting, weight loss, bleeding), as can the liver (hepatitis), spleen (splenitis, enlargement), and skin, which oftentimes shows signs of inflammation (stretch marks, i.e. striae; granulomas, hard fibrous areas over the knuckles, elbows, and Bacillary angiomatosis, which are tumor-like masses, raised dark areas, papules, nodules, and lesions in the skin, bones, and organs).

Bartonella is a frequently found infection in those suffering from chronic Lyme disease—I’ve seen it in up to 80-90% of all of my chronically ill patients these days and should be considered in any and all cases of FUO (fever of unknown origin).

[From: Cheslock, M.A.; Embers, M.E. Human Bartonellosis: An Underappreciated Public Health Problem? Trop. Med. Infect. Dis. 2019, 4, 69. https://doi.org/10.3390/tropicalmed4020069%5D

Transmission of Bartonella

Part of the reason Bartonella has been a controversial topic in the Lyme community–at least among certain physicians and researchers–is because there has only been one study to date regarding tick transmission of the bacteria, and this was in European species of deer ticks (Ixodes ricinus) with one species, called Bartonella birtlesii.

The bacteria is, however, being found in ticks throughout the world, and other studies have shown the bacteria in different ticks and in chronic Lyme disease patients.

When I was co-chair of the HHS Tick-borne Disease Working Group (TBDWG) back in 2018, I had to fight to get Bartonella included as a co-infection of importance; whether all species are able to be transmitted by ticks or not, makes no difference.

Why? To date, the number of species able to transmit Bartonella keeps increasing over the years, and most of us are exposed to these vectors on a regular basis. The most common vectors transmitting the bacteria are fleas, mites, lice, keds (not the sneakers!), spiders, red ants, ticks (probable), sand flies, black and yellow flies, and mosquitoes.

Bartonella is showing up in a broad range of vectors, so it’s possible to get exposed from many different sources. That is why the vast majority of my sick patients are testing positive for it. In fact, for most of us living on this planet, I daresay we’ll all likely be exposed to Bartonella at some point during our lives. How we handle it, and whether we get symptoms, will depend on how our immune system is functioning.

Testing for multiple Bartonella species

The table below shows some of the most common species of Bartonella seen in human disease. This is not comprehensive, as there are now at least 45 species of Bartonella, and 18 of them or more are pathogenic [capable of causing disease].

Some of the most common ones are: B. henselae (Cat scratch disease, CSD; endocarditis, neuroretinitis, lymphadenopathy), B. quintana (Trench fever, endocarditis, bacillary angiomatosis [BA]), B. clarridgeiae (bacteremia, endocarditis, CSD, chest wall abscess), B. elizabethae (endocarditis, neuroretinitis),  B. bacilliformis (Carrion’s disease), B. koehlerae (endocarditis, including culture negative endocarditis), B. vinsonii subsp (bacteremia, endocarditis, fevers, neurological symptoms), B. berkhoffi (endocarditis, bacteremia, neurological symptoms), and B. grahamii  (neuroretinitis).

[From: Rebekah L. Bullard, Emily L. Olsen, Mercedes A. Cheslock, Monica E. Embers, Evaluation of the available animal models for Bartonella infections, One Health, Volume 18, 2024,100665, ISSN 2352-7714, https://doi.org/10.1016/j.onehlt.2023.100665.%5D

How do we test for Bartonella?

As you can see from the above table, testing for just one species makes no sense, because we can be exposed to a broad range of Bartonella species during our lifetime. I started to test for Bartonella over two decades ago. This is from an abstract I presented at the 16th International Scientific Conference on Lyme disease in 2003:

You can see from this abstract, even 22 years ago, by just testing for Bartonella henselae, one of the most common species, we found that using an ELISA and IFA (Immunofluorescent Assay) was positive in less than 50% of patients–but using DNA analysis with a PCR (Polymerase Chain Reaction) in the blood, we found 53% were positive when standard antibody assays were negative.

Which means the rule of thumb when testing for Bartonella is go as broad as you can. It is fine to start with local lab testing.

Level 1 testing

Using local labs like Quest, Labcorp, or Bioreference, you can send off antibody titers to B. henselae, B. quintana and B. bacilliformis, as well as PCRs and even a VEGF (vascular endothelial growth factor), an indirect marker of Bartonella exposure, indicating inflammation in the blood vessels (vasculitis). Often, however, you’ll want to use several specialty labs to prove infection.

Level 2 testing

If the above testing is negative, as it usually is, but you clinically suspect Bartonella, move on to the next level of tests. The three specialty labs include IgeneX laboratory (Bartonella IgM/IgG Immunoblots, Bartonella FISH [Fluorescent In-Situ-Hybridization test, an RNA test], T Labs (Bartonella FISH) with confocal microscopy, and Galaxy Laboratories, using their 4 species IFA antibody panel (for the most common species), and their ddPCR (direct droplet PCR) tests. The Bartonella Digital ePCR™ platform combines highly sensitive ddPCR technology with culture enrichment (BAPGM™).

I usually start with IgeneX laboratory and find that most of my patients have indeterminate or positive Immunoblots. Many times a negative Bartonella FISH test will turn positive later on during treatment, after the bacteria has been flushed out from the intracellular compartments where it’s been hiding.

I follow VEGF levels over time, as an indirect marker of Bartonella, when reactivation of infection is suspected. Keep in mind VEGF can be positive for other reasons (including Long Covid or cancer with metastases).

Level 3 testing

Skin biopsies can be done of the classical Bartonella rashes. Dr. Marna Ericson from T Labs has done this for me several times, and she found positive Bartonella in the skin, under biofilms, when it couldn’t be found through other methods.

I suspected Bartonella in two of my patients, but despite all classical testing, couldn’t prove exposure. The Bartonella fluoresces red under the microscope with this technique. I don’t suggest it as first level testing, but it can be very useful if you have looked for Bartonella using any and all of the above laboratories and methodologies.

Stay tuned for parts 2, 3, 4 and 5

In Part 2, I’ll discuss more about establishing a diagnosis as well as an overview of how other co-infections may overlap and affect Bartonella symptoms. Part 3 will discuss effective treatments, and Parts 4 and 5 go into more detail about these treatments.

Dr. Richard Horowitz has treated 13,000 Lyme and tick-borne disease patients over the last 40 years and is the best-selling author of  How Can I Get Better? and Why Can’t I Get Better? You can subscribe to read more of his work on Substack or join his Lyme-based newsletter for regular insights, tips, and advice

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Category:

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

History, Therapeutic Mechanisms & Safety of Chlorine Dioxide

https://pierrekorymedicalmusings.com/p/the-history-and-therapeutic-mechanisms?

The History and Therapeutic Mechanisms Of Chlorine Dioxide

Chlorine dioxide was discovered over 200 years ago. It’s use has steadily expanded into many industries and therapeutic applications despite a near global regulatory blockade on clinical research.

Pierre Kory, MD, MPA
Jan 26, 2025

I believe that my writings on chlorine dioxide are the most important (and the most dangerous) work I have yet done on Substack. Although several experts have written extensively on this topic previously (here, here, and here), this similar effort of mine simply results from my wish to become as knowledgeable as possible about this critically important therapeutic (there is no better way to do so than personally researching and writing about a topic).

This is the 3rd in my ongoing series of posts. In the first two I presented the political context in which chlorine dioxide has been attacked during Covid (“Trump’s Bleach Conference”) and in the 2nd post I detailed the success achieved by Bolivia’s national chlorine dioxide program against Covid.

In this post I will review its discovery, chemical properties, industrial applications, and therapeutic mechanisms. Upcoming posts will cover the history of the attacks faced by the pioneering researchers and practitioners, followed by a review of the safety studies of oral ingestion and a compilation of studies showing efficacy in a number of diseases. Be sure to subscribe so as not to miss out on these critical upcoming posts.

Ultimately, what me and my growing network of clinical and scientific experts of this therapeutic compound want to achieve, is for the FDA (and the copycat regulatory agencies worldwide) to lift its restrictions on performing clinical research trials of chlorine dioxide in human diseases. If anyone from MAHA is reading this right now (and I know some are), please add chlorine dioxide (and DMSO) to the list of therapies currently being suppressed by the FDA that need to be reversed (RFK Jr listed more than a dozen other such therapies in the below recent tweet).  

Overall, studies and treatment experiences reveal that treatment with chlorine dioxide:

  1. is broadly antimicrobial against nearly all infectious pathogens
  2. reduces inflammation
  3. prevents scarring
  4. aids in wound healing
  5. is non-toxic when orally ingested (in appropriate concentrations)
  6. reduces oral plaque
  7. treats oral atrophic candidiasis
  8. is a potent deodorizer
  9. has in-vitro anti-cancer cell effects, stimulates an in-vivo anti-cancer cell immune response and is also effective when injected intra-tumorally, or via a combination of oral, enema, and IV administration.

This combination of properties is not found in any other compound. The therapeutic uses for chlorine dioxide are endless. (See link for article as well as for the reasons it’s different than bleach)

________________

https://pierrekorymedicalmusings.com/p/the-safety-of-orally-ingested-chlorine?

The Safety Of Orally Ingested Chlorine Dioxide At Commonly Used Treatment Doses

Contrary to the edicts of regulatory agencies worldwide that chlorine dioxide is “bleach,” “bleach-like,” or a “poison,” numerous studies show the safety of oral ingestion at treatment doses.

Pierre Kory, MD, MPA
Jan 30, 2025

Disclaimer:

Due to the history of persecutions and attacks on researchers and practitioners of chlorine dioxide as a therapy, I have to emphasize that in these posts, my intent is not to recommend treatment via oral ingestion of chlorine dioxide because;

  • It is not FDA approved for oral ingestion to treat any disease
  • It is not approved as an orally ingested therapy by any other regulatory agency in the world.
  • It is not classified as a food supplement.

Further, no chlorine dioxide formulation product on the market either meets or has been evaluated in terms of quality and safety for oral ingestion and thus do not meet Good Manufacturing Practice (GMP standards. Also, even if the over the counter products are relatively safe, it is doubtful that people know how to correctly make or store the resulting solution. For instance, it must be mixed with distilled water and be kept out of sunlight in amber glass or plastic bottles (never metal!). Further, (when exposed to sunlight there is a chance that chlorine can be produced, something that can introduce the potential for harm).

Thus, it would be illegal and irresponsible for me to recommend treatment via oral ingestion with it, despite the fact that numerous over-the-counter products for mucosal or skin applications have been allowed on the market (oral, nasal, sinus, and skin).

What is weird is that although it would be illegal for me or anyone to treat Covid with it, a law was passed in Bolivia in early Covid (over the strenuous objections of the regulatory health agencies) which allowed for the widespread manufacture and distribution of chlorine dioxide to be taken by oral ingestion by the military and universities there (albeit under controlled and standardized processes). Millions of Bolivians thus were treated with oral ingested chlorine dioxide for Covid. This effort, I believe, is the reason Bolivia’s outcomes in Covid were the best in South America, something I covered in a prior post on chlorine dioxide here.

From ChemicalSafetyFacts.org: Nearly 500 years ago, Swiss physician and chemist Paracelsus expressed the basic principle of toxicology: “All things are poison and nothing is without poison; only the dose makes a thing not a poison.” This is often condensed to: “The dose makes the poison.” It means that a substance that contains toxic properties can cause harm only if it occurs in a high enough concentration.  (See link for article)

_______________

**Comment**

Kory points out that ‘authorities’ don’t recommend oral CDS due to toxicity and danger, but they never clearly indicate either the dose or administration route for this supposed toxicity.  Since it is regularly used globally for water purification, humans routinely ingest CDS.

The EPA has registered CDS as a “pesticide” [i.e. antimicrobial] due to its ability to eliminate microorganisms such as bacteria, viruses, and parasites from surface water, thereby rendering it safe to drink(EPA, 2006)

Kory then goes through all the hoops to show the doses used in treatment protocols are far less than what has been established to produce adverse effects in chronic ingestion and nowhere near the levels used in industrial applications.  It’s also less lethal than caffeine.  He explains the differences between Mineral Miracle Solution (MMS) and Chlorine Dioxide Solution (CDS) as well as chlorine, chloride, chlorate and chlorite. Dr. Klacker mo longer recommends the two-component CD (also known as MMS) due to adverse effects like diarrhea or vomiting, more acidic pH level, and sodium chlorite which can cause secondary reactions in the stomach.  CDS (ClO2) us a gas dissolved in water which is neutral pH and does not contain chlorite salts.

There are dozens of papers extolling the benefits and safety of topical CDS for wound management and microbial control.  A guidebook also states a mouthwash with CDS managed chronic candidiasis.  Due to the organisms the make up our microbiome generating significant amounts of reactive oxygen species (ROS), we are protected from the oxidizing effects of CDS, but it is strong enough to kill pathogens.

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Category:

Activism, Treatment

Live DMSO Webinar: Wed. Feb 26, 2025

https://mailchi.mp/advs.ca/live-webinar-max-capacity-issue-solved?

Live DMSO Webinar 

With Amandha Vollmer
Mark Your Calendar
Date: Wednesday, February 26th, 2025
Time: 7:00 PM Eastern Time
Where: LIVE on Zoom (Invite link will be provided early next week)
Since Amandha will be hosting the event, she will ensure a larger max capacity so everyone can join the conversation. Plus, we’re excited to announce that this is just the beginning…
More Great News!
We’ll be launching a whole series of events on the natural healing power of DMSO in the near future — stay tuned for more details.
Thank you for your support and enthusiasm. We can’t wait to see you there!
The Team at DMSO.store

Good News:

The webinar recording will be available on the Yummy.Doctor website within the next week. 

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Category:

Activism, Pain Management, Treatment

Homeopathy the Film: Feb. 17, 2025 For FREE

https://childrenshealthdefense.org/introducing-homeopathy

Introducing Homeopathy The Film

Don’t miss the film that is so compelling, it will open people’s eyes to homeopathy. Premiering on CHD TV February 17, 2025 at 10 a.m. ET & 6 p.m. ET. Go to top link to sign up to watch!

Homeopathy is a powerful healing modality that changes lives. Until now, its voice has been silenced across the medical landscape. Introducing Homeopathy is a new professionally produced, feature-length film dedicated to bringing homeopathy into every household and healthcare system globally.

A team of award-winning producers and writers tell the story of homeopathy through interviews with some of the world’s leading homeopaths, medical practitioners, and scientists.

Together, they reveal the true power of homeopathy.

PREMIERINGFEBRUARY 17, 2025
10 a.m. ET & 6 p.m. ET

“This is an excellent documentary, thank you for making it. It’s definitely a very powerful film. Everyone needs to see this.“  – Polly Tommey, CHD Films

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Category:

Activism, Treatment

New Review Paper on HCQ for COVID

https://drlf.substack.com/p/new-review-paper-on-hydroxychloroquine?

New review paper on hydroxychloroquine by Professor Christian Perrone’s research group

Eleftherios Gkioulekas
Feb 12, 2025

I am pleased to report about the new peer-reviewed research paper published on the use of hydroxychloroquine in the treatment of COVID-19 by Professor Christian Perronne’s research group. The corresponding author is Dr. Alexis Lacout affiliated with the Surgical Medical Center of Tronquieres in Aurillac, France. This is a review paper, so no new results are presented. However it puts together a definitive compendium of the available evidence in favor of the use of hydroxychloroquine based multidrug protocols for the treatment of COVID-19. Xavier Azalbert, one of the paper’s co-authors, gave an informative interview about this work with John Davidson.

The authors review in detail the early evidence available in favor of hydroxychloroquine from China and the mechanisms of action that made it plausible that it would be an effective treatment for COVID-19. They also give a brief overview of the flawed studies that followed, which purported to discredit the use of hydroxychloroquine in COVID-19 treatment. The authors then review the cardiac safety of the medication, and discuss blatantly fraudulent studies attempting to discredit hydroxychloroquine, that were subsequently retracted. The paper concludes with a review of the positive evidence in support of the prophylactic use of hydroxychloroquine to prevent symptomatic COVID-19 infection, and other studies supporting the efficacy of hydroxychloroquine in preventing hospitalizations and deaths.

This paper does not cover the same ground as my shorter comment publication that was published last year in the Tasman Medical Journal, focusing on the analysis Dr. Zev Zelenko’s early data of his triple drug hydroxychloroquine-based protocol which enhanced Dr. Didier Raoult’s protocol with the addition of zinc. Also not mentioned was the early meta-analysis by Dr. Raphael Stricker in support of the prophylactic use of hydroxychloroquine based on several early studies on Indian health workers. Nevertheless, this paper stands its ground on its own, and perfectly complements my work and the work by Dr. Stricker.

Although ivermectin-based protocols, such as the one by Dr. Jackie Stone, have proven themselves to be superior, ivermectin does have some limitations, e.g. it cannot be used with pregnant women, and during 2021 the community standard of care advocated by Dr. Zelenko combined both medications. That being said, this is an important paper for educating the Neanderthals that have not yet realized that they were lied to by the powers that be about hydroxychloroquine. With the worst of the pandemic in the rearview mirror, the persecution of pioneering doctors like Dr. Didier Raoult has intensified. The guilty understand that they are wrong and are now trying to erase history. They want their sins forgotten. This must never be allowed to happen.

(See link for article)

________________

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Dr. Perronne is one of the good guys.  He’s the one that said the COVID policy is ‘Completely Stupid” & ‘Unethical’.

He was then summarily fired.
A year later the French Order of Physicians exonerated him for acting in the best interest of citizens and his profession.

Oh, what a difference a year makes.

Category:

research, Treatment, Viruses