The International Lyme and Associated Diseases Society (ILADS) is a nonprofit, international, multidisciplinary medical society dedicated to the diagnosis and treatment of Lyme and other complex inflammatory diseases. With these educational blog posts from experts and members of our board, ILADS aims to promote awareness and understanding of health and wellness, especially as it relates to complex inflammatory diseases, so that we can all learn and grow together. If you have any questions or want more information, you can email us at contact@ilads.org.
Disclaimer: Every patient is an individual with unique characteristics. This blog article is not medical advice. It does not constitute a physician-patient relationship. It is for educational purposes only. Do not try out what is in this article without medical advice, working with your licensed physician and licensed healthcare providers
For people grappling with chronic Lyme disease, Bartonella and Babesia are increasingly in the spotlight. These stealthy microbes are often linked to some of the most debilitating symptoms, yet there’s a puzzling twist: they rarely cause severe acute illness in otherwise healthy individuals. This paradox may hold the key to understanding why traditional antibiotics often fall short—and why herbs, with their complex and synergistic properties, might offer a more promising path to lasting relief.
Babesia
Babesia is a protozoan. It shares characteristics with Plasmodium, the protozoa that cause malaria, but its potential to make people acutely ill is much lower. Instead of mosquitoes, it’s spread primarily by ticks. The most common species of Babesia are Babesia microti, Babesia divergins, and Babesia duncani, but about a dozen species have been associated with human illness.
Like Plasmodium, Babesia invades erythrocytes (red blood cells). Symptoms associated with an acute infection of Babesia, however, tend to be mild and may not appear at all: About 1 in 4 cases are asymptomatic. Symptomatic cases in immunocompetent (healthy) individuals generally resolve without treatment. Significant acute illness is mostly isolated to immunocompromised individuals and those lacking a spleen. Because most cases resolve without treatment, only about 2,000 cases are reported in the U.S. each year.
Bartonella
Bartonella is a slow-growing, gram-negative bacterium. The most common species include Bartonella quintana (trench fever) and Bartonella henselae (cat scratch fever), but a variety of Bartonella species infect humans; in fact, every mammalian species on earth (including whales!) harbors some species of Bartonella. Bartonella is spread primarily by insect and other arthropod vectors, including fleas, lice, and ticks.
Bartonella is a facultative intracellular bacterium, meaning it can live either inside or outside cells. It has a preference for invading endothelial cells lining small blood vessels. Like a tiger waiting for prey, this places the bacteria at an ideal location to invade and scavenge nutrients from erythrocytes.
As with Babesia, symptoms of acute infection with Bartonella are generally mild, and asymptomatic infections are not uncommon. Most infections in immunocompetent individuals resolve without treatment and go unreported.
A Balanced Relationship is a Natural State
Their main survival strategy is persistence, not aggression. (This is true of Borrelia and all the Lyme coinfections as well). Overwhelming a host with infection doesn’t work in the microbes’ favor. An equilibrium in which the host isn’t severely affected but the microbes can persist offers a stable environment for the microbes and — importantly — allows ongoing opportunities to spread to new hosts.
Of course, the host’s immune system would rather not have them there at all and makes every effort to root them out. The microbes, however, match that effort with sophisticated moves that allow them to persist. It’s a chess game that’s been going on between hosts and microbes for millions of years. In the end, a balanced host-microbe relationship is a natural outcome.
Mechanisms of Persistence
A key strategy used by all the Lyme microbes is invading and surviving inside cells. The internal environment of a living cell offers isolation from both the immune system and antibiotics. Different microbes invade different cells. Babesia and Bartonella have a preference for invading erythrocytes (red blood cells).
Another key strategy is the ability to slow their growth or even go dormant. Slowed growth or dormancy (quiescence) allows microbes to remain inside a cell without affecting the cell’s functions or alerting the immune system that the cell has been compromised.
Babesia parasites are cleared primarily by macrophages in the spleen (which is why not having a spleen is a big risk factor for severe acute illness). When red blood cells become swollen with parasites, the swollen red blood cells become trapped and then eliminated. By slowing their growth rate, red blood cells infected with parasites don’t swell, which allows infected red blood cells to pass through the spleen undetected.
Persistence of Babesia for greater than two years has been documented in asymptomatic individuals. Transmission of Babesia by blood transfusion is a leading risk to the blood supply in the United States, suggesting that individuals harboring Babesia asymptomatically are not uncommon.
The same strategy is used by Bartonella. It has been documented that the bacteria can achieve a slow enough growth rate to survive undetected for the lifespan of infected erythrocytes. In addition to lodging within erythrocytes, these bacteria may exist within lymphocytes and other cells in the body. Numerous studies have documented an asymptomatic carrier state for Bartonella in healthy individuals.
That isn’t to say that Babesia and Bartonella aren’t pathogens. They most certainly are. But they wait until they have the advantage. And they can wait — quietly residing inside cells — for a long time.
And it isn’t just Babesia and Bartonella. All the Lyme microbes use intracellular persistence as a strategy, though each microbe goes about it in a different way and has preference for different cell types. Together they form a silent reservoir of pathogens hiding out in blood and tissues — all waiting for an opportunity.
Reaching the Boiling Point
That opportunity comes if the host’s health is compromised.
Sometimes it’s a sudden event — like a severe trauma or infection with a more virulent microbe, such as SARS-CoV-2 (COVID-19) — that tips the balance. But more often it’s multiple factors adding up over time: years of eating a poor diet, inadequate sleep, chronic exposure to toxic substances, or a sedentary lifestyle. All of those factors may weaken cells.
Once infected cells are weakened by stress, the microbes are free to grow unchecked. Unchecked microbes destroy cells. The types of symptoms that result correspond to the types of cells that are damaged.
Destruction of erythrocytes by Babesia results in symptoms including anemia, headache, muscle and joint aches, air hunger, an enlarged spleen and liver, brain fog, jaundice, bruising, petechiae, and dark urine.
Invasion of endothelial cells (cells that line blood vessels) by Bartonella bacteria can cause constriction of blood flow, which can result in symptoms including bone pain, pain in the soles of feet, endocarditis, and liver or spleen enlargement. Damage to red blood cells can result in anemia. Entry into the central nervous system can cause a range of neurological symptoms.
Babesia and Bartonella, of course, don’t account for all the symptoms that occur with chronic Lyme disease. Compromised host status allows the unchecked growth of not only Babesia and Bartonella but also Borrelia and any other pathogens that might be lurking in the host’s blood and tissues. Because different microbes invade and damage different cells in the body, a wide range of symptoms is possible.
It’s like a pot boiling over on the stove. Increased microbial activity compounds stress on the host, which unleashes greater microbe activity. It becomes a vicious cycle with cellular destruction caused by a frenzy of unleashed microbes throughout tissues.
Where Treatments Fall Short
Whereas, antibiotics might seem like the logical solution, antibiotics only kill active microbes, but have minimal impact on the total reservoir of slow-growing or dormant intracellular microbes in tissues. As soon as the antibiotics are discontinued, new microbes emerge and the patient relapses.
What’s more, antibiotics don’t restore the body’s ability to contain the microbes. In fact, prolonged use of antibiotics further compromise this ability by:
- Disrupting normal flora in the gut and skin, which are a key part of the body’s natural defenses
- Generating antibiotic-resistant pathogens, which has become a major health hazard worldwide
- Being toxic to cells and mitochondria in the body
Winning the battle requires long-term suppression of microbe activity — without causing further stress to the body. In other words, you have to counter the microbes with the same strategy they use — with persistence instead of aggression.
The best suited option to achieve that goal is herbal therapy.
The Herbal Advantage
Herbs are plants. Like all living organisms, plants must maintain defenses against invasive microorganisms. They accomplish that task with a sophisticated defense system made up of hundreds of chemical substances known as phytochemicals.
It’s not a random collection of chemicals, however. The plant phytochemical defense system functions somewhat like an immune system. It’s selective for a wide range of pathogenic bacteria, viruses, protozoa, fungi, and parasites — but doesn’t adversely affect normal flora.
This gives herbs a distinct advantage over synthetic antibiotics. The regular use of herbs actually balances the microbiome of the gut and skin, instead of disrupting it. Though well recognized, this phenomenon has been documented by science.
The advantages don’t stop there.
Antimicrobial resistance occurs most rapidly with the use of synthetic antibiotics. This creates antibiotic-resistant “superbugs.” In contrast, the same type of resistance doesn’t occur to herbs. In a world where antibiotic-resistant pathogens have become a major problem, herbs may be our best hope.
Instead of being toxic to cells (like antibiotics and many therapies), the phytochemical defense provided by herbs protects cells throughout the body from a wide range of stress factors by neutralizing free radicals, harmful radiation and toxic substances. This provides a high level of protection to cells.
Herbs are plants that humans have selectively consumed for hundreds or even thousands of years as both food and medicines. Not surprisingly, the most commonly used herbs have a very low potential for toxicity.
While all herbs provide broad-spectrum antimicrobial properties, some herbs are more potent than others — and many of these herbs have found their way to treatment of chronic Lyme disease.
People have been using herbal therapy to treat chronic Lyme disease with good results for over two decades. Their stories and accounts, posted on the internet and social media, provide strong support for herbal therapy as a viable option for overcoming chronic Lyme disease.
The popularity of herbs for Lyme disease caught the attention of researchers at Johns Hopkins University. In a study published in 2020, a dozen herbs commonly used for treatment of chronic Lyme disease were evaluated for activity against Borrelia burgdorferi. Of the twelve, seven herbal extracts were found to have greater activity against both motile and cyst (dormant) forms of the bacteria than commonly used antibiotics.
The list included
- Cryptolepis sanguinolenta
- Juglans nigra (Black walnut)
- Polygonum cuspidatum (Japanese knotweed)
- Artemisia annua (Sweet wormwood)
- Uncaria tomentosa (Cat’s claw)
- Cistus incanus
- Scutellaria baicalensis (Chinese skullcap)
In the same year, two other studies were published using some of these same herbs against Babesia and Bartonella. In one study published in Frontiers in Cellular and Infection Microbiology, Cryptolepis sanguinolenta, Artemisia annua, Scutellaria baicalensis, Alchornea cordifolia, and Polygonum cuspidatum were found to have good in vitro inhibitory activity against Babesia duncani in the hamster erythrocyte model.
In a second study done at Cold Springs Harbor Laboratory, Cryptolepis sanguinolenta, Juglans nigra, and Polygonum cuspidatum were able to eradicate all stationary phase Bartonella henselae cells within 7 days.
The fact that several of the herbs — Polygonum cuspidatum (Japanese knotweed), Scutellaria baicalensis (Chinese skullcap), and Cryptolepis sanguinolenta — had good activity against more than one of the microbes shows the wide range of activity found in herbs. When herbs with strong broad-spectrum antimicrobial properties are combined with immunomodulating and adaptogenic herbs and medicinal mushrooms, the results can be phenomenal.
Rebuilding the Body Back Better
The low potential for toxicity associated with these herbs allows you to do something that isn’t possible or practical with most chronic Lyme therapies — never let up. Herbal therapy can be continued until all symptoms are resolved, even if that takes years. Instead of being in a perpetual war, however, you can think of it as rebuilding your body from the ground up.
Learn more about Dr. Rawls’ approach to treating chronic illness with herbal therapy on RawlsMD.
References
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**Comment**
Please keep in mind this is one doctor’s opinion who just happens to make money off the very thing he promotes, so there’s a definite conflict of interest.
Also, since treating over a long period of time is often required, keep an open mind, and be willing to experiment. It is common knowledge that people respond quite differently to treatment. Wisdom and finesse is required for this journey. Your best bet is to see an experienced Lyme literate doctor.
Personally, I can say I’ve used nearly everything out there – and some things definitely worked better than others, but again, what worked for me may not work for you. Also, it’s important to understand dosages, pulsing, and cycling of treatments as these issues can make all the difference.
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