When & How to Treat Parasites in Lyme Disease

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When & How to Kill Intestinal Parasites in Lyme disease Image from Marty Ross MD

About Intestinal Parasites in Lyme Disease

I consider treating for intestinal parasites in Lyme disease because they lead the immune system to produce too many cytokines. Cytokines create fatigue, body pain, poor thinking and the whole range of symptoms seen in Lyme disease. Not only does Lyme trigger these cytokines, but other infections, like intestinal parasites can too. Read more about cytokines and steps you can take to lower them in Control Cytokines: A Guide to Fix Lyme Symptoms & The Immune System.

The problem with intestinal parasites is that they are hard to diagnose. The way most doctors test for parasites is to perform a microscope stool exam. But studies show, depending on the kind of parasite, that testing can work anywhere from 20 to 90% of the time. This means that testing is very poor and not reliable, if the test result is negative.

And hidden parasites are a major cause of ongoing fatigue and dysfunction. In 1990, Leo Galland MD showed that 50 percent of people with chronic fatigue syndrome had intestinal parasite infections that were missed by physicians.

Marty Ross MD Talks About Intestinal Parasites in Lyme

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Video Thumbnail


When to Consider Intestinal Parasites in Lyme Disease

If You Have Symptoms

Consider treating for intestinal parasites if you have ongoing intestinal symptoms like gassiness, bloating, intestinal cramping, and mushy/loose stools even after treating for intestinal yeast overgrowth. Read more about diagnosing and treating yeast in these two articles A Silent Problem. Do You Have Yeast? and Kills Yeast: A Brief Guide.

If You Have Risks

Even if you do not have intestinal gassiness and bloating, consider treating for intestinal parasites if you have traveled to less developed countries where you could have gotten parasites from contaminated food or water. Also consider parasites if you drink well water, even if the well has tested clean. If you are an outdoors person who drinks untreated water from rivers lakes, consider treating for parasites too.

If a person has a lot of intestinal symptoms after treating for yeast, I suggest treating for intestinal parasites early, near the beginning of treatment. In others, who have risk of parasite exposures like I explained above, consider treating for parasites at the six to nine month point in treatment if a person is following all of the steps in The Ross Lyme Support Protocol and is not getting a lot better.

About Testing for Intestinal Parasites in Lyme Disease

Even though testing is not perfect, I still suggest sending three separate stool samples to the lab, for an ova and parasite microscope test,  to see if they can identify parasites. If possible use a high quality intestinal parasite lab like Genova Diagnostics. Also consider having an EIA test performed for common parasites. EIA testing can find common parasites 90% or more of the time when they are present. But such testing does not exist for all types of parasites. This type of test attaches a marker to parts of parasites so they can be seen.

The reason I suggest testing, is to see if the type of parasite is known. If you know which parasite you have, then the treatment option is to use a prescription anti-parasite for that specific parasite.

How to Treat Intestinal Parasites in Lyme Disease

If you can identify which parasite you have, use the prescription medicine that is shown to work best for that specific parasite.

If you are unable to figure out which parasite you have, then treat using one of the prescription options below, or with one of the natural medicine options. Note, based on my experience, I find the prescription options to work well about 85 to 90% of the time. The natural medicine options work about 60% of the time.

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I find the Alinia works best, but can be quite expensive. Alinia is universal anti-parasite medication that should work against most parasites.

  • Alinia 500 mg 1 pill 2 times a day for 3 weeks, or
  • Biltricide 600 mg 1 pill 3 times a day for 3 days, then 21 days after the first pill take 1 pill 3 times a day for 3 more days.

Natural Medicines

I recommend black walnut in natural medicine parasite regimens based on its traditional use for this purpose. However, there is limited to non-existent science showing it works. Also artemisinin and oregano oil can help. Use both approaches below for at least 2 months.

Option 1.

Take all three of these herbal medicines at the same time.

  • Black Walnut 250 mg to 500 mg 3 times daily
  • Artemisinin 100 mg 2 pills 3 times a day
  • Oregano Oil 500 mg 3 times day.

Option 2.

Use Biocidin Liquid Drops or Capsules. Biocidin is an herbal mix that has a number of herbs in it that can treat parasites. Two of these are black walnut and oregano. In addition, some of the other agents appear helpful. For more information see Biocidin: A Potent Antimicrobial & Biofilm Breaker.

  • Biocidin Liquid. Start at 2 drops on the tongue 3 times a day and increase every other day by 1 drop per dose till you reach 10 drops 3 times a day. If you develop a herxheimer die-off reaction do not increase until it passes. Take without food by taking more than 30 min before food and over 2 hours after food.
  • Biocidin Capsules. Start at 1 capsule 2 times a day and after 2 days increase to 1 capsule 3 times a day. Every 2 days add 1 capsule till you take 2 capsules 3 times a day. If you develop a herxheimer die-off reaction do not increase until it passes. Take without food by taking 30 min before food and over 2 hours after food.


  1. Force M, Sparks WS, Ronzio RA. Inhibition of enteric parasites by emulsified oil of oregano in vivo. Phytother Res. 2000;14(3):213-4
  2. Galland L. Intestinal parasites, bacterial dysbiosis and leaky gut. Foundation for Integrated Medicine website. http://mdheal.org/parasites.htm. Accessed August 13, 2018.
  3. Krishna S, Bustamante L, Haynes RK, et al. : Artemisinins: their growing importance in medicine.Trends Pharmacol Sci. 2008;29(10):520–527. 10.1016/j.tips.2008.07.004
  4. McHardy IH, Wu M, Shimizu-Cohen R, Couturier MR, Humphries RM. Detection of intestinal protozoa in the clinical laboratory. J Clin Microbiol. 2014;52(3):712–20.

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