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Empower Your Health: A Comprehensive Guide to Bartonella Treatment

Navigating the complexities of Bartonella treatment, whether on its own or as part of a Lyme disease strategy, is difficult. Understanding the latest approaches significantly enhances your healing journey. Below is an in-depth guide designed to empower you with the necessary knowledge and tools for optimal treatment outcomes.

Understanding Bartonella: Key Insights

Bartonella is not just another tick-borne infection associated with Lyme disease; it presents unique challenges requiring a specialized approach. Recent scientific advancements have significantly shifted our understanding.

Key Concepts:

  • Active Growth State: These are Bartonella bacteria in their most dynamic state, marked by rapid growth. Targeting these active forms is crucial, as they are more vulnerable to antibiotics and treatments that disrupt their replication.
  • Persister Growth State: Unlike active forms, persisters are dormant and resistant to many antibiotics, necessitating targeted treatment strategies.
  • Biofilms: These are protective slime layers—formed by Bartonella to shield itself from antibiotics and immune responses—held together in a fibrin protein skeleton.
  • Fibrin Nests: These clusters contain Bartonella and fibrin, without the slime of biofilms, forming in blood vessels and potentially obstructing treatment efficacy.
  • Endothelial Glycocalyx: The endothelial glycocalyx is a crucial, gel-like layer lining blood vessels, vital for vascular health. It regulates permeability, maintains blood flow and blood vessel dilation by producing nitric oxide, and prevents clotting. Bartonella infects blood vessel endothelial cells which may damage the glycocalyx.
  • Treatment Length: For 85% of individuals with Bartonella, treatment requires 4 to 6 months of continuous herbal or prescription antibiotics. The remaining 15% may need months to years of treatment.
  • When to Change Antibiotics: If an antibiotic combination is effective—showing a reduction in symptoms by 2 months on prescription antibiotics or 3 months on herbal antibiotics—continue the regimen for 6 months before making changes. If ineffective, alter the regimen.
  • Effectiveness of Herbal vs Prescription Antibiotics: Herbal antibiotic treatments are effective 75% of the time, whereas prescription regimens are effective 85% of the time. If one combination fails, the next has a similar chance of success. For example, failing one herbal antibiotic combination does not mean all herbal antibiotic combinations will not work.
  • Maintaining a Healthy Intestinal Microbiome: Herbal antibiotics do not harm the intestinal microbiome the way prescription antibiotics do. Because of this, I prefer herbal antibiotics over prescription antibiotics. To see why this is important read Your Guide to a Healthy Intestinal Microbiome—Even on Antibiotics.

Building an Effective Bartonella Treatment Plan

A successful Bartonella treatment strategy should address the bacteria's growing and persisting forms, as well as biofilms and fibrin nests. Follow these five steps for your best chance of recovery.

Step 1: Boost Your Immune System

  • Follow All the Steps in The Ross Lyme & Tick-borne Disease Support Protocol: Enhance immunity by
    • correcting sleep patterns,
    • following a plant-forward diet to decrease inflammation,
    • using adaptogens like Ashwagandha,
    • protecting the intestinal microbiome,
    • balancing hormones,
    • providing essential nutrients, and
    • addressing any intestinal yeast overgrowth.

Step 2: Use Continuous Herbal or Prescription Antibiotic Therapy

  • Consistent Use: Bartonella replicates every 24 hours, necessitating a continuous antibiotic regimen to prevent regrowth. Avoid intermittent (pulsing) antibiotic usage.

Step 3: Incorporate Biofilm and Fibrin Nest Breakers

  • Disrupt Fibrin Nests: Use enzymes like lumbrokinase to break down fibrin nests. Consider alternatives such as nattokinase or serapeptase, though they may be less potent.
    • Lumbrokinase 20 mg 1 pill one or two times a day taken on an empty stomach with water only during the 1 hour before and after taking it.
  • Biofilm Disruption: Use products like Biocidin LSF or BioDisrupt. BioDisrupt is a preferred choice for dismantling biofilms effectively because it is backed by research showing effectiveness*.
    • BioDisrupt by Researched Nutritionals work to 2 pills 2 times a day.

Step 4: Repair Damaged Endothelial Glycocalyx

  • Repair Damage: If Bartonella treatment is stagnating, add Arterosil HP by Calroy Health Sciences designed to repair the endothelial glycocalyx*.
    • Arterosil HP by Calroy Health Sciences 2 pills 2 times a day for 2 months, then decrease to 1 pill 2 times a day.

Step 5: Use Two to Three Antibiotics at The Same Time

  • Combination Therapy: The most effective treatments include two to three antibiotics targeting growing or persister Bartonella. This can involve herbal, prescription, or a mix of both.

Step 5 Bartonella Antibiotics Expanded

 

  Best Herbal Antibiotic Combination

  • Cryptolepis 5 ml (1 tsp) 3 times a day by starting at 1 time a day and increasing every other day if tolerated to 3 times a day.
  • Japanese Knotweed 5 drops 2 times a day of each herb, increasing the dosing every day by 1 drop per dose until taking 30 drops 2 times a day. If you get a Herxheimer die-off reaction, do not advance the dose until it decreases.
  • Liposomal Cinnamon, Clove, and Oregano Oil Combination. 1 pill 2 times a day.

Comment: This combination kills Bartonella, Babesia, and Borrelia. I include the oil combination to break up Borrelia and Bartonella biofilm. In addition, it treats growing and persister forms of these two germs. The research says the clove oil in this combination may help with Babesia as well. These oils penetrate deeply and disrupt the protective barriers that these pathogens form, enhancing the efficacy of the treatment regimen.

  Best Prescription Antibiotic Combination

  • Methylene Blue: 50 mg, one pill twice a day (from a compounding pharmacy).
  • Fluconazole 200 mg 1 time a day or Itraconazole 100 mg 2 times a day

Comment: This combination seems best at clearing the brain fog seen in Bartonella. Methylene blue and the azoles (fluconazole and itraconazole) treat growing and persister forms of Bartonella. Methylene blue also is effective at breaking up Bartonella biofilm. Learn more about methylene blue in Mighty Methylene Blue for Tick-borne Infections and More.

 

Additional Prescription and Herbal Antibiotic Options

Azole-Based Treatments

This approach involves a three-antibiotic combination to target both the persister and growing phases of Bartonella.

  • Persister and Growing Phases (take both of the following agents):
    • Fluconazole (200 mg, one pill daily) or itraconazole (100 mg, one pill twice daily).
    • Liposomal cinnamon, clove, and oregano oil capsule, containing 75 mg of oregano, twice daily.
  • Growing Phase: Combine the above with one of the following:
    • Azithromycin (500 mg, one pill daily)
    • Clarithromycin (500 mg, one pill twice daily)
    • Minocycline (100 mg, one pill twice daily)
    • Doxycycline (100 mg, one pill twice daily)

Rifamycin-Based Treatments

This regimen also involves a three-antibiotic combination focused on the growing and persister phase of Bartonella.

  • Growing Phase: Choose one rifamycin:
    • Rifampin (300 mg, 2-4 pills divided once or twice daily)
    • Rifabutin (150 mg, 2-4 pills divided once or twice daily)
  • Additional Growing Phase: Combine with one of the following:
    • Azithromycin (500 mg, one pill daily)
    • Clarithromycin (500 mg, one pill twice daily)
    • Minocycline (100 mg, one pill twice daily)
    • Doxycycline (100 mg, one pill twice daily)
    • Bactrim DS (one pill twice daily)
  • Persister Phase: Add one of the following persister agents:
    • Methylene blue (50 mg, one pill twice daily, compounded)
    • Liposomal cinnamon, clove, and oregano oil capsule, containing 75 mg of oregano, twice daily

Macrolide and Tetracycline-Based Treatments

This treatment involves a three-antibiotic combination targeting the growing and persister phases.

  • Growing Phase: Start with one macrolide:
    • Clarithromycin (500 mg, one pill twice daily)
    • Azithromycin (500 mg, one pill daily)
  • Growing Phase: Combine with one tetracycline:
    • Minocycline (100 mg, one pill twice daily)
    • Doxycycline (100 mg, one pill twice daily)
  • Persister Phase: Add one of the following:
    • Methylene blue (50 mg, one pill twice daily, compounded)
    • Liposomal cinnamon, clove, and oregano oil capsule, containing 75 mg of oregano, twice daily

Methylene Blue-Based Treatments

This regimen targets the growing and persister phases, plus biofilms, using a three-antibiotic combination.

  • Growing and Persister Phases plus Biofilms:
    • Methylene blue (50 mg, one pill twice daily, compounded).
  • Growing Phase: Combine with one of the following macrolides or tetracyclines:
    • Azithromycin (500 mg, one pill daily)
    • Clarithromycin (500 mg, one pill twice daily)
    • Minocycline (100 mg, one pill twice daily)
    • Doxycycline (100 mg, one pill twice daily)
  • Growing Phase: Add a rifamycin:
    • Rifampin (300 mg, 2-4 pills once or twice daily)
    • Rifabutin (150 mg, 2-4 pills once or twice daily)

Fluoroquinolone-Based Treatments

Fluoroquinolones are a category of antibiotics that encompass medications such as levofloxacin (Levaquin) and ciprofloxacin (Cipro). Despite their effectiveness against a wide variety of bacterial infections, the use of fluoroquinolones is accompanied by significant risks. These antibiotics have been associated with potential side effects, including the risk of permanent tendon pain and even tendon rupture. Due to these potential adverse effects, I no longer use of fluoroquinolones in my treatment protocols.

Houttuynia and Sida Acuta Plus Oil Combination

This combination, initiated in 2015, includes houttuynia and Sida acuta, enhanced by Dr. Zhang's research to treat persisters and biofilms.

  • Houttuynia: Begin with 5 drops twice daily, increasing by 1 drop per dose until reaching 30 drops twice daily.
  • Sida Acuta: Start with ¼ tsp three times daily. After one week, if tolerated, increase to ½ tsp three times daily.
  • Liposomal Cinnamon, Clove, and Oregano Oil: One capsule twice daily (each capsule should contain 75 mg of oregano).

If someone cannot tolerate the cinnamon, clove, and oregano capsules, then for persisters (and growing Bartonella) I substitute either cryptolepis or Japanese knotweed.

  • Cryptolepis 5 ml 3 times a day; or
  • Japanese Knotweed 30 drops 2 times a day.

I am not impressed with other herbal options. For instance, I have tried a formula called A-BART by Byron White, which are herbs that seem to help less than 50 percent of the time. Likewise, houttuynia by itself only works 50 percent of the time. I have not had any success using the Beyond Balance herbal products.

Disclaimer

The ideas and recommendations on this website and in this article are for informational purposes only. For more information about this, see the sitewide Terms & Conditions.

* These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.

References

View Citations

  1. Buhner SH. Healing Lyme Disease Coinfections: Complementary and Holistic Treatments for Bartonella and Mycoplasma. Healing Arts Press; 2013.
  2. Biswas S, Rolain J-M. Bartonella infection: Treatment and drug resistance. Future Microbiol. 2010;5(11):1719-1731. doi:10.2217/fmb.10.133 (View)
  3. Lindner H. Chronic Babesiosis caused by Babesia odocoilei: Pathophysiology, diagnosis and treatment. Lecture presented at the Annual International Lyme and Associated Diseases Scientific Conference; October 2021; Orlando.
  4. Ma X, Leone J, Schweig S, Zhang Y. Botanical medicines with activity against stationary phase Bartonella henselae. Infect Microb Dis. 2021;3(3):158-167. doi:10.1097/IM9.0000000000000069 (View)
  5. Mozayeni RB. Bartonella Update. Lecture presented at the Annual International Lyme and Associated Diseases Scientific Conference; November 14, 2021; Orlando, FL.
  6. Li T, Feng J, Xiao S, Shi W, Sullivan D, Zhang Y. Identification of FDA-approved drugs with activity against stationary phase Bartonella henselae. Antibiotics (Basel). 2019;8(2):50. doi:10.3390/antibiotics8020050 (View)
  7. Ma X, Shi W, Zhang Y. Essential oils with high activity against stationary phase Bartonella henselae. Antibiotics (Basel). 2019;8(4):246. doi:10.3390/antibiotics8040246 (View)
  8. Zheng X, Ma X, Li T, Shi W, Zhang Y. Effect of different drugs and drug combinations on killing stationary phase and biofilms recovered cells of Bartonella henselae in vitro. BMC Microbiol. 2020;20(1):87. doi:10.1186/s12866-020-01777-9 (View)
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About The Author

Marty Ross, MD is a passionate Lyme disease educator and clinical expert. He helps Lyme sufferers and their physicians see what really works based on his review of the science and extensive real-world experience. Dr. Ross is licensed to practice medicine in Washington State (License: MD00033296) where he has treated thousands of Lyme disease patients in his Seattle practice.

Marty Ross, MD is a graduate of Indiana University School of Medicine and Georgetown University Family Medicine Residency. He is a member of the International Lyme and Associated Disease Society (ILADS), The Institute for Functional Medicine, and The American Academy of Anti-Aging Medicine (A4M).

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