The Ross Lyme Support Protocol 

A Chronic Lyme Disease Support & Treatment Guideline

Updated November 9, 2021

Ross Lyme Support Protocol  Update Image

"The Ross Lyme Support Protocol is a chronic Lyme disease support and treatment guideline. It is more comprehensive than the ILADS, IDSA, and CDC treatment guidelines. Discuss these approaches with your healthcare provider to see if they are right for you."   

– Marty Ross MD

Forward & Introduction
1. Sleep
2. Diet
3. Cytokine Control
4. Adaptogen
5. Hormones
6. Essential Micronutrients
7. Detoxification
8. Exercise
9. Immune System Boosters
10. Yeast
11. Lyme Infection
12. Coinfections: Bartonella & Babesia
13. Additional Supports and Treatments
14. Special Considerations
15. Health Decline after Doing Better

About The Ross Lyme Support Protocol

Forward to The 3rd Edition 

The Ross Lyme Support Protocol is a living document. From time to time I update it based on the latest science and the experience I have treating people with tick-borne illnesses and mold toxicity in my Seattle clinic. This 3rd edition, released November 9, 2021, includes major additions and subtractions. Read the full Forward to The 3rd Edition to see what is new before diving into the protocol below. 

Introduction

These are support and treatment guidelines to treat chronic Lyme and associated diseases. This protocol addresses most problems that keep a person from getting well. It is more comprehensive than the antibiotic focused Infectious Disease Society of America (IDSA), International Lyme and Associated Disease Society (ILADS), and United States Centers for Disease Control and Prevention guidelines. While herbal and prescription antibiotics may decrease the germ load in chronic Lyme, they often do not correct the underlying problems that cause ongoing symptoms. 

The Ross Lyme Support Protocol includes essential steps for the beginning and throughout a chronic Lyme disease treatment. It is designed to:

  • boost the immune system,
  • improve detoxification,
  • speed recovery,
  • kill the infections, and
  • protect and repair from the harmful effects of the infections and the herbal or prescription antibiotics.

While the following Lyme disease treatment approach focuses on a limited number of areas, it may correct most of the problems like:

  • low energy,
  • pain,
  • insomnia,
  • brain, neurologic, and thinking problems (brain fog), and
  • immune compromise and suppression.

Herxheimer Reactions. When a person starts a Lyme disease treatment or changes herbal and prescription antibiotics, it is common to experience some worsening in symptoms. See Herxheimer Die-off Reaction: Inflammation Run Amok for more information about this and the steps you can take to treat it.

Treatment Length and Persistence. Generally, it takes a minimum of six months to see if these supports and treatments will help. Supplements can speed recovery, but treating Lyme still takes time. Once you have marked improvement, then you can likely stop many of these nutritional supports except for probiotics, curcumin, ashwagandha, and a good multivitamin. See Getting Healthy: Will I? When? How Do I?for more information about Lyme disease treatment length and persistence.

About Supplements. Throughout this protocol I include supplements as nutritional supports based on their known functions. Basic research and my clinical experience show they may help the various symptoms and problems in Lyme disease.

Disclaimer

These guidelines are based on the best available research, and what I find clinically useful in my Seattle practice. The ideas and recommendations on this website and in this guideline are for informational purposes only. For more information about this, see the sitewide Terms & Conditions.

Diagnosis, Tests, and Relapse Prevention

The Ross Lyme Support Protocol is a set of Lyme disease support and treatment guidelines. Read or watch the following articles found on Treat Lyme for information about diagnosis, tests, and relapse prevention.

Diagnosis

Tests

Relapse Prevention

Before Treating Lyme Disease

Make Sure It Is Not Mold Toxin Illness

Mold toxin illness can look just like Lyme disease. Both trigger a reaction in the immune system that produces too many inflammation chemicals called cytokines, and cytokines cause most of the problems seen in both of these illnesses.

If your illness began while you were living or working in a building with obvious mold, I suggest treating for mold toxin illness first. I find correcting this issue may prevent the need to treat for Lyme disease. Once the mold toxins are removed, the immune system can keep Lyme under control. For more information, read Mold and Lyme Toxin Illness and Positive Lyme Test, No Symptoms, Don't Treat.

Very Allergic? Treat Mast Cell Activation Syndrome

Chronic infections can trigger excessive allergic reactions to food, prescription and natural medicines, and to the environment. If this is your problem, consider using supplements, diet, and medicines for Mast Cell Activation Syndrome. For more information, read Mast Cell Activation Syndrome & Lyme.

Part 1. Sleep

Use either supplements that support sleep or prescription medicines. Do not mix supplements and prescription medicines together as a first treatment, though you can do so later.

Action Plan

Supplements:

(You can take these two supplements together or use in combination with the prescription medicines, if needed.)

  • L-Theanine 100 mg 1 to 6 pills a night 1 hour before bed. Do not exceed 1,200 mg a day if using for nerve pain or anxiety during the day, as well. Excessive amounts in the day are very sedating. and/or
  • Herbal Sleep Combination 1 to 2 pills 1 hour before bed. (Common herbs in sleep combination pills include valerian root, lemon balm, passionflower, hops, yams, wild lettuce, L-theanine, and others.)

Prescription Medicines:

  • Zolpidem (Ambien) 10 mg 1 pill 30 minutes before bed. (Use if your primary problem is getting to sleep. It is short-acting.) and/or
  • Trazodone 50 mg 1/2 to 2 pills 30 minutes before bedtime. (Use this if your primary problem is staying asleep.)

For more information about these items or for additional options about sleep hygiene, see Sleep in Lyme Disease: The Basic Steps. For information about sleep herbs and supplements, see Sleep: The Natural Medicines.  For more information and sleep prescriptions options, see Sleep: The Prescription Medicines.

Why These Actions May Help

Sleep is often disturbed in chronic Lyme disease. Lack of adequate sleep worsens pain, increases fatigue, and suppresses the immune system. It appears that in response to infection, the excess inflammatory cytokines produced by the immune system decrease the output of sleep inducing hormones to the sleep centers of the brain. And lack of sleep increases cytokines. A restorative amount of sleep is seven to nine hours of sleep per night. Sleep in the few hours before midnight is most restorative.

Part 2. Diet

Action Plan

Eat a Paleo-based diet rich in organic foods, healthy fats, proteins, and vitamin rich vegetables. For more detailed information about the diet, see The Best Brain, Inflammation, Pain, Energy & Detox Diet Ever.

An elimination diet is another diet to consider starting. For detailed information, see Elimination Diet to Find Food Problems.

Why These Actions May Help

A Paleo diet is low in simple sugars, which decreases the chances of developing intestinal yeast. It also promotes brain health and supports the energy factories—called mitochondria—found in every cell. Because it is low in sugar, it may decrease inflammation.

An elimination diet helps a person find which foods that trigger allergies or inflammation reactions. If you are reacting to foods, consider trying an elimination diet first. Removing allergic and inflammatory foods from your diet leads to decreased pain and improved energy.

Part 3. Cytokine Control

Action Plan

Supplements:

  • Curcumin 500 mg 1 pill 3 times a day. Choose a liposomal product. In such a product, the curcumin is microscopically wrapped in oil like sunflower oil to increase its absorption. or
  • Anti-Cytokine Combination 1-2 pills 3 times a day. Anti-cytokine combinations include cur- cumin, resveratrol, black tea extract, and N-Acetyl Cysteine (NAC).

Prescription Medicine:

There are no effective and safe options.

Why These Actions May Help

Cytokines are inflammatory chemicals made by the immune system in chronic Lyme disease. Nutritional supports like curcumin, resveratrol, black tea extract, NAC, and antioxidants found in a good multivitamin (see Part 6.) may lower cytokines. This can

  • correct many Lyme symptoms,
  • boost the immune system, and
  • limit Herxheimer die-off reactions.

On the one hand, cytokines are good because they turn on the immune system. They perform a number of functions that include:

  • making antibodies work more effectively,
  • increasing active white blood cells to fight infections,
  • recruiting white blood cells to the location of an infection,
  • turning on white blood cells to fight infections, and
  • decreasing viral and bacterial replication.

On the other hand, in chronic Lyme disease the immune system makes too many cytokines, which is bad. Too many cytokines

  • suppress the immune system,
  • cause pain,
  • decrease hormone production from organs like the thyroid and the adrenal glands,
  • disturb sleep,
  • decrease brain function,
  • increase fatigue and tiredness,
  • waste muscles,
  • cause depression, and
  • decrease the function of various organs throughout the body, resulting in many other symptoms and medical problems.

At the beginning of treatment or when antibiotics are changed, the cytokines are made in even greater amounts, which causes a person to feel much worse. This is called a Herxheimer dieoff reaction.

See Control Cytokines: A Guide to Fix Lyme Symptoms & The Immune System for more information and additional herbal medicine options to use in a Lyme disease treatment.

Your source for
quality supplements

Shop Now

Part 4. Adaptogen

Action Plan

Supplement:

  • Ashwagandha 400 mg 1 to 2 pills in the morning and 1 to 2 pills between 12 pm. Taking ashwagandha late in the day may disturb sleep.

Why These Actions May Help

An adaptogen is a substance that helps the body deal with the harmful medical and emotional stress of being ill. Adaptogens have been used for centuries in Ayurvedic and Chinese medicine with greatly observed benefits. Based on animal experiments, ashwagandha may improve

  • energy,
  • immune function, and
  • adrenal and thyroid function.

It likely has additional beneficial effects that have not been researched.

Part 5. Hormones

Read the "Why These Actions May Help" section below to determine, based on symptoms alone, if you could have low hormones.

Action Plan

     A. Adrenal Insufficiency

Start with the supplement or prescription medicine. It is possible to use both together if the symptoms of low adrenals persist.

Supplement:

  • Ashwagandha 400 mg 1-2 pills in the morning and 1 to 2 pills between 1-2 pm. Taking late in the day may disturb sleep.

Prescription Medicine:

In my practice, I rarely used this because there is a very small risk of immune suppression using prescription hydrocortisone. However, the doses I recommend are the normal amounts the adrenal glands should make. I prefer ashwagandha because it is a supportive herb that does not suppress the immune system.

  • Cortef 5 mg 1 to 2 pills in the morning and 1 to 2 pills between 12 pm. Taking late in the day may disturb sleep.

     B. Low Thyroid

Supplements:

  • Ashwagandha 400 mg 1 to 2 pills in the morning and 1 to 2 pills between 1-2 pm. Taking late in the day may disturb sleep. Also use with
  • Zinc 20 mg, Selenium 100 to 200 mcg, and Iodine 200 to 300 mcg 1 time a day. (These are often found in multivitamins or you can supplement them individually.)

Use these nutritional supports first for one to two months before adding or trying the prescription medicine option below. Often, working with these supplements corrects the thyroid so you do not need to take thyroid prescription medicines.

Prescription Medicines:

  • Desiccated Thyroid 1⁄2 grain or Armour Thyroid 1⁄2 grain 1 pill in the morning 30 minutes before anything else and on an empty stomach with water only. Increase every 3 to 4 weeks by 1⁄2 grain if low thyroid symptoms persist.

For more information about how to manage thyroid, even if your tests are normal, read my comprehensive article: Hypothyroidism. The Best Tests, Meds, & Vitamins.

Why These Actions May Help

Fixing low adrenals and/or low thyroid can help the immune system work better and possibly im- proves energy. A person could have normal range testing for each of the hormones, but still have clini- cally low hormones. Because of the unreliability of testing, treatment for low hormones should occur if there are clinical symptoms of low hormones as long as the treatment does not increase hormone levels above the upper end of normal.

Diagnose Based on Symptoms

If you have a number of these symptoms, consider using the natural medicine approaches for each respective problem.

  • Adrenal Insufficiency: fatigue, recurrent infections, poor recovery from infections, low blood sugar with shakiness and irritability relieved by eating, low blood pressure and dizziness on standing, afternoon crashing, and sugar cravings.
  • Low thyroid: fatigue, achiness, dry skin, cold intolerance, weight gain, constipation, and changes in menstrual periods.

Part 6. Essential Micronutrients

Action Plan

Supplement:

  • Multivitamin. Use a vitamin that has numerous amino acids, antioxidants, minerals, and various vitamin Bs, including B12 and folate. I prefer powders by Thorne and Integrative Therapeutics and capsules by Researched Nutritionals.

Why This Action May Help

In my opinion, to heal and feel better requires a multivitamin with an essential set of vitamins, minerals, amino acids, and antioxidants. A good multivitamin can improve functioning of the immune system, muscles, brain and nerves, hormones, organs including the kidney and liver, and detoxification, in addition to decreasing inflammation. It also may protect the body from the toxic effect of prescriptive antibiotics.

Part 7. Detoxification

Action Plan

Reduce the total load of negative environmental influences on your health by

  • eating organic foods,
  • avoiding gluten, scents, alcohol, and tobacco, and
  • decreasing emotional stress.

Supplement and Diet

Support Liver detoxification.

  • Liposomal Glutathione 400 to 500 mg 1 pill 1 time a day. Glutathione is the master detox chemical used by the liver to remove toxins. It also helps remove neurotoxins and repair brain tissue. It works better than other herbal options like Pinella or Burbur. Read more in Glutathione: The Great Fixer.
  • Detox Diet: Drink water regularly to support kidney detoxification. A general rule of thumb is to drink half of your ideal body weight (measured in pounds) as ounces of non-caffeinated liquids a day. For example, a person with a 150-pound ideal body weight should drink 75 ounces a day of non-caffeinated liquid. Eat healthy vegetables and a limited number of fruits a day for vitamins and for fiber. Fiber binds toxins in the intestines and promotes their removal from the body through regular bowel movements.

See The Basic Lyme Detox Steps for more detailed information.

Why These Actions May Help

Lyme produces toxins that lead to inflammation from cytokines. This suppresses the immune system and gives many of the Lyme symptoms. In addition, many of the natural and prescription medicines can have toxic effects. These detoxification steps may protect against and fix toxin issues.

Part 8. Exercise

Action Plan

Exercise to tolerance. Find a level you can do that does not make you worse the next day. This may mean you can only walk half a block at the beginning. Furthermore, over exercise—an amount that makes a person feel worse—may suppress the immune system and impair healing. Be careful. At the beginning of treatment, you may have to wait to begin exercise until you have some improvements.

Why This Action May Help

Exercise improves blood flow to all tissues. This improves the penetration of antibiotics and helps with detox. Exercise also releases various chemicals like endorphins and enkephalins that produce healing effects and improve immune function.

Part 9. Immune System Boosters

The entire Ross Lyme Support Protocol is designed to support and boost your immune system. Because of this, most people do not need to take specific immune system boosters. The Ross Lyme Support Protocol supports the immune system through:

  • sleeping
  • lowering cytokines
  • detoxing
  • using an adaptogen
  • fixing hormonal problems
  • killing Lyme, yeast, and coinfections
  • exercising as tolerated and
  • eating a Paleo or elimination diet to fix immune system dysfunction.

In addition to these steps, there are additional supplements you can take. To read more about these options, see How to Boost the Immune System in Lyme. I do not recommend these additional supplements at first. Consider adding them six to nine months into treatment or during antibiotic holiday periods.

Part 10. Yeast

Read “Why These Treatments May Help” below to determine if you may have a current intestinal yeast overgrowth problem requiring treatment.

Action Plan

Prevention or Treatment

  • For yeast overgrowth prevention, use probiotics and antifungals in A & B.
  • For current intestinal yeast overgrowth treatment use probiotics and antifungals in A & C.

     A. PROBIOTICS

Supplement:

  • Probiotic. Use spore-forming bacteria strains (Bacillus sp.) combined with human bacteria strains (Lactobacillus sp. and Bifidobacterium sp.) for best results. You can do this using 1-2 pills 1 time a day of a combination product which includes the spore-forming and human bacteria strains. Or use two separate products and take 2 pills 1 time a day of each. For more information see Probiotics in Lyme Treatment.

     B. ANTIFUNGALS FOR PREVENTION:

Use either the supplement or prescription medicine. You do not need to use both together.

Supplement:

  • Herbal Combination 2 pills 2 times a day. Common herbs found individually or mixed together include: Pau D'arco, caprylic acid, rosemary oil, thyme oil, garlic, and grapefruit seed extract. 

Prescription Medicine:

  • Nystatin 500,000 IU 2 pills 2 times a day.

     C. ANTIFUNGALS FOR OVERGROWTH:

Do this if you have a yeast screening score of 140 or higher (see below). When you complete treatment, then start yeast prevention antifungals as above. Use the supplement or prescription medicine option, but not both together.

Supplement:

  • Herbal Combination. 2 pills 2 times a day. Common herbs found individually or mixed together include: Pau D'arco, caprylic acid, rosemary oil, thyme oil, garlic, and grapefruit seed extract. 

Prescription Medicine:

Use both of the following together.

  • Nystatin 500,000 IU 2 pills 2 times a day, and
  • Fluconazole (Diflucan) 200 mg 1 time daily for 30 days. Use in combination with nystatin to prevent drug resistance. This combination will take 30 days to get yeast under control.

Additional Options:

Some have great difficulty getting rid of intestinal yeast overgrowth. See Kills Yeast: A Brief Guide for more herbal and prescription medicine options.

Why These Actions May Help

Too many yeasts in the intestines (yeast overgrowth) is a common problem that occurs in those with chronic Lyme disease either during or prior to beginning Lyme disease treatment.

Antibiotics used to treat Lyme can lead to too many yeasts. Immune suppression prior to starting antibiotics can also cause yeast overgrowth. Yeast overgrowth can result in an ongoing systemic allergic reaction to the yeast that can suppress the immune system. Yeast overgrowth also leads to inflammatory cytokine excess that causes many of the Lyme disease symptoms and pain. Food allergies and sensitivities can be the result of yeast overgrowth, too.

A reliable test for yeast overgrowth does not exist. While some physicians may test for antibodies to intestinal yeast in the blood, antibodies are common even when yeasts are in balance. In addition, it is normal to have stool cultures grow yeast; so, a culture does not indicate if yeasts are in excess. For this reason, yeast is diagnosed using my yeast screening questionnaire. This questionnaire evaluates for the possibility of yeast overgrowth based on yeast overgrowth risk factors and intensity of symptoms. In general, I find people benefit from treatment if the score is 140 or higher.

At the beginning of a Lyme disease treatment, often before antibiotics are started, it is essential to treat yeast. Doing so can limit the severity of Herxheimer die-off reactions from treating Lyme because removing yeast removes one source of inflammatory cytokine excess.

Part 11. Lyme Infection 

“Based on my experience, these supplement and prescription medicine options have equal chances of helping a person. The chance they will help is 85 to 90 percent over a six-month period of time.” Marty Ross, MD

Action Plan

Option 1. Supplements

Take the supplements below together for a complete treatment.

  • Otoba Bark Extract and Cat’s Claw. 5 drops 2 times a day of each herb, increasing the dosing every 2 days by 1 drop per dose until taking 30 drops 2 times a day. Take on an empty stomach. Do not take 30 minutes before through 2 hours after having food, medicines, or supplements. 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

 

Option 2. Prescription Medicines And Supplements

I generally start with oral antibiotics. For considerations about IV antibiotics, see A Lyme Disease Antibiotic Guide.

Take one item from each of the three parts together for a complete treatment.

     Part 1.

  • Doxycycline 100 mg 2 pills 2 times a day or 4 pills 1 time a day. Take with food to prevent nausea. Do not take with calcium supplements or calcium-fortified dairy products like milk, cheese, or milk substitutes like rice milk. OR
  • Clarithromycin (Biaxin) 500 mg 1 pill 2 times a day. Use doxycycline if you have an Anaplasma Ehrlichia coinfection.

     Part 2.

  • Rifampin 300 mg 2 pills 1 time a day OR
  • Rifabutin 150 mg 2 pills 1 time a day OR
  • Tinidazole 500 mg 2 or 3 times a day OR
  • Grapefruit Seed Extract 250 mg 1 pill 2 times a day.


     Part 3.

  • Liposomal Cinnamon, Clove, and Oregano Oil Combination 1 pill 2 times a day.

For many more Lyme infection supplement and prescription antibiotic options, see A Lyme Disease Antibiotic Guide.

Why These Actions May Help

These action steps address the different forms and growth states of the Lyme germ.

  • Forms: Lyme has two extracellular forms which are called spirochete and cyst. Lyme also lives inside cells as an L-form which does not have a covering.
  • Growth States: Lyme spirochetes and cysts exist in a persister (hibernating) phase and a growth phase.

Lab experiments suggest the great majority of spirochetes and cysts are in a growth phase. Persisters generally do not respond to regular antimicrobials. In my experience, the best outcomes with my patients occur when I address spirochetes and cysts in the growth phase and persister phase at the same time. The Action Step options above both do this.

Otoba parvifolia extract and cat’s claw are supplements that reach all forms of Lyme inside and outside of cells. Because these herbs are dosed using drops, they are more easily regulated to manage a die-off reaction by not increasing the dose until the reaction lessens. In my experience, any oral antibiotic combination works as well as the otoba parvifolia extract and cat’s claw combination, which is 85 to 90 percent of the time.

Doxycycline or clarithromycin treat the spirochete. They also treat Lyme in and out of cells. Rifampin, rifabutin, tinidazole, and grapefruit seed extract treat the cyst form.

I include Liposomal cinnamon, clove, and oregano oils because they are shown in laboratory experiments to eliminate persisters and growth phase Lyme. They also appear to remove biofilm slime layers that cover germs and can block out antimicrobials and immune cells.

About Disulfiram. Disulfiram has gotten a lot of press due to its effect on persisters. I do not include it in this protocol, but some of you may want to consider trying it. Disulfiram is a very hard drug to take due to side effects and dietary restrictions. While it appears effective against persisters in the laboratory, it is only moderately effective against the growth phase of Lyme infection. If you are new to treating Lyme disease, I do not recommend starting with a disulfiram alone treatment due to how difficult a treatment can be and the fact it may miss growing forms of Lyme.

Read More About Persisters. To read more about all persister options, including when it might be ok to try disulfiram, see How to Treat Persister Lyme & Bartonella.

Part 12. Coinfection Treatments

Action Plan

Generally, I do not recommend that a person start supplements or prescription medicines that target Bartonella or Babesia coinfections at the initial visit. Wait one month or longer to adjust to the Herxheimer die-off reaction from treating the Lyme infection and to stabilize on the supportive supplements.

If you have both of these coinfections, support or treat one first before adding a support or treatment for the other. When both are present, my preference is to address Bartonella first for two to three months and then add support or treatment to address Babesia. You can address these coinfections at the same time you treat or support the Lyme infection.

Bartonella

Option 1. Supplements:

In my experience, these supplements work 70 to 75 percent of the time and take four to six months. If you do not have improvement in Bartonella symptoms by two months, then change to prescription medicines. For Best results use all three of these supplements at the same time.

  • Houttuynia 5 drops 2 times a day of each herb and increase the dosing every 2 days by 1 dropper dose until taking 30 drops 2 times a day. Take on an empty stomach. Do not take 30 minutes before through 2 hours after having food, medicines, or supplements. AND
  • Sida Acuta 1/4 tsp 3 times a day for 1 week, then increase to 1/2 tsp 3 times a day. It is best to take this without food. It can be taken at the same time as the Houttuynia. AND
  • Liposomal Cinnamon, Clove, and Oregano Oil Combination 1 pill 2 times a day.

Option 2. Supplement and Prescriptions:

In my experience, this prescription antibiotic-based option has a 10 percent better chance of working than the supplement-only option above. For best results use the two prescription medicines and the supplements at the same time. Note: This option is also a full Lyme infection support and treatment.

  • Clarithromycin 500 mg 1 pill 2 times a day. AND
  • Rifabutin 150 mg 2 times a day or 2 pills 1 time a day or Rifampin 300 mg 2 pills 1 time a day. AND
  • Liposomal Cinnamon, Clove, and Oregano Oil Combination 1 pill 2 times a day.

Babesia

Option 1. Supplements:

In my experience, these supplements work 75 to 80 percent of the time and take four to five months. If you do not have improvement in Babesia symptoms by two months, then change to prescription medicines. Any of my recommended prescription options works about 80 to 85 percent of the time.

  • Cryptolepis 5 ml 3 times a day. AND/OR
  • Artemisinin 100 mg 2 or 3 pills 2 times a day for 3 days on the medication then take 11 days off. Continue this 14-day cycle. The goal is to reach 5 pills 3 times a day on the 3 days the med- ication is taken. I use artemisinin this way because the intestines develop an enzyme that destroys this herbal medicine if it is used longer than three days. Be aware the dose on the 3 days is quite strong. Often it causes a worsening of the Babesia symptoms beginning on the second day and sometimes lasting until six days later. If a person is very medicine sensitive, I start at 1 or 2 pills 3 times a day. Artemisinin often does not work well for Babesia from tick bites on the East Coast of the U.S.

Option 2. Prescription Medicines:

  • Clarithromycin 500 mg 1 pill 2 times a day. AND
  • Atovaquone/Proquanil (Malarone) 250 mg/100 mg 1 pill 2 times a day. Note: Do not take rifampin or rifabutin at the same time as this medication. These antibiotics lower atovaquone levels.

Additional Prescription Medicines

See Kills Bartonella: A Brief Guide and/or Kills Babesia: A Brief Guide for prescription approaches you can take to treat these infections.

Why These Actions May Help

Based on my experience, a person will not recover from Lyme if these two Lyme coinfections are not treated when they are present. It is as though they protect Lyme. Conversely, Lyme seems to protect them, as well, which is why it takes months to get rid of these infections.

Recent research from Johns Hopkins University shows Bartonella, like Lyme, has persisters too. I include liposomal cinnamon, clove and oregano oil capsules to address this issue. For more information about persisters options see: How to Treat Persister Lyme & Bartonella.

Part 13. Supports and Treatments

Many other supplements or prescription medicines can help manage symptoms and problems existing in Lyme disease. Wait one month after beginning a Lyme disease treatment to start these. For additional treatment ideas based on your specific medical problems, see articles in the following medical problem chapters. For instance, if you have severe brain fog or numbness, find helpful articles in the Brain & Nerves chapter.

Part 14. Special Considerations

Disulfiram

One of the strongest Lyme infection persister medications or supplements is Disulfiram. Clinical experience shows it can get over 36 percent of people who have been on extensive antibiotic regimens in the past into enduring remission. This is a repurposed prescription medication that is used to treat alcoholism. Laboratory and human research publications show Disulfiram is helpful for Lyme infection. However, laboratory experiments and my own experience show this is not an effective medication for Bartonella.

As I noted in the Lyme Infection section, I do not suggest a person new to chronic Lyme treatment start with a Disulfiram-only regimen because of the potential for severe side effects and the fact we do not know if it also effectively treats growth phase Lyme. However, in people who do not have active Bartonella or Babesia coinfections that have already tried a year or more of prescription antibiotics, I do think it is worth a try as stand-alone antimicrobial. For more information about the potential benefit, risks, dietary restrictions, and how to take the medication see: Disulfiram for Lyme Update (treatlyme.net). For additional supplement and prescription medication persister options see: How to Treat Persister Lyme. What Works?  

If You Are Becoming More Allergic With Treatment

Chronic infections can trigger excessive allergic reactions to food, prescription and natural medicines, and to the environment. If this is your problem, consider using supplements, diet, and medicines for Mast Cell Activation Syndrome. For more information, read Mast Cell Activation Syndrome & Lyme.

Two Months: Difficult Babesia or Bartonella

On an effective Bartonella or Babesia antimicrobial regimen, improvements in symptoms that come from the respective infection should start to improve by one to two months of treatment and support. If there is no improvement, then change the antimicrobials to another option.

Another reason the symptoms may not improve by two months is fibrin-germ plaques (also called fibrin nests) that form on blood vessel walls. These include babesia woven into fibrin protein or bartonella woven into fibrin protein. Fibrin is a protein found in blood to help with blood clotting. In plaques, fibrin can block out antimicrobials and the immune system. Lumbrokinase is a nutritional support composed of enzymes that may breakdown fibrin. Consider adding Lumbrokinase at two months.

  • Lumbrokinase 20mg 1 pill two times a day. Take on an empty stomach except for water by avoiding food, medicines, or supplements one hour before and after taking it.

Six Months and Beyond

There are additional support and treatment steps to consider by six to nine months of Lyme disease treatment if you are not having adequate improvement. Read these articles online at Treat Lyme (treatlyme.net) for more information.

Detoxification

Biofilms

Chronic viral infections

Boost energy, fix mitochondria cell energy factories

Co-infections

Continually review your symptoms to see if you have a coinfection that was missed. Treating Lyme is like peeling the layers of an onion. As you treat, it sometimes becomes more apparent which coinfections are present. In addition, it is possible to have coinfection relapses.

Autoimmune illness and chronic Inflammation due to Th1/Th2 imbalance

Repair Damaged Tissues

Yeast

If you have a number of these symptoms—such as increased sugar cravings, intestinal gassiness or bloating, recent vaginal yeast infection, oral yeast, and/or vaginal or rectal itching—consider treating for yeast overgrowth in the intestines.

Part 15. Health Decline after Doing Better

It is common to have ups and downs during a Lyme disease treatment. In some cases, there can be a significant decline after a person is doing better. In these cases, consider yeast overgrowth of the intestines or relapse of a Bartonella or Babesia coinfection. In my experience, most major health declines are due to yeast overgrowth in the intestines. This is true even if significant symptoms of yeast do not exist.

Excessive yeast in the intestines lead to increased levels of cytokines. Because excess cytokines cause many of the chronic Lyme disease symptoms, it could seem like your Lyme disease is getting worse.

Yeast could be the cause of your decline if you have a number of these symptoms: increased sugar cravings, intestinal gassiness or bloating, recent vaginal yeast infection, oral yeast, and/or vaginal or rectal itching. For information on diagnosing yeast, see A Silent Problem: Do You Have Yeast? For yeast treatment information, see Kills Yeast: A Brief Guide.

References

View Citations

Mold Toxin Illness:

  1. Brewer JH et al., Detection of Mycotoxins in Patients with Chronic Fatigue Syndrome. Toxins 2013, 5, 605-617; doi:10.3390/toxins5040605. (View)
  2. Nathan, Neil (2016). Mold and Mycotoxins: Current Evaluation and Treatment 2016. Pennsauken, NJ: BookBaby.
  3. Shoemaker, Ritchie (2005). Mold Warriors. Baltimore MD: Gateway Press.
  4. Shoemaker, Ritchie (2010). Surviving Mold. Baltimore, MD: Otter Bay Books.
  5. Shoemaker, Ritchie. Mold Illness & the Surviving Mold Official Book. http://www.survivingmold.com/

Mast Cell Activation Syndrome:

  1. Theoharides, T. (2016). Mast Cell Activation. Lecture presented at ILADS annual meeting, Philadelphia.
  2. Theoharides, T., Valent, P., Akin, C., Mast Cells, Mastocytosis, and Related Disorders. N Engl J Med,373;2, 163-172. (View)
  3. Talkington, J., & Nickell, S. P. (1999). Borrelia burgdorferi Spirochetes Induce Mast Cell  Activation and Cytokine Release. Infection and Immunity, 67(3), 1107–1115. (View)

Sleep:

  1. Krysta K, Krzystanek M, Bratek A, Krupka-Matuszczyk I. Sleep and inflammatory markers in different psychiatric disorders. J Neural Transm (Vienna). 2017;124(Suppl 1):179–186. doi:10.1007/s00702-015-1492-3 (View)
  2. Lu K, Gray MA, Oliver C, Liley DT, Harrison BJ, Bartholomeus CF, Phan K L, Nathan PJ. Hum. Psychopharmacol. Clin. Exp. 2004;19:457-465. doi:10.1002/hup.611 (View)
  3. Lyon MR, Kapoor MP, Juneja LR. The effects of L-theanine (Suntheanine) on objective sleep quality in boys with attention deficit hyperactivity disorder (ADHD): a randomized, double-blind, placebo-controlled clinical trial. Altern. Med. Rev. 2011;16(4):348–354. (View)
  4. Liu L, Liu C, Wang Y, Wang P, Li Y, Li B. Herbal Medicine for Anxiety, Depression and Insomnia. Curr Neuropharmacol. 2015;13(4):481–493. doi:10.2174/1570159X130415083112273. (View)
  5. Gooneratne NS. Complementary and alternative medicine for sleep disturbances in older adults. Clin Geriatr Med. 2008;24(1):121–viii. doi:10.1016/j.cger.2007.08.002 (View)
  6. Romero K, Goparaju B, Russo K, Westover MB, Bianchi MT. Alternative remedies for insomnia: a proposed method for personalized therapeutic trials. Nat Sci Sleep. 2017;9:97–108. Published 2017 Mar 17. doi:10.2147/NSS.S128095 (View)
  7. Buysse DJ. Insomnia. JAMA. 2013;309(7):706–716. doi:10.1001/jama.2013.193 (View)
  8. Proctor A, Bianchi MT. Clinical pharmacology in sleep medicine. ISRN Pharmacol. ;2012:914168. doi:10.5402/2012/914168 (View)

Diet:

See the references sections for The Best Brain, Inflammation, Pain, Energy & Detox Diet Ever and Elimination Diet to Find Food Problems.

Cytokines:

  1. Ballatori N, Krance SM, Notenboom S, Shi S, Tieu K, Hammond CL. Glutathione dysregulation and the etiology and progression of human diseases. Biol. Chem. 2009;390:191–214. doi:10.1515/BC.2009.033. (View)
  2. Bocci V, Valacchi G. Nrf2 activation as target to implement therapeutic treatments. Frontiers in Chemistry. 2015;3:4. doi:10.3389/fchem.2015.00004. (View)
  3. Butler T. (2017). The jarisch-herxheimer reaction after antibiotic treatment of spirochetal infections: a review of recent cases and our understanding of pathogenesis. Am. J. Trop. Med. Hyg. 96:46–52. 10.4269/ajtmh.16-0434 (View)
  4. D’Andrea G. Quercetin: a flavonol with multifaceted therapeutic applications? Fitoterapia. 2015;106:256–71. (View)
  5. Gulcubuk A, et al. Effects of curcumin on proinflammatory cytokines and tissue injury in the early and late phases of experimental acute pancreatitis. Pancreatology. 13(4):347-354. (View)
  6. Krysta K, Krzystanek M, Bratek A, Krupka-Matuszczyk I. Sleep and inflammatory markers in different psychiatric disorders. Journal of Neural Transmission. 2017;124(Suppl 1):179-186. doi:10.1007/s00702-015-1492-3. (View)
  7. Lee DW, Gardner R, Porter DL, et al. Current concepts in the diagnosis and management of cytokine release syndrome. Blood. 2014;124(2):188-195. doi:10.1182/blood-2014-05-552729. (View)
  8. Linus Pauling Institute, Oregon State University. Curcumin. Micronutrient Information Center; Phytochemicals website. lpi.oregonstate.edu/mic/dietary-factors/phytochemicals/curcumin Accessed August 18, 2018.
  9. Lu SC. Glutathione synthesis. Biochimica et biophysica acta. 2013;1830:3143-3153 (View)
  10. Pall M. Approaches to curing chronic fatigue syndrome/myalgic encephalomyelitis, fibromyalgia, multiple chemical sensitivity, gulf war syndrom, and possibley many others. Townsend Letter. 2010 (Feb/March) www.townsendletter.com/FebMarch2010/cureNO0210.html Accessed August 19, 2018
  11. Peacock BN, Gherezghiher TB, Hilario JD. et al. New insights into Lyme disease. Redox Biol. 2015;5:66–70. doi.org/10.1016/j.redox.2015.03.002. (View)
  12. Pizzorno J. Glutathione! Integrative Medicine: A Clinician’s Journal. 2014;13(1):8-12. (View)
  13. Pound MW, May DB. Proposed mechanisms and preventative options of Jarisch-Herxheimer reactions. J. Clin. Pharm. Ther. 2005;30:291–295. 10.1111/j.1365-2710.2005.00631.x (View)
  14. Shachar I, Karin N. The dual roles of inflammatory cytokines and chemokines in the regulation of autoimmune diseases and their clinical implications. J Leukoc Biol. 2013;93(1):51–61. doi: 10.1189/jlb.0612293. (View)
  15. Sinha R, Sinha L, Calcagnotto A, Trushin N, Haley JS, Schell TD, Richie Jr JP. Oral supplementation with liposomal glutathione elevates body stores of glutathione and markers of immune function. European Journal of Clinical Nutrition. 2018;72:105–111. (View)
  16. Strle K , Drouin EE, Shen S, El Khoury J, McHugh G, Ruzic-Sabljic E, Strle F, Steere AC. Borrelia burgdorferi stimulates macrophages to secrete higher levels of cytokines and chemokines than Borrelia afzelii or Borrelia garinii. The Journal of Infectious Diseases. 2009;200(12):1936–1943, doi.org/10.1086/648091 (View)
  17. Strle K, Sulka KB, Pianta A, Crowley JT, Arvikar SL, Anselmo A, Sadreyev R, Steere, AC. T-Helper 17 cell cytokine responses in Lyme disease correlate with Borrelia burgdorferi antibodies during early Infection and with autoantibodies late in the illness in patients with antibiotic-refractory Lyme srthritis, Clinical Infectious Diseases. 2017;64(7):930–938. doi.org/10.1093/cid/cix002 (View)
  18. Zhao F, Gong Y, Hu Y, Lu, M, Wang J, Dong J, Qiu F. Curcumin and its major metabolites inhibit the inflammatory response induced by lipopolysaccharide: Translocation of nuclear factor-κB as potential target. Molecular Medicine Reports. 2015;11:3087-3093. doi.org/10.3892/mmr.2014.3079 (View)

Adaptogen:

  1. Mishra L, Singh B, Dagenais S. Scientific Basis for the Therapeutic Use of Withania somnifera (Ashwagandha): A Review. Altern Med Rev 2000;5(4) 334-346. (View)
  2. Liao LY, He YF, Li L, et al. A preliminary review of studies on adaptogens: comparison of their bioactivity in TCM with that of ginseng-like herbs used worldwide. Chin Med. 2018;13:57. Published 2018 Nov 16. doi:10.1186/s13020-018-0214-9 (View)

Hormones:

  1. Mishra L, Singh B, Dagenais S. Scientific Basis for the Therapeutic Use of Withania somnifera (Ashwagandha): A Review. Altern Med Rev 2000;5(4) 334-346. (View)
  2. Liao LY, He YF, Li L, et al. A preliminary review of studies on adaptogens: comparison of their bioactivity in TCM with that of ginseng-like herbs used worldwide. Chin Med. 2018;13:57. Published 2018 Nov 16. doi:10.1186/s13020-018-0214-9 (View)
  3. Jefferies, W. (2004). Safe uses of cortisol. Springfield, Ill.: Charles C. Thomas.
  4. Wiersinga WM, Duntas L, Fadeyev V, Nygaard B, Vanderpump MPJ. 2012 ETA guidelines: the use of l-t4 + l-t3 in the treatment of hypothyroidism. Eur Thyroid J 2012;1:55-71. (View)
  5. Jonklaas J, Bianco AC, Bauer AJ, Burman KD, Cappola AR, Celi FS, Cooper DS, Kim BW, Peeters RP, Rosenthal MS, Sawka AM. Guidelines for the Treatment of Hypothyroidism. Prepared by the American Thyroid Association Taskforce on Thyroid Hormone Replacement. Thyroid 2014;24(12):1670-1751. (View)
  6. Canaris GJ, Steiner J, Ridgway C. Do Traditional Symptoms of Hypothyroidism Correlate with Biochemical Disease? J Gen Intern Med 1997;12:544-550. (View)
  7. Garber JR, Cobin RH, Gharib H, Hennessey JV, Klein I, Mechanik JI, Pessah-Pollack R, Singer PA, Woeber KA. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocr Pract. 2012;18(6):988-1028. (View)
  8. Burch HB, Burman KD, Cooper DS, Hennessey JV. A 2013 survey of clinical practice patterns in the management of primary hypothyroidism. J Clin Endocrinol Metab 99: 2077-2085. (View)
  9. Kelly G. Peripheral metabolism of thyroid hormones: a review. Alt Med Review 2000;5(4):306-333. (View)
  10. Bianco AC, Kim BW: Deiodinase: implications of the local control of thyroid hormone action. J Clin Invest 2006;116:2571-2579. (View)
  11. Shoemaker R. “The Biotoxin Pathway.” The Biotoxin Pathway | Surviving Mold, www.survivingmold.com/diagnosis/the-biotoxin-pathway.
  12. Riedel W, et al. Secretory pattern of GH, TSH, thyroid hormones, ACTH, cortisol, FSH, and LH in patients with fibromyalgia syndrome following systemic injection of the relevant hypothalamic-releasing hormones. Z Rheumatol. 1998;57 Suppl 2:81-7. (View)
  13. Lukaczer D. Advanced assessment and treatment of thyroid dysfunction. Oral presentation at: The Institute for Functional Medicine Hormone Advanced Practice Module; July, 2017; Chicago, IL.
  14. Hoang TD, Olsen CH, Mai VQ, Clyde PW, Shakir MK, Desiccated thyroid extract compared with levothyroxine in the treatment of hypothyroidism: a randomized, double-blind, crossover study. J Clin Endocrinol. 2013 May;98(5):1982-90. (View)
  15. Toulis KA Anastasilakis AD, Tzellos TG, Goulis DG, Kouvelas D. Selenium supplementation in the treatment of Hashimoto’s thyroiditis: a systematic review and a meta-analysis. Thyroid 2010 Oct;20(10):1163-73. (View)
  16. Van Zuuren EJ, Albusta AY, Fedorowicz Z, Carter B, Pijl H. Selenium supplementation for Hashimoto’s thyroiditis: summary of a Cochrane systematic review. Eur Thyroid J 2014;3:25–31. (View)
  17. Roy S, Loh HH, Effects of opioids on the immune system. Neurochem Res 1996;21: 1375-1386. (View)
  18. Risdahl JM, Khanna KV, Peterson PK, Molitor TW, Opiates and infection. J Neuroimmunol 1998;83:4-18. (View)
  19. Younger, Jarred, et al. Low‐dose naltrexone for the treatment of fibromyalgia: findings of a small, randomized, double‐blind, placebo‐controlled, counterbalanced, crossover trial assessing daily pain levels. Arthritis & Rheumatism 2013 Feb;65(2):529-38. (View)
  20. Smith JP, et al. Low-dose naltrexone therapy improves active Crohn's disease. American Journal of Gastroenterology 2007;102(4):820-828. (View)
  21. Bruce AC, et al. Pilot trial of low dose naltrexone and quality of life in MS. Annals of Neurology 2010 August;68(2):145–150. (View)
  22. Howell JG, Staehling NW, Flanders WD, et al. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab. 2022: 489-499. (View)
  23. Kratzsch J, Fiedler GM, Leichtle A, et al. New reference intervals for thyrotropin and thyroid hormones based on National Academy of Clinical Biochemistry criteria and regular ultrasonography of the thyroid. Clin Chem. 2005 51:1480-1486. (View)
  24. Biondi B. The normal TSH reference range: what has changed in the last decade? J Clin Endocrinol Metab, September 2013, 98(9): 3584-3587. (View)
  25. Flynn, RW, SR Bonellie, RT Jun, et al. Serum thyroid stimulating hormone concentration and morbidity from cardiovascular disease and fractures in patients on long-term thyroxine therapy. J Clin Endocrinol Metab 2010;95:1. (View)
  26. Andersen S, Pedersen KM, Gruun NH, Laurberg P. Narrow individual variations in serum T4 and T3 in normal subjects: a clue to the understanding of subclinical thyroid disease.J Clin Endocrinol Metab. 2002 Mar;87(3):1068-72. (View)
  27. Gaby AR. “Sub-laboratory” hypothyroidism and the empirical use of armour thyroid. Alt Med Review 2004 (9)2:157-179. (View)
  28. Caturegli P, De Remigis A, Chuang K, Dembele M, Iwama S. Hashimoto’s thyroiditis: celebrating the centennial through the lens of the Johns Hopkins hospital surgical pathology records. Thyroid 2013. Feb; 23(2):145-50. (View)
  29. Canaris GJ, Steiner J, Ridgway C. Do Traditional Symptoms of Hypothyroidism Correlate with Biochemical Disease? J Gen Intern Med 1997;12:544-550. (View)

Essential Micronutrients:

  1. Teitelbaum, J. Chapter 6: "N" — Nutritional Support, the Building Blocks of Good Health. In: From Fatigued to Fantastic!. 3rd ed. New York, NY: Penguin; 2007.

Detoxification:

  1. Pizzorno, J. The Toxin Solution: How Hidden Poisons in the Air, Water, Food, and Products We Use Are Destroying Our Health--AND WHAT WE CAN DO TO FIX IT. New York, NY: HarperCollins; 2017.
  2. Pizzorno J. Glutathione! Integrative Medicine: A Clinician’s Journal. 2014;13(1):8-12. (View)
  3. Sinha R, Sinha L, Calcagnotto A, Trushin N, Haley JS, Schell TD, Richie Jr JP. Oral supplementation with liposomal glutathione elevates body stores of glutathione and markers of immune function. European Journal of Clinical Nutrition. 2018;72:105–111. (View)

Exercise:

  1. Larun L, Brurberg KG, Odgaard-Jensen J, Price JR. Exercise therapy for chronic fatigue syndrome. Cochrane Database Syst Rev. 2017;4(4):CD003200. Published 2017 Apr 25.  doi:10.1002/14651858.CD003200.pub7 (View)
  2. Jones, D. (2010). Textbook of functional medicine. Gig Harbor, WA.: Institute for Functional Medicine.

Immune System Boosters:

  1. Myers, A. The Autoimmune Solution: Prevent and Reverse the Full Spectrum of Inflammatory Symptoms and Diseases. New York, NY. HarpperOne; 2015
  2. Jones, D. (2010). Textbook of functional medicine. Gig Harbor, WA.: Institute for Functional Medicine.

Yeast:

  1. Kumamoto CA, Inflammation and Gastrointestinal Candida Colonization. Curr Opin Microbiol. 2011 August; 14(4): 386-391. Doi: 10.1016/j.mib.2011.07.015 (View)
  2. Bowe WP, Logan AC. Acne vulgaris, probiotics and the gut-brain-skin axis - back to the future?. Gut Pathog. 2011;3(1):1. Published 2011 Jan 31. doi:10.1186/1757-4749-3-1 (View)
  3. Olmstead S. et al. Candida, Fungal-Type Dysbiosis, and Chronic Disease: Exploring the Nature of the Yeast Connection. Townsend Letter, June, 2012 townsendletter.com/June2012/candida0612.html.

Lyme Infection Treatment:

  1. Buhner SH. Healing Lyme: Natural Healing of Lyme Borreliosis and the Coinfections Chlamydia and Spotted Fever Rickettsioses. 2nd ed. Silver City, NM: Raven Press; 2015.
  2. Cameron DJ, Johnson LB, Maloney EL. Evidence assessments and guidelines recommendations in Lyme disease: the clinical management of known tick bites, erythema migrans rashes and persistent disease. Expert Rev Anti-Infect Ther. 2014;12:1103–1135. doi: 10.1586/14787210.2014.940900. (View)
  3. Datar A, Kaur N, Patel S, Luecke D, Sapi E. In vitro effectiveness of samento and banderol herbal extracts on the different morphological forms of Borrelia burgdorferi. Townsend Lett. 2010;7: 1–4.
  4. Goc A, Rath M. The anti-Borreliae efficacy of phytochemicals and micronutrients: an update. Ther Adv Infect Dis. 2016;3(3-4):75–82. doi:10.1177/2049936116655502. (View)
  5. Miklossy J, Kasas S, Zurn AD, McCall S, Yu S, McGeer PL. Persisting atypical and cystic forms of Borrelia burgdorferi and local inflammation in Lyme neuroborreliosis. J Neuroinflammation. 2008;5:40. (View)
  6. Sapi E, Kaur N, Ananwu S, Luecke DF, Luecke DF, Datar A, Patel S, Rossi M, Stricker RB. Evaluation of in-vitro antibiotic susceptibility of different morphological forms of Borrelia burgdorferi. Infect Drug Resist. 2011;4:97–11. (View)

Coinfections Treatment:

  1. Buhner SH. Healing Lyme Disease Coinfections: Complementary and Holistic Treatments for Bartonella and Mycoplasma. Rochester, VT: 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. Buhner SH. Natural Treatments for Lyme Coinfections: Anaplasma, Babesia, and Ehrlichia. Rochester, VT: Healing Arts Press; 2015.
  4. Vannier E, Gewurz BE, Krause PJ. Human Babesiosis. Infect Dis Clin North Am. 2008;22(3):469-ix. doi:10.1016/j.idc.2008.03.010. (View)

Special Considerations:

Lyme Persisters

  1. Sharma B, Brown AV, Matluck NE, Hu LT, Lewis K. Borrelia burgdorferi, the causative agent of Lyme disease, forms drug-tolerant persister cells. Antimicrob Agents Chemother. 2016;59:4616–4624. doi:10.1128/AAC.00864-15. (View)
  2. Feng J, Auwaerter PG, Zhang Y. Drug combinations against Borrelia burgdorferi persisters in vitro: eradication achieved by using daptomycin, cefoperazone and doxycycline. PLoS ONE. 10(3): e0117207. doi:10.1371/journal.pone.0117207. (View)

Bartonella and Babesia Fibrin Nests

  1. Lindner HH. Chronic Babesiosis odocoilei Pathophysiology, Diagnosis, and Treatment. Lecture presented at: ILADS 2021 Annual Scientific Conference; November 15, 2021; Orlando, FL.
  2. Mozayeni RB. Bartonella Update. Lecture presented at: ILADS 2021 Annual Scientific Conference; November 14, 2021; Orlando, FL.

Mast Cell Activation Syndrome

  1. Theoharides, T. (2016). Mast Cell Activation. Lecture presented at ILADS annual meeting, Philadelphia.
  2. Theoharides, T., Valent, P., Akin, C., Mast Cells, Mastocytosis, and Related Disorders. N Engl J Med,373;2, 163-172. (View)
  3. Talkington, J., & Nickell, S. P. (1999). Borrelia burgdorferi Spirochetes Induce Mast Cell Activation and Cytokine Release. Infection and Immunity, 67(3), 1107–1115. (View)

Health Decline After Doing Better:

  1. Kumamoto CA, Inflammation and Gastrointestinal Candida Colonization. Curr Opin Microbiol. 2011 August; 14(4): 386-391. Doi: 10.1016/j.mib.2011.07.015 (View)
  2. Olmstead S. et al. Candida, Fungal-Type Dysbiosis, and Chronic Disease: Exploring the Nature of the Yeast Connection. Townsend Letter, June, 2012 townsendletter.com/June2012/candida0612.html.
Marty Ross MD Image

See full profile: on LinkedIn 
Follow: on Twitter, YouTube, and Instagram

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) and The Institute for Functional Medicine.

 

Your source for quality supplements

Shop Now

keep up with our LATEST!

Join our email list and receive a FREE pdf download book: Antigerm Action Plans for Lyme Disease, 10 email health tips, updates, special offers and more.

© 2022 TREAT LYME