Some Lyme information (mostly James Schaller)

Quote from Dr Schaller

I have repeatedly seen patients fully normal on dubious routine Lyme titer tests and Western Blot tests, only to explode with symptoms and/or positive tests done at more sophisticated labs a couple weeks later.

Any physician who follows the impaired sensitivity of common "backyard" lab testing, knows little about real Lyme. If they only test for Lyme and not the 2-3 common co-infections that can be carried by ticks, they know little about Lyme.

However, I want to talk about how it is occasionally being missed by solid and brilliant cutting-edge Lyme physicians. As I look over this past season, some patients were missed, and I think I know why.

As you may know, Lyme can present with virtually any medical complaint. And since all doctors agree that we cannot do sophisticated expensive testing on everyone, we have to pick and choose.

So who should get tested?
Here is where a person can be burned. Let me show you with a real case.

Laurie is a 45 year-old teacher. The only outdoor experience she has is walking to the mailbox -- even her car is inside the garage. She broke her ankle last year in a fall from a bike. The ankle was supposed to be fully "recovered" according to the orthopedic doctor, but about 3 months after the cast was removed she still had pain in the ankle -- mild pain.

She worried that the doctor did not set the bone correctly or that it had healed wrong.

However, a year later I tested her blood to evaluate her hormones, along with specialized chronic disease prevention labs. I added a few basic Lyme tests that are not reliable for Lyme.

However, two bands showed up that did not qualify her as officially having Lyme. But on sophisticated tests, she was found to clearly have both Lyme and a malaria-like bug called Babesia.

After three months of treatment, including three antibiotics and an anti-malaria medication, she was feeling much better. And her ankle felt great.

The point? When you are infected with Lyme it may first present by making an area of bodily weakness more of a problem. You can tell yourself it is merely the old problem, but it may be the infection and the chemicals the infection and the body creates, causing the resurrection of the old body problem.

So if you are prone to migraines, they may get worse. If you are prone to knee aches because of degeneration, they may get worse. But it is actually the Lyme making your weakness more apparent.

It requires a solid expert to help you sift through the old body vulnerabilities and new Lyme making worse.

Best to Your Health!

In my recent past articles I discussed the 11 new human Babesia species, the problem some have removing Lyme's surface biotoxins, the trouble with having indoor mold while treating tick infections, and I mentioned that Bartonella has 30 ways of damaging the body dangerously and it has 200 symptoms.

These were sample reasons for treatment failure. But I am increasingly meeting smart doctors and patients who do not know how to read a Western Blot. This is the test which usually gets you a basic Lyme diagnosis. So let us go over this so you understand why some labs are better than others. And help you make sense of this medical test which is so very confusing.

Lyme has many varieties and it is amazing that some companies soberly use Lyme strains in their test which are not representative of more than a small region. So this obviously makes the chances of a positive virtually zero. If you are looking for Asian people in Alaska, can we agree you will find few compared to Japan?

Proteins Tested
The numbers on a Western blot such as 18kDa merely mean they have identified a piece of the Lyme bug that weighs 18 kilo Daltons. Over the years, labs have become very good at separating out these parts of Lyme. In a quality lab, the Western Blot tests form any proteins and not just a few. But I would imagine many still feel the source of the eccentric numbers on the Western Blot do not make any sense. The numbers are simply parts of Lyme in the same way you have a nose, mouth, arm, and liver. Some labs only check for the "nose" and others check for up to 13 Lyme parts.

One important feature of a top Lyme lab is the way they get these proteins. One lab grows Lyme for a long period and harvests key proteins as the Lyme modifies itself - just like when you change your outer clothing each day.

Other labs do not harvest all these changing outer proteins. And if they have some they are not in equal amounts. IgeneX is the only lab I know which has 13 proteins tested from 2 important strains representative of international Lyme. And amazingly, they have equal amounts of the search proteins.

Valid Results or Nonsense
In order to be licensed in New York State you are sent clear negative samples and clear positive samples of Lyme proteins in blind tubes. IGeneX results have been exceptional and approximately 100% year after year. I have this posted on my site along with the exact results and all of their licenses at In contrast, I have had patients covered in deer ticks or with a classic, grossly obvious bull's eye rash who, months after the rash when seeking treatment, were negative at many labs. Some of these well known labs have dummied down their results and testing because "they were getting too many positives.

"The Dr. Jones' Approach to Reading Western Blots: A Common Sense Position
One of the happiest days of my recent career was when this 78-year-old veteran doctor, beloved all around the USA for his treatment of over 10,000 Lyme-infected children, agreed to treat my children. His reading of Western Blots is not affected by any Big Government agencies. He is not accountable to any lab over-sight government entity. And no one at the CDC, FDA or any medical board in the USA has his massive experience in treating Lyme in youth and reading Western Blots. So read below his clear and convincing reasoning on the interpretation of the Western Blot.

Before I offer Dr. Jones's material, let me put them in context, and share a few basics. First, the Western Blot measures the antibodies your body makes to attack the Lyme infection. One problem I have found with this is that if a child has the infection at a very young age the Lyme can hide and be missed on rare occasions even with a top lab. In my Babesia textbook, I quote the brilliant Dr. Robert Bransford (page 312--314), who lists 28 ways Lyme hides from the immune system. How do I know these "negative" Western Blot little children had Lyme? I found all the other co-infections. And after treatment, they began to make Lyme antibodies and became positive over time.

Also, it is important to note that like most progressive Lyme experts, Dr. Jones assumes you have a Western Blot from IgeneX, which is an internationally famous, tick-only lab, with full lab certification in every possible state offering a license and also is CLIA and Medicare approved. Other massive cheap national labs process hundreds of types of tests, and millions of patients. They rarely find a positive result even in epidemic counties, in people who have profound and advanced Lyme clinical symptoms.

However, if you have had a Western Blot done at a junk lab, please still glance at the result. Why? Because you may find, as I did with one relative, that one of the antibodies or "bands" was positive. In this relative, the band was a "fingerprint" band. Meaning, Lyme is the only organism that makes the human body make this antibody. The child was positive.

But what is a "finger-print" band or the important numbers on a Western Blot?
Simply, if you are blind-folded and touch the side of an elephant, you may not be sure it is an elephant - perhaps this is a rhino? This is the 41 band. It is from the flagellas, the parts inside Lyme that help it move - they get a lot of attention in the body, in the same way a whip snaps and gets attention in the hands of an expert user. However, the 41 antibody is not specificto Lyme, since many organisms have flagella.

Now, what if you touch this same elephant on its tusks or on its long peanut-eating tubular nose? You know it is an elephant. Period. One touch and you are certain, because these parts are very unique to this huge animal. This is Dr. Jones' point. If you see a Western Blot 18 antibody that has a positive, you have Lyme. You do not need to check any other bands, because the 18 antibody is highly specific to Lyme - just like double tusks on an elephant.

What Do the Number of Pluses Mean?
IGeneX gives levels of antibodies. One "+" means you have some antibody of that type. A single positive is plenty strong, because that is the same level of brightness seen in the positive control run next to your blood test. This means they run a fake sample with all 13 proteins which should always show 13 positives. It helps confirm no error in the testing.

If you have a "++" or are "+++", this means you have a very large amount of antibody of this Lyme part. However, Lyme ruins immune system functioning and the number of positives sometimes goes up with treatment and healing of the immune system. People with no aggressive past Lyme treatment, should be lucky their body has made any antibodies at all, since Lyme is very good at both hiding from the immune system and hindering it.

Also, many people have "IND" or indeterminate findings on an antibody. This means the lab tech is seeing something, but is not ready to call it a clear positive. Consider a simple positive (+) to result in a lab band that is like a sharpie flair black line. I consider the "IND" to be a black pen line. In my experience, many of these patients also show high Epstein Barr labs, which means this common infection is not in check and the immune system is very weak. And after we treat the patient, the "IND" sometimes becomes a clear "+" which means you now have new and clear antibodies against this part of the Lyme bug. I consider all "IND's" as weak positives. This is my opinion.

Currently, IGeneX does not use Dr. Jones' criteria. I have not asked them why. Perhaps because they are accountable to different laboratory regulating agencies and in general the government is perhaps decades behind real-world clinical medicine. Apparently, the government and many insurance companies blindly follow 14 individuals who actually think they can control 800,000 physicians and 300 million Americans.

Charles Ray Jones, M.D. Quotes Regarding Western Blots
There are nine known [Lyme] Borrelia burgdorferi species specific Western Blot antibodies (bands): 18, 23, 31, 34, 37, 39, 83 and 93. Only one of these Borrelia burgdorferi genus specific bands is needed to confirm that there is lab evidence of exposure to the Borrelia burgdorferi spirochete and can confirm a clinical diagnosis of Lyme disease.

CDC Criteria are Confusing in Real Clinical Settings
CDC Western Blot IgM surveillance criteria includes only two burgdorferi genus species specific antibodies for IgM 23 and 39 and excludes the other seven Borrelia burgdorferi antibodies. CDC Western Blot IgG surveillance criteria include 18, 23, 30, 37, 39 and 93 and exclude bands 31, 34 and 83. It does not make sense to exclude any Borrelia burgdorferi genus species-specific antibodies in a Lyme Western Blot, and to include only two of these antibodies in IgM because all the antibodies in IgG were once IgM.

The CDC wrongfully includes five non-specific cross-reacting antibodies in its Western Blot surveillance criteria: 28, 41, 45, 58 and 66. This leads to the possibility of false positive Lyme Western Blots. There can be no false positives if only Borrelia burgdorferi genus species-specific antibodies are considered.

One can have a CDC surveillance positive IgG Lyme Western Blot with the five non-specific antibodies without having any Borrelia burgdorferi genus species specific antibodies.This does not make sense.The CDC recommends that the Lyme Western Blot be performed only if there is a positive or equivocal Lyme ELISA. In my practice of over 10,000 children with Lyme disease, 30% with a CDC positive Lyme Western Blot have negative ELISA's. The Lyme ELISA is a poor screening test. An adequate screening test should have false positives, not false negatives.

[Dr. Schaller inserted all bolding in Dr Jones' article above, inserted some spacing and simplified a number of medical terms.]

About the Author

Dr. Schaller is an award-winning top-rated physician with awards from physicians and national and international patients. He has written six books on Babesia and thirteen books on tick infections. His newest book on biofilms is the bestselling book on the topic in the world, and the second best seller under Cystic Fibrosis. He has published respected journal articles and books on cancer cures, parasites, nutrition, hormones, mystery illnesses, depression, inflammation, flea-, lice- and tick-borne infections, and a respected NIH endorsed set of entries on Babesia, Bartonella and Lyme disease. He is the author of over 30 books and 27 top peer-reviewed journal articles. All infection academic books have at least a year of full-time reading behind them.
Quote from Dr Schaller's site

As the author of three Babesia books, I was profoundly stunned that to see that the 30 books and 1,000 articles on Chronic Fatigue Syndrome and Fibromyalgia I have reviewed this year, have no reference to any deer-tick infections. For example, Babesia is a highly common infection found in wooded areas like so many of the "outbreak" locations, and yet no one mentions Babesia, which causes crippling fatigue routinely. I feel like we are talking about France without any French citizens.

Further, Bartonella and Lyme disease are not rare or casual infections, and cause some fatigue and body aches, and virtually all of the criteria for these syndromes. The latter infection Lyme, according to the patents and grant requests of many infection leaders, is very damaging. Below are some very basic thoughts from a respected researcher who is only commenting on Lyme disease. If I injected 100 people with Babesia, I wonder how many would be dealing with crippling fatigue. As it is, we cannot use hamsters to grow some Babesia strains because it kills them.

I guess Babesia is not a fluffy little trivial infection.


Fibromyalgia, Chronic Fatigue Syndrome and Lyme Disease

by Bonnie Gorman RN

Dr Sam Donta presented a comprehensive, compassionate, cutting-edge lecture to Mass. CFIDS/FM Association members on November 3rd, 2002. His topic was "The Interface of Lyme Disease with CFS and FM: Diagnostic and Treatment Issues." Dr. Donta is a nationally recognized expert on Lyme disease. He is the Director of the Lyme Disease Unit at Boston Medical Center and a Professor of Medicine at BU Medical School. He is a bacteriologist and an infectious disease specialist, who views CFS and FM from that vantage point. He is also a consultant to the National Institutes of Health (NIH), and presented at NIH's scientific meetings on CFS research.

What does Lyme disease have to do with CFS and FM you might be asking? Some people believe that Lyme disease may be one of the causative factors in both CFS and FM. Others believe that some CFS and FM patients are really misdiagnosed chronic Lyme disease patients and vice versa. Some believe that there is no such thing as chronic Lyme disease, instead these patients actually have CFS or FM. We asked Dr. Donta to help sort all this out.

Parallel Symptom Patterns

Dr. Donta presented the symptom lists for chronic Lyme disease, chronic fatigue syndrome (CFS), fibromyalgia (FM), and Gulf War Illness (GWI). He pointed out the similarities between them, and found there were few differences. He has treated hundreds of patients with these illnesses. He found that CFS and GWI have identical symptoms, and FM is only distinguished by a positive tender point exam, that is often positive in CFS and GWI as well. Clinically it is almost impossible to distinguish or differentiate these illnesses. He has concluded that chronic Lyme disease is remarkably similar to CFS, FM, and GWI. These multi-symptom disorders have similar symptom patterns consisting of fatigue and neurocognitive dysfunction, along with numerous other symptoms that probably relate to altered neurological function. Musculoskeletal symptoms may be more frequent in FM and in some patients with chronic Lyme than in CFS, but the definition of CFS and GWI also includes muscle aches (myalgias) and joint aches (arthralgias).

Lyme Disease Symptoms

Flu-like illness, fever, malaise, fatigue, headache, muscle aches (myalgia), and joint aches (arthralgia), intermittent swelling and pain of one or a few joints, "bull's-eye" rash, early neurologic manifestations include cognitive disorders, sleep disturbance, pain, paresthesias (including numbness, tingling, crawling and itching sensations), as well as cognitive difficulties and mood changes. The only symptom difference in Lyme disease is the expanding circular rash with a clearing area and center resembling a "bull's eye." He pointed out that Lyme has multiple types of rashes and half of the rashes are not typical, they may not even include the "bull's eye" rash. They can appear from two day after the bite, then go on for a week or so. Patients who are infected may not develop or see the rash, and may not develop any future symptoms. In studies, only one third of the patients were actually aware of their tick bites.

30-50% of acute Lyme disease patients went on to develop chronic Lyme disease. Additionally, some previously asymptomatic patients may reactivate their infection following various stressors such as trauma, surgery, pregnancy, coexisting illness, antibiotics treatment, or severe psychological stress. The Lyme vaccine can also reactivate their infection. Similar triggers such as trauma, surgery etc. are known to precipitate CFS, FM and GWI as well. This is not a new phenomenon with infectious diseases. We know infectious diseases (i.e. TB) will reactivate after illnesses or surgery — any stressor. Dr. Donta reported on the effects of gender on host susceptibility in Lyme disease, CFS, FM and other multi-symptom diseases. In all these disorders, women appear to be more affected than men, usually at about 2:1 ratios. He noted that neural cells contain estrogen and progesterone receptors, and that herpes viruses can utilize estrogen receptors to gain access to the reservoir in the cell nucleus. Treatment of chronic Lyme disease also seems to be gender-dependent to some degree, with men generally having more speedy and complete recoveries compared to women. He concluded that gender relationships are known for a number of infectious diseases, so it would not be surprising that such a relationship exists for chronic Lyme disease, CFS, FM and other multi-symptom disorders.


Lyme Disease: A distinct difference between Lyme disease, CFS and FM is that the origin of Lyme is clear. Lyme disease is caused by spirochetal bacteria transmitted by the bite of an infected deer tick. This bacteria is the Borrelia burgdorferi bacteria. It was identified in the late 1900s in Europe. The US was late to recognize what Europe had described. Lyme disease was not formally identified by the CDC until 1977 when arthritis was observed in a cluster of children in and around Lyme, CT. Since that time Lyme disease has been identified in many states. The CDC reports that it causes more than 16,000 infections per year in the US. Some researchers feel that the prevalence is higher than that.

CFS and FM: Dr. Donta feels that Lyme disease is an important cause of CFS and FM. In addition to Lyme, there are a number of other possible causes. The evidence is still circumstantial though. Epstein-Barr virus (EBV), the major cause of infectious mononucleosis, continues to be debated as a cause of CFS. It is uncertain whether EBV can cause symptoms other than fatigue, such as myalgias and arthralgias that are not seen during acute or reactivated EBV infection in patients who are being immunosuppressed, but it remains possible that EBV could cause one type of chronic fatigue disorder. There are also other herpes viruses i.e. HHV6 that are being evaluated as potential culprits.

Dr. Donta reported that recently recognized species of Mycoplasma (Mycoplasma fermentans, Mycoplasma genitalium) have been implicated in CFS, FM and GWI. These same bacteria have also been implicated as causative agents of rheumatoid arthritis, based on PCR-DNA evidence in patients with these disorders in which 50 percent are found to have the DNA of the Mycoplasma in circulating white blood cells, compared to 5-10 percent of a normal population. Whether the presence of this DNA represents past exposure or ongoing infection remains to be resolved. No long-term studies have yet been performed in patients with CFS and FM to determine whether the finding of Mycoplasma DNA persists over months or years or whether such patients have any evidence of other infection such as Lyme disease or infection with Chlamydia species.

Central Nervous System Involvement

Dr. Donta reported that in Lyme disease, the nervous system seems to be the primary target for the bacteria causing the disease. Patients with Lyme disease express many neurologic symptoms such as pain, paresthesias including numbness, tingling, crawling and itching sensations, as well as cognitive difficulties and mood changes. Even the joint pains and occasional arthritis appear to be neuropathic in origin, as anti-inflammatory agents such as ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAID) have little if any effect on the pain. Experimental evidence from animal models also affirm the localization of B. burgdorferi DNA to the nervous system. Dr. Donta postulates that the disease mechanisms could involve inflammatory responses, autoimmune responses or toxin-associated disruption of neural function. Any inflammatory responses appear to be weak, and there is no compelling evidence that Lyme disease is a result of immunopathologic mechanisms.

Commenting on his research, Dr. Donta speculated that if they are correct, and lyme bacteria is a nerve toxin that interferes with the transmission of the nerve impulse, then that is all you need to impede the normal flow of information. There is a lot of cross-talk in the nervous system. This toxin will decrease that cross-talk causing delayed responses resulting in cognitive problems — the brain fog so commonly described in all these multi-symptom disorders.

Although the disease pathways for other possible causes of CFS and FM have not been defined, Dr. Donta postulates that the central nervous system would appear to be a logical target for other pathogens or other disease processes. These illnesses clearly affect the brain and are bound to cause many neurological manifestations. Any changes in immunologic function would not appear to be sufficient to explain the various symptoms, and are likely to be secondary to other disease processes.

He feels we have been thinking too simplistically about finding whole organisms replicating in chronic diseases. It is highly likely that there is no single cause for these illnesses. It's more likely that there are multiple causes — different organisms causing the same final set of symptoms. Researchers need a better algorithm to study these fatiguing illnesses. We need to be more inclusive, rather than trying to separate the illnesses. Sometimes in medicine, if an illness is too complex to study, research interest dwindles. We have the technology to do the research, but there hasn't been the will and the momentum to get it done.

Clinical Diagnosis

Dr. Donta reiterated that the diagnosis of Lyme disease is primarily based on clinical grounds, just as with CFS and FM. Once other disorders are ruled out, the combination of symptoms over months is sufficient to make a presumptive clinical diagnosis. The diagnosis of Lyme is made easier if a typical rash is present during the early phase of infection. After that, it is difficult to distinguish the flu-like illness that can occur a few weeks later, or can recur over a number of months.

Dr. Donta reported that some patients develop severe headaches and an aseptic (infection free) meningitis, which frequently is diagnosed instead as viral meningitis. If a Bell's palsy occurs (drooping of one side of the face), the possibility of Lyme disease is likely. If an unprovoked arthritis occurs, causing swelling of a single joint, especially the knee, but sometimes more than one joint, then the possibility of Lyme disease should also be given high consideration.

He emphasized that it is the chronic phase of the disease that causes most problems for physicians and patients, because of the lack of objective signs and the presence of so many symptoms that it causes some doctors to attribute psychological reasons for the patients' symptoms. Many patients then receive a diagnosis of CFS or FM, when they may have underlying chronic Lyme disease as the cause of their symptoms.

Diagnostic Tests

Tests for Lyme disease, like tests for other infectious diseases, are often confusing and circumstantial, and their analysis and interpretation has often been flawed. In infectious diseases you do a Western blot test to see if you have a specific reaction. Western blot separates out proteins antigens of an organism you are looking for. It tells you if a person has been exposed. It is not a direct measurement of the organism. It is a measurement of whether the person has antibodies to it. Antibody tests are useful in the early stages of illness as with other acute infectious illnesses. Once the illness is in a chronic phase, antibody tests are not useful.

Just as viruses change from year to year, we know the Lyme bacteria mutates. There are a number of organisms that can shift their surface protein in a matter of hours and that is how they evade detection and patients test negative. These organisms attach themselves to proteins and conceal themselves — creating a cloaking mechanism that defies detection. This allows them to get where they want to go — the nervous system. Once they are inside a cell, the immune system can't see them.

That said, Dr. Donta explained that lab tests have been helpful is some patients with Lyme disease, especially those with arthritis, in whom there are stronger antibody responses than in those with the chronic, multi-symptom form of Lyme. The criteria for the laboratory diagnosis has been patterned after the arthritic form of the disease, and not the chronic form; as a result, there are many physicians who are misinformed about the test's lack of value in chronic Lyme disease. The Lyme Western Blot is helpful when it shows reactions against specific proteins of B. burgdorferi, but can be negative in 25-30 percent of patients who otherwise have chronic Lyme disease.

PCR-DNA tests for Lyme in blood, urine and spinal fluid are rarely positive, most likely because the bacteria and their DNA are not present in those body fluids, but inside nerve cells. Additionally, PCR-DNA studies are very easy to contaminate.

In chronic Lyme disease, the MRI exam of the brain is positive in about 10-20 % of patients. It can show some white spots (unidentified bright objects- UBO) in various areas, similar to those seen in multiple sclerosis (MS), a neurologic disease of unknown cause that has some overlapping symptoms with Lyme disease, CFS and FM, such as the numbness and tingling or paresthesias. (There are also positive MRI findings in CFS and FM patients as well.)

Dr. Donta reported that the brain SPECT scan shows some changes in blood flow to various parts of the brain, primarily the temporal (cognitive processing) and frontal (mood) lobes in about 75 percent of patients with chronic Lyme disease. Patients with CFS have also been reported to have some brain SPECT scan changes, frequently involving the occipital lobe. No comparative studies have been made among patients with chronic Lyme disease, CFS and FM. The mechanisms underlying these changes remain to be defined, but may be due to a mild vasculitis (inflammation of blood vessels) or to a signaling problem within the nerve network of the brain in those specific areas. It is promising that these changes are reversible in most patients treated with antibiotics that appear to be effective in treating the chronic Lyme disease. These MRI changes are often slow and may take a year to reverse themselves.

These are covert organisms we are dealing with. We need more direct detection methods for blood, spinal fluid and other body fluids. How do you detect organisms in spinal nerve roots or brain? Right now we can't. Nobody is going to biopsy patients. We need an illness registry so we can do direct detection studies, particularly of the brain, after death.

Treatment: Persistence Pays Off

Dr. Donta reported that there are lots of drugs that are active against the Lyme bacteria in the test tube, but the big question is whether the drug can get to the bacteria? Lyme bacteria lives in the cells of the nervous system, perhaps other cells. Dr. Donta has experimented with various intracellular-type antibiotics. He reviewed his journey through various antibiotics. After listening to his patients he decided that some antibiotics were better than others. He then looked at clarithromycin (Biaxin) and azithromycin (Zithromax) which he found had powerful activity against Lyme bacteria in a test tube. But the antibiotics, by themselves, did not seem to do any good. He found that you need to change the cellular pH (the degree of acidity or alkalinity), making it more or less acidic, to maximize the effectiveness of the antibiotic. This allows the antibiotic to work better i.e. doxycycline seemed to work better when the pH was higher. Dr. Donta has experimented with various agents to adjust pH i.e. amantadine (used to treat flu) and plaquenil (used to treat malaria). He just submitted proposals to NIH to study various agents to determine which is most effective.

Dr. Donta emphasized that the most important aspect of treatment is that it must be long-term — 12-18 months, sometimes 24-36 months. This length is not unusual in the treatment of infectious diseases i.e. TB. In the first few months of treatment patients can expect an adverse reaction, symptoms will increase and you'll feel worse. You need to be able to hang in through this period, and allow 3-6 months of a treatment trial to determine if it is working. The earlier in the disease process that you start on treatment, the more successful it is. The more chronic the condition the less successful it is, and you'll need to treat over a longer period of time. This treatment resulted in substantial improvement and cures in 80-90% of patients with chronic Lyme disease. There are 10-20% who do not respond — generally those with a strongly positive Lyme test.

Dr. Donta reported that similar results have been found in some patients with CFS and FM of unknown cause, supporting the hypothesis that some patients with CFS and FM have an underlying infection responsive to those antibiotics. Antibiotic trials in CFS and FM have been limited to one month, a duration that is inadequate to properly evaluate the potential of certain antibiotics to have a positive effect on the disease. Additional studies, examining both potential etiologic agents of CFS and FM as well as treatment trials should lead to a better understanding of both the cause and treatment of patients with CFS and FM.

Q & A

Q: If the Lyme lab tests are inadequate and the symptoms are the same as CFS and FM, why not just treat all CFS and FM patients with the Lyme protocol?

A: You want to be conservative with your medicines. I think we have enough info now to tell CFS and FM patients to consider going on a 3-6 month trial of antibiotics and see if you're better. Consider all the other meds you are already taking that just treat symptoms and not the cause of your illness. They all have side-effects that can be hazardous. Is it worth it to you to consider a primary treatment aimed at a cause? There will be resistance from some MDs. They need to be educated. Your primary MD will need to consult an LD specialist re the treatment protocol.

Q: Do patients with Lyme disease also have bowel and bladder problems like interstitial cystitis (IS) and irritable bowel syndrome (IBS)? How are they affected by treatment?

A: Yes, many patients with Lyme have IS and IBS. He was surprised how much the bowel disorders affected treatment. Tetracycline generally helps the IBS. Plaquenil can sometimes irritate the bowel.

Q: I have received different results for the western blot Lyme test. Why?

A: Lyme test results are not reproducible from one lab to the next. You will get different findings from different labs. The western blot is not a great test for Lyme since the responses to Lyme bacteria are already very small responses.

Q: I've been sick for 15 years with CFS and my Lyme test was negative. Is there any value in treating now?

A: If the test was negative but you have the complex of symptoms and there is no other obvious answer, why not give antibiotics a try.

Q: I had the Lyme vaccine then got Lyme symptoms. Why?

A: Lyme vaccine was pulled from the market because it was causing reactions and reactivating a slow onset of Lyme disease.

Q: What are the ocular problems in Lyme?

A: He sees optic neuritis, similar to that seen in atypical MS patients.

Q: Is there any Lyme connection to cutaneous lymphoma?

A: He has looked closely for any cancer/ Lyme associations, but has not seen many.

Q: Is there a connection with thyroid problems?

A: Thyroid problems are a very common co-existing condition with Lyme, as they are with CFS.

Q: How do I differentiate itching from allergic reactions?

A: The same sensory nerve fiber pathways that carry pain carry itching, numbness, tingling etc. Rash is common symptom. Rashes could be caused by medications, especially if they are body-wide. Is it an allergic reaction or hypersensitivity reaction? Get a complete blood count (CBC) with differential. Eosinophils will be elevated if allergic reaction. If not, then it's a hypersensitivity reaction. Treatments are similar.

Q: How do we get funding for research to advance these illnesses?

A: He stressed how important it is to combine advocacy and research efforts. Ultimately it will be a political solution. Get active legislatively in DC. The CFS Coordinating Committee is a very good forum. Lyme does not have anything like that. Groups need to work together, not fight with each other. There should be a coalition of all these groups. We also need to show insurance companies the benefits of primary treatment to patients, as well as to insurer's bottom line.

Quote from Dr Schaller's site

The author's clinical experience has led him to conclude that oxygenative antioxidant therapies such as nasal oxygen and intravenous infusions of ozone-oxygen gas mixture and hydrogen peroxide are among the most beneficial therapies for reversing the ORPEC state.

Since oxygen, ozone and hydrogen peroxide act as oxidants in a laboratory setting, therapies employing those agents are generally deemed oxidative therapies.191-193 Until recently, the author accepted that view uncritically. However, it is clear from studies presented in this article that this is a gross error. In reality, such therapies in the context of the ORPEC state are powerful oxygenative and antioxidant therapies. The reason for that widespread misconception is the failure to clearly understand the complex biologic consequences of adding oxygen, ozone, and hydrogen peroxide to severely impaired enzymatic and cellular ecosystems in patients with accelerated oxidative injury.

A Burst of Thunderstorm, A Burst of Oxidants
An analogy of a burst of thunderstorm may be used to explain the possible mechanism action of ozone. The still air in a city on a hot, humid summer afternoon is thick with stagnant smog. The traffic on city streets is snarled. Tree leaves are dry and limp. Many persons are distressed by air pollution. Suddenly, dark clouds loom large and bring a heavy thunderstorm. Strong winds push out the polluted air. Tree leaves are bombarded by heavy rains. The healthy and robust leaves of trees withstand the storm well, while older and weakened leaves are severely damaged. Many withering leaves on tree brances are blown away. After the thunderstorm subsides, the air is clean and crisp. The trees looked washed, their leaves fresh and shiny. Bursts of intravenously injected ozone and hydrogen peroxide affect the blood elements the same way. The membranes of healthy erythrocytes withstand the oxidative stress of ozone and hydrogen peroxide well, recovering their normal morphology after initial membrane deformities. The senescent cells, by contrast, shrink and undergo lysis.

Below, some theoretical, clinical and experimental considerations are presented that shed light on the apparent paradox of agents that are oxidizing in their essential roles, and yet provide the basis for oxygenative antioxidant therapies.

Intermittent Nasal Oxygen
The oxygenative role of nasal oxygen is self-evident. Oxygen is also a powerful oxidizer, as discussed earlier in the section devoted to spontaneity of oxidation in nature. The ORPEC hypothesis provides a clear scientific basis for oxygen's ability to also serve the opposing antioxidant role. As discussed earlier, anoxia increases oxidative stress directly by facilitating the generation of toxic reactive species as well as indirectly by causing acidosis.

In this author's clinical experience, the use of intermittent nasal administration of oxygen (2.5 to 3.5 L/min given for periods of one hour two or three times a day) benefits most patients in the ORPEC state. It is also the opinion of the author that oxygen therapy is very underutilized in the care of patients in the ORPEC state, such as those with fibromyalgia, chronic fatigue state, severe autoimmune disorders, and spreading malignant tumors. Oxygen is readily and inexpensively available to all patients. Also available are inexpensive portable rental units that may be used in travel as well.

When used intermittently and in moderate doses as described here, this therapy has been found to be completely free of adverse effects. The author also has limited experience with oxygen therapy in patients with severe pulmonary emphysema and pulmonary interstitial fibrosis. Evidently, the use of oxygen in such patients must be monitored closely so that oxygen therapy does not cause further deterioration in the function of central sensors for oxygen and carbon dioxide.

Intravenous Ozone Therapy
Ozone is triatomic oxygen with a high electrovoltaic potential. Ozone gas infused intravenously at the Institute consists of a gaseous mixture with oxygen containing a very low concentration of ozone. It is prepared by passing pure oxygen through a high voltage field. The concentration of ozone generated depends on the rate of flow of oxygen as well as on the conditions of voltage and spacing of electrodes. The gaseous mixture used in our clinical practice is titrated to contain from 0.3 to 2.5% (30 to 50 ug O3/ml O2). Thus, intravenously administered "ozone" in reality represents 97 to 99.7% of pure oxygen. Practitioners who have never administered ozone gas mixture intravenously often express concern about the possibility of air embolism caused by gas infusion. Such concern is totally unwarranted. Pure oxygen and ozone diffuse immediately into the blood and do not persist as gases. The author has tested for that on numerous occasions by injecting 2 ml of the ozone mixture into a large vein, then immediately drawing the blood back. Except on uncommon occasions, the blood drawn back from the vein is pink (ozone turns dark venous blood into pink blood) and free of any gas bubbles. One can safely presume that the process of dissolution of the gas mixture would be complete by the time it reaches the large veins in the thorax.

Another concern expressed by those unfamiliar with the clinical uses of ozone mixture is the toxicity of ozone as discussed by environmentalists. It must be recognized that those individuals are perturbed by the products of reaction of ozone with other ecopollutants such as oxides of nitrogen. Ozone is a highly reactive molecule. Indeed, ozone owes its many antiviral, antibacterial, and antifungal properties to this aspect of this specific aspect.

Microscopic Evidence for the Antioxidant Role of Intravenous Ozone Therapy
In the concentration used our in clinical practice, ozone causes temporary and reversible erythrocyte membrane damage as evidenced by clumping and red cell membrane deformity. The evidence for the oxidative nature of such erythrocyte membrane deformities has been previously demonstrated by the reversibility of such changes with antioxidants such as ascorbic acid, tocopherol, and taurine.56,57

How may the observed overall invivo antioxidant effects of ozone, a powerful invitro oxidant, be explained? Ozone has well established effects of improving tissue perfusion and cellular oxygenation.67 Just as the duality of oxygen allows it to be a molecular Dr. Jekyll and Mr. Hyde, reactive oxidant species also play dual roles. Not only do they inflict oxidative damage to enzymes, induce mutations, and damage cell membranes, they also serve many useful functions such as modulation of cellular redox dynamics, activation of gene transcription, signal transduction, and apoptosis.93-95 It seems that ozone evokes an upregulatory response from cell membrane-associated antioxidant enzyme systems just as all oxidants do from all biologic antioxidant systems. Though, direct quantitative data for those effects are not yet forthcoming. One may also, with good reason, speculate that ozone elicits similar responses from other matrix- and cell organelle-related antioxidant systems. There is yet an other important mechanism by which ozone protects patients with chronic illnesses from accelerated oxidative stress. Viruses, bacteria, fungi, PLFs and parasite inflict cellular injury by causing oxidative stress. Ozone also is a well established antiviral, antibacterial, and antifungal agent.58-63. Ozone through its powerful antimicrobial effects reduces the overall oxidative stress on persons with chronic viral, bacterial, fungal and PLF overgrowth syndromes. Thus, the ORPEC hypothesis carries strong explanatory power for the empirically observed biologic antioxidant effects of ozone.

Intravenous Hydrogen Peroxide Therapy for the ORPEC State
The biologic antioxidant effects of hydrogen peroxide, a potent oxidizer like ozone, are mediated by all the mechanisms cited for ozone in the preceding section. The clinical benefits of hydrogen peroxide infusions observed at the Institute in patients with fibromyalgia and chronic fatigue syndrome are the subject of a separate report.72

Reference from the complete article in The Journal of Integrative Medicine 1998;2:4-55

My thanks to this interesting physician: July 17, 2003

(Abridgement from The Journal of Integrative Medicine article: Oxidative Regression To Primordial Cellular Ecology (ORPEC))





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