The purpose of this website is to educate and help sufferers and their loved ones. No product is sold by the author, nor does he receive any remuneration for his efforts. The content may be freely used and distributed by anyone without notifying or compensating the author.

Contents:
Overview
Transmission
Detection
Symptoms
Chronic Lyme disease
Treatment
Side effects of antibiotic treatment
Alternative remedies
Adjunctive substances and treatments
Who needs to get tested
Where to go for help
Further reading and resources

There are many vector-borne illnesses. This website focuses on Lyme disease and bartonellosis. These two diseases are very similar in terms of modes of transmission, symptomatology, and difficulty in detection. They often appear as coinfections.

There is considerable information on the Web regarding vector-borne illnesses. In the case of Lyme disease and bartonellosis, new discoveries are occurring each month as the medical community is making slow but steady progress in understanding these illnesses, so by the time many papers are published, they're already obsolete.

Borrelia burgdorferi (Bb) is the main cause of Lyme disease (LD) in the U.S. (Borrelia afzelii and Borrelia garinii cause most European cases.) It is a spirochete. Spirochetes belong to a phylum of distinctive Gram-negative bacteria that have long, helically coiled cells. Spirochetes are distinguished from other bacterial phyla by the location of their flagella (sometimes called axial filaments), which run lengthwise between the cell wall and outer membrane. Other diseases are caused by spirochetes, for example, syphilis is caused by the spirochete Treponema pallidum.

Bb is the most genetically complex bacterium identified to date. It contains 132 functional genes, compared to the syphilis spirochete's 22. Ninety percent of these genes are novel to all bacteria. Bb contains 21 plasmids, more than any other bacteria. This characteristic allows the organism to be highly adaptive to its environment, with the ability to survive in a number of different hosts. Under stress, in the presence of antibiotics or cerebrospinal fluid (CSF), the organism changes morphology. Currently identified morphological variations include spirochetal form (coiled and uncoiled), cystic form, blebs and granules, and cell wall-deficient (L-form). They enable the organism to become latent for long periods of time, resist treatment, and evade immune recognition. (source)

Bb and red blood cells. (Source)	While only 0.2-0.3 microns wide, Bb's cell length may exceed 15 microns. (Source)	Detailed microscopic photo of Bb. (Source)

Bartonellosis is possibly the most common tick-borne pathogen (source). It is caused by a genus of Gram-negative bacteria called Bartonella. At least eight species are known to infect humans. Different species cause different diseases. For example, Bartonella henselae causes cat scratch disease. Other species such as Bartonella vinsonii subspecies berkhoffii have an affinity for red blood cells (RBCs) and the tissues that line the insides of our blood vessels (source). This causes intravascular disease, which hinders nutrient and oxygen delivery to tissues, resulting in fatigue and pain, as well as cognitive and emotional problems. Bartonella actually enters RBCs (source1 source2). Inside RBCs the bacteria multiply, and when a biting insect takes blood from the host, it picks up infected RBCs, thereby becoming a carrier that can infect other animals or humans. At least one Bartonella species secretes a substance called deformin that causes RBCs to become misshapen (source).

Bartonella (small dark specks) and red blood cells. (Source)

Ticks can transmit several parasites and thus infect us with several diseases. Protozoa of the genus Babesia cause babesiosis, Anaplasma phagocytophilum causes human granulocytic anaplasmosis (HGA), bacteria of the genus Ehrlichia cause ehrlichiosis, Rickettsia rickettsii causes Rocky Mountain spotted fever, and Francisella tilarensis causes tularemia. Thus it is very common for victims to be coinfected.

In North America, the main vectors are ticks, including the black-legged tick or deer tick (Ixodes scapularis, formerly Ixodes dammini), the western black-legged tick (Ixodes pacificus), the brown dog tick (Rhipicephalus sanguineus) and the American dog tick (Dermacentor variabilis). There is some debate about some tick species. For example, one source says that the Lone Star tick (Amblyomma americanum) causes LD while others such as this one say that it doesn't. The bottom line is that all ticks should be avoided because nobody except experienced entomologists can tell the species apart, and even if a tick doesn't contain Bb or Bartonella, it could very well carry any of the other vector-related pathogens.

This tiny insect is an adult deer tick. (Source)	American dog tick. (Source)	Brown dog tick. Left: fully engorged female. Top center: female. Bottom center: larva. (Source)

Ticks are not the only vectors. Any infected biting insect can transmit a number of diseases including LD and bartonellosis. This includes mosquitoes, fleas, lice, and possibly biting flies (horse flies and deer flies). (source)   Bites and scratches from infected animals - including pets - can also transmit illnesses.

Mosquito. (Source)	Flea life cycle. 1: Fed adult. 2: Eggs. 3: Larva. 4: Pupa (covered with dirt). 5: Unfed adult (remains in suspended animation until it detects a host). (Source)	The louse in its 3 forms. (Source)

Horse fly. (Source)	Deer fly. (Source)

LD is the fastest growing vector-borne disease, due to suburban sprawl (which brings people close to forests), increasing deer populations, ticks being carried by migratory birds, and other factors. (source)

Alarmingly, Bb and Bartonella can be passed from mothers to their unborn children, and also to blood transfusion recipients. (source)

Bb and Bartonella are two extremely difficult organisms to detect. Identification is not a simple matter of having blood drawn and seeing the organism or specific antibodies in the sample. If it were that easy, everyone could be easily diagnosed. The bacteria have an affinity for bodily tissues rather than fluids. They can be difficult to culture from tissue samples. Sometimes, but not always, antibodies are found. Enzyme-linked immunosorbent assay (ELISA) is used to detect antibodies, but it is not always accurate. Another test, Western blot, is used to detect specific proteins, but this test is also not always accurate. Even when these two tests are run, a full one-third of cases go undetected. There are also occasional false positives. Why are these tests so inaccurate? For a number of reasons:

• Bacteria may be living inside body cells, making them difficult to detect in blood samples.
• The host's immune system might not recognize the pathogen so it does not produce antibodies.
• One infecting organism might contain a protein that is very similar to a protein that the organism being tested for contains, yielding a false positive. For example, any of several types of virus can cause a false positive Bb test (source). The cause of a false positive test for one vector-borne pathogen might even be another vector-borne pathogen. For example, Bartonella can cause a false positive Bb test (source: my life partner's Lyme/bartonellosis specialist).
• Test results might be misinterpreted. Click here and here for an explanation.

A CD-57 test might be helpful. Chronic Bb infections are known to decrease the quantity of the CD-57 subset of the natural killer cells. While other infections can depress the immune system, it is believed that only Bb will depress the CD-57. (source)

If an infected person is lucky, he/she will develop a skin rash called erythema migrans. This will alert the victim that he/she has been infected so that prompt antibiotic treatment can kill the bacteria before it spreads throughout the body. Unfortunately this only happens about half the time, and victims are not aware that anything is wrong until the illness is systemic.

Bb can inhibit the immune system, activate inflammatory processes, and trigger autoimmunity by mimicking bodily cells. The result is pains, aches and weakness. Bb can adhere to a number of cell types, including glia (cells that support, feed and insulate neurons) and the interior surface of blood vessels.

In advanced LD, the spirochete crosses the blood-brain barrier (BBB). This is termed neuroborreliosis. The antibiotic minocycline is indicated because it, too, crosses the BBB. Minocycline can be neuroprotective, possibly by inhibiting inflammatory substances that damage or kill brain cells (source1 source2 source3).

Because Bartonella bacteria can burrow into our cells, they avoid our immune defenses, and the only antibiotics that have any chance of killing them are ones that also penetrate our cell walls. Azithromycin and rifampin are often preferred. Rifampin is very good at infiltrating almost all of our bodily cells, as well as the CSF because it crosses the BBB. Rifampin can cause liver damage (source1 source2). It increases the liver's production of CYP3A4, which increases the rate at which the liver metabolizes some other drugs and thereby necessitates higher doses of them. (example)

Bartonella might or might not cross the BBB, but even if it doesn't, damage to brain tissue could occur via imbalances induced by the organism. For example, induction of high systemic levels of cytokines such as tumor necrosis factor alpha, produced in response to infection, could lead to temporary or permanent damage to brain tissue.

The specific areas of the body affected by Bb and Bartonella very widely. Just about any joint or muscle can become achy, painful, tender, weak, and/or easily fatigued. Other symptoms are possible, including but not limited to fever, loss of appetite, dizziness, and loss of libido.

Both Bb and Bartonella, when they affect the brain, cause irritability, depression, cognitive impairment, short-term memory loss, and other mental problems. The psychological effects can be dramatic, causing victims to become easily upset and angry (source). One culprit is cerebral hypoperfusion (lack of oxygen and nutrient delivery) to the white matter of the brain. This is usually detected by single photon emission computed tomography (SPECT) or magnetic resonance imaging (MRI). The white matter lesions and the associated symptoms are common in demyelinating or inflammatory disorders such as multiple sclerosis and lupus, hence Lyme or bartonellosis symptoms can cause erroneous diagnoses. Furthermore, it is possible to have Bartonella-induced multiple sclerosis, so while a diagnosis of multiple sclerosis might be correct, medical personnel making the diagnosis might not know what is causing it and therefore will not know that it is curable.

The psychological effects can be devastating to relationships. Friends, family members and significant others have abandoned loved ones when their hypersensitivity has caused them to become critical and aggressive toward others. Also, the inability to engage in social situations has left victims alone and frustrated. Victims can become so worn down and hopeless after several months without relief that they may become depressed and suicidal. It is important for loved ones to understand that it is the illness, not the person, that is being difficult to deal with. It is ironic that people can be very understanding when loved ones are afflicted with other brain disorders, such as mental retardation, clinical depression and Alzheimer's disease; but when it comes to psychiatric Lyme/bartonellosis, they lose sight of the disease and ascribe difficult behavior to the individual rather than the disease. I am one of the many people who have been guilty of this. On several occasions I have walked out on my life partner, lashed back verbally, and sent her e-mails expressing my displeasure with her behavior. The knowledge that a loved one's behavior is caused by a physical disorder often takes a back seat when one has to deal with undeserved criticism and lack of affection every day for months on end. One's ability to be patient and understanding during this difficult time depends on a number of factors. Although one's basic personality type cannot be changed, there are several other factors that a victim's loved ones can control:

• realization that the aberrant behavior is merely a disease effect
• coping skills (e.g., saying "I need a break" and walking away instead of emotionally reacting)
• frequency and length of interaction with the victim
• psychiatric help (counseling, medication)
• support groups

Bb and Bartonella can cause RBCs to stick together (any inflammation can cause this via the body's increased production of fibrinogen). This makes it difficult for RBCs to pass through capillaries, which are only as wide as a single RBC. This contributes to hypoperfusion and the associated fatigue and psychological problems.

People who don't know they have one of these infections, but experience symptoms, are often diagnosed with "fibromyalgia" or "chronic fatigue syndrome", both of which have "unknown" causes and are "incurable". Treatment is focused merely on easing the symptoms via pain killers, steroids, behavioral therapy, exercise, antidepressants, and even antifungals.

The effects of both LD and bartonellosis in the body are profound and widespread because vascular damage and inflammation can affect every bodily system. For example, organs such as the adrenals, brain and thyroid, which produce hormones, can be disrupted, causing hormone imbalances that result in many symptoms such as weight gain or loss, anxiety, and hair loss. Additionally, the the inflammatory cascade can block cellular hormone receptors, resulting in insulin resistance and hypothyroidism despite normal T3 and T4 levels.

Inflammation of the inner surface of blood vessels (the endothelium) is the first step in atherosclerosis, so Bb, Bartonella, or any other pathogen can cause heart disease and stroke. Once arterial endothelium is damaged, monocytes (a type of white blood cell) adhere to the endothelium and become macrophages (cells that rid the body of foreign cells by engulfing them). The endothelium and macrophages release free radicals, which oxidize the polyunsaturated fat portion of low density lipoproteins (LDLs), creating oxidized LDL (OxLDL). The macrophages engorge themselves with OxLDL and take on a foamy appearance, at which point they are referred to as foam cells. They form yellow fatty streaks. Platelets adhere and aggregate at the site. This causes the artery to secrete collagen, elastin and proteoglycans, leading to the formation of fibrous tissue, called a plaque, lesion or atheroma. (Note: Atherosclerosis happens only in arteries, not in veins, because arterial smooth muscle cells have binding sites for a component of LDL called apoB-100.)

(a) fatty streak;   (b) lesion;   (c) advanced lesion;    (d) obstructive lesion.    (Source)

Since many of the symptoms of LD and bartonellosis are similar, it is very common to assume that a victim has LD, since LD is the most commonly known tick-borne disease. Many sufferers actually have bartonellosis, but since most people have never heard of it, LD is used as a general term. It is important for people to be made aware that LD is but one of several vector-borne diseases.

How can one differentiate between LD and bartonellosis? Aside from a conclusive blood test, symptomatology can help. Although many symptoms of these two diseases are similar, a few differ. For example, bartonellosis sufferers sometimes get erythematous papules, which are red splotches or slightly raised red spots that may appear on the limbs, head or neck. Painful soles are also specific to bartonellosis.

Much controversy surrounds the idea of chronic Lyme disease. There are certainly people who have had Lyme and/or other vector-borne diseases for a long time and have suffered many symptoms. However, a significant number of people in the medical community believe that some chronic illnesses that are not Bb-related are misdiagnosed as "chronic Lyme disease". They contend that some sufferers were never infected with Bb, and that others were infected with Bb at one time but the spirochete has been eliminated and they are now suffering from "post-Lyme disease syndrome" (source1 source2). Studies such as this one cast doubt on the prevalence of chronic LD, but it could be that either the detection methods failed for any of the reasons described above; or the "chronic Lyme" was really chronic bartonellosis, or chronic ehrlichiosis, or chronic babesiosis. All of these pathogens should be tested for before the possibility of infection is dismissed, and also to make sure that the right pathogen is identified so that the right antibiotic treatment is administered.

Lyme disease is one of the most controversial illnesses in the history of medicine (source). The controversy over chronic LD has become fierce and political. One one side are the believers, such as the International Lyme and Associated Diseases Society (ILADS). On the other side are the non-believers, who say that long regimens of antibiotics are unnecessary and even dangerous (source). This group includes the Infectious Diseases Society of America (IDSA). Many insurance companies are in the latter camp (source), perhaps in order to reduce costs rather than to provide needed treatment. Some doctors have even been prosecuted and had their licenses suspended for treating Lyme patients in a manner that departs from what medical boards define as "acceptable and prevailing standards" (example).

Often more than one antibiotic is required even if a patient is infected with only one bacterium. For example, since Bb can take so many forms, a particular antibiotic might be effective against one form but not another, so a single antibiotic might kill only a portion of the bacterial population. One such case involved my life partner, who in 2007 was given a 30-day course of intravenous ceftriaxone via a peripherally inserted central catheter in her arm. Her symptoms eased for a while, but she later relapsed. It turns out that cephalosporins such as ceftriaxone do not kill the cystic form of Bb (source). Bb has the ability to make cystic forms when exposed to antibiotics commonly used for treating Lyme disease. The effectiveness of most antibiotics requires active metabolism by the bacteria, so while active spirochetes might be killed, the cysts remain unaffected. Once antibiotic treatment is over, the cysts can reconvert to normal mobile spirochetes, causing a reactivation of the disease after an illusory cure. (source)   One antibiotic that can be effective against the cyst form is metronidazole (source1 source2 source3).

Antibiotic treatment can take many months if LD and bartonellosis are not caught early. Why should this be, when other infections such as strep throat can be cleared up within a week or two? One reason is the longer life cycle. Bartonella takes 24 hours to divide, and Bb takes anywhere from 12 hours to 7 days -- much longer than that of Streptococcus pyogenes (the bacterium that causes strep throat), which takes anywhere from 20 minutes to 8 hours to divide. Since most antibiotics work best while bacteria are replicating, a longer replication cycle necessitates a longer treatment course. (source1 source2 source3)

Once antibiotic treatment begins, patients often experience the Herxheimer reaction, which occurs when large quantities of toxins are released into the body as bacteria die from antibiotic treatment. Typically this occurs faster than the body can remove the toxins. "Herxing" is manifested by fever, chills, headache, myalgia (muscle pain), etc. It can last for as little as a few hours or, in the case of LD, months.

One might ask, "What specific toxins do bacteria release when they die?" Little data is available on this matter, because there is currently no reliable test for identifying these toxins. The existence of toxins is usually inferred from symptoms and the presence of cytokines, hormone resistance, etc.

One possible toxin produced by Bb is ammonia. Ammonia can cause "leaky brain syndrome" by damaging the BBB, thus enabling larger molecules to cross, touch brain tissues, and cause hypersensitivities, cognitive dysfunction, and other problems (source). Ammonia can also redistribute cerebral blood flow from cortical to sub-cortical structures (source).

It could be that ammonium compounds, rather than ammonia per se, are produced by bacteria. For example, ciguatoxin, which is produced in fish by certain dinoflagellates, is an ammonium compound (source).

Click here for some general information about bacterial toxins.

Cytokines produced by the victim's body in response to bacterial toxins can be a significant component of the Herxheimer reaction.

Some sources recommend cholestyramine to aid in the binding/elimination of toxins, but other sources oppose it either because they don't believe cholestyramine works, or because cholestyramine can also bind/eliminate medications and vitamins.

A common side effect of long-term oral antibiotics is proliferation of yeast, mainly Candida albicans, which is normally a minor fraction of the gut flora but becomes a major part as bacteria - both harmful and beneficial - are killed. The symptoms of candidiasis are usually intestinal bloating, cramps, poor digestion, constipation and/or diarrhea. In advanced cases the normally round yeast can metamorphose into a mycelial form that shoots out filaments that penetrate into the intestinal walls, thus allowing undigested food, yeast and bacteria that normally stay in the gut to pass through into the bloodstream (source). This is called leaky gut syndrome.

Candida albicans in normal form. (Source)	Candida albicans in mycelial form. (Source)	Candida albicans burrowing into living tissue. (Source)

There are some dietary modifications that can help keep yeast in check. High-glycemic index foods such as sugar, white flour and white rice provide easily digestible material for the yeast, resulting in acute bloating, so these foods should be avoided. You can also take probiotics to help repopulate the gut with beneficial bacteria, but these must be of high quality since there is much variation in cell viability between products. Even with dietary modifications and probiotics, it is still often necessary to take antifungals such as fluconazole and nystatin to reduce the yeast cell count. Even these aren't always effective, as Candida albicans can form biofilms that make them resistant to antifungal medications (source).

Unfortunately, Lyme disease can cause the same gastrointestinal disorders listed above (source), thus fooling some victims into believing that they have candidiasis when in fact they don't.

• Oregano oil's most active ingredient, carvacrol, has been shown to inhibit a number of organisms including Candida albicans.
• Turmeric inhibits the response of the body to inflammatory agents both directly and indirectly, by stimulating production of natural corticosteroids from the adrenal glands, "sensitizing" cortisone receptor sites on cells, and preventing the breakdown of cortisol. Turmeric's main active ingredient, curcumin, is anti-inflammatory, anti-oxidative, and anti-cancer. (source)  
• Cat's Claw is immune-strengthening, anti-inflammatory, anti-oxidant and anti-cancer.

• Carvacrol has a minimum inhibitory concentration (MIC) of 100 PPM (source), and since the normal dose is only a few drops, which get diluted by substances in the digestive system, it is unclear whether the concentration that reaches intestinal Candida is sufficient to inhibit them.
• Very little curcumin is absorbed from the intestinal tract (source).
• Even the National Center for Complementary and Alternative Medicine admits that there is not enough evidence to determine whether Cat's Claw works for any health problem (source).

Some people believe that rife machines can weaken or kill Bb by exposing them to certain electromagnetic frequencies. Again, it is difficult to tell whether these claims are true.

In any case, it is important that sufferers not rely on alternative treatments alone. Bb and Bartonella are elusive, insidious invaders that need proper medical treatment. Alternative supplements usually do not interfere with conventional treatment, but if a patient forgoes conventional treatment because he/she believes that alternative treatment is the answer, that can be dangerous.

Alternative supplements are not as tightly regulated as pharmaceuticals are. As a result, some do not contain what their labels claim they contain (source). Additionally, it is known that these products sometimes contain harmful substances such as heavy metals (source1 source2).

Some alternative supplements are sold in "homeopathic" concentrations. Homeopathic preparations are highly diluted substances. The idea in homeopathy is that just a tiny bit promotes healing. Less is more, if you will. This idea seems counterintuitive to many folks, causing it to be another area of debate. Homeopathic product labels usually denote potency using either a logarithmic X scale, where the number in front of the X denotes dilution by a power of 10; or a logarithmic C scale, where the number in front of the C denotes dilution by a power of 100. For example, 2X is one part in 10², or a 1% solution. 3X is one part in 10³, or a 0.1% solution, and this is actually considered by many people to be a higher potency than 2X (remember, less is more). This idea is sometimes taken to such extremes that the dilution makes it improbable that the product contains even a single molecule of the ingredient. For example, a 60X (30C) product such as this one would have to be dissolved in 10⁶⁰ other molecules. That would require a container more than 30 billion times the size of the Earth. Another example is a supposed flu medication called Oscillococcinum. It is a 400X (200C) dilution of duck liver. That's 1 part in 10⁴⁰⁰. There are only 10⁸⁰ atoms in the known universe. Thus, 10³²⁰ more universes would be required for there to be the slightest chance that all the Oscillococcinum on Earth contains even one molecule of duck liver. Homeopaths claim that molecules of a particular substance leave an "imprint" in the dilution that causes a healing effect on the body even in the absence of the substance itself, but available evidence does not support efficacy beyond placebo (source).

Since the area of alternative medicine is so hotly debated, my (amateur) advice to any vector-borne illness victim is to take only those alternative supplements that are prescribed by a VBILMD; don't self-medicate based on the word of a website or someone working the register at a health food store.

Boluoke® contains a fibrin-dissolving enzyme called lumbrokinase, which is extracted from two species of earthworm (Lumbricus rubellus and Eisenia fetida). Earthworm has been used in Eastern medicine for many centuries to treat circulatory problems. Since Bb and Bartonella cause endothelial inflammation that can lead to fibrin deposits that cause hypoperfusion, lumbrokinase can reverse the process and restore normal nutrient and oxygen delivery by dissolving those fibrin deposits. It might also reverse atherosclerosis. Another way in which it can be helpful is in dissolving the fibrin coating that Bb uses to evade immune recognition. Lumbrokinase has been thoroughly tested and is deemed safe. The main side effect is that it inhibits adhesion molecules on platelets, which can cause cuts to bleed more than usual.

Hyperbaric oxygen therapy (HBOT), which is the medical use of oxygen at greater than normal atmospheric pressure, can be used as a possible way to help the brain recover. Cerebral hypoperfusion might stun, but not kill, brain cells, and HBOT might stimulate them back to normal functioning. However, it is not wise to give HBOT to patients before they are bacteria-free because inflamed tissues can be further damaged by the elevated pressure of HBOT.

Digesta Guard® is a combination of many strains of Lactobacillus and Bifidobacterium bacteria. It is supposedly better than store brands at replacing beneficial gut bacteria that are killed by antibiotics.

Vitamin and mineral deficiencies are common in Lyme disease and bartonellosis. A daily multivitamin is a good idea. Magnesium and vitamins B₁₂ and D are often particularly low, so high doses of these might be needed. Blood tests to uncover vitamin and mineral deficiencies should be done so that the patient can take the proper supplements.

Anti-oxidants such as N-acetylcysteine, alpha-lipoic acid, selenium, etc might provide general health benefits and therefore help support the Lyme/bartonellosis patient. Vitamins C and E act in synergy with some anti-oxidants to boost their power.

Omega-3 supplements such as fish oil and flaxseed oil are beneficial because they help reduce inflammation and they are essential nutrients that are often lacking in the average diet.

Inflammation can also be reduced by other dietary methods. For example, raw garlic (whose anti-inflammatory component is allicin) and most teas (which contain catechins) are two beneficial and readily available substances (source).

Ornithine might aid the body in eliminating ammonia (source1 source2), but then again it might not (source).

GABA supplements have improved mood and/or sleep for some patients, including my life partner.

Drinking lots of water will help the body flush out toxins.

Sometimes baby aspirin (80 mg) is prescribed as an anticoagulant.

Plenty of rest is necessary when undergoing LD or bartonellosis treatment. These diseases wreak havoc on the body, and a lot of energy is needed for the body to heal. Tobacco and alcohol are to be avoided. (source)

Exercise is recommended in order to raise oxygen delivery to hypoperfused tissues. This does not have to be vigorous exercise. In fact, patients should not push themselves beyond their comfort zone because inflamed tissues can be further damaged by overwork.

My life partner is being treated by a good VBILMD in Rockville Maryland, but for some reason he doesn't want to be mentioned on this website. One good resource for finding a good VBILMD is here. A few Maryland doctors are listed here. A Google search will help you find VBILMDs and discussion groups pertaining to your particular disease(s) where you can ask forum members if they know of a good VBILMD. The Lyme Disease Foundation has a database (registration is free) that will help you find a physician near you.

Psychiatric help is available for sufferers. Until the pathogens are eliminated and the brain can heal, patients can be treated for their psychological disorders. However, not just any psychiatrist will necessarily be able to provide proper treatment, because merely prescribing antidepressants for pathogenically caused psychological problems can be ineffective or even harmful. Certain psychiatrists are educated in vector-borne illnesses and can provide appropriate treatment. Again, a Google search or the Lyme Disease Foundation's database might be of help.

You might have to pay out-of-pocket for good medical help. It is sad but true that insurance companies are driven by profit, not your health. It is in their interest to ignore or even deny the existence of certain diseases. Some doctors do not take insurance because treating an illness that insurers object to can have adverse consequences. However, there is hope as legislation is starting to be passed that protects doctors.

Veterinarians and doctors must work together to combat vector-borne illnesses. Veterinarians have a good amount of experience in this area since animals tend to remain outdoors longer than humans and hence are more prone to being infected.

We are lucky to live in this era of information and medicine, when so many previously untreatable ailments are now treatable. Until recently sufferers of advanced LD and bartonellosis were not so lucky, but their luck is now turning around.

Further reading and resources

When to Suspect Lyme (alternative link here)

Novel Diagnosis of Lyme Disease: Potential for CAM Intervention

Chronic Lyme Disease and Co-infections: Clinical Overview

Practice Guidelines for the Treatment of Lyme Disease

Healing Lyme Disease: An Integrated Approach to Curing Chronic Infection

Long-Term Inflammation in Lyme Borreliosis

What Every Primary Care Physician Should Know About Lyme Disease

Lyme Toxins the Primary Cause of Your Symptoms

Hemagglutination and Proteoglycan Binding by the Lyme Disease Spirochete, Borrelia burgdorferi

Studies on the Cystic Form of Borrelia burgdorferi

Ticks and Biting Insects Infected with the Etiologic Agent of Lyme Disease, Borrelia burgdorferi

Advanced Topics in Lyme Disease

The Marshall Protocol

Psychiatric Lyme Disease

The Psychotropic Management of Late-Stage Lyme and Associated Diseases

Lyme disease statistics by state

An Overview of Bartonella vinsonii subspecies berkhoffii Infection in Dogs

Bartonellosis: Veterinary and Human Implications

Bartonella sp. Bacteremia in Patients with Neurological and Neurocognitive Dysfunction

Ecological fitness and strategies of adaptation of Bartonella species to their hosts and vectors

Bartonella Infection in Animals: Carriership, Reservoir Potential, Pathogenicity, and Zoonotic Potential for Human Infection

Recommendations for Treatment of Human Infections Caused by Bartonella Species

Molecular and Cellular Basis of the Internalization of Bartonella henselae by Human Endothelial Cells

Entry of Bartonella bacilliformis into Erythrocytes

The World’s Top Stealth Bug Ends Marriages, Friendships and Jobs

Bartonella bacilliformis: Molecular Mechanisms of Invasion

Molecular and Cellular Basis of Bartonella Pathogenesis

An Infection Can Change Your Personality -- There's Plenty of Proof

International Lyme And Associated Diseases Society

NC State University College of Veterinary Medicine

Lyme Disease Research Foundation of Maryland

Lyme and Tick-Borne Diseases Research Center

A Complete Guide to Testing

Candida Albicans Overgrowth

Candida and Gut Dysbiosis

Candidiasis

Fungal Biofilms and Drug Resistance

Neuroprotection by minocycline facilitates significant recovery from spinal cord injury in mice

Minocycline, a Tetracycline Derivative, Is Neuroprotective against Excitotoxicity by Inhibiting Activation and Proliferation of Microglia

Minocycline Provides Neuroprotection Against N-Methyl-D-aspartate Neurotoxicity by Inhibiting Microglia

Purification and Characterization of Six Fibrinolytic Serine-Proteases from Earthworm Lumbricus rubellus

Reducing Inflammation With Diet and Supplements: The Story of Eicosanoid Inhibition

Tick Management Handbook

As stated previously, the author has no medical training, nor does he purport to offer better medical information than that offered by medical professionals. The purpose of the information on this site is to inform, but its accuracy cannot be ascertained.

Comments? Suggestions? E-mail lymebartonellosis@yahoo.com