In this episode of The Lyme Insider, we sit down with Dr. Joe Burrascano, MD, a leading expert in Lyme disease testing, to discuss the complexities of diagnosing Lyme disease and its co-infections. This interview dives deep into the challenges faced by patients and healthcare professionals alike, as we explore the latest advancements in testing technologies, how co-infections affect diagnosis, and the impact of the immune system on chronic Lyme disease.

Key Discussion Points:

1. Common Misconceptions in Lyme Disease Testing

   • Why Lyme testing is often misunderstood by both patients and healthcare providers, and the importance of education in improving diagnosis accuracy.

2. Limitations of Early Lyme Disease Strains

   • How the original Lyme strain, B31, isolated from a tick, may not represent all cases of Lyme disease across the country, leading to potential diagnostic gaps.

3. The Challenge of Co-Infections

   • The role of co-infections like Babesia and Bartonella in complicating both diagnosis and treatment, and what patients should be aware of when they receive Lyme disease testing.

4. Indirect vs. Direct Testing Methods

   • A breakdown of the differences between indirect tests (which measure immune response) and direct tests (which detect the organism), and how doctors should decide which test is appropriate.

5. How Antibody Levels Change During Treatment

   • A look at how Lyme disease treatment can alter antibody levels over time, and what these changes reveal about a patient’s progress and infection status.

6. The Importance of Recombinant Technology in Testing

   • How advancements like recombinant technology are improving the accuracy of Lyme disease testing, overcoming the shortcomings of traditional methods like the ELISA and Western blot.

7. The Immune System's Role in Chronic Lyme Disease

   • Exploring the immune response in chronic Lyme patients and how newer tests like IGXSpot, which measure T-cell activity, provide a clearer picture of these patients’ conditions.

8. Testing During Symptom Flares

   • Why testing during Lyme disease symptom flares or treatment pauses can often yield more accurate results, and the science behind these recommendations.

9. New Technologies for Early Lyme Detection

   • How cutting-edge tests from iGenex are changing the landscape of early Lyme detection, and why early diagnosis is crucial for better patient outcomes.

10. Personalized Lyme Treatment Based on Testing

    • How to tailor Lyme disease treatment plans according to specific test results, particularly for patients dealing with chronic Lyme or multiple co-infections.

Guest Bio:

Dr. Burrascano is an expert in Lyme disease research and testing, with years of experience in diagnosing and treating tick-borne illnesses. They have worked closely with iGenex to advance Lyme disease testing technologies and provide better diagnostic tools for healthcare professionals and patients alike.

Key Takeaways for Listeners:

• Understanding why Lyme disease testing can be complex and how to navigate through the different options available.
• The importance of co-infections in Lyme disease diagnosis and treatment.
• How new testing methods and technologies are improving the accuracy of Lyme disease diagnosis.

Tune in to gain valuable insights into the latest advancements in Lyme disease testing and how to approach diagnosis and treatment more effectively.

In this episode of the Lyme Insider, Dr. Tom Moorcroft is joined by Dr. Eboni Cornish as they discuss the often-overlooked parasite, Toxoplasma gondii, and its implications for chronic infections and neuropsychiatric symptoms. They explore the role of toxoplasmosis in various chronic illnesses, including tick-borne diseases, and delve into Dr. Cornish's clinical practice at the Amen Clinic. They emphasize the importance of accurate diagnosis using spec scans and brain imaging to tailor treatment approaches. Dr. Cornish shares insights into innovative diagnostics, including oral microbiome testing and personalized treatments for neuroinflammation. The episode also highlights Dr. Cornish's dedication to finding the root cause of health issues and providing effective therapies for recovery.

00:00 Introduction to the Elusive Parasite
00:10 Meet Dr. Eboni Cornish
00:34 Understanding Toxoplasma Gondii
00:48 Neuropsychiatric Symptoms and Infections
01:30 Diving into Diagnosis and Treatment
02:02 Live from the MAPS Conference
02:42 Clinical Insights and Practices
03:40 Exploring Oral Infections
04:26 The Role of Neuroimaging
06:06 Innovative Treatment Approaches
12:28 The Importance of Oral and Nasal Health
19:21 Addressing Perianal Strep
21:40 Exploring Liposomal Formulations
22:43 Balancing Testing and Treatment
24:45 The Role of Clinical Diagnosis
30:21 Integrating Conference Learnings
32:50 Personalized Patient Care
36:02 The Importance of Basics in Treatment
41:09 Innovative Programs and Final Thoughts

In this episode of the Lime Insider, Dr. Tom Moorcroft discusses video game addiction with Dr. Koichi Tanji, a naturopathic physician and addiction specialist. The conversation covers the signs and symptoms of video game addiction, its potential impacts, and similarities with substance abuse. They discuss strategies for identifying and treating gaming addiction, the risks involved, and how to foster healthier relationships with technology. The episode emphasizes the importance of awareness and offers insights into managing screen time for both children and adults.

00:00 Introduction to Video Game Addiction

00:38 Meet Dr. Koichi Tanji: From Boxer to Addiction Specialist

01:11 The Rise of Screen Time and Its Consequences

02:17 The Importance of Addressing Video Game Addiction

06:17 Understanding the Symptoms of Gaming Addiction

09:20 The Psychology Behind Gaming Addiction 12:53 The Dangers of Unsupervised Internet Access

18:17 Strategies for Managing Gaming Addiction

21:58 Impact of COVID on Screen Time

22:24 Pandemic Screen Time Statistics

23:43 Understanding Gaming Addiction

24:36 Treatment Approaches for Gaming Addiction

26:59 Parental Guidance and Healthy Coping Skills

30:34 The Importance of Boredom and Creativity

35:08 Final Thoughts and Future Conversations

Summary

Dr. Ed Breitschwerdt discusses his interest in Bartonella research and the challenges associated with studying this bacteria. He explains the discovery of Bartonella and its unique aspects, including the various vectors and modes of transmission. The prevalence of Bartonella and the challenges in diagnosing the infection are also discussed. Dr. Breitschwerdt highlights the difficulties in testing and diagnosing chronic Bartonella infections and the use of digital PCR for more accurate detection. The chapter concludes with a discussion on the pathophysiology of chronic Bartonella infection. The conversation explores the challenges in accurately diagnosing Bartonella infections and the differences in results from different labs. It highlights the importance of using the correct isolates of the organism for testing and the prevalence of different strains. ThKe discussion also touches on the phenomenon of patients stopping the production of antibodies to Bartonella and the interplay between acute and chronic infections. The conversation emphasizes the need for better diagnostic tests and the development of a vaccine to protect animals and humans from Bartonella infections.

Takeaways

Bartonella is a complex bacteria with various vectors and modes of transmission.

Diagnosing Bartonella infection, especially chronic cases, can be challenging.

Digital PCR is a promising tool for more accurate detection of Bartonella.

Chronic Bartonella infection can lead to a range of symptoms and recrudescence. Different labs may use different isolates of Bartonella, leading to different results in testing.

Patients may stop producing antibodies to Bartonella, making serology testing less reliable.

Exposure to Bartonella species is common, and many individuals may be asymptomatic carriers.

Bartonella infections may contribute to a spectrum of neurologic and neuropsychiatric diseases.

The development of a diagnostic test and a vaccine for Bartonella are important goals for future research.

Chapters

00:00 Introduction and Background

00:42 Interest in Bartonella Research

05:38 Challenges and Unique Aspects of Bartonella

08:37 Transmission of Bartonella

11:11 Vectors and Transmission to Humans

14:58 Prevalence of Bartonella and Challenges in Diagnosis

29:35 Chronic Bartonella Infection and Recrudescence

32:20 Pathophysiology of Chronic Bartonella Infection

36:06 Diagnostic Challenges and Digital PCR

41:13 Challenges in Accurate Diagnosis

42:02 Different Results from Different Labs

42:16 Different Isolates of the Organism

43:42 Prevalence of Bartonella Henselae Strains

44:41 Patients Stop Making Antibodies

45:56 Interplay Between Acute and Chronic Infections

46:45 Serofast State in Bartonella Henselae

47:21 Exposure to Bartonella Species

48:19 Testing Blood Donors for Bartonella

49:47 Role of Bartonella in Neurologic Diseases

52:43 Symptoms of Bartonella Infection

54:03 Understanding Bartonella on a Cellular Basis

57:34 Developing a Diagnostic Test for Bartonella

01:00:09 Vaccine Target for Bartonella

01:11:44 Protecting the Human-Animal Bond

01:18:03 Future Goals: Diagnostic Test and Vaccine

Dr. Ed Breitschwerdt, DVM , DACVIM

Learn more about Dr. Breitschwerdt and his work at NC State University

Learn more about Dr. Breitschwerdt’s work at Galaxy Diagnostics

Donate to the NC State Bartonella/Vector Borne Research Fund

Tom Moorcroft, DO

Learn more about Dr. Tom’s Lyme Disease Practitioner Training program.

Summary

In this conversation, I’m joined by Dr. Choukri Ben Mamoun and Dr. Tim Sellati to discuss Dr. Ben Mamoun’s recent study on the use of combination therapy for the treatment of Babesia infection entitled: Tafenoquine-Atovaquone Combination Achieves Radical Cure and Confers Sterile Immunity in Experimental Models of Human Babesiosis.

We explore the key findings of the study, including the use of immunocompromised mouse models and the potential for long-lasting immunity. The conversation also delves into the importance of understanding the differences between tick-borne infections and the challenges of translating research findings into clinical practice. The discussion highlights the need for further research on dosing and the therapeutic index of different drugs.

Overall, the conversation provides valuable insights into the current understanding of Babesia treatment and the potential for future advancements. The conversation covers topics such as combination therapy and resistance, dormant parasites and relapse, terminology and immunocompromised, immune dysregulation and cold exposure, diagnostic testing for Babesia, improving diagnostic testing, and the goal of helping patients.

Key Takeaways

Combination therapy with tafenoquine and atovaquone has shown promising results in the treatment of Babesia infection.

Immunocompromised mouse models are valuable tools for studying the efficacy of different treatments.

Understanding the differences between tick-borne infections is crucial for accurate diagnosis and treatment.

Further research is needed to determine optimal dosing and the therapeutic index of different drugs for Babesia treatment.

Recrudescence and treatment failure are important considerations in Babesia treatment.

Combination therapy can reduce the probability of resistance in parasites.

Dormant parasites may be responsible for relapse in Babesia infections.

The terminology used in scientific research may differ from the general public's understanding.

Factors like sleep, stress, and nutrition can contribute to immunocompromised states.

Diagnostic testing for Babesia needs improvement to reduce false negatives and false positives.

The ultimate goal is to help patients get better by finding the right diagnosis and treatment.

There is a need for collaboration between clinicians, researchers, and patients to advance the understanding and treatment of tick-borne infections.

Chapters

00:00 Introduction and Overview

03:00 The Study and Key Findings

06:35 Understanding the Research and Clinical Implications

11:56 The Importance of Animal Models

14:43 Immunocompromised Mouse Models

23:22 Differences Between Tick-Borne Infections

26:34 Combination Therapy: Tafenoquine and Atovaquone

32:26 Dosing and Therapeutic Index

36:48 Artemisinin as a Treatment Option

46:20 Recrudescence and Treatment Failure

48:23 Combination Therapy and Resistance

50:24 Dormant Parasites and Relapse

53:18 Terminology and Immunocompromised

56:15 Immune Dysregulation and Cold Exposure

59:14 Diagnostic Testing for Babesia

01:03:22 Improving Diagnostic Testing

01:12:12 The Goal of Helping Patients

01:20:22 Caring and Finding the Truth

Link to the paper we discussed:

Tafenoquine-Atovaquone Combination Achieves Radical Cure and Confers Sterile Immunity in Experimental Models of Human Babesiosis - https://pubmed.ncbi.nlm.nih.gov/38169301/

Learn More About My Guests:

Choukri Ben Mamoun, PhD - Professor of Medicine (Infectious Diseases) and of Microbial Pathogenesis; Affiliated Faculty, Yale Institute for Global Health https://medicine.yale.edu/profile/choukri-benmamoun/

Timothy Sellati, PhD - Chief Scientific Officer, Global Lyme Alliance https://www.globallymealliance.org/

Learn more about Dr. Tom’s Lyme Disease Practitioner Training program.