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From the Archives of the Townsend Letter
July 2009

Guest Editorial
Why Lyme Treatments Fail, Part 1
by James Schaller, MD

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Added online May 2010

My average patient has been to 10 to 50 physicians before me. Below are some sample reasons for treatment failure.

1. Many patients and health-care workers are profoundly ignorant about how to read a western blot. If a person has one "fingerprint band," he/she has Lyme disease. These specific bands are the 18, 23, 25, 31, 34, 39, 83, or 93 bands. The lab can be a junk lab that invests nothing to optimize its kit; but if one of these is positive, even once – Lyme is present. IGeneX has the best western blot in the world. No other lab has invested so much for so long to create the best test. If your clinician wants to first use an ELISA (enzyme-linked immunosorbent assay), simply run. The ELISA as a screen test is utter junk, and misses profoundly PCR-positive patients.

2. Ten years of Lyme treatment is not acceptable. The use of IV treatment year after year means that the practitioner has a 1990s treatment approach. "Cure" treatments often merely lower body loads or decrease symptoms without fully killing all the infectious agents.

3. Some treatments simply are useless. For example, hyperbaric oxygen therapy (HBOT) for tick infection treatment fails. Its use in mice is not applicable. I self-funded a study examining HBOT results on Lyme, Babesia, Ehrlichia, and Bartonella. After 120 treatments at 2.4 atmospheres for 90 minutes each, all participants still had clear positive findings for all four infections. So advertising that HBOT "kills" Lyme disease has no validity. I have talked to the late Dr. William Fife in detail and carefully evaluated the HBOT research of Dr. Robert Lombard. I love this treatment for many medical problems, but it is not a tick infection cure. 

4. Ignoring new data leads to treatment failures. For example, I have published many new books on advanced tick-borne infections. Some "Lyme-literate" MDs only buy them after years have passed and educated patients are throwing copies at them. They all show new critical information.

5. Some health-care workers believe in a pope or president of Lyme literacy. But no perfect expert exists. Some offer useful information from past investigations. No one has mastered all of tick-borne medicine and all the newest coinfection information.

6. I have been asked by a number of physicians to share my new findings. Most ask because they are ill themselves. I have told them to stop treating themselves and to do an hour consultation with very extensive labs. Most have refused. What they could have learned by fixing themselves would have translated into real help for their patients.
7. Current treatment recommendations are often profoundly flawed. IV treatments are often used without a herbal or synthetic antibiotic cyst buster. The most common treatment for Babesia is 750 mg/teaspoon of Mepron taken twice a day. The most commonly used Babesia herbal cures are artemisinin, or artesunate (Zhang Artemisiae from, one capsule three times a day. All four of these approaches listed above fail even after long trials.

8. The flaw in all Bartonella treatment is the lack of one-year follow-up studies. I have found that Levaquin, rifampin, Zithromax, doxycycline, Mycobutin, Cumunda, Banderol, and Rife machines at various frequencies and power may lower body load and lead to initial feelings of improvement. None of these treatments lead to Bartonella cure.

9. The current testing for Babesia, Bartonella, and Ehrlichia is markedly flawed. Some DNA or PCR (polymerase chain reaction) tests processed by an East Coast lab often miss a positive infection ten times. If you need to do ten urine or blood samples to show a positive, this is not functional. Some labs are only fair at tissue PCR testing, when the tissue has clear Lyme, Babesia, and Bartonella that can be visualized microscopically. This is a diagnostic disaster. Amazingly, some use large national labs to do manual examination of red blood cells to look for Babesia and Bartonella. I have never seen a large national lab detect Babesia or Bartonella in over 1,000 manual smears.In patients with certain Babesia and Bartonella, no large national lab captured these infections even once. I repeatedly offered to assist them in improving their technology by linking them with hematology experts in tick infections. They were not interested.

10. The knowledge base about both Bartonella testing and treatment borders on the disastrous. Bartonella is one of the most common infections in the world. Calling it a "coinfection" is nonsense; if anything, Lyme is the "coinfection." It is found in vast numbers of common vectors, including dust mites, fleas, flea feces, pet saliva, and ticks. Amazingly, it can turn off or lower antibodies to Lyme disease, Babesia, Ehrlichia, Anaplasma, and even itself. Bartonella floats in blood and also enters all blood vessel walls without causing a fatal fever, and indeed actually lowers fevers. It is the ultimate stealth infection. It turns off antibodies, fevers, and immune function defense chemicals as it damages organs in 20 to 60 ways.

11. The use of fixed "protocols" or "procedures" in the treatment of tick infections is sadistic medicine. Why? It treats each ill human person as a machine that is built the same and has the exact same problems. This is making a patient into an object and has hints of the sociopathic. A serious criminal makes people into things to fit his perceptions of the world. To force an immensely unique human body, with a unique infection cluster, and a unique biochemical response, into a protocol is objectification of the patient. It is junk "mill medicine."

12. Since Bartonella turns off the production of antibodies to infections like Babesia microti or Babesia duncani and Lyme disease, I suggest that this infection must be considered in all initial consults. I would encourage learning the 40 skin patterns from  Bartonella or Bartonella/Lyme mixed infections that are made by increased tissue and blood vessels. It is also useful to know the indirect labs associated with Bartonella alone, or Bartonella with Babesia, such as IL-6, IL-1B, TNF-a, ECP, and VEGF. I discuss clinical patterns from lab results of thee infections in my book Babesia Update 2009.

13. Some patients have very few Babesia protozoa parasites, but they cause serious trouble in the body. Their small numbers cause them to be missed in a visual FISH (fluorescent in-situ hybridization) exam or a PCR test. 

14. If your lab does not test for new species such as Babesia duncani or the many other documented species of Babesia or Bartonella that infect humans, you cannot rule out these infections with a "negative result." One way to decrease treatment failures is to use a new medical trick to detect stealth Babesia, whose presence can cause ongoing fatigue, headaches, weight gain, and Lyme treatment failure.

The "trick" is simple. A patient is given at least two Babesia-killing medications such as Mepron, artesunate at a high useful dose, or Malarone (for the proguanil). These medications are used for ten days at a dose you and your physician think is worth the risk, and usually at least one will kill a few Babesia parasites. Approximately 10 to 14 days later, a second ECP (eosinophil cationic protein) level is taken to compare with baseline. If the ECP pops up significantly, it is usually a sign of Babesia die-off. Eosinophils are releasing ECP, possibly injecting Babesia debris.  ECP is meant to kill parasites. 

An alternative or added option is to wait five weeks and have the patient tested for antibodies to B. microti or duncani. One young patient with profound illness was finally diagnosed in this manner, and after three weeks of triple Babesia treatment, had significant clinical improvement for the first time in six years. Stealthy low-volume Babesia is a common problem in tick and flea infection treatment. Talented health-care workers commonly miss these red blood cell parasites, but this trick usually causes them to show up and can save someone from years of failed treatment.

15. The Bartonella testing of most national labs is useless. It is stunning to read of "sages" reporting that a patient does not have Bartonella because a large lab has found negative antibodies. First, they do not understand that Bartonella turns off its own antibodies; these large labs only check for one (or two) species that infect humans, and their cut-off titers are unrealistically high. Thankfully, IGeneX Bartonella FISH testing is expected to be available this month to everyone but citizens of New York State.  

16. Infections and inflammation decrease insight. Tick-borne infections routinely lead to a personality change and/or rigid resistance to testing. This is largely due to an impaired frontal lobe that is the part of the brain involved in self-awareness. Examples of decreased insight are shown in the following situations:

       a. Some think they are cured when they are only improved.
       b. Others intentionally go to practitioners using inferior labs. 
       c. Some refuse to be tested with eccentric resistance.
       d. Positive results are amazingly dismissed with a wave of the hand.

17. Some patients think that their trouble is not tick-borne infections but mold. They cannot believe that both are important, and either could be "the last straw." Some patients get ill after a flood, large leak, or other water-intrusion problem. They think that they are ill only because of mold mycotoxins that form 36 to 48 hours after water intrusion into drywall, insulation, carpeting, and other dust- or cellulose-filled materials. The Environmental Protection Agency reports that 30% of US structures have indoor mold. Some of these indoor molds have war-grade chemicals on their surfaces. When the mold-filled tomb room of the last king of Poland, Casimir IV, was opened in Paris in 1973, 10 of the 12  scientists present died. One survivor had expertise in mold and subsequently found three toxic mold species. 

Given the average of 40,000 to 120,000 inhalations per week by those residing in a moldy location, it is no wonder that some are not easily cured of tick and flea infections. This is why I have written two mold remediation books. 

We have also known since the 1880s that dust and high humidity lead to mold and bacteria growth indoors. Their presence makes Lyme disease much more difficult to cure.

18. Lyme has at least one surface biotoxin, the patented BbTox1. Patients with 15/16–6/5–51 HLA patterns probably are unable to remove Lyme biotoxins and require a binder, like cholestyramine, which has been used to bind biotoxins since the 1970s. 

19. Many patients who have had tick-borne infections have very high inflammation levels. Therefore, all starting doses of medications or herbs should be very low and then raised to high levels with liver-protecting substances. Starting at full dosing in a "medically sensitive" patient is chemical battery. Massive die-offs can be confused with allergic reactions and can cause panic attacks, shortness of breath, chest pain, and severe migraines. This sloppy, one-size-fits-all approach, is common in large practices in which a few major "protocols" are routine. 

20. Medical "Band-Aids" are often required to save a job or a marriage and to care for children. They are often a normal part of care. Pain, fatigue, severe insomnia, depression, and anxiety often are increased with the die-off of any of the infections carried in deer ticks. Band-Aid treatments are often useful and helpful. I treat people who run companies, schools, very large families, and professional teams. They want to sleep 13 hours per day. They need stimulants for a period of time. The use of natural or synthetic stimulant options is discussed in my book The Diagnosis and Treatment of Babesia. Patients do not benefit from sleep in excess of 8½ hours. It may just serve to get them fired! 

21. If you have health-care workers who are uncomfortable being aggressive with treatment and diagnosis of all the top tick and flea infections, you are at the wrong place. If your health-care provider has not spent 1,000 hours learning this complex emerging area of medicine requiring a great deal of study, find someone who is serious about it, not someone "doing you a favor" by simply running a few tests. 

22. Some relapse due to treatment fatigue. Meaning, you have been treated for many years. You have done IV antibiotics or IV nutrients, you have taken 40 pills per day, you have tried a wide range of specialized treatments, and now you are fed up with it all. You can now function at 80% of your baseline. You are at the end of your treatment rope. This is what happens when someone does not treat you fully and effectively at the beginning of your treatment. You can get treatment fatigue. Consider a short treatment break, and discuss this frankly with your health-care provider. Do not confuse cure with improvement.

23. The treatment approach that leads to cure is not the same dose that leads to stunning organisms. Cure does not does not equal a reduction in bacteria load. For example, using Bicillin once a week with no cyst buster will never cure you of Lyme disease because it does not remove cysts. So years after receiving this treatment, your cancer-fighting cells, marked by some as the CD57 level, may be under 90. This is one good test that is possibly specific for Lyme disease or at least tick-borne infections. (The C3a and C4a test is definitely not specific for Lyme). 

24. Cynical relatives, friends, or other health-care workers may defame Lyme experts and persuade patients to drop providers who are helping. They usually use the "money" or "speed of your recovery" argument to cut you off from someone sincerely trying to help you. If you have been infected years with multiple infections, you cannot be cured in six months.

25. In 2008 a Lyme biofilm appeared to have been discovered. Organizations with millions in grants and research money have never addressed this issue. We know that many spirochetes have biofilms. Indeed, many spirochetes in your mouth are known to cause biofilms, and they are believed to limit antibiotic effectiveness.  

I am currently working on a textbook that addresses the many options for attacking biofilms. No article nor book yet exists that explores the 20-plus ways I would propose to beat a Lyme biofilm. It is believed by some professionals that highly specific enzymes (or one mineral) can undermine a Lyme biofilm. Yet enzymes are like keys, and no single enzyme is a proven "key" to undermining a Lyme biofilm. 

26. Self-treatment is easy to pursue. Many experts are expensive, and you are uncertain of their level of knowledge. The Internet seems to offer many effective options. Some health-care providers seem too narrow. Others are open to virtually everything. So you get in a medical boat and push yourself out to sea. You read like crazy. You try A, B, and C. You read testimonies of hundreds of patients. You try a wide range of nonprescription options. Some days, weeks, or months you feel better; other weeks, you are not so good. You are upset. You ask yourself, why do I have to do all the work and learning? This is not a good place. There are people who have already explored virtually all the things you are going to explore in the next ten years. You need a mentor. Many practitioners will do nonpatient consults with you to save you time.

27. In many of my books and many Internet sites, you can read about preventing flea and tick bites. You do not need to be reinfected with Bartonella, Lyme, Babesia or any other infection. So learn the basic steps to protection in about 30 minutes of reading. 

28. Tick and flea-borne infections cause isolation. They ruin relationships due to resulting fogginess, poor insight, depression, various addictions, rage, extreme hostility – even violence – and refusal to get treatment. Bartonella is likely the worst offender, but Lyme and Babesia and their die-offs can also increase these problems. Isolation leads to decreased treatment options. It can ultimately lead to divorce and the loss of family relationships and friendships. This, in turn, leads to decreased resources and support while ill. Isolated humans, as Mother Teresa often said, are the poorest beings on earth. 

James Schaller, MD


James Schaller, MD, has been elected by his physician peers a "Best Doctor in America." He has published more books on tick infections than probably any physician in history. He is the author of 26 books and 27 papers published in highly respected medical journals on topics covering 10 areas of medicine. He is the author of Babesia Update 2009: A Cause of Excess Weight, Migraines and Fatigue? A Common Reason for Failed Lyme Disease Treatment; The Health Care Professional's Guide to the Treatment and Diagnosis of Human Babesiosis: An Extensive Review of New Human Babesia Species and Advanced Treatments; Artemisinin, Artesunate, Artemisinic Acid and Other Derivatives of Artemisia Used for Malaria, Babesia and Cancer; The Diagnosis, Treatment and Prevention of Bartonella: Atypical Bartonella Treatment Failures and 40 Hypothetical Physical Exam Findings; A Laboratory Guide to Human Babesia Hematology Forms; Mold Illness and Mold Remediation Made Simple: Removing Mold Toxins from Bodies and Sick Buildings; When Traditional Medicine Fails, Your Guide to Mold Toxins; A.D.D., Irritability and Oppositional Disorders: Cutting Edge Solutions Sincere Therapists and Doctors Miss; and Suboxone: Take Back Your Life From Pain Medications.

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