James Schaller, MD Makes a Hypothesis: Treatment of Lyme Disease Should Be Changed When Bartonella is Suspected
Many fine researchers and clinicians have offered us tens of thousands of articles on these infections. Others with a wide range of differing guidelines have offered many clinical pearls. This builds on their helpful sacrifice.
Point One: What Does Bartonella Do to Immunity?
Many fine researchers and other agencies have funded studies which directly or indirectly show that Bartonella lowers immunity. It is not HIV, but it is not a regular bacteria.
Point Two: What Does Lyme Do When Immune Function is Low?
Before addressing this question, this article is not about treatment duration. Our position is that the duration for any individual is unknown and should be left up to each patient and their physician, based on a reading of as many articles as possible from a wide range of positions.
We also worry most deer tick infections might be missed. So additional tick or flea bites during or after treatment would change a person's tailored treatment—most seem to agree with this position regardless of ideology. Let us be very clear. We are talking about what happens when a period sized painless bite happens and years pass with Bartonella and Lyme both present in a body. Perhaps the answer is partly found in the reports of clinicians surrounding the actions of spirochetes in the presence of immune suppressing steroids. They generally report that Lyme disease symptoms become worse, especially if the steroid use is more than a brief trial. And this should not be a surprise, because many infectious agents are more trouble in the presence of ongoing steroid use.
Yet some report that even a few steroid injections into the spine in a Lyme patient who has not been treated or fully treated, seem to help briefly with a relapse of even worse pain and function, or worse pain and function.
Based on research that Bartonella suppresses immunity and that Lyme acts more aggressive in a low immune fighting body, we feel that the presence of both together causes a logarithmic increase in body spirochete numbers of Lyme disease and increased damage and penetration into tissue.
We have yet to see any guideline alter duration or their approach to the presence of Bartonella, and we hope in the next ten to fifteen years this will be addressed.
Proposal: Re examine Lyme Disease Guidelines to When Bartonella is Also Present. Based on this small discussion, the assumption Bartonella has no effect on Lyme disease is a concern. It may be a risky assumption.