Episode Transcript
[00:00:01] Speaker A: Welcome back to Integrative lyme Solutions with Dr. Karl Feldt. I am so excited about the show that we have ahead of us. We have some phenomenal information that could save lives.
You're gonna need to tune in to what's going on today. The information is jam packed, so don't step away.
Well, I am so pleased to have Dr. Steven Harris with me here today. Thank you so much for spending some time on Integr Lyme Solutions.
[00:00:33] Speaker B: Thank you for having me.
[00:00:35] Speaker A: So you and your dad, I mean, it was your dad started the Igenics and you're the one that's pretty much running it now.
And I'm really one of the challenges, obviously with Lyme, is to kind of figuring out is it Lyme or is it not Lyme and what co infections are part of the whole journey.
Can you just kind of give me a little understanding what brought you guys down this road? Because this is a road that obviously not a lot of people are, are thinking about traveling, especially being a trailblazer like you guys have been.
[00:01:12] Speaker B: Well, I don't know that I would call myself a trailblazer. I think my father, Nick was a trailblazer. I actually only do consulting for the lab at this point. I'm not involved in hygienics anymore. Jatsana Shah and Sudhir Shah actually run and own the lab, so. But yes, my father started it, gosh, back in.
Must have been in the early 90s, probably actually maybe even 88, 89.
And there was this new.
This new disease type that seemed to be coming out primarily on the east coast at the time where, where we knew we had just learned through Willie Burgdorf or that this was spirochetal infection.
And so my dad, in conjunction with a few other people, developed tests, primarily antibody tests at first, and then later DNA tests, and now have expanded into quite a few different tests to address this new infection. And so I was actually just in the background as a student, hearing my father talk to doctors and patients on the phone, usually around dinner time, and hearing stories about what a situation we gotten ourselves in as a society and that many patients weren't able to get diagnosed, doctors didn't know how to diagnose and how to treat this infection.
And I would see over the years that, that there was more and more polarization between what was being said in many textbooks and what was being actually really understood and seen on the ground watching really, really back from the. What is that, 40 years nearly, that this disease and understanding has come quite a long way, we have a long way to go.
I was just at a conference in Chicago and there was still quite a bit of ignorance and denial with respect to the presence, the prevalence, the incidence and the enormity of this infection.
And so we're still, we're still in it, in a battle to try to get more understanding. And so Igenx is one of those labs. There's very many, there's a lot of labs that are out there as well. They're doing great work with new technologies, with high specificity and sensitivity.
While we talk about that we don't have good enough testing. Yes, we don't have good enough testing to diagnose every time or to find the presence of the organisms or the proper immune cells, the antibodies and T cells and every time. But we're a lot better than we used to be.
[00:04:14] Speaker A: Yeah. And yeah, speaking a little bit on that, I mean, where do you feel we're at now? I mean, what have we achieved? I mean it sounds like the testing aspect has really evolved quite a bit from let's say a couple of decades, two, three decades ago.
But where do you feel kind of the medical community, is it shifting in some way or is this still still the same kind of ignorance and bias?
[00:04:42] Speaker B: There's still two communities. There's, there is a lack of general understanding about how. And with respect to Lyme, I'll talk about Borrelia, which is the agent that causes Lyme in particular. But when I talk about this, I am talking about other intracellular infections and some people would call them co infections such as Babesia which is a red blood cell parasite or Bartonella and than the many species of Bartonella which is a gram negative bacteria, and then the Ehrlichia rickettsial infections and a plasma infections. But so if we're just going to talk about Borrelia because it's a good model for how to understand this, but realizing that there is a little bit more complexity behind it.
One of the issues with Borrelia is that there's not a lot of organisms when it infects us. There's not a lot of organisms in bacterial terms that are actually in the body at the time. These organisms, they divide very slowly. They do really pack a punch. But unlike their dumb cousin Treponema which causes syphilis where nearly every cell is infected, Borrelia, which is a much more complicated organism than Treponema, there's not a lot of them. So when you're just trying to culture or do DNA testing or even RNA testing, Looking for the actual presence of the organisms. It is looking for a needle in the haystack oftentimes. Now we do know that there is predilection for certain cells. And so if we do cultures and if we do biopsies of various areas, we're more apt to find them in the bladder and oligodendrocytes and in various cells we may be able to find them better. But we're not usually doing real biopsies in standard practice, in the clinician's office at least. So, so there is that. There's the less organisms than many other infections and the borrelia itself, it doesn't induce a very brisk immune response.
It doesn't have a lot of so called bacterial resistance per se. So when we get into treatment there's not a lot of true resistance, but there is a lot of evasion strategies to avoid our immune system. And that also meets out in the, in the testing. And so when we have what was determined to be the best case testing, so called two tiered antibody testing or immune testing, what you do is you look, you do a quantitative test first. It's called an ELISA or an ifa, these two immunofluorescence antibody enzyme LinkedIn aminosorbin assay and that has a quantity of antibodies.
And, and if you reach a certain threshold then the theory was to go to a second tier to really determine if that was a false positive. And then you do a so called western blot or immunoblot looking at specific antibodies. And so what we found over time, very early on in this, this process actually back in 1996, even when they came up with this two tiered strategy, is that borrelia doesn't induce a brisk response. You can find the specific antibodies if you do that second test first. But if you're doing this so called screening test like we used to do for hiv, HIV people would have a, they would have an ELISA positive and then you would go and do a confirmatory test and you could see for Borrelia it doesn't work like that most of the time. Especially if more than four or five months have elapsed since the infection, the quantity of antibody response goes down. So to use a quantitative test as a screening test really misses definitely more than half of the cases, sometimes up to 70% of the cases has been shown in the literature that are missed.
So many of the doctors who are in one community of treating Lyme, they often will even avoid doing that first test, that ELIZA screening test in favor of doing the more specific Western blood or immunoblood, it's called.
[00:08:54] Speaker A: And do you feel the ELISA tests, you know, bring in a value at any point, or do you feel it. It's just. It's so inaccurate, you know, we should just scrap it in regards to Lyme?
[00:09:06] Speaker B: Well, I have opinions about scrapping it. I think that there is quite a bit of debate about this, and there's a lot of people very invested in this test, both in academia and in publications.
And I think that it's probably going to be hard to remove that test completely. And there are attempts to try to make it a bit more sensitive. There's something called a C6 ELISA which may be a bit better, especially in early Lyme. It's a better test.
And then there are some scientific methodologies that may make that test more sensitive. But for my purposes, when I have patients who are in crisis and I need to know if they have an infection, unless I have to for insurance purposes or for other academic reasons, or for study purposes like irb, if I'm in a study, I'm really not doing that test. It's not giving me much by way of clinical value. I will do an immune test, the immunoblot. And there's a lot I can say about the immunoblot as well, because there's a lot of differences in controversy about that as well. But the way that I think about testing is that there's indirect tests that look at your immune response, and so they are an inference based on what you're seeing, that if your immune system says it's there, then it's likely there. Now, that's not always the case. We know that with lymphomas and with certain different kinds of autoimmune issues that we may make antibodies against things that we don't have.
And so, but, so the immune tests are useful, but they're not perfect. And so what we also use is we use direct testing. And direct testing is looking for pieces of the organism, the organism itself, nucleotides such as DNA and RNA antigen, sometimes pieces of the. Of the organism. And so if we can combine strategically the immune response testing and the actual direct testing, we can often hit. We can usually find most of the cases I find.
[00:11:11] Speaker A: Yeah, I mean, like you mentioned, you know, it is not everywhere in the body, like syphilis. You know, it is just very specific location. So when you're looking for pieces of the. Of Borrelia, you know, are. Is it. Is it a high likelihood that you'll find it?
[00:11:29] Speaker B: Then it Depends.
It depends on when we're looking for the borrelia itself, when we're looking for the organisms itself. If we're doing a DNA test called a pcr, there are certain times that we may find the organisms in the blood. Now when we think about the actual characteristics of the borrelia organism, it doesn't like oxygen. It's called a facultative anaerobe because of that it's going to stay away from places where there's a lot of oxygen like the bloodstream. And so it goes to tissues. In fact, it moves faster as a corkscrew shaped organism. It moves faster through tissue than it does through blood. There's not a lot of benefits that the organism gets from being in the blood typically unless it's using it, just having the blood move it from one place to another. So when we're testing the blood, we're not always going to find it there because it's not the typical place it resides.
But that being said, there are times, usually four days before menses we can often see target it and menstruating women more will find it positive in the blood. Usually if people are going through their.
Many Lyme patients, especially chronic Lyme patients, will have this, this monthly flare that's, that's somewhat predictable. And so during that flare time we found over, over the decades that we will find it more, more likely. I do still feel though that you're not finding it more than 40% of the time, even when it's there by PCR. PCR can, can detect very small amounts of the organism, but if there's none in the sample that you've looked at, no amount is going to find it. So serial testing is not very practical because of the cost of all of these tests.
And so while the PCR has a very high so called positive predictive value depending on where people were but when they were tested, meaning what location they might have been bitten and such gets into quite another controversial idea, this idea of positive predictive values because it has to do with the incidence of the area or the prevalence of the infection in a certain area. That being said, when you see it, it's usually positive. There are some criticisms that, well, if you see a positive DNA it doesn't mean that you have live organisms in you, but in general after 4, 5 weeks the organisms are most likely going to be gone. They're going to be degraded by, by various enzymes that we have. So the, so a positive DNA test or positive PCR is helpful, but the sensitivity is low. Specificity is high.
So if, if you see it, it's probably real. But the sensitivity, the being able to find it when it's there is, is kind of low. So there are some new tests that hygenics and that T lab and that infecto lab and that Armand lab and some of these other fantastic labs are doing.
We can actually use some of these other technologies. There's some RNA or so called fish testing, called fluoroscopic and situ hybridization, where you're actually looking at organisms that are tagged their RNA under a microscope. That can be useful culturing the organism, which has been notoriously very difficult. But a few companies have found ways to use things besides that typical, that typical blend used to be called bsk, still called bsk. But there are other ways to, to, to, to be able to culture these organisms and then do DNA testing that's also very useful. We can do so culture testing, DNA testing, RNA testing with some labs. And then we can also do some of these different immune tests, the immunoblots, as well as something called T cell testing, which looks at a different kind of immune cell, the T cells. And that if they've been, if these T cells which are other immune cells have been recently exposed to that organism, then it's not necessarily a memory like antibodies, but that they do get re triggered with certain chemicals which when provoked with that same offending organism. So if you use this at the right timing and each person's a little bit different when I'm going to use these different employees, different tests.
And it is one of the questions when I do consulting for hygienics and how do I, so I have a patient and they're immunoblot negative, what do I do with them? And so there are strategies to try to bring out the infection. And so that's been kind of an exciting thing that we can, if we look in a few different sequences, we can find it probably more than 85, 90% of the time.
[00:16:25] Speaker A: Yeah, I mean, I know some strategies, you know, some doctors do, like intravenous hydrochloric acid, you know, to kind of open things up and then being able to have a better yield for the test. And so there are certain strategies to try to kind of activate or improve the results, so to say some therapies like that.
[00:16:50] Speaker B: Right. So yeah, so one of the things, knowing that this organism, besides just not being in the bloodstream, it does live often inside of cells, so it's considered an intracellular organism. The immune system generally is not inside the cells and, and so it's not going to pick it up. But if you could pull some of those organisms out of the cells back into the bloodstream, then your immune system can often find it. And so what we can do sometimes is we can actually provoke someone with an antibiotic or other kind of antimicrobial that goes intracellular. And so I use a fair amount of pharmaceuticals, but I also use naturals. And so there's a lot of different techniques that we can employ.
And then if you, knowing that that immune response is going to take 10 to 20 days to really to kick in and then you can test the, one of the components of the ImmunoBlot, the IGM it's called, and you can test that three to four weeks after starting that antimicrobial treatment. Then a lot of times you can really enhance the yield that you're going to find a positive test. So it's, there are definitely strategies that we can do for that and we've done that with various herbal strategies and things like that as well.
[00:18:03] Speaker A: So when you have a patient in front of you and they come, they express symptoms of Lyme, they have not had it confirmed, but we suspect.
Do you mind kind of just taking me through your thinking process in regards to the investigation aspect?
What type of labs do you like to run initially and then you know, what kind of provocation do you do?
Do you mind just kind of. So we have kind of a bird's eye view of what, what, what your process looks like.
[00:18:39] Speaker B: Sure.
So one of the things I think that as, as a so called Lyme doctor I need to contend with is the criticism about the over diagnosis of Lyme, which I actually don't believe is really a big thing. I think that there's an under diagnosis of Lyme. But I do have a lot of people looking over my shoulder in academic institutions and pharmaceutical and insurance and other doctors, of course. And so I want to be right. I don't want to overshoot or over diagnose.
So part of what I'm doing when I'm seeing people, and usually I'm seeing them after they've been to many other providers, is that what else could it be? What else could it be? And so I'm thinking of the differential and the differential is big. You have to obviously rule out various blood cancers and hyperparathyroidism, other kinds of endocrine issues, other kinds of rheumatoid or autoimmune issues.
So assuming that I'm doing all of those things too. Right.
Because it's important to find, we do find other things. It doesn't happen a lot because a lot of people self select. By the time they come to some of the doctors who, who are in chronic complex illness, many of them have been through the basics already and so a lot of them self select and it is, they do have, there is a pretty high yield for some of those, those patients.
And so someone comes in, I'm there. There are certain aspects that I'm going to consider.
One is do we want to do everything now to see do I want to do Lyman and co infection testing now knowing that there's an added cost to that or do I want to get a diagnosis of Lyme? If it's there and if that is positive then to go in and look at CO infections because this stuff can run, you know, upwards of 18, 25 hundred dollars. And so, so I want to be very mindful of that. Right. And if I could like if I had, if someone has no resource limitations, I'm probably going to do two labs, maybe even three labs and I'm going to do immune testing and I'm going to do DNA testing, I'm going to look at the co infections and I'm going to do all of that. But if someone comes in and they don't have a classic Babesia like presentation or a classic like Bartonella like presentation or a classic anaplasma rickettsial presentation and I can get into that if you'd like but, but if it doesn't sound like that then I'm going to generally prefer to really look and investigate for Borrelia burgdorferi, you know, Lyme, maybe the, the tick borne relapsing fever, Borrelia, which can, can overlap in its, in its symptoms and treatment.
And, and so it's, and a lot of it is going to be, you know, what patients can do if I'm limited in resources that I'm going to do an immunoblot, I'm going to do an IGM and an Igg immunoblot and that's basically what I'm going to start with. If I can do a little bit more going to do a IgG IgM immunoblot and serum and whole blood PCR and then I may do from, from Armand labs or from T labs, I may do a T cell test as well or Igenics, they do IGX spot. So I might do a T cell test too. I don't typically like to open with the T cell test. I like to have a diagnosis and then use the T cell test more to follow the infection.
But the, but if, if I have someone just coming in, I'm going to typically start with those tests. If they're on antimicrobials already, the yield for the PCRs is even lower. So I may not do the PCRs. If someone's on some strong antimicrobials, even herbal antimicrobials, I may hold off on that. What's interesting is that, and what many people don't know, and it just actually came up on the ilads discussion about IGMs and the positive IGMs and, and one of the things, at least with borrelia that's so important is that, you know, just, I mean, as you know, but for your listeners, they. So typically when there's a new infection, IgM is the first part of our immune response or antibody response. And after about four months, because it's a large molecule and gets broken down in the liver, after four months that IgM goes down. Before it goes down, our immune response will turn, so called convert to an IgG predominance. And then it's the IgG molecules that give us memory of infections and help us fight infections better. That's how vaccines work and such. There are some infections like toxoplasmosis and leishmaniasis and borreliosis where the organisms, they could switch their proteins on, on the surface of the organism. And so when they switch their proteins it every time they switch, every four months or so that they switch, they, it looks to the body like a new infection. So even people who have been sick for 20 years, they still may be IgM positive. And it's a really curious, really controversial kind of one of the hallmarks of the debate of chronic Lyme vs not chronic Lyme about the persistence of persistence of this igm.
And to me, it's somewhat been a huge important part of my career and it's been one of the flags that my father and many of the ilads doctors and chronic Lyme warriors, as it were, have really held on to is the persistence of the igm. So many people who come in and they're sick, they may be IgM positive, IgG negative.
When they give those results to their infectious disease doctor or their other specialist, a lot of them will say, well it's probably a false positive because it's a new, it's not a new infection. And so what we actually find in a lot of these patients, these chronic patients, is they don't Actually seroconvert from M to G. They don't become G positive until they start getting better. That's the amazing thing that's been so incredible over the years is that it actually really happens, is that the patients are IgM positive and they're sick. IgM, IgM, IgM. You treat them, you treat them, you treat them. Maybe treat them a little bit more. And then the M goes down and then the G comes up and you see them better. And it's such a phenomenal thing.
And we don't have a common understanding of that model.
We have some examples, but we don't have, as a medical society, real understanding of that. And I think that's one of the other reasons why so many people go undiagnosed. I mean, I can't. Probably 10, 15 times a year I'll have someone who comes in and they have results. And they said, well, I went to this great institution or I went to that great doctor and they said, I don't have Lyme and here, look at my negative results. And I say, oh My gosh, your IGM is 2339 positive.
And the.
And it's like, well, yeah, you're positive three years ago.
And they said, well, because I was G. I was. They said I wasn't. And so it's, it is a very frustrating aspect, but it's also something super rewarding because patients do get better.
And I mean, look, in this day and age, we have so many other environmental pollutants. I mean, you know, all the things that we see.
So it's usually not just about Lyme, it's about Lyme. And, and Lyme sometimes makes the conditions right for all the. And.
But it's a chronic, complex, complex illness.
It is amazing to have people get their lives back after years of not. And it really happens.
[00:26:27] Speaker A: Hello, dear listeners, this is Dr. Michael Karlfeld, your host of integrative Lyme solutions. Today I'm excited to share an exclusive opportunity from the Karlfeld center where we blend healing power of nature with groundbreaking therapies to combat Lyme disease and its associated challenges. At the Karfel center, we're not just fighting Lyme. We're revolutionizing the way it's treated with cutting edge therapies like photodynamic therapy, full body ozone IV therapy, silver IVs, brain rebalancing, autonomic response testing, laser energetic detoxification, and more. We aim to eradicate Lyme. Our approach is comprehensive, supporting your body's immune system, detoxification processes, hormonal Balance and mitochondrial health. Ensuring a holistic path to recovery. Understanding Lyme disease and its impact is complex, which is why we're offering a free 15 minute discovery call with one of our Lyme literate naturopathic doctors. This call is your first step towards understanding how we can personalize your healing journey, focusing on you as a whole person, not just your symptoms. Our team, led by myself, Dr. Michael Karlfields, is here to guide you through your recovery with the most advanced diagnostic tools, individualized treatment plans, and supportive therapies designed to restore your health and vitality. Whether you're facing Lyme disease head on or seeking preventative strategies, we're committed to your wellness. Take the first step towards reclaiming your health. Visit us at thecarlefullcenter.com or call us at 208-338-8902 to schedule your free discovery call. At the Karlfield center, we believe in healing naturally, effectively and holistically. Thank you for tuning in into integrative lyme solution with Dr. Karl Feld. Remember, true health is not just the absence of disease. It's achieving the abundance of vitality. Let's discover yours together.
And the thing is that, you know, Lyme exists in a terrain and that terrain obviously guides its activity and how aggressive and replication all of that. So, yeah, it's not all about Lyme.
It's all about kind of the terrain that the Lyme exists in and the infection.
So that's important for people to obviously understand.
So I'm curious with you, bring it up in the IgG. So IgG, you know, memory antibody.
So if somebody is 0 on IgM, IgG is elevated and they're symptomatic. So would you then say that, well, you've had Lyme, but, you know, we don't know if you have it now or you don't have it now because IGM is not positive. Yeah. What goes through your head when just igg is positive?
[00:29:24] Speaker B: Well, what goes through my head is what we were taught initially with Lyme is that Lyme is a clinical diagnosis.
And this is where the story. And this is where being with the patients, this is where the exam, this is where the potential exposure, this is where medicine happens. Right.
And so I have a lot of people who are igg positive who had exposure and don't have symptoms. And I think that maybe they don't have Lyme at this time, but if they're symptomatic and they have igg, then depending on their symptoms and depending on their story, some of those people are going to have active Lyme. And it's true because you don't know because some people are going to follow the textbook rules. Some of them are, you know, like we see a lot of people with, with various infections with the mycoplasma and with chlamydia and with Epstein Barr. And not all of them are going to be manifesting IGAs or IGMs or positive PCRs, but we're taking that into account. Someone comes in with chronic fatigue and very high IGG titers of HHV6 or Epstein Barr or CMV, some of those other viruses.
We're going to use our clinical judgment on is there a reactivation of these infections? And so similar with Lyme, I think that, that. Well, Lyme does reactivate, it does go into periods of dormancy, it does lose its cell wall, some of the organisms and, and become a so called cyst form or Lister form or so, you know, cell wall deficient. There's a lot of different terms for it.
And, and so it goes into periods of quiescence and dormancy oftentimes which gets into the terrain when our body becomes dysregulated and our immune dynamics go down. And there's often triggers. But whether it's stress or surgery or other infections or other tick bites or you know, root canals, I mean, there's a lot of different things that trigger a dormant infection becoming active again. And so Borrelia is one of the classic models where that happens. Because I think that if you look at how many people in America at least, and in the world probably at large are seropositive for Borrelia, but don't have symptoms, but, but something happens to them and they can get symptoms or develop new symptoms, that there is a case to be made kind of like tuberculosis, right? Where, where there can be these years and years of dormant non active disease that can change because the terrain becomes, you know, altered negatively.
[00:31:55] Speaker A: So I'm curious, in that kind of a situation, if you have somebody that's not symptomatic, you know, the igg, you know, is elevated, you know, would you suggest then treating that person with antimicrobial or would you just kind of have a watch and wait type of position?
[00:32:14] Speaker B: Well, it's tricky. I mean, I think one of the places where it really becomes an important issue is pregnancy.
Because pregnancy, you, you know, that is a future that you're treat. Like a lot of times I say well, I don't know that we can treat the future. I don't know that we can prevent you from not getting sick if we treat you now when you're not sick. Especially since we're not necessarily as Lyme docs treating for a prescribed amount of time, 14 days, 28 days, 5 days, some people are advocating for. So if we're not treating for a set of amount of time and we're treating based on overall presentation and we don't have those symptoms to actually follow to help guide our treatment, like what's going to be enough? Is one little course of doxycycline enough? Do we need a triple IV antibiotic? Like what is enough if someone's not symptomatic? So I'm a little hesitant to just to go in and treat. Sometimes depending on the situation and the circumstances, I will try to maybe if they're up for it, maybe provoke the system, maybe use and it's a great time to use herbals. I use a lot of different provocational, safe herbs that sometimes if they have those infections dormant, don't have symptoms, those symptoms will come out in a predictable way. And so then we get some clinical response to go with the lab response, then we can have more of a case to treat. But it's pretty hard, especially in the pharmaceutical world to give people pharmaceuticals that aren't benign.
If I don't know what my endpoint is.
[00:33:47] Speaker A: I know strategies have been you're talking about pregnancy when a because there is that risk of obviously the Lyme spirochetes or co infections to then pass through the placenta.
So do you feel. And I know strategies in the past and maybe they should be on like Cystis tea continually or a low dose doxycycline while being pregnant. You know, is that a valid strategy? Do you feel or has the thinking shifted?
[00:34:19] Speaker B: Yeah, I don't know that I would use doxycycline. Doxycycline is not, maybe not our best choice for during pregnancy, but there are some class B drugs that are reasonable to use and so it does truly become a risk benefit analysis. Right. I'm probably going to. If someone is coming in pregnant and for some reason they want to be tested and they, and for, you know, whatever reasons they have, whether it was a tick bite or a family member or they saw a podcast of some kind or other, you know, the, that I'm going to be very hesitant to, to treat them off the bat or with an IGG positivity, you know, I, I have a lot of stories that I could refer back to. But the thing is is that I would really want to find more evidence than an IgG in an asymmetric symptomatic person before treating a pregnant woman.
Even though I could use amoxicillin, I could use azithromycin. And there is, there is a real case to be made for treating in known Lyme pregnancy because the transmission, the vertical transmission to fetus is a real issue. And I think we're going to find out more and more about it over the years. The next few years studies are coming and, and it is, it is really a thing that many of us have, have been very concerned with over, you know, the past at least 30 years.
[00:35:50] Speaker A: And you were talking about testing T cells, you know, when, just to kind of check to see progression or impact of treatment. You know, why are you choosing that, you know, at that point versus earlier, you know, why, what's the benefit of the T cells at that time?
[00:36:12] Speaker B: So I find that the, the sensitivity of the T cell testing may not be as, as good as the, as the antibody testing. I think the T cell testing, if you know that someone has Lyme, it's a lot easier to monitor and measure the T cell functioning against those infections.
I mean, sure, we can look at T cell competence and we can do various immune maps to see how good their T cells are. But the other thing is that the T cells do, they do stop releasing their chemicals over time. So it doesn't really give you enough information if you're going in cold. In my opinion, doing, doing T cell testing as a diagnostic. But if I have a, if I know that someone is positive and actively infected, I can use T cells sometimes I can look at the, the interferon or the interleukin two levels associated with those T cells and get a sense of is there a very active infection, is it the so called mop up phase with Interleukin 2? And, and the time is, it's much more real time. Like Even with an IgM antibody, if I do an anti, if someone's positive and they're IgM positive, I don't know if they're positive today or if they're positive four months or three and a half months ago. So it doesn't give me as close of a window to now. Whereas a T cell is going to tell me within two weeks if there was an active problem. So it gives me much more real time data than the antibody testing alone.
[00:37:47] Speaker A: So essentially doing the antibody testing to kind of identify what agents are we dealing with, with infections and then we can then knowing that it exists in there, then we can see how we are doing by the T cells how they are behaving in response to our treatment.
[00:38:07] Speaker B: Right, that's the goal. Yeah. And it does, it's not as clean all the time as I'd like it to be, but it is very helpful, very useful.
[00:38:16] Speaker A: And you were talking about for somebody and you're absolutely right. I mean all these tests, they do cost money because the technology has had to be so advanced in order to be able to identify these little critters. But then these immunoblot tests for screening and I know there are some exciting new ones that have come out.
How do they function and how are they, what do they identify and what is an immunoblot test?
[00:38:51] Speaker B: So yeah, an immunoblot is a broad term that basically is taking antibodies.
You're using a patient sample that has the infection or infectious pieces and, and you have, you know.
Well, sorry, you're taking the antibodies that the patient has and you're, you're having it bind to infectious pieces, you know, and then you're measuring if there's a binding or not. And so immunoblots are basically, you know, are a more specific way. You're using recombinant antigens. So you're using things that are known infectious particles of the organism. And I talked about that epitope switching. So in this case there are different proteins that are on the surface of the, of the organism. That is what we usually make antibodies to because we can't make antibodies against the whole organism. It's too complicated for our immune system to grapple with. So it's the pieces, so we have those various antigen pieces that we're now allowing the sample, the patient sample to bind with, which is a little bit different than your standard western blot. Same technology, although you would sonicate, you would basically break up the organisms themselves and then you would put the pieces of the organism itself into the. Well essentially or the paper.
But there was a little bit more cross reactivity when you're using the whole organism rather than using the very clean, clean recombinant antigens. So it's. So basically you're testing a patient's antibodies against known proteins that are associated with the organism. Some of those proteins are very specific just for that organism. Other ones are more common among other bacteria. So they're not quite as helpful to tell us. Oh yeah, someone's you know, so called band 58 positive. That doesn't really tell me so much. Like a 23 or 39 or 31, 34 which correspond to the Antibody to the molecular weight that when you run it, I mean it's complicated but when you run it against electrode and so it runs at a certain point and it shows the molecular weight of the antibody and so it corresponds to a different protein weight on the organism.
[00:41:20] Speaker A: And I know like the accudart, you know, they, they come out with a pretty kind of in home testing kit, you know, where people can do it in home and then, and then screen and then also Armen, you know, arm and labs like you mentioned, they, they do some good immunoblot testing as well.
[00:41:40] Speaker B: So.
[00:41:41] Speaker A: Yeah, and that, that's, I think that's really nice. You know, where it's, you know, you can do it for less money and do kind of like a screening and, and it's, it's, it's pretty accurate would you say? Or what?
[00:41:54] Speaker B: I mean the sensitivity is not as good as the, as the in house lab test. I mean the, where you send your lab, your blood to the labs. And it doesn't specify IgM versus IgG, the acid art, at least. So, so you don't know is it active infection or is it igg?
And so you, but, but you are getting a positive or negative and then what it does, I mean the point of it is then to, for, for you to go and see, you know, really try and confirm it. But because some people, you know, who have lupus or rheumatoid arthritis or scleroderma or multiple sclerosis, you know, some of those people may not have those diseases and actually have borrelia. And so it's easy. You know, you've been sick for so long with all this chronic stuff and the prednisone and the, you know, this and that aren't getting you better and that to go and test you, you know, it might be really informative and then you can take that to the next level. So that's really the purpose of the accudart test is to make, give patients a little bit more power, you know, without compromising science and then, you know, and to not make it so, so expensive. But it is really a first step. I wouldn't go with that. I wouldn't. If someone came in with a positive accudart, it's hard for me to say, oh yeah, you have Lyme. You know, I do need to probably do a more effective workup. Not, not because of, but again, it's a clinical diagnosis.
[00:43:16] Speaker A: And so we were talking a little bit about the different infections in regards to how they present.
Do you mind just kind of Giving a quick, you don't need to go in extensive detail each one, but just kind of a quick feeling of what each infection, co infection, how they tend to present, like Babesia versus Bartonella and a plasma versus Borrelia ehrlichia. I mean what are some of the kind of the general ideas in regards to these different infections?
[00:43:52] Speaker B: Sure.
First of all, Borrelia can be anything.
And so they call it protean, Protean infection, where it can look anyway like any kind of infection, any organ system. And so there is that. So that one's confusing. But if you think about migrating pain, migrating joint pain and migrating arthritis, there's not a lot of things that cause a migratory arthritis. So going from an elbow on one side to a knee on the other side, like those kinds of things. That is one of the main hallmarks for Borrelia burgdorferi infections.
Fatigue, brain cognitive dysfunction, memory loss, digestive issues, bladder, all those can be Borrelia. So that one's a tricky one.
And so it can be everything. But the co infections on the other hand, are a little bit more clear. Not always. But Babesia, which is a red blood cell parasite similar to malaria, has some overlap with symptomatology of malaria. Head pressure is a big one. Air hunger, not being able to get a full breath or feeling like that, you can't get a full breath.
Night sweats, very profound night sweats, very vivid dreams, significant aggression, profound depress depression. And then some of these in the presence of Lyme, having some of these neurologic conditions like multiple sclerosis, not saying that they cause multiple sclerosis, but a presentation that looks like multiple sclerosis in the presence of someone who's positive for Lyme. Typically Babesia makes Lyme a much more aggressive bad infection.
There's a synergy, it has to do with complement levels, which is another immune marker primarily. But there's a lot of unknowns. Why, why Borrelia becomes so much more of a problem in the presence of Babesia. But those are, those are the big ones. The head pressure, think in particular some of the bad mood things, the night sweats, the. And then for Bartonella, we know Bartonella primarily from cat scratch disease and from trench fever and a few other things. But Bartonella that is in the, in this context causes a different kind of headache. Not the pressure, more of an ice pick, lancinating like headache. Hypersensorium issues with like photophobia or sound sensitivity, taste sensitivity, touch sensitivity, fibromyalgia like symptoms.
Mast cell activation is a really big thing for.
For Bartonella. It's. It's quite. Quite remarkable about the mast cell association and. And Bartonella in the presence of Lyme. Pains in the bottom of the feet, plantar pain, costal margin pain and tenderness, major abdominal issues, funny rashes, striae, some other things that look like folliculitis, carbuncles and things like that, and terrible anxiety, sometimes bipolar, like presentation, agitation, and then lymphadenopathy, like underarms, neck. With Lyme, you get lymph nodes in the groin, but more in Bartonella, you see it a little bit everywhere else.
And then ehrlichia or anaplasma, which is a kind of rickettsia, which is different than. I mean, rickettsia is a pretty broad organism that one lives inside of white blood cells, and this one is actually easier. And I don't always test this one because I'm typically going to get to its treatment when I'm doing other things. There's cases. I mean, there's a lot of situations where there's acute ehrlichiosis. It's a big problem.
But in the chronic version, muscle pain, which, of course, these other things can cause, but myalgia, not joint pain, not arthralgia, but muscle pain, liver enzyme elevation, low white blood cells, low gray fever, bad fatigue. And so those are. So if someone's presenting, like, major predominance of those, I'm sure I missed some symptoms on those, but, you know, at least on Bartonella, because Bartonella, you can go off on symptoms forever, but the. But when you see those as predominant hallmarks. Yeah, I'm probably going to want to test one of those with the Lyme testing, too.
[00:47:55] Speaker A: Yeah. Love it. Well, Dr. Harris, you know, thank you so much for. For what you're doing for this community. I mean, the tools that your father's brought forth and that you've been there to support that process is phenomenal and help so many people to kind of unravel, you know, what was going on with their health. And then the knowledge that you bring in as a provider and consultant is phenomenal. So thank you so much for spending some time with me today and appreciate everything you're doing.
[00:48:28] Speaker B: Thank you very much. I appreciate it.
[00:48:37] Speaker A: The information. This podcast is for educational purposes only, and it's not designed to diagnose or treat any disease. I hope this podcast impacted you as it did me. Please subscribe so that you can be notified when new episodes are released. There are some excellent shows coming up that you do not want to miss if you're enjoying these podcasts, please take a moment to write a review. And please don't keep this information to yourself. Share them with your family and friends. You never know what piece of information that will transform their lives. For past episodes and powerful information on how to conquer lyme, go to integrativelimesolutions.com and an additional powerful resource, limestream.com for Lyme support and group discussions. Join Lyme Conquerors Mentoring Lyme warriors on Facebook.
If you'd like to know more about the cutting edge integrative Lyme therapies my center offers, please visit thecarlfeldtcenter.com thank you for spending this time with us and I hope to see you at our next episode of Integrative lyme Solutions with Dr. Karl Feld.
