James Schaller, M.D., M.A.R.

The following checklist is not meant to be complete or authoritative. Information about Lyme disease is constantly emerging and changing. Therefore any checklist is intended for use as a starting point. In traditional medicine, a physician performs a complete history and physical. Labs and studies assist in clarifying the differential diagnosis. In Lyme disease, much debate exists about laboratory kits, the alteration of kits to have fewer possible bands, and which labs are optimally sensitive and specific. This checklist is not intended to address that issue or treatment.

Over 200 vectors carry the Ixodes tick, which is the most commonly known insect spreading Lyme disease. With so many vectors, the underlying assumption behind this checklist is that Lyme is not rare in North America, Europe, South America, Russia, Africa or Asia.

We know Lyme disease is highly under-reported.

Immediately upon the onset of a tick bite, it transmits a pain killer, anti-histamine and an anti-coagulant. Based on animal studies, it is also possible the bulls-eye rash is less common then assumed, in part because injections of spirochete related material in laboratory animals only show a rash with the second injection.

This checklist is offered with the sincere wish that others will improve on it. It is this author’s personal belief that tick and flea-borne infection medicine is as specialized as HIV and Hepatitis medical science.

Some of the checklist materials might be new to you, which underscores the need for another scale to add to the ones currently in existence. This list is based on a massive review of thousands of papers over a decade of full-time reading, 2012 science revelations, and/or massive chart reviews. Since modern Lyme disease seems to focus on tick borne disease and other laboratory testing, I will start with lab testing considerations. If a lab test has a value or a percentage, the numbers I am picking are meant to avoid missing positive patients. I am concerned about physicians and other healthcare workers not treating an infected patient, who over time can experience disability or death at a frequency that is impossible to determine.

LABORATORY TESTING—INDIRECT AND DIRECT

1. Vitamin D level is in the lowest 20%. If you supplement, it should be in top 50%.
2. CD57 or CD58 is in the lowest 20th percentile
3. Free testosterone is in 10th percentile or below
4. In 5% of patients the testosterone or free testosterone is over the normal range.
5. DHEA is in lower 20%. Or rarely is it fully over the top level.
6. Free dihydrotestosterone is in the lowest 20th percentile or well over the normal range.
7. Epstein Barr Virus is abnormal in any measure. [This virus is believed to be positive over normal positive levels in the presence of infections or high inflammation.]
8. On the Western Blot, IgG or IgM any species specific band at any blood level, e.g., 18, 21, 23, 30, 31, 34, 37, 39, 83, 93.
9. A free T3 level under 2.8 [the normal bottom range in 1990 was 2.6; the influx of large numbers of elderly patients reset the healthy “normal” range].
10. Positive for viruses such as CMV, HHP-6, Coxsackie B Types 1, 2, 3, 4, 5, 6, Parvo B-19 or Powassan virus
11. Positive for Mycoplasma, e.g. mycoplasma pneumoniae.
12. The patient is positive for infections other than routine Lyme, [that is Borrelia burgdorferi sensu stricto, Borrelia afzelii and Borrelia garinii]. Some of the other infections also carried by infectious ticks, fleas or other vectors include Babesia (duncani, microti or other), Anaplasma (HGA), Ehrlichia (various species/strains), Rocky Mountain or other Spotted Fevers, Brucellosis, Leptospirosis, Q-fever, STARI (Master’s Disease), Malaria, and Bartonella [e.g., B. henselae, B. quintana, B. elizabethae and B. melophagi]. Once tests are commercially available for testing all forms of protozoa affecting humans, including FL1953, all Bartonella species, and Borrelia miyamotoi and other Lyme species, reporting should increase.
13. IL-B is in lowest 10th percentile
14. IL-6 is in lowest 10th percentile
15. TNF-alpha is under 2, or in lowest 20th percentile
16. A WBC count was, or is, under 4.5
17. Eosinophil level in the CBC manual exam is either at 0-1 or 6-7
18. Total manual Eosinophil level is 140 or less
19. XRAY or other study shows cartilage defects in excess of injury or age median
20. If a full auto-immunity panel is run with at least eight different tests, two are positive; for example, you have a positive anti-gliadin and a positive thyroid peroxidase.
21. Positive or near positive (borderline) ELISA, PCR, or a positive tissue biopsy; or a tick from your body is positive for Lyme or other tick infection
22. Lab tests show high inflammation, e.g., a high C4a, elevated cholesterol and C-peptide. These are never specific just for Lyme
23. Lab tests show a MSH level under 30 [the reference range of 0-40 is due to the increase of very sick patients tested, and 40-85 is a better reference range which was used before the flood of the sick reset the range of normal]. MSH is an anti-inflammatory hormone.
24. VIP is under 20. This is an anti-inflammation chemical.

BODY EXAMINATION RESULTS

25. Weight loss or gain in excess of 20 pounds in 12 weeks
26. A round or oval rash with a dark center was or is present in a loose “bulls-eye pattern.” Other size and shape rashes that have no other cause after exposure to ticks and vectors.
27. Healing is slow after scratches or surgery. For example, after a cat scratch, flea bite or tick bite the mark is still visible later.
28. Skin on arms, hands or feet has a texture like rice paper.
29. Clear reaction and effect seen with antibiotic treatment. Specifically, a marked improvement or worsening of a serious medical problem or function is observed with a spirochete killing treatment, e.g., doxycycline, tetracycline, minocycline, any penicillin such as amoxicillin, azithromycin, clarithromycin or cefuroxime.
30. Presence of skin tags, red papules of any size, excess blood vessels compared to peers, and stretch marks with color or in significant excess of peers.
31. Moles and raised or hard plaques in excess of the few on normal skin.
32. Areas of skin with ulcerations such as those seen in syphilis, but at any location on the body.
33. Areas of clear hypo-pigmentation and hyper-pigmentation
34. Positive ACA (Acrodermatitis chronica atrophicans) which is a sign of long term untreated Lyme disease. Some report ACA begins as a reddish-blue patch of discolored skin, often of the hands or feet. It may include the back in some patients. The lesion slowly atrophies over months to years, with many developing skin that is thin, dry, hairless, wrinkled and abnormally colored. The color of the extremities such as hands and feet can be red, dark red, brown, dark blue or purple.
SAMPLE NEUROLOGY EXAM
35. Patient’s short-term memory is poor. For example, if asked to recall these numbers—23, 5, 76, 43 and 68—the patient cannot recall them.
36. Patient cannot reverse four numbers, so if given—18, 96, 23 and 79—the patient cannot do it.
37. If asked to subtract 17 from 120, (college graduate), it cannot be done in a timely manner. If a high school graduate, subtract 7 from 100 and continue to subtract by 7 four times in 20 seconds.
38. Light headedness upon standing quickly in excess of peers, and with no clear cause
39. Dizziness unrelated to position
40. Dizziness made worse by Lyme killing antibiotics
41. Trouble doing a nine step heel to toe straight line walk test with fingers slightly in pockets [The patient should not sway or need their hands pulled out to prevent a fall]. In patients with past experience in skating, skiing, dance or ballet this should be very easy and is rarely a challenge to such people. If it is not easy, it is suspicious medically, but not only for Lyme disease.
42. Trouble performing a one leg lift, in which one leg is lifted 12-18 inches off the ground in front of you, as you count, e.g., “one Mississippi, two Mississippi, etc.”
43. Positive nystagmus [your eye jerks when you look right or left]

PATIENT’S REPORTED PHYSICAL HISTORY

44. Illnesses that come and go and decrease functioning with no certain cause
45. Serious illnesses that undermine function with no clear cause, and which affect more than one body organ
46. An abnormal lab result, physical exam finding or illness that is given many diagnoses or has no clear cause.
47. Mild to severe neurological disorders or psychiatric disorders
48. A very profound neurological disease which does not clearly fit the labs, studies and course of the illness
49. A moderate or severe medical, psychiatric or neurological illness. [Many severe disorders can be associated with spirochetes such as those causing syphilis, and some propose that Lyme is also related to a well-known serious brain disease].
50. Severe medical, psychiatric or neurology illness with uncommon features, such as Parkinson’s disease, appearing at a young age
51. Facial paralysis (Bell’s palsy)
52. Personality has changed negatively and significantly for no clear reason.
53. Psychosis at any age, but especially after 40 years of age when usually it would have already manifested itself
54. Severe anxiety
55. Mania or profound rage
56. Depression
57. Depression or anxiety that did not exist when you were less than 25 years of age
58. Irritability
59. Any one of the following: paranoia, dementia, schizophrenia, bipolar disorder, panic attacks, major depression, anorexia nervosa or obsessive-compulsive disorder.
60. Adult onset ADHD/ADD [Primary psychiatric biological ADD or ADHD is present at 7 years of age. Adult onset is a sign of a medical condition.]
61. Increased verbal or physical fighting with others
62. Functioning at work or in parenting is at least 20% reduced
63. Patience and relational skills are decreased by 20% or more
64. A mild to profound decrease of insight, i.e., an infected patient does not see their decreased function, failed treatment or personality change
65. A new eccentric rigidity to hearing new medical or other important information
66. Difficulty thinking or concentrating
67. Poor memory and reduced ability to concentrate
68. Increasingly difficult to recall names of people or things
69. Difficulty speaking or reading
70. Difficulty finding the words to express what you want to say
71. Inability to learn new information as well as in the past [receptive learning]
72. Repeating stories or forgetting information told to close relations, such as a spouse, roommate, sibling, best friend or parent
73. Confusion without a clear reason
74. An addiction that results in relapse in spite of sincere, reasonable and serious efforts to stop
75. Fatigue in excess of normal, or fatigue that is getting worse
76. Trouble sleeping including mild to severe insomnia and disrupted sleep
77. Sleep in excess of 9 hours a day or night, or sleeping in excess of 9 hours every day if allowed
78. Trouble falling asleep
79. Trouble staying asleep [Taking a 5 minute bathroom break does not count]
80. Gastritis or stomach sensitivity not caused by H. Pylori
81. Intestinal troubles that are unable to be fully managed and/or which have no clear diagnosis
82. Nausea without a clear reason
83. Sensitivity to lights, sounds, touch, smell or unusual tastes
84. Sensitivity to cleaning chemicals, fragrances and perfumes
85. Ear problems such as pain or increased ear “pressure.”
86. Any trouble with the senses (vision, sound, touch, taste or smell). The use of corrective lenses or contacts does not count, unless the prescription is changed more than expected.
87. Buzzing or ringing in ears
88. Double vision, floaters, dry eyes, or other vision trouble
89. Conjunctivitis (pinkeye) or occasional damage to deep tissue in the eyes
90. Blood clots fast when you get a cut, or you have a diagnosed problem with clotting. This may also be seen in blood draws where blood draw needle clots when blood is being removed. If on a blood thinner, blood thinness level goes up and down too much.
91. Cardiac impairment
92. Chest pain with all labs and studies in normal range
93. Occasional rapid heartbeats (palpitations)
94. Heart block/heart murmur
95. Heart valve prolapse
96. Shortness of breath with no clear cause on pulmonary function tests, examination, lab testing, X-rays, MRI’s, etc.
97. Air hunger or feelings of shortness of breath
98. Someone in your neighborhood within 400 yards in any direction of your dwelling has been diagnosed with a tick borne infection. [This includes vacation locations].
99. You have someone living with you with any type of tick-borne infection—this assumes they were not merely tested for one infection. [It is not proven that the small Lyme-carrying ticks only carry Lyme, and it is possible some carry other infections without carrying Lyme at all].
100. You have removed any ticks from your body in your lifetime.
101. You have removed ticks from your clothing in your lifetime.
102. After a tick or bug bite, you had a fever for at least 48 hours.
103. After a tick or bug bite, you were ill.
104. Grew up or played in areas with many small wild mammals.
105. When you are in a room that has visible mold or smells like mold and you start to feel ill, you do not return to your baseline health in 24 hours.
106. Any discomfort within two minutes of being in a musty or moldy location
107. Gaining or losing weight in a manner clearly inconsistent with diet and exercise
108. New or more food allergies than ten years ago
109. Feel worse after eating breads, pasta or sweets
110. No longer tolerate or enjoy alcohol
111. Anti-histamines are bothersome, more so than in the past.
112. Reaction to medications is excessive (you are very “sensitive” to medications)
113. Your response to antibiotics is significantly positive and you feel more functional, or you have the opposite reaction and feel worse, feeling ill, fatigued or agitated.
114. Numbness, tingling, burning, or shock sensations in an area of skin
115. One or more troublesome skin sensations that move over months or years and do not always stay in one location
116. Rash or rashes without a simple and obvious cause
117. Rashes that persist despite treatment
118. Eccentric itching with no clear cause
119. Hair loss with no clear cause
120. Muscle pain or cramps
121. Muscle spasms
122. Muscle wasting without a clear cause
123. Trouble with your jaw muscle(s) or joint insomnia (TMJ)
124. Joint defects in one joint with no clear cause if 20 or younger
Joint defects in two joints or more if 35 or younger
Joint defects in three or more locations if younger than 55 with no clear trauma
125. Swelling or pain (inflammation) in the joints. [Most patients never have joint disease].
126. Joint pain that shifts location
127. Neck stiffness
128. Chronic arthritis with or without episodes of swelling, redness, and fluid buildup
129. Chronic pain in excess of what seems reasonable
130. Nerve pain without a clear cause
131. Headaches that do not respond fully to treatment, or which are getting worse
132. New allergies or increased allergies over those of your peers
133. Any autoimmunity–Lyme and other tick infections, over many years, increase inflammation and decrease anti-inflammation chemicals. We believe this leads to increased food sensitivities, increased autoimmunity and a heightened sensitivity to various chemicals and medications.
134. Day time sweats
135. Night time sweats
136. Chills
137. Flu-like symptoms
138. Bladder dysfunction of any kind
139. Treatment resistant interstitial cystitis
140. Abnormal menstrual cycle
141. Decreased or increased libido
142. Increased motion sickness
143. Fainting
144. A spinning sensation or vertigo

ENVIRONMENT

145. Pets or farm animals positive with ANY tick borne virus, bacteria or protozoa, or clinical symptoms without a clear diagnosis or cause.
146. The patient’s mother is suspected of having or has been diagnosed with Babesia, Ehrlichia, Rocky Mountain Spotted Fever, Anaplasma, Lyme, Bartonella or other tick borne disease based on newer direct and indirect testing, or clinical signs and symptoms.
147. A sibling, father, spouse or child with any tick borne infection
148. Casual or work-related exposure to outdoor environments with brush, wild grasses, wild streams or woods (Examples- golf courses, parks, gardens, river banks, swamps, etc.)
149. Pets, e.g., horses, dogs or cats, have had outdoor exposures to areas such as brush, wild grasses, wild streams or woods.
150. Exposure to ticks in your past homes
151. Clear exposure to ticks during vacations or other travels
152. You played in grass in the past.
153. You have been bitten by fleas.
154. You have been scratched by a cat or dog.

FINAL WORDS

Some of the above listed signs and symptoms fit other infections that may be more common than Lyme disease. Unfortunately, the research and experience indicating diverse infections carried by the Ixodes and other ticks is ignored. Further, “testing” usually involves one test for a mono-infection–Borrelia or Lyme. Ticks and other vectors should never be assumed to carry only Lyme disease.

Please note that when we are talking about the Ixodes tick we are not referring to this as a “deer tick” since it has over 200 vectors (Ostfeld). Many of the tick reduction options presently suggested are not successful in accomplishing their goals. Reducing deer populations, once thought to reduce tick populations and incidence of Lyme disease, may simply increase tick numbers in mammals and other carriers that live closer to humans.

All healers have their familiar way of thinking, testing and treating. Kuhn has shown we are all biased and struggle to be objective. Further, tick and flea infections have almost infinite pathological effects because the human body and these clusters of infections are so complex. I have not suggested a grid or a set number of symptoms, because one would not fit this list. Simply, the goal of this checklist is to have you think broadly.
You cannot use this checklist to diagnose Lyme disease or to rule it out.
A Lyme checklist is very medically important, since it is still an emerging illness and can sometimes disable or increase mortality risk in patients of any age if not diagnosed and treated early in the infection.
Writings in the past fifteen years have either viewed Babesia and Bartonella as mere “co-infections,” or a footnote of a spirochetal infection [i.e., Lyme]. Either infection can hide for decades, and then possibly disable or kill a person by causing a clot, heart arrhythmia or by other means.
The detection of Lyme from stained tissue samples or blood is very difficult. Currently, the well-established indirect lab test patterns presented are not used or understood by all health care professionals. While this is fully understandable, I hope it may change in the coming decade. Tick infections have systemic impacts on the body, and are not limited to effects reported in journal articles, a few books or any national or international guidelines.
Dr. Schaller has published the four most recent textbooks on Babesia and the only recent textbook in any language on Bartonella. His most recent book on Lyme, Babesia and Bartonella includes a “researchers only” list of over 2,600 references considered to be a start for basic education in tick infection medicine.
He published articles on both Babesia as a cancer primer and Bartonella as a profound psychiatric disease under the supervision of the former editor of the Journal of the American Medical Association (JAMA). He also published entries on multiple tick and flea-borne infections, including Babesia, Bartonella and Lyme disease, in a respected infection textbook endorsed by the NIH Director of Infectious Disease.
Dr. Schaller is the author of seven texts on tick and flea-borne infections. He is rated a TOP and BEST physician, with the latter being awarded to only 1 in 20 physicians by physician ratings. He is also rated a TOP physician by patients, again ranking in the top 1 in 20 physicians.
COPYRIGHTED C 2011 JAMES SCHALLER, M.D., M.A.R. version 22.
This form may not be altered if it is printed or posted, in any manner, without written permission. It can be printed for free to assist in diagnostic reflections, as long as no line is redacted or altered, including the introduction or final paragraphs. Dr. Schaller does not claim that this is a flawless or final form, and defers all diagnostic decisions to your licensed health professional.

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Zalaudek I, Leinweber B, Kerl H, Müllegger RR. Acrodermatitis chronica atrophicans in a 15-year-old girl misdiagnosed as venous insufficiency for 6 years. 173. J Am Acad Dermatol. 2005 Jun;52(6):1091-4. PMID:15928636

Zeaiter Z, Liang Z, Raoult D. Genetic classification and differentiation of Bartonella species based on comparison of partial ftsZ gene sequences. J Clin Microbiol. 2002 Oct;40(10):3641-7. PMID:12354859

Zu-Rhein GM, Lo SC, Hulette CM, Powers JM. A novel cerebral microangiopathy with endothelial cell atypia and multifocal white matter lesions: a direct mycoplasmal infection? J Neuropathol Exp Neurol. 2007 Dec;66(12):1100-17. PMID:18090919

Borrelia afzelii
Borrelia burgdorferi
Borrelia garinii
Borrelia hermsii
Borrelia parkeri
Borrelia valasiana
Brachyspira aalborgi
Bracyspira hyodysenteriae
Ehrlichia ewingii
Francisella tularensis
Mycoplasma fermentans
Rickettsia spp (9 species)
Treponema pertenue
Treponema carateum
Treponema denticola
Coming very soon Babesia microti

As I said, I don’t know much more about the lab at this point, but I wanted to share their existence with readers. Website:

http://www.spirostat.com/index.html

4757 36th Ave. S.
Seattle, WA 98118

http://www.npjulie.com

206-760-9266

FEBRUARY 2009 NEWSLETTER

Testing for Lyme disease and Co-infections

As you know from reading this book (and will learn more about in Appendix B) Lyme disease diagnosis and treatment is highly controversial and difficult. Unfortunately, there is not a general consensus on which types of tests are most accurate and useful for diagnosing Lyme disease. Numerous tests are available, each of which uses different methodology for detecting Borrelia and related co-infections.

What is agreed on, however, is that most Lyme disease tests can produce false-negative test results (meaning that the test indicates no presence of the Lyme infection when, in fact, it is present). For this reason, regardless of which test(s) you choose, it is critical to keep in mind that a negative result does not mean that Lyme disease is not present!

Robert Bransfield, MD, (www.mentalhealthandillness.com) offers 27 reasons why Lyme disease tests produce false-negative results:

1.      Recent infection before immune response

2.      Antibodies are in immune complexes

3.      Spirochete encapsulated by host tissue (i.e.: lymphocytic cell walls)

4.      Spirochete is deep in host tissue (i.e.: fibroblasts, neurons, etc.)

5.      Blebs in body fluid, no whole organisms needed for PCR

6.      No spirochetes in body fluid on day of test

7.      Genetic heterogeneity (300 strains, 100 in U.S.)

8.      Antigenic variability

9.      Surface antigens change with temperature

10.  Utilization of host protease instead of microbial protease

11.  Spirochete in dormancy phase (L-form) with no cell walls

12.  Recent antibiotic treatment

13.  Recent anti-inflammatory treatment

14.  Concomitant infection with Babesia may cause immunosuppression

15.  Other causes of immunosuppression

16.  Lab with poor technical capability for Lyme disease

17.  Lab tests not standardized for late stage disease

18.  Lab tests labeled “for investigational use only”

19.  CDC criteria is epidemiological, not a diagnostic criteria

20.  Lack of standardized control

21.  Most controls use only a few strains as reference point

22.  Few organisms are sometimes present

23.  Encapsulated by glycoprotein “S-layer” which impairs immune recognition

24.  “S”- layer binds to IgM

25.  Immune deficiency

26.  Possible down regulation of immune system by cytokines

27.  Revised W.B. criteria fails to include most significant antigens

In the event that a negative test result is received, there are other methods by which the presence of Lyme disease can be confirmed. One such method is known as a “therapeutic trial,” in which a person who is suspected of having Lyme disease undergoes a trial period of Lyme disease therapy for the purpose of determining whether or not the therapy leads to clinical improvement. If clinical improvement or herxheimer reactions result, there is a high probability that, despite negative test results, Lyme disease is actually present.

Another method for confirming or denying the presence of Lyme disease after a negative test result is to simply use a different testing method. The following section includes general information about the available testing methodology. The Lyme Induced Autism (LIA) Foundation provided significant contribution to this section via their handout entitled Testing for Lyme/Borrelia and Multiple-Infections.

In addition to testing for Lyme disease and co-infections, it is also helpful to identify which heavy metals, if any, are present. See Appendix C for more information on testing for and treating heavy metal toxicity.

Testing Guidelines for Infections and Parasites

Testing for Lyme disease, Borreliosis and multiple-infections can be difficult to understand. We hope that this guide will help to narrow down the lab testing and options available. One thing to keep in mind is that many times the lab testing that our insurance generally pays for is not necessarily the most appropriate or accurate available. To avoid needless blood draws, wasted time and resources, we recommend getting the appropriate testing done first so that parents can have a clear picture of their child’s infection load prior to starting therapy interventions.

Testing for Lyme disease (Borrelia burgdorferi), Babesia, Anaplasma, Ehrlichia and Bartonella

Testing for Lyme disease/Borrelia and other infections is not a simple task. A person with a compromised immune system may not make the necessary antibodies needed to generate an accurate reading. No test is perfect and someone may have the organism(s) in their body and still have a negative test result. A positive antibody test shows evidence of the body’s response to an organism, not the organism itself.

There may also be multiple strains of an organism, yet we typically can only test for one, such as Bartonella, which has nine pathogenic strains but antibody tests only exist for one or two. Therefore, testing should be viewed as helpful information that must be considered within the context of the patient’s history and physical findings—testing should not be considered 100% accurate for a final diagnosis.

The “lyme titer” or “ELISA” test that is often first ordered as a “screen” by some clinicians can be very inaccurate. The Lyme/Borrelia “Western Blot” is a more sensitive test. Standard laboratories do not test for all of the “bands” in the Western Blot that are specific to Lyme/Borrelia. Many people will get a false negative from the commercial labs or from a doctor who is not trained to interpret tests properly. It is important to note that if the test comes back negative, the results may be inaccurate.

Testing Laboratories

Although the LIA Foundation does not recommend a specific lab, the following is a list of labs which we believe offer a superior quality of test compared to the standard lab.

IGeneX

This lab has a variety of panels and individual tests available. Most Lyme literate practitioners will order the Western Blot IgG / IgM for Borrelia (#188, #189). This Western Blot is the only one that tests for every Borrelia-specific band. They may also choose to order the PCR or IFA as well. IGeneX also offers testing for Babesia, Ehrlichia, Anaplasma and Bartonella (in addition to antibody tests for these infections, you should also strongly consider the “FISH” test [discussed below], which is a direct fluorescent staining of the organism).  IGeneX offers a “complete co-infection panel”(#5090) and also a “western regional complete co-infection panel” (#5080). A PCR test is best done during a symptom “flare” or during menses, if applicable. IGeneX recommends having at least two Borrelia specific bands, in addition to associated symptoms, to make a positive diagnosis.

Phone: (800) 832-3200

Website: www.igenex.com

NeuroScience/NeuroImmunology Labs

This lab has 3 panels which include the standard Western Blot, antibody testing, and testing for many of the co-infections such as Babesia, Ehrlichia and Bartonella. Not all specific bands are checked on the Western Blot, only those in the CDC “panels.” In addition, this lab does specialty testing for Autism Spectrum Disorder.

Phone: (715) 294-2852 – Email: info@neuroimmunologylabs.com

Central Florida Research

Central Florida Research
342 E. Central Ave.
Winter Haven, Florida 33830

CFR is open Monday – Friday from 8 a.m. – 5 p.m. EST (GMT -5:00)
Phone Number: (863) 299-3232
Fax Number: (863) 299-3355

Medical Director: Clifford H. Threlkeld, DO, FCAP

Florida State License Number: 800021816
CLIA Certificate #: 10D1059481

Website: www.centralfloridaresearch.com

Fry Clinical Labs

This lab does direct visual microscopy of a blood sample and thus can identify Babesia, Bartonella and others even when antibodies are not present or at very low levels. A positive visual identification of the pathogen(s) may be definitive; however, a result indicating that “no organisms were seen” does not necessarily rule out the possibility that the organisms are present but missed during the test. Some organisms, especially Lyme/Borrelia, are often difficult to detect due to their elusive presence in deep tissue which are not examined or visible during blood tests.

Phone: (480) 991-4555

Testing for Mycoplasma

According to research done by the Institute for Molecular Medicine and reported on their website at www.immed.org, “we have identified systemic infections, such as those produced by Mycoplasma species, Chlamydia pneumoniae and Human Herpes Virus-6 (HHV-6), in a high percentage of Autism Spectrum Disorder (ASD) patients, and these infections are likely to be important in determining the treatment strategies for many ASD patients.”

Medical Diagnostic Laboratories (MDL)

Professor Garth Nicolson’s work from the Institute for Molecular Medicine found that 58% of ASD children have multiple strains of Mycoplasma. This lab offers the “Mycoplasma General PCR test” and “Mycoplasma Fermentans PCR test.” Also, HHV-6 (human herpes virus-6), can be tested here; both antibody and PCR.

Phone: (877) 269-0090

Website: www.mdlab.com

Testing for Viruses

It is a good idea to test for HHV-6 as many children have a significant viral load. A subset of children with autism have shown improvement by using anti-viral treatments.

ViraCor Laboratories

Direct effects of HHV-6 include fever, rash, hepatitis, encephalitis, pneumonitis and delay or suppression of bone marrow engraftment. This lab tests for HHV-6 by the PCR method.

Phone: (800) 305-5198

Website: www.viracor.com

Parasites, Yeast and Gastrointestinal Testing

The bodies of children and adults suffering from chronic illnesses are typically ideal environments for parasites and yeast. It is important to discover which microbes are causing trouble. Below is a list of labs which are commonly used for this type of testing.

Diagnos-Techs, Inc.

The “GI Health” and “Expanded GI Health” panels test for several types of parasites, food intolerances, gut function and general GI health.

Phone: (800) 878-3787

Website: www.diagnostechs.com

Genova Diagnostics

This lab offers several panels, including the “Parasitology profile” or, for a more detailed panel, the “Comprehensive Stool Analysis.”

Phone: (800) 522-4762

Website: www.gdx.net

Great Plains Laboratory

Many physicians have confidence in this lab due to their specialized testing. For Candida testing, an “Organic Acid Test” or “Microbial OAT Panel” can give a clear picture as to the yeast or bacterial overgrowth in the patient.

Phone: (800) 288-0383

Website: www.greatplainslaboratory.com

Metametrix Clinical Laboratory

This laboratory can be used for stool cultures, organic acids, and metabolites of bacteria and pathogenic yeast. They also offer tests for fatty acids, metabolism, Krebs cycle issues, and functional vitamin deficiencies.

Phone: (800) 221-4640

Website: www.metametrix.com

Doctors Data

Doctors Data offers comprehensive stool analysis, parasitology, and microbiology panels which help to investigate the health of the GI tract. In addition, this lab is great for heavy metal toxicity testing.

Phone: (800) 323-2784

Website: www.doctorsdata.com

Heavy Metal Testing

It is well known that autism can be associated with heavy metal poisoning, by elements such as arsenic, copper, mercury, and others. For this reason, heavy metal testing should be conducted. The labs most often relied on are Great Plains Laboratory and Doctors Data. See Appendix C for more information. Since heavy metals are not always found in the blood and many prefer tissue, bone or other locations, this is a useful screen test. At times, it requires some expertise to read the results since some minerals can be high or low and either can be a flag for further follow up. 

According to Dr. James Schaller, MD:

Based on my research, all Americans have levels of some toxic heavy metals which undermine optimal health. This research was based on using a wide variety of respected chelation challenge agents, and doing pre- and post- testing which fit each agent’s mechanism. All patients were found to have heavy metal ranges that would undermine health.

If this is true, why allow autistic or Lyme infected children to have this additional burden on neurologic and immune function to exist? There are many child-friendly chelation agents available at this time. So talk to an expert in chelation and read widely.

Some health care professionals might be too frozen into using a limited number of options, and may not be familiar with the full range of non-IV options presently available.  

These 300 Medical Conditions are related to Lyme Borreliosis:

• Abdominal pseudo-eventration
• Acrodermatitis chronica atrophicans (ACA)
• Acute Acral Ischemia
• Acute conduction disorders
• Acute coronary syndrome
• Acute exogenous psychosis
• Acute meningitis
• Acute myelo-meningo-radiculitis
• Acute peripheral facial palsy
• Acute perimyocarditis
• Acute pyogenic arthritis
• Acute reversible diffuse conduction system disease
• acute transitory auriculoventricular block
• Acute transverse myelitis
• Acute urinary retention
• Acquired Immune Deficiency Syndrome (AIDS)
• Algodystrophy
• Allergic conditions
• Allergic conjunctivitis
• Alopecia
• Alzheimer’s Disease
• Amyotrophic lateral sclerosis
• (ALS – Lou Gehrig’s Disease)
• Amyotrophy
• Anamnesis
• Anetoderma
• Anorexia nervosa
• Antepartum fever
• Anxiety
• Arrhythmia
• Arthralgia
• Arthritis
• Asymmetrical hearing loss
• Atraumatic spontaneous hemarthrosis
• Atrioventricular block
• Attention Deficit Disorder (ADD)
• Attention Deficit Hyperactivity Disorder
• (ADHD)
• AUTISM 
• Bannwarth’s Syndrome
• Behcet’s disease
• Bell’s Palsy
• Benign cutaneous lymphocytoma
• Benign lymphocytic infiltration (Jessner-Kanof)
• Bilateral carpal tunnel syndrome
• Bilateral facial nerve palsy
• Bilateral follicular conjunctivitis
• Bilateral keratitis
• Bilateral papilloedema
• Biphasic meningoencephalitis
• Bipolar Disorder
• Brain Tumor
• Brown recluse spider bite
• Brown-Sequard syndrome
• Cardiac Disease
• Cardiomegaly
• Cardiomyopathy
• Carditis
• Carpal tunnel syndrome
• Catatonic syndrome
• Cauda equina syndrome
• Central vestibular syndrome
• Cerebellitis
• Cerebral atrophy
• Cerebro-vascular disease
• Cervical facet syndrome
• Cheilitis granulomatosa
• Chiasmal optic neuritis
• Chorea
• Choriocapillaritis
• Chronic encephalomyelitis
• Chronic Fatigue Syndrome
• Chronic muscle weakness
• Chronic urticaria
• Cerebellar ataxia
• Cogan’s syndrome
• Collagenosis
• Complete flaccid paraplegia
• Complex Regional Pain Syndrome (CRPS)
• Concomitant neuroretinitis
• Conduction disorder
• Conus medullaris syndrome
• Coronary aneurysm
• Cortical blindness
• Coxitis
• Cranial Neuritis
• Cranial polyneuritis
• Craniopharyngioma
• Cutaneous B-cell lymphoma
• Dementia
• Demyelinating disorders
• Depression
• Dermatomyositis
• Diaphragmatic paralysis
• Diffuse fasciitis
• Dilated cardiomyopathy
• Diplopia
• Discopathy
• Disseminated choroiditis
• Dorsal epiduritis
• Encephalitis
• Encephalomyelitis
• Encephalopathy
• Endogenous paranoid-hallucinatory syndrome
• Eosinophilia
• Eosinophilic fasciitis (Shulman syndrome)
• Epilepsy
• Epileptic crises
• Episcleritis
• Epstein Barr
• Erythema chronicum migrans
• Exanthema (local and generalized)
• Extrapyramidal disorders
• Facial diplegia
• Fascicular tachycardia
• Fatal adult respiratory distress syndrome
• Fetal death
• Fever
• Fibromyalgia
• Fibrositis
• Focal nodular myositis
• Frontotemporal atrophy
• Generalised motor neuron disease
• Geniculate neuralgia
• Giant cell arteritis
• Gonarthritis
• Granuloma annulare
• Guillain-Barré Syndrome
• HLA-B27 negative sacroiliitis
• Headaches (severe)
• Hearing loss
• Heart block
• Hemiparesis
• Hemophagocytic syndrome
• Hepatic disorders
• Hepatitis
• Herniated discs
• Holmes-Adie syndrome
• Horner’s syndrome
• Human necrotizing splenitis
• Hydrocephalus
• Hyperacusis
• Hyperbilirubinemia
• Hypothyroidism
• Idiopathic atrophoderma of Pasini and Pierini
• (IAPP)
• Idiopathic facial paralysis
• Infarction pain
• Impaired Brainstem response
• Infantile sclero-atrophic lichen
• Infectious Mononucleosis
• Infiltrating lymphadenosis benigna cutis
• Inflammatory cerebrospinal fluid syndrome
• Influenza
• Internuclear ophthalmoplegia
• Interstitial granulomatous dermatitis
• Intracerebral haemorrhage
• Intracranial aneurysm
• Intracranial hypertension
• Intracranial mass lesions
• Intrauterine growth retardation
• Iritis
• Irritable Bowel Syndrome
• Isolated acute myocarditis
• Isolated lymphadenopathy
• Isolated neuritis of the sciatic nerve
• Isolated oculomotor nerve paralysis
• Isolated posterior cord syndrome
• Jaundice
• Juvenile Rheumatoid Arthritis
• Keratitis
• Keratoconus
• Left sided sudden hemiparesis
• Lichen sclerosus
• Livedo racemosa
• Lofgren’s syndrome
• Lupus
• Lymphadenosis benigna cutis
• Lymphocytoma cutis
• Lymphoma
• Lumboradicular syndrome
• Melkersson-Rosenthal syndrome
• Memory impairment
• Meningeal lymphoma
• Meningitis
• Meningoencephalomyelitis,
• Meningoencephalomyeloradiculoneuritis
• Meningoradiculitis
• Migraines
• Mono-arthritis
• Monolateral chorioretinitis
• Morgagni-Adams-Stokes syndrome (MAS)
• Morning glory syndrome
• Morphea
• Motor neuron syndrome
• Multiple mononeuropathyMultiple SclerosisMyelopathyMyofascial pain syndrome
• Myositis
• Neonatal respiratory distress
• Neuromyotonia
• Nodular panniculitis
• Normal-pressure hydrocephalus (NPH)
• Oculomotor paralysis
• Oligoarthritis
• Opsoclonus-myoclonus syndrome
• Nodular fasciitis
• Non-Hodgkin’s lymphoma
• Obsessive-compulsive disorder
• Optic atrophy
• Optic disk edema
• Organic mood syndrome
• Optic nerve lesion
• Otoneurological Disorders
• Panuveitis
• Papillitis
• Paralysis of abdominal muscles
• Paraneoplastic polyneuropathy
• Paranoia
• Parkinsonism
• Parotitis
• Pars plana vitrectopy
• Parsonage and Turner syndrome
• Peripheral facial palsy
• Peripheral neuropathy
• Peripheral vascular disorder
• Pericarditis
• Perimyocarditis
• Persistent atrioventricular block
• Pigment epitheliitis
• Polymyalgia rheumatica
• Polyneuritis cranialis
• Polyneuropathy
• Polysymptomatic autoimmune disorder
• Porphyrinuria
• Posterior scleritis
• Primary lymphoma of the nervous system
• Presenile dementia
• Progressive cerebral infarction
• Progressive facial hemiatrophy (Parry-Romberg
• syndrome)
• Progressive stroke
• Progressive supranuclear paralysis
• Prolonged pyrexia
• Propriospinal myoclonus
• Pseudo tumor Cerebrae
• Pseudolymphoma
• Pseudoneoplastic weight loss
• Psychosomatic disorders
• Radiculoneuritis
• Ramsay Hunt syndrome (pleocytosis)
• Raynaud’s syndrome
• Recurrent paralysis
• Reflex sympathetic dystrophy
• Reiter’s Syndrome
• Respiratory failure
• Restless legs syndrome
• Retinal pigment epithelium detachment
• Retinal vasculitis
• Reversible dementia
• Rheumatic Fever
• Rheumatoid Arthritis
• Rhombencephalitis
• Sacro-iliitis infection
• SAPHO syndrome
• Sarcoidosis
• Schizophrenia
• Schoenlein-Henoch purpura
• Scleroderma
• Secondary syphilis
• Seizure Disorders
• Sensorineural Hearing Loss
• Septal panniculitis
• Septic arthritis
• Seventh nerve paralysis
• Sick sinus syndrome
• Spontaneous brain hemorrhage
• Stevens-Johnson syndrome
• Stiff-man syndrome
• Still’s disease
• Stroke
• Subacute Bacterial Endocarditis
• Subacute multiple-site osteomyelitis
• Subacute organic psychosyndrome
• Subacute multiple-site osteomyelitis
• Subacute presenile dementia
• Subarachnoid hemorrhage
• Sudden deafness
• Sudden hemiparesis
• Sudden infant death syndrome (SIDS)
• Sudeck’s atrophy
• Synovitis
• Syphilis
• Symmetric Polyarthritis
• Temporal arteritis
• Temporomandibular joint syndrome
• Thrombocytopenic purpura
• Thyroiditis
• Tourette’s syndrome
• Transient Ischemic Attack
• Transient left ventricular dysfunction
• Trigeminal Neuralgia
• Unilateral interstitial keratitis
• Unilateral papillitis
• Urticaria
• Uveitis
• Vasculitic neuropathy
• Vasculitic mononeuritis multiplex
• Vasculitis
• Ventricular asystole
• Vertigo
• Vestibular neuronitis
• Vitreous clouding

NutraNews / New Thinking, New Discoveries in Nutraceutical Research
October 2003

Co-Infections with Lyme Borreliosis

Confirmations are coming in from the medical and alternative health communities about many co-infections traveling with Bb. The term Lyme disease refers to a complex illness consisting of several co-infections. The list includes – Babesias (parasites), Ehrlichia, tularemia ( bacteria), Colorado tick fever,(virus), Leptospirosis (sprirochete) and many others. All of these must be treated. VEMMA is the best multi-purpose product that fights all of these pathogens at the same time. It also provides adequate vitamins, minerals, amino acids, and other necessary nutrients.Testing for Lyme BorreliosisBb has devised ingenious way to elude detection by our immune system-and laboratory tests don’t fare much better. The Center for disease control says that a clinical diagnosis is based on history and a physical exam -lab tests may be used to confirm but not rule out the disease.The Western Blot blood test or the ELISA test is presently used by most doctors. These tests are looking for antibodies which the body isn’t actively making against Bb so the tests are inadequate. Dr. JoAnn Whitaker has developed the Q-RIBb test which identifies the spirochete shaped bacteria. It is presently going through FDA approval. It makes more sense to be adequately protecting yourself from many pathogens that can be infiltrating your body. Everyone will be in contact with someone who is carrying Bb. Don’t wait until you are sick with one of the 300 conditions connected to Lymes – be active in protecting yourself.

Here are several peoples’ experiences with the Fry Laboratory tests:

I had a great experience with Fry Lab and would highly recommend it. It identified babesia and  ehrichiosis on the blood smear. The antibody testing had me positive for two forms of ehlichiosis and babesia. I got the complete panel (blood smear and testing) for $495.  

I had all the coinfection tests done at Igenex only a few weeks before the fry test and was negative for ALL the coinfections except HME.

 

My LLMD was extremely impressed with the quality of the smear and the testing at the lab- apparently the quality of my pictures was so good that the lab called my LLMD to discuss the pictures. I think they are more reliable for coinfection testing than Igenex, at least for me. The lyme test I had was at Igenex- I don’t believe Fry does tests for lyme.

I did the Fry test earlier this month. I did have my nurse practitioner order the test so I don’t know if they will do the test if you want the results sent to you rather than a medical professional. I think most labs want to send results to a medical professional for legal reasons.
 
Anyway, I tested negative for Lyme on the Western Blot and Igenex. I have been sick for 10 years and in my quest to find out what is wrong with me I ended up having the Fry test done. It cost me $495 and I am not sure if my insurance will reimburse me because I am still waiting for the CPT codes from Fry Laboratories to turn into my insurance company.
 
I tested positive for Bartonella.
 
I started on Levaquin about 1 1/2 weeks ago. I felt bad the first two days, then amazingly good for about a week. Now I am flaring again. I would love to hear from others who tested positive for Bartonella and how they are doing with treatment, etc. 

Dr. James Schaller, M.D., of Florida, http://www.personalconsult.com, is one of the current pioneers in using the Fry Blood Smear test. Contact Dr. Schaller for more information, or contact Fry Clinical Laboratories at: