Recently, I interviewed Dr. Brian Plante, and we talked about vector-borne infections, including Lyme, bartonella, and babesia. If you would prefer to listen to the interview you can access it by Clicking Here [1].
Dr. Eric Osansky:
I am super excited to chat with Dr. Brian Plante as we are going to be talking about vector-borne infections, including Lyme, bartonella, and babesia.
Let me give Dr. Plante’s impressive bio here: He is a licensed naturopathic doctor with extensive training in integrative, whole-person healthcare approaches. He works closely with those suffering from complex immune dysfunction, including Lyme Disease, chronic viral infections, environmental toxicity such as mold illness and heavy metal toxicity, autoimmune disease, mast cell activation syndrome, fibromyalgia, chronic fatigue syndrome, chronic encephalomalacias. Through compassionate listening, detailed instruction, and a commitment to helping patients see lasting change in their lives, he hopes his presence will leave each person feeling deeply supported through their journey to optimal health. Thanks so much for joining us, Dr. Plante.
Dr. Brian Plante:
Thanks so much for having me.
Dr. Eric:
I’m really looking forward to having this conversation about vector-borne infections with an emphasis on Lyme, bartonella, and babesia. Before we do this, can you give your background? You focus on a lot of complex conditions. How did you start down this path?
Dr. Brian:
I was always really interested in some of the more challenging cases, where you have to think like a detective and put all the pieces together. When I did my residency at a naturopathic clinic in the Sacramento area a few years ago, I saw a lot of tick-borne infections and mold toxicity. I don’t think I had realized, being in school in Portland, Oregon, just how prevalent it was in California, particularly northern California and the Bay Area. Part of it arose from an aptitude and desire to work with more complex cases. But a big part of it came from the demand. There was just such a need in that area geographically, and there weren’t many of us.
The doc I trained with, Dr. Jamie Kunkle, taught me most if not everything he knew about it. I got about five years of education in about a year and a half, and it took off from there. Like I said, the need for support with those conditions.
Dr. Eric:
How common are vector-borne infections? Some people get the impression that they’re only common in certain areas, for example, the Northeast. Other areas, they are not as common. Do you see them pretty much everywhere? I don’t know if you work with people remotely, so if you have an opportunity to work with people in different states, and you see them being widespread. Or if you consult with colleagues who say it doesn’t make a difference where the person is if they are susceptible to getting these infections.
Dr. Brian:
I do work remotely and get some of that first-hand- I don’t necessarily want to call it data, but exposure. They are a lot more prevalent than people realize, including in places where we previously didn’t see a high prevalence. There are places in the country where it is much higher incidence, particularly the East Coast. When we are working with cases like that, it’s not uncommon for people to have had two, three, or more exposures to an infection. This time, it’s a lot more severe in their acute presentation.
Even in southern California, I have seen cases of Lyme. The ticks that are endemic to this area are not well known to be carriers of Lyme. We are scratching our heads a little bit about that. I have also seen cases in Arizona, where it wasn’t suspected to be as common.
I’m always asking about tick bite exposures as well as fleas and other biting insects. Cats and dogs because they still think there is a lot we don’t know about just how these organisms can be transmitted. I suspect they are a lot more prevalent than we realize.
It is important to delineate between a Lyme infection, maybe where you have the organism, and Lyme disease, where there are a lot of observable symptoms and an increased need for treatment. I still think there is a lot of debate on just how common these organisms are and to what extent we really need to be screening for them and treating them in patients with a variety of chronic degenerative conditions.
Dr. Eric:
One of the questions I was going to ask is can there be vectors other than ticks? You answered that because you mentioned fleas. I don’t know if mosquitoes could also transmit; there is some controversy over that. Would you say ticks are the most common? Is it just something we don’t know?
Dr. Brian:
Good question. For Lyme, the black-legged ticks on the Pacific side and the East Coast. I am not remembering the exact species names. They are the primary vector for Lyme.
With bartonella, it’s cats and fleas that are more common transmission vectors than ticks. We can talk in more detail about that if you’d like.
The jury is still out on mosquitoes. I wonder about babesia because it reads a lot like malaria. There have been instances where I have had people with babesia with no other known animal exposures, and their mother didn’t have it, so they weren’t born with it.
The ones leading the research are the veterinarians, particularly in the bartonella landscape. I still think unfortunately there is a lot we don’t know as a medical community, and even in the veterinary community, about how these organisms can be transmitted.
Dr. Eric:
I was diagnosed with chronic Lyme in 2018. Not only did I test positive for Lyme but also bartonella. There was no evidence of a tick bite. Just because there was no evidence doesn’t mean I wasn’t bitten by a tick. It makes me wonder if fleas could possibly be a source. Whether it’s a flea or tick, it sounds like with Lyme, there is a greater chance of ticks. Is there any evidence of fleas with Lyme? Or is it pretty much ticks with Lyme, and then with bartonella and babesia-
Dr. Brian:
I haven’t heard specifically about fleas with Lyme. I would have to do a more updated literature review on that and see if there is anything newer out. The statistic that is most recent that I heard is about 30% of people living in the United States with Lyme disease never recall having had a tick bite. I suspect that is underreported. There are questions about tick size, particularly the young ticks. Whether we did actually get a bite but didn’t see it, or if there are other animal and insect vectors. It’s probably a little bit of both.
Dr. Eric:
For those who have gotten bit by a tick, and they know they got bit right away, how soon- Obviously, the sooner you act, the better. Let’s say within three days, but others say a few hours as far as transmission of someone getting Lyme or bartonella.
Dr. Brian:
We used to think the tick attachment time, like how long it was embedded before it was removed, was a significant determinant of the risk of transmission. Some of the newer data has questioned that and suggested that it doesn’t really matter how long the tick has been attached. It was only attached for a few hours, but we did have to remove it with tweezers.
I still recommend sending off the tick to be tested as well as testing the person for antibodies although there can be issues with that test in terms of how quickly we are going to see those responses. It’s very common to do some sort of empiric therapy or treating early if there is suspicion. There doesn’t seem to be a clear association with how long the tick was attached.
Dr. Eric:
Do you have a favorite lab that you send ticks to that you recommend?
Dr. Brian:
I thought you were going to ask me that. I remembered the University of Massachusetts for a while had one. I should have looked that one up before this. I haven’t had to do it in a while, to be honest. I don’t see a lot of acute cases where I’m located. If you have a resource page, I can give you an updated list after this.
Dr. Eric:
Yeah, that’d be great. I can put it in the show notes. Medical Diagnostic Laboratories, they do some testing for vector-borne infections. I think they also look at the tick, too. I don’t know if these other places are free. I’m pretty sure they charge to evaluate the tick.
Dr. Brian:
I think so.
Dr. Eric:
How about symptoms? What are some of the common signs and symptoms? I know there can be a lot of them. Not to focus on all of them, but I guess, some of the more common ones. If there are differentiating factors. With babesia, night sweats are common. That’s maybe one differentiating factor. If you could dive a little bit deeper.
Dr. Brian:
There is a lot of overlap. There can also be some variation between acute presentations or new infection versus chronic or long-standing, well-established infection.
With Lyme, we can see the hallmark summer flu symptoms, in the sense of feeling flu-like headaches, fatigue, brain fog, muscle aches, or joint pain. We tend to see a lot more joint pain with Lyme than with the other ones, at least in my experience.
With bartonella, we can see more neurologic or neuropathic symptoms: numbness, tingling. I see a lot of foot pain with bartonella, like pain in the bottoms of your feet. Bartonella infects the blood vessels. Anywhere where there are small blood vessels, if there is inflammation in those, we can see more unusual pain presentations. We can see headaches as well.
The hallmark for me is the psychiatric symptoms: irritability and rage, especially if folks have reported parents or the patient themselves. “It doesn’t feel like it’s really me; I am overcome with this episodic rage and irritability.” That was one of the most eye-opening symptoms for me when I was in residency. I saw a few teens and young adults who presented, and they were quite irritable and difficult to work with. When we did antibiotics, we started to see some improvement in their entire temperament, which was very eye-opening.
With babesia, the differentiating symptoms are the night sweats and air hunger, feeling like you just can’t get enough air in. That’s because it’s a protozoa or microscopic parasite that infects the red blood cells. It can affect oxygen uptake at that level.
We can see fevers and chills with all of those. Of course, the classic tick-borne relapsing fever, which is a type of Borrelia infection in the same genus as Lyme but a different species. Actually, there are several species that can cause that. We tend to see relapsing fever, meaning you have fever for a few days, and then not for a while, and then it comes back.
Lyme and babesia, we can see some psychiatric symptoms as well. I often recommend testing for all three because there can be so much overlap. There can be times where you’re like, “This is for sure babesia,” and babesia is negative, but bartonella is positive. And vice versa. You think it will be bartonella because it’s a pediatric, autoimmune, psychiatric, or PANS case, and we end up finding it’s babesia driving the neuroinflammation.
Dr. Eric:
If you will test for Lyme and bartonella, even if it’s someone not experiencing the night sweats and air hunger, would you still recommend testing for babesia?
Dr. Brian:
If their budget allows. Cost is the biggest barrier when it comes to some of the specialty, higher sensitivity testing. We could do a whole talk on testing. There is not a perfect test. Ideally, yes. I would test for the big three. I might even look for tick-borne relapsing fever or Rickettsia as well, which includes Rocky Mountain spotted fever, anaplasmosis, orientia. I am more concerned about those on the East Coast, or with acute presentations, than I am with chronic ones.
Dr. Eric:
Are you able to rank the prevalence? Would you say Lyme is the #1 vector-borne disease that you test for that comes back positive? Bartonella is second, or maybe bartonella is #1.
Dr. Brian:
Some of this is regionally dependent. In the current CDC statistics, Lyme is by far the most prevalent. Part of why I got so interested in bartonella as a topic and specializing in working with that in my time in the Sacramento area is I was seeing quite a bit more bartonella than Lyme in that region. That has not been the case in southern California, where I have been for the last year. It was also less the case in the Bay Area, where I was practicing for a year as well, and San Jose. Of course, we work with people all over the San Francisco Bay Area, where tick-borne infections are well known to be prevalent, particularly Lyme. But I remember being surprised.
I don’t want to misquote him, but at the time, Dr. Kunkle was fairly convinced that bartonella was as common or more common than Lyme. Babesias, we are seeing a lot more around the east coast, but it is here on the west coast and beyond as well.
Part of that is tick habitats are expanding. With climate change, we have longer seasons. Ticks are surviving through the winters more. There is also a lot more transportation, so you have ticks going to regions where maybe they weren’t in previously. It’s very difficult for us to say definitively just how prevalent these infections are, not to mention the issues with diagnostic testing.
Dr. Eric:
In your practice, it sounds like you help with all of these, but you have more of a focus on bartonella. That is more of a specialty when it comes to these vector-borne infections.
Dr. Brian:
Initially. Like I said, I’m seeing a lot less of it in the last couple of years, which I suppose is good, that it’s not present in this area. I was fairly well trained in managing bartonella in my first couple years. It’s thrown me for a loop a little bit. What I’m finding is that I am needing to test for all three as a result because I’m seeing the ones that I didn’t expect to see, and I’m not seeing the ones, particularly bartonella, that I was expecting to see.
Dr. Eric:
Before I pressed record, I asked you if we could talk a little bit about dysautonomia, POTS, because in some cases, that is associated with these infections.
Dr. Brian:
Yeah, I see it frequently, as well as with long-haul COVID. What dysautonomia is is any condition affecting the function of the autonomic nervous system, which is the automatic nervous system, the part that regulates non-voluntary functions, like breathing, heart rate, blood pressure, temperature regulation. Those are the primary ones.
We can have a variety of mechanisms from these vector-borne infections that trigger dysautonomia. One is the actual direct infection of the Vagus nerve by some of these organisms. That has been postulated as one theory of chronic Lyme or differentiating between chronic Lyme as an infection and post-treatment Lyme disease syndrome, which is when you have all the same symptoms but are not responding as favorably to antibiotic therapy. That can occur in the Vagus nerve. I suspect that is a big part of what we are seeing with long-haul COVID causing dysautonomia. The inflammatory signaling that happens with these infections is very complicated and part of why they are so difficult to test for.
The primary assumption, which is that an infection is going to stimulate the immune system to make antibodies, and we are going to rely on those antibodies to determine whether or not that infection is active. That assumption doesn’t apply with some of these low abundance chronic infections.
These organisms have evolved and adapted the capability of creating anti-inflammatory and immune disruptive signaling molecules as a response. They can often confuse the immune system, which creates a very altered landscape of cytokines and other inflammatory mediators. Those can impact how blood flow to the autonomic nervous system is regulated. It can cause oxidative damage to autonomic neurons. Of course, that gets complicated quickly if we add environmental toxicants, like mycotoxins for mold and toxic metals and organic chemicals.
The short of it is I do frequently see dysautonomia with chronic infections, especially when there are several infections present and environmental toxins. Our approach is to not only address those contributing factors, but to restore regulation to the nervous system. Depending on where the damage is, that can look different from person to person.
Dr. Eric:
You mentioned mold. How common is it for people who have mold when dealing with these infections?
Dr. Brian:
Arguably, extremely common in my experience. I often use the analogy of the overflowing bucket. Anything toxic, inflammatory, infectious, or traumatic, both physically or psychologically, which are not ultimately separate in terms of the effects they have on our physiology, gets added to the bucket. When we start seeing the bucket close to overflowing and actually overflowing, that’s when we see symptoms. That is when we see chronic illness not responding to conventional, symptom-based management.
More often than not, the folks who have the most severe, nonresponsive cases other than vector-borne infections have unaddressed environmental toxicity. They may have genetic factors that influence how quickly they are able to metabolize those things, or they have an ongoing exposure that they don’t know about, or they thought they were fine until they moved to a moldy apartment, and that’s what overflows the bucket. They find out they actually have Lyme.
In fact, I was just seeing somebody about a month ago, maybe 2-3 weeks ago, who knew she had chronic Lyme and was doing treatment in Mexico—stem cells, ozone, those kinds of things. She thought her Lyme was flaring but found out that it was actually a severe mold problem in her new apartment. Now, we’re working on detox. It oftentimes is the obstacle that people don’t realize is still there.
Even just a couple of days ago, I was talking with somebody who I have been working with for a while. We were going down the bartonella rabbit hole. We assumed mold was already dealt with because she had already worked with a provider who had done detox therapies. We found there were still significant levels of mycotoxins, all of the classes of them, in the urine. There was some ongoing excretion going on, or colonization of mold in probably the sinuses or GI tract, which hadn’t been addressed.
It’s difficult both for the practitioner and the patient to try to parse these things out and figure out what’s making them sick. Is it Lyme, bartonella, or mold? Yes. To some extent, it’s how these organisms and toxins have dysregulated the immune system, mitochondrial energy production, and the nervous system, and how all of that can affect hormones, the gut, other organ systems. We often have to repair and support those organs in their function while also addressing the things that are triggering the imbalance in the first place.
Dr. Eric:
Since it is so prevalent, do you do a urinary mycotoxin test on everybody? Does it depend on their history? If you suspect that it might be a mold problem, that’s when you have them do it?
Dr. Brian:
Similar to specialty testing for vector-borne infections, none of these tests are perfect. We have to think about their limitations. I am always transparent with patients about that.
Urine mycotoxin testing is one way we can determine if there are elevations in mycotoxins coming out of the body. Because it’s only measuring what’s coming out of the body, we don’t currently have blood mycotoxin testing available although I’m told it’s being looked at. Food can affect it, if there are food-borne molds.
Also, the rate of excretion, which depends on how able a person is to detox, if we are going to see those levels high. People always want to know, “Does this tell me there is mold in my environment now, or does it tell me it’s from a previous mold exposure?” We don’t know that. We just know it’s coming out of the body.
Usually, my approach to mold assessment in a patient is to have them do a screening. Can I mention specific labs?
Dr. Eric:
Sure.
Dr. Brian:
I do a screening home test kit, like a self-collect, dust sample through EnviroBiomics. I like the Actino Plus HERTSMI-2. It looks for mold. Like an ERMI, but more refined though. The Actino looks for a bacteria that is associated with water-damaged buildings that some of the newer research suggests may be more responsible for chronic inflammatory response syndrome or sick building syndrome than the mold itself. But it does not produce mycotoxins, at least not to my knowledge. They are looking at slightly different things.
Test the home, and test the patient. If a screener like that comes back positive, I try to get them have an inspector come out who is sufficiently trained. There is quite a bit of debate as to what criteria are needed for an inspector to be trustworthy in that regard.
Also, I might think about doing a Lab Corps or Quest blood panel looking at the chronic inflammatory response markers, which are immune markers that tend to be dysregulated and in mold illness.
If budget allows, I will also do a nasal culture for antibiotic-resistant Staph, which is associated with water-damaged building exposure. I will do fungal culture as well.
Maybe an organic acid test, which is a urine test, but it will tell us if there is GI colonization of mold. By colonization, we mean there is living mold, mold spores that got in and created an infection in the area rather than just inhalation or ingestion of mycotoxins without there actually being living mold.
The diamond approach would be to test the home, urinary mycotoxins, test the sinuses and/or gut, and look at how the immune system is behaving. Usually, if we get two, three, or even four of those things, it gives us a clearer idea as to where we need to be focusing our energy.
Dr. Eric:
How about Lyme? What are your favorite labs to look at Lyme, bartonella, babesia, or other vector-borne infections?
Dr. Brian:
I still prefer IGeneX over Lyme. It’s reliable. I haven’t seen a lot of false positives with it.
People often ask me about Vibrant Wellness given the low cost. I have not found this to be a particularly sensitive test, which is maybe a point of contention with some. I have talked to other colleagues in my profession who find that test to be fine. In my experience, I have done split sampling before with patients who could afford it and done either IGeneX or Galaxy Diagnostics for bartonella. We found it on those and did not find it on Vibrant.
I usually use IGeneX. It just came out in the last year and a half with a Babesia ImmunoBlot that I have found to be quite helpful. Currently, I am using IGeneX for Lyme, babesia, and tick-borne relapsing fever. Using Galaxy Diagnostics, which is co-founded by a lot of veterinary researchers, I am using that one for bartonella.
You mentioned MDL. That is a decent screener as well. I just have less experience with that one.
Dr. Eric:
When I was diagnosed with chronic Lyme, I worked with a Lyme literate practitioner. I was mentioning IGeneX because that is who I was familiar with. She mentioned MDL. She is like, “Let’s do that. It’s less expensive. It may not pick it up, but it might. If it does, it could save money.” I was listening to her advice, and it did pick up chronic Lyme as well as bartonella. IGeneX is the most well-known lab for those.
Why do you prefer IGeneX? I know they test for different species of Borrelia. I don’t know if it’s the same with other vector-borne infections. Is it because they look deeper than the antibodies, the comprehensiveness of the test?
Dr. Brian:
I was an undergrad chemistry major, but I don’t have a lab science background. I’d have to get into the methodologies that they’re using. I’ve just found it’s a relatively low false positive rate. Of course, there will always be false negatives that we have to think about. Is it missing an infection? If suspicion is high, the International Lyme and Associated Diseases Society (ILADS) still recommends that these are clinical diagnoses rather than laboratory diagnoses, meaning if suspicion is high, and other conditions have been ruled out, you still want to treat them. As well as talking with other professionals who are Lyme literate physicians, it has stood the test of time.
They continue to refine their approaches by adding new tests, but they don’t seem to be- Excuse me, in my experience, chasing bells and whistles. I don’t do PCR through them. I just use the ImmunoBlot, which is a more sensitive western blot for Lyme as well as the Babesia ImmunoBlot.
I have seen bartonella missed a couple of times, which is why I use Galaxy. I use their antibody test, the IgG immunofluorescence assay, which is about $500. It’s about the same cost as the individual infections on IGeneX. It gives you a titer number, which I like. If you see it as borderline, you may be interpreting that a little different than if you see it as maxed out to the maximum dilution. You will see those numbers come down with appropriate treatment.
Dr. Eric:
A lot of people listening to this have Graves’ or Hashimoto’s. Have you seen a relationship between these vector-borne infections and autoimmunity, whether it’s thyroid autoimmunity or other autoimmune conditions?
Dr. Brian:
Empirically and clinically, yes. The data varies on which organisms are associated with what in terms of autoimmunity. Essentially, the way I explain it to patients is the concept of molecular mimicry, which is that there is a molecular structure or protein on the bacterial cell wall or cell membrane that looks structurally very similar to the proteins on our own cells.
If a battle ensues between the immune system trying to get rid of the organism, there can be priming of the immune system to react to very similar molecules that it may see in the wild, so to speak, aka in the rest of the body. The immune dysregulation that we tend to see in autoimmunity is often activated initially by an infection or toxin or both.
When we’re thinking about autoimmune thyroid disease specifically, I am almost always having a conversation about vector-borne infections, opportunistic viral infections like the herpes viruses or COVID. I have seen some Hashimoto’s specifically following COVID, as well as mold and heavy metals because we know mercury can be thyroid-toxic.
Dr. Eric:
Quick question with viruses. Would you consider Epstein-Barr to be more like a stealth infection when it comes to viruses?
Dr. Brian:
Good question. The herpes family of viruses is a large family. It includes herpes simplex 1 and 2, which are the viruses we typically think of when we think of herpes. The virus that causes chickenpox and shingles is also in that family, as is EBV and cytomegalovirus, as well as a few others. One of them that is often tested for is human herpesvirus 6 or HHV6.
I consider these to be opportunistic infections. What that means is they are fairly ubiquitous. About 90% of adults have been exposed to them and produce antibodies to them. But under normal, healthy conditions, the immune system is able to keep them in check, and we don’t seem to have major problems.
When the immune system is compromised, either from a more primary infection like the ones we’re talking about, the environmental toxins, or just being in fight or flight all the time, whether that’s from PTSD, chronic illness, the medical trauma of living with these conditions, we tend to see a lot more reactivated and chronic herpes viruses.
I see a lot of providers going and trying to play whack a mole with these infections. To some extent, people can get transient relief. Oftentimes, if they are persistently activated, not seeing those antibody levels come down on blood testing, there is something more primary going on that needs to be addressed.
Dr. Eric:
If you could talk now about some of the treatments that you prefer for these vector-borne infections. Related to that, you mentioned with bartonella, you will see the titers going down. I am guessing the same with the others.
The second part to the question: Can you get rid of these permanently? Are these like EBV, where you will always have it? Is it possible to permanently eliminate Lyme, bartonella, babesia from your body?
Dr. Brian:
I am skeptical that we can entirely eradicate these infections permanently, in the sense that we are not going to see eradication, and then they return later at another time. That’s not the goal that I communicate to patients. It’s a great question though. I think I’ve talked about this in the past as well.
The goal is to promote more of—it sounds hippie to say this—a harmonious relationship between the immune system and the other microbes. Essentially what we want to do is restore appropriate immune signaling, or promote more immune regulation, where it responds as needed to an acute infection, but is less reactive in an ongoing sense to organisms that may not be causing active problems. I’m saying that overly simplifying the TH1, TH2, TH17, T regulation, regulatory T cells, different branches of the immune system that have different jobs in all of this. If we can marginalize the infection, if we can get the relative burden of it down to the extent that the immune system can pick up the slack and do what it’s supposed to do, we tend not to see as many problems.
I have often said that if we had enough money to screen two million people in the general population who are asymptomatic for these infections, we would probably find positive results in several of them who were not sick. When we’re starting to see problems in terms of chronic degenerative disease or complex chronic illness, it tends to be when the immune system has multiple insults that it’s trying to deal with at the same time. Restoring immune competence, regulating the nervous system, and marginalizing the infection are the primary goals, as well as correcting any damage these infections may have caused by activating the immune system in the way that they do.
Dr. Eric:
Do you use a combination of treatments, like antibiotics or other things you may use? I don’t know if you use herbs or ozone.
Dr. Brian:
I highly individualize it. When I was trained, Dr. Kunkle used a lot of prescription antibiotic therapy, including IV antibiotic therapy, along with the best of what naturopathic medicine has to offer.
I always joke that my last name, Plante, was fitting for using a lot of herbal medicine. I love plants. They are incredibly useful in that they tend to be a little more sparing of the good microbes and tend to be broadly acting. They have a lot of coverage against a variety of not only vector-borne infections, but several of them are also anti-fungal, if there is opportunistic yeast overgrowth. Many of them are also anti-viral. If we don’t entirely know what we’re treating, or testing is cost-prohibitive, or it’s really complicated, I will often rely more heavily on the botanicals.
The best results that I’m seeing are when there is a combination. If a patient can tolerate prescription antibiotics, I will use those alongside herbal medicines as well as trying to correct the underlying immune signaling, promote adequate detoxification, and die-off support. If hormones and other systems are impacted, we target those as well.
In my current practice, we don’t do IV therapy, at least not in the Orange County location. In my previous offices, we did quite a bit of IV therapy. This is a little more for viruses than for cancer, but high dose IV Vitamin C is an oxidative therapy that has an antimicrobial effect. We did a lot of IV ozone therapy, including EBU, or extracorporeal blood oxygenation and ozonation. You take blood out, ozonate it, and put it back in continuously although people have often done the 10 pass as well. I do find ozone to be helpful. I don’t think it is a miracle. It won’t do all the heavy lifting, but it can be very helpful.
The one that I am probably the most passionate about Is methylene blue, whether oral or intravenously. There are a lot of cautions to be mindful of if you are doing it intravenously. I like it because it has a mitochondrial regenerative effect. It enhances oxygen utilization by the mitochondria. It is also neuroprotective, in which many patients infected by these infections have neurological symptoms as well as complications. It is a mononucleooxidase inhibitor, so you get more serotonin, dopamine, and norepinephrine. Brain fog, depression, anxiety, those kinds of things, it can be very helpful for. It tends to be a little gentler on the good microbiome.
I call it a prescription antibiotic, but it doesn’t really fit into the classic categorizations of antibiotics, like doxycycline. We can talk about specific regimens, too, if we want to. I’ll use a variety of tools tailored to what the person can tolerate and what they need. The best results I’m seeing are a combination of prescription antibiotics and herbal antimicrobials.
Dr. Eric:
With methylene blue, do you recommend IV or orally?
Dr. Brian:
It can be administered IV. You have to be very careful of its serotonin effects when it’s administered intravenously. If folks are on prescription antidepressants that interact with serotonin or other medications that raise serotonin levels, if you do either oral or IV methylene blue, you can cause serotonin syndrome, which is a toxicity caused by too much serotonin in the brain. IV, the risk is much higher. If that was being administered in the hospital for a non-antimicrobial purpose, but for something else, you’d have to be off antidepressants for several days to minimize that risk.
I’m always cautious about that with folks, but I have done it. It can have a pretty potent effect. It’s potentiated by red light. It’s a photosensitive molecule that becomes more oxidative when exposed to red light wavelengths. There are some devices that shine red light on it. We used some at my last clinic. It was a wristband that shined red light on your wrist as the IV methylene blue was being dripped into the other arm, with the idea that it activates it from the inside. It is a lot more potent intravenously, both therapeutically and with the risks.
Dr. Eric:
I know everybody is different, but on average, how long is someone taking the methylene blue, either orally, or maybe not as long with the IV since it’s more potent?
Dr. Brian:
With oral, I’m typically averaging around six months, sometimes longer. Sometimes 9-12 months. Sometimes shorter, depending on how they’re doing. It will turn your urine blue. Some folks say their toilets got stained.
I have only had a handful of folks over the years report a digestive upset or a urinary pain, which prohibited us from continuing with it. In many cases, it’s very well tolerated, and we don’t tend to see the GI side effects that we might see with prolonged other classical antibiotics.
Dr. Eric:
I know you have to go soon. I do want to ask you what are some of your favorite plant-based botanicals that you use?
Dr. Brian:
What I will often do is start with a broad spectrum formula, like a biocytin, which has a variety of botanicals in it. It’s a mild biofilm disruptor as well. It’s often not sufficient, but it’s a good place to start because it breaks up biofilm, but not in a way that flares people the way I see with the phase two biofilm disruptors. It has broad action.
The one that has been shown in the research to be the most potent against multiple vector-borne infections is Cryptolepis sanguinolenta, which is a West African shrub. Sometimes, they can experience more significant die-off symptoms, so I don’t usually start with that one.
I usually start with biocytin or Japanese knotwood, which has also been shown to be effective against all three.
I think LymeDisease.org just recently published a post on a research article they were citing that made this chart, where they looked at what was effective against stationary phase bartonella and the Borrelia, Lyme, as well what was effective against babesia. They didn’t differentiate between the different phases of babesia. You look at it and go, “Okay, methylene blue has activity against all three. Japanese knotwood has activity against all three. So does Cryptolepis.”
I like Japanese knotwood because it has resveratrol and other anti-inflammatory molecules in it. The die-off symptoms tend to be more mild. What I see with that one from a side effect standpoint is nausea, particularly at higher doses, like encapsulated versions of it.
Chinese skullcap can be helpful as well.
Those are the main ones that I rely on.
Cistus incanus, which is a rock-rose. That is a fun one that less folks are familiar with. It’s very broadly antimicrobial. If someone is dealing with viruses, yeast, tick-borne infections, a little bit of everything, you can make that as a tea. It’s a traditional Mediterranean herb that was used to keep people’s teeth clean. It has this wonderful floral flavor to it. That’s another one that is often used as a preventative. Dr. Kunkle, when he lived in Maine, would drink that as a tea every day to prevent infection. Those are just a handful of them.
Dr. Eric:
Just curious: Do you have any experience using homeopathy?
Dr. Brian:
I was trained in naturopathic medical school with some bioclassical homeopaths. I am using it a lot less in my own practice. It’s one of those tools that I really wish that I knew more about how to use expertly, particularly constitutional or classical homeopathy. It requires quite a bit of effort to get proficient at.
I have had some folks report that DesBio was helpful, which I think is homeopathic in nature, as well as some of the nosodes, which are diluted forms of microbes themselves. I have a little more experience with low dose immunotherapy, which is in my opinion a cross between vaccines and homeopathy, but that’s the extent of it.
Dr. Eric:
You mentioned DesBio. I actually took some of their products when I was dealing with chronic Lyme and bartonella.
Dr. Brian:
The best thing I have heard is their viral protocol is apparently pretty good.
Dr. Eric:
For EBV and cytomegalovirus, and parvovirus and herpes simplex, yes, they have a whole line against all these different viruses and vector-borne infections.
Before we wrap it up, is there anything else that I should have asked you that I didn’t ask you? Anything else you want to wrap up with?
Dr. Brian:
I think what I would say is a lot of folks are asking the question about what is long-haul COVID? What is going on with that? We could do a whole talk on that. We won’t. What I often find is folks have undiagnosed and untreated vector-borne infections and/or environmental toxicities. That is what is causing the bucket or cup to be close to full before they got COVID-19. I’ve had a number of folks post-COVID-19 vaccination experience symptoms of long-haul COVID. Of course, there are approaches that are more specifically targeting the spike protein and issues with that. More often than not, I’m seeing untreated other infections.
If you’re struggling with long-haul COVID, and are working with an integrative practitioner, don’t hesitate to bring the question of whether vector-borne infections could be influencing what your immune landscape is doing and why it is responding so significantly to COVID or the spike protein.
Dr. Eric:
You shared a lot of valuable information. Where can people find out more about you, Dr. Brian?
Dr. Brian:
If you go to our clinic’s website, AmenClinics.com, you can find me. You can also just Google me, Brian Plante, MD. I am not super active on social media. I do have pages, but I’m not super active.
If you’d like to get some support, I do some health coaching out of state. I am currently only licensed to work deeply with patients in California. If folks have outside providers they are working with, I will often act as a consultant, which tends to work well if they are able to manage prescriptions. I’d be happy to support you.
I’m going to put more content like this out there. Stay tuned if you are interested in learning more about these topics.
Dr. Eric:
Wonderful.