THE BEST PROTOCOL FOR CHRONIC LYME 
& BARTONELLA IN MINNESOTA

 (With complete neurological rehabilitation) 

CHIROPRACTIC NEUROLOGY  |  FUNCTIONAL MEDICINE

"Many times patients come to see us thinking they have Chronic Lyme. With testing, oftentimes we learn they don't have Lyme, but instead, have Bartonellosis. If you have a cat (or dog) and you have symptoms that are very similar to Chronic Lyme you really need to look at Bartonella!"
 
- Dr. Kyle Warren, DC, CFMP

How does your Lyme Protocol change with the type of co-infection!
Take Bartonella for example...

Early signs of Bartonellosis include fever, fatigue, headache, poor appetite, and an unusual streaked rash 
that resembles “stretch marks.” Swollen glands are typical, especially around the head, neck and arms. 
Depression, anxiety and OCD are very common symptoms associated with long-term Bartonella.

The problem with Bartonella is that it's not only being transmitted by ticks; it's transmitted by flies, lice, fleas, mosquitos and even spiders. We are exposed to many different insects all the time, so, understandably, Bartonella is much more widespread throughout the world than Lyme.

Bartonella is great at hiding within our system. It can hide undetected in the body for years after the initial transmission & before someone becomes ill.

Scroll down to watch our videos for more info!

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**This page is for anyone who believes they could have Bartonella, wants to get tested, and take additional steps from there. Learn about the limitations with conventional Testing, the best tests, and an effective protocol for Bartonellosis.**

Could my "Chronic Lyme" be Bartonellosis?

Bartonella (Cat Scratch Fever): 
Mysterious and More Common Than You Think

"If you have a cat (or dog) and you have symptoms that are very similar to Chronic Lyme you really need to look at Bartonella." 
- Dr. Kyle Warren, DC, CFMP

Bartonella: Transmission and Testing
Question # 1

Why is it so hard to identify Bartonella in our system?

In the above video, Dr. Kyle explains the best approach for detecting Bartonella in our system.

"Now unfortunately, testing is not great for Bartonella. This is the one co-infection I always test a minimum of two times. So I will test you once and then, if you're still, when we're doing re-tests maybe a couple of months later, we're going to check Bartonella again even if you were negative because we do have some problems with it being very, very hard for your immune system to identify. One reason why it's really hard for your immune system to grab onto it is it is an “intracellular bacteria,” so it actually loves blood cells, and loves endothelial cells, and including immune cells in your blood, not just red blood cells. It then goes inside your cell, so because it's inside your cell it's a little harder for your immune system to identify. And then secondly, it actually takes over part of your cell which creates a vacuole. Now, this is a normal process your cells do, if we’re going back to 10th grade biology, you can actually create a little “compartment” where you can store stuff, maybe that'll harm your cell. Well Bartonella uses this in its favor to create its own little home inside your cell. And this is one reason why it's pretty hard for your immune system to get at, because it hides. It's a double membrane-bacteria that then hides inside your cell and then it hides inside a vacuole, so it's got four layers of protection to help it survive inside your system.
There are people who actually believe Bartonella may be an even bigger problem than Lyme, it just doesn't get, you know, as much press and as much funding! "

How is testing for Bartonella different between seeing a medical doctor and Functional Medicine?


Q: In terms of Testing; if I went to my medical doctor versus coming to a functional medicine practitioner such as yourself, will there be difference in how this is tested? 
"Your primary doctor will run Bartonella Henselae. We do that test, but also we have access to some more advanced testing, and you can run, like, if I run a big co-infection panel, we run nine bartonella markers as part of it as opposed to just, you know, just one. So, and then you can get even more specialized from that, but like our big co-infection panel does somewhere between three and nine, you know, ways to look at it, if I can put it that way.
Simple serological test doesn’t always work to detect Bartonella.
If you test positive with the simple serology test, you know you have Bartonella.
If you test negative, but show symptoms of Bartonella, the more extensive Bartonella panels may be recommended."

When are the more expensive advanced panels recommended in testing for Bartonella?

Dr. Kyle explains how he decides which of his patients need the more specific and therefore, more expensive, 
Bartonella panels.

"There are two labs which now are pushing some Bartonella. One is called Galaxy Diagnostics. They were started as a Bartonella lab. Now, they have some of the other tick-borne stuff now, but they're agenda’s really trying to help people be aware that Bartonella may be an even bigger problem than Lyme disease, at least a possibility. And then also Igenex, who anyone in the Lyme disease world is usually familiar with Igenex as a lab. They also have some, you know, specialized Bartonella testing to try and better visualize this problem. The problem with both these labs is they're very expensive. And so what we often do is we run, like I said, we run two tests which can be run very well, and if we're still suspicious, sometimes I have a talk with patients about, you know, maybe spending the money to run one of those, kind of, more specialty Bartonella panels."  
How much does it cost?
"Depending on which version of things you run, it's often about a thousand dollars, and that's just A LOT to answer the one question of, do you have bartonella or not, right? It doesn't answer any other question, it doesn't look at other tick-borne things, doesn't look at inflammation, doesn't look, it just is to answer the question of, do I have Bartonella or do I not? And, so that's a decent amount of change to answer you know, a very narrow, you know, very narrow question."  
If a patient is hesitant to spend the money on the Bartonella panels (roughly $1000) Dr. Kyle has an ingenious way to determine if Bartonella is really causing the issues for his patients…Dr. Kyle explains…
"Because we know that there's a little bit of a Bartonella blind spot possibility, you can also do some things to be, you know, clinically relevant. Like for example, Bartonella really attacks endothelial cells, so we get into blood flow. This is why it's documented, I think it's the third leading cause of seronegative endocarditis, which is a heart infection, and it really causes a lot of blood flow issues. Well because of this, the nutrient arginine or L-arginine or also L-citrulline, people with Bartonella tend to feel better with this. And I remember going through this, we were doing some different blood, this is just blood flow, nutrition, pretty basic stuff if you look up those things, there's research with heart and with workout for these nutrients. And I remember just doing this randomly with people, and some of my chronic people felt really good with this. And I actually back-ended to realize when I was doing some reading, that bartonella patients typically respond very well to that because it actually kind of addresses some of the imbalances Bartonella causes. So part of what I'll do when I'm suspicious is, I’ll have somebody try something that improves nitric oxide, which is what arginine and citrulline do, and if they respond very positively to nitric oxide based supplementation, then I become more suspicious that Bartonella may be a big player."
Question # 2

What is The Best Approach 
to Recover From Acute and 
Chronic Bartonella Infection?

Understanding the role of antibiotics (meds) 
in a Bartonella infection.

"We get into this with Lyme disease also, is that, you know, theoretically think, people think, well I have a, I have a bacteria, I should take an antibiotic and I'll be all better. There is some truth to this. We think antibiotics are part of many people's regiments. Now you can also use, you know, herbals or other things that have antimicrobial activity, but we do run into this problem really head-on with Bartonella that I think is also the main problem with Lyme disease, which is, once you have a chronic infection, they are really not enough to, you know, get you over the hump. You know, if we look at Lyme disease as a model. If you catch Lyme disease in the first three months, just take antibiotic. 93% success rate if you want to be a negative on the research, 99% success rate if you're probably looking at more accurate data. So if we get an acute case in the first three months, we're just going to the antibiotics, no questions asked. 
You can do probiotics afterwards or some other gut healing stuff afterwards, but antibiotics are extremely successful if you can catch this in the acute phase. Now unfortunately, if we get into chronic, we get into I've had this. People go, what's chronic? 3-6 months is where you're starting to get into chronic. Past 3 months some people will say now it's chronic. Past 6 months... pretty much going to have everybody saying now we're chronic. So that's kind of your phase. So once you're in that mode, the success rates for antibiotics really go way down. And I learned this somewhat the hard way, actually the first thing that I ever did when we had this was, you know, 8 years ago we were basically doing, you know, antimicrobial herbs. And when I looked at my own stats, about 2 out of 10 times it went really well, including my very first patient who had Bartonella. We were doing some oregano oil for them and they did marvelous and they sang my praises to the roof and they sent me six more people with Lyme disease and I did the same thing and they all got terribly worse. And this was my experience of, when you have chronic patients, if you hit them with anti-microbials, whether it's herbs or other meds, you get a lot of negative reactions mixed with that. If you look at Dr. Horowitz who's a famous Lyme Disease lecturer and Bartonella lecturer, you know, he kind of jokes he's got a, he's got a book, you know, it's like 400 pages. And he goes through the antibiotic regimens for what he uses on, like, pages 50 to 80. And he goes, the book doesn't end at page 80. There's like 320 more pages of, kind of, the, you know, the complications for this. And that's what we would tell people with, you know, with both Bartonella and Lyme, is if you are dealing with this chronically, you may or may not have antibiotics as part of your protocol but they're not the only thing if you're doing that." 

Taking antibiotics after 3-6 months, are they effective at all? 

"Well that's a good question. So I can tell you what, what we, kind of, see in our clinic. So in our clinic what I'll often do for, for tick-borne diseases is we start with some detox support and some immune support. Remember there's a lot of people who just get this and get better, so we tell people the primary problem with both these diseases is immune failure. There are some people who think that about 25% of all mammals have Bartonella, including humans. That would mean there's about 80 million Americans who have Bartonella, now most of these are asymptomatic. And really, when I look at symptomatic, there's somewhere between maybe a million, maybe two million people infected with Bartonella. If there's really this big reservoir, a quarter of the population has it and only 1-2% of people are actually sick with it, the problem really is your immune system is unable to handle the problem that it should be able to handle."

Similar to Lyme disease, if symptoms are showing up due to a Bartonella infection, the immune system becomes a critical focus. 

"Now, we do antimicrobial herbs at the clinic, and I usually do them for 6-8 weeks and then I rotate. I can usually clear Lyme disease about 30% of the time after one rotation, so in about, you know, 3 months total. And by the time we hit about 7 months, which is about 3 rotations, I've got about 80% success rate in that part of the protocol. And once again, I want to tell people it's not like in chronic Lyme, you just eliminate the bug and it all magically goes away. There's, kind of, a rehabbing the body process, helping the inflammation system work, helping the liver work again. And if you just look at, you know, Dr. Horowitz or Dr. Hammond or Dr. Shoemaker, they kind of emphasize this point in eliminating the bug. Whether they're using herbals, whether they’re using antibiotics is part of the program and maybe an important part, but we honestly feel like it's a part that gets over-emphasized and the rest of the protocol to bring it together gets under-emphasized. People have a lot of hope that if they just took the right antibiotic it would all magically go away. And I'm really here to tell you that I'm sorry but that's not the way it's going to work if you missed that acute window." 

...transcription continued

Some people, at least on the internet, research this stuff. Some people suggest long-term antibiotic treatment, and so what I'm wondering in my mind is, is that even valuable? And then secondly, with what you do in functional medicine, can that work together? 

"So some people are not going to get better without antibiotics, and they really need that as part of their, you know, protocol and regimen. But I also am very hesitant because I see a lot of people who have, first you fight through the regular medical system and you go, I'm sick. And they go, we can't find anything. You finally find someone who's more literate in Lyme or Bartonella, and you go, oh my gosh, you have Bartonella, you have Lyme disease, you have, oh my gosh we found it. Okay then, here's 3 different antibiotics, high-dose, and you're going to take these for 3 years. And then I see them 3 years later and, once again, what I find is the antibiotic portion has been hit really hard for 3 years and the rest of the protocol, the detox, the immune support, has really been given a very fluffy, nonspecific approach. And I, kind of, challenge a lot of Lyme, of my Lyme colleagues and go, if you paid as much attention to your detox protocol and your immune support protocol as you did to your antibiotic protocol, I think you'd be much more successful with some of these tough patients. You know, the 12th round of antibiotics isn't going to be, you know, what magically cures them."

Definitely, that makes a lot of sense. Not to mention the side effects of antibiotics and the additional damage that they're doing.  

"Well, and this is one reason why I said we use antibiotics, I have some good partnerships, we work with some medical doctors, and some of our colleagues to help get people what they need, but antibiotics, especially for that long term, are a little bit of a double-edged sword, and let's not pretend they don't cause any problems. So if we can get it without long-term antibiotics we really prefer to, but we do, you know, partner to use them in cases where we think it's worth it." 

I like your approach Dr. Kyle, because your approach is all about healing the body from within. The question I have for you is, how long does that typically take? 

"Well that's a good question I get, how long. So we, generally as a rule, tell most tick-borne people it takes 12-18 months to get you all the way better. Now my record’s 5 months, 5, 5-1/2. I don't like to count on you being the record or breaking the record, but I tell people, so usually when we just look at stats, you know, 30% of people are through what I call kill phase in about 3 months, and about 80% are through in about 7 months. So then after that there's some you know liver help, some immune help, some other things to help walk out, but at the end of this disease, people feel good, they function well. Usually they're a little paranoid about going out in the woods, they don't want to get bit again, and so I have to calm them down and tell them they have to keep living their life. But, you know, usually you can make a very, very complete recovery. You can have brain function, you don't have to have pain all the time, you know, you can have energy again, you can really be, you know, healthy and functional and well, you know, after these, after these things, if not maybe a little more aware of ticks and your own body then you were before."

That’s great. One of the things that, testimonials from your patients that's, that jumps at me is that they say that you keep them feeling good even as they're going through this. Can you talk a little bit about that? Because the word detox scares most Lyme patients…

"It does. This is actually a big thing in our office. So when I tell people it's going to take 12-18 months, they go, oh gosh. And I say, but if we balance the parts correctly, you really should feel better, you know, during the process. I had a patient who just finished, and he said, well it took 15 months, but it was the best year I had in about 4 or 5 years. And I really strongly disagree with doctors who really push patients very hard through detox, or what are what are known as Herx reactions."

"To me, a really, really strong Herx reaction is a signal that you're doing something wrong, you're doing the wrong order, doing the wrong dose, you're not balancing the protocol correctly. So if you'd balance, you know, the detox portion, the immune support portion with, you know, some of those killers in the right way, you can actually feel decent and better and improved while you go through moving forward, as opposed to, sometimes I feel like doctors go, you feel bad now wait till I hit you with this detox reaction you'll be lying on your couch an invalid. And I go, goodness, we really don't think that's the way to do it, especially with Bartonella and Lyme causing so many neurological complaints. So that was really the kicker that made us want to stop doing that was, if you're getting a lot of neurological complaints when you detox, that means you're getting nerve damage. Nerves are very slow to heal and so I'm always wary of causing more nerve damage because it can take such a long time for you to recover from that. If there's any way possible to avoid that while you heal, then we want to make sure we protect you while we're getting you better." 

That’s great!

"My big thing for all Lyme disease patients is just have hope. There are some really smart people working on this, there's some great people who, this is kind of their mission in life is to make this more aware and know that there are solutions. Just know that there are people out there, there's other people who have gotten better, so you can do it. I've seen it now. And we were looking at our stats, and since I've been doing this, 7 or 8 years, I think we're up, like 250 to 300 different, you know, Lyme and tick-borne patients that we've seen, so, you know, I've seen it time and time again. And if you're sick and without hope please, please know that there is hope for you. You can be healthy and you can, you know, 
go live your life."

Frequently Asked Questions
Q: Could my Chronic Lyme be Bartonella?
A: Yes, it can be. This is why in our clinic we always test for Bartonella in addition to Chronic Lyme when you come in. If the simple Serology test comes back positive you know for sure you have Bartonella. But, sometimes, that test may come back negative. I have different approaches in this instance and in rare cases I might suggest the more expensive panels to determine for sure.

Q: Which other tick-borne illnesses are possible in Minnesota?
A: The most common co-infections are Babesia, Bartonella, Mycoplasma, and Anaplasmosis. Anaplasmosis is #1 most common co-infection in Minnesota. Here is something everyone should know. it could be possible you don't have Lyme, but you have one of these other tickborne infections such as Anaplasmosis. We see this many times in our office. Also, may doctor's offices will check for Lyme and if that comes back negative, not test for any of the co-infections. We think this is the wrong approach. A better approach is to test for Lyme with two to three of the most common Minnesota co-infections depending on your clinical symptoms. At our office we can run tests for Lyme plus top co-infections for under $500. Co-infections such as Anaplasmosis can be tested alone for under $100.

Q: What is Anaplasmosis?
A: Anaplasmosis is a bacteria just like Lyme disease bacteria (Borrelia), but it infects a person’s white blood cells. We talk to most doctors about this and it’s very mysterious to them because it causes low white blood cell counts and a slight elevation in liver enzymes. Showing a low white blood cell count can quickly confuse doctors if they aren’t already thinking about Anaplasmosis because 98% of all infections cause HIGH white blood cells. 

Q: I don't have Lyme. Could I have other tick-borne illnesses?
A: It is possible to have tick-borne illness that is NOT Lyme disease.  We often run a co-infection panel, or at a minimum, run a Babesia and Anaplasma tests in patients with chronic illness in Minnesota.

Q: Is there any additional testing for tick-borne illnesses? What is the cost? Will my insurance cover this?
A: The price for testing has come down significantly in recent years. We will either run Anaplasma and Babesia for about $225 or a larger co-infection panel for roughly $500. This testing 5 years ago was double to quadruple those costs! Insurance coverage truly varies. Because of its commonality in Minnesota I am hopeful that more insurance will routinely cover this testing in the future.

Q: My symptoms are different from other patients I know who have Chronic Lyme; why is that?
A: The top symptoms of chronic Lyme are fatigue, joint/muscle pain, and neurological complications (such as brain fog, vertigo, neuropathy, or depression). However only 75% of Lyme patients have fatigue, and only 50% have pain, and about 60% have neurological involvement. These relatively low percentages can mean Lyme patients can look very different from one another. Also, which co-infections you are dealing with can change the clinical symptoms as well. For example, Babesia with Lyme may clinically show up differently than Anaplasmosis with Lyme.

Q: Handling Lyme seems complicated; why is that?
A: The topic of co-infections can complicate things. Doctors have said that “the tick is nature’s dirty needle.” These ticks live and eat mice blood and deer blood, so when you are bitten by a tick, often times it’s not like you get just one present...you may have gotten a whole cocktail of bugs and there are many different tick borne illnesses to consider. The other complication with handling Lyme and Chronic Lyme is the difference in opinions for published criteria between the CDC and IDSA (Infectious Diseases Society of America) on how to test for it. The best advice I can give you is to work with a Lyme Literate doctor, to always get a second opinion and to know that if you are not feeling better in 3-6 months you need to do something different or work with a different MD.
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This is what clients have said about the Restorative Health Solutions Team
See our testimonials...
             Having been seeing Dr. Kyle since March, he has given me a life back after being diagnosed with Lymes in 2015. He's compassionate, a true wealth of knowledge and takes a multiple step process when working with his patients. I cannot say how much he has changed my life for the better!"

-Lori Paul
             Impressive, Smart, Top Notch. I have nothing but good things to say about my experience at RHS. From my initial appt to my follow up. Dr. Kyle and Dr. Paul were great to work with and both encouraged me to better health through testing, exercises and education. Also their support staff Katie and Randi are wonderful as well. Prompt, courteous, and always available for questions! I highly recommend RHS! Cheers to better health."

-Tara Schwagmeyer
             I have been seeing Dr Warren for a few years and he has improved my health and my life greatly. I have many health issues and had been diagnosed with chronic fatigue 8 years ago, after I had to leave my career. I tried almost every traditional medical specialist and even a few naturalpathic specialist without any continued improvement in health. Most told there was nothing wrong with me. Dr. Warren has taken the time and done a vast amount of research to help me with autoimmune, thyroid, chemical sensitivities, and even my gallbladder. He truly cares, takes the time to hear you and your health challenges, and is always willing to try additional routes. I am back working and able to have a fulfilled life again! I am so thankful to have the best doctor!" 

-Erin Harty
             I arrived at Restorative Health Solutions feeling extremely fatigued, had brain fog and not a high quality of life. I was just getting through the day. After being treated I now have energy and a sense of well-being. I feel like I am now being proactive on having a healthy life. I am grateful for having found Restorative Health Solutions." 

-T Lancello
             I have been seeing Dr. Kyle and Dr. Paul for about 10 months now for Lyme disease. Prior to this, I was searching high and low for answers and getting no where. I was feeling fatigued, brain fog, stomach issues, anxiety, light sensitivity, dizziness... just a multitude of symptoms that I couldn't piece together.
The team at Rhs has been instrumental in me reaching my goals. Lyme disease has been extremely challenging and Rhs has been there every step of the way.
Lyme disease doesn't go away on it's own and it is a marathon, but Restorative Health Solutions has a process that works, follow it, be open and communicate. This is a two way street, they can't read your mind, so come in with the mentality of a partnership.
I would recommend anyone go and see them if you need to find answers on your Lyme disease journey." 

-Aaron Lindholm

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