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Losing your mind or are you sick?

“I Think I’m Losing My Mind”: When Treating Tick-Borne Illness Feels Worse Before It Gets Better

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She’s 23. Bright, motivated, kind and always eager to smile. She came to our office after years of searching for answers to her fatigue, body aches, temperature swings, and lightheadedness that started without warning.

Testing eventually revealed she was dealing with Babesia, one of the lesser-known but highly impactful tick-borne co-infections. We started a targeted treatment plan that included antimicrobials, detox support, acupuncture and mitochondrial nutrients. In the first few weeks, she felt hopeful, after having an occipital nerve block done, her headaches were less frequent, she had less body pain and her energy had started to return.

But then something changed.

When she was weeks into her protocol, her mom called the office one Monday morning, worried. Her daughter had become withdrawn, anxious and couldn’t sleep.. She said she felt “like I’m going crazy”. Her heart raced at night. She had dark, intrusive thoughts that made no sense to her. And worst of all, she had stopped her medication without checking in because she felt like she just couldn’t swallow anymore pills—afraid that the treatment was making her worse.

It’s a story I hear often.

What Was Happening?

The medications to kill the parasitic Babesia caused an overall inflammatory response of the brain.

She wasn’t losing her mind. The process of die-off reaction can trigger a wave of inflammation and neurotoxicity—especially in sensitive patients or when infections like Babesia are involved.

Babesia in particular is a red blood cell parasite that releases pro-inflammatory molecules, affects oxygen delivery, and can trigger severe mood and neurologic symptoms. Inflammatory cytokines can cross the blood-brain barrier, activating microglia (the brain’s immune cells) and producing symptoms like:

  • Panic and paranoia
  • Intrusive or obsessive thoughts
  • Nightmares and air hunger
  • Brain fog, rage, or emotional volatility

These are not just mental health concerns—they’re signs of neuroinflammation. And they are treatable—with the right tools and support.

What Helped Her?

Luckily, her family saw changes and brought her back in. She cried when we explained what was happening—but this time, with relief. She wasn’t broken. Her brain was inflamed, and her nervous system was overwhelmed by the die-off. We sat down together and made a plan:

  • Paused medications for a few days to let the inflammation calm down
  • Restarted treatment at a lower dose, with pulsing to avoid overload
  • Burbur and pinella drops in water to help detox
  • Continuing her glutathione and binders to support detox
  • Doing an IV with glutathione in the clinic to help detox her body faster
  • Encouraged her to take her magnesium, L-theanine, and omega-3s to support her brain
  • Encouraged gentle movement, hydration with electrolyte drinks, acupuncture, salt baths and infrared sauna

But most importantly—we agreed that she would not stop treatment without calling us first. Because when you’re navigating a complex illness, especially one that hides in the nervous system, staying connected to your care team is as important as any prescription.

The Takeaway

Communication is the key to successful treatment…. Don’t assume it means you’re regressing—or broken. It may be a signal that your body is fighting hard—and just needs help navigating the process. Pause. Reach out. Let’s reassess and adjust the plan.

Tick-borne illnesses can affect every part of us—the body, the brain, the mood, and the spirit. But with the right support, healing is possible. And more often than not, you are far stronger and more resilient than you realize.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

The_Health_Fix-podcast

LISTEN NOW: Dr. Gary Kaplan on infections and chronic illness

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Dr. Gary Kaplan was recently interviewed on The Health Fix podcast, hosted by Dr. Jannine Krause, aka “Dr. J”.

Episode #397: How chronic illnesses provoke the body to attack you vs. the bug

The effects of bacteria, viruses, parasites, molds, and other infections can linger in the body long after the infection. These molecules of invaders can trigger your body to attack itself. This is a common phenomenon that has been going on for a long time but has been gaining publicity with long-haul symptoms since the pandemic. Turns out viruses aren’t the only bugs causing long-haul syndromes. In this episode of The Health Fix, Dr. J interviews Dr. Kaplan on how to identify if your chronic symptoms are related to lingering effects of previous infections.

You can access the podcast via any podcast streaming website/app (Apple Podcast link below).

What You’ll Learn:

  • Why chronic fatigue is a sign of brain inflammation
  • 20-50% of people do not make enzymes to neutralize mold toxins
  • How pieces of the bugs that you get infections from cause inflammation in your body
  • Why mold, Lyme, strep, viral infections, and parasites could be keeping you sick
  • How mental health issues can be related to chronic infections, especially in kids
  • Tests commonly used to sleuth out chronic infections
  • The connection between sleep apnea and chronic illness
  • How to test yourself for the autoimmune condition POTS by taking your blood pressure

There are over 20 million Americans suffering from a group of chronic disabling disorders who are diagnosed without a clear elucidation of pathophysiologic mechanisms. Fibromyalgia, Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome (ME/CFS), Neuropsychiatric illnesses, Posttreatment Lyme Syndrome, Pediatric Acute on Neuropsychiatric Syndrome (PANDAS/PANS).

Adding to this massive disease burden the CDC now estimates that of the 40% of Americans who were infected with COVID-19 1 in 5 continue to suffer with what is now referred to as Post-acute sequelae of COVID (PASC). Research has demonstrated that common to all of these conditions is dysregulation of the immune system resulting from an infectious insult. Dramatic advances have occurred in our understanding of all of these conditions as a result of COVID. We are entering an incredibly exciting period in medicine where these diseases are beginning to coalesce around an understanding of shared pathophysiology. We are entering a period of true hope for those millions who are suffering where we will finally be able to provide comprehensive solutions for their illness.

This conference will bring together some of the leading researchers and clinicians from around the world to discuss the advances in our understanding of these conditions and breakthroughs in diagnostic and treatment options.

For more info and to register, visit https://medstar.cloud-cme.com/course/courseoverview?P=0&EID=20362

 

Managing Fibromyalgia Pain with an Integrative Approach

Managing Fibromyalgia Pain

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Characterized by widespread pain, fatigue, and cognitive difficulties, fibromyalgia (FM) is a complex disorder of the central nervous system (CNS). It affects the brain’s messaging system causing those who have it to experience heightened sensitivity to pain. A fibromyalgia flare-up can last for months at a time and cause debilitating physical and emotional distress. Symptoms can vary from person to person and often suggest other conditions, making it a very difficult diagnosis. Despite all that has been learned about fibromyalgia over the last two decades, people with FM can go years without a proper diagnosis.

Fibromyalgia is associated with many other conditions like Chronic Fatigue Syndrome (also known as Myalgic Encephalomyelitis), sleep dysfunction, infections like Lyme disease or E-BV (Epstein-Barr Virus), digestive problems such as SIBO (Small Intestinal Bacterial Overgrowth), or Celiac Disease and other food allergies that can cause leaky gut. It can lead to autoimmune disorders like Hashimoto’s thyroiditis or autoimmune arthropathies. People suffering from FM may also exhibit reactions to environmental toxin exposure, like mold or heavy metals, which can be diagnosed through specialty labs looking at stool, urine, breath, and bloodwork.

A functional approach to treatment

Once you receive a fibromyalgia diagnosis, there are various treatment options and lifestyle habits to consider. As a functional medicine practitioner, my approach to treating fibromyalgia is multifaceted; I look at digestion and diet, sleep, hormone imbalances, injuries (psychological and physical), infections, environmental exposures, genetics, and more.

For example, I often find that fibromyalgia is related to a deficiency in delta-wave deep sleep; medications like Xywav, which promotes deep-wave sleep have been helpful in reducing chronic pain. If you don’t get enough deep delta wave sleep your body can’t recover, and chronic pain can be an issue. (We find that this is common in those with fibromyalgia.)

A common area of pain is the cervical spine. Treatments like physical therapy, acupuncture, or injection therapies like prolotherapy, perineural injection therapy (PIT), or PRP (platelet-rich plasma) therapy may be helpful. You may also consider having your jaw evaluated for TMJ by a dentist specializing in temporomandibular joint problems, which can often cause referred pain in the head, neck, and shoulders.

Another treatment to consider is Low-Dose Naltrexone (LDN). When chronic pain is a result of neuro-inflammation (brain inflammation), LDN can help by reducing the upregulation of the microglia that cause this inflammation.

If you have leaky gut from a food allergy, then inflammation of the intestinal tract leads to nutritional deficiencies and toxicity; I’ll want to look at dietary changes and supplementation. Supplements that may be helpful include D- ribose, fish oil, glutathione, and IV magnesium with B complex and Vitamin C (also known as Myers cocktail).

Because FM affects the CNS, it can influence your experience of pain and emotional sensations; therefore it’s very important to consider my patients’ emotional health which is often not addressed in chronic pain. There are many stress-reduction therapies that can be done from the comfort of your own home including yoga, mindfulness-based meditation, breathing exercises, and even a therapy called Emotional Freedom Technique which involves tapping acupressure points and utilizing positive affirmations. However, if you feel overwhelmed by symptoms, look for a psychotherapist who specializes in working with people with chronic pain. Dealing with chronic pain is emotionally exhausting; seeking help can be a vital lifeline for many.

As with other chronic illnesses, treating fibromyalgia is not a straightforward process; it requires a multifaceted treatment approach with close collaboration to help you recover or better manage your illness.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

Additional Resources:

Consumer Guide: 18 Things You Should Know Before Choosing a Doctor to Treat Your Fibromyalgia

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Dr. Kaplan to Co-chair Chronic Illness Symposium

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Dr. Gary, Kaplan and Craig Shimasaki are co-chairing the upcoming 3-day symposium, New Developments in Understanding Chronic Illnesses Conference: The Role of Immune Dysfunction and Infections

Date & Location

Wednesday, November 8, 2023, 10:00 AM – Friday, November 10, 2023, 3:00 PM
Marriott Marquis, Washington, DC

Overview

There are over 20 million Americans suffering from a group of chronic disabling disorders analogous to the confused interplay of language described in the biblical Tower of Babel, who are diagnosed without a clear elucidation of pathophysiologic mechanisms. Fibromyalgia, Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome (ME/CFS), Neuropsychiatric illnesses, Post-treatment Lyme Syndrome, Pediatric Acute on Neuropsychiatric Syndrome (PANDAS/PANS).

Adding to this massive disease burden the CDC now estimates that of the 40% of Americans who were infected with COVID-19 1 in 5 continue to suffer with what is now referred to as Post-acute sequalae of COVID (PACAL). Research has demonstrated that common to all of these conditions is dysregulation of the immune system resulting from an infectious insult. Dramatic advances have occurred in our understanding of all of these conditions as a result of COVID. We are entering an incredibly exciting period in medicine where our current Tower of Babel of diseases is beginning to coalesce around an understanding of shared pathophysiology. We are entering a period of true hope for those millions who are suffering where we will finally be able to provide comprehensive solutions for their illness.

This conference will bring together some of the leading researches and clinicians from around the world to discuss the advances in our understanding of these conditions and breakthroughs in diagnostic and treatment options.

Target Audience

Specialties – Allergy/Immunology, Family Medicine, Infectious Disease, Internal Medicine, Neurology, Pain Medicine, Pediatrics, Psychiatry, Psychology , Rheumatology
Professions – Dietetic Technician Registered, Non-Physician, Nurse, Nurse Practitioner, Nutritionist, Physician

Registration is now open. For more information or to register, visit: www.chronicillnessconference.com

lyme disease

Lyme Disease – Four Reasons It May Go Undetected

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If left undiagnosed and untreated, Lyme disease and other tickborne illnesses can have detrimental long-term effects on the body.

Lyme disease is the most reported vector-borne illness (diseases transmitted through mosquitoes, tick, and flea bites) in the United States. The latest numbers from the CDC estimate that approximately 476,000 patients are diagnosed and treated for Lyme each year.* People who are diagnosed early and receive proper treatment consisting of 28-30 day antibiotic therapy usually recover rapidly and completely. However, others who are correctly diagnosed and treated sometimes fail to fully recover, and, for a variety of reasons, still others go undiagnosed and untreated.

This article explores 4 reasons why Lyme disease may go undetected and/or become a chronic illness.

1) It is not always possible to confirm a tick bite

bullseye rash on arm from tick bite is a sign of Lyme disease

A key component of early diagnosis is recognition of the characteristic “bulls-eye” rash. Courtesy of the CDC/PHIL.

The only way you can contract Lyme disease is through the bite of an infected tick.  If you develop the telltale bull’s eye rash (medically referred to as erythema migrans), there is no disputing the fact that you have Lyme disease, but not all patients have a rash and sometimes the rash does not have a bull’s eye appearance.

Ticks vary from the size of a poppy seed to a sesame seed, which makes them hard to see; and they prefer latching onto hard-to-see areas of the body such as armpits, groin, or scalp, so it’s likely you won’t notice their presence. This means, more often than not, you won’t know if you’ve been bitten, and by the time you start feeling sick – the incubation period for Lyme ranges from a few days to a few weeks – the tick will be long gone.

2) Lyme disease symptoms are very similar to other non-tickborne chronic illnesses.

Another factor that can make it difficult to obtain an accurate diagnosis is the similarity of symptoms that present with Lyme and other tickborne diseases (fever, chills, fatigue, headache, and joint aches) with those of many other non-tickborne illnesses, such as flu and other viral or bacterial infections.

If left undiagnosed and untreated, there can be detrimental effects on the body’s musculoskeletal and nervous systems. Symptoms such as chronic joint pain & headaches, extreme fatigue, and mood disorders can subsequently be misdiagnosed as fibromyalgia, chronic fatigue syndrome, or depression. This similarity of symptoms can cause delays in getting tested, and in turn causing delays in treatment.

There is also evidence indicating that chronic cases of Lyme disease (when symptoms persist after taking the typical short-term dose of antibiotics – also called Post Treatment Lyme Disease) contribute to a sustained inflammatory condition throughout the body that interferes with the healthy functioning of the nervous system. Known as Central Sensitization Syndrome, CSS has been implicated in several chronic illnesses and pain conditions, including fibromyalgia, chronic fatigue syndrome, depression, and Lyme disease.

Questions? Give Us a Call!

703-532-4892 x2

3) The patient may also be co-infected with another tickborne disease.

Ticks can carry multiple bacteria and parasites, including Babesiosis, Ehrlichiosis, Anaplasmosis, Bartonella, and Rocky Mountain Spotted Fever (also called Spotted Fever Rickettsiosis), and it’s not uncommon to see patients with multiple tickborne infections, but you won’t find them if you don’t look.  In fact, some studies suggest that as much as 30 percent of ticks that carry Lyme also carry another infectious agent that produces similar symptoms to those of Lyme disease, but requires completely different antibiotics and lengths of treatment.  Because of this, it is extremely important for physicians to test for all forms of tickborne diseases and not just for Lyme.

4) Laboratory tests, while important, have room for improvement

Unless you’re among the small percentage of people who present the classic bulls-eye rash, a confirmed diagnosis is a little trickier. Blood tests, can get you another step closer to a diagnosis – and more importantly – a treatment. But before deciding to run diagnostic testing, a doctor must consider a patient’s physical symptoms and obtain a comprehensive history that assesses their personal exposure risk. For example, if an individual is experiencing some suspicious symptoms and often hikes or horseback rides, and/or owns a pet that spends time outdoors, a Lyme test is in order.

Unfortunately, the tests aren’t perfectly reliable, especially if the order includes testing for Lyme and other tickborne diseases. Different labs have varying levels of sensitivity, and some testing can miss some cases of infection. To accurately interpret test results your physician needs to understand the sensitivity and specificity – or, in other words, the limitations — of the lab testing they are ordering.

So what’s the takeaway?

Be your own healthcare advocate. The best medicine is prevention. Before recreating outdoors, cover your body in light-colored clothing. Use an insect repellant on yourself and make sure to treat your pet. Take the time to check yourself and your pet for ticks after spending time outdoors. If you do find a tick, do not throw it away. It can be sent to a lab, such as tickreport.com, and tested for multiple tickborne diseases. Having this information will allow you to request the proper treatment faster.

If you do notice Lyme-like symptoms, a helpful first step is the Horowitz Lyme Questionnaire. Developed by Lyme expert, Dr. Richard Horowitz, this test should not replace medical advice from your physician but can be a useful tool to determine the likelihood of Lyme or other tickborne illnesses. The only way to confirm or rule out a Lyme diagnosis is with a blood test.

Every individual is unique in their genetic makeup, medical history, and environmental exposures. Each of these factors can affect how Lyme disease manifests itself in your body. If some of your symptoms persist, even after you have been treated — don’t give up! Be your own advocate; keep asking questions and seeking answers until you find the right treatment options for you.

Looking for natural ways to protect yourself?

This Washington Post article outlines several non-toxic, protective measures against tick and mosquito bites that are also less harmful to the environment: Nontoxic methods to protect yourself against mosquitos and ticks.

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*This number includes both actual infections and patients that are treated presumptively but may not actually be infected.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

This article was originally published in July 2017. It was reviewed and updated on May 2023.

PODCAST: “Stress, Sleep And Total Recovery With Dr. Gary Kaplan”

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Dr. Gary Kaplan, Director of the Kaplan Center for Integrative Medicine and author of Total Recovery, A Revolutionary New Approach to Breaking the Cycle of Pain and Depression joined Cate Stillman, founder of the YogaHealer Podcast to chat about the various impacts of stress and sleep deprivation on the brain and overall health. Topics he covered included:

  • What is Mast Cell Activation Syndrome
  • What causes brain inflammation and how it impacts our quality of life
  • Why sleep is so crucial for long-term health and tips on how to optimize your sleep
  • How Yoga treats pain
  • Why meditation is so effective for sleep and pain disorders
  • Why sleep apnea is so dangerous for your overall health
  • What really causes Lyme disease
  • What is EDS and how does it impact the body on a deeper level

Listen now –>>

 

Timestamps:

  • 4:00 – 9:00 Stress and inflammation in the brain
  • 9:00 – 17:00 Optimal sleep and sleep disorders
  • 17:00 – 24:20 Sleep Apnea
  • 25:30 – 29:30 Disease in adolescents and belief systems
  • 29:30 – 36:00 Meditation, processing emotions and gratitude
  • 36:00 – 40:30 The benefits of habits on overall health
  • 40:30 – 46:00 Lyme disease and EDS

More helpful links:

“Combating Chronic Lyme,” a Presentation by Dr. Gary Kaplan

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Dr. Kaplan delves into the very controversial topic of identifying and treating chronic Lyme disease, a tick-borne illness that lingers past standard courses of treatment.  This presentation by Dr. Gary Kaplan was recorded on Sept. 26, 2019.

Dr. Kaplan discussed the difficulties in correctly diagnosing chronic Lyme as well as new research and treatments that are currently available.

To download any of the handouts that were provided, click on the links below. You can also download a pdf copy of Dr. Kaplan’s PowerPoint presentation.

Questionnaire:
Horowitz Lyme-MSIDS Questionnaire

Research study:
“Disulfiram (Tetraethylthiuram Disulfide) in the Treatment of Lyme Disease and Babesiosis: Report of Experience in Three Cases“

Research study:
“The Use of Dapsone as a Novel “Persister” Drug in the Treatment of Chronic Lyme Disease/Post Treatment Lyme Disease Syndrome“

PowerPoint presentation:
Solving the Puzzle of PTLDS, a Presentation by Dr. Gary Kaplan, DO

To subscribe to the Kaplan Center’s YouTube channel visit http://bit.ly/1N4YqmA.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

Why You Should Get Your Shingles Vaccine

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According to the Centers for Disease Control, almost 1 out of 3 people in the United States will develop shingles during their lifetime. Shingles is a painful viral infection caused by the varicella-zoster virus, the very same virus that causes chickenpox. The reason for this is that the virus never completely leaves the body, instead, it remains inactive in nerve tissue near your spinal cord and brain and years later it may reactivate as shingles.

What do you need to know?

  1. Most cases of shingles occur in people who are over 50 and the risk continues to increase as you get older.
  2. A weakened immune system may also put you at higher risk.
  3. Shingles can cause severe pain. The most common symptom is a painful skin rash that usually appears on either side of your torso or can affect the trigeminal nerve around and over the eye. The rash and accompanying symptoms can last anywhere from 2 to 4 weeks and unfortunately for some, the pain can last for months, or even years, after the rash goes away. Postherpetic neuralgia (PHN) is the most common complication of shingles, affecting approximately 10-15% of shingles cases. Integrative treatments that can help ease the pain of PHN include acupuncture, medications, stress reduction techniques, and IV therapy.
  4. You can get shingles more than once. If you have had shingles you should not assume that you will not have it again!
  5. In 2017, the Food & Drug Administration approved a new, more effective vaccine called Shingrix. This new vaccine is reported to be more than 90% effective when taken as recommended according to the Centers for Disease Control (CDC). This is a far higher effectiveness rate than the old vaccine, Zostavax. For maximum effectiveness, the vaccine is given in two shots, 2-6 months apart.

Who should get the vaccine? 

Adults over 50 years old who:

  • have had chickenpox or can’t remember if they have had chickenpox
  • have already had shingles
  • have already been vaccinated with the Zostavax vaccine

If you meet the criteria above or have questions about the vaccine, talk to your primary care physician right away.

Getting vaccinated will significantly reduce your risk of getting shingles and the complications that it may cause.

If you have questions about the Shingrix vaccine or if you are not sure if you are a good candidate, ask them if it’s right for you. You can also visit https://www.cdc.gov/shingles/index.html for more information from the CDC.

If you currently have shingles and would like to talk to a nurse about our treatment protocol, call us today at 703-532-4892.

save your tick

CDC Report: Vector-Borne Disease Cases Rapidly Rising

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Vector-borne diseases (diseases transmitted by insects) in the United States are steadily – and in some cases, rapidly – increasing, according to this 2018 report by the Centers for Disease Control (CDC).

An analysis of data collected over the span of a decade showed that disease cases from tick, flea, and mosquito bites more than tripled nationwide between 2004 and 2016. While this increase is evidence enough of a serious public health concern, some estimate that the actual number of infections (including unreported or undiagnosed cases) far surpass the reported numbers. The CDC report also confirmed that since 2004, 9 new germs have been discovered or introduced in the United States, including Zika virus and West Nile Virus.

If you have been diagnosed with Lyme disease, you are already well aware of how detrimental its effects can be on the body. Vector-borne diseases can cause serious disability and neurological harm if left undiagnosed and untreated and can have serious effects on the body’s musculoskeletal and nervous systems. Symptoms can linger for months, and sometimes are permanent. In older populations and with young children the risks can be far more serious and can even result in death.

With the risk of infection steadily rising, taking precautions to reduce the number of bites you get is more important than ever before. Along with wearing clothing that covers exposed skin during peak hours, an effective repellent is a must. We recommend that you choose a repellent that contains one of the following: Picaridin (20%), IR3535 (20%), DEET (20-30%) or Oil of Lemon Eucalyptus (30-40%).

But for those who are more inclined to try DIY repellents or natural bug sprays due to concerns over chemical additives, most important is to know that what you’re using actually works. Finding a repellent that is both safe and effective can be difficult, so Dr. Jane Marke has analyzed some homemade remedies and natural bug sprays to see what works best.

For those who are interested in natural solutions to treat lawn and garden, Arbico Organics offers a wide array of pesticide-free products.

After spending time outdoors, always check for ticks! If you find one, watch this video to see how to remove it safely.

Talk to your provider right away if you experience symptoms such as fever, joint aches, headaches or other flu-like symptoms, as these are also common to vector-borne illnesses.

You don’t have to sacrifice enjoying the outdoors, but you do have to be diligent in protecting yourself.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2