Symptoms: common and less common Lyme Disease Misdiagnosed as Photos: Lyme Rash Bartonella Rash

1. Lyme Maybe yes, Maybe no! • Symptoms: common and less common • Lyme Disease Misdiagnosed as • Photos: • Lyme Rash • Bartonella Rash • Lyme Under the Scope • How is Lyme Transmitted? • How is Lyme Diagnosed? • Treatments Options: • Anti-biotics • Botanicals • Precious Metals • Nutrition/Gastro Intestinal • Hormonal • Dental • Heavy metals • Co-Infections • Parasites – Fungus/Yeast • Herxheimer Reactions • Hyper coagulation • Explaining the Sodium / Potassium Pump

2. Treating Lyme Disease By Steve Hines, N.D. N.E. Co-Founder with Dr. Elio Rivera, M.D. of

3. IMHO - In My Humble Option

4. Conflicts of interest Disclaimer: Steven serves on the Board of Directors for KS3 Diagnostic Laboratories, Lubbock Texas Steven is a dealer for Bemer America Steven is a dealer for BioMat Infrared Mat Steven is a principal at Hope Wellness Center Inc.

5. Symptoms: Common and Not So Common fatigue joint pains muscle pains / tight muscles headaches/migraines hormone disturbances thyroid problems multiple chemical sensitivity fasiculations-muscle twitches tinnitus-ringing in the ear low grade fever night sweats sleep pattern disturbance most all mental/nervous disorders

6. Lyme Disease Often Misdiagnosed as: Auto Immune: Fibromyalgia, Lupus, Chronic Fatigue Syndrome, Multiple Sclerosis Arthritis/Bone/Joint: Rheumatoid Arthritis, Juvenile Rheumatoid Arthritis, Osteoarthritis, Osteoporosis Neurological: Parkinson's, Autism, Migraine Headaches, Dementia, Alzheimer, ALS Digestive: Gastric Reflux, Irritable Bowel, Constipation, Crohn’s Disease, Hiatal Hernia Dermal: Scleroderma, Eczema, Psoriasis Endocrine: Hashitmotos-hypothyroidism, Cushings or Addison’s disease Cancer: Lymphoma, Leukemia Emotional: Depression, Anxiety Attacks, Panic Disorders. OCD Blood Sugar: Hypoglycemia, Diabetes And a couple hundred more! My Personal Favorite: Nothings wrong - It’s all in your head

7. ElectrolyteDisturbances: K+ / MG++ Dental Toxicity: Root Canals Mercury Fillings Mental / Nervous: Depression, Anxiety, OCD Lyme Disease GastricDisturbances: Food Allergies, IBS, IBD,Constipation HormonalDisturbances: Estrogen Dominance Adrenals, Thyroid NutritionalDeficiencies: B12, B1, Folate, Vit D Lyme Disease a Multi-Faceted Problem

8. Lyme Rashes

9. Lyme Rashes

10. Lyme Rashes

11. Lyme Rashes

12. Bartonella Rashes

13. Bartonella Rashes

14. Bartonella Rashes

15. Bartonella Rashes

16. Bartonella Rashes

17. Lyme Disease Under the Scope

18. Lyme Disease Under the Scope

19. Lyme Disease Under the Scope

20. How is Lyme Disease Transmitted? Mosquitoes, Ticks, Horse flies: 22% of horse flies, deer flies and mosquitoes  are infected with Borrelia and co‐infections  in endemic areas! The etiologic agent of Lyme disease in deer flies,  horse flies and mosquitoes, J Infect Dis 154  (1986), 355‐358, LA Magnarelli, JF Anderson, AG  Barbour,  In utero transmission: Borrellia has been shown to be passed from mother to baby during gestation. Blood Transfusion:This obviously possible because blood banks do not test for Lyme and co-infections. Sexual Transmission:Spirochetes have been cultured out of saliva, semen, the oral mucosa as well as vaginal secretions. Breast feeding moms:Spirochetes can be transmitted through breast milk.

21. How is Lyme Disease Diagnosed?Laboratory test of blood and urine Western Blot: deemed “Standard of Care” yet still results in 30-50% false negatives. Only tests for a few organisms. ELISA: The least sensitive test. Usually used as a rapid screening test for acute stage. Very poor test. Tissue biopsy: tissue culture rarely produce positive test. PCR (polymerase chain reaction): very accurate, if enough antigen is available. Rarely is there enough antigen! IMHO Preferred Test: KS3 Diagnostic Labs

22. KS3 Diagnostic LaboratoryA New Era for Detecting Lyme and Common Co-Infection Organisms • Rapid identification of a variety of spirochete bacteria and common Lyme related co-infections with high sensitivity of detection. • KS3 uses modern molecular assays: • Molecular diagnostics are well known to be highly sensitive and specific • With molecular methods diagnostic results are not skewed when a patient is receiving immune suppressing medication- looking for Bacterial DNA, not antibodies! • Results not dependent on organism viability • Detection of non-culturable and slowly proliferating organisms • A single, inexpensive two stage testing panel: • PCR Component- cutting edge/proprietary methodology and reagents • Molecular Sequencing Component-most accurate validation/identification available

23. KS3 Diagnostic laboratoriesDiagnostic Panel www.ks3labs.com • Francisellatularensis • Leptospira biflexa • Leptospira borgpetersenii • Leptospira interrogans • Leptospira kirschneri • Leptospira wolbachii • Mycoplasma fermentans • Mycoplasma hyopharyngis • Ricketsia species (9 species) • Treponema carateum • Treponema denticola • Treponema pallidum • Treponema pertenue • Anaplasma phagocytophila • Bartonella henselae • Afipia 97.5% same as Bartonella • Borrelia afzelii • Borrelia burgdorferi • Borrelia garinii • Borrelia hermsii • Borrelia lonestari • Borrelia parkeri • Brachyspiraaalborgi • Brachyspirahyodysenteriae • Coxiellaburnetii • Ehrlichia chaffeensis • Additional test available for Babesia microti.

24. Treatment Options Anti-biotics: “Standard of Care – 28 days of anti-biotics” –Anti-biotics are quite effective in most cases however there are many side effects and the incidence of reoccurrence is very high. Some side effects are: Yeast overgrowth, Nausea, Reflux, Headaches, Liver toxicity, Hematological changes such as IPT, low RBC’s, and Anemia. Botanicals: Herbs are gaining prominence for many reasons. No prescription necessary, highly effective except in Neuro-Borelliosis, No yeast infections, inexpensive. We are still learning which botanicals are the most effective for each particular strain of organism. IMHO Best Option: Hope’s clinical experience has shown a combination of anti-biotics and herbs has been far superior than either one alone.

25. Treatments: Anti-biotics “Standard of Care – 28 days of Doxycycline” At Hope, we generally do not jump to anti-biotics as a first line defense but after we have treated as well as we can with botanicals, minerals and precious metals. The primary exception at this time would be obvious Neuroborreliosis and Lyme carditis. These are very dangerous cases with potential clinical side effects such as seizures and Atrial Fibrillations and heart attacks. Anti-biotics used effectively for Borrelia: Rocephin, usually 1 gram bid, I.V. is most effective. In Mexico, we use Rocephin with DMSO. Flagyl or Tindamax to kill the cyst form of the spriochette. We also use Flagyl I.V with DMSO. Zithromax and Minocyclin are valuable tools. We always give Nystatin 500,000 units bid and 1 foil packet of HLC (probiotic) by Pharmax when using anti-biotics. Fungal infections are rare while on this regime.

26. Treatments: Botanicals Samiento (Uncaria tomentosa) / Banderol combination: At Hope, treatment begins with 3 drops of each in 1 pint of water, sip slowly over 2 hours. Over the next 12 days increase dose a drop or 2 daily. Some people feel so poorly that they cannot bear increasing the dose anymore. This is fine simply stay at the tolerable level until symptoms diminish. Then begin increasing dose again. At Hope, the treatment periods are 12 days on and then 3 days off. After the first 12 days on Samiento/Banderol combo and a 3 day rest, then begin the Cumanda cycle. IMHO Preferred Supplement:NutraMedixwww.nutramedix.com Vitamin Research Products www.vrp.com

27. Treatments: Botanicals Cumanda: As with the Samiento/Banderol combo, start with 3 drops in a pint of water, sip slowly over 2 hours. Then each day add a drop or 2 for the next 12 days or up to the level where the Herxheimer is too uncomfortable. This happens often. After 12 days take 3 day break and the switch back to the Samiento/Banderol combo and repeat the cycle. The ultimate goal is 90 drops of each botanical with no pain. If you can take 90 drops of these botanicals with no more pain this is a good sign you have substantially lowered the total body burden of bacteria. IMHO Preferred Supplement: NutraMedix www.nutramedix.com

28. Treatments: Botanicals Takuna: If you suspect viral involvement Takuna is an excellent anti-viral. At Hope, treatment is with 30-40 drops a day in a pint of water for 2 months. IMHO Preferred Supplement: NutraMedix www.nutramedix.com

29. Treatment: Botanicals Olive Leaf Extract (OLE): Olive Leaf Extract has many properties, anti-amoeba, anti-viral, anti-fungal, anti-mycoplasma. At Hope treatment is with 1000 mg bid. IMHOPreferred Supplement: Sea Gate. www.seagateproducts.com. Sea Gate grows their own olive trees and harvest fresh leaves. This is a very potent product.

30. Treatments: Botanicals Lomatium dissectum (LDM-100): Most professionals recommend 20 drops 2-3 times a day. Start low and work up to target dose. Many patients do get a rash, The rash will generally last from 7-14 days. This rash can be severe! Be aware! Lomatium does have anti-viral and anti-fungal properties. Lee Cowden believes many patients who have skin reactions to this herb is do to an undiagnosed chronic measles infection. Be very respectful with this herb! Preferred supplement: Generation II Barlow Herbal Specialties www.barlowherbal.com

31. Treatments: Precious Metals Meso Silver has become one of Hope’s most effective tools for not only spirochetes but many co-infections seem to be responding also. We have found the best treatment is by combining Meso Silver with the Samiento, Cumanda Regime. We start with 1 oz. daily and work up to 2 oz. 3-4 times daily. The Herxheimer can be severe, don’t go to fast! IMHO Preferred supplement: Meso Silver www.purestcolloids.com/mesosilver.htm

32. Nutrition / Gastro Intestinal Poor nutrition and gastric infections greatly contribute to hormonal imbalance. Often there are other infections such as amoebas, tape worms, ascaris, trichinella and fungal/yeast infections. The panel Hope runs is the GI-02 panel. We usually add salivary SIg-A to the panel to test the gastric immune system. The test includes major food allergies: gluten, soy, egg, milk. IMHO Preferred Test:Diagnostechs / www.diagnostechs.com Genova Diagnostics www.gdx.net

33. Fighting disease takes a lot of energy. This is a commodity that most patients fighting a disease need in abundance.  Hope recommends a strict diet that contains zero artificial anything, and zero sugar or grains, a no disaccharide diet. The purpose of the this type of diet is to heal the GI tract and minimize the inflammatory process, inhibit the growth of yeast, normalize peristalsis and avoid the most common allergens associated with the Standard American Diet (SAD). IMHO preferred Diet and DVD: “The Road to Health: Overcoming Chronic Illness through Nutrition” by Laura L. Schroeder and Steven W. Hines / www.hopewellness.com/products.html “Learn How to Treat Yourself: Digestion and Digestive Disorders" by Steven W. Hines / www.hopewellness.com/products.html Nutrition / Gastro Intestinal

34. Another important test is the Vasoactive Intestinal Polypeptide(VIP). This peptide is a master regulatory peptide in the gut that can effect many aspects of health from motility, immunity, vasodilatation and Neuronal function. VIP is one of the most abundant molecules found in the respiratory tract. Department of Respiratory Medicine / Hanover Germany IMHO Preferred Test: Aruplabs / www.aruplab.com/guides/ug/tests/0099435.jsp If the test is abnormal, VIP is available in a nasal spray thru: Hopkinton Pharmacy www.rxandhealth.com Nutrition / Gastro Intestinal

35. The FASEB Journalexpress article10.1096/fj.02-1029fje. Published online August 15, 2003. Vasoactive intestinal peptide prevents activated microglia-induced neurodegeneration under inflammatory conditions: potential therapeutic role in brain trauma Mario Delgado*,† and Doina Ganea* *Department of Biological Sciences, Rutgers University, Newark, NJ 07102; †Instituto de Parasitologia y Biomedicina “Lopez-Neyra,” CSIC, Granada 18001, Spain Corresponding author: Mario Delgado, Instituto de Parasitologia y Biomedicina “Lopez-Neyra,” CSIC, Granada 18001, Spain. E-mail: mdelgado@ipb.csic.es Ritchie Shoemaker has done a tremendous amount of research on this peptide, this is his highly informative website. www.biotoxin.info Nutrition / Gastro Intestinal

36. Supplemental stomach acid is essential. (Betaine HCL) A broad spectrum digestive enzyme Mastic Gum/DGL (Vitamin Research Products) vrp.com Probiotics. IMHO Preferred supplement: HLC by Pharmax, / www.pharmaxllc.com 1 foil packet at bedtime Saccharomyces Boulardii, (friendly yeast) Potassium 400mg bid Zinc 25mg Magnesium 250-1000 mg daily IMHO Preferred supplement: Natural Calm, 1 tsp in hot water at bedtime Nutrition / Gastro IntestinalSupplementation – “The Basics”

37. Hormonal Issues Adrenal maladaption, upregulation of aromatase, 5 alpha reductase and alterations in the conversion of T4 to T3, alterations in binding affinity to carrier proteins and estrogen dominance are some of the major issues. Normalizing hormones can be very challenging. Hope uses Sabre’s Circadian panel to assess Cortisol, DHEA, Testosterone, Estradiol, Progesterone, salivary electrolytes as well as urine amino acids. Sabre will create a custom hormone support formula for each patient based on the lab results. Sabre uses liposomal delivery system to efficiently deliver hormone and hormone precursors as well as adaptagenic herbs and synergistic nutrients to the intracellular compartments. IMHO Preferred Test: Sabre Sciences in Carlsbad California. www.sabresciences.com If bioidentical Estradiol, is needed, Denton Prescription Shop makes liposomal encapsulated hormone support formulas. IMHO Preferred Pharmacy:www.dentonprescriptionshop.com

38. Dental Issues Root canals, Cavatations, Mercury Fillings, Nickel Crowns over Mercury. Root canals are almost always infected, they pose a much greater potential health danger than Lyme disease and should always be placed in priority above Lyme! Root canals should be removed along with the dental ligament (the lining of the tooth socket). Always use a biologically trained dental specialist. Google “Root Canal Cover-up”. Cavatations are an infected socket that should be reopened, ligament removed and reclosed. Charlie’s story. Mercury fillings can cause depletion of Glutathione which in turn lowers anti-viral immunity. Google “Smoking Tooth”. Nickel over mercury creates a battery effect overdriving electrical signals. Have seen negative 56 milli volts and greater when readings should be zero in the mouth. Can produce seizures, head aches, depression, anxiety etc. To find a biological dentist visit www.iaomt.org.

39. Heavy Metals • At Hope we often utilize testing to determine toxicities in immune compromised patients. • Heavy metals: Mercury, Lead, Cadmium, Arsenic, Antimony • How to assess Heavy Metal? • Heavy metals challenge test • Challenge agents; DMSA, MDF • Pre and Post Provocative Challenge IMHO Preferred Test:Metametrix Clinical Laboratory / www.metametrix.com Doctors’ Data, Inc. / www.doctorsdata.com Quick Silver Scientific/www.quicksilverscientific.com (mercury)

40. Treatments for Heavy Metals Oxidative Stress Reduction (OSR), Intestinal Metals Detox (IMD), Diatomacious Earth (DE),

41. Co-Infections Lyme disease is rarely just a lone spirochete. Most patients are infected with more than one organism. This makes Lyme disease complicated for the clinician trying to treat the patient. Of ticks that carry BorreliaBurgdorferi in the Northeast, they also carry: Bartonella: (Cat scratch fever) 12% Go Ted Nugent! Babesia: over 66% HGE: Human Granulocytic Ehrlichiosis: 8% carry this one Afipia: 97.5% the same as Bartonella, we see 5 times more than Bart Francisellatularensis CoxiellaBurnetti: also known as Q-fever, common with ranchers Leptospira: we see 2 to 3 times more than Borrelia species! 95% over lapping symptoms with Borrelia!

42. Co-Infections Other Common Co-Infections seen in Lyme Patients: Mycoplasma: in one study 50% of Lyme patients with primary joint symptoms also had this organism in their synovial membranes. HHV-6, HHV-8: Herpes Virus:

43. Treatments for Co-Infections Super Saturated Potassium Iodine (SSKI) Miracle Mineral Supplement (MMS), Green Hull of Walnut – (GHW), Olive Leaf Extract (OLE), Oxidative Stress Reduction (OSR), Glutathione (G), Lomatium (LDM), Coconut Oil (CO), King Solomon Herb (KSH), Ground Papaya Seeds (GPS)

44. Parasites and Fungus/Yeast Parasites: Amoebas Tape worms Ascaris Trichinella Flukes Hook worms Strongyloids Fungus / Yeast: Candida Aspergillis

45. Treatments for Parasites Super Saturated Potassium Iodine (SSKI) Miracle Mineral Supplement (MMS), Green Hull of Walnut – (GHW), Olive Leaf Extract (OLE), Oxidative Stress Reduction (OSR), Glutathione (G), Lomatium (LDM), Coconut Oil (CO), King Solomon Herb (KSH), Ground Papaya Seeds (GPS)

46. Treatments for Fungus/Yeast Super Saturated Potassium Iodine (SSKI) Miracle Mineral Supplement (MMS), Green Hull of Walnut – (GHW), Olive Leaf Extract (OLE), Oxidative Stress Reduction (OSR), Glutathione (G), Lomatium (LDM), Coconut Oil (CO), King Solomon Herb (KSH), Ground Papaya Seeds (GPS), Grapefruit Seed Extract (GSE), Florastor (F), Oregano Oil (OO)

47. Herxheimer Reaction This is one of the most difficult problems in managing Lyme patients. During the Syphilis era, Dr. Jarish and Dr. Herxheimer described the pain that occurred when killing the syphilis bacteria which has become known as the “Herxheimer Reaction”. IMHO the cause of this reaction is the secondary immune response to the dying organisms cell membrane components being attacked by the immune cells. This creates a host of inflammatory chemicals that cause painful joints and muscles. Typical Symptoms: wide spread pain muscle aches Headaches Fatigue Dizziness nausea

48. Managing the “Herx” Z-Naturals Micro Chitosan, a micronized Chitosan from Japan Gallbladder Liver Flush www.hopewellness.com Colonics I.V. vitamin C / 50 grams Magnesium Pushes 1500-2000mg Massage therapy Far Infrared Saunas Saunex.com Biomats FIR hopewellness.com Dietary considerations (no Grain Diet) The Road To Health Hormone replacement therapy (rhythmic dosing) Wiley Protocol and Sabre Sciences 24 hour circadian panel Dental Issues (root canals, cavitations, mercury)

49. Managing Hypercoagulation Nattokinase IMHO Preferred Supplement: info@hopewellness.com Serrapeptase IMHO Preferred Supplement: Vitamin Research products (vrp.com) and Nutramedix.com Lumbrokinase Fibroboost IMHO Preferred Supplement: Allergy Research Group www.allergyresearchgroup.com Edta Subcutaneous Heparin Fish Oils

50. Hypercoagulation Linked to Chronic Fatigue, Fibromyalgia, MS, Infertility, Chronic Illness Interview with David Berg David Berg is the Director and Cofounder, with Lois Hill Berg, of HEMEX Laboratories. Along with Dr. Harold Harrison and several clinical collaborators, they have developed the idea of the hypercoagulation/ immune system activation of coagulation theory in chronic diseases, a proposed cause of Chronic Fatigue Syndrome and Fibromyalgia, and have proposed an appropriate treatment that reduces many related symptoms. Mr. Berg has a M.S. degree in clinical pathology and laboratory medicine, and has been in practice for 35 years. HEMEX Laboratories offers testing and consultative services relating to the diagnosis, treatment, and monitoring of hematological, clotting and/or bleeding disorders.