A tale of two pandemics: exploring the links between Lyme and COVID
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IHCAN lyme disease
A tale of two pandemics:
exploring the links between
Lyme and COVID
Psychiatrist Dr ROBERT BRANSFIELD, MD, has been helping Lyme patients for more than 30 years.
His ground-breaking research revealing how Lyme creates psychiatric illness has led to a
comprehensive system of patient assessment. Here he also provides clinical insights from new
research showing that patients under active treatment for Lyme seem to be protected from COVID-19.
I
’ve been treating Lyme patients for more multi-system illnesses; they have their mental
than 30 years, and now we’re suddenly manifestations, neurological manifestations;
dealing with COVID-19. We have to you see fatigue, brain fog, you see poor quality
ask: how are they similar, how are they testing – and they can be financially catastrophic
different? – although some people can make money from
Both are zoonotic diseases, both them.
have multiple strains that show different There’s a gap between frontline physician
manifestations, both can be avoided by wearing observations and healthcare bureaucratic
protection. Both are global diseases, both have policies. In both cases there’s a focus on
no symptoms in some and severe symptoms public health and vaccines, and a lack of focus
in others. Both have some scientific support on effective treatment. And in both cases,
suggesting that you can get reactivated, both there are regulations that sometimes impede
This article is edited and extracted from a transcript
can be relapsing, both have a spectrum of very provided by AONM (The Academy of Nutritional effective treatment. There’s misinformation in
different symptoms in different patients, both Medicine). Dr Bransfield’s presentation is one of both cases, there are theories about biological
a compelling (and ongoing) AONM webinar series
are very complicated and difficult to understand, on COVID-19. Full details – and Dr Bransfield’s full manipulation or warfare that may have started
both are associated with co-infections and both webinar – at: https://aonm.org/webinars. these infections, and there’s dogma interfering
are associated with very complicated immune with forward progress. And with both there’s
reactions including cytokine storms. They’re this debate about on-label versus off-label
18 ihcan-mag.com I JULY 2020
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complications. For instance, in the pandemic
What is Evidence-Based Medicine?
of 1918 you saw a lot of Parkinson’s – there
were actually two pandemics at that time, and
they were kind of jumbled together. But we see
psychiatric symptoms that are a part of this
SARS Cov-2 microbe that causes COVID-19, and
we can see that there’s some of the same issues:
there’s this immune reaction and that immune
reaction in turn causes cytokine storm, and that
can cause some symptoms.
One thing that makes COVID-19 a little bit
different than other infections is that you see
hypoxia because of the damage to red cells.
So, some of the patients who have recovered
According to the Institute of Medicine, strong evidence
AND strong consensus for a particular medical seem similar to patients with carbon monoxide
treatment usually occurs only 2% of the time. poisoning or drowning victims, where they
have encephalopathy – and you do see memory
treatment. So in many ways this is what many problems, you see emotional problems. There innovators, early adopters, and people who
of us have been dealing with for a long time. It’s can be a lot of small vessel, large vessel clots are laggards and sceptics who take a long time
just – how is COVID-19 different? because there’s a clotting disorder. So there’s to adjust. We can look back – and this was a
Lyme is a spirochete, whereas COVID-19 strokes and other problems; it’s a complicated catastrophe – at what was called the Tuskegee
is caused by a virus. And PCR testing, which aftermath that we’re beginning to see. And you study, where syphilis was studied. This study
is quite reliable with many things, is seen as may see this brain injury in people that maybe was continued long after penicillin – that could
being a reliable indicator of the presence of didn’t have a very severe disease – yet they had have stopped the disease progression – became
COVID-19, but for some unusual reason, it’s neurological sequelae from it. We’re seeing a available. We have to not over-study, we have
seen as unreliable with Lyme disease. number of suicides of people that have acquired to know where to draw the line and implement
Lyme has been an ancient problem. From COVID-19, so that’s somewhat similar to what treatment, even if our research is imperfect – it
archaeological information we’ll probably be we see with Lyme. is never perfect.
here a long time from now, whereas COVID-19 It’s bad enough to deal with one pandemic – Many people are saying, “Let’s wait for a
may come and go. Lyme is a more gradual but what about two? So is there hope for us to vaccine and let’s use public health treatments
onset, COVID-19 is more abrupt, and there’s deal with this? In order to move forward, we have like social distancing”. We’ve been waiting for
more disease than related to Lyme. There’s to have some medical plan, and when I propose a vaccine for HIV for a very long time. It’s still
less attention and funding for Lyme disease things in some public health groups, a lot of not here. We’re waiting for a vaccine for the
than there is for COVID-19, and there’s more times the answer is: “Well, you need double-blind coronavirus common cold – and I don’t think
questioning the legitimacy of Lyme symptoms. controlled studies before you can implement there’s any RNA virus vaccine that’s ever been
We see more advocacy groups with Lyme any treatment”. But in only about 2% of the time developed. We may never have a vaccine for
disease, and that’s the major source of funding is there strong evidence, strong consensus (see SARS-Cov-2 even though there’s a lot of talk
for forward progress, whereas COVID-19 gets graphic above). In many ways this is like landing about it. So when we have this complicated,
a very large amount of funding from private on Omaha beach in Normandy in World War II quickly-emerging disease we have to think
industry and governments. and saying: “What should we do, how should we outside the box. Whether it’s Lyme, COVID-19
And then there’s the question of person- deal with this?” “Well let’s wait till there’s double- or something else, we have to revert back to
to-person spread. It is more prominent with blind controlled studies before we do anything”. the true definition of evidence-based medicine,
COVID-19, although there’s some degree that So we have to have treatments quickly. But how which isn’t just absolute scientific evidence,
seems to occur with Lyme. Now there’s a couple much evidence is enough? Do we need all this but evidence that’s blended with clinical
of questions that come up. If you have Lyme complicated proof, or should we look at frontline judgment and patients’ values and preferences.
and COVID-19, both at the same time, what’s doctors and see what works and what doesn’t The old picture (below) of mental illness
the effect? How does COVID-19 affect Lyme work? when I entered psychiatry in the early 1970s.
disease and how does Lyme disease affect Some people sneer at that being anecdotal This is what we saw in the state hospitals. It
COVID-19? I’m going to come back to this. and inadequate evidence, but when you’re was catastrophic, and we wondered how to
In an article I did a couple years ago while dealing with a quickly-moving pandemic you understand it. “Is there something more that
celebrating the 100th anniversary of the end need to sometimes look at things differently. we can do to help people that are lost souls
of World War I, the issue was: did infections And whenever there’s anything new that with chronic mental illnesses?” Before that,
caused by World War I contribute to causing happens, there are always people who are mental hospitals were filled with syphilis
World War II? My basic hypothesis was that patients; once they recognised there was a
many people came out of these infections, be connection, they gave penicillin and that
it the pandemic of 1918 or some of the other emptied a lot of the hospitals. We can’t forget
infections that were part of World War I – and that lesson; we have to go back to what we
there were a lot of them – with brain injury. learned and understand also the physiology
Did that brain injury and a very large number and combine that with our psychodynamic
of people affected, probably millions of people, theories. Presently we look at evolutionary
lay a foundation for civil disruption and the medicine, the microbiome, psychoimmunology
violence that was the foundation of causing and PCR microarray testing, and that expands
World War II? our knowledge.
We can look back and see that other In a 2019 paper I looked at psychosomatic,
pandemics cause neuropsychiatric somatopsychic or multi-system illness and the
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IHCAN lyme disease
connections between them. There of their symptoms and then
are a lot of terms that are used: it’s developed a diagnostic
in your head, it’s somatic symptom system based on that. We
disorder, bodily distress disorder, included only “CDC positive”
bodily distress syndrome… patients. (We’re going to
.”medically unexplained do another study looking
symptoms” was a favourite term. at people that didn’t quite
But a lot of times these terms are meet the CDC definition to
thrown around when someone see if there’s any difference.)
doesn’t understand the brain- And then we compared
body connection, and then they that to healthy medical
call it something inappropriate students who did not have
like conversion reaction, or Lyme disease, compared
psychosomatic, or Munchhausen’s symptoms of the patients
when it’s not – and there’s an before they were infected,
understandable pathophysiological and made a comparison
explanation. Usually, complex, to what studies showed to
difficult to understand diseases be the prevalence of these
can get mislabelled this way. medical conditions in the
In “Proposed Lyme Disease general population.
Guidelines and Psychiatric Illness” The average patient was
Recent articles by Dr Bransfield and colleagues expolored in his presentation.
I looked at the proposed guidelines nine years post-treatment,
for diagnosing Lyme and found post-infection, and there
that they fail to really address psychiatric different ways in different people. In one study was a very significant statistical difference.
conditions. The guidelines rely on surveillance they looked at twins with Lyme and found that The average patient pre-infection had 4.6
definition for defining the presence or absence the twins weren’t infected by the same tick, clinical findings and 82 clinical findings
of Lyme disease, which is an inaccurate thing to so they did have different symptoms. A lot of post-infection. The healthy medical students
do, even by CDC standards. times I see people later in the disease when had only four clinical findings, on average. In
In order to find out whether there actually is they have more of the psychiatric symptoms; people with other chronic illnesses, not Lyme,
there a link between Lyme disease and mental there are general patterns, but each patient the average was 22 clinical findings.
illness, we carried out a systematic review that presents a little bit differently. We see some of This slide (overleaf) is the National
included around 1,958 citations. After sorting the same with COVID-19. Comorbidity Study where they asked: “What
through them, we found 387 articles saying In a review article, I drew a connection is the prevalence of different mental illnesses
that Lyme causes psychiatric illness and 73 between Lyme and a large spectrum of in the general population?” This was a control
saying Lyme causes dementia. In the guidelines psychiatric conditions and also explained it. group; as you can see, pre-infection, my 100
they only cherry-picked four articles, two of When you get the infection, you have immune patients and the National Comorbidity Study
which failed to show an association. So out provocation that then contributes to the correlated quite exactly, so it did help to
of around 467 peer-reviewed journal articles symptoms and disease progression, and then validate our study.
that showed a connection, they used only 0.4% the person’s own stress adds to the stress and Let’s look at breaking down these different
of the literature. That was evidence bias, not compromised immunity. It’s a vicious cycle symptoms, looking first at attention span. In
evidence-based reporting. (see above graphic). the general population there’s about 7% or so
There are many faces to Lyme disease, and In a more recent article, I looked at 100 attention deficit disorder in the population.
that’s one of the difficulties: it presents in late-stage Lyme patients, looked at the pattern Some studies more, some studies less. But
20 ihcan-mag.com I JULY 2020
lyme.indd 20 25/06/2020 13:56
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IHCAN lyme disease
then post-infection it went from particularly see a lot of eye
7% to 84%. findings, like sensitivity to
In Lyme we see dyslexia- light, and then you see the
type symptoms affecting cranial nerves that affect
processing: fluency of speech, the eyes, double vision,
reading comprehension. There’s pain on the side of the
slow processing, and this is a face or weakness or loss of
white matter issue – Lyme is sensation, Bell’s palsy.
predominantly a white matter A fair number of
encephalopathy, and so you see people have mal de
these acquired dyslexia-type debarquement, that’s
symptoms that these patients when you feel like you’re
invariably did not have before on a boat and you feel like
they were infected. Executive you’re rocking, so it gives
functioning, which is the ability a vertigo kind of symptom.
to create and sustain goal- Tullio’s – which is loud
directed behaviour, so brain fog, noises make you nauseous
trouble concentrating, trouble and dizzy, then seizures,
prioritising modal symptoms, more so partial seizures.
a time management problem – Many of these people
time escapes a lot of patients. disorders, non-restorative sleep, difficulty get misdiagnosed as having psychogenic
And then imagery. And this is an area falling asleep staying asleep, delayed shift. seizures. Tingling, sometimes formication –
that I did a journal article on. I think it’s They stay up late, they become night owls. which is crawling under the skin, and people
rather significant. You see a lot of vivid Appetite disturbance is often anorexia, earlier think that’s delusional parasitosis – it’s a
nightmares, hypnagogic hallucinations, weight gain later, sometimes carbohydrate neuropathy symptom.
where someone starts dreaming before craving causing weight gain and then And there can be a weakness tremor,
they fall asleep sometimes, and intrusive decreased libido, a few patients increased restless leg, quite a spectrum of neurological
images. That correlates with temporal lobe libido and temperature control. Often low findings. A new thing I’ve noticed is
inflammation. People describe it sometimes as body temperature, sweats, pills, intolerance of sensational wetness or sensation of vibration
horrific intrusive images, almost like flipping heat, intolerance to cold. that people describe. It seems like it’s a
through the channels seeing horror movies, sensory impairment peripheral neuropathy
cheap horror movies, one after the other. Headaches rather than radiculopathy, which is in the
And then the emotional symptoms, mood In Lyme there’s almost a symphony of nerve root.
swings. Anhedonia is a big thing – decreased headaches, so there can be the tension
capacity to feel pleasure, decreased frustration headache, there can be the headaches from The Lyme joint
tolerance, depersonalisation is common (that’s the neck that shoot up into the scalp or behind And then the joint problems. You can
a feeling of detachment) and then decreased the eye, those are cervical radiculopathy invariably see migratory arthralgia, which
job performance, decreased social functioning headaches, there can be TMJ headaches, is quite unique to Lyme, and different from
and a lot of family problems. Suicidalities, migraine headaches, sinus headaches, cluster other forms of arthritis. It affects joints,
substance abuse – and a small percentage of headaches, sexual triggered headaches and you see deep bone pain, particularly with
patients become homicidal. also a description of a sense of pressure inside Bartonella, the feet can be sore, fibromyalgia
I did a lot of analysis of Lyme and suicide, the head and cranial nerve impairments. and epicondyle tenderness on the surface of
estimating in the United States probably All cranial nerves are affected, not just the bone – so that’s quite unique. Periostitis
1,200 patients commit suicide per year from the 7th cranial nerve, and I invariably do with Lyme and cardiovascular rapid pulse as
Lyme. And substance abuse is an overlooked an assessment of all the cranial nerves. You pain, rapid than the heart rate, POTS – but
area. Many Lyme patients have you can also see orthostatic
chronic pain and anxiety and hypotension sometimes.
particularly when they can’t get You see cardiac induction
treatment through mainstream defects and on rare occasions
channels they self-medicate, and some of the more severe
sometimes you see overdoses – cardiac complications. Then
including opioid overdoses. there’s shortness of breath:
We see depression, OCD you can see air hunger,
and generalised anxiety, so especially when there’s
panic disorder that can be long Babesia present, tooth pain,
duration. It can last much longer gum disease, GI problems – a
than other panic attacks that lot of patients can acquire
we see outside of Lyme. Social what looks like irritable
anxiety disorder, post-traumatic bowel, so they can get
stress – sometimes from the abdominal bloating, upper
trauma of the illness and GI distress, lower GI distress
sometimes from the intrusive and sometimes gallstones.
symptoms. Fatigue is a big The gallstones aren’t from
thing. We have fatigue and sleep Rocephin, the Ceftriaxone
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antibiotic used in Lyme, they’re the dose of 400mg a week; at that
from the Lyme disease itself. dose you really don’t have the QT/
Spastic bladder: a person has heart issues in these susceptible
to urinate a lot of times. Bladder individuals, and that may be a good
is one of the first places it can prophylactic dose.
go to. Urinary incontinence and That’s what Dr Stricker and Dr
other general urinary symptoms. Fesler advise. If you do get worse,
And then other symptoms: then you go on antibiotics very
chronic pain, intolerance to quickly, very early, particularly if
alcohol, thyroid problems, you’re on oxygen, and you get an
sometimes enlarged spleen. ACA, oxymeter to show if your oxygen
which is a rare complication level drops.
I’ve seen more with European There are other treatments that
patients, where there’s a wasting seem to have a prophylactic effect,
of subcutaneous tissue. based on test tube studies; these include
So I do that assessment and then ask, disulfiram, ivermectin, methylene blue,
have symptoms progressed over time? Do quercetin and vitamins. A, B3 and D, zinc and
they fluctuate, do you see Herxheimer NAD. So there are other treatments that have
reactions, have antibiotics helped effects. This is I think the core to preventing
it? Those are some of the things I this – prophylactic treatment of high-risk
look at, and then we compare these people or maybe even the general public.
findings to other studies.
One of the comparators was my Is there hope?
group of 50 homicidal patients. So back to that question: is there hope when
Those were the worst of the worst. there’s two pandemics?
This is post-infection. What have Yes – if we’re better at recognising these
other studies shown about these symptoms and we have effective treatment,
symptoms? How do they correlate with my we can prevent needless suffering, disability,
findings? Now my findings may be skewed developmental
somewhat, more towards people impairments, learning
that have more psychiatric symptoms since disabilities and
I’m a psychiatrist. Those cases would be more was protecting them. Here’s my hypothesis. If economic and non-
referred to me. The Rebman study found that someone has a latent interactive case of Lyme economic costs. Let’s
fatigue was the number one symptom, and tick-borne disease and is not in treatment protect, let’s develop a
that’s what you generally find, that’s usually and they acquire COVID-19, there’s an initial protective legacy and
the worst symptom. We saw a oxidation exacerbation of Lyme yes, there is hope.
similar thing with the LDA study, where that tick-borne disease symptoms in addition to Two years ago, I
showed fatigue was number one and very the COVID-19 symptoms. And that’s what I’ve began a presentation
similar findings from two totally independent seen with patients who were not on treatment. talking about a very complicated Lyme case.
studies. However, some who have fever reported The patient had hours of down-lows and
Like anything, you have to do a screening later improvement in Lyme symptoms, she was all over the place. She was told she
assessment. I developed screening questions, possibly from some type of immune activation. was psychosomatic, that she was having
so there’s a quick 24-question screen, a 61- On the other hand, if someone’s in treatment, psychogenic seizures, that she was hysterical,
item screen and then a more comprehensive active treatment, and acquires COVID-19, it’s that she was going to be paralysed for life
assessment that’s around 800 items. We a milder infection and they may get adaptive whatever she did. She was told “Never, never
also run the co-infection screen, which is immunity. It seems like a number of these get pregnant, because that’ll make you totally
good to do for Bartonella, Babesia, Ehrlichia, treatments seem to be effective. I’ve had Lyme paralysed”. This picture above shows how
DNA viruses and mycoplasma. Doing this patients in active treatment and everybody this patient’s doing today. I asked her, and
we were able to show the pattern, show that around them is sick and they’re not. she is quite happy to be the face of hope. Our
it’s a causal relationship, and we compared There was a study showing the most commitment really does help patients. IHCAN
it to other studies with control groups. So common treatments – among them and
it’s a controlled study with more than one antibiotics. It’s odd why antibiotics should
control. Pre-infection these were very healthy help a virus, but they seem to in some way About the speaker
people; post-infection they were not. These that’s not well understood. Dr ROBERT BRANSFIELD, MD, DLFAPA,
clinical assessment forms were developed and Hydroxychloroquine only works if you is a board-certified psychiatrist and is an
Associate Clinical Professor at Rutgers Robert
validated from this study. give it early in infection. It doesn’t really Wood Johnson Medical School who also
So back to the question: Lyme and work when you give it late. It’s a zinc works in private practice. He’s held teaching
appointments at Hahnemann Medical College
COVID-19 – how does the one affect the ionophore, bringing zinc into the cell, so and Eastern Virginia Medical School, and has a particular
other? One article that just came out on that there’s a question about the effects this interest in psychopharmacology, a unified theory of mental
subject was by Lyme specialist Dr Ray Stricker might have on the QT interval seen on health and illness, the link between microbes and mental
illness, Lyme and other tick-borne disease and also the link
and Dr Melissa Fesler. They found that all his electrocardiograms. However, we’ve been using between microbes and violence. He is the past president of
Lyme patients under treatment did not get hydroxychloroquine in a preventative way for the International Lyme and Associated Diseases Educational
Foundation, past president of the International Lyme and
COVID-19. decades without ever this being a problem, Associated Diseases Society, and past president of the New
So something about the Lyme treatment and the CDC has recommended it. But that’s at Jersey Psychiatric Association.
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