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Monday, June 29, 2015

Lyme and mast cells

I have been asked to provide more feedback regarding mast cell therapies for Lyme disease. I present a brief, recent patient case. 

A 46 year-old woman sought my help this past March. She suffered with a multisystem disorder which had ultimately led to disability. She suffered with severe fatigue making it a struggle to get out of bed each morning. She had trouble thinking clearly and experienced significant memory loss. She found it difficult to communicate with others and because of this withdrew from a church social group, because of embarrassment. (Severe fatigue was also a factor). At the time I met her she felt helpless and hopeless. She complained prominently of facial pressure and headache. Additional symptoms included: episodic fevers and chills; mild night sweats; insomnia; sudden hearing and writing; episodes of confusion and disorientation; weakness, numbness and tingling, dropping things and an overall inability to think and other cognitive and psychological symptoms. Severe pain was a major disabling symptom. 

She recalled finding an embedded tick in her back one year prior to our visit. She believed the tick was removed shortly after attachment and had no concerns at that time. Over time, she has found numerous ticks crawling on her body. She lives in a wooded area. Her back yard backs into Rock Creek Park in Montgomery County Maryland.  She sees groups of deer in her back yard daily. She has three dogs, all diagnosed with Lyme.

Additional history: She suffered with severe childhood asthma treated with and iron lung. She has experienced severe, recurring respiratory infections causing scarring in her lungs. She has chronic sinusitis and congestion causing permanent hearing loss. She reports a history of random itching and rashes on her skin. She has dermatographia: when you write on her skin the letters remain visible.

A standard Lyme test was negative.  A Lyme test from Stony Brook was negative.  Coinfection testing was positive for Bartonella (MDL) and a blood smear failed to show any Red blood cell parasites. 

Prior to our visit a rheumatologist diagnosed fibromyalgia. She told me she learned about Lyme from a movie “Punk Singer”; I have not looked it up. 

Her illness forced her to sell her business: dog boarding and walking. 

Treatment: I treated her for Lyme and coinfections with standard therapies. (I have modified my regimens – cannot discus here). I also treated her for excessive mast cell degranulation. 

See previous post: Treatment is difficult and comprehensive. 

Three months later she states she is incredibly better in all areas. She is functioning well with a good quality of life and is now able to exercise. Memory loss has remained impaired but brain fog has cleared significantly.

Comments:  When anti-mast cell therapy works it seems to do so quickly (if patient on correct regimen) and results can be dramatic.

She presents with many clues suggesting that this therapy might work, especially dermatographism which is a mast cell mediated phenomenon.

I am not diagnosing my patients with true MCAD or with any other formal diagnosis. Rather I view my patients as experiencing hyper- stimulation and degranulation of mast cells, as a complication of Lyme disease, especially if symptoms only started with the Lyme diagnosis.


G said...

Good afternoon, doc! I am interested to know why some patients develop MCAD and others don’t (besides genetic, environmental reasons, and so on, i) And how you figure it out that is one patient case it is MCAD involved too... ? thank you in advance for your answer,

Anonymous said...

Perhaps it is a lack of "mast cell stabilizers" -- plant bioflavonoids and vitamin C.
Especially with regard to the latter, all humans could be seen as deficient since in nearly the rest of the animal kingdom, ascorbate is an endogenously secreted compound which performs many functions vital to health. Its secretion is higher during times of stress (including
We, higher primates, guinea pigs and perhaps one other mammal are the unlucky few who don't get our own daily "megadose" of vitamin C. And any infection drains even the little vitamin C we may get through our diets or our paltry, RDI-crippled vitamin C supplements.
Just as important are the flavonoids. Is quercetin better than Cromolyn? I know it helps me.

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