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Postural Orthostatic Tachycardia Syndrome (POTS)

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POTS (postural orthostatic tachycardia syndrome) is a serious complication of chronic tick-borne diseases, and often renders patients bedridden for many months. POTS is generally found in more women than men suggesting a hormonal component to the etiology as well. Typical symptoms of POTS include:

  • Fatigue
  • Headache
  • Tremors
  • Syncope (fainting)
  • Dizziness
  • Poor ability to concentrate
  • Exercise Intolerance
  • Lightheaded
  • Heat intolerant
  • Shortness of breath
  • Cold Extremities
  • Low blood volume
  • Drop in blood pressure on standing
  • Elevated plasma norepinephrine
  • Mast Cell Activation Syndrome

These symptoms indicate dysregulation of the autonomic nervous system between the brain and the heart. Somehow and not yet fully understood, the heart and brain get out of synchronization causing the above symptoms. Chronic infection, toxin accumulation, inflamogens, etc…are likely the cause of this constellation of symptoms, and correcting the underlying adrenal issues is important. You can certainly heal from POTS symptoms, however, it may take some time to heal the autonomic nervous system. Please consult with Dr. Marra if you are concerned about this.

Dyslipidemia and Lyme Disease

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Dyslipidemia is abnormal lipid metabolism. Patients who have had or have Lyme Disease often have significant abnormalities in their lipid metabolism.  This results from chronic inflammation and prolonged activation of the proinflammatory cytokines such as IL-1, IL-6, and tumor necrosis factor-alpha (TNF alpha).  Elevated cholesterol, triglycerides, VLDL, and LDL are commonly seen, while HDL (the good cholesterol) is decreased.  Dr. Jones and I believe that these elevations in cholesterol are not only related to diet and genetic predisposition but may be a compensatory response of the body in an attempt to repair cell membranes (that are composed of lipids) that have been damaged by infection. The piercing of the cell membrane by organisms such as Borrelia, Bartonella, and Mycoplasma on their way to the intracellular compartment where they prefer to reside, can render changes in lipid metabolism and increase lipid peroxidation.  Lipid peroxidation is a biochemical reaction resulting from damaged lipid-containing cells that increases the concentration of free radicals in the body and contributes to a state of overall oxidative stress.  Oxidative stress affects not only cells but the vascular endothelium which can lead to increased stroke and myocardial infarction.  The presence of biofilm created by spirochetes and other organisms also contributes to plaque formation in the arteries, which affects blood flow to peripheral tissues and the overall health of the cardiovascular system.

Optimizing lipid metabolism may require diet and lifestyle modifications as well as nutritional intervention.  Dr. Marra’s extensive knowledge and experience in Lyme Disease and Functional Medicine will help you to regain optimal health in a reasonable amount of time.

For more detailed information about the glycemic index of foods (how much sugar they contain), please visit www.Mendosa.com and go to the food tab. You can search through the various options. This website is a phenomenal resource for everyone who wants to change their diet and needs help understanding what foods they can and can’t eat to improve their metabolic condition.

Autoimmune Disease

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Frequently we see autoimmune diseases associated with Lyme Disease and coinfections such as Multiple Sclerosis, Lupus, Hashimoto’s Thyroiditis, Scleroderma, Graves Disease, Celiac Disease, etc. Essentially any tissue in the body can fall prey to autoimmune disease if the autoimmunity is driven by infection.

When pathogenic infections invade tissues, the bacteria produce LPS (lipopolysaccharides) which are found on their outer cell membrane and promote inflammation. These molecules are produced and fool the host’s immune system into thinking that there is a foreign invader. The body naturally mounts an immune response, but the response is against its own tissue, yielding autoimmune disease.

In 18 years of practice, most of my patients’ autoimmune conditions are completely eradicated with proper long-term antibiotic use as well as targeted nutraceuticals. If you decrease the infection in the tissue, the concentration of LPS decreases, inflammation decreases, and tissues can return to their healthy state. If the infection is allowed to persist, autoimmune disease simply gets worse.

It is my belief that most if not all autoimmune diseases are infection-driven. The challenge becomes to identify the exact pathogen and then treat it accordingly.

A close up view of a finger with Scleroderma

Bartonella and Scleroderma

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Scleroderma and Bartonella… Is there a connection?

Dr. Marra has been treating patients with tick borne illness since 1999 in both Westport Connecticut and Seattle Washington. She has had two patients with severe Raynaud’s Syndrome, a Scleroderma diagnosis, and a positive Bartonella henselae serology test, one from each coast.

Dr. Marra does not think that this is a coincidence as Bartonella is known to reside in the vascular system along the inside of the vessel endothelium. She strongly suspects that Raynaud’s Syndrome and Scleroderma could have an infectious etiology that has been overlooked by the medical community because Bartonella is just now considered an emerging zoonotic infection. There is sparse scientific literature on Bartonella infection implications, and she would like to see more research done in this area.

To date, there is no literature indicating an infectious etiology for either Raynaud’s Syndrome or for Scleroderma. There is also very few treatment options offered to patients with these diagnoses. Typically they are left to suffer with these diseases, and Scleroderma can be extremely painful.

Dr. Marra suggests to any patients that have Raynaud’s Syndrome or Scleroderma to be tested for Bartonella henselae through Igenex laboratory. It’s important that the test be done accurately so that tests document the presence of an infection. If an infection is present, prompt use of antimicrobial herbs or antibiotics is extremely important. It is also beneficial that herbs or antibiotics are taken just prior to a very hot shower so that the medicine can reach the peripheral tissue.

In both patients who were found to have a Bartonella infection, subsequent antibiotic therapy was initiated with substantial symptom relief. Better blood flow occurred and the pain and swelling in the fingers receded. Of course this is simply anecdotal evidence, but in the face of having no scientific articles to turn to, this may be a valuable clinical observation for patients with either Raynaud’s Syndrome or Scleroderma.

Alzheimer’s Disease

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Alzheimer’s disease is a neurodegenerative disease that may have genetic (APOE4) and environmental influences on its manifestation in 60-70% of cases. The loss of cognitive function generally starts slowly and progressively gets worse with time and age.  The disease is characterized by the development of amyloid plaques in the brain, neurofibrillary tangles, and neuronal degradation in the brain.  It affects about 6% of people over 65 years of age and is expected to increase substantially by 2030. Dr. Alan MacDonald, a pathologist found that 7 out of 10 brains examined post autopsy were positive for Borrelia, the bacteria that causes Lyme disease. His findings have not been well accepted by mainstream medicine, and he continues to try and publish his data and change the thinking on the disease etiology. Here are a few videos  where Dr. MacDonald explains his research, as well as some articles of research on the disease:

There is no definitive test for Alzheimer’s disease other than a western blot test for Borrelia, and there is currently no treatment, except for antibiotics, which are highly controversial for this disease.

I hope in the next decade, there will be a greater awareness of the role infections play in the development of this neurodegenerative disease.