LYME DISEASE & CO-INFECTIONS

Lyme Disease Is Rarely Just Lyme

You may have been told your Lyme test came back negative. Or that you were treated and should be better by now. Or that what you're experiencing is "post-treatment syndrome" — implying there's nothing more to do.

None of that means you're well. And none of it means you're out of options.

Dr. Scott Richmond works with patients across Iowa and nationwide who are living with the real burden of Lyme and tick-borne illness — including the co-infections, the chronic inflammatory cascade, and the compounding factors that keep people sick long after a standard course of antibiotics.

Finally — A Provider Who Takes This Seriously

Dr. Richmond has navigated Lyme personally. He knows what it's like to be told the tests are negative when your body is clearly telling you otherwise.

He knows what it's like to be dismissed by providers who aren't trained to look deeper.

He looks deeper.

📍 In-person: Urbandale, Iowa (serving greater Des Moines) 💻 Telehealth: Available nationwide

The Problem With Standard Lyme Testing

The conventional two-tier testing protocol (ELISA + Western Blot) misses a significant percentage of Lyme cases — particularly chronic or late-stage presentations. It was designed to detect active infection, not the complex immune dysregulation that defines chronic Lyme.

Dr. Richmond uses the Vibrant Tick-Borne 2.0 Panel — one of the most comprehensive tick-borne illness panels available — which tests for:

Borrelia burgdorferi (Lyme) with expanded antibody markers
Bartonella (often called "the great masquerader")
Babesia species
Ehrlichia and Anaplasma
Rocky Mountain Spotted Fever
Additional emerging tick-borne pathogens

This matters because co-infections are not secondary issues. Bartonella, Babesia, and Ehrlichia can drive symptoms as aggressively as Lyme itself — and they require different approaches. Testing for Lyme alone while missing co-infections is one of the most common reasons patients plateau.

What Chronic Lyme Actually Looks Like

Tick-borne illness is one of the great mimics in medicine. It shows up differently in nearly every patient — which is part of why it's so frequently missed or misdiagnosed as fibromyalgia, MS, lupus, anxiety disorders, or depression.

Common presentations include:

Migratory joint pain and muscle aches
Profound fatigue unresponsive to rest
Neurological symptoms — brain fog, memory loss, word-finding difficulty
Neuropathy, tingling, and unusual sensations
Heart palpitations and dysautonomia
Psychiatric symptoms — anxiety, rage, depression, depersonalization
Hormonal disruption and adrenal dysfunction
Heightened chemical and environmental sensitivity

Lyme Doesn't Travel Alone Either

Just as mold illness rarely exists in isolation, neither does Lyme. In Dr. Richmond's clinical experience, patients with chronic tick-borne illness almost always present with compounding factors:

Mold and biotoxin exposure (which severely suppresses the immune response needed to fight Lyme)
Heavy metal accumulation (which creates the biofilm environment where Lyme bacteria hide)
Gut dysfunction and parasitic co-infection
Nervous system dysregulation that keeps the body locked in survival mode

Treating Lyme without addressing these layers is incomplete — and it's why so many patients cycle through treatment after treatment without reaching true recovery.

The Cellular Metabolix Approach to Lyme Recovery

Dr. Richmond's approach doesn't chase the pathogen in isolation. It restores the terrain — the internal environment — so the body can do what it was designed to do.

That means opening drainage pathways, clearing the compounding toxic burden, restoring gut and immune function, addressing the emotional and nervous system components, and systematically working through each layer of the Cellular Metabolix framework in the right sequence.

This is a fundamentally different approach than most Lyme practitioners — and it's why patients who've tried everything else find traction here.

Frequently Asked Questions About Lyme Disease & Co-infection

Can I have Lyme disease if my test came back negative?

Yes — and this is extremely common with chronic or late-stage Lyme. The standard two-tier testing protocol (ELISA + Western Blot) was designed to detect acute infection and misses a significant percentage of chronic presentations. The Western Blot has documented sensitivity limitations, particularly for patients whose immune systems have been suppressed by co-infections or mold illness. A negative standard Lyme test does not rule out infection — it rules out what that specific test was designed to detect. Advanced testing like the Vibrant Tick-Borne 2.0 panel offers substantially greater sensitivity and tests for co-infections that the standard protocol doesn't evaluate at all.

What are Lyme disease co-infections and why do they matter?

Co-infections are other tick-borne pathogens transmitted alongside Borrelia burgdorferi (the Lyme bacteria) by the same tick bite. The most clinically significant include Bartonella, Babesia, Ehrlichia, and Anaplasma. Co-infections are not secondary issues — they can drive symptoms as aggressively as Lyme itself, and they require different treatment approaches. Treating Lyme without testing for and addressing co-infections is one of the most common reasons patients plateau in Lyme treatment. The Vibrant Tick-Borne 2.0 panel tests for the full spectrum of tick-borne co-infections, not just Borrelia.

What is Bartonella and how does it relate to Lyme disease?

Bartonella is a bacterial co-infection transmitted by ticks (and potentially other vectors including fleas and lice) that is sometimes called "the great masquerader" because of its wide and varied symptom presentation. Neurological symptoms are particularly prominent in Bartonella — anxiety, rage, depersonalization, psychiatric manifestations, and unusual nerve sensations are characteristic. Bartonella can be present without Lyme, can be transmitted separately from Lyme, and is frequently missed by providers who only test for Borrelia. It requires specific testing and specific treatment approaches distinct from standard Lyme protocols.

Why am I still sick after finishing Lyme treatment?

Persistent symptoms after standard Lyme treatment are common and have several potential explanations. The most frequent causes include: unidentified co-infections (Bartonella, Babesia, Ehrlichia) that weren't tested for or addressed; compounding mold illness that is suppressing the immune response needed to fully clear the infection; significant heavy metal burden that perpetuates inflammation and creates the biofilm environment where Lyme bacteria persist; and nervous system dysregulation that has become self-perpetuating independent of active infection. A comprehensive assessment of all compounding factors — not just retreatment for Lyme — is almost always what's needed.

Can Lyme disease cause psychiatric symptoms?

Yes. Neuropsychiatric Lyme disease is a well-documented but frequently missed presentation. Borrelia burgdorferi can cross the blood-brain barrier and directly affect neurological function. Bartonella co-infection is particularly associated with psychiatric manifestations. Common neuropsychiatric symptoms include anxiety, panic attacks, depression, rage episodes, obsessive thoughts, depersonalization, and cognitive changes that can resemble early-onset psychiatric disorders. Many patients with neuropsychiatric Lyme are treated psychiatrically for years before tick-borne illness is investigated.

Do I need a tick bite or bull's-eye rash to have Lyme disease?

No to both. Studies suggest that fewer than 50% of Lyme patients recall a tick bite — ticks at the nymph stage (the most common transmission stage) are the size of a poppy seed and frequently go unnoticed. The bull's-eye rash (erythema migrans) is considered diagnostic when present, but it occurs in only 70–80% of early Lyme cases — meaning up to 30% of infected individuals never develop the characteristic rash. Absence of a remembered tick bite or visible rash does not rule out Lyme disease.

What is the connection between mold illness and Lyme disease?

Mold illness and Lyme disease co-occur with significant frequency — and for a biological reason, not coincidence. Mold biotoxins suppress the innate immune response that is the primary defense against Borrelia and tick-borne co-infections. Patients with significant mold burden have measurably impaired immune surveillance, making them far more susceptible to Lyme establishing and far less capable of controlling it. This means that patients with both conditions will plateau on Lyme treatment until the mold burden is addressed — the immune system cannot clear the infection when it is being suppressed by biotoxins.

Is chronic Lyme disease a real diagnosis?

This is contested in conventional medicine — but the clinical reality is unambiguous for practitioners who work with this patient population. The controversy centers on nomenclature and mechanism, not on whether patients with persistent post-treatment symptoms are suffering. Whether it's called "chronic Lyme," "post-treatment Lyme disease syndrome," or "persistent tick-borne illness," the clinical picture of patients who remain significantly ill after standard treatment is real, measurable, and treatable when the full picture — including co-infections and compounding factors — is properly investigated.