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

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.

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