Tick Boot Camp

In this powerful in-person interview at the Tick Boot Camp studio, Matt Sabatello sits down with Dr. Somer DelSignore, DNP, a board-certified pediatric practitioner specializing in Lyme disease, tick-borne co-infections, PANS/PANDAS, autoimmune and neuroimmune disorders, autism-like regression, and congenital tick-borne illness. This episode is essential listening for parents who have been told to “wait and see,” families who have seen multiple specialists without answers, and anyone trying to understand how infection, inflammation, immune dysfunction, and nervous system imbalance can impact a child’s brain and development. 🎙 About Dr. Somer DelSignore Dr. DelSignore began her career in traditional pediatric medicine before recognizing that many children with complex chronic illness could not be properly treated in 10–15 minute appointments. Her clinical evolution accelerated after: Training with Dr. Richard Horowitz (tick-borne disease complexity and layered treatment strategies) Training with Dr. Kenneth Bock (autism and autoimmune encephalopathy patterns) Identifying the infectious and immune triggers driving neuropsychiatric symptoms Today, she runs a private practice in upstate New York where she treats children (and a small cohort of adults) using a comprehensive, root-cause framework. 🧠 Autism, Lyme & Autoimmunity — Connecting the Dots Dr. DelSignore explains that autism is often a cluster of symptoms, not a single-gene condition. In her clinical experience, many children experience immune-triggered neuroinflammation that presents as: OCD Anxiety Rage Intrusive thoughts Impulsivity Hallucinations Developmental regression Lyme and co-infections such as Bartonella and Babesia can activate autoimmune responses that interfere with neurotransmitter signaling. When inflammation blocks receptors for dopamine and serotonin, psychiatric symptoms emerge. Her message is clear:These symptoms are often biomedical — not simply behavioral. 🦠 Why “Root Cause” Is Rarely One Thing Healing rarely comes down to one pathogen. Children may present with overlapping contributors such as: Lyme disease and co-infections Mold and mycotoxins Heavy metals Epigenetic pathway dysfunction Detox impairment Nervous system dysregulation Dr. DelSignore emphasizes layered pattern recognition and systematic evaluation rather than single-diagnosis thinking. 🧬 Treatment Approach: Layered, Sequenced & Individualized There is no cookie-cutter protocol. Her framework may include: Targeted antibiotic combinations Herbal antimicrobials Biofilm and fibrin support Gut protection from day one Detox support (liver, kidney, lymphatic) Ozone therapy SOT (gene-silencing therapy) IVIG for autoimmune modulation (when appropriate) Plasmapheresis referral Regenerative PRP strategies Sequencing matters. Some children require detox and nervous system stabilization before antimicrobial treatment begins. 🧱 Biofilms & Tissue Infection Dr. DelSignore confirms: Biofilms are real and clinically significant Microbes communicate and protect one another Chronic infections often reside in tissue, not just blood Killing pathogens without detox support can worsen flares Her philosophy:Eliminate pathogens while simultaneously rebuilding the body. 🌿 Detox, Regeneration & the Nervous System Pathogen elimination is only part of recovery. Healing also requires: Supporting liver and kidney detox pathways Encouraging lymphatic flow Gentle sauna when tolerated Epsom salt baths Breathwork and box breathing Vagus nerve stimulation Nervous system retraining Many children are stuck in chronic sympathetic (“fight-or-flight”) mode. True recovery requires shifting into parasympathetic “rest and repair.” ❤️ A Story of Hope Dr. DelSignore shares the case of a child born with congenital tick-borne infections who: Was non-verbal Required feeding tube support Was diagnosed with autism After comprehensive treatment and immune regulation, the child: Became verbal Engaged socially Reached developmental milestones Thrives in school It’s a reminder that recovery is possible—even in severe presentations. 🏥 The Care Coordination Challenge Families often see 10–15 specialists before reaching her office. Dr. DelSignore stresses the importance of: A “medical home” One lead clinician acting as quarterback Coordinated communication among providers She also discusses the urgent need for legislative and insurance reform to support time-intensive chronic illness care. 🌎 Looking Forward Dr. DelSignore hopes for: Increased research funding Broader recognition of infection-driven neuroinflammation Earlier pediatric intervention A shift toward prevention and health-promotion medicine Her belief: When properly supported, the body can heal. 🔑 Key Takeaways Trust parental intuition Neuropsychiatric symptoms may be immune-driven Detox and gut health are foundational Nervous system regulation is critical Healing is possible—even in complex cases

Frédéric Roscop, French-born osteopath and founder of AEQUIL, joins the Tick Boot Camp Podcast as our first-ever in-studio international guest, flying in from London to Long Island to share his personal battle with chronic Lyme disease—and the breakthrough that reshaped his life and career. After decades of unexplained symptoms, misdiagnoses, heart inflammation, neurological dysfunction, and failed treatment attempts across multiple countries, Frédéric discovered that killing microbes alone wasn’t enough. His recovery began when he shifted focus from chasing pathogens to restoring the body’s foundational terrain—supporting immune regulation, detoxification, cellular function, stress physiology, and energetic balance. In this deeply reflective and technical conversation, Frédéric shares how childhood tick exposure in rural France, years of undiagnosed Borrelia and Bartonella infection, and repeated medical dead-ends ultimately led him to develop a patented biotech system designed to help others reset their foundational wellbeing. What You’ll Learn in This Episode Growing Up in Tick Territory Frédéric describes growing up in rural France, frequently covered in ticks as a child—long before Lyme disease was widely recognized in Europe. Early symptoms included: Chronic insomnia and hyperactivity Digestive dysfunction and blood sugar instability Visual disturbances and light sensitivity Emotional instability and neurological symptoms Recurrent inflammation At 16, following general anesthesia for a broken nose, he experienced what he now recognizes as a major Lyme “crash,” leading to cognitive decline, emotional dysregulation, and worsening physical inflammation. Heart Inflammation & Athletic Collapse By age 17–18, Frédéric’s promising volleyball career ended due to inflammatory joint disease and recurring pericarditis (heart inflammation)—which would return six times over the next 15 years. Antibiotics temporarily improved symptoms, but the root cause remained unidentified. “I Didn’t Even Know What Lyme Disease Was” As a young osteopath in practice, Frédéric recalls a patient asking whether her symptoms could be Lyme disease. At the time, he had never been trained on it. Years later, another patient was hospitalized with Lyme-related encephalitis—triggering Frédéric’s realization that Lyme might explain both his patients’ suffering and his own. This episode includes an honest discussion about: Medical training gaps Diagnostic limitations The importance of humility in healthcare Why the doctor–patient relationship must be a partnership Diagnosis: Borrelia, Bartonella & More Specialty testing eventually revealed: Borrelia Bartonella Viral findings including Epstein-Barr Virus (EBV) Heavy metal burden (notably elevated mercury) Frédéric began aggressive antibiotic and detox protocols—but experienced severe gut collapse and worsening terrain. Despite trying treatments across Europe, the U.S., China, India, and Switzerland—including antimicrobial, herbal, and integrative approaches—he improved only marginally. The Turning Point: It’s Not Just the Bug — It’s the Terrain Frédéric revisited the foundational debate in medicine: Louis Pasteur: It’s the germ. Claude Bernard: It’s the terrain. His breakthrough came when he shifted focus to rebuilding: Gut function Cellular membranes Detox pathways Nervous system regulation Emotional and energetic resilience Rather than focusing exclusively on killing microbes, he asked: Does the body have the capacity to self-regulate and self-repair? From that question, AEQUIL was born. What Is AEQUIL? AEQUIL is a biotech wellness system built around a patented technology Frédéric calls Liquid Intelligence — a formulation combining: Structured/dynamised water Botanicals Vitamins and electrolytes Biochemical and biophysical support The system supports: Brain, heart, gut, liver, and immune foundations Detoxification and lymphatic flow Stress physiology Emotional and energetic regulation The AEQUIL Deep Reset System Maintain (Foundational Support) A daily liquid formula designed to nourish the body’s core systems and support cellular regulation. Suggested use: ½ teaspoon morning ½ teaspoon evening Reset (Deep Reset Protocol) A structured approach to support: Microorganisms (bacteria, viruses, fungi, parasites) Micro-toxins (detox pathways) Micro-traumas (stress and emotional stagnation) The protocol is phased to reduce Herx reactions and build resilience gradually, with many users reporting a noticeable physiological shift around weeks 8–10. Everyday Support Wearable patches and digital wellness tools (affirmations, breathwork) designed to support mood, sleep, energy, and immune balance during recovery. Core Message of This Episode Chronic Lyme recovery is rarely about one silver bullet. It requires: Restoring foundational systems Supporting detox and immune function Addressing nervous system and stress patterns Recognizing both biochemical and energetic influences Frédéric’s story is one of humility, evolution, and transformation—from a practitioner unaware of Lyme disease to a global wellness innovator working to support both patients and healthcare providers. 🎧 Tick Boot Camp Listener Exclusive AEQUIL is offering Tick Boot Camp listeners: 30% off with code: TB30 Listeners can email: info@aequil.com Emails will connect you directly with Frédéric for guidance on: The Deep Reset protocol What to expect Choosing the right welcome pack

GLP-1 Agonists, MCAS, Lyme Disease, and the Future of Precision Medicine In this powerful Tick Boot Camp Podcast interview, Matt Sabatello sits down with Dr. Tania Dempsey, MD, a board-certified internal medicine physician and internationally recognized expert in Mast Cell Activation Syndrome (MCAS), Lyme disease, autoimmune conditions, and complex chronic illness. In this comprehensive conversation, Dr. Dempsey delivers one of the most forward-thinking and in-depth discussions ever featured on the podcast — connecting the dots between persistent symptoms after Lyme, immune dysregulation, biofilms, nervous system dysfunction, and groundbreaking research on GLP-1 receptor agonists as mast-cell stabilizers. This episode offers science, clinical insight, and — most importantly — hope for patients who have tried everything and are still struggling. Lyme Disease, MCAS, and Why Patients Stay Sick Why Treating Lyme Alone Is Often Not Enough Dr. Dempsey explains why many patients continue to experience inflammation, pain, neurological symptoms, and relapses even after treating Lyme disease and co-infections. According to her clinical experience, this is most often due to primary Mast Cell Activation Syndrome, not persistent infection alone. Key insight: > Lyme disease frequently acts as the trigger, but MCAS is often the driver of ongoing symptoms. Dr. Dempsey clarifies the critical difference between: Primary MCAS (pre-existing immune dysfunction worsened by infections) Secondary MCAS (rare; resolves completely once infection is treated) She notes that in decades of clinical practice, she has never seen true secondary MCAS fully resolve without ongoing mast-cell management. SOT Therapy: When, Why, and How It Works Best Dr. Dempsey provides a nuanced and experience-based explanation of Supportive Oligonucleotide Technique (SOT) for Lyme and co-infections. She addresses common criticism: One-time SOT treatments are rarely sufficient Chronic Lyme often involves multiple strains of Borrelia , Babesia , and Bartonella Her most successful cases involve: Repeated testing Sequential SOT treatments targeting specific strains Immune system support between rounds Adjunctive therapies such as herbs, antiparasitics, and mast-cell stabilization She shares a remarkable case of a young woman with severe neuropsychiatric symptoms who — after years of persistent SOT treatment combined with MCAS management — is now thriving, off psychiatric medications, and successfully completing college. Biofilms: Why They Matter in Chronic Infection Dr. Dempsey firmly states that biofilms are a critical barrier to recovery in chronically ill patients. Key points: Biofilms exist in the gut, sinuses, blood, and tissues They protect microbes from antibiotics, herbs, and immune attack Resistant biofilms may involve extracellular DNA (Z-DNA), discussed at ILADS Therapies discussed: Enzymes such as lumbrokinase and nattokinase Ozone therapy Therapeutic Plasma Exchange (TPE) for severe cases Her message is clear: if you cannot reach microbial reservoirs hidden in biofilms, infections cannot be fully controlled. GLP-1 Agonists, Immune Modulation, and Breakthrough MCAS Research GLP-1 Receptor Agonists as Mast-Cell Stabilizers Dr. Dempsey presents groundbreaking findings from her published case series: “The Utility of GLP-1 Receptor Agonists in Mast Cell Activation Syndrome” Key details: 47-patient case series Micro-dosing of GLP-1 agonists Primary medications used: tirzepatide (Mounjaro / Zepbound) and semaglutide (Ozempic / Wegovy) Unlike weight-loss protocols, Dr. Dempsey uses very low doses to target immune modulation — not appetite suppression. What GLP-1 Therapy Improved in MCAS & Lyme Patients Reported improvements included: Cognitive clarity and brain fog Chronic pain Neuropsychiatric symptoms Anxiety and depression Gastrointestinal symptoms Systemic inflammation Hormonal dysregulation In some cases, patients experienced improvement within one or two doses. Dr. Dempsey explains that mast cells express GLP-1 receptors, and activation sends a signal of safety, reducing inflammatory mediator release. Unexpected Findings: Muscle Mass and Antibody Reduction Contrary to common concerns, Dr. Dempsey observed: Preserved or increased muscle mass in the majority of patients Improved mitochondrial function and exercise tolerance Reduction in chronic antibody production (including Lyme Western Blot bands) She shares a striking case where a patient with long-standing positive Lyme antibodies saw antibody levels decline for the first time in over a decade after GLP-1 therapy — despite infection already being treated. This supports her hypothesis: > MCAS can drive persistent immune activation even when infection is no longer present. Side Effects, Screening & Who Should Not Use GLP-1s Potential side effects (usually mild): Nausea Delayed gastric emptying Occasional vomiting in sensitive patients Important clinical notes: Some patients respond better to semaglutide vs tirzepatide A small subset may require dose cycling or pulsing Antibody formation against GLP-1 drugs is a potential research focus Non-Pharmaceutical Alternatives to Increase GLP-1 Activity For patients who cannot tolerate medications, Dr. Dempsey outlines alternatives. Herbal & Supplement Options OptimumGLP Synergy (herbal blend designed to support GLP-1 signaling) Calocurb (GLP-1 supportive compound) These options may: Reduce inflammation Help stabilize appetite and blood sugar Calm mast-cell activity Diet-Based Strategies Dr. Dempsey explains why higher-protein and carnivore-leaning diets may benefit MCAS and Lyme patients: Protein and fat stimulate endogenous GLP-1 Reduced food triggers Improved metabolic stability Patients do not need to eat exclusively meat — but increasing high-quality protein intake is often beneficial. Nervous System, Trauma & Mast Cell Feedback Loops The episode explores how: Mast cells and nerves exist in a bidirectional feedback loop Chronic fight-or-flight worsens immune activation Therapies discussed: Limbic retraining programs ( Primal Trust , Gupta Program) Vagal nerve stimulation Apollo Neuro wearable Ketamine-assisted therapy Psychedelic microdosing (emerging area) Breaking the mast-cell / nervous-system loop is often essential for healing. Women’s Health, PCOS & Autoimmune Illness Dr. Dempsey shares a critical insight: > In her practice, every PCOS patient also has MCAS. She explains how: Mast cells respond to estrogen, progesterone, insulin, and cortisol Hormonal fluctuations can trigger MCAS flares MCAS may underlie PMS, PMDD, endometriosis, and reproductive pain syndromes GLP-1 therapy may offer new hope for women suffering from inflammatory gynecologic symptoms linked to Lyme and MCAS. Advocacy, ILADS & The Future of MCAS Research Dr. Dempsey discusses her work with: ILADS (International Lyme and Associated Diseases Society) ISMCAS (International Society for Mast Cell Activation Syndrome) ISMCAS goals include: Funding MCAS research Educating clinicians globally Supporting patients and advocacy efforts She encourages patients to: Educate themselves Share credible research with providers Move on from doctors unwilling to listen Final Takeaway This episode redefines what root-cause medicine truly means. Healing chronic Lyme disease often requires addressing: Immune dysregulation Mast cell activation Nervous system dysfunction Hormonal imbalance Metabolic inflammation Dr. Tania Dempsey offers a roadmap — grounded in science, compassion, and innovation — for patients

In this special Tick Boot Camp Podcast conversation recorded for Dr. Bill Rawls’ Vital Plan Network as part of the Cellular Healing Boot Camp Series, Tick Boot Camp co-hosts Matt Sabatello and Rich Johannesen join Liza Blas (Vital Plan Network Community Manager) to unpack one of the most overlooked—but most transformative—parts of chronic illness recovery: rebuilding identity. This episode serves as a follow-up to Lesson 16 in the Boot Camp (watch full lesson) and expands the framework Rich introduced in the lesson—showing how chronic Lyme disease and complex chronic illness can dysregulate not only the body, but also the mind, nervous system, and sense of meaning and connection. Together, they explore the “patterns” they’ve observed through 650+ Tick Boot Camp interviews with patients, doctors, and researchers—and how those patterns point toward a more complete roadmap for healing.https://community.vitalplan.com/ What You’ll Learn in This Episode Why healing from chronic Lyme disease is rarely “just physical” The key recovery patterns observed across 650+ patient interviews How identity gets disrupted by chronic illness—and how to rebuild it The difference between faith vs. doubt as forms of belief The “Big Three Lies” that shape a harmful Lyme identity How the nervous system, stress hormones, and immune dysfunction feed each other Why “it’s never just one thing” when it comes to recovery Practical tools for hard days: breathwork, gratitude, pacing, and nervous system support A step-by-step “path forward” that includes physical, psychological, and spiritual healing Key Themes and Takeaways 1) The Tick Boot Camp Origin Story (and Why Patterns Matter) Rich shares the moment Tick Boot Camp was born: seeing Matt go from a healthy, high-performing young man to being severely disabled by chronic illness—then watching him fight his way back. That personal crisis, combined with Rich’s own tick bite and lack of competent medical guidance, revealed a hard truth: The real experts are the people who’ve lived the journey. Tick Boot Camp became a platform to capture what actually works in real life—through deep, long-form interviews that expose patterns you don’t see in short appointments or isolated protocols. 2) The Biggest Pattern: Recovery Requires More Than Medicine Matt explains one of the most important—and most triggering—lessons he had to accept: Chronic Lyme is not only a physical illness. It impacts your nervous system, psychology, relationships, and identity. He also highlights two massive recovery truths seen again and again: Believing you can heal matters, because hopelessness prevents action. It’s never one thing. Healing is cumulative—built through layered interventions over time. This isn’t “it’s all in your head.” It’s acknowledging that infection changes brain chemistry, stress responses, and perception—and that those changes must be addressed as part of recovery. 3) Tick Boot Camp's Framework: Three “Immune Systems” That Can Break Down Rich expands the “immune system must win the day” concept from Dr. Bill Rawls’ book Unlocking Lyme, and explains how it applies beyond the body. He argues many people experience a breakdown across three interconnected systems: Physical immune system: fatigue, pain, inflammation, mitochondrial dysfunction Psychological immune system: stress response, nervous system dysregulation, belief filtering Spiritual immune system: purpose, meaning, connection, and “place in the world” The more systems involved, the more complex and longer the recovery journey can be. 4) Belief: A Two-Sided Coin (Faith vs. Doubt) Rich explains why his early messaging triggered Matt—and what finally clarified it: Belief isn’t something you either “have” or “don’t have” Belief is always present It comes in two forms: Faith: belief you’re more likely than not to get the outcome you want Doubt: belief you’re more likely than not to get the outcome you don’t want People enter the chronic illness journey carrying belief—but often it has been converted into doubt through repeated invalidation, medical dismissal, and prolonged suffering. 5) The Big Three Lies That Create “Lyme Identity” Across hundreds of interviews, Rich says the same three narratives appear repeatedly: “You don’t look sick.” “It’s all in your head.” “You can’t get better.” These lies—coming from doctors, family, society, and even internal self-talk—can form what Rich calls a “lie-dentity”: a false identity built from invalidation and survival-mode thinking. 6) Matt’s Personal Breakdown Across All Three Systems Matt describes how, in hindsight, he was dysregulated in all three systems: Spiritual/meaning: loss of connection, loneliness, relationships collapsing due to cognitive disability Psychological: new anxiety, doom, depression, fear, hyper-control while having no control Physical: severe neurological symptoms including seizures, tremors, hallucinations, inability to walk properly, and crushing fatigue He emphasizes therapy can be valuable—not because illness is imagined—but because anyone would struggle emotionally when their life collapses physically. Practical Recovery Tools Mentioned Nervous System Support and Emotional Bandwidth Matt shares that HPA Balance from Vital Plan became a turning point by calming his nervous system enough to safely pursue antimicrobial healing steps. He describes it as helping him feel “normal” again—creating the emotional bandwidth needed to keep going. He also mentions: Napiers Ashwagandha Root Tincture (Withania somnifera) Passionflower Tincture (Passiflora incarnata) Used as-needed when overstimulated, anxious, or overwhelmed. Cellular/Mitochondrial Recovery and Broad Support Matt outlines a layered approach aligned with Dr. Rawls’ cellular recovery philosophy, including: foundational supplementation adaptogenic support mitochondrial support broad-spectrum herbal antimicrobial support A Practical “Holiday” Tool Matt notes using chlorella as a personal strategy to offset inflammation after dietary triggers—supporting his ability to recover more quickly after “human moments” like holiday dessert. The Path Forward: A Simple Roadmap Rich’s recommendation for moving forward begins with something many people avoid: Step 1: Sit with it Reflect honestly on: What’s happening physically What’s happening emotionally (stress, fear, self-talk) What’s happening spiritually (meaning, connection, purpose) Step 2: Support the physical system with basics sleep diet gentle movement when possible consistent, realistic routines Step 3: Protect the psychological immune system from “lies” Recognize how invalidation can become internalized, and how survival-mode thinking can shut down healing physiology. Step 4: Rebuild meaning through service and connection Rich suggests small steps that re-establish purpose and belonging—especially for those who are still very sick. Even minimal action can restore identity and hope over time. Participate in LymeDisease.org's My Lyme Data Survey Volunteer with the Center for Lyme Action Volunteer with Lyme organizations, like Global Lyme Alliance, Project Lyme, and Lyme Warrior “When you have a bad day, how do you keep the faith?” Matt shares a practical approach: pause and breathe gratitude practice (family, progress, community, relationships) nervous system support tools when needed Rich adds: the brain can change negatively—but also positively—and building a recovery “toolbox” helps you stay stable through inevitable ups and downs. Why This Episode Matters Many chronic illness conversations focus narrowly on protocols, supplements, and symptom management. This conversation zooms out to address what chronic Lyme truly disrupts: identity, confidence, relationships, and the ability to trust yourself again. If you feel stuck, lost, or disconnected from who you were—or who you’re becoming—this episode offers a framework for understanding why that happens and how people rebuild from it. About Tick Boot Camp Tick Boot Camp is a Lyme disease awareness and recovery platform built around long-form conversations with the people who know the journey best: patients who have lived it, plus the doctors and researchers working to improve outcomes. With 650+ interviews, the show documents the common patterns behind recovery and resilience.

In this powerful and science-forward episode of the Tick Boot Camp Podcast, host Matt Sabatello sits down with Amy Proal, PhD, a leading microbiologist whose work is reshaping how the medical community understands chronic Lyme disease, post-treatment Lyme disease (PTLD), ME/CFS, and Long COVID. Dr. Proal brings a rare combination of deep scientific expertise, lived experience with chronic illness, and real-world clinical integration, offering listeners clarity on why so many patients remain sick long after standard treatment ends — and what science is finally doing about it. 👩‍🔬 About Amy Proal, PhD Amy Proal, PhD, is an internationally recognized microbiologist specializing in the molecular mechanisms by which persistent pathogens alter human immunity, metabolism, and gene expression. She currently serves in two major leadership roles: President & Research Director, PolyBio Research Foundation Scientific Director, Cohen Center for Recovery from Complex Chronic Illness (CORE) at Mount Sinai Her work focuses on infection-associated chronic illness, including: Chronic Lyme disease & tick-borne co-infections Post-treatment Lyme disease syndrome (PTLD) ME/CFS Long COVID Dr. Proal is widely known for helping shift the scientific narrative away from psychosomatic explanations and toward biological root causes driven by persistent infection and immune dysregulation. 🧬 PolyBio Research Foundation: Rewriting the Science of Chronic Illness Dr. Proal co-founded PolyBio Research Foundation in 2018 alongside neuroscientist Dr. Michael VanElzakker, after recognizing that most chronic illness research ignored root cause biology, particularly infection. What Makes PolyBio Different Led by scientists, not administrators Focused on tissue-based research, not just blood tests Actively recruits researchers from HIV, tuberculosis, and virology fields to study Lyme and ME/CFS Designs research programs before fundraising, ensuring scientific rigor PolyBio has played a major role in advancing research on: Pathogen persistence in human tissue Hidden reservoirs of infection Why standard diagnostics often fail 🏥 Cohen Center for Recovery from Complex Chronic Illness (CORE) Dr. Proal also serves as Scientific Director of the Cohen Center for Recovery from Complex Chronic Illness (CORE) at Mount Sinai in New York City. CORE’s Mission Treat patients with Long COVID and chronic tick-borne illness within an insurance-based system Integrate clinical care with active research and clinical trials Establish new standards of care for infection-associated chronic disease At CORE, Dr. Proal helps design studies that leverage real patient visits — asking critical questions such as: Where is the pathogen hiding? What tissues are affected? What immune pathways are disrupted? 🧠 Persistent Infection & Why Blood Tests Fail A central theme of the episode is that chronic infection is often a tissue-based disease, not a blood-based one. Dr. Proal explains: Pathogens like Borrelia (Lyme) and SARS-CoV-2 actively avoid the bloodstream Blood is heavily patrolled by immune cells — tissue offers protection Absence of evidence in blood ≠ absence of infection This helps explain why: Lyme disease often goes undetected by standard serology Patients remain symptomatic despite “negative tests” Tissue biopsies and advanced imaging are essential for progress 🧬 Molecular Mimicry: How Infection Triggers Autoimmune Symptoms Dr. Proal provides a clear explanation of molecular mimicry, a key mechanism linking infection and autoimmunity. What Is Molecular Mimicry? Pathogens produce proteins that closely resemble human proteins The immune system attacks the pathogen — and accidentally attacks the body This creates autoimmune-like disease, even though infection is the trigger This mechanism helps explain: Why immune suppression may reduce symptoms but worsen disease Why many autoimmune diagnoses may actually be infection-driven Why treating the pathogen matters, not just calming the immune system 🔁 Successive Infection: Why Some Patients Get Sicker Than Others A major insight from this episode is Dr. Proal’s concept of successive infection. Rather than genetics alone, she suggests severity is often driven by: Prior infections (Lyme, Bartonella, Babesia, viruses) Environmental exposures (mold, toxins) Physical trauma (concussions, brain injury) Each “hit” dysregulates the immune system, making the next infection harder to clear — a cumulative burden that explains why: Some people become severely ill from Lyme Others remain asymptomatic despite repeated tick exposure 🧠 Neurological Lyme, the Brain & the Vagus Nerve Dr. Proal discusses multiple ways Lyme and infections affect the nervous system: Direct CNS Infection Pathogens crossing the blood–brain barrier Microglial activation causing neuroinflammation Indirect Neurological Signaling Infection in the gut, heart, or lungs activating the vagus nerve nearby Direct infection of the vagus nerve with Lyme Brainstem signaling triggering fatigue, pain, dysautonomia, and brain fog This dual-pathway model explains why neurological symptoms can occur even without detectable brain infection. 🧫 Tissue, Imaging & the Future of Diagnostics One of the most exciting parts of the episode covers next-generation diagnostics, including: Tissue biopsies (gut, lymph nodes, nerve, synovium) Ultra-sensitive molecular detection Immune cell exhaustion markers (e.g., PD-1) Advanced imaging that can map pathogens in the body Dr. Proal explains how future tools may: Identify not just presence , but activity of infection Distinguish nervous system involvement Enable targeted clinical trials and personalized treatment 🧠 Infection, Alzheimer’s & Neurodegenerative Disease Dr. Proal also discusses compelling research linking infection to Alzheimer’s disease, including evidence that: Amyloid plaques may be part of the innate immune response Plaques form around viral, bacterial, and fungal pathogens Removing amyloid alone fails because it ignores root cause This framework aligns with decades of overlooked research connecting Lyme, herpesviruses, and neurodegeneration. 🌱 Hope for the Lyme & Chronic Illness Community Dr. Proal closes the episode with optimism, highlighting: Rapid advances in diagnostics Better-designed clinical trials Increasing collaboration across institutions A long-overdue shift toward biological validation Her message is clear: Patients were right. Science is finally catching up. 🔑 Key Topics Covered Chronic Lyme disease Post-treatment Lyme disease syndrome (PTLD) Persistent Borrelia infection Molecular mimicry and autoimmunity Successive infection model Long COVID pathogen persistence Tissue-based diagnostics Neurological Lyme disease Vagus nerve and dysautonomia Cohen Center for Recovery from Complex Chronic Illness PolyBio Research Foundation

In this groundbreaking episode of the Tick Boot Camp Podcast, we interview Dr. Jayakumar Rajadas, a Stanford Medicine researcher who has discovered multiple breakthrough therapeutic candidates for Lyme disease, Babesia, and Bartonella. His work includes the discovery of Disulfiram’s effectiveness against Lyme and Babesia, Azlocillin’s potent activity against Lyme and Bartonella, and advanced targeted drug-delivery systems designed to preserve the gut microbiome. Dr. Jay's research has been featured in TIME Magazine (Azlocillin) and Forbes (Disulfiram), and connects deeply with the work of leading Lyme researchers, including Dr. Monica Embers (Tulane), Dr. Kim Lewis (Northeastern), Dr. Kenneth Liegner, and Dr. Brian Fallon (Columbia University). This interview delivers hope, science, and unprecedented detail on what may become the next generation of Lyme disease treatments. Key Topics Covered 1. How the Stanford Tick Initiative Sparked a New Era of Drug Discovery In 2012, Stanford launched a major initiative in response to community demand for better Lyme treatments. Dr. Rajadas was selected to lead drug development, focusing specifically on persistent/chronic Lyme disease, where few researchers were working. 2. Understanding Borrelia: Active vs. Stationary Forms & Why Chronic Lyme Persists Dr. J explains the three key survival modes of Borrelia burgdorferi: Active Phase The bacteria are replicating and metabolically active. Easier to kill with standard antibiotics. Stationary Phase Bacteria reach population limits and slow down growth. Represents early persistence mechanisms. Persister Forms Triggered by stressors like antibiotics (e.g., doxycycline). Bacteria fold into round bodies, spiral forms, or compact “cement-like” protective balls. These forms: Shut down metabolic pathways Resist penetration Survive antibiotic exposure Why Doxycycline Can Fail Doxycycline can induce persisters, causing Borrelia to form impenetrable protective shells rather than die. This is why many patients initially feel better, then relapse. 3. Disulfiram (Antabuse): Lyme + Babesia Breakthrough Featured in Forbes One of the biggest scientific shocks of the last decade: Discovery Through Stanford’s high-throughput screening of FDA-approved drugs, Disulfiram emerged as a top hit. Clears Borrelia (including persistent forms) Clears Babesia — a major advantage over standard antibiotics Does NOT harm the gut microbiome Is already FDA-approved and widely used for alcohol aversion therapy Highly potent but requires careful dosing due to side effects in inflamed patients. Why Some Patients Improve, and Others Suffer Chronic Lyme patients already have heightened inflammation. Disulfiram is a powerful molecule whose polymorphic forms behave differently in different people. His lab developed: Less toxic formulations Buccal & sublingual delivery systems Rectal delivery options These may reduce neuropsychiatric side effects reported by some patients. Clinical Connections Dr. Kenneth Liegner pioneered clinical use and published cases Dr. Brian Fallon conducted NIH-listed clinical trials. Many clinicians now use Liegner’s protocols. Real-world example: Matt shares the story of Brooke Stoddard (Generation Lyme), who regained his life after Disulfiram treatment under Dr. Liegner. 4. Azlocillin: The Antibiotic That TIME Magazine Called a Gamechanger If Disulfiram is the Lyme and Babesia weapon, Azlocillin may be the frontline tool for Lyme and Bartonella. Why Azlocillin Is Revolutionary Eradicates both active and persister forms of Borrelia. Destroys doxycycline-induced “cement ball” persisters by drilling into their vulnerable cell-wall synthesis pathways. Proven effective against Bartonella when paired with azithromycin, based on research by Dr. Monica Embers (Tulane) . The Cell-Wall Vulnerability Breakthrough Persisters STILL must maintain minimal cell-wall synthesis to survive. Azlocillin exploits this tiny vulnerability: It penetrates the protective sphere Breaks the “cement wall” Forces the bacteria out of hibernation Kills them rapidly This discovery is one of the biggest scientific leaps in Lyme research in a decade. The Delivery System That Protects the Gut Microbiome Azlocillin is extremely hydrophilic, making absorption difficult.Dr. Jay fixed this by creating: A magnesium-lipid nanoparticle formulation Designed to release in the upper intestine Avoiding the colon (where most microbiome lives) This allows: High bloodstream absorption Minimal microbiome damage Oral availability of a drug previously only available via IV Why Azlocillin May Be Better Than Disulfiram Hits Borrelia + Bartonella Stronger anti-inflammatory effects No polymorphism issues Fewer side effects Potent against persisters A company is preparing to bring his oral formulation to clinical trials by next year. 5. Loratadine (Claritin): The First Clue from 2012 Before Disulfiram and Azlocillin, Dr. Jay’s lab identified Loratadine (Claritin) as a manganese transporter inhibitor of Borrelia. Why it mattered: Borrelia uniquely relies on manganese, not iron. Blocking manganese uptake may weaken the bacteria. The discovery went viral, with many patients reporting improvement even at OTC doses—though the binding affinity was weak. This project introduced the concept of drug repurposing for Lyme to the scientific community. 6. Melittin (Bee Venom) — The Micro-Needle Patch Alternative Bee venom therapy is widely used in the Lyme community, but risks stings and allergic reactions. Dr. J is developing: Melittin micro-needle patches Delivering the active peptide without stinging Using dissolvable, painless needles A safe, controlled, pharmaceutical-grade delivery approach This could modernize bee venom therapy and make it more accessible. 7. Mechanism of Brain Fog & Fatigue in Lyme: A Major Breakthrough Dr. Jay’s lab published a neuroscience paper demonstrating: Outer Surface Protein (Osp) Nanoparticles Borrelia sheds lipid-coated outer membrane particles. These form stable nano-vesicles that: Enter the bloodstream Cross into the brain Cause mitochondrial dysfunction Reduce ATP production Result: Brain Fog, Fatigue, Cognitive Dysfunction This explains why neurological Lyme can persist even after bacterial levels drop. This work ties strongly to ongoing research at Columbia University under Dr. Brian Fallon. 8. Collaborations With World Leaders in Lyme Research Dr. J’s research intersects with: Dr. Kim Lewis (Northeastern University) Reproduced and validated Disulfiram findings publicly. Helped launch interest in persister-killing therapies. Dr. Monica Embers (Tulane University) Demonstrated Azlocillin + Azithromycin effectiveness against Bartonella. One of the world’s foremost experts in persistent infection models. Dr. Kenneth Liegner Early clinical pioneer of Disulfiram therapy. Published stunning recovery cases. Dr. Brian A. Fallon (Columbia University) Leading psychiatrist specializing in post-treatment Lyme. Conducted planned Disulfiram clinical trials. These collaborations form a powerful network accelerating treatment development. 9. New Anti-Inflammatory Discoveries: Galangin & More Dr. Jay recently co-authored a 2025 paper on: Galangin (Thai ginger rhizome extract) Which may reverse cardiac inflammation and fibrosis His team is also exploring other nutraceutical molecules for chronic inflammation relief in Lyme patients. 10. Dr. Jay’s Personal Story of Illness and Hope He reveals for the first time: He was diagnosed with Stage 3 Multiple Myeloma Lost the ability to walk Suffered unbearable pain After cutting-edge therapies and research, he is now in full remission His message to Lyme patients: “There is ALWAYS hope.”

Dr. Bobbi S. Pritt joins Tick Boot Camp Podcast for a scientific deep dive into Lyme disease diagnostics, co-infections, and emerging tick-borne pathogens. Dr. Pritt is Professor and Chair of Laboratory Medicine and Pathology at Mayo Clinic and Director of the Clinical Parasitology Laboratory in Rochester, Minnesota. An internationally recognized expert in vector-borne diseases, she is globally known for discovering new tick-borne pathogens—including Borrelia mayonii and Ehrlichia muris eauclairensis—and for advancing cutting-edge molecular and metagenomic diagnostic testing used nationwide. This episode offers essential clarity for anyone navigating Lyme disease, unexplained symptoms, or confusing test results. Dr. Pritt explains why standard tests often miss early Lyme, how PCR and molecular tools can detect active infection, and what metagenomic sequencing may offer for more accurate and comprehensive diagnostics in the future. Episode Summary Dr. Pritt breaks down how Lyme and other tick-borne diseases are detected through antibody testing, PCR, tissue analysis, and cutting-edge molecular methods. She explains how her lab discovered multiple new pathogens in the upper Midwest, the role of tick species in disease transmission, and why co-infections complicate diagnosis. This conversation also explores geographic spread, climate change, tick behavior, and the strengths and limitations of today’s test algorithms. Key Topics • Discovery of Borrelia mayonii as a second cause of Lyme disease in the U.S. • Identification and characterization of Ehrlichia muris eauclairensis • Geographic hotspots and why the upper Midwest produces unique pathogens • Tick species differences: blacklegged vs. lone star ticks and their hunting strategies • Co-feeding in ticks and its role in pathogen evolution • Why early Lyme tests often return false-negative results • The science behind false positives and cross-reactivity • PCR advantages and limitations for detecting Borrelia • When skin biopsies can outperform blood tests • Differentiating Lyme, B. miyamotoi, Anaplasma, Babesia, and Powassan virus • When clinicians should order a full tick-borne disease panel • How climate and ecological changes drive new tick-borne threats • The promise of metagenomics and immune-signature diagnostics What You’ll Learn • Why current Lyme testing algorithms struggle in early infection • How new tick-borne pathogens are discovered and validated • Why lone star ticks are more aggressive and changing regional risk • When and why molecular testing is more effective • What symptoms point to co-infections needing additional testing • Why doxycycline is not effective for certain pathogens like Babesia • How metagenomic sequencing could identify every pathogen in a single sample • Where diagnostic innovation is heading and what patients can expect

What makes Lyme disease resolve quickly in some people but turn into a life-altering chronic illness in others? In this episode, world-leading immunologist Dr. Michal “Mikki” Tal, Principal Scientist at MIT, explains what her team is discovering through the MAESTRO Study — the largest clinical research project in MIT’s history and the first of its kind to include real Lyme patients in a multi-system biological analysis. Dr. Tal’s work sits at the intersection of immunology, bioengineering, and women’s health, uncovering how infections like Lyme and COVID can cause persistent inflammation, immune miscommunication, and hormonal imbalance. Through MAESTRO, she’s mapping how recovery breaks down — and what can be done to predict, prevent, and ultimately reverse chronic illness. 👩‍🔬 About Dr. Tal Dr. Michal “Mikki” Caspi Tal, PhD Principal Scientist, MIT Department of Biological Engineering Associate Scientific Director, MIT Center for Gynepathology Research Head, Tal Research Group A Yale-trained immunologist (PhD under Dr. Akiko Iwasaki) and former Stanford researcher in Dr. Irving Weissman’s lab, Dr. Tal specializes in infection-associated chronic illnesses. She has received NIH NIAID fellowships and the Bay Area Lyme Foundation Emerging Leader Award for her pioneering research on the immune mechanisms linking Lyme disease, Long COVID, and chronic inflammation. 🧬 What You’ll Learn 1. Why 10% of People Don’t Recover from Lyme Roughly 90% of Lyme patients recover after antibiotic treatment — but 10% continue to experience long-term symptoms. Dr. Tal explains that this is not psychological; it’s biological. In these individuals, the immune system’s “off switch” fails, leading to chronic inflammation, tissue injury, and immune exhaustion — a state she calls catastrophic recovery failure. 2. The MAESTRO Study: Measuring Absolutely Everything MAESTRO (Mucosal And systEmic Signatures Triggered by Responses to infectious Organisms) integrates advanced biology, neuroscience, and patient experience. Participants provide: Blood, saliva, urine, and swab samples for immune and microbiome profiling EEG brainwave tests (WAVi), eye-tracking (RightEye), and cognitive testing (BrainCheck) NASA Lean Test for autonomic dysfunction (POTS) and capillaroscopy to visualize microvascular flow Evie Ring wearable tracking sleep, heart rate, and oxygen Plainly: MAESTRO maps the connection between what patients feel and what’s happening biologically inside their brains, blood, and immune systems. 3. Sex-Based Immunity and Hormonal Differences Every immune cell carries receptors for estrogen, progesterone, and testosterone. These hormones literally change how the immune system responds. Men: more severe acute infections. Women: more likely to survive but develop chronic post-infectious illness. This isn’t “in their heads” — it’s a biological trade-off built into human evolution. 4. Lyme and Reproductive Health Dr. Tal’s group uncovered Borrelia (Lyme bacteria) in the uterus and bladder of infected animal models, and population studies show a twofold increase in gynecologic conditions (like endometriosis and PCOS) after Lyme infection, even post-treatment. This challenges the old view of Lyme as a joint or nerve disease — revealing it as a whole-body infection that can affect reproductive and hormonal health. 5. Immune Checkpoints: How Borrelia Hits the Brakes The immune system uses checkpoint molecules as brakes to avoid self-destruction. Dr. Tal found that Borrelia’s P66 protein can engage SIRP-alpha, a human “stop signal,” effectively telling the immune system to stand down too soon. This immune hijacking may explain persistent infection and the biological differences in recovery between men and women. 6. Collagen, Mast Cells, and Hypermobility Many chronic Lyme patients report joint laxity or Ehlers-Danlos-like symptoms. Dr. Tal’s research shows Borrelia can reside within collagen-rich tissues, provoking mast cells (inflammatory immune cells) to attack both the bacteria and the body’s connective tissue — weakening ligaments, causing pain, and perpetuating inflammation. 7. Allergy-Type Immune Reactions to Bacteria Around one-third of chronic Lyme patients produce IgE antibodies (normally linked to allergies) against Borrelia and oral spirochetes such as Treponema denticola. In simple terms: the immune system becomes “allergic” to its own bacteria, keeping inflammation alive even after infection clears. 8. Brain Biomarkers: Reaction Time and Neuroinflammation By using EEG and eye-tracking technology, the MAESTRO study reveals that people with chronic Lyme and Long COVID have measurably slower reaction times — a neurological signature of inflammation that validates patient-reported “brain fog.” The data prove that cognitive slowdown is not subjective — it’s an objective biomarker of neuroinflammatory illness. 9. Predicting Chronic Illness Before It Happens The ultimate goal: identify the biological patterns that forecast who will develop chronic Lyme. Using multi-omics (proteomics, metabolomics, genomics) integrated with functional tests, Dr. Tal’s team aims to create the first predictive diagnostic framework for infection-associated chronic disease. 🧠 Key Quotes “MAESTRO stands for Measure Absolutely Everything. That’s how we make invisible illness visible.” “Every immune cell listens to hormones. That’s why recovery looks different between men and women.” “Borrelia can tap the immune system’s brakes — that’s how it survives.” “Reaction time is data. It’s what brain fog looks like when you can finally measure it.” 🧩 The Big Picture Dr. Tal’s work bridges hard science and patient reality, validating what millions of Lyme patients have felt for decades. Her data suggest that chronic Lyme disease, Long COVID, and similar conditions share a common root: a failure of immune resolution. By decoding these patterns, her team is paving the way for real diagnostics, targeted treatments, and renewed hope. 🧪 Participate The Tal Research Group's MAESTRO program is seeking Chronic Lyme Disease and Acute Lyme Disease patients to participate in their large clinical study. Participants provide samples and complete neurological and physiological testing at baseline, 6-month, and 12-month visits. Visit Tal Research Group MAESTRO website to learn more or be connected with the MAESTRO research team.

In this episode of the Tick Boot Camp Podcast, Matt Sabatello sits down with Yuri Kim, the lead clinical research nurse for MIT’s MAESTRO study, described as one of the largest studies in MIT history focused on Lyme disease and Infection-Associated Chronic Illnesses (IACI). Yuri explains how MAESTRO is collecting deep symptom histories and objective measurements—from eye tracking and EEG/P300 auditory testing to NASA Lean dysautonomia testing, capillaroscopy, and multi-sample biological collection—to identify patterns that validate patient experiences and accelerate real-world clinical understanding. Yuri’s story is equally compelling: she began as an ER nurse in a Level 1 trauma center, transitioned into research nursing (including neurodegenerative and traumatic brain injury work), moved to South Korea during the pandemic, and ultimately joined MIT after a conversation with Dr. Mikki Tal changed the course of her career. Throughout the conversation, Yuri shares what she’s learned from MAESTRO participants: a community often exhausted and dismissed, yet profoundly motivated to help others and drive scientific progress forward. Key Takeaways (Fast Scan) MAESTRO is nearing ~200 participants enrolled, with the chronic Lyme cohort full and enrollment closing soon. The study aims to objectively measure symptoms often dismissed as “anxiety” or “depression,” especially brain fog and dysautonomia. MAESTRO uses multiple cognitive and neurologic measures, including RightEye eye tracking, EEG + P300 auditory “oddball” testing, and remote cognitive battery tests. The team added capillaroscopy (nailfold and toe microvascular imaging) to explore vascular patterns and hemorrhages in chronic illness cohorts. Dysautonomia testing includes NASA Lean Test plus an earpiece device to estimate proxy cerebral blood flow, sometimes showing abnormalities even when vitals look “normal.” Extensive biological sampling (oral, blood, vaginal/rectal) supports proteomics/immune profiling and deeper molecular analysis. Yuri emphasizes: patients’ willingness to participate—despite severe symptoms—is the engine of progress and future change. Detailed Chapter-by-Chapter Show Notes 1) Meet Yuri Kim: The Human Side of Cutting-Edge Lyme Research Matt introduces Yuri as the clinical research nurse leading day-to-day operations of MIT’s MAESTRO study—positioning her as a rare bridge between lab science, clinicians, and patients. Yuri shares that the study is approaching enrollment completion and that the team is eager to analyze a large dataset to “speak up” for participants who have suffered without clear explanations. Highlights: MAESTRO is one of MIT’s largest studies, with enrollment nearing completion. The mission is to transform patient suffering into measurable signals, data, and insight. 2) Yuri’s Background: Pharma, ER Nursing, Research, and Why This Work Became Personal Yuri explains her path: early work as a medical information specialist in pharma (including literature searches and clinician guidance, often involving off-label questions), then an intense period as a Level 1 ER nurse where she witnessed both acute crises and chronic illness desperation. Key insight:Yuri notes that in pharma and ER settings, she repeatedly saw the same reality—patients searching for answers, clinicians constrained by time, and chronic illness voices falling through the cracks. 3) From the ER to Neuro Research: Brain Inflammation, TBI, and the Gap in Chronic Illness Care Yuri left ER work largely due to the physical toll of night shifts and moved into academic research at Boston University. She worked on complex studies involving Alzheimer’s, amyloidosis, and traumatic brain injury. Matt asks whether Lyme came up in those neuro settings. Yuri says no—but now she views neurodegenerative symptoms differently and believes clinicians should consider underlying root causes, including infection. Listener connection:This segment reinforces how often Lyme-related cognitive decline can be misinterpreted or missed when viewed through siloed specialties. 4) Lyme Awareness Outside the U.S.: South Korea, Tick-Borne Illness, and Global Blind Spots During the pandemic, Yuri relocated to South Korea. She shares that Lyme isn’t commonly discussed there, though other tick-borne illnesses exist. Yuri underscores a global concern: agricultural and rural communities face tick exposure without awareness of the chronic implications. 5) How Yuri Joined Dr. Mikki Tal and MAESTRO (And Why She Changed Her Mind) One of the most memorable segments: Yuri reveals she had already accepted another MIT nursing role—but after speaking with Dr. Tal, she pivoted immediately, calling it the best career decision she’s ever made. Why it matters: It shows how MAESTRO is not just a study; it’s a mission-driven effort that attracts top clinical talent. 6) Day One at MAESTRO: Meeting the Severely Ill and the Community’s Unmatched Generosity Yuri recounts a powerful early experience: meeting a participant who was bedbound and profoundly symptomatic, yet eager to contribute anything possible to help the community. Matt connects this to Tick Boot Camp’s origin story: people with minimal energy still showed up to help others. The theme becomes clear—Lyme patients are often depleted but relentlessly generous. What MAESTRO Measures (The Four-Hour Visit Breakdown) 7) Brain Fog: Why MAESTRO Treats It as a Complex Phenomenon Yuri explains MAESTRO’s approach: brain fog isn’t one symptom. It can involve memory, processing speed, visual stimulation sensitivity, pain-triggered cognition changes, and motor response delays. Core idea: MAESTRO attempts to measure brain fog from multiple angles—visual processing, auditory processing, reaction time, and executive function. 8) RightEye Eye Tracking: Visual Stimulus + Reaction Time as Objective Signal Participants complete a structured set of ocular motor tasks (pursuit, saccades) and reaction-time games (shape recognition mapped to numbered inputs). Yuri notes many chronic illness participants struggle even with basic saccades, often aligning with reported visual disturbances. What MAESTRO is measuring: Ocular motor control Visual processing Decision speed Reaction time consistency 9) EEG + P300 “Oddball” Test: Auditory Processing Meets Motor Output Participants wear an EEG cap (19 regions) and listen to tones: common low-pitch and rare high-pitch. They must press the spacebar only for the rare tone. Yuri notes that even a 4-minute test can be exhausting for people with cognitive dysfunction, and participants often describe a frustrating “delay” between knowing what to do and physically doing it. Why this matters: This may help validate cognitive dysfunction even when standard office screening looks normal. 10) Remote Cognitive Battery Testing: Scaling Measurement Beyond MIT Participants complete executive function tests at home (memory, Stroop-like color-word matching, trail-making tasks). Yuri emphasizes why this matters: many patients can’t travel, and symptoms vary dramatically by day, cycle, and crash patterns. Big future direction: Remote testing could expand access to bedbound patients and capture “good day vs bad day” variability. 11) Dysautonomia & POTS: NASA Lean Test + Proxy Cerebral Blood Flow Yuri details NASA Lean testing: supine rest, then standing/leaning while monitoring vitals and symptoms. The standout: sometimes vitals appear stable while patients feel intensely symptomatic—yet the cerebral blood flow proxy measurement fluctuates significantly. Clinical implication discussed: This approach could become a tool for identifying dysautonomia-related issues when standard vitals “look fine.” 12) Capillaroscopy: Nailfold + Toe Microvascular Imaging MAESTRO added capillaroscopy to examine microvascular patterns, including abnormal shapes and possible hemorrhages seen more frequently in chronic cohorts (as her clinical observations suggest). They also measure capillaries pre- and post-NASA Lean to explore whether symptomatic shifts correlate with microvascular changes. Why patients find it meaningful: They can visually see something measurable that aligns with how they feel. 13) Standard Neuro Screening Doesn’t Capture Lyme Brain Fog Yuri shares a crucial point: participants often perform fine on standard screens like the Mini-Mental State Exam, suggesting that infection-associated cognitive dysfunction can be subtle, dynamic, and not detected by traditional tools—reinforcing the need for MAESTRO-style measurement. Biological Samples: “Measure Everything” (Head to Toe) 14) Multi-Sample Collection: Oral, Blood, Vaginal, Rectal Yuri explains the breadth of biological sampling, including saliva/oral samples (cotton chew + gum swab), multiple blood tubes, and sex-specific sampling to explore immune, hormonal, microbiome, and gynecologic dimensions. Why it’s being done: To connect symptom clusters to molecular patterns and explore sex differences in chronic illness response. 15) Storage, Batch Effects, and What Happens After Enrollment Closes Samples are aliquoted and stored at -80°C until they can be processed/shipped in ways that minimize batch effects. The next phase is analysis and collaboration—including proteomics and immune signaling exploration. 16) Giving Back to Participants: The Challenge and the Intention Yuri acknowledges the “fine line” between research-only testing and clinically actionable reporting, but stresses MIT’s intention to return what can be responsibly shared through certified partners—while being careful not to over-interpret research findings. Collaboration, Scaling, and What Comes Next 17) Collaboration Across Institutions: The Missing Platform Matt compares Lyme research needs to cybersecurity threat-sharing between banks: competitors collaborate because the threat is bigger than any one organization. Yuri agrees and highlights the need for secure data-sharing platforms—similar to large national efforts in other fields. 18) What’s Next: Focus on Female Brain Fog, Hormones, and Remote Studies Yuri previews upcoming directions: Brain fog and hormone cycle relationships Differentiating infection-associated cognitive dysfunction vs menopause-related brain fog Remote/at-home measurement studies to reach more symptomatic and bedbound patients Potential collaborations with pediatric and neuroimmune experts Closing Message: Hope Without Hype Yuri’s message to patients and families is simple and emotional: “Please don’t give up.” She believes answers are coming because serious teams are working together—and because patients are driving the research forward with their participation.

Mary Beth Pfeiffer, the pioneering investigative journalist who transformed national understanding of Lyme disease, joins the Tick Boot Camp Podcast for a landmark conversation. Before her work, Lyme disease was widely dismissed as rare, mild, and easily treated. After her reporting, that narrative collapsed. Through her award-winning journalism and her groundbreaking book Lyme: The First Epidemic of Climate Change, she became the first major voice to expose the truth: Lyme disease is a global, climate-driven epidemic that is chronically misdiagnosed, dangerously underestimated, and systematically mishandled by mainstream medicine. In this interview, Mary Beth shares how her earlier investigative work on mental illness in U.S. jails prepared her to recognize patterns of institutional failure within the Lyme disease system. For decades, she documented how people with bipolar disorder and schizophrenia were misunderstood, punished, or dismissed by the very institutions meant to protect them. When she turned her attention to Lyme in 2012, she immediately recognized the same dynamic: patients with neurological and psychiatric manifestations were told they were anxious, depressed, or “crazy,” rather than infected. Families were blamed, symptoms were minimized, and children were left to suffer. Her background gave her a rare lens into how biological illness becomes mislabeled as psychological and how systems silence the very people who need help. Mary Beth explains how her investigative series for the Poughkeepsie Journal went viral worldwide, surprising even her editors. Her reporting was read in all 50 states and across Europe and Australia, prompting the CDC to contact her directly. She details what she uncovered through Freedom of Information Act requests, including internal emails between NIH and CDC officials referring to patients as “Lyme loonies” and framing the situation as a “war” against advocates. These documents revealed attitudes inside the highest levels of public health that shaped decades of policy, diagnostic guidelines, and patient care. The conversation dives into how a small group of early Lyme researchers defined the disease in the 1980s and then used their influence to control medical journals, shape NIH grant funding, and enforce rigid IDSA treatment guidelines. As Mary Beth explains, these early assumptions—often based on limited data and flawed antibody tests—became dogma. Their conclusions created an ecosystem where only short-course antibiotics were considered acceptable, chronic symptoms were dismissed, and doctors who treated beyond the guidelines were punished by medical boards. The result was a generation of patients abandoned by the system, forced to self-fund care, travel to distant specialists, and in many cases bankrupt themselves in search of answers. Mary Beth discusses how patients became her greatest teachers. She shares emotional stories, including children who lost years of their lives, athletes whose careers were derailed, and an 11-year-old boy misdiagnosed for so long he ended up in a hospital bed in his living room before finally being rescued by Dr. Charles Ray Jones. She describes support groups filled with people who had seen five, ten, or fifteen doctors and were told their symptoms were anxiety, depression, or “anything but Lyme.” The interview covers the scientific evidence supporting Lyme persistence, including animal studies, autopsy tissue findings, and molecular research showing Borrelia surviving standard treatment. Mary Beth explains why the two-tier antibody test has failed generations of patients, why indirect antibody tests are inherently flawed for immune-dysregulated populations, and why the future of accurate diagnosis depends on direct detection methods. She highlights emerging technologies, including promising work by Aces Diagnostics and Researcher Holly Ahern, which may finally offer accurate testing across all stages of infection. The conversation moves into the larger systemic problem: how money, insurance policies, medical boards, industry influence, and journal gatekeeping have shaped what doctors are allowed to do. Mary Beth and the Tick Boot Camp team explore why clinicians who try to help chronic Lyme patients often lose insurance coverage, face board complaints, or have their licenses threatened. They discuss how electronic monitoring, AI systems, and corporate-owned medical practices further restrict doctors from practicing individualized, patient-centered medicine. The second half of the interview focuses on the environmental drivers behind the explosion of Lyme disease. Mary Beth explains how warming temperatures, shorter winters, and ecological fragmentation have created ideal habitats for ticks. She describes how ticks have climbed mountains, expanded into higher latitudes, colonized suburban landscapes, and gained longer active seasons. These environmental changes, combined with human development patterns, have dramatically increased opportunities for exposure. She also addresses public interest in the bioweapons question raised by Chris Newby’s book Bitten, explaining why historical documentation and FOIA evidence convinced her that military tick experiments occurred, even if their impact on today’s epidemic is still unknown. The episode closes with Mary Beth’s reflections on prevention, vigilance, and the psychological cost of losing the innocence of nature. She describes how she now sees fields, forests, and even yards differently and why she teaches her grandchildren to treat nature with both respect and caution. She shares her hope for the future: better diagnostics, more independent research, journalists willing to challenge medical orthodoxy, and a cultural shift that frees doctors to practice real medicine rather than rigid algorithms. This interview is essential listening for anyone affected by Lyme disease, anyone questioning why chronic illness is so often dismissed, and anyone seeking to understand how climate change, medical politics, and investigative journalism intersect in one of the most important health crises of our time.