What would you consider the best treatment for Lyme when you also have MCAS? 

What would you consider the best treatment for Lyme when you also have MCAS? 

A lady here has MCAS and Lyme disease. She's saying, what would you consider the best treatment for Lyme when you also have MCAS and being super sensitive to everything? 
Yeah. There's no best treatment, unfortunately. There are lots of options. My approach with patients who are really sensitive and have MCAS is to really try to address the MCAS to calm down the system as much as possible, which will be a little bit difficult if the infections are continuing to be the trigger for the MCAS. 

But in some cases, I can modulate the immune system enough and calm the mast cells down enough that then you can start to add the different treatments. And the treatments vary depending on whether it's truly Lyme or Borrelia burgdorferi, that particular organism that causes Lyme. 
But there are Lyme cousins. There's Bartonella and Babesia and Ehrlichiosis and Anaplasma and Brucella. And so, oh my gosh, there are lots and lots of infections. And some people use the term Lyme as an umbrella term. 

I would just use vector-borne infection because they all come from a vector, could be a tick, but like for Bartonella, it could be various insects of other kinds, could be fleas and lice and spiders. 
So the point is that each of those things are treated a little bit differently. Things have different activity against those bugs. We know that the infections can change forms in certain cases, like we know that Lyme can exist as an intracellular form, can exist as an L form, as a cell wall form, as a cyst form. 

And so there are different modalities that address these different forms. In general, the infections tend to go into these states of persister cells, where they sort of persist and a lot of things don't get them. 
So we look at things that we call persister protocols and there are various things that we can do. And then I can use things like herbs and homeopathy. I can use ozone therapy, which for some of my mast cell patients has been very, very helpful. 

I can use antibiotics. I can use SOT therapy, which is another therapy that is very molecularly targeted. I think the main point is that it's a little bit of a balance between dealing with the mast cells and dealing with the infections.