Why is it so hard to identify Bartonella in our system?
"Now unfortunately, testing is not great for Bartonella. This is the one co-infection I always test a minimum of two times. So I will test you once and then, if you're still, when we're doing re-tests maybe a couple of months later, we're going to check Bartonella again even if you were negative because we do have some problems with it being very, very hard for your immune system to identify. One reason why it's really hard for your immune system to grab onto it is it is an “intracellular bacteria,” so it actually loves blood cells, and loves endothelial cells, and including immune cells in your blood, not just red blood cells. It then goes inside your cell, so because it's inside your cell it's a little harder for your immune system to identify. And then secondly, it actually takes over part of your cell which creates a vacuole. Now, this is a normal process your cells do, if we’re going back to 10th grade biology, you can actually create a little “compartment” where you can store stuff, maybe that'll harm your cell. Well Bartonella uses this in its favor to create its own little home inside your cell. And this is one reason why it's pretty hard for your immune system to get at, because it hides. It's a double membrane-bacteria that then hides inside your cell and then it hides inside a vacuole, so it's got four layers of protection to help it survive inside your system.
There are people who actually believe Bartonella may be an even bigger problem than Lyme, it just doesn't get, you know, as much press and as much funding!"
In terms of Testing; if I went to my medical doctor versus coming to a functional medicine practitioner such as yourself, will there be difference in how this is tested?
"Your primary doctor will run Bartonella Henselae. We do that test, but also we have access to some PCR testing, and you can run, like, if I run a big co-infection panel, we run nine bartonella markers as part of it as opposed to just, you know, just one. So, and then you can get even more specialized from that, but like our big co-infection panel does somewhere between three and nine, you know, ways to look at it, if I can put it that way."
Simple serological test doesn’t always work to detect Bartonella.
If you test positive with the simple serology test, you know you have Bartonella.
If you test negative, but show symptoms of Bartonella, the more extensive Bartonella PCR panel may be recommended.
Understanding PCR panels: Dr. Kyle explains how he decides which of his patients need the more specific and therefore, more expensive Bartonella panels.
"There are two labs which now are pushing some Bartonella. One is called Galaxy Diagnostics. They were started as a Bartonella lab. Now, they have some of the other tick-borne stuff now, but they're agenda’s really trying to help people be aware that bartonella may be an even bigger problem than Lyme disease, at least a possibility. And then also Igenex, who anyone in the Lyme disease world is usually familiar with Igenex as a lab. They also have some, you know, specialized Bartonella testing to try and better visualize this problem. The problem with both these labs is they're very expensive. And so what we often do is we run, like I said, we run two tests which can be run very well, and if we're still suspicious, sometimes I have a talk with patients about, you know, maybe spending the money to run one of those, kind of, more specialty Bartonella panels."
How much does it cost?
"Depending on which version of things you run, it's often about a thousand dollars, and that's just a lot to answer the one question of, do you have bartonella or not, right? It doesn't answer any other question, it doesn't look at other tick-borne things, doesn't look at inflammation, doesn't look, it just is to answer the question of, do I have Bartonella or do I not? And, so that's a decent amount of change to answer you know, a very narrow, you know, very narrow question."
If a patient is hesitant to spend the money on the Bartonella panels (roughly $1000) Dr. Kyle has an ingenious way to determine if Bartonella is really causing the issues for his patients…Dr. Kyle explains…
"Because we know that there's a little bit of a Bartonella blind spot possibility, you can also do some things to be, you know, clinically relevant. Like for example, Bartonella really attacks endothelial cells, so we get into blood flow. This is why it's documented, I think it's the third leading cause of seronegative endocarditis, which is a heart infection, and it really causes a lot of blood flow issues. Well because of this, the nutrient arginine or L-arginine or also L-citrulline, people with Bartonella tend to feel better with this. And I remember going through this, we were doing some different blood, this is just blood flow, nutrition, pretty basic stuff if you look up those things, there's research with heart and with workout for these nutrients. And I remember just doing this randomly with people, and some of my chronic people felt really good with this. And I actually back-ended to realize when I was doing some reading, that bartonella patients typically respond very well to that because it actually kind of addresses some of the imbalances Bartonella causes. So part of what I'll do when I'm suspicious is, I’ll have somebody try something that improves nitric oxide, which is what arginine and citrulline do, and if they respond very positively to nitric oxide based supplementation, then I become more suspicious that Bartonella may be a big player."