In this Gordon Medical Forum Webinar, Dr. Steven Harris answers community questions about therapeutic strategies for Lyme disease and other tick-borne illnesses. The conversation explores how clinicians approach complex Lyme presentations — including Lyme arthritis, neurologic symptoms, relapse after periods of dormancy, and overlapping conditions like chronic fatigue, mold illness, and mast cell activation. Dr. Harris discusses how treatment often requires addressing multiple factors beyond infection alone, such as inflammation, immune dysregulation, detoxification capacity, and co-infections like Bartonella and Babesia. The discussion also covers evolving therapies, diagnostic challenges, and why treatment plans often need to be individualized and layered over time for people with chronic or persistent illness.

0:00 — What definitively distinguishes Lyme arthritis from rheumatoid arthritis?

2:00 — Is there a peptide that can help heal neurologic damage from Lyme?

3:10 — Do people with chronic Lyme disease ever get completely healed? If so, what would it take?

6:10 — What is your opinion of hyperthermic therapy (like what Clinic St. George in Germany offers)?

8:15 — Is it possible to treat MCAS + Lyme/co-infections + SIBO + MARCoNS + limited diet, etc., while still having reactions? Or do you need to be fully reaction-free (or on mast cell stabilizers / change environments) before you can begin treating?

11:50 — Can Lyme be sexually transmitted?

13:40 — Can you discuss Lyme with ADHD and Lyme with OCD?

18:05 — Can you discuss Bartonella’s involvement with small vessel disease in the brain?

20:05 — A recent paper suggests that about half of those with severe ME/CFS cases may involve Bartonella/Babesia and could be treatable — what’s your take on that?

23:00 — I have Lyme coming back after years dormant and started daily IV Rocephin for two weeks — is this a good idea? (Plus: blurry vision, neuropathy, knee replacement acting up.)

28:20 — How can we find out about the trials for Hygromycin A and Piperacillin (and their progress)?

31:45 — Treating Lyme while treating mold: should you start Lyme treatment only after lowering mold burden in the system?

33:50 — What are the short- to long-term effects of IV antibiotics on gut microbiome diversity (and other body microbiomes), and how can negative changes be mitigated beyond lots of pre/probiotics?

37:05 — Best medication combo for Lyme + Bartonella (and plasma/plasmapheresis) for someone who hasn’t responded to anything in the past (currently on IV doxy + Rocephin + oral methylene blue)?

42:10 — How can you tell if Lyme is chronic or not?

47:05 — Can you talk about the potential treatment: piperacillin?

48:30 — Can having Lyme affect your ability to have children, and can babies be born with the disease?

53:15 — When exercise triggers neuro symptoms after past Lyme treatment, should I meet with a provider before working out again, or try working out and find a provider if a flare happens (given cost barriers)?

57:35 — Can you explain (in basic terms) the pathophysiology of neurologic complications from Lyme? Is there scientific support for serum antibody testing for neurologic markers (myelin or “gal” proteins)?

57:59 — What testing do you suggest to evaluate someone who’s been out of active treatment for some time but has current chronic Lyme symptoms? Is it better to assess via symptoms rather than testing?