Introduction

Dr. Pamela Cipriano is a nurse practitioner and founder of The Practice of Health and Wellness in Connecticut, with deep training in functional medicine, ILADS-trained Lyme disease treatment, and complex chronic illness. In this episode, she joins me to talk about one of the most misunderstood and misdiagnosed conditions out there — chronic Lyme disease and its co-infections — and why mainstream medicine keeps getting it wrong.

Episode Highlights

From ICU Nurse to Functional Medicine Practitioner

Dr. Cipriano's path from critical care nursing to running her own functional medicine practice was shaped by frustration with how poorly chronic patients were being managed in conventional settings. Her nursing background gave her a prevention-first mindset that conventional medicine simply doesn't prioritize.

• As a nurse, she was trained to prevent disease — not just wait for it to happen and then treat it
• Her doctorate research focused on preventing the progression from pre-diabetes to diabetes
• She opened her own practice in 2016, and a year later her son's health crisis changed everything
• Functional medicine felt like a natural extension of nursing — understanding how the body actually heals itself

Her Son's 10-Year Lyme Battle — and How She Finally Solved It

Dr. Cipriano's son was bitten by a tick at age six, got a bullseye rash, and was treated with a short course of antibiotics. He seemed fine — until a hernia surgery at 19 triggered a total collapse. For ten years, no one could figure out what was wrong. Dr. Cipriano eventually did.

• His symptoms included joint pain, brain fog, inflammation, bladder and bowel issues — and every test came back negative
• He was told "it's all in your head" — a diagnosis too many of our listeners know far too well
• The key breakthrough was the HNK-1 natural killer cell test: his level was 10 (normal is 60–360), meaning his immune system was too suppressed to even show a positive result on standard Lyme tests
• He was treated with antibiotics for about three years before his HNK-1 rose to 60 — at which point an Igenex test finally came back positive for Lyme
• He is now in his late 30s and doing well

The Lyme Biofilm Problem — and How to Break Through It

Borrelia, the bacteria behind Lyme disease, builds a protective biofilm inside the body that antibiotics and even the immune system cannot penetrate. Researcher Eva Sapi at the University of New Haven discovered that liquid stevia can break open this biofilm — but only when combined with the right enzyme in a human body.

• Borrelia uses your own proteins to build a biofilm "housing structure" that protects it from antibiotics and your immune system
• Even IV antibiotics cannot penetrate this biofilm
• Stevia (the plant extract) was found to break open biofilms in the lab; clinical trials added serrapeptase or nattokinase to make it effective in humans
• Serrapeptase is derived from silkworms — the same enzyme they use to break out of their cocoons — and it eats away non-living structures like biofilm
• This combination is what Dr. Cipriano used to help her son heal

Why Standard Lyme Tests Are Unreliable

Mainstream Lyme testing wasn't designed to diagnose Lyme — it was designed for epidemiological research. That's a critical distinction most patients and even many doctors don't know. Dr. Cipriano breaks down exactly why these tests fail so often.

• The standard Western blot test only has 3 out of 10 bands that are actually specific to Lyme disease; you need 5 of 10 to be considered positive — meaning a true positive is essentially impossible to achieve with this test alone
• If a patient's HNK-1 natural killer cell count is below 60, a false negative result is almost guaranteed
• She relies on Igenex (California) for comprehensive tick-borne disease testing and Galaxy Labs specifically for Bartonella
• If clinical signs point to tick-borne disease and the HNK-1 is low, she will treat even without a positive test
• Thorough documentation is critical — the government scrutinizes practitioners who treat Lyme disease

Bartonella, ALS Misdiagnoses, and the Danger of Missed Co-Infections

Bartonella is a co-infection that can be transmitted by ticks, cat scratches, spider bites, fleas, horse flies, and even mosquitoes. When left undetected, it can drive neurological deterioration so severe that patients are diagnosed with ALS — a terminal diagnosis. Dr. Cipriano is seeing this pattern repeatedly.

• ALS is a diagnosis of exclusion — if everything else is ruled out, that label gets applied. But if Lyme testing was never done correctly, the real cause is missed
• One patient she was treating declined rapidly despite her efforts and passed away before more aggressive treatment could begin — a loss that still affects her deeply
• Bartonella can also cause autoimmune markers like ANA and RA factor to test positive; when the infection is treated, those markers often disappear
• The internet — including information from prominent medical centers — is filled with misinformation about Bartonella, parasites, and Lyme that even well-meaning physicians believe
• If you have unresolved neurological symptoms, she urges you to find a Lyme-literate provider before accepting a neurological diagnosis

Seizures, Autoimmune Encephalitis, and the Herxheimer Reaction

Dr. Cipriano published a peer-reviewed paper on two of her patients — one 14 years old, one 25 — who developed seizures after starting antibiotic treatment for Lyme. What looked like a drug reaction was actually a Herxheimer reaction: a sign the treatment was working but triggering intense inflammation.

• The 25-year-old went into status epilepticus, was placed on life support and an Ativan drip, and was transferred to a larger medical center
• Neurologists kept adding more antiepileptic medications — none of which stopped the seizures
• Dr. Cipriano followed a Mayo Clinic protocol for virus/bacteria-induced seizures (used for hepatitis C) and treated with high-dose steroids (Solu-Medrol) followed by IVIG
• Both patients are now seizure-free
• She compares having Lyme disease to having cancer: you will likely feel worse before you feel better, and patients need to hold on through that period

Ivermectin, Antiparasitics, and Emerging Treatment Approaches

Dr. Cipriano is collecting data on the use of ivermectin for Bartonella and has found that patients turn the corner much faster when it's added to their protocol. She's seeing promising results and plans to publish her findings.

• Her current dosing protocol: twice a week to start, then every other day, then daily depending on patient response
• Ivermectin has been around for decades, has a good safety profile, and she hasn't found significant drug interactions in her patient population
• She also uses antiparasitics for patients with residual bladder and pelvic symptoms — even her own son benefited from a recent round
• Contrary to what many U.S. doctors claim, you don't need to travel internationally to acquire parasites
• She sees patients in person in Connecticut, via telehealth across the U.S., and works with providers internationally for patients in countries like Germany, Italy, and Australia

Notable Quotes from this Episode

The ANA can be positive. The RA can be positive. The lupus can be positive. And then you get rid of the tick-borne disease and all those positives turn to a negative. And then the rheumatologist says it was a coincidence. And it's like, no, this was not a coincidence.
Dr. Pamela Cipriano

Having a tick-borne disease is like having a cancer. You will get better eventually, but you're gonna get worse with the treatment before you get better. You're gonna wanna quit the treatment, and then all of a sudden, one day you're gonna turn that corner.
Dr. Pamela Cipriano

You have one life. We treat our cars better than we treat our bodies. We can replace a car tomorrow. We cannot replace this body.
Dr. Pamela Cipriano

If you don't have the time or you don't have the knowledge, then you should be referring out to somebody who does.
Dr. Pamela Cipriano