Bartonella and Babesia Symptom Checklists, According To James Schaller, MD, MAR

James Schaller, MD, MAR, has spent many years researching and treating Bartonella and Babesia, two important tick-borne infections implicated in chronic Lyme disease. He is a prolific writer who has published several books on these infections, as well as on other topics relating to chronic illness and tick-borne infections. Below I share with you Dr. Schaller's recently-compiled symptom checklists for Babesia and Bartonella, which most often cannot be adequately diagnosed via lab tests. Bear in mind, symptoms for different infections often overlap, which is why having an exhaustive list of symptoms for each infection may help to sort out which infections are predominant in a person's symptom picture. For example, fatigue and headaches are symptoms of a myriad of diseases, but if ten or twenty other symptoms in the body point to Babesia, it may be that this is the predominant cause of a person's fatigue and headaches.

(Note: All information has been re-copied directly from Dr. Schaller's documents, by permission, and has not been modified for any reason).

The Bartonella Checklist

Increasing Suspicion of This Emerging Stealth Infection
1. Insomnia [If profound fatigue this might not apply].
2. Current anxiety that was not present at age ten.
3. Current anxiety or depression not present at twenty years old.
4. Knee-jerk emotional responses worse than past decades and worsening.
5. Unusual discomfort on the soles of your feet
6. A temperature under 98.3 in a sick person. A temperature under 99.0 if Lyme disease or Babesia is present
7. Puffy tissue on insole or any part of ankles
8. Depression
9. Depression that is not fully controlled. [Improvement of mood is not successful in depression treatment].
10. Gingivitis or bleeding during flossing
11. Anxiety is poorly controlled with average dosing
12. Depression is poorly controlled by reasonable medication trials
13. Sleep medicines work poorly at routine dosing
14. Rage worse with time
15. Irritability worse with time
16. IL-6 is very low
17. IL-1B is very low
18. TNF-a is in lower 10% of normal range
19. Any skin markings or growths greater than most people
20. Blood vessels or color on skin greater than most people
21. Impatience > in personality when compared to ten years ago. [in a child, any can be any irritability]
22. Cursing or hostile speech that is worse over time.
23. One or more medical problems with unclear cause(s) and “idiopathic.”
24. Red papules of any size.
25. Skin tags including ones removed by dermatologist or shaved off.
26. Unusual blood vessels of any kind including inside organs such as bladder or intestinal walls
27. Any skin finding in excess of 95% of most humans
28. Skin findings showing increased blood vessels of any size
29. Skin findings showing increased tissue formation that is increased over the flatness of surface skin.
30. Skin showing blood vessels that are too large or too many for the location of the blood vessels, e.g., surface thigh and calf skin with very thick surface blood vessels. Or legs, upper arms or shoulders have explosions of many fine blood vessels.
31. Increased addictions that are more resistant to recovery than average.
32. Increased impulsivity in contrast to past years or past decades.
33. Burning skin sensations [this may have many causes].
34. Itching without a clear cause and which is hard to control and remove
35. Skin erosion without a clear cause such as a fire or chemical burn.
36. Minor cuts or scratches which heal slowly.
37. After a surgery, you heal very slowly.
38. You have two tick or flea infections with two positive tick or flea borne viruses, bacteria or protozoa. [Bartonella has >30 published species in public genetic databases and has more vectors than possibly any infection in the world. Therefore, the presence of other infections such as tick borne viruses, bacteria or protozoa, should raise suspicion.
39. Exposure to cats and dogs in excess of very incidental rare contact.
40. The patient’s mother is suspicious for Bartonella based on newer direct and indirect testing.
41. A sibling, father, spouse of child with any tick or flea-borne infection who shared a residence or vacation with proximity to brush.
42. Exposure to outdoor environments with brush, wild grasses, wild streams, golf courses or woods.
43. Outdoor expose in locations such as brush, wild grasses, wild streams or woods which happened without the use of DEET or without very high off- gassing essential oils on exposed skin areas.
44. The outdoor exposures such as brush, wild grasses, wild streams or woods which occurred without permethrin on shoes, socks and all clothing.
45. Clear exposure to lice, fleas or ticks. [Bartonella is carried by a huge number of carriers, but for now, the % that carry Bartonella is not known. Further, the capacity to detect all new species in the vectors or in humans infected, does not exist or is not routinely available in direct testing of all human infectious Bartonella organisms in both large or specialty labs].
46. Stretch marks in eccentric locations, e.g., arms, upper side under armpit, around armpit or on the back.
47. Stretch marks filled with red, pink, purple or dark blue color.

Certainty claims or criticism about Bartonella positions without reading at least parts of 1,000's of articles is confusing. How is this possible with new Bartonella findings and understandings each month? There are also new species genetically sequenced to show uniqueness almost every month in public databases. In this spirit, this scale is meant to merely increase suspicion of Bartonella, which is a super stealth infection that takes perhaps fifty days to grow out on some bacteria growth plates, and floats in the blood as it lowers fevers. It also clearly suppresses some key immune system fighting chemicals. Cure claims are made without the use of indirect testing markedly documented in superior journals, but which are not used by immensely busy clinicians working full-time.

Dr. Schaller is the author of 29 books and 27 top journal articles. His publications address issues in at least twelve fields of medicine. He has the most recent textbooks on Bartonella. He has published on Bartonella under the supervision of the former editor of the Journal of the American Medical Association (JAMA), and his entries on multiple tick and flea borne infections, including Bartonella [along with Babesia and Lyme disease] were published in a respected infection textbook endorsed by the NIH Director of Infectious Disease. He has approximately six texts on tick and flea-borne infections based on his markedly unique full-time reading and study practice, which is not limited to either finite traditional or integrative progressive medicine. Since he has a medical license he has been able to sort through many truth claims by ordering lab testing. He does not follow truth claims without indirect testing laboratory proof. He has read full-time on these emerging problems for many years.

C COPYRIGHTED 2011 JAMES SCHALLER, MD version 11.

This form cannot be altered if it is printed or posted in any manner without written permission. Posting in a critical negative evaluation is forbidden. Printing to assist in diagnostic reflections is encouraged, as long as no line is redacted or altered including these final paragraphs. Dr. Schaller does not claim this is a flawless or final form, and defers all diagnostic decisions to your licensed health professional.

The Babesia Checklist
Improving Detection of A Common Emerging Stealth Infection

Below are examples of signs, symptoms and indirect ways to help increase the diagnosis of Babesia. An examination of public genetic databases shows well over thirty-five species exist, many of which have variants.

Please note that an unknown percentage of people infected have no symptoms, at least for many years.

This checklist is not meant to be used as a definitive tool to diagnose Babesia. I would suggest that no definitive 100% or even 98% sensitive tool exists.
My goal is merely to decrease illness resulting from false negative patients, i.e., people who are positive but do not show up positive on a basic direct test.
Indeed, it is not uncommon for a patient with Babesia to present with a negative test result over ten times, regardless of the lab, and then to show up positive on DNA testing when exposed to two or three protozoa treatments for three days, or to have positive antibody testing six weeks after a similar provocation trial.
I do not oppose or endorse such approaches, but feel it necessary to mention that this has happened with “malaria” prevention treatment. Additionally, there have been instances in which the use of herbs, such as artesunate, for cancer prevention, has resulted in an unintended outcome: the conversion of a Babesia titer from negative to positive.

The path to expertise with Babesia is not simply to read a summary article or guidebook (of which I have authored four on the topic). Nor is expertise acquired by viewing the sickest 1% of patients as the “norm” in Babesia diagnosis.
If someone seeks expert knowledge of the infection, it begins by reading the entire world Pub Med literature over a few years, then utilizing that knowledge by focusing on treating this infection for over five years.

In summary, how can any certain Babesia position exist, when new species that infect humans are routinely emerging, and for which there is not even a direct test—regardless of sensitivity?

Please circle (consider) any symptom that applies:

1) I react to any derivative of Artemisia (Sweet Wormwood). *Note: the reaction does not need to last more than a day and any immediate stomachaches or loose stool do not apply.

2) I react to a malaria drug. (It requires profound wisdom for a clinician to distinguish between a side effect and a reaction caused by an effective Babesia treatment. For example, insomnia caused by the synthetic drug Larium is meaningless, since Larium has this as a side effect in uninfected patients. But fatigue and a severe headache resulting from a teaspoon of Mepron on day one are very suspicious symptoms for a known protozoan like Babesia or Malaria or other similar infections that are newly identified genetically).

3) Headaches with no clear cause
4) Headaches that are hard to control
5) Weight gain in clear excess of diet and exercise
6) Weight loss with reasonable eating and average exercise
7) Fatigue in excess of that experienced by most people in the same age range
8) Fatigue that produces need for sleep in excess of 8 ½ hours daily
9) Fatigue with ongoing insomnia [consider the possibility of both Bartonella and Babesia in this case]
10) Absolute Eosinophils in the low or high range [this is not definitive in any manner, but is a useful tool]
11) A percentage of Eosinophils in low range or high normal range
12) Very high Eosinophils [rare with Babesia, but other findings suggest other possible causes]
13) Mood changes with any herb or drug that kills protozoa like Babesia, with the exception of Larium
14) Shortness of breath [no clear asthma, pneumonia, COPD or other common cause]
15) Swelling in limbs and other parts of body
16) Night sweats
17) Excessive perspiration during normal daily activity
18) Hot flashes in a normal temperature room
19) A poor appetite
20) Intermittent fever
21) Chills
22) A high fever
23) A high fever in excess of three days
24) Slowed thinking
25) Listlessness
26) A normal or low VEGF lab result in the presence of Bartonella
27) A TNF-a in excess of 1.0 in the presence of Bartonella
28) A CD57 or CD57/8 level that drops right after the start of a Babesia treatment, or which falls steadily with ongoing treatment
29) Pets, farm animals or local relatives with ANY tick borne virus, bacteria or protozoa
30) Excess breast tissue in a man or boy
31) Any decreased in appetite
32) Severe chest wall pains
33) Random stabbing pains
34) Any enhanced sense: sensitivity to light, touch, smells or sound
35) Family, friends or others report you look tired or foggy
36) You have received blood from another person
37) Muscle aches or joint aches/pain, especially worse after use of a protozoa killing medicine such as proquanil, Alinia, ativoquone, clindamycin, or one of many new emerging progressive natural medicine or synthetic malaria drug treatments
38) Nausea or vomiting
39) Hemolytic anemia with lab positive blood products in your urine [this is not a routine finding]
40) Dark urine [this is rarer than some articles intimate]
41) An enlarged liver (which sits under your right rib cage)
42) An enlarged spleen (under your left rib cage). This is falsely believed to be a common human sign; actually it is very rare.
43) A yellow hue on eyes, hands and skin (jaundice) with no other clear cause.
44) Sexual contact is a debated form of communication of some tick and flea borne infections. I have no position. Isolation in a body fluid does not mean that is a route to spread the infection. If you and your healer feel this is a possible route of infection, has the patient had intimate contact with the sharing of body fluids with an infected person?
45) The patient’s mother is suspected of having or has been diagnosed with Babesia, Ehrlichia, Rocky Mountain Spotted Fever, Anaplasma, Lyme or Bartonella based on newer direct and indirect testing or clinical signs and symptoms.
46) A sibling, father, spouse or child with any tick borne infection who shared a residence or vacation with proximity to brush (wooded area).
47) Exposure to outdoor environments with brush, wild grasses, wild streams, golf courses or woods in excess of ten minutes in any location lived or visited since the age of eighteen months of age.
48) Outdoor exposure in locations such as brush, wild grasses, wild streams or woods which took place without the use of DEET or without very high off-gassing essential oils on exposed skin areas.
49) Enlarged lymph nodes (but also in Lyme, Bartonella, other infections, high inflammation, tumors and other diseases)
50) After Babesia treatment with clear protozoa killing agents used also to kill malaria, IL-6 moves from very low to an increased level.
51) After Babesia treatment with clear protozoa killing agents used also to kill malaria, IL-1B moves from very low to an increased level.
52) Brain troubles such as trouble keeping up with past routine life demands, lateness due to trouble with motivation and organization, and trouble with concentration [Any of these would be a positive]
53) Memory troubles [this is not specific to one infection or one disease process. For example, exposure to indoor mold’s biological chemicals can decrease memory within an hour depending on the species mix]
54) Profound psychiatric illnesses [this is not limited to a single infection]
55) Daytime sleep urgency despite nighttime sleep
56) Waves of generalized itching [this infection and inflammation sign is not limited just to Babesia].
57) Spike of a fever over 100.5 after a possible tick bite.
58) Insomnia after taking a malaria killing herb or drug
59) Anxiety and/or depression after taking a malaria killing herb or drug
60) Rage or temporary personality regression right after use of a malaria killing herb or medication
61) Excess fat in lower belly area that is in excess of lifestyle and activity.
62) Lumps or other types of tissue collection with no clear cause [Other tick and flea-borne infections can also cause these growths]
63) One or more medical problems with unclear cause(s), with changing or contradictory diagnoses, or which are eventually called “idiopathic.”
64) Psychiatric label(s) given for all of your troubles or a child or relative’s troubles when clear medical problems exist as shown by abnormal laboratory results (only if wide testing is done which includes inflammation and anti-inflammation chemicals, hormones, nutrient levels, and other immune system chemicals).
65) You have two tick or flea infections with two positive tick or flea borne viruses, bacteria or protozoa. The presence of other infections such as tick borne viruses or bacteria raises suspicion of a Babesia infection.
66) Your clinician understands the use of indirect testing and feels your lab pattern is suggestive of the presence of Babesia. This involves more than an ECP spike.
67) Since direct testing for Babesia by any lab misses many human species and is of variable reliability, and the common presence of Bartonella suppresses some antibody tests, a positive or “indeterminate” is likely a positive. Have you had an “indeterminate” or “borderline” Babesia result?
68) You have neighbors living near you with a tick or flea infection diagnosis.
69) Your pet(s) or family animals of any type, e.g., horses, have had outdoor exposures to areas such as brush, wild grasses, wild streams or woods. If the pets were animals such as dogs, which can be given anti-tick and flea treatments, were these animals always on schedule with these treatments?
70) Have you had clear exposure to ticks in your current or past homes as an adult?
71) Have you had clear exposure to ticks during vacations or other travels?

A WORD ON MANUAL BLOOD EXAMINATIONS

No blood smear will be positive for Babesia unless you have a profoundly massive number of infected red blood cells, which is rare. Therefore, no blood smear should be considered negative unless it has been examined for thirty minutes. While a 2-3 minute exam of large white blood cells may be fully sufficient to identify cancers and other diseases, a search for over eighty Babesia red blood cell presentations under 1000x, as found in my Hematology Forms of Babesia book, requires at least thirty minutes, which requires private contracting with a microbiologist or pathologist or a favor from a lab director. Please appreciate that stains help define whether a substance is what it appears to be.

Babesia is an emerging infection. Any certainty claims or criticism about Babesia positions without reading at least parts of 1,500 articles is a premature certainty. Again, new Babesia species are emerging every one to four months. Indeed, even a new protozoan has been found that looks like Babesia under a high powered microscope. But when it is genetically sequenced it is not Babesia or immature malaria, which can look similar. It is a new infection.
Therefore, since this is a new emerging illness, this scale is meant to merely increase awareness of Babesia, an infection that can kill patients of any age. Writings in the past fifteen years have either seen Babesia as a mere “co-infection” or a footnote of a spirochete infection [Lyme]. Anything that can hide for a couple of decades, and then possibly kill you with a clot or by other means, is not a casual infection.

Babesia cure claims should be made with the use of indirect testing birthed from extracts of superior journals read over five years. Currently, these many indirect well-established lab test patterns are not used or understood by immensely busy and smart clinicians working full-time. While this is fully understandable, I hope it may change in the coming decade.

Dr. Schaller is the author of 29 books and 27 top journal articles. His publications address issues in at least twelve fields of medicine.
He has published the most recent four textbooks on Babesia.
He has published on Babesia as a cancer primer under the supervision of the former editor of the Journal of the American Medical Association (JAMA), and his entries on multiple tick and flea borne infections, including Babesia [along with Bartonella and Lyme disease], were published in a respected infection textbook endorsed by the NIH Director of Infectious Disease.

Dr. Schaller has produced six texts on tick and flea-borne infections based on his markedly unique full-time reading and study practice, which is not limited to either finite traditional or integrative progressive medicine. With a physician’s medical license, he has been able to sort through many truth claims by ordering lab testing. He does not casually follow the dozens of yearly truth claims, without indirect testing laboratory proof. He has read full-time on these emerging problems for many years. He is rated a TOP and BEST physician. One of these award ratings is based on physician peer ratings.

COPYRIGHTED 2011 JAMES SCHALLER, MD, MAR version 26.
This form may not be altered if it is printed or posted, in any manner, without written permission. Posting a critical or negative evaluation is forbidden. Printing to assist in diagnostic reflections is encouraged, as long as no line is redacted or altered, including these final paragraphs. Dr. Schaller does not claim that this is a flawless or final form, and defers all diagnostic decisions to your licensed health professional.