7

Natural Healing of Ehrlichia and Anaplasma

A class of herbal medicines, known as immunomodulators, alters the activity of immune function through the dynamic regulation of information molecules such as cytokines.

K. SPELMAN, J. J. BURNS, D. NICHOLS, ET AL.,
“MODULATION OF CYTOKINE EXPRESSION
BY TRADITIONAL MEDICINES:
A REVIEW OF HERBAL IMMUNOMODULATORS”

The effects of plant based remedies may be due to one active compound with a single mechanism of action, to compound(s) that possess multiple modes of action, . . . to the combined activity of more than one active ingredient in a single species, . . . or the synergic interactions of different active ingredients from several plant species processed as a medicinal formula.

E. ELISABETSKY, “PHYTOTHERAPY AND THE NEW PARADIGM OF DRUGS MODE OF ACTION”

Despite the sophisticated modulation of the immune system that these bacteria are capable of, it is quite possible to reverse it. Plant medicines are very good at subtle remodulations of immune function, in fact much better than pharmaceuticals. They are excellent for reducing the levels of cytokines that cause inflammatory damage in the body while simultaneously upregulating immune-supporting cytokines that the bacteria have inhibited. Plant medicines are also very effective at protecting the various organ and cellular systems that have been adversely affected, helping them heal any damage that has occurred, and stimulating the organs to work more efficiently. And finally, they are excellent for reducing or eliminating many of the symptoms that infection causes.

 

Treating Ehrlichiosis and Anaplasmosis with Natural Protocols

First, some basics . . . I know this is repetitive, but there seems to be a general confusion that commonly arises among both practitioners and the infected about the following points, hence the continual repetition (I get scores of communications about these points every month

The herbs and supplements in this book are not the only ones in the world that will help. Please use the protocols outlined herein only as a starting place, a guideline. Add anything that you feel will help you and delete anything that you feel is not useful. Bacteria, when they enter a human body, find a very unique ecosystem in that particular person. Thus the disease is always slightly different every time it occurs. This means that a pharmaceutical or herb that works for one person may not work or work as well for another. There is no one-size-fits-all treatment that works for all people in all times and places.

Also: there is no one thing that always has to happen first, that has to be treated first, or that you must always do or must never do in order to get well. There is no one herb that will always work for everyone; there is no one protocol that contains the solutions to all the infectious organisms that exist or all the forms of infection that the Lyme group can cause.

Again: there is no one-size-fits-all treatment that works for all people in all times and places.

Anyone who says there is, is either trying to sell you something or doesn’t really understand the Lyme group of infectious organisms (or has powerful self-image needs involved). There is not and never has been one single way to health such that in all times and in all places and with all people it will always work. Life, and disease, and the journey to wellness are much more complex and challenging than that.

All of us, practitioners and the infected alike, of necessity must learn to see what is right in front of us and adapt our interventions to what is actually occurring in the unique ecological system we are encountering. Our interaction with these disease complexes has to occur out of a living communication—with the organism, with the body, with the medicine. Each treatment intervention, as treatment progresses, will become unique to each person. It has to do so for healing to occur.

Thus the protocols in this book should solely be considered as a foundational place to begin. For most people they will help considerably; for some they will clear the infection completely. Nearly everyone (practitioners and the infected alike), however, will find that they will need to add this or subtract that. Please do so. Please trust your own feeling sense and pay attention to what your body is telling you. You are the best judge of whether something is working for you or not, whether you need to add something else or not, whether you are getting better . . . or not.

Now, about dosages: I will often suggest a dosage or a range of dosages for the herbs and supplements that can help. If you have a very healthy immune system, or a very mild case, you will probably need smaller doses; if your immune system is severely depleted or if you are very ill, you may need to use larger doses. If you are very sensitive to outside substances, as some people with Lyme and these coinfections are, then you might need to use very tiny doses, that is from one to five drops of tincture at a time. (This is true for about one percent of the people with these infections.) I have seen six-footfive-inch, 280-pound men be unable to take more than five drops of a tincture and a tiny, 95-pound woman need a tablespoon at a time. Dosages need to be adjusted for each person’s individual ecology. Again . . . dosages need to be adjusted for each person’s individual ecology. And now, a few other points that commonly arise:

 

1. Yes, you can combine all the herbs together in the liquid of your choice. You do not have to take them separately.

2. Yes, these herbs can be taken along with antibiotics.

3. No, the bacteria do not develop resistance to the herbs.

4. Yes, you can take these herbs along with protocols suggested by other practitioners.

5. No, except for a very few herbs (such as the 1:1 form of eleutherococcus tincture), you do not need to pulse the herbs—that is, to take them in an on-again, off-again cycle, such as five days on and two days off. In fact, I have continually heard from people struggling with the Lyme group of infections that they were getting better, were told to pulse by their personal practitioner, and once they did, relapsed.

6. Yes, it is common for about half the people who use an herbal protocol, when they begin to get better, to be so excited about being themselves again, that they do too much, overexert themselves, and relapse. This is extremely common (and very understandable; it’s tiring being sick for so long). So, please be very careful once your strength and joy begin to return. It may seem as if you can immediately begin exerting yourself as you used to do; however, your body has been under a long-term stress, and its reserves are low. It will take, if you have been ill for a long time, at least a year to rebuild.

Part of the function of serious chronic illnesses is to increase personal awareness (I know from personal experience). There is the life you had before Lyme, there is the life you have after. It is very rarely possible to go back to being unaware of the impacts of stress on your system, the kind of self-caretaking your body (and spirit) needs, or the dangers of overextending yourself and your energy. Ignorance may be bliss (however short that bliss may be) but awareness is empowering . . . and health enabling.

And, finally, please be conscious of how you respond to the medicines you are taking. If something disagrees with you, if you feel something is not right in how you are responding to a medicine, stop taking it. Remember: you will always know yourself better than any outside physician.

 

INITIAL INTERVENTION PROTOCOL

The initial intervention, using a natural protocol, suggested for mild to moderate anaplasmal and ehrlichial infections, relapsing or not, entails: 1) the use of herbs that interfere with the organisms’ ability to invade their target cells; 2) organ-protective herbs; 3) immune modulators to restructure the immune response; 4) cytokine disruptors to remodulate the bacteria-controlled cytokine cascade; and 5) herbs for reducing specific symptoms. To be a bit more specific:

1. Antibacterial herbs. A caveat: please note that there has been very little study on herbs that are directly antibacterial for these organisms. Specifically, “directly” means testing for plants that kill these bacteria upon contact with the plants. Hence, I approach this category of intervention through the use of herbs that interfere with or interrupt the mechanisms used by the bacteria to infect their host cells, control those cells’ DNA, prevent host cell apoptosis, or reproduce inside those cells. Plants that have these kinds of effects are antibacterial; they just don’t directly kill the invading organisms.
       (Because similar organisms cause so much illness in domestic animals, primarily livestock, especially in Africa, there is a fairly broad range of plants that have been used to treat them. I include an extensive list at the end of this chapter; please consider exploring them in treatment.)
2. Organ support and protection. These bacteria create powerful impacts on a number of the body’s organs, including the spleen and lymph system, liver, and bone marrow. Supporting and strengthening those systems reduces infection impacts and enables those organs to better combat the infection.
3. Immune modulation. These bacteria restructure the architecture and response of the immune system to meet their own needs. Counteracting the pathogen restructuring restores immune integrity and supports the clearance of the organisms from the body.
4. Cytokine disruptors. Herbs that are specific for interfering with the cytokine cascade that the organisms initiate will stop most inflammation in the body and interfere with the pathogens’ abilities to find and enter target cells, gather nutrients, and reproduce.
5. Specific symptom treatment. These bacteria can create a rather broad range of symptoms. Reducing symptoms helps restore quality of life and feelings of joy, which in and of themselves produce potent beneficial effects during healing. These herbs and supplements are covered in the expanded treatment protocol (page 161).

Again, there are thousands of plants that can be, and are, used in the treatment of disease. While I include a wide range of plants that are active in the categories I just outlined, the following list contains the ones that, based on use, analysis of the organisms and the herbs, exhaustive journal research, and the experiences of both practitioners and those with the diseases, I think are the most effective. (This includes some that may be very good, which I have not used, and which I think show promise.) This does not mean there are not others, not listed herein, that are just as effective.

Antibacterial Herbs

As discussed in the previous chapter, the following categories of herbs are effective at counteracting the unique mechanisms the bacteria utilize to enter and control their host cells and their cellular function. If you are using antibiotics, these herbs can be used at the same time; they will help potentiate the antibiotics’ actions.

• PLCG2 inhibitors: Euphorbia kansui (gan sui), Houttuynia spp. (houttuynia), Peganum harmala (Syrian rue), Salvia miltiorrhiza (red sage, danshen).
• Caspase-3 (and caspase-9) upregulators: Aphanamixis polystachya (stem and root bark), Cynomorium songaricum, Dalbergia odorifera, Eucommia ulmoides, Glycyrrhiza spp. (licorice), Goniothalamus cheliensis, Gynostemma pentaphyllum, Houttuynia spp. (also upregulates caspase-9), Magnolia officinalis, Paeonia lactiflora, Panax ginseng, Phellodendron amurense, Salvia miltiorrhiza (a potent modulator, raising or reducing it as needed), Scutellaria spp. (baikal skullcap, Chinese skullcap; also upregulates caspase-9), Tinospora cordifolia, and the isolated constituents apigenin (strongly so; also upregulates caspase-9), arctigenin, beta-sitosterol, butein, curcumin, and emodin (caspase-9 only).
• Bax/Bcl-2 apoptosis pathway remodulators (which specifically increase Bax and reduce Bcl-2): Artemisia spp., Glycyrrhiza spp., Goniothalamus cheliensis, Gynostemma pentaphyllum, Houttuynia spp., Leonurus cardiaca (motherwort), Rhodiola spp., Scutellaria spp., and the isolated constituents arctigenin, beta-sitosterol, and curcumin.
      Note: Salvia miltiorrhiza is an apoptosis modulator. It modulates the actions of Bax/Bcl-2, decreasing or increasing the ratio as needed during inflammatory episodes, e.g., it increases apoptosis of cancer cells but decreases apoptosis of hypoxia-damaged cells.
• JAK/STAT remodulators (which counteract bacterial apoptosis inhibition): Andrographis spp., Bletilla striata, Salvia miltiorrhiza, Silybum marianum (seed, standardized), and Withania somnifera (ashwagandha).
• Histidine kinase inhibitors: Aphanamixis polystachya (stem and root bark), Pueraria spp. (kudzu root), and the isolated constituents genistein (strongly so but needs higher dosages) and quercetin.
• PKA inhibitors: Aphanamixis polystachya (stem and root bark), Brosimum acutifolium (bark), Cinnamomum zeylanicum (cinnamon), Empetrum nigrum (crowberry), Punica granatum (pomegranate), Syzygium aromaticum (clove), and the isolated constituent EGCG.
      Note: Aphanamixis is a traditional herb in Asia and in Ayurveda. It has a fairly broad antimicrobial activity against Gram-negative bacteria and is also liver protective, reduces spleen inflammation, regulates thymus action, normalizes lymph function, stimulates apoptosis, and acts to inhibit PKA and histidine kinase while upregulating caspase-3. It has a broad range of actions for the systemic effects of both ehrlichia and anaplasma bacteria; it should be explored as a primary antibacterial for these organisms. (As of 2014, I have not yet used it.)

Organ Support and Protection

The most important parts of the body to protect during these infections are the spleen, lymph nodes and lymph system, liver, bone marrow function—specifically the bone marrow’s stem cells—and mitochondria. Secondary systems to protect are the heart (see the expanded treatment protocol on page 161, as well as the profiles of hawthorn and Salvia miltiorrhiza in chapter 9) and lungs (see the expanded treatment protocol, page 161). Other important specifics are lowering ALT and AST levels and increasing red blood cell and platelet counts. Here are the primary supportive herbs and compounds to utilize in supporting organ function during ehrlichial or anaplasmal infection.

1. Salvia miltiorrhiza (a.k.a. danshen). Danshen is a Chinese herb specific for spleen and liver inflammation and malfunction.
       In the past I have relied primarily on red root (Ceanothus spp.) for diseases that affect the spleen. I like red root because it is strongly protective of the spleen and to some extent the liver. It acts to reduce inflammation in both of those organs. It also stimulates the immune activity of the spleen, helping to clear the body of infection while optimizing the removal of microorganism and immune system debris during infections. However, red root is also a blood coagulant. Because intravascular coagulation is so common during some Lyme coinfections, I now prefer the use of Salvia miltiorrhiza. (If you do want to keep using red root, then please supplement its use in this disease with anticoagulants such as nattokinase, ginkgo, and aspirin.)
2. Silybum marianum (milk thistle) seed. The combined compounds known as silymarin that are extracted from milk thistle seed are strongly liver protective and regenerative. There are four main constituents of silymarin: silibinin, isosilibinin, silicristin, and silidianin. This herb, if standardized, will strongly protect the liver from inflammatory damage, reduce inflammatory infiltrates, protect the Kupffer cells, reduce ALT and AST levels, and help remodulate the JAK/STAT pathway. (Salvia miltiorrhiza is also strongly liver protective and may be used instead, though I do strongly suggest the use of milk thistle seed given the considerable damage that these bacteria can do to the liver.)
3. Herbs to support bone marrow. The most active herbs for the bone marrow’s stem cells (reducing myelosuppression and stimulating hematopoiesis) are Agaricus blazei, Angelica sinensis, Astragalus spp., Bidens spp., Cordyceps spp., Ganoderma lucidum (reishi), Glycyrrhiza spp., Paeonica lactiflora (peony root), Panax ginseng, Salvia miltiorrhiza, Tinospora cordifolia, Tricholoma matsutake, Zataria multiflora, and the supplement carnosine. The strongest are astragalus, angelica, Salvia miltiorrhiza, Panax ginseng, and cordyceps. All reverse anemia, leukopenia, and thrombocytopenia. All counteract hematopoiesis suppression in the bone marrow.
       Note: Salvia miltiorrhiza increases white blood cell counts, reduces neutrophil adhesion (inhibits intercellular adhesion molecule 1, or ICAM-1), inhibits MCP-1 (CCL2, a myelosuppressive cytokine), reduces ALT and AST, improves liver, spleen, thymus, and lymph node function, and stimulates the production of bone marrow progenitor cells.
4. Herbs to support mitochondria. The mitochondria are best protected by Leonurus cardiaca (motherwort), Rhodiola spp., Salvia miltiorrhiza, Schisandra chinensis, and the supplements luteolin, coenzyme Q10, and fermented wheat germ extract.

Immune Modulation

Again, the point here is to modulate immune function in a specific manner during mild to moderate infections. Of initial importance is the downregulation of IL-10 and the upregulation of IL-2, IL-12, IL-18, and IFN-γ, essentially switching the immune response from Th2 to Th1. The primary herb for this is ashwagandha (Withania somnifera). It counteracts, with great specificity, the exact modulation of the immune system that the tick saliva and the bacteria initiate and maintain.

Other herbs and supplements useful for this kind of immune modulation are (in no special order) licorice, i.e., Glycyrrhiza spp. (downregulates IL-10, acting primarily as an immune modulator and tonic); standardized milk thistle (silymarin inhibits IL-10 overexpression and helps support endothelial health); Cannabis sativa (inhibits IL-10 overexpression); Scutellaria spp. (downregulates IL-10 and Treg); Panax ginseng and Panax japonicus (both upregulate Th1 dynamics); Labisia pumila (upregulates Th1 response); Carica papaya leaves (as a tea; stimulate IL-12, IFN-γ, and TNF-α); Lycium barbarum fruit (lychii berries); neem leaf; boneset (Eupatorium perfoliatum, primarily via its caffeic acid derivatives); and any plants containing scopoletin (an IL-10/Th2 downregulator) such as noni, manacá, passion flower (Passiflora spp.), stevia, Artemisia spp. (especially A. scoparia and A. capillaris), nettle leaf (Urtica dioica), and black haw (Viburnum prunifolium). Plants containing daucosterol are also effective in stimulating a Th1 response and downregulating a Th2-dominant dynamic; among them are Garcinia parviflora and Gardenia jasminoides.

Cytokines Disruptors

In addition to IL-10, the primary inflammatory cytokines that need downregulation are TNF-α, MMP-9, IL-1β, IL-6, IL-8, IL-13, CCL2, CCL3, CCL4, CXCL1, CXCL2, and CXCL11. Here is a list of plants active for downregulating those cytokines:

TNF-α inhibitors: Andrographis paniculata, Cannabis spp., Cordyceps spp., Eupatorium perfoliatum (boneset), Glycyrrhiza spp. (licorice), Houttuynia spp, Panax ginseng, Polygala tenuifolia (Chinese senega) root, Pueraria lobata (kudzu), Salvia miltiorrhiza, Sambucus spp. (elder), Scutellaria baicalensis, Tanacetum parthenium (feverfew), Zingiber officinalis (ginger).

MMP-9 inhibitors: Polygonum cuspidatum (Japanese knotweed), Salvia miltiorrhiza.

IL-1β inhibitors: Cordyceps spp., Eupatorium perfoliatum, Polygala tenuifolia (Chinese senega) root, Polygonum cuspidatum, Pueraria lobata, Salvia miltiorrhiza, Scutellaria baicalensis.

IL-6 inhibitors: Andrographis paniculata, Isatis spp., Pueraria lobata, Salvia miltiorrhiza, Scutellaria baicalensis.

IL-8 inhibitors: Cordyceps spp., Isatis spp., Polygonum cuspidatum.

IL-13 inhibitors: Unknown at this time.

CCL2 (MCP-1) inhibitors: Coptis chinensis, Lonicera japonica, Salvia miltiorrhiza (strongly so), Scutellaria baicalensis, Sophora flavescens, Tanacetum parthenium.

CCL3/CCL4 inhibitors: Panax ginseng, Scutellaria baicalensis.

CXCL1 (GRO-KC) inhibitors: Curcuma longa (turmeric), Euterpe oleracea (acai) berry, Lonicera japonica, Panax ginseng, Rhododendron brachycarpum, Uncaria spp. (cat’s claw).

CXCL2 (MIP-2) inhibitors: Andrographis paniculata, Angelica sinensis, Lithospermum erythrorhizon, Scutellaria baicalensis, Tanacetum parthenium, and the isolated constituent quercetin.

CXCL11 inhibitors: Andrographis paniculata, Panax ginseng.

Cytokines to upregulate include the following:

IL-2: Angelica sinensis, Bidens pilosa, Cordyceps spp., Ganoderma lucidum, Lycium barbarum, Salvia miltiorrhiza, Smilax spp., Tylophora asthmatica, Withania somnifera.

IL-12: Astragalus spp., Cannabis spp., Cordyceps spp., Ganoderma lucidum, Grifola frondosa, Lycium barbarum, Panax ginseng, Tinospora cordifolia, and the kampo formulation juzentaihoto.

IL-18: Cordyceps spp., Tinospora cordifolia (also restores thymus function), Salvia miltiorrhiza, and the kampo formulation juzentaihoto.

MHC-II: Achyranthes bidentata, Astragalus membranaceus, Astragalus mongholicus, Cordyceps spp., Morus spp. (mulberry fruit), Panax ginseng, Phellinus linteus, Plantago asiatica.

 

Primary Herbs Suggested for Treating Ehrlichial/Anaplasmal Infections

The following are the herbs that possess the strongest actions and/ or cross over into the most categories of action. Salvia miltiorrhiza is the foundational herb for treating these bacteria, closely followed by Withania somnifera (ashwagandha) because of its modulation of the specific immune dysregulation that is occuring.

Antibacterial actors: Glycyrrhiza spp., Houttuynia spp., Pueraria lobata, Salvia miltiorrhiza, Scutellaria baicalensis, and the supplement genistein.

Immune modulators: Angelica sinensis, Astragalus spp., Cordyceps spp., Glycyrrhiza spp., Houttuynia spp., Panax ginseng, Salvia miltiorrhiza, Scutellaria baicalensis, Withania somnifera (primary).

Bone marrow protectors/modulators: Angelica sinensis, Astragalus spp., Cordyceps spp., Glycyrrhiza spp., Panax ginseng, Salvia miltiorrhiza.

Liver protectors/modulators: Salvia miltiorrhiza, Silybum marianum.

Spleen/lymph node protectors/modulators: Salvia miltiorrhiza, Ceanothus spp.

 

A BASIC PROTOCOL FOR EHRLICHIOSIS AND ANAPLASMOSIS

Note: Regimen will likely need to be followed for about 12 months (or until infection resolves).

1. Tincture combination of Salvia miltiorrhiza and Houttuynia spp. (equal parts of each), ½ teaspoon 6x daily. (This can be increased substantially in more severe or recalcitrant infections, from 1 teaspoon to 1 tablespoon 6x daily.)
2. Genistein, 250 mg 2–3x daily (Note: Please see contraindications in chapter 9). Quercetin is a decent substitute; take 1,000 mg 2x daily.
3. Tincture combination of Scutellaria baicalensis, Cordyceps spp., Pueraria lobata (equal parts of each), ½ teaspoon 3–6x daily.
4. Tincture combination of Astragalus spp., Angelica sinensis, Glycyrrhiza spp. (equal parts of each), ½ teaspoon 6x daily.
5. Tincture of Withania somnifera, ½ teaspoon 3x daily. (Note: May cause drowsiness.)
6. Tincture of Panax ginseng, ¼ teaspoon 3x daily.
7. Silybum marianum (milk thistle) seed, standardized, 1,200–2,400 mg daily, depending on severity of condition (function: protection of liver).

ADD TO THE BASIC PROTOCOL, BASED ON SYMPTOMS

If you have ehrlichiosis or anaplasmosis . . .

With severe anemia, use:

1. Sida acuta tincture, ¼ teaspoon 3–6x daily until condition resolves, plus . . .
2. N-acetylcysteine, 4,000 mg 2x daily until condition resolves, and add . . .
3. Angelica sinensis tincture, 1 teaspoon 3x daily.

With severe intravascular coagulation, use:

1. Ginkgo, standardized tincture, ½ teaspoon 3x daily, plus . . .
2. Nattokinase, 200 mg 3x daily (same as 4,000 FU 3x daily), plus . . .
3. 4 adult aspirins, 3x daily, or . . .
4. Salvia miltiorrhiza, at an increased dosage of 1 teaspoon up to 6x daily.

With drenching sweats, use:

1. Boneset (Eupatorium perfoliatum), strong infusion, 1 cup 3–6x daily.

With fever, use:

1. Coral root (Corallorhiza maculata or equivalent) tincture, 30 drops each hour, or . . .
2. Boneset (Eupatorium perfoliatum), strong infusion, 1 cup each hour or two, or . . .
3. Peppermint tea, 1 cup each hour or two, as needed.

With nausea, use:

1. Peppermint tea, 1 cup each hour or two as needed.

With extreme nausea, use:

1. Peppermint essential oil, one drop only, on the tongue, followed by water, as needed.

With muscle and joint pain, use:

1. Pedicularis spp. tincture, 1 teaspoon each hour as needed, or . . .
2. Monotropa uniflora (Indian pipe) tincture, ¼–1 teaspoon up to 6x daily.

With severe pain, use:

1. Salvia miltiorrhiza, 1 tablespoon (yes, that’s right) every 15 minutes, slowly lowering dosage as the pain subsides.

With headache, use:

1. Pedicularis tincture, 1 teaspoon each hour as needed, and/or . . .
2. Indian pipe (Monotropa uniflora) tincture, ¼–1 teaspoon up to 6x daily, and/or . . .
3. Pueraria lobata (kudzu) root tincture, ¼–½ teaspoon up to 6x daily.

With anxiety/hysteria, use:

1. Pulsatilla spp. (pasqueflower) tincture, 10 drops each hour as long as necessary, and/or . . .
2. Motherwort (Leonurus cardiaca) tincture, ¼ to ½ teaspoon to 6x daily, and/or . . .
3. Coral root tincture, 30 drops (full dropper) to 6x daily.

With extreme fear, use:

1. Verbena officinalis (vervain) tincture, 30 drops to 6x daily.

With sleep disturbance, use:

1. Melatonin liquid, manufacturer’s directions, one hour before bed, and/or. . .
2. Ashwagandha (Withania somnifera) tincture, ½ teaspoon one hour before bed or powder or capsules, 1 gram an hour before bed, and/or . . .
3. Motherwort (Leonurus cardiaca) tincture, ¼ ounce (yes, that is right) in liquid just before bed (if the melatonin does not help).

With severe fatigue, use:

1.  Eleuthero (Eleutherococcus senticosus) tincture (a 1:5 ratio, not the 2:1 Herb Pharm brand), ¼ teaspoon 3x daily, plus . . .
2. Rhodiola (Rhodiola spp.) tincture, ¼ teaspoon 3x daily, plus . . .
3. Schisandra (Schisandra chinensis) tincture, ¼ teaspoon 3x daily, plus . . .
4. Motherwort (Corallorhiza maculata) tincture, ½ teaspoon 3x daily, and . . .
5. Fermented wheat germ extract, if you can afford it. All for 6 months.

With wasting (i.e., severe weight loss), use:

1. Fermented wheat germ extract, 9 grams daily (best choice), or (not as good) . . .
2. Shiitake mushrooms (Lentinula edodes), powdered or as food, 6–16 grams per day. A pure extract of lentinan can also be used: 1–3 grams per day.

For detoxification and help with Herxheimer reactions, use:

1. Zeolite powder, 2 heaping teaspoons daily (do not accidentally inhale), or 3 capsules 3x daily.
2. Activated charcoal, 2 capsules 2x daily.
3. Bentonite clay may also be of help. Soak 1 teaspoon in a full glass of water for 30 minutes to 2 hours. Take on an empty stomach, early in the morning or just before bed.

SEVERE HME AND HGA VERSUS MILD, MODERATE, AND CHRONIC FORMS

Severe or acute infections with either of these bacteria can occur, often accompanied by extremely low parasite loads. Despite the low loads, under certain circumstances, this can lead to sepsis, septic shock, multiple organ failure, coma, and death. In general, the more acute forms that do not include sepsis will respond perfectly well to the protocol for mild, moderate, and chronic forms. A few specifics are offered in chapter 8.

ETHNOVETERINARY APPROACHES

Plants used in ethnoveterinary practice in Africa for treatment of Anaplasma and Ehrlichia infections in domestic animals include the following:

Allium cepa root, water extract with sedimentary rock, salt, and ampicillin; Aloe dawei leaf, water extract; Aloe ferox sap, decoction; Aloe tweediae exudate, water extract; Aspilia mossambicensi root, water extract combined with Solanum spp. fruit; Capparis fascicularis var. elaeagnoides bark, water extract; Capparis spp. root or branch, water extract; Capparis sepiaria var. citrifolia root, decoction; Capsicum annum fruit, water extract; Carissa spinarum root, infusion; Chasmanthera dependens root, water extract; Cissus quadrangularis leaf, water extract; Coccinia adoensis root, infusion; Croton megalocarpus root bark, decoction; Cucumis spp. fruit, water extract combined with Warburgia salutaris and sedimentary rock (CaCO3); Cussonia spicata bark, decoction; Euphorbia bongensis whole plant, water extract; Euphorbia candelabrum stem, water extract with sedimentary rock (CaCO3); Fagaropsis angolensis bark, water extract; Grewia occidentalis leaf combined with Olea europaea ssp. africana leaf, Zanthoxylum capense leaf, and Aloe ferox sap, soaked in cold water (water extraction); Ledebouria revoluta leaf, decoction; Leucas capensis leaf mixed with Brachylaena ilicifolia leaf, decoction; Leucas deflexa plant, macerate; Marrubium vulgare leaf, decoction; Pentarrhinum insipidum leaf, hot decoction; Podocarpus latifolius bark, decoction; Sideroxylon inerme bark, decoction; Solanum aculeatissimum and S. incanum fruit, water extract; Tephrosia spp. whole plant, paste; Terminalia brownii bark, paste; Teucrium africanum leaf, decoction; Tinospora caffra root, water extract; Trichilia prieuriana bark, water extract; Warburgia salutaris bark, decoction and decoction combined with sedimentary rock (CaCO3); Zanthoxylum chalybeum bark or root, water extract.

And Urginea sanguinea, Aloe marlothii, Elephantorrhiza elephantina, and Rhoicissus tridentata have been found, during in vitro tests, to be active against Ehrlichia ruminantium.