Positive for Lyme, Bartonella & Babesia? What to Do Next

You finally get your Lyme disease test results back.

Positive for Lyme disease. Positive for Bartonella. Positive for Babesia.

And maybe that's not all.

Your report might also mention Epstein-Barr virus (EBV), Anaplasma, Ehrlichia, or several other infections you've barely heard of.

Suddenly, you're staring at a long list of positive test results, wondering:

• Do I really have all these infections?
• Which Lyme co-infection should I treat first?
• Do I need a different treatment protocol for each one?
• How am I supposed to manage all of this?

If this sounds familiar, you're not alone.

One of the biggest challenges people face when navigating Lyme disease and potential co-infections is figuring out what actually needs attention.

The good news? A long list of positive test results doesn't automatically mean you need an equally long list of treatments.

Let's break down what these results mean, how the infections differ, and how to approach your next steps without making your recovery unnecessarily complicated.

What Are Lyme Disease Co-Infections?

Lyme disease is caused by bacteria belonging to the Borrelia burgdorferi group.

However, ticks can carry and transmit other pathogens, too.

When someone acquires more than one tick-borne infection, this is called a co-infection.

Some of the infections commonly discussed alongside Lyme disease include:

• Babesiosis: A parasitic infection caused by Babesia species.
• Anaplasmosis: A bacterial infection caused by Anaplasma phagocytophilum.
• Ehrlichiosis: A group of bacterial infections caused by Ehrlichia species.
• Bartonella infections: Bacterial infections that can be transmitted through several routes, including fleas, lice, and animal scratches. Bartonella is frequently discussed in Lyme communities, but it is not an established common co-infection transmitted by the same ticks that spread Lyme disease.

Each infection has different characteristics, diagnostic considerations, and treatment requirements.

That's why understanding your actual diagnosis is more important than simply counting the number of positive results on your lab report.

CDC — Lyme Disease Testing and Co-Infections

Does a Positive Lyme or Co-Infection Test Mean You Have an Active Infection?

Not necessarily.

This is one of the most important things to understand about Lyme disease testing.

Many tests look for antibodies produced by your immune system in response to an infection.

These antibodies can remain detectable long after the infection has resolved.

For example, the CDC explains that antibodies against the bacteria responsible for Lyme disease may remain elevated for months or even years after an infection.

That means a positive antibody test does not necessarily tell you whether the infection is currently active.

Understanding IgM, IgG, and PCR Testing

You may encounter several types of tests on your laboratory report.

IgM antibody testing

IgM antibodies can appear relatively early in an immune response. However, an isolated positive IgM result does not necessarily establish a recent infection.

For Lyme disease specifically, interpreting IgM results more than 30 days after symptom onset increases the risk of misleading conclusions.

IgG antibody testing

IgG antibodies often develop later and can persist long after an infection has cleared.

A positive IgG result may indicate previous exposure rather than an infection that requires treatment today.

PCR testing

Polymerase chain reaction (PCR) testing looks for genetic material from a pathogen.

A positive PCR result can provide more direct evidence that pathogen DNA is present, although its significance depends on the organism, specimen, and clinical circumstances.

A negative PCR result does not always rule out an infection.

What About Epstein-Barr Virus (EBV)?

EBV is another common source of confusion.

Most adults have been infected with Epstein-Barr virus at some point in their lives.

Certain EBV antibodies can remain positive indefinitely.

So, seeing EBV flagged on your laboratory report does not automatically mean you have an active EBV infection that requires treatment.

The takeaway: Don't build an entire treatment protocol around positive test results without first understanding what those results mean.

Lyme Disease vs. Bartonella vs. Babesia: What's the Difference?

Although these infections are frequently discussed together, they're not interchangeable.

Let's look at each one.

1. Lyme Disease (Borrelia)

Lyme disease is a bacterial infection most commonly associated with Borrelia burgdorferi in the United States.

Symptoms can include:

• Fatigue
• Fever and headaches
• Muscle and joint pain
• Swollen joints
• Certain neurological symptoms
• Heart-related complications in some cases

Some people develop the characteristic expanding erythema migrans rash, although not everyone notices one.

Treatment considerations: Antibiotics are the established treatment for active Lyme disease. The specific medication and duration depend on the stage and manifestations of the infection.

CDC — Clinical Testing and Diagnosis for Lyme Disease

2. Bartonella

Bartonella refers to a group of bacteria capable of causing several different illnesses.

One of the best-known species is Bartonella henselae, which causes cat-scratch disease.

Depending on the species and clinical presentation, Bartonella infections can cause:

• Fever
• Swollen lymph nodes
• Fatigue
• Skin lesions in certain conditions
• More serious complications in some patients

Bartonella testing can be challenging, and antibody results do not always establish an active infection.

Treatment considerations: Some Bartonella infections resolve without antibiotics, while others require specific antibiotic regimens. Treatment depends on the confirmed illness and its severity.

CDC — Bartonella Testing and Diagnosis

3. Babesia

Babesia is different from Lyme disease and Bartonella because it's a parasite rather than a bacterium.

Babesia parasites infect red blood cells and can cause an illness called babesiosis.

Possible symptoms include:

• Fever
• Chills
• Sweating
• Fatigue and weakness
• Muscle aches
• Anemia
• Shortness of breath in more serious cases

Babesiosis can be particularly dangerous for people who are immunocompromised, lack a spleen, or have other risk factors.

Diagnosis often involves examining blood under a microscope or using PCR testing.

Treatment considerations: Symptomatic babesiosis typically requires prescription antiparasitic treatment, often a combination of atovaquone and azithromycin.

CDC — Clinical Care of Babesiosis

Can One Treatment Address All Three?

Not necessarily.

Lyme disease, Bartonella infections, and babesiosis involve different organisms and may require different medications.

Some confirmed infections may need to be treated simultaneously.

Others may not require treatment at all, depending on whether there is evidence of active disease.

This is why an individualized medical evaluation matters.

Which Lyme Co-Infection Should You Treat First?

This is probably the biggest question people have after receiving multiple positive results.

But I think there's a better way to approach it.

Instead of asking, "Which infection should I kill first?", start by asking three questions.

Question 1: What's Actually Confirmed?

Look carefully at your laboratory results with your healthcare provider.

Are you dealing with:

• A confirmed active infection?
• Evidence of a previous infection?
• A positive antibody result that needs further interpretation?
• A possible false-positive result?
• Symptoms that could have another explanation?

These distinctions matter.

For example, a person with a positive Babesia antibody test but no symptoms or evidence of active infection may have very different treatment needs from someone with confirmed babesiosis and significant anemia.

Before deciding what to treat, make sure you understand what has actually been diagnosed.

Question 2: What Needs Medical Attention First?

Not every health concern carries the same level of urgency.

Certain symptoms deserve prompt medical evaluation, including:

• Persistent or high fever
• Significant anemia or unusual weakness
• Chest pain, fainting, or an irregular heartbeat
• Shortness of breath
• New facial weakness or other neurological problems
• Severe or rapidly worsening symptoms

These aren't situations where you should simply experiment with more supplements and hope for improvement.

Some tick-borne infections can cause serious complications if appropriate treatment is delayed.

Medical urgency should take priority over any preferred treatment sequence.

Question 3: What Can You Realistically Manage?

Once urgent concerns and confirmed infections are being appropriately addressed, think about the practical side of your recovery routine.

Can you understand your plan?

Can you follow it consistently?

Do you know which treatments are necessary and which supplements are optional?

Are you introducing so many things that you can't tell what's helping or causing side effects?

A manageable routine can make it easier to stay organized and communicate effectively with your healthcare team.

That doesn't mean delaying necessary medical treatments. It means avoiding unnecessary complexity around them.

Why Trying to Address Everything at Once Can Backfire

I've seen how quickly Lyme recovery routines can become overwhelming.

Someone starts with a few supplements.

Then they read about another herb.

Then a detox product.

Then something for the gut.

Then another supplement for inflammation.

Before long, they're taking 20 or 30 pills every morning and spending hundreds of dollars every month.

And here's the problem:

More supplements don't automatically mean better results.

When you introduce several products simultaneously, it can become difficult to identify which ones are helping, which ones are unnecessary, and which ones may be causing adverse reactions.

For optional supplements, introducing changes gradually with professional guidance may make reactions easier to recognize.

Is Feeling Worse Always a Herxheimer Reaction?

No.

The Jarisch-Herxheimer reaction is a recognized inflammatory response that can occur after antibiotic treatment of certain infections, including Lyme disease.

However, not every worsening symptom is a Herxheimer reaction.

Feeling worse could also reflect:

• A medication or supplement side effect
• An allergic reaction
• An untreated or worsening infection
• Dehydration
• Another medical condition

Don't automatically interpret worsening symptoms as proof that a treatment is working.

If symptoms are severe, new, or concerning, seek medical evaluation.

Build a Lyme Recovery Foundation You Can Actually Maintain

While you're working with your healthcare provider to address confirmed infections, don't overlook the everyday factors that support your general health.

These basics might not sound as exciting as an elaborate supplement protocol, but they're worth paying attention to.

Prioritize Sleep

Consistent sleep supports immune function, cognitive performance, and overall well-being.

Try to maintain a regular sleep schedule and create an environment that encourages restful sleep.

Eat Enough Nutritious Food

Your body needs adequate energy, protein, vitamins, and minerals.

You don't necessarily need an extremely restrictive diet to support your health.

Focus on nutritious foods you tolerate, and address any diagnosed deficiencies with appropriate professional guidance.

Stay Hydrated

Adequate hydration is important for normal bodily function.

Your needs may increase during fever, sweating, or illness.

Choose Activity Based on Your Current Tolerance

Physical activity can be beneficial, but the appropriate amount varies considerably.

If you experience significant symptom worsening after exertion, don't force yourself through it.

Work with a healthcare professional to determine what level of activity is appropriate.

Keep Your Routine Simple

You don't need to spend every waking hour researching Lyme disease, tracking symptoms, and experimenting with new products.

A practical routine should support your life rather than consume it.

The goal isn't to become better at managing an increasingly complicated protocol. The goal is to improve your health and get more of your life back.

Where Do Herbal Supplements Fit Into Lyme Recovery?

Herbal supplements are popular in the Lyme disease community, and they're part of my personal story.

When I was dealing with Lyme disease, I became interested in herbs alongside improvements to my diet, sleep, and daily routine.

That experience eventually inspired me to create LymeWars.

However, it's important to distinguish personal experience from established medical evidence.

Herbs such as Japanese knotweed, cat's claw, and andrographis have been studied for various biological properties, but they have not been established in clinical trials as effective treatments for Lyme disease, Bartonella infections, or babesiosis.

They should not replace antibiotics or other prescribed medications when those treatments are indicated.

The LymeWars Approach: Keep It Simple

One of the reasons I created the LymeWars Recovery Kit was to make it easier for people interested in herbal supplements to follow a straightforward routine rather than continually adding more products.

Our three-herb kit includes:

• Japanese Knotweed
• Cat's Claw
• Andrographis

The kit is designed as an optional herbal supplement routine, with educational guidance to help people understand the ingredients and use them responsibly.

It is not a proven treatment for Lyme disease or its co-infections, and anyone considering these herbs should discuss possible interactions, contraindications, and side effects with their healthcare professional.

If you're interested in learning more about our approach, you can explore the LymeWars Recovery Kit here.

Frequently Asked Questions About Lyme Disease Co-Infections

Can you have Lyme disease, Bartonella, and Babesia at the same time?

It is possible for someone to have more than one infection. Lyme disease and babesiosis are recognized tick-borne co-infections. Bartonella can also occur in someone who has Lyme disease, although transmission of Bartonella by the same ticks is not established as a common route. Each suspected infection requires appropriate evaluation.

Is Babesia harder to treat than Lyme disease?

Not necessarily. Babesiosis and Lyme disease are different illnesses with different treatments. The difficulty of treatment depends on factors such as infection severity, immune status, and complications.

Does a positive Bartonella IgG test mean I need treatment?

No. A positive IgG test alone does not necessarily establish active Bartonella infection. Your healthcare provider should interpret the result alongside your symptoms, exposure history, and other findings.

Can Lyme disease antibodies stay positive after treatment?

Yes. Lyme disease antibodies can remain detectable for months or years after successful treatment. Repeat antibody testing generally cannot determine whether treatment worked.

Do I need to treat every positive result on my Lyme disease panel?

No. Some results may reflect previous exposure, while others may require confirmation or additional evaluation. Treatment decisions should be based on the diagnosis and clinical circumstances rather than the number of positive tests.

Can herbs treat Lyme disease and co-infections?

Although certain herbs have shown interesting effects in laboratory studies, there is insufficient clinical evidence to establish herbal supplements as effective treatments for Lyme disease, Bartonella infections, or babesiosis. They should not replace indicated medical treatment.

Final Thoughts: Your Life Shouldn't Revolve Around Lyme Disease

If you've tested positive for Lyme disease, Bartonella, Babesia, or several other infections, I understand how overwhelming that can feel.

But a long list of test results doesn't mean you need to panic.

Start with what you actually know.

Work with your healthcare provider to understand which infections are confirmed, which concerns need immediate attention, and which results may simply reflect previous exposure.

Then focus on building a routine you can realistically maintain.

You don't need to chase every supplement, every new protocol, or every theory you come across online.

Your recovery efforts should help you move toward living your life, not make Lyme disease the center of everything you do.

That's the philosophy behind LymeWars.

If you'd like to explore a simpler approach to optional herbal supplementation, learn more about our three-herb Recovery Kit here.

Or start with our free Lyme Fatigue Reset Guide for practical ideas on supporting your daily routine.

Medical Disclaimer: This article is intended for educational purposes only and does not constitute medical advice, diagnosis, or treatment. Lyme disease, babesiosis, and certain Bartonella infections can require prescription medications. Always consult a qualified healthcare professional before making treatment decisions or starting new supplements.