1. LymeTestingUK In Conjunction With The Center for Bio-Individualized Medicine 1 LymeTestingUK.com

2. Agenda  Lyme Disease- Cause and Symptoms  Who Should Be Checked for Lyme Disease  Routes of Infection  A Primer on Lyme Disease Testing  Why We Use MDL Labs in USA  How We Compare With Other Labs in Service and Pricing 2

3. Our Passion  To See That Suffering from Chronic Illness is Eradicated  Lyme and it’s Co-Infections are the leading cause of suffering in the world today  We are making the testing for Lyme disease and all associated infections:  Accurate  Unbiased and  Affordable 3

4. CAUSE & SYMPTOMS Lyme Disease 4

5.  Lyme disease is a bacterial infection that is spread through the bite of one of several types of ticks.  Lyme disease (Lyme borreliosis) is an infectious disease caused by at least three species of bacteria belonging to the genus Borrelia. Borrelia burgdorferi is the main cause of Lyme disease in North America, whereas Borrelia afzelii and Borrelia garinii cause most European cases.speciesbacteriagenus BorreliaBorrelia burgdorferiNorth AmericaBorrelia afzeliiBorrelia gariniiEuropean  Texas (being Texas) had to have it’s own strain….hence Borellia Lonestari….The Lonestar Tick  Wikipedia (c) Dr. Jess P. Armine 2015 5

6. Risk Areas 6

7. (c) Dr. Jess P. Armine 2015 Lyme is EVERYWHERE!  Incredible But True! Lyme Disease is in over 80 Countries!  The Subantarctic is a region in the southern hemisphere just north of the Antarctic Circle which contains the Campbell Islands and îles Crozet. According to the "Encyclopedia of the Antarctic Vol.1" (ed: B. Riffenburg, 2007 p.335), "The zoonosis Lyme disease is caused by the spirochaete Borrelia burgdorferi, which is carried by sea birds transmitted by Ixodes ticks. It has been found through DNA analysis in ticks on the Campbell Islands and the îles Crozet. King penguins on the îles Crozet have antibodies to B. burgdorferi.“  http://www.lymediseaseassociation.org/index.php/about-lyme/cases-stats-maps-a-graphs/940- lyme-in-more-than-80-countries-worldwide 7

8. WHO SHOULD BE CHECKED FOR LYME DISEASE ? 8

9. The Answer is Quite Simple  As you'll see, Lyme disease can manifest in about 1000 different ways. Often, "diagnoses" like chronic fatigue syndrome, chronic pain syndromes, autoimmune diseases, ADD, OCD, fibromyalgia, and many others have Lyme disease are one of the co- infections as their root.  The answer to this question is simply this:  If you, a loved one, or a friend (or even an acquaintance) has been diagnosed with a syndrome that is responding poorly or not at all to standardized treatment Lyme disease or one of the co-infections may be the untreated cause of that syndrome. 9

10. Common Symptoms…Perhaps Common Causation? 10 SymptomChronic LymeFibromyalgiaME/CFS Dysautonomia FatigueXXX X Chronic PainXXX X Mood ChangesXXX X Confusion/ Brain Fog XXX X Numbness TinglingXXX X Sensitivity to lightXXX X InflammationXXX X

11. IS IT LYME OR CAN IT BE OTHER MICROBES? Recalcitrant Chronic Illnesses 11

12. Vectorbourne Diseases Borellia Burgdorferi  Borellia  Garinii  Afzelli  Lonestari Co-Infections  Bartonella  Babesia  Anaplasma  Ehrlichia  Rickettsia 12 LymetestingUK.com checks for all these via several modalities

13. LymetestingUK.com Includes at no extra cost Tests for:  Candida Albicans (Yeast)  Toxoplasmosis (brain parasite)  Parvovirus 13

14. Chronic Illness Can be caused by all the microbes we test for singularly or in combination. So, why test just for Lyme? 14

15. ROUTES OF INFECTION 15

16. (c) Dr. Jess P. Armine 2015 Routes of Infection  Tick bite (Myth: the tick has to be attached for 36- 48 hrs. before it can transmit the microorganism…some studies are showing as little as 30 min…when in doubt, check it out!)  From infected parents, breastfeeding from infected parent (Hotly debated) http://www.lymedisease.org/resources/children.htmlhttp://www.lymedisease.org/resources/children.html  Blood transfusion or receiving blood from other parasitic insects  New evidence that there can be sexual transmission http://afmr.org/Western 16

17. (c) Dr. Jess P. Armine 2015 Ticks 17

18. (c) Dr. Jess P. Armine 2015 When In Doubt…Check It Out! If you find an embedded Tick and you remove it…take it to the doctor. The tick can be submitted to the lab to test for Lyme. 18

19. (c) Dr. Jess P. Armine 2015 19

20. (c) Dr. Jess P. Armine 2015 What to Look for…The “Bulls Eye Rash” But this rash DOESN’T always happen and the presence or history of this rash SHOULD NOT BE USED AS AN EXCLUSION CRITERIA! 20

21. (c) Dr. Jess P. Armine 2015 21 The Lyme Organism is a Spirochete

22. (c) Dr. Jess P. Armine 2015 Symptoms Numerous and Varied  Because the bacteria spreads through the blood to tissue, joints, bone marrow, organs and the brain (CNS), the symptoms are both numerous and varied. They can include: 22

23. (c) Dr. Jess P. Armine 2015 23

24. (c) Dr. Jess P. Armine 2015 Children's Symptoms Lyme pediatric specialist Charles Ray Jones, MD, compiled a list of common symptoms of infection in his young patients: severe fatigue unrelieved by rest insomnia headaches nausea, abdominal pain impaired concentration poor short-term memory inability to sustain attention difficulty thinking and expressing thoughts difficulty reading and writing being overwhelmed by schoolwork difficulty making decisions confusion uncharacteristic behavior outbursts and mood swings fevers/chills joint pain dizziness noise and light sensitivity Dr. Jones has also documented congenital, or gestational, Lyme disease in some children who were infected in utero or by breastfeeding. In these patients his suspicion is raised when the child has: frequent fevers increased incidence of ear and throat infections increased incidence of pneumonia irritability joint and body pain poor muscle tone gastroesophageal reflux small windpipe (tracheomalacia) cataracts and other eye problems developmental delay learning disabilities psychiatric problems http://www.lymedisease.org/resources/children.html 13 24

25. 25 February 20, 2014 newspaper article

26. LYME DISEASE TESTING A Primer On 26

27. (c) Dr. Jess P. Armine 2015 Testing...Here Thar Be Dragons Matey!  ELISA (Enzyme Linked Immuno-Sorbent Assay) (Ig, IgG)  Western (immunoblot)Blot ( to separate and identify proteins. In this technique a mixture of proteins is separated based on molecular weight, and thus by type, through gel electrophoresis. These results are then transferred to a membrane producing a band for each protein. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3456489/)http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3456489/  Polymerase chain reaction (PCR) (multiplies DNA)  Lyme Culture Blood Test™ Advanced Laboratory Services, Inc.  Indirect findings on other lab tests 27

28. (c) Dr. Jess P. Armine 2015 Problems: False Positives and False Negatives  The most common tests measure the patient’s antibody response to infection (ELISA). When your body is invaded by the Lyme spirochetes, your immune system makes antibodies to fight the infection. Tests that measure antibody levels are indirect tests because they measure the body’s response to infection rather than the presence of the bacteria themselves.  During the first 4-6 weeks after exposure, most people have not developed the antibody response that the test measures.  Doctors commonly order an ELISA first to screen for the disease and then confirm the disease with a western blot. However, current ELISA tests are not sensitive enough for screening and may miss over half the true cases.  Because of this, the best antibody test to use for diagnosis is the western blot (immunoblot). 28

29. (c) Dr. Jess P. Armine 2015 Western Blot (Immunoblot)  The read-out from the western blot looks like a bar code. The pattern produced by running the test with your blood is compared to a template pattern that represents known cases of Lyme disease. If your blot has bands in the right places, and the right number of bands, it is positive. Some of the bands are more significant than others.  Different criteria from different sources are used to determine the presence of Lyme. 29

30. (c) Dr. Jess P. Armine 2015 30

31. (c) Dr. Jess P. Armine 2015 PCR  Polymerase chain reaction (PCR) multiplies a key portion of DNA from the Lyme bacteria so that it can be detected. While PCR is highly accurate when the Lyme DNA is detected, it produces many false negatives. This is because Lyme bacteria are sparse and may not be in the sample tested. 31

32. Why MDL Labs One of the finest and most accurate labs in the US  Certified by:  New Jersey State Department of Health  Pennsylvania Department of Health  Florida Clinical Laboratory State  New York State Department of Health  Rhode Island Department of Health  California Department of Health  Maryland Department of Health  CLIA  Medicare  CAP – http://www.mdlab.com/company/certifications-licenses/ http://www.mdlab.com/company/research-development/  Some Lyme Publications:  Meer-Scherrer L, Adelson ME, Mordechai E, Tilton RC. 2006. Neuroborreliosis associated with Alzheimer’s disease. Curr Microbiol, 52(4):330-2.  Drisko J, Bischoff B, Giles C, Adelson ME, Rao RV, McCallum R. 2005. Evaluation of 5 probiotic products for bacteria by DNA extraction and PCR analysis. Dig Dis Sci, 50(6):1113-7.  Adelson ME, Feola M, Trama JP, Tilton RC, Mordechai E. 2005. Simultaneous detection of herpes simplex virus types 1 and 2 by Real-Time PCR and Pyrosequencing. J Clin Virol, 33(1):25-34.  Adelson ME, Rao RV, Tilton RC, Cabets K, Eskow E, Fein L, Occi JL, Mordechai E. 2004. Prevalence of Borrelia burgdorferi, Bartonella species, Babesia microti, and Anaplasma phagocytophila in Ixodes scapularis collected in northern New Jersey. J Clin Microbiol, 42:2799-2801.  Meer-Scherrer L, Adelson ME, Mordechai E, Lottaz B, 32

33. MDL is the ONLY lab that allows The Clinican ToVisualize the Immunoblot IgG Reports 1 when I see 7 bands With Human Eyes, the test meets CDC criteria Proper Interpretation = Less False Negatives Reports zero when I see 3 bands 33

34. (c) Dr. Jess P. Armine 2015 Hong Kong: 27 year old female with recalcitrant anxiety IGG IGM 34 The associated Neurotransmitter Test showing extreme excitation (anxiety)

35. 35

36. PCR  Polymerase chain reaction (PCR) multiplies a key portion of DNA from the Lyme bacteria so that it can be detected. While PCR is highly accurate when the Lyme DNA is detected, it produces many false negatives. This is because Lyme bacteria are sparse and may not be in the sample tested. 36

37. How to Diagnose Lyme?  History, history, history  Clinical findings  Results of testing  Rely on the preponderance of evidence…Not Just The TESTS! The diagnosis of Lyme is a CLINICAL DIAGNOSIS!!!  LymeTestingUK.com includes a person-to-person, unbiased consultation with the healthcare provider for the purpose of explaining the testing and sitting you on the right road. At other labs, this is available at extra cost. 37

38. What LymeTestingUK Offers  Complete, Accurate Testing for:  Lyme Disease. Borellia Burgdorferi (Immunoblot, PCR, C6 Peptide)  Co-Infections (Babesia, Bartonella, Rikettesia, Ehrlichia, Anaplasma)  A Common Brain Parasite (Toxoplasmosis)  Yeast (Candida Albicans)  Parvovirus  Mycoplasma  We Check for ALL forms of Lyme Disease: 38 Borellia lonestari by Real- Time PCR Borellia garinii by Real-Time PCR Borellia afzelii by Real-Time PCR Babesia WA1 by Real-Time PCR

39. LymeTestingUK.com Includes  An Unbiased, Interpretive Consultation with A Health Care Provider*  Door to Door Shipping  No hidden or extra costs * The Health Care Provider will interpret your tests results to help you decide on your future course of action. Please note, purchasing this test does not make you one of our registered patients and so we cannot offer treatment just guide you in choosing your options. 39

40. Why Such Extensive Testing? Because Chronic Illnesses May Be Caused By Numerous Microorganisms…not Just Borellia Burgdorferi 40

41. HOW DO WE COMPARE? 41 LymetestingUK.com? Igenex? InfectoLab? Armin Labs?

42. 42 Test Lyme Testing UK Price £ Infectolab Price £ ARMIN LAB Price £ IGENEX Price £ Babesia PCR INCLUDED21799.02INCLUDED Babesia IGG Babesia IGM INCLUDED 127 51.24 INCLUDED Bartonella henselae PCR Bartonella IGG/IGM INCLUDED 217 153 99.02 102.48 INCLUDED B. burgdorferi (Lyme) PCR INCLUDED19884.17INCLUDED Ehrlichia PCR INCLUDED21799.02NOT INCLUDED Ehrlichia IGG/IGM INCLUDED19751.24NOT INCLUDED Western Blot Lyme (IMMUNOBLOT) Lyme IGG/IGM INCLUDED INCLUDED 156 197 79.20INCLUDED Mycoplasma INCLUDED17934.65NOT INCLUDED Lyme Disease C6 peptide by ELISAINCLUDEDNOT AVAILABLE NOT INCLUDED Borellia lonestari by Real-Time PCRINCLUDEDNOT AVAILABLE NOT INCLUDED Borellia garinii by Real-Time PCRINCLUDEDNOT AVAILABLE NOT INCLUDED Borellia afzelii by Real-Time PCRINCLUDEDNOT AVAILABLE NOT INCLUDED Babesia WA1 by Real-Time PCRINCLUDEDNOT AVAILABLE NOT INCLUDED Anaplasma phagocytophilum IgG/IgM by IFAINCLUDEDNOT AVAILABLE NOT INCLUDED Anaplasma phagocytophilum PCRINCLUDEDNOT AVAILABLE NOT INCLUDED Rickettsia rickettsii (RMSF) by Real-Time PCRINCLUDED15184.17NOT INCLUDED Candida albicans by Real Time PCRINCLUDEDNOT AVAILABLE34.65NOT INCLUDED Toxoplasma gondii by Real Time PCRINCLUDEDNOT AVAILABLE34.25NOT INCLUDED Expert ConsultationINCLUDEDNOT INCLUDEDAT EXTRA COSTNOT INCLUDED Shipping INCLUDED 36.93NOT INCLUDED Use of Credit CardINCLUDED +2.95% £699.00£2009.00£969.45£862.00

43. Other Labs  Do Minimal Testing  Charge for Shipping  Health Care Provider Consultation is at Extra Cost  LymeTestingUK.com  All Inclusive Price  No Hidden Costs  Extensive Testing  Less Costly 43

44. LymeTestingUK Pricing  For Nearest Equivalent Tests:  IgeneX  £ 969.45  Armin Labs:  £ 862.00  InfectoLab:  £ 2009.00  LymeTestingUK.com:  £ 699.00!!  All Inclusive…No Hidden or Extra Costs 44