A reader wrote:

How does having Ehrlichia and Rickettsia in high values in the sample correspond to having these Lyme coinfections systemically? These are fairly common to see in the sample but my values are very high 96 and 99%.

From a reader

What is he talking about?

Ehrlichia is a genus of Rickettsiales bacteria that are transmitted to vertebrates by ticks. These bacteria cause the disease ehrlichiosis, which is considered zoonotic, because the main reservoirs for the disease are animals… Originally called Rickettsia ruminantium, and is currently named Ehrlichia ruminantium. [Wikipeadia]

Rickettsia is the name of a single genus, …Many new strains or species of Rickettsia are described each year… Some Rickettsia species are pathogens of medical and veterinary interest, but many Rickettsia are non-pathogenic to vertebrates, including humans[Wikipedia]

He mentions they are common to see, let us look at the upload stats. From Ehrlichia: NCBI 943

And looking at Rickettsia: NCBI 780

The microbiome raises Yellow Flags only

For both of the above, the species or strains you have may be non-pathogenic (or even you are not susceptible to them). There are two steps that should be considered:

• Do you have any symptoms for either condition?
  • See Ehrlichiosis
  • See Rickettsiosis
• If you have symptoms — then take the microbiome results to your MD quickly and ask for further testing (the above pages enumerates the appropriate tests)
• If you do not have any symptoms, then for your next regular appointment, mention this — your MD may or may not do tests. Typically some symptoms is needed to justify the testing cost to insurance.

Is the Microbiome a Leading or Trailing Indicator?

A leading indicator is one that has the microbiome shifting before the diagnosis is usually done. This could be viewed as the microbiome shift feeding the condition. A trailing indicator means that the condition develop and then the microbiome changes.

We so not know the answer. I tend to favor it being a leading indicator, thus, when the shifts are towards a known condition then you can take action and either slow the progression or prevent it. Since the main mechanism (diet change) is extremely safe and usually very affordable — it appears to be rational.