Episode 605: Lyme Disease, Immune Dysfunction & Hidden Environmental Bacteria – Jacki Meinhardt | LIVE from ILADS

Could overlooked environmental bacteria, immune dysfunction, and mitochondrial health help explain why some Lyme disease patients remain sick despite years of treatment?

In this LIVE from ILADS interview, Tick Boot Camp co-host Rich welcomes back Jacquelyn “Jacki” Meinhardt, DNP, FNP-BC, a nurse practitioner at Amen Clinics in Northern Virginia, to explore the complex relationship between Lyme disease, tick-borne co-infections, environmental exposures, inflammation, and persistent symptoms.

Recorded at the 2025 International Lyme and Associated Diseases Society (ILADS) Conference in San Antonio, Texas, the conversation explores why some patients struggle to improve after seeing numerous healthcare professionals—and why listening, comprehensive evaluation, and patient-centered care are so important.

Jacki discusses medical gaslighting, the growing recognition of Anaplasma and Ehrlichia infections, cardiovascular complications of tick-borne diseases, and an often-overlooked environmental concern: actinomycetes, a group of bacteria that can be found in indoor environments.

She also previews her work on mitochondrial medicine, including cellular energy production, NAD metabolism, inflammation, and the possible relationship between mitochondrial dysfunction and chronic fatigue.

Throughout the interview, Jacki emphasizes a principle that resonates deeply with the Lyme disease community: Patients deserve to be heard, believed, and thoroughly evaluated—even when their symptoms remain unexplained.

Meet Jacquelyn “Jacki” Meinhardt, DNP, FNP-BC

Jacquelyn “Jacki” Meinhardt is a doctorally prepared, board-certified family nurse practitioner whose clinical interests include neuroinflammation, immune dysfunction, tick-borne infections, environmental illness, and complex chronic health conditions.

At the time of this interview, she had worked at Amen Clinics in Northern Virginia, outside Washington, D.C., for approximately four years.

Jacki also teaches at Georgetown University, bringing her clinical and academic experience to discussions about medical education and emerging research.

During the interview, she shares that she had been nominated for the ILADS Board of Directors.

Since this conversation was recorded, Jacki has joined the ILADS Board, becoming its first nurse practitioner board member.

Her involvement reflects her interest in expanding interdisciplinary collaboration, improving education, and helping healthcare professionals better understand patients with complex chronic illnesses.

Learn more about her work through her Amen Clinics professional profile.

Why Some Patients Remain Sick After Seeing 20 Doctors

Jacki explains that many patients arrive at Amen Clinics after extensive medical journeys.

Some have consulted as many as 20 healthcare professionals, including functional medicine practitioners, without achieving meaningful improvement.

They may have undergone numerous laboratory tests, received multiple diagnoses, and tried different treatment plans.

Rather than immediately recommending another intervention, Jacki begins by asking questions.

She reviews previous testing, medical history, symptoms, treatment responses, and possible environmental exposures.

Her goal is to identify what may have been overlooked.

She also emphasizes the importance of treatment sequencing.

Sometimes patients have received several reasonable recommendations, but Jacki believes the order in which interventions are introduced may affect how well they tolerate or respond to care.

Her approach focuses on understanding the individual patient's circumstances rather than automatically adding more treatments.

Medical Gaslighting, Medical Trauma, and the Power of Being Believed

One of the most meaningful moments in the interview occurs when Jacki discusses the emotional consequences of prolonged diagnostic uncertainty.

She describes patients who have repeatedly been told that their test results are normal or that nothing is medically wrong.

After years of symptoms and unsuccessful treatments, some become fearful that another healthcare professional will dismiss their concerns.

Jacki describes this experience as a form of medical trauma.

She explains that one of the first things she tells patients is:

“I believe you.”

That reassurance can help patients feel safe enough to share their experiences and participate in a productive medical conversation.

Rich asks whether medical gaslighting always involves intentional dismissal or whether some situations reflect limitations in medical education and diagnostic tools.

Jacki emphasizes education rather than assigning blame.

She believes healthcare professionals can improve patient care by communicating more effectively, remaining curious, and recognizing the limitations of their knowledge.

The discussion reinforces an important message: Unexplained symptoms are still real symptoms, and patients deserve compassionate medical attention.

Immune Dysfunction: Finding Common Ground Across Medical Specialties

Jacki explains that she frequently uses the term immune dysfunction when communicating with clinicians who may be unfamiliar with some of the terminology used in Lyme disease and environmental medicine.

Rather than beginning with a discussion of Borrelia, Bartonella, Babesia, mold, or other specific organisms, she focuses on how the immune system may be functioning.

She believes this approach creates opportunities for collaboration across medical specialties.

Jacki also discusses how the COVID-19 pandemic increased public awareness of immune responses, inflammation, and cytokines.

She views the resulting research and medical conversations as opportunities to improve understanding of other complex illnesses.

However, immune dysfunction is a broad concept, not a single diagnosis. Specific immune disorders require appropriate clinical evaluation, and not every chronic symptom is caused by an abnormal immune response.

Lyme Disease Co-Infections: Beyond Borrelia, Bartonella, and Babesia

Rich asks Jacki whether she is seeing changes in the types of infections identified among patients with Lyme disease.

He describes Tick Boot Camp's observations of patients reporting combinations of Borrelia, Bartonella, and Babesia.

Jacki explains that she has considered multiple tick-borne infections in her clinical evaluations for many years.

She also discusses other pathogens that may be relevant depending on a patient's symptoms and exposure history.

These include:

• Borrelia: Bacteria responsible for Lyme disease and certain relapsing fever illnesses
• Babesia: Parasites that infect red blood cells and cause babesiosis
• Bartonella: Bacteria associated with several human diseases
• Anaplasma: Bacteria responsible for anaplasmosis
• Ehrlichia: Bacteria responsible for ehrlichiosis
• Rickettsia: Bacteria associated with spotted fever illnesses, including Rocky Mountain spotted fever

Jacki reports encountering more Anaplasma and Ehrlichia in her practice over the preceding two years.

She acknowledges that she cannot determine whether this reflects changing infection patterns, improved diagnostic testing, or increased clinical awareness.

Her experience highlights the importance of considering other tick-borne infections when a patient's history and symptoms warrant investigation.

It does not mean that every person with Lyme disease has multiple infections.

Cardiovascular Symptoms and Tick-Borne Disease

Jacki discusses her interest in cardiovascular and circulatory health.

She explains that when evaluating patients with certain cardiac abnormalities, she considers whether an infectious disease could be contributing to their symptoms.

The conversation includes heart block, atrial fibrillation, and tick-borne infections that may require further investigation.

Lyme carditis is a recognized complication of Lyme disease that can disrupt electrical signaling in the heart.

Other tick-borne infections may also produce serious systemic complications.

Jacki emphasizes reviewing which infections have already been investigated and whether additional testing is appropriate.

New chest pain, fainting, significant palpitations, or suspected heart block require prompt medical attention.

For another discussion of Lyme disease's neurological and cardiovascular effects, explore Tick Boot Camp's interview with Dr. Medeya Tsnobiladze.

Environmental Actinomycetes: Could There Be More Than Mold in Water-Damaged Buildings?

One of the most distinctive parts of this interview focuses on environmental actinomycetes.

Jacki explains that patients investigating building-related health concerns frequently focus on mold.

However, she believes certain bacteria present in indoor environments deserve additional attention.

Actinomycetes are a diverse group of bacteria found in soil, water, and other environments. Some are also normal members of the human microbiome.

Jacki discusses how these organisms can enter buildings through shoes, clothing, pets, and ordinary outdoor exposure.

She explains that moisture and environmental conditions may influence microbial growth.

Her clinical interest includes evaluating possible environmental exposures in patients with persistent symptoms and complex medical histories.

Actinomycetes, Biofilms, and Indoor Environments

Jacki describes actinomycetes as organisms capable of contributing to biofilm formation under certain conditions.

She discusses how investigating bacterial contamination may differ from evaluating fungal contamination.

She also references research she reports publishing with Dr. Ritchie Shoemaker in 2019 concerning environmental organisms and chronic inflammatory illness.

According to Jacki, understanding these exposures may help clinicians investigate cases where patients continue experiencing symptoms after addressing suspected mold problems.

She also describes considering culture results from different body sites when evaluating selected patients.

Scientific context: The presence of actinomycetes in a building or clinical sample does not automatically establish that they are causing illness. Their proposed role in chronic inflammatory conditions remains under investigation, and laboratory findings require careful interpretation.

Mold, Environmental Testing, and Chemical Sensitivities

Jacki explains that she considers the patient's broader environment when reviewing complicated cases.

Homes, schools, and workplaces can have different environmental conditions, including moisture problems, microbial contamination, and other potential exposures.

Some patients arrive with previous environmental testing results that may need further interpretation.

Jacki believes clinicians should review these findings alongside medical history and symptoms rather than assuming a single exposure explains every health problem.

She also discusses how certain patients report sensitivity to fragrances or cleaning products.

For these individuals, she emphasizes considering cleaning methods and product tolerability when developing practical recommendations.

The conversation illustrates the importance of investigating documented environmental problems without assuming that every detected organism represents a health hazard.

Mitochondrial Medicine: Understanding Energy Production and Chronic Fatigue

Near the end of the interview, Jacki reveals that she is preparing to present on mitochondrial medicine at ILADS.

Mitochondria are cellular structures responsible for producing much of the energy used by the body.

Jacki is interested in how energy metabolism may relate to inflammation, vascular health, and persistent symptoms.

Her presentation explores:

• Mitochondrial function and cellular energy production
• The Krebs cycle
• Pyruvate and lactate metabolism
• NAD and its role in cellular processes
• Endothelial function and blood vessel health
• Inflammatory signaling and metabolic changes

Rich connects this discussion to the profound fatigue frequently reported by people living with Lyme disease.

Jacki believes research into cellular energy pathways may help clinicians better understand some aspects of complex chronic illness.

However, fatigue has many possible causes. It cannot automatically be attributed to mitochondrial dysfunction, and research into energy metabolism does not establish that NAD supplementation or other mitochondrial therapies treat Lyme disease.

Why Medical Education Must Evolve Faster

Jacki expresses frustration that new research findings can take years to reach everyday clinical practice.

She believes physicians, nurse practitioners, physician assistants, and other healthcare professionals need opportunities to learn about emerging evidence more quickly.

Her involvement with ILADS reflects that commitment to continuing education.

Rich agrees that greater collaboration between clinicians, researchers, and advocates can improve awareness and patient care.

Their conversation emphasizes the importance of evaluating new research carefully while helping healthcare professionals remain informed about developments relevant to complex chronic illness.

Key Takeaways

• Patients deserve validation. Jacki emphasizes listening carefully to people who have experienced years of medical dismissal.
• Complex cases require comprehensive evaluation. Reviewing medical history, previous testing, and environmental exposures may reveal overlooked information.
• Immune dysfunction is an important area of investigation. Understanding specific immune abnormalities requires appropriate medical assessment.
• Tick-borne infections extend beyond Lyme disease. Jacki discusses Babesia, Bartonella, Anaplasma, Ehrlichia, and other infections.
• Cardiovascular symptoms warrant careful attention. Certain tick-borne infections can cause serious cardiac complications.
• Environmental actinomycetes are an emerging research topic. Their proposed relationship with chronic inflammatory illness requires further validation.
• Mitochondrial health may provide insights into persistent fatigue. Research into cellular energy metabolism continues to evolve.
• Medical education can help improve care. Jacki advocates for collaboration, research awareness, and better communication across specialties.

About This LIVE from ILADS Interview

This conversation was recorded at the 2025 International Lyme and Associated Diseases Society Conference in San Antonio, Texas.

Rich welcomes Jacquelyn “Jacki” Meinhardt, DNP, FNP-BC, back to Tick Boot Camp to discuss Lyme disease, immune dysfunction, environmental actinomycetes, and mitochondrial medicine.

During the interview, Jacki discusses her nomination to the ILADS Board of Directors. She has since joined the board, becoming its first nurse practitioner member.

Explore more conversations with physicians, researchers, and advocates through Tick Boot Camp's LIVE from ILADS interview series.