Episode 546: When the Brain Pathobiome Becomes Personal: Polymicrobial Drivers of Cognitive Decline – Nicole Bell

Overview This special episode of the Tick Boot Camp Podcast was recorded live at the 2nd Annual Alzheimer’s Pathobiome Initiative (AlzPI) and PCOM Symposium in collaboration with Pathobiome Perspectives. Hosted by Ali Moresco in partnership with Nikki Schultek (Executive Director, AlzPI), the conversation advances the Tick Boot Camp mission of exploring infection-associated chronic illness (IACI)—including Lyme disease and other tick-borne infections—within the global Alzheimer’s and neuroimmunology community. Tick Boot Camp co-founders Matt Sabatello and Rich Johannesen partnered with Ali and Nikki to amplify voices connecting tick-borne illness, microbes, and cognitive decline. This episode features Nicole Bell—author, entrepreneur, and CEO of Galaxy Diagnostics—whose memoir What Lurks in the Woods documents her late husband Russ’s misdiagnosed tick-borne illness and their search for answers. Guest Nicole Bell Author of What Lurks in the Woods CEO, Galaxy Diagnostics Advocate for tick-borne and neurodegenerative disease BS/MS, Materials Science & Engineering (MIT) MS, Biomedical Engineering (Duke University) At the Symposium, Nicole presented “When the brain pathobiome becomes personal,” sharing her family’s journey and new findings from Russ’s donated brain: laboratory evidence of Borrelia burgdorferi, Chlamydia pneumoniae, and Babesia otocoli (a species long thought to be deer-restricted) in brain tissue—data now being prepared for publication. Researchers also noted elevated heavy metals (lead, mercury), underscoring how polymicrobial infection plus toxic exposures may converge to drive neuroinflammation and Alzheimer’s-like decline. Key Discussion Points Nicole details how repeated “normal” neurology workups masked a complex pathobiome process. She explains why standard two-tier Lyme serology can miss true infection, how direct detection can change care, and why patients should consider Bartonella and Babesia alongside Lyme. She outlines hallmark Bartonella clues—including striæ that resemble stretch marks (often more visible after hot showers), neuropsychiatric manifestations (irritability, anxiety, OCD, tics), ocular and joint involvement—and highlights non-tick vectors (notably fleas and household cats) that expand risk beyond forest exposure. Nicole advocates for building a diagnostic toolkit that combines serology with sensitive direct tests to clarify which pathogens are active—critical because Borrelia, Bartonella, and Babesia require different treatment paradigms. Looking forward, she envisions comprehensive screening panels for midlife cognitive changes that integrate pathogen load, host immune signatures, and toxin status, enabling earlier, targeted interventions. “Everyone wants a simple A→B. But the toughest chronic conditions are subtle and multifactorial. Accurate data, direct detection, and a clinician who will go on the journey with you can change everything.” — Nicole Bell Why It Matters Nicole’s story humanizes the science: polymicrobial infection + toxins + host factors can look “psychiatric” or “idiopathic” until modern testing reveals the underlying pathobiome. Her advocacy pushes medicine toward precision diagnostics, earlier detection, and pathogen-informed care that may prevent years of decline. About the Event Recorded at the 2nd Annual Alzheimer’s Pathobiome Initiative (AlzPI) and Philadelphia College of Osteopathic Medicine (PCOM) Symposium on October 3, 2025, at Ohio University (Dublin, Ohio). The meeting convened global experts investigating how microbes, the microbiome, and immune responses contribute to Alzheimer’s, dementia, PANS/PANDAS, and other infection-associated chronic illnesses (IACI). This episode is part of a Tick Boot Camp series connecting chronic Lyme research with cutting-edge brain-immune science. Learn More Learn more about the Alzheimer’s Pathobiome Initiative (AlzPI) Listen to Tick Boot Camp Podcast episodes, including Episode 406: Pathobiome – An Interview with Nikki Schultek, Episode 101: The Young Gun – An Interview with Alex (Ali) Moresco, and Episode 216: What Lurks in the Woods – an interview with Nicole Bell discussed in this interview.