What You Need to Know About Anaplasma – The Lyme Staller

One of the most unchecked, underreported and underestimated Lyme co-infections and tick-borne illnesses is Anaplasma. In this article, I’m going to tell you what you need to know about Anaplasma because few doctors are covering this important topic. 

It’s vital to know about this stealthy bacteria because Anaplasma is the fourth most common tick-borne illness in the United States and the third most common Lyme co-infection. It not only brings its own set of problems, but it can also stall your ability to heal from Lyme and other co-infections. 

What is Anaplasma? 

Anaplasma is an obligate intracellular bacteria, meaning it needs a host cell in which to replicate. It learns to evade and overcome antibacterial agents so it can establish itself inside your body. 

Bartonella and Babesia live in your red blood cells, but Anaplasma likes to live in your white blood cells, which can significantly affect your immune system’s ability to function and kill other bacteria (such as Lyme!). 

Where tick-borne illnesses like to live:

  • Lyme (Borrelia) likes to live in between the cells.
  • Bartonella lives in the endothelial lining of blood vessels and skin cells.
  • Babesia lives in the red blood cells.
  • Ehrlichia and Anaplasma live in the white blood cells.

Where is Anaplasma most often found in the USA? 

Anaplasma is most often found in Minnesota, Wisconsin and the Northeast, but just like other infections, it can be found elsewhere because wherever deer and other animals go, infected ticks can go too, and it will undoubtedly start spreading more prevalently across the country.

Since anaplasmosis cases are most prevalently found in Minnesota and Wisconsin, researchers and institutions aren’t putting as much of a focus on researching this illness. This is why I hope the Mayo Clinic, the University of Minnesota, or some other Midwestern institution or organization will start researching this disease more thoroughly as soon as possible.

What are the most common symptoms of anaplasmosis?

Just like Bartonella likes to wreak havoc on the cardiovascular system and Babesia harms the spleen, Anaplasma’s organ of choice to attack is the liver. Of course, the effects of these illnesses go much further than these particular systems in your body. This is because every system is connected, so symptoms are often much more widespread. 

Like most tick-borne illnesses, Anaplasma can often cause flu-like symptoms in its beginning stage. It can also look just like Lyme Disease with headaches, muscle and joint pains, fatigue, and/or fevers.

Chronic anaplasmosis symptoms can vary, but I become extremely suspicious of Anaplasma if you are reactive to scents, chemicals, medications, supplements, foods, etc. Because Anaplasma negatively affects the liver, many people start reacting to common household products and chemicals they didn’t before.

Another major problem Anaplasma can cause is it can simply protect other bacteria by inhibiting normal immune system function and making it nigh impossible for you to kill Bartonella or Lyme.

It can also infect your mitochondria directly, causing severe fatigue, but Lyme, Babesia, and Bartonella can all cause fatigue for their own reasons as well. However, Anaplasma is the only infection that can directly attack your cell powerhouse and shut down your energy cycle right where it’s made.

How do Ehrlichia and Anaplasma compare?

Ehrlichia and Anaplasma are similar organisms and are closely related. They are obligate intracellular bacteria, and according to one study, “they exploit host cells and evade immune responses.” 

Originally thought to be a different type of Ehrlichia, Anaplasma eventually was reclassified as its own disease. While Ehrlichia is thought of as being a more serious illness by many in the medical community, they are often unaware of or overlooking the impact chronic anaplasmosis can have on patients, particularly those who are dealing with other tick-borne infections. 

Both Ehrlichia and Anaplasma are similar in that they both infect white blood cells and lower immune system function, but they like to infect different cells of the immune system.

Ehrlichia is called HME (human monocytic ehrlichiosis) and typically infects white blood cells called monocytes. Anaplasma is called HGA (human granulocytic anaplasmosis) and typically infects white blood cells called granulocytes or neutrophils.

Neutrophils are your primary immune, bacteria-fighting cells, so by inhibiting neutrophils, your immune system becomes less effective, particularly at killing bacteria which is vitally important if you’re trying to kill other bacteria that accompanied the tick bite (such as Lyme or Bartonella). 

Because of this, it’s common to have low white blood cell count, low platelets, and high liver transaminases. But the majority of the time, your regular doctor will restest you and levels will appear to be back to normal. 

The following findings on bloodwork are often a dead giveaway that you’re dealing with Anaplasma, but it’s not the only indication, especially if you’re a chronic case.

Common blood findings on HGA and HME:

Leukopenia (low white blood cells)

Thrombocytopenia (low platelets)

Elevated Transaminases (AST and ALT)

The myth of “normal” bloodwork: How Anaplasma confuses your doctor

When you have Anaplasma but you’re also dealing with other tick-borne illnesses, such as Bartonella and/or Babesia, you could appear to have totally normal blood work. 

Most infections will raise white blood cell levels. This is the case with Bartonella, Lyme and Babesia.  But here’s where it gets strange: Anaplasma lowers white blood cells and platelets, while Bartonella, Lyme, and Babesia raise white blood cell levels. Because of this, they can meet in the middle and make your blood work appear normal. 

Anaplasma can halt or slow down your healing – takes longer to see progress!

Along with how low white blood cell counts minimize the strength of your immune system, low blood platelet counts will slow down healing. Having low platelet levels can halt or slow down your healing from not only Anaplasma but also other bacterial illnesses, like Lyme and co-infections. This can also make you more prone to injury.

WARNING: Elevated transaminases = liver damage and more symptoms

Elevated transaminases come from liver damage. You may see higher levels when testing, only to have them lower when you retest. However, doctors may still ask if you abuse drugs or alcohol and may not believe you when you say you don’t.  

Poor liver function causes practical problems!

Another issue with liver damage is that a stressed, overburdened liver can lead to more symptoms. It can make it harder for you to handle alcohol, mold, medications, and other chemicals. It can even make it more difficult to tolerate supplements and herbs because the liver’s capacity is low and unable to process chemicals at a regular rate.

If you have Anaplasma and you combine the problem with mold, chemical toxicity, and/or another tick-borne illness, like Lyme, Bartonella, or Babesia, it can create very strange and disturbing scenarios and symptoms. For this reason, we will often test for a variety of toxins, including chemicals, mold, and heavy metals when we know Anaplasma is present.

My slowest patients to heal have been those with a combination of Anaplasma and other problems because it can be a negative feedback loop of liver inhibition and toxins.

Anaplasma can cause histamine/MCAS problems

As Anaplasma damages the liver, histamine problems can arise. This can make food, mold and chemical reactivity worse. In my opinion, this is the hardest part of this disease in chronic patients. You become vulnerable to exposure to other toxins.

Babesia, Bartonella and Anaplasma can all drive your body to mast cell activation syndrome (MCAS) and heightened histamine levels. You can have gut, skin and neurological problems from histamine and MCAS issues. 

Anaplasma can block your Lyme and co-infection healing progress

Because Anaplasma goes into and inhibits the neutrophils (the most important immune cells to kill bacteria) you will inherently have a harder time killing other bacteria. This means neutrophils infected with Anaplasma can’t kill things like Lyme or Bartonella.

When Anaplasma is present, your neutrophils (white blood cells) are about as effective at attacking Lyme as fun noodles are for defending yourself against dangerous criminals. Your neutrophils may be able to create high levels of inflammation, but they are practically useless at killing bacteria. 

As a reminder: 

  • Lyme is hard on your joints and nerves
  • Bartonella is particularly hard on the cardiovascular system.
  • Babesia is especially hard on the spleen.
  • Anaplasma is extremely hard on the liver.

What can you do to defeat Anaplasma and regain your health?

Anaplasma tries to break the immune system, enabling itself and other bacteria to stay alive. These are a few reasons why missing Anaplasma is a big deal, but how do you get rid of it? 

Liver support, liver support and liver support. Did I mention liver support? 

Whenever I have a patient with Anaplasmosis, I immediately put them on liver support due to how much strain Anaplasma places on the liver. I highly recommend NutriRestore’s Liver Support.

NutriRestore’s Liver Support

Liver Support contains silymarin (aka, milk thistle) and Oregon grape. Many people know that milk thistle is excellent for the liver, but you can enhance the benefits by adding Oregon grape. These two ingredients are incredibly effective at supporting and stimulating the liver. Liver Support also contains yellow dock, which aids patients in emptying their bowels.

The benefits of using Liver Support: 

  • Support healthy liver and kidney function
  • Support health detoxification
  • Supports healthy nerves and brain health because these are the most sensitive tissues to most toxins
  • Supports healthy gallbladder function for fat digestion
  • Enhances liver metabolism for hormone activation and processing

NutriRestore’s Red Sage

Red sage (Salvia Miltiorrhiza) comes from the Latin term “salvus” which means “safe.” Salvia can also mean “healing plant.” Red sage is really the superhero for patients with Anaplasma. It counteracts the effects of Anaplasma by providing support for the lymph, liver, and bone marrow. These areas are often targeted by Anaplasma. Red sage also counteracts elevated cytokines/inflammation caused by Anaplasma and is antibacterial. 

The vast benefits of Red Sage and how it counteracts Anaplasma:

  • Antibacterial to Anaplasma
  • Supports the lymph, liver, and bone marrow that are hurt by Anaplasma
  • It’s anti-inflammatory and counteracts cytokine/inflammation of Anaplasma
  • Also supports healthy spleen function
  • Helps the liver and immune system rebalance after toxic exposures
  • Mitochondrial protective
  • Useful for irregular menstruation


The number one reason why Anaplasma matters is because if you have it and you either don’t know about it or don’t do anything about it, you won’t feel well and you probably won’t get better—from Anaplasma or other tick-borne illnesses you may have. It’s time the medical community took this bacteria much more seriously. 

To summarize:

  • Anaplasma is the most underrated, underestimated Lyme co-infection/tick-borne illness and needs to be taken more seriously.
  • Anaplasma is an obligate intracellular bacteria. It needs a host cell in which to replicate and learns to evade and overcome antibacterial agents so it can establish itself inside your body. 
  • Currently, Anaplasma is most prevalent in Minnesota, Wisconsin and the Northeast.
  • Anaplasma infects white blood cells and lowers immune system function.
  • When you have Anaplasma but you’re also dealing with other tick-borne illnesses, such as Bartonella, Lyme, and/or Babesia, you could appear to have totally normal blood work, even though you are far from being healthy. 
  • Anaplasma can halt or slow down your healing.
  • Elevated transaminases = liver damage and more symptoms.
  • Anaplasma can cause histamine/MCAS problems.
  • Anaplasma can block your Lyme and co-infection healing progress.
  • You must support your liver.
  • The products we most recommend for patients with anaplasmosis are NutriRestore’s Liver Support and Red Sage. 

By Dr. Kyle Warren

Edited by Meghan Feir Walker