In this powerful return appearance on the Tick Boot Camp Podcast, Dr. Alan MacDonald joins hosts Matt Sabatello and Richard Johannessen for a deep, unfiltered conversation about the research he spent a lifetime pursuing — research that remains controversial, increasingly validated, and deeply consequential for patients with chronic Lyme disease.

Recorded decades after his earliest discoveries, this interview captures Dr. MacDonald in his later years: reflective, candid, and still fiercely committed to uncovering the truth about Borrelia burgdorferi, chronic infection, and neurodegenerative disease.

This episode serves as both a scientific masterclass and a historical record of how far Lyme research has come — and how far it still has to go.

A Pioneer Still “Ahead of the Curve”

Dr. MacDonald, a retired hospital pathologist trained at Columbia University and NYU Bellevue, dedicated his career to diagnosing disease through direct tissue, blood, and molecular evidence, rather than relying solely on indirect antibody testing.

Long before Lyme disease entered mainstream awareness, he was documenting Borrelia in human tissue, identifying alternative bacterial forms, and warning that chronic infection could persist, evade treatment, and drive long-term neurological damage.

Dr. MacDonald recently passed away, but this interview preserves his voice, his science, and his insistence that medicine must follow evidence — even when it challenges entrenched narratives.

Major Themes Explored

Chronic Lyme Disease as a Persistent Infection

Dr. MacDonald explains why Lyme disease cannot always be viewed as an acute, easily treated illness. He outlines how Borrelia survives by:

• Changing form (spirochete, cystic, granular, L-form)

• Embedding in protective biofilms

• Persisting in tissue, blood, and the nervous system

Biofilms and Why Treatment Often Fails

A central focus of this episode is biofilm biology. Dr. MacDonald describes biofilms as organized microbial communities that shield Borrelia from antibiotics and immune attack, making chronic Lyme especially difficult to treat.

He discusses biofilms found:

• In Lyme-related skin lesions

• Circulating in blood

• Embedded in brain tissue

• Within Alzheimer’s disease plaques

He emphasizes that biofilms are a hallmark of chronic infection, not acute disease.

Lyme Disease and Alzheimer’s Pathology

Dr. MacDonald revisits his groundbreaking work identifying Borrelia DNA, proteins, and biofilms in Alzheimer’s brains. He explains how amyloid plaques may function as an antimicrobial response, coating infectious biofilms rather than forming randomly.

Drawing parallels to tertiary syphilis, he argues that infection-driven dementia should not be dismissed — only rigorously studied.

Lewy Body Dementia and Neurodegeneration

Beyond Alzheimer’s, Dr. MacDonald discusses evidence linking Borrelia infection to Lewy Body Dementia, reinforcing the idea that chronic infection may play a role in multiple neurodegenerative conditions.

DNA-Based Diagnostics vs. Antibody Testing

Dr. MacDonald details why standard Lyme antibody tests fail many patients, particularly those with chronic illness. He explains the advantages of DNA-based detection, including:

• Fluorescence in situ hybridization (FISH)

• Direct visualization of Borrelia DNA in tissue and fluid

• Reduced false negatives compared to serology

Parasites, Coinfections, and Lyme Persistence

The conversation explores Dr. MacDonald’s research identifying parasitic organisms in Lyme patients, including evidence that parasites may harbor Borrelia internally. He explains how this relationship could:

• Protect Lyme bacteria from antibiotics

• Contribute to symptom flares

• Help explain why antiparasitic treatment benefits some patients

The Politics of Lyme Disease Research

Dr. MacDonald speaks candidly about:

• Being accused of fraud for publishing pathology findings

• Barriers to publication in major medical journals

• How “standard of care” is shaped by politics rather than patients

• Why clinicians fear treating chronic Lyme

Despite this resistance, he expresses hope that modern science is finally revisiting long-dismissed evidence.

Exclusive Tick Boot Camp Presentation by Dr. Alan MacDonald

In addition to this interview, listeners can also view an exclusive Tick Boot Camp presentation created by Dr. MacDonald.

This special presentation features:

• High-resolution microscope images of Lyme bacteria

• Visual examples of Borrelia in tissue, blood, and biofilms

• Clear descriptions of the various Lyme disease forms

• Visual context for the topics discussed in this interview, including chronic infection, neurodegeneration, and diagnostic challenges

This presentation offers a rare opportunity to see what Dr. MacDonald saw under the microscope — and understand why his conclusions were so difficult to ignore.

A Living Legacy

Episode 300 stands as a testament to a scientist who refused to stop asking difficult questions, even when doing so came at personal and professional cost.

Update: Though Dr. Alan MacDonald has recently passed away, his work lives on — in emerging research, in the patients he helped, and in a growing scientific willingness to revisit infection-driven chronic disease.

As new studies explore Lyme-related neuroinflammation and neurodegeneration, his contributions remain foundational.