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Examples may include: Lyme meningitis Lyme encephalopathy Significant central nervous system involvement Severe neurologic symptoms when oral therapy has not been sufficient Selected cases of neuroborreliosis with objective findings Cases where oral therapy is not tolerated or not clinically appropriate However, not every patient with fatigue, brain fog, nerve pain, dizziness, or chronic manifestations of Lyme disease automatically needs IV antibiotics

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Liu X, Ge Y, Yu Q, Liu Y, Zhang W, Yin T (2024) Seasonal variability of global intraseasonal SST perturbations from 1982 to 2021

Sigma-1 receptor (Sigmar1), a specific chaperone located in mitochondria-associated endoplasmic reticulum membranes (MAMs), interacts with the SERCAs to catalyse the production of mitochondrial ATP, which carries Ca 2+ reabsorption from the cytoplasm and carries calcium ions from the cytoplasm to the endoplasmic reticulum, a process that generates Ca oscillations and thus affects bone homeostasis in RA