Episode 614: Long COVID or Lyme Disease? The Hidden Infection Connection – Dr. Ben Sinclair | LIVE from ILADS
Could some people diagnosed with long COVID also be dealing with Lyme disease, Bartonella, Babesia, or other infections that have gone undetected?
In this LIVE from ILADS interview, Tick Boot Camp co-host Rich sits down with Dr. Ben Sinclair, founder of Dr. Finlay's Private Practice in the United Kingdom, to explore the complex relationship between long COVID, Lyme disease, tick-borne infections, immune health, and chronic illness.
Recorded at the 2025 International Lyme and Associated Diseases Society (ILADS) Conference in San Antonio, Texas, the conversation examines how Dr. Sinclair's own debilitating illness following COVID-19 transformed his medical career and led him to investigate Lyme disease and associated infections.
After becoming severely ill with COVID-19 while working as a medical director within the UK's National Health Service (NHS), Dr. Sinclair spent approximately three months largely confined to bed. His symptoms included profound fatigue, neurological difficulties, and a remarkable period during which he struggled to speak English but could communicate in German.
Initially believing he was experiencing long COVID, he later pursued testing for Lyme disease, Bartonella, and other infections.
His personal experience inspired a broader clinical focus on patients with persistent fatigue, neurological symptoms, and complex post-infectious illnesses.
Rich and Dr. Sinclair discuss the three Bs—Borrelia, Bartonella, and Babesia—along with tick exposure in the UK, climate change, deer populations, neurological symptoms, nervous system regulation, nutrition, and the challenges of accessing Lyme disease care through the NHS.
Throughout the conversation, Dr. Sinclair emphasizes the importance of looking at the whole patient rather than focusing exclusively on a single diagnosis.
Meet Dr. Ben Sinclair: Founder of Dr. Finlay's Private Practice
Dr. Ben Sinclair is a UK physician and founder of Dr. Finlay's Private Practice, a multidisciplinary private healthcare practice serving patients with complex chronic illnesses, including long COVID and suspected tick-borne infections.
The practice operates primarily from London, near Oxford Street, with additional clinical services in Birmingham and other parts of the United Kingdom.
Dr. Sinclair previously worked within the NHS, including serving as a regional medical director overseeing healthcare services across approximately 14 prisons.
Alongside his NHS responsibilities, he developed an interest in preventive medicine, nutrition, health optimization, and integrative approaches to chronic illness.
His practice now brings together healthcare professionals from several disciplines, including:
- Physicians with interests in functional and integrative medicine
- Clinicians experienced in evaluating Lyme disease
- Psychologists
- Nutritionists
- Breathing specialists
- Physiotherapy and rehabilitation professionals
Dr. Sinclair explains that the practice offers in-person and virtual consultations, including support for patients who are housebound or bedbound.
When a Doctor Becomes the Patient: Dr. Sinclair's Long COVID Journey
Dr. Sinclair's interest in complex post-infectious illness became deeply personal after he contracted COVID-19.
Before becoming ill, he describes himself as physically fit and health-conscious.
He grew up on an organic farm, spent time in the military, and maintained an active lifestyle.
Despite this background, his COVID-19 illness was followed by debilitating symptoms.
He recalls spending approximately three months largely confined to bed.
His symptoms included severe fatigue, cognitive difficulties, and problems with speech.
One particularly unusual experience involved temporarily struggling to speak English.
Although English is his native language, he found that he could communicate more easily in German, a language he had previously learned.
His wife spoke German, allowing them to communicate during this period.
Dr. Sinclair believes neurological inflammation may have contributed to these symptoms, although the interview does not establish the underlying neurological mechanism.
His experience gave him a new understanding of what patients face when everyday activities become overwhelming.
From Long COVID to a Lyme Disease Diagnosis
Initially, Dr. Sinclair believed his symptoms were related to long COVID.
As he began seeing patients with similar complaints, however, he noticed that some were not improving with the approaches his practice commonly used.
Many reported persistent fatigue, neurological symptoms, and difficulty returning to their previous level of functioning.
Dr. Sinclair began asking more detailed questions about potential tick exposure.
To his surprise, some patients recalled previous tick bites or activities that placed them at increased risk of exposure.
He also reconsidered his own history.
Dr. Sinclair describes spending time outdoors during military service, traveling extensively, and experiencing tick bites during childhood, including one in a Canadian forest when he was approximately eight years old.
He subsequently pursued testing for Lyme disease and other infections.
After attending an ILADS conference in Europe, he reports receiving a Lyme disease diagnosis.
He also describes laboratory findings involving Bartonella and Epstein-Barr virus.
Dr. Sinclair believes these findings helped him better understand his illness and influenced his clinical approach.
However, the presence of antibodies or other laboratory markers does not necessarily establish active infection or prove that an infection caused long COVID symptoms.
Research continues to investigate how SARS-CoV-2 infection, immune responses, and other infectious conditions may contribute to prolonged illness.
Can COVID-19 Trigger or Reactivate Other Infections?
One of the central questions in the interview is whether COVID-19 can influence previously acquired infections.
Dr. Sinclair discusses the possibility that immune changes following COVID-19 may contribute to the reactivation of certain pathogens or the emergence of symptoms associated with other illnesses.
He specifically raises questions about:
- Lyme disease and Borrelia
- Bartonella
- Babesia
- Epstein-Barr virus (EBV)
- Other possible contributors to post-infectious illness
Some research has identified associations between long COVID and evidence of Epstein-Barr virus reactivation or altered immune responses.
However, the hypothesis that COVID-19 routinely reactivates persistent Borrelia, Bartonella, or Babesia infections remains unproven.
Dr. Sinclair describes these possibilities as part of his evolving clinical perspective.
The conversation highlights the importance of investigating other potential diagnoses when patients experience persistent symptoms rather than automatically attributing every symptom to long COVID.
The Three Bs: Borrelia, Bartonella, and Babesia
Rich and Dr. Sinclair discuss three pathogen groups frequently mentioned in the Lyme disease community.
Borrelia: The Bacteria Associated With Lyme Disease
Borrelia burgdorferi and related bacteria cause Lyme disease.
Infections can produce symptoms involving the skin, joints, nervous system, and cardiovascular system.
Bartonella: A Group of Bacterial Infections
Bartonella species can cause several different human diseases.
Dr. Sinclair discusses Bartonella in relation to neurological symptoms and complex chronic illness.
He also raises questions about possible exposure through fleas, lice, and other arthropods.
Transmission pathways vary by Bartonella species, and some proposed routes remain uncertain.
Babesia: A Tick-Borne Parasite
Babesia parasites infect red blood cells and can cause babesiosis.
Symptoms may include fever, chills, fatigue, sweating, and anemia.
Severe disease can occur, particularly in people with certain underlying health conditions.
Dr. Sinclair explains that he has become increasingly interested in identifying possible Babesia infections among patients with overlapping symptoms.
Rich observes that more Tick Boot Camp guests have discussed diagnoses involving multiple pathogens in recent years.
They consider whether this reflects greater awareness, changes in testing, increased exposure, or other factors.
Importantly, not every Lyme disease patient has Bartonella or Babesia, and overlapping symptoms do not establish the presence of multiple infections.
Why Tick-Borne Diseases May Be Increasing in the UK
Dr. Sinclair discusses several environmental factors he believes may contribute to changing patterns of tick exposure in the United Kingdom.
These include:
- Climate change and milder winters
- Changes in seasonal tick activity
- Expanding or changing deer populations
- Migratory birds transporting ticks
- Greater awareness and reporting of tick-borne diseases
- Changes in land use and human exposure to tick habitats
He notes that his practice sees patients from areas associated with forests, deer populations, and known tick habitats.
He also discusses the New Forest and Bournemouth area, where tick exposure is an established concern.
Dr. Sinclair believes that environmental changes deserve more attention in public health planning.
While climate and wildlife ecology can influence tick distribution, the specific contribution of each factor varies by location and requires careful research.
Deer, Sheep, Migratory Birds, and Tick Exposure
Rich asks Dr. Sinclair about the relationship between wildlife populations and tick-borne diseases.
Dr. Sinclair describes observations from areas of England where deer populations have increased.
He recalls growing up near Knole Park, a historic deer park, and describes changes in the surrounding environment following a major storm in 1987.
He believes changes in deer movement and habitat may have influenced local tick exposure.
The conversation also turns to sheep farming and Babesia.
Dr. Sinclair notes that parts of southwestern England, including Cornwall, Devon, and Somerset, have substantial sheep populations.
He discusses possible ecological relationships involving livestock, ticks, and Babesia species.
These relationships are complex.
Different Babesia species have different animal reservoirs and transmission cycles, and the presence of deer or sheep does not automatically establish the source of human infection.
The discussion underscores the importance of understanding local ecology when investigating tick-borne disease risks.
Why Tick Prevention Matters Beyond the Woods
Dr. Sinclair and Rich emphasize that tick exposure is not limited to remote forests or wilderness areas.
People can encounter ticks while gardening, walking in parks, visiting rural properties, or spending time in areas frequented by wildlife.
Changing tick habitats make prevention education increasingly important.
Practical precautions include checking for ticks after outdoor activities, using appropriate repellents, wearing protective clothing, and removing attached ticks promptly.
For step-by-step prevention and tick bite guidance, explore Tick Boot Camp's Tick Bite Blueprint.
A Multidisciplinary Approach to Complex Chronic Illness
Dr. Sinclair explains that his private practice was designed to bring different healthcare disciplines together.
He believes that patients with complex illnesses may benefit from coordinated care addressing multiple aspects of health.
His team includes physicians, psychologists, nutrition professionals, breathing specialists, and rehabilitation providers.
The practice considers:
Medical evaluation: Investigating possible infections, post-infectious conditions, and other causes of symptoms.
Nutrition: Supporting adequate dietary intake and addressing relevant nutritional concerns.
Sleep: Identifying sleep disturbances and improving sleep routines where possible.
Psychological support: Helping patients cope with medical trauma, uncertainty, and the emotional effects of prolonged illness.
Breathing and rehabilitation: Addressing breathing-pattern difficulties, autonomic symptoms, and functional limitations.
Dr. Sinclair emphasizes that patients should not be reduced to a single symptom or laboratory result.
His approach reflects a broader philosophy of individualized, multidisciplinary care.
Medical Trauma, Stress, and the Nervous System
Rich and Dr. Sinclair discuss the psychological burden of living with an illness that is difficult to diagnose or treat.
Dr. Sinclair explains that his practice includes psychologists because patients may experience significant emotional distress after prolonged illness, repeated medical appointments, and feeling dismissed by healthcare professionals.
He also discusses how chronic stress, poor sleep, and autonomic nervous system disturbances can influence overall well-being.
The conversation recognizes that psychological support may be valuable even when a patient's primary illness is physical.
Medical trauma and emotional distress do not mean symptoms are imaginary or that patients are responsible for their illness.
Supporting mental health can be an important part of comprehensive care without replacing appropriate medical evaluation or treatment.
For a related conversation, listen to Tick Boot Camp's interview with Cathleen King about Primal Trust and nervous system regulation.
Breathwork, Dysautonomia, and Long COVID Recovery
Dr. Sinclair describes becoming interested in breathwork during his own recovery.
While largely confined to bed, he listened to podcasts discussing breathing techniques, including approaches associated with Wim Hof.
He subsequently incorporated breathing support into his practice.
His team works with patients experiencing breathing-pattern difficulties and certain autonomic symptoms.
He mentions approaches such as:
- Box breathing
- Slow, paced breathing
- Concordant breathing
- Individualized breathing exercises
Dr. Sinclair emphasizes that more intense methods, including Wim Hof-style breathing, are not appropriate for everyone.
This distinction is particularly important for people experiencing dysautonomia, post-exertional symptom exacerbation, dizziness, or other complex symptoms.
Breathing exercises may help some patients manage stress or breathing-pattern difficulties, but they are not established cures for Lyme disease or long COVID.
Patients should seek individualized guidance and avoid techniques that provoke significant symptoms.
Nutrition, Sleep, and Immune Health
Dr. Sinclair describes several lifestyle strategies he incorporated during his own recovery.
These included paying closer attention to nutrition, sleep, stress management, and daily routines.
He discusses:
- A diet emphasizing fiber and nutrient-rich foods
- Adequate sleep and consistent sleep patterns
- Natural daylight exposure to support circadian rhythms
- Meditation and relaxation
- Appropriate physical activity within individual limitations
- Breathwork and stress management
He also mentions experimenting with cold-water immersion.
However, cold-water immersion can pose risks, especially for people with cardiovascular problems or autonomic dysfunction, and it is not an established treatment for Lyme disease or long COVID.
Dr. Sinclair believes that supporting general health can complement medical treatment.
Lifestyle measures may contribute to overall well-being, but they should not be presented as substitutes for evidence-based treatment of active infections or other diagnosed conditions.
Treating Housebound and Bedbound Patients
One of the challenges Dr. Sinclair's practice addresses is access to care for people who cannot easily travel.
He explains that some patients are housebound or bedbound because of severe fatigue, neurological symptoms, or other functional limitations.
His team offers virtual consultations and, where available, home visits.
They may also work with family members and caregivers to coordinate care.
Dr. Sinclair says the practice serves patients throughout the UK and internationally, subject to professional and insurance restrictions.
At the time of the interview, he explains that the practice could not provide services to patients in the United States or Canada because of insurance limitations.
Children, Long COVID, and Complex Illness
Dr. Sinclair also discusses the growing number of children seen by his practice.
He explains that parents receiving care sometimes sought help for children experiencing persistent symptoms after COVID-19.
Drawing on his background in family medicine, he expanded the practice's work with pediatric patients.
He describes an interest in understanding whether some children with prolonged symptoms may have other medical conditions requiring investigation.
The conversation includes his clinical observations about possible infections such as Bartonella.
However, his estimates regarding the proportion of long COVID patients with co-infections are preliminary impressions from his practice, not established population-level findings.
Pediatric patients with persistent symptoms require careful, individualized assessment, and proposed infectious explanations should be evaluated using appropriate clinical evidence.
Lyme Disease Recognition and Treatment in the United Kingdom
Rich asks Dr. Sinclair whether Lyme disease awareness and medical support in the UK are improving.
Dr. Sinclair acknowledges growing recognition of tick-borne disease risks.
He also expresses concern that UK clinical guidance and healthcare systems have not evolved as quickly as he would like.
He discusses challenges involving:
- Access to specialized diagnostic testing
- Limited awareness of complex presentations
- Differences in clinical perspectives
- Financial constraints within the NHS
- The pace of research and guideline development
- Professional scrutiny surrounding controversial treatment approaches
Dr. Sinclair believes international conferences such as ILADS provide opportunities for clinicians to exchange research findings and learn from colleagues.
His comments reflect his personal assessment of the UK healthcare environment.
Established clinical guidance, emerging research, and contested treatment approaches should be distinguished when evaluating care options.
Why Dr. Sinclair Attends ILADS
Dr. Sinclair explains that ILADS provides an opportunity to connect with physicians and researchers from around the world.
He attends to learn about developments in testing, treatment, and scientific understanding of Lyme disease and associated conditions.
He values discussions with clinicians who work with patients experiencing complex symptoms.
The conference also allows him to compare his clinical experiences with those of practitioners in other countries.
Dr. Sinclair believes this international collaboration is especially valuable as research into post-infectious illness continues to evolve.
How to Work With Dr. Ben Sinclair
Dr. Sinclair is the founder of Dr. Finlay's Private Practice.
The practice provides private medical consultations focused on complex chronic illness, preventive medicine, and multidisciplinary care.
Services discussed in the interview include:
- In-person consultations in the United Kingdom
- Virtual medical consultations where permitted
- Evaluation of persistent symptoms and possible tick-borne infections
- Nutrition and lifestyle support
- Psychological support
- Breathing and rehabilitation services
- Coordination with patients' existing healthcare professionals
Dr. Sinclair explains that the practice operates on a self-pay basis and is not covered by insurance.
He emphasizes that his team cannot promise a cure but aims to provide individualized care and support.
Visit Dr. Finlay's Private Practice to learn more about services, locations, and appointment availability.
Key Takeaways
- Dr. Sinclair's own illness changed his medical career. After COVID-19, he experienced severe fatigue and neurological symptoms that left him largely bedbound for three months.
- Long COVID and other illnesses can have overlapping symptoms. A thorough evaluation may be necessary when patients experience persistent or unexplained problems.
- He later received a Lyme disease diagnosis. His personal experience influenced his interest in tick-borne and vector-borne infections.
- The three Bs are an important discussion topic. Borrelia, Bartonella, and Babesia can cause different illnesses with some overlapping symptoms.
- COVID-related immune changes remain an active research area. Proposed relationships between long COVID and persistent tick-borne infections require further investigation.
- Environmental changes may affect tick exposure. Climate, wildlife, habitat, and human activity can influence tick distribution.
- Medical trauma deserves recognition. Psychological support can help patients cope with the emotional burden of chronic illness.
- Multidisciplinary care may provide broader support. Dr. Sinclair's practice combines medical evaluation with nutrition, psychology, breathing support, and rehabilitation.
- Patients with severe limitations need accessible care. Virtual appointments and home visits may help those unable to travel.
- Hope and scientific curiosity can coexist. Dr. Sinclair encourages continued investigation while acknowledging that no treatment can guarantee recovery.
About This LIVE from ILADS Interview
Recorded at the 2025 International Lyme and Associated Diseases Society Conference in San Antonio, Texas, this conversation features Dr. Ben Sinclair, founder of Dr. Finlay's Private Practice in the United Kingdom.
Rich and Dr. Sinclair discuss his experience with long COVID, his subsequent Lyme disease diagnosis, possible co-infections, tick-borne disease awareness in the UK, and his multidisciplinary approach to complex chronic illness.
The interview also explores the role of nutrition, sleep, nervous system support, and coordinated healthcare in helping patients manage persistent symptoms.
Discover additional conversations with international physicians, researchers, and patient advocates through Tick Boot Camp's LIVE from ILADS podcast series.