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LIVE from ILADS: What happens when a Lyme disease patient needs a medication—but the standard dose, ingredients, or delivery method simply don't work for them?
Tick Boot Camp welcomes back Ray Solano, RPh, MBA, CCN, founder and owner of PD Labs, a specialty compounding pharmacy that works with practitioners to create personalized medications for patients with Lyme disease, CIRS, mold-related illness, pain, and other complex conditions.
This is Ray's second consecutive LIVE from ILADS conversation with Tick Boot Camp.
The first interview introduced Rich to the world of compounding pharmacy. This time, they go deeper into what personalized compounding can actually mean for someone with complex Lyme disease.
The discussion explores:
- Liposomal antibiotics
- Alternative medication delivery methods
- Medication sensitivities
- Methylene blue
- Low-dose naltrexone (LDN)
- Peptides
- BPC-157
- KPV
- Larazotide
- Curcumin
- Gut health
- Immune modulation
- Off-label prescribing
- Practitioner-pharmacist collaboration
- Precision medicine
The larger message is simple:
When one size doesn't fit all, changing the dose, formulation, delivery system, or inactive ingredients may give a practitioner additional options for an individual patient.
This interview was recorded live at the ILADS conference, so you may hear some of the energy and background activity of the event throughout the conversation.
What Is a Compounding Pharmacy?Most people are familiar with traditional retail pharmacies.
A doctor writes a prescription for a commercially manufactured medication.
The pharmacy dispenses it.
Compounding works differently.
A compounding pharmacy can prepare a customized medication based on a prescription for an individual patient's needs.
That might involve changing:
- The dose
- The strength
- The dosage form
- The delivery method
- Certain inactive ingredients
A medication might need to be prepared as a capsule for one patient, a sublingual formulation for another, or a topical preparation in another situation.
Solano compares it to ordering a customized meal at a restaurant.
Someone may need one ingredient removed because of an allergy or intolerance. Another person may need something prepared differently.
The underlying idea is personalization.
PD Labs currently describes its work similarly, emphasizing customized medications and specialized formulations for conditions including Lyme disease, CIRS, pain, and other complex health challenges.
Why Compounding Can Matter in Complex Lyme DiseasePeople with complex Lyme and tick-borne illness can present with dramatically different needs.
One patient may tolerate a standard medication.
Another may struggle with the dosage.
Another may react to an inactive ingredient.
Another may need a different delivery method.
Solano believes this is where compounding can become particularly useful.
Instead of assuming the commercially available version is the only option, the prescribing practitioner and compounding pharmacist may be able to explore whether a different formulation better fits that particular patient.
That makes the pharmacy another member of the personalized-care team.
The Patient-Doctor-Pharmacist TriadOne of the most important ideas in this interview is what Solano describes as a triad:
Patient + Prescribing Practitioner + Compounding Pharmacist
The patient brings their experience and response to treatment.
The practitioner evaluates the patient and determines the medical strategy.
The compounding pharmacist brings specialized knowledge about formulation, dosing options, delivery methods, and what can appropriately be prepared under a prescription.
Solano says PD Labs also educates practitioners about available options and collaborates with them when developing individualized formulations.
For complicated Lyme disease cases, that collaboration may expand the practitioner's therapeutic toolbox.
Liposomal Antibiotics & Lyme DiseaseOne of the most interesting areas Solano discusses is liposomal medication delivery.
A liposome is essentially a tiny lipid-based structure that can be used as a drug-delivery vehicle.
Solano discusses using lipid-based formulations with oral antibiotics commonly prescribed in Lyme disease care, including doxycycline.
He describes PD Labs' approach as an attempt to change how certain medications are delivered and absorbed and, in some patients, potentially improve tolerability.
This is particularly relevant when a patient needs a medication but struggles with the conventional formulation.
Solano specifically discusses gastrointestinal irritation associated with doxycycline and describes the pharmacy's experience using alternative lipid-based formulations.
These are claims and clinical observations discussed by Solano during the interview and should not be interpreted to mean that a liposomal formulation is proven superior to standard doxycycline for Lyme disease or appropriate for every patient.
Can Delivery Method Change Treatment Tolerance?This becomes a recurring theme throughout the conversation.
Sometimes the question isn't simply:
Which medication?
It may also be:
How is that medication getting into the patient?
The same active ingredient can potentially be formulated in different ways depending on the medication, prescription, and patient's needs.
For people who have become highly reactive during chronic illness, those details can matter.
This connects naturally with many of Tick Boot Camp's other ILADS conversations about precision medicine:
The objective isn't finding the protocol for Lyme disease.
It's finding an appropriate strategy for this patient.
Methylene Blue & Lyme DiseaseSolano also discusses methylene blue, a medication with a long history of medical use that has attracted interest among some Lyme-literate practitioners.
During the interview, he specifically references work involving Dr. Richard Horowitz, methylene blue, dapsone, and botanical combinations.
Solano describes PD Labs' work developing alternative methylene blue formulations intended to improve delivery and tolerability.
Methylene blue is a prescription medication with important contraindications, interactions, and dosing considerations. It is not appropriate for everyone and should only be used under appropriate medical supervision.
For more Tick Boot Camp conversations about complex pharmaceutical Lyme treatment strategies, explore Dr. Richard Horowitz's interviews.
Low-Dose Naltrexone: Same Medication, Different DoseAnother useful illustration of compounding is low-dose naltrexone, commonly called LDN.
Naltrexone is commercially available at substantially higher doses for FDA-approved indications involving alcohol and opioid use disorders.
In integrative and functional medicine, practitioners may prescribe much smaller doses off-label for other purposes.
That creates a practical compounding need.
Solano discusses customized tablets that can help practitioners adjust or titrate doses rather than forcing patients into one fixed strength.
The example illustrates why compounding isn't necessarily about inventing a completely new drug.
Sometimes the innovation is in how an existing medication is prepared for an individual patient.
Peptides & Complex Chronic IllnessThe conversation then moves into one of the fastest-evolving areas discussed throughout the ILADS interviews:
peptide therapy.
Peptides are short chains of amino acids that can act as signaling molecules within the body.
Solano discusses several peptides or peptide-related compounds being explored by practitioners working with complex chronic illness, particularly in relation to inflammation, gastrointestinal function, tissue repair, and immune regulation.
The compounds discussed include:
- BPC-157
- KPV
- Larazotide
Rich notes that several Tick Boot Camp guests have described BPC-157 as part of the rehabilitative phase of their personal recovery journeys.
Solano discusses PD Labs' work with alternative formulations designed around these emerging practitioner protocols.
Peptide therapies vary considerably in their regulatory status and evidence base. Discussion in this interview should not be interpreted as establishing these compounds as proven treatments for Lyme disease.
Gut Health After Lyme TreatmentWhy discuss the gut during a conversation about Lyme disease?
Because patients undergoing prolonged or complicated treatment frequently report gastrointestinal challenges.
Solano discusses patients who have:
- Gut inflammation
- Significant food restrictions
- Difficulty tolerating foods
- Gastrointestinal symptoms during chronic illness
His peptide discussion partly centers on strategies practitioners may explore when attempting to support gastrointestinal function.
The broader principle is familiar to the Tick Boot Camp community:
Recovery isn't necessarily finished when microbial treatment ends.
Some patients need a significant period of rebuilding and rehabilitation.
BPC-157 & RehabilitationRich specifically asks about BPC-157 because previous Tick Boot Camp guests have described using it during recovery.
Solano discusses a lipid-particle BPC formulation that PD Labs developed as an alternative to injectable delivery.
This is another example of the larger theme of the episode:
The molecule is only part of the equation.
Dose, formulation, delivery, tolerance, and the individual patient's needs can all influence how a practitioner approaches treatment.
Curcumin & InflammationSolano also discusses curcumin and tetrahydrocurcuminoids in the context of inflammation and pain.
Rather than focusing only on conventional capsules or powders, he describes applying similar lipid-delivery concepts to these compounds.
Again, this discussion reflects Solano's formulation philosophy rather than establishing a particular compounded curcumin product as a Lyme disease treatment.
Alpha-Gal, Sensitivities & Inactive IngredientsThe Lyme and tick-borne disease community has an especially important reason to think about medication ingredients:
alpha-gal syndrome and other sensitivities.
Some patients may need to consider whether medication formulations contain mammalian-derived ingredients or other components they don't tolerate.
Others may react to dyes, fillers, binders, or particular capsule materials.
The active medication may be appropriate while the commercially manufactured product is not.
A compounding pharmacist can sometimes work with the prescriber to determine whether an alternative formulation is possible.
This is where personalization becomes much more practical than simply saying every patient needs a unique treatment plan.
Sometimes customization comes down to the actual ingredients inside the capsule.
Off-Label PrescribingThe interview also addresses a subject that can confuse patients:
off-label medication use.
Off-label prescribing generally means an appropriately licensed clinician prescribes an approved medication for a use, dose, route, or population not included in its FDA-approved labeling.
It does not automatically mean that the treatment is illegal or inappropriate.
Off-label prescribing is used throughout medicine.
However, an off-label use also shouldn't automatically be interpreted as proven safe or effective for a particular condition simply because a clinician can legally prescribe it.
Solano describes compounding pharmacies as working with prescribers when an individualized formulation is needed to carry out an appropriate prescription.
Precision Medicine Is More Than Choosing a DrugRich repeatedly brings the conversation back to precision medicine.
Precision isn't simply deciding which antimicrobial to use.
It may involve:
- Which medication
- What dose
- How quickly to titrate
- Which delivery method
- Which inactive ingredients
- What the patient can tolerate
- Which other conditions are present
- What phase of treatment or recovery the patient is in
Solano describes working with practitioners to match formulations to those individual needs.
That flexibility is particularly relevant to patients who sit outside the middle of the traditional bell curve.
Immune Modulation & the Future of CompoundingLooking forward, Solano is especially interested in immune modulation and peptide therapies.
He describes peptides as potentially highly targeted signaling tools and points out that peptide-based medicine itself isn't new—insulin and oxytocin are familiar examples of peptide hormones.
His interest is in how newer or differently applied peptide strategies might eventually expand options available to practitioners working with immune dysfunction and complex chronic illness.
As with many emerging areas discussed at ILADS, more research will be necessary to determine which approaches provide meaningful clinical benefit, for whom, at what doses, and with what risks.
Today's Tools—and Tomorrow'sOne reason Tick Boot Camp returned to Ray Solano for a second interview is the message of hope through expanding options.
Complex Lyme patients often reach moments when they feel they've tried everything.
But medicine isn't static.
New research emerges.
Existing drugs are investigated in different ways.
Delivery technologies evolve.
Practitioners learn from patients.
Pharmacists develop new formulation options.
None of that guarantees that the next treatment will be the answer for a particular person.
But it does mean that today's toolbox isn't necessarily tomorrow's toolbox.
For someone who has been sick for years, knowing that clinicians, researchers, pharmacists, and patients are still working to develop better options can itself be meaningful.
About Ray Solano, RPh, MBA, CCNRay L. Solano, RPh, MBA, CCN is the founder and owner of PD Labs, a specialty compounding pharmacy based in Cedar Park, Texas.
Solano is a pharmacist and board-certified clinical nutritionist with decades of experience in pharmacy and integrative healthcare. He graduated from Mercer Southern School of Pharmacy with an emphasis in nuclear pharmacy and has pursued advanced training in areas including sterile compounding, nutritional medicine, hormones, and specialized formulations.
PD Labs creates customized medications and works with prescribing practitioners on formulations for a variety of patient populations, including people with Lyme disease, CIRS, mold-related illness, pain, and other complex health conditions.
Solano also hosts Healthy Choices, a health-focused podcast and radio program featuring conversations with practitioners, researchers, and other healthcare professionals.
Key Topics in This EpisodeRay Solano, PD Labs, Prescription Dispensing Laboratories, compounding pharmacy, Lyme disease compounding pharmacy, Lyme disease treatment, personalized Lyme treatment, precision medicine, liposomal antibiotics, liposomal doxycycline, doxycycline Lyme disease, methylene blue Lyme disease, Dr. Richard Horowitz, low-dose naltrexone, LDN, peptides, peptide therapy, BPC-157, KPV, larazotide, curcumin, alpha-gal syndrome, medication sensitivities, Lyme disease gut health, immune modulation, off-label medications, customized medications, specialty pharmacy, integrative medicine, Lyme disease recovery, ILADS, and tick-borne disease.
About This LIVE from ILADS InterviewThis short-form conversation was recorded in person at the 2025 International Lyme and Associated Diseases Society Annual Scientific Conference, From Terrain to Treatment: Advances in Vector-Borne Illness, held October 9–12, 2025, in San Antonio, Texas.
Ray joined Tick Boot Camp at ILADS for the second consecutive year. Their first conversation introduced the fundamentals of compounding pharmacy; this follow-up focuses more deeply on the formulations and emerging tools being used or explored by practitioners caring for complex Lyme disease patients.
Because these interviews were recorded live at the conference, they have a different feel from Tick Boot Camp's traditional long-form virtual and studio conversations—shorter, focused, and surrounded by the energy and activity of ILADS.
Explore all Tick Boot Camp LIVE from ILADS interviews.
More from Tick Boot CampHear directly from Lyme disease doctors and healthcare professionals about the different approaches being used in complex chronic illness care.
Explore the Tick Boot Camp Podcast for patient stories and conversations with doctors, researchers, pharmacists, advocates, and other voices working to improve understanding of Lyme disease and tick-borne illness.
