Dr. Todd Maderis

Dr. Todd Maderis Contact information, map and directions, contact form, opening hours, services, ratings, photos, videos and announcements from Dr. Todd Maderis, Doctor, 700 Larkspur Landing Cir, Suite 205, Greenbrae, CA.

I specialize in treating Lyme disease and tickborne infections, mold-related illness, autoimmune conditions, chronic viral infections, and conditions with complex chronic illnesses - mast cell activation disorder and chronic fatigue syndrome.

You cleared mono decades ago, but the virus never left.Epstein-Barr virus infects most people in their teens or twenties...
08/03/2026

You cleared mono decades ago, but the virus never left.

Epstein-Barr virus infects most people in their teens or twenties. After the initial infection, EBV hides inside B cells and stays dormant, sometimes for decades. When the immune system is under stress from other infections, mold exposure, or overexertion, EBV can reactivate.

Reactivation increases inflammatory signals that contribute to fatigue, brain fog, and poor recovery. EBV also exhausts the immune cells responsible for keeping it in check, creating a cycle that keeps symptoms going.

Research has linked EBV reactivation to ME/CFS, Long COVID, multiple sclerosis, lupus, and autoimmune thyroiditis. Yet standard antibody testing often misses it because over 90% of adults have elevated IgG from past exposure.

Comment MONO and I will send you my full article on Epstein-Barr virus in chronic fatigue and autoimmune disease.

Follow for more insights on chronic infections and complex illness.

07/30/2026

One of the biggest misconceptions about Lyme carditis is that it only happens when Lyme disease is missed or untreated.

A recent case report described a young man who had already been diagnosed with Lyme disease and started doxycycline. His headache improved within 24 hours. Four days later, he developed complete heart block requiring temporary cardiac pacing.

The authors note that cardiac inflammation may continue even after antimicrobial treatment has begun. It is an important reminder that improvement in one symptom does not always mean every manifestation of the infection is resolving at the same rate.

Lyme carditis remains uncommon, but it is one of the reasons new cardiac symptoms should never be ignored in patients with known or suspected Lyme disease.

Comment RHYTHM and I will send you my full article on Lyme carditis.

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Most people associate Lyme disease with fatigue, joint pain, or neurological symptoms. Far fewer realize the infection c...
07/29/2026

Most people associate Lyme disease with fatigue, joint pain, or neurological symptoms. Far fewer realize the infection can affect the heart.

Lyme carditis occurs when Borrelia spreads into cardiac tissue and disrupts the electrical system that controls heartbeat. In some cases, this can lead to complete heart block, a condition where electrical signals can no longer properly travel through the heart. Studies have found that nearly half of Lyme carditis patients develop high grade or complete AV block.

What made this recent case particularly interesting was that the patient had already been diagnosed with Lyme disease and started doxycycline. His headache improved within 24 hours, yet four days later he developed complete heart block requiring temporary cardiac pacing. The authors note that inflammation within the heart may continue even after antimicrobial treatment has begun.

Lyme carditis remains uncommon, but it highlights how Lyme disease can affect far more than the joints, nervous system, and immune system.

Comment RHYTHM and I will send you my full article on Lyme carditis, including symptoms, diagnosis, treatment, and how Lyme disease can affect the heart.

Follow for clinical insights on Lyme disease, tick borne infections, and complex chronic illness.

When a POTS patient presents with irritable bowel syndrome, it is rarely treated as part of the same clinical picture. I...
07/28/2026

When a POTS patient presents with irritable bowel syndrome, it is rarely treated as part of the same clinical picture. It is referred out, managed separately, and the autonomic connection is never addressed.

A 2026 systematic review and meta-analysis of 8,268 POTS patients found IBS prevalence at 26.8%, compared to a global population prevalence of 3.8% by Rome IV criteria. That is a sevenfold difference. IBS was the most common gastrointestinal disorder identified across the entire dataset, appearing more frequently than reflux, dysphagia, or any other gastrointestinal diagnosis. The mechanisms driving this overlap are not fully established, but autonomic dysfunction, altered gut motility, visceral hypersensitivity, and central sensitization are all implicated. Treating IBS in a POTS patient without evaluating the autonomic component is addressing a consequence while the underlying driver remains unaddressed.

Comment HYPER and I will send you the full 2026 research paper on gastrointestinal symptoms and systemic comorbidities in POTS.

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POTS has long been framed as a cardiovascular condition, yet the research tells a more complex story.A 2026 systematic r...
07/27/2026

POTS has long been framed as a cardiovascular condition, yet the research tells a more complex story.

A 2026 systematic review and meta-analysis of 8,268 POTS patients confirms what clinicians treating complex chronic illness have observed for years: the burden of this condition extends well beyond heart rate dysregulation. 60% of patients carry concurrent gastrointestinal symptoms, with nausea present in 70%. But the extra-intestinal picture is what demands closer clinical attention. Anxiety, chronic fatigue, migraine, MCAS, and depression each affect over one third of POTS patients, occurring at rates that exceed the gastrointestinal comorbidities. Autoimmune conditions including Sjogren's syndrome appear at nearly 80 times the rate seen in the general population.

For patients presenting with this constellation of symptoms, the diagnostic path rarely leads to POTS first. Each condition is evaluated in isolation, treated separately, and the shared autonomic and immune mechanisms underlying all of them go unaddressed. Understanding POTS as a multi-system syndrome changes how the clinical workup should be approached from the start.

Comment HYPER and I will send you the full 2026 research paper on gastrointestinal symptoms and systemic comorbidities in POTS.

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07/23/2026

Patients often ask where they should spend their money when trying to improve their health. There is certainly no shortage of products, treatments, and technologies being marketed today, but not all of them have the same clinical value.

The five on this list are interventions I frequently recommend or incorporate into treatment plans when they are appropriate for the patient. A sauna can support detoxification and improve circulation. IV phosphatidylcholine may help restore cell membrane integrity and support detoxification in patients with chronic illness. Inuspheresis is a more advanced therapy that can reduce inflammatory compounds and environmental toxins in carefully selected cases. Clean water and clean air are fundamental because they reduce the ongoing exposures that can continue driving inflammation and immune dysfunction.

None of these replace identifying the root cause of an illness, and they are not necessary for every patient. The right intervention always depends on the individual sitting in front of you. But when used in the right context, these are some of the health investments that can have the greatest impact.

What health purchase has made the biggest difference for you?

Postural orthostatic tachycardia syndrome did not emerge with Long COVID. The connection between viral infections and au...
07/22/2026

Postural orthostatic tachycardia syndrome did not emerge with Long COVID. The connection between viral infections and autonomic dysfunction has been documented for decades.

Epstein-Barr virus is one of the most well-established infectious triggers of POTS. The same pattern of immune dysregulation, neuroinflammation, and autonomic destabilization that COVID-19 produces has been observed after EBV, influenza, and other viral illnesses long before the pandemic brought this conversation into mainstream medicine. What Long COVID did was create a large enough patient population that the medical community could no longer dismiss post-infectious autonomic dysfunction as rare or psychosomatic.

For those of us treating complex chronic illness, this is not new. The mechanisms driving POTS after COVID-19 are the same mechanisms we have been treating in patients with chronic EBV reactivation, Lyme disease, and mold illness for years. Infection destabilizes the autonomic nervous system. The specific pathogen matters for initial treatment, but the downstream autonomic damage requires its own systematic evaluation and management regardless of the trigger.

If your symptoms began after any viral illness and have not resolved, autonomic dysfunction belongs in the workup.

Comment VAGUS and I will send you my full article on POTS and dysautonomia in chronic illness.

Follow for clinical insights on POTS, Long COVID, and complex chronic illness.

Before 2020, POTS was considered a rare condition affecting well under 1% of the population. That number changed signifi...
07/21/2026

Before 2020, POTS was considered a rare condition affecting well under 1% of the population. That number changed significantly after COVID-19.

A study of 467 highly symptomatic Long COVID patients found that 31% met the full diagnostic criteria for POTS. That is not a small subset. That is nearly one in three patients with persistent post-COVID illness developing a measurable autonomic disorder. And it is not surprising when you understand the mechanisms involved. COVID-19 drives immune dysregulation, mast cell activation, mitochondrial dysfunction, autoimmunity, and pathogen persistence. These are the same mechanisms that destabilize the autonomic nervous system and produce POTS.

What concerns me clinically is how rarely this connection is being evaluated. Most Long COVID clinics are managing symptoms without a systematic workup for autonomic dysfunction. Patients are told their fatigue, brain fog, racing heart, and exercise intolerance are post-viral and will resolve with time. For a significant number of them, what is actually present is a diagnosable, treatable autonomic disorder being missed because no one is looking for it.

When POTS develops after an infection, the infection is not incidental. It is the starting point for the entire clinical picture.

Comment VAGUS and I will send you my full article on POTS and dysautonomia in chronic illness.

Follow for clinical insights on Long COVID, POTS, and complex chronic illness.

07/20/2026

20,000 followers is a milestone worth acknowledging.

This page was created to bring clinical depth to conditions that have been underserved by conventional medicine for decades. Lyme disease, mold illness, MCAS, ME/CFS, Long COVID, tick-borne co-infections, and the overlapping mechanisms that connect them. These are not rare diagnoses. They are complex, measurable, and treatable when approached with the right clinical framework.

What gets shared here comes directly from my clinical practice and from the research that is shaping how these conditions are understood and treated. The goal has always been to give patients and practitioners access to information that is evidence-based, specific, and actionable.

Comment below what has been most useful to you on this page, and what you would like to see more of going forward.

Follow for clinical insights on Lyme disease, mold illness, MCAS, and complex chronic illness.

Most people associate Lyme disease with joint pain, fatigue, and the classic bull's eye rash. The neurological timeline ...
07/16/2026

Most people associate Lyme disease with joint pain, fatigue, and the classic bull's eye rash. The neurological timeline is less understood and far more significant.

In 10 to 15% of Lyme disease cases, the bacteria migrate through host tissue and reach the central nervous system within two weeks of infection. At that point, the clinical picture shifts entirely. Neurological Lyme disease can present with cognitive impairment, mood disturbances, headaches, and in documented cases, dementia-like symptoms. What makes this particularly relevant in the context of current research is that the molecular changes triggered by Lyme bacteria in the brain overlap directly with pathways associated with Alzheimer's disease. The window between initial infection and neurological involvement is narrow, and it is rarely discussed in standard Lyme disease education.

Early identification of neurological involvement changes the treatment trajectory significantly. For patients with unexplained cognitive or neurological symptoms following a known or suspected tick exposure, Lyme neuroborreliosis deserves serious consideration in the diagnostic workup.

Comment PLAQUES and I will send you the full research paper on Lyme disease and Alzheimer's-like pathology in the brain.

Follow for clinical insights on Lyme disease, neurological illness, and emerging research.

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700 Larkspur Landing Cir, Suite 205
Greenbrae, CA

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Monday 9am - 5pm
Tuesday 9am - 5pm
Wednesday 9am - 5pm
Thursday 9am - 5pm

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