AUTOIMMUNE DISEASES CAUSED BY AN INFECTION?

[shijing]

I asked him to clarify that a bit and he confirmed that he was talking about a condition called SIBO (small intestinal bacterial overgrowth). It's when proper colon bacteria get up into the small intestine and colonize there. It's not that they're bad bacteria, it's that they're in the wrong spot. There were a number of paleo bloggers talking about it a year or two ago, including Chris Kresser. Kresser had said that adding a typical probiotic in this situation can be like adding gasoline to a fire. He recommended using non-lactic acid producing strains, like soil-based probiotics, to combat the problem. One called "prescript assist" was a popular recommendation (both Kresser and Mark Sisson recommend it), but there are others like AOR Probiotic 3. Taking one of these should help with species diversity, too.

OK, I remember that now, and thanks for bringing that up dugdeep. I actually started supplementing with some powdered probiotics a few weeks ago, twice a week, but maybe I should put that on hold until I find out more about what's going on in my own system since I don't want to be unintentionally exacerbating a potential problem. It looks like Foxx started a thread on soil-based probiotics, and I'll try to take a closer look at it later when I'm able.

I'm a bit confused on the implications of the ketosis feeding fungus.

Does that mean we should aim to eliminate the fungus first before going into ketosis?

Or is it better as he states, to cut carbs to half or a third of the SAD to balance out the fungus with the bacteria, etc?

I'm not going to pretend to have the answers yet since this is all new to me -- I'll defer to other members who have more training and knowledge, or wait to see what we uncover with our ongoing research.

I can share a few personal observations, but remember these are specific to me. When we first started the ketogenic diet a few years ago, it had a mixed effect on me. Positive effects included reduced body fat and increased muscle tone when I combined it with exercise. However, I never experienced the boost in energy that a lot of other members described, and to an extent it made me more fatigued at certain times. I already had (what I assume to be) the candida symptoms I mentioned above before starting the diet; they abated for a few months in the beginning, but then returned, and would flare up unexpectedly even though I couldn't correlate the flare-ups to carb consumption (maybe the candida were becoming keto-adapted at the same time that I was?). Would things have been different if I had treated the candida before going on the diet? I don't know -- what I do know is that candida is always present in our system naturally, and we never get rid of it completely (if we did, that would actually be a problem, OSIT) -- we can only try to find a way to balance its place in our gut so that it doesn't overgrow.

There have been two other things which have had an impact -- the first (unsurprisingly) is prolonged stress. I experienced some of that in the first part of last year, and the effect on my energy levels, anxiety, cardiovascular and candida symptoms was quite noticeable. I spent last summer trying to get that under control, and by the time I felt like I was getting back to normal, all of a sudden my local utility company installed smart meters throughout my neighborhood (I posted about that on the EMF thread last fall and winter). This set me back again, and I was only able to get it under control again when I started a prolonged heavy metal detox last spring. Since fungi seem to enjoy EMF exposure about as much as we do, I think part of the problem was that any excess candida (or whatever else) I had in my system at the time reacted poorly and started excreting more toxins as a defense mechanism. Around the same time (last fall), my experience with smoking also changed -- I was only able to smoke a fraction of what I had previously, because smoking too much increased my anxiety and made me feel aggressive. That was new, and I'm not sure yet why it was the case, although the symptoms implicate a dopamine issue.

I've been experimenting with my diet in the past year, and what seems to work best for me is to eat keto for the first half of the day. The one change I made was to start adding some green leafy vegetables (spinach, kale, etc) to my usual breakfast of bacon, eggs and butter -- that seemed to help, probably because of the methylation issues. I added more carbs in the evening, but had to be careful about what kinds I introduced -- if I ate anything with sugar or simple carbs, the candida symptoms would flare up; foods with complex carbs (tubers, gourds, vegetables) seemed to be fine, and I had a bit more energy doing things this way. I've also had difficulty at times with intermittent fasting and hypoglycemia symptoms -- not consistently, but it may be due to what Dr Rostenberg talked about re: the inability to completely absorb fats and losing the full benefit of fat consumption due to excretion what isn't absorbed. That may also be why some carb consumption makes me feel better, because my body is making up for what it can't get solely from the fat that I eat.

Again, keep in mind that this is just my personal experience -- I'm not about to make sweeping recommendations for anyone else, because I'm still trying to figure out what's going on with my own body. Suffice to say that it's important to observe yourself, experiment, and adjust accordingly.

 

[dugdeep]

Around the same time (last fall), my experience with smoking also changed -- I was only able to smoke a fraction of what I had previously, because smoking too much increased my anxiety and made me feel aggressive. That was new, and I'm not sure yet why it was the case, although the symptoms implicate a dopamine issue.

Just to add a possible dot connection here, tobacco is a fairly potent anti-fungal. One of the symptoms of candida overgrowth is almost complete intolerance to tobacco smoke (you know those people who will complain at the slightest whiff of smoke, even in the open air? Likely candida sufferers, if not self-righteous anti-smokers). Perhaps what you're dealing with was some kind of die-off reaction.

Just a thought.

 

[shijing]

Just to add a possible dot connection here, tobacco is a fairly potent anti-fungal. One of the symptoms of candida overgrowth is almost complete intolerance to tobacco smoke (you know those people who will complain at the slightest whiff of smoke, even in the open air? Likely candida sufferers, if not self-righteous anti-smokers). Perhaps what you're dealing with was some kind of die-off reaction.

Just a thought.

Thanks dugdeep -- that hadn't occurred to me, but I'll try to pay attention and see if I can observe anything else that either supports or falsifies that hypothesis. I do notice that the negative effects of smoking for me are worst in the morning after I wake up, and calm down as the day progresses. I used to look forward to that 'smoker's high' in the morning as I set about tending to my acetylcholine deficit from the night before, but those days are over, at least for now. The daytime pattern I just described could indicate the buildup of something while I'm sleeping -- either yeast and/or catecholamines.

 

[Yas]

I agree with everyone that this is very interesting stuff...

One thing I was thinking about is that my Hidradenitis Suppurative actually started when I went keto. I considered this before, but overall I feel much better in other things so I thought it was just some sort of coincidence (because HS normally starts in the 20s and I that's when I started the diet), or even a deeper problem that just got exposed with the keto diet. Similar to all my allergies that became evident once I started the diet.

Another thing is, I was diagnosed with candidiasis a long time ago and when I started the paleo diet, before going fully keto, I did a candida treatment recommended by my doctor who follows the paleo/keto diet approach. He is one of the proponents of killing all the bad stuff before everything, so I think he will be really interested in this protocol as well... The thing is that, I've been having some candida symptoms again lately, but I thought it couldn't be possible since I'm fully keto, yet, we see that this is not the case.

Also, when I'm on full keto , i think my anxiety levels drop drastically for the body is more relaxed (also helped by exercise) - hence i'm quite keen to try the low-dose doxy for 6 months, just as an experiment to see if i can completely flush out any remaining critters.

Apologies if this has been asked before to Forum Mods/Admins, as i tried the search function, but could really find a thread on "low-dose doxycycline " - is there a unique thread for this, or is it part of other health section threads ? Many thanks for the help.

I think that what is being discussed here is not so much a low dose doxy protocol, but 300 mg a day for 6 months. The low-dose protocol, which I did for a year a few years ago, is about 50 mg per day.

Gaby also noted that one can try a couple of antibiotics to see if there is a Herx reaction so as to determine what type of critter may be present. Obviously, whatever I had REALLY didn't like the metronidazole. And I guess my low-dose doxy run didn't really kill off the baddies. So now, I'm going to do the 300 mg per day for the next four months - having done the metro for two months already - with one cycle of metro for two days a month.

For those who just want to try the doxy, you can get it at fludan.com. It's a bit pricey, but when you consider that a 25 gram bottle is 25000 mg, or 250 doses, which is enough for 83 days (100 mg 3 X day), it's not too bad. A 100 gram bottle is enough for the full 6 months with some left over. You can read up about doxycycline on wikipedia. It's a useful thing to have on hand anyway.

On amazon, there is a set of measuring spoons:
http://www.amazon.com/Libertyware-Smidgen-Pinch-Measuring-Spoon/dp/B002X9I4RC/ref=sr_1_3

The "drop" measure is 50 mg. The "smidgen" measure is 100 mg. I checked with a gem scale. That's a flat measure, not rounded.

When you take cycline medications, you need to limit your sun exposure and no dairy, I think. Read up on it at wikipedia.

Thanks for this Laura!

I would like to try the protocol starting with doxy first, but I'll see if I can get a cheaper one locally. And I would also like to speak to my doctor about it before I start...

One thing I don't clearly get is... does "100 3 X day" means you have to take it everyday for 6 months, or do you take it in cycles such as one day per week?

Another thing is, what would be the best way to supplement with probiotics, I mean, when is it best to take them? Which kind of probiotic is the best? Would the general Culturelle brand be OK?

I downloaded the PDFs sent by Gaby now and I will read them and try to understand them... and send them to my doctor.

ADDED: I also wanted to mention that when I had my first HS major flare up 2 years ago, I took an antibiotic (Cefixime 400mg once a day for 7 days) and I had a REALLY strong reaction to it, including high fever. According to Wikipedia it is a third generation cephalosporin, a broad spectrum bacteria killer. I thought it was a reaction to the drug, but... could it be a Herx reaction?

When I had my surgery in December I took another antibiotic (I don't remember which one now, but I'll search) and the reaction wasn't that bad... just a little upset stomach.

In both cases I had diarrhea for a long time after the treatment.

 

[Gaby]

I would like to try the protocol starting with doxy first, but I'll see if I can get a cheaper one locally. And I would also like to speak to my doctor about it before I start...

One thing I don't clearly get is... does "100 3 X day" means you have to take it everyday for 6 months, or do you take it in cycles such as one day per week?

Another thing is, what would be the best way to supplement with probiotics, I mean, when is it best to take them? Which kind of probiotic is the best? Would the general Culturelle brand be OK?

I downloaded the PDFs sent by Gaby now and I will read them and try to understand them... and send them to my doctor.

ADDED: I also wanted to mention that when I had my first HS major flare up 2 years ago, I took an antibiotic (Cefixime 400mg once a day for 7 days) and I had a REALLY strong reaction to it, including high fever. According to Wikipedia it is a third generation cephalosporin, a broad spectrum bacteria killer. I thought it was a reaction to the drug, but... could it be a Herx reaction?

When I had my surgery in December I took another antibiotic (I don't remember which one now, but I'll search) and the reaction wasn't that bad... just a little upset stomach.

In both cases I had diarrhea for a long time after the treatment.

The papers are very clarifying and the protocol very reasonable. Perhaps your doctor will find it interesting and other people might benefit. Immunosuppressant drugs can cost hundreds of dollars per ampoulle, the antibiotics cost 3 dollars per box. No comparison!!

Doxycycline 100 mg three times per day if you are a big person. If you are small, then 100 mg twice per day with a tall glass of water and an empty stomach. Don't lie down immediately afterwards (to avoid esophagic reflux) and don't seek the sun deliberately while on these antibiotics.

The bugs are speculated to cycle, so the antibiotic can be taken every other day just as long as it is taken strictly that way. Forgetting one day is not allowed. In case of mistake or forgetfulness, it is best to take it every single day so you won't forget, aiming for 6 months.

Probiotics can be taken in between doses. Lactobacillus rhamnosus gg will promote the growth of a good flora, regardless of their names, so that is a good option. Alternatively, whatever is accessible will be good.

Mitochondrial energy supplements are good: CoQ10, alpha lipoic acid, NAC, L-carnitine, methyl supplements.

Interesting, it could have been a Herx reaction, but usually cefixime doesn't address the types of microbes that lack a cell wall and/or parasites.

The cefixime is good for typical bacteria with cell walls, but usually you use doxycycline, azythromicn, ciprofloxacin and related to treat atypical bacteria (i.e. which don't have cell walls) and which behave more like viruses.

It will be interesting to know which was the second antibiotic.

Overall, I feel optimistic about this protocol, despite its difficulty. :)

 

[Yas]

Interesting, it could have been a Herx reaction, but usually cefixime doesn't address the types of microbes that lack a cell wall and/or parasites.

The cefixime is good for typical bacteria with cell walls, but usually you use doxycycline, azythromicn, ciprofloxacin and related to treat atypical bacteria (i.e. which don't have cell walls) and which behave more like viruses.

It will be interesting to know which was the second antibiotic.

Overall, I feel optimistic about this protocol, despite its difficulty. :)

Thanks for your answer Gaby, I will check the documents.

The second antibiotic was another cephalosporin discovered by GlaxoSmithKline ( ), Cefuroxime, 500gm each 12 hours. But I also had probiotics with it, so that might be why the reaction wasn't so strong this time.

According to what I read, strong reactions to cephalosporin antibiotics aren't very rare... so I guess it was just that.

I'm sending some files to my doctor now, he's not very keen to write emails, but I'll tell you if he answers something interesting. ;)

Other than that, I will try the protocol, so I'll let you know when I start.

 

[SeekinTruth]

Shijing and dugdeep, you covered some of what I was going to say/suggest. So thanks for your input. I agree that constant research, networking, and experimenting is essential to get to the bottom of individual issues and to optimize health as much as possible. And yeah, EVERYTHING is connected, including EMF exposure and all kinds of stress....

 

[Laura]

These are the things I've extracted from the papers regarding the protocol so far. Others who have read them please correct me if I have misunderstood anything.

It begins with:

1) Six month treatment of antibiotic - a "cycline" such as doxycycline, minocycline, etc He mentions that one can take doxycycline AND metronidazole concurrently to suppress secondary bacterial or yeast type infections. He mentions that 200 mg of doxycycline should be taken in the morning, and 100 mg in the afternoon. That is probably due to the half life properties. First six months without a break is recommended several times though he does mention the "every other day thing" with some expressions of doubt.

2) Followed by 6 weeks on and 2 weeks off cycles of same or different antibiotic. Didn't see where it was indicated how long this was to continue.

3) Also, antivirals can be taken concurrently for the first three weeks. Ganciclovir 1000 mg 3X day for three weeks.

4) Replacement of gut flora on an ongoing basis: take 3 X per day, at leas 2 hours AFTER the antibiotic.

He mentions combinations of antibiotics work best because they have different active mechanisms. See number one above.

He seems rather doubtful about the "every other day" thing.

To alleviate Herx reactions, he suggests benadryl, not cortisone.

Also suggests alkalinizing the system with something called Plaquenil. Would taking baking soda do as well?

Herbals that can be used concurrently: red clover, rosemary, lemon balm, barley grass, lauric acid.

Vitamins: B complex (sublingual) C, E, CoQ10.

Minerals: Zinc, magnesium, chromium and selenium. I would add boron for sure. Minerals should be taken at least 3 hours after antibiotic.

He mentions "lipid replacement therapy". Obviously, persons on high fat diets won't need this.

Hyperbaric treatments or baths in epsom salts and hydrogen peroxide.

Dry saunas. (FIR?) 3 X weekly.

One must avoid direct sunlight (I messed up on this and got a rash on my legs.)

Drink lots of fluids.

There are all the usual warnings about drug interactions which should definitely be read. Also, against taking anything while pregnant or nursing, etc.

Basically, it's a busy schedule as you can see, and one has to figure out how to get the probiotics and minerals in on a reasonable schedule. I guess if one gets up early enough for the first dose of antibiotics/antivirals - keeping in mind that doxy should be taken on an empty stomach, before eating while metronidazole needs to be taken after eating and the antiviral needs to be taken with food also; then the probiotics can be taken at midday along with the vitamins. Then, the late afternoon dose of anti/bs and antiviral; and then the minerals a few hours later before bed. I guess if you take a probiotic first thing in the morning and don't eat for an hour or so, that helps you get in three doses a day. But, I guess if you only get one or two, that's better than nothing.

If I find anything else really important, I'll add it here.

I played around with it and here's what I came up with for someone 150 pounds or more. (Though Nicholson doesn't say anything about different doses for different weights that I've seen so far).

For Six Months

Get up in morning and take 200 mg doxycycline. Drink full glass of water with 1/4 to 1/2 tsp baking soda with meds.

For first week, also take Benadryl at this point.

½ hour later, eat breakfast

Following breakfast take 500 mg metronidazole and antiviral. Metronidazole only every other week. Antiviral only for first 3 weeks.

2 hours later, take probiotics.

1 hour later take 5 grams Vitamin C. Dissolve Sublingual B vites under tongue.

Late afternoon/early evening: Take 100 mg doxycycline.

½ hour later, eat light dinner and take 500 mg metronidazole and the antiviral. Same rule as above for metronidazole – every other week and antiviral only for first three weeks.

3 hours later, before bed, take probiotics, magnesium, selenium, chromium, zinc, boron, vitamin E and CoQ10.

 

[Gaby]

1) Six month treatment of antibiotic - a "cycline" such as doxycycline, minocycline, etc He mentions that one can take doxycycline AND metronidazole concurrently to suppress secondary bacterial or yeast type infections. He mentions that 200 mg of doxycycline should be taken in the morning, and 100 mg in the afternoon. That is probably due to the half life properties. First six months without a break is recommended several times though he does mention the "every other day thing" with some expressions of doubt.

For the additional antibiotic, he suggests doxycycline plus ciprofloxacin or azithromycin, especially if there are limited responses to either alone.

Metronidazol is used additionally to treat parasites (cysts forms). Also nystatin and other anti-fungals might be needed if those infections arise.

2) Followed by 6 weeks on and 2 weeks off cycles of same or different antibiotic. Didn't see where it was indicated how long this was to continue.

It is 6 week cycles which can be repeated if there is relapse.

3) Also, antivirals can be taken concurrently for the first three weeks. Ganciclovir 1000 mg 3X day for three weeks.

4) Replacement of gut flora on an ongoing basis: take 3 X per day, at leas 2 hours AFTER the antibiotic.

He mentions combinations of antibiotics work best because they have different active mechanisms. See number one above.

He seems rather doubtful about the "every other day" thing.

To alleviate Herx reactions, he suggests benadryl, not cortisone.

Also suggests alkalinizing the system with something called Plaquenil. Would taking baking soda do as well?

To prevent acid reflux, it should. Also aloe vera could be considered. It could be reserved if there are reflux symptoms.

For Six Months

Get up in morning and take 200 mg doxycycline. Drink full glass of water with 1/4 to 1/2 tsp baking soda with meds.

For first week, also take Benadryl at this point.

½ hour later, eat breakfast

Following breakfast take 500 mg metronidazole and antiviral. Metronidazole only every other week. Antiviral only for first 3 weeks.

2 hours later, take probiotics.

1 hour later take 5 grams Vitamin C. Dissolve Sublingual B vites under tongue.

Late afternoon/early evening: Take 100 mg doxycycline.

½ hour later, eat light dinner and take 500 mg metronidazole and the antiviral. Same rule as above for metronidazole – every other week and antiviral only for first three weeks.

3 hours later, before bed, take probiotics, magnesium, selenium, chromium, zinc, boron, vitamin E and CoQ10.

I would try the doxycycline first to see if there are Herx reactions. I would add the metronidazol when Herx reactions with doxycycline subside.

I have second feelings about the anti-virals :/, but according to Nicoloson's experience, they could be taken to deal with the various viruses.

 

[Oxajil]

Now, another thing has been on my mind over the last few weeks. Keep in mind that today I'm finishing up my 8th cycle of metronidazole and on this one, have had virtually no reaction that I can detect. What is on my mind, what I have noticed for a few weeks now, is a subtle change in thinking. I don't want to say too much because I need to continue to observe this, but what I will say is that it is like chains are falling off my mind.

In addition to that, there is a different feeling in my legs. I've commented often enough about the fact that my legs have always felt leaden especially when I go up and down stairs. Well, it's too soon for a significant change, but there is enough difference to notice.

That is very good to hear! Thank you for the information regarding the protocol and for sharing your experiences, and everyone else who contributed. I hope this will help out a lot of people! I'll have a look into it as well.

 

[Laura]

Maybe starting out with the doxycycline for one week, then take the metronidazole for only two days of subsequent weeks, more or less like the metro protocol, though for the 6 month period, and also, kick in the antiviral in the second week???

I was reading somewhere that there was a guy who took a cocktail of antibiotics and antivirals and cured HIV. So my thinking is kind like the nuclear option here: don't mess around and take any prisoners. Kill 'em all.

 

[Gaby]

Maybe starting out with the doxycycline for one week, then take the metronidazole for only two days of subsequent weeks, more or less like the metro protocol, though for the 6 month period, and also, kick in the antiviral in the second week???

Yes, that is an excellent idea!! It is not that hard (it doesn't have the allopurinol), but it does combine both protocols and deals with all the bugs: intracellular bacteria, cysts, viruses. It also leaves some space to distinguish where the Herx reactions are coming from.

 

[Gaby]

Here are the first highlights of the treatment article, FWIW:

Considerations when undergoing treatment for chronic illnesses and autoimmune diseases.

6 months (no break) treatment, then 6-week on 2-week off antibiotic cycles.

Antibiotics: doxycycline, ciprofloxacin, azithromycin, minocycline, clarithromycin or others work best as oral capsules without starch fillers.

Combinations of antibiotics are useful such as doxycycline plus ciprofloxacin, especially if there are limited responses to either alone.

Combinations of antibiotics with different mechanisms of action work best. {This justifies the use of metronidazol as the other option to doxycycline, IMO. That way cysts AND intracellular bacteria are dealt with. If one uses ciprofloxacin, then only intracellular bacteria is being treated. Adding anti-virals will deal with everything}

Hydroxychloroquine (Plaquenil), an anti-malarial has been suggested to alkalinize cellular compartments and improve killing since infections are intracellular. {This has important side effects though, an eye check up must be done. I would leave it out.}

Some recommend every-other-day dosing, which presumes the microorganisms cycle, which is true, but compliance is important if this approach is used.

Oral antibiotics must be taken with a full glass of water and do not lie down for 1 hour.

Direct sunlight must be avoided for most antibiotics.

Herxheimer reactions: chills, fever, night sweats, muscle aches, joint pain, short term memory loss, fatigue, a general worsening of symptoms or other adverse reactions. Herx reactions last for up to 12 weeks.
To overcome Herx reactions: Diphenhydramine (Benadryl), 50mg taken half an hour before antibiotics and lemon/olive drink (1 blended lemon, 1 cp fruit juice, 1 tbs olive oil). The fruit juice could be skipped. {If this anti-histaminic is not available as it happens in some countries, any other one should do. In fact, I would use one which doesn't make people sleepy, i.e. bilaxten}

If there are bacterial infections: Cycles of augmentin can used concurrently or in between the 6-week cycles.
Metronidazol (Flagyl) is useful to kill cyst forms, it is used to treat bacterial and protozoal infections.

Some add antivirals for the first few weeks. Mycoplasmas may have some characteristics of viruses and viral infections are important in chronic diseases. Often patients have multiple bacterial infections along with other co-infections.

Antivirals to cover human herpes virus 6A and citomegalovirus: ganciclovir 1000mg 2X/day in 3 week cycles. Alternatively Famvir 500mg 2x/day for two weeks. Lauric acid inhibits lipid metabolism of viruses.

Vitamins and minerals: B vitamins, C, E, CoQ10, alpha lipoic acid, L-carnitine, stabilized NADH, zinc, magnesum, selenium, chromium. They should not be taken at the same time (3-4 hour difference) as antibotics or antivirals (or oxygen therapy). {He has an updated article on mitochondrial supplements, alpha lipoic acid is really very important, other supplements can variate according to availability}

Hyperbaric oxygen, 60 minutes treatments, IV ozone are useful. Peroxide baths: 2 cups of Epsom salts in a hot bath or jacuzzi. After 5 minutes, add 2-4 bottles 16 oz. Of 3% hydrogen peroxide. Repeat two to tree times per week. No vitamins or antioxidants 4 hours before the bath. The hydrogen peroxide is added after your pores open. Hydrogen peroxide can also be applied to the skin after a work out or hot shower. Leave the hydrogen peroxide for 5 minutes, then wash off. Oral irrigation with 1 part 3% hydrogen peroxide combined with 2 parts of water can be used as an oral mouth wash three times per day.

Probiotics should be taken three times per day and 2 hours after any antibiotics. For help with bowel and bladder infections, D mannose can be used.

Natural immunomodulators and remedies: herbal teas, olive leaf extract, wormwood extract, laktoferrin, echinacea-C.

Yeast/fungal or bacterial overgrowth: Especially vaginal infections. Diflucan, anti-yeast creams, metronidazol has been used. Also nystatin and fluconazol for fungal infections that can occur while on antibiotics. Pau d’arco, 7 capsules two times per day is also useful. Grapefruit seed extract, oregano complex, caprylic acid and garlic extract is also useful. For superficial fungal infections, such as a fungal nail, a topical mixture of laminsil in 17% DMSO twice per day is effective.

Bacterial overgrowth can occuer in between cycles of antibiotics or after antibiotics/anti-virals have been stopped. This can be controlled with 2 weeks courses of Augmentin (500mg three times per day) in between cycles or concurrenty with other antibiotics.

Anti-depressants and narcotics should be decreased and gradually eliminated. They interfere antibiotic uptake.

 

[Gaby]

A word on doxicycline, highlights from Garth Nicolson's article:

It is a broad spectrum tetracycline with good lipid solubility and ability to penetrate the blood-brain barrier. It is readily absorbed by the (normal) gut and peak blood concentrations are maintained between 2-18 hours (half-life, 18-22 hours) after an oral dose of the drug.

Food, calcium, magnesium, antiacids and some drugs reduce absorption. {If you don't have acid reflux, don't take baking soda or anti-acids, it will reduce the drug absorption}

Minocyclin can be used for rheumatoid arthritis because it penetrates tissues better (same dose/day).

Dose: 200-300mg per day (2 to 3 capsules per day, 2 in the morning) for 6 months. After 6 months, 6 week cycles are suggested (2 weeks off in between).

Herx reactions on doxycycline: exacerbation of chronic symptoms. Adverse reactions such as gut discomfort, skin rashes, transient fever are usually reduced within a few weeks. In some patients, major symptoms are not alleviated until after 12 weeks. Some people react to the starch filler in the capsules, so they need to use a granular form of doxycycline.

Virtually all patients relapse if they stop therapy before 6 months.

Doxycycline has been used successfully in addition to other antibiotics in situations where either antibiotic alone had minimal effects (i.e. doxycycline plus ciprofloxacin or doxycycline plus azithromycin)

Doxycycline deals with several microorganisms, mainly gram negative bacteria (i.e. Haemophilus influenzae, shigella, yersinia pestis, brucella species, vibrio cholera; gram positive bacteria (i.e. streptococcus pneumoniae, s. Pyogenes); mycoplasmas; others (i.e. clostridium species, chlamydia species, entamoeba species, plasmodium falciparum (malaria) and borrelia (Lyme disease).

Avoid direct sunlight and drink fluids liberally, especially with oral capsules. Patients with impaired kidney function should not take doxycycline.

Adverse reactions: gastrointestinal irritation, anorexia, vomiting, nausea, diarrhea, rashes, mouth dryness, hoarseness in rare cases hypersensitivity reactions, hemolytic anemia and reduced white blood cell counts. {A blood check needs to be done after starting the antibiotics just to discard these last two.} In general, doxycycline is a very safe drug and there are few adverse reactions reported in literature.

 

[Gaby]

A word on ganciclovir, from Garth Nicolson’s article:

It is a synthetic antiviral active against cytomegalovirus (CMV) and related herpes simplex viruses, such as HHV-6 viruses. It inhibits replication of herpes viruses by inhibiting viral DNA replication by its incorporation into viral DNA and by inhibition of viral DNA elongation.

For oral use, ganciclovir 1000mg three times per day with food for 3 weeks. It reaches a maximum blood dose within 3 hours after oral administration with food with a half-life of 4.6 hours.

Precautions: It should not be used in patients with kidney failure or those who have an absolute neutrophil count of less than 25,000 cells/microliter {It is important to do a general check up blood test before and during this protocol}. It should not be used in pregnancy or nursing mothers, same with doxycycline. Elderly patients should pay special attention to kidney function before and during the protocol as the doses should be adjusted if kidney function is low.

Amphotericin B (anti-fungal) should NOT be used with ganciclovir.

Adverse reactions: Reductions of white blood cells (6-29%) {blood test monitoring would be useful}, anemia (9-19%), impairment in fertility, chills (7%), sweating (11%), abdominal pain (15%), vomiting (13%), diarrhea (40%), paresthesias (8%), retinal detachment (8-11%), chest pains, headaches, malaise, constipation, cough, anxiety, confusion, depression, dizziness, dry mouth, insomnia, tremor and edema. NOTE: These values are taken from patients with AIDS, organ transplants and CMV retinitis and may not reflect the actual incidence rates in chronic illness patients.