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Posted 6/8/2017 8:25 PM (GMT 0)
Hi Folks,

I have come up with the following plan to fight effectively and target different aspects of BB. I would appreciate any comments/recommendations from you guys.

Monday ,6 Dox ,6 Mox,1.5 Met
Tuesday ,4 Dox ,6 Mox,1.5 Met
Wednesday ,2 Dox ,6 Mox,1.5 Met
Thursday ,2 Dox ,3 Mox,4.5 Met
Friday , -
Saturday , -
Sunday , -

Dox: Doxicycline 100 mg
Mox: Amoxicillin 500 mg
Met: Metronidazole 500 mg

The goals to achieve:
1) 3 days off to let the bacteria come out of hiding / inactive form, give my body time to detox and my immune system to rebuild.
2) Start with a high dose of doxy in the beginning to kill spirochete forms (after the off period).
3) High dose of Met at the end to help kill cyst forms created after a few days on antibiotics (especially Dox).
4) Limit the antibiotics intake to 2 Dox, 3 Mox, and 1.3 Met on average per day, while achieving high dosage when needed, and not too much on a single day.

Post Edited (Jay Kay) : 6/8/2017 2:36:58 PM (GMT-6)

Posted 6/8/2017 8:46 PM (GMT 0)
I don't know if starting high dose of doxy (600 mg is high) and reducing each day is a good idea.

Usually we will start lower...and increase to the higher amount - usually 400 mg a day. (I have seen 600 mg, but usually 400 is typically the dose prescribed) Starting lower is the usual plan because starting at full dose sometimes is difficult and we need to gradually increase to optimum dose.

Same with the amoxy - starting high and going lower...not what is usually done...

Do you have a LLMD prescribing this...or are you self-treating?
Posted 6/8/2017 8:47 PM (GMT 0)
Hi Jay Kay -

You've put together a fine protocol. The pulsing should probably be based on the lifecycle of the Bb. I think this is why most do a 7-day cycle. I did 5 days Rocephin on, 2 off. Others might have better input with your unique abx combo.

You might also want to incorporate herbal antimicrobials for the Lyme to more comprehensively address the infections.

And what are you doing to detox? Diet? Support of other systems?

-p
Posted 6/8/2017 8:57 PM (GMT 0)
Thanks very much Girlie and Piruette!

I am very new to Lyme and do not have too much experience. I have been reading only during the last couple of weeks, and I have not found an LLMD yet.

about the high dose in the beginning, is it bad because it may hurt too much from Herx? If I can tolerate it, I think it is more effective to surprise them with a high dose before they go into hiding.

What herbal antimicrobial do you suggest? And should I use them during the on period only? Do spirochetes become inactive if they sense antimicrobial herbs?

For detox, I do not much. I just consume detox tea (I think one is a combination of turmeric, ginger, lemon, and green tea). The other one is for liver (I have forgotten the ingredients).
Posted 6/8/2017 9:16 PM (GMT 0)
I'll let Girlie answer your questions on dosing. She or Traveler might also be able to help you find a Lyme specialist if you're interested.

I appreciate your desire to surprise the microbes but I'm not sure they are going to respond like you want - it's more likely that you'll get overwhelmed. It's better to start low and titrate up slowly. I did this fairly quickly with one abx, couldn't do it with another. Same with herbs - some were more intense than others. The touble with overwhelming your body is that it could set your tx back quite a bit and require time to recover.

There are several herbal protocols like Buhner and Cowden that use individual herbs to create a symbiotic approach. Others like Byron White and Beyond Balance include combination herbal tinctures that have multiple herbs in them. It's probably better to start with the individual ingredients so that you'll know if you react to something and why. Although I went straight for the combo tinctures and did great with a few, not-so-great with a few.

Unfortunately, you'll probably just need to test things out to see how your unique response will be.

Some people pulse herbs - some don't. I think there are good reasons to stop all the antimicrobials and give your body a breather but I don't think the Bb respond to herbs (run into hiding) like they do with abx but maybe others can chime in about that.

The detox tea is great. You should probably incorporate a few more detoxing protocols to cover:

skin - our largest detox organ (sweating, soaks with epsom salts/sea salt/hydrogen peroxide)

lymphatic drain (red root, dry brushing)

gut/GI (binders)

and brain (I like Nutrimedix Pinella and BurBur).

Start with one thing and slowly build intensity, frequency over time.

Hope this is helpful - if not, just keep asking q's!

-p
Posted 6/8/2017 9:33 PM (GMT 0)
Thanks very much Pirouette! Really useful tips.
Posted 6/8/2017 9:48 PM (GMT 0)
Jay Kay - Maybe spend a few days reading posts...seeing what others have done - what their protocols look like, etc. and then form a protocol.

I can't say what you've set up won't work...I just haven't seen a schedule like that before of reducing the meds each day...

But, again....read posts...you can do a search on this site (top blue bar - search button) - just type in something like: lyme protocols OR pulsing antibiotics
Posted 6/8/2017 9:51 PM (GMT 0)
piro is the best...have you already treated babs and bart jayk?
dont forget 100 billion probiotic and maybe s. boulardi
Posted 6/9/2017 12:22 AM (GMT 0)
Thanks, Bluelyme and Girlie!

I do not yet know what co-infections I have. I am going to test for them soon. I have been waiting to finish my course of antibiotics and after a few days off antibiotics I will go and test.

My idea was not to reduce the meds each day, but to replace them with more effective ones (when I reduce Dox, I increase Met and vice versa). I agree that I should test and see how it goes. I may end up lowering Dox dose from 600 mg in the first day to 400 mg, and maybe increasing the third day to 400 mg as well.

Also, I will try the probiotics for the off days. Thanks for the suggestion.
Posted 6/9/2017 12:34 AM (GMT 0)
It looks like a good protocol, but it will be ineffective against co-infections if you have them. Also, how do you know that 3 days will be enough of a break to bring the bugs back out of hiding? Doxy half life is 18 hours, so you will still have some left in your system once you resume abx again. Dr. Jemsek pulses usually 2 weeks on 1 week off from what I have seen.

If it was me I would add in another cyst drug like grapefruit seed extract, another intracellular drug like zithromax or rifampin, biofilm busters (maybe not in the very beginning), and persister meds after a few months (depending on how sick you are). I do like the idea of 600mg doxy. Some doctors do use that much. It is very rare though. Also, make sure to not take doxy with foods containing calcium, magnesium, or iron. In fact, if I were to do abx over again... I would do doxy with only a small meal inside my stomach to increase absorption, but not a totally empty stomach as this is very painful.

It is interesting to note that drugs.com suggests that rifampin will reduce the effectiveness of doxy, and doxy will reduce the effectiveness of amoxicillin. I don't know if this is accurate or what to do about it.

Edit: Also - I may switch out flagyl for tindimax because tindi works well on biofilms in test tubes. I don't how comparable tindi is when busting cysts though...
Posted 6/9/2017 1:16 AM (GMT 0)
Sheeks175,

All very interesting points and I agree with them.

On the number of days, I think we also do not exactly know how fast they can grow in a week. Note that bacteria grow exponentially and if we give them enough time, we may get back to first place. I short, to me 3 days off means better be safe than sorry.

I actually developed a mathematical model in Excel of how the bacteria and antibiotics will interact after several cycles/rounds of pulsing. The model of course was based on several parameters/assumptions (parameters such as growth rate, rate of making cyst on the on periods, percentage of bacteria killed, speed of becoming active during the off periods, etc.). I was trying to see which regimen (number of days on and off) will work better under different input assumptions. It turned out that 4 days on 3-4 days off works very good under different inputs.
Posted 6/9/2017 1:41 AM (GMT 0)

Sheeks175 said...
It looks like a good protocol, but it will be ineffective against co-infections if you have them. Also, how do you know that 3 days will be enough of a break to bring the bugs back out of hiding? Doxy half life is 18 hours, so you will still have some left in your system once you resume abx again. Dr. Jemsek pulses usually 2 weeks on 1 week off from what I have seen.

If it was me I would add in another cyst drug like grapefruit seed extract, another intracellular drug like zithromax or rifampin, biofilm busters (maybe not in the very beginning), and persister meds after a few months (depending on how sick you are). I do like the idea of 600mg doxy. Some doctors do use that much. It is very rare though. Also, make sure to not take doxy with foods containing calcium, magnesium, or iron. In fact, if I were to do abx over again... I would do doxy with only a small meal inside my stomach to increase absorption, but not a totally empty stomach as this is very painful.

It is interesting to note that drugs.com suggests that rifampin will reduce the effectiveness of doxy, and doxy will reduce the effectiveness of amoxicillin. I don't know if this is accurate or what to do about it.

Edit: Also - I may switch out flagyl for tindimax because tindi works well on biofilms in test tubes. I don't how comparable tindi is when busting cysts though...

Should be effective against rickketsials like Ehrlichia and Anaplasma.
Posted 6/9/2017 3:00 AM (GMT 0)

Jay Kay said...
Thanks, Bluelyme and Girlie!



My idea was not to reduce the meds each day, but to replace them with more effective ones (when I reduce Dox, I increase Met and vice versa). I agree that I should test and see how it goes. I may end up lowering Dox dose from 600 mg in the first day to 400 mg, and maybe increasing the third day to 400 mg as well.

Also, I will try the probiotics for the off days. Thanks for the suggestion.

Mon/Tues/Wed you are reducing doxy...and amoxy and flagyl are staying the same (doses aren't raised)

Only on Thursday you are increasing the Flagyl. Like i said - I can't say it won't work...but have not seen that schedule before.


Monday ,6 Dox ,6 Mox,1.5 Met
Tuesday ,4 Dox ,6 Mox,1.5 Met
Wednesday ,2 Dox ,6 Mox,1.5 Met
Thursday ,2 Dox ,3 Mox,4.5 Met
Posted 6/9/2017 3:04 AM (GMT 0)

Jay Kay said...


Also, I will try the probiotics for the off days. Thanks for the suggestion.

You really need to take probiotics every day...not just three days a week.
You need to replenish the bacteria in your gut that is being killed off
Posted 6/9/2017 3:55 AM (GMT 0)

Girlie said...

Jay Kay said...


Also, I will try the probiotics for the off days. Thanks for the suggestion.

You really need to take probiotics every day...not just three days a week.
You need to replenish the bacteria in your gut that is being killed off

The risk to not taking probiotics everyday can be significant, like c.diff infections.
Posted 6/9/2017 6:06 AM (GMT 0)
Thanks, Girlie and Mustard Seed! It seems I had underestimated the importance of probiotics.
Posted 6/9/2017 5:53 PM (GMT 0)
I have a few concerns about consuming probiotics and antibiotics simultaneously though:

1) Is there any chance that we are killing them and therefore there in not much benefit from the probiotics?
2) Will antibiotics be used up (chemical reaction) for probiotics instead of fighting the infection? At least, they will be weaker.
3) Killing probiotics will add to the inflammation and will be another burden on the body to get rid of the killed bacteria/toxins.
4) Introducing them during the off days has another advantage that they compete with the infection for resources (less food for invading bacteria).
Posted 6/9/2017 6:01 PM (GMT 0)

Jay Kay said...
...I actually developed a mathematical model in Excel of how the bacteria and antibiotics will interact after several cycles/rounds of pulsing. The model of course was based on several parameters/assumptions (parameters such as growth rate, rate of making cyst on the on periods, percentage of bacteria killed, speed of becoming active during the off periods, etc.). I was trying to see which regimen (number of days on and off) will work better under different input assumptions. It turned out that 4 days on 3-4 days off works very good under different inputs.

Very interesting work!

Regarding probiotics: These are good questions. The proper way to take probiotics is AFTER doses. When I was taking probiotics, I'd do it only after my evening abx dose and before bedtime so that my GI had a chance to recover... until the next abx dose. You can only do so much. Some people benefit tremendously and the 1/2 day relief is considerable.

The abx generally circulate through the body, given good and appropriate absorption function in the gut... So not all of it hits the probiotics.

I'm not sure that the competition for resources between probiotics and bacteria is that straightforward. I think you can try taking them only on the off-days and see how you feel but the cause-and-effect of killing all good bacteria also allows other imbalances to develop over time and you're playing a lot of catch up on your off-days if you don't intervene before then. You might just have to try things out and troubleshoot the best approach for you.

-p
Posted 6/9/2017 6:11 PM (GMT 0)

Jay Kay said...
I have a few concerns about consuming probiotics and antibiotics simultaneously though:

1) Is there any chance that we are killing them and therefore there in not much benefit from the probiotics?
2) Will antibiotics be used up (chemical reaction) for probiotics instead of fighting the infection? At least, they will be weaker.
3) Killing probiotics will add to the inflammation and will be another burden on the body to get rid of the killed bacteria/toxins.
4) Introducing them during the off days has another advantage that they compete with the infection for resources (less food for invading bacteria).

1) If you take the probiotics close to the antibiotics - yes they will be killed. So, space them a few hours apart.
I like to take probiotics in the evening a few hours after my last antibiotic dose - so they can be in my gut while I sleep and populate.

2) I'm not sure what you mean. The antibiotics won't be weaker, no. And..you will be spacing them apart.They won't be in the stomach at the same time.

3) See #2

4) I'm not sure they compete for food sources anyway.


PLUS: It really isn't an option - to NOT take the probiotics daily. C-Difficile is a real risk with long-term antibiotic use.
Posted 6/9/2017 8:10 PM (GMT 0)
Thanks, Piro and Girlie! Very interesting and intuitive points!

To clarify (2), my understanding is that each bacteria killing = some antibiotic molecules are used (converted to other chemicals). So, if you happen to use them for killing probiotics, it is similar to taking a lower dose of antibiotics (without the added burden of cleaning killed probiotics).
Posted 6/9/2017 8:15 PM (GMT 0)
Also, would you please clarify why if probiotics are taken a few hours later, they will not be killed by the antibiotics. Isn't it the case that a lot of antibiotics will be present all the time (considering the large doses and half-life of some of these antibiotics)?

Post Edited (Jay Kay) : 6/9/2017 2:18:13 PM (GMT-6)

Posted 6/9/2017 8:36 PM (GMT 0)
The antibiotics will be present in your bloodstream, yes.


The probiotics are in you gut - in your intestines.
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