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Posted 11/27/2022 1:02 AM (GMT 0)
I'm having some bad issues with my urethra I'd say and not exactly sure what's causing the pain during urinating. It feels like a tiny parasite is literally opening its teeth inside my urethra then a tugging sensation and me feeling the need to urinate. Similar to cystitis. Im taking bactrim (since its a very broad spectrum abx) in case even though uti was negative (some bacteria can't be cultured or found) and the bactrim is barely touching the pain or issue, and I'm taking metronidazole . Can the bactrim be causing a bart flare seeing that I'm so fatigue and experiencing more anxiety?? It's an out of nowhere knocked on my a** type tired with anxiety out of no where. My heart will start beating faster and I'll feel extremely anxious like on edge just like when I have my ptsd an there's touch chaos. Been on bactrim 3 days and this started up but idk thinking it's a bart flare. While on the abx I also started getting sharp rib cage pain like shooting pains. Felt like when I breath it got sharper. So I don't confuse anyone this post is about bactrim and now fatigue, anxiety, and rib pain with nausea. I brought up the urethra issue as this is the reason I'm taking bactrim in the first place. Also had burning feet today .
Posted 11/27/2022 1:24 AM (GMT 0)
Sounds like it could be. I have seen folks use bactrim for bart so it seems like it has action against it. Have you been treating for bart?
Posted 11/27/2022 4:52 AM (GMT 0)
Yup - bactrim is used to treat Bartonella - could be a herx
Posted 11/27/2022 12:34 PM (GMT 0)
It could be a herx, but... Trimethoprim (component of bactrim) is known to mess with sodium excretion in the kidneys. If you have a history of kidney problems this seems a risky thing to take. Also metronidazole caused me high blood pressure.

"knocked on my a** type tired with anxiety out of no where" seems like adrenal insufficiency, and bactrim + flagyl seems rather high risk for someone with adrenal problems, since messing with your blood pressure and sodium/potassium is going to put more stress on your adrenals.
Posted 11/27/2022 2:22 PM (GMT 0)
sounds like a pretty typical herx reaction to me from treating

ramped up anxiety
fatigue
rapid heart beats
aches and pains

all are typical herx signs

it could be that you have to ease off treatment a little or take breaks for a few days at a time if it gets too much to manage - juts go at a pace you can sustain

indeed chronic UTI's have recently been found to be another biofilm forming infection. they can be culture negative - as biofilm forming infections can be very hard to culture - or the organism responsible simply does not grow in the culture medium they lab is using.

i think it quite likely that something like Bart - if present - inflamed and weakens the tissues in the urinary tract - which then allows something else to take hold ( much like it does in the gut and causes dysbiosis etc ).

biofilm forming infections are often hard to treat and recurrent - like middle ear infections for instance - this may be why they do not always respond fully to the normal few weeks of antibiotics - which is i think what you have described.
for this reason - i think if it were me - i would think in terms of longer term treatment with the use of some biofilm disrupting agents to try to help the abx to do their job.

you may have to go slowly - especially at first - as people with chronic infections often react v strongly to biofilm agents - so the process might be a gradual phased approach - introducing one thing at a time - and building the dose over time.
Posted 11/27/2022 7:08 PM (GMT 0)
As Quin mentions, Bacrim can mess with kidneys. I can't take it. Doesn't mean it would happen with you.

And going slow, as Garze mentions, is something I find a good thought. Bu8ilding up can't hurt anything, but there's no going back from higher doses that cause herx. You have to ride the herx out. Don't know if what you are are experiencing is a herx, but there is a chance it is.

I've had a herx hit a week after I start something.
Posted 11/28/2022 1:27 AM (GMT 0)
bactrim is a folate inhibitor btw . i had a sulfa reaction 7-10days in and burned the linings of my blood vessels and seared my nerve endings with a mild sjs reaction. not everything is a herx .....
Posted 11/28/2022 1:52 AM (GMT 0)
MCAS can cause interstitial cystitis, so that's what comes to mind for me when I hear about UTI symptoms with negative cultures and no response to meds. MCAS also gives me the other symptoms you mentioned - knocked on my a** tired, anxiety, fast heart rate, nausea. I have a history of costochondritis, so the added inflammation of an MCAS flare leads to rib pain, too. Just another angle to consider! MCAS can be triggered by infections, a recent virus, stress, or herxing, so it can come up for a lot of reasons.
Posted Yesterday 2:46 AM (GMT 0)
I also got fatigue and anxiety from low folate. Not as much from bactrim, but definitely from malarone (proguanil).

If you're taking any of those meds, you should be having blood tests to check your folate.

I don't know why you started with flagyl + bactrim. That is an effective way to kill bartonella, but rather risky due to the side effects. I had pretty good success with minocycline+atovaquone+azithromycin, which has fewer side effects. There is a risk that bartonella becomes resistant to azithromycin, but combining it with other drugs seems to overcome that. If you take minocycline, you should pulse it, since it suppresses the immune response you'll want to take a day or two off to let your immune system recover.
Posted 12/4/2022 4:43 AM (GMT 0)

Quin said...
I also got fatigue and anxiety from low folate. Not as much from bactrim, but definitely from malarone (proguanil).

If you're taking any of those meds, you should be having blood tests to check your folate.

I don't know why you started with flagyl + bactrim. That is an effective way to kill bartonella, but rather risky due to the side effects. I had pretty good success with minocycline+atovaquone+azithromycin, which has fewer side effects. There is a risk that bartonella becomes resistant to azithromycin, but combining it with other drugs seems to overcome that. If you take minocycline, you should pulse it, since it suppresses the immune response you'll want to take a day or two off to let your immune system recover.

Never thought of folate huh. I did however start taking sublingual b12 which dissolves under tongue. I've had the most energy I've had in years. Not much fatigue anymore. My b1 also low so I wouldn't doubt low folate, plus having the MTHFR gene as well.
Posted 12/4/2022 4:44 AM (GMT 0)

morningstars said...
Sounds like it could be. I have seen folks use bactrim for bart so it seems like it has action against it. Have you been treating for bart?

..No just loads of detox. My llmd just sent out a prescription for bactrim and azithro to start me up on. The old bactrim was for a uti.
Posted 12/4/2022 4:47 AM (GMT 0)

Girlie said...
Yup - bactrim is used to treat Bartonella - could be a herx

I've had terrible herxes where I thought I would die ,so this was a lot lighter. The fatigue was noticeable though I'd say.
Posted 12/4/2022 4:52 AM (GMT 0)

Quin said...
It could be a herx, but... Trimethoprim (component of bactrim) is known to mess with sodium excretion in the kidneys. If you have a history of kidney problems this seems a risky thing to take. Also metronidazole caused me high blood pressure.

"knocked on my a** type tired with anxiety out of no where" seems like adrenal insufficiency, and bactrim + flagyl seems rather high risk for someone with adrenal problems, since messing with your blood pressure and sodium/potassium is going to put more stress on your adrenals.



My llmd didn't seem concerned or bother to mention high risk for adrenal fatigue. He just sent me a prescription for bactrim and azithromycin out too. However I do use salt and take potassium to replace all the salt or sodium lost during adrenal fatigue, so should that help??
Posted 12/4/2022 4:55 AM (GMT 0)

Garzie said...
sounds like a pretty typical herx reaction to me from treating

ramped up anxiety
fatigue
rapid heart beats
aches and pains

all are typical herx signs

it could be that you have to ease off treatment a little or take breaks for a few days at a time if it gets too much to manage - juts go at a pace you can sustain

indeed chronic UTI's have recently been found to be another biofilm forming infection. they can be culture negative - as biofilm forming infections can be very hard to culture - or the organism responsible simply does not grow in the culture medium they lab is using.

i think it quite likely that something like Bart - if present - inflamed and weakens the tissues in the urinary tract - which then allows something else to take hold ( much like it does in the gut and causes dysbiosis etc ).

biofilm forming infections are often hard to treat and recurrent - like middle ear infections for instance - this may be why they do not always respond fully to the normal few weeks of antibiotics - which is i think what you have described.
for this reason - i think if it were me - i would think in terms of longer term treatment with the use of some biofilm disrupting agents to try to help the abx to do their job.

you may have to go slowly - especially at first - as people with chronic infections often react v strongly to biofilm agents - so the process might be a gradual phased approach - introducing one thing at a time - and building the dose over time.

What's good for breaking up biofilms for uti? Is pau d'arco good for it, I've heard it is? I hadn't started treatment yet, I was using bacteim strictly for uti symptoms, but then noticed fatigue. B12 definitely boost me up and helped though.
Posted 12/4/2022 4:57 AM (GMT 0)

Quin said...
I also got fatigue and anxiety from low folate. Not as much from bactrim, but definitely from malarone (proguanil).

If you're taking any of those meds, you should be having blood tests to check your folate.

I don't know why you started with flagyl + bactrim. That is an effective way to kill bartonella, but rather risky due to the side effects. I had pretty good success with minocycline+atovaquone+azithromycin, which has fewer side effects. There is a risk that bartonella becomes resistant to azithromycin, but combining it with other drugs seems to overcome that. If you take minocycline, you should pulse it, since it suppresses the immune response you'll want to take a day or two off to let your immune system recover.

I haven't started treatment yet, the bactrim was just for a suspected uti. My llmd just sent out a prescription for bacrim and azithromycin though to start me on for treatment.
Posted 12/4/2022 5:04 AM (GMT 0)

running wild said...
As Quin mentions, Bacrim can mess with kidneys. I can't take it. Doesn't mean it would happen with you.

And going slow, as Garze mentions, is something I find a good thought. Bu8ilding up can't hurt anything, but there's no going back from higher doses that cause herx. You have to ride the herx out. Don't know if what you are are experiencing is a herx, but there is a chance it is.

I've had a herx hit a week after I start something.

[Quote] Bu8ilding up can't hurt anything, but there's no going back from higher doses that cause herx. You have to ride the herx out

Why can we not go back from higher doses? Do you mean once we're on a higher dose that we can't back down to a lower dose ? Then the treatment wouldn't work?
Posted 12/4/2022 5:28 PM (GMT 0)

MedicalNerd said...


What's good for breaking up biofilms for uti? Is pau d'arco good for it, I've heard it is? I hadn't started treatment yet, I was using bacteim strictly for uti symptoms, but then noticed fatigue. B12 definitely boost me up and helped though.

many herbs have some anti-biofilm properties - pau d'arco is one of them i think - but i take a huge amount of herbs and still have biofilm in my blood in my microscopy slides, so i cannot really attest to how effective they are on their own.

if it were me i would wait until i was stable on the abx first

then try adding small amounts of some of the well known biofilm agents used in lyme and bart

try one at a time

only a little to start with - wait a few days to gauge reactions

expect increased herx

candidates i would try
-xylitol
-lactoferrin
-bromelain
Posted 12/4/2022 8:13 PM (GMT 0)

MedicalNerd said...
My llmd didn't seem concerned or bother to mention high risk for adrenal fatigue. He just sent me a prescription for bactrim and azithromycin out too. However I do use salt and take potassium to replace all the salt or sodium lost during adrenal fatigue, so should that help??

Replacing the sodium and potassium did solve the headaches I would get from salt loss. The bigger problem that I had with adrenal fatigue was the pituitary response which would secrete high levels of ACTH and beta-endorphin. The beta-endorphin caused a lot of gut motility issues, and resulted in insulin resistance which messed with my blood sugar. LDN worked somewhat, but eventually I needed to take hydrocortisone.
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