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Is my Virus Herxing or Abilify failing?

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Posted 3/25/2024 1:57 AM (GMT 0)
My wife has been treating Lyme, Bart, Bab, Anaplasmosis for years and has had success pulsing IV Antibiotics that we do at home with a picc line. (in addition to a host of other meds for treatment and support)

She tests high for viral load and has been at a stead dose of Valtrex 500mg BID for the past many years.

She had very low energy and high body aches until this past Fall when we added 2mg Abilify to her 30mg Citalopram. Instant energy. Hiking every day, yoga, driver herself, etc. Game changer. It worked so well she dropped her Citalopram to 20, then to 10mg within the first month.

A couple months ago we upped her Valtrex really quickly to 1000mg Valtrex BID. It clobbered her so we dropped it to 1500mg total a day. She's still really suffering from high anxiety, intrusive dark thoughts, really really low energy and higher aches and pains.

I didn't realize Valtrex supposedly went after Bart Bab and Borellia. Thought we were just just mostly managing her viral load while immune system overwhelmed.

Does this set of symptoms which has been pretty steady for the past couple months sound like Valtrex herx or does it sound more like the Abilify stoped working.

Thoughts and experience with Valtrex herx appreciated.

Help please. Is she herxing or has the Abilify stopped working and needs a reset??
Posted 3/25/2024 2:49 AM (GMT 0)
Lyme in particular seems to be susceptible to Valtrex. I herxed pretty bad from it.

https://www.healingwell.com/community/default.aspx?f=30&m=4304866
https://www.healingwell.com/community/default.aspx?f=30&m=4313527
https://www.healingwell.com/community/default.aspx?f=30&m=4327214
https://www.healingwell.com/community/default.aspx?f=30&m=4331414
Posted 3/25/2024 3:33 AM (GMT 0)

Quin said...
Lyme in particular seems to be susceptible to Valtrex. I herxed pretty bad from it.

https://www.healingwell.com/community/default.aspx?f=30&m=4304866
https://www.healingwell.com/community/default.aspx?f=30&m=4313527
https://www.healingwell.com/community/default.aspx?f=30&m=4327214
https://www.healingwell.com/community/default.aspx?f=30&m=4331414

Thanks. She’s been on it for a long time. Probably 6+ years at 500x2 daily. I wouldn’t expect such a marked change with a dose increase at this point. That’s what has me questioning it in this case.
Posted 3/25/2024 3:12 PM (GMT 0)
Is there a chance the long-term Valtrex has damaged her liver, causing some of these symptoms? That's one angle to check when long-term antivirals. I hope she gets back to a better baseline soon!
Posted 3/25/2024 3:33 PM (GMT 0)
I think (could be wrong) that anti viral medications are much more associated with kidney damage rather than liver damage. I took valtrex and another anti viral medication acyclovir for years and had kidney function tested regularly whilst I was on them for this reason
Posted 3/25/2024 3:46 PM (GMT 0)
Yeah kidney and liver Fx constantly being monitored.
Posted 3/25/2024 8:00 PM (GMT 0)
IMO it sounds just as likely infections are causing symptoms being that they’re not being maintained.

It’s hard to know which infections are causing which symptoms hence why comprehensive approaches are favorable.

Generally a herx should go away 1-2 weeks after stopping the cause. So that might be the only way to know if the Valtrex is indeed causing this.

Sometimes we also just don’t handle things well on an individual level.

Sounds like some experimentation with the prescribing doc might be appropriate.
Posted 3/25/2024 8:22 PM (GMT 0)
for info

if the diagnosis of "high viral load" is based on serologic tests

there is very limited awareness in the lyme community that there is known cross reactivity between antibodies to several common viruses - especially those in the herpes family (notably EBV and CMV - but likely others also) - and borrelia (lyme)

as a result - serologic testing - cannot reliably differentiate between borrelia infections and these viral infections. a patient with positive serology may have one, the other, or both - or simply been exposed to one in the past - serology cannot really tell which.

despite this being well documented in the scientific literature - many doctors - even LLMD's are known to diagnose and treat chronic viral infections with long courses of antiviral medications based on serologic tests - and seem unaware - or gave insufficient weight to - the cross reactivity issue.

direct molecular methods - like PCR - are specific for viruses - and can differentiate between active viral infections like EBV - and borrelia infections

often in these cases there are unusual patterns to the serologic results - like very high titres of one EBV antibody but low or non existent titres of another EBV antibody - normally expected to go along with it. very high titres and unusual patterns are red flags that something unusual is going on.

members here have had very high EBV titres and yet negative PCR tests

conversely - as posted by Quin - there are papers out there showing some antiviral medications may have off target effects on bacterial organisms - which is not well researched and therefore also serves to add confusion to the true underlying cause.

just wanted to post this in case it helps you navigate your wife's case
Posted 3/26/2024 3:07 AM (GMT 0)

Garzie said...
conversely - as posted by Quin - there are papers out there showing some antiviral medications may have off target effects on bacterial organisms - which is not well researched and therefore also serves to add confusion to the true underlying cause.

Yes, research in vitro found that borrelia burgdorferi is vulnerable to several antiviral drugs

https://www.ncbi.nlm.nih.gov/pmc/articles/pmc4790293/

The good news is that valtrex can kill borrelia and get rid of it. I got better after taking valtrex. Just be careful with the herx and the side effects.
Posted 3/26/2024 4:44 AM (GMT 0)
She’s been on it for 6+ years though. More like 8 I bet. I’m super surprised if being on it for that long at 1000mg/day, and increasing it to 1500 at this point has such a drastic impact.

I’ve been surprised before though.
Posted 3/26/2024 12:33 PM (GMT 0)
Since she’s been treating for so long without recovery, I am wondering if there may be mold exposure involved. Have you looked into that at any point?
Posted 3/26/2024 4:33 PM (GMT 0)
Yeah we have and luckily it isn’t an issue. I don’t remember the test used but we’ve been seeing some terrific doctors, primarily Steven Harris. We e had some setbacks that interrupted treatment but it’s been pretty steady progress from bed-ridden and seizures with a 9/10 headache (for years) to hiking and yoga and gardening and skiing 🤘
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