Afraid to Take rifampin, need some words

i think the main risks to be aware of and asses in any individual case is the drug interactions - due to liver enzyme interactions

here you can't pluck an assessment from the air - or from others - you just need to read the specific potential interactions for rifampicin vs each of the other drugs you are taking - and then decide if the benefits outweigh the risks - remembering that those other drugs also have risks and benefits - and the benefits of rifampicin in treating a root cause may outweigh those of the other drugs, which are mainly masking symptoms - at least for a time.

the potential liver damage effects are not something that typically occurs overnight - but tend to occur over weeks or months of continuous use - and are easily tracked by regular safety labs - ie LFT, KFT and CBC
which i would recommend anyone undertaking long term ABX combinations do.

i have not seen major psychological effects from rifampicin itself

i know others have written about cortisol lowering effects - but the scientific studies on rifampicin's effects on cortisol metabolism seem to be describing effects on cortisol half life when supplementary cortisol or steroids are being given to patients with addisons disease ( damaged adrenal glands ) - not in people with who are not taking additional cortisol.

i do not recall experiencing anything noticeable when taking it for months continuously ay 600mg / day
just mild worsening of overall symptoms for 4-6 weeks followed by very gradual mild improvement

ceftriaxone is active and useful for lyme - esp as part of combination protocols - but doesn't seem to be very effective on its own as an alternative for bartonella - rifabutin is another option that is active for bartonella -

with lyme - its easy to work oneself up into a panic over any new perceived risks - while being completely blind or desensitised to the risk of the drugs or other things one is already taking or doing.

its even easier to ignore the risk of not treating the disease at its root - viewing the disease as some kind of steady state that is unlikely to change or cause other future problems or diseases ( clearly an unrealistic view ) and thereby exposing oneself to many more risks of future complications if its not treated

i think this is one of the factors that keeps people stuck - we often focus on the near term decisions only - and avoid the pain, uncertainty or potential risks of treatment in the near term - focusing instead on symptoms and just getting through the days ( which is an entirely natural sentiment) but which leads to insufficient action on the root of the problem

like everything in lyme treatment - there are no zero risk options for effective treatment - but also greater risks or costs in terms of ill health and lost years of life in not treating - so a calm rational step by step approach to a risk vs benefit assessment is the best way to approach it.

there is little or no evidence of actual antimicrobial resistance of bartonella building in actual people

especially not in a few days

it has been achieved with a single antibiotic in the lab in ideal conditions and many passes of dosing and culturing specifically designed to promote resistance

antimicrobial resistance actually occurs rarely - and is then passed from host to host - rather than occur in each host separately - eg the occurrence of the now well known MRSA can be tracked to a single gene mutation that occurred in India some decades ago and gradually spread around the world carried by people on airplanes etc

Thanks, both of you have been very helpful.

I will start on monday.

The Thing is, i have Always believed in treating root causes in general. I'm a strong enemy of the Sunset of ME/CFS people who Just Accept their illness and do basically nothing but symptomatic Treatment. Everybody has His right to choose, but I View it as wrong

What has discouraged me is the amount of antibiotics that haven't been helpful for me so far. The only ones that ever worked at all for me were Doxycycline and Minocycline.

Cats claw = nothing, Banderole = nothing, artemesia annua = nothing, Azithromycin = nothing, Ceftriaxone= nothing, tinidazole = nothing

I have done a somewhat fair amount of antimicrobial Regimens already so you might Understand where my negativitiy comes from.

The rifampin / minocycline is a somewhat Last Resort because the Most stuff i mentioned above is inactive for bartonella, so adressing Bart instead of lyme Primary - might make a Change for me and i really Hope so.

Else I start to believe my CFS-like illness comes from somewhere Else. Not that i would ever Just Accept it (i think you know i wouldnt lol)

Thank you two again
Cheers

be prepared to give it time blazer -

often it has taken our bodies decades to reach the point of collapse - and antibiotics are not a quick fix
they can help to start moving the needle in the right direction - but often there needs to be a lot of other supportive treatment, lifestyle changes etc to help the body get back on proper terms with its environment

i took rifampicin doxycycline and azithromycin for around 6 months - i had some improvement - but not night and day - and bartonella was clearly visible in my blood afterwards

i don't mean to discourage you from taking the antibiotics - just to have realistic expectations
and it can be quicker than that for some people - but best to be prepared - and not shoot off on a tangent if things don't go as hoped

hope it goes well for you

all the best!

Yeah, i do wanna get rid of the infection thats why I have treated before

@pinkblossom: my experience with Phoenix Rising is mainly good but for lyme,Bart,Babs questions this Forum Here is the absolute Gold Standard. People on Phoenix Rising are Not discouraging and CDC worshippers and they are indeed very helpful but AS you See its quite obvious: PR Forum is more broad spectrum and healingwell/lyme is focused on one specific Thing.

Both Forums have their Advantage and I am Happy i use both. I would place my lyme questions Here however.

@garz: thanks for letting me know your Treatment has taken time aswell. I mean yeah it Takes time getting better right?

I myself have finally moved from Bedbound to Housebound with Lots of stuff I do and I am very Happy about that. But yeah, Its good to Recall that this step has taken Lots of time and effort aswellm

Cheers and thanks for having me

No effect at all. The only Things that ever helped me were:
- Citalopram
- Mino, Doxy
- PACING
- black seed oil
- adressing mitochondria (d-ribose, NAD+, NAC, Q10)
- Breathing exercises

Only issue I had with rifampin was teeth staining (plaque build up in between teeth, looked like black lines formed) plus a really weird taste in the mouth with that. I think it altered my oral microbiome. Couple years later and the staining stopped (cleaned easily by dentist but would come right back - no longer comes back).

I still have an odd taste in my mouth at times but I’m less certain that’s rifampin related.

Hey blazer!

I'd focus on what bad effects from rifampin could not be undone after a small course. Like garzie said, I don't think it would cause permanent liver issues that quickly. Same with cortisol and other issues. I think it's unlikely, to cause permanent harm from a short simple test. It's not like levaquin which can rupture your tendons (permanent damage).

So just small and work up.