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Biaxin/Rifampin combo for...lyme?

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Posted 7/15/2012 4:29 AM (GMT 0)
So I went to see my doctor today - after a couple of amazing months on Buhner's protocol, I went to see my LLMD today and my CD 57 is still in the 30s (after having been 58 last time!) so I begrudgingly agreed I need more abx.

Currently I'm on biaxin 500mg BID for a wicked sinus infection for 2 weeks, then the plan (which changes every 5 minutes with this doctor) is to go to biaxin "full time," along with rifampin. I was under the impression that this combination is usually used for bartonella? It's weird, actually, as I was arguing with her about my belief that my CD57 won't go up because I have undiagnosed/untreated bart, I told her that my bart-specific herbs have really helped in that department (my anxiety is literally just GONE with herbal remedies!) - I think that got through to her and she might be treating me for bart without actually telling me? Which is fine with me.

Apparently biaxin is good for the intracellular form and rifampin for the cyst? Any thoughts? And - awkward question but - biaxin...does it give you orange urine? I certainly hope so!

Posted 7/15/2012 12:02 PM (GMT 0)
Hi border,

Hope the new meds get you back on track.

My doc had me on Biaxin and rifampin and Bart was not one of the the things I was troubled with.

It's the rifampin that stains the urine, tears and feces red (or orange). I found it only really did it at first. BTW, don't take Milk Thistle with rifampin!!
Posted 7/15/2012 12:41 PM (GMT 0)
Hi,

I have been put on the same combo - according to my LLMD rifampin is also active against the cyst form of lyme so I guess one could consider it as targetting lyme with bartonella coinfection.

AG - why no milk thistle with rifampin? Do you have a source for this info?

Thanks, Hugh
Posted 7/15/2012 12:44 PM (GMT 0)
I get bright orange urine on Rifampin. It's gross. My LLMD warned me about it before I started taking it. It can also stain contacts apparently, but I haven't had that problem yet.

I haven't heard of Rifampin being used for they cystic form. I thought only Flagyl, Tindamax, GSE and possibly Plaquenil could be used for that but maybe not.

I took biaxin but only for a short time because my liver enzymes went up really high. I had an episode of extreme OCD on biaxin but I'm starting to think it was something else that caused it because it's been happening again lately.

I hear that Rifampin can be very hard on the liver. For some reason my liver enzymes finally went into the normal range after several weeks on 600mg of Rifampin. Everyone was pretty surprised by that result. We were expecting my liver to give me a hard time with this med. Nevertheless, I would be careful and have them watch your liver enzymes on Rifampin. I've been on it for about a month and so far I don't feel any better. I take it on an empty stomach early in the morning. I'm noticing a lot more pain (muscle, bone, joint) and twitching/spasms on Rifampin. I've also had some pretty severe mid-day exhaustion that makes it nearly impossible to work. I was warned to expect really bad headaches from Rifampin, but so far I have not had any.

I also have a really low CD57. What range does your doctor want to see it in? Mine is supposed to get up over 150 before considering switching to all herbs or maintenance. I'm getting worried because mine has stayed under 20. My LLMD doesn't even want to check it right now because he's worried it dropped further.

I did not know you can't take milk thistle with Rifampin. Thank you for mentioning this achievinggrace. Do you know why you can't take them together?
Posted 7/15/2012 1:07 PM (GMT 0)
Borderlyme-
Which herbs did you find most helpful for your anxiety and bart symptoms? Thanks
Posted 7/15/2012 1:10 PM (GMT 0)
Ive just read up on rifampin milk thistle interactions and it seems that whilst rifampin upregulates liver pathways the milk thistle does the opposite. The concern seems to be that the milk thistles effect can lead to higher than intended levels of rifampin in the body as a consequence. It does appear however that some people are using the two and report no difficulties with LFTs. An alternative, although less potent, to milk thistle for use with rifampin is curcmin apparently.

Love to hear everyones thoughts on this as am on MT and due to start rifampin tomorrow!

BTW LLMD prescribed both for me!

Hugh
Posted 7/15/2012 2:31 PM (GMT 0)
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1865122/pdf/nihms20441.pdf

Gives good support for the use of milk thistle and rifampin together.

Hugh
Posted 7/15/2012 7:17 PM (GMT 0)
The milk thistle warning was on the info sheet I got with my Rifampin Rx. I didn't look into it any further than that.
Posted 7/16/2012 1:01 AM (GMT 0)
It's hard to say whether any specific herb is helping or of its the combination/the fact that I've healed that symptom. I take a eleuthero tincture which helps with the agitation and low stress tolerance, andrographis has a mild sort of numbing effect, on my body and my mind. I'm also taking knotweed, cat's claw, and red root so, like I said it's tough to tell what's what but the knotweed and red root specifically act on bartonella, as far as I know.

Thanks for the milk thistle tip - I'll have to look into that one! I haven't started rifampin yet, for now we're just doing biaxin to get rid of this nasty sinus infection - although I think it's making me herx anyway - you can't really tell the abx which bacteria to kill!

Posted 7/31/2012 8:54 AM (GMT 0)
How are you doing on this combo? I am thinking of adding biaxin, but on an interaction checker it says that biaxin combined with Rifampin will lower the biaxin's effects and also increase the Rifampin effects which can have adverse liver effects. It's listed to avoid this combo. Has anyone heard of this?

Zith isn't covered for me so I'd like to do biaxin, but since I just got my liver under control, I'm not sure if it will be a good idea.
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