Cortisol and antibiotic questions

I was just diagnosed with Lyme. My LLMD was able to get me in yesterday evening for a phone consult. He is starting me this weekend on lots of probiotic, good yeast, and a low (very low .8mg) cortisol. He's starting me Monday on Cephalexin, Flagyl on Wed., and Azithromycin on Fri. I went to pick up the Cephalexin from the pharmacy today and the pharmacist made me really nervous. She said the dosage is 3 times the normal dosage and that she was concerned. I also feel like this is a LOT of antibiotics to start in such a short amount of time. Is this "normal" for Lyme treatment? This many antibiotics and at this high of a dose? Also, I keep reading that cortisol is not good w/ Lyme disease. All of this is making me nervous, but at the same time I don't have much choice. I have to try something!

Hi Mysteryillness,

I have had the pharmacy say the same thing to me many times. Usually it's the one that doesn't get any Lyme patients (big chain pharmacy in my area). The antibiotic doses need to be higher in Lyme. It's relatively safe and common for LLMD's to give more than one antibiotic at a time to combat the several different forms of Lyme along with co-infections. Using more than one helps to prevent resistance. You have Flagyl for the cystic form, azithromycin for the cell-wall deficient and I suppose cephalexin for the spirochete (although that one is less commonly used).

I have also been on cortisol. You are on a physiological dose likely to help your adrenals? This is different than a pharmacological dose which would be immune suppressive. It's safe to take that dose. 0.8 is VERY low. I was taking 10mg per day. Your own body (when healthy) produces the equivalent of about 30 mg of cortisol a day, so up to that amount is considered okay.

That being said, if you are uncomfortable with your treatment you should definitely talk to your LLMD and have him or her explain their rationale behind the meds. It can be very scary to take all these meds and I think sometimes doctors forget that people like to understand exactly why they are taking them and what the function is.

Good luck!

You will want to work up to those doses, and certainly introduce each new antibiotic after you have made sure you haven't reacted to the previous one.

There is a temptation to "throw everything at this disease" but remember, the laws of physics apply here: For every action there is a reaction!!