Wow, interactions are a mine field. I'm not sure whether to over think it (my usual response) or throw up my hands in despair. Although I'm not real keen on antibiotics anyway.......
One little gem, from an MD who taught pharmacology when I was in the four year Master's program for traditional Chinese Medicine: Once you put together three or more drugs (I'm pretty sure he would include herbal medicines) you *can not predict* the interactions.
In other words, even with the best of information, which nobody has on Lyme and co, you are unlikely to be completely safe by looking up the drugs and herbs on a list and not mixing A with B, and so on.
On the other hand, most Chinese and Tibetan doctors that I know, say that if you have to take both herbs and pharmaceuticals, leave at least a two hour gap between them.
And I know that in Chinese medicine, probably also in Tibetan, if a formula is giving side effects, it gets changed. sometimes very small tweaks make a huge difference. TCM capitalizes on the interactions and puts them to use.
And all of us with chronic Lyme have our immune systems kinda messed up.
So, my plan: Add herbs one by one, in small amounts, at least a few days apart. Look for unpleasant reactions. Be especially careful with ones that are known for bad side effects in some people. And go with your intuition. Buhner suggests all of these precautions.
And I would add, some of the herbs are more like food, with lower potential toxicity, and some are out and out detoxifiers. Which doesn't mean that they won't cause problems for YOU, just look at all the common food intolerances! But these are the first ones to combine with pharmaceutical antibiotics, because they are more likely to complement the antibiotic approach.