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Can you take Artemisinin with Mino/Rifampin?

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Posted 6/15/2018 1:22 PM (GMT 0)
Hi all,

Been treating Bart with Mino and Rifampin since last week of April and feeling amazing. However, I am concerned about possible return of Babesia and want to be proactive - my LLMD suggested I finish the 3 months of Bart (I see him at the end of July and plan to discontinue Abx after that) and then take Artemisinin for 4 months just to be sure. I had treated Babs duncani with 1 month of Mepron/Zith and 2 months of Coartem/Zith prior to beginning Bart treatment. We actually have some doubt if I ever had Babs or not (all I ever had was one “equivocal” Igenix test and none of the hallmark symptoms. I also didn’t really get much better when treating for it and instead made tremendous gains when attacking Bart. Only thing that may suggest I had Babs was that I yawned quite often the first few weeks of treatment (air hunger?).

Anyways, can I take Artemisinin now with this protocol? If so, what dosing do people usually do? My LLMD suggested 500mg 3x/day for the 4 months once done with Abx.
Posted 6/15/2018 3:00 PM (GMT 0)
The only concern that I am aware of is you don't want to overwhelm your liver and artemisinin is processed through the liver. I can't recall if Rifampin and Mino are but most drugs are at least partially. I'm so glad you are feeling better!!!

At the time I was in treatment my herbalist was concerned about artemisia being a bit rough so I used a red blood cell protector (sida acuta). That protects red blood cells but does not kill parasites. I think there are other RBC protectors but that is the one that I recall.

Don't let your concerns guide your treatment, let your body guide you-with the help of your physicians!

~beth
Posted 6/15/2018 4:36 PM (GMT 0)

opugirl said...
The only concern that I am aware of is you don't want to overwhelm your liver and artemisinin is processed through the liver. I can't recall if Rifampin and Mino are but most drugs are at least partially. I'm so glad you are feeling better!!!

At the time I was in treatment my herbalist was concerned about artemisia being a bit rough so I used a red blood cell protector (sida acuta). That protects red blood cells but does not kill parasites. I think there are other RBC protectors but that is the one that I recall.

Don't let your concerns guide your treatment, let your body guide you-with the help of your physicians!

~beth

Thank you for the advice! Is there anything else besides sida acuta or artemisinin in the herbal world that may help?
Posted 6/15/2018 4:42 PM (GMT 0)
We've had discussions on the Cytochrome p450 herbs/meds and the interactions.

I go 'round and 'round on this.


Artemisinin is on the list...so is Rifampin.

It's complicated - some on the list are inducers...others' are inhibitors.


BUT, I have been prescribed Artemisinin and Artesunate (a stronger form/concentrate of Artemisia) while taking Rifampin.

Here's a thread on it...including a post with a link to the list of meds and some herbs.



/www.healingwell.com/community/default.aspx?f=30&m=3748094


But, what should be adhered to is pulsing the Artemisinin. (not whole herb artemisia) -
Most LLMD"s agree with this.
What is the schedule? Depends on who you talk to.
The small intestine can create an enzyme that will render the Artemisinin useless...if you don't pulse.

LLMD MR says after 3 days you need a break - and has his patients take 7 days off.

My LLMD has patients pulse it M/W/F (but he pulses all the meds)

I've also seen 7 days on and 7 days off.
Posted 6/15/2018 4:43 PM (GMT 0)

Solaris719 said...

opugirl said...
The only concern that I am aware of is you don't want to overwhelm your liver and artemisinin is processed through the liver. I can't recall if Rifampin and Mino are but most drugs are at least partially. I'm so glad you are feeling better!!!

At the time I was in treatment my herbalist was concerned about artemisia being a bit rough so I used a red blood cell protector (sida acuta). That protects red blood cells but does not kill parasites. I think there are other RBC protectors but that is the one that I recall.

Don't let your concerns guide your treatment, let your body guide you-with the help of your physicians!

~beth

Thank you for the advice! Is there anything else besides sida acuta or artemisinin in the herbal world that may help?

For Babesia - Crytolepis is often used.
Posted 6/18/2018 12:07 PM (GMT 0)

Girlie said...
We've had discussions on the Cytochrome p450 herbs/meds and the interactions.

I go 'round and 'round on this.


Artemisinin is on the list...so is Rifampin.

It's complicated - some on the list are inducers...others' are inhibitors.


BUT, I have been prescribed Artemisinin and Artesunate (a stronger form/concentrate of Artemisia) while taking Rifampin.

Here's a thread on it...including a post with a link to the list of meds and some herbs.



/www.healingwell.com/community/default.aspx?f=30&m=3748094


But, what should be adhered to is pulsing the Artemisinin. (not whole herb artemisia) -
Most LLMD"s agree with this.
What is the schedule? Depends on who you talk to.
The small intestine can create an enzyme that will render the Artemisinin useless...if you don't pulse.

LLMD MR says after 3 days you need a break - and has his patients take 7 days off.

My LLMD has patients pulse it M/W/F (but he pulses all the meds)

I've also seen 7 days on and 7 days off.

Thank you Girlie. I'm having a little trouble following the inhibitor/inducer thing. I don't mind if taking something will increase the amount of rifampin in my blood, I just don't want to take something that will reduce levels. Is Artemisinin something that will inhibit (and thereby increase blood levels) or vice versa?

Also, do you happen to have a link the the study or research that Artemisinin needs to be pulsed? I'd like to bring it to the attention of my LLMD if he isn't aware of it already.

Post Edited (Solaris719) : 6/18/2018 6:13:30 AM (GMT-6)

Posted 6/18/2018 12:13 PM (GMT 0)
Also, what about taking Artemisia instead of artemisinin? Does that have to be pulsed? Can I take that with Rifampin/mino?
Posted 6/18/2018 12:18 PM (GMT 0)
the german clinic i treat at is having artemisinin+rifampin+mino as their core protocol to treat lyme (plus zithromax) - i would assume it would not have been there for so many patients if there were a problem, they treated tens of thousands so far.
Posted 6/18/2018 2:15 PM (GMT 0)
I am so happy for you, that you are feeling better!!

Since we kind of had all the same symptoms, this gives me lots of hope!!

I switched to mino/rifampin combo just a couple weeks ago and havent felt any different. I thought I was starting to make progress with biaxin and rifampin, but my doc really thought mino was better. So since starting it I feel like I took a couple steps back.

On this combo when did you start feeling completely different?

One other thing... did you have issues with alcohol? I can't even drink a beer without feeling extremely dizzy and I've been like that since being sick for the last couple years.

Did that get better for you?

Post Edited (NicHostetler) : 6/18/2018 9:18:34 AM (GMT-6)

Posted 6/18/2018 4:29 PM (GMT 0)

NicHostetler said...
I am so happy for you, that you are feeling better!!

Since we kind of had all the same symptoms, this gives me lots of hope!!

I switched to mino/rifampin combo just a couple weeks ago and havent felt any different. I thought I was starting to make progress with biaxin and rifampin, but my doc really thought mino was better. So since starting it I feel like I took a couple steps back.

On this combo when did you start feeling completely different?

One other thing... did you have issues with alcohol? I can't even drink a beer without feeling extremely dizzy and I've been like that since being sick for the last couple years.

Did that get better for you?

Nich - I lost several symptoms on riffy and mino - was on it for over a year - did switch to Biaxin and Rif for a few months.
Tailbone pain, right knee pain (flared first), right shoulder tendonpathy, swollen and painful clavicle lymph node, rib pain, bakers cysts, etc
Posted 6/18/2018 4:56 PM (GMT 0)
I think taking arteminisin is not a good idea, unless your are currently having babesia symptoms. I think you have to wait till the bugs are active to kill them off. You could still try some and see what happens.

Also it seemed to bother my liver, but I think I was getting liver problems already-I turn yellow if I don't take milk thistle.
Posted 6/18/2018 5:21 PM (GMT 0)
Dr. J in DC overlaps Artemisinin with Rifabutin so its ok to take at same time.

Rifabutin alone has some action but pairing it with Minocycline really does something. what i don't know but its kicked my butt quite a few times. currently i'm doing 3 consecutive days a week of my monthly cycle doing Rifabutin/Bactrim/Mino. it's a potent combo.
Posted 6/18/2018 6:43 PM (GMT 0)

Notime4lyme said...
I think taking arteminisin is not a good idea, unless your are currently having babesia symptoms. I think you have to wait till the bugs are active to kill them off. You could still try some and see what happens.

Also it seemed to bother my liver, but I think I was getting liver problems already-I turn yellow if I don't take milk thistle.


Not according to Dr. J in Washington, DC. Babesia is treated first - as he says it often blocks the treatment of the others'.
Posted 6/18/2018 6:43 PM (GMT 0)
The whole herb (Artemisiae ) is not pulsed...like the Artemisinin is.
Posted 6/18/2018 8:15 PM (GMT 0)

NicHostetler said...
I am so happy for you, that you are feeling better!!

Since we kind of had all the same symptoms, this gives me lots of hope!!

I switched to mino/rifampin combo just a couple weeks ago and havent felt any different. I thought I was starting to make progress with biaxin and rifampin, but my doc really thought mino was better. So since starting it I feel like I took a couple steps back.

On this combo when did you start feeling completely different?

One other thing... did you have issues with alcohol? I can't even drink a beer without feeling extremely dizzy and I've been like that since being sick for the last couple years.

Did that get better for you?

I noticed a big difference after 4 weeks - the color in my face returned, appetite improved, rapid heart rate/POTS resolved, and anxiety improved. I did the first week at 1x300mg per day and then after that the full does of 300mg morning and night - had to take 2 days off after the 3rd week due to herx-like symptoms, but after that it's been pretty great (until a few days ago - I'm gunna post a new thread after I respond in here, feels like I'm relapsing with babesia).

As for alcohol, I had my first drink in prob 8 months last Saturday (during a 2 day Abx break) and had 1/2 of a vodka club at the restaurant with my wife without issues, but I didn't want to push it. Can't wait to have some craft beer again!
Posted 6/18/2018 9:17 PM (GMT 0)
I was getting confused about babesia . . . I think I'm having a little more brain fog then I realized.
Posted 6/19/2018 1:12 PM (GMT 0)

Solaris719 said...

NicHostetler said...
I am so happy for you, that you are feeling better!!

Since we kind of had all the same symptoms, this gives me lots of hope!!

I switched to mino/rifampin combo just a couple weeks ago and havent felt any different. I thought I was starting to make progress with biaxin and rifampin, but my doc really thought mino was better. So since starting it I feel like I took a couple steps back.

On this combo when did you start feeling completely different?

One other thing... did you have issues with alcohol? I can't even drink a beer without feeling extremely dizzy and I've been like that since being sick for the last couple years.

Did that get better for you?

I noticed a big difference after 4 weeks - the color in my face returned, appetite improved, rapid heart rate/POTS resolved, and anxiety improved. I did the first week at 1x300mg per day and then after that the full does of 300mg morning and night - had to take 2 days off after the 3rd week due to herx-like symptoms, but after that it's been pretty great (until a few days ago - I'm gunna post a new thread after I respond in here, feels like I'm relapsing with babesia).

As for alcohol, I had my first drink in prob 8 months last Saturday (during a 2 day Abx break) and had 1/2 of a vodka club at the restaurant with my wife without issues, but I didn't want to push it. Can't wait to have some craft beer again!

Ahh that's so exciting!! I've been craving a corona and lime during these hot days that we have been having! Rifampin has been keeping me away from even trying alcohol which may be a good thing.

I've been on rifampin for almost three months now (with zithromax then biaxain and now minocycline) and still my foot pain is bad in the mornings.. maybe the minocycline combo will work better?

Post Edited (NicHostetler) : 6/19/2018 8:57:05 AM (GMT-6)

Posted 6/22/2018 1:54 AM (GMT 0)

NicHostetler said...

Solaris719 said...

NicHostetler said...
I am so happy for you, that you are feeling better!!

Since we kind of had all the same symptoms, this gives me lots of hope!!

I switched to mino/rifampin combo just a couple weeks ago and havent felt any different. I thought I was starting to make progress with biaxin and rifampin, but my doc really thought mino was better. So since starting it I feel like I took a couple steps back.

On this combo when did you start feeling completely different?

One other thing... did you have issues with alcohol? I can't even drink a beer without feeling extremely dizzy and I've been like that since being sick for the last couple years.

Did that get better for you?

I noticed a big difference after 4 weeks - the color in my face returned, appetite improved, rapid heart rate/POTS resolved, and anxiety improved. I did the first week at 1x300mg per day and then after that the full does of 300mg morning and night - had to take 2 days off after the 3rd week due to herx-like symptoms, but after that it's been pretty great (until a few days ago - I'm gunna post a new thread after I respond in here, feels like I'm relapsing with babesia).

As for alcohol, I had my first drink in prob 8 months last Saturday (during a 2 day Abx break) and had 1/2 of a vodka club at the restaurant with my wife without issues, but I didn't want to push it. Can't wait to have some craft beer again!

Ahh that's so exciting!! I've been craving a corona and lime during these hot days that we have been having! Rifampin has been keeping me away from even trying alcohol which may be a good thing.

I've been on rifampin for almost three months now (with zithromax then biaxain and now minocycline) and still my foot pain is bad in the mornings.. maybe the minocycline combo will work better?

Minocycline made the 2nd biggest difference for me after Rifampin. I started the Mino about 2-3 weeks prior to Rif which I think helped made the addition of Rif fairly easy. I had a true Herx on Mino (the first 2 days I had extreme fatigue, after that it was smooth sailing). For whatever reason, the Doxy and Zith thst I was on for 6 months with had no impact on my Bartonella - I got my positive Bart Igenix testing in March after being on Doxy/Zith/tindamax for 12 weeeks and then Mepron/Zith/Doxy for a month then coartem/Zith/Doxy for 3 months. I knew Mino was hitting it immediately, and even though I spent a weekend on the couch, I was quite happy. I hope it works for you!
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