I've been on LDN while on abx for quite a while now. So normally I think this shouldn't be a problem.
I would def talk to your doctor about
the various options in regards to treatment strategies. Dr J in DC likes to target babesia first, really knock that back, then target bartonella/lyme. His hypothesis is you need to knock out babesia first, makes it easier to treat everything else. That said, such a strategy is far from established, but it is based on his vast clinical experience. In my case, bartonella was the dominant infection, so my doctor really focused on treating that one first. I did convince him to circle back and hit babesia, which is also involved in my case.
It does come down to a lot of trial and error, even for the best practitioners this is an educated guessing game. Each patient is their own unique puzzle. One basic rule of thumb I like is that I think meds need to be rotated when a patient plateaus, isn't responding to meds (no herx), or isn't seeing improvement (after some months).
Imo, with your situation, if you are getting such a response from the antimicrobials I think it means you are hitting them! I think the problem is not that the meds aren't effective, but that they are overly effective and your body isn't able to detox fast enough, hence this high-intensity long-lasting herx/inflammatory response.
This is how I see it, often you'll get a lot of efficacy from antimicrobials early in treatment, you knock out the low-hanging fruit. As you dig deeper and get further along in treatment, you have to be strategic with rotations in therapeutics to get at the residual pathogen load. It might not be possible to nail every last pathogen, but I don't necessarily think it is necessary either. The goal imo is to knock back the pathogen load significantly, and empower the body's systems to get back online (like the immune system) to keep everything in check.
Given that your doc put you on PZA, my guess would be they wouldn't want to pull you off of it right away because they might be worried about
stop/starting it because of resistance issues. And PZA has to be combo'd, usually with another intracellular(s) plus macrolide.
Post Edited (sebreg) : 8/10/2018 7:15:07 AM (GMT-6)