Irrational fear of azithromycin

Hello guys,

first of all I have very good news. My mitral valve sclerosis seems to decrease a lot since I have started taking abx, as shown in the heart-mrt/mri. This shows me, that despite feeling worse some days it is going into a good direction.

After completeting minocyclin for 6 weeks my doctor told me it is quite unusual to feel worse on minocyclin so he changed my abx.

I will now take azithromycin paired with artemesia annua.
I am a bit freaked out by the QT Time changes this abx can cause.

Doctor made a ekg before and said its all good so I can take it without a problem,

am I being irrational?

Greetz.

Agreed - nothing irrational about side effect concerns!

Do you think that buying and using an at-home EKG device might ease your mind? I have one from the brand Emay that I find helpful.

herx reactions can last as long as you are taking antibiotics - or until the infection is gone

can be months - or years for some people

in the macrolides group azithromycin is actually one of the lesser problematic ones for long QT - compared to the others

what can often happen and confuse the issue is that the type of nerve signal disruptions that are caused by lyem and bart etc - are actually thought to be driven by inflammation in the heart tissue - and infiltration of white blood cells which disrupts the nerve signals - leading to things like Long QT, arrhythmias etc

when antibiotics ( of any type) are given - the herx like reaction is, as far as the most recent research on the subject suggests, actually caused by the abx damaging and slowing down bacteria - and the immune system mopping them up - and then releasing more inflammatory signalling chemicals - actually increasing inflammation - which can cause more arrhythmia's, palpitations etc

people reading that azithromycin ( or other drugs ) may increase risk of arrhythmia or long QT or TdP - then often assume that this is a chemical imbalance type drug reaction - rather than a natural consequence of killing bacteria.

i get increased palpitations from everything that kills bacteria - including all potent bart/lyme herbs - essential oils etc

i did a deep dive into it and the literature actually shows that the vast majority of people taking macrolides who had fatal TdP ( the stage after long Qt - long QT is not a problem in and of itself - but is used as a surrogate risk measure of TdP - which can be fatal) been taking intravenous macrolides and were either given IV macrolide overdoses by mistake - or had one of more other risk factors - like co-administration of other long QT or TdP drugs ( a big no no) and v v few deaths from TdP on oral macrolides

i dont have it to hand - but i think i posted the link to the paper on this before -

happy to help

i think a home EKG could be worth a go as long as you are confident you can use it to determine what your actual qt interval is - ideally before starting abx and then during - so you have a baseline to compare to

but there are some problems - as its an understudied area.
instead its more of a general assumption that long Qt is a precursor to TdP ( the type of sudden complete arrhythmia that can be fatal).
in reality its more that lengthening QT is about the only measure we have to warn of possible TdP - but TdP is also though to happen without long QT and is far more common than once thought - so far from being always fatal - many people are thought to experience brief bouts of it on various treatments that go unnoticed

i mention this only for a more rounded picture -
as - as usual - everything relating to lyme is grey - rather than black or white