Bruises associated with borrelia herx

I am getting bruises associated with borrelia herx. It looks a bit like thrombotic thrombocytopenic purpura, ie

https://en.wikipedia.org/wiki/ttp_(disease)

However, the bruising is only in areas associated with bacterial die-off, and not elsewhere. Usually TTP would be over the entire body, but I am only getting bruises in specific areas where I am also getting pain from the herx. I'm not getting a lot of bilirubin, although I am peeing a lot. The urine is sometimes white or cloudy.

Can anyone explain the mechanism behind this bruising, and is there a way to prevent it?

This occurred due to borrelia die off associated with valacyclovir, at a dose of one 500 mg pill, taken once per week. I suspect that what is going on is that when borrelia detects DNA damage, it upregulates its DNA repair, making it susceptible to further DNA damage from the acyclovir. Under such circumstances, borrelia becomes extremely vulnerable to the nucleotide analogue, even at a very low dose.

I don't understand what is causing the bruising though. Any ideas?

sorry my bad i got petechia not purpura!

in the article it states that thrombotic thrombocytopenic purpura, is caused by auto-antibodies to the enzyme the cleaves large molecules of von Willebrand factor into smaller units - interfering with normal clotting processes - so perhaps the inflammation from the herx is increasing auto-immunity

i have seen others with borrelia or bartonella get spontaneous bruising - on 2 occasions occurring in front of my eyes over a period of 60 seconds with no trauma at all associated with it as a cause - on other occasions a similar effect but following a mild bump or scrape.
however, I am not sure if the TTP mechanism is at work - or something else - as there are probably a dozen or so mechanisms that could cause spontaneous bruising.

So as we all know, many common antibiotics such as amoxicillin or doxycycline will not cure Lyme disease. It just goes into a dormant (persister) state and then relapses when you stop the antibiotics.

If you want to kill and eliminate the bacteria, the options are disulfiram, dapsone, valproate, valacyclovir, some other nucleotide analogues, high-dose cephalosporins, and maybe one or two other things.

Disulfiram made me extremely manic-depressive even at low doses. There was no way I was going to tolerate the doses necessary to eliminate a borrelia infection, so that's out.

I didn't want to risk taking dapsone because I had difficulty tolerating other anti-folates, so that's out.

High dose cephalosporins generally requires IV administration, something I don't have a provider for.

Another forum member (SlowButSteady) had some success with IV antibiotics and also Flagyl (metronidazole) but metronidazole caused me too many bad side effects and just made me feel totally sick, so that's out.

Aside from valacyclovir, borrelia is susceptible (at least in vitro) to some other inhibitors of the DNA polymerase, including nevirapine, gancyclovir, didanosine, and lamivudine. Most of these are reported to have worse side effects than valacyclovir.

So that leaves valproate, which I've had some success with. The biggest problem with valproate for me right now is the insulin effect and weight gain, because I'm already way overweight. The neuro effects are a bit annoying, it feels something like painkillers and antidepressants. This doesn't make me feel bad, just a bit tired and can't really pay attention to anything. It doesn't really matter that much right now because with all this herxing, I'm not getting any work done anyway.

Valproate apparently interferes with the glycolysis pathway of borrelia, which results in a pungent odor of fermentation byproducts (likely including malate, acetoin, diacetyl) but aside from the smell, this seems to be an otherwise harmless side effect. So if I can get the weight gain problem under control, valproate is next up.

i want to add on that i am always surprised that valacyclovir is mentioned in the active for borrelia aswell.

i mean we know abx is active for borrelia but an antiviral? its sounds a bit unusual, but i am open to new things. specially because i really dislike the gut side effects from standard abx and i always hope for new treatment horizons such as herbs, other pharma drugs etc.

cheerio

Garzie said...
Quin - i am not sure if i have asked before (apologies if so) - but is there any evidence in the scientific literature that Valproate is actually active for borrelia?

Valproate is known to be active against several microorganisms, eg

https://pubmed.ncbi.nlm.nih.gov/12755481/
https://pubmed.ncbi.nlm.nih.gov/34339265/

AFAIK no one has done a specific study on valproate and Lyme disease.

thanks for sharing

Three weeks later, I am still herxing from this, and I haven't taken any more valtrex. Most of the bruises have gone away, but I still have some poor circulation in my fingers, which feel a bit tingly as if I slept on my arm.

I slept almost 16 hours last night (and most of the day) and only got up a few times to pee. I'm still getting slightly dehydrated and hyponatremic from the detox, but not as bad as before.

Also the dead borrelia is really starting to stink. The smell is a bit hard to describe, but it's quite different from the ammonia and asparagus smell of bartonella. It smells a bit like soy sauce or some other fermented foods, along with occasionally some other smells like vinegar or buttered popcorn.

The herx messed up my immune system, and I got a fungal infection which looks like athlete's foot. I also got a sore throat and itchy eyes, which I suspect is covid. Mepron worked for both.