Low dose antibiotics and good bacteria

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Low dose antibiotics and good bacteria

Postby rhythmspring » Wed Feb 13, 2013 8:14 pm

Hi, new here, but not new to rheumatoid arthritis. I'm 23, and I've had it since I was 18. It's VERY severe. I've already had 2 hip replacements, and almost all my joints are bone-on-bone to some extent. I am trying everything in the book. Anyway, here are my initial questions:

How does low dose tetracycline or minocycline affect beneficial gut bacteria? Have any studies to back that up?

also:
If low dose tetracycline works for rheumatoid arthritis, would a regular course of tetracycline (prescribed for suspected recent lyme infection) have an affect on the rheumatoid arthritis as well?
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Re: Low dose antibiotics and good bacteria

Postby Maz » Wed Feb 13, 2013 10:19 pm

rhythmspring wrote:Hi, new here, but not new to rheumatoid arthritis. I'm 23, and I've had it since I was 18. It's VERY severe. I've already had 2 hip replacements, and almost all my joints are bone-on-bone to some extent. I am trying everything in the book. Anyway, here are my initial questions:

How does low dose tetracycline or minocycline affect beneficial gut bacteria? Have any studies to back that up?

also:
If low dose tetracycline works for rheumatoid arthritis, would a regular course of tetracycline (prescribed for suspected recent lyme infection) have an affect on the rheumatoid arthritis as well?


Hi Rhythmspring,

Nice to meet you and welcome!

Yes, all abx will affect beneficial gut bacteria to some extent. However, folks who are on AP (antibiotic protocols) will use probiotics (good bacteria) to replace those lost as the abx pass through the gut. Probiotics need to be taken with at least a two hour window either side of the abx dose (so abx do not kill good bacteria in probiotics) and are just as important as the abx in this context. Finding a good probiotic and one that works well for the individual is perhaps the bigger question, as everyone's bowel tolerance will be unique. Folks who have been on immune-suppressive medications, such as methotrexate and prednisone, may already have fungal overgrowth in the gut and, upon starting AP, find they quickly develop overt infections that require prescription anti-fungal treatments. All in all, finding a good quality probiotic with beneficial strains and taken in adequate quantities as a chaser to the abx is key....and staying on top of fungal overgrowth is really important, because it is easier to prevent it than to have to treat overgrowth after the fact.

Yes, higher doses of tetracyclines will work for RA, too. However, in higher doses, the herxheimer response tends to also be greater. This creates tissue hypersensitivity that may need to be reversed. Higher doses of tetras are required for Lyme disease at the outset, so it can be a challenge to get around this problem. I took high dose tetras in my first year for chronic Lyme that triggered my RA (750mg BID, along with other oral abx in high doses). The herxheimer lasted several months and I was in a pretty hypersensitive state due to circulating antigens (toxins released from dying bugs) and just wish, in retrospect, that I knew more about detoxification then. I think it could have spared me a lot of discomfort.

With Lyme, the question is...is tetracycline alone sufficient to treat it? Most Lyme Literate MDs don't think so. Usually, they will employ compatible oral combinations to hit all the pleomorphisms of Lyme (cell-walled spiral forms, cell-wall deficient forms and cystic forms). Some also believe that for entrenched cases, such as those with neurologic or joint involvement, that IV abx are a necessity. The other question is....how long to treat chronic Lyme. The standard course is 2 to 4 weeks, but LLMDs believe patients need treatment until full resolution of all symptoms...this can be years or, by some estimates, for as long as one has had the infection(s). which isn't always known. Additionally, if Lyme is suspected, there are other tickborne coinfections to consider. Ticks are nature's "dirty needles," and can pass a multitude of other diseases, which, if left untreated, can leave patients unwell, no matter how hard they are hitting the Lyme. Some coinfections may be treated effectively with just a tetracycline, but others may require different classes of abx and sometimes in rotations. Chronic babesiosis is a case in point...because chronicity that accompanies this infection can be worsened by immune-suppressive therapy and may require long-term therapy with multiple classes of abx....e.g. tetracyclines, choroquinine, mepron, azithromycin, flagyl or tinidazole, clindamycin, artemisinin, etc.

The thing is not to get overwhelmed at the outset and this can be avoided by working with a really experienced LLMD, if at all possible. The best kind are those who are integrative and who can provide immune supports, such as dietary advice (e.g. sugars, alcohol, etc will feed candida and cutting out gluten and dairy may be pivotal in some folks), hormone supports (thyroid, adrenal, HPA balance is very often upset with Lyme and rheumatic disease), inflammatory support (such as detoxification methods and anti-oxidative therapies to help the body remove free-radicals that cause damage), help with biofilm-busting, etc.

It's worth reading through the ILADs and Burrascano treatment guidelines to get an idea of the complexity of Lyme protocols and what is involved in terms of longer term treatments. Many LLMDs are now preferring the terms, "MSIDs," or "mixed systemic infectious diseases syndrome," realizing that when Lyme takes out immunity, other tick-borne infections and latent pre-existing infections, can become opportunistic in the host. So, they're dealing with a whole mess of issues...other infections, biofilms and the pleomorphisms of Lyme, all causing persistence if inadequately or inappropriately treated.

http://www.ilads.org/lyme_disease/treat ... lines.html

Tetracyclines are considered by rheumatologists to be a weak DMARD for RA and usually not mentioned as a treatment option due to the fact that most do not adhere to infectious theory and consider minocycline or doxycycline purely and simply for their immune-modulating effects. They also probably don't recognize the herxheimer effect and, when patients with RA and a lot of inflam are prescribed the higher daily doses, believe the patient is worsening because the abx is not working. It is in fact working...just too well! ;)

If you check out the labs chart in my Personal Progress Thread (link in my sig line), you will see which abx combinations I was on in my first year and how my labs worsened initially and then all began to come down after those first few months. I can't say it was an easy year, because although my RA improved by about 50% in that first year, the hypersensitivity was quite difficult to deal with.

I hope this helps in your researches, Rhythmspring. We're not really here to convince anyone to use or not use abx therapy, just provide support and educative materials to those who do choose it. Getting as informed as possible (reading the Scammell books and all the info on the main site) and becoming one's own advocate is strongly encouraged, because this is a slow therapy with no overnight cures. Like me, you have severe RA, however, you have youth on your side, so you should stand a good chance of turning things around more swiftly.

Are you using any other drugs currently or in the past? If you can add a signature line, it will really help to generate responses. There are many RA/Lyme patients here and each will be taking a unique path to wellness, depending upon the doc they are working with and pathogen load. We're all here to offer support as you go, so please feel welcome to post away with any questions or support for others. :)
RA/Lyme - ABX since 11/06
Personal Progress Thread: viewtopic.php?f=3&t=301
Current Abx Protocol:
Clarithromycin 500mg BID re-started 11/5/13 (dose increased to 500mg BID on 7/3/14
Compounded Liposomal Artemisinin ("Artemisinin Essentials") restarted 7/3/14, 2 caps twice daily, 5 days per week for 3 weeks each month with 7 days off
Ivermectin 2mg (rx compounded) daily, started 9/21/11
Various staple supps: Enhansa, NAC, ALA, Morinda Supreme, KriaXanthin, B Complex, Milk Thistle, Dessicated Adrenal, Adaptan-All, Probiotics, Systemic Enzymes, Vit D3, Magnesium Citrate, Sodium Ascorbate, ImmunoPro, Nrf2 Activator, Liposomal glutathione, compounded topical progesterone.
Intermittent supps: Chemet every third day, along with NAC and BioPure Chorella followed by BioActive Minerals day following oral chelation. Weekly Myer's Cocktails and Glutathione IV Pushes for detoxification. Tri-salts and Opticleanse GHI.
FIR Sauna and other detox methods as described in Personal Progress Thread.
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Re: Low dose antibiotics and good bacteria

Postby rhythmspring » Wed Feb 13, 2013 11:15 pm

Thank you so much for the thorough response.

I have in fact gone down the whole lyme road... it led to a dead end. I worked with a LLMD for a good year, tested + for lyme and babesia, did a long course of all sorts of hardcore antibiotics (mepron included), herbs and supplements.

No herx, no improvement, whatsoever.

I'll write up a signature shortly.
rhythmspring
 
Posts: 4
Joined: Wed Feb 13, 2013 8:09 pm

Re: Low dose antibiotics and good bacteria

Postby Maz » Thu Feb 14, 2013 1:30 pm

rhythmspring wrote:
No herx, no improvement, whatsoever.

I'll write up a signature shortly.


Yes, one year on treatment may not be enough for some folks. Even those who use minocycline oral therapy alone with severe, entrenched disease, may not experience significant changes until past one year. If you get a chance, try to watch the Dr. Brown video at the top of the General Discussion threads. The bone scans Dr. Brown shows during the video of a patient over the course of 3 years exemplifies how long it can take for some patients to reach remission. It is a very slow, fwd and backward dance all the way to remission. He often remarked in the literature that it could take up to 2 to 5 years for severe RA to reach remission on the treatment. He also recommended IV clindamycin for severe cases as an adjunct to oral minocycline.

http://roadback.org/index.cfm/fuseactio ... d/123.html

LLMDs tend to use tetracycline, simply because it's better tolerated than minocycline in the higher doses needed for Lyme. However, in my second year of treatment, after I'd hit the Lyme hard (like you), I switched out to low dose, pulsed minocycline (100mg twice daily on Mon, Wed and Fri) and took just one azithromycin every week and was in remission within 10 months. Minocycline is believed to have superior tissue penetration than tetracycline, so if your do is open to prescribing it, you may find you will do better on this type of protocol. Just a thought to consider as you continue researching the best path for you. ;)
RA/Lyme - ABX since 11/06
Personal Progress Thread: viewtopic.php?f=3&t=301
Current Abx Protocol:
Clarithromycin 500mg BID re-started 11/5/13 (dose increased to 500mg BID on 7/3/14
Compounded Liposomal Artemisinin ("Artemisinin Essentials") restarted 7/3/14, 2 caps twice daily, 5 days per week for 3 weeks each month with 7 days off
Ivermectin 2mg (rx compounded) daily, started 9/21/11
Various staple supps: Enhansa, NAC, ALA, Morinda Supreme, KriaXanthin, B Complex, Milk Thistle, Dessicated Adrenal, Adaptan-All, Probiotics, Systemic Enzymes, Vit D3, Magnesium Citrate, Sodium Ascorbate, ImmunoPro, Nrf2 Activator, Liposomal glutathione, compounded topical progesterone.
Intermittent supps: Chemet every third day, along with NAC and BioPure Chorella followed by BioActive Minerals day following oral chelation. Weekly Myer's Cocktails and Glutathione IV Pushes for detoxification. Tri-salts and Opticleanse GHI.
FIR Sauna and other detox methods as described in Personal Progress Thread.
User avatar
Maz
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Posts: 7368
Joined: Sat Feb 16, 2008 9:33 pm
Location: Connecticut USA


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