General Med questions for SD

[Kat0605]

I just started treatment for suspected Lyme disease with early sclero symptoms (skin changes, swelling, mild Raynauds).

Since I’m pregnant and being treated by an LLMD, my protocol is a bit different than a normal sclero patients.

I’ve had terrible heartburn that has reared its ugly head after I stopped taking Prilosec due to interactions with ABX. In my Lyme book, Dr H says that I can take Zantac.

My question is what time of day should I take it? Right now my meds are spaced like the following:

Wake-up levrothyroxine (and Zantac?)

Breakfast 1-2 hours after waking up (oatmeal and banana) fish oil, sertraline, Ceftin, and Azithromycin (4 days a week).

Lunch: prenatal

Dinner: ceftin

Bedtime- probiotics (I’m taking 2 different ones) and trazodone for sleep.

Because I have muscle cramps/spasms I’d like to also take magnesium oxide (have been taking for 3-4 months and they help with cramps a lot!)…. I was taking at night but I read it interferes with absorption of probiotics. When should I take them? Also so far my gut has been ok- but I do get slightly nauseous with morning antibiotics. Should I add a probiotic at lunch?

Finally, I know it’s super early to be asking this question- but since I’m starting before I’ve had any official skin tightening (though my forearm has definitely started tightening), will it take less time for my symptoms to improve? All I want to feel like things aren’t progressing. Feeling normal again would be amazing, but I’m trying not to get my hopes up. Any thoughts? Thank you in advance!!

Symptoms started in 9/16 after 2 miscarriages, diagnosed with Lyme 4/17, Daughter born 6/17 (not breastfeeding). ANA negative by IFA as of 8/17, positive by ELISA with positive Anti-DSDNA antibodies the same month (false positive?). Symptoms that have come and gone include sicca and skin tightening and telangiactiasia. Currently dealing with migraines, arthralgia, morning stiffness, neuropathy, slight swelling, slightly elevated liver enzymes, and bubbly urine. Current protocol: minocycline 100 mg QID, azi

[Maz]

Hi Kat,

Kat0605 wrote:

I’ve had terrible heartburn that has reared its ugly head after I stopped taking Prilosec due to interactions with ABX. In my Lyme book, Dr H says that I can take Zantac.

Ugh, PPI rebound – poor you, Kat. Must be rotten for you on top of the reflux one can get from just being pregnant. Just wondering….has anyone tested you for H. Pylori? H. Pylori is another spirochete that can produce symptoms similar to Lyme, especially in SD and has actually been correlated to SD in the scientific literature. Have you looked through the SD Research section yet? Just thought to mention that, because if you do find you’ve had H. Pylori, then it might be worth looking at a combo protocol to treat it. Barry Marshall’s website (guy who discovered H. Pylori as a major cause of stomach ulcers, gastritis, GERD, etc.) is pretty interesting to browse, if you have a moment:

http://helicobacterpylori.net.au/

My question is what time of day should I take it? Right now my meds are spaced like the following:

Wake-up levrothyroxine (and Zantac?)

Breakfast 1-2 hours after waking up (oatmeal and banana) fish oil, sertraline, Ceftin, and Azithromycin (4 days a week).

Lunch: prenatal

Dinner: ceftin

Bedtime- probiotics (I’m taking 2 different ones) and trazodone for sleep.

There is an interaction between Zantac and Ceftin….the Zantac can reduce the effectiveness of the antibiotic. Did the doc tell you to space them well away from each other? If so, good advice! Although Zantac isn’t supposed to have any interactions with levothyroxine, though, I’d probably set my alarm an hour or so before taking the Zantac, especially while pregnant. Levo is best absorbed on an empty stomach (especially the generics) and it’s a good idea to wait 30-60 mins to eat. I set my alarm for 6am, take my Tirosint (brand levo in a gelcap for better absorption and no fillers), then roll back to sleep and take my Cytomel at 8am, which I can eat breakfast with. Just thinking that although there are no listed interactions, keeping thyroid levels in the perfect range to maintain the pregnancy, it might help to just take the Zantac an hour after the levo? This might be a moot point, but just something to ask your ob/gyne who is likely watching your thyroid labs carefully throughout your pregnancy.

Because I have muscle cramps/spasms I’d like to also take magnesium oxide (have been taking for 3-4 months and they help with cramps a lot!)…. I was taking at night but I read it interferes with absorption of probiotics. When should I take them? Also so far my gut has been ok- but I do get slightly nauseous with morning antibiotics. Should I add a probiotic at lunch?

There are magnesium spray oils you might find to be a better solution? Can usually get these from Vitamin stores. Here is one brand, but you may find better ones by searching online:

https://www.vitacost.com/life-flo-pure-magnesium-oil-8-oz-3

Another way to get magnesium is to soak in a daily Epsom salt bath, if you’re able to get in and out of the tub okay.

Finally, I know it’s super early to be asking this question- but since I’m starting before I’ve had any official skin tightening (though my forearm has definitely started tightening), will it take less time for my symptoms to improve? All I want to feel like things aren’t progressing. Feeling normal again would be amazing, but I’m trying not to get my hopes up. Any thoughts?

Well, this is the #1 question everyone wants to know when they begin AP, so you aren’t alone! Certainly, starting early, before any collateral damage has occurred from the use of the more powerful meds, will usually bode well for a swift response. The question, in your case, because you are pregnant and unable to use the core treatment – minocycline – leaves a bit of a question mark and it will likely have to remain a wait-and-see kind of thing. When is the little one due, Kat?

[Kat0605]

Thanks Maz! So oral magnesium is a no-go? I’ve been a few days without it and my hands cramped up today at work. I have the spray, but I’d like to completely prevent cramps if possible. With this disease- I never know what symptoms I will get on a given day.

The baby is due in 10 weeks! I know women with SD tend to deliver early (even those undiagnosed), so I’m thinking she will appear in June, hopefully not earlier though.

So scared about a postpartum flare. All of my symptoms, though annoying, have been manageable from a pain/disability perspective. I’m really scared I won’t be able to take care of my baby. I’m hoping I can make some progress on Azithromycin before she arrives. Wish I would’ve started earlier.

Symptoms started in 9/16 after 2 miscarriages, diagnosed with Lyme 4/17, Daughter born 6/17 (not breastfeeding). ANA negative by IFA as of 8/17, positive by ELISA with positive Anti-DSDNA antibodies the same month (false positive?). Symptoms that have come and gone include sicca and skin tightening and telangiactiasia. Currently dealing with migraines, arthralgia, morning stiffness, neuropathy, slight swelling, slightly elevated liver enzymes, and bubbly urine. Current protocol: minocycline 100 mg QID, azi

[Lynne G.SD]

Hi Kat;
I know many people who only use Zith and do just as well as those that use Mino.Some use it one week on and one off.Others take it 5 days a week.From what I have heard from them both ways work.If I was pregnant I would use the one week on then one off.

[richie]

Hi I always take my prilosec between lunch and dinner –works for me –

[Author]

Posts