Doryx

[Anonymous]

Hello!  Doryx doxycycline has become too expensive and generic doxycycline did not work for me.  Clindamycin shots worked well – has anyone used oral clindamycin with success? Any other ideas? I'm scared of skin discoloration with Minocin – and, again, it has become too expensive. Thanks, Margie.

[Maz]

Hi Margie,

Have you thought of asking your doc about low dose minocycline in combo with azithromycin? Users of pulsed, low dose mino are said to be less likely to develop hyperpigmentation, especially when Vit C is taken daily. Zith can also be pulsed and used together with mino.

It probably depends on your disease and severity and weighing the risk of hyperpigmentation against this. For sclero patients who have to take daily mino, a few blue patches are definitely worth it to turn their disease around. I got the browny/grey blotches on my forearms last summer from tetracycline, but they faded over the winter. The blue hyperpigmentation seen with mino seems to be slightly different and a study I checked out said that biopsies of these patches were found to be accumulations of iron just under the skin. Vit C helps with the absoprtion of iron and makes this less likely. Also, slathering on the sunblock and refraining from too much time in the sun helps. This, bearing in mind that not everyone is prone to the blue hyperpigmentation, either, so perhaps it wouldn't hurt to try it and, if you begin to notice any small patches, you could always stop and try something else.

I've heard of oral clindamycin being used, but it may be very hard on the gut and is a known 'cause' of c difficile. Actually, I'm not 100% sure it causes it. I personally think what happens is that we have all sorts of bacteria in the gut (good and bad) and when certain strains are wiped out by an antibiotic like clindamycin, then the c difficile that is likely resistant to the clindamycin just gets the upper hand. That's just a layman's perspective, though. 😉

Other antibiotics that have been used (I 'think' it's page 250 in The New Arhtirits Breakthrough under a topic called something like “The Safety of the Tetracyclines”) are the “mycins”, like clarithromycin or erythromycin. I used the former in combo with tetracycline last year and made good progress with my RA. The only reason I didn't start with minocycline is because I had to take very high doses for Lyme Disease. I'm now on low dose mino and zith (as per my signature below).

Hope this eases your concerns a little?

Peace, Maz

[Maz]

PS. Many here buy Stiefel brand name “Minocin” from an online pharacy, called buylowdrug.com.  For 100 count of 100mg caps, the cost is approx. $115 (incl postage and packing).  As I only use 6 caps a week, this supply keeps me going for about 4 months…so not too bad, cost-wise.

[Anonymous]

Thanks for the information.  I feel lucky that my doctor will even consider using antibiotic therapy.  She was new to the area and said she didn't realize how many people had contracted Lyme in N.E.   Ghe is going to run tests for Lyme and mycoplasma! It's a step forward – nobody up here knew about using antibiotics for RA symptoms..  Just send them to a rheumatologist for methotrexate!

   Are there any tests I should be requesting?   Thanks, Margie.

[Maz]

[user=279]Margie RA[/user] wrote:

   Are there any tests I should be requesting?   Thanks, Margie.

Hi Margie,
If you look on the Education pages, under Assemblying a Physician Packet and clicking on “Historical Protocol,” the last section, entitled, Appendix B – Laboratory Tests,” you'll find a listing of recommended tests to have done while on AP.

https://www.roadback.org/index.cfm?fuseaction=studies.display&display_id=184#Anchor-Appendix-7638

A newer test for RA that isn't mentioned here is called, “Anti-CCP” (anti-cyclic citrullinated peptide antibody test). This test is specific to RA and will confirm a diagnosis as well as degree of severity. Although many rheumies do not retest for anti-CCP or RF on a regular basis (probably because they don't change much while on masking drugs and are just used for initial diagnostic purposes), these can be very interesting to watch as one progresses on AP. Although it's also worth bearing in mind that some people are seropositive with no symptoms and some are seronegative with severe symptoms, so these tests can only be really be watched with time to see how/if they reflect your personal progress and shouldn't make you feel discouraged if you're feeling better on AP and they are slow to respond. Sometimes these markers improve before we do and sometimes we improve before the tests reflect this. Everyone is so unique with this.

We've had a few discussions recently about anti-CCP you may be interested to check out here on the board from a week or so ago. 

Hope this helps….there is a lot of info under Education on this site that you might find very helpful and encouraging to print out for your doc. She sounds very open to helping you, which is a real gift. Perhaps she might also enjoy reading your copy of “The New Arthritis Breakthrough” by Henry Scammell?

Peace, Maz

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