Flagyl problems

[toml]

Hello
Returning after several months. Better now but have ? about drugs.

I was clinically diagnosed with Lyme on the basis of a high C4a and strong clinical symptoms. Originally was with a HMO that diagnosed arthritis and treated as such which did nothing to help the pain. Saw a out of state LLMD who diagnosed Lyme and am currently being treated by a local naturepath. Abx had an immediate positive effect on the pain.

Current protocol consists of Bicillin injections 2xweek, Falgyl 500mg 2xday and Biaxin 500mg 2xday. I built up to this level of treatment by starting with Biaxin alone then adding another one and finally now on all three. Supposedly this protocol covers all forms of Lyme.

My concern is with the flagyl as is has been very difficult to tolerate. Feels like I swallowed a mouse every time I take it even with food and seem to be depressed, irritable more. Saw here that some use a pulse regime and others take it a few days a month. Any comment would help me as I am very near to asking the naturepath to stop the flagyl!

Tom

[Maz]

@toml wrote:

Current protocol consists of Bicillin injections 2xweek, Falgyl 500mg 2xday and Biaxin 500mg 2xday. I built up to this level of treatment by starting with Biaxin alone then adding another one and finally now on all three. Supposedly this protocol covers all forms of Lyme.

My concern is with the flagyl as is has been very difficult to tolerate. Feels like I swallowed a mouse every time I take it even with food and seem to be depressed, irritable more. Saw here that some use a pulse regime and others take it a few days a month. Any comment would help me as I am very near to asking the naturepath to stop the flagyl!

Hi Tom,

For some, flagyl is hard to tolerate. Difficult to know if it’s a side-effect of the drug or die-off (maybe a bit of both?), which can come with depression and irritability. However, there are substitutes that can be used, such as Tinidazole or Alinia (used in pediatrics, but also for Lyme) that some folk seem to tolerate better.

Flagyl is used for the cystic form of Lyme as well as to treat babesiosis…and it has some nice anti-parasitic props for anything else in the mix. However, it can also reveal latent candidiosis that is holed up in bio-film, as can any of these anti-parasitics. I’m currently on Ivermectin, which has been compounded in a specially low dose, but my LLMD wants to gauge my reaction to it without clobbering me over the head all at once with a high dosage. His philosophy is not to release too many animals out of their cage (bio-film) all at once. Flagyl is notorious for exposing candida, a bio-film loving flora, and after discussing anti-protozoan meds with my new LLMD, he agreed it was likely because certain protozoans persist by creating bio-films. When hit, however, they disperse, removing that protective slimey barrier that candida really loves,too…thus revealing what is under that slimey matrix – candida and other bugs enjoying that protected environment. This may also be why some people herx mightily while on flagyl in a combination therapy and why a low/slow approach might be better tolerated, all in all.

There seem to be two perspectives on all this in the Lyme world with some LLMDs saying the only way to hit Lyme is to hit it heavy and hard and the other camp saying it’s better to allow Lyme patients some quality of life while being treated. The thing about hitting Lyme hard is that huge amounts of herxing can occur in some folk and it can be hard with rheumatic patients to control the excessive inflammation that goes along with that. The thing about hitting it low and slow is that it may only be acting to suppress the infections, but not really eradicating them in the longer term. Borreliosis is a much different infection from the slow-growing mycoplasma, for instance, so finding and striking that balance can be very tricky. In any of these scenarios, a critical clue in how well a patient is responding early in treatment is whether or not they are herxing. Herxing is a sign the abx are hitting their targets…never pleasant, but how a LLMD gauges response.

Everyone here is either on low dose, pulsed protocols as per Dr. Brown or monotherapy with minocycline prescribed conventionally as a DMARD, or on individualized combination protocol to hit multiple infections – again – some in high daily doses (like with Lyme) and some in low, pulsed doses (as with the Wheldon Protocol for chlamydia pneumoniae), so it can muddy the waters to know how best to go and all this variation can confuse the picture. In this regard, it’s probably not worth comparing one’s own protocol with someone else’s. Even in the case of “Lyme,” each person will have a unique pathogen load – some ticks may only pass Lyme, others a multitude of different bugs that complicate treatment.

I don’t think you mentioned how long you’d been on flagyl, so I’m not clear if you might be past the worst of herxing or not, but if taking flagyl has become intolerable, then it might be worth asking your treating doc for a switch of meds. Would also be as vigilant as possible about candida, especially as you’re also on bicillin IM shots as well – both encourage candida. The combination you’re on is interesting and it’s not one I’m familiar with though I can see the rationale – bicillin to hit cell-walled forms, biaxin to hit coinfections and cell-wall-less L-forms and flagyl to hit coinfections and cystic forms. When I was on bicillin IM, however, my doc used diflucan in combination with it….the bicillin shots were great for the arthritis….however, one can’t take diflucan with a macrolide, like biaxin as both shut down the P450 cytochrome in the liver (major detoxification pathway).

Perhaps it’s worth putting in a call to your doc to share the symptoms you’re experiencing and to ask if it might be worth trialing either Alinia or Tinidazole in place of flagyl to see if one of these is better tolerated?

That’s about all the comes to mind for now, Tom, but perhaps someone here has some personal experience to share re: flagyl side-effects and their herxing experience to help shed light on what you’re also experiencing. I haven’t personally used flagyl as my doc didn’t like it.

Let us know what your doc thinks and hope a switch in drug might do the trick for you. 🙂

[toml]

Hi
Thanks for the usual prompt and thorough reply.

You hit on the real dilemma in this recovery work which I spend many hours at night thinking about…..how to discern if I am just herxing at an acceptable rate or causing too much trauma to my system thus weakening my natural defenses and ability to heal.

My pain and pre-drug arthritis symptoms of arthritis pain are not a problem. That is all but gone with this abx protocol which was started in May 2011.

But my digestive system is doing all the reacting. Before Flagyl I was on hydroxychloroquine for 3 months but it caused so much severe diarrhea that the switch to Flagyl just this past week was made. Now it is cramping and an upset growling, gurgling stomach for 4-6 hours after I take the meds even with food.

I am sure part of the issue is the challenge of just being on meds. I was med free till this stuff hit me and the general malaise I feel may just be that my system is not used to drugs.

I will let you all know what my ND thinks about switching to another med.

Take care

Tom

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