flares

[SandiS]

I have been on minocin (generic) since Sept. 08 with great results. Labs are near normal and more importantly I feel so much better . The first improvement was the lifting of extreme fatigue which I didn't even realize was part of the disease until I read “the Road Back”. I had reached the point of having very little joint pain.  I had to go off my meds for a couple of weeks in early April  due to minor surgery.  I immediately started having those old pains ( though not as bad as before). When I restarted my Meds I switched to brand name Minocin (mid April).  Since then I have had  one flare after another each becoming more painful and moving around in different areas. I'll be fine for a couple of days and then the pain will be back  off and on for  almost 2 months now. Did stopping for 2 weeks really cause this?  Or could it be herxing because I changed brands?  How long does this usually last?

Thanks

Sandi

[Maz]

[user=921]SandiS[/user] wrote:

I had to go off my meds for a couple of weeks in early April  due to minor surgery.

I immediately started having those old pains ( though not as bad as before). When I restarted my Meds I switched to brand name Minocin (mid April).  Since then I have had  one flare after another each becoming more painful and moving around in different areas.

I'll be fine for a couple of days and then the pain will be back  off and on for  almost 2 months now. Did stopping for 2 weeks really cause this?  Or could it be herxing because I changed brands?  How long does this usually last?

Hi Sandi,

This is just speculation from a fellow patient, but three things could be going on here:

Post-surgical flares aren't uncommon. Could be stress from surgery (even minor surgery), the drugs used during surgery, trauma to the body that is healing, etc. I've heard (not fact) that it can take up to 6 weeks for general anesthesia (if that's what you had) to work its way out of the body…so could be that your body is trying to detox.

Changing your minocycline to brand could also have precipitated a herx situation. Some people report that the brand is definitely stronger for them.

Re-starting at the same dose as you were on before without working up from a smaller dose could also be an issue.  

Going off AP for a couple weeks isn't generally too much of a problem in most cases, but changing to brand and re-starting at the same dose as before, in combination with a surgery, could potentially trigger a flare and a herx.

Are you working with a knowledgable AP doc? What dose are you on? Do you use any detox methods? See if it's okay with your doc to lower your dose for a while until things settle. If things don't settle in a few weeks, might be time to go back to the drawing board.

Sorry to hear you're going through this, Sandi. Must be so unsettling, especially after you were doing so well. Hang in there!

Peace, Maz

 

 

[SandiS]

Thanks Maz. I'm taking 100 mg MWF same as before except brand name now. Still having a lot of pain so Im going back to the generic for a few days to see if that makes a difference. Thanks for the advice.

sandi

 

[Noel]

Hi Sandi,

I recently cut my dosage down from daily, because I was doing so well, to MWF and got herx flares 7/10 as opposed to 1/10. I have a blog that may explain why. Here is the link:-

http://www.palindromic.org/forum/weblog_entry.php?e=675

?

Noel

[Joe M]

Noel, on your blog you say:

“My research shows that the half life of Doxycycline in the body can be anything from 12 to 24 hours.  So lets take the worst case scenario, an antibiotic taken for example at 8am on Friday will be completely out of the system by 8pm.”

I think you have a misunderstanding of half-life.  Half life is not the time it takes for the drug to leave your system.  It is the time it takes for HALF the medicine to leave your system.  So in your example, if the half life is 12 hours and you took 100mg at 8am, at 8pm there would be 50mg left in your body.  At 8am the next day there would be 25mg left in your body, and so on. 

[Noel]

The research is based on a 200mg dose, again using worst case, 80% of the doxy dose in the circulation is reported to be bound to plasma proteins. This can be reduced further depending on what has been eaten and other factors.  My dosage is 100mg, therefore my statement is close enough.

I?ve been around forums long enough to know there is always a resident troll waiting to jump in at every opportunity. One should never feed a troll, therefore this will be my final post in this forum. I?ll revert back to lurking from now on.

Good luck all.

[Joe M]

[user=1137]Noel[/user] wrote:

  My dosage is 100mg, therefore my statement is close enough.

Your statement it would be out of your system by 8pm Friday night is nowhere near “close enough” for someone wanting accurate information.  Your 100 mg dose taken at 8am on a Friday would not be out of your system until Tuesday or Wednesday  of the next week, assuming a 12 hour half-life. 

People who read your blog could be dosing incorrectly based on your erroneous understanding of half-life, thereby putting their health at risk.  If providing accurate information makes me a troll, so be it.  And if you don't want comments about your blog, don't link to it.

[Lynne G.SD]

Noel;
    If you read the MP site or http://www.bacteriality.com site you will see why low pulsedlow dose creates the wanted herx.There is an awful lot to learn and after a good 5 years of reading I still have trouble comprehending it all.I am not on MP but do lower and raise varied antibiotics and still herx when doing so especially with Zith.It just pulls the rug out from under me.

[Noel]

Then answer the question yourself.

If 200mg is found to bind antibiotic to plasma protein at a rate of 80% worst case. The percentage of antibiotic free and therefore able to feed active mycoplasma must be 20%.

Given the above and assuming it to be correct.

What would the percentage antibiotic bound to plasma protein be if the dose is 100mg and what percentage is then antibiotic free and therefore available to feed active mycoplasma?

At 100mg initial dose, what percentage is bound to plasma protein at 12 hours and what would the affective percentage available to feed active mycoplasma be?

At what point would you say the amount of antibiotic free plasma protein available to feed active mycoplasma would be in order to consider the antibiotic effect, effectively out of the system?

 

Now I really am done.

[Joe M]

[user=1137]Noel[/user] wrote:

Then answer the question yourself then.

If 200mg is found to bind antibiotic to plasma protein at a rate of 80% worst case. The percentage of antibiotic free and therefore able to feed active mycoplasma must be 20%.

Given the above and assuming it to be correct.

What would the percentage antibiotic bound to plasma protein be if the dose is 100mg and what percentage is then antibiotic free and therefore available to feed active mycoplasma?

At 100mg initial dose, what percentage is bound to plasma protein at 12 hours and what would the affective percentage available to feed active mycoplasma be?

At what point would you say the amount of antibiotic free plasma protein available to feed active mycoplasma would be in order to consider the antibiotic effect, effectively out of the system?

Wiki has an in-depth discussion of half-life if you want to learn more.  A 100 mg dose with a half-life of 12 hours would take about four days to exit the body with only trace amounts (less than 1 mg) remaining.

http://en.wikipedia.org/wiki/Biological_half-life

[Maz]

[user=1137]Noel[/user] wrote:

At 100mg initial dose, what percentage is bound to plasma protein at 12 hours and what would the affective percentage available to feed active mycoplasma be?

Hi Noel,

Nice to see you posting here and thank you for sharing your blog with us. 🙂 

I was flipping through The New Arthritis Breakthrough last night and fell upon a section very near the end on page 298 (last paragraph and continuing to next page) that may bear some relevance to your questions. This may be moot, if you've already considered this, but I'll type it out here for your possible interest or for anyone else interested:

“The principle behind this irregular schedule (pulsing) was based on the fact that tetracycline will stay in the body for forty-eight hours or more after oral administration. The spacing allowed the body to rest between doses without losing the cumulative impact of the antibiotic, which is held in low-metabolizing tissues such as bones and cartilage where it can still be drawn into the systm, albeit at lower levels, even on days when no drug is given. The Road Back Foundation recently developed a graph showing the relationship between the peaking of antibiotic activity and the subsequent peaking of antigenic activity with the use of minocycline. Daily doses creat a relatively steady condition in whihc the minocycline might be expected to initiate a hypersensitivity reaction, while alternating doses avoids the overlapping effect and can sometimes, although not always, allow the hypersensitivity reaction to remit. Likewise, too much antibiotic at any one time can trigger a similar problem that is oftn relievd by nothing more complex than an adjustment in the dose.

Dr. Brown's longtime laboratory director, Harold Clark, says two other advantages of the pulse method are that the off days give the body tissues a respite from the oxidation associated with the use of antibiotics, as well as providing an interim for restoration of normal protein synthesis in the cells. Mycoplasmas ar relatively lethargic reproducers, so any such small hiatus is unlikely to encourage a breeding spree.“

I'm going to see if I can find the graph that was prepared by Road Back that Scammell is referring to. I believe John McD posted it a while back, as Trevor Marshall had used it in an article of his….but it's probably something that would be valuable to have added onto the site and I don't recall seeing it on the main site.

Another thing that came to mind….Scammle's final comment above appears to be a generalization. My best layman's guess after some research is that myco reproduction likely varies between species…some may be faster than others, but that very likely, in general, they are slow reproducers (except perhaps in acute infection states).

Peace, Maz

 

 

[Maz]

Noel, found the graphs in question. If you go to this link and scroll down the page, you'll find one graph that illustrates serum concentrations for both daily dosing and QOD (every other day) dosing:

http://www.sarcinfo.com/minocin.htm

There is likely some variation between the tetracyclines, so it would be interesting to see similar graphs for the other more commonly used tetras.

Hope this helps in some way.

Peace, Maz

PS Please note the link to the graphs (above) were not those prepared by Road Back, but by Trevor Marshall (see copyright on graphs). Still have some digging to do to find the RBF ones. 😉

[Noel]

Thank you maz you are a gem, that,s very useful info. Although it does refer to minocycline which I believe I?ve read may have a much deeper penetration then that of doxycycline and therefore would have a different accumulative reservoir effect.

Of course each of us is different and what gives a good balance of dosage to herx flare in one may require different dosage for another in order to defeat the mycoplasma and maintain some kind of useful life without too much pain.

Thank you for taking the time to dig out that information.

[maz.aust]

Hi Noel, it's nice to see you are still here and on the programme.  I do hope you are continuing to do well on your abx.

I believe it depends entirely on your own system as to what works for you as opposed to what works for me. 

Dosage and different abx's certainly makes a difference to me.  When I was put onto only 50mg Doxy in late Nov last year I got a doozy of a herx, it was pretty painful I can tell you, back then I did the 'whole lemon drink' thing and then tried MSM to combat the pain – I found MSM worked for me and the pain went down to tolerable.  After the Xmas holidays, when I got home, I stopped the MSM and found that I wasn't herxing any more. 

I do know the difference between my flares & herx pain … with a flare my pain levels get to 9 to 9-1/2 on the old painometer within 1/2 to an hour of it starting, then I have that pain level for 3 full days and nights … when I experience a herx the pain sits between 5-8 on the pain scale but it is spasmodic, nothing like the pain from my flares.   

It seems to me that you have been experiencing some herxing brought on by the change of abx.

Dec07: Diagnosed PRA, (CTD; Fibromyalgia; suspected Lyme):
Mar08: Diet to heal gut/bolster immune system (no gluten, dairy, sulphites or sugar)

Jan 2018: ABX Mon/Wed/Fri (started AP 2008)
1/2 x 150mg Roxithromycin(Biasig), 1/2 x 150mg Clarithromycin (Klacid),
1/2 x Fungillin, 1 x 250mg Cephalexin (Keflex)

All off days Probiotics

[Noel]

Hi maz.aust,

Nice to here from you, glad you have come through your recent troubles ok.

[user=492]maz.aust[/user] wrote:

It seems to me that you have been experiencing some herxing brought on by the change of abx.

 

That is exactly right and it?s understanding the relasonship between dosage and the half life of that dose and what exactly that means in terms of killing mycoplasma or not between doses.

I would urge anyone who really wants a better understanding, to put some figures to the question I set above ( repeated below) that went unanswered. It?s not difficult to work out and by folk putting their own numbers to it, they will be able to see for themselves the effect on mycoplasma over time for that dose, rather than just accepting someone else?s word for it.

?

If 200mg is found to bind antibiotic to plasma protein at a rate of 80% worst case. The percentage of antibiotic free and therefore able to feed active mycoplasma must be 20%.

Given the above and assuming it to be correct.

What would the percentage antibiotic bound to plasma protein be if the dose is 100mg and what percentage is then antibiotic free and therefore available to feed active mycoplasma?

At 100mg initial dose, what percentage is bound to plasma protein at 12 hours and what would the affective percentage available to feed active mycoplasma be?

At what point would you say the amount of antibiotic free plasma protein available to feed active mycoplasma would be in order to consider the antibiotic effect, effectively out of the system?

?

As you?ll know from the heckling you have experienced yourself elsewhere in the past, some people listen but getting them to hear is something else.

Anyway I don?t want to start another forum war because we all know that certain types of people will bait you so that you have little option but to respond. I?m not going to allow the hard work that?s gone on here by others to be compromised in that way and since I would find it extremely difficult not to respond, I?ve decided that I will no longer post here while that condition exists. Will keep in touch though.

 

P.S  I'm doing fantastically well thanks maz. I?m now playing golf several times a week and living life to the max. 

Disease, what disease!

All the best,

Noel

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