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Hi Nord,
I don't have any specific references for you. It was my impression from reading the treatment protocol(s) that there were steps, something like step 1 NAC, step 2 Doxy, step 3 ?, step 4 flagyl pulses, and that one should not move on to the next step until the current step was well tolerated. That along with reading some of the blogs where people were well into the pulses (like 20+ or even 30+ pulses), it seemed that the protocol required one tolerate quite a bit. Maybe “no pain- no gain” was an unfair characterization.
Todd
Hello Todd!
You are correct about the treatment plan, but it also includes the warning that one shoud take great care not to increase dosage or add antibiotics at a too fast pace, and leave a lot of time between nitroimidazole pulses.
Before the “first step” there is another, call it 0. Supplements to be taken for several months to prepare the body. In the NAC step a reaction is actually actively sought, as the Chlamydiae are the only pathogens susceptible to it (and also only one of the life-stages the EBs, hence no reaction does not exclude infection).
The treatment is very unpredictable, some experience unexpected reactions from Nitroimidazole pulse (-s) compared to identical previous ones (the opposite is more intuitive, as there is less and less bacteria to eliminate).
My own experience underlines this: I had only small reactions to the initial NAC and Vitamin D, and only improvements to the Tetracycline and Macrolide (Step 3.), despite ramping up dosage and steps at higher clip than recommended. I felt that this will be easy, I'll get cured quickly (and per many who belive that the goal is just to control the infection, also partly the view of Brown/AP, I could go on to maintenance). One tablet of Tinidazole brought me back to reality, this is an unpredictable journey. Obviously there are a lot of cryptic/persistent Cpn or Cyst Lyme that I have to deal with. Other may think, why suffer, why not just go for easy maintenance? The answer is that my problems were obviously brought on by the cryptic form (that form of Cpn is the one that probably makes the most long-term damage, although not being so visible, as it does not trigger the immune system). It's an investment, saving instead of borrowing.
So, I don't need that mantra, although others may need it to follow through 😉
Edit: added to last part
Hello Todd!
Not officially, I think. There are several slightly different protocols, and basically, Metronidazole is the Nitroimidazole mentioned. However, Wheldon mentions Tinidazole as an alternative (Sarah, his wife switched to it after an few pulses). Some prefer metro and finds it has stronger effect, and some prefer tini, mainly because its lesser side-effects.
There is a lot of discussion of the two in the forum. I think one point for Metro was that it was more readily available in the U.S. at the time of designing the original protocols, and that it was more reasonably priced.
It is important to understand the different effects of the different abx, the reason to implement each one. There are alternatives for each abx class: Initially, Amoxicillin was initially used instead of NAC (which is also a liver protectant and a few other good effects, while Amoxi increases the load on the liver); Doxycycline can be replaced by Minocycline; Azithromycin can be replaced by Roxithormycin or Clarithromycin; Metro by Tini as discussed. Stratton uses Rifampin and then it can possibly replace the tetracycline (Doxy or Mino, Tetra is not used). Other modifications are possible to target other co-infections, but one has to know the effect of each abx, otherwise one may leave an escape route for the Chlamydias. Different dosages for each abx, obviously.
I chose to start with tini just because of the milder side-effects (emphasising the going easy approach ;)), the higher CNS penetration, and longer half-life (least important). I'll try Metro when I know my way around the pulses and reactions. 🙂
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