Pulsing Vs daily dosing

[Nason]

Hi,  I was taking 200mg of minocin for RA every day for three years with good results.  I had to take a break from minocin  for 6 months because of discoloration patches on my face. During  the break time my RA slowly came back, especially  in my feet.  I started pulsing minocin 100mg every other day with  500mg azithromycin every 10th day. I have been pulsing for 3 weeks now.  I have two questions.  First, my herx is much worse on this smaller dose with pulsing. Is that a good thing?  When I started daily dosing 3 years ago. I did not herx at all. (The only side effect was dizziness for a couple of weeks) I ask because this time I am using my local doctor who has no experience with Ap. Seond question.  I would like to exercise by walking but I am afraid I will do damage to the joints in my feet as several joints are pretty flared up. Does a lot of walking on swollen joints do damage to them? I know that this site does not give medical advise, but I was wondering if anyone has had personal experiences with either of these two issues. Thanks

[lynnie_sydney]

Nason – I noticed that you asked the same question on July 12th. Maz gave you a very comprehensive answer in her reply post. You may like to re-read that. This is the link to that thread: http://www.rbfbb.org/view_topic.php?id=2741&forum_id=1&highlight=daily+dosing There have also been other discussions on this topic that may be of use – just type in 'daily dosing' in the search box above and they will come up. 

It is likely that the anti-inflammatory action in the mino prevented any symptoms of herx last time. If you accept the infectious theory, then many will tell you that daily dosing in RA is immuno-modulating but doesnt kill pathogens. Pulse dosing, on the other hand, kills the microbes and therefore what you are experiencing now is the result of cell die-off. Your pulse schedule (every other day) plus zith every 10 days is still very  vigorous. You may need to dial it back to make the herxing tolerable. More is not necessarily better with this approach – less is often more. It is quite hard for conventional doctors to understand this counter-intuitive way of using abx. You may need to experiment, but the most common pulse dose is 100mg mino on MWF. If that is too much, you can start lower and work up. You also need to take care of inflammation if it is severe. The abx will not be able to reach thier target otherwise. Herxing is definitely a good thing, because it means that the abx are reaching their target. But, in the words of of a long-term APer and former regular here, the idea is to kill microbes, not the patient. Best to you. Lynnie  

Be well! Lynnie

Palindromic RA 30 yrs (Chronic Lyme?)
Mino 2003-2008 100mg MWF - can no longer tolerate any tetracyclines
rotating abx protocol now. From Sep 2018 MWF - a.m. Augmentin Duo 440mg + 150mg Biaxsig (roxithromycin). p.m. Cefaclor (375mg) + Klacid 125mg + LDN 3mg + Annual Clindy IV's
Diet: no gluten, dairy, sulphites, low salicylates
Supps: 600mg N-AC BID, 1000mg Vit C, P5P 40mg, zinc picolinate 60mg, Lithium orotate 20mg, Magnesium Oil, Bio-identical hormones (DHEA + Prog + Estrog)

[Kim]

Hey Nason,

I've always had excellent results with pulse-dosing.

kim

[Maz]

[user=1470]Nason[/user] wrote:

Seond question.  I would like to exercise by walking but I am afraid I will do damage to the joints in my feet as several joints are pretty flared up. Does a lot of walking on swollen joints do damage to them? I know that this site does not give medical advise, but I was wondering if anyone has had personal experiences with either of these two issues.

 

Good question, Nason….and the asnwser is probably, yes. Any weight bearing exercise on inflammed joints adds extra stress to the joint and could cause further damage. If you want to exericise, while your feet are bad, it might be a good idea to stick to cycling on a recumbant bike for a while, until your herx/flare passes. Exercise is important for RAers, but unfortunately not at the expense of further harming a joint.

As Lynnie mentioned, the purpose of pulsed dosing is to elicit herxing, but the herxing should be kept tolerable and should ultimately peak and then pass so that you feel much improved after. On the other hand, flares tend to be more prolonged and are a harbinger of worsening. Either way, though (herx or flare, both cause increases of inflammation, which need to be kept to a minimum to prevent further joint damage.

Hope your herxing period passes quickly for you, Nason. There are some  supportive adjuncts you can do to help you through these rough patches, including the epsoms/peroxide baths, lemon olive oil detox drink, drinking plenty of water to flush out toxins and supportive detox supps. You should find much info on any of these by using the search box, but if you have any trouble, let us know.

Peace, Maz

 

[Rosemary Perth Aust.]

Nason you did not mention using Zithromax the first time Is it possible you are herxing badly with that.

The other thing is this often happens when you stop treatment it can come back with a vengance.  Most of us have tried at some stage to go off treatment and found things get nasty once you do.  some are fortunate enough to be able to stop after a while and seem to be cured. It is great to be able to ask what happens to others thats how we all learn what to do.

[PhilC]

Hi Nason,

Did a doctor tell you to stop taking Minocin, or did you stop taking it on your own?  The reason I ask is that it seems to me that an experienced AP physician would not have done that.  Based on what I've read, a good AP doc would have switched you to a different antibiotic, such as doxycycline, rather than have you just drop the antibiotic completely.  Also, you probably should have been switched to pulsed mino sooner.

Phil

"Unthinking respect for authority is the greatest enemy of truth."
- Albert Einstein

[Author]

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