Questions about doxycycline, minocycline, etc.

[BG]

I need help sorting out a problem.

Some of my labs have gotten worse so I’m trying to sort out if doxycycline could be contributing to the problem, in preparation for a required physician visit where I will most likely be told I have to stop taking doxycycline.

Has doxycycline caused or contributed to any of the following lab test results/changes for anyone?

Urine pH 5.0, down from 6.5 a year ago and 5.5 on 9/14/11
Carbon Dioxide 34 H, a dramatic increase from 25 on 9/14/11
Anion Gap 8 L, a dramatic drop from 15 H on 9/14/11
Hematocrit 45.4% H, an increase from 41 on 12/23/11
MCV 100 H, an increase from 93.7 on 12/23/11
MCHC 31.3 L, a decrease from 34.9 on 12/23/11. MCHC is usually High for me so this is a dramatic and unusual change.

All of these changes are unusual for me in that they have never happened before so I don’t know what to make of it. I am 99.9% certain they are going to blame it on the doxycycline and discontinue my prescription so I need to know if anyone else has experienced these changes while on doxycycline or any of the other tetracycline drugs such as minocycline.

My creatinine level has dropped and stabilized at .7 and my eGFR has increased from 65.01 on 2/21/11 to 86.56 on 12/23/11. It has stabilized at that level as well. BUN is normal at 18.

Any ideas would be appreciated. I still experience fever, sweats, chills, bradycardia and heart arrhythmia which get gradually worse whenever I stop taking the doxycycline so the thought of it no longer being prescribed (or of it causing organ failure) terrifies me.

Barb

[PhilC]

Hi Barb,

I doubt that doxycycline is the cause, and if your doctor tries to blame doxycycline then he or she better have a very good explanation to justify taking you off of it. Although I am not a doctor, the impression I get from looking at the trend in your test results is that you may have some lung involvement. Are you taking NAC?

Phil

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

[BG]

Phil,

I’m not taking NAC and I don’t have any lung involvement that I know of — no shortage of breath when I walk, climb stairs or hills, bike, etc., no cough, and I don’t feel like I’m not receiving enough oxygen.

Barb

[BG]

I should add that my lymphocyte count is back within the normal range for the first time in 5 years so some labs have improved while others have gotten worse or just plain weird.

Barb

[Maz]

Hi Barb,

Dr.S. in Iowa is very kind to answer questions like this freely. Would you like his contact info? I don’t recall if you have been to see him or not in the past, but he may be able to provide you with answers and reassurance. So sorry to hear you’re dealing with this added concern now.

[BG]

Thanks Maz, hadn’t thought of that. I’ll email him to see what he says. I haven’t seen him because I can’t afford his services but, hopefully, he’ll respond to my email and provide some insight.

Barb

[BG]

I haven’t heard from Dr. S yet, but based on my extensive research, it’s hemolytic anemia http://emedicine.medscape.com/article/201066-overview. My father has this as well so there is most likely a genetic component as well as other factors involved (drugs, infection, SLE and or other autoimmune reactions).

Hydroxychloroquine and aspirin can cause this and, in one condition, tetracycline drugs can cause it http://www.fpnotebook.com/hemeonc/pharm/DrgIndcdHmlytcAnm.htm, http://www.merckmanuals.com/professional/hematology_and_oncology/anemias_caused_by_hemolysis/autoimmune_hemolytic_anemia.html#v969941 so I have stopped all drugs except low dose prednisone (a recommended treatment for this type of anemia) to see if the anemia improves. If it doesn’t, then something else is most likely the cause (infection and or autoimmune).

Barb

[Maz]

@BG wrote:

Hydroxychloroquine and aspirin can cause this and, in one condition, tetracycline drugs can cause it http://www.fpnotebook.com/hemeonc/pharm/DrgIndcdHmlytcAnm.htm, http://www.merckmanuals.com/professional/hematology_and_oncology/anemias_caused_by_hemolysis/autoimmune_hemolytic_anemia.html#v969941 so I have stopped all drugs except low dose prednisone (a recommended treatment for this type of anemia) to see if the anemia improves. If it doesn’t, then something else is most likely the cause (infection and or autoimmune).

Barb

Hi Barb,

Let us know whether your suspicions of hemolytic anemia are borne out by your doctor’s diagnosis.

With Lyme involvement, it’s also possible that babesiosis is the culprit, well-known for causing hemolytic anemia. Perusing the list of suspected drugs in this condition, I always have to wonder and scratch my head as to whether underlying babesiosis was already present and just being stirred up (as many of these drugs are used in Lyme txs for TBDs). After all, as you’re likely already well aware being the great researcher that you are, the tetras are used as prophylactics for a similar protozoan infection, malaria.

http://www.cdc.gov/parasites/babesiosis/disease.html

“Because Babesia parasites infect and destroy red blood cells, babesiosis can cause a special type of anemia called hemolytic anemia. This type of anemia can lead to jaundice and dark urine.”

If it does turn out that this is being caused by babs, then you may get IV clindamycin without too much of a battle, but what a terrible shame for anyone to have to become this sick before it is properly identified.

Barb, I’m putting it out there for you that you can find some proper answers and get this sorted out in good time. Please stay in touch and let us know how you get on.

[PhilC]

Hi Barb,
@BG wrote:

I haven’t heard from Dr. S yet, but based on my extensive research, it’s hemolytic anemia

I doubt that you have hemolytic anemia. Since your hematocrit is normal, it is very unlikely that you have any kind of anemia.

Phil

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

[BG]

Thanks Maz! I did think about babesia, among other things. In my research mycoplasma came up repeatedly as a cause of this kind of problem.

Phil, hematocrit isn’t normal per the lab test results I received (reference range used by the lab 33.0 – 44.0) The actual test results state it’s HIGH.

FYI, I have had a form of anemia my whole life. It has been largely asymptomatic, addressed via diet and vitamin supplements. The changes above are new and have never been seen before. It’s definitely a form of anemia and based on my research, it looks like my bone marrow is making enough blood cells but something is destroying my blood cells.

The lab test results also mentioned Macrocytosis and Hypochromasia. Normal Range is defined as ABSENT. My result for both is SLIGHT.

Barb

[BG]

About hypochromic macrocytes:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC501630/?page=1

[PhilC]

Hi Barb,

I think you should see a doctor about your concerns. Soon.

Phil

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

[BG]

Phil,

After seeing the results, my doctor contacted me and requested I make a follow-up appointment. Her first available date is June 6th so I have to wait until then for follow-up on this.

Barb

[jims]

BG,This is off the subject of doxy/mino but since you have awhile to see your doctor, my MD/ND told me he feels almost everyone is mildly dehydrated. I have personally seen this affect labs, once the tank is filled back up (3 bags) the labs normalized. Not to say this is the case but it is something I have to stay on myself about, to drink plenty of fresh filtered (hopefully clean) water. Also to try to cook foods with meat/bone broth instead of water(like rice) to get the biggest bang for the buck to hydrate, while feeding my cells. On the subject of Doxy, there is one LLMD (Dr. B.) who now recommends doxy given for 3-4 days on 3-4 days off, with larger doses 300mg-600mg daily. This could minimize the effect of doxy on gut ecology. Personally after reading daily for several years now I think lyme is present in almost all of us, in some fashion. The differnce being how our individual body chemistry copes with it. jims

[PhilC]

Hi Barb,
@BG wrote:

After seeing the results, my doctor contacted me and requested I make a follow-up appointment. Her first available date is June 6th so I have to wait until then for follow-up on this.

If your schedule is somewhat flexible, I would call her office and ask to be put on the list of people to call if there are any cancellations.

Phil

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

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