Started on 200 mg a day

[Shari]

Hi everyone: I am new on this site with AS. My new Rheumy started me on 200 mg mino per day but my 100 pound 35 year old body couldn’t take the dizziness and nausea so he said I can go down to 100 per day. Nausea and dizziness have imoroved but still there. Can the side-effects go away with time? I am desperate right now. I am on Enbrel but keep getting sick. And forgot to mention, I think I still have a sinus infection.

[Kim]

Hi Shari,

That is a whopping starting dose and can give you a severe herx response. Some people start off as low as 50-100 mg Mon/Wed/Fri and then either stay with pulsed dosing or go on to daily. This is where you and your doctor have to access what’s working for you and what’s not. If you click on the dark blue banner at the top of the page it will take you to the Home section and you can refer to the Physician’s Pages for dosing information.

Dizziness is not uncommon at first, but gets better as you clear out some of the toxins. Detox, detox, detox. 😉

Please remember to load up on probiotics to avoid yeast issues.

Take care……kim

[Shari]

Hi Kim: Thanks for the quick response. I asked him about going down to the three days a week but he said stop it if I can’t tolerate it daily. I don’t know if he knows about this website, but I will bring it up to him. I don’t want to give up. I have been living with AS since my 20’s and and it has severely changed my life.

I have had problems with yeast from antibiotics. I eat a yogurt a day. Should I be taking a supplement too and if so, how much and which one?

Shari

[Kim]

@Shari wrote:

Hi Kim: Thanks for the quick response. I asked him about going down to the three days a week but he said stop it if I can’t tolerate it daily. I don’t know if he knows about this website, but I will bring it up to him. I don’t want to give up. I have been living with AS since my 20’s and and it has severely changed my life.

I have had problems with yeast from antibiotics. I eat a yogurt a day. Should I be taking a supplement too and if so, how much and which one?

Shari

No, Shari, yogurt is not enough. Here is a link to another recent discussion on probiotics: viewtopic.php?f=1&t=5337. Lots more if you use the “search”, in fact, more than you ever wanted to know about probiotics. 😆

Take care…….kim

[carries]

Hi! Welcome to RBF. I started low and slow as well. I didnt experience any of the dizziness or nausea…I was taking a antihistame…like allegraD when I started and I know that it can help with herxing. I didnt herx for the first year up until recently….well I think it was a herx…still dont know. Also the lemon olive oil drink helped to detox too!

I would also got on a strong probiotic. I take GNC 50 billion a day probiotic. Its pretty expensive…but I think its done its job. I havent had any yeast issues that I am aware of….I also take 3 billion acidopholus by Solar Ray. I do refrigerate both products so they stay live.

[MINOCINMAN]

@carries wrote:

Hi! Welcome to RBF. I started low and slow as well. I didnt experience any of the dizziness or nausea…I was taking a antihistame…like allegraD when I started and I know that it can help with herxing. I didnt herx for the first year up until recently….well I think it was a herx…still dont know. Also the lemon olive oil drink helped to detox too!

I would also got on a strong probiotic. I take GNC 50 billion a day probiotic. Its pretty expensive…but I think its done its job. I havent had any yeast issues that I am aware of….I also take 3 billion acidopholus by Solar Ray. I do refrigerate both products so they stay live.

I was dizzy for a 2 or 3 days, but then got use to 100mg in am and 100mg in pm.

[Shari]

Carrie and Kim: Thanks for the info on the probiotics. How much do I need right now on the 100 mg per day Minocycline and which brands do u guys think work the best?

Could I be having a herx reaction with the dizziness and nausea? If so, how long does it typically last?

Thanks for all the support.

Shari

[lynnie_sydney]

@Shari wrote:

Carrie and Kim: Thanks for the info on the probiotics. How much do I need right now on the 100 mg per day Minocycline and which brands do u guys think work the best?

Could I be having a herx reaction with the dizziness and nausea? If so, how long does it typically last?

Thanks for all the support.

Shari

Shari – if it were me, I would consider having a wash-out period of about a week then starting at 100mg (or lower) MWF. I agree 200mg daily is a HUGE starting dose. Trouble is rheumies often dont understand the ‘less is more’ nature of this approach to treatment and also tend to use Minocin as a DMARD rather than subscribing to the infectious nature of rheumatic disease. Yes, dizziness and nausea are part of herxing and it’s different for everyone as to when this subsides. Info on herxing symptoms etc can be found in the Education of our main site. Just click on the banner at the top of the Forum to access it. 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)

[Eva Holloway]

Shari,
I had a bad sinus infection when taking Enbrel and my pulmonary doctor actually put me on Biaxin to stop that problem, since I took that first 500mg twice a day I actually did not have any side effects, I added Minocin later and never really had a bad herx.
Hope you will feel better soon,
Eva 🙂

Eva Holloway

[Shari]

Thanks guys for your help. I am going to do a week wash out due to the dizziness and nausea, get my sinuses under control and try the medicine again 3 days a week at a lower dose. I will keep you guys posted 🙂

[Maz]

@Shari wrote:

Could I be having a herx reaction with the dizziness and nausea? If so, how long does it typically last?

Hi Shari,

Don’t know if this will help or not, but minocycline is classed as a second generation tetracycline, developed and launched in 1971/72 after doxycycline and the earlier tetracycline (there are others in the series, too, including tigecycline, which was developed later).

Minocycline has superior lipid solubility, which gives it some distinct advantages over older tetras, one important one being that bacterial resistance is less likely to occur, because it is able to penetrate the outer lipid layer of cells more easily. This is quite important, because it is on the outer wall of cells where resistance is formed. One of the ways that this occurs is for cells to thicken this outer lipid cell wall layer and prevent penetrance of the antibiotic. This greater lipid solubility also means that minocycline is a tetra with a difference, because it is better able to penetrate the blood/brain barrier – something older tetras are unable to do. The blood/brain barrier is what prevents foreign substances from crossing over this protective layer of the brain…but, minocycline is able to do this.

Two of the known early side-effects of minocycline therapy are: secondary intracranial hypertension, which can lead to headaches, visual disturbances and confusion, but also what is known as “vestibular disturbances,” which can lead to the same symptoms as motion sickness…dizziness, nausea, vertigo and vomiting.

You can read further about this here:

http://www.emedexpert.com/facts/minocycline-facts.shtml

Fortunately, these early side-effects are transient and do pass. However, it’s one of the reasons why minocycline is best started “low and slow.” Question is, whether or not vestibular disturbances are “herxing” in the classic sense or whether it is just a temporary drug side-effect, as the brain and nervous system acclimatizes to being “penetrated” by the drug. I don’t think there has been any solid, conclusive evidence as to whether it is actually herxing, but that doesn’t mean that it isn’t either. “Absence of evidence isn’t evidence of absence, so to speak.” It just means we don’t really know at this point. ❓

The very good side of all this is that it is now documented that minocycline has some pretty great neuroprotective properties and has actually been studied for use in neurodegenerative diseases, such as MS and Huntington’s, and is also being used in hospital settings for patients who have had strokes, as long as it is given within a short time frame after the event, due to these neuroprotective and anti-inflammatory capabilities.

Anyway, this info is just to help put your mind at ease that these early symptoms are usually transient in nature and can be controlled with a low and slow approach to beginning treatment. The nausea can also be reduced by taking a little food with a dose (preferably foods low in mineral content). This is actually mentioned on the Triax website (bearing in mind that this info is as it relates to the pelleted brand version of Minocin):

http://www.triaxpharma.com/which_page_13.html

[szara]

Hi Shari,

I’m a newbie to AP – just completing my third week. I was started on 100 mg M/W/F. My experience to date has been that during the first week the dizziness, headache and mental fog were unbelievable. I still managed to work, but I felt very much like I was coming down with a severe case of the flu and had spent the day riding a roller coaster (personally not a good thing).

That week my HB said he could see my body reacting in waves. It took me about a week to get through that initial struggle with the nausea, headache, and dizziness factor and it settled down to a manageable amount. I find when it happens I need to drink more water. I just switched from Watson generic to brand name made by Stiefel but the same doseage. I’m pretty much starting over w.r.t the headache and vertigo. My headaches are unreal at times. I take Primal Defense HSO probitotic which is ridiculously expensive and I drink coconut keifer with prebiotics when I take the buggers so that if they make it to their ultimate destination they have a little something to live off of.

I’m ready to get past this phase. I really hate feeling dizzy and/or ditzy. 😯

[carries]

Hi Shari! Not sure if this is going to help with the herxing but try taking an antihistamine….like allegra d or benedryl. That may help

[spfister]

@Shari wrote:

Hi everyone: I am new on this site with AS. My new Rheumy started me on 200 mg mino per day but my 100 pound 35 year old body couldn’t take the dizziness and nausea so he said I can go down to 100 per day. Nausea and dizziness have imoroved but still there. Can the side-effects go away with time? I am desperate right now. I am on Enbrel but keep getting sick. And forgot to mention, I think I still have a sinus infection.

Hi Shari, was interested in your post, since we have a lot in common. My name is Shari (same spelling) also and I’m 100 lbs. But a little older than you 🙁

I started Ap last spring at 200 mg three days a week, but was soo dizzy also. The people here advised be to slow down so I went to 100 mg 3 time a week with food 2 hours before bed. I havent had any trouble since. I continued on just 100 mg and the improvements I made are just amazing. My Rhematoid factor went frome over 800 to what it was last check 200, and my Crp showed no inflamation. And I feel so much better no stiffness at all, but a little foot pain when walking a lot. Just stick with it, and find out what workes for you. I figured because of my small frame (and yours) 100 mg was probaby a pretty good dose for me.
take, care and keep us posted 😀

[Author]

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