Friday, July 18, 2008

Do You have to take Flagyl?

Flagyl tastes bad and you can't drink alcohol with it: two negative. It causes a significant Herx. It is thought to only kill Lyme cysts. The alternative drug is Tindamax. Many internet entries claim that Plaquenil also kills Lyme cyst. I have found no substantiation of this claim. Some patients respond great to Flagyl while others do not. Again, Stratton has found it to be a critical part of his CPN protocol. One could argue that cysts convert back to the other active forms and that long term therapy against spirochetes and L-forms is adequate. My experience is that Flagyl is helpful. Spirochetes bathed in Rocephin or Doxycyline have been shown to convert to the cystic form within hours. I don't want to give the Lyme any place to run to. Have meds on board which can kill any of the three forms. I will reiterate that pulses doesn't make sense to me. This allows for periods of time for the accumulation of large cyst loads. Once daily Flagyl, 250 mg or 500mg is adequate. (Don't tell anyone, but most patients who take low dose Flagyl in the morning seem to be able to drink at night without throwing up). Cysts show up in the brain tissue of people with brain Lyme. So I can't say it is they are not disease causing. Nobody really knows. I don't use Flagyl in early therapy because patients Herx too much. It should work as well orally as it does IV. Although there is no evidence based research to support this; many of my worst patients with neuroborreliosis have responded remarkably well when IV Rocephin, Zithromax and Flagly are given. Another plus of Flagyl is that it treats C. diff. Any patients with a history of C. diff, pseudomembranous colits, are routinely given Flagly to help prevent recurrences of this potentially serious infection.

5 comments:

Sonia said...

Question:
I had undiagnosed lyme for 8 yrs, just finished 4 months of treatment. Starting 5th month.
I feel great! I couldn't get out of bed at all or drive due to memory fog.
I have been feeling literally at 90% for 2 months and it is scary! that i will get very sick again.
I am on Zith. 500/mg, Malarone 250mg for Babs and Flagyl 500mg-1x per day. I'm on the first month of malarone and zith and 7 th day of flagyl.
I haven't had any herx at all with malarone, zith or flagyl.
Is it too early to herx on flagyl or what does it mean?
I just finished 4 full months of
Rifampin 600 mg, ceftin 1000/mg and doxy 400mg/day (4 months for latent TB and incidentally to treat bartonella). I have been expecting to get really sick w flagyl due to massive cysts...
does it mean i didn't have too many or is too early to herx?
thank you!
sc :)

Ritz said...

I took flagyl when I was diagnosed with Lyme and was taking it only to treat H. Pylori (I have no idea how I got that).

Flagyl AND Biaxin gave me MAJOR PSYCHE ISSUES. I literally just changed personalities right after taking the antibiotics and when I stopped, returned to my normal mental state. The FDA should write these as warnings for side effects. Extreme feelings of hopelessness and hysteria and depression.

mb said...

A certain Dr. in CT prescribed Tinidezole for my child (age 11) after several months of minocycline.
My child's reaction to Tinidazole was scary, as in, he behaved in a psychotic manner.
We were too scared at the time to continue (herein lies a possible reason to "pulse"??)
Went back to Mino alone.
Today the kid is presenting with profound CFS. Hypothesize that Mino pushed spirochetes into cell deficient forms - and that he has a co-infection or two (although tested negative at the prominent TBD labs)
Idea: Is this awful reaction to Tini/Flagyl a very strong Herx? Is it an indication of how profoundly embedded the cyst forms are in the brain?
Wondering whether or not to put son back on it...but no LLMD avail. to advise.

Lee said...

Sounds like a herx to me.

I'm on Ceftin, Biaxin and Flagyl. I take Flagyl 3x day at 500 mg per dose. Yikes.

But I've had sores that would not heal for years that were closing up with the first 2 meds -- started Flagyl and I woke in the middle of the night with those sores pulsing, tingling, swollen, painful.

I figure what the dr told me is on the mark. LYme can retreat into a cyst. With the first two drugs, it did, and I felt better (well, except for falling, fever, blah blah -- at least I could think straight for the first time in years.

I think the first two meds attacked the Lyme, it retreated, the Flagyl was a "sneak attack". I feel like -- well, very, very bad. Barely functional and I need to function, so I feel pretty desperate.

Point is, I think Flagyl is very necessary. My dr believes in an aggressive, high dosage, two week course. I see her point. If it's pulsed, there's always a chance it's not knocked out totally, just momentarily eased.

I've got babeosis (sp?) and many breathing problems, too.

I am half in awe, half in hell, thinking that I can be on three antibiotics and I still have skin lesions all over (although reduced) and any scratch I get still has a 50% chance of getting infected.

I was just dx'd and I've had it 25 yrs. I have no idea how I lived, all that time.

Lee said...

Forgot -- I believe the Flagyl is a cyst buster. I went on it, what was resolving got worse -- but that is exactly what I was told would happen. Yes, I made progress, but Flagyl would shake out all the cysts and create the worst ever Herx. So I'd assume herx over "allergic reaction".

You could (and should) always call your dr if you have a question, tho.