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.