Friday, October 30, 2009

Odds and ends and ILADS

Patients treated for Bartonella seem to experience of lot of itching which may be associated with rashes, bumps or normal skin. It seems to be some sort of Herx reaction.

Eva Sapi's research: very revealing. Lyme in the test tube quickly convert to cyst form when doxycyline is added to the cultures. Plaquenil also increases cyst formation (some Lyme literature claims that Plaquenil is an anti-cyst drug). Three drugs were shown to reduce the cyst load. In order of increasing potency: albendazole, metronidazole (Flagyl) and tinidazole (Tindamax). Of course this is in a test tube or culture medium. There are no cells. L-form transformation cannot be observed.

The ILADS' conference was great this year. Presentations were scientific and evidenced based.
Sessions discussing therapeutic options were great as well. I started my first patient on tigacyline, a drug much favored by Dr. Burasanno.

I have liked the layering approach for very ill patients. Start with IV Rocephin, add IV Zithromax and then add IV Flagyl. Dr. Martz agrees with my approach. We have both found this to be very effective. Other physicians recommend pulsing antibiotics in very high doses, primarily with Rocephin. Dr. Burasanno and Dr. Horowitz were animated and informative. "There is no one right way to treat Lyme."---Dr. Burascanno.

9 comments:

Max said...

So I was wondering isn't inducing cysts counterproductive? - it drives bacteria into hiding guaranteeing its persistence. That unless flagyl can penetrate cell walls and destroy l -forms along with cysts

glytzhkof said...

I am wondering as well, because I think that's what has happened to me after months of treatment with Clarithromycin and Plaquinil - I think Borrelia's primarily in hiding now.

I am doing mostly fine, but still notice intermittent problems - probably caused by toxins still present in my system as well as Borrelia reconverting to spirochete form perhaps.

Wouldn't the real solution be to trigger mass conversion to spirochete form and then hit hard with both cyst and spirochete drugs?

Are there any theories as to how to invoke such conversion? Are there any drugs that will make the spirochetes decide to convert to their normal form?

Brooke said...

In Lyme with CNS involvement, is it best to go straight to IV or can treatment success be achieved with orals?

I know that European studies seem to suggest Doxy is as effective. Does that seem to be the same here?

Dave said...

LymeMD, I was wondering if from your experience while treating Bartonella you see exacerbation of the Bartonella rash (e.g. red stretch marks appearing in more places around the waist, back and thighs). Nobody really talks about it, but since testing for Bartonella is very poor, this could be a very important sign. Could that be herx of Bartonella too?

MJ said...

I am thrilled to hear from LymeMD that "albendazole, metronidazole (Flagyl) and tinidazole (Tindamax)" are good helpers, yesss! As a "Lymie" I've been "promoting" them like the big fighters because they kill bugs, simple; so we do need the antibiotics first and then, boom, kill the bugs and clean the house! Plus the difference of the symptoms, at least in my case went from sometimes feel fine, to sometimes really BE fine! But I heard from this Doctor in South America that they found that Albendazole used in long periods could be strong or even harmful for the Central Nervous system - and we certainly don't want that - so instead they are using "Ivermectin" (Stromectol in the US). The Ivermectin they use is in drops, comes in small bottles similar to those used for eye drops, just 5 ml bottles, and they give one drop per kilogram; but they repeat the dose one every week for three, six months or even a year. They say Ivermectin is a "dewormer that also attacks parasites and bacteria"? I mention it here because it is good to know about medicines used elsewhere, specially because the Ivermectin here in the US, called Stromectol comes in three pills and it is given as one unique dose, never ever again, and it seems the repetition is really required because bugs have cyclic lives so the medicines should be there to kill them when they're reproducing again. I am no expert; this is just a thinking that hopes might help in this search for answers this Doctor "J" does in this blog. I am thrilled to see that all your research and search for answers, plus this teaming up with Clongen and the trust and love of your patients is coming up to good results!!! Thank God! About time!

Orlando said...

Couldn't find the complete information about "Eva Sapi's research", just her story about having Lyme and Doctors almost laughing at her and her now new search for detecting what causes Lyme so Doctors can properly treat it. Couldn't find what she said about Flagyl or those medicines, but did find something that scared me a little.. that because she is seeing that this bacteria is so resistant to antibiotics and has a way to "reject them and fight them" the researcher seems to conclude that long term antibiotic therapies are not helpful... ah? please help; don't let her say that; might be an interpretation not a conclusion right?

Tom Carolan said...

Orlando, I am also unable to locate Sapi E.'s publications regarding Lyme treatments. If anyone can find them please post a url for all who were unable to attend this years meeting. Thanks!

Andrew said...

Google "sapi tinidazole" then read "Summary of conference 2010"

5shoes said...

LymeMD, I was wondering if you by chance went to the 2011 ILADS conference? and what you thought of it...