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» LymeNet Flash » Questions and Discussion » Medical Questions » Artemesinin - Why pulse it?

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Author Topic: Artemesinin - Why pulse it?
nefferdun
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Why must we pulse artemesinin/artesunate and other derivatives of artemesia? Why are there so many different options for how to pulse it? Does it matter?

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old joke: idiopathic means the patient is pathological and the the doctor is an idiot

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nefferdun
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I am researching this and here is one quote which is in reference to treating dogs with bone cancer. I didn't realize it was a treatment for cancer!

"A marked decrease of the gut absorption of artemisinin occurs within days if it is given daily. We hypothesize that high, pulse-dose artemisinin will be safe and effective in cancer treatment because it is unlikely to induce absorption resistance and it can achieve higher blood concentrations. "

"Artemisinin has two derivatives: Artesunate, which has a relatively short half-life; and Artemether, which may be a more effective derivative, because it stays in the body longer. It also may be more effective than Artemisinin alone in brain cancers, because it penetrates the blood-brain barrier more readily."

Artemether is in Coartem.

Boy, you can find really great research on dogs!!!

"A product called Artemix is available from Wellcare Pharmaceuticals. It contains Artesunate, Artemether, and Artemisinin. The combination capsule may be more effective than Artemisinin alone."

http://www.bonecancerdogs.org/main/document/50

Well I answered my own question - hope anyone reading this learned something too. The last article states there are different ways to pulse and it just depends on what seems to work best for you (the dog).

I ordered the Artemix. It has twice as much artemether in it as Coartem! Dog research!

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old joke: idiopathic means the patient is pathological and the the doctor is an idiot

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Lymetoo
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I never pulsed it.

--------------------
--Lymetutu--
Opinions, not medical advice!

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Heleneh
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Our LLMD had us pulse it for three months. Ten days a month we took it.

In Dr. B's handout when he gave his talk in Wisconsin, he listed to pulse it.

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James1979
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I read somewhere that the stomach starts to create enzymes which de-activate the beneficial effects of the artemisinin, so after a while it loses its benefits. But if you pulse it then the body doesn't have a continuous supply of those enzymes, hence the active ingredients are allowed to pass through.
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nefferdun
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That makes a lot of sense James. They said there was a decrease in gut absorption when taken daily without breaks - but did not explain how or why.

I wondered why Coartem was only taken three-four days. I know it cures malaria in that amount of time but not babesia. Artemether is the first drug in Coartem so I guess that should not be taken daily. But I wonder if this drug could be pulsed like artemsinin or artesunate and be more effective.

Lumafantrine is the second drug and it lasts 4 days in the body so it seems like pulsing Coartem 3 days on and 4 days off would theoretically work. Lumafantrine has very low toxicity.

I have been looking for more information but there is none. There are two people that have posted pulsing it 4 days on, three days off, at a much lower dose. One person was having very good results.

If anyone is interested, here is a site with 12 anti-malarial drugs so you can compare them.

http://www.itg.be/itg/distancelearning/lecturenotesvandenendene/02_Malariap12.htm

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old joke: idiopathic means the patient is pathological and the the doctor is an idiot

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Mo
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hi,

i pulsed artimisinin and cured my babesia, holley pharamceuticals had research to the effect of the above statements. that's the brand i used, after 2 or 3 rounds of riamet apparently failed.

vet research i read at the time supported pulsing as well, taking into account the fact that babesia is spawned from the liver in cycles. time off the medication gives it time to repopulate the blood, and artimisinin is highly effective at killing babesia there.

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scorpiogirl
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Thanks God I saw this post... which prompted me to double check my treatment plan and sure enough I am supposed to pulse this too!! Luckily I had only started this on Monday so I took one extra day of it. Ooops!!

Doctor wants to do 5 days on 2 days off for the first two weeks of the month. So today should have been my off day. [Frown]

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jackie51
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When I took this, I was on 3 weeks, off 1 week. So, there are different ways to pulse. (ARG Artemisinin.)
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Jamers
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I also took it 3 weeks on, 1 week off.

--------------------
Diagnosed Pos. Lyme Nov. 17, 2010, Igx.
Pos. Babesia Duncani March 2011, Igx.
Clinical diagnosis for Bartonella

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nefferdun
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Sometimes doctors go no further in their recommendations than to say it is best to pulse herbs of any kind so it does not build resistance. Most of the time it is recommended to take breaks from supplements and herbs - several weeks on - one off.

But if research is right that the stomach begins to produce enzymes blocking it's absorption, after 3-4 days, then it would make sense to pulse it in shorter periods of time.

Mo, it is very interesting that babesia is spawned from the liver in cycles. Is it believed that the babesia in the liver will be "used up" after so many cycles or do they replenish themselves?

If they continue to re-populate in the liver, I don't see how allowing them to enter the blood and killing them over and over would make a difference.

Is there any site where more information is given about the life cycles of babesia?

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old joke: idiopathic means the patient is pathological and the the doctor is an idiot

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patty7
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I have been pulsing 2 weeks on, 2 weeks off. This sounds different from most of you. Have you heard of this?
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lymeboy
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Wow, thanks for this! I just purchased some Artemesia. Was not advised by LLMD to take, but I'm taking it anyway. You saved me a bunch of questions here. Awesome!
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scorpiogirl
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Lymeboy go S L O W L Y! Don't do what I did... I am normally very cautious but since these are herbs and I didn't have any reactions on Samento & Banderol I got cocky. Took the full doses right off the bat and then some. It is kicking my butt in the worse way!! I have not felt this bad in a year!! Who knew Art can do that!! Live and learn... slow and easy does it. Gotta have respect for those herbs!

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lymeboy
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What is a good starting dose for Art? I ordered the caps, 100 MG. Should a pill be split at first? should I get a lower dose to begin with?
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scorpiogirl
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Mine is 200mg and I took 1 pill 2x/day and that was too much too soon for me. I wish I had done just one pill a day!

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nefferdun
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I started Zhang's artemesia, which is supposed to contain artesunate, this morning and took two instead of one. I have had bad air hunger all day. It has 400 mg per capsule and the recommended dose is one three times a day.

In Dr. S' book he says to take between 1200 and 2500 mg of artemesinin, a derivative of artemesia.

For artesunate or artemether, which are much stronger, he says to take 4 mg per kilo (2.2 lbs) of body weight.

I was really surprised that you can buy artemether without a prescription because it is one of the two "drugs" in Coartem.
You are supposed to take 8 tablets a day and each one contains 20mg of artemether.

A bottle of Artemix has 50mg each of artesunate and artemesinin and 40 mg of artemether. It is really expensive - 30 capsules for $60. To take as much artemether as you would with Coartem, you would have to take 4 capsules a day - three days on, four days off. Considering the other forms that are in it, I think I will try two a day with malarone.

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old joke: idiopathic means the patient is pathological and the the doctor is an idiot

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Mo
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hey there,

back when i was researching this, the docs weren't pulsing it. , or using it much, and riamet was NOT available in this country!
i feel proud of my decisions back then. [Cool]

the info on life-cycles was particular vetrinary medicine articles that are in my crashed computer
(along with allot of other great medical research). i plan to revive that thing at a geek squad just as soon as i can...
which won't be soon, lol.

i'll post if i find these articles again, but it was veterinary research, the only place i found to even discuss the lifecycles in this way.

if bpeck is still around, she could link us.

and yes, the idea is to continually decrease the load until the immune system took over the liver stage, so to speak.

mo

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Mo
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not vet research, but a good article if you haven't seen it.

babesiosis.

mo

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Mo
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http://artemisinin.pbworks.com/w/page/13759315/FrontPage

ok, that's an excellent article, but you have to go thru the link because when i paste it here it does that thing where the page stretches reeeeeaaaallly wide.

i just found this one, worth checking out.

mo

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nefferdun
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Thanks Mo!

Those sites are very informative. It is good to remember that high doses of Artemether is toxic. That site says to never take more than 1 mg per kilo of body weight. In the treatment with Coartem, you take four tablets twice a day and each tablet has 20 mg artemether which is 160 mg -

But in Dr. S' book on babesia, he says the WHO (world health organization) recommends using (for malaria) 4 mg per kg of body weight for three days, when a second synthetic medication is combined with it (like lariam, lumafantrine etc).
So that is a much higher dose consistent with Coartem (in fact, much higher than Coartem).

If you do not use a second medication you take it for seven days, instead of three. You use 4 mg per kg the first day and 2 mg per kg the last 6 days.

Artesunate, according to one vet site, is the most active and least toxic but it has the shortest life in the body. Another thing I learned is not to take any artemesia product with food containing a lot of iron because it blocks absorption.

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old joke: idiopathic means the patient is pathological and the the doctor is an idiot

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Marcie
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neff- I just started zang art too. Did you start on the full dose 3 a day or lower? I am starting on 1 day for the first three days to see what happens. So far so good. How are you pulsing yours? I am doing three a day for 10 days then repeat in a month.
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nefferdun
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I am doing three a day. I even added in my left over artesunate (from another company) in the morning dose so it is hitting me. I am taking it 4 days on and three days off.

I read you will increase the blood concentration if you take it with grapefruit juice. In fact, someone on here posted that Dr. K had a protocol for artemesinin with grapefruit juice that is very effective.
You don't want to take it with iron.

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old joke: idiopathic means the patient is pathological and the the doctor is an idiot

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Mo
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nefferdun,

i also noted the info on how many jillions of these parasites are passed at the tick injection
site. sobering information.

i believe i may have a brand new babesiosis infection.

did you note the list of sources on that last link?

what do you think of the first one by allergy research? others are interesting too.

i tend to lean toward as close to a whole plant formula on herbs as the most effective.

an old-school herbalist who practices in a region endemic to maleria says a tea of the whole plant artemesia cures very effecitvely.

however, in this case it seems there is benefit to have at least the concentrate of artemisinin.

i'm trying to choose what to do otc at this point, in addition to possibly coartem through my doctor.

mo

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Mo
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so,
after pouring over the page i linked above on artimisinin,

artimisinin page

..which should be noted that the suggested protocols listed there are for use in cancer, not malaria.

i see that cancer patients want artemisinin to penetrate tissue, with babesia, we want it to target red blood cells in the bloodstream.

more recent vet research excludes a "liver stage" in babesia, however i believe there must then be rebirth, or birth,
coming from RBC's that sequester there or elsewhere, hence the need for repeated rounds.

i also read this cautioning use of the stronger derivatives for babesia:

http://www.personalconsult.com/posts/coartem-for-babesia.html

after considering all, i would agree with doc s in that artemether and perhaps also artesunate
are too toxic in long courses. they are used to treat malaria in four day spans. i also believe they are not necessary for babesia.

so, with the idea to target rbc's in the bloodstream, to have maximum blood concentration of artimisinin, for toxicity concerns, and because it worked before for me..

i'm going to go with artemisinin but different formulas this time, the super artimisinin plus the phytoartimisinin (listed on the artemisinin website) by allergy research or nutricology.

i'll do 1200mg dose of artemisinin total,
split in three, for three days on and four off.
or four on and three off, not sure on that yet.

my head hurts more from reading. [loco]

i'll post on how it goes.

how are you, nefferdun?

mo

[ 08-17-2011, 12:33 AM: Message edited by: Mo ]

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nefferdun
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I still have the air hunger but otherwise I feel pretty good.

These are the symptoms that I have gotten rid of (for the time being).
Depression/anxiety
extreme fatigue
headaches
large muscle pain in thighs and occasionally back (cramps)
burning on shins (added Bactrim DS- bart?)
inability to think clearly/ feeling drugged and out of it
hot flashes (!!!!) with sweats

The remaining symptom that I am aware of is air hunger and lack of stamina. Doesn't mean I won't get sick again - can't be too optimistic.

I took aretemesinin with bactrim DS for 9 months and the babesia got much worse. I have duncani which is harder to treat.
The LLMD told me taking it without an antimalarial drud probably just created resistance to it. I don't think it is a good idea to take it alone for this reason.

As for artesunate or artemether, they are the strongest derivatives of the herb. My babesia was obviously resistant to artemesinin. According to Dr. S' book Zhang's artemesae contains artesunate, not artemesinin. That is just what HE says.
I go with the strongest version, highest dose these days.

I have also been researching low dose naltrexone and am going to try that when I see the GP next week.

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old joke: idiopathic means the patient is pathological and the the doctor is an idiot

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Mo
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i wonder if it wasn't resistance, but rather the decreased blood concentration issue.

what dose were you on for the nine months, and did you pulse it?

i was considering the artesunate, hepalin brand is noted on that webpage. i'm going to start with the two artimisinins and see.

in any event, my understanding is it's pretty difficult to develop resistance to an herb,
perhaps you can still utilize artemisinin and/or it's derivatives if you pulse (no more than three to four days consecutive dosing, and then a three to four day break.)

air hunger is an awful symptom. i haven't developed that yet, i'm in the headache, fever, sweating, neck pain, dark urine, muscle pain stage.

yay. are we having fun yet?

mo

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nanaaaaa
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i agree mo, air hunger is such an awful thing, am not finding any words for that. combined with that horrible fatigue it makes me beg to die sometimes.

i started art2 of zhang too, 2 month ago. could take it for 2 weeks and had to stop it. herx was worse but if you keep saying your brain "get through it" you can make it. my prob were elevated liver enzymes (5 times higher than the normal maximum) also my leucocytes moved down dangerously...i felt so sick, i couldnt even eat, sometimes i had to puke because i drank WATER lol...
i could do 2 courses of this until now, i think despite everything i am feeling it is doing something good for me: attacking my babs.
so i try to pulse it now.
have not used another brand or derivate of arte until now. only zhangs #2

hoping for more discussion

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nanaaaaa
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i pulse 3 days on 4 days off. today first pulse is starting.
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WPinVA
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I started out with 300 mg of Arteminisin 2x a day for 3 days a week, 3 weeks on and one week off. Now I'm supposed to work up to 500 mg, which LLND says is the full dose.

Has anyone cured their babs with Arteminisin alone? I went to my appt today expecting to get more drugs for babs, but instead she is keeping me on just Art for now, since we're still going after the Lyme and also need to start hitting Bart.

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Mo
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hi again,

i'm still pulsing, since th end of august.

three days on, three off, then to three days on four off because that just felt better.

each time the round causes a flare followed by improvement.

but still, this week again, i have had the sweat return, and day one on art knocked it out yet again.

i plan to continue pulsing until symptoms are gone, but it has definately reduced symptoms, much like it did for me when i used it a couple of years ago.

-- that was post allot of mepron and other pharmaceuticals..and artemisinin got rid of it for me.
this time is started on a "fresh babs" case.
then and now i am not on a macrolide with it.

from my experiences, i think pulsing makes a huge difference in toxicity, resistance, and efficacy against babesia.

that said, i do have one coarse of riamet i plan to use once symptoms are almost gone to see my response, which will be soon.

i have lad liver panels run weekly, and all is perfect.

i know art can stress the liver, mainly from the die-off, i believe.

mo


mo

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The Swede
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Hello! I have a question.. Does anyone know if you need to pulse liposomal artemisinin as well? I have Quicksilver Scientifics Artemisinin Emulsion. My health practicioner doesn´t know about pulsing, everyone is telling different things and I get confused.. Thank you very much in advance!

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Karin

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mrsfarmer
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Swede,

That is what I am taking. I was told to pulse 5 days on, and take the weekend off (so 2 days off). Do this for 3 weeks, then take the whole 4th week off.

Then repeat. But I know others will say lots of different things as it seems to be quite different depending on the doctor. [Smile]

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bcb1200
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Yes for the same reasons discussed above. Your body builds up some enzyme or something and it gets less absorbed.

I’m also on Liposomal art. Called “Artemisinin Essentials” by Hopkinton. Actually they are now called something else but it is still Hopkinton.

The best protocol as discussed is 5 days on per week, 3 weeks per month.

--------------------
Bite date ?
2/10 symptoms began
5/10 dx'd, after 3 months numerous test and doctors

IgM Igenex +/CDC +
+ 23/25, 30, 31, 34, 41, 83/93

Currently on:

Currently at around 95% +/- most days.

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mrsfarmer
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bcb1200. That is the same kind I am on as well.
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