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» LymeNet Flash » Questions and Discussion » Medical Questions » Pulsing ABX, yay or nay?

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Author Topic: Pulsing ABX, yay or nay?
Mystery
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I haven't started anything yet, still need to get with the right LLMD, but from something I read on here from TF what are you thoughts on the effectiveness on pulsing of the nature: 1 week on, 1 week off, probiotics throughout, repeat this pattern for the entire duration of your abx treatment.

The advantages I see as maybe being possible with such a method is that you get 1 week of abx to kill the bad stuff that way, then 1 week off and your immune system picks up during that week where the abx left off (rinse and repeat), that way your body can easily recover your good stuff and keep immune system from becoming weakened from the good gut bacteria not getting any break to recoup.

I don't see a disadvantage, as the abx will work on the Lyme on abx treatment weeks and your immune system can pick up the slack on non-abx treatment weeks.

Thoughts?

[ 05-28-2014, 05:16 PM: Message edited by: Mystery ]

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TF
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Just to clarify--I took notes on a talk given by Dr. Alan MacDonald, pathologist. Please note: He is not a lyme treating physcian. He is a pathologist.

It was Dr. MacDonald that suggested pulse therapy, not me.

Dr. MacDonald said:

"Treatment

Pulsed therapy (meaning one week on meds and one week off) may be the best treatment. The week off helps the gut and the probiotics also. The pulse treatment may also rotate antibiotics.

Another possibility is using electromagnetic energy (a certain type of ultrasound). I am not talking about a rife machine."


By the way, I don't agree with Dr. MacDonald regarding this type of pulse treatment. I am a Burrascano girl all the way. That's how I got well--following the Burrascano protocol. And, so did 5 of my friends.

Mystery, just know that Dr. MacDonald was not talking from experience. No record of success.

I would say he was talking theoretically, as a pathologist trying to find something effective against lyme biofilms. And, he certainly didn't make the statement with certainty. It was a hypothesis, in my opinion.

See where he says "pulsed treatment MAY be the best treatment." Then, he suggested a certain type of ultrasound treatment also. (This may not be available at present.)

I don't believe most people's immune systems will "pick up the slack" on non-abx treatment weeks. If the immune system is that functional, then you caught the lyme very early--like within months.

See this quote from Burrascano:

"A very important issue is the definition of “Chronic Lyme Disease”. Based on my clinical data and the latest published information, I offer the following definition. To be said to have chronic LB, these three criteria must be present:

1. Illness present for at least one year (this is approximately when immune breakdown attains clinically significant levels)." (page 3)

http://www.ilads.org/lyme_disease/B_guidelines_12_17_08.pdf

Lyme compromises the immune system--breaks it down and destroys it--like AIDS. So, it isn't able to function as you hope.

That's why the vast majority of lyme doctors are not treating as you suggest.


To see my notes, go to:

http://flash.lymenet.org/ubb/ultimatebb.php/topic/1/128852#000000

They are from a talk he gave in 2013.

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Lymetoo
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I was sure wondering about that, TF! I thought maybe I'd been asleep! I don't see how pulsing like that would be good either.

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

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surprise
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In my opinion, and I have seen it first hand in my daughter,
and it happened to me with Rifampin:

pulsing the same antibiotic on and off (except a cyst buster, like Tindamax or Flagyl, which according to Burrascano guidelines is recommended 2 weeks on/ 2 weeks off)

Anyway, the other antibiotics pulsed on and off:
the bacteria build up a resistance.
The particular antibiotic no longer becomes effective, and loses power.

--------------------
Lyme positive PCR blood, and
positive Bartonella henselae Igenex, 2011.
low positive Fry biofilm test, 2012.
Update 7/16- After extensive treatments,
doing okay!

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desertwind
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I pulsed once I was symptom free for 6 months. One week on, one week off, one week on, two weeks off and so forth. Did this for about 4 months.

This was done after very long treatment of full time aggressive abx.s. Been treating for close to ten years w/ the past 2.5 yrs. by Dr. H.

Also taking herbs.

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surprise
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I would think there would be a very big difference between pulsing after full time aggressive treatment,

and starting treatment with pulse method.

--------------------
Lyme positive PCR blood, and
positive Bartonella henselae Igenex, 2011.
low positive Fry biofilm test, 2012.
Update 7/16- After extensive treatments,
doing okay!

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springshowers
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Pulsing is best method I have found !
Also I have researched for infections it's been Proven lower doses pulsed can be much more affective than higher constant dosing. Also on biofilms.
The bugs learn to hide more if you don't pulse and rotating is also good but we all know that.

I've tried both methods.
I do think there is a place for hard core ongoing IV treatment but only a few months probably if that hard core hit is needed

Yes it is true antibiotic suppress the immune system
Add herxes and your hit down more.

Alan McDonald is correct in my opinion.

I though pulse certain meds 4 days on three days off when it's for protozoans and the Lyme meds one week on one week off .
I've tried two weeks on and two weeks off
You kinda gauge based on your reactions and I have done three weeks in one week off too.

I recently have been trying 4 days on and 7 days off as I need less hitting but not stopping.

Ps. I've tested using my full dosing pulsing and half that dose same pulsing. I make more progress half dosing. Its small increments but increments indeed.

Depends on where your at in your treatment and what your treating as to exactly what you do.

My doc has given me freedom over years to experiment with pulsing techniques.

I regret the times I treating ongoing with any anit biotic
I think I even damaged myself moreso thinking I had to push through that schedule.

More is not always better.
Only one time did I need constant IVs and even then after a month I was told to take weekends off.

Many llmds use pulsing and for a list of good reasons.

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susank
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I thought that pulsing also meant - on the off week - that the bugs would think the threat was gone and so come out. Hit them again when they were out.

Out of tissue? Cyst form? Other forms?

Would that lead to resistance? Even if rotating the same antibiotics?

--------------------
Pos.Bb culture 2012
Labcorp - no bands ever
Igenex - Neg. 4 times
With overall bands:
IGM 18,28,41,66 IND: 23-25,34,39
IGG 41,58 IND: 39
Bart H IGG 40

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yanivnaced
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Conceptually I think pulsing would prevent the plateau effect.

Things would get stirred up during the off week by bringing some infections back to the forefront. The herxing would happen again and again giving a chance to chip away rather than have the bugs hunkered down and resistant all the time.

From my experience with several LLMD's, the more up to date ones recognize that pulsing is a good thing.

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Lymetoo
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But springshowers.... It must not work very well if you are still sick??

There is a difference between "backing off the meds when herxing heavily" and "taking a week off" on a regular schedule. (a schedule the keets could easily figure out)

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

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GretaM
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Pulsing tinidazole or flagyl...
Yes!

Pulsing other abx?

No!

Sounds like a recipe for MRSA or other non-TBD related resistent bacteria.

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oceangirlSA
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I was at a local lyme conference recently, and Dr P who was a keynote speaker, discussed how he uses pulsing when people reach a plateau in their treatment.

He said he finds pulsing very helpful in this situation and it almost always gets them over the hump.

My doctor does not pulse, but he does pulse when treatment is complete, with two weeks on, two weeks off.

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CherylSue
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Interesting info!
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springshowers
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Still sick ?

Lyme too

I am on my last symptom that I could only get 50 percent improved. I got rid of a list of 50 symptoms. !
Still sick ? No
Trying to sustain progress yes
Rebuilding yes
Targeting last cause of last symptom Yes !

Still pulsing a certain type and dosing yes
To sustain mostly and add to modalities I'm used on my vein issues where harder tougher attached plaque areas of biolfilm have established from years of disease blocking veins in neck and to heart . I even know exactly where they are and what veins and have verified through targeted external treatment tests.

The rest of my body is 90 percent clear.
Near of disease and clear of symptoms.
Never felt better !
Now
Rebuilding stage of muscle strength and cellular health and immune strength and nerve healing .

Finding answer to last issue and sustaining progress

Still sick. ?

Oh my. not even close !

Still treating the disease and its affects on me after years
You bet.

If I knew then what I know now I never would ever do continuous antibiotics. Ever

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springshowers
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Do your research.

I find many here are stuck in some old ways of thinking at times and if you make sure to research these subjects with newest findings and new techniques and find out why from places that are science based you can make your decision.

Finding out what has worked best fir people its great to do polling on sites like this

I can only share what I know and how it worked for me.
I have tried both methods for good periods of time and base my response on that and the comparison,

Take that plus others experienced and you can definate learn from it and do more research.

Opinions based on opions if you have no experience is kinda questionable but valuable if there is basis to research that opinion. That's what I do with responses from here.

Also many variables
Timing
Meds
Infections
Immunity
Toxicity
Symptoms
Other meds
List goes on and on as to why some attempts on certain techniques can work or fail.

I tend to like to read actual research or testing or such and scientific reports and it takes digging but you can find Them.
There are some comparing pulsing to not and high dose pulsing vs low dose pulsing. And explanations as to why which works better and on what. I read one on Lyme bacteria and one on biofilms. I am sorry I can't find those I read at one point right now as I used to keep a folder on my web browser and I got a new computer and did not get to transfer my browser settings etc. Sadly.

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rowingmom
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Pulsing was the only way we could use tindamax for our daughter. She was simply unable to detox from continuous tindamax - symptoms just ramped and ramped.

We did notice while pulsing (3 days on 4 off) that with each initiation the herx would be smaller than the previous one had been, and that the baseline achieved in between pulses was continuously improving. We weaned when she was no longer significantly herxing and switched at that point to herbals.

--------------------
13 yo DX PANS/Tourette's/Asperger's/ADHD treated for Igenex positive bartonella/IND lyme with 2 years of abx treatment. Weaned off abx April 2013 at 80% improvement. Continuing with Buhner bartonella/babesia protocols. Aug 2014 99% improvement.

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springshowers
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"By the way, I don't agree with Dr. MacDonald regarding this type of pulse treatment. I am a Burrascano girl all the way. That's how I got well--following the Burrascano protocol. And, so did 5 of my friends."

By the way all and TF
Even in Burrascano 2008 - treatment guidelines - 6 years ago
He recommends pulsed therapy and combination
Therapy of antibiotics.
Page 20.

So that's so weird you would question it based on your
Allegiance to Dr B.

Also Dr MacDonald being a pathologists knows a ton more than most doctors on how Lyme and biofilms work and thrive and life cycles and forms and environment and conditions and behaviors etc.
Huge asset. His quotes on treatment ideas from his knowledge plus he collaborates with doctors and researchers and other people in the field.
That's huge wealth of info that is way more advanced than just a doctor. And by the way he used Dr B as his resource too and highly respects him. Along with many others.

And pulsing is a common and widespread technique used with success by many docs including Dr B

I feel that opinion is misguiding your advise to people here and your a senior member who helps so many and I admire your wealth of links and info you share.

In this subject I believe your not accurate and not reporting the info very well for others to learn from,

Again Page 20 . And that
6 years ago and I can bet Dr B has developed new reasons he could add that he has learned along the way including from Dr Alan McDonald and others researching this area
I saw two other videos recently of two another researchers and doctors on same subject.

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springshowers
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"Pulsing was the only way we could use tindamax for our daughter. She was simply unable to detox from continuous tindamax - symptoms just ramped and ramped.

We did notice while pulsing (3 days on 4 off) that with each initiation the herx would be smaller than the previous one had been, and that the baseline achieved in between pulses was continuously improving. We weaned when she was no longer significantly herxing and switched at that point to herbals."


Same timing pulsing that works well for me!
And your right. Adding to list of all other reasons and the research on how bugs behave to the pulsing vs non pulsing
Exactly the need to clear the herx and be ahead of the build up is exactly right.

Thanks for adding that and it is so engrained in my protocol over years to allow herxes to clear and pulsing gives windows so the continuous build up and herx do not occur is very important reason to add and point out.

Especially for this with detox issues and who have toxic build up and also have hard time tolerating meds.

Even if not there is research that pulsing has valid reasons behind it to avoid bug to dig and burry deeper and to be in constant slime and biofilm hiding.

Did you know once hiding in biofilm they can just live and stop multiplying which double tricks immune system to go on by and not see them as a threat. It's there life cycles and activity of replication that triggers the need to target them.

If your plateauing it could be that reason and there are various reasons and behaviors for do called resistance.

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Kudzuslipper
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But spring, how long were you on abx before you tried pulsing? Mystery has had no treatment yet.

Mystery, we're all different. I think there are places for pulsing, but resistance is a scary possibility. It's hard to do, but if you find a llmd you have confidence in, I would do all the research but allow them to guide you.

Good luck.

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CherylSue
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bump-pulsing info
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Keebler
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-
This remains a frequent question. Action is best guided by one's LL doctor.

Pulsing is not for early treatment, only AFTER a certain level of success has been achieved. See the particular posts here, three of them, by Pamela Weintraub, an excellent LL journalist who only pulsed after four years of consistent treatment:

http://flash.lymenet.org/scripts/ultimatebb.cgi/topic/1/91327?#000036

Topic: How did Burrascano cure himself?
-

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Keebler
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-
Any move we make, everything we do, needs to have as the basis of decision the science of lyme. It's a good idea to see the books / articles of various LL doctors on this subject. For a start:


https://www.youtube.com/watch?v=uj0H3T9HMeQ

"Why Can't We Get Better?" - slides are not showing, but his book has detail

VIDEO

One Hour & seventeen minutes - video presentation
Recorded at Western Connecticut State University on May 12, 2015.

Sixteen point model to consider with any treatment plan for lyme / tick borne infection / chronic stealth infections . . . .

" . . . Really, there are solutions for a vast majority of patients . . . ."

website & book: http://www.cangetbetter.com/

by a leading ILADS LLMD - November 2013

- Why Can't I Get Better?: Solving the Mystery of Lyme and Chronic Disease


http://www.lymedoctor.com/

The Lyme Disease Solution

Another excellent and well respected LLMD, book, website, etc. A new book is also due out very soon.


www.ILADS.org

ILADS conference presentations, etc. might also be checked for this topic.
-

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bluelyme
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I thought i heard burrascano's tell of how he finally pulsed for lyme with ceftin and herxed harder than on iv?. Also that its ok except for bart treatment. ..dr j does it ?...

--------------------
Blue

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tickbite666
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for the past three month I've been pulsing Ceftin 2 wks on/2off, while taking Cipro and Plaq full time.

Next week I drop Cipro and Plaq, and add Bactrim to the Ceftin pulse cycle, and take Alinia full time. I've plateaued at 85 to 90% after 6 years of intense ABX protocols combined with herbals.

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bluelyme
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Tick 666 ,Keep us posted on the alinia, i am supposda start this also

--------------------
Blue

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