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» LymeNet Flash » Questions and Discussion » Medical Questions » Question about proper antibiotic treatment

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Author Topic: Question about proper antibiotic treatment
adamsito
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My wife has many symptoms consistent with Lyme Disease and is waiting for her blood results to come back. She has had a great deal of exposure to ticks (over the last 5 years) as we have lived in the Northeast and we have seen ticks on our clothes, dog and even found a couple of ticks in our home. (She had similar symptoms several years ago, but the doctor never suspected Lyme Diseaes.)

Yesterday, my wife had a fever, joint pain and swollen lymph nodes so the doctor prescribed azithromycin (Z-Pack) 250mg for 4 days. The doctor suggested a Lyme Disease test, and we are waiting for the results. The doctor said that if my wife does have Lyme Disease, she will switch the antibiotic to tetracycline.

What are the best antibiotics to use for Lyme Disease? What is the best dose and duration of treatment? As I mentioned, my wife is taking 250mg of azithromycin. Is this dose high enough to be helpful against Lyme Disease? Should she double the dose to 500mg? (She is not allergic and she is not having stomach problems.) How long should she continue the antibiotics? Is it better to switch to tetracycline for Lyme Disease?

Thank you very much for your help.

Posts: 13 | From Pennsylvania | Registered: Aug 2008  |  IP: Logged | Report this post to a Moderator
Keebler
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-

Oh, I am sorry to hear this. And sorry to hear that you will need to see another doctor.

Mono-therapy is NEVER enough. Four days' worth of one drug is not enough.

p. 248 of Singleton's book states that the dose range for zithromax is 250 - 600 mg. daily. It produces better results by IV, however (at 500 mg. IV daily).


There are different types of tetracycline. Tetracyclines should not be used by pregnant women or those who are breast-feeding.

Doxycycline is the one most commonly used. Sun exposure is to be totally avoided. A high dose is needed.

Minocycline is used, too, but that causes much more problems with vertigo, tinnitus and balance and can be ototoxic.

Again, a combination of a couple different kinds of antibiotic is needed to address the different forms and cycles of the lyme bacteria. Flagyl is added for the cyst form.

==


If she had the test done yesterday, she did not have it done by Igenex Labs (as they require tests drawn early in the week).

Did she maybe have it done by Fry Labs?

Was it a Western Blot IgG and IgM?

Did they test for co-infections?

--

I happened to be the first on to read your posts. So, you will be loaded with reading (I used to be a teacher, so it's my MO).

This is such a complex subject and it's so important.

You have officially landed in a graduate level course (and, BTW, doctors get NO training in this at all).

There are some doctors, ILADS members, who are informed and I'll post articles explaining the sad political posture of lyme in the U.S.

Please don't panic, yet, you must be proactive here.

I can tell you exactly what the test will say when it comes back if it's an ELISA test. It will show negative. But that will not mean lyme may not be involved.

And, in addition to lyme co-infections, there are other chronic stealth infections to consider such as HHV-6 and Cpn. However, with your family's history with ticks, I'd say the regular tick-borne diseases (TBD) are more suspect.

I hope this works out well, but you cannot be sure until your wife has been properly evaluated - not just tested.


-

[ 16. August 2008, 12:10 AM: Message edited by: Keebler ]

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Keebler
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-

Co-infections (other tick-borne infections or TBD - tick-borne disease) are not discussed here do to space limits. Still, any LLMD you would see would know how to assess/treat if others are present.


http://tinyurl.com/2dmvs2


From the May 2007 issue of Clinical Advisor (home page: www.clinicaladvisor.com )


CONTROVERSY CONTINUES TO FUEL THE "LYME WAR"
By Virginia Savely, RN, FNP-C

*****

As two medical societies battle over its diagnosis and treatment, Lyme disease remains a frequently missed illness. Here is how to spot and treat it.

Excerpts:


" . . .To treat Lyme disease for a comparable number of life cycles, treatment would need to last 30 weeks. . . ."


`` . . .Patients with Lyme disease almost always have negative results on standard blood screening tests and have no remarkable findings on physical exam, so they are frequently referred to mental-health professionals for evaluation.


"...If all cases were detected and treated in the early stages of Lyme disease, the debate over the diagnosis and treatment of late-stage disease would not be an issue, and devastating rheumatologic, neurologic, and cardiac complications could be avoided..."


. . . * Clinicians do not realize that the CDC has gone on record as saying the commercial Lyme tests are designed for epidemiologic rather than diagnostic purposes, and a diagnosis should be based on clinical presentation rather than serologic results.


- FULL ARTICLE AT LINK ABOVE.


=====================
=====================


AFTER reading the Savely article (link above) this will make more sense


http://www.ct.gov/ag/cwp/view.asp?a=2795&q=414284

Connecticut Attorney General's Office

Press Release

Attorney General's Investigation Reveals Flawed Lyme Disease Guideline Process, IDSA Agrees To Reassess Guidelines, Install Independent Arbiter

May 1, 2008

Attorney General Richard Blumenthal today announced that his antitrust investigation has uncovered serious flaws in the Infectious Diseases Society of America's (IDSA) process for writing its 2006 Lyme disease guidelines and the IDSA has agreed to reassess them with the assistance of an outside arbiter.


- cont'd at link.

Printable version: www.ct.gov/ag/cwp/view.asp?a=2795&q=414284&pp=12&n=1


-

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Keebler
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-

Be sure to see both NEWBIE threads at the top of the medical forum.

======
======

Find your local support group for help in finding a doctor, etc.

www.lymenet.org/SupportGroups/UnitedStates


======
======


Post in: SEEKING A DOCTOR

http://flash.lymenet.org/ubb/ultimatebb.php?ubb=forum;f=2


=======
=======

This is also why you get the response you do from doctors and why you can't afford to mess around with anyone but the best.


http://tinyurl.com/6leeq5

CURE UNKNOWN: Inside the Lyme Epidemic - by Pamela Weintraub

"In the year 1993, I spread a map across the sunken living room of our co-op apartment in Forest Hills, Queens, and marked a bull's-eye..." (more)

(21 customer reviews)

==============
==============


This book, by an ILADS member LLMD, has a lot of good information and is the most valuable tool for learning right now:


http://tinyurl.com/6lq3pb (through Amazon)

THE LYME DISEASE SOLUTION

- by Kenneth B. Singleton , MD; James A. Duke. Ph.D. (Foreword)

You can read more about it and see customer reviews.

============

Also search books Amazon: Schaller, Babesia.

You need to see what the specialist say about babesia.

He also has an article at www.ilads.org - see the "articles and presentations"


-=============
==============


www.ilads.org ILADS

International Lyme and Associated Diseases Society

you can download the ILADS treatment guidelines here.

If you want to compare to the IDSA guidelines, you can google those to compare.

============
============

www.lymeinfo.net/index.html

WELCOME TO LYME INFO

---

www.lymeinfo.net/alt.html

LYME DISEASE ALTERNATIVE THERAPIES

========================

Note: the experience of most lyme patients is that complementary medicine is vital to treatment with supplements that are of nutritional support. Singleton's book (above) outlines abx and complementary formulas.

Some herbs can be very powerful. However, some naturopathic doctors are not properly educated about nature of lyme and TBD. And some herbs are not nearly strong enough.

However, there are two or three protocols that have seen levels of success. You would sure still want to consult with a LLMD.

The two books below have very specific information and a good understanding of these infections. Some patients do these alone, some LLMD's incorporate these.


http://tinyurl.com/5vnsjg

Healing Lyme: Natural Healing And Prevention of Lyme Borreliosis And Its Coinfections - by Stephen Harrod Buhner

www.gaianstudies.org/lyme-updates.htm

=======================================


http://tinyurl.com/5drx94

Lyme Disease and Modern Chinese Medicine (Paperback)
by Dr. QingCai Zhang (Author), Yale Zhang (Author)

you can access his web site through www.hepapro.com or try www.sinomedresearch.org and use "clinic" and then "clinic" for the passwords or call Hepapro.


=============
=============

testing:

www.igenex.com IGENEX

Fry Labs, also for certain other tests.


-

Be sure, to see the NEWBIE threads. One by BettyG and One by Treepatrol.


Good luck.


-

[ 16. August 2008, 12:11 AM: Message edited by: Keebler ]

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Keebler
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-

Oh, in the meantime: best to avoid alcohol, steroids and lumbar punctures (spinal taps).

Alcohol will make lyme worse and stress the liver.


Steroids (even localized shots) can make lyme blossom - unless for a life-threatening emergency (and then with specific anti-lyme abx).


Lumbar punctures are not a very good test for lyme.

============================
============================


This excellent article explains a lot about what chronic neuroborreliosis can do. It also details other chronic stealth infections, such as Cpn - and others - that should also be assessed in all chronic patients, especially those with neurological symptoms.

-----------------------------------------------


http://tinyurl.com/preview.php?num=64y3rv

(then clink "PROCEED TO THIS SITE")


May 2008 Volume 39 Number 5 LABMEDICINE
www.labmedicine.com - American Society for Clinical Pathology


CHRONIC BACTERIAL AND VIRAL INFECTIONS IN NEURODEGENERATIVE AND NEUROBEHAVIORAL DISEASES


- by Garth Nicolson, Ph.D.


=======================================

That author's site is:

The Institute for Molecular Medicine

A nonprofit institute dedicated to discovering new diagnostic and therapeutic solutions for chronic mycoplasma infections.

www.immed.org

www.immed.org/illness/clinical_testing.html

Patient Clinical Tests


-

[ 16. August 2008, 09:53 PM: Message edited by: Keebler ]

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Sojourner
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You should get her to a lyme literate medical doctor (LLMD) as soon as possible. Get your regular doc on board if you can, but don't count on her knowing enough about lyme to treat it properly.


Being in Pa should afford you a couple fairly close by physicians. Post in "Seeking a Doctor"

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adamm
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Lyme txment should last for 2 months after all symptoms resolve.
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adamsito
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We just received the test and they were negative. Only one band was reactive. We did a Western Block at Quest Lab.
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Keebler
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I'm sorry to say this - for many reasons - but

Quest is not a reliable lab and they do not test all necessary bands.


WHAT NUMBER BAND WAS REACTIVE - and on IgG or IgM?

Even one band, with the specific clinical symptoms can be very important.


I hope you've been able to read all the stuff above.

First: the SAVELY article - http://tinyurl.com/2dmvs2

Please read all that. From what you describe, I still think your wife should see an ILADS' educated LLMD.


Others will be by with more personal experience.

-

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Keebler
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This excellent article explains a lot about what chronic neuroborreliosis can do. This can be avoided with proper treatment. It also discusses other chronic stealth infections that a LLMD would consider.

-----------------------------------------------


http://tinyurl.com/preview.php?num=64y3rv

(then clink "PROCEED TO THIS SITE")


May 2008 Volume 39 Number 5 LABMEDICINE
www.labmedicine.com - American Society for Clinical Pathology


CHRONIC BACTERIAL AND VIRAL INFECTIONS IN NEURODEGENERATIVE AND NEUROBEHAVIORAL DISEASES


- by Garth Nicolson, Ph.D.


-

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adamsito
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Thanks Keebler. The reactive band was the 41 KD Band for IgG. Thanks for your help and advice.
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sixgoofykids
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IGeneX is the best lab for testing. Quest is not very sensitive.

Lyme is also a clinical diagnosis based on symptoms supported by tests. The test alone is not useful for diagnosis all by itself.

Some of those who are the most ill will have a negative test because it's not a test for Lyme, but for antibodies. Some people fail to produce antibodies after a while.

With your wife's symptoms and known exposure to ticks, I would take her to see an Lyme specialist (LLMD) for evaluation.

--------------------
sixgoofykids.blogspot.com

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adamsito
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She also just started taking a small amount of Synthroid for her thyroid. The interesting thing is that I am also feeling fatigued and my temperature is consistently low (around 96). Also, a few days ago I was feeling some pain in my left hip. Is it possible that we both were bitten by a tick? Are there other ways of getting the disease? Reading all of the stories many times families are getting Lyme together. What about us both having hypothyroid?
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sixgoofykids
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It is very common for husband and wife, and even children to all have Lyme Disease. The reason is that you all spend time in the same places.

Lyme loves the thyroid, so it is also very common for a Lyme patient to be hypothyroid. I take Synthroid and Cytomel.

It is pretty certain that you are hypo with that low temp. Google basal temperature thyroid or Broda Barnes thyroid and you will see more about the connection between Lyme and thyroid.

Personally, I'd get to an LLMD. They do a very impressive differential diagnosis to be sure they are treating the right thing. [Smile]

--------------------
sixgoofykids.blogspot.com

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efsd25
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Hi Adamsito,

I agree with one of the earlier posts, find a LLMD and get a second opinion, and this time with a western blot from Igenex and tests for coinfections for both of you.

The testing is simply problematic, so one more shot at it is a good idea. Otherwise you will end up like many of us...+ 10 years before diagnosis! If you can get right on it, you can keep working thru treatment. The longer you have it, the harder it is to get rid of. In fact, some folks(like myself) , may never get rid of it, but can manage the effects thru treatment fairly well.

Bottom line, be agressive with the diagnosis. See a LLMD and find out for sure.

Hope this helps,
Ernie,
Washington state

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