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» LymeNet Flash » Questions and Discussion » Medical Questions » Enough Doxy?

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Author Topic: Enough Doxy?
average joe
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My Doc who is an llmd only had me on 200mg of doxy daily. I did do 6 weeks though and had some inmprovement. Not enough??

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If you play at the beach, expect to get some sand in your shorts [Smile]

Posts: 223 | From central pa | Registered: May 2010  |  IP: Logged | Report this post to a Moderator
janet thomas
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http://www.lymediseaseresource.com/BurrGuide2008.pdf

You can read the above & decide for yourself.

IMO, not enough.

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I am not a doctor and this is not medical advice but only my personal experience and opinion.

Posts: 2001 | From NJ | Registered: Mar 2005  |  IP: Logged | Report this post to a Moderator
BackinStOlaf
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should be 400 mg

--------------------
First Symptom 9/09
Multiple docs, negative Labcorp test
LLMD: 1/10
Positive Igenex/CDC test
Treatment 2/10
2/10-8/10 Amox, ceftin, zith, flagyl
Currently: Bicillin, Minocycline, still dealing with severe breathing issues

 -

Posts: 1121 | From New York, New York | Registered: Dec 2009  |  IP: Logged | Report this post to a Moderator
LightAtTheEnd
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You need a higher dose than that, though my doctor had me start out that way and then increase it later, and you need more than 6 weeks. The guidelines cited above say to keep treating until a couple months past when you become symptom-free.

If you are still having symptoms, then you are not over it yet. If your doctor says that's it, you're done, even if you're still sick, then he's not a real LLMD.

--------------------
Don't forget to laugh! And when you're going through hell, keep going!

Bitten 5/25/2009 in Perry County, Indiana. Diagnosed by LLMD 12/2/2009.

Posts: 756 | From Inside the tunnel | Registered: Jan 2010  |  IP: Logged | Report this post to a Moderator
average joe
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Sorry I didn't mean to mislead any of you folks. The doc has switched me to 2000mg amox then I need to add z-max to the mix after 1 month. This seems about right to me. Any thoughts? He didn't imply in any way that I am done as I still have symptoms.

When I asked about a higher dose of the doxy he said he is cautious about that in the summer because of sensitivity to the sun. this made perfect sense to me, when I went to the beach this summer I got burned somewhat in spite of staying out of the sun as much as possible. It felt like I was being chased by a big yellow monster lol. It wasn't bad though just needed to be carefull.

--------------------
If you play at the beach, expect to get some sand in your shorts [Smile]

Posts: 223 | From central pa | Registered: May 2010  |  IP: Logged | Report this post to a Moderator
TF
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I believe your doc prescribed this to treat ehrlichia. It is best to treat lyme patients with doxy first to get possible ehrlichia treated and out of the way. And, the doxy also treats the lyme.

From Burrascano lyme treatment guidelines, page 25:

Ehrlichia
"Standard treatment consists of Doxycycline, 200 mg daily for two to four weeks. Higher doses, parenteral therapy, and longer treatment durations may be needed based on the duration and severity of illness, and whether immune defects or extreme age is present."

Posts: 9931 | From Maryland | Registered: Dec 2007  |  IP: Logged | Report this post to a Moderator
sixgoofykids
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It sounds like he's using the right meds and TF makes a good point.

Keep in mind, the amoxy dose may need to be ramped up to a higher dose. I eventually ramped up to 2500 mg three times daily for a total of 7500 mg per day. I had a peak level blood test to determine the proper level.

I also took Probenecid to keep it in my bloodstream longer.

I did start out at a lower dose and work up. I also had other meds with it.

Sounds like your'e off to a good start.

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sixgoofykids.blogspot.com

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average joe
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Wow sixgoof 7500mg! I thought my 2000 was alot lol. Did you have any issues with c-dif or anything to that effect with such a high dose? Doc did not mention higher doses but as I mentioned he wants me to add 500mg z-max in a month.

He also said I might get hit with herx pretty good somewhere between day 4 and 7 after starting the amox. I did ask him about stayin on the doxy for now but he said not. Kind of disappointing since it did help but he seems to know what he is doing. I have to admit I am considering staying on the doxy as well. Does amox work well on lyme and bart???

Thanks TF for the input. I was starting to think the last month was all for nothin.

--------------------
If you play at the beach, expect to get some sand in your shorts [Smile]

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Lymetoo
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Amoxy will do nothing for bart.

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

Posts: 95809 | From Texas | Registered: Feb 2001  |  IP: Logged | Report this post to a Moderator
sixgoofykids
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No, I didn't have c diff problems. I took VSL#3 with the amoxy and most of the time during my treatment. It has 450 billion organisms.

Sounds like the right timing for the herx. Amoxy was tough!! I built up over a long time, was on it for 5 months.

Amoxy does not work for bart. Typically, rifampin or levaquin is used for bart.

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sixgoofykids.blogspot.com

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TF
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I was given 1500 mg of amoxi 3 times per day, with probenecid. Total of 4.5 grams per day.

Then, flagyl was added for 2 months to kill the cyst form of lyme. That's how I got rid of lyme disease.

From Burrascano:

"Because of its short half-life and need for high levels, amoxicillin is usually administered along with probenecid." (p. 14)

"*Amoxicillin- Adults: 1g q8h plus probenecid 500mg q8h; doses up to 6 grams daily are
often needed." (p. 18)

The above reads 1 gram [1000 mg] every 8 hours plus probenecid 500 mg every 8 hours....

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

The probenecid is not an antibiotic. It is an agent that keeps the body from filtering out the antibiotic so that it stays in your bloodstream longer. So, it really is necessary. High blood levels are one of the keys to killing this germ.

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average joe
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Sounds like I'm not on enough of this amox. I don't understand since the doc said bart was an issue also why he would take me off the doxy and put me on amox. <----previous sentence edited from first thought to make appropriate to post lol. Doxy indications are lyme and bart amoung a hundred other things so again why would the doc take me off when i was just starting to feel decent. grrrrr. I hope one of you kind folks can give me some insight on the logic here

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If you play at the beach, expect to get some sand in your shorts [Smile]

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BackinStOlaf
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My first med was Amoxi 3000 mg a day. Then after one month they added Zith and was on that combo for a few months.

I think dosages vary for each person

--------------------
First Symptom 9/09
Multiple docs, negative Labcorp test
LLMD: 1/10
Positive Igenex/CDC test
Treatment 2/10
2/10-8/10 Amox, ceftin, zith, flagyl
Currently: Bicillin, Minocycline, still dealing with severe breathing issues

 -

Posts: 1121 | From New York, New York | Registered: Dec 2009  |  IP: Logged | Report this post to a Moderator
sixgoofykids
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My LLMD switched things around often to keep going after the bugs from different angles. You were on doxy at a lower dose for Lyme and for a short time, so what TF said makes sense, and in that case, you would need to either increase the dose or change to a different med.

Being summertime, your LLMD must have decided changing meds was the way to go.

That is how I interpret the situation ..... you can always ask at your next appt.

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

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'Kete-tracker
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"some improvement" is Not "all better now"... IS it??

200mg b.i.d. might be enough for a short, plump lady who weighs 95#.
But Kareem abdul Jabbar might need 500-600mg b.i.d. [He's a Tall basketball player, BTW]

Get my drift? Weight, metabolism & total skin AREA.
There IS no magic universal dose. (Never was!)

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eightybarb
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I was given 200 mg of Doxy then 4 weeks later BactrimDs got added.
Posts: 96 | From Germantown | Registered: Mar 2010  |  IP: Logged | Report this post to a Moderator
average joe
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LOL Kete I am aware of Kareem. The some improvement statement was my logic getting the better of me. It would seem logical that if you are starting to feel better you would continue on the same meds just as if route 66 was taking you to your destination why would you turn onto no mans land dirt road. What I wasn't taking into consideration was that Lyme & Co is apparently not logical at all. I am still concerned about the dosage but I'll wait to see what the herxing is like before I consider bumping it up.

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If you play at the beach, expect to get some sand in your shorts [Smile]

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'Kete-tracker
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Yup... and I spoke too soon here. Only saw your 1st post.

Glad to hear the doc has you on amoxy (what with it being summer & all) after the 6 weeks of doxy.
Zith is good to add to the amoxy. It's usually added in later so if there are any "issues", it won't be a guessing game.

Not sure how much you weigh, but he may add in Probenecid- as well- to keep the amoxy level in the blood up.. or he might "up" the amoxy dose.

I was on 4000mg/day for MONTHS. Thank God I was.
Worked real well for Me, after some 'sorta effective' abx protocols (involving doxy or Ceftin).

Work with your doc on this. You sound like you're "on the right road". Good luck!

And keep taking those probiotics... DAILY (away from the meds). Plain yogurts (mix the brands around), Kefir, acidophilus capsules, etc. You know the drill. (I'd hope!)

Posts: 1233 | From Dover, NH | Registered: Sep 2008  |  IP: Logged | Report this post to a Moderator
average joe
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Thanks for the info Kete and all. I don't see the doc again for 2 months. It would appear he is tryin to start me out slowly on the amox, add in the zith for a month then I guess maybe up the dose of amox (if I don't beat him to it).

This is purely a guess on my part though. By the way I'm at about 205# right now thats why I am so paranoid that 2000mg isn't enough to kill the critters, especially without the probenicid.

The low doxy dose makes sense after reading TFs' post but I'm thinkin the amox should be more. If I seem impatient it's because I am. I like everyone else just want this crap gone!

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If you play at the beach, expect to get some sand in your shorts [Smile]

Posts: 223 | From central pa | Registered: May 2010  |  IP: Logged | Report this post to a Moderator
   

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