One man's wife on here herxed horribly on orals, any orals, even low dose, and was near death. She was started on something like 75 mg of IV rocephin and using that has steadily improved.
I remember ArtistDi was also probably near death and she was started on 50 mg of IV doxy, along with low dose steroids to help tolerate it and she slowly improved.
I simply cannot understand how 1/10th or 1/20th of a dose of IV can slowly improve someone who is literally at death's door from lyme and can't tolerate orals. How much can it be killing if even megadoses of IV apparently don't kill the bug and you have to take it for months or years? And why is the very low dose IV tolerated anyway?
I cannot figure out the mechanism. I don't see this in other diseases. You can't take 1/10th of a dose of penicillin for strep throat for instance.
Does anyone understand this disparity in treatment approach and response?
Posted by ByronSBell 2007 (Member # 11496) on :
My dotor told me this as well, IV patients dont seem to herx as bad as oral ABX patients. But really with IV hey are getting a higher dose because the liver is not processing it... weird Posted by CaliforniaLyme (Member # 7136) on :
Because with orals there is more, like Byron said, stress on the body in processing-?? Makes sense to me!!! I have NO clue!!! None whatsoever!!! WHat Byron said makes sense though* )!*)!)*! My angel LLMD said IV would get into the tissue better than orals ever would!!! Better penetration-
Sincerely clueless, but going along with Byron on this one, and my LLMD re better penetration, less stress, also perhaps doesn't activate immune defenses... a sneak attack????!!!!!!!!!!!
Something to think on if I wake up in the night *)!*)!*!
Have good nights all,
Posted by Marnie (Member # 773) on :
All drugs go thru the liver or kidneys (depending on which drug) whether or not they are IV, IM, sub cutaneous, or oral.
To overcome Herxheimer reactions or other adverse responses, IV antibiotics have been used for a few weeks--
followed by oral antibiotics.
IV abx. given ``piggy back'' using WHAT IV solution...5D/W?
Could indeed make a difference!!!
Dextrose...delta glucose...d-glucose.
Posted by barksplinter (Member # 13249) on :
The theory is based in the idea that "herxing" is not just uncomfortable.. it is hard on the body, and can inhibit healing, and therefore should be kept to a minimum as much as possible.
Also there is thinking is that "herxing" is harmful to tissues... neuro tissues in particular. ANOTHER reason to keep "herxing" to a minimum.
Posted by barksplinter (Member # 13249) on :
The theory is based in the idea that "herxing" is not just uncomfortable.. it is hard on the body, and can inhibit healing, and therefore should be kept to a minimum as much as possible.
Also there is thinking is that "herxing" is harmful to tissues... neuro tissues in particular. ANOTHER reason to keep "herxing" to a minimum.
Posted by Dave6002 (Member # 9064) on :
Long term and Low dose of allergen have been successfully used to treat allergy, which is due to the overactive immune system.
Wondering if low dose of IV Rocephin is acting as a stimulator to tame down the overactive immune system and at same time it can kill the bugs.
In another word, high dose of Rocephin might be triggering severe immune response, which would exacerbate the symptoms as well as protect the bugs from killing by the medicine...just a hypothesis
Posted by Marnie (Member # 773) on :
Very good hypothesis David!
I believe the immune system is indeed in overdrive. It keeps trying and trying and trying.
A BIG part of the problem lies with the fact that this pathogen has a PKC (protein kinase C) INHBITOR. I think it is PKC delta...looks that way.
There are many PKC inhibitors...some man-made ones. Tamoxifen is one. That drug is given to DESTROY cancerous breast cells.
Bb infects our 1st line of defense (Langerhans cells) right out of the starting gate.
Posted by oxygenbabe (Member # 5831) on :
Thanks Bark & Dave. Bark, I looked at that writeup of Dr. M's and how insanely elevated TNF alpha is. So I'm thinking that maybe high dose of anything does activate the immune response as lots of bugs are killed...and TNF alpha goes up even more, or other cytokines? It's the highly inflammatory cytokine response that is paralyzing the immune system in the first place I believe, and that is toxin-mediated (bug's toxins).
Even so I can't understand why a very low dose of orals for your wife (zith) would herx for days...and IV not...in low dose. So maybe the liver is involved but I don't know.
I'm thinking YES as dave said that rocephin, like other abx, has anti inflammatory properties.
Also I just read a study that three separate classes of bactericidal abx work in part by creating excess free radicals in the bacteria which cause their death.
Free radicals cause damage, cytokines cause damage etc.
So maybe low dose rocephin inhibits growth of bugs without killing outright, while also in some other way, lowering inflammation.
But then why would IV doxy low dose have worked for Di? On the other hand, she also added inl ow dose steroids to stop that runaway inflammatory response.
It is all confusing to me and I simply can't understand it. Maybe it is equivalent to doing my mild hyperbaric chamber once a week for an hour.
I think its really important we try to understand these mechanisms. If one person can slowly get much better or perhaps well on 75 mg and others are taking 1-2 grams, we have to try and figure that one out.
If I recall, ArtistDi was going twice a week for her doxy. Low dose.
![[Roll Eyes]](rolleyes.gif)