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» LymeNet Flash » Questions and Discussion » Medical Questions » Warning Headaches & the cyclines ie doxy,tetra,mino.

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Author Topic: Warning Headaches & the cyclines ie doxy,tetra,mino.
treepatrol
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I posted this in another post but thought we should know about it on its own thread.

I have had mild headaches and slight fever since starting minocycline last month.

Minocycline

Tetracycline

Doxycycline


Cautions and side effects
In addition to those common to the Tetracycline antibiotics group, minocycline may be used in renal impairment, but may aggravate systemic lupus erythematosus.[1]

Also, more so than other tetracyclines, minocycline can cause the rare condition of secondary intracranial hypertension which has initial symptoms of headache, visual disturbances, and confusion.

Minocycline, like all Tetracyclines, becomes dangerous past its expiration date. While most prescription drugs lose potency after their expiration dates, tetracyclines are known to become toxic over time; expired tetracyclines can cause serious damage to the kidneys.

Minocycline's absorption is impaired if taken at the same time of day as calcium or iron supplements. Unlike some of the other tetracycline group antibiotics, it can be taken with calcium rich foods such as milk, although this does reduce the absorption slightly (by ~5%).


Headache caused by cyclines could be Idiopathic intracranial hypertension.
Idiopathic intracranial hypertension


Modified Dandy Criteria

Something to keep in mind?

[ 27. March 2007, 11:19 AM: Message edited by: treepatrol ]

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trueblue
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Thanks Tree!

I didn't know about Tetras and their expiration dates.


I had massively scary headaches on just few days of Doxy. It felt like my head was going to explode. My choices were very suddenly: stop or go to the ER.

I'm never ever trying Mino. [shake]

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Geneal
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Dear Tree,

What a timely posting. My neighbor (with Lyme)just started mino and says that she has such head pains.

She threw up several times on the way home from work two days ago.

I informed her of the article and told her to call our LLMD.

How do you know if it is a herx? Or something potentially much more serious?

Thanks for the heads up. I myself can't take mino....extreme vertigo and itching.

Hugs,

Geneal

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dontlikeliver
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Scary. Anyone here who has had that problem?

DLL

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bpeck
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It's sometimes difficult to separate herx from drug side effect (and I've been bashed before for suggesting a symptom is a drug side effect and not a herx.) but here goes:

If the head ache/fever is from herx, you still need to stop the drug. - it should subside in a few days if you stop the Doxy (or mino). - then when you resume it you shouldn't feel as bad.

If you continually get a head ache, dizzy (nauseous) or ringing in your ears ( especially mino) then it most likely is a drug side effect.

And yes.. the tetracyclines are a drug class that you shouldn't take if they are expired.

Barb

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treepatrol
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Sofar I havent stopped abx's during any herx and I have had some bad ones over the years especially in the beginning.

There were a few I maybe should have at least skipped a dose.
But all I could think of was that I was not going to give any bacteria the chance to become resistent to the abx.

Thats what will happen if you dont follow through antibiotic coarse.

Like in Tb someone has it and are being treted and as soon as they are feeling better they stop tada now you have educated the tb bacteria.


Mechanisms of antibiotic resistance

The four main mechanisms by which micro-organisms exhibit resistance to antimicrobials are:

Drug inactivation or modification: e.g. enzymatic deactivation of Penicillin G in some penicillin-resistant bacteria through the production of β-lactamases.
Alteration of target site : e.g. alteration of PBP - the binding target site of penicillins - in MRSA and other penicillin-resistant bacteria.
Alteration of metabolic pathway: e.g. some sulfonamide-resistant bacteria do not require para-aminobenzoic acid (PABA) - an important precursor for the synthesis of folic acid and nucleic acids in bacteria inhibited by sulfonamides. Instead, like mammalian cells, they turn to utilizing preformed folic acid.
Reduced drug accumulation: by decreasing drug permeability and/or increasing active efflux on the cell surface.

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jazzygal
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This is something you DO NOT want to ignore!
I was diagnosed with "Pseudotumor Cerebri" also known as "Intracranial Hypertension" and this is a condition known to be caused by the tetracycline druges--especially in overweight patients.

Since doxy and mino are COMMON drugs for treating Lyme, I believe there are many cases of undiagnosed secondary PTC-IH cases...and if left untreated, the fluid pressure buildup can cause permanent BLINDNESS.

Below is an aricle I recently wrote in the PHA about this issue:

What Every LLMD Should know about
Pseudotumor Cerebri:

The Not-So-Benign Intracranial Hypertension

by Dawn Irons

Treating the Lyme disease complex of Borrelia Burgdorferi, and its myriad of co-infections, has about as many twists and turns as an Olympic gymnast. Lyme literate medical doctors (LLMDs) and professionals know how difficult it is to treat the Lyme bacteria in its many forms: the spirochete, the cyst form, and the cell wall deficient form. It is a delicate balancing act.

The symptoms of Lyme disease are so vast that it has been called ``The Great Imitator'' since it mimics many other diseases such as ALS, Lupus, Multiple Sclerosis, Parkinson's, Autism and Alzheimers. Some of the more vague symptoms like extreme fatigue, frequent headaches, tinnitus, and eye floaters are often hard to tag down, and many times it is just assumed to be part of the irritating symptoms of the disease. But there may be something more to these symptoms than meet the eye.

The following information is something that every LLMD needs to understand and consider as they treat their patients. Several medical journals from Neurology to the journal of the American Board and Family Medicine have published research showing that doxycycline and minocycline, which are usually the first line of defense for antibiotic treatment of Lyme disease, can cause a fluid build up behind the optic nerve. This fluid build up can cause the optic nerve to swell, and if it is not treated and resolved, this can lead to permanent blindness. This condition is called Pseudotumor Cerebri (PTC), or benign intracranial hypertension. The word benign can be very misleading, in that permanent blindness is not really a benign issue, and one that can be avoided.

So knowing that the first line of defense in treating Lyme disease, the tetracycline drugs, is known to be a cause of this problem, one should look at other risk factors concerning PTC to see if whether doxycycline and minocycline are really the best option for treating certain patients with other risk factors.

PTC is primarily found in women in of childbearing years. There is also a trend to see this condition more commonly in overweight people. Men are not exempt from this problem, neither are people of normal weight. Children have been diagnosed as well. It has been diagnosed across the board in all kinds of people.

If a Lyme disease patient is experiencing frequent headaches, migraine headaches, pressure behind the eyes, stiff neck, blurred or double vision, floaters in the eyes, swooshing sound in the ear, backache and extreme fatigue it would be advisable to consider ordering an MRI. Often times the MRI can reveal a fluid build up behind the optic nerve, but not always. A lumbar puncture, though much more invasive, can bring a definitive diagnosis of PTC.

For the sake of prevention, LLMDs should not prescribe the tetracycline drugs to patients that are overweight. Other antibiotic options should be considered in light of the risk factors for PTC. Diagnosing and treating Lyme disease is difficult enough, and long-term antibiotic use is not without certain risks. With the constant scrutiny of our LLMDs, we need to do all we can to educate ourselves, and fellow medical professionals, of this potential problem with what would normally be our first line of defense in treating Lyme disease.

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jazzygal
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Here is one specific related to Lyme:

Lyme Complicated by Pseudotumor Cerebri
http://www.journals.uchicago.edu/cgi-bin/resolve?id=doi:10.1086/375691&erFrom=-6663099480855670260Guest
I will attach the PDF for this one in this email


Pseudotumor cerebri secondary to minocycline intake:
http://www.jabfp.com/cgi/content/abstract/15/3/229

Doxyccline and intracranial hypertension
www.neurology.org/cgi/content/abstract/62/12/2297

Not so benign intracranial hypertension
http://www.bmj.com/cgi/content/full/326/7390/613

Operational Medicine: Doxycycline (look under precautions)
http://www.brooksidepress.org/Products/OperationalMedicine/DATA/operationalmed/Meds/doxycycline.htm

Doxycycline induced intracranial hypertension
http://www.bmj.com/cgi/content/full/326/7390/641

The outcome of pseudotumor cerebri induced by tetracycline therapy
http://www.blackwell-synergy.com/links/doi/10.1111/j.1600-0404.2004.00327.x/abs/

Lyme Disease (scroll down to "procedures"
http://www.emedicine.com/ped/topic1331.htm
Procedures:


Lumbar puncture: In cases of cranioneuropathy, it is controversial whether all patients require lumbar puncture before treatment.

Occasionally Lyme disease presents as pseudotumor cerebri; an opening pressure is essential for diagnosis.

Currently, in most patients with isolated Bell palsy and no associated signs of aseptic meningitis, most physicians do not perform a lumbar puncture. For most other patients with cranioneuropathies and suspected Lyme disease, a lumbar puncture should be performed; CSF pleocytosis leads to treatment as indicated for CNS Lyme disease.

Obtain a CT scan or MRI before the lumbar puncture if increased intracranial pressure or mass lesion is suspected. Occasionally, Lyme disease presents as pseudotumor with frank papilledema; imaging should be done prior to LP in these cases.

Pseudo Tumor Cerebri Details (lists Lyme specifically as being linked to PTC)
http://www.findmemyhouse.com/ptc/ptcfacts.html


These are the highlights...there were over 820 hits on google when I searched for Lyme Disease, Pseudotumor Cerebri, doxycycline

Kind of blows my mind that there is so much info on this! I just assumed all my symptoms were lyme...but look at the pTC symptoms...they are lyme-like! This could be a very dangerous situation if LLMDs are not made aware of this connection!

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aklnwlf
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Hi Tree,

I vaguely remember taking Mino for about 3 days. It almost killed me! Needless to say, I can't take it.

Am on Levaquin and Septra everyday for Bart. Tried 2 months and that wasn't long enough so when my meds were decreased the Bart came back with a vengance.

Now, back to square one.

Am wondering about this intracranial pressure thing....

My head hurts all the time and my neck too. Sometimes ice will help but it just feels like it's swelling in there.

It's either that or vasculitis. I already take 4 Diamox for fluid buildup. Sometimes it doesn't help at all.

Anyways, thanks for the info.

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treepatrol
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The only thing that seemed to help me when I was taking it was acetemetaphen in motri,or vicodine ,oxycodone,oxycotin but I cant take acetemetaphen for very long or I get rls restless leg syndrom at night when weening down to one pill a day so now Iam taking asprin or percocet with asprin in it.

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trueblue
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quote:
Originally posted by jazzygal:
If a Lyme disease patient is experiencing frequent headaches, migraine headaches, pressure behind the eyes, stiff neck, blurred or double vision, floaters in the eyes, swooshing sound in the ear, backache and extreme fatigue it would be advisable to consider ordering an MRI.

Thank you Dawn. (good to know I'm not really a wimp)

That's exactly what happened (less the MRI) in under 3 days @ 100 mgs of Doxy. I stopped and restarted a few days later at an even lower dose.

First dose and it started again, this was really scary, I was worried about losing my sight or hearing. When I saw the doctor he said that was a toxic reaction and crossed tetras off my list of options.


I might have considered Diamox but knew I was allergic to it. I see now it's just as well I couldn't.

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dontlikeliver
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If this happens, what is the treatment for it, or will it just go away if you stop the abx??
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treepatrol
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quote:
Originally posted by dontlikeliver:
If this happens, what is the treatment for it, or will it just go away if you stop the abx??

In my case the headache is gone as of this morning and Iam left with a herx my head is all stuffed up right nostril is burning and I feel pretty crappy.

It donned on me lastnight that friday is my day off and for the last 4 months this has happened so Iam right on schedual bummer.

If that is what you were asking?

The treatment is listed in this link


Treatment The primary goal in treatment of IIH is the prevention of visual loss and blindness. Elevated CSF pressure generally causes the optic nerves to swell. The bulging of the optic disc (the round bundle of nerve fibers visible at the back of the eye) can be seen through an ophthalmoscope during a routine eye exam. This swelling can lead to irreversible loss of vision and, in the most severe cases, optic nerve atrophy and blindness.

IIH is treated mainly through the attempted reduction of CSF pressure and, where applicable, weight loss.[1] The treatment of increased ICP of a known origin (SIH) consists of removing the inciting cause, if possible, and attempting to reduce CSF pressure. IIH may resolve after initial treatment, may go into remission and relapse, or may continue chronically.


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heiwalove
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just wondering if anyone else has any ideas about PTC and its possible relation to lyme.. ?

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dontlikeliver
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I'd forgotten totally about this thread and it's ironic that after several days of a headache, on/off nausea and literal pain in the neck and upper back, it dawned on me that perhaps it had something to do with the Doxy I've been on for about 12 days. I have not actually vomited though, thank goodness.

I called my LLMD last night and had to go to ER at 11pm. The doc there looked in my eyes with a light and said there was no swelling of the disks (or something similar) and therefore not likely to be intracranial pressure from Doxy. He told me that would be a 'late sign' of the condition, and that I did not have that 'late sign'.

But, having googled "increased intracranial pressure, doxycyline" I am still concerned out about this.

I've had the moderate to horrible persistent headaches and neckpain/upper back/spine pain, nausea and tinnitus (but I have tinnitus anyway)-- I am overweight, in my late 30s, and have PCOS, so according to all info I've seen, I am high risk for this.

I've stopped the Doxy (obviously) since last night.

If I have increased intracranial pressure, is it likely to just go away by itself assuming I have an early stage/presentation of this condition?

My LLMD said it was unlikely that I have this, but as I am 3000 miles away from him, he suggested ER to be sure. So, after having my eyes looked at - can I safely assume I am safe??

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dontlikeliver
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Another question I have, if anyone knows, is it always BAD to have this, or can it just be mild and transient and just go away quickly?
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tailz
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I didn't know tetracyclines became toxic past the expiration either. Thanks!

Anyone on mino though should know that it can stain your teeth a greyish or even brown color, even if you have taken it in the past with no problems.

Some of it will come off, but not all of it. I was told by my dentist that I would need to get my teeth cleaned every 3 weeks to keep up with the stains.

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pab
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I wanted to reply about the weight issue. My 2 boys (17 & 21) have pseudo-tumor cerebri and have never been overweight.

Their neurosurgeon believe the PTC is from the untreated chronic infections.

Both of my boys have constant, severe headaches. The only relief for them is a spinal tap. On average, their headaches are a 7-10 (on a 1-10 scale) everyday. The headaches have been there since at least 1999.

They don't have the eye problems.

PTC is an horrible illness to have!

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Lymetoo
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Thanks for bringing this to the top!!

I just threw out my expired mino last night!!! It was 2 yrs old!

I'm beginning doxy today for a sinus infection and I gotta tell ya, I'm not ready for MORE headaches or more intense pain from headaches.

AAARRRRRGGGGHHH!!!!!!!!!!

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vin
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I've been taking doxy for 5 or 6 weeks. Headaches that felt like my brain was swollen are a common symptom for me, especially after lifting weights. During my first 2 to 3 weeks of doxy, I was getting mild to moderate headaches every day and I was quite nervous about the intracranial hypertension, especially considering the headaches I normally get, but they eventually stopped and I haven't had one in a few weeks! Hopefully it will stay that way. [Smile]
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susiecv
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Do have a little Doxy stored for emergency use but realized that I have never seen an expiration date on a RX bottle! Would be helpful to have this info. Does anyone know how long it generally lasts?

Since most Rxs are given with the expectation that you will take the meds right away, seems it would be worth asking the pharmacist to include this info on the label. (at least for all the Lymie abx hoarders [Smile] )
Sue

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hurtingramma
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I have persistant headaches that get much worse when I'm on Plaquenil. Any ideas there? I have been having my eyes tested regularly and they never find anything wrong, except for the floaters, of course.

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Greatcod
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susiecv asked "Do have a little Doxy stored for emergency use but realized that I have never seen an expiration date on a RX bottle! Would be helpful to have this info. Does anyone know how long it generally lasts?"

I know it is true for tetracycline and that it may be true of other meds of that class.
After a year, they are dangerous.

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pab
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There are other medications related to increased Intracranial Pressure:

1. Amiodarone
2. Chlordecone (Kepone): Insecticide
3. Systemic Corticosteroids (withdrawal)
4. Cyclosporine
5. Growth Hormone
6. Leuprolide (Lupron)
7. Levothyroxine (children)
8. Lithium Carbonate
9. Nalidixic Acid
10. Norplant
11. Antibiotics (sulfonamides, tetracycline related compounds - doxycycline, minocycline, accutane)
12. Mineralocorticoids
13. Vitamin A (supplementation, retinoic acid)
14. Oral Contraceptives

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~ ~ Hope is a powerful medicine. ~ ~

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AliG
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up ^

--------------------
Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner.

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adamm
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Hmm...this was my first neuro symptom, and I got it while on doxy.
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