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» LymeNet Flash » Questions and Discussion » Medical Questions » Herx After Stopping Antibiotics?

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Author Topic: Herx After Stopping Antibiotics?
littledebbie
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I just started a 5 day on 2 day off antibiotic schedule. On my first day off, my joint pain worsened within hours of my 1st missed dose. I asked the nurse at my doctor's office about it and she said it sounded like a herx response. Does this sound accurate? Will someone herx w/ joint pain after stopping antibiotics? To me I thought it seemed more like the antibiotics are working and then when you stop taking them the infection flares. I was bitten only 1 month ago and I want to try to beat this early, not worsen the problem.
Posts: 11 | From Raleigh | Registered: Jul 2008  |  IP: Logged | Report this post to a Moderator
Hoosiers51
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EDIT: I am taking away what I said here, because for some reason I missed the fact that you are "pulsing." Your subject line was "stopping" antibiotics, so it confused me, and I was like, "Yup, that is bad if you stopped and now you have symptoms." (like, i thought you weren't pulsing them, etc)

But I just reread your initial post and saw what you really meant.

[ 28. July 2008, 05:21 PM: Message edited by: Hoosiers51 ]

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Vermont_Lymie
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Some antibiotics do accumulate in the body. So it seems possible that after 5 days you still have the antibiotics in your system and could kill bacteria (and herx)from it.

However, my understanding is that amoxicillin is excreted fairly rapidly and has a relatively short half-life; you should be able to research this on-line and with your doctor. I think that zith accumulates in the body having a longer half-life, and that is worth checking out too.

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northstar
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Antibiotics have half lives....how long they stay in the system, measured by hours to half concentration.

For example, amoxi is 1.4 hours maximum. So anyone taking amoxi b.i.d. is actually pulsing.

On the other hand, an antibiotic such as zithromax, has a half life of 68 hours, which is 2 days and 20 hours.


What pulsing may do, is allow the immune to kick in a little, then lyme is slapped down on the first dose of the new 5 day schedule. So, the joint pain could still be a herx, albeit from the immune, and even from the extended half life of whatever antibiotic you are using.

Pulsing is debatable by some llmd's (and IDSA thinks it is hogwash...or some such word), but it is still done, from what I have read here, when there is a high initial load (to prevent overkill and life threatening herx) or as a transition after heavy treatment, to allow the immune to kick in.

Repeated pulses, in my case, resulted in ever decreasing symptoms on those days off. Eventually, there were only small symptoms on the first day of the "on" cycle.

It also helped me detox, and gain strength, as some abx, such as zith, can actually suppress the immune system.

Also, your personal situation, as you posted in your first post, may warrant a unique approach to your situation (pregnancy, early detection of bite). Your protocol is extremely individual, based on your presenting condition and facts.

So, I would recommend a google search for
half life (name the antibiotic)
to see if it is still in your system during these 2 days.

Northstar

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feelfit
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It is said that if the relapse is so quick that it is a co-infection causing your symptoms.

Have you been tested?

The cramping and head stuff sound like Bart to me....maybe some babesia symptoms too.

Feelfit

edited to include that the above applies to St John

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littledebbie
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I am seeing a lyme specialist who has come highly recommended from a couple difference sources including my local lyme chapter. I just spoke to one of the leaders of the lyme chapter last night and asked her the same question I posted on the board. She explained why she felt that the pulsing approach works. She felt confident that my joint pain was from herx and not from the bacteria flaring back. She said that lyme bacteria only replicate once every 24 hours and that the only time they can be killed is when they are replicating. She said that antibiotics surpress your immune system and that taking the 2 days off gives your immune system a chance to identify the lyme bacteria and strengthen against it. She also said that when this kind of bacteria dies, it literally explodes and releases a lot of toxins. She felt very confident that if I follow this doctor's protocols, I will be fine eventually. I felt a lot better about things after speaking to her.
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METALLlC BLUE
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Which antibiotic (s) were used? 5 days is around the time line of when Herxheimer reactions begin. 5-7 is most common. A Herxheimer reaction "would" be very common, even in the face of stopping some antibiotics, as they continue to work in the body at a therapeutic level (some, not all), and so you could easily have a Herxheimer reaction.

Also a Herxheimer reaction doesn't mean bugs "are" being killed at that specific moment, but rather than enough have died to cause an immune response, causing the significant increase in symptoms.

So, you could have been killing them for a few days, and the toxins and debri piled up, thus causing a Herx, even when antibiotics were stopped.

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I am not a physician, so do your own research to confirm any ideas given and then speak with a health care provider you trust.

E-mail: [email protected]

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TheCrimeOfLyme
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One flares off of antibiotics, not herxes, BUT you had just ended treatment and antibiotics ( depending on which ones) do stay in the body for some time considering their half lives, so it IS possible you were herxing.

Another thing not mentioned is that antibiotics DO suppress the immune system. Its true, and necessary to fight lyme. Sounds contradictive, but its not in the long run. In any event, off antibiotics, your immune system kicks back in... and you could have simply been feeling that as well.

When I quit antibiotics, I had to stay off them for three months to feel normal. THIS WAS AFTER FIVE YEARS TREATMENT and thats ME, so don't try that at all. Keep on the antibiotics.

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You want your life back? Take it.

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Hoosiers51
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Whether or not what you are experiencing is a Herx, I would get a second opinion to be sure it's okay to "pulse" antibiotics during pregnancy.

To me, it seems like there could be a lot of complicated issues with that. Are you sure the lady you talked to knows pulsing during pregnancy is okay? 2 days off antibiotics may or may not be the right thing for the fetus.

PS----read my "EDIT" post above

[ 28. July 2008, 05:23 PM: Message edited by: Hoosiers51 ]

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sixgoofykids
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What med are you pulsing?

I am pulsing Zith because it has a long half life. Zith hits me hard and the only way I can take a full dose is to take it for three days, then off for four.

But if it's Amoxy, that is a short half life .... I don't know that pulsing is a good idea for Amoxy ... but I don't know .... I'd have to ask a doctor.

According to Dr. B pulsing is used to enable you to take a higher dose of abx (just read this in the guidelines today).

I don't think Lyme symptoms would come back that quickly, so it's either a herx, or it's a coinfection. Coinfections can come back quickly when you stop meds, but Lyme does not.

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sixgoofykids.blogspot.com

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James Marschner
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I have the feeling that herxes are delayed sometimes. That can be misleading as to whats actually making you the sickest.

I've always felt pulsing was a good idea simply b/c you tend to get big herx reactions after the first dose after a break.

I believe the Lyme (Since they are pleiomorphic.) quickly revert into a "survival-mode" of sorts where all the bacteria retreat inside cells and cysts...where they are relatively safe.

Pulsing can "trick" the bacteria into coming back out into the open and begin their growth phases where they are most vulnerable.

Continuous, long-term abx exposure (I think.) causes a seige-like stalemate between bacteria and abx that can last for years w/o strong herxing.

Posts: 269 | From Valencia, CA | Registered: Aug 2007  |  IP: Logged | Report this post to a Moderator
   

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