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» LymeNet Flash » Questions and Discussion » Medical Questions » What's the preventative dose of doxy?

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Author Topic: What's the preventative dose of doxy?
ralphi
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Hypothetically, say a healthy person found 2 imbedded ticks in a lyme-endemic area and wants doxy treatment.

All the ILADS guidelines says is treatment for 28 days; no doses given.

I was thinking 100mg 2x/day for some reason, but could it be 200mg 2x/day?

TIA!

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ralphi
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Ah, found it on ILADS site:

Administration of doxycycline (100 mg twice daily) or amoxicillin (500 mg 3 times daily) for

14�21 days is recommended for treatment of early

localized or early disseminated Lyme disease

associated with erythema migrans, in the absence

of neurological involvement or third-degree

atrioventricular heart block (see Tables 3 and 4

of the original guideline document) (A-I). In

prospective studies, these agents have been

shown to be effective in treating erythema

migrans and associated symptoms

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ralphi
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Wait, now I am seeing something different on Dr. B's guidelines:

*Doxycycline- Adults: 200 mg bid with food;

doses of up to 600 mg daily are often

needed, as doxycycline is only effective at high

blood levels. Not for children or in

pregnancy.

If levels are too low at tolerated doses, give

parenterally or change to another

drug.

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Lymetoo
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I would definitely do 200mg twice a day.... 6-8 wks.

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

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Keebler
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Doxycycline, alone, though cannot keep spirochetes from going into their cyst mode and they may do this within 20 minutes of the first dose.

Therefore, IMO, and what seems to be highly likely is that doxycycline (or other antibiotics of similar nature), alone, can cause chronic lyme to develop down the road. A combination approach is very important.

Those guidelines were written before the work of Eva Sapi in that regard. Detail:


http://flash.lymenet.org/scripts/ultimatebb.cgi?ubb=get_topic;f=1;t=120369;p=0

Topic: replication within cystic forms of lyme
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Keebler
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This author says that a minimum of 30 weeks treastment - combination treatment - is required to cover the cycles of borrelia. See last line below.


Discusses differences in the methods of the IDSA from those of ILADS - and why you need an ILADS-minded doctor.

http://www.clinicaladvisor.com/controversy-continues-to-fuel-the-lyme-war/article/117160/

CONTROVERSY CONTINUES TO FUEL THE "LYME WAR" - 2007

Excerpts:

. . . Each of these forms is affected by different types of antibiotics. If an antibiotic targets the bacterium's cell wall, the spirochete will quickly morph into a cell-wall-deficient form or cyst form to evade the chemical enemy. . . .

. . . Within the tick gut are hundreds of different types of pathogens . . . .

. . . Phase and antigenic variations allow B. burgdorferi to change into pleomorphic forms to evade the immune system and antibiotics.

The three known forms are the spiral shape that has a cell wall, the cell-wall-deficient form known as the �L-form� (named not for its shape but for Joseph Lister, the scientist who first identified these types of cells), and the dormant or latent cyst form.

Encapsulating itself into the inactive cyst form enables the spirochete to hide undetected in the host for months, years, or decades until some form of immune suppression initiates a signal that it is safe for the cysts to open and the spirochetes to come forth and multiply.

Each of these forms is affected by different types of antibiotics. If an antibiotic targets the bacterium's cell wall, the spirochete will quickly morph into a cell-wall-deficient form or cyst form to evade the chemical enemy.

Borrelia burgdorferi has an in vitro replication cycle of about seven days, one of the longest of any known bacteria.

Antibiotics are most effective during bacterial replication, so the more cycles during a treatment, the better.

Since the life cycle of Streptococcus pyogenes (the bacterium that causes strep throat) is about eight hours, antibiotic treatment for a standard 10 days would cover 30 life cycles.

To treat Lyme disease for a comparable number of life cycles, treatment would need to last 30 weeks. . . .
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randibear
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Any good for chronic???

--------------------
do not look back when the only course is forward

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Keebler
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IMO, EVERY case of lyme, no matter how "new" has the potential to set up as chronic in a matter of minutes. If Sapi's petri dish findings translate to inside the human body, that could be just 20 minutes.

The "Controversial" article above explain how certain antibiotics cannot treat all forms of borellia and even cause development of others and - also - how borellia is not the only thing to address.

Other authors in the Cystic Form links set explain their findings and thoughts, too.

If we want to prevent CHRONIC lyme, we have to realize that treatment must be combination from the get-go. And, if we want to prevent other CHRONIC STEALTH infections that often travel with ticks, we also have to be aware from the start.
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Keebler
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Now, we all know someone who seemed to do just fine with a short course of doxycycine. And, apparently, these are the ones that the IDSA doctors must limit their practices to (&/or not know that many of their patients likely go elsewhere when continuing symptoms are ignored).

The STRAIN of borrelia makes a huge difference.

Usually my note taking is better than this. The first couple sentences do not sound like how I talk. But I did not note who else may have said this. Perhaps some of this from the book and some from myself -- clearly below is from the book, where marked.


What many people don't know is that 10 strains of lyme cause only the lyme rash. They don't cause any lyme disease at all.

So, that's why a person can get a rash and just take a little doxy and be fine. They actually would have been fine even without the doxy.

On the flip side, if lyme is present just doxycycline can CAUSE lyme to become chronic as doxy pushes spirochetes to go into the cyst form.

Combination treatment - with very specific Rx to address cyst form as well, is vital to prevent that. Antibiotics do not do this.

Back to the rash but no symptoms: as mentioned above, that may be true for NOW but it can change. Still, maybe not.


Here is an exerpt from the book "Cure Unknown" by Pam Weintraub in which she talks about this aspect of lyme disease:


p. 342 tells how Ben Luft, infectious disease specialist and Daniel Dykhuizen, evolutionary biologist, working together at Stony Brook went out into the field collecting ticks and analyzing Borrelia.

A few years later, they had a graduate student travel the Eastern seaboard as far north as New Hampshire and south through the Carolinas collecting ticks infected with B. burgdorferi spirochetes.

p.343 �The Borrelia were duly isolated and compared for differences in their genes.

Eventually the researchers focused on twenty strains, each with a different version of the changeable OspC. Working with those twenty strains, Luft learned that six didn�t infect humans and ten caused only a rash.

Only four of the twenty could leave the skin to invade other tissue like the heart and joints or the brain.

The most virulent of the strains turned out to be the prototypical B31, the version of B. burgdorferi � ultimately isolated by Burgdorfer and Barbour at the Rocky Mountain labs in 1981.

The implications are profound.

One of the most important is that if just four strains of the twenty cause disseminated infection, then the roster of rash-based studies on the treatment of early Lyme disease, conducted from the 1980s to the present, would have to be reassessed.

Take a moment to ponder the simple math: It would be impossible to accept results based on the assumption that 100 percent of Lyme rashes can cause invasive disease when a significant percent cannot.

Some of the classic studies claim very high cure rates for early infection; yet if the causative strain were of the rash-only variety, then even orange juice would be a �cure.�

Are recommended treatment protocols truly curing most of those with early, invasive borreliosis? Or has noise from rash-only strains obscured less rosy results?� (p. 344)

References From:

http://www.cureunknown.com

Cure Unknown - by Pamela Weintraub
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Lymetoo
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randi .. Some people take it for chronic Lyme.

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

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randibear
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when i first got bit the doctor only gave me doxy for two weeks, by christmas i was a goner...

it was years before i got the final diagnosis and then too late of course.

my llmd uses biaxin and flagyl and occasionally throws in diflucan but you have to beg for it.

he did at one time want me on six different abx at one time at very high doses but i just couldn't tolerate it, so we had to stop it.

he eventually said i was not improving on abx and put me on full cowden. i'm not sure i'm seeing results yet tho....sigh...

--------------------
do not look back when the only course is forward

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ralphi
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Thanks for all the replies!
My mother found 2 embedded ticks the day before yesterday, but they hadn't been there long. She is healthy and has had no lyme symptoms.

I have 60 doxy pills left from my own treatment so she wants to take 2 a day for a month, just to be on the safe side.

I read on Dr. B's guidelines that no treatment is really needed for a bite unless you're in an endemic area, have low immunity, patient requests it, etc.

Of course, if she starts to show symptoms of any sort, we'll get her to an LLMD as soon as we can.

Thanks again!

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randibear
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look for that lyme bull's eye or rash. course alot of people don't get it, but man i did....

--------------------
do not look back when the only course is forward

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Keebler
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ralphi,

Of course, you / your mother can do whatever you wish. Posting this for you, though, just so you know. And others, especially those who may be new to this, I'd like to address a few misconceptions for the sake of safety.

1. Tick attachment time. It does not matter how long. Even just a bite with withdrawal can cause lyme and other infections if the tick is infected.

It's myth that it needs to be attached for any amount of time. There is no magic window regarding the clock. No more so than with a mosquito.

The tick's stomach (where all the bad boy infections are said to be kept until it's been attached 24-48 hours and it's so full it starts to reguritate) is NOT hermetically sealed.

Stuff can ooze out but, more importantly, as it went in, some can remain on the tick's mouth parts and all parts, really.


2. It does not matter if one is in an endemic area or not - if a tick is infected, it's infected. As long as birds fly and rodents scamper, EVERY tick should be suspect.

Ticks infected with lyme can be anywhere, even at the south pole (really, and that was a surprise, of course, to penquins there).


3. Even someone with the best immune system can fall from lyme. Lyme dismantles the immune system and it can do so in anyone.

Burrascano is, by far, the most positive voice for those with lyme and his guidelines are exceptional. Still, they are now several years old. We have learned more since they were last updated.

And, in all fairness, even he may have to toe a political line and not seem to cause alarm by being more forceful about just who should be concerned after a bite. It's true that not every tick is infected, of course. But so many (if not most) are - and that can be anywhere.

One reason that more locations are not declared "endemic" is due to politics and the sharp desire of the IDSA and many state medical boards, insurance companies and tourism offices to ignore lyme.

Most places don't even do tick checks and the tests they run on those few ticks that may be caught are not always the best tests, yielding false negative and, therefore, "endemic" never comes into view even though it well may be.

My state is one that simply "outlaws" lyme so it's not declared endemic. But we have one of the highest populations for all kinds of neurological disease.


4. Embedded ticks. Be sure - absolutely, positively that all tick parts are removed from the bite site. ANY remaining part can cause continued infection for years to come, and even twart treatment. This is from some European countries that always excise a bit of surrounding tissue when they remove embedded ticks.
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Lymetoo
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www.TreatTheBite.com

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

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Keebler
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If your mother (or you) can locate anyone near to her who has a RIFE machine who might just be able to let her use it, that would be a great consideration.

If all households had a rife machine, I think we could be so much more prepared for any tick or mosquito bite.

There may also be certain - very specific - supplements of help. A good LL ND (naturopathic doctor) would know more about all that.


http://flash.lymenet.org/scripts/ultimatebb.cgi?ubb=get_topic;f=1;t=117755;p=0

Topic: RIFE Machine - Reference LINKS

LL Naturopathic links here, too.
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hiker53
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My friend had an embedded tick for about 24 hours and the doctor would only give her one dose of doxy at 100 mg even though she had the bull's eye rash. Some MD's just don't understand.

Hiker53

--------------------
Hiker53

"God is light. In Him there is no
darkness." 1John 1:5

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Lymetoo
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Maybe now patients will have to lie about how long it's been embedded!

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

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