This is topic First Visit with LLMD ... (question/concern about dosage) in forum Medical Questions at LymeNet Flash.


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Posted by yankees237 (Member # 25791) on :
 
I caught my Lyme within 48 hours and was on Doxy immediately from my reg doc (doxy 200 mg a day x3 weeks)...My LLMD extended the treatment for an additional 3 weeks but didnt up the dosage...

im hearing 200 mg per day isnt enough and it should be at least 400 mg per day...why didnt he up the dosage? should i be concerned/ or see another llmd?

[ 05-13-2010, 12:06 AM: Message edited by: yankees237 ]
 
Posted by yankees237 (Member # 25791) on :
 
by the way i i'm male about 5'10 160 lbs
 
Posted by TerryK (Member # 8552) on :
 
My understanding is that 200 mg per day would be bacteriostatic (inhibit) but not bactericidal (killing). 200 per day is typically given via IDSA guidelines but the dose would typically be twice that via ILADS trained doctors.

Is your doctor a member of ILADS?
wwww.ilads.org

Were you tested for babesia, bartonella or any of the other common co-infections?

Here is a paragraph from ILADS guidelines that might help.
http://www.ilads.org/files/ILADS_Guidelines.pdf
21. Prompt use of antibiotics
Although no well designed studies have been carried out, the available data support the prompt use of antibiotics to prevent
chronic Lyme disease. Antibiotic therapy may need to be initiated upon suspicion of the diagnosis, even without definitive proof. Neither the optimal antibiotic dose nor the duration of therapy has been standardized, but limited data suggest a benefit from increased dosages and longer treatment, comparable to the data on tuberculosis and leprosy which are caused by similarly slow-growing pathogens [25].

Terry
 
Posted by littlebit27 (Member # 24477) on :
 
I'm on only 200 mg too. My doc seems to be a good LLMD and is very educated about Lyme. Before my test he said he was positive I had lyme and was a walking text book case of it. He said it takes a long time to treat but hang in there and he would help me through it.

I'm going to ask on my next appt. May 27th about the dosage because I keep hearing it is not enough on here. I'm not sure if he just wants to start slow or what. I would ask your doc the same thing, why does he have you on only 200 mg.
 
Posted by t9im (Member # 25489) on :
 
When on Doxy avoid the sun. Just a few minutes can be quite a burn.
 
Posted by bcb1200 (Member # 25745) on :
 
I'm on 400 mg (200 mg 2x / day)
 
Posted by yankees237 (Member # 25791) on :
 
thanks guys

please more advice is welcomed
 
Posted by LymeXtu (Member # 24590) on :
 
I was started on 200 ( 100 mg 2x day ) by my pcp and my LLMD increased to 400 ( 200 mg 2x day ).

I only weigh 120 lbs.

In his opinion the higher doses yield the best results if tolerated.

Dr B guidelines = " Doxycycline is only effective at high blood levels" !!!!
 
Posted by bcb1200 (Member # 25745) on :
 
Let me expand...I started my treatment this week. 400 mg Doxy. I am 6'2" and weigh 215 lbs. A "big guy" (although I'm down 25lbs from February when my symptoms began.)

I also will start a 3 day pulse of 1000 mg of Flagyl every 2 weeks next tuesday. Ug.
 
Posted by yankees237 (Member # 25791) on :
 
so everyone agrees 400mg ?
 
Posted by sutherngrl (Member # 16270) on :
 
TerryK said......My understanding is that 200 mg per day would be bacteriostatic (inhibit) but not bactericidal (killing).


You can still get rid of the spirochetes by inhibiting them. Inhibiting will stop them from replicating and "over time" they will die off. This would be a more long term treatment.

My doc actually treats with low dose doxy. Says your tissues(where the spirochetes are) can only absorb a certain amount of the antibiotic anyway. Taking larger doses doesn't help. And it should be dispensed according to weight.

I did larger doses of other meds however, earlier in my treatment. I think the low dose doxy has helped me the most. Just my experience!
 
Posted by Lymetoo (Member # 743) on :
 
What's scary is that you have a small window of opportunity to KILL the KEETS!!

If you're chronic already... 200mg is an "OK" beginning... but NOT if you are recently bitten.
 
Posted by stork (Member # 24167) on :
 
Just because your doc is ILADS doesn't mean he/she is going to give you the best dose for you. I had a doc who was very high ranking in ILADS, and he seemed to have an arbitrary approach to kinds of ABX paired with a low-dosing schedule.
 


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