This is topic How do I know it's hexing and not lyme? in forum Medical Questions at LymeNet Flash.


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Posted by luvema (Member # 26650) on :
 
I was wondering how do you know it you are herxing or if it's your lyme symptoms. My lyme symptoms can get really bad...

When does a herx usually happen?

I been on doxy for five days now 400 mg a day.

I have really bad pain all over... My bones hurt, but the pain is mostly on my side and lower back..

Also lots of pain in my legs and hands and a sore throat that comes and goes.


I am not sure if it's lyme disease or a herx
 
Posted by TF (Member # 14183) on :
 
Page 17 of Burrascano Guidelines:

"Several days after the onset of appropriate antibiotic therapy, symptoms often flare due to lysis of the spirochetes with release of increased amount of antigenic material and possibly bacterial toxins. This is referred to as a Jarisch Herxheimer-like reaction. Because it takes 48 to 72 hours of therapy to initiate bacterial killing, the Herxheimer reaction is therefore delayed. This is unlike syphilis, in which these reactions can occur within hours.

It has been observed that symptoms will flare in cycles every four weeks. It is thought that this reflects the organism�s cell cycle, with the growth phase occurring once per month (intermittent growth is common in Borrelia species). As antibiotics will only kill bacteria during their growth phase, therapy is designed to bracket at least one whole generation cycle. This is why the minimum treatment duration should be at least four weeks. If the antibiotics are working, over time these flares will lessen in severity and duration. The very occurrence of ongoing monthly cycles indicates that living organisms are still present and that antibiotics should be continued.

With treatment, these monthly symptom flares are exaggerated and presumably represent recurrent Herxheimer-like reactions as Bb enters its vulnerable growth phase and then are lysed. For unknown reasons, the worst occurs at the fourth week of treatment. Observation suggest that the more severe this reaction, the higher the germ load, and the more ill the patient."

http://www.ilads.org/lyme_disease/B_guidelines_12_17_08.pdf

So, here Burrascano is saying that a herx can happen "several days after appropriate antibiotic therapy." 5 days would fit the bill.

Then, he goes on to state that lyme disease normally flares every 28 days. So, if you are worse today, mark it down on the calendar. Then, count 28 days into the future and see if it happens again.

When I was treating lyme, I was able to predict my bad days by counting 28 days into the future from the last bad day. This way, I didn't get upset when I had a bad day, and I could plan for the bad day. I didn't plan to do anything important for the future expected bad days.

By doing this, you can be more calm and in control. It helps a lot.

Hope this helps you.
 
Posted by luvema (Member # 26650) on :
 
Thank you!! This is so helpful.

I am doing five days on and four days off doxy...

Then the after that i take an antifungal.. For two weeks.
 
Posted by TF (Member # 14183) on :
 
This is not normal lyme treatment at all. You should be on the doxy continuously.

Most lyme doctors put patients on the doxy for at least 30 days at the beginning of lyme treatment because that gets rid of ehrlichia if you have it plus it kills lyme in the spirochete form.

Then, they usually switch you to 2 lyme meds. that you take daily for months. And, often, they add another med or 2 to kill the coinfections.

I don't know how you will ever make progress just taking the doxy this way. Read Burrascano and you will see what good lyme treatment looks like.

See in the quote above where he says: "As antibiotics will only kill bacteria during their growth phase, therapy is designed to bracket at least one whole generation cycle. This is why the minimum treatment duration should be at least four weeks."

I hope you know that you have to avoid the sun when on doxy. Even your hands can burn through the car windshield. It is a nasty medication burn, not a regular sunburn.

For this reason, lyme doctors generally stop giving doxy this time of year as folks want to be outside.
 
Posted by luvema (Member # 26650) on :
 
TF,

Thank you so much for the help.

I am not sure why she put me five days on and four days off, and then two weeks of anti fungal treatment then back again to doxy.

And oh geez, I was sitting outside in the sun for a while today. Thanks for the info, I didn't know that!
 
Posted by Judie (Member # 38323) on :
 
I'm shocked your doc didn't tell you the sun and doxycycline. I'm also shocked that your doc isn't suggesting a minocycline/doxy combo to cut down on the chance of you burning in the summer.

You're in southern California for God's sake.

Sorry for getting angry, but something doesn't seem right. ALL my docs mentioned doxy and the sun.

I would seriously consider consulting with a couple more LLMDs.

I consulted with 3 until I found the one that worked for me (taking doxy the whole time while shopping for the right doctor).

Minocycline penetrates the central nervous system. Personally, I was allergic to it, but it can really help some people.
 
Posted by Lymetoo (Member # 743) on :
 
Ema.. maybe you need to read more on this board. Lots of important information here. If you're doc isn't telling you things, stay on top of it for your own sake.

Begin here .. and also read other people's threads.

http://flash.lymenet.org/scripts/ultimatebb.cgi?ubb=get_topic;f=1;t=088555;p=0
 
Posted by TF (Member # 14183) on :
 
Another important thing about doxy is to take it in the middle of a meal. If you don't, you can end up with terrible stomach upset, reflux, and even vomiting.

Eat half of a meal, take the pills, and then eat the other half.

This is what the lyme docs tell their patients to do.
 
Posted by lax mom (Member # 38743) on :
 
Usually the RX bottle says to stay out of the sun.

Very odd that you are pulsing doxy and taking breaks in order to take anti-fungals.

I was on Diflucan at the same time.
 
Posted by Keebler (Member # 12673) on :
 
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http://flash.lymenet.org/scripts/ultimatebb.cgi?ubb=get_topic;f=3;t=030792;p=0

LIVER & KIDNEY SUPPORT & and several HERXHEIMER support links, too.
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