Here is an article re: flagyl and its effect on both spirochetes and cysts. Annotations are mine.

The research supports the opinion that:

1)While flagyl alone does not kill normal mobile spirochetes,

2) Nor does it cause conversion of the spirochete to cystic form

3)Flagyl DOES degrade the contents (spirochetes)of the cyst and

4)Cause cysts to rupture (my note: viability of contents post-rupture not specifically addressed here)

5)Flagyl also inhibits the replication process of the spirochete in the cyst.

Here is the study:

An in vitro study of the susceptibility of mobile and cystic forms of Borrelia burgdorferi to metronidazole.

Brorson O, Brorson SH.

Department of Microbiology, Vestfold Sentralsykehus, Tonsberg, Norway.

The aim of this study was to examine the susceptibility of mobile and cystic forms of Borrelia burgdorferi to metronidazole.

Because B. burgdorferi is a microaerobic bacterium like Helicobacter pylori, metronidazole (MZ) was chosen in the susceptibility test.

For both microaerobic and aerobic incubation the normal mobile spirochetes were resistant to this antibiotic with an MBC > or = 512 microg/ml.

Conversion of mobile spirochetes to cystic forms was not observed when they were incubated with MZ.

When they were incubated under microaerobic conditions, the biologically active cystic forms had an MBC > or = 4 microg/ml, but the MBC was > or = 32 microg/ml with aerobic incubation at 37 degrees C.

Staining with acridine orange (AO), dark field microscopy (DFM), and transmission electron microscopy (TEM) revealed that the contents of the cysts were degraded when the concentration of MZ was > or = MBC. Some cysts were also ruptured.

When incubated with a sufficient concentration of MZ, core structures did not develop inside the cysts, and AO revealed less RNA in the cysts.

Our observations may help efforts to treat resistant infections caused by B. burgdorferi with a combination of MZ and other antibiotics in order to eradicate both cystic and mobile forms of B. burgdorferi.

Best regards,
andie

[This message has been edited by andie-ws (edited 29 January 2005).]

I ask this because i have been on 1000mg for a few days and my stomach is fine... the stuff did destroy my brain though.

�
Induction of cystic forms by different stress conditions in Borrelia burgdorferi.

Murgia R, Cinco M.

Spirochete Laboratory, Dipartimento di Scienze Biomediche, Universita' degli Studi di Trieste, Via Fleming 22, 34127 Trieste, Italy. [email protected]

Cystic forms of Borrelia burgdorferi might represent a low metabolic activity state or phase of B. burgdorferi cells that allows the spirochete to survive in a hostile environment until conditions are favourable to multiply again. In this study we evaluated the rate of cyst formation induced by oxidative stress, pH variations, and heating, reconversion of cysts to vegetative forms, and some aspects of their metabolic activity. We observed cyst formation in the presence of extreme pH values, and at high temperature, but the best production of cystic forms was observed in the presence of H2O2. When transferred to BSK II medium, the cystic forms reconverted to spirochetes in relation to their age and type of induction treatment. Furthermore, we demonstrated a low metabolic activity of cystic forms by measuring amino acid incorporation. Overall, these data suggest that the phenomenon of conversion to cysts by B. burgdorferi provides a limited survival potential. This short-term survival, however, gives borreliae an additional chance to overcome unfavourable environmental conditions.

andie,

The Brorson team also showed the same capabilities to bust cysts wrt Tinidazole and Hydroxychloroquine.

Brorson O, Brorson SH,
``An in vitro study of the susceptibility of mobile and cystic forms of Borrelia burgdorferi to tinidazole''
International Microbiology, 2004, Vol.7, No.2, pp.139-142. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt =Abstract&list_uids=15248163
(full article freely available!!!)

Brorson O, Brorson SH,
``An in vitro study of the susceptibility of mobile and cystic forms of Borrelia burgdorferi to hydroxychloroquine''
International Microbiology, 2002, Vol.5, No.1, pp.25-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list _uids=12102233&dopt=Abstract

Now when are we going to see some in-vivo experiments with these cyst busters?

Here's how it might be done.

Take a population of 50 seronegative Lymies with chronic Lyme disease and which exhibit roughly the same symptoms, say mostly neurological symptoms.

Then, at treatment start, measure their Lyme titer level at Bowen (which IS able to pick up the cysts.)

Then put half of them on say Minocycline and "a cyst buster" and the other half only on Mino.

Then remeasure the populations titer level at Bowen after say 3 months and see if there's any significant difference in the average titer level of each group.

Comments anyone? Isn't this a reasonable AND even doable experiment?

Michael

a lot of the study information is difficult for me to understand. espesially today.

i see my llmd on weds. have been taking zith 500 mg iv for 12 wks now. symptoms have been improving nicely.

early herxs sent me to er twice so i know llmd didn't want me in flagl or other cyst buster early on.

I am not well understanding if these studies are saying these drugs are or are not beneficial to wellness.

can someone please put info in easy terms to help me know how to ask good questions on weds?

Questions for those of you who are much more well read and informed than myself on the effects of metronidazoles or "cyst killers"....

First, I'm on the combo abx of Biaxin (1000mg/day) and Tinidazole (1000mg/day...but still am trying to get past 500mg/day)...Are both these "cyst killers"...do either kill them Bb in 'kete form? Any supporting info on how long it takes orally vs IV abx to diminishing the Bb load?

My experience is the Biaxin really helped with the GI probs, appetite, cold hands/feet and especially sleep...when I went on Tinidazole, my cold hands/feet came back dramatically, as did alot of head stuff, such as vision, dizziness and the brain fog feels like being intoxicated or "doped" up on meds....I thought that these abx were to help clear up the neuro stuff due to the fact they crossed the Blood Brain Barrier. Anyone have ideas/thoughts on why this occurs?

JamesH--I can relate to the feeling of it feels "like its destroying my brain"...what exactly do your symptoms feel like...and do they pass after awhile? Feels like it's just a constant head herx for the month at times for me.

Thanks again for a great thread and some really helpful info everyone.

Thanks Zip!

for the great article. Also Michael for the articles on Tini and Plaquinel being good cyst busters, too.

Interesting Zip about the low metabolic activity/low amino acid incorporation of the cysts.

Is "low amino acid incorporation" a measure of what it is taking from its environment or just from its own internal resources?

Either way, I wonder how the cysts are getting the energy to reproduce spirochetes. The mechanism is apparently not very amino acid dependent.

Would the low metabolic activity contribute to the cyst being a relatively more benign presence in the host than the spirochete?

I also noticed that cysts formed in the presence of high temperatures. Could that be a reason that people feel relief after using hot baths, hot tubs, saunas, etc?

I know this is done to alleviate herx symptoms, remove toxins and to theoretically kill spirochetes, but if it is instead just driving them into cyst form that would be a negative approach to healing without an adjunctive cyst buster.

James and Hiker:

I'm so sorry you are both feeling lousy on this stuff. JC is on oral and feels horrible on it...kind of like chemo I think.

I don't know about the relative advantages of IV over oral. Maybe there are others out there who know?
Great stuff on the Tini and Plaquinel Michael!

Yes, Michael, I agree. Your experiment sounds like a good one. Can it be possible that it hasn't been done?!

I would imagine that there are a lot of candidates here with the sero negativity and cyst titers.

Not JC though. He's just your run of the mill Lyme mess. Titers for cysts, lots of antibodies as well as immune suppression.

Java:

The following needs to be validated by others with more knowledge than myself. My understanding is that the biaxin is killing the keets and the tini is getting the cysts.

Your dramatic physical improvement on the biaxin mirrors our experience with rocephin, as does the neuro decline for a period after starting the flagyl. My guess on that is: herx and neurotoxins. Plus, it just makes you feel crummy!

Btw, our LLMD just likes flagyl better for neuro stuff than flagyl even though it is harder to tolerate. Just based on his experience, not hard data.

Which brings me to Foggy!!

Yes! JC just curls up in a fetal position and goes green when he sees me coming at him with that flagyl 2x a day!

Thank you for the tip about coating it with something tasty. The poor little guy!! It really does make him feel like road kill.

Achey!

Trust me when I say I am just feeling my way along here with all this stuff but I will try to give you what I understand about cysts and the busters.

I'm gonna tell it in simple story form that is in no way a reflection of you. So no offense intended if it sounds silly. This is actually just the way my mind works.

OK.

You know our Lyme friend, the spirochete, aka "keet". He's a nasty little corkscrew worm of a guy who pushes himself along throughout our bodies and brains causing all manner of problems.

Well, there are several antibiotics that are very toxic to him. You could call this a "hostile environment" to the little creep. We'll call this antibiotic #1.

Well, antibiotic #1 can kill some creeps but it can't kill em all because they wise up fast to the fact that they are under attack.

So, what do they do? They have a sneaky defense mechanism that protects them from #1's toxic soup. It's almost like body armour that cannot be penetrated.

The corkscrew keet begins to curl up into a ball, tighter and tighter. It develops a shield around this ball that antibiotic #1 cannot penetrate. The keet has now officially become a CYST.

In addition to now being immune to antibiotic #1, this little ball has plans to "get busy".

Thats right, our cyst starts making little cute miserable rotten baby keets inside the ball. And it waits...

Until the coast is clear (ie, no more of that nasty antibiotic #1 around)

and BAM!

It pops open like a birthday (literally) surprise and gives birth to a mess of baby squiggly keets.

Out they swim and go back to making your life miserable.

Unless of course they encounter antibiotic #1 and get nailed again and the whole cycle starts over.

(They've got other tricks too but thats for another post)

Now, whats so nifty about Cyst Busters, like Flagyl, Tinidazole and Plaquinel?

Well, they are a different kind of antibiotic (call it antibiotic #2)and they CAN beat up those cysts and their little babies, too!

So, basically, what the various articles said was:

1)Cyst buster antibiotics cannot hurt the keets when they are just out there swimming around

2)Cyst busters don't make the keets want to curl up into a ball

3)But they Do degrade the contents of the balls (keets) by calling them names - (NO! NO! Just kidding around..)

4)And cause the balls to rupture

5)And interfere with the making of baby keets while in the ball shape.

And that, achey, is what I think the articles said about cyst busters.

Many LLMDs like to start people on abx #1 for awhile in an attempt to get the keet load down. Some antibiotics make keets into cysts faster than others.

It also gives the person a chance to see how well they are tolerating the medicine or if it is working well for them.

After a time, many llmds move on to the next phase where they add a cyst buster. As Michael mentioned, a test can be done to
determine cyst load.

Hope that helps and I hope it is not all factual nonsense.

Better to check with others, too.

later gator and good luck at your appointment!

ciao,
andie, JC & Julie

[This message has been edited by andie-ws (edited 30 January 2005).]

Here's something I wrote for my website. If you go to the link above there are links to more cyst info.

Life phases and morphology of spirochetes

Morphology Simplified- The words "cyst" and "bleb" are interchangeable in regards to lyme spirochetes. Same thing. In some of the older literature in particular, cysts are also called "granular" forms. Same thing. People in the Marshal Protocol camp also tend to call them "granular" forms. All this tends to confuse everyone, not just you and I.

Although the terms "egg" and "larvae" are not used in describing bacteria, these commonly used biology terms are appropriate. These terms may not be correct here to some microbiologists but thinking of them is useful in understanding what the heck these studies are talking about. Young spirochetes have been observed and documented as emerging from cyst forms. I call the cyst forms "eggs" when describing them to someone. You can call cyst forms whatever you like, but that's what at least some of them are. Reproductive forms serving the function of eggs. Eggs! Yep, that's right. Eggs. ""L" form variants" or "Young Spirochetes" have been observed and documented emerging from cyst forms. You can see a great family picture of well formed little spirochete babies safe and snug inside their cozy transparent egg on the homepage of this website, along with a picture of a parent carrying it's slimey little egg cases around. I wouldn't go so far as to use the term "Larvae" for "L" forms though. They might not be very different from the adults. I don't think anyone knows yet.

Also I wonder if it is possible if some of the cysts serve the function of hibernation-like chambers for adults. I haven't seen any direct observational statements that spell that out specifically, that adults not hatchlings sometimes emerge from the eggs. There are references to "adult spiral forms" emerging, but it's not clear to me at least, that the person observing this is differentiating "L" forms from adult Spiral forms. Some observers see them as the same.

Or maybe the adults don't use cyst forms to hibernate in, maybe when adults die off the eggs all just delay "hatching" until conditions are right and it's as simple as that. I hope so.

Morphology, or changing form, is not unusual in nature. Think of the life stages of butterflies or frogs. The lyme bacteria (a spirochete bacteria) has a simpler life cycle than either of those; Cyst (egg) to "L" form (just emerged or "hatched"), then to Spiral form (adult). Not too complex. For an example of real complexity, do a google for the life cycle of Babesia!

B.b. bacteria also "exchange genetic material". In other words- they mate. Don't ask me how- I've never watched it myself. Are they male and female or hermaphrodites? I don't know. I don't know if anyone knows. But they don't just reproduce by splitting in two. Nope, they mate and lay all their eggs in you, the little buggers...

oh, you are wonderful!
I don't feel belittled at all, I finally understand! Thank you!

Kinda freaking out now.... how has my 12 wks of zith driven keets into cysts. I hadn't figured that cysts were like egg sacks to reproduce more keets. I thought they were just hiding places....

That goes a long way to explain my health over the past 30 yrs.

robi

Your website is awesome!!! You have really put together an amazing collection of material.

I only had a chance to peruse the cyst section and it is superb!! I can't wait to check out the other sections, too.

For anyone who hasn't seen it, don't miss out! You will learn a lot and Caat has put it together in such an organized way.

I'm continually amazed by the caliber, drive and generosity of folks who post on this board in spite of being sick.

Patty7,

You and your kids are very welcome for my little contribution to the lyme education cause.

Yes, I admit it, kids and "brain fogged minds" are definately my target audience!

Achey!

You, too, are very welcome!

You know, I JUST read a post a little while ago that listed some of the popular keet abx and their relative potentials to create cysts.

Arg! I can't remember who posted it! Seems like something Tree or caat or minoucat would do. If it was someone else, I apologize for not remembering and giving credit where due!

What I can tell you is that ROCEPHIN is the abx that is infamous for pushing keets into cysts. Which explains why people feel so much better on it and relapse so hard after.

Alot of llmds avoid it for that reason as well as the fact that it only comes in IV form (which carries a whole host of potential problems). Rocephin also causes bile sludging which can neccesitate removal of the gall bladder!

Never mind that it's ridiculously expensive so insurance companies are particularly nit picky about justifying its use and covering for it.

On the up side, rocephin is just about the best abx around for crossing the blood brain barrier so it is great for neuro lyme .Also about the only one for kids since they can't take any of the cyclines (of which doxy is one). IVs can also be a godsend for people who can't tolerate oral abx.

The other thing I seem to recall is that Biaxin is one of the LEAST likely to cause cyst forms while still being an excellent keet killer! I think the other major abxs fall in between rocephin and biaxin in terms of cyst promotion.

Better check on that but thats what I seem to recall.

Robi,

Yeah, kicking cyst butt is pretty gratifying.

Also, pretty toxic and tough for many people to tolerate between the nausea and neuro symptoms.

On the relative merits of each, bear in mind that people react differently to them.

I "think" that flagyl, tinidazole and plaquinel are about equal in efficacy in vitro. Some llmds have preferences and some may work better for particular symptoms than others.

But, it is my understanding that flagyl is the most difficult to tolerate.

Tinidazole is supposed to be basically the same compound and just as effective as flagyl but without certain additives that cause adverse side effects.

However, as I mentioned above, just based on his own on-going observations, JC's llmd likes flagyl better for heavy neuro lyme.

I don't know enough about plaquinel to give you much info there.

After seeing Caat's website, I'll bet she has some ideas!!

Good luck at your appointment tomorrow, Achey!!!