posted
Does anyone know if there is a reason why a doctor would prescribe a lower than usual dose at the initial onset of treatment for chronic/late stage Lyme?
Posts: 39 | From Alabama | Registered: Jul 2010
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TF
Frequent Contributor (5K+ posts)
Member # 14183
posted
I am imagining here:
--because he has some idea that the patient will not be able to handle the theraputic dose based on something in the patient's history
--because he believes in starting out with really low doses so as to avoid a massive herxheimer reaction which he does not want the patient to go through
--in case the patient will be allergic to the med (something is warning him that they may be allergic to it)
--based on the patient's weight, it is the proper dose
--he doesn't know what he is doing
--he believes in a lyme treatment philosophy that he should not try to kill the lyme bacteria but just stop it from multiplying. Therefore, he prescribes bacteriostatic doses (not bactericidal doses) on purpose and waits for the patient's immune system to kill the bacteria. Known as the "low and slow" approach to lyme treatment.
--I could go on and on, but you get the idea?
Posts: 9931 | From Maryland | Registered: Dec 2007
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posted
LOL...Yes, I get the idea. I was just hoping this might be a very common approach in the treatment of Lyme and that the answer would be a simple one. I won't see the doctor for two more months, so if I want to make sure it is not a mistake and want to know, I have to call his office.
Doc has prescribed minocycline 100 mg once a day for two months to start, at which point I am to see him again to re-evaluate/retest and make any necessary changes.
Posts: 39 | From Alabama | Registered: Jul 2010
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TF
Frequent Contributor (5K+ posts)
Member # 14183
posted
If it's not a mistake, then you have a believer in the "low and slow" philosophy on your hands--very low and very slow.
That's the only reason to have a person on that dosage for 2 MONTHS!
Maybe he doesn't know for sure that you have lyme.
I'm a Burrascano girl myself. So, I would not want such a doc. Waste of my time.
Posts: 9931 | From Maryland | Registered: Dec 2007
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posted
Mino is hard to take in the beginning. But 2 months is a long time to be on a low dose.
Ask him about it when you see him again!
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96239 | From Texas | Registered: Feb 2001
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Keebler
Honored Contributor (25K+ posts)
Member # 12673
posted
- * Is your doctor an ILADS-educated, truly lyme literate doctor?
* Have you been assessed for other tick-borne or other stealth infections? Different meds are needed.
* Have you been advised on some nutritional supplements to help support your liver and adrenals? Advised to eat a clean diet?
* Did he tell you to take PROBIOTICS?
If "no" to any of the above, find an ILADS-educated LLMD. Now, it may be you are starting low to avoid a herx but a 2-month time lapse between appointments with you on so low of a dose concerns me.
You REALLY Need liver support when taking mino. It will help with possible ear /balance symptoms from mino. B-6, also.
I am concerned that will not adequately treat infection. On the other hand, full treatment can be just too hard on some people (but so can under-treated infection).
Did he say anything about The Road Back Foundation? Sounds similar. It could be that's the approach he's taking.
** Nutritional Supplements in Disseminated Lyme Disease **
J.J. Burrascano, Jr., MD (2008) - Four pages
==========================
It's very important to have this book as a reference tool for self-care and support measures. It answers so many questions in detail that is impossible here on the forum.
In addition to the usual coinfections from ticks (such as babesia, bartonella, ehrlichia, RMSF, etc.), there are some other chronic stealth infections that an excellent LLMD should know about:
Topic: TINNITUS: Ringing Between The Ears; Vestibular, Balance, Hearing with compiled links - including HYPERACUSIS -
Posts: 48021 | From Tree House | Registered: Jul 2007
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karenl
Frequent Contributor (1K+ posts)
Member # 17753
posted
He might think you have a heavy bacterial load and does not want a mega herx because of ? maybe your liver or kidney or because you are working or some reason.
I started low dose and I am doing so much better. The question is do you feel a lot of die off or do you feel nothing at all.
My LLMD would say you cannot take mino without a cyst buster. He would not allow mino alone. Maybe this is right. I started also only mino / doxy alone but I was so sick I needed very low dose and slow treatment.
Posts: 1834 | From US | Registered: Oct 2008
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posted
Thank you guys so much for the replies. You have given me a lot to look at and think about.
I am still working, but the work I do I am able to do from my house...thank goodness, because I know I would not have been able to hold down a job any other way.
Posts: 39 | From Alabama | Registered: Jul 2010
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METALLlC BLUE
Frequent Contributor (1K+ posts)
Member # 6628
posted
Stupidity is usually the correct answer.
-------------------- 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.
---these physicians come under fire constantly and don't know who is walking into their office claiming that they are sick,
maybe this is a way that some doctor have to do things just to protect their practice
then once they saw that I was legit, they started changing doses and meds and treating me for Bart, the same way everyone here has been treated for it, and now I am being treated for Babs
---but they did the 2 months of low and slow, so maybe it is just how they like to start to get a real good assessment of their new patient,
---unless we are near death or something, I could still walk, talk , etc, I felt like death, but I wasn't near death yet, not like some are
I am now building up really high doses or orals with the babs treatment, it is really intense and they had wanted to add meds for the cyst form, but I couldn't yet (long story),
this same LLMD has mentioned that in two months I may need to finally go on IV
maybe, for some reason they have to be really careful because of all the past investigations
Posts: 606 | From somewhere out there | Registered: Sep 2009
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seekhelp
Frequent Contributor (5K+ posts)
Member # 15067
posted
I agree.
quote:Originally posted by METALLlC BLUE: Stupidity is usually the correct answer.
Posts: 7545 | From The 5th Dimension - The Twilight Zone | Registered: Mar 2008
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posted
I think that without knowing more about the docs track record people are making assumptions.
Even the great Dr B started hubby on Mepron every other day for the first 10 days -- hubby did have an allergic reaction starting on the 10th day.
He also only started him on Levaquin by itself for the first month before adding in the Mepron. Then he planned to add in Doxy. Hubby had previously done 2 months of IV Rocephin 6 months before the initial appointment with Dr B.
Treating multiple infections is very complex and must be individualized for each patient.
At least the doc did not start her on the mino only 3 days per week as some docs do.
Personally if this was me, I would start the mino at 50 mg for a week or two and then increse it by 50 mg every week or two and call up the doc before you run out and tell him you have increased the dose and need a refill. This is the way we usually handle med changes for hubby.
You do have to be your own advocate. It is your treatment and either you are a partner with your doc or you just let him call all the shots. You need to find out relatively quickly if this is a doc you can work with going forward.
this is not medical advice, just my opinion based on hubby's experiences.
Bea Seibert
Posts: 7306 | From Martinsville,VA,USA | Registered: Oct 2004
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METALLlC BLUE
Frequent Contributor (1K+ posts)
Member # 6628
posted
I should make one correction:
For chronic Lyme Disease and other co-infections, patients should be started on only one medication at a time, and the dose should be built up, only to make sure the patient doesn't have a severe reaction.
This build up shouldn't take months for "one" medication, but the full therapy as a combination of drugs, may take a couple months.
Hope this makes sense.
-------------------- 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.
METALLlC BLUE
Frequent Contributor (1K+ posts)
Member # 6628
posted
It's the doctors who "keep" a patient as sub-therapeutic levels and don't engage the full combination of therapies necessary that I was talking about when I mentioned "stupidity."
-------------------- 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.
sutherngrl
Frequent Contributor (1K+ posts)
Member # 16270
posted
I think its my doc!
I am on low dose doxy now. Have been for over a year. Started out on a few months of different antibioitics and more aggressive doses and with a cyst buster for the first month. Treated a year with moderate doses of various meds.
I have had the most improvement on the low dose doxy. For me low and slow is paying off.
I spent the first year sick and miserable with no improvement. After taking low dose doxy for about 9 months, I started to see gradual improvement.
PM me if you want more info!
Posts: 4035 | From Mississippi | Registered: Jul 2008
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Keebler
Honored Contributor (25K+ posts)
Member # 12673
posted
- If you are confident that the doctor is fully educated about lyme, that is the key point. You can ask why he's chosen this path - and for a two month stretch.
Just be sure the doctor is fully lyme literate and ILADS-educated. Many LLMD are but still have different methods.
It's true that only the doctor can tell you WHY. You take it from there with the discussion. -
Posts: 48021 | From Tree House | Registered: Jul 2007
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posted
Mino can cause such dizziness that some people have to quit taking it. So, a lower dose might be a way of avoiding this outcome.
Posts: 8430 | From Not available | Registered: Oct 2000
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