Those taking or have taken Rifampin with success: question(s)

Sorry - more questions:

I am on Rif and mino. Taking 300 mg Rif twice daily.
Took a few weeks to get to the full dose.
Due to herxing I have had to cut back to once daily every 4 or 5 days.And one day I didn't take any.
I only need to do that once and then the herx subsides.
I am concerned about resistance. I do feel the Rif is helping so don't want to ruin a good thing.

Questions:
- Did you take a day off here or there during treatment? And did you have improvement and after how long of treatment?
- or, did you just cut back to half dose when herxing, and did you improve?
- Did you just push through the herxing - maintained the full dose and the herxing subsided with detoxing.

I haven't tried pushing through - I have upped my detox as I had gotten lax when I was on the abx break...but am still not sure I should push through - the detoxing helps somewhat, but if I don't feel enough relief by the time it's time to take it again, I either skip it or take half dose.

Your thoughts?

I am worried about abx resistance - as bart is different than lyme...
But I really don't know if it's a valid concern.

I am having a bad herx day every 4 days or so...so I guess you could say it's hellish. I've been taking Mino for about 6 weeks now.

Update: Just had my LLND appt.

He told me to 'push thru' my herxes...he wants me to take a different curcumin supplement now to help with the inflammation/pain.

I told him I was taking Rif with food because it was causing phlegm in the back of my throat and some esophageal burning.
He told me he'd like me to take it on an empty stomach. I had read that if you need to take with food to take with non-fat and non-protein...so I asked if I could do that. He told me to get some DGL and some aloe vera juice and try one or both - 15 minutes before rifampin.
If that doesn't work, then to take with a small amount of carbohydrates. He said it has to do with stomach acid...

He was very pleased that my liver enzymes are the best they've been since starting treatment...that's his main concern at the moment...that they stay there.

I asked him about adding back the Buhner herbs..and he agreed that I should wait until I stabilize on the Rifampin - and he also said that the herbs could add to the liver enzyme issue...and he really wants to see those stay down.

Have you ever read this?
www.lymediseaseblog.com/jarisch-herxheimer-reaction-lyme-disease/

As your die off decreases so will the potency of the herx. The more you stick with it the better it will get and the better you will get.

By backing off your prolonging your pain and you know that the next day when you start up again it's going to be awful again. That's not really giving you relief since you have the mental expectation weighing on your shoulders.

Dangle the proverbial carrot.

Girlie-

First, the milk thistle...I would ask your LLMD about this because I have read in several places that MT and Rifampin together are not a good idea, but in the end it is individualized choices.

Second- I think I have mentioned to you before that I am also on Rifampin. I had horrible herxing at 450mgs and had to go back down to the lowest dose for a few days to come out of it, but I never stopped for the same resistance fear you have.

Also, I took Mino for two weeks along with the Rifampin for a suspected UTI and kidney pain. I did not notice much of a difference in my twitching and shivers by adding this in...BUT...due to the strange bite and subsequent rash I had last week, I have added in Doxy at the lowest possible dose so far (I have to be outside with my kids and the weather here is still warm and sunny) and I have noticed a decrease in the muscle twitching and shivers and it has only been a few days.

I am considering increasing either the Doxy (100mgs day) or Rifampin (300 mgs a day) because I have been chugging along pretty well with improvements and no other herx symptoms except mild fatigue and irritability. I figure maybe the bacterial load is decreased enough at this point that I can add more and see what I get. But I am kind of the opposite of you, I would rather not deal with the herx at all! lol! My husband travels for work and I have both kids and all their activities...I don't want to be the grumpy, tired mommy all the time with them.

Anyway, just thought I would mention to you the differences I saw with Mino+Rifampin vs Doxy+Rifampin if that is an option for you at some point.

Tickbite and Lymie mom (and anyone else who has been on Rif) - did you take on empty stomach? If so, any issues?

Yes, I take Rif on an empty stomach and never had a problem. I do however take Doxy with food because it tends to make me nauseous and hurt my stomach if I don't.

I had been on Doxy for a month prior as well. It was the first thing I was prescribed back in December. Only lasted about 5 weeks before stomach issues caused me to quit. By then, I was able to get into an LLMD and he then put me on Mino for the first time. HUGE emotional herxes with Mino. Depression, sobbing, dark thoughts. I didn't have any the second time around for the 2 weeks, but I went easy on the dosing.

The biggest downside right now with the Doxy & Rif is it caused a nasty yeast infection. I tried several natural approaches including tea tree oil, garlic, coconut oil and nothing has helped. I have been on heavy probiotics twice a day and it still became a problem. I had to resort to Diflucan. This is the first really bad yeast infection I have had since I started treatment last December. I swear some days the candida die off is almost as bad as herxing for lyme & co.

It is best on empty stomach...but if it continues to burn, and cause issues in my esophagus, I will have to take with food. LLND said that would end up damaging my digestive track.

So, I will try aloe vera first...see if that works.

Jrpsf- lol....yup...I think you're right...this LD has made me a whiney, crybaby.

Yes, I get your humour....

I'm of the same mindset as LymePickle.

That doesn't mean that I'm not a raving nasty female dog when the herx is beating my detox. There's no getting around how much treatment can suck.

I know I question if the protocol I'm on is doing enough when it doesn't totally suck. Right now I'm on daily IM Invanz and I'm handling that pretty well. Besides the last few hours I've started planning for going into my office a few times a week for a few hours versus only working from home. I can walk out if I need to and get a ride home if I'm really not ok.

I want my life back. Starting LDN tomorrow and Provigil soon after that.

Girlie the combo that made the biggest difference for me was Biaxin Rifampin and Alinia. Pulsing the Alinia. I pulsed the Alinia 3 weeks on, 3 weeks off. It was hell but at the end of the 3 weeks there was such a dramatic difference I was willing to do it again. My LLND said I could pulse 2 days on 2 off. I just went for the 3 weeks and the second round was easy.

Since herxing comes from the die off of your toxin load imo the faster you kill the toxins (obviously within reason) the less time for the bacteria to replicate which equals less toxins. You are going to herx =to the amount if toxins regardless, right? You can take it really slow or grin and bare it and get it over with. It's still going to be the same amount of herx in the long run. You'll just get to the finish line faster.

I don't know if that made any sense...my writing skills and lyme don't go together

I have decided I will push through my next herx - but hopefully the ramped up detoxing will help with that.

I would back off on meds dose when treating lyme...but I know bart is a different animal and I'm concerned with resistance. I think bart is my dominant infection....time will tell.

Revive - So you went to 300 mg for a couple weeks? Did you only have to do that once?

Remind me: you did 600 once daily, or 300 twice daily?

I am taking ALA - and this homeopathy support: apoHEPAT - by Pekana.

I have read mixed comments about Milk thistle. One I read said that it increases the amount of Rif in your system...don't know if that's correct.

How are you doing Revive? Still good with the bee venom therapy?

Had to do 300 for a few weeks cause of herxing so bad. I took it once a day at night, so all at once.

Doing great with the bee venom, even got hubby doing it now and he is herxing a lot but then feel better once he comes out of it. Come and join us, I feel so normal now it's unbelievable.

Well after 18 months of putting ANX in my system and realizing it was going to take a lot more to do the trick and then you really don't know since I've had it for years. I love not popping all the pills and being on a schedule, I just sting 3 times a week, M, W, F and take the weekend to detox.

Get brave and come join us.