Some pulsing abx questions

hey folks, im having my appointment next week with dr Reinhard. I maybe will suggest to try pulsing, because my virus load always gets to wild after severals weeks of abx. So i got some question for you about pulsing. When did you start pulsing abx? (did you first treatet long term abx (over3 months) and startet then pulsing) What abx did you mostly use for pulsing? What was the time between off and on? And did you took buhner herbs all the time or just in the off days? Thank you so much! Enjoy your sunday!

Hi Palermo, I have been pulsing my the combination I have shared in the other tread (IV abx). Previously pulsing more simple combinations like doxy-claritro, then mino-rifampicin, then more complex combinations. Most of the time I had a hope to be able to continue only with herbs, eg Buhner. But every time my symptoms relapsed. Now being off abx, I actually feel better in terms of less abx load, but most recently I could stay off abx only 4-5 days max 7 days. I hope to stay longer off, but its not easy knowing borrelia or bart have woken up and give more symptoms in the brain. Some symptoms or sensation change, some remain same or similiar. Shifts between strong abx combo and then going off might be intense, there is definitely a change of dynamics. Last time I really felt it was too much and I had some indications to better stop and go off. This is briefly my experience, but again I think Garzie and Girle have more experience and are more knowledgable. PS. Dr.Burrascano used to suggest even 2 month off period. I have tried to do that in the beginning of this year, mainly to help IS, but at the end i did not make it, I had to start taking abx, I felt overwhelmed and had tough neuro symptoms. Also it seems to me that body has some sort of intuition, or gives sings or signals, which, without interpretative bias, can be good. Of course gross pain in some organ can be such sign, but also like feeling of being overloaded with abx, there is a specific heaviness or feeling that its too much. Then going off there is a sense of relief and basically good feeling of being off-loaded. I dont want to sound irational but i believe there is some sort of body-related intuition.

Hi Garzie,
I m pretty much following a similiar route, alternating abx and herbs, and gradually applying that which appears to help.
I m having a question though, which should perhaps be in the other tread... what is your experience with diagnosis and treatment of viruses, say common virus such as EBV, HSV, HBV, and their influence, after testing positive taking stuff like valacyclovir, isoprinosine, etc ? - These possible can play a role, but honestly I dont have any glue or knowledge at all, only I m obviously having herpesvirus giving sore on lips time to time. Not sure if going for tests and then trying to deal with it along the Lyme and Co, is important and helpful too.
Best regards
B

Dear Garzie,
thank you. It makes sense. Best wishes, B

as far as i know its just what he has found works best empirically

Dear Garzie,

may I have few additional questions?

- after off period, when starting abx again do you still have herx?
- which abx combination are you taking at the moment?
- do you take the same herbs when in abx on and off period? or do you lower doses or adjust when in on period?
- which particular biofilm busters and anti-cyst agents are you using? is it same in on and in off period?

I hope its not too many questions
Thank you for your answers in advance.

Best regards, B

PS. Also Girlie or anyone else please feel free to answer too, I m really interested to know more details or your experiences, what has been working for you.

i guess it makes sense, also quite important to take a cystbreaker like tini or quensyl. Im adding tini next week to my protocoll too. But when the main die off is gone, im looking forward to do a protocoll like you. A pulse Mix of buhner herbs and 2,3 abx.

i think the only viable measure is if recovery continues

strong herx after a break is not necessarily an indication of bacteria having regrown

one of the main reasons for pulsing strategies is to try to encourage bacteria to come back out of their persister state, where they are virtually impervious to antibiotics ( around 1000x more tolerant than normal mode bacteria of the same species ) and start behaving more like planktonic normal metabolising bacteria which antibiotics are designed to work against ( persister cells were not known when antibiotics were developed)

when they do this they are again much more susceptible to antibiotics - and able to be killed more easily

but, in reality they are not all behaving in a simple coordinated homogenous on/off manner - but each bacteria has a probabilistic chance of being in one of several states at any one time - so as we change the conditions the proportion being in persister state or normal state is changing with the circumstances.

thus the strategy for pulsing is based on getting more of the population to be susceptible - and thereby chipping away at the overall population more with time.

lab studies have show that this can be more effective than dosing continually with antibiotics
this, combined with the other advantages of pulsing, are the basis for its use
-less overall drugs are used - lower cost - lower burden on patient
-breaks allow detoxification and reduction in load on organs like liver / kidney etc
-may be less damaging to the microbiome vs continuous antibiotics
-breaks make the treatment easier to tolerate - not continuous herx reactions
-gives the doctor / patient a better means of evaluating progress - via monitoring herx during successive pulses

this is not to say its the only way to treat - plenty of people have recovered by using continuous antibiotic combinations also - its just another tool in the toolbox that can be used

i would expect relatively strong herx reactions on the first handful of pulses - gradually reducing as the bacterial load is gradually reduced - but its not always linear - sometimes its the second round of a given antibiotic combo that produces the strongest herx

hi Bhava

could you perhaps phrase your questions as a clear question - rather than a statement with a question mark at the end

that way think i may be able to understand what you are asking better and answer more clearly without causing the need for more back and forth

in general - all antibiotics - including those termed "persister drugs" were originally designed to work against rapidly growing planktonic bacteria and as a result have only limited effectiveness against persister cells - but since they are all we have - that is what is used.

even the definition of persister drug and non-persister drug classifications are misleading - because - lab trials show that adding conventional antibiotic like doxycycline to another drug increases the killing (or reduces the growth) of bacteria over time -

in lyme treatment we must kill both the easy to kill rapidly dividing bacteria - and the persister cells in the population - most of the focus is on the persister cells because these are the hardest to kill by far - and so anything we do to kill these - will by default kill plenty of the rapidly dividing ones

as a mentioned - in practice - individuals in a population of bacteria are randomly dropping in and out of persister states and back into normal growth over time - so its not necessarily helpful to think of them as separate populations.

in reality - its likely that most lyme bacteria in a human patient with chronic disease exist in microcolonies housed in biofilm - and as is normal in any biofilm - there will be a high proportion of persister cells present - which have dropped into this persister state due to pressure from host immune action - and nutrient availability.

we have no drugs that can kill all bacteria in these colonies outright without killing the patient
therefore the job is to whittle away at them over time

there are a few trials of pulsing antibiotics -

the one proof of principal study i believe we have discussed before - showed that a pulsed cephalosporin at achievable biological concentration killed all borrelia bacteria in the test tube after 4 pulses -- where combinations of 3 antibiotics given continuously for the same period of time in the same study did not