My next treatment change - advice?

Why not consider mino to go with your rifampin? Mino gets into the nerves and brain better, and doesn't cause the sun sensitive issues that doxy does, and is easier overall on the digestive tract. Also has anti inflammatory properties. Apparently rifampin causes blood levels of doxycycline to drop, it also does this to clarithromycin. But it doesn't cause mino, septra DS, or azithromycin levels to drop. So those 3 are probably the best rifampin pairs but azithromycin may not get into the brain.

My plan is rifampin, azithromycin, septra DS, and the full Buhner bart/mycoplasma protocol. Lol not sure how well it's going to turn out, but I am trying to throw as much at it as I can.

I feel pretty good right now though. I only had a burning like headache today. But either I die or the bart dies lol and I'm not going down without a fight.

Yes, LP - I have read that Rifampin reduces the doxy blood levels...but Dr. M.R. says (in his guidelines) he still finds it effective.
I'm not sure why Dr. C. hasn't offered mino to me yet. He seems to prefer doxy.
Was it Dr. C. or Dr. R. who prescribed mino for you?

So, not wise to use a cyst buster while on Rifampin. - Even if the tini is only for a couple days per week?
Maybe the Rifampin won't be prescribed until I've used Tinidazole for a couple of months and then I can get off the Tini.
...or how long should I be on Tini.

I am considering mino...but Dr. C. is suggesting doxy. I don't know why...I guess i will bounce it off him next appt.

But, does Mino go with Ceftin?

I'll have to look that up. Or maybe, I'll drop the Ceftin for Rifampin.

Jeez - this isn't easy - deciding what protocol to try next.

I am sure Lymepickle's Dr is reputable, but his opinion is quite odd in that doxycycline is actually known to be better than mino when it comes to treating lyme - my Dr has said that, and I have read it on a few different websites. Take a minute to read this, Girlie, it may help you understand/decide what to do. Although minocycline worked well for you, Lymepickle, it may not be the best choice for everyone, so I would be careful in suggesting others on this site to go with mino first.

http://lymemd.blogspot.com/2013/03/blood-brain-barrier.html

and if you are going to drop an abx, I would definitely drop biaxin, but I am not familiar with the protocols - I should get that chart and print it out so that I have it handy. All I remember was that when the doxy got too toxic for me, my dr wanted to switch me to ceftin, but couldn't because I am allergic to cephalesporins. I am not sure how often ceftin and doxy are taken together.

so my initial treatment was doxy alone, then doxy plus Zithromax, then Bactrim plus Zithromax.
amoxicillin is also an option -

http://lymemd.blogspot.com/2013/07/updates-antibiotics.html?m=1

Also the same LLMD who made the blog you are posting also states that minocycline is the better choice against bartonella over doxy.

Girlie-- Ya there are some risks with rifampin. It has the potential to cause oxidation inside of cells and it literally goes inside almost all of the cells in your body. Because of that I believe it needs to be taken with anti-oxidants to reduce cellular damage. I used to think anti-oxidants are anything that has color lol!!! Usually that is the case with vegetables and fruits, so I thought because rifampin is so red it much be an antioxidant too! So I researched that I found the exact opposite!!! So Ya I learned something, you need to take lots of antioxidants if you want to protect your cells when you are on rifampin. That is probably the case with many intracellular abx though but esspecially rifampin... But it's probably even worse with something like the Fluorquinolones.

LP - re: 6 months bart treatment necessity - is that any type of treatment? Or, Rifampin based?

If I do three months, then several months of Buhner's herbs for bart - wonder if that will suffice

UGH - I hate this...questioning...reading...deciding...questioning...changing my mind...reading..questioning....deciding....reading....questioning...changing my mind....going crazy!

I am faced with similar choices at the mo - I started another thread about my own dilemmas with changing my treatment plan, all pretty similar to this, ie, rifampin or herbs, mino or doxy, when to take tinidazole - and my head is spinning with all the options and all the various pros & cons. I really hate this. Girlie, I completely agree with your feelings on all this decision making and reading and researching and having to choose a path. Hate, hate, hate this!! :-(

Hey Speyfisher... So another one for the mino?

For lyme, they are both good. But the key differences between the two is where exactly they end up in the body.

Doxy wins for blood infections, (it being slightly more water soluble). There's 1 point for doxy.

Mino wins for deeper tissues, skin (as mentioned to be better in a study on mino vs. doxy for treating acne), nerves, and brain infections. There's 1 point for mino. Mino also gets an extra point for crossing better into cells and even penetrating the bacteria a little better... They say it even works sometimes when bacteria have tetracycline resistance.

Overall the mino as it least twice as lipophilic over doxy. But I read reports that rate it between 2-5 times more lipophilic than doxy, other reports say 2.85 times. But either way most will agree that a dosage of 200 mg of mino is equivalent to the 400 mg of doxy in terms of getting actual concentrations of the antibiotic into the cerebral spinal fluid. German lyme treatment guidelines report say of a particular amount of doxy taken, 14% will pass through the blood brain barrier, but 40% of a particular amount of minocycline will pass the blood brain barrier.

Also the doc from lymemd, doesn't like to prescribe mino off the bat because of severe psychiatric herxing that can happen. So again it shows doxy is still a better starting treatment.

If you want a powerful dose to kill lyme in the blood doxy wins over mino, but even better than doxy is tetracycline. But that huge dose from tetracycline (which is prescribed at much higher doses) will change lyme into cyst forms. But also killing a large amount of it. I guess doxy is a good compromise between tetracycline and minocycline.

Doxy has a the sun sensitivity side effect, mino has a skin hyper pigmentation side effect. Mino is easier on the digestive tract as it is better and faster absorbed, mino is less affected by consuming it with calcium in the diet. Mino is harder on the thyroid, doxy I don't think carries the same toxicity to the thyroid. Mino has anti-inflammatory properties, does doxy? I think all kill 95% of lyme germs in their growth phase. (Doxy was the one actually used demonstrating this in the experiment as it is often chosen for lyme). So this class of drugs works better for the lyme growth phases than amoxi, penicillin, or metronidazole. (According to that new study released last July)

Now, I will admit I probably researched the heck out of this a bit too much and went overboard. When I first got sick I fluked out and had a 6 month unused prescription of minocycline that I got just the year before (for my minor acne, but I never filled the prescription). I remember the dermatologist warning me, don't take anymore than the prescribed dose otherwise this medication gets into the brain. I was freaking out when I first got sick because I was self treating with 200 mg of mino a day but I wanted the doxy as I thought that was the one I needed! I think the mino turned out to work fine though. I wonder where is all this knowledge is going to get me after my lyme days are done. I want to enjoy a good mino vs. doxy debate while I still can! Lol.

Post Edited (LymePickle) : 1/26/2015 9:07:09 PM (GMT-7)

Great info, thanks lymepickle. It does sound like mino might be better than doxy for me, as my symptoms have been ALL neuro and I want to get this out of my brain! Can you tell me about the skin pigmentation side effect of mino? My doc mentioned it but I don't really know what to expect exactly :-/. Do you think pairing it with rifampin would be a good combo, and maybe hit any Bart I may or may not have? I'm a bit scared of rifampin tbh :-/.

I have heard a few times that omnicef (didn't realise that was the same thing as ceftin, so thanks for that!) is good for neuro issues too. My doc hasn't mentioned that one . . . does that hit Bart too?? Would mino plus omnicef be a better option than mino plus rifampin?? For lyme and/or Bart?

How are you getting on with all these impossible decisions girlie?? Wish we could all sit down in a room together with a cup of coffee, and thrash the whole thing out until we had the definitive answers for all of us! ;-)

I think Omnicef and ceftin are different cephalosporins. Ceftin is cefuroxime a 2nd generation cephalosporin. Omnicef is cefdinir which is a 3rd generation cephalosporin

Ah . . . OK . . . I think I've done cefuroxime. So omnicef is slightly different to ceftin/cefuroxime . . . could still be an option I haven't tried then, that could work for me? :-/.

Speyfisher - I know you said you're taking am omnicef/mino combo . . . can I ask, is that for mostly neuro symptoms? Lyme? Bart? :-/