Commencing Bart treatment with Rifampin (also, Bart herx from Mino?)

So, I saw a new LLMD, and after almost 3 months of Lyme/Babs Duncani treatment with Doxy/Zith/Coartem (first month Mepron), the LLMD recommended I go fully after the Bart based on symptoms and the serology report from my latest igenix testing. I’ve been on Minocycline for 3 weeks now (had to switch since being on Doxy since October) and now starting rifampin today, 300mg 2x/day, though I will prob do 1x/day for the few days at least to ease into it. Anyone care to share some experiences/tips? I hope that the 6+ months on a tetracycline class drug and Azithromyicin has chipped away at some of it leading up to attacking with rifampin/Mino.

Also, last Sat night I developed Lower neck pain, headaches, and a low grade fever after trying to do the Mino 3x/day as prescribed on Thursday and Friday... the fever resolved by Sunday night but I’ve felt crummy since, could this be a result of the Mino hitting the Bart? It started 2 weeks after Starting Mino and 2 days after upping to 300mg, which Ive lowered back to 2. I’ve had no appetite, abdominal pain (but no diarrhea, bloody stool, or anything), some headaches, and the neck pain continues (it’s mostly in the c5-c7 region, joint pain) though it’s better today. I also had some sub-sternal pain with inspiration on Wed which resolved after a day but spooked me). I did see the LLMD Wed and he examined me and said no liver swelling, spleen swelling, heart sounds normal, etc. He took extensive bloodwork to send to a new lab but my most recent bloodwork from 2 weeks ago was pretty normal (cbc, liver enzymes, etc). Only areas out of whack were slightly elevated Candida igA and igM (1.3 and 1.4, are those levels anything to be concerned about? LLMD said to hold off on Diflucan and gave me clotrimazole (mycelex chewables) for the oral thrush since the nystatin seems To have lost its effect. Does all this sound like a Bart herx? Or should I be concerned about something else? The abdominal pain isn’t a ton but it does worsen with inspiration.


Appreciate all the info, tips, and experiences shared!

Girlie said...
Mino and Rifampin are a good duo for Bart

I was on those two for many months and got rid of some Bart symptoms.

Tailbone pain, swollen clavicle lymph node, bakers cysts, 80% of my joint pain are a few symptoms that improved.

Did you take any herbs while treating? How long on abx before you noticed improvements?

3 days in so far at Half dose, and I have to say the predominate symptom is fatigue. Had to take an hour+ nap both yesterday and today around mid-day. Hopefully this is a sign that the Bart is being attacked. It honestly reminds me exactly of the first few weekends where I was cycled onto Tindamax, didn’t leave the couch too much but within a few cycles I was feeling so much better. Hoping the Rifampin will give similar results especially when I jump up to the full dose next weekend (got a wedding to attend Friday night, figure I’ll wait until that’s out of the way). My new LLmD says by month 2 most of his patients feel better.

I hope you continue to improve, Girlie! I’ve been fortunate that I’ve been able to keep working throughout my treatment though it’s really hard most days. Also grateful that I have a fantastic wife who has taken over most of the household chores and cooking so I can rest when I’m home.

Random anecdote: The medicine does turn the urine reddish though, even when I take it on an empty stomach.

mudshark said...
Hopefully you will be able to stay on the rifampin for the duration. I was on it for 6 weeks and really felt like it was making improvements in my remaining bart symptoms, but one of my liver enzymes elevated and my LLMD had me stop. Now I'm taking Azith instead of rifampin with bactrim. 2nd day on azith I started herxing like crazy.

And yes rifampin turns your pee red orange, more so I think when taken on an empty stomach. Colors the poo, too.

Yes, from what I’ve read, Rifampin is pretty tough on the liver, so I’m going to up my intake of milk thistle and continue with other detox elements. Did you do the full dose of rifampin (300mgx2) right away or work up to it? I’m doing the first week at half dose then going full (split morning and evening). Did you herx on rifampin at all? So far I just have the mid day fatigue and some headaches intermittently.

I'm on Rifampin now. For the second time. I took it starting last July through maybe September. I saw huge improvements with it, as Bart is my biggest problem right now. Since I had such good result with it the first time, we're trying it again with a different combo. I was doing Zmax, Rifampin and Plaquenil. Now doing Doxy, Rifampin and Alinia. That combination has been so rough. I am coming off of a two week killing break, and decided to start the Rifampin back first this time. I'm on half a dose and dying. lol. Fatigue is definitely my biggest die off symptom. Fatigue and depression. But those are my two biggest lingering symptoms anyways. The first time I was on it, my joint pain pretty much disappeared, my depression seemed like it was gone for good, and I started being able to do things on the weekend. Where I have seen a slight overall improvement in the fatigue since then, I still have worsening fatigue with Rifampin herxes. I just hope that now my worsening fatigue is a little better than the worsening fatigue a year ago. Have fun going after Bart. We are killing kind of both Babesia and Bart now with the Rifampin and Alinia. Good luck. Definitely support your liver in any way you can. That has been a huge drawback to starting Rifampin this time. Usually within an hour or two of taking it I get terrible liver pain. Castor oil packs help tremendously. Feel free to email me if you have any other questions about it.

MA10 said...
I'm on Rifampin now. For the second time. I took it starting last July through maybe September. I saw huge improvements with it, as Bart is my biggest problem right now. Since I had such good result with it the first time, we're trying it again with a different combo. I was doing Zmax, Rifampin and Plaquenil. Now doing Doxy, Rifampin and Alinia. That combination has been so rough. I am coming off of a two week killing break, and decided to start the Rifampin back first this time. I'm on half a dose and dying. lol. Fatigue is definitely my biggest die off symptom. Fatigue and depression. But those are my two biggest lingering symptoms anyways. The first time I was on it, my joint pain pretty much disappeared, my depression seemed like it was gone for good, and I started being able to do things on the weekend. Where I have seen a slight overall improvement in the fatigue since then, I still have worsening fatigue with Rifampin herxes. I just hope that now my worsening fatigue is a little better than the worsening fatigue a year ago. Have fun going after Bart. We are killing kind of both Babesia and Bart now with the Rifampin and Alinia. Good luck. Definitely support your liver in any way you can. That has been a huge drawback to starting Rifampin this time. Usually within an hour or two of taking it I get terrible liver pain. Castor oil packs help tremendously. Feel free to email me if you have any other questions about it.

Thank you for the advice! When it was so effective the first time - why did you stop?

My new LLMD is fairly convinced that Bart/Lyme has been my issue all along, which would explain why when I switched to treating babesia (based on an equivocal igenix result) in January I didn’t really get anywhere. I’m feeling similar to how I did when I first started abx for the first time in October (fatigue, headache in the same places) so I’m feeling optimistic that now I’m hitting the bullseye.

Bart typically hangs out in the liver, spleen, and CNS right? And digestive tract? (Whereas babs is in the RBCs). I ask because I did notice some gastritis like symptoms last week while only on Mino/Zith.