testing, anti-cyst/L-forms agents

Dear friends,

let me have few general questions:

1. In the past I was tested positive for Borrelia/Bartonella/Yersinia/Chlamydia Pn. Currently how can I know which of the symptoms are more related with which infection? Is it knowable? I have sofar assumed that bart is perhaps the bad guy i charge of most troubles. Recently during a conversation with a friend she suggested regular testing. Does anyone have any experience with testing or close tracking of various co-infections while going through abx therapy? Or what would you advice?

2. Regarding cyst/L-forms of borrelia, it is my assumption that metronidazole or plaquenill or eventually also dapsone are agens that kind of go against cysts and make spirochettes to change their form from round bodies or cysts to more vulnerable form. Are there any insights or studies on this phenomenon, in terms of their effectivity, specificity, or which is more apropriate? Is it righ understanding that in fact also pulsing abx, - off abx period - makes then feel more safe and this effect is produced by the very suspension of abx and other anti-bacterial agens?

3. What is your experience with plaquenill vs. metronidazole in this regard? Plaq can have side efects on eyes, but its half life is huge so I believe, even if taken for few days, as if pulsed, it can support the main abx for many days and weeks to come. This is my quess.

Best wishes, B

attempting to answer questions in turn
1,
there is a great deal of overlap between the symptoms of all of these infections - almost complete overlap
and in any case - the infections all infect the same host as a complex - therefore in a tissue infected with multiple pathogens the effects is due to the cumulative effect of all of them - so no i don't think its really possible to say with any certainty which is causing which symptom
and beyond that it could be that a bacteria that is present in low numbers - eg borrelia - could be incapacitating the immune system in some way that favours others - say bartonella - which could allow that one to prosper and do more damage
so in the end its a complex - and all the main ones likely have to be treated to reach remission
this is what most LLMD's seem to do - ie if they treat the 3 B's - this covers most other bacteria by default - and most people recover

ref testing - the problem with repeat testing are twofold
I, is that the tests are generally poor for these stealth pathogens - false negatives are common - so with each test over time - you could get random differing results - which, becuase you take the infrequently might look meaningful - or like there is an expected pattern - but are in fact just random results over time, merely as a product of the test performance - not necessarily providing true information on what is going on in your body ( this is exactly what you would expect with the test that is only 50% sensitive or less - and most antibody based tests are worse than 50%)

II, most tests are not in any case measures of infection - but indirect tests of immune reaction - antibodies may be raised for years after infection is resolved - or negative despite firm evidence of active infection

Armin Labs have a test made by Tezted ( Finland) that uses antigens expressed by round body forms of borrelia. so a person could take that test and see if they had those antibodies - but what would this actually tell them?- only that they had an infection with borrelia - which if they already have a positive test result they already know. another person might test positive for borrelia but not have those specific antibodies. its just being used by Tezted to broaden the test sensitivity.

so, once you have had a positive test - there is v little to be gained by repeat testing
still many people do it and convince themselves its useful - but mostly its only useful for the testing companies.

2, round bodies and cysts are different names for the same phenomenon
some % of a borrelia population enter this state when their environment becomes threatening
some antibiotics are known to cause this more than others - eg Doxycycline
metronidazole or tinidazole are known to be active for killing these cysts forms directly ( when used alongside 1 or more other antibiotics - eg doxycycline ) - as opposed to causing them to become motile forms again.
for this reason some LLMDs give 2 days of metronidazole at the end of a pulse of antibiotics - eg the last 2 days alongside doxycycline and ceftin ( Dr J )

to my knowledge dapsone appears to be active for all forms of borrelia - but possibly not sufficiently active to be used as a single agent - so is also usually used in combinations with - doxy, azithro/clarithro, ceftin, rifampicin ( Dr H )

i am not aware of plaquenil being directly active for cysts forms of borrelia - Dr H claims it "alkalizes the intracellular space" and by doing so increases the effectiveness or other regular borrelia antibiotics. but that is not targeted at Cysts and i am not sure many others use it this way

3, the theory of pulsing was tested in vitro when researchers showed a single antibiotic pulsed on and off 4 times killed all borrelia in a culture - whereas in the control arm of the study a combination of 3 antibiotics given continuously for the same period of time failed to kill all the borrelia - despite high concentrations ( its long been known that its not possible to kill all borrelia in a culture with combinations of common antibiotics at physiological concentrations - so this was an important finding)
the researcher hypothesized that there is a high biological cost to the organism - when it changes state from motile to cysts and back - and doing this several times exhausts / damages it in some way - leading to eradication after multiple cycles.
central to this approach is removing all antibiotics for long enough for the spirochetes to start multiplying again - then reapplying them
the mechanism is expected to be conserved in other bacteria species - so it likely the same effect occurs in other species that have dormant ( persister cell) states - as a result LLMD's use pulsing for more than just borrelia - but to my knowledge we don't have studies supporting this yet

1, as i mentioned - Tezted use the antigens from round bodies to increase the sensitivity of the test - not to detect if a person has round body forms - everyone with lyme does - as its a universal feature of lyme.

most bacteria are capable of forming "persister cells" which may or may not be morphologically distinct from their normal forms - these cells effectively serve the same function as round bodies or cysts in borrelia -

in essence there are always sub populations of any bacterial population that exist in the persister cell state - in this state they are in an extremely low metabolic state - not growing - or growing only incredibly slowly - using very little energy - and taking in little or nothing from the environment - as a result they do not take in antibiotics from their surroundings - and do not need to make cell wall or other proteins to grow - since they are not growing - and as such they are effectively immune to most antibiotics ( studies show they can survive 1000 to 1500x higher concentrations that those needed to kill their fast growing brothers and sisters).

most research on bacteria to date has been done on fast growing forms in cultures in the lab - as these were the easiest to work with - and it was assumed that whatever worked for the fast growing bacteria would work for slow growing ones too - which was not in fact the case.
so until recently little was known about persister cells - and it s still an area of active research

bartonella forms persister cells

2, i believe all tetracycline class antibiotics act much the same way - and will promote the production of round body forms of borrelia

3, tinidazole - i believe Dr J uses 1000mg or 1500mg / day total - so 500mg 2-3x

4, i am not familiar with those brands - but please - USE ONLY PHARMACETICAL GRADE METHYLENE BLUE - and from a source that provides a C of A - as the manufacturing process includes heavy metals that are usually present in the end product - unless it has been specifically purified for pharmaceutical use. if the supplier does not provide a third party testing C of A - either have it tested yourself ( probably a few hundred euro ) or use another source that has.

Dear SlowbutSteady, are you taking plaquenill and flagyl in a pulsing way on weekends? Which doses? And what is your experience?

Bhava123 said...


- As for pulsing abx, isnt there a danger of any of bacteria develop resistance?

B

there is a great deal of misunderstanding in the general public around antimicrobial resistance

in host anti microbial resistance development is very rare and very little studied - as
if it does happen its a v difficult thing to catch happening.

its a different thing to general antimicrobial resistance and spread through a population - which is what is normally meant by the term antimicrobial resistance.

for example - in the most famous case - a mutation occurred in a staphylococcus bacteria in India 10 years or more years ago causing it to become resistant to multiple antibiotic drugs. this was termed methicillin-resistant staphylococcus aureus (MRSA) and is now present in many countries - not because it has spontaneously evolved in those new locations - but because the original mutated organism has been transported by people from place to place. this is how antimicrobial resistance works

the medical establishment try to discourage over use of antibiotics - not because there is a high risk of developing antimicrobial resistance in any single patient - but because if done millions of times all around the world - it increases the probability of a mutation happening somewhere in the world that renders a bacterium, fungus or protozoa resistant to antimicrobials - and then these resistant microbes get transmitted to more and more countries over time causing problems for healthcare systems.

there is a lot of fear in general in the chronic illness community - and people who are fearful are often biased to believe the worst possible outcomes are happening to them - and for this reason often assume they have developed antimicrobial resistance to one of more drugs - say, if their treatment doesn't appear to be moving forward as they had hoped - when in fact you can see from the above example this is in fact an extremely infrequent event - happening around once a decade for any given bacteria after millions of doses of antibiotics in the whole world - rather than after a few weeks or months in any given individual.

the general principle used to prevent in host antimicrobial resistance from forming - even at the population level - is to use several antibiotics at once - as the chances of an organism mutating in such a way as to defeat 2 or 3 different
antimicrobial mechanisms of action simultaneously are much much smaller than just
one. this is advisable for the treatment of any chronic infection.

in addition - many lyme doctors pulse antibiotics now - including some of the
best known and trusted - eg Dr J - Dr SP and now Dr H - as far as we know
without any obvious resistance issues - and again they are pulsing multiple abx.

Bhava123 said...

- In the abx off-period, does any take any Buhner herbs or these are to be avoided? And supplements?
B

i have not seen any research on this - to my knowledge its not been done

some people stop all antimicrobials in the off periods - some continue antimicrobial herbs and other supplements in the off periods

kind regards

Dear Garzie and SlowB, thank you for your answers.

Dear Quin,

what you are saying is very interesting. These differences in dynamics or mechanics of how borrelia and bart operate. So are saying that mino and azitro helping you to kill bart?

I d like to ask also to others, what would be optinal lyme-bart abx protocol? Based on observations, I have noticed that combo mino-rifa-azitro works best and now i m pulsing flagyl/metronidazol for few days. I m on pulsing therapy and trying to have longer off-days, but then I m getting nervous from weird symptoms in my brain, lymph nodes indicating active infections, due to which i tend to re-start abx intake more rapidly, which probably is not good, for the whole idea of pulsing approach to work properly. I hope to improve.

My last question is that only recently i have observed that in fact mino can be taken on empty stomach and seems it works better that way, so now I take Rifa on empty stomach, half n hour later mino, and then only after other half hour one hour im having food with other abx. Its strange but looks like it works more effectively.

Thank you for your views and answers. Best regards.

Dear Quinn,

thanks for your answer. I m not sure if I m responding on your post. Currently I m having more an neurological issue, eg sudden arising and passing pain in the brain, feelings of having hair pullled inside the brain or that kind of problem which I think means that something is still there and active, it seems its not neuropathy, unfortunately mino and rifa with azi where unable to stop it, neither few days pulsing high-dose flagyl. Its not easy for me to stop taking abx and go to off period of pulsing, knowing there is still something going on in my brain. Perhaps due to fear, i m afraid some damage can take place or worsening If i go to say 7-10 days off abx now... I m unable to figure out which of B's is doing it or whether it is perhaps Chlamydia or other virus/bacteria... Best wishes

Hi Quinn,

thanks for your answer. At the moment I dont have anything better. Being alergic on amoxy, I have to take Cefixime from the betalactams, which I somehow find helpful especially due its penetration to brain and CNS, since mainly my recent main symptoms and issues where related with that. I took rifa for many weeks and month and now from bactericidal abx I swtiched to Cefixime and I find it helpful, it seems it works much better to rifa especially on brain issues - which might be indication i indeed had active borrelia in the brain that has been hit, becasue some of the weird pulling-of-hair like symptoms are reduced now. I have also realised how being on self-medication, one can make many mistakes and be on wrong track. Brain Syptoms not getting with my previous abx combo forced to change it, and i could feel severe herx and subsequent release. Perhaps it also means our friends (lyme and co) somehow manage to form a good defence mechanism for specific abx, but then are vulnerable for others, which is again only a working hypothesis or assumption. To at least make them dormant and find release from torture of symptoms is already a a kind of achievement for me - I dont want to go around knowing to have active infection in the brain and not doing anything to at least suspend it. To sum up having switchef from mino-azi-rifa to mino-claritro-cef I m finding helpful in reducing neuro/brain problems. This is my recent observation.

Thank you for other suggestions. I had reddish urine mainly from rifa. I hope now bart is not main problem, I will see from CBC counts am I m about to take next week. In recent days and weeks, brain issues where main pain in the neck so I have now tacke that. I will see how it will go but then I will have to go to off-abx period, since I m basically on pulsing therapy. To add other experience.

Afterter feeling somewhat better I will need to go to more thorough virus testing, but at the moment I m afraid it would add extra heaviness on my since taking care about all i m goign through is already a lot. My assumption is that if abx therapy is going well, symptoms are reduced over the time. If they remain or even looks like getting worse, there is something wrong. If not eradicated, if at least put into dormancy, I m finding it already good and abx has done its good job with at least half result.

As for herx, even its painful, i m trying to practice rejoicing in it, since its a good sign. My experience - if herx is really sever, pain prevents me from sleeping in the night and I cant but take pain killers. Until that points its a kind of bearable. And its better than taking abx - not herxing - symptoms getting gradually worse. That would mean inapropriate combination of abx. Sorry for writing too much - whole novel - but I found these insights helpful to share here.

Best regards,