Failure of herbal treatment

Such a quick relapse is usually attributed to bartonella, however I've found that borrelia can start to become active after about 3 days off antibiotics, especially if I've been breaking up biofilm.

Antibiotic resistance is a problem in bartonella but it doesn't develop that quickly. I got a bartonella infection that was resistant to rifampicin from the start, but never became resistant to minocycline. Bartonella is often spread by cats, and people give their pets antibiotics, so there's quite a lot of resistant bacteria out there already.

Dear Quinn and Girlie, thanks for your answers. Yes, I m currently taking 3fold combo cefuroxime-mino-rifampicin and every other day supportive fluconazole against yeast-candida. It is strange that symptoms do come back that quickly, I do not understand why. It s said Borrelia has a longer replication time, but since I ve used several biofilm breakers too, I guess it is possible. Strange thing is the persistency - before off period I used 5-6 combination - dapsone-azithromycin-rifampcin-minocycline-methylen blue (together with anti mycotics - fluconazole) for about a month and still such a relapse after less than a week, its quite strange...Anyway thanks for your answers. Kind regards, best wishes, B

i am currently pulsing antibiotics combinations - 2 week son 1 week off

i quite often get a minor surge in symptoms that feel much like a herx in the week off antibiotics
things like disturbed sleep, increased fatigue, sore head, mild fevers / sweats

but these are temporary and typically resolve again before i restart antibiotics in the next pulse - and overall i am moving forward over time

i think its more likely just some recapitulation effect of the immune system - in between the antibiotics pulses

many of the antibiotics we use are anti-inflammatory in nature and suppress parts of the immune system while they are in the system - eg tetracyclines and macrolides - so its normal for there to be some rebalancing during the off period as they come out of the system

Dr J believes the off periods in pulsing regimes are actually vital for the immune system to recovery

thats correct

different LLMD's have different approaches - all seem to work to varying degrees - or they wouldn't do them - but this doesn't necessarily mean the underlying theories are correct.

Dr J prefers rifabutin over rifampicin - and uses that in pulsed regimes

bartonella like to live in endothelial cells preferentially often staying in them or cycling into them for periods before coming out again to infect red blood cells and multiply inside them - then cycle back into the endothelium again

borrelia seems to drill through the endothelium on its way to other sites in the body that it prefers - eg low oxygen sites deep in connective tissues

Dr J's persister regimes are intended specifically to target bartonella and other persister cells - they include dapsone and rifabutin and are pulsed.

ultimately we don't have the research studies done in humans to know for certain which works best - or if both work equally well. but he does seem to get a good proportion of people well - even when they have failed prior antibiotic treatments and so represent a higher proportion of hard cases ( most of his patients see him as a last resort )

overall - we can see that even in the test tube - with the very best triple or quadruple antibiotic combinations - after 7 days of continuous maximum possible biologic drug concentrations - some borrelia ( and other pathogens too) are still surviving
this is just an indication of how hard it is to completely eradicate these organisms

in real people where its not possible to chive these drug concentrations in all tissues, cells and body compartments - and certainly not continuously - so even with continuous quadruple antibiotics - you are only ever chipping away at the infectious load.

there are some that feel continuous antibiotics are best for some faster growing organisms

but in reality, in the case of say bartonella - while it can reproduce faster than borrelia - in chronic infections the problematic bacteria we are trying to kill are not the fast growing ones - but are the ones in a persister state that are hardly growing / reproducing at all and are very hard to kill( often 1000x more tolerant to antibiotics vs their fast growing siblings).

there are also the studies that we have discussed before that showed for borrelia - a pulsed single antibiotic was more effective in the lab than triple antibiotic combo's used continuously.

i think you have to pick a philosophy and approach and follow it - rather than try to mix and match - as they are coming from different paradigms

i hope its of some help

Bhava123 said...
Quinn, I seem to have also issues with endothelium, but I have always attributed it to bart. I thought lyme can't give concrete symptoms worsening that fast, within few days.

I initially assumed it was bart too, but after successfully treating bartonella I still had problems with endothelial inflammation, and research has shown that borrelia can get inside the endothelial cells:

https://www.ncbi.nlm.nih.gov/pmc/articles/pmc8001052/

Bhava123 said...
In any case this time I had really painful start of abx in terms of pain in my head, liver, sides. Strangely enough it was different to previously ever experienced herx which was more flu-like all-over-the-body dull pain.

I'm guessing this is because of metronidazole. Unlike the bacteriostatic antibiotics (eg amoxicilin/cefuroxim/rifampicin) borrelia seems not to detect cytotoxic drugs like metronidazole. It will not form cysts or round bodies, but will move around and damage the endothelium and then cause a huge inflammatory response when it dies.

Be careful with antifolates (dapsone) if you have MTHFR mutation or blood tests show high homocysteine. You might want to try a lower dose of dapsone, and then hit borrelia with nucleoside analogues instead to block its DNA polymerase. Just be aware that this can trigger a bad inflammatory response as you found with metronidazole. Obviously dapsone can block the DNA polymerase by itself, but this requires a high dose.

Dear Quinn and Garzie,
thank you very much! It is definitely helpful. I will reflect and check on YouTube for more informations...