Antabuse Dosing And Duration
An average treatment length for Disulfiram is eight months. Disulfiram triggers a large Herxheimer reaction in many people. Because of this, the medicine is started low and slow working to a target dose. It can take up to four months to reach the target dose in many patients. Once a person reaches the target dose, or a lower dose they can tolerate, they stay at that dose for four months.
The target dose for disulfiram is based on your weight. If a person can tolerate it, I try to reach 4 to 5 mg/kg a day. To figure out how many kilograms you weigh, divide your weight in pounds by 2.2. Here is the calculation of the target dose for a person weighing 150 pounds:
- 150 lb/ 2.2 = 68 kg
- 68 kg X 4 mg/kg = 272 mg
- 68 kg X 5 mg/kg = 340 mg
For this weight I choose a target dose of 312.5mg which is between 4 to 5 mg/kg. Disulfiram is manufactured as a 250 mg and 500 mg pill. It is also compounded as a 62.5 mg pill. One and ¼ 250 mg pill or five of the 62.5 mg pills equal 312.5 mg.
I usually start patients at 62.5mg mg every 3rd day for 10 days, then I advance to 62.5 mg every other day for 10 days, then to 62.5 mg 1 time a day. Based on the response in the first month, I decide how rapidly I will increase the dose from there.
How Do You Know If Its A Herx And Not An Adverse Drug Reaction
It is important to distinguish between a herx and an adverse drug reaction . The onset of a Herxheimer reaction is somewhat diagnostic of a spirochetal infection. So, if youre being treated for Lyme based on a clinical diagnosis, the herx can actually be a good sign that you are killing the right bacteria.
Ive talked to patients whove had Herxheimer reactions and almost all of them tell me it is a very intense experience. One patient described it as an altered state. Said one: Every cell in my body feels like its being crippled. Its mentally overwhelming and physically exhausting. I usually have a pulsing feeling in my body which distinguishes it from a medication side effect.
Adverse drug reactions, on the other hand, can range from mild to severe and can be mistaken for a herx. So how do you tell the difference?
Another patient distinguishes the two reactions as follows: Herxes for me seem to be more all over and include psych symptoms. Drug reactions seem to be more in line with what is described in the drug manufacturers papers. With antimicrobials, you can have both simultaneously, of course.
Mild ADRs will typically resolve shortly after the medication is stopped. On the other hand, a severe allergic reaction, called anaphylaxis, causes swelling of the airways, and can be fatal if not treated immediately .
How To Determine If Youre Having A Herx:
A Herxheimer reaction is created when youve increased or changed your treatment protocol for Lyme disease and co-infections. But it can be really hard to tell if the difference between a herd, a flare-up, or other reasons for an increase in symptoms. Our guidemay help you determine the cause of your increase in symptoms.
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What Were My Symptoms Before My Chronic Lyme Disease Diagnosis
For decades before my diagnosis, I had numerous seemingly unrelated symptoms, all of which hinted at an autoimmune syndrome of some kind. If I had to pick a time when it all may have begun, it would have been in 1993, when I missed so much school due to a low-grade fever, joint aches, and fatigue that I nearly had to repeat my semester. I dont recall ever being bitten by a tick, or seeing the telltale bullseye rash on my body. We thought I had mono at the time, though I tested negative. I have, in recent years, tested positive for the Epstein-Barr Virus, which causes mono, but its estimated 90% of adults also have it.
Chronic sinus infections
A mysterious problem that was documented on this blog was years of chronic sinus infections. I nearly constantly had a sinus infection. I thought I had discovered a cure when I started using the sinusrinse, but my improvements were short-lived. I was still getting a sinus infection about once a year, which most doctors dismissed as normal. When I didnt have a sinus infection, I was usually congested.
Ive hardly had any sinus infections since I quit eating gluten back in 2007, and now I rarely even get the common cold. My food sensitivities have spread to other groups, which I discuss further down in this article.
Yeast on the back of knees, eczema under eyelids
I also develop similar patches on the tops of my eyelids. I dont know for sure whether those are yeast or eczema, but they are sensitive to my eating patterns .
About Disulfiram And Lyme Disease
For 30 percent of people with chronic Lyme disease, disulfiram is a game changer. This is a medicine historically used to treat people with alcoholism. Ground-breaking research from Dr. Rajadas Stanford University lab in 2016 showed disulfiram kills persister and growing forms of Lyme germs. Based on Rajadas research, disulfiram is being repurposed as a Lyme antibiotic.
In alcoholism, disulfiram prevents the breakdown of a toxic alcohol by-product called acetaldehyde. As acetaldehyde builds up, it makes a person sick with severe abdominal pains and even headaches. In alcoholism, a person takes this medicine daily to prevent them from drinking out of fear it will cause severe illness if they drink alcohol.
In Lyme disease, we do not know the mechanism of how disulfiram works. But we do know in the laboratory that it kills Lyme persisters and is moderately effective at treating growing Lyme too. We also theorize that it breaks up biofilm slime layers that protect the germs.
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Good Herx Vs Bad Herx
Dr. Horowitz describes the difference between a good herx and a bad herx. Basically, with a good herx, the patient will have a reduction of symptoms and begin to feel better after the flare. With a bad herx, the patient will return to their prior baseline after the flare with no reduction in symptoms overall.
The Herxheimer reaction is a normal part of treatment for late stage or chronic Lyme disease, but it is important to make it tolerable. A few methods one can utilize to reduce the flare are described below. In rare instances, a severe herx can be life threatening. I advise going to the nearest Emergency Room if you are experiencing extreme symptoms.
On Previous Or Current Antibiotics
I am using disulfiram in patients who do not fully recover after using prolonged antibiotics targeting growing Lyme for a year or more. One reason these patients may not recover is that persister forms of the Lyme germ develop that are missed by regular antibiotics. In these patients, I use disulfiram alone. For some of these patients, if they do not respond to disulfiram alone, I am also using antibiotics that target growing forms of the Lyme germ better than disulfiram. You can read about these antibiotics inA Lyme Disease Antibiotic Guide.
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What Is The Right Way To Do This
There are a few BVT Protocols out there,
yet these are two we enjoy.
Lyme Disease Protocol BVT
This protocol includes BVT along with a detox protocol. Live bee stings are used 3 times/week , your weekends are free. This is a time to take it easy and detoxify. This weekend break is important for the body to have a chance to recuperate and remember how to heal itself. I have discovered that the detox protocol is just as important as the live bee sting therapy. The detox protocol involves Epsom salt baths, plus drinking lots of purified water, and 1-2 teaspoons of Braggs apple cider vinegar in a large glass of water every day but not too close to stinging. You can add some honey to taste.
It is also helpful to take a minimum 300 mg of magnesium per day , also a good multi-vitamin, and an excellent probiotic.
Some people find that Alka Seltzer Gold is helpful for nausea. You can take up to six tabs at one time in a glass of water, no more than 3 times per week.
There are some side effects that people with Lyme Disease undergo while doing BVT. These side effects are due to the neurotoxins that are given off when the pathogens are killed and die-off. This process is called the Jarisch-Herxheimer Reaction, known as herxing, or herx. It is believed that herxing results from the destruction of pathogens. The body has trouble handling the surge of toxins into the bloodstream, provoking a cascade of reactions very quickly.
Whats A Herx How Do You Know If Youre Having One And What Do You Do About It
The Herxheimer reaction is also known as the Jarisch-Herxheimer reaction, the die-off reaction, or just herx. The Herxheimer reaction is the reaction your body has to the Lyme bacteria as they die. When the Lyme bacteria die, they release endotoxins. The body reacts to these endotoxins with inflammation from the immune system.
A Herxheimer reaction feels like a worsening of symptoms as opposed to feeling better immediately with treatment. Common symptoms associated with a herx are flu-like symptoms , headaches, digestive issues, nausea, and worsening of any other existing Lyme symptoms.
Typically, in healthy bodies, the immune system responds in a way that promotes healing by going after infections, but in the case of a herx, too many toxins are released and the immune system WAY overcompensates.
Think again of the dying bacteria as an egg smashed against a wall each piece of the eggshell is an immune irritant. Since the egg has been smashed, the yolk and egg white are all over the wall now too. The yolk and white represent endotoxins in this metaphor. Endotoxins are inflammatory toxins. But they are different from the toxins most people think of.
The body responds differently to endotoxins than it does, for example, to toxins like alcohol or pesticides. Endotoxins are toxic to some degree, but mostly they get the immune system to respond with more inflammation, making it less focused on the actual infections, distracted and over-reactive.
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Extra Considerations For Reducing A Herxheimer Reaction
|Consider adding an anti-inflammatory agent such as Japanese Knotweed, curcumin, fish oil, or all of the above as part of a treatment protocol to help shut down inflammation.Consistently take glutathione, red root for lymphatic drainage, a good multivitamin designed for phase l and ll liver detoxification, drink plenty of water, get adequate sleep, treat an MTHFR gene mutation , and take a good binder designed to attach to fat based Lyme and pathogen toxins — such as modified citrus pectin — to lessen the chances of having of herx. Instead of having one massive herx that stalls treatment, by working a good detox regimen, herxing becomes less frequent and severe throughout treatment.|
How To Handle A Herxheimer Reaction:
Theres a great rule to follow to minimize herxing: Pull it out, calm it down
- Pull it out refers to the detox support we recommend. Pull out the toxins that are causing the herx. Making sure you have regular bowel movements is really important for managing the Herxheimer reaction.
- Calm it downthis refers to our tips to minimize inflammationand irritation which will help the symptoms of a herx.
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Having A Flare Up Heres Some Home Remedies That Have Helped Me
Ive been dealing with Lyme disease for over ten years, and to this day I still get caught off guard with herxs and flare-ups. When they happen, theres always this moment of complete terror when I think that my life as I know it is going to come crumbling down around me. At the first sign of symptoms I instantly think its a relapse, and even though this has been my life for over a decade, I feel helpless and at a loss of what to do next.
And then it hits mea wave of relief. A herx! This could be a herx! I can do that!
Over the years Ive gotten so many recommendations for different home remedies to help when my symptoms flare up, but as is the case for most peoplewhat works for one person, doesnt necessarily work for me. Ive basically tried them all, and only a few have stayed with me as keepers.
First and foremost, the absolute most helpful tool in my toolbox is a supplement called Lymph Detox, by Professional Botanicals. Its always my go-to supplement during herxs, and there have been numerous occasions where I have gone from laying in bed due to weakness, to walking around the house feeling so much better within an hour of taking it.
I decided to ask a few of my Lyme and mold friends what home remedies have helped them. Here is what they had to say:
Lyme Sci: The Dreaded Jarisch
Lyme disease and tick-borne diseases are complicated illnesses and because of that, treatment can be complex. Patients whove gone through treatment will often say your symptoms get worse before they get better. One of the reasons for this is something called a Jarisch-Herxheimer reaction.
The Jarisch-Herxheimer reaction often shortened just to Herxheimer or herxinghappens after you start antibiotic treatment for spirochetal infections like syphilis, Lyme disease, and tick-borne relapsing-fever.
The reaction was first described in 1895 by Adolf Jarisch, an Austrian dermatologist, and later in 1902 by Karl Herxheimer, a German dermatologist. Both doctors documented a pattern of an increase in symptoms shortly after their syphilis patients started treatment.
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Update: As The Post Has Circulated Some Have Asked How To Best Test For / Treat Lyme
TESTING: The test we used was from DNA Connexions. A positive test indicates the presence of DNA from Lyme and/or other co-infectors in the urine. Its finally a reliable test that makes older, often inconclusive lyme tests practically obsolete.
TREATMENT: I cant adviseyou on what to use but I can share our current list of antimicrobials and antibiotics were using for Lyme, Bartonella and Ehrlichia and some of the best resources Ive found.
Herbs : Houttuynia, Sida Acuta, Alchornea Cordifolia, Isatis, Berberine, Neem, Grapefruit Seed Extract, Cats Claw, Gou Teng, Artemisia, Mimosa Pudica & Usnea
Antibiotics : Rifampin, Doxycycline, Flagyl / Tindamax, Cefdinir, Biaxin
Its commonly held by Lyme Literate MDs that supporting the body, with recommendations in this detox post is as important as the antimicrobial agents chosen.
So its critical to remember to not begin killing microbes without the proper support to detox. If you do, the herxheimer symptoms may be unmanageable and the toxins can be re-absorbed.
Reference links for 3 protocols for fighting Lyme
- Cowden: The Cowden Support Program
LLMDs can help you select the best treatment tailored to your needs, often also addressing parasites as part of an overall Lyme elimination program.
To purchase: Buhner herbs in tincture or capsules are available from several retailers on . You can find them individually or in combination with others by searching the herb name.
Cowden herbs are available at Nutramedix.
Detox Methods For Near
|Its not the increasing of a treatment protocol that makes a person feel bad , its the immune systems response to the presence of an excessive amount of dead pathogens and their toxins.This condition can be created by not just increasing an antibiotic and/or antimicrobial, but many other ways such as treating a biotoxin illness, treating the MTHFR gene mutation, heating up the body, or a full moon in which Lyme spirochetes reproduce , exposing their ribosomes to the already present and unchanged antibiotic and/or antimicrobial dosage this kills them.|
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My Chronic Lyme Disease Diagnosis
In October 2014, I got a call. Hi, this is from the Illinois Center for Disease Control. I knew the CDC collected data about certain diseases. What I didnt know is that sometimes they call you.
The disease I tested positive for was Ehrlichia chaffeensis, or Ehrlichiosis. Its carried by ticks, and causes fever, chills, malaise, pink eye amongst other things. Sometimes it kills people.
I never see this. When this came in, I was like give me that one! Perhaps I had gotten too cordial with the agent who called me, and he had dropped his professional demeanor. Erhlichiosis is pretty rare. Almost one in a million .
I didnt recall any tick bites, and I hadnt been acutely ill, like one would expect with Ehrlichiosis, anytime in recent memory. Where this Ehrlichiosis came from was and still is a mystery. Theres some chance it could have been a false positive, but its too late to know now. By the time I got tested again 6 months later, it was gone.
But, with Ehrlichiosis in the picture, it started to add up. Tick-borne illnesses travel in packs. A tick that infects you with, say Ehrlichiosis, probably carries a bunch of other diseases, such as Bartonella, Babesiosis, and Lyme.
Unfortunately, the tests for these diseases arent reliable. For Lyme, for example, the CDC standard is called the Western Blot, which basically looks for antibodies to body parts of spirochetes in your blood.
Low Platelet, Low CD57 Natural Killer Cells, & high C4a