Oral Antibiotics For Lyme Disease
Lyme treatment using combination of oral antibiotics:
If you have decided to treat your Lyme disease with antibiotics, you should be aware that no matter what form of treatment, you will most likely go through a series of Jarisch Herxheimer reactions, an increase in the symptoms of a spirochetal disease also called a herx.
This will occur in all forms of treatment, but will noticeably occur when introducing a new antibiotic to your body, be it by IV or oral. When on antibiotics, it is strongly advised to make sure you take probiotics to try and maintain healthy gut flora and digestive bacteria. Not taking probiotics can lead to infection. Diet is also very important.
Doctors can recommend a combination of 2 to many oral antibiotics at a time to combat Lyme & other infections. More success has been seen with “pulsing” antibiotics which means taking them at intermittent cycles such as twice a day every other day or only on certain weeks.
You can incorporate some supplements, but always ask your doctor or a pharmacist if there are contraindications when using certain vitamins while taking specific antibiotics.
Take supplements 2 hours away from any antibiotics.
This is one of the more common forms of treatment and most readily available through a Lyme Literate doctor.
Insurance might cover the cost of the antibiotics.
Antibiotics are not effective for everyone.
Noras Lyme Disease Treatment
When Noras health began to rapidly decline more than a decade after she was bitten by a tick, she suspected she might have Lyme disease. With a sense of humor and plenty of determination, Nora started an online fundraiser to pay for treatments at a reputable Lyme disease center in Idaho. She raised over $22,000 that put her on the path to recovery.
Macrolide Plus Grapefruit Seed Extract Plus Cryptolepis
- clarithromycin 500 mg 1 pill 2 times a day
- grapefruit seed extract 250 mg 1 pill 2 times a day.
- cryptolepis 5 ml 3 times a day
- Grapefruit seed extract is better tolerated than both tinidazole and metronidazole and supports killing of Lyme cysts.
- Cryptolepis can treat persister and growing Lyme. If a person also has Babesia, cryptolepis can treat this too.
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Penicillin Plus Azole Plus Lipsomal Cinnamon Clove & Oregano Oil
- amoxicillin 500 mg 4 pills 3 times a day
- tinidazole 500 mg 1 pill 2 or 3 times a day for 4 days on and 3 days off in 7-day cycles.
- liposomal cinnamon, clove, and oregano oil capsules 1 pill 2 times a day.
- This is a very high dose of amoxicillin, which is four times stronger than physicians prescribe for other infections like ear infections. I consider this dose to be nearly as effective as IV antibiotics.
- This is a pulse dose regimen of the tinidazole. It may be more effective than continuous regimens.
- The essential oils are added to treat persister Lyme.
Lyme Disease Antibiotics Overview
The following are four general rules I use to develop a Lyme disease antibiotic regimen.
- Rule 1. Combine antibiotics to treat all forms of the germ.
- Rule 2. Combine antibiotics to treat Lyme living outside and inside of cells.
- Rule 3. Combine antibiotics that work in different ways to attack the germ from different angles.
- Rule 4. Treat all growth phases of Lyme at the same time – this means treatments should include antimicrobials that address persisters in addition to the growth phase of the term.
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Hidden Costs Of Lyme Disease Are Considerable
Health care costs continue to rise in our country, and it is imperative that we address the underlying source.
This article regarding the hidden costs of Lyme disease was recently published by Marcus Davidsson, an independent researcher and economist.
He discusses the scientific controversies and health care politics involved in Lyme, and three main questions that need to be answered to justify treatment for chronic Lyme disease.
Do chronic Lyme disease patients without treatment suffer from a low Quality of Life than the general population? Four National Institute of Health studies have shown that the answer to that question is yes .
Are the symptoms of chronic Lyme disease patients reduced because of antibiotic treatment? The answer to that question is yes .
Can an untreated chronic Lyme disease lead to premature death? The answer to that question is yes.
This article is a good overview of where we have come from and where we need to go, reviewing the history of the politics and science behind Lyme disease, but there is an overemphasis on the use of IV antibiotics as an answer for patients.
IV treatment may have its role in certain clinical situations, but without a discussion of the role of borrelia persisters and biofilms , the discussion is incomplete.
My new book How Can I Get Better? discusses these regimens in chapter 4 on Persisters and Pulsing for Treating Resistant Lyme Disease.
Demographics Of The Samples
The distributions of age, sex and region of the Lyme disease cases in our sample are consistent with what one would expect given national statistics on Lyme disease . Both cases and controls are approximately 51% female. Nearly half of both groups are aged 45â64 years, with 31% between ages 21â44 and the remaining 19% under 20 years of age. The vast majority of those in our studyâapproximately 80%âreside in highly endemic geographic regions, including the Northeast, Mid-Atlantic and Great Lakes regions . The smaller number of cases in other regions may be due to travel exposure or to the possibility of low rates of transmission from ixodes scapularis vectors in southeastern states. This hypothesis is strengthened by the fact that the majority of our ânon-endemicâ cases came from the southeast and Appalachian regions and not from the central, plains or desert regions. The seasonal diagnosis of Lyme disease among our sample peaked in June and July, with a nadir in January and February , consistent with national statistics for Lyme disease.
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For Depression And Anxiety
Both psychotherapy and pharmacotherapy have proven benefits for improving mood. Psychotherapy has many different types such as supportive, dynamic, cognitive behavioral, dialectical behavior therapy, transference focused psychotherapy each of which offers benefit. Pharmacotherapy also has many different types. For depression the first-line options usually are SSRIs, SNRIs, Tricyclics or other agents with more unique modes of action.
A few noteworthy tips on anti-depressant agents:
- Most anti-depressant agents also help in reducing anxiety. However the opposite isn’t necessarily true. Specific anti-anxiety agents such as clonazepam or diazepam may not necessarily help fight depression.
- Most anti-depressants take three to eight weeks before an effect is seen. Therefore, it is unwise to stop an anti-depressant after only three or four weeks, as staying on it another two to three weeks may lead to a good response.
- Dosage makes a difference. Some anti-depressants work fine at low doses some medications however are effective only at higher doses. Some medications are more effective as the dose is i increased. Other antidepressants may have a therapeutic range one has to achieve at least a certain dosage .
How Effective Are Iv Antibiotics For Lyme Disease
If youve been wondering about how impactful IV antibiotics for Lyme disease is, then youre in the right spot! Lets dive right into the details.
Antibiotics are the first line of defense doctors use when treating Lyme disease in patients. Even if a confirmed diagnosis has not been made, doctors will often prescribe a round of antibiotics. In Lymes early stage, the antibiotic regimens typically include a week or two of doxycycline or amoxicillin.
Antibiotics such as these are antimicrobial substances that fight bacteria that lead to infections, making them perfect for combating Lyme disease and some co-infections. Antibiotics can weaken bacteria and keep it from replicating.
Antimicrobial substances are not all the same, however. Those in the form of antibiotics are used to treat infections in the human body. Disinfectants and antiseptics are also antimicrobial substances, but if ingested, they can be dangerous or fatal. They are used to kill bacteria found on surfaces. Antiseptics are often used on the surface of the human body to prevent infections, especially during surgeries. Disinfectants are used on non-living surfaces like countertops.
Pinpointing the stage of Lyme disease you are in can help your doctor determine the best treatment.
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For Memory Concentration And Focus
Improving memory is a challenge. In Lyme disease, short-term memory problems and word-retrieval problems are common. These often improve substantially with appropriate antibiotic therapy. Over time, most patients regain their cognitive function.
When memory is a problem, consider that this could due to a primary problem with attention or with mood. An individual who can’t focus won’t be able to remember because he/she didn’t “attend” to the item in the first place. This happens to all of us when we hear someone’s name at a party if we don’t focus on the name and perhaps make a mental association to the name to enhance memory storage, we will forget that name within minutes. Patients with depression often experience problems with memory and verbal fluency when the depression is resolved, the memory and verbal fluency typically resolve as well.
- Medications: Attention can be improved with certain medications, such as bupropion , atomoxetine , modafinil , or stimulants . Medications that temporarily slow cognitive decline in Alzheimer’s disease or memantine ) have not been studied in Lyme disease.
- There is some evidence that online brain training programs can enhance concentration or processing speed.
- Neurofeedback may be helpful in improving attention, as well as in improving sleep and reducing pain. This has been studied for migraines, fibromyalgia, and ADHD.
Economic Evaluations Assessing Ld
Seven studies assessed the economic burden of LD using total healthcare costs, three studies included diagnostic testing costs only, and one study included Lyme cardiac treatment costs only. Five studies used a healthcare payer perspective, six studies used a societal perspective, and two studies used a third-party payer perspective. Approximately 91% of cost analyses used a time horizon between 0 and 5 years. Only four studies completed any form of sensitivity analysis, and two studies used discounting with rates between 3 and 4%.
Outcomes reported are summarized in . Cost analyses focusing on overall healthcare costs included direct medical costs: outpatient visits and related healthcare utilization, hospitalizations, emergency room visits, home health care, prescription medication , cost of subsequent manifestations , consultations, laboratory costs, and treatment side effects. Diagnostic cost analyses only included serologic test costs and laboratory costs.
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Macrolide Plus Quinine Derivative Plus Azole Plus Methylene Blue
- azithromycin 500 mg 1 pill 1 time a day
- hydroxychloroquine 200 mg 1 pill 2 times a day
- metronidazole 500 mg 1 pill 2 or 3 times a day
- methylene blue 50 mg 2 times a day
- Since azithromycin is not as effective as other macrolides like clarithromycin, hydroxychloroquine is used to increase the effectiveness.
- Tinidazole could be substituted for the metronidazole because it may remove biofilms more effectively.
- Methylene Blue can treat persister Lyme.
Oral Antibiotics For Early Treatment Of Lyme
The bacteria involved in spreading Lyme disease throughout the body are intelligent. They find ways to hide in the bloodstream along the lining, making it hard for antibiotics to find and attack. The bacteria are also robust. They can move and replicate even when traveling against the flow of blood.
Plus, to eliminate Lyme bacteria, Borrelia burgdorferi, the bacterias antibodies must be present at the time of antibiotic treatment. This means that if your doctor prescribes antibiotics for two weeks, the bacteria are in hibernation during those two weeks, and they can remain after the treatment ends.
Timing is everything when using oral antibiotics. This becomes even more true for patients who have had Lyme disease for a long time. Oral antibiotics are not as successful when treating late or chronic Lyme disease, plus they can have side effects.
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Lyme Has Two Growth States
Research published in 2015 shows that Lyme has two different growth states. There is a growing phase of the germs and there is a persister phase. Think of the persisters as germs that are in hibernation. These persisters – hibernating phase germs – ignore regular standard antibiotics we traditionally use to treat Lyme.
Government Assistance For Lyme Disease
While there arent many government assistance programs that help offset Lyme disease costs, filing for disability can make life easier while you receive treatment. Applying for Lyme disease disability benefits can be tricky, but the Benefits.gov website lists the benefit programs from every state with information on how to apply.
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Antimicrobials That Kill Growing Phase Spirochetes
- Amoxicillin 500 mg 1 to 2 pills 3 times a day. Alternatively as an alternative to IV antibiotics take 3 to 4 pills 3 times a day.
- Amoxicillin/Clavulanic Acid 875 mg/125 mg 1 pill 2 times a day
- Bicillin LA 2.4 million units IM 3 times a week with one day between each injection
- Ceftriaxone 2 gm IV 2 times a day for 4 days in a row then off for 3 days of each 7 days
- Cefotaxime 2 gm IV every 8 hours
- Cefuroxime 500 mg 1 pill 2 times a day
- Cefdinir 300 mg 1 pill 2 times a day
Additional IV Antibiotics
Vancomycin, imipenem, and ertapenem are possible alternatives if someone is allergic to Ceftriaxone or Cefotaxime.
Intracellular and Extracellular
- Clarithromycin 500 mg 2 pills 2 times a day
- Azithromycin 500 mg 1 time a day or 500 mg IV 1 time a day
- Doxycycline 100 mg 1 or 2 pills 2 times a day or 200 to 400 mg mg IV 1 time a day
- Minocycline 100 mg 1 pill 2 times a day
Antibiotic Treatment Of Lyme Carditis
Table 1. Mild
|100 mg, twice per day orally||N/A|
|500 mg, three times per day orally||N/A|
|500 mg, twice per day orally||N/A|
|4.4 mg/kg per day orally, divided into 2 doses||100 mg per dose|
|50 mg/kg per day orally, divided into 3 doses||500 mg per dose|
|30 mg/kg per day orally, divided into 2 doses||500 mg per dose||14-21||3|
Table 2. Severe *
|2 grams intravenously, once a day*||N/A|
|5075 mg/kg intravenously, once a day*||2 grams per day||1421||3 5 12|
*After resolution of symptoms and high-grade AV block, consider transitioning to oral antibiotics to complete treatment course .
Tissue sample from a patient who died of Lyme carditis. Image taken using Warthin-Starry stain at 158X.
The heart on the top shows how an electrical signal flows from the atrioventricular node to the chambers in the lower half of the heart, called the ventricles.
The heart on the bottom shows a case of third degree heart block. In this illustration, the electrical signal from the AV node to the ventricle is completely blocked. When this happens, the electrical signal of the atria does not transmit to the ventricles , which causes the ventricles to beat at their own, slower rate.
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Antimicrobials That Kill Growing Phase Cysts
Intracellular and Extracellular
Note: I work with the following agents as anti-cyst agents based on the mechanism by which these antibiotics work and some scientific experiments. For the Rifamycins, there are no laboratory experiments showing these agents work against cysts. Clinically, I see great benefit in using the Rifamycins as my anti-cyst agents – so I list them here.
- Rifampin 300 mg 2 pills 1 time a day or 1 pill 2 times a day
- Rifabutin 150 mg 2 pills 1 time a day
- Tinidazole 500 mg 1 pill 2 or three times a day usually pulsed for four days on then three days off of each 7 days
- Metronidazole 500 mg 1 pill 2 or three times a day usually pulsed for four days on then three days off of each 7 days.
- Grapefruit seed extract 250 mg 1 pill 2 times a day. Note this is an herbal antibiotic that I find as effective as the prescription options in this list.
Tom Johannes Lyme Disease Fund
Another victim of a tick bite, Tom suffered from Lyme disease unknowingly for many years before he was finally diagnosed with late stage neurological Lyme Disease. Once an outdoor enthusiast, the disease left Tom unable to perform basic tasks or care for his family. Toms brother stepped up and created an online fundraiser that has brought in $26,000 to help Tom and his family find hope and financial peace.
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Stages Of Lyme Disease
There are three stages of Lyme disease. Early localized Lyme disease is defined as being diagnosed soon after a tick has bitten you. You may have seen the tick, removed it, and noticed a rash. You may even be starting to feel like you have the flu or coping with headaches.
This is the best time to treat Lyme disease. This is, for many, the only stage in which oral antibiotics are successful. Once the disease begins to move to other places in the body, as it does in the Early Dissemination stage, oral antibiotics may not be strong enough to fight infection.
In the third stage, Late Lyme, it is unlikely oral antibiotics alone can rid you of the bacterial infection. This is when doctors and patients start to look at alternative methods of treatment.