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Welcome to the Rheumatic Support FAQsThese are FAQs that have been asked repeatedly. We are not physicians but empowered, knowledgeable patients sharing what was done for us and others for many years on this therapy with excellent results for inflammatory rheumatic illness. What is antibiotic therapy? (AP) AP is a low dose antibiotic therapy mainly using the Tetracycline drugs. The theory is to go after the source... Mycoplasma. This has controlled the disease and allowed people to be able to discontinue the use of steroids and Dmards while still controlling the disease and in some cases bringing about remission. Why try antibiotic therapy? How does it differ from traditional treatments? Why not try it! It has fewer side effects than traditional treatments. One of the most interesting reasons for using this therapy is the rationale that these diseases could have an infectious cause. If that be the case, the antibiotics are addressing the cause. Low dose antibiotics, such as the Tetracycline (Minocin) drugs, attack the source...infection. It is not a band-aid concept but rather a long term therapy. There are great anti-inflammatory properties as well as anti-collagenase properties making this attractive to many physicians. It requires patience and networking with others on this therapy for the best success. Are there various protocols for AP? There are various protocols for the use of antibiotics. Dr Thomas Brown's work was based on the use of IV Clindamycin followed by Tetracycline MWF, now Minocin the brand. This is still used by many. Are there other antibiotics that can be used? Some people that have sensitivities to Tetracyclines use the Erythromycin, which was used decades ago by Dr . Brown. This is also used in children 8 and under as Minocin in young children can cause permanent tooth discoloration of the secondary teeth. Some physicians favor using Zithromax and some favor Doxycycline as well as the Clindamycin. Other physicians add Flagyl and Ketek as it addresses other organisms and can add a boost to the Minocin alone. What are some situations that need to be addressed when doing this therapy for it to be a success? (hypercoagulation, allergies, yeast, diet and inflammation, hormone balancing) There are several things we as patients have found that were causing us to respond slowly. For others, the therapy was not working well and caused "plateauing." Yeast is the first issue we need to look at. It needs to be controlled by diet, adding acidophilus at the very beginning of the treatment. Some people start a probiotic before they even begin AP as addressing the yeast will only help their response. Some have used herbal supplements to help with yeast issues such as Clarkia, Black Walnut Hull, and Primal Defense just to name a few. Prescription medications can also be used on your physician's advice. Allergies have to be kept under control as otherwise Minocin will respond to the allergies. Using a neti pot and clearing the sinuses with salt water is excellent as well as increasing Vitamin C. Benedryl, as well as other OTC antihistamines, helps to reduce the histamines that are released when the bacteria are dying. Some also have had luck with NAET (naet.com), an allergy elimination technique. Hypercoagulation, one of the newest concepts that many of us suffer with on a daily basis, can inhibit the protocol. With rheumatic diseases many of us have sticky, thick blood and the use of enzymes, such as Nattokinase or Lumbrokinase, can be useful (under supervision). To be assessed for this condition by your doctor is imperative as taking something that thins your blood without proper testing and monitoring is dangerous. Having a fibrinogen and anticardiolipin test done can detect this. Much information on this can be found at http://www.hemex.com Inflammation must be addressed if high as lowering inflammation will allow penetration of the antibiotic. Some products to use for high inflammation include fish oil, Wobenzyme-N or Bromelain on an empty stomach and Turmeric. When patients have a chronic disease, their endocrine system may be in disarray and their hormone levels are often depressed. Furthermore, when such diseases remain active, hormone levels will be further suppressed. Proper evaluation and utilization of natural hormones can often correct this endocrine imbalance and result in a reversal or slowing of the disease process. Without adequate levels of thyroid hormone, the immune system will not perform optimally, resulting in the body's becoming more susceptible to infection and chronic illness. Are there any negative results from using Minocin that might occur? (hyperpigmentation, nausea, dizziness) Some doctors are fearful of using Minocin as they feel it might cause DIL...drug induced Lupus. Many AP physicians feel this is not so and do prescribe Minocin freely but slowly as they know the herxheimer effect is greater with Lupus patients. This herxheimer effect is what many non AP physicians are actually seeing when they use the term DIL. If the physician feels strongly about DIL then Doryx can be used with excellent results. Minocin is the drug of choice, but for those having any difficulties with it, Doryx or Doxycycline can be used. We recommend you drink a full glass of water and remain sitting upright for at least 30-60 minutes whenever taking any antibiotic in the tetracycline family in order to prevent esophageal injury. For this reason, do not take this medication immediately before going to bed at night or sitting way back in a recliner. Instead, remain sitting upright long enough to be sure the pill reaches the stomach and does not remain stuck in the esophagus, where it might dissolve and cause painful esophageal burning and scarring. Nausea, although not a usual side effect, if experienced, can be helped by drinking unflavored seltzer when taking the Minocin. If need be, dry saltines and/or unsweetened applesauce may be used if nausea persists. It usually abates after a few weeks. Increasing acidophilus has also helped. Hyperpigmentation is experienced by some on the 200 a day dose especially if fair skinned and after awhile on the therapy. Minocin is the drug that is used when this hyperpigmentation occurs. To counter this, it has been recommended by AP physicians to take high dose Vitamin C (3000mg a day) according to studies done. This does help reduce the risk of hyperpigmentation. Doryx (doxycycline) can be used at the same dosage in place of Minocin and the hyperpigmentation will be reduced after time. How long does it take on this therapy before seeing positive results? This varies with the individual. Some see positive results as early as 3 months, others may take as long as a year or two. It depends on how long you have had the disease(s), or other meds you might be taking or have taken in the past. Dr Brown refers to this as failed protocols and cites this as a reason for the amount of time to respond. Also, having co-infections of other diseases will have an effect on response time. Severity of disease has to be noted as well. Is this therapy a cure? This is NOT a cure, however, it will put you in control of your disease without destroying other organs with the use of toxic meds. Better quality of life is often achieved as well. What is the Jarisch-Herxheimer Reaction? It is a short term flare induced by the use of the antibiotics and the toxins being released by dying microorganisms. A change in dose of the antibiotic can also cause this flare to happen. Lowering the dose for a short while usually aids in the flare lessening. We have found that lowering other drugs seems to also lend itself to a short "herx" as more antibiotic seems to be absorbed and the body "feels" a different dosage, even though no dosage change was made. What adjunct therapies may be considered after being on AP for a while? Massage works well as it drives the bacteria from the tissues just to be addressed by the AP. Naet for allergies (naet.com), and looking into hemex testing for hypercoagulation of the blood (www.hemex.com What diet should be followed? This is a very individual area. Many have to watch wheat, dairy, meats, nightshade vegetables, etc. Some do not need any dietary change. Once again, anyone feeling a particular food is triggering a poor outcome with their disease, through a process of elimination, don't eat that particular food for awhile and see if there are positive changes. Rotation of foods helps (not eating the same things each day) as well as an elimination diet. Naet, for others, has proved effective as it eliminates the allergy totally and the person can consume the foods again without reaction. Reducing the load on the immune system is the key here whatever route you take. What tests are needed as a follow-up by my doctor? Some suggestions are: CRP, Sed Rate, ANA, Liver Enzymes, Candida, Fibrinogen, CBC, BUN, Creatinine, Anticardiolipin, RF. Do I need Mycoplasma testing? This is not necessary but can prove helpful if you ever decide on seeing a doctor for the IV approach. Having a diagnosis of Mycoplasma infection will enable the insurance to cover all costs. Some of us already on AP used the mycoplasma fixation antibody test as there was no washout period needed. If you are just beginning, now would be the time, before you start AP, to get the testing done by PCR. We have recommended labs on this site. Do I need an antibiotic therapy doctor and how do I locate one? An antibiotic therapy doctor is not always needed as many use their primary care physician with success. To access an antibiotic therapy doctor, post a request on our Bulletin Board and include your e-mail address and we will send physician names to you from your area. We do not post doctor names on the BB. Also, you can email the contacts for the site. What improvements should I look for? Are there any negative effects? Improvements may be subtle. Perhaps some brain fog has lifted or there is less pain in a particular joint. Fatigue will lift and the mood often picks up. You will experience small windows of feeling better. There is also the possibility of feeling worse before feeling better. We use the expression, three steps forewords, and two steps backwards. There is also the possibility of nausea or dizziness in the beginning, but in most cases this clears within a couple of weeks. Lessening the dose often helps this. Can I use AP with other medications? Practical experience says yes as many of us were given Minocin while still on MTX and Prednisone, Plaquinal etc. Many times the Minocin is given at a higher dose (the clinical trial dose) and then, in a few months, the weaning off the other medications starts, slowly, one medication at a time. What about supplements? In our experience, whatever you are taking, stay with them. Add your AP and acidophilus but let your body get used to it for 6 months before adding more. Also, don't think you have to follow using supplements that others are using. Stay with doctor recommendations until you are seeing positive results. Sometimes these temptations to try many supplements can interfere with AP. Many of us did take Milk Thistle from the beginning to ensure the liver enzymes stayed low. If this protocol is so good, why is this not recommended by all physicians? Most physicians have no education or training in how to use this medication. The drug representatives instruct the physicians how to use the various drugs that are produced so when they get to AP, they also look for that quick fix. Antibiotic protocol sometimes is done best by the physicians who studied how to administer it as it takes patience by both physician and patient. One more reason is cost. The Minocin costs far less than the arthritis drugs prescribed and needs less monitoring with blood tests as it is safer. The same pharmaceutical company that manufactures Minocin also makes some of the more expensive medications, so they are not promoting its use. |
Information, support and networking for people who are on or considering antibotic therapy.
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