[quote]fong520 wrote:
did u mean i should be doing one or the other or both?. currently im taking doxycycline hyclate and have about 10 days left till im done that (for a total of 30 days). should i be taking the oral therapy afterwards for another 4-6 months?
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Lyme spirchetes go through long periods of dormancy where antibiotics can not affect them. It’s believed that antibiotics can only kill Lyme during the growth phase, which occurs for some short period of time every 4 weeks or so. Therefore, treatment needs to last longer than just 4 weeks and your symptoms need to be watched 4 weeks after treatment starts.
Here’s why: patients undergo something called the Jarisch-Herxheinmer effect, or herxing for short. Essentially, the bacteria contain a neurotoxin that is released as they die off. The body is slowly overwhelmed in it’s ability to filter out the neurotoxin and a new bout of symptoms occur that may include flu like symptoms as well as a rash and itchiness. Although it sounds awful, it’s actually a good thing. It means that the antibiotics are working. The first bout of herxing may take place 48-72 hours after treatment starts, and then apporximately every 4 weeks thereafter. Once you stop herxing, you continue to take antibiotics until another 4 weeks elapses. No herxing means that no living bacteria are present.
Continued use of Doxy is the oral therapy referred to above. Additionally, it’s been shown that higher serum levels of Doxy results in more killed bacteria than stable serum levels, therefore 200mg qd (once a day) is better than 100mg bid (twice a day), provided your stomach can handle it. Doxy is caustic so take it with plenty of water, you don’t want it getting stuck in your esophagus. Pick up some acidophilus to keep your intestinal flora intact. Doxy is a relatively benign antibiotic otherwise, and is well tolerated. It’s also well researched for prolonged use and it’s given to teens commonly for months at a time to battle acne.
A little bit of my story: I found a tick on me and the tell tale bulls eye rash 3 days later. I went to my doc the next day and got a 2 week course of Doxy. A little more reading and I realized how serious the consequences of untreated Lyme (or failed treatment) could be, so I went to the University of Chicago Library, parked my ass in a chair for a couple weeks and read everything I could. Most striking was the divergence in courses of treatment between the Infectious Diseases Society of America and the International Lyme and Associated Diseases Society. The treatment recommended by the IDSA was inadequate IMHO, given the risks of long term infection, so I brought the ILADS treatment guidelines to my doc and told him this his how I wanted to be treated. After 6 weeks, I believe that the living organisms were eradicated.
Best of luck, let me know if you have any other questions.
Thanks to BBB for answering the second part of the OPs question.