Cpnhelp.org

"this approach uses 6 grams of calcium pyruvate one hour before taking the antibioticsi"

Wait. My doxyi insert says not to take anything with calcium (or iron, zinc, magnesium, aluminum) for 2-3 hours before or after taking doxy. So how does that work? I also have the additional problem of taking thyroid meds, which also have to be taken 4 hours away from calcium, and on an empty stomach, which means first thing in the morning. So my morning goes, get up take thyroid meds first thing, wait a half hour, take herbal supplementsi that need to be taken on an empty stomach, wait another half hour or more, take doxy/azi, wait another half hour or more, eat breakfast and take non-calcium containing vitamins and supplementsi. It's now at about 9:30AM. This makes it so I can't take calcium until afternoon. Then I take my evening dose of doxy around 9:00PM. So basically I only have between 12:30PM and 6:00PM to take any calcium supplements. Not sure how that will work with that pyruvate protocol. How are others here juggling their doxy and calcium/iron/zinc/magnesium?

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GFAi - asthmai, sinusitis/rhinitis, tendonitis, low back pain, hypothyroid. Started azi 1000mg/week Jan 9, '08. Increased azi to 250mg/day, added 20mg Benicar daily Mar 13, '08. First Flagyli pulse started June 30, '08. Added Doxyi 200mg/day Aug 16.

Sunni, we've had this question come before. The upshot was that calcium pyruvate is supposed to be absorbed within an hour, so shouldn't affect abxi in any major way if they are taken an hour later.

Going back to the original question, I knew that JimK had posted an update to his experiences here. So it seems as if Jim is no longer pursuing the updated protocol. Has anyone continued the pyruvate protocol for an extended period?

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Hunter: Don't think - experiment

Ok, I tried some yesterday afternoon. I took a total of about 3g spread out throughout the day. By evening the old early azi symptoms came back .... symptoms I got when I first started taking azi .... cold hands/feet, chills, sweats, anxiety, increased blood pressure (though not much this time thanks to the Benicar). This morning I had a hard time waking up. I wanted to sleep until noon. I have a headache, my brain's fogged, and the doxyi made me nauseated this morning, which is the first time that's happened. Is this the pyruvate doing something or just a strange coincidence? Would it work that fast and with so little? I thought I was being cautious with only 3 grams but I think I'll need to ramp up a little more slowly.

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GFAi - asthmai, sinusitis/rhinitis, tendonitis, low back pain, hypothyroid. Started azi 1000mg/week Jan 9, '08. Increased azi to 250mg/day, added 20mg Benicar daily Mar 13, '08. First Flagyli pulse started June 30, '08. Added Doxyi 200mg/day Aug 16.

Sunni,

My understanding and replies from Jim about if/when to incorporate pyruvate into CAPi is that when you take it an hr before the abxi, it helps keep the bacteria from hibernating into cryptic formi and so you're supposed to be able to eradicate more of them w/o a pulse just from the Z and doxyi.  

That would mean you would feel worse without a pulse because of increased die off but it would mean you would have less cryptic forms and the toxins that accompany them so pulsing would be (should be) easier.  

In addition, it's recommended to use the pyruvate AFTER the abxi to help with symptoms.  Each single dose is recommended as 4-6 grams I believe.    

I'm only taking the pyruvate at this time after the abx (4 gms)  to help with symptom relief but you're recommended to use it for both (before and after) when you're using it to help coax the cryptics (sounds like some gang name!) out of hiding to zonk them! 

Have you also tried the prilosec?   That's also supposed to help with this process if I recall, by preventing the pumps from eliminating the antibiotics from inside the infected cells we're treating.

PS I'm now wondering from your comment about taking 3 grams spread throughout the day if the pyruvate I'm taking is causing my daily CAP to be more "effective" and that's why maybe I'm feeling more horrid on a daily basis.  I think I may want to halt the pyruvate for awhile to see if this causes symptom improvement.  (I was just planning on taking my daily 4 gm dose but... ?) 

OTOH, it might be better to eradicate more bacteria w/o pulses as long as I'm not feeling absolutely horrid all of the time anyway.  But I think for today I'll skip the pyruvate and see what happens.   

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NACi 2.4g, Zithi 250mg/MWF, minoi 200mg, Tinii 5day/1g/5 pulses, Valcyte
Iodoral 12.5mg, Supps, CFIDSi/FMSi, Hashimoto's, Psoriasis, PA, IBSi, Sec Addisons

Don't believe everything you think!  

garcia,  I wish I had something helpful to offer, but all I can say is that I'm watching this thread, happy to see you make a shift, and hoping the best for you. 

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Joyce~caregiver-advocate in Dallas for Steve J (SPMSi).  CAPi since August 06, Cpni, Mpn, B. burgdorferi, systemic candidiasis, EBVi, CMV & other herpes family viral infectionsi, elevated heavy metals, gluten+casein sensitivity. 

Thanks Joyce, I'm just about to try the protocol myself. Have ground up the horse pills into powder, which hopefully I'll be able to digest. Even if this approach is only temporary, I still see it as worthwhile to winnow down the cryptic load. I can even see this becoming a standard stage in the CAPi between the bacteriostatics & pulses. A schedule might look something like this:

- Stage1: Start off with all the supps (e.g. B12 & melatonini), IR sauna & Vitamin Di
- Stage2: Start the bacteriostatics adding in first one, then when tolerated the other
- Stage3: When gains dry up add in Pyruvate
- Stage4: When gains from pyruvate dry up, start pulsing.

If I were starting the CAP that's the order I would do things in.

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Hunter: Don't think - experiment

Okay, been holding off on commenting here until I had some conversation with Dr. S. The hope that this approach would make the CAPi easier doesn't seem to be holding. It does appear that the pyruvate prior to abxi does generate stronger die-off, suggesting that more bacteria is in RB form rather than cryptic, but over the long run use it doesn't result in feeling better when used constantly. He said that it appears that people are trading "getting hammered by HSPi (inflammationi) for getting hammered by die-off (porphyrins and LPSi endotoxini reactions). All this is clinical observation and not yet proven in the lab.*

I found this myself. My pulses since using the pyruvate have been next to nothing in terms of reactions, but the longer I used the pyruvate the more foggyness seemed to be building up from regular day-to-day antibiotics. I'll try to report some of my latest experiments, but suffice it to say I stopped the daily use of pyruvate.

Dr. S. feels the use of pyruvate would be best used in a pulsed fashion. For example, doing a week of it with the regular antibiotics, or using it with the metronidazolei/tinii pulses. The main interest here is that, when the Cpni drops out of the cryptic state is there anything "cidal" to meet it. In this arena he thinks this would work best if something like rifampin was there to meet it. You can see how complicated this starts to get, at least I started to zone out in my conversation about here trying to hold the logic of the whole sequence together!

In addition, he's seeing that for high-load patients doing a week pulse of low-dose (5-10mg) prednisone with a potent antichlamydial like Levaquin, or Biaxin, or Rifamycin/Rifampin (yes I know all the problems some report about Levaquin, but this is straight from him) is an approach that seems to knock down the load faster while both countering many of the side effects and at the same time potentiating bacterial kill. There is evidence that prednisone potentiates bacterial kill in low doses, although he doesn't see it as strong a potentiator as the pyruvate. So if you are one of those who get really hammered (his term) by NACi or by pyruvate, adding a "pulse" like this might allow you to knock down more of your load without suffering so much from inflammatory effects. It still doesn't answer the porphyrin issue although it would counter some of the tissue damage effects of the porphyrins to some degree.

He did not say so, but by implication it seemed that using pyruvate to counter after-effects of die-off was still fine.  

So, for now, I'm going to use the pyruvate for a week out of the month and for those few times I'm having reactions after taking things. This is still an experimental version of the CAP, so I wouldn't recommend it for newbies without enough experience to sort out your reactions from each other and glean some usable data for decision making. You are certainly on your own here. I have not yet tried the prednisone/rifampin pulse, but this may be on my list. I'll try to post a blog soon on my own recent experiments.

*The Cpn Lab at Vanderbilt will come back into existence, but various miscues and delays, and the slow workings of academic systems have slowed the progress. Once all the bureaucratic ducks are fully in a row (just about now) it will take about 6 months to convert the space, hire the tech's and have a working lab. I was disappointed in how long this is taking, but glad that it is grinding along, although at glacial pace. We are all so pent up to see some real work on this that it rankles to see it delayed. 

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CAPi for Cpni 11/04. Dx: 25yrs CFSi & FMSi. Currently: 150mg BID Roxithromycin, Doxycycline 100mg BID, Tinii 1000mg/day pulses; Vit D2000 units, T4 & T3

What Reenie has said on taking calcium pyvurate:

"That would mean you would feel worse without a pulse because of increased die off but it would mean you would have less cryptic forms and the toxins that accompany them so pulsing would be (should be) easier"

That was my experience in June 2008.

My pure coincidence I am now doing calcium pyvurate in a similar way to Jim  - i.e. not every week at the moment, usually the week or two leading up to a pulse.

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M.E./CFSi 20 years, intermittent.  Wheldon Protocol - Started NACi and supplementsi Sept 2007. Doxyi and Roxy full dose by Dec '07.  First Flagyli pulse January 2008.

Susan- Very interesting! I think your timing of this "a week or two leading up to a pulse" probably ideal for this. It might give a stronger hit for the regular antibioticsi, so not ideal for people early in treatment who are already struggling with this, but may make pulses easier. Only way we'll know for sure is by reports we all are making here.

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CAPi for Cpni 11/04. Dx: 25yrs CFSi & FMSi. Currently: 150mg BID Roxithromycin, Doxycycline 100mg BID, Tinii 1000mg/day pulses; Vit D2000 units, T4 & T3

Jim,

I was only using the pyruvate after and in between antibiotics but like Sunni commenting about taking it throughout the day HERE, I felt like I still got more die off during the bacteriostatic use of abxi or maybe during my 2 day pulse because I was taking 4 gms of pyruvate daily.  

I think the pyruvate may stay in the body longer than anticipated and may keep those cryptics from hiding from the abxi longer than was previously thought.  

Yes, it will be great to have some lab research on this but I think this is another aspect which we ought to consider.  I think the pyruvate might make one feel better AND help with coaxing cryptics back into RB form but it also seems that my understanding and experiences would (loosely) support that if you're using pyruvate, regardless of the timing, you might get a two fold reaction:

1.  more die off w/o pulsing (due to effect on RBs)

2.  some symptom resolution due to the effects that pyruvate has on cellular energy

Oh, and of course all of this would help one deal with pulses easier, I think, so that may be the REAL benefit mainly. 

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NACi 2.4g, Zithi 250mg/MWF, minoi 200mg, Tinii 5day/1g/5 pulses, Valcyte
Iodoral 12.5mg, Supps, CFIDSi/FMSi, Hashimoto's, Psoriasis, PA, IBSi, Sec Addisons

Don't believe everything you think!  

Thanks Jim, I know that must have taken a lot of effort on your part. And as always thanks to Dr Stratton for generously sharing his thoughts.

I have a few questions/issues to ponder:

• I agree with Reenie's comments above - the pre-dose of pyruvate should also energise and reduce symptoms and the post-dose of pyruvate could also theoretically tempt the cryptics out to play.
• What this whole procedure relies upon is an antibiotic gradient, i.e. that its low enough at one point to tempt the cryptics out to play, but then becomes high enough later on to kill them. This is counter to the standard CAPi where we aim for as steady a gradient as possible.
• Since the pre-dose of pyruvate relies on there not being too much abxi already present (otherwise the cryptics won't come out to play), might it be an idea to dose abxi once a day? When I started CAP, I used to dose only once a day, and got a much bigger abx gradient. Not good if you want to prevent replication, but presumably good if you want cryptics to turn into RB's.
• Is Dr S suggesting that rifampin itself can be pulsed, or merely the prednisone is pulsed (whilst taking rifampin consistently)?

I've started taking pruvate myself (in combo with Biaxin & Bactrim DS), so will hopefully add to the excellent observations here soon. Many thanks.

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Hunter: Don't think - experiment

Interesting debate.   I did try following the pyruvate one hour before antibioticsi, but was only able to continue it for about three weeks as the heartburn I tend to suffer got intolerable.   I can't say that I noticed any difference in terms of die off but maybe the pulse that followed was a little more unpleasant than usual, but it is hard to tell with just one pulse.

One thing that did occur recently was that after three weeks of 300mg rifampicin a day, and upon starting the pulse I had a very strong flu like reaction which resulted in a marked fever, abdominal discomfort, sinus pain and lung congestion.   After two days of this I stopped taking the Flagyli, noticed that my urine was very, very dark indeed in spite of the consumption of gallons of water and very little else in that time.  A couple of days later I had recovered enough to continue with my interrupted pulse and had minimal reactions to it, noting in particular that my urine looked normal during the three days I was taking Flagyl.

 

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Michèle (UK) GFAi: Wheldon CAPi 1st May 2006. Daily Doxyi, Azi MWF, metroi pulse. Zoo keeper for Ella, RRMSi, At worse EDSSi 9, 3 months later 7 now 6.5 Wheldon CAP 16th March 2006

Garcia,

Good point about the antibiotics.  I take mine 2x/day so it might be why the timing of the pyruvate may have not mattered as much for me.  The concentration of the abxi may have always been too even to make much difference whether the pyruvate was taken before or after. 

I've d/c'd the pyruvate for now, along with Quercetin too,after realizing Quercetin is also a potent inhibitor of CYP3A4.

 

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NACi 2.4g, Zithi 250mg/MWF, minoi 200mg, Tinii 5day/1g/5 pulses, Valcyte
Iodoral 12.5mg, Supps, CFIDSi/FMSi, Hashimoto's, Psoriasis, PA, IBSi, Sec Addisons

Don't believe everything you think!  

I haven't tried taking it before my abxi because I have to take my thyroid meds then and can't take calcium with it. But I have been taking it a couple hours after abxi and the last few days I seem to have worse die-off symptoms with more pain/inflammationi. So, for me at least, the idea that it could be used to help relieve die-off symptoms by taking it after abx doesn't hold true but, in fact, makes it worse. I suppose that could be a good sign, though, showing it's help bring the buggers out of hiding?

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GFAi - asthmai, sinusitis/rhinitis, tendonitis, low back pain, hypothyroid. Started azi 1000mg/week Jan 9, '08. Increased azi to 250mg/day, added 20mg Benicar daily Mar 13, '08. First Flagyli pulse started June 30, '08. Added Doxyi 200mg/day Aug 16.

I've been taking Pyruvate 1 hour before ATB's (which I take twice daily) for several months.  Can't say I've notice a whole lot of difference.  However, the Flagyli pulses have given me less reaction during this time.

Also, excuse the need for repeating yourselves, but what is the thing that one takes to produce a sure-fire reaction if you still have a CPni load.  I only remember that it seemed like a better gauge of CPn than serum testing.

Garcia, your initial post with the stages is refreshingly clean in it's presentation.  Nice work!

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DD

Dx:CFSi/ME;CPni;Post Polio:  On CAPi since 3/05. Azith 500mg MWF, Doxyi 200mg bid, NACi 1200 mg bid, Calcium Pyruvate 6GM bid, flagyli pulses,  B6, B12, Magnesium/Potasssium 2400/400 dly, Magnascent, Cholestyramine, D3 2GM dly, .