Cpnhelp.org - Chlamydia Pneumoniae Treatment

I've been trying to put down my tentative thoughts on this important subject.

 

Everyone's reactions seem different, and may tell us a great deal about the contracts / treaties which we have made with our microbial tenants.

 

A big reaction to doxycycline / azithromycin likely means that a large population of bacteria were in the active, replicating, fast-metabolizing mode; such persons are often in a frankly toxic state before they started. Myriads of organisms are suddenly prevented from actively keeping their distance from the death-dealing lysosomes, the chambers where proteins are broken down, and die.

 

Few reactions to doxyxyxline / azithromycin may mean that most of the organisms are in the persistent state already.

 

Some people get big reactions to metronidazolei which carry on long after the agent is stopped; this happened in my case. During the second pulse of metronidazole I had very unpleasant bacteriolytic reactions which continued for a few weeks after it was stopped. Reactions to further pulses were negligible. One might infer from this that the organism had, in dying, been presented to an immunei system from which the organisms had been purged. Game over.

 

Some persons get continued reactions to metronidazole for months if not years. These may have a relatively anergic immune system which is compromised by bacterial infection. It is these persons who may benefit from an elongation of metronidazole schedules, along the lines discussed by Chuck Strattoni and Jim K.

 

Some lucky persons never get reactions; for them treatment is as peaceful as a spectator's view of a bowling-green.

 

This is very speculative, based on observations, but it does show that treatment is not a 'one size fits all' thing: therapy must be carefully tailored to be effective on one hand and not to discourage on the other. Any kind of schedule of treatment is only a possible precis.

 

D W - [Myalgia and hypertensioni (typically 155/95.) Began (2003) taking doxycycline and macrolide and later adding metronidazole. Now on intermittent treatment. Normotensive.]

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D W - [Myalgia and hypertensioni (typically 155/95.) Began (2003) taking doxycycline and macrolide and later adding metronidazolei. No medication now; just supplementsi and IR sauna. Morning BP typically 105/75]

David- These are very important inferences. They help us to sort out, even if tentatively, the host-organism interaction that is so much a part of the infectious cycle and is lost in a blanket treatment approach, as well as the possible telltales for understanding our differing reactions to treatment. Rather than ascribe our reactions to "the flagyli" or to "the antibioticsi" it makes more sense to ask how they characterize the infectious state and the host condition. Bravo. I've been looking for this kind of parsing for a while, just didn't have the medical mind to see it.

As we are re-writing the treatment section, I'd like to incorporate these observations, labeled as speculative but reasoned from a medical source, credited also, as they help make sense out of much. You've known how I've long hated the misuse of the term "herx" and used the more general term "die-off" because the former term implies a singular response when in fact there are a number of different ones to sort out: endotoxini (more appropriately called a herx), secondary cytokinei/inflammationi, porphyriai, apoptosisi and immunei clean up, etc.). Broad brush terms tell us nothing about our condition nor about appropriate steps to counter reactions. Your post has added some very useful distinctions.

It's interesting that we have enough anecdotal data available on site and from treatment for a mind like yours to begin to speculate on some possible patterns emerging. 

CAPi for Chlamydia pneumonia since 11/04. 25yrs CFSi & FMSi- Currently: 150mg INHi, 200 Doxycycline, 500mg MWF Azithromycin, 1000mg Flagyl daily (Continuous protocol)

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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

I LOVE how neatly and succinctly this is written! It makes event the most addled mind able to understand.  And I find it very meaningful, cutting right to the chase.  Thank you, DW

Diana

Thanks, Diana and Jim!

Yes, Jim, I'm sure there are many reactions other than the 'Herxheimer'. I think this chronic infection throws so many systems out of kilter that, even after the organisms have gone, these same systems 'hunt' to find their ideal. The organisms have caused many types of cell proliferation which are seemingly addressed for months and years afterwards. (I think there may even be bone restructuring.)

 

D W - [Myalgia and hypertensioni (typically 155/95.) Began (2003) taking doxycycline and macrolide and later adding metronidazolei. Now on intermittent treatment. Now normotensive.]

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D W - [Myalgia and hypertensioni (typically 155/95.) Began (2003) taking doxycycline and macrolide and later adding metronidazolei. No medication now; just supplementsi and IR sauna. Morning BP typically 105/75]

Wow, DW...this sounds very much like what I went thru for a full year after I finished the protocol in early 2004...I knew the infection was gone, but intuitively, I could feel that I needed to bring my body back to proper working order. I felt I was at about 90-95% of what I could be after finishing the protocol.  My immunei system seemed very strong for the first time in many years, energy was good, but strength and endurance wasn't what it should be...this alone, could be attributed to not using the muscles hard for so many years. So, I began to  "fine tune" my hormones, was able to finally bring full strength back to my adrenals (with 4 months of 5mg cortef daily and conitnuing my vites and supps) after having attempted to do that for over 35 years of doing all I knew to strengthen adrenals; I had gone thru menopause at age 53, during the protocol and yet, last Dec. was pronounced by a specialist in gynecology that, not only am I NOT in menopause anymore, but my ovaries are viable and my reproductive organs are like those of a 35 year old woman,  the monthly bleeding I hadn't had in years turned out to be a period (yikes! the first regular ones I have ever had!), what doctors suspected was a VERY abnormal ultrasound for a post-meno woman turned out to be the picture of a very healthy younger woman, when I was sent to a gynecological oncologist for assessment. 

My skin and complexion look better than I can ever remember them looking...my skin is firm again, my color is good, my hair is getting full again, my b/p runs around 120/70, my [cardio]c-reactive protein and cardio homocysteinei levels are both in the lowest risk catagory. My liver checks out as very healthy and normal, my mental state is clear, focused and optimistic, and now nearing age 58, I feel as though I am  finally experiencing  the robustness of health  which I didn't have in my twenties, thirties or forties.

Diana

 

Jim, this is your blog and I'm still in a quandry about beginning continuous "flagylation" treatment as suggested by Dr. Stratton. I guess I'm psyching myself in preparation (for the nasty tasting metronidizole). But DW, your explanation allows such clarity and insight that I have to follow from that "intuitive" place to which Diana refers when discussing her astounding progress to date. 

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CAPi 2/14/06 for Cpni-CFSi/FM/CD

DW, I find this comment interesting: A big reaction to doxycyclinei / azithromycin likely means that a large population of bacteria were in the active, replicating, fast-metabolizing mode; such persons are often in a frankly toxic state before they started. Myriads of organisms are suddenly prevented from actively keeping their distance from the death-dealing lysosomes, the chambers where proteins are broken down, and die. I had such a reaction to Doxy when I added it to Zith pulsing that I spent more than 2 months getting tests for my lungs and heart and in and out of the ER. Everything checked out OK except for a small 3mm nodule on my right lung that the Dr. wants rechecked in a year. I have herxed before a few years back on Minocin but it was more in my joints and had forgotten how badly my lungs were infected. I took 6 weeks off from all abxi and the nightly episodes of air hunger, SOB were still a problem. I think I was still reacting to the abxi. I recently went back on Zith pulses (MWF) and feel better but still have the air hunger waking me at night. I will be adding in Minocin next week, but slowly. Best, Chris CAPi since 11/06 for CFSi. Cpni, Myco P, CMV, HHV-6 infectionsi. Zith 500 mg Tues, Thurs/Doxy 200mg MWF. All supplementsi.

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CAPi since 11/06 for Cpni, Lyme, Bartonella, Myco P, CMV, HHV-6 infectionsi. Doxyi 200mg daily, Zithromax 250mg MWF. NACi 2250mg daily. All other supplementsi.

I quote "David, as always, you are the voice of perceptive inquiry. Woe to us without your generosity of spirit and knowledge." end qoute

Oh my, yes indeed so well put. Brilliant reasoning DW, why did we not all see that- it seems so obvious now! My own experience was one of frustratingly mild reactions to the azith/dox. I was half thinking it was "poor me, no CPn" but when I took NACi... MY GOD! I am not kidding you, it made me very ill, so much so that I believed it must not be NAC flu but rather an actual but super bad flu (nope wrong). I have always wondered how it was that I had so little reaction to the abxi (when some have a terrible time adjusting and have to titrate them in slowly) when it was such a non event for me and at the same time I was so profoundly ill (obviously full of EB'si) with NAC that I was the one titrating carefully and taking my time getting up to dose on that drug. Now it comes clear.
Wow, thank you so much for that. BTW I have been moving towards continuous for some weeks now. Get at those cryptic bugs!
marie

On CAPi since Sept '05 for MSi, RAi, Asthmai, sciatica. EDSSi at start 5.5. Currently on: Doxy 200, Azith 3x week, Tini 2x month, all supplementsi.
"Color out side the lines!"

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On CAPi since Sept '05 for MSi, RAi, Asthmai, sciatica. EDSSi at start 5.5.(early cane) Now 6 (cane full time) Currently on: Doxyi 200, Azith 3x week, Tinii cont. over summer '07, back to pulses of flagyli winter '08 all supplementsi. "Color out side the lines

I want to say thanks to everyone for sharing their experience & comments.  This helps in so many ways & in particular for the newbies like myself who are just crash coursing juniors, trying to get our minds around the plethora of information we need for protocol preparation & staying the course.

I have learned a tonne so far.

You all are great.

My prayers for everyone going through this tiny bit of hell.

With Christ in Faith

Ruth 

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CFIDSi/ME 32 yrs, FMSi, IBSi, EBVi, CMV, Cpni, chronic insomnia, Lymes, HME, Natural HRT peri-M, NACi 2.5 gm, 6-07 Doxy 200 mg day pm, Azith 375 mg M/W/Fday, Pulse#14 1000 mg X 5 days 9-19-08

Question regarding NACi? Since both amoxicillini and NAC do esentially the same thing as far as killing EBi's..has anyone noted a different reaction to NAC vs amoxicilln? I think my son has one...he seems to have no adverse symptoms when he takes amoxicillin or even something similar, like a high dose of Augmentin three times a day...but NAC is difficult for him, even at 600mgs. Could this be? or could I just be seeing some other die-off reaction from one of the other things taken the same day, like doxyi or azith?

There are times when he tolerates zithromax and/or doxy very well...other times, for days on end, he has terrible die-off. I kind of figured that this is like what I experienced...there were times when I was not at all fazed by the drugs, and other times where I would get tired or feverish or wracked with pain. I figured that this happened because higher numbers of certain stages of the cpni were being killed off at certain times when it was particulary bad. But amoxicillin and NAC both attack the same thing....so why would one give anyone a different reaction than the other? 

The other thing that comes to mind is....does NAC work the same  way as amox ONLY for cPn?  If so, and if a person has other co-infectionsi, such as mycoplasms along with the Cpn which they are addressing, then maybe this would be a reason that amox and NAC are experienced differently.  But one would think that, since NAC is friendlier to the liver plus helps feed the cells, it would cause less havoc when one takes it....

In any event...this is what i am presently pondering about : ) any ideas? anyone else with the same reaction?

Diana

Hey Jim, watch how much you flagellate yourself. Someone might take you for one of those medieval monks who roamed from town to town. Bring out the sackcloth and ashes. Seriously, I think I may have lots of cryptic bugs like you. Time to have a talk with my medical advisor. And Diana, I had an amazing thing happen lately with my hormones. I actually began making some in the midst of menopause---had to cut back on the HRT I was taking. My doctor who prescribed the HRT doesn't believe it, but couldn't those ovarian cells have been immortalized with Cpni---frozen in time? And once cleared, began to function somewhat again? Or at the least, released hormones as they went into apoptosisi. Truly amazing--thanks for sharing---thought I was going crazy!! Glad you are doing so well. Hang in there, Jim. You could use an acai and kiefer smoothie right now.Sending good thoughts your way! Raven CAPi since 8-05 for Cpn and Mycoplasma P for MSi and/or CFSi.

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98% well and going for 100! CAPi since 8-05 for Cpni and Mycoplasma P. for MSi and/or CFSi Also EBVi and HHV6 My grateful thanks to all the CAP docs!!!