There has been some negative discussion lately on this site about using Plaquenil in combination with antibioticsi [3].  Poking around on the internet, I find that this combination is not that unusual.  Also, there's information on the use of it to manage porphyriai [104] symptoms in the Cpni [101] handbook (generic name is hydroxychloroquine).

More particularly, I'm interested in this because someone I know who has Lupus has been taking Plaquenil for a few years and has enjoyed better success with it than with any prior treatment.  She has been reading information on this site and on rheumatic illness sites that present antibiotic treatment information.  She has worked herself up to the full dosage of NACi [62] with nasty die-off reactions.  I'm not sure she would be willing to give up the one best treatment she has used thus far, and if I had Lupus, I might feel the same. One of her great aunts died from Lupus. 

I was diagnosed with rheumatoid arthritis and cfsi [107] about 5 years ago.  I have taken minocin for my rai [75]i [108] for about 3 years and thought I was doing quite well.  I had not really addressed the cfs or c. pneumoniae during this time.  I didn't even mention the cfs to anyone much.  It sounded like a fancy name for being lazy and I blamed most of my fatigue on the rheumatoid arthritis.  The minocin I thought was keeping the ra pretty much in check, but the fatigue had gotten much worse and I decided to start doing everything I could to make some headway in truly feeling better.  I talked my doctor into the protocal for c. pneumoniae and I have just started taking the zithro along with my minocin.  I had already added the NACi [109] of course.  I was wondering if there was anyone here who also had rhuematoid arthritis?  I'm suffering probably herxing from the ra and maybe the cfs at this time.  I'm having some discomfort in the bronchial area and more swelling in joints.  I will add the flagyli [44]i [110] in about 2 more weeks.  I'm not doing my diet as I should and I will try to cut out the white stuff better.  Just wanted to share that treading water with minocin has certainly proved not to be all I should have been doing all this time.  Good luck to all.

My friend Cynthia has costochondritis, and fatigue. She asked me to send some cpni [101] links. While googling, I found this intriguing stub -- but don't have the subscription for the full article.

 

Joint and Bone Infections [112]
JS Axford - Medicine, 2002 - extenza-eps.com
... Chlamydia are coccoid micro-organisms and all three ... C. trachomatis, C. psittaci,
C. pneumoniae) can be ... Acute costochondritis and acute bilateral carpal tunnel ...
Web Search [113] - extenza-eps.com [114] - dx.doi.org [115]

I have culled from Mitchell & Stratton patent #6,884,784 an exhaustive list of diseasesi [40] where Cpni [101] has been implicated as a possible cause or co-factor (reference: Mitchell & Stratton patent #6,884,784):

Diseases where an association has been discovered between chronic Chlamydia infection of body fluids and/or tissues with several disease syndromes of previously unknown etiology in humans which respond to unique antichlamydial regimens include:

Editorial comment: Strong findings from their research. If you have any of these it suggests to me that at least an empirical course of the combination antibiotic therapy is strongly indicated, with or without serologyi [54].

Multiple Sclerosis (MSi [60])
Rheumatoid Arthritis (RA)
Inflammatory Bowel Diseasei [36] (IBD)
Interstitial Cystitisi [52] (IC)
Fibromyalgiai [43] (FM)
Autonomic nervous dysfunction (AND neural-mediated hypotension);
Pyoderma Gangrenosum (PG)
Chronic Fatigue (CF) and Chronic Fatigue Syndromei [8] (CFSi [107]).

Does it work?

It has been noted that most users of the combination antibiotic protocolsi [72] commenting here have not been on the treatment long enough to give a big enough pool of reports to feel assured of the efficacy of this approach. I had asked Drs. Stratton, Wheldon, and Powell to perhaps tally up at least some basic numbers from their case experience to help us out with this problem, but this would involve problems of confidentiality and use of private data, etc.  

Then, I suddenly realized that we already have a good list of anecdotal reports of response to treatment reported data available to us... right in the Stratton/Mitchell patent materials! (Sheepish, embarrassed grin). So I took it as a project to summarize this data by disease treated. Occasionally I have used the exact wording from the patent materials as they were brief and descriptive. We have the full text referenced in our treatment and links if you want to see more detail.

All reported had with positive serologyi [54] for Cpni [101] using the highly sensitive tests developed by Stratton/Mitchell. I left out a few whose diagnosis was not clear to me, you can see them in the patent materials #6,884,784
All on some form of the combination antibiotic therapy protocol.

My daughter sent me a link to http://fm-cfs.ca/2000Abs.pdf [120], which shows that CFS, FMA, and TMD (Temporomandibular Disorder) are associated. Knowing what I do at this point, I googled "Temporomandibular and Chlamydia", and bingo!

Turns out that the connection to C. trachomatis is documented. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&lis... [121]

Hmmm. Wonder if C.Pn can cause TMD, or C. Trachomatis can cause CFS/FMA?

 

Ron 

 

I am trying to connect the dots, and was wondering if I could get an opinion from some of you who have been here a while, and know more about CPni [101].  Several years ago, and I can pinpoint it to within a couple of months, I began feeling "not right".  I was first dx with pernicious anemia after complaining of brain fog and fatigue, then irritable bowel syndrome for chronic unrremitting diarrhea.  These were followed by numbness in two toes, which the neuroi [63] determined was caused by diabetic nueropathy (after three glucose tests, one came up a little off, and he dx'd glucose intolerance).  I beleive I have glucose intolerance, but diabetic nueropathy from it?  Anyway, after that, psoriasis, which I had had problems with for years without knowing what it w

I spoke with a rheumatologist in California, Dr. Michael Powell, who is cautiously using a combination of antibioticsi [3] in conjunction with standard therapeutics for the treatment of nanobacterium (including Cpni [101]) in patients suffering from FM, CFSi [107] and autoimmune disorders. His results with this treatment program have been encouraging. He faxed me some examples of patient feedback forms, excerpts from which you can see below. Recovery is not instantaneous, but tends to occur over a 6 to 12 month period. The graphs of subjective improvement are drawn from visual analogue scores compiled during each visit. When summarized in this manner these data give a time-lapsed impression of the response to treatment.

One of the interesting things he mentioned was in relation to negative patient serologyi [54] for Cpn when other clinical signs lead him to suspect some involvement. Serologic assays for IgGi [25], IgM and IgA are sent to confirm infection prior to treatment. He would like to see a positive serologyi [81] in patients before engaging them in a combination antibiotic protocol, but recognizes that patients may not have antibody reactions. This may be due to the ability of intracellulari [124] organisms like Cpn to evade a humoral response (antibody production), immunoglobulin depletion, or other factors. In these cases, when there is a high index of suspicion for the infection without a humoral response, he tests the spouse of the partner for Cpn. He sees the "non-symptomatic" partner as a good indicator of Cpn in the patient, given the infectious nature of Cpn. Thus far, most spouses are positive when an ill family member is non-reactive.

In our discussion Dr. Powell pointed out the many similarities between TB and Cpn.  Both organisms  can evade our immune system.  Both organisms can be carried from the lungs, the original site of infection, and infect other tissues. Both require prolonged treatment with multiple drugs to eradicate the infection.  Both are sensitive to stress levels. Optimal therapy is being evaluated at various research centers and new medications for Cpn are on the horizon (see activbiotics.com).

INHi [51] and supplementsi [83] for endotoxinsi [10]-
Dr. Powell finds most patients improve on a standard combination antibiotic protocol for Cpn. Rheumatologist have apparently been using doxycycline for many years with success for inflammatory arthritis but there is evidence that using doyxcycline in combination with rifampin is even more effective. Some patients plateau after about 8 months of treatment he has found variations in the treatment protocol have made a difference. One protocol he uses involves the use of NACi [62] 600 mg twice daily, INH 300 mg once daily before breakfast, and metronidazolei [44] 500 mg twice daily pulsed with 5 days on and two weeks off.  It is essential to start each agent separately and gradually increase the dose over weeks or months as tolerated.  The use of Vitamin C 500 - 1000 mg four times daily (the half life of vitamin C is 30 minutes and little remains after 3 hours) to offset the release of toxins during therapy.  B6 is important to control INH related peripheral neuropathy.  Monthly laboratory evaluation of AST, ALT, Cr, and CBC are recommended for all who engage in this protocol.  It is not uncommon for liver enzymes to show a mild elevation during the initial stages of treatment.  Antibiotic therapy should be temporarily discontinued during periods of toxicity, should it arise. He emphasized the importance of insuring that yeast and fungal infectionsi [11] do not overgrow during protracted antibiotic use. He recommends the use of acidophillus, nystatin, diflucan, oregano oil, and/or grapefruit seed extract as needed to prevent secondary opportunistic infection during treatment.

Covering for the possibility of yeast and fungal overgrowth during antibiotic therapy is essential.  If diarrhea develops, stool must be evaluated for antibiotic associated diarrhea (C. difficile).  This is not a simple protocol and it is best if it is guided by an experienced clinician who is familiar with the medications and methods of minimizing toxicity related to killing the nanobacterium.

A link to Dr. Powells clinic may be found on our links page. Dr. Powell does do telephone consultations by arrangement and may be a resource for those who have had difficulty finding a Cpn knowledgeable doctor in their area. He requires an initial visit with a physical examination before initiating therapy (lab work can be performed prior to the initial visit to facilitate diagnosis and treatment), and monthly laboratory testing with monthly phone consults are then the norm. Treatment of related hormone imbalances in the thyroid system and nutritional support, temporary antidepressant support as needed, and sleeping medications are useful adjuncts to the antibiotic protocol. It is necessary for patients to have a primary care physician to monitor health matters that are unrelated to FM, CFS and autoimmune disease.