Protocols

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Treatment protocols for Chlamydia Pneumoniae, usually using combination antibiotics.

Initial and Following Blood Tests in CAP's Treatment

Initial and following blood work is not just a matter of Cpni related indicators, but also relevant to your particular history and case, as determined by your doctor. Suggestions drawn from experts treating Cpn in a variety of conditions include the following.

Initial blood work can be obtained for the following tests:

  1. CBC & Differential
  2. Liver function tests
  3. Uric acid
  4. Serum iron studies (typically depleted by Cpn: low iron levels are more diagnostic, and are not necessariy indicators to supplement, which may actually increase Cpn infection-- see references below).
  5. Red blood cell ALA dehydratase
  6. Red blood cell PBG deaminase
  7. Vitamin B-12 level
  8. Homocysteinei levels
  9. Serum methymalonate level.
  10. Vitamin Di levels
  11. Thyroid panels (standard plus free T4, free T3, revers T3) [Endocrine disturbances common in Cpn and associated diseasesi]
  12. Creatinine
  13. AST
  14. ALT
  15. 24-hour urine and 24-hour stool specimens for porphyrins

Dr Stratton has noted relative to porphyrins:

Reactions to CAP Treatment: That "Kissed by a Dementor" kind of feeling*

Bacterial Endotoxini reactions, Cytokinei (immunei) reactions and inflammationi<

These are often casually. but inaccurately, referred to as “herx” reactions, or scientifically as “herxheimer-like” alluding to the Jarisch-Herxheimer reaction to bacterial toxins specifically from syphilis. All gram-negative bacteria, of which Cpni is one, have contain Lipopolysaccharide endotoxinsi as well as HSPi's (heat shock proteins) which are released as a matter of course during infection and are in part responsible for the on-going symptoms of the infection.

When these bacterial are killed en masse during treatment, they release relatively large amounts of endotoxin, causing significant symptoms especially during initial phases of treatment, as well as when an additional antibiotic agent is added to the protocol. If the amount of endotoxin exceeds the body's ability to get rid of it, these toxic effects can be life threatening. But even in less threatening amounts, the endotoxins and the resulting reactions can cause oxidative stress and damage to body organs.

Stratton Combination Antibiotic Protocol Update: February 2006

Dr. Charles Strattoni writes: 

As far as the ideal Cpni Antimicrobial Regimen is concerned, my thoughts (as of 2/06) are as follows:

Combination Antibiotic Treatment Protocol's (CAP's)

This section covers the most current update of the Combination Antibiotic Protocol's (CAPi's) for treating Chlamydia Pneumoniae. New material includes an updated protocol from Dr. Stratton, his most current observations on protecting the liver during treatment, as well as new charts to help users organize and understand suggested supplementation.

Yes indeed, I have improved!

In an email to me, one of our new members noted how long I'd been on the protocol and asked me if I'd improved on it. It was a legitimate question, and one that on a day to day basis is not always clear to me, since I continue to have symptoms, and the slope of my improvement has been very gradual. As has been said elsewhere on this site by experts, the longer you've had Cpni, the more systems involved, the higher the bacterial load and so on, the longer and more arduous is the treatment. My CFSi diagnosis means that it's been a chronic condition- underline the C in FS.

So I wanted to report my assessment of this based on some recent experience.

Yes, the protocol has indeed helped. I've had this bug seriously (undiagnosed) for at least 20 years, so my tissue loadi was very high to begin with, and I had to go very gradually to get at it. As you can read in my Patient Story, I was not feeling very patient about the whole thing, wanting to push up doses too fast, suffering more because of that, and so on.  The longer you have had it, the harder to treat, the more reactions to treatment, etc. Certainly so for me. And the slope on the curve of improvement is also very low in such cases.

I've reported other changes in my Patient Story and in previous blogs, but had a very clear reference point recently as to how much I've improved. I travel and teach workshops overseas. By Spring 2004 I could no longer tolerate the travel and feel I could deliver quality teaching. I stopped traveling for a year and started treatment in fall of 2004.

Finished 7th pulse

Monday was my 5th and last day of this pulse. Had about two days of feeling achy and fatigued, third day mildly crappy, and the last two days felt much better, more energy.

Now the day after the pulse I have a mild stomach bug and feel fluey, tired and nauseated-- but the same thing has been through other family members, so I know it isn't from the Tini pulse! Just "normal" crappiness. When I told my wife I dismissively that was "just" having a bout of the stomach flu she kindly said, "Well, you  struggle with feeling bad so much, you could use a break instead of getting the flu too."

I have to say that this pulse felt a more difficult than the last one, and I think it has to do with the extra effect of the INHi. Just a suspicion. I'm still only on 150mg of it, and will ramp up next weekend perhaps, but will also be doing the Tini pulses every two weeks, following Dr. Powell's protocol. So there will be a report on my 8th pulse sooner rather than later. 

1st day of 7th Tini pulse: first one on INH

I thought I'd mark this startup of my first day on my 7th tini pulse, and the first one I've taken having added INHi (currently at 150mg). I have no idea what difference being on INH will make, if any. Theoretically, one would think that it's increased potency for Cpni might drive more RB's into the cryptic phase than the other abxi I'm on, making for a bigger die-off reaction on the Tini.

I had about three days last weekend on the INH of feeling a surge of energy and mental ability, then during the week the endotoxini reactions (cold, fatigue, ache) came back. Today on the Tini I had some wave of aches, but feel a bit more energy buzz as I often do in the first hours of a pulse, before the toxin release gets too bad. At least I know that a Vitamin C flush on day 3 usually does the trick. I'll report in as this pulse continues. 

Stratton/Mitchell & Siram Case Reports

Does it work?

It has been noted that most users of the combination antibiotic protocols 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 for Cpni 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.

Much ado about a small poll

Summary of our Cpni Treatment Poll:

The poll was out for two weeks, and represents a snapshot of protocol users at this point in time. We had slightly different numbers participating in each section of the poll, perhaps some questions did not have exclusive answers for those voters. Obviously, 25-28 people is not enough to draw scientifically valid results from, but I intend to speculate on some suggestive patterns in the data.

Gender:
Female: 61% (17 votes)
Male: 39% (11 votes)
Total votes: 28
This ratio is commonly reported in CFSi/FM, MSi and other "autoimmune" diseasesi, so is not surprising. We would expect that if more people with Cardiac diseases were searching out Cpn treatment, with a higher male to female ratio, this might change.

Age:
20-29 years = 7% (2 votes)
30-39 years = 14% (4 votes)
40-49 = 32% (9 votes)
50-59 years = 39% (11 votes)
60-69 years = 7% (2 votes)
Total votes: 28
Our largest group is between ages 40 to 59. I suspect that this age does not reflect the period when people are morel likely to be infected, but rather a range where long term persistent infectionsi are have accumulated enough damage to force us to seek out "desperate measures" such as the multi-antibiotic protocol recorded here.

Primary diagnosis:
Over half the total in the poll have a diagnosis of MS. The second largest group are those with a diagnosis of CFS/FMSi. This likely influences the treatment response reported later which suggest that improvements are noticed most after 5 or more pulses.
CFS/FM = 28% (8 votes)
MS = 55% (16 votes)
Asthmai = 3% (1 vote)
Cardiac disease = 3% (1 vote)
OTHER = 10% (3 votes)
Total votes: 29

Serologyi<
Positive blood test for Cpn
48% (12 votes)
Negative blood test for Cpn
16% (4 votes)
Not been tested for Cpn
36% (9 votes)
Total votes: 25
Well over half either have negative or no serologyi for Cpn, suggesting that they are engaging in a completely empirical (based on symptoms or theoretical connection between disease and Cpn) protocol.

Antibioticsi<
I take AT LEAST TWO of: doxycycline/azithromycin/roxithromycin/rifamcini/minocycline/INHi-: 73% (19 votes)
Single antibiotic only: 20% (5 votes)
I take only INH: 8% (2 votes)
Total votes: 26
This poll speaks for itself. 73% are already on the dual antibiotics, a small number appear to be early in treatment, confirmed by findings below that 40% have not yet done a pulse of bacteriacidal,  and have only added one agent. As INH is used as a single agent with the flagyl pulses in some versions of the Cpn protocol and, together with NACi for the EBi phase I have reported it separately.

Bacteriacidal Agent Used-
I take metronidazolei (Flagyl) for bacteriacidal pulses
81% (13 votes)
I take tinidazole (Tinactini) for bacteriacidal pulses
19% (3 votes)
Total votes: 16

Pulses of bacteriacidal
I've done NO pulses yet of metronidazole/tinidazole
40% (10 votes)
I've done some partial pulses of metronidazole/tinidazole
4% (1 vote)
I have had LESS than 5 full pulses (at least 5 days each) of metronidazole/tinidazole
24% (6 votes)
I have had MORE than 5 full pulses (at least 5 days each) of metronidazole/tinidazole
32% (8 votes)
Total votes: 25
Over half in this small pole have done at least a full pulse of bacteriacidal agent, with only 8 people reporting 5 full pulses or more. This shows that we are still, as a group, in earlier phases of treatment. As the results below suggest, more significant improvement starts to accrue beyond 5 pulses of the bacteriacidal.

Response to treatment-

1. On 1 0r 2 antibiotics ONLY My primary condition is the SAME or WORSE
13% (3 votes)
2. On 1 0r 2 antibiotics ONLY My primary condition is SOMEWHAT improved
13% (3 votes)
3. On 1 0r 2 antibiotics ONLY My primary condition is SIGNIFICANTLY improved
13% (3 votes)
4. Less than 5 full pulses: My primary condition is the SAME or WORSE
13% (3 votes)
5. Less than 5 full pulses: My primary condition SOMEWHAT improved
9% (2 votes)
6. Less than 5 full pulses: My primary condition SIGNIFICANTLY improved
4% (1 vote)
7. MORE than 5 full pulses: My primary condition is the SAME or WORSE
0% (0 votes)
8. MORE than 5 full pulses: My primary condition SOMEWHAT improved
13% (3 votes)
9. MORE than 5 full pulses: My primary condition SIGNIFICANTLY improved
22% (5 votes)
Total votes: 23

These results are more obvious when grouped.
If we collect together everyone in early phase of treatment (#1-6) and we see that 26% are the SAME or WORSE
28% are SOMEWHAT IMPROVED
17% are SIGNIFICANTLY IMPROVED
Actually, to have 35% already reporting any improvement in their condition this early in the protocol is striking to me. I expected less noticeable improvement at this stage, especially given the numbers being treated for otherwise "intractable" diagnoses such as MS and CFS/FM.

But it is when users of the protocol get to 5 pulses (#7-9) or more, in this small sample, that the number in SIGNIFICANTLY IMPROVED seems to begin to creep upwards. Perhaps when we get a better sample of longer term users we will be able to sort out the "magic number" of pulses where more significant improvements take place. From reports in blogs and forums on this site, somewhere around 7-9 pulses seems to be a period where people are feeling much better and more significant changes in their primary diagnosis are occurring.

Take the Two Week Cpn Treatment Poll

I'm trying an experiment with a series of polls that will gather a quick snapshot of cpnhelp.org users experience in treatment. It will only be available 12/30/05 and 1/13/06. Let's see what we get from everyone on a combination antibiotic protocol!

To take the series click on each link below in turn, vote on the appropriate choice, then return here and take the next one in the series.

  1. Primary Diagnosi<s
  2. Serology<
  3. Antibiotics<
  4. Antibacteriacidal<
  5. Pulses<

Finished at 7 Days of Tinidazole

Finished this Tinii pulse after 7 days of it. Thought I was going to do at least a couple more days but seemed to reach a personal limit of feeling "enough!"

Interestingly, I had significantly less joint ache this round, no sacroilliac pain, no hip joint pain, only mild aching in knees and ankles. Mostly I just felt tired, a little sick, little appetite and kind of generally crummy. This is a far cry from the misery and pain I've had on earlier pulses, but did convince me that pulsing is the right thing for me-- a body needs to recover from this stuff!

 It also convinced me that not only do we need to bring the cryptic load down to tolerate this better, and slowly  over time, but that there seems to be some optimal tissue concentration level reached after about 3-5 days which, at least by subjective symptoms, seems to reach deeper layers of tissue like joints, deep muscle layers and so on. I suspect this is true for nervous tissue as well (recall reading an abstract on metronidazolei needing 3-4 days to reach adequate killing concentrations in either brain or cerebrospinal fluid).

Into my 5th full pulse of Tinidazole

Into my 4th day of tinii, this will be my 5th full pulse (at least 5 days full dose--1500mg per day). So far I'm generally achey, but had distinct bursts of energy, lessening brain fog, and ankle achiness. Not the sacroiliac and back pain, and less knee pain than last pulse. So some things are getting easier. It may also be helping that I'm taking a low dose of Benicar (20mg) about every other day. I'll stay with this tini pulse as long as I feel it's useful. Last time I got to 10 days before feeling too loggy with toxicity. We'll see how it goes.

Never give up!!

The beginning of my adventure into life with PPMSi.

I was going to Vandy originally w/ my wife as she had symptoms that appeared to relate to MS,
I started doing a lot of research into MS trying to find all that I could about MS. Well what I was finding related so much w/ what I was experiencing too.

I set out to get a referral with a local Neurologist in a fairly large metropolitan south of where I live. This guy I believe had yet to complete his course at Sears. He scheduled me for a lumber puncture (LP) to be performed at his office. Well the day of the LP came around and I went in to have it done. This guy stuck me not once but three times and misses it all three times. Now mind you my wife was the nurse after the third time he got a little miffed and left the room. My wife had to clean up the mess that he left.

Jim's Blog 11/12/05

I've pushed this latest Tinidazole pulse to 10 days! Mostly because it was giving me more energy and brain power than I'd had in a while. Thought about staying with it indefinitely, but last 2 days have been less energetic and more deep aching in lower back and other joints. Feels like the build up of toxicity is starting to overweigh the improvements. Besides, I'm at a conference and would like to be able to have a beer by the end of the week! You do know that Tini and Flagyli are a no-no with alcohol? Acts just like Antibuse.

This will also help me sort out what effects I'm getting from NACi. I'm pretty sure the burning feet and skin, especially in the mornings, is due to the NAC. Off the tini it will be clearer. 

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