Matthew Goss's Lyme Disease InformationDrugs
I got the names down, drugs were the next thing. There are lots of them
that are used to treat Lyme, Babesia, Bartonella and Ehrlichia. Some abbreviations
commonly used are abx (means antibiotics), tx (treatment), and dx (diagnosis).
Treatment becomes complicated when there are coinfections, that is, if you have Lyme and another one or more of the other bacteria and protozoa such as Babesia or Ehrlichia. Often treatment of Lyme is more successful when coinfections are first eliminated.
One of the more common drugs used, at least in the beginning, is Doxycycline. Doxycycline is part of the tetracycline family of antibiotics, and is effective in treating Lyme and Ehrlichia in the early stages if taken in the proper doses.
Experienced Lyme doctors recommend taking doses of 400 to 600 milligrams per day, or as much as the patient can tolerate (some people who take "doxy," as it is known, get an upset stomach when they first start treatment, but your body will often adjust if you build up to the higher dose). The standard protocol used by mainstream medical doctors has been 200mg per day for 3 weeks, but experienced Lyme doctors have found this dose to be inadequate . The key is to take a bactericidal dose (a dose capable of killing bacteria) that is capable of crossing the blood brain barrier.
Your brain has tiny blood vessels (capillaries) that do not allow many larger moleculed drugs to pass through, leaving a hiding place for the disease away from the drugs that would kill them. If you take a drug that does not cross into the brain, then as soon as you stop taking the drug the bacteria will spread back to the rest of your body and you will be at square one.
Doxycycline is capable of crossing into the brain, and a dose of 500mg per day of Doxycycline is considered enough to be bactericidal. Any lesser dose is considered bacteristatic (bacteristatic means it can stop the bacteria from spreading but is ineffective at eradicating the disease).
Lyme disease is capable of forming a cyst around itself when it encounters a hostile environment, such as when you are on antibiotics. This cyst cannot be penetrated by your immune system and normal antibiotics, and these dormant bacteria can come back to life once you stop treatment.
The theory that has emerged over the past couple of years is that in order to successfully treat Lyme, you must first eliminate coinfections. Once you have eliminated coinfections you must attack Lyme from three different angles: in the blood stream, intracellular, and in its cyst form. This leaves the bacteria nowhere to hide.
Antibiotics from the tetracycline family, the penicillin family, and cephalasporin family are typically used in the blood stream. Macrolides such as Rulid (roxythromycin), Zithromax (azithromycin), and Biaxin (clarithromycin) are used intracellular. Flagyl (metronidazole), Fasigyn (tinidazole) and Plaquenil (chloroquine) are used to combat the cyst form.
An added benefit to combinations of drugs is that it prevents bacterial resistance from developing because they are simply overwhelmed by being attacked from all different angles.
Drug combinations are where the expertise of an LLMD comes in. Especially when treating coinfections whose treatments are not easily tolerated due to toxicity and side effects of the drugs, and when using some of the more toxic drugs that attack the cyst form of Lyme.
Often the dose of these drugs are built up over time, starting with a small dose and slowly increasing it. Other times they are rotated and changed so that your body can rest from the toxic effects of the drugs. Some doctors have developed protocals for these rotations and changes, and they know what works because they have the experience of all of their previous patients.
Common practice says that a patient should be 100% symptom free for two months before stopping antibiotic treatment. If you still have symptoms, you are not cured.
The following table is a list of drugs that are commonly used to treat Lyme disease and the coinfections. The table was compiled using information that people posted to a message board, and reflects the dosages of those individuals that shared their treatment information. The dosages listed are provided as an overview and are not meant to suggest an appropriate dose. If you have any questions about drug doses, please contact a doctor who specializes in the treatment of Lyme Disease.
The Matthew Goss Lyme Disease Information content is no longer being updated by Matthew Goss. A new home on the web for this information is provided by Melissa Kaplan's Anapsid.org Herp Care and CND & Lyme Information. Please report any webpage errors to Melissa Kaplan.
Last Update: 10/22/2004