Rheumatic Support

for Antibiotic Therapy

Frequently Asked Questions

Are there any negative results from using Minocin that might occur? (hyperpigmentation, nausea, dizz
Some doctors are fearful of using Minocin as they feel it might cause DIL...drug induced Lupus. Many AP physicians feel this is not so and do prescribe Minocin freely but slowly as they know the herxheimer effect is greater with Lupus patients. This herxheimer effect is what many non AP physicians are actually seeing when they use the term DIL. If the physician feels strongly about DIL then Doryx can be used with excellent results. Minocin is the drug of choice, but for those having any difficulties with it, Doryx or Doxycycline can be used.


Are there any negative results from using Minocin that might occur? (hyperpigmentation, nausea, dizz


Some doctors are fearful of using Minocin as they feel it might cause DIL...drug induced Lupus. Many AP physicians feel this is not so and do prescribe Minocin freely but slowly as they know the herxheimer effect is greater with Lupus patients. This herxheimer effect is what many non AP physicians are actually seeing when they use the term DIL. If the physician feels strongly about DIL then Doryx  can be used with excellent results. Minocin is the drug of choice, but for those having any difficulties with it, Doryx or Doxycycline can be used.  Erthromycin has been used by some ap physicians as well.




Are there other antibiotics that can be used?


Some people that have sensitivities to Tetracyclines use the Erythromycin, which was used decades ago by Dr . Brown. This is also used in children 8 and under as Minocin in young children can cause permanent tooth discoloration of the secondary teeth. Some physicians favor using Zithromax and some favor Doxycycline as well as the Clindamycin. Other physicians add Flagyl and/or Zithromax as it addresses other organisms and can add a boost to the Minocin alone.




Are there various protocols for AP?


There are various protocols for the use of antibiotics. Dr Thomas Brown's work was based on the use of IV Clindamycin followed by Tetracycline MWF, now Minocin the brand. This is still used by many. Many use a pharmacy in Canada for cost reasons to obtain the brand. Other practitoners have used the clinical trial protocol of 100 mg every day 2x a day. Starting this hiigh can cause a huge herxheimer reaction so be mindful of that.



 Other physicians like using the antibiotic for 5 days giving the weekends off,



Another approach is a threefold  used  some  physicians using minocin, flagyl, and diflucan to help with yeast. Other physicians add Zithromax to the minocin as it does help with other organisms.




Can I use AP with other arthritis medications?


Practical experience says yes as many of us were given Minocin while still on MTX(methotrexate) and Prednisone, Plaquinal etc. Many times the Minocin is given at a higher dose (the clinical trial dose) and then, in a few months, the weaning off the other medications starts, slowly, one medication at a time.




Do I need an antibiotic therapy doctor and how do I locate one?


An antibiotic therapy doctor is not always needed as many use their primary care physician with success. To access an antibiotic therapy doctor, post a request on our Bulletin Board and include your e-mail address and we will send physician names to you from your area. We do not post doctor names on the BB. Also, you can email the contacts for the site.




Do I need Mycoplasma testing?


This is not necessary but can prove helpful if you ever decide on seeing a doctor for the IV approach. Having a diagnosis of Mycoplasma infection may enable the insurance to cover costs. Some of us already on AP used the mycoplasma fixation antibody test as there was no washout period needed. If you are just beginning, now would be the time, before you start AP, to get the testing done by PCR. We have recommended labs on this site.




How long does it take on this therapy before seeing positive results?


This varies with the individual. Some see positive results as early as 3 months, others may take as long as a year or two. It depends on how long you have had the disease(s), or other meds you might be taking or have taken in the past. Dr Brown refers to this as failed protocols and cites this as a reason for the amount of time to respond. Also, having co-infections of other diseases will have an effect on response time. Severity of disease has to be noted as well. It is thought too yeast plays a part in no response as wellas allergies. Hormones need to be tested as well.




Is this therapy a cure?


This is NOT a cure, however, it will put you in control of your disease without destroying other organs with the use of toxic meds. Better quality of life is often achieved as well. Some do report remission and are able to go off the drug while others are not. Some ap physicians feel even when remission is reached 1x or 2x a week dosing continues to keep the medication in the system in case of a future flare.




What about supplements?


In our experience, whatever you are taking, stay with them. Add your AP and acidophilus but let your body get used to it for 6 months before adding more. Also, don't think you have to follow using supplements that others are using. Stay with doctor recommendations until you are seeing positive results. Sometimes these temptations to try many supplements can interfere with AP. Many of us did take Milk Thistle from the beginning to ensure the liver enzymes stayed low.     Many doctors do recommend Vitamin B-12, Vitamin D to their patients. Most physicians feel a Vitamin D level (25-OHD) should be drawn before taking Vitamin D.   Nac is also thought to be a big help.



 



There are many other good supplements to augment this therapy but getting the protocol down is key.



 




What adjunct therapies may be considered after being on AP for a while?


Massage works well as it drives the bacteria from the tissues just to be addressed by the AP. Naet for allergies (naet.com), and looking intotesting for sticky thick blood called hypercoagulation  is imperative. Thyroid and hormones must be checked as both seem to affect the protocol and how we feel. Dr Brown felt we must keep all infections and allergies under  control so the antibiotic could work on the rheumatic disease. for example sinusitis, yeast infections etc. Dr Brown used benedryl every night and many of us do as well.



 




What are some situations that need to be addressed when doing this therapy for it to be a success? (
There are several things we as patients have found that were causing us to respond slowly. For others, the therapy was not working well and caused plateauing." Yeast is the first issue we need to look at. It needs to be controlled by diet


What are some situations that need to be addressed when doing this therapy for it to be a success? (
There are several things we as patients have found that were causing us to respond slowly. For others, the therapy was not working well and caused plateauing." Yeast is the first issue we need to look at. It needs to be controlled by diet


What are some situations that need to be addressed when doing this therapy for it to be a success? (


There are several things we as patients have found that were causing us to respond slowly. For others, the therapy was not working well and caused plateauing." Yeast is the first issue we need to look at. It needs to be controlled by diet and or antifungals or anti yeast supplements. Acidophilus is a huge help. Other infections, as well, limit the efect of the treatment. Allergies need to be addressed as the body percieves them as another infection.




What diet should be followed?


This is a very individual area. Many have to watch wheat, dairy, meats, nightshade vegetables, etc. Some do not need any dietary change. Once again, anyone feeling a particular food is triggering a poor outcome with their disease, through a process of elimination, don't eat that particular food for awhile and see if there are positive changes. Rotation of foods helps (not eating the same things each day) as well as an elimination diet. Naet,(naet,com), a desensitization technique, for some has proved effective as it eliminates the allergy totally and the person can consume the foods again without reaction. Reducing the load on the immune system is the key here whatever route you take. Reducing inflammation is necessary as well. Not reacting to certain foods like gluten can reduce the inflammation in your body . It's an approach to think about.



For many of us here reducing the carbs we take in as well as sugar helps enormously as it will not feed yeast. Yeast can be  caused by many things including prednisone estrogen and antibiotics. if  you are like some here who did traditional treatments before this therapy, yeast was a huge problem  as  then there was  a faulty immune system sometimes caused by dmards or biologioc drugs.(Methotrexate,enbrel etc)



With a reduced white count, the immune system is over run with infections like yeast.  Certain supplements are a help like oil of oregano, CDX, candida plus, acidophilus, Grapefruit Seed extract.




What improvements should I look for? Are there any negative effects?


Improvements may be subtle. Perhaps some brain fog has lifted or there is less pain in a particular joint. Fatigue will lift and the mood often picks up. You will experience small windows of feeling better. There is also the possibility of feeling worse before feeling better. We use the expression, three steps foreword, and two steps backwards. There is also the possibility of nausea or dizziness in the beginning, but in most cases this clears within a couple of weeks. Lessening the dose often helps this.




What is antibiotic therapy? (AP)


AP is a low dose antibiotic therapy mainly using the Tetracycline drugs. The theory is to go after the source... Mycoplasma. This has controlled the disease and allowed people to be able to discontinue the use of steroids and Dmards/Biologics while still controlling the disease and in some cases bringing about remission.




What is the Jarisch-Herxheimer Reaction?


It is a short term flare induced by the use of the antibiotics and the toxins being released by dying microorganisms. A change in dose of the antibiotic can also cause this flare to happen. A change in the route of administration( from IV to oral) can cause this or a change in  the antibiotic itself.



Lowering the dose for a short while usually aids in the flare lessening. We have found that lowering other drugs seems to also lend itself to a short herx" as more antibiotic seems to be absorbed and the body "feels" a different dosage. The common one here was prednisone and the other arthritis drugs as this protocl many times is begun while still on traditonal treatment. As the arthritis drugs are weaned, many have reprted a herxheimer reaction as it is thoiught that more antibiotic was absorbed.




What tests are needed as a follow-up by my doctor?


Some suggestions are: CRP, Sed Rate, ANA, Liver Enzymes,  Fibrinogen, CBC, BUN, Creatinine, Anticardiolipin, RF.




Why try antibiotic therapy? How does it differ from traditional treatments?


Why not try it! It has fewer side effects than traditional treatments. One of the most interesting reasons for using this therapy is the rationale that these diseases could have an infectious cause. If that be the case, the antibiotics are addressing the cause. Low dose antibiotics, such as the Tetracycline (Minocin) drugs, attack the source...infection. It is not a band-aid concept but rather a long term therapy. There are great anti-inflammatory properties as well as anti-collagenase properties making this attractive to many physicians. It requires patience and networking with others on this therapy for the best success.