216 replies to this topic

[Lufega]

This is the study posted by notlupus. It has very important implications...

Clinical effects of fluconazole in patients with neuroborreliosis.
Schardt FW.

Betriebsärztliche Untersuchungsstelle, Bayerische Julius-Maximilians-Universität, Würzburg, Germany. Fritz.Schardt@mail.uni-wuerzburg.de

Eleven patients with neuro-borreliosis had been treated with 200 mg fluconazole daily for 25 days after an unsuccessful therapy with antibiotics. At the end of treatment eight patients had no borreliosis symptoms and remained free of relapse in a follow-up examination one year later. In the remaining four patients, symptoms were considerably improved. At the end of therapy immune reactivity (IgM+) disappeared in three patients. Since borrelia spp. are almost exclusively localised intracellular, they may depend on certain metabolites of their eucaryotic host cell. Inhibition of P450 and other cytochromes by fluconazole may incapacitate Borrelia upon longterm exposure.

[Lufega]

Just realized Funk already spoke about fluconazole in his Lyme thread. Although, I'm still interested in trying this. I've taken diflucan in the past for what I think (thought) is/was candida overgrowth and I always felt better while I was on it. Do we have more info. on Lyme and p450?

Added manganese again. If it does make BB more virulent, then this should speed up immune recognition when added to doxycycline, before I send my sample to Igenex. I should feel like hell again come morning. Im also going to continue taking lithium with doxy. I think the studies that showed doxy can raise lithium to toxicity most likely tested lithium carbonate/citrate. I'm using lithium orotate so in theory, this should make a small dose give me more bang for my buck.

Edited by Lufega, 29 March 2009 - 06:04 AM.

[Lufega]

Wow, that didn't take long. I already feel sleepy and run down. I can't keep my eyes open and I feel like passing out in my chair. Maybe the manganese is doing something else here. I use this formula. I don't think it's the chelated glycine.

http://www.iherb.com...?pid=13270&at=0

I use glycine in high doses and never feel this way.

[Lufega]

The fluconazole study seems promising but I don't like how it didn't mention the subject's liver status during the trial. If I were to try fluconazole, 200 mg for long term, would taking milk thistle be enough to curve any liver problems?

[notlupus]

I found an interesting site, looks like fluconazole is the only strong inhibitor of 2C9. http://medicine.iupu...khart/table.htm

I think I might be ordering some to try. Looks like grape juice and tea have similar effects but not as strong Firefox is screwing up and I'm going to have to restart my computer so I can't post a link right now. It's PMID: 16413247

[nameless]

Pomegranate juice may inhibit 2C9 to a certain degree, if that's what you are trying to achieve there. Of course make sure nothing else you are taking is metabolized by 2C9, or there could be some unexpected consequences.

That manganese product listed above is close to double the UL. Why take so much? And why try to make BB more virulent, if you have an existing heart condition possibly related to Lyme? Sounds sort of dangerous until you know more about your heart issue.

[notlupus]

Looks like Kava inhibits 2C9 as well! dihydromethysticin (DHM) kavalactone inhibits it the most.

Article at http://dmd.aspetjour...full/30/11/1153

I might try the same regimen as the article suggest for diflucan. 25 days. If it doesn't cure it, I might do another 25 day course after a month.

[rwac]

Notlupus, Lufega

Do either of you know how 2C9 inhibition affects Lyme ?

[Lufega]

Pomegranate juice may inhibit 2C9 to a certain degree, if that's what you are trying to achieve there. Of course make sure nothing else you are taking is metabolized by 2C9, or there could be some unexpected consequences.

That manganese product listed above is close to double the UL. Why take so much? And why try to make BB more virulent, if you have an existing heart condition possibly related to Lyme? Sounds sort of dangerous until you know more about your heart issue.

I am deficient in manganese and I also have many connective tissue problems. Manganese has a role in connective tissue function as well as in Dopamine production. You made a very good point regarding my heart troubles. Most antibiotics work on bacteria while they are dividing. This is when they are the most metabolically vulnerable. Borr. Burg. exits in a few forms, one of which is the cystic kind. Taking any kind of antibiotics and anti-bacterial herbs will do nothing to the bacterial load while it's in this form. I am essentially trying to "wake up" these guys and stimulate metabolic activity as much as possible. I have no references to prove that manganese stimulates BB from cystic form to the active forms, it's just a hunch. But this same approach is used in other bacterial infections but more commonly in parasitic infections that like to hide away in cystic form.

I would like to see a comparison of manganese levels in Lyme patients to see if this hunch has any validity.

[Lufega]

I thought I'd lost the paperwork, but it turns out it wasn't hard to find so I'll go ahead and type it now. Things I've been tested for:

chlamydia pneumoniae
epstein-barr (VCA, NA, etc)
CMV
E. Chaffeensis (ehrlichia)
candida
babesiosis
HHV6
M. pneumoniae (mycoplasma)
carnitine levels
celiac panel

This is in addition to all the normal panels.

What were the results of these? I'm specially curious about epstein-barr.

[Lufega]

I just came back from the Doc. My heart problem is worse than I thought. At the ripe old age of 29, I am diagnosed as having grade 1 heart failure almost reaching grade 2 with lung infiltration, dilated bronchiles, all 4 chambers of the heart are dilated and hypertrophied and I have cardiomegaly. My blood pressure was 90/70. I also have aortic notch dilatation surely leading to aortic aneurism. However, I present none of the typical clinical signs for someone with this problem so the Doctor's were stumped. They said soon I will need Digitalis and diuretics. They ruled it out as being "of genetic origin." I guess they've never heard of Lyme carditis.

I'm going to add Ubiquinol 200 mg healthy origins and pomegranate seed extract to my stack.

Sorry to hear about that. What is your ejection fraction at now? And were you prescribed Coreg or an ace inhibitor? Although it's tricky for you, due to your already low blood pressure.

And what diagnosis did the doctor give you for your heart condition?

I wasn't given a diagnosis yet, but reading more about idiopathic dilated cardiomyopathy, that is exactly what I have. Tomorrow I'm having a battery of tests done; EKG, Echo, etc.

http://www.ccjm.org/...1.full.pdf html

I found this article and it's a great read. It lists common causes of IDC of which I have a few like B1 def. previous EBV infection and carnitine def. Also, second-degree atrioventricular block is listed as a cause which I also have. AV blocks are one of the first signs of Lyme carditis. Did your Doctor determine whether you have an AV block? Your EKG should show this. The AV node is made up of connective tissue so it's easy to see how Lyme can affect this. I never tested for Carnitine but supplementing with it for the last few weeks had given so many benefits, I see that I was clearly low.

On a side note, I have aged tremendously in the last two years. This coincides with the start of my heavy supplementation. I wonder how many of the things I take or have taken have increased oxidative stress?

Edited by Lufega, 30 March 2009 - 12:45 AM.

[nameless]

I wasn't given a diagnosis yet, but reading more about idiopathic dilated cardiomyopathy, that is exactly what I have. Tomorrow I'm having a battery of tests done; EKG, Echo, etc.

http://www.ccjm.org/...1.full.pdf html

I found this article and it's a great read. It lists common causes of IDC of which I have a few like B1 def. previous EBV infection and carnitine def. Also, second-degree atrioventricular block is listed as a cause which I also have. AV blocks are one of the first signs of Lyme carditis. Did your Doctor determine whether you have an AV block? Your EKG should show this. The AV node is made up of connective tissue so it's easy to see how Lyme can affect this. I never tested for Carnitine but supplementing with it for the last few weeks had given so many benefits, I see that I was clearly low.

On a side note, I have aged tremendously in the last two years. This coincides with the start of my heavy supplementation. I wonder how many of the things I take or have taken have increased oxidative stress?

That's a great article, thanks for posting it. I just had time to glance over it quickly, but plan to read it in detail later.

The tricky thing about removing 'idiopathic' from the diagnosis is proving any single thing caused it. And barring ischemic causes or some rare things, it usually doesn't even matter, because treatment is the same regardless. Lyme being an exception, but up until recently I didn't know Lyme testing was so unreliable.

I don't recall ever being told I had AV block, but I do remember one doctor telling me I was close to it, but it wasn't quite there yet. I'm not sure exactly what close to AV block means, but I guess it's not exactly normal. When I see an ILADS doc, I imagine he'll want to take a look at my EKGs.

I don't know what you supplement with, but I wouldn't suggest going overboard until you get a diagnosis. My own supplement list is a lot shorter and basic than most here. Also keep in mind that you most likely will have to be put on Coreg + ace inhibitor, at the least, assuming it is cardiomyopathy. And then there are drug interactions to think about too. Due to your low blood pressure, adding medications may be tricky, so your doctors may suggest dropping any supplements that you are currently taking that lowers blood pressure, just so Coreg can be tolerated.

The echo will tell a lot, as will the cardiac MRI, which is even more accurate. Due to your age you will most likely be spared the burden of ischemic testing, such as an angiogram (not a fun test). Best of luck and hopefully the tests will show only minor heart dysfunction.

[notlupus]

I thought I'd lost the paperwork, but it turns out it wasn't hard to find so I'll go ahead and type it now. Things I've been tested for:

chlamydia pneumoniae
epstein-barr (VCA, NA, etc)
CMV
E. Chaffeensis (ehrlichia)
candida
babesiosis
HHV6
M. pneumoniae (mycoplasma)
carnitine levels
celiac panel

This is in addition to all the normal panels.

What were the results of these? I'm specially curious about epstein-barr.

C. pneumoniae IgG and IgA were high
EBV VCA IgM normal
EBV VCA IgG high
EBV nuclear AG(EBNA) IgG really high
Candida IgG negative
CAndida IgA weak positive
Candida IgM equivocal
HHV6 IgG high
HHV6 IgM normal
TSH 0.03
Thyroid peroxidase ab high
thyroglobulin ab high
Gliadin IgG high, IgA normalfd
M. pneumoniae IgM negative, IgG high
low total and free carnitine (total 26 range 31-67, free 19 range 25-55)
Carnitine esters were normal
Lyme PCR was negative

These were all done back in 12/07 by Quest. I'd forgotten about the low carnitine and quit taking it so I'll have to add that as well.

Just trying to correct the deficiencies caused by lyme I'm starting to feel like supplements make up a substantial part of my diet. Forgetting the reason I was taking the carnitine just goes to show you how bad I got while I was off the doxy for 6+ months (my stomach couldn't handle it and valcyte at the same time).

[notlupus]

double post

Edited by notlupus, 30 March 2009 - 02:48 AM.

[notlupus]

Lufega, what dose of carnitine do you use? I'm thinking I might not have been taking enough last time and that's why I didn't notice a difference.

Edited by notlupus, 30 March 2009 - 03:04 AM.

[notlupus]

I'm starting to get really excited about fluconazole. Here's an interview with Schardt, the author of the article on lyme and fluconazole.

http://www.lymenet.i...chardt_2005.htm

[k10]

I'm very skeptical about fluconazole being very effective by itself for lymes disease. I think fluconazole would be a good treatment after a prolonged period of antibiotics, but I doubt that it would cure lyme symptoms by itself.

[FunkOdyssey]

I'm very skeptical about fluconazole being very effective by itself for lymes disease. I think fluconazole would be a good treatment after a prolonged period of antibiotics, but I doubt that it would cure lyme symptoms by itself.

+1

[notlupus]

I'm very skeptical about fluconazole being very effective by itself for lymes disease. I think fluconazole would be a good treatment after a prolonged period of antibiotics, but I doubt that it would cure lyme symptoms by itself.

Have you read the article and info on lyme? fluconazole severely limits p450 function and lyme only has one P450 like enzyme called putidaredoxin so it makes sense to me at least that it'd be one of the things lyme is very sensitive to. Schardt also suggests alternating diflucan with penicillins.

[k10]

I'm very skeptical about fluconazole being very effective by itself for lymes disease. I think fluconazole would be a good treatment after a prolonged period of antibiotics, but I doubt that it would cure lyme symptoms by itself.

Have you read the article and info on lyme? fluconazole severely limits p450 function and lyme only has one P450 like enzyme called putidaredoxin so it makes sense to me at least that it'd be one of the things lyme is very sensitive to. Schardt also suggests alternating diflucan with penicillins.

I read about fluconazole a while ago when I first found out about lyme and all these articles by Schardt. Fluconazole I think is effective, but like I said I don't believe it would work very well as a stand-alone medication for lyme. Schardt himself said fluconazole doesn't kill the bacteria, but he believes it just inhibits the replication. I personally believe the only reason it worked for him is because of a systemic fungal infection which can cause similar vague symptoms as lyme.

Fluconazole is a good medication, but only after you have the lyme bacteria under good control with antiobiotics.

[notlupus]

I'm very skeptical about fluconazole being very effective by itself for lymes disease. I think fluconazole would be a good treatment after a prolonged period of antibiotics, but I doubt that it would cure lyme symptoms by itself.

Have you read the article and info on lyme? fluconazole severely limits p450 function and lyme only has one P450 like enzyme called putidaredoxin so it makes sense to me at least that it'd be one of the things lyme is very sensitive to. Schardt also suggests alternating diflucan with penicillins.

I read about fluconazole a while ago when I first found out about lyme and all these articles by Schardt. Fluconazole I think is effective, but like I said I don't believe it would work very well as a stand-alone medication for lyme. Schardt himself said fluconazole doesn't kill the bacteria, but he believes it just inhibits the replication. I personally believe the only reason it worked for him is because of a systemic fungal infection which can cause similar vague symptoms as lyme.

Fluconazole is a good medication, but only after you have the lyme bacteria under good control with antiobiotics.

Well, since I don't work in an infectious disease lab and can't do the experiments myself we'll just have to guess. It's a guess I'm willing to try, esp. when combined with pen injections and the fact that I've never been on systemic antifungals but had a positive candida IgA and IgM in the past.

[FunkOdyssey]

You notice that the original protocol was simply fluconazole for 25 days, and then it was lengthened to 50 days and now includes an antibiotic known to be effective against Lyme, which represents a huge confounding factor. The efficacy of the current protocol may be due entirely or almost entirely to the antibiotic, not fluconazole. The fact that the regimen did evolve quickly to include a known-effective antibiotic (in the space of less than 75 patients) suggests to me that fluconazole alone is not the answer.

I am also inclined to think he was treating a fungal infection in himself. If you take a bunch of Lyme patients that have been on Lyme-killing antibiotics long-term but still feel crappy, it makes sense that some of them may have killed off the majority of the Lyme only to be dealing with a chronic fungal infection as a result, which now responds to the fluconazole.

Edited by FunkOdyssey, 30 March 2009 - 07:55 PM.

[notlupus]

You notice that the original protocol was simply fluconazole for 25 days, and then it was lengthened to 50 days and now includes an antibiotic known to be effective against Lyme, which represents a huge confounding factor. The efficacy of the current protocol may be due entirely or almost entirely to the antibiotic, not fluconazole. The fact that the regimen did evolve quickly to include a known-effective antibiotic (in the space of less than 75 patients) suggests to me that fluconazole alone is not the answer.

I am also inclined to think he was treating a fungal infection in himself. If you take a bunch of Lyme patients that have been on Lyme-killing antibiotics long-term but still feel crappy, it makes sense that some of them may have killed off the majority of the Lyme only to be dealing with a chronic fungal infection as a result, which now responds to the fluconazole.

The original protocol was for patients that didn't improve after having already had antibiotics, and I think the new protocol is for treatment of lyme patients without prior antibiotic use. I've already been on high dose amoxi for 6 months, it's had time to work and I obviously need something more. The metronidazole isn't it, so the fluco might as well be the next step.

[FunkOdyssey]

My current opinion is that aggressively targeting all forms of the bacteria simultaneously offers the best chance for a successful outcome. Amoxicillin is only active against the spirochetal form and taken alone, should provide the environmental pressure to send your borrelia population into the other two forms where they live to bother you another day.

[notlupus]

My current opinion is that aggressively targeting all forms of the bacteria simultaneously offers the best chance for a successful outcome. Amoxicillin is only active against the spirochetal form and taken alone, should provide the environmental pressure to send your borrelia population into the other two forms where they live to bother you another day.

Even temporary relief would be nice. My symptoms have improved but are definitely still present so there has to be something else going on in my case. Metronidazole was intolerable, so I might as well try fluco while figuring out what the next step should be.

I've also read that andrographis might help with the cystic form, and I'm up to 2 400mg tabs twice a day of that. I'm not planning on it being enough by itself, but maybe it'll help while I get the rest sorted out.

[FunkOdyssey]

I've also read that andrographis might help with the cystic form, and I'm up to 2 400mg tabs twice a day of that. I'm not planning on it being enough by itself, but maybe it'll help while I get the rest sorted out.

Reference?

[notlupus]

I've also read that andrographis might help with the cystic form, and I'm up to 2 400mg tabs twice a day of that. I'm not planning on it being enough by itself, but maybe it'll help while I get the rest sorted out.

Reference?

I've just read it on other forums, mentioned in combo with grapefruit seed extract. I think it's part of buhner's protocol. I'm taking it as a can't hurt/might help sort of thing and might add the grapefruit seed extract as well.

[Lufega]

I'm very skeptical about fluconazole being very effective by itself for lymes disease. I think fluconazole would be a good treatment after a prolonged period of antibiotics, but I doubt that it would cure lyme symptoms by itself.

I agree. I think it should be used in combination as we are already doing. I was surprised to see the candida antibodies show up positive for Notlupus. Fluconazole is a must in her case but keep in mind the liver concerns and add NAC and/or milk thistle. I had a hemoculture done just for kicks and it came back negative. Then again, I'm not sure if all pathogens were covered (bacterial, fungal, protozoa, etc. ) and how exactly they cultured the blood. Does anyone know if the spit test for candida has any credibility? I've been using suggested herbal antifungals for a while now and the degree of "strings" has reduced considerably but it's not totally gone. I have to say I've tested the spit of "normal" people and it has no "strings". Their spit is normal and floats with no residues.

Fluconazole is not too radical of an idea to pursue. I almost considered drinking phenolated iodine. It's supposed to retain the killing function of iodine without affecting the thyroid. I've also considered H2o2 therapy as a means to increase tissue oxygenation, since lyme seems susceptible to increase [O2] but I don't know enough about this to pursue it.

I've been on doxy for a week now but I don't think it's doing anything. I feel exactly the same. However, taking a high dose of venus fly trap or oreganol gives me a herx-like feeling. What's the next antibiotic in the chain? Ceftriaxone, tetracyclines? Once I finish the what doxy I have left, I will try the fluconazole along with my herbals. I need something for this brain fog. Yesterday, after reading about xylitol and how it's toxic for dogs, I went and brushed my chihuaha's teeth with an MSM toothpaste that contains xylitol. Right away, I tried to induce vomiting, gave her lots of milk and fluids and silymarin in honey to combat the hypoglycemia and liver toxicity effects. I'll have to monitor her for a few days. Today she peed all over my curtains while I was out, as usual, so she seems to be fine.

Phewwwww.....

Edited by Lufega, 30 March 2009 - 11:09 PM.

[FunkOdyssey]

What dose of doxycycline have you been using?

[Lufega]

300 mg (This is madness!, Madness?) twice a day, fasted and away from minerals.