O leczeniu fibro antybiotykami

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Treating Hidden Antibiotic Sensitive Infections in CFS/FMS

by Jacob Teitelbaum MD
Because of the immune dysfunction present in CFS and Fibromyalgia, most of us
have had not one, but many different infections associated with our illness.
These include Yeast/Candida, Viral infections, Parasites, and Antibiotic
Sensitive Infections (including Lyme and many others). Unfortunately, the
tests we have available are largely geared toward picking up early infections,
and miss most chronic infections. We have discussed viral infections and the
problems with lab testing elsewhere. In addition, Professor Montoya will be
presenting his placebo controlled research results later this month on using
Valcyte to treat CFS at the Baltimore HHV-6 conference. I suspect the results
are positive as the drug company offered me $1,500 to come to a meeting
discussing the results (I declined), but I look forward to seeing the results
as we have found Valcyte to be very helpful in those with HHV 6 IgG blood
tests of 1:320 or higher.

The good news is that you do NOT need to treat most of the infections seen in
CFS/FMS. Most of these infections are called "opportunistic", which means they
get quickly eliminated when your immune system gets healthy. Because of this,
treating with the SHINE Protocol will result in 91% of you getting better
without antibiotics (see our research study). In addition, natural treatments
to boost immune function can be very helpful. As your immune system recovers,
your body will eliminate most infections on its own.

Some infections (especially yeast/Candida), however, need to be treated for
you to recover. Some have chronic Lyme, though testing for this is very
unreliable (see Lyme testing). In addition to treating for Candida, Lyme, and
occasionally viruses and parasites, a subset of people with CFS/FMS need long
term antibiotic therapy. I find this is the case if any of the following are
present:

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1. A fever over 98.6°F—even 99°F—and/or

2. Chronic lung congestion,

3. Recurrent scalp sores which scab,

4. A history of bad reactions to several different antibiotics (people
misinterpret the die-off reaction as being an allergic reaction),

5. A history of your CFS/FMS transiently improving in the past when given an
antibiotic,

6. Severe vertigo—this is when you feel like you or the room is spinning in a
circle and is not to be confused with the disequilibrium experienced by most of
us with CFS,

7. Severe night sweats which persist after treating the Candida and hormonal
deficiencies.

If you have any of these, you may benefit from a trial of antibiotics. Let's
look at this further.


How Do I Treat These Infections?

People with these symptoms seem to be more likely to have infections that
respond to special antibiotics. Fortunately, Lyme, mycoplasma and chlamydia
infections, as well as many other infections that are difficult to test for in
CFS, are often sensitive to the right antibiotics. The antibiotics most likely
to affect these organisms are the following:

Doxycycline or preferably minocycline, usually at dosages of 100 milligrams
twice a day. These two antibiotics are in the tetracycline family. They are very
effective against a number of unusual organisms (for example, Lyme disease).
They sometimes cause some stomach upset. If this occurs, take the medicine with
food and a full glass of water or lower the dose. They should not be given to
children under eight years old because they can cause permanent staining of the
teeth.

Ciprofloxacin (Cipro), usually 500-750 milligrams twice a day. Although
expensive, this is usually a well-tolerated antibiotic. It has a very wide range
of effectiveness against a large number of organisms. Cipro has an additional
benefit for men, as it also treats any hidden prostate infections, as does
doxycycline. You should not take oral magnesium or any supplement containing
magnesium within 4 to 6 hours of taking Cipro or you may not absorb the Cipro as
completely. A small percent of the population has a genetic defect that prevents
them from breaking down Cipro. In this group, taking Cipro can actually trigger
FMS and this family of antibiotics should be avoided if you have a family member
that developed fibromyalgia after taking Cipro. Cipro should only be used in
adults.

Azithromycin (Zithromax), 250-600 milligrams a day taken with food, or
clarithromycin (Biaxin), 500 milligrams twice a day, taken on an empty stomach.
These antibiotics are in the erythromycin family. Zithromax tends to be fairly
well tolerated. Biaxin is more likely to cause a bit of nausea in some patients,
but it is usually also well tolerated. They may work against infections missed
by doxycycline and Cipro. Begin with this antibiotic if you have scalp or skin
sores or scabs.
Although all of these antibiotics can be effective, it is not uncommon for
infections that are sensitive to the erythromycin antibiotics (Zithromax or
Biaxin) to be resistant to tetracycline antibiotics (doxycycline, minocycline)
and Cipro, and vice-versa. Therefore, it is best to try either doxycycline or
Cipro first. If they are not effective, then try the Zithromax or Biaxin. The
antibiotic should be taken for at least six months. If there is no improvement
in four months, switch to or add the other antibiotic or simply stop the treatment.

As mentioned earlier, I am more likely to use antibiotics for CFS patients who
have temperatures over 98.6°F, even if it is only 98.8°F (I consider 98.8°F a
fever because CFS/FMS patients usually have low body temperatures). If you do
have low-grade, chronic temperature elevations, be sure that you monitor your
temperature during treatment. If your temperature drops with the antibiotic, it
suggests that you do have one of these nonviral infections and the antibiotic is
helping. This would encourage me to continue the antibiotic trial—even if it
takes up to eighteen months to see an improvement in your symptoms.

If you are clearly better, I would probably take the antibiotic for at least six
to twelve months. It can then be stopped. If symptoms recur, keep repeating six-
to eight-week cycles until the symptoms stay gone. It may take several years of
treatment for the infection to be totally eradicated. To put this in
perspective, this is how long children often take antibiotics for acne—which
unfortunately, if not taken with antifungals, can lead to yeast overgrowth and
possibly trigger CFS. You should therefore take two tablets of the herbal
Anti-Yeast mix twice a day while on the antibiotics. It is a good idea to take
an acidophilus supplement as well. Also, be aware that birth control pills may
become ineffective while you take antibiotics, so be sure to use an alternative
form of birth control.

It is very common to get what is called a Herxheimer (die-off) reaction that
includes chills, fever, night sweats, and general worsening of CFS/FMS symptoms
when the antibiotic first kills off the infection. Many people mistakenly
confuse these with an allergic reaction. These symptoms can be severe and last
for weeks. Stop the antibiotic and let the die-off reaction subside. Then resume
the antibiotic at a much lower dose (e.g., 25 mg of Minocycline every other day)
and work the dose up slowly as able. The Nicholsons, who pioneered this
treatment of antibiotic sensitive infections, note that if you have been sick
for years, it is unlikely you will recover in less than one year of treatment,
so you should not be alarmed by symptoms that return or worsen temporarily.

One more "antibiotic sensitive infection" deserves mention. If spastic colon
symptoms persist after treating for yeast and parasites, consider treating for
"SIBO" (Small Intestine Bacterial Overgrowth), which is common in CFS/FMS and
another key cause of bowel symptoms. Having a low thyroid increases your risk of
SIBO. Research has shown that treating empirically with the antibiotic Rifaximin
400 mg 3x day for 10 days can result in long lasting improvement of the symptoms
of irritable bowel syndrome/spastic colon.45

Unfortunately, most physicians are not familiar with the immune function seen in
CFS/FMS and will not treat if the tests are negative (even though the tests are
not reliable). To find a physician who knows how to treat these infections, find
a holistic doctor or see a Fibromyalgia and Fatigue Center physician. CFS and
FMS are very treatable, and treating these hidden infections is one more piece
of the puzzle!

[jolac171]

Artur pięknie tylko szkoda ,że nie po polsku ale dzięki może ktoś z
tego skorzysta,. bo ja niestety nie...