Why am I so tired after pulsing?

I have been on CAP for 11 months now and have not experienced any real breakthrough against my CFS since I started (I have been through my 7th pulse recently). I know that one have to be patient, and that many of you here have been under this protocol much longer before experiencing positive results. However, we have also to admit that putting so much antibiotics into your body for such a long period still remains a bit strange and tough. In particular, I am still concerned by the CAP's effect on the gut bacteria on the long run.

In that respect, I am still wondering why I become much more tired on average after pulsing (until last December, I was used to pulse for 10 days, as recommended initially by my doctor, and it killed me, I usually do 5 or 6 days in a row now). Indeed, even with shorter pulses, I would still feel much more tired than usual and it could last up to 3 weeks after the pulse.

Therefore, I would have 2 questions:

1/ It seems normal to get more tired because of the Metro pulse since your body has to get rid of the toxins from the killed bacteria. However, I guess that the pulse antibiotics do NOT only target CPN (or Lyme's bacteria), but also potentially a lot of good bacteria from your gut, which would also produce toxins while being killed, isn't it?

2/ How would you assess when your are finally ready to stop the CAP? Indeed, it seems that there is not a strong consensus on that question. If I remember well what I read, we are supposed not to feel any side effect anymore during our last pulses. Would it be indeed a correct way to assess that we're done with the protocol from your perspective?

 

Edit after the initial post: I also forgot to mention that in addition to Metro, my doctor also prescribed me (as recommended by the ILADS's guidelines since he is a "Lyme doctor") to pulse with Amoxicillin (1g 3 x day).

Frederic, you are right about number two: David says that when you cease to feel any side effects, all the pathogens are dead, but as for getting tired AFTER a pulse, I never did, but at the same time, I never pulsed for more than five days.  Maybe the two facts are related?

Completed Stratton/Wheldon regime for aggressive secondary progressive MS in June 2007, after four years, three of which intermittent.   Still improving bit by bit and no relapses since finishing treatment.

After pulses, I was very tired.  I talk about this in my blogs.  After a long while, it was better, and continued to improve over years.  Now, I am back to normal levels and it is wonderful.

Rica

3/9 Symptoms returning. Began 5 abx protocol 5/9 Rifampin 600, Amox 1000, Doxy 200, MWF Azith 250, flagyl 1000 daily. Began Sept 04 PPMS EDSS 6.7 Now good days EDSS 1 Mind, like parachute, work only when open. Charlie Chan  In for the duration.&am

From my experience, it's still very early days for you, Frederic.  Yes, you have to be patient.  We have quite a similar list of infections.  I do recall have glimmers of improvement along the way, but I don't think I saw any real progress until about 2 or 3 years of CAP.  But I had to go very slowly with pulsing - you are doing far better than I ever managed.

Yes, I took amoxicillin as well.  I found it worked well with the other CAP abx.

Perhaps increasing detox would help with the tiredness.  Epsom salt baths or footbaths, drinking lemon water, chlorella, Nutramedix burbur and pinella all helped me.  Also, (if you are in the US) Alka Selzer Gold (it has to be the US version and I found it amazing!).

I never worried about my gut and took abx for 6 years.  I did always take probiotics at least 2 hours after abx, and always timed my evening abx so that I could take the probiotics just before bed, to give them all night to work their magic.  I also drank kefir and kombucha and ate fermented foods such as sauerkraut.

Neuro symptoms & many health problems from 1989. NAC+all supps(04/11) CAP(05/11)

 

I  was getting terrible fatigue during the metro pulses but I learned I have to eat when I take it. That seems to make it not so bad but there is still some fatigue. 

Can someone elaborate on what is a high vs alow titer?

Boadicea, what probiotic did u take? How many cfu’s? 

 I read The protocol is 12 months of full ABX treatment - doxy twice a day, azithro 3 days per week, metro pulse one week of month and then 12 months pulsing them. So is it longer than that?

Trish

2003 Asthma diagnosis - 2004 took doxycycline per Dr. David Hahn work - asthma free. 2014 developed upper body myalgia/arthritis and asthma returned. Dec 2015 c pneumonia bloodwork IGG titer 1:512. Took 6 months of doxy for asthma flare up - again asthma gone but myalgia stayed. Dec 2017, extreme fatigue started. Emailed Dr. Wheldon. Research on cpnhelp.org - Jan 2, 2018 started Wheldon protocol.

Trish - probiotics - I've always tried to go for ones with at least 50billion cultures, various brands, usually bought from iherb, as the ones sold in health food shops here are pretty much hopeless. I also make kefir using kefir grains and I've been brewing kombucha for the last few years.

The 12 months mentioned for the protocol is really a minimum for the full time abx, before going intermittent. Many of us here have needed to take the abx for a lot longer than that though. I think it's quite a personal thing, really depending on bacterial load, how well you tolerate the abx and how well your body detoxes. Personally, I think it is wise to continue for as long as you're still responding to the abx and bacteria is still being killed, and symptoms still improving. I had to go very slowly and I took abx for six and a half years. 

Neuro symptoms & many health problems from 1989. NAC+all supps(04/11) CAP(05/11)

Ok. Thank you for the feedback!

2003 Asthma diagnosis - 2004 took doxycycline per Dr. David Hahn work - asthma free. 2014 developed upper body myalgia/arthritis and asthma returned. Dec 2015 c pneumonia bloodwork IGG titer 1:512. Took 6 months of doxy for asthma flare up - again asthma gone but myalgia stayed. Dec 2017, extreme fatigue started. Emailed Dr. Wheldon. Research on cpnhelp.org - Jan 2, 2018 started Wheldon protocol.