Cpn Treatment for Rosacea - Red's Story

Submitted by Red on Wed, 2006-10-25 14:18


I thought I'd chronicle my treatment progress for rosacea, etc so others might have this information as reference in the future. I probably should have started this blog at the beginning of treatment but as you all understand, I had my hands full with just getting through treatment in the early days. At any rate, I've tried to piece together my early progress here from early posts and some recollection. And I'll continue updating this blog until treatment is complete. A full tracking of all my posts in chronological order can be found via tracking my Id here:


My primary symptoms include(d): rosacea, seb derm, thermoregulatory issues, folliculitis and/or keratosis pilaris, cluster headaches, ibs, allergies

BTW, I hit the flagyl really hard in my first few months of treatment and then backed off to the standard Wheldon protocol of a 5 day pulse every month later in treatment. I also "monkeyed around with several other OTCs in early treatment. I found that I seemed to function and recover from symptoms much better with the standard abx and flagyl pulse therapy, although since this was in later months it is difficult to determine if this was due to decreased cpn loads, etc. Still, if I were doing this over again, I would choose the slower, standard Wheldon protocol therapy, particularly initially. I now realize that this treatment is as much about minimizing reactions as it is about killing the cpn...

I also seem(ed) to react negatively to many of the supplements on the Wheldon and Stratton protocols, but luckily I found early in treatment that GliSODin seemed to serve me well as an alternative. I've used it as an alternative to the OTC supplements (other than NAC) since early treatment...

Jan '06 - (Month 1)

Started Azithromycin @ first week of Jan with an initial loading dose of 500mg a day for 3 days, then switching to 250mg 3x per week (MWF). I had herx reactions for @ days 2-7 of Azithro (flu-like symptoms of congestion, sinus troubles, headache, fever, muscle aches and exhaustion). Also had stomach/intestinal problems. I actually was pretty much in bed days 2-4. I thought it actually might have been the flu, but it stopped just about as fast as it started. Interestingly, even through the herx, my rosacea symptoms (flushing, burning and p&p's) were much better.

Feb '06 - (Month 2)

I started Doxy @ a first week of Feb, and my face started flushing and burning like crazy within a few hours of the first dose (not unusual for a rosacean). I also noticed more pain behind my eyes (sinus pain), but this was about it. I decided that this might be a new herx reaction and decided to add the NAC (2x 600mg a day) the next day to get over any new herx reaction with it and the Doxy at the same time. Interestingly, my face stopped flushing and burning within @ 20 minutes of taking the NAC. I worried for @ a day that the NAC might somehow be cancelling out the effectiveness of the Azithro/Doxy combo, but then was hit again with the flu-like symptoms I had experienced with the initial introduction of Azithro, probably with even more congestion. I also had a horrible stiff neck which progressed into a really bad headache one day. Also had stomach problems.

I'm assuming all this "herxing" would suggest that Cpn might play a role in my case. Now, @ 1 week after adding Doxy and NAC, I'm feeling much better. I woke up with almost no congestion today, maybe still a little left in my ears (making me a little dizzy still), but much better. I'm still having odd muscle / joint pains (mostly lower arms and legs), and haven't slept well the last week. Still, it seems like the worst is over.

@ 3weeks later...

Well, 4 days into my first pulse of Flagyl, started @ 3 weeks after adding the doxy and NAC, I really hit the wall. I know I probably should have done a shorter pulse (1 dose or 1 day treatment) on my first round, but I felt ok after the first couple of days and decided to carry on. Although I experienced some fatigue (short bursts that usually occurred 2 hours after dosing and lasted for 2 hours or so) and muscle/joint pain on days 1 -2 of the pulse, on day 4, I woke up absolutely exhausted and in fact rolled back over for another 4 hours of sleep (total of 12). When I finally did get up, I was dizzy, feverish and generally "toxic" feeling. By mid afternoon, I started to feel nauseous and within an hour or so I felt like I could toss my cookies at any moment. Only having Vitamin C with calcium in the house and afraid the calcium would interfere with the absorption of some of the abxii, I decided to try some GliSODin after doing some quick additional research to make sure it wouldn't interfere with treatment...

Within 20-30 minutes the nausea was completely gone, and within 2 hours the exhaustion was gone as well. After about 3-4 hours I felt downright giddy/manic and this lasted another 4 hours or so. Interesting as I had taken GliSODin before for my rosaceaii and noticed a much, much milder form of "giddiness". The level of euphoria must be directly related to the amount of ROSi available to be catalyzed by te SOD. I took GliSODin again this morning and have experienced only milder euphoria so far - more like the effects of a good strong cup of coffee.

BTW, with the nausea and extreme fatigue on day 4 of the Flagyl pulse, I also experienced much more facial redness and burning (typical rosacea symptoms), and I also noticed a slight increase of the strange rashes I get during the entire Flagyl pulse (although not as bad as before starting the abx - but these were something the NACi/Doxyi/Azithro combo seemed to be clearing up nicely). I'm assuming (and hoping?) that this is just one of my body's particular reactions to the endotoxinsi.

It's interesting that I'm also getting the muscle aches and joint pains that many of you have as more primary symptoms. although these are generally fairly mild for me. I did experience a slight increase in congestion with the Flagyl pulse, but I would say that most of the congestion I experienced came from the inclusion of the Azithro and NAC and was mostly over by the time I started the Flagyl pulse.

Mar '06 - (Month 3)

@ 1st week of March...

I took another 1.2g dose of flagyli yesterday and was a little achey (joints and muscles) and had some odd muscle twitches last night (mostly in my neck, arms and legs), but woke up feeling well this morning. Given the two weeks of flagyl (400mg 3xper day) and the three 1.2g doses of flagyl, I figure might be somewhere near what I might expect to be at 5 months or so of once a month flagyl pulse and still seem to making some progress.

@ last week of March...

After reading that aspirin and salicylates seem to help kill Cpn, I decided to add 2 regular aspirin a day (650mg total) to my regimine @ 3 weeks ago after I seemed to stop noticing any major new die-off reactions during therapy. With the addition of the aspirin, I noticed a huge increase in die-off reactions which really kicked me in the backside, particularly around my flagyli doses (I'm currently taking two 1.2g doses per week) and particularly for the first 2 or 3 flagyl doses after starting the aspirin. I've since noticed a decreased reaction to it. But, interestingly, I have noticed the aspirin seems to have brought on the "metal" taste that many have reported after taking flagyl (I hadn't experienced this before), and the aspirin seems to have eliminated the buzzed feeling I used to get from the Glisodin.

Apr '06 - (Month 4)

Continued NAC, GliSODin, doxy, azith, combo with flagyl (1.2mg taken twice a week)...

May '06 - (Month 5)

@ 1st week of May...

I did try aspirin for 1 month and found that although I experienced an increase in die-off reaction, I didn't feel that I made much progress with it (if at all) for the extra "pain". So I dropped it, thinking that it was probably just causing more porphyria related symptoms for me than actual killing effect. Since quercetin is also a cox inhibitor, I'm wondering if it would be similar for me...

BTW, I did try artemisinin (200mg per day) for a week while on my regular NACi/Doxyi/Azithro/Flagyli/GliSODin regimine. Seemed to get an increase in die-off (mostly additional muscle soreness and some additional sinus pressure while taking it and then actually a full on NAC like flu the week after taking it - with symptoms increasing right after taking each dose of NAC/Doxy/Azithro/Flagyl, particularly the Flagyl), but may have made a good step up in recovery once the flu-like symptoms cleared. The week while taking it was really pretty much of a breeze, but the week with NAC-like flu wasn't all that wonderful (I've not really had this type of reaction since starting NAC 3 @ months ago or so). It's been a couple of weeks since I tried it though, and I'm thinking of giving it another shot to see if I get the same reaction and then, more importantly, another positive step up.

(Note: as of Oct '06, I have not tried Artemisinin again...)

Moved to standard flagyl once per month pulse of 5 days of 400mg 3x per day.

Jun '06 - (Month 6)

@ 1st week of June...

I've been taking the luteolin in the form of Lutimax lozenges, which contains 100 mg luteolin (along with 10 mg Vit C, 50 IU Vit D, 5 mg Vit E, 50 mg calcium and 100 mg rutin), twice a day for a week now and it seems to be helping quite a bit with symptoms.

The remaining rash on my stomach has cleared up nicely, I have even noticeably less edema in my face, neck and elsewhere, and it seems to have helped clear up the cough that reappeared immediately after stopping the flagyli dose I was taking twice a week (I've decided to go to the standard 5 days a month pulse). It also has seemed to help give me energy (or rather decrease the fatigue), help with some remaining IBSi symptoms, and help eliminate most of the aches and pains I seemed to experience even while off the flagyl.

I did have a glass and a half of wine the other night and noticed that I ended up tossing and turning all night and woke up in a pool of sweat a couple of times, and woke up with a bit of a rash that cleared up quickly, so I don't think I'll be drinking while on it.

All in all, it seems to help pretty well with symptoms and this kind of makes me a bit nervous based on my experience before with things (5-lox inhibitors) that masked symptoms well but seemed to allow these little buggers to multiply underneath the mask. I think I'll tentatively continue using it as it seems to provide benefit while studies seem to suggest it kills Cpn, although I have no idea if it is actually killing any Cpn.

I will also report its interaction with flagyl on my next pulse (I'm due for one, but I'm kind of enjoying being pretty much symptom free right now.) I'm also hoping it helps with the endotoxini die-off reaction based on some of the studies above, but we'll have to see...

(Note: Stopped taking Lutimax after a couple of weeks due to increased restlessness at night...)

Jul '06 - (Month 7)

@ 1st week of July...

As a little background for those who don't already know, while my primary symptoms were cutaneous (rosaceaii and other rashes, etc), I also had major thermoregulatory issues and a host of allergies (including IBSi and asthmai like symptoms), chemical sensitivities, etc. I also recognize now that some aches and pains (including 30 years of cluster headaches) and lack of energy that I had (and assumed where "normal") were definitely related to Cpn (mostly because these same symptoms seem to ebb and flow with abxii treatment, yet they are now mostly gone except during flagyli pulses, as are my other symptoms). Prior to abx treatment, I would experience one to two week long periods every couple of months where all these symptoms would flare in unison, leaving me wiped out with my own flavor of what many of you would probably recognize as NACi flu like symptoms (fatigue, fever, congestion and sinusitis, headache, brain fog, rosacea, rashes, etc).

The reason I mention these symptoms here is, exercise or anything more than minor physical exertion in temps above 65 degrees F, prior to abx treatment didn't just seem to leave me fatigued due to stealing ATP, it would initially leave me with asthma-like respiratory symptoms and heat exhaustion symptoms, and then leave me with as short as a few days to as long as a couple of weeks of NAC flu like symptoms (again fatigue, fever, congestion and sinusitis, headache, brain fog, rosacea, rashes, etc).

I'm wondering if, in my case, since these symptoms were so similar to the die-off symptoms from abx, that maybe exercise (and many of my other guaranteed "triggers" like salicylates, etc) might have been inducing a die-off of Cpn (or at least irritating the crap out of the little buggers) to cause a major dump of toxins into my system. The other possibility of course is that exercise could have increased porhyrin levels, making symptoms worse, but it really seems like there was some increase cytokinei involvement (from what I understand of the difference) given the congestion and sinusitis I would also see as a result of some of my triggers.

Anyway, just a thought. I know most of the members on this site are undergoing treatment for CFS/FMSi or MSi, but Cpn infection seems to have many different manifestations other than those involved with these diseasesi, causing many different symptoms and reactions to treatment and other triggers. It's interesting how many of the symptoms are or can be shared, but if you consider the fact that in a nutshell Cpn causes an upregulated and continuous systemic inflammatory reaction and combine this with some genetic predispositions and / or some some additional co-pathogens, and you can have some major problems in just about any of the body's organs or systems.

The interesting thing related to exercise is that given my particular manifestation(s), after 6 months of abx treatment, I'm now able to exercise daily, and it actually seems to be helping to speed recovery for me. I do stop exercising shortly into flagyl pulses for a few of days though as the flagyl still makes many of my old symptoms return on its own, and exercise only seems to make this worse. Hopefully, soon, this won't be the case...

@ last week of July...

Just wanted to post a quick note about a bad reaction to Acetyl L-Carnitine in case my experience might help someone else identify a possible bad reaction to it...

After reading several posts about how Acetyl L-Carnitine might help promote added energy and reduced brain-fog, and after experiencing a period with mild but annoying amounts of both of these, I decided to give it a try. The supplementsii did seem to increase mental focus, but unfortunately, after two 500mg doses (@ 12 hours apart), I started noticing a worsening of my rosaceaii symptoms (much increased flushing and burning and some increase in rashes) along with a dull headache, sleep disturbances, heart palps and asthmai like lung congestion. It lasted for the three days I continued to take the supplements and cleared up about a day after I stopped taking them (and tossed them in the trash to avoid any temptation to take them again!).

Aug '06 - (Month 8)

@ 1st week of Aug...

I agree that it's really hard to find rhyme or reason in the reaction levels Lee, at least where I'm at in treatment now (btw, I just realized I moved into month 7, yahoo!).

The pulse I took before this last one was a total breeze, with no reactions whatsoever, and I was starting to think I was over the hump and not going to see any new reactions during pulses. Just to humble me though, my last pulse (M-F of last week) included reactions that started @ day 4 in the pulse, got better during day 5 and then worse again @ days 2 - 6 post pulse (mostly morning fatigue, IBSi symptoms and nagging cough for me this time). Why I felt better on day 5 of the pulse and the first day after, I'll never know. I didn't change my diet or supplement routine at all during this period.

FYI, I also find that I personally get kind of moody and a whiney for lack of a better description when I get these type of reactions, and they make me personally start doubting my progress. And even though I'm a firm believer that the cytokinei reactions resulting from Cpn infection and abxii treatment can cause changes in serotonin levels and cause these types of feelings (see cytokines and depression), it's often hard to keep them in mind when I'm feeling, well kind of crappy and down.

My reactions seemed to get better by yesterday afternoon though, and I'm really feeling fine (actually great) again today (and am hoping to stay this way until my next pulse). I am also happy to say using Jim's stock analogy, my overall progress is like a stock in a steady uptrend. This includes a strong trend of higher highs and higher lows in the form of either actual pullbacks or plateaus, with the highs occuring between and just before flagyli pulses for me and the lows or plateaus occuring during and right after flagyl pulses. If I look at it from a longterm perspective (easier done when I'm feeling really good), I can see this trend strongly. If I look at it from every little uptick or downtick (as I tend to do when I'm not feeling all that great) it's harder to see the trend...

I think I'll go for a run this afternon to celebrate what I'm hoping is a victory in my last little battle with these little buggers, and get some endorphins to help mentally prepare for the next one. On to new progress heights!

Also was thrilled to find patient on early anti-chlamydial treatment (an older Vanderbilt protocol) who reported that treatment cleared up their rosacea:


Sep'06 - (Month 8)

@ 1st week of Sept...

After noticing a continuous hacking cough, increased skin rashes, heartburn, a slight increase in stomach troubles and fatigue after my last couple of flagyli pulses (actually increasing with each of the last couple of pulses), I decided this might be due to some effects of yeasts brought on by the antibioticsi (although I've been taking a good probiotic regularly throughout treatment). So, I decided to try taking Garden of Life Fungal Defense as I believe Astrodiana recommended.

Itt contains mostly Oregano, something I was never able to take prior to starting NACi and abxii as it would cause me to flush like crazy. Thankfully, as with many or really most of the other things that used to make me flush, it no longer seems to cause this problem.

Anyway, I took the Fungal Defense according to the directions on the bottle (1/2 dose for 2 days and then full dose for 13 days - while not taking my normal probiotics), and noticed it seemed to help with symptoms almost immediately (within the first day or two), but then I'm thinking it was about a week into taking the Fungal Defense, I got hit with a bout of really horrible stomach troubles (of the kind John has described and then some). It lasted for several hours one evening and I felt weak the next day, but then recovered to finish out the 15 days on the product uneventfully.

The hacking cough, increased skin rashes, heartburn, and a slight increase in stomach troubles and fatigue all seemed to have gone away nicely when I noticed a couple of days after completing the Fungal Defense that my rashes came back again, probably worse than they had been for several months, and I noticed some nasal congestion after my NAC doses which meant to me that it was now killing something again. This continued for a week or so, and I kind of felt like I had taken a couple of steps back in treatment, so I decided after reading DW's page on NAC again to double my dose to the full 1200mg twice a day.

Although I've had transient congestion (for a couple hours after each NAC dose) for a week now after doubling the dose, this seems to be subsiding now, and the extra NAC seemed to clear up my extra rashes almost overnight (definitely within the first couple of days). I now seem to be doing better than ever. Yahoo!!!!

Although I will take the Fungal Defense again if I notice a return of symptoms, I'm hoping the extra NAC might help prevent this from happening again. Based on my experience with the Fungal Defense seeming to cause a bit of a step back in progress, I don't want to take something like it regularly in case it really is hindering progress (it's hard to tell, but I hadn't experienced stuffiness after taking the lower dosage of NAC since early treatment). For now, I'll stick with the probiotic and extra NAC.

@ 2nd week of Sept...

About a week ago I after completing a two week course of an antifungal and then feeling like I slipped backwards a bit in Cpn load (mostly because I noticed I was reacting to a twice a day 600mg dose of NACi again like I had earlier in treatment - when initially starting to take NAC and interestingly, now that I think of it, right after some of my experimenting with things like artemisin, aspirin, etc), I decided to bump up my dose of NAC to 1200mg twice a day. After a week of congestion from this increased dose, this seems to have mostly subsided now, and I'm having some of the same great, almost giddy/euphoric feelings of energy I had early on in treatment that I associated with starting to take GliSODin.

I'm now wondering if this might be due to some combination of the NAC and GliSODin. This morning, after a short (for me) but restful 7 hour sleep, I got up and had my verison of the breakfast of champions - you know, 1200mg NAC, 1000mg GliSODin, a probiotic capsule, two and a half mugs of coffee, and toasted whole wheat bagel with a strawberry jelly schmear. As has been happening over the last several days on this dose, within a half hour, I transformed from the Couch Potatoe Wonder to CAPTAIN ANTIOXIDANTi. I honestly had so much energy that I went for a run, did some house and yard work, paid some bills, and then called up some friends and nearly chatted their ears off, all before 11am!

I don't know about you, but this is unheard of for me. As a child, I put the capital "H" in ADHD, but since I was a teenager, I've been much more likely to be associated with the 's' in sloth. One of my friends who I obviously annoyed on the phone this morning even remarked that he'd like two of whatever I was on. Hmmmm...

It's weird, but I sure feel GOOD! And my skin, stomach, and ache and pain problems seem to all be doing well too. Let's hope this lasts. I'd love to think that maybe I'm just regaining some energy and this is the way "normal people" might react to a couple of strong mugs of coffee - you know, getting a buzz from it instead of needing it just to get moving...

Meanwhile, I'll enjoy feeling like I can leap tall buildings in a single bound for as long as it lasts...

Oct '06 - (Month 10)

@ last week of Oct...

Continuing treatment with NAC (1200mg 2x a day), Doxy (200mg a day in single dose), Azith (250mg MWF), and GliSODin (1000mg a day in a single dose), and flagyl pulse (one 5 day course each month of 400mg 3x per day) and doing very well. Most of my symptoms are now only evident on occasion at this point in treatment, and usually only after an additional die-off reaction due to abx, not being careful with diet (anti-porphyria), etc... I'm very pleased. One thing I've noticed since doubling the NAC is much decreased swelling, particularly in my face and neck, but really from head to toe. My watch now slides easily up and down my wrist and my ankles appear to be much smaller than they were a few weeks ago. Really, my all over body "puffiness" has been dramatically reduced, not that I realized I had all over body puffiness until it seemed to go away...

After reading some posts about food decreasing effectiveness of antibiotics, I decided to try taking my evening dose of abx and NAC at least one hour before food. I noticed a fairly good sized die-off reaction that seemed to culminate @ 3-4 days in with additional rash, some rosacea flushing and burning, nausea, dizzyness, and fatigue. Now @ 1 week into this, the effects have subsided and I'm feeling great. Extra rashes, etc have now gone away as well...

I tried taking doxy and azith without food in early treatment, but I could not due to much more violent of the many of the ill effects mentioned above. It seems that many of these ill effects from taking these abx on an empty stomach may be related to cpn load at least for me...

Nov '06 - (Month 11)

@ last week of Nov...

Am currently feeling great...

After experimenting a bit with my dietary carb and sugar intake recently to see how I seem to react to different levels of carbs/sugars, and after a couple of weeks of a lower carb/sugar diet, a week on a higher carb/sugar diet, and a couple of days back on a lower carb/sugar diet, I definitely notice quite a difference:

lower carbs/sugars: less congestion, less flushing, less swelling, less rashes, slightly increased facial burning, slightly increased fatigue, and slightly increased aches and pains (including tendency towards slight headache)

higher carbs/sugars: more congestion, more flushing, more swelling, more rashes, less facial burning, less fatigue, less aches and pains (including headache)

I decided to try another round of Fungal Defense to see if it would help resolve these symptoms, and after completing another 14 days of Fungal Defense, they have resolved nicely. My normal monthly 5-day flagyl pulse overlapped with the 14 day Fungal Defense round, and although it may have made the flagyl pulse slightly more difficult (with increased fatigue mostly), @ 11 months into abx treatment, the side-effects from both the Fungal Defense and flagyl pulse were pretty mild.

I'm thinking at this point that I may include 5 days of Fungal Defense during my normal 5-day flagyl pulse each month in order to make sure any potential fungal problems remain at bay and in order to assure that I have 3 weeks to recover between the combined 5-day flagyl and Fungal Defense pulse each month.

Also, after reading on this site about the many positive effects of Vitamin D3, I started taking 4000 iu of Vit D3 daily yesterday. I'll post more on my results with this in my next log entry...

Dec '06 - (Month 12)

After starting taking Vit D3 the last week of Nov, and I had initial very positive reactions, including decreased inflammationi (in form of rosacea/rash symptoms, congestion, aches/pains, etc), increased energy, mental clarity, etc. These positive effects seemed to show up within a day of my initial dose and continue building over a couple of weeks.

Jan '07 - (Month 13)

@ 2nd week of Jan...

Gradually the positive effects of Vit D3 began to fade, and by the last couple of weeks, I started to associate the Vit D3 supplementation with an actual increase in fatigue. In fact, I am probably feeling more fatigued than I have in several months. I also caught a cold a couple of weeks ago, and just could not seem to get over the congestion, which included blood in my nasal discharge. I may have noticed an increased tendency towards skin rash too over the last couple of weeks.

I tried additional magnesium supplements which initially seemed to help with these new symptoms, but determined that after only a couple of days it seemed to cause stomach cramps and headache so discontinued its use and concentrated instead on getting enough sleep to help minimize the fatigue. I often seem to have the odd negative reaction to supplements, so my personal odd reaction to magnesium is not all the surprising to me. It may work very well for others...

Feb '07 - (Month 14)

@ 1st week of Feb...

I just completed my 2nd flagyl pulse since starting the Vit D3, and let me say, it was probably as difficult as some of my earliest flagyl pulses, much more difficult than any I've had in the last 6-9 months anyway. I had nausea after the 2nd dose on my first day, pretty major muscle and joint aches, IBS issues again like I haven't had in quite a while, a horrible headache by the end of my 4th day, and had to sleep in late on my 5th day. All in all, one tough pulse.

I thought I had been noticing a bit of a reaction (extra congestion, a bit of that dizzy/sick sort of feeling) a couple hours after taking my daily doxy, and particularly on the day when it was combined with the azith this last couple of weeks. Now, after this last flagyl pulse, I'm pretty convinced that the Vit D3 is accelerating the die-off reactions fairly dramatically (which is good news in my mind)...

The additional good news is that 2 days after the pulse, I have recovered nicely and seem to be back on track towards continued improvement...

Mar '07 - (Month 15)

@ 3rd week of Mar...

After adding 4000iu of Vit D3, the 4th flagyl pulse was not quite as bad as the 3rd, so I'm hoping the effects of Vit D3 have peaked. One other thing is that, for me, the Vit D3 has not only made the days during a pulse more difficult, but it has also seemed to greatly increased the after pulse recovery time, making many of my symptoms (congestion, fatigue, etc mostly now) show up for a good week or even two following the pulse, whereas before they only seemed to last a couple of days, particularly at the point in treatment that I was where I had seemed to plateau on just the antibiotics (I started Vit D3 @ 11 months into treatment).

Apr '07 - (Month 16)

@ 2nd week of Apr...

My last flagyl pulse seemed to be much easier and recovery much quicker than the previous pulse so either the effects of 4000iu of Vit D3 have peaked for me or since I combined my normal 5 day "pulse" of Fungal Defense (mostly oregano) with the last flagyl pulse again (I had not been doing this over the last several pulses), potentially the oregano dampens some of the inflammatory effects of the flagyl pulse. Potentially it's partially some combination of both.

Anyway, I seem to be seeing and feeling continued improvements...

On Combined Antibiotic Protocol for Cpn in Rosacea 01/06 - 07/07, On Vit D3 + NACi since 07/07 and daily FIR Sauna since 08/07


As an added note, at this point, although I still have a ways to go in treatment, I just can't explain how glad I am that I stumbled across the study linking Cpn and rosaceaii and then this site, where I have found such positive, supportive people who, even while treating their own illnesses, have always taken the time to cheer me along and answer my questions along the way.  If I were still feeling like I did last year or even worse, I'm not sure how I would have handled it.

I put the rosacea chronicles together hoping to help other rosaceans in treatment in the future, particularly to help them (and those with other illnesses) get through the initial worsening of symptoms. As you can see in my chronicles (although sometimes you have to read between the lines or follow the tone), I often felt like total crap in early treatment, and even @ 5 months in I was still talking about worsening symptoms, depression and doubts during flagy pulses.

CAP treatment is tough, and it's certainly not like traditional anti-inflammatory therapies where you often just start feeling better due to the anti-inflammatory effects, even while possibly allowing the infection to get worse by suppressing the immunei reaction with these anti-inflammatories. With CAP treatment, you are killing off the Cpn, not just suppressing your immune reaction to it, and you will feel at your worst if not actually worse before you feel better.  You may even recognize a few odd symptoms during treatment that you had not even associated with Cpn infection initially.

Obviously the faster you go in treatment, the more Cpn you kill, the more endotoxinsi you release into your system, and the worse you will feel.   The answer to why during treatment you feel worse, then better, then worse, then better in a sometimes not all that apparent uphill climb to eventual good health, to use the popular phrase, is simply, "it's the endotoxins, stupid".   

So IMHO, you really want to take your time and manage your reactions during slow and steady treatment.     When you start feeling a little better in early treatment, the natural tendency is to rush.   Hear me now and believe me later, resist this urge at all costs, and give yourself time to heal during  slow and steady treatment.   And when times are tough, reach out to the cpnhelp community for some support and reassurance and continue on in treatment, knowing that you will get better with time as others have done before you...

On Combined Antibiotic Protocol for Cpn in Rosacea since 01/06

Treatment for Rosacea

  • CAP:  01/06-07/07
  • High-Dose Vit D3, NAC:  07/07-11/08
  • Intermtnt CAP, HDose Vit D3:  11/08-01/09
  • HDose Vit D3, Mg, Zn: 01/09-



You are an inspiration to not only people who suffer from rosacea but to all of us.  I read your posts with interest and find many things in common.  Plenty of work went into your research. Good Job.


 sjogren's diagnosed 2/03, 200mg minocin daily, mwf zithromax, flagyl every 3 weeks all supplements


200mg doxy daily, 500 zithromax mwf,flagyl 1000 m-fri.rifampin 2x daily,chloestryramine 2x daily

Echo yahoo, Red!  Wonderful progress, well described and well written.  Congratulations on all this and I would bet it will last a lifetime with even more improvement.  So, so happy for you! You have earned it.

Rica        EDSS 6.7 at beginning - now 2
Ignorance is voluntary bad luck.  Lauritz S.   A true Viking
If you come to a fork in the road, take it. Yogi Berra

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

Red, I might be totally making this up, but I think zith may actually be more completely absorbed with food (especially fatty food?). I am really unsure about that, but it should be pretty easy to find the abstracts on google scholar, of the studies where they actually made the measurements.

Of course, there is the possibility that the speed of absorbtion might make some difference to the effects on pathogens, and the speed might be reduced when its taken with food. If one is taking zith regularly, then each given dose is not going to have much effect on the intracellular zith concentration, which will already be quite high as zith has such a long half-life. However, each given dose may have a significant effect on the extracellular zith concentration, which is pretty low one each dose gets sucked into cells.

Actually, the same thoughts I'm having about the extracellular space might apply to the cell body, as after a zith dose "settles in" it may be mostly in the lysosomes. It is definitely concentrated in the lysosomes, but I do not recall whether it is so concentrated in them that the bulk of the drug ends up in them. Or maybe no one is really sure.

Anyway, these effects likely make a really small difference, if any, so there's probably no reason for anyone to go so far as to take abx in a way that's nauseating (except of course as far as the standard medical recommendations go, of course; you don't want to take INH with food for example). Personally I've got an iron stomach for zith and tini, but with doxy I definitely need substantial food.


Cpn Treatment for Rosacea - Red's Story Continued...

Updates moved to inital blog entry above... 

On Combined Antibiotic Protocol for Cpn in Rosacea since 01/06

Treatment for Rosacea

  • CAP:  01/06-07/07
  • High-Dose Vit D3, NAC:  07/07-11/08
  • Intermtnt CAP, HDose Vit D3:  11/08-01/09
  • HDose Vit D3, Mg, Zn: 01/09-

Again, beautifully written and it resounds so in my own mind. Your experiences parallel my own closely. It really makes it easier to accept the regressions once you have established and observed the rhythm of your reactions. Every time someone benefits from this is such a wonder. Thanks for writing.


Rica PPMS  EDSS 6.7 at beginning - now 2.  Began CAP Sept, 2004 with Rifampin 150 mg 2xd, Doxy 100 mg 2xd, added regular pulses Jan 2005. Jan 2006 switched to Doxy, Azith,  cont. flagyl  total 39 pulses NC USA

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


Cpn Treatment for Rosacea - Red's Story Continued


May '07 - (Month 17)

I'm finding the effects of Vit D3 to still be cumulative. I'm now 5+ months on 4000iu on Vit D3 + CAP, and I'm finding that even between pulses now (I'm actually due for one now but have company out and don't want to subject them to me on flagyli) I'm now getting major die off symptoms - aches, pains, fatigue, more fatigue, etc. My skin is a little more reactive and burning, but luckily I'm not having any major problems with rosaceaii. But many of these reactions remind me of the reactions I was getting in pulses @ 6-8 months into treatment, and they seem to be permanent again now. Not pretty really...

I'm thinking this next flagyl pulse is going to be quite a doozy. So I'm trying to mentally prepare myself for it. Something wicked this way comes...

Jun '07 - (Month 18)

@ 2nd week of June

I started taking @ 4000iu of Vit D3 for the first time @ 11 months into treatment. At the time I started, I was doing really well. Many / most of my particular symptoms had resolved for the most part and I was full of energy. I took the Vitamin D3 for @ 6 months, and seemed to progressively get more and more fatigued (and more and more of my other symptoms - rashes and aches and pains seemed to kind of sneak back in too, but fatigue really was the biggest problem).

About 3 weeks ago I stopped Vit D3 because I felt the fatigue had become overwhelming, and within a couple of days I started feeling better. Now, @ 3 weeks later, I'm feeling much, much better again. I'm thinking better than before I started taking Vit D3 now almost 7 months ago.

So, I'm thinking the Vit D3 really was working in my case, but at the cost of some pretty hefty die-off / porphyria symptoms (I'm really thinking porphyria and have discussed it in the recent Porphyria thread). BTW, I'm hoping to get back on Vit D3 soon as I really do think it is a very important part of treatment. I'm actually even more convinced now that I feel better after being on it for 6 months.

Jul '07 - (Month 19)

I don't want this to confuse any newbies out there, but I've been doing a little experimenting over the last couple of months and thought I'd report the results just in case it might help others.

First, a couple of months ago I came to the realization that my 6+ months of supplementation with 4000iu Vit D3 / day (in addition to Wheldon protocol CAP) had made me so fatigued that I could no longer really function very well. I also was experiencing additional rashes, aches and pains, sleep troubles, brain fog, etc. I assume this was likely due to secondary porphyriai as paying careful attention to a high carb diet + plenty of glucose tabs seemed to help it somewhat, although certainly not completely.

So, I stopped taking the Vitamin D3 altogether and seemed to see relief from symptoms (again the fatigue was the big thing) within a couple of days. I stayed off the Vit D3 for @ 3 weeks and by the end I felt pretty great again.

I wanted to get back on Vit D3 again though, so I added it back in. Almost immediately I was hit with sleep troubles and fatigue again, but I noticed (after stopping again) that this seemed to last only a day or two after the Vit D3 dose. So, for three weeks, I tried taking the Vit D3 in a once a week large dose (28,000iu once a week) to see if I could avoid most of the sleep difficulties (and therefore much of the fatigue). It seemed to work well for the first couple of weeks, but after @ 3 weeks, the symptoms listed above reappeared again, I'm assuming after my blood levels of Vit D3 had built back up.

About a week ago, after much consideration and realizing that I added Vit D3 into my regimine last November after seeming to plateau after @ 11 months of CAP, I decided to go off CAP and just try Vit D3 + NACi for a period of time, potentially going on intermittent CAP along with this. Two days after stopping CAP, all the above symptoms resolved again, and I was able to increase my Vit D3 dosage first to 8,000iu and then to 10,000iu / day. So far, I am feeling great, with each step up in Vit D3 dosage actually giving me more energy and feelings of well-being rather than the oppoosite as it seemed to do when I was on CAP in addition. I also may be noticing a little improvement over CAP only already in terms of IBSi issues, nasal congestion and skin rashes, aches and pains, etc.

I'm going to give myself a few weeks on 10,000iu Vit D3 + 2400mg NAC / day to see what type of improvements I make before deciding how to proceed with intermittent CAP. I may have to lay off the Vit D3 for the 10 days while actually on the intermittent CAP. I may of course also go back to CAP without Vit D3...

I hope nobody reads my post above and thinks that I am doubting the benefits of CAP for those diseasesi/disorders that have been linked with Cpni via study. Quite to the contrary, I give CAP full credit for what I consider my own amazing recovery last year.

It was just that in my own case, I seemed to plateau a bit in recovery between months 9 thru 11 and then decided to add 4000iu Vit D3 daily. After 6 months of CAP + Vit D3 I just seemed to continue to backslide in terms of symptoms. And after withdrawing the Vit D3 for several weeks, I popped right back up in terms of levels of improvement, but I in my own opininion, I don't think that I had actually made much ground in terms of where I was prior to starting Vit D3 6 months earlier, certainly not enough to balance against the amount of "pain" I had gone through.

Thinking that perhaps the combo was too much and not allowing for enough recovery, I thought I'd try just high dose Vit D3 + NACi for a bit to see what happens. And while I have found that I seem to be improving a bit while on it in terms of many symptoms, I also seem to notice increased sinus drainage and a couple of other odd symptoms that I didn't get while just on CAP that make me think possibly the Vit D3 is reaching something that CAP alone wasn't. Perhaps some other co-pathogen. Who knows...

Again, I thought I'd give high dose Vit D3 + NAC a try for a bit, and I may try to combine it with intermittent CAP. Or I may go back to CAP without Vit D3. The only thing I know for certain is that CAP + Vit D3 is too much for me to handle..

Aug '07 - (Month 20)

@ last week of August...

Continuing with Vit D3 (currently 6000IU daily) + NAC (2400mg daily). Added Fir Sauna (30 minutes daily) starting first week of August and am doing very well.

I have noticed that when I get a big die-off reaction still, some rosacea-like symptoms appear for a short period again, but disappear very soon after. For all intents and purposes, my rosacea symptoms are now gone, but I'm still very careful about how aggressive I am with my current regimine. Too much die-off, caused by too high a dose of Vit D3, or too aggressive use of FIR sauna mostly gives me fatigue at this point, but it also can stir up rashes and a very mild version of some of my old rosacea symptoms...

On Combined Antibiotic Protocol for Cpn in Rosacea 01/06 - 07/07, On Vit D3 + NAC since 07/07 and daily FIR Sauna since 08/07

Treatment for Rosacea

  • CAP:  01/06-07/07
  • High-Dose Vit D3, NAC:  07/07-11/08
  • Intermtnt CAP, HDose Vit D3:  11/08-01/09
  • HDose Vit D3, Mg, Zn: 01/09-

Thanks Red for putting all you story in one place.   It makes interesting reading and illustrates very clearly the progress of your recovery and your experience with the ABX.

Although I do not have rosacea, but replace rosacea with alopecia and your journey reflects mine as the other symptoms you suffer are also mine.   Like you I have found that increasing certain elements of the protocol do bring on more reactions, and sometimes I feel as if I am starting all over again, the difference between now and the beginning of the treatment is that I now have much more hair than I used to, but at the same time it is still falling out... 

The stories of patients (especially older patients) illustrates the collateral damage of a Cpn infection. There are people who are unlucky enough to have MS and CFS who unfortunately get disabled earlier on in their life as a result of Cpn, but there is a multitude of other people who suffer less debilitating diseases such as mild asthma, sinusitis, IBS, and who as the get older display signs of disabling conditions such arthritis, diabetes, peripheral neuropathy, parkinsons and alzheimers.  

The more stories like yours are know the more likely it is that doctors will take notice of these seemingly disparate symptoms and start learning about Cpn and the available treatment for it. 

Michele (UK) GFA: Wheldon CAP1st May 2006 . Daily Doxy, Azi MWF, Flagyl at 400mg for 7 days prior to 5 day pulses at 1200mg three weeks cycle. Spokesperson for Ella, RRMS Wheldon CAP 16th March 2006

Michèle (UK) GFA: Wheldon CAP 1st May 2006. Daily Doxy, Azi MWF, metro pulse.

thanks Red,

great information & inspiration.  I have mild rosacea which pops up on my nose & I have been having scalp issues for a number of year.  I hope these too will be addressed as well as my other health issues sometime down the road.


CFIDS/ME 25yrs, FMS, IBS, EBV, Cpn, (insomnia - melatonin, GABA, tarazadone, temazepam, novocyclopine, allergy formula, 2 gm tryptophan), Natural HRT peri-M, NAC 2.5 gm, 6-07 Doxy 200 mg day pm, Azith 250 mg M/W/Fday, 8-21-07 1st pulse 1 X 250 mg Metro

CFIDS/ME, FMS, MCS, IBS, EBV, CMV, Cpn, H1, chronic insomnia, Chronic Lyme, HME, Babesia, Natural HRT-menopause, NAC 2.4 gm,Full CAP 6-2-07, all supplements+Iodorol, Inositol-depression, ultra Chitosan, L lysine Pulse#27 04-19-10 1gm Flagyl/day-5 days<


Nov '08 - (Month 35)

Sorry, I've been remiss in keeping my blog entry current...

To summarize the 15 months between my last blog entry in Aug '07 above and the present, I continued with high-dose Vit D3  + NAC (2400mg daily) + FIR Sauna therapy, slowly increasing my Vit D3 levels to 10,000iIU, only increasing these levels after most of the reactions from the previous increase had stopped.    I reached 8,000IU of Vit D3 by @ November '07 (Month 23) and then 10,000IU by @ January '08 (Month 25).  This last jump was a bit too quick, but I stuck with it...

Over the next 9 months or so, I continued to have decreasing reactions and increased health improvements from this alternative treatment plan and continued to see a drop off of the secondary porphyria that seemed to cause such difficulties for me.

By September '08, I began to feel that I was ready to add another agent to my treatment, and I first tried Iodoral.   At first, the Iodoral seemed to give me increased energy and no negative reactions, but after a couple of weeks it seemed to cause adverse reactions of additional fatigue, skin rashes and weight gain.    Due to these side-effects, and particularly the weight gain, I stopped Iodoral after a month.

It took another full month to shake the side-effects of the Iodoral (although after 6 weeks + I'm still trying to shed some of the addional weight!),  but again I began to feel that I was ready to add another agent to my treatment.    I decided to add the intermittent CAP on top of the high-dose Vit D3 therapy and see how it went.    

So far, so good.   I am now at the last day of the 5 day course of metronidazole and the 8th day of a 10 day course of Doxy and Azith, and all is well.   

In fact, I'm glad to report that I've experienced only minor fatigue, aches and pains, etc and really none of the heavy reactions that I reported in May and June of '07 above when I was on CAP + only 4000IU of Vit D3, all while now taking 10,000IU of Vit D3 through the intermittent pulse.    It would seem that I've made some really good progress while on the alternative protocol over the last 15 months.   I sure am feeling better these days...

Anyway, I'll continue on the daily 10,000IU of Vit D3 and continue doing monthly intermittent therapy for awhile to see if I can't get additional improvement.    Hopefully this will be the case as I'm still continually amazed at how much better I can feel as I continue to kill off this infection...

More later...

Treatment for Rosacea

  • CAP:  01/06-07/07
  • High-Dose Vit D3, NAC:  07/07-11/08
  • Intermtnt CAP, HDose Vit D3:  11/08-01/09
  • HDose Vit D3, Mg, Zn: 01/09-

Dec '08 - (Month 36) - Wow, 3 years.   Time flies...

I continue with intermittent CAP on top of the high-dose Vit D3 therapy.   Two intermittent courses now nearly complete.   5 days of metronidazole complee.   Only a couple of days of Doxy + Azith left...   

I'm glad to continue to report that I've experienced only minor fatigue, aches and pains, etc and really none of the heavy reactions that I reported in May and June of '07 above when I was on CAP + only 4000IU of Vit D3, all while now taking 10,000IU of Vit D3 through the intermittent pulse.   

I felt good enough to have a couple of glasses of red wine last night on the last night of my 5 days of metronidazole.   Luckily I experienced no real problems with resulting secondary porphyria.  This alone represents an amazing testimonial to how much I've recovered since secondary porphyria was such a problem for me prior to treatment, in early treatment, and even only a year ago or so.

More later...



Treatment for Rosacea

  • CAP:  01/06-07/07
  • High-Dose Vit D3, NAC:  07/07-11/08
  • Intermtnt CAP, HDose Vit D3:  11/08-01/09
  • HDose Vit D3, Mg, Zn: 01/09-

Red, would you be willing to describe the structure of your intermittent pulse.  Timing of onset of each medication and the full duration of each?  Thanks, Louise
  • CAP(TiniOnly): 06/07-02/09 for CFS
  • MethylationProtocolSupplements: Started08/08
  • Intermtnt CAP: 02/09-02/10
  • Full MethylProtocol & LDN 02/09
  • Off CAP: 02/10, cont LDN & MethlyProtocol support


You are well on your way to becoming another success story.  I am so happy for you! 

I find myself wondering if you have had your D level checked recently.  As you probably remember, mine finally reached 50.  I have dropped from my 8000 IU per day to my current 4000, but think with the winter I will go back up to 6000.  

Congratulations on doing so wonderfully!


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


Hi Rica, Thanks!    Although I haven't had my Vit D3 levels checked yet, I am thinking seriously of getting them checked early next year.   I'll post the results then...

Hi Louise,  Sure.    I'm doing a slightly modified version of the Wheldon intermittent pulse, in my case doing 10 days (not 14) of 200mg doxy each day, 10 days (not 14) of 250mg azith every other day (not mwf), and 5 days of 1gm metro on days 4-8   As I have done through much of the later months of my antibiotic use, I take the antibiotics all at once at dinner so I can take probotics at breakfast and theoretically let these good bugs thrive all day long before slaying them again that night (incidentally with the antibiotics).   I split my usual daily 2400mg of NAC and 10,000IU of Vit D3 into equal breakfast and dinner doses.   I don't take any other supplements.     So far, so good...

Hope this helps.   Take care...

Treatment for Rosacea

  • CAP:  01/06-07/07
  • High-Dose Vit D3, NAC:  07/07-11/08
  • Intermtnt CAP, HDose Vit D3:  11/08-01/09
  • HDose Vit D3, Mg, Zn: 01/09-

Red is this a 10 days on 20 day off type of rotation or is there a longer break before restart of the cycle?  Also Red you are an avid study reader it seems to me.  I know that Doxy and Clarityromycin are both detoxed by the P450 pathway.  Do you have any knowledge from your passing reading regarding Rifampin detox pathway and Roxi detox pathway.  I anticipate a conversation with my MD soon and it seems to me that I could be ready to switch to Rifampin if it uses another detox pathway, could be advantagious to my hepatic organ.  Roxi is hard for me to research because it is from across the pond.  You are such a good data guy, I make my own informed decisions in cooperation with my very literate MD.  Still I like to have data prepared prior to conversations. 

I will post my Vit D3 from the end of this year when it is drawn I too am interested in what my dosage has done for my level.

I always learn much and have much to ponder with the post that you provide.  Thanks for being so helpful here to all.


  • CAP(TiniOnly): 06/07-02/09 for CFS
  • MethylationProtocolSupplements: Started08/08
  • Intermtnt CAP: 02/09-02/10
  • Full MethylProtocol & LDN 02/09
  • Off CAP: 02/10, cont LDN & MethlyProtocol support

Your overview and detailed account of your treatment are very interesting to say the least. It is wonderful that you recorded it all here for us to read and learn from you. I am rather fatigued today so unfortunately didn't absorb everything to the degree I would like. But I will review you thread again over time to glean inspiration & knowledge. As I am dealing daily with congestion for several months now it was somewhat reassuring to read that you also did. It would seem C. pneumoniae has been sitting silently in my lungs for years. The antibiotics certainly do bring out the worst overall. But that is progress! It is truely great to read of your improvements over time. So very happy for you. Thank you for all you share with us.

2002:CFS. (2008-09:CPN - CAP/5 pulses)  3/2010: Restart CAP: 200Doxy/250Zith-MWF/Tini pulses. 6/2010: HighBP/Benicar, 7/2010: EBV, HHV6. 2012: 6,000 IU daily vit. D., Citioline CDP choline = sleep improvement dramatic. 


Thanks Miying!   You're on your way too, so hang in there!  

Louise, It's 10 days on each month so roughly 10 days on 20 days off.     This is not the standard recommended Wheldon intermittent treatment so be sure to check with your doc before doing this.   I wanted to maximize the time off for recovery though so this is the reason to go with 10 vs 14 days on Doxy and Azith.   I also time mine to start on the first Sat of the month so that I start Metro on Tues and take my last two (of 5) doses on Fri and Sat night.    This leaves the heavier reactions for days I can sleep in if necessary (although this hasn't been a problem so far)...

I'll have to check on Rifampin and Roxi metabolism.  I'll post what I find...

Treatment for Rosacea

  • CAP:  01/06-07/07
  • High-Dose Vit D3, NAC:  07/07-11/08
  • Intermtnt CAP, HDose Vit D3:  11/08-01/09
  • HDose Vit D3, Mg, Zn: 01/09-

Hi Red,

I can see now why I missed your blog.  I wasn't online much at all in Dec. Image removed.

This is a nice detailed account of your treatment.  I'm extremely interested in the idea that at some point we ought to rest more in between and allow our bodies to do the work naturally.  It's good to see you can do that and still improve. 

I'll be sure to go back and read thru it all! Thanks for sharing!  Image removed.

PS Are you strictly only using doxy/zith/flagyl?  Do you plan to use any of the additional abx Stratton uses such as rifampin or INH?  

NAC 2.4g, Zith 250mg/MWF, mino 200mg, Tini 5day/1g/5 pulses, Valcyte
Supplements, CFIDS/FMS, Hashimoto's, Psoriasis, PA, IBS, Sec Addisons

Don't believe everything you think!  

Hi Reenie,

I'm currently only using doxy/azith/flagyl, but this could change of course.   I'll never say never...

Treatment for Rosacea

  • CAP:  01/06-07/07
  • High-Dose Vit D3, NAC:  07/07-11/08
  • Intermtnt CAP, HDose Vit D3:  11/08-01/09
  • HDose Vit D3, Mg, Zn: 01/09-

Red, thanks a lot for sharing your story. It gives a lot of hope to us that cant find a doctor to help with CAP. At least we can start with Nac and work up to high D3. I think it helps a lot.

I also do my own program with using AllicinMax for almost a year. When I started I was not able to do much at all. Now im better.But not easy because of toxins and porphyria,as we all know.

So I think this(nac,d3,allicin) is helping me getting better.

I hope I will find a doc for CAP too. Meanwihile I carry on with my anticpnprogram! 

Thanks again and good luck with your treatment!

Best Wishes, Maria

Cpn since sep 2006. Autoimmune thyroid,hypofunction.levaxin,b12+folic acid.All classic cpn,porphyria and toxinsymtoms.Not able to work.Selftreating cpninfection with AllicinMax(garlic), NAC, high vitamin D3. CAP for over 3 years. Back to work and life