Dr. David Wheldon's succinct summary of the different reactions to Cpn and its treatment helps in sorting out the different responses and what to do about them. I've moved this from his comment in another members blog post to a page of it's own here in the Cpn Treatment Handbook.
Jim K (Editor in Chief)
Five Ways of Feeling Lousy
I am inclined to think that there are five major mechanisms behind those unpleasant side effects of chronic large-load infection with C pneumoniae which worsen in the short-term with antichlamydial treatment.
a) Lipid peroxidation may likely get worse in the short-term as bacterial products are released both by breaking down EBs and by apoptosisi of infected cells. Antioxidantsi and B vitaminsi (including B12) may help with this. I find melatonini at night helpful.
b) Release of endotoxinsi. These evoke a nonspecific host reaction. Antioxidants and Vitamin D may be very helpful. Vitamin D has many immunomodulatory properties aside from calcium regulation. (The Vitamin D page is very helpful: thanks Marie.)
c) Disturbance of the haem synthesis pathway. Although called 'porphyria', this is a slightly misleading word here. The haem-pathway disturbance found with this infection is probably very complex and likely involves many steps as the metabolites cross and re-cross the mitochondrial membranes. It's important to realize that mitochondria were once separate, free-living creatures, and the mitochondrial membrane is the interface between two interdependent kingdoms: it is the waist of a 'biochemical hourglass'. I don't profess to be a biochemist, but it seems to me that this disturbance of the mitochondrial / host interface here is not really like the medically described porphyriasi. I suppose one might say that it most closely resembles Porphyria Cutanea Tarda, except that in PCT skin lesions are usually the first symptoms. PCT-like skin lesions are uncommon in in my experience in this infection. One suspects that this infection may disturb several steps in the haem production pathway. Testing for haem precursors is well-described by Basil; in my experience you can have normal porphobilinogen and delta aminolaevulanic acid levels in profoundly 'porphyric' urine. I found glucose, high fluid intake and propranolol very helpful. Some people find charcoal invaluable.
d) Release of bacterial antigens. As bacteria die they release numerous antigens. Some are likely to be specific. Do you recall the old Typhoid / Paratyphoid A and B vaccine? If you are of a certain age you may vividly remember the murky fluid in the barrel of the glass syringe (syringe made by 'Record'; needles re-usable, with a 'Glydin' pattern tip.) But the effect of the blunt needle was as nothing compared to the effect of the vaccine. A feeling of general ill-being commonly occurred after this 'jab', particularly when it was repeated. The after-effects were so unpleasant it was rumoured that the British Army used to administer the stuff to recruits just before they went on weekend leave. C pneumoniae, like Salm typhi, is a Gram negative organism. When we give antibioticsi to kill intracellulari C pneumoniae we are creating in effect a sequence of crude, whole-germ immunisations. One might expect that Vitamin D would help with this, and also curcumin. Looking on the bright side, we may be protecting ourselves from further widespread infectionsi with this organism.
e) Functional Vitamin B12 deficiency. The Vanderbilt workers have found that in this infection antibodies incidentally binding to Vitamin B12 are induced. This means that B12 may have a normal concentration in the blood but effectively cannot get into nerves. Flooding the system with B12, either by injection or oral methyl cobalamin, can produce profound effects; these seem to be quite short-term, suggesting that supplemental B12 is quickly bound.
So, we have at least five mechanisms for feeling lousy: possibly a number of them are working in synergy at the same time.
This being said, I wouldn't want to put anyone off taking treatment because of the fear of reactions. If we don't deal with these germs they'll likely deal with us.