27 Apr 2018
Jim K

INH (Isoniazid) Safety: Some references


INH is used by some Cpn doctors, especially due to it's efficacy in the Mitchell/Stratton studies. Because of a potential for liver toxicity, and early reputation that it is significantly so, it's safety among most doctors is considered low. However, more current studies using large cohorts in public health for treating TB have shown different results. I've excerpted the conclusions and given links for a couple studies below.The following study of over 11,000 people looks at long term safety of INH for treatment of TB, which requires long-term use.


Jim, I know hepatoxicity is only a fairly minor event but I also know that many GPs even in the US are reluctant to prescribe  rifampicin and INH for reasons of the danger of litigation as much as anything.  David as a hospital doctor knows that in this country it is an accepted course of treatment for TB, but then it is closely monitored by the chest physicians.  He would be prescribing it for an unrecognised treatment.

Also no matter how much you or I are uneasy with this, many people are treating themselves and they need to stick with something kinder.  There are many people even ion this site who are temporarily stopped by their physician when taking INH because of raised liver enzyme levels. Never mind whether this stopping and starting is a good thing or not, many people would not know if they were doing it themselves, so what we need to do is concentrate on hw to get more GPs to do more than just blithely dismiss the treatment, whether because they think MS should be treated by a neurologist who still blindly thinks of it as an auto-immune disease, or thinks that chronic fatigue and fibromyalgia are more diseases of the neurotic imagination.  Too many still do...........Sarah

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.

Sarah- I absolutely agree that INH should only be used with a Doctor's monitoring. Every place it's mentioned in the Handbook that is emphasized, and it's potential liver toxicity as well. I don't think it's an especially appropriate drug for MS, or many of the Cpn related diseases. Where it has the most significant effect, at least clinically, is in Chronic Fatigue Syndrome and Fibromyalgia, diseases where it is likely that a main culprit infected by Cpn is the immune cells, which INH seems to clear the best. I would not recommend self treating with it. For those worried about liver toxicity, I think Dr. Stratton's suggested use of INH as a pulsed treatment, with the flagyl/tini pulse is probably the safest alternative as you are not using it long enough to build up liver toxicity unless your liver is already compromised (only your doctor can know this for sure).  On the other hand, if the pulses are agony for you, adding INH is not going to make it better!

On CAP's protocol for Cpn in CFS/FMS since December 2004.
Currently: 150mg INH, Doxy/Zith, Tini pulses 

"I really didn't say everything I said." Yogi Berra