MediTest
J R

I spent a couple of hours this evening trying to figure out what an intermittent protocol might look like - and finally found the details in Sarah's story on David's website. Thought I'd re-post to save others the trouble if they are using the search on this site.

From: http://www.davidwheldon.co.uk/updates.html

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Dec 2004

"Sarah stopped the continuous antibiotics two months ago. Improvements continued after they were stopped. We have decided to give a discontinuous maintenance therapy of 14 days doxycycline 200mg daily and roxithromycin 300mg daily*. Metronidazole, 400mg three times a day, is given for the final five days. This maintenance schedule is to be repeated at two month intervals."

*If roxithromycin is unavailable, azithromycin may be used. Rifampicin is not suitable for intermittent use.

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I have some questions with respect to intermittent therapy, as I'm unsure that my doctor will support antibiotics indefinately. I wonder if anyone can help.

Are there other standard CAP intermittent schedules?

Do people 'take a break' from continuous antibiotics with a period of intermittent therapy? Is this advisable?

On this site people have been on CAPs for fairly short (1 year or so) to much longer times e.g. 5 years or more. I still feel worse when pulsing - generally more tired, more easily upset and usually experience bad asthma (which is a side effect of tinidazole - the antibiotic I pulse - but I guess it's possible that the side effect is a result of killing CPn). Is there a way to tell if its time to go intermittent? Does it differ for MS or ME/CFS? I have heard it said that CFS sufferers often have a higher CPN load.

Is there a practicing expert that my doctor (a PCP/GP) could ask questions of? I know of Stratton (I heard it is hard to reach him now) and D W (now deservedly retired). The ME/CFS center at Stanford used to have information on CPn (https://web.archive.org/web/20170228000756/http://med.stanford.edu/chro…) but now does not - I am not sure if anyone has experience with them. Is there anyone else with specialist experience on CAP?

OK maybe that's enough questions for one post Smile.

J R

CAP I am using is as follows:
-Doxycycline Hyclate 200mg twice daily, started 03/2016
-Azithromycin 500mg once daily, started 03/2016
-Regular 5 day pulses consisting of 500mg Tinidazole twice daily for 5 days (as tolerated), started in aug 2016 - now up to around 20 pulses
- +4g Cholestrymine USP 2x daily, 1x daily ultra-binder (basically activated charcoal) - cholestrymene atarted only around Easter 2017
-NAC 1200mg 2x daily
-Many other supplements incl. B12, methyl folate, D3 (not high dose) etc.

Hi JR,

I am now on intermittant protocol-4 weeks off, 4 on with a 5 day Flagyl pulse. I've been on CAP for 3 and a half years and no longer have reaction to pulsing other than being dehydrated. I think there is a chart somewhere on this site with intermittant protocol. I am doing bloodwork monthly during the cycles. Just started so I hope it will work for me.

Chloe 

Hi JR!

Perhaps it's because you wear a ten gallon hat ... or perhaps it's that you just do everything big in Texas. Did I read that right; you are talking 500 mg of azithromycin every day? Mere Brits like me are only up for taking 250 mg of the stuff three times a week. That is a big difference!

Smile

G

“Don't believe everything you read on the internet.”

―    Abraham Lincoln

JR, David would willingly expain the reasons for both pulsng and intermittency to your doctor.  You can find his email on his website.................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.
J R

Supaguy: Yes I really am taking a lot of Azithromycin - it's basically because my doctor is a Lyme doctor and they are doing a mix of the protocols on this site and their standard Lyme protocol. They're also a bit nervous about me doing more than a year of antibiotics - becuase I think they usually only do a year of their protocol. To keep the Dallas joke alive (for those of us old enough to remember the TV show) - apparently a real JR quote: "When your holding a double barrel shotgun use both barrels." (Note to others - I am actually a mixed Brit/American and live in New England - but hey the Dallas fantasy is more fun! Yee haw...). Maybe I should try to drop the dose for the sake of my liver...

Chloe: thanks for the info - I guess waiting until the pulses don't cause symptoms is a good way to decide to go intermittent. Hopefully my doctor will check with David. Good luck...

Sarah/David: Thanks so much - I will see my doctor in mid Dec - and will try to get her to write. I'd like to keep at the protocol as it seemed to make a significant difference intially.

All Americans: Happy thanksgiving y'all!

'NORMAL' CAP is a 18-month to 2 to 3-year stint (depends on 'loading'), then a couple of years or so off the antibiotic part (but continue the suppliments/vitamins) to clean your system out and prevent resistence build-up. Then the antibiotics are re-started once Cpn symptoms re-appear or any type of system deterioration happens and the cycle goes on again ~ 18-month to 2 to 3-year...

'INTERMITTENT' CAP is different - it uses a two week antibiotic with pulse in middle of the time period, then repeat monthly at first (ie two weeks on, two weeks off), then go to two weeks on and a month between stints or even six to eight weeks between stints. This enables continuous antibiotic without the 'NORMAL' CAP couple of years or so between stints...

We find consultations, we learn tricks with which we deceive ourselves, but the essential thing - the way - we do not find. Listen to the river...