Submitted by cypriane on Thu, 2007-03-29 16:51

At this time, we do not have a list of physicians who prescribe a long term combined antibiotic protocol (CAP), and our policy is to maintain the public anonymity of those CAP doctors who have not made themselves public. Please do not e-mail requests for a list or a referral on the "feedback" link. We offer the following strategies and considerations, though, to help you find a doctor to treat you on the protocol.

One strategy is to try the doctors you already know. For this angle, you should prepare yourself. Understand that the doctor might be unfamiliar with the concept. It’s a plus if the doctor senses that you have a firm grasp of the concept yourself. Here’s a little "cheat sheet" on the critical points:

1. Chlamydia pneumoniae (Cpn) is also known by its newer name of Chlamydophila pneumoniae.  It is an intracellular pathogen, that is, the infection is inside your cells.

2. Cpn has three main life cycle phases:

  • The elementary bodies (EBs) – seed-like or spore-like phase that spreads the infection.
  • The reticulate bodies (RBs) - this is the active and reproducing phase.
  • The cryptic bodies (CBs) – relatively inert "hibernating" phase.

3. Chlamydia pneumoniae is persistent. The reticulate form is the phase that attracts the most attention from your immune system and, ultimately, its presence is the trigger that results in most of the "collateral damage" heaped on the surrounding tissues by the immune response. Threatened by bacteriostatic antibiotics, it can convert to the cryptic form to protect itself. When the threat is gone, it converts back to the reticulate form and continues to reproduce and spark the damage.

4. Only a long term combined antibiotic protocol effectively and safely kills Cpn in all three phases.

5. It is necessary that the protocol be a long, gradual kill-off of Cpn in order to avoid too much apoptosis (natural cell death) at once. Natural cell death and replacement is an ongoing process occurring in the bodies of everyone, well and unwell alike. Cpn has developed the ability to keep host cells alive for an artificially long time. When Cpn is killed inside the host cell, the "immortalizing" effect goes away, and the host cell dies as it should have done already. If the whole arsenal, that is the full complement of the combined antibiotics, were hurled at the Cpn population from the beginning of the treatment, too many host cells would die at one time…this could cause organ failure. The protocol employs a gradual ramping-up of the antibiotics which brings about a gradual winnowing-down of the Cpn population. This approach makes the protocol comparatively safe.

6. Cpn infects immune system cells themselves. As more ineffectual immune cells die-off and get replaced with non-infected cells, the immune system progressively improves and behaves more normally.

7. A steady pattern of consistent improvement should not be expected. A pattern of ups and downs, two steps forward/one step back is more likely.

Your doctor may have specific medical concerns---make sure you understand the gravity of the concerns and how the protocol addresses them. These are the main concerns:

1. Development of bacterial resistance~~~The combination of the antibiotics in the protocol prevents this by attacking Cpn in more than just one way. Here is a helpful article by Dr. Charles Strattoni of Vanderbilt University on the subject.

2. Potential damage to the liver and other organs~~~The recommended supplements and the gradual approach of the protocol help to prevent damage. Monitoring through appropriate blood testing is recommended.

3. The potential consequences of gut flora disruption~~~The recommended supplements include antifungals and multi-strain probiotics to forestall these potentialities:

  • Overgrowth of Candida (yeast) and other fungi. 
  • Overgrowth of Clostridium dificile and other harmful bacteria. C. dificile is a particularly nasty bug that can cause diarrhea to the point of dangerous dehydration~~~The multi-strain probiotic should include Saccharomyces boulardii which is especially helpful in controlling the C. dificile population.

4. Secondary porphyria may be a symptom that is already happening if your liver is infected with Cpn. Antibiotic treatment may exacerbate this problem~~~Avoiding red meats and trans-fat consumption and increasing complex carbohydrate consumption are helpful. Another method of control is taking glucose tablets before eating. For more severe cases, propanolol and other medications are discussed on the website.

5. Bacterial die-off reactions are no walk in the park. This is caused by the release of endotoxins from the Cpn that have been killed~~~The symptoms are manageable. Some of the most effective ways to limit these reactions are by supplementing extra vitamin C and activated charcoal, using vitamin C flushes, taking Epsom salts baths, and drinking plenty of water. Maintaining bowel regularity is helpful, as a quicker elimination of the endotoxins from the gut lessens their reabsorption.

Bring documentation to the appointment, but don’t shove too much paper in your doctor’s face at once:

1. A letter similar to the sample letter in the Cpn Handbook. It should reflect that you understand the concept of the CAP; the risks; the responsibility you accept in proactively taking measures to forestall the risks; and the responsibility you bear in seeking help to manage those potentialities in the event they should arise and warrant medical attention.

2. A copy of the Cpn Handbook bound in a notebook for later reference.

3. Tuck some supporting research articles into the notebook pocket.  Those with MS would do well to include the critical sections from Dr. David Wheldon's website.  Your doctor may appreciate his concise protocol presentation.

4. The opinion of an uninvolved physician can be found here.

Don’t discuss this subject with the doctor, but do understand that there is an element of risk for the doctor in treating you with a CAP. Weigh the possible benefit of long term CAP treatment against continued use of other treatments and progression of your illness. Decide if you are willing to sign a waiver for the doctor and be prepared to make that offer if you are committed to pursuing a CAP treatment. Receiving this treatment requires that you be an informed patient and accept a degree of responsibility beyond what your previous medical experiences might have required. Incorporate this new way of thinking into your pursuit of effective treatment.

You might consider doctors other than those who specialize in your illness like your primary care physician: a general practitioner or internist. You may find that an osteopath or an MD with alternative medicine leanings is more receptive to a CAP.

Try a "Lyme literate" doctor who is already familiar with long term antibiotic treatments.

Another approach is to seek a doctor who is already treating one of our site users. Make a personal blog entry asking for help with a title that includes your location and illness. Be flexible and willing to travel a distance that you can manage.

One site user, Ken H, was successful in using a truly unique approach: target an assembled group of doctors and see who’s game.

Best wishes and Godspeed to you.