Doing well on azythromycin

[msf]

Hi jesse, I had a pulse regimen of Azithromycin (3-4 days a week) + Doxycycline every days for 4 months from february to may 2017



yes I know, it's a bit strange, but azithromycin seems to be very quickly absorbed (the peak in the blood is known to be at 2-3 hours after intake), so it is possible that azithromycin put a pressure on mitochondrias as soon as it arrives in the blood, and then the blood lactate control system happens to start out and to regulate the lactate peak.

I have done 167 blood lactate controls on me since I started the monitoring two months ago (just after my 4 months antibiotics regimen), so I'm still under investigations and hypothesis are not closed, you can add yours!

The first curve I made was my post acetyl Salicylic acid lactate curve, a known mitochondria toxic drug that is partly absorbed by the stomach. I took One Alkaseltzer (324 mgr acetyl salicylate) . At this dose, we shouldn't see any toxicity, but the test clearly showed that my blood lactates regulation systems were not very good:

18.05.17 fasting Blood Lactates at 6h30 = 1,7 mmol/l ...intake 1 alkaseltzer (no food)
7h30 BL = 2,9 (alka+1h)
8h30 BL= 3,1 ( alka+2h00 )
9h30 BL = 3,3 (alka+3h00 )
10h30 BL = 2,2 (alka+4h00 )
12h00 BL = 1,8 (alka+4h30 )

The few tests I've done with azithro (without any food intake) said that my lactates has a peak at 1 hour, and then goes low at 1h30


16.07.17
18h10 BL= 2,7 zithromax 250 mg + glass of water then laying
19h14 BL=3,2
19h44 BL=1,9
17.07.17
14h00 BL= 2,7 azythro 250 mg +glass of water
15h00 BL = 3,6
20h15 BL = 2,4 azythro 250 mg + glass of water
22h12 BL = 2,1
18.07.17
13h30 BL = 1,9 azythro + water
14h40 BL = 2,7
19h00 BL = 3 azythro + water
20h00 BL = 3,3
21h00 BL = 2,3

Very interesting. The lactate peak you have observed with Azithro does not fit the absorption peak you mentioned though. So unless you are absorbing Azithromycin faster than normal, then I think it is probably some effect that Azithromycin in having on your gut itself.

Have you ever measured your day-to-day lactate on and off Azithro? I would love to see a study done on that, or on Rapamycin.

 

[pattismith]

Very interesting. The lactate peak you have observed with Azithro does not fit the absorption peak you mentioned though. So unless you are absorbing Azithromycin faster than normal, then I think it is probably some effect that Azithromycin in having on your gut itself.

Have you ever measured your day-to-day lactate on and off Azithro? I would love to see a study done on that, or on Rapamycin.

yes I would love that more monitoring on lactates to be done on patients, I don't understand why there is not more!

I did many monitoring on me, but more focused about the effect of food intake, because it's an issue for me (blood BL peak one hour after a meal). I discovered the peak after azithro by chance, so now I systematically monitor my BL after any antibiotic or drug.
The problem I have now, is that my Thiamine treatment interfers with the results...and I really need it!

 

[pattismith]

It looks that Thiamine supplementation saved me from my hyperlactatemia.

I started Benfotiamine 300 mg per day on July 6 th, then I jumped to 900 mg per day on July 10th, then I started Thiamine injections on August 07th

Before starting Thiamine, my morning fasting lactates level were between 1.3-1.7 with levels higher than that during the day, with peaks up to 2.5 and sometimes 3.5 mmol/l, depending on activity factors ( my muscles/intestine/brain needs for energy) and vascular factors...

I started to see levels dropping at levels ranges from 0.8 to 1 mmol/l on July 27th (17 days after I raise Benfotiamine at 900 mg/day) when I took a treatment of Amoxicilline/clavulanic acid for 5 days. (It seems that Clavulanic acid works in synergia with Thiamine to lower blood lactates, but I will start a specific thread about clavulanic acid, it could be an interesting product, unfortunatly not available without the amoxicilline association...)


2 days after I started benfotiamine 900 mg per day, my abdominal muscles pains stopped (I had it since my bronchitis in juanary, because my muscles couldn't recover after three weeks of badly coughing ). I stopped totally Tramadol I was taking for almost years (low dose, but I couldn't do without it).

24h00 after I started Thiamine injections, my blood lactates levels fell into the normal ranges.

Now I feel much less heavy legged and armed I was before, my strengh has mostly came back, it's hard to believe it, I wish this result won't vanish in the air after so much efforts to go back to life, after so many years of poor health...
I will still work on how to keep this result, I am confident now, even though I'm not sure my brain will ever recover totally...

 

[pattismith]

After some more investigations, I think that my high blood lactates induced by Azythromycin/Doxicycline had several possible mechanisms:

-Direct inhibition on mitochondrias
-Killing the Prevotellas in the gut (the bacterias known to secrete Thiamine, which deficiency leads to Lactic acidosis)
-Selecting Lactic acid bacteria in the gut (the bacterias known to secrete Lactic acid)

It seems that the best supplements that helped me to recover from the side effects I had from my Antibiotics seemed to be:

-amino acids (maybe)
-thiamine injections (more probably)

6 months later, I have to update this thread with new informations.

I discovered I suffer from a Low T3 syndrome (Low fT3 with very high rT3) with some symptoms of hypothyroidism (muscle disease, weakness... intracranial hypertension, slow brain, intolerance to exercise,...).

The acute worsening of these symptoms I had with azythromycin, other Macrolides, Tetracyclines, and even with Metronidazole can be the result of their ability to interfer with either ion channels, thyroid hormons metabolism, or OXPHOS.

All these symptoms dramatically improved when I started taking T3 (very low dose).

I must say that I have already done a T3 trial some years ago without real success, so maybe things today are not exactely the same as they were.

 

[Wonkmonk]

some doctors that think we have to deal with persistant intracellular bacteriologic infections (Lyme doctors as an example) may do it.

This is interesting, I did a short course of IV Ampicillin/Sulbactam two weeks ago, and it feels like since then I am slowly improving. I took it because of a positive Antistreptolysin O titer (indicating streptococcal infection) and a very low, but still elevated IgG titer for Mycoplasma Pneumoniae.

I do not believe at all that these bacteria caused my CFS and it is now going to disappear, but I could well imagine that bacteria are exacerbating symptoms.

 

[pattismith]

The antibiotics you took are effective against a lot of bacteria (both intracellulars or in the gut, or elsewhere), so if you had an improvement with it, it could be one or several of those:

• aérobies à Gram + : Corynebacterium diphtheriae, Enterococcus faecalis, Erysipelothrix rhusiopathiae, Listeria monocytogenes, Nocardia asteroides, staphylococcus méti-S, streptococcus, Streptococcus pneumoniae
  
• aérobies à Gram - : Bordetella pertussis, Branhamella catarrhalis, Citrobacter koseri, eikenella, Escherichia coli, Haemophilus influenzae, Haemophilus para-influenzae, klebsiella, Neisseria gonorrhoeae, Neisseria meningitidis, Pasteurella multocida, Proteus mirabilis, salmonella, shigella, Streptobacillus moniliformis, Vibrio cholerae ;
• anaérobies : actinomyces, Bacteroides fragilis, clostridium, fusobacterium, peptostreptococcus, porphyromonas, prevotella, Propionibacterium acnes ;
• others : bartonella, borrelia, leptospira, treponema.

But they are not active against:

• aérobie à Gram + : staphylococcus méti-R ;
  
  
• aérobies à Gram - : acinetobacter, alcaligenes, campylobacter sp., Citrobacter freundii, enterobacter, klebsiella, legionella, Morganella morganii, Proteus rettgeri, Proteus vulgaris, providencia, pseudomonas sp., serratia, Yersinia enterocolitica ;
• other : chlamydia, coxiella, mycobacterium, mycoplasma, rickettsia.

 

[Wonkmonk]

Thanks for the comprehensive list!

I can't find it right now, but I am pretty sure Amicillin + Sulbactam is effective against mycoplasma spp.