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Hello, just some info from a retired pharmacologist and chronic neuroborreliosis victim, over 3 decades (at minimum)... I first started with i.v. ceftriaxone (Rocephin (R)) in 1993, on a clinical diagnosis (several serological tests were negative). Clear benefit lasted only for weeks, then many symtoms returned, and new ones developed over the years following. After a second course of ceftriaxone in 1995 I read of additional (oral) doxycycline benefit after ceftriaxone. When I tried that in January of 1996 my cardiac arrhythmia (very frequent VES) disappeared after 5 years of cardiac irregularity (NO reaction after twice i.v. ceftriaxone): I suspect that B.burgdorferi survives inside cells, where ß-lactam antibiotics like penicillin ... ceftriaxone have no access, but doxy, which is lipophilic and easily crosses cell membranes, unlike penicilline and the like. To make it short: in chronic neuroborreliosis a permanente cure often cannot be achieved. Prof. Preac-Mursic from Munich in the 80's of the last century suggested an interval therapy, which might stimulate immune responses against very slowly multiplying bacteria like borreliae. Over the years I developed the following dosing scheme: Once per month I take a total of 800 mg doxy over just two days (body weight ca. 87kg): 300-100-100-100-100-100 with ca. 8 hour intervals. This way two 50 tablet packages of doxy lasts for about a year. I have not experienced side effects. (Forget "herx": seems to result from fear, maybe stress from "angst", which impairs immune function and will promote bacterial proliferation, cf. stress in MS... Prof. Norbert Satz, Switzerland, denies the existence of a Herxheimer reaction in antibiotic lyme therapy, after thousands of patients treated!) With body weight less than 65..70 kg even 200-100-100-100 mg doxy over two days, that is with ca. 12 (instead of 8) hour dosing intervals, will produce similar concentration curves in blood / tissue / CNS = central nervous system. As far as I know, such a scheme with long intervals of several weeks between the 2day-courses minimizes the risk of bacterial resistance development against doxy (which for B.burgdorferi never has been demonstrated, only for a few other bacteria). Note: doxy should NOT be given to children - could be deposited permanently in growing bones and teeths... After years I tried to expand the interval from 4 to 6 weeks, but had the impression of insufficient efficiency. With this dosing scheme I have been almost symptom free for many years by now, at minimal cost and with practically no side effects. This would qualify such a scheme for mass therapy - which would be necessary in (Southern) Germany, where I live. Epidemiolgical work here has revealed that prevalence of CHRONIC lyme disease (there is NO spontaneous healing, just like in syphilis...) reaches ca. 25% of the population, that is MILLIONS, at age 50...60 years. IMPORTANT: Note that certain symptoms may disappear quite slowly, over weeks, months - inflammation decay and repair of damage (e.g. long peripheral nerves) can take time, so be patient. The CNS often can circumvent permanent damage (scars, visible in NMR imaging) - but that might take even years. So don't give up early - I know from own experience! One more info: meanwhile there is growing evidence that MS is just a severe form of neuroborreliosis (depending on a genetic predisposition for MS) - and can be "stopped" by an interval dosing scheme as outlined above with doxy or minocycline. Both doxy and minocycline are standard in acne therapy over months, but doxy is preferred because of lower risk of liver damage (which seldomly may develop with CONTINUOUS minocycline dosing over months). This demonstrates that especially doxy is comparably VERY safe, based on decade-long experience in millions of acne patients. With the interval dosing scheme of doxy any risk of severe adverse reactions certainly is reduced even further, to practically "nothing" in my own experience over more than a dozen years. By the way, doxy seems to be effective in many more diseases than lyme and MS (e.g. malaria, rheumatoid arthritis, osteoarthritis... - probably lots more...). Ancient Nubians some 1500 and more years ago in upper Egypt / Sudan fermented sorghum resulting in effective concentrations of tetracycline, the parent structure of doxycycline (which has been modified chemically half a century ago to be better absorbed orally, to stay longer in the body ---> drastically reduced dosing (including dosing intervals), better passage into the CNS...): This shows that such tetracycline antibiotics may be part of normal diet - nothing "unnatural" at all! To me doxycycline is optimized natural tetracycline, with a remarkable safety record over half a century by now. I am confident that seemingly intractable chronic (neuro)borreliosis can be stopped - not with massiv attack but with a "less is more" approach. (Date: 11-1-11, something special...)
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