In conversations with Dr. Michael Powell, he has found INH to be so much more effective in eradicating Cpn that he often uses it as first line. Like NAC vs amoxi, INH does not effect bowel flora, so you avoid the candida issues this way. It does have potential liver toxicity, and he takes monthly liver panels. If toxicity shows up, he gives a 2 week break and then back on. He also uses milk thistle to support the liver while using INH.
From the Cpn site:
CPn Help/?q=node/162
Dr. Powell finds most patients improve on a standard combination antibiotic protocol for Cpn. Rheumatologist have apparently been using doxycycline for many years with success for inflammatory arthritis but there is evidence that using doyxcycline in combination with rifampin is even more effective. Some patients plateau after about 8 months of treatment he has found variations in the treatment protocol have made a difference. One protocol he uses involves the use of NAC 600 mg twice daily, INH 300 mg once daily before breakfast, and metronidazole 500 mg twice daily pulsed with 5 days on and two weeks off. It is essential to start each agent separately and gradually increase the dose over weeks or months as tolerated. The use of Vitamin C 500 - 1000 mg four times daily (the half life of vitamin C is 30 minutes and little remains after 3 hours) to offset the release of toxins during therapy. B6 is important to control INH related peripheral neuropathy. Monthly laboratory evaluation of AST, ALT, Cr, and CBC are recommended for all who engage in this protocol. It is not uncommon for liver enzymes to show a mild elevation during the initial stages of treatment. Antibiotic therapy should be temporarily discontinued during periods of toxicity, should it arise. He emphasized the importance of insuring that yeast and fungal infections do not overgrow during protracted antibiotic use. He recommends the use of acidophillus, nystatin, diflucan, oregano oil, and/or grapefruit seed extract as needed to prevent secondary opportunistic infection during treatment.
Mike tells me that INH is particularly useful in plateau on the other meds, and Stratton's research indicates it's much more effective than anything else in clearing macrophages, monocytes and endothelial smooth muscle. He says there's about two weeks big reaction, then significant improvement. Now, remember, he is treating mostly CFS, FMS, and RA, not neurological diseases. The bigger die-off in the nervous system with MS might be a significant wack. That's especially why I wouldn't take it in combination, other than with the NAC and flagyl pulse, until you know how it effects you. But you may get more rapid improvement too.
I would not take Rifampcin and INH together. The stronger kill effect with INH is enough. I might continue with azith or doxy, given their immunomodulatory effects, but I've had better counter to the inflammation using Benicar (if you can tolerate lowering blood pressure). [/quote]
