LNN

This thread (#18) outlines what I did to sort it all out http://latitudes.org/forums/index.php?showtopic=3928&page=2 - pick up from #5. I really found the heartfixer doc listed in this link to be the best, "simplest" guideline. Yasko - for me - was difficult. She recommends so many supplements, including the RNA formulas that don't have any research proving their effectiveness. As Seeking says, you also need to consider the VDR status before you can make a decision on COMT. But I'd hesitate on the SSRI and also on an SNRI. Both COMT and MAO-A downregulate the rate at which your body degrades serotonin - which is also what an SSRI also does, in a somewhat different way. So you may be "flooding the carburetor" with serotonin. Instead, you can read the heartfixer doc to get an idea of what blend of methylfolate, some form of B12, vitamin D and other Bs to use. Keep some small doses of niacin or niacinamide on hand for bed temper days. 50mg of niacinamide calms my kids greatly - but my DD (an undermethylator with MTHFR, COMT, VDR, CBS and MTR/MTRR issues) can only tolerate niacinamide greater than 10mg during a meltdown. Otherwise, it sucks up too many methyl groups for her. Do yourself a big favor and only address one gene at a time. Yasko says start with CBS for 4-6 weeks. But then I'd move to MTHFR for at least 4 weeks - maybe longer until you're sure you've got the dose and frequency right (my DD only needs 67mcg of methylfolate 3x/wk - you don't need much to see a big change sometimes). Then address COMT/VDR, then use phosphatidyleserine for MTRR if ADHD is an issue. Then for MAO-A, check copper/zinc levels and consider supplementing with 2mg copper daily. Copper upregulates MAO-A. FWIW - my DS also had lyme and Pandas, along with pyroluria and a mold sensitivity.Treating methylation certainly helped, but getting on top of lyme was really our turning point and unfortunately, some days just required pushing through.

Nancy, My DD is an undermethylator like your son. But she doesn't do well on NAC because she has a mutation on her CBS gene (as do I) and we can't tolerate supplements high in sulfur - our bodies don't do a good job neutralizing the bad effects of excess sulfates. So NAC makes her a mess because of her CBS mutation, not because of her general methylation status and not (necessarily) due to any relationship with glutamate (there might be one, I'm just not aware of it) . I took NAC for a few months last winter for a cough (NAC thins mucus) and it seriously elevated my liver enzymes, I stopped the NAC, rechecked the liver 4 weeks later and my ALT and AST had dropped from the 80s down to the 20s (above 50s is a concern). So as you've said, NAC helps some but if you have a CBS mutation, I'd stayaway from it. Rachel - on tremors...my DD had tremors. An EEG came back normal and the dr looked at the video I took and suggested she was having anti-cholinergic reactions whenever she took cold meds, cough meds or antihistamines - all of which can block choline receptors. She tested deficient in choline and this, combined with taking meds that blocked choline receptors, was causing the tremors and also tachycardia (sometimes her heartbeat would race to 150 bpm even lying down in bed - and stay that way for 1-2 hrs). I stopped the zyrtec she used to take and started supplementing choline daily and the tremors went away. So just something else to consider...

We had negative experiences with Omega 3's. Been too long for me to remember exactly what I saw, but remember I didn't like it. Then DS tested positive for pyroluria and Klinghardt says those with pyroluria need Evening Primrose (non-inflammatory form of Omega 6s) more than they need Omega 3s. We've given EPO for 3 yrs now. I recently ran out and stopped for a time. Didn't see any huge change but maybe a slight decrease in tolerance, mental sharpness. So I've added it back. Phosphatidylserine, on the other hand, is a definite keeper in my house. Saw immediate improvement in ADHD symptoms. I used to give 100mg in the am and 100mg at dinner to help him focus on homework in the evening. I've now backed off to just morning dose unless he has some concentration issue and then I may add back the dinner dose for a few days while I look for the cause. For DS, PS100 is one of his important supps (we use Jarrow - most affordable I've found and even that's not cheap).

I agree that TS is nothing more than a label a doctor uses for "I don't know why your child is making these movements or noises". It comes with no known "cause" and offers no adequate treatment. It's a useless term and you do yourself a disservice worrying about it, IMO. I know - because I used to turn myself inside out over tics. Tics, in my experience, as just the canary in the coal mine. They tell you something is amiss. But they can be triggered by many things. For my son, they tell me his body is having a hard time getting rid of toxins - toxins released by dying bacteria (a herx), from toxins released by yeast, from toxins released by mold. My son, who had lyme and strep-triggered symptoms, spent 4.5 yrs fighting to get well as we unraveled that onion. I had to let go of my insistence that antibiotics alone would get rid of them. Once I did, I started finding other triggers and then solutions - cures, if you will. He's been off abx for 11 months now. All symptoms that once plagued him are gone. But he's had an eye blink tic that waxes and wanes. We finally found mold/mildew on his bedroom and bathroom windows (fish tank and hot showers were the culprits) and once we cleaned that up, the eye blink stopped. It has just returned, so I'm waiting for Amazon to deliver a dozen petri dishes so I can do a poor man's mold test in every room. We'll then do intense cleaning and inspections in any room that shows mold as an issue. 3 times in the past 5 years, mold has been the cause of his tics, not Pandas or lyme. And I'm not talking tons of black mold from a flood. I'm talking small amounts of mildew on the windows, damp boxes in the basement, and mildew on the inside of the washing machine. Things that didn't bother the rest of the family. Every house, no matter how clean or new, can have mold issues in places you'd never thing to look. So yes, kids heal and leave their issues behind. Many of the parents who joined this forum around the time I did have all made it out of the woods. No, I don't believe your child will have to endure lifelong tics. But I do believe he may have become ultra sensitive to toxins (the same way you can become more and more allergic every time you're stung by a bee). And toxins can come from multiple sources. Remove the toxin and I think you could very well see the tics stop. But you may need to look beyond strep and antibiotics to find the solution.

Oh Smarty - so bummed! Nancy has great tips (as always). But my one devil's advocate question is "do you really want the teacher's side of the story in writing?" You're in a he said/she said but as Nancy says, the teacher, who is being defensive, has every reason to paint a lopsided story. Do you want it in writing to follow your son? Or just leave it be and let your son know you support him, regardless of what's been said? I hear you on the waffling on the 504. My DD is my borderline kid, and I too hesitate to do much, especially as she's a good student. And there've been times I've considered dropping DS's 504 as he needs it less and less. But then we run into a teacher that Nancy describes - one who feels kids shouldn't be accommodated, that standards are already too low, and were it not for the legal force of a 504, would make DS's life miserable. So I'm glad we have it, even if it isn't used that often. It sounds like this teacher will not get it, not matter what you do. There could be things behind the scenes you're not aware of, so focus on the end game, not on the details of getting there. I was so irked by my son's 4th grade teacher, yet I was hesitant to get involved and when I did, it made things worse. At the end of the year, she was fired and I found out lots of parents had the same beef I did. Before you revise your opinion of the AP, wait for it to play out. Just get your DS moved and stay on the good side of the AP, especially if getting a 504 written is a potential goal. Right now, you understandably feel the need to clear your son's name. But if it's not in writing, it may very well fade and be forgotten. If you push, it may not come out the way you'd like. I can only say what I'd do - and that would be to stay on good terms with the AP, get off on the right foot with a new teacher and pave the way for a better way forward for DS. Today on Humans of New York's FB page is a guy who says "I'm trying to fight less with people. If you want to stay stupid, stay stupid. but me, I'm moving forward." Seems like the best advice for this situation.

Hey Peglem! I just got in from work (new job which is great for replenishing the $$$$ we've spent on medical and my being "underemployed" for 3 yrs while fighting DS's lyme - but adds a whole new wrinkle to juggling things!). Picking up the kids in a bit, but will be happy to give this some thought over the weekend. In the meantime, can you PM me DDs behavioral hurdles? I know a bit about her background but not sure which issues are front and center at the moment. Also, PM me what she's taking medication and supplement-wise, plus your email if you don't mind, so I can send you a "customized" heartfixer doc.

There's a blood test for antibodies to it. Pretty inexpensive, available at most labs and covered by insurance. There are anti-virals you can use. Some docs say to just let the body fight it. But my DD couldn't lick it on her own. She ended up on a 504 and could only make it thru 1/2 days at school - they sent a tutor to our home int he after noons for 6 weeks. Our LLMD tried artimisinin but it didn't do much. I then tried l-lysine - an OTC amino acid - 500mg twice a day. She started to feel better within a few days. It still took time for her to be able to return to school full time, but the lysine was the turning point for her. CoQ10 also helped her with some energy.

Em - I'm so sorry!!!! Down the road, you might consider 23andMe, as this could help your Dr determine which SSRIs would or wouldn't be most helpful and/or what alternative to meds could help. (I'd also happily help decipher the methylation stuff with you if you're ever interested). But in the meantime, while I have no experience with prescription meds, tryptophan always helped my kids pretty quickly. I've taken it a few times and it did help with panic/anxiety w/in 20 min or so. I think MomwithOCDSon used valerian root. Rooting for you!! You'll kick this!

We did Pex w/Dr L 5 yrs ago. I admire her a lot and am very grateful for her help when no one else would take us seriously. We did Pex and at first I thought it was awesome, but the improvements didn't last. 6 weeks later he regressed. We did IVIG and he got even worse. It turns out my son had undiagnosed lyme. We spent 2.5 yrs treating lyme and other issues with an LLMD and my son is now in a great place. I respect Dr L but the test she uses for lyme is the standard western blot, which is unreliable. I have no idea if your son has lyme or not. But you can't rule it out using the standard WB. Under the pinned threads at the top of the forum page, you'll see "helpful discussions for lyme" - under that heading you'll find articles explaining the various tests. Before parting with $27,000 of my own money I'd rule other things out. The list of conditions that can trigger neuropsych issues is a long one - Pandas, lyme, myco, mold, pyroluria, methylation, heavy metals, nutritional deficiencies (particularly the Bs and zinc), excess copper, .....$27,000 pays for a lot of doctor's appts and treatments. I know two families who were really helped by Pex and their daughters were severe. But I also know families that didn't see lasting improvements. If your son still has high myco, I'd be sure that was gone first, at the very least. otherwise, the trigger is still there and you can remove auto-antibodies, but what would stop the body from making more if the myco is still there? What are you doing to treat the myco?

I contacted two of the moms I mentioned above and asked them to PM you. Yes, I do think additional time on antibiotics will help. But be sure to get probiotics into her, 2-3 hrs away from abx. You don't want to destroy "good" gut bacteria - which play a role in neurotransmitter synthesis and impact nutrition/absorption. And you don't want to develop yeast issues. yeast can trigger symptoms that look like Pans. So use about 50 billion CFUs of a good probiotic (one that's refrigerated - not the stuff you see on the grocery shelves tha may have been sitting in a warehouse for 6 months. CP-1, Theralac and Kirkman's High Bifido have all worked well for my kids.

I have no doubt those who can pull this off enjoy benefits. But I have to confess to a personal failure here. We tried GF for 9 days and threw in the towel. We were hoping it would help DS11 with an eye tic he'd had for several months and other things we'd tried hadn't helped. DS did not have elevated antibodies on the gliadin or other gluten blood work. But I was running out of ideas. If his health depended on it, we could've kept going. But it was really hard, because the whole family consists of picky eaters - many GF menu items were unappealing. So while he was able to do GF, he wasn't necessarily eating healthy. He tended to eat more sweets in place of a snack that would normally be a carb. He ate eggs for dinner more nights than either of us felt was balanced. etc. If you have a versatile eater, I think it's more doable than if you start out with a long list of things he won't touch. But I did find it more expensive and very time consuming to plan and cook. The ending to our personal story was that his blood work came back showing elevated inflammation markers for mold illness. I went hunting for mold (something i've had to do two other times on our journey) and found significant mold on his bedroom and bathroom windows. Normally, I put plastic over the bedroom windows but didn't this year. The extreme cold weather, plus windows that I forgot to lock tight in the fall (so they were open by a hairline at the top), led to higher than usual condensation and a mold overgrowth. I cleaned the windows, vacuumed with a help filter, cleaned the hard surfaces with clorox wipes, washed linens and curtains...and his eye blink greatly diminished within two days. It's mostly gone now, 12 days later. So for us, GF was worth a try, but didn't pan out. I greatly admire those who can do it! Thankfully, we found a different path that paid off.

To PM someone, if they've replied somewhere in a recent post, you can click on their name and it will bring you to their profile page. From there, you can click on "send me a message". If it's someone who hasn't been on in awhile, you can go to the search bar in the upper right corner at the top of the page and use the drop down menu to select "search members" (click on the icon of the magnifying glass to change from "search this forum" to "search members". The type in the person's screen name and click search. This will give you results and then you can click on the person you're looking for. This will bring you to their profile page and from there, select "send me a message" Speaking of books, you may also get some good info from this one: http://jamesgreenblattmd.com/anorexia-overview/ where Greenblatt (Tufts integrative psychiatrist) outlines the role of zinc deficiency in anorexia. Zinc is critical for both the immune system and neurotransmitters. If your DD was low in zinc and then got sick, it could have turned a mild zinc deficiency into a catastrophic one, trigger the anorexia as a result of having to divert zinc resources toward fighting an infection. Just a thought.

I've not found tons of info on the detox snps thru regular googling. Your best bet is to try the FB groups like MTHFRSupport (they have a website as well) and ask there where you can find useful links, reading, etc. You can also try Yasko forums. Wish I had more to offer, but it's not an area I ever got around to exploring.

I don't want to put words in his mouth, but my personal experience with Dr M is that his training as an osteopath with a natural/integrative bent puts him in the camp that feels psych issues are medical in their causes - whether it be due to infection, nutrition, environmental toxins, methylation imbalance.... If your DD was fine and then suddenly was not, there's a physical/medical cause. People don't go nuts or turn anorexic for no reason. Especially children. I've not had to deal with severe eating issues. Ours were mild compared to what you're dealing with. But I'd put real emphasis on getting a balance of nutrients into her, more so than calories. It's the nutrients - the B vitamins, the zinc, magnesium, Vitamin C - that are critical to neurotransmitter production and balance as well as immune system health. There are many, many nutrients involved, but these are the biggies for the immediate term. Zinc deficiency is implicated in some anorexia and is also essential to the immune system. The Bs are essential to neurotransmitters. Most commercial multi-vitamins are poor quality (e.g. they use cheaper, less than ideal forms of certain vitamins) but it's a start. See if you can get her to drink the ensure for calories and then take a multivitamin - or buy a liquid multivitamin that you can sneak into the Ensure. Try (and I know it's hard) to no obsess about the eating. It invites power struggles and feeds into OCD behaviors if you start feeding her as a bribe to get her to eat. You can never win when you try to bribe OCD. It's a wretched, slimy bastard that can't be trusted to uphold its end of any bargain. If you get 1200 calories into her and a daily dose of the above vitamins, that's all I'd strive for. But then, I'm not the expert on the food issues. EAmom, KaraM, DCMom and a few others have fought these battles more than I have. EAmom's daughter was hospitalized for restrictive eating. You might try PMing them, as they're not on forum often anymore but are willing to share their advice if you contact them.

My son is better than he was before this all hit. But it took 5 yrs to get to this point. This isn't to discourage you. We thought we were only dealing with strep. But it turned out he also had lyme, so the first 2 yrs of treatments weren't fully effective because we weren't covering all bases. In addition to strep and lyme, we also ended up treating pyroluria, mold, yeast and methylation issues. So healing was a matter of peeling away layers of an onion. Each time we hit upon something and treated it, he moved forward. When we pursued something that wasn't an issue (e.g. metals) we saw no change. So his response told us whether we were onto something. The way I see PANS in hindsight is that before any infection entered the picture, DS had nutritional/methylation deficiencies. This caused him to get sick all the time, catch every bug at daycare and take twice as long to recover. Sometimes he'd exhibit behavioral issues when he was sick, but I'd never heard of Pandas back then. Then when he was 5, he was bitten by a tick on his scalp. I didn't appreciate the risks and never looked for any sort of rash under his hair. A month later, he was very erratic in his behaviors and anxiety was sky high, but then it subsided and I never made the connection to the tick. Didn't realize that lyme can cause neuropsych symptoms. Then a few months later, he got strep for the first time. I think his body was already nutritionally deficient (from pyroluria and methylation defects), he had inflammation from his mold "allergy" and his immune system was already fighting lyme. So strep was the straw that broke the camel's back. Treatment started with strep, But we ended up working backward, making progress each time we eliminated one of the "perfect storm" contributors. So what did recovery look like for DS? It was very saw-tooth. Two steps forward, one step back, until we removed or detoured around another roadblock. Now that I "think" we've done that, DS is in a better place than he was before all this started, because we've addressed many of the issues that led to the cascade of collapse in the first place.

Our LLMD doesn't use CD57 on kids - doesn't feel it gives reliable info. He uses C4a and HLA-DR tests for mold suceptibility, so you could look into those to see if you need to go on a mold hunt. Here's a list of tests Shoemaker uses: http://www.survivingmold.com/diagnosis/lab-tests I don't know a ton about mold, despite going down the mold trail twice now. Some of Shoemaker's tests showed DS was struggling with inflammation and toxins so we emptied the basement of 10 yrs of clutter, mildewy cardboard boxes, etc - 8 trips to the town dump on the hottest day of the year - if DH didn't leave me then, he never will. DS's symptoms improved after that. He made great progress with lyme for 1.5 yrs and went off abx last spring. He was good for a short time, then relapsed. We treated yeast and he was 90% better but still had an eye blink tic. Shoemaker's labs again came back somewhat elevated so last weekend, I went on another mold hunt - and found some on the bedroom and bathroom windows. The wicked cold air outside had collided with warm inside air and made enough condensation that mold was nasty where the two double-hung windows met. The kids' bathroom window was really bad (they've developed a love for hot showers). You wouldn't think such a little bit of mold would be a problem but for DS it was. I cleaned the windows, vacuumed with a hepa filter and the next day, the eye blink was considerably less. Within 2 days, it was all but gone. A week later, I may have seen the eye tic once in 3 days. I know it sounds nuts, but for DS it caused significant neurological symptoms. So I guess where I fall on mold is do the Shoemaker labs (not necessarily all of them - I'm sure your LLMD has ones he/she prefers). Then if they suggest mold reaction, go hunting. I know you can go back to the archives and find lots of discussion in the '10-'11 time frame (lord, I've been on here too long). about ERMI testing and mold treatments. Some have found major problems, requiring major expense. I've been able to avoid that and take care of simpler issues and gotten good results. Depends on so many factors. But I think the blood work is a good place to start. Mold can be an enormous money suck. Start with data from the body. Other things that stalled my son's progress- pyroluria and methylation roadblocks. If you're not seeing sustainable progress, it seems that there's something you're missing beyond lyme.

I am no expert on this, despite my many postings. It's a topic I'm passionate about but passion does not equal expertise. So this is only my understanding... when you test too high in B12, I think it means you have unmethylated/unused B12 hanging around. Meaning you either have too much B12 or not enough B9 (in the form of methylfoate). Think of it as trying to make purple. You need equal amounts of methylfolate + methylB12 to make the shade of purple you're after. Instead, your purple is leaning heavily toward the reddish side. You probably need to take in less red (b12) and more methylfolate (blue) to get balance. So personally, if it were me experimenting with my own child, I'd keep the sublingual methylB12 but stop the methylguard, which has both methylfolate and methylB12. In place of the methylguard, I'd give just straight methylfolate. I use Holistic Health's Methylmate B liquid drops because it helps me tweak doses very easily. But once you settle on a dosage, you can use something different - tho it's hard to find things that don't also contain some form of B12. This would accomplish two things at once - first, you could adjust the dose of methylfolate upward to team up with that excess B12, thus adding more blue to your puddle of excess red, making more purple. Also, by eliminating the methylguard, you'd be putting less B12 (red) into the system. These two steps "should" help sop up your puddle of excess red at some point. However, after a time when the puddle was gone, you might need to readjust dosages of both methylfolate and methylB12 and find a new equilibrium. Other options would include switching from methylB12 to hyroxyB12 (Perque makes a hydroxy sublingual). This would cause the body to use up a methyl donor to convert the hydroxy into the methyl form and could possibly reduce the amount of unmethylated B12 hanging around. But my science is weak here and someone more knowledgeable might say I was mistaken about this. Do some research - don't take my word.

ACN - the parent non-profit that runs this forum, also has a Pandas primer for parents who are new to the disorder. It might answer some of your questions. It's an e-book http://latitudes.org/store/should-you-consider-pandas-ebook/

I'd move the evening abx dose to 6pm just before dinner and give the probiotic after 8pm/bedtime. I'm not sure what the reason is for the probiotic mfr to suggest taking with a meal. My LLMD feels they work best if taken at bedtime, away from meals, so the stomach acid is lower and doesn't kill as many of the probiotic good guys. Also allows probiotics to sit in a less active intestine, theoretically allowing better cultivation. Perhaps consider a different probiotic (ideally with Lactobacillus and Bifido strains) We use CP-1, Therlac or Kirkman's High Bifido complex.

http://www.ocfoundation.org/uploadedFiles/MainContent/About_OCD/Expert_Opinions/IOCDF%20Expert%20Opinion%20-%20PANDAS%281%29.pdf Above is a test link. It seems to be working ok for me.

funny - I recognize some of the parents and their stories. I don't agree with Swedo and while I even agree with her that some docs give a dx of Pandas when they should dig deeper, I disagree that a child has to be neurotypical prior to onset. How do you know if an infant diagnosed with autism was ever neurotypical? Sometimes, we're still so much in the dark ages.

Many here use Sacc B/Florastor as their probiotic of choice, because Sacc B is a yeast and isn't killed off by abx, so you can give it at the same time you give abx. This is a big help when doing various meds at various times of the day. Other probiotics need to be given 2-3 hours away from abx or the abx will kill the probiotics. Unfortunately, despite this advantage and Sacc B being a "good" yeast, it send my DS over a cliff. He reacts to it with many of the same symptoms he shows during a PANS flare - aggression/rage/short temper, brain fog, hyperactivity, intrusive thoughts. I don't have a scientific reason for his reaction, but I've seen it more than once and we now not only stay away from Sacc B supplements but have put him on diflucan and nystatin when it's showed up in stool tests. For him, it's as bad as any other yeast infection. So it has many things going for it and if your child can take it without side effects, it's worth trying. But if you see an increase in unwanted behaviors, stop the Sacc B and see what happens. It's a very individual thing.

250 mg of zith seems low - is your treating dr. open to increasing it? My kids were on 500mg. for lyme & Pandas FYI - NAC isn't tolerated by everyone. It can cause neuropsych issues for those who are intolerant. Makes my DD flip out with bipolar symptoms. NAC made me depressed and elevated my liver enzymes. But it helps others. depends on your genetics. Try eliminating the NAC for a week and see what happens. it could be that your DD does fine on it. But its worth an experiment. You can give probiotics once a day. Just make sure it's at least 50 billion CFUs. CP-1, Theralac and Kirkman's Bifido complex are all good ones. My docs have always said to give zyrtec in the evening, as it can cause drowsiness. If she's ok with it in the am, you can leave it. But if she's complaining of fatigue, you can move it to bedtime. But do be cautious - long term use is not without risks. It triggered anti-cholinergic tremors in my DD a few times. She's now off it and only uses it in emergencies. Try this schedule: Morning - zith, vitamin C Evening - D3, magnesium, 50 billion probiotic - take at bedtime when she hasn't eaten in awhile, so the stomach acids are lower and the bowels will be slower over night. It hives the probiotics a better chance of surviving the stomach acids and having longer to colonize the GI tract in a quiet time. (no physical activity or incoming meals to move the bowels) The term for die off is Herxheimer Response - google that + lyme and you'll find a lot of info. Also consider CBT and ERP tools. Search the forum archives for these terms. They're great tools to help kids cope with compulsions and fears. It may not eliminate the rituals during the peak of a flare, but they help kids feel more empowered and understand what's going on, less victimized.

You might find this resource helpful http://latitudes.org/store/should-you-consider-pandas-ebook/ As a very, very loose guide, you need two things in order to see improvement - you must eradicate the infection and you must give the body time to stop the cascading cycle of inflammation. Sometimes you see immediate results and other times, it can take several weeks of the right antibiotic. It depends on whether there's chronic strep (hiding in the crevices of tonsils, in sinuses, adenoids) or if a bacterial infection that isn't sensitive/vulnerable to the particular antibiotic you're using. If strep is your trigger and you get on the right antibiotic, I'd expect to see improvement (maybe not complete remission) within 6 weeks. If you don't see that, consider changing antibiotics or screening for other triggers such as mycoplasma pneumonia, lyme... and make sure you give @50billion CFUs of a good probiotic while on antibiotics. Take the probiotic at least 2-3 hrs away from the antibiotic (preferably on an empty stomach so that stomach acids aren't stirred up, which tend to kill more of the probiotics before they have a chance to reach the GI tract). So if the last dose of antibiotic is 6pm, give the probiotic at bedtime after 8. Theralac, Kirkman's Bifido Complex and CP-1 are all good probiotic blends that come in the higher doses you need.

DeeDee - YEAH!!!!!!!!!! :wub: :wub: :wub: :wub: :wub: Qannie - the 23andMe high dive isn't for everyone. You do need to bring your brain along for an adventure. But I'm an art major, with no interest or aptitude in biology, organic chemistry or genetics until Pans came along. But I've been able to finally understand some of it and from all I can tell, you'd be able to figure out which end of the elephant you were dealing with too. Best test I've ever, ever done on my kids.