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What is Causing Rash?


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We finally found a local pediatrician to treat PANDAS. She takes an integrative approach & has suggested many vitamins/supplements in addition to antibiotic based on various tests she ran. We started everything at once 2 weeks ago, which was clearly a bad idea, because DS keeps getting rashes. They are itchy/burny feeling red bumps that have cropped up first on his back, then legs, now face. At first I was thinking it was from detox/dieoff, but now I'm worrying he's allergic or having a bad reaction to something. I think I'll have to discontinue everything & reintroduce one at a time. Any ideas on which of these items is more likely to be causing rashes?:

 

Augmentin for PANDAS

Diflucan for yeast & fungal infection in sinuses

Kirkman chewable multivitamin

5-MTHF for MTHFR mutation

Vitamin B6 & B12 lozenge

Vitamin D

Fish Oil

Probiotic

 

I'm just really hoping he doesn't have an allergy to Augmentin. He's taken it before, but I suppose he could suddenly be allergic?

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Yes, unfortunately, introducing one thing at a time would've made this a little easier. But it is what it is. To start, I think I'd stop all but the augmentin. Give that a week. Then add the probiotic (at least 2 hrs away from abx). If you've used both before, I might consider keeping both on board. Then a week later, add the diflucan back or consider something like garlic (depending on your dr's preferences).

 

I think I'd then add back the B6 as that helps detox pathways. Then I'd go back to the methylfolate. Then the Vitamin D.

 

The fish oil and the multivitamin are to me the two that need the most cautious approach. Not that they'd be causing the rash but because they're the ones that are most likely to disagree with someone. If you have pyroluria (KPU), you need evening primrose oil and not an omega 3 fish oil. So you may want to rule out pyroluria. For the multivitamin - since it seems you know you have an MTHFR issue, I'd avoid anything that contains regular folate. Even tho I've read sites that say it's only an issue for those who are heterozygous (2 mutations), my DD who has only one mutation reacts badly to any multi with regular folate (even Thorne's which has 200mg regular folate and 200 mg methylfolate). She also gets angry if she eats fortified cereal. So I stopped buying it. Haven't yet found a suitable multi for her.

 

Nothing aside from the augmentin screams out as a source for a rash. And like you, I think "die off". I'd probably be using an antihistamine to make sure that you didn't run into a breathing crisis if it does happen to be an allergic reaction. But if you can establish that it's not an allergy, then I think using an antihistamine and introducing things back gradually might get you back on track. Good luck!

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I think, too, that if you try an antihistamine, like Benadryl, and see that the rash improves/goes away, then it may tell you that it IS an allergy to something. If it doesn't go away with the antihistimine, then it may be something else causing the rash. Do others agree with this logic? Dr. B. mentioned it to me when we asked about a rash by dd had. (Conversation went something along the lines of: "Did it go away with Benedryl?" "No." "Then it wasn't an allergy.")

 

 

 

Nothing aside from the augmentin screams out as a source for a rash. And like you, I think "die off". I'd probably be using an antihistamine to make sure that you didn't run into a breathing crisis if it does happen to be an allergic reaction. But if you can establish that it's not an allergy, then I think using an antihistamine and introducing things back gradually might get you back on track. Good luck!

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LLM just curious how much methylfolate are you giving? My DD8 has one mutation and Dr O started her on a half capsule of 5-MTHF daily - each capsule is 10 mg so she is taking ~5 MG. You wrote below 200MG so was just wondering. Also how long did it take to see real results. Thanks

 

Yes, unfortunately, introducing one thing at a time would've made this a little easier. But it is what it is. To start, I think I'd stop all but the augmentin. Give that a week. Then add the probiotic (at least 2 hrs away from abx). If you've used both before, I might consider keeping both on board. Then a week later, add the diflucan back or consider something like garlic (depending on your dr's preferences).

 

I think I'd then add back the B6 as that helps detox pathways. Then I'd go back to the methylfolate. Then the Vitamin D.

 

The fish oil and the multivitamin are to me the two that need the most cautious approach. Not that they'd be causing the rash but because they're the ones that are most likely to disagree with someone. If you have pyroluria (KPU), you need evening primrose oil and not an omega 3 fish oil. So you may want to rule out pyroluria. For the multivitamin - since it seems you know you have an MTHFR issue, I'd avoid anything that contains regular folate. Even tho I've read sites that say it's only an issue for those who are heterozygous (2 mutations), my DD who has only one mutation reacts badly to any multi with regular folate (even Thorne's which has 200mg regular folate and 200 mg methylfolate). She also gets angry if she eats fortified cereal. So I stopped buying it. Haven't yet found a suitable multi for her.

 

Nothing aside from the augmentin screams out as a source for a rash. And like you, I think "die off". I'd probably be using an antihistamine to make sure that you didn't run into a breathing crisis if it does happen to be an allergic reaction. But if you can establish that it's not an allergy, then I think using an antihistamine and introducing things back gradually might get you back on track. Good luck!

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Ooops! I should've typed MICROgrams (mcg) not MG. Thorne's contains 200mcg of methylfolate.

 

As for my DD, she takes a very, very low dose - just one drop of Yasko's methylmate B liquid, which is approx 67mcg of methylfolate.

When we started out, I started at one drop and built up to 3 drops/day (the label says 1-6 drops/day). The first few weeks, I saw nothing but she was also in a good place. We built up and then all h**l broke loose. I didn't make the connection at first but when we stopped all supplements to do an amino acid test, evil child melted away within 36 hrs. So I slowly added things back and when I got to 2 drops evil child started to come back. I read www.mthfr.net almost in its entirety and found a case study where a guy was overdosing himself. Dr Lynch suggested a small amount of niacinamide (50mg) to counteract the overmethylation. Sure enough, DD's rage/evilness dissipated in about 45 min. So I backed off the methylfolate and now she's been steady mood-wise for months. Evil child (rapid cycle mood swings, provokes fights, ODD) - starts to show up if she takes the multi with the regular folate.

 

But there doesn't seem to be a set protocol. Everyones' needs seem to be different and its very much trial and error. I only knew where DDs line was by crossing it and then backing down. Highly recommend scouring mthfr.net for tidbits or you can PM me. I don't mean to hijack the thread.

 

LLM just curious how much methylfolate are you giving? My DD8 has one mutation and Dr O started her on a half capsule of 5-MTHF daily - each capsule is 10 mg so she is taking ~5 MG. You wrote below 200MG so was just wondering. Also how long did it take to see real results. Thanks

 

Yes, unfortunately, introducing one thing at a time would've made this a little easier. But it is what it is. To start, I think I'd stop all but the augmentin. Give that a week. Then add the probiotic (at least 2 hrs away from abx). If you've used both before, I might consider keeping both on board. Then a week later, add the diflucan back or consider something like garlic (depending on your dr's preferences).

 

I think I'd then add back the B6 as that helps detox pathways. Then I'd go back to the methylfolate. Then the Vitamin D.

 

The fish oil and the multivitamin are to me the two that need the most cautious approach. Not that they'd be causing the rash but because they're the ones that are most likely to disagree with someone. If you have pyroluria (KPU), you need evening primrose oil and not an omega 3 fish oil. So you may want to rule out pyroluria. For the multivitamin - since it seems you know you have an MTHFR issue, I'd avoid anything that contains regular folate. Even tho I've read sites that say it's only an issue for those who are heterozygous (2 mutations), my DD who has only one mutation reacts badly to any multi with regular folate (even Thorne's which has 200mg regular folate and 200 mg methylfolate). She also gets angry if she eats fortified cereal. So I stopped buying it. Haven't yet found a suitable multi for her.

 

Nothing aside from the augmentin screams out as a source for a rash. And like you, I think "die off". I'd probably be using an antihistamine to make sure that you didn't run into a breathing crisis if it does happen to be an allergic reaction. But if you can establish that it's not an allergy, then I think using an antihistamine and introducing things back gradually might get you back on track. Good luck!

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Thanks for the help! I discontinued everything except Augmentin today. The rashes look better. However, he ran a fever today, was lethargic & a little congested, so I think he's coming down with a cold virus now. Hopefully fever, etc. is not a reaction to the Augmentin. Will continue to watch closely tomorrow & have Benadryl on hand if needed. Will eventually add the other things back one at a time very gradually & probably start at lower doses & work up to full dose.

 

LLM, thanks for the info about the folate. Looks like the Kirkman multi we're using has 400mcg folic acid in it. The B6 & B12 lozenge also has 800mcg folate as "calcium folinate". Should that form be avoided as well? Dr. had wanted us to start out with 1g of the 5-MTHF, but after reading your story, I think we'll start at a fraction of that & slowly work up. My son has 2 copies of the C677T mutation.

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Since your son has two mutations, it makes sense that he'll need more than my DD once you figure it all out. From what I've read, people with one mutation turn folate into methylfolate @ 40-60% effectively and people with two mutations can only convert @ 10% of the folate they consume. So your DS is probably going to need more than my DD. But the three "experts" I've read (Yasko, Van Konyenberg and Lynch) suggest that 400mcg methylfolate is a rough target for children and 800mcg for adults. They all say there's no set amount, that everyone is different. But 1gram for a child seems quite high for an initial goal.

 

Given that you'll be working up and also adding back other things and trying to figure out the rash, it's going to be tricky. I'd probably consider two things - not going above 400mcg until you've got everything else figured out and I'd also get some niacinamide. If you see a rage or oppositional behavior and you think it could be from methylfolate, sprinkle a small amount of niacinamide (vitamin B3) into something he can eat (I hide mine in the creme of an oreo). Lynch suggests 50mg. I could only find 500mg capsules, so I open one up and try to sprinkle about 1/10 of the capsule - hardly an accurate measurement but the best I could do. If you see a calming effect, then you'll know to back down on the methylfolate. For us, it only took a day or two for things to calm down when I lowered the dose. It's a pretty fast-acting response.

 

If in a few months, if you're still seeing mood issues and infection doesn't seem to be the driving factor, then circle back and tinker with an increase in methylfolate. It's also possible that illness could cause the body to need more methylfolate than it does on a regular basis. So in the back of my mind, I remind myself DD may need a bit more if she gets sick and I see mood issues return.

 

I know a lot of people cringe at the idea of messing around with this in such a "mad scientist" sort of way. But it's such a relatively new idea that there just isn't any way to know what one individual needs without tinkering. It's virtually unstudied in kids, yet I think it could be at the root of so many "childhood bipolar" diagnoses.

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