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On zpack for active strep (LLM, question for you, too)


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Hi all,

 

DS11 is probably PANDAS. Sudden onset at age 6, consistently high titers in the past, positive on Dr. Cunningham's panel. Also probably positive for Lyme and definitely MTHFR homozygous for C677T with abnormal methylation markers.

 

He has been off all antibiotics for about 8 months. He was just diagnosed an hour ago with active strep while we are on vacation. One day of self-resolving high fever and a mildly sore throat. That's it! When I got strep (once!) I was in so much pain I couldn't believe it. I think these PANDAS kids just present differently.

 

Local urgent care doctor put him on a zpack (250 azithromycin for 5 days). This is DS11's first case of active strep in years, and only his second active case ever, although he is probably an active carrier, based on past high DNASE and high ASO titres. For the past year, the DNASE and ASO have been down to normal levels so we thought maybe he'd beaten this.

 

I have calls out to our regular doctors, but this urgent care doc was certainly not going to be treating based on PANDAS. In your opinion, is the zpack going to be enough? Will it be enough for a few days till we get back home? We just haven't had to deal with active strep in years, and it is the holiday weekend far from home. Any advise is appreciated.

 

LLM, any thoughts re: strep and methylation? He is on methylfolate, which helps more than anything else we have tried, but only seems to help the anxiety, not the tics and OCD.

 

Thanks!

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Zith seems to work well for some kids and not for others. But I'm guessing it'll be ok until you get home. Then depending on how he's feeling/behaving, you can always ask your pedi for additional abx if needed. Consider some zinc to help the immune system and some B6 and alpha lipoic acid for glutathione production.

 

If you're seeing OCD, you can try using 5-HTP or tryptophan to bump up the BH4 cycle(my DS10/82 lbs takes 500mg 1xday normally, 2xday in a flare). If you find yourself using it for any length of time, consider adding tyrosine as well (maybe 250mg? to start), as it's best to use both for balance.

 

For the tics, you can try taurine. This helps my DD when she's a little jittery. But what helps my DS for tics is detox - B6, milk thistle, alpha lipoic acid, resveratrol, activated charcoal. No instant cure but they help the tics subside more quickly. Not all tics are caused by toxins, but for my son, his tics come out when we fight an infection and the toxins from the dying bacteria overwhelm his transsulfuration/detox pathway. We see it when we treat strep and when we do cyst busting. The supplements I listed help him. And don't forget the motrin.

 

If you're freaking, try some Gaba or tryptophan or valerian root (for you, not your child). I find I handle things better when I'm calmer and I've come to like Gaba - mild. I stay feeling normal but when I look back on the day, I realize I stayed calmer than I might have otherwise.

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Thanks! Off to the store for supplements.

 

Zith seems to work well for some kids and not for others. But I'm guessing it'll be ok until you get home. Then depending on how he's feeling/behaving, you can always ask your pedi for additional abx if needed. Consider some zinc to help the immune system and some B6 and alpha lipoic acid for glutathione production.

 

If you're seeing OCD, you can try using 5-HTP or tryptophan to bump up the BH4 cycle(my DS10/82 lbs takes 500mg 1xday normally, 2xday in a flare). If you find yourself using it for any length of time, consider adding tyrosine as well (maybe 250mg? to start), as it's best to use both for balance.

 

For the tics, you can try taurine. This helps my DD when she's a little jittery. But what helps my DS for tics is detox - B6, milk thistle, alpha lipoic acid, resveratrol, activated charcoal. No instant cure but they help the tics subside more quickly. Not all tics are caused by toxins, but for my son, his tics come out when we fight an infection and the toxins from the dying bacteria overwhelm his transsulfuration/detox pathway. We see it when we treat strep and when we do cyst busting. The supplements I listed help him. And don't forget the motrin.

 

If you're freaking, try some Gaba or tryptophan or valerian root (for you, not your child). I find I handle things better when I'm calmer and I've come to like Gaba - mild. I stay feeling normal but when I look back on the day, I realize I stayed calmer than I might have otherwise.

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