Worse after starting azith?

[jan251]

I am speculating on possible reasons that OCD would get worse on zithromax and would love to hear experiences or thoughts.

Besides yeast, what would cause the OCD to get worse? If the zithromax was killing mycoP (or anything else, for that matter), might that do it, some sort of herx? Or killing off lesser bugs so that the big bad one, whatever it is, has no competition?

Edited November 20, 2014 by jan251

[BeeRae22]

I don't know any of the background history, so I'm not sure how long you've tried other treatments or abx, but here's my initial reaction to your post....

 

"The day following that first night's 500 dose, ds was calmer and while the ocd was still there it seemed somewhat lessened" -- "the next day, the ocd was clearly, clearly worse. It is still worse again today" -- "Patience is not my middle name".

 

When you say ds was calmer, but ocd was still there, and then the ocd was worse, what do you mean by that exactly? Was it worse than ever? Worse than the day before? How about a week before that? Ocd morphs, twists, and transforms all the time. One day it can be focused on one thing, and something different the next. Just looking for clarification on "worse". If you're saying that ds is suddenly raging or exhibiting new behaviors worse than ever before that's different... But generally speaking, I would say that it's honestly difficult to differentiate ocd behaviors in the span of only 3 days, because ocd and anxiety can morph much quicker than that, even throughout 1 day. How long has your son had pandas?

 

With that said, unless something really out of the ordinary is happening, our Pandas/Pans doctor feels that anything less than a 2 week trial for an abx is insufficient. With my daughter, she saw improvement at the 12-14 day mark with each new abx she has tried in the past year. (Unfortunately, her improvements would level off and then she would start declining again...damn myco-P). If your son has significant pandas/pans symptoms, it could take some time for real improvement. Patience is not my middle name either, I get it I really do. Especially when your child is hurting. My 8 yr old dd had stopped eating and was literally starving and disappearing right before my eyes and there was nothing i could do about it. It took about 6 months of different abx combos and trials to bring real changes. I remember that feeling of resistance each day I was giving her more and more meds, trying new ones, the frustration and fears and doubts I had about it.... Here I am, almost a year of abx later- and now I'm afraid to take her off of them. Amazing how your perspective can change when you're on the Pandas/Pans path!

 

MycoP can be really, incredibly difficult to eradicate. It took about 8 or 9 months of various abx for us to see a reduction in myco p... IGM is finally within range, but her IGG are still over 5 (should be <.90)

 

What abx have you tried? Duration? Have I tried combinations, or only one at a time?

 

I am just beginning to explore MTHFR. I suspected dd had methylation issues, and had a bit of a confirmation when I upped a dose of folate on her once.... That one is just like it looks like, it's a MTHFR! From what I can tell. For my dd, I believe it may be a contributing factor, but not the main source of anything. I do think it may be hindering her treatment.

 

I'm sorry that I'm probably not saying anything you want to hear I was so frustrated for so long... We all want our babies to be better NOW. This disease is so hard. Good luck. I'm no expert by any means, but I wouldn't change anything for awhile... If you change too quickly, than you don't know what's causing what. Give each treatment a fair trial (unless something's really gone wrong of course). Take a lot of notes, track everything because you will forget. There are many, many experienced, helpful and understanding members on this board- lean on them, ask lots of questions, read, read, and read some more. And take care of yourself too, you ds needs you at your best best wishes...

[kim]

Jan,

 

You might want to read through some discussion here

http://forums.phoenixrising.me/index.php?threads/my-hypothesis-on-th2-to-th1-immunomodulators-in-cfs.8447/

 

When an anti biotic switches the action of the immune system (activates an alternate arm) you may be increasing the function of a more inflammatory response at least initially. Probiotics can have this effect too.

 

Just another perspective to consider.

[nicklemama]

Herxheimer reaction to killing off bacteria. Inability to detox the toxins from it.

[jan251]

Thank you all. I know I need to be patient. I'm just hoping for a sign that this is good, that this is the right path, to get me over the tough moments. (Herx would do that for me.)

 

Thanks for the link, Kim. So, the idea is that the immunomodulation aspects of something like the zith shift the immune system to killing bacteria (I think?) but if there were a virus(es), those might then have the opportunity to pick up steam.

Edited November 20, 2014 by jan251

[kim]

Jan,

 

You're welcome. I hope I'm getting this right!

 

but if there were a virus(es), those might then have the opportunity to pick up steam.

 

I think that was speculation from the thread I posted? I would have to reread this too.

 

This is more that I copied from some notes that I had saved. The paper talks about clarithromycin (macrolide) as is azith.

IL4 was particularly interesting since kids were loaded with seasonal allergies per testing. I think that's what caused me to take notes on this.

http://jac.oxfordjournals.org/content/56/3/502.full.pdf

Differential effects of three antibiotics on T helper cell
cytokine expression

 

Under conclusion

However, clarithromycin decreased only interleukin-4 expression
such that the Th1/Th2 ratio increased. Since a Th1 profile is considered favourable for resolution of infec-
tion, elucidation of immunomodulatory profiles of antibiotics may permit more rational antibiotic choice

 

from wiki

Function

IFNγ, or type II interferon, is a cytokine that is critical for innate and adaptive immunity against viral, some bacterial and protozoal infections. IFNγ is an important activator of macrophages and inducer of Class II major histocompatibility complex (MHC) molecule expression. Aberrant IFNγ expression is associated with a number of autoinflammatory and autoimmune diseases. The importance of IFNγ in the immune system stems in part from its ability to inhibit viral replication directly, and most importantly from its immunostimulatory and immunomodulatory effects. IFNγ is produced predominantly by natural killer (NK) and natural killer T (NKT) cells as part of the innate immune response, and by CD4 Th1 and CD8 cytotoxic T lymphocyte (CTL) effector T cells once antigen-specific immunity develops.[7][8]

Function

IL4
It has many biological roles, including the stimulation of activated B-cell and T-cell proliferation, and the differentiation of B cells into plasma cells. It is a key regulator in humoral and adaptive immunity. IL-4 induces B-cell class switching to IgE, and up-regulates MHC class II production. IL-4 decreases the production of Th1 cells, macrophages, IFN-gamma, and dendritic cell IL-12.

Overproduction of IL-4 is associated with allergies.[2]

 

 

Here are a couple of things on anti inflammatory effects of macrolides. Wonder if there are changes depending on where you are in the course of treatment?

 

http://www.ncbi.nlm.nih.gov/pubmed/15590715
Anti-inflammatory effects of macrolides--an underappreciated benefit in the treatment of community-acquired respiratory tract infections and chronic inflammatory pulmonary conditions?

http://www.ncbi.nlm.nih.gov/pubmed/16153572
Macrolides and airway inflammation in children.

Edited November 16, 2014 by kim