Discussion in 'Fibromyalgia Main Forum' started by victoria, Aug 23, 2006.

  1. victoria

    victoria New Member

    Azithromycin is one of the abx used by LLMDs for the treatment of Lyme disease as well as in the Marshall Protocol as well ... plus the link with L-carnitine... which is why this study is particularly intriguing, in my humble opinion:

    From PubMed:

    J Transl Med. 2006 Aug 15;4(1):34 [Epub ahead of print]

    Azithromycin in Chronic Fatigue Syndrome (CFS), an analysis of clinical data. -- Vermeulen RC, Scholte HR.

    ABSTRACT: BACKGROUND: CFS is a clinical state with defined symptoms, but undefined cause. The patients may show a chronic state of immune activation and treatment with an antibiotic in this subgroup has been suggested.

    METHODS: In a retrospective study, the response of CFS patients to azithromycin, an antibiotic and immunomodulating drug, has been scored from the patients records and compared with clinical and laboratory data.

    Azithromycin was not the first choice therapy, but offered when the effect of counseling and L-carnitine was considered insufficient by the patient and the clinician.

    RESULTS: Of the 99 patients investigated, 58 reported a decrease in the symptoms by the use of azithromycin. These responding patients had lower levels of plasma acetylcarnitine.

    CONCLUSION: The efficacy of azithromycin in the responsive patients could be explained by the modulating effect on a chronic primed state of the immune cells of the brain, or the activated peripheral immune system.

    Their lower acetylcarnitine levels may reflect a decreased antioxidant defense and/or an increased consumption of acetylcarnitine caused by oxidative stress.

    PMID: 16911783 [PubMed - as supplied by publisher]
    [This Message was Edited on 08/23/2006]
  2. mrdad

    mrdad New Member

    Ya know I count on you for all the latest in research
    and findings!! Saves ME a lot of time and energy! You
    Posts are always so informative. Much appreciated!

  3. Chootik

    Chootik New Member

    My doc has prescribed it but I haven't taken it yet.

    I'm still doing the Accyclovir (Anti-Viral) and as soon as I'm done with that, I'm going to start with this.

    So should we do AZITHROMYCIN and L-CARNITINE at the same time??

    Just wondering if that would be even better than doing it alone.

  4. victoria

    victoria New Member

    I'm no medical professional, but from what that study says, I don't see what the harm is in taking acetyl l-carnitine supplements with the Azith, in fact it seems likely it would help... since there was a deficiency at least in these patients.

    bumping up for more comments!

  5. Mikie

    Mikie Moderator

    Is one of the ones used for mycoplasma infections. If the Doxy hadn't worked so well for me, I would likely have tried it.

    Thanks for the info.

    Love, Mikie
  6. ckball

    ckball New Member

    What is the difference between Azithroycin and Zithromax? I was given the second drug a couple years ago in the hospital for a bad bronchial infection. It made me so sick.

    I threw up within the first 30 minutes.

    I just wondered if you knew how they were relatedD

    BTW My lyme Dr has the results of my western blot and will not tell me until my appt on monday. Wouldn't even say ya or na. I called and they would not let me have a copy of it either. The nurse said the Dr liked to go over the tests with the patients. So I wait. Been too busy to worry about it, I am feeling much better lately, Carla
  7. victoria

    victoria New Member

    and also from talking with my son's doctor, it seems that many LLMDs feel that many/probably most never really get rid of it if it is not caught in the acute stage and treated properly then. Fro what I've been told, treatment stops 2 months after symptoms have 'resolved', but that a pulse of abx once or twice per year is recommended.

    And HanginIn, yes, it does seem to get worse over time in most if not all if not treated or 'kept in check' ... and definitely causes the memory problems/brain fog, lethergy & lack of ambition/motivation!

    One of the women in my local support group who now sees my son's doctor and found she also was positive on the lyme test was told she would likely not get rid of it since it is apparent she has had it a long time, but could reach hopefully a higher level of functioning over time.

    I am hoping for my son because of his age (he was 17 when started treatment 15 months ago) that that will be on his side. While azithro/zithro has been rx'd for him, he has never actually tried doxycycline, not sure why unless it has been found to be less effective perhaps for lyme in the southeast.

    I think for everyone it is going to be based on some key things like : what variety of Bb one has (there's over 100 in US), if the right abx are found, how long one has had it, how old we are when being treated, and bottom line, our genetics... some will be more susceptible in more deleterious ways than others.

    And there are always surprises... Minimonkey on the Lyme board here I think felt better within a relative few months, about 5(?) even tho she felt she'd had it a very long time. Others can take a few years but ultimately can return to a normal life. Others don't.

    I know that Dr. JoAnne Whitaker, developer of the (still unaccepted) Bowen Test (that actually sees the lyme in the cells), found it in herself to her surprise; she wrote she does a routine of abx one or more times/year but also does herbal remedies like samento and body-mind things like the bowen technique. Diet and treatment for candida, Immune boosters, using lost of probiotics, etc, of course are also important, seems like problems pile one on top of the other as we all know.

    I honestly think the consensus is that at least some abx are required since it is such an insidious infection, that herbal alone will not do the trick.

    I do remember hearing about a vet curing some dogs in Italy that seemed like they had CF, and then he and his wife felt like it - they used (low) doses of arsenic; I think I'd rather use abx, myself ...

    ... but for myself of course I am still doing the marshall protocol, which is difficult because of the (dim) light requirements plus trying to deal with 'life' (we have my husband's senile mother living with us now).

    We have gotten some books on neurofeedback as there seems to be evidence that it can help boost the immune system. I haven't read them yet, this is my husbands area (PhD in neurophysiological psychology) but he is encouraged so far by what he has read.

    ... and I want him to take a second look at the Rife machine book on its use for lyme; Mikie (--? --I think?) uses or used it for mycoplasma.

    hope this helps, the more I read about it and read/hear about different people's experiences, the more complex it seems.

    all the best,

    [This Message was Edited on 08/24/2006]
  8. Mikie

    Mikie Moderator

    I wish I had a Rife machine because they can be used to identify pathogen infections. They cost a lot but you can use discrete frequencies based on what is identified. I just use the lowly zapper but it really does work. It uses a "one size fits all" frequencies for pathogens in the blood. Problem is that both the Lyme and mycoplasmas can be in a latent form deep inside body tissue long after it appears that one has been healed. As you know, Dr. Nicolson told me this about both the Lyme and mycoplasmas. They lie in dormacy in their cyst state.

    If the reactivate, once they have killed their host cells, they will go into the bloodstream in search of new cells to invade. That is when they are vulnerable to the low-voltage, low-frequency waves of both the Rife machines and zappers.

    I also believe that if both these illnesses are not treated aggressively in their active state, they will go chronic and be much, much more difficult to try to control. I was only give several weeks worth of ABX when the mycoplasma was active because no one then knew much about them. The protocol for mycoplasma infections, even when caught in the active stages, now is six months on ABX and then pulsing them. As you know, it took 2 1/2 years on the Doxy for me to get this under control. That was a long time on them full time and a long time pulsing them.

    I still have to pulse the Doxy if I get run down and the mycoplasmas try to reactivate. I've had a hellova time with them ever since the Red Tide outbreaks down here. For several days, I've had temperatures and am back on the Doxy. If it doesn't clear up, I will have to see my doc. It could be some other kind of infection.

    I think I may consider the mycoplasma transfer factor. As you know, I am a big fan of the TF's. When I get this under control and am no longer on the ABX, it will be time to pulse the TF's. The TF C, which I take, targets Lyme. Whatever ABX one takes, I believe it really helps to pulse them after the initial full time dose.

    Love, Mikie
  9. victoria

    victoria New Member

    I'm wondering, has flagyl been used for cyst form of myco? It is routinely used in the Lyme Protocol by LLMDs specifically for this form of Lyme, wondering if it wouldn't work for myco as well. . . would make sense that it could.

    Well, when my DH gets around finally to reading the Rife book that is specifically about Lyme treatment, I'll let y'all know his educated opinion, for whatever it's worth...

    but it may be a while... right now he is in Chicago, he is not only a retired psychologist with a research degree, he is a pro boxing trainer LOL, weird combination I know but no lie, and one of his boxers has a fight there tonight. Alas, it will not be televised, oh well.

    all the best,
  10. ckball

    ckball New Member

    Thanks, I thought they were the same thing. I am also allergic to tetracycline. It seems IF I have Lyme I will have to go another way.

    I will know on Monday. My guess is no and the Dr just wants her office call. I am feeling back to my old self in the last two weeks. None of the symptoms I was having in June,May.

    My Dr thinks if was just a CFS flare, I know that sounds strange "just a flare" but I can live with that. Dealing with Lyme is a different story.

    Wish me luck- Carla
  11. victoria

    victoria New Member

    just wondering, have you also been tested for common tick co-infections of lyme, like bartonella or ehrlichiosis or babesiosis (altho these tests are even more unreliable);

    or for mycoplasma, c. pneumonia, and other "stealth pathogens"?

  12. victoria

    victoria New Member

    I wonder if there exists a list anywhere online for what meds are used for what diseases that we are running into...

    but considering there are also probably varieties of each disease like myco or cpn (don't even know if there are really), I'd guess there'd be a huge overlap as to what treats what anyway?

    Which is why I'm guessing my son's RXs keep getting changed around to "see" what happens.

    all the best,
  13. victoria

    victoria New Member

    I'll give it a try, it would be interesting... wonder if anyone has compiled an allover 'list' for it all - wouldn't that be something, esp if it would be interactive!

    altho my search may have to wait until I have a sleepless night... hopefully not tonight lol...

  14. Cromwell

    Cromwell New Member

    I am currently on Zithromax.

    The new protocol for this is 500mg three times a week for three weeks.

    This is said now to help as much as long term.

    When I take probiotics with it I have no problems at all with it and I am usually med sensitive.

    It is supposed to be as effective as flagyl except for stomach parasites.

    I can tell you that already my symptoms have definately lessened in particular some of the head and neck pain.

    I took Cipro in February for a kidney infection/UTI and although it laid me out(the cipro) it did lift a great deal of the vertigo/dizzyness then.

    My new doctor thinks all of the people who do respond may have some sort of parasites. This is interesting to me as I was very ill a few years ago when this dd started with giardia and crypto which took double doses of flagyl and almost killed me. Strangely when I had the giardia and crypto besides the awful stomach and retching for months, the weight loss etc. I was badly affected in my muscles and head.

    Love Anne
  15. karinaxx

    karinaxx New Member

    extreem allergic reaction to two,(doxi, and kidneys went into strike, liver tox. and after a few weeks severe autoimmune like reactions like MS.
    i researched the topic of antibiotics and autoimmunety a bit and it seems that some antibiotics can induce autoimmune illnesses or exaberate certain preexisting ones.
    many, (30%) who have tried to treat Mycoplasma have gone much worse (cfsresearch site from nico is know closed , because he is so much worse) and there are doctors, which described this problems with antibiotic treatm. in cfids patients.
    i know that you mickie never had much problems, but there are some which have huge ones and therefore i would not take abx treatment so lightly as some do.
    i think it should be treatments under an exp. doc, like inf. desesease specialist or AIDS doc. IF that is possible.
    never the less here one usefull site for M.treatments.
    take care

    Supportive Care ANTIBIOTICS
    Self Care
    Jarisch-Herxheimer Reaction
    Resident Bacteria Loss
    There are a number of supportive care considerations when undergoing therapy for mycoplasma infections. Self-care approaches to better manage therapy includes understanding and managing long-term antibiotic treatment, including controlling adverse reactions to treatment and preventing side-effects of treatments.

    Antibiotics are usually recommended to treat mycoplasma infections. The list of antibiotics effective include the following: doxycycline, ciprofloxacin, azithromycin, minocycline, clarithromycin, biaxin and levaquin. They may be at varying doses (high, low or pulsed) and are usually prescribed for an extended length of time. Physicians usually prescribe doxycycline at first. But, if an individual is chemically sensitive, ciprofloxacin may be the first antibiotic of choice. Many antibiotics cannot be used during pregnancy or by infants.

    Oral administration works well for most patients, but a few highly-sensitive individuals may need to have an initial course of antibiotics given intravenously (IV). minocycline is what most specialists have used for an IV antibiotic. This requires that a heparin loc or PICC catheter be inserted into a vein for ease of administration. A dose every day (sometimes twice a day) for at least the first two weeks may be ordered. The IV antibiotic can be self-administered or a physician's office or home IV services can be used.

    The typical natural life cycle of a mycoplasma organism is six (6) weeks. Most specialists prescribe the length of antibiotics to extend beyond numerous natural life cycles of the mycoplasma organism. Therefore, it is not uncommon to expect an antibiotic regime to be several continuous months.

    The type of antibiotic and dosage and length of treatment is determined for each individual and is usually based on presenting symptoms, age, weight, etc. A general rule of thumb is to continue the antibiotic until symptoms disappear and then extend it another six (6) weeks to include another life cycle.

    When most of one's symptoms are gone, it is not certain if one is “cured” or the organism is reduced in enough numbers for the immune system to keep it under control (dormant). Therefore, a periodic cycle or a maintenance low dose of antibiotics may be necessary for months or years. Once the mycoplasma infection is adequately treated, a healthy immune system may be all that is needed to keep the organisms dormant. It has been recommended that antibiotics should not be used solely or exclusively to treat mycoplasma infections. In addition to antibiotics, careful consideration of dietary and life-style changes may be necessary to strengthen one's immune system. For instance, avoid the use of alcohol, caffeine, smoking, strenuous exercise, chemical exposure, extreme stress, etc. Also, some selected alternative therapies may be helpful in augmenting nutritional deficiencies, aid in the removal of toxic agents, or help to manage pain or stress.

    Do not take antibiotics at the same time as minerals (such as those found in vitamins and antacids). It is best to take these supplements at least 2-3 hours before or after the antibiotic. Do not drink alcohol at any time while taking antibiotics. It has been found that minerals and alcohol may decrease the absorption and effectiveness of the antibiotic.

    Some of these antibiotics may cause sun sensitivity (especially doxycycline). Avoid direct sunlight and tanning salons. Be sure to use sunscreen and wear a hat, wear long sleeves and pants to prevent a sunburn. Report any burning sensations or severe red skin or rash to your physician.

    All antibiotics can decrease effectiveness of birth control pills. It is advised that those who take antibiotics should use other means of contraception, like condoms or other barrier methods while taking antibiotics.

    Antibiotics can cause gastro-intestinal problems. For those antibiotics that are to be taken on an empty stomach, ingesting one small cracker before taking the antibiotic seems to help. If indicated, take the antibiotic with food. Do not lie down for two hours after taking antibiotics as it may cause a burning sensation in the stomach area. Report any symptoms to your physician of burning or gnawing pain in your stomach, nausea, lack of appetite, bloating or excessive gas and diarrhea.

    Antibiotics may adversely affect one's liver. Some supplements that have been known to protect the liver are Silymarin (milk thistle), ALA (alpha lipoic acid), and vitamin C. Avoid alcohol and acetaminophen (Tylenol) and drink at least 8 glasses of water a day while taking antibiotics. To monitor your liver while taking antibiotics, your physician may prescribe regular blood studies.

    Mycoplasma Support does not make specific recommendations for individuals, nor does Mycoplasma Support endorse commercial products. The recommendations for self-care listed in this section are potentially useful; however, they are only examples that could be beneficial to individuals with chronic mycoplasma infection.

    The information contained in the supportive care information is not intended to replace the advice of a physician or other health care professional. The information presented is to help you make informed decisions about your self-care. The information should not take the place of medical advice. The information should not be considered complete, nor should it be relied upon or interpreted to suggest a course of treatment for any individual. It is information only and it should not be used in place of a visit, call, consultation or the advice of your physician or other qualified health care provider. You are encouraged to share this information with your physician.

    (Created 7/10/05 by Sharon Briggs)

    ©2005 Mycoplasma Support All Rights Reserved
    Revised 9/23/05

  16. karinaxx

    karinaxx New Member

    Reprinted from the Intern. J. Medicine 1998; 1:123-128. Plus Supplemental Suggestions:prof. Nicolson 1/14/02

    Considerations when Undergoing Treatment for Gulf War Illness/CFS/FMS/Rheumatoid Arthritis

    by Prof. Garth L. Nicolson

    The Institute for Molecular Medicine, 15162 Triton Lane, Huntington Beach, California 92649-1041 USA
    Tel: (714) 903-2900 Fax: (714) 379-2082 E-mail: Website:

    There are a number of considerations when undergoing therapy for chronic illnesses, including whether to use traditional as well as integrative nutraceutical approaches. These are discussed in the following sections, including antibiotic/antiviral/antifungal therapies and dietary supplements. The Institute for Molecular Medicine is a nonprofit institution and does not endorse commercial products. The products and procedures below are only examples of the types of approaches and substances that could be beneficial to patients with chronic illnesses. Consult your personal physician for advice on treatments, dosing and schedules that can vary for each patient.


    Antibiotic Therapy for Chronic Infections

    Subsets of GWI (~40-45%), FMS (~60%), CFS (~50%), RA (~45%) and other autoimmune patients (MS, ALS, SLE, etc.) have chronic infections of Mycoplasma, Chlamydia, Borrelia and other bacterial, viral (HHV-6, CMV etc.) and fungal infections. For intracellular bacterial infections, 6 months [no break], then 6-wk on 2-wk off antibiotic cycles (doxycycline, ciprofloxacin, azithromycin, minocycline, clarithromycin or similar, p.o., work best as capsules without starch fillers). Some patients benefit from combinations of antibiotics, such as doxycycline plus azithromycin or ciprofloxacin, especially if there are limited responses to either antibiotic alone. Oral antibiotics must be taken with a full glass of water, crackers or bread to avoid esophageal irritation (do not lie down for at least 1 hr). For many antibiotics direct sunlight must be avoided. To overcome Herxheimer reactions (die-off involving chills, fever, night sweats, muscle aches, joint pain, short term memory loss and fatigue or a general worsening of symptoms) or other adverse responses i.v. antibiotics have been used for a few weeks—then oral. Oral Benadryl (diphenhydramine, 50 mg) at least 30 min before antibiotics and lemon/olive drink (1 blended whole lemon, 1 cup fruit juice, 1 tbs olive oil—strain and drink liquid) are useful. This period usually passes within a few wks and differs from allergic reactions that can cause rashes, itching, swelling, dizziness, trouble breathing—if these occur, seek immediate medical attention. Many antibiotics cannot be used during pregnancy or by infants. Cycles of Augmentin in between the 6-wk cycles or concurrently, if needed, can help to suppress secondary bacterial infections. Some add the antiviral Famvir (500 mg 3X/day) or other antivirals (Ganciclovir, 1000 mg 2X/day) for the first 2 wks in a 6-week antibiotic cycle (see next section). Mycoplasmas may have some characteristics of viruses, so this can be useful, and viral infections, such as HHV-6, are also important in these illnesses. Nutriceuticals, vitamins and other products can be found at (877-576-7979 or 213-483-3736).

    Antiviral Therapy for Chronic Infections

    Large subsets of chronic illness and other autoimmune patients have chronic viral infections, such as HHV-6A and CMV. For CMV infections, Ganciclovir is the antiviral of choice. This can be used i.v. (5 mg/Kg i.v. over 1 hr every day) or oral (1000 mg 2X/day) in 3-wk cycles. Some patients with HHV-6 have benefited from the use of Famvir. This can be used as an oral dose (500 mg 2X/day for 2 wks. Nutraceutical treatments can be used instead or concurrently, such as Genistein (in soy/red clover) to inhibit viral kinase, rosemary/lemon balm to reduce complement activation, selenite (see minerals) to inhibit viral replication, barley grass and lauric acid to inhibit lipid metabolism of viruses and Phyllanthus amarus/niruri to inhibit viral reverse transcriptase. Immune enhancement is very important (see section below).

    General Nutritional Considerations

    Chronic illness patients are often immunosuppressed and susceptible to opportunistic infections, so proper nutrition is imperative. You should not smoke or drink alcohol or caffeinated products. Drink as much fresh fluids as you can, lots of fruit juices or pure water are best. Try to avoid high sugar and fat foods, such as military (MRE) or other fast foods and acid forming, allergen-prone and system stressing foods or high sugar/fat junk foods. Increase intake of fresh vegetables, fruits and grains, and decrease intake of fats and simple or refined sugars that can suppress your immune system. To build your immune system cruciferous vegetables, soluble fiber foods, such as prunes and bran, wheat germ, yogurt, fish and whole grains are useful. In some patients exclusive use of 'organic' foods has been beneficial. Diet is also important to control yeast infections. For heavy metal removal, Garlic Plus (Longevity, 800-580-7587, 520-474-3684) has proved useful. For help with bowel bacteria and bladder infections, many recommend D-mannose (Biotech Co., 800-345-1199). This natural sugar inhibits binding of bacteria to biological membranes.

    Vitamins and Minerals

    Chronic illness patients are often depleted in vitamins (especially B complex, C, E, CoQ-10) and certain minerals. These illnesses often result in poor absorption. Therefore, high doses of some vitamins are useful; others, such as vitamin B complex, cannot be easily absorbed by the gut (oral dose). Sublingual (under the tongue) natural B-complex vitamins in capsules or liquids (also injectable) (Total B, Real Life Research, Norwalk, CA, 562-926-5522 or GNC) should be used instead of swallowed capsules. General vitamins plus extra C, E, CoQ-10, beta-carotene, folic acid, bioflavoids and biotin are best. L-cysteine, L-tyrosine, L-glutamine, L-carnitine, malic acid and especially flaxseed or fish oils are reported to be useful. Certain minerals are depleted in chronic illness patients, such as zinc, magnesium, chromium and selenium. Some recommend up to 300 mcg/day sodium selenite, followed by lower doses. Vitamins and minerals should not be taken at the same time of day (3 hr difference) as antibiotics or antivirals (or oxygen therapy), because they can affect absorption or act against therapy. Some recommend that antioxidant vitamins be taken at least 4 hr before or after oxygen therapy. The suggested doses of vitamins can vary dramatically among patients; consult with your physician or nutritionist for appropriate dosage. Some patients may require analysis of vitamins, minerals and amino acids so that appropriate doses can be recommended. Some sources are: Nu-Life (Sophista-Care, 760-837-1908), Immune-Pak (Care Management Products, 888-845-1467).

    Oxidative Therapy for Chronic Infections

    Oxidative therapy can be useful in suppressing a variety of anaerobic infections: several wks of Hyperbaric Oxygen (1.5-2.0 ATM, 60-90 min) treatments, American Biologics Dioxychlor, i.v. ozone or hydrogen peroxide are useful, or peroxide baths using 2 cups of Epsom salt in a hot bath or Jacuzzi. After 5 min, add 2-4 bottles 16 oz. of 3% hydrogen peroxide. Repeat 2-3X week; no vitamins 8 hr before the bath. The hydrogen peroxide is added after your pores open. Hydrogen peroxide can also be directly applied to skin after a work-out or hot shower/tub. Leave hydrogen peroxide on for 5 min, and then wash off. For oral irrigation, mix 1 part 3% hydrogen peroxide with 2 parts water and use like a mouth wash 3X per day. Most chronic illness patients have periodontal problems, and oral infections and bone cavitation infections are common. These should not be ignored, because these infections can become systemic and spread to other sites.

    Replacement of Natural Gut Flora

    Patients undergoing treatment with antibiotics and other substances risk destruction of normal gut flora. Antibiotic use that depletes normal gut bacteria and can result in over-growth of less desirable bacteria. To supplement bacteria in the gastrointestinal system yogurt and especially live cultures of Lactobacillus acidophilus in capsules or powder are strongly recommended. Mixtures of Lactobacillus acidophillus, L. bifidus, B. bifidum, L. bulgaricus and FOS (fructoologosaccharides) to promote growth of these probiotics in the gut (example, DDS-1, NutraCeuticals, DDS-Plusor Multi-Flora ABF, UAS Labs, 800-422-3371); Intestinal Care-DF. L. acidophillus mixtures (>3 billion live organisms) should be taken 3X per day. For irritable bowel, the nutraceutical Calm Colon (Samra, 310-202-9999) has proven to be very effective in clinical trials.

    Natural Immunomodulators and Remedies

    A number of natural remedies, such as ginseng root, herbal teas, lemon/olive drink, olive leaf extract with antioxidants are sometimes useful, especially during or after antibiotic therapy. More important examples are immune modulators, such as bioactive whey protein (ImuPlus, 800-310-8311, 775-841-7020; Immunocal, 800-337-2411, 209-669-8955), ImmunoPro (Needs, 800-634-1380), Transfer Factor (4-Life, 886-548-2020, 888-454-3374, 801-765-0595), Immuni-T (Longevity, 800-580-7587, 520-474-3684), MGN3 (Lane Labs, 800-526-3005). Some additional remedies are: olive leaf extract (Immunoscreen, 818-966-1610; Creations Garden, 661-775-5933), NSC-100 (Nutritional Supply, 888-246-7224), Tahitian Noni (Morinda, 800-445-8596), Laktoferrin (Nutricology, 888-563-1506), Echinacea-C (NF Formulas, 800-547-4891) or Super Defense Plus (BioDefense Nutritionals, 800-669-9205). These products have been used to boost immune systems. Although they appear to help many patients, their clinical effectiveness in chronic illness patients has not been carefully evaluated. They appear to be useful during therapy to boost the immune system or after antibiotic/antiviral therapy in a maintenance program to prevent relapse and opportunistic secondary infections.

    Yeast/Fungal or Bacterial Overgrowth

    Yeast overgrowth can occur, especially in females (vaginal infections). Gynecologists recommend Nizoral, Diflucan, Mycelex, or anti-yeast creams. Metronidazole [Flagyl, Prostat] has been used to prevent fungal or parasite overgrowth or other antifungals [Nystatin, Amphotericin B, Fluconazole, Diflucan or Pau d’ arco, 7 capsules/2X/day] have been administered for fungal infections that can occur while on antibiotics. Some patients have as their principal problem systemic fungal infections that can be seen using dark field microscopy of blood smears. For superficial fungal infections, such as fungal nail, a topical mixture of Laminsil in 17% DMSO 2X/day is effective. As mentioned above, L. acidophillus mixtures (>3 billion live organisms) are used to restore gut flora. Bacterial overgrowth can also occur, for example, in between cycles of antibiotics or after antibiotics/antivirals have been stopped. This can be controlled with 2-wk courses of Augmentin (3 X 500 mg/day) in between cycles or concurrent with other antibiotics. Nutraceutical approaches to controlling yeast infections include: Pau d’ arco, grapefruit extract, olive leaf, caprylic acid, garlic extract and oregano oil.

    Antidepressants, Narcotics, etc.

    Antibiotic uptake and immune responses may be inhibited by some drugs, and antidepressants (sertaline [Zoloft], fluoxetine [Prozac], amitriptyline [Elavil], maprotiline [Ludiomil], desipramine [Norpramin], clomipramine [Anafranil], nortriptyline [Pamelor], bupropion [Wellbutrin]), muscle relaxants (cyclobenzaprine [Flexeril]), opiate agonists, anticonvulsives or certain analgesics (oxycodone [Percodan], carbamazepine [Tegretol], acetaminophen/ hydrocodone [Vicodin]), narcotics (codeine w/Penergan, propoxyphene [Darvon], morphine), antacids, antidiarrheas among others should not be taken, if possible, or gradually decreased during therapy. Some drugs (certain antibiotics, antidepressants, analgesics, narcotics, etc.) may inhibit immune responses and interfere with therapy. These should be decreased and gradually eliminated.

    Flying, Exercise and Saunas

    Flying, excessive exercise and lack of sleep can make signs/symptoms worse. Flying exposes you to lower oxygen tension, and can stimulate borderline anaerobes that grow better at low oxygen (see above). Some exercise is essential, but avoid relapses due to overexertion. Dry saunas help rid the system of chemicals, and saunas should be taken 3X per week--moderate exercise, followed by 15-20 min of dry sauna and tepid shower. Repeat saunas no more than 2X per day. Work up a good sweat, eliminating chemicals without placing too much stress on your system, and replace body fluids during and after each session. During exercise patients should always avoid pollutant and allergen exposures. For recovery after exercise and to decrease muscle soreness, some use a Jacuzzi or hot tub, but only after a sufficient cool-down period. Don’t get overheated in the process. Don’t over do it!!!


    Antibiotics/Antivirals Recommended when Indicated for Treatment of Gulf War Illness/CFS/FMS/Arthritis

    by Prof. Garth L. Nicolson

    The Institute for Molecular Medicine, 15162 Triton Lane, Huntington Beach, California 92649-1041

    Tel: (714) 903-2900 Fax: (714) 379-2082 e-mail: Website:


    Doxycycline (aka Vibramycin, Doxychel, Doxy-D, Doryx)

    Doxycycline is a broad-spectrum tetracycline with good lipid solubility and ability to penetrate the blood-brain-barrier. This antibiotic acts by inhibiting microorganism protein synthesis; it is readily absorbed by the (normal) gut, and peak blood concentrations are maintained between 2-18 hrs (half-life, 18-22 hrs) after an oral dose of drug. Food, calcium, magnesium, antacids and some drugs reduce absorption, and alcohol, phenytoin [Dilantin] or barbiturates reduce blood half-life or suppress the immune system. Minocycline [Minocin] can be substituted, and for some illnesses (RA) it is preferred because it penetrates tissues better (same dose/day).

    For bacterial infections associated with chronic illnesses, the recommended oral dose is 200-300 mg/day (2-3X 100 mg capsules, 2 in the morning) for 6 months. After 6 months, 6 wk cycles are suggested (2-wk in-between). Initially, doxycycline can exacerbate chronic signs and symptoms (Herxheimer reactions or adverse responses, such as transient fever, skin, gut discomfort, etc.) but these are usually reduced within a few wks (see first section). Patients usually start feeling better with alleviation of major signs and symptoms within 12 wks, but in some patients’ major symptoms are not alleviated until after 12 wks. Severe reactions or prior damage to the gastrointestinal track may require i.v. administration of 100-150 mg/day (rapid i.v. administration must be avoided) for 2-3 wks, then the remainder of the course should be oral (to avoid thrombophlebitis and other complications that can occur with prolonged i.v. therapy). Some patients react to the starch filler in the capsules and must use Doryx, a granular form of pure doxycycline. Virtually all patients relapse (show the same major signs and symptoms) if they stop therapy before 6 months. In a pilot study, ~85% relapsed after 12 weeks of therapy, so the first 6 months without a break is recommended. Doxycycline has been used successfully in addition to other antibiotics in situations where either antibiotic alone had minimal effects (i.e., doxycycline plus ciprofloxacin or doxycycline plus azithromycin).

    Doxycycline and minocycline are primarily bacteriostatic and effective against the following organisms: gram-negative bacteria (N. gonorrhoeae, Haemophilus influenzae, Shigella species, Yersinia pestis, Brucella species, Vibrio cholera); gram-positive bacteria (Streptococcus pneumoniae, Streptococcus pyogenes); mycoplasmas (Mycoplasma pneumoniae, Mycoplasma fermentans [inc. incognitis strain], Mycoplasma penetrans); others (Bacillus anthracis [anthrax], Clostridium species, Chlamydia species, Actinomyces species, Entamoeba species, Treponema pallidum [syphilis], Plasmodium falciparum [malaria] and Borrelia [Lyme] species).

    Precautions: Avoid direct sunlight and drink fluids liberally, especially with oral capsules. Doxycycline or minocycline therapy may result in overgrowth of fungi or yeast and nonsensitive microorganisms (see Considerations, first page). Patients on anticoagulants may require lower anticoagulant doses. Use during pregnancy or in children under 8 years is not recommended, in the latter case due to tooth discoloration, but lower doses of doxycycline have proven to be very effective in children with GWI/CFS (weight 100 lbs. or less, 1-2 mg/LB divided into two doses; weight over 100 lbs use adult dose). Patients with impaired kidney function should not take doxycycline, and the following drugs should not be taken with doxycycline: methoxyflurane [Penthrane], carbamazepine [Tegretol], digoxin or diuretics. Other drugs can effect uptake or immune systems (see above). For complicating bacterial infections, 2 wks Augmentin (3X 500 mg/day) can be taken in between courses of antibiotics. For fungal and yeast complications, please see the instructions above.

    Adverse Reactions: In a few patients doxycycline causes gastrointestinal irritation, anorexia, vomiting, nausea, diarrhea, rashes, mouth dryness, hoarseness and in rare cases hypersensitivity reactions, hemolytic anemia, skin hyper-sensitivity and reduced white blood cell counts. In general, doxycycline is considered a very safe drug, in that there are few adverse reactions reported in the literature.

    Ciprofloxacin (aka Cipro, Cifox, Cifran, Ciloxan, Ciplox)

    Ciprofloxacin is a broad spectrum synthetic fluoroquinolone antibiotic with good absorption characteristics. This drug acts on bacterial DNA gyrase to inhibit bacterial DNA synthesis. Ciprofloxacin is secreted rapidly in the urine and has a half-life in the blood of ~4 hrs. Food delays the absorption (by ~2 hrs) but doesn’t effect total absorption; antacids containing magnesium, aluminum or other salts as well as various drugs reduce absorption and should not be taken at the same time of day.

    For chronic illness use, the recommended dose is 1,500 mg/day (oral, 3X 500 mg capsules, 2 in morning) for 6 months, then 6 wk cycles of therapy. Ciprofloxacin may or may not be taken with meals. Initially, ciprofloxacin may exacerbate some signs/symptoms (Herxheimer reactions or adverse antibiotic responses) but these are usually gone within a few wks or so. Patients report that doses of 1000 mg/day or lower are not effective in alleviating symptoms. Patients usually start feeling better with alleviation of major signs/symptoms within 4-6 wks, but in some patients signs/symptoms are not reduced until after 6 wks. Ciprofloxacin has been used for patients in which doxycycline cannot be tolerated or in some patients that no longer respond to doxycycline. In a few cases ciprofloxacin has been used simultaneously with doxycycline. Herxheimer reactions, if present, usually pass within days to a few wks; prior damage to the gastrointestinal system may require i.v. 400-500 mg X2/day (over one hr per each infusion, rapid i.v. administration is to be avoided) for 2-4 wks, then the remainder on oral antibiotic (oral doses). Virtually all patients relapse (with major signs/symptoms) if drug is stopped at in 6-12 wk course of therapy. Additional antibiotic courses result in milder relapses after drug is discontinued. Subsequent cycles of antibiotics may require the use of doxycycline or other antibiotics. Sparfloxacin, a fluoroquinolone with better tissue penetration, can be substituted (oral dose, 400 mg/day) but some patients indicate greatly increased sun sensitivity.

    Ciprofloxacin is effective against the following organisms: gram-negative bacteria (Shigella species, Citrobacter diversus, Citrobacter freundii, Escherichia coli, Klebisella pneumoniae, Haemophilus influenzae, Enterobacter species, Proteus vulgaris, Psuedomonas aeruginosa, Yersinia pestis, Vibrio cholera), Moraxella catarrhalis; gram-positive bacteria (Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus hominis, Staphylococcus aureus, Staphylococcus saprophytieus); mycoplasmas, moderately active (Mycoplasma species); others (Clostridium species, Chlamydia species, Mycobacterium tuberculosis).

    Precautions: Direct sunlight is to be avoided, especially with sparfloxacin, and patients should not take floxacin and theophylline concurrently. Ciprofloxacin therapy may result in drug crystals in the urine in rare cases, and patients should be well hydrated to prevent concentration of urine. Pregnant women and children should not use this drug due to reduction in bone and cartilage development.

    Adverse Reactions: Adverse antibiotic responses resulted in discontinuing drug in ~3.5% of patients, and such reactions included nausea (5%), diarrhea (2%), vomiting (2%) abdominal pain (1.7%), headache (1.2%) and rash (1.1%). In rare cases cirprofloxacin may cause cardiovascular problems (<1%) and central nervous system (dizziness, insomnia, tremor, confusion, convulsions and other reactions (<1%). Small numbers of patients have experienced hypersensitivity (anaphylactic) reactions that have required immediate emergency treatment. Other drugs may effect absorption and immune systems.

    Azithromycin (aka Zithromax)

    Azithromycin is a azalide (macrolide) antibiotic with good absorption and a serum half-life of ~68 hrs. This class of drug acts by binding to the 50S ribosomal subunit of susceptible organisms where it interferes with protein synthesis. Food decreases absorption rate, but absorption is unaffected by antacids containing magnesium, aluminum or other salts; other drugs may affect absorption (see above).

    For GWI/CFS/FMS use, the recommended dose is 500 mg/day (oral, 1-2X 250 mg capsules taken at once) for each 6-wk cycle of therapy. Azithromycin should not be taken with meals (1 hr before or 1 hr after). Initially, azithromycin may exacerbate some symptoms but these are usually gone within a few weeks. Patients usually start feeling better with alleviation of most major signs/symptoms within several weeks, but in some patients major symptoms are not alleviated within months. Azithromycin has been used for patients in which doxycycline cannot be tolerated or in patients that no longer respond to doxycycline. Herxheimer reactions usually pass within a few days to weeks. Virtually all patients relapse (show the same major signs/symptoms) after terminating therapy in less than 12 wks. Additional cycles of antibiotic result in milder relapses after drug is discontinued. Azithromycin has been shown to be safe for pediatric use (10 mg/kg/day is recommended for children under 14, but see below).

    Azithromycin is effective against the following organisms: gram-negative bacteria (Bordetella pertussis, Shigella species, Haemophilus influenzae, Chlamydia species, Yersinia pestis, Brucella species, Vibrio cholera); gram-positive bacteria (Streptococci group C, F, G); mycoplasmas (Mycoplasma species); others (Clostridium species, Treponema pallidum [syphilis], and Borrelia species).

    Precautions: Azithromycin is principally absorbed by the liver, and caution should be exercised with patients with impaired liver function. Antacids containing magnesium, aluminum or other salts should not be taken at the same time of day with azithromycin. Other drugs can also interfere. Macrolides plus terfenadine [Seldane] or astemizole [Hismaral] may dangeriously elevate plasma antihistamine and cause arrhythmias and increase serum theophyline levels in some patients, particularly those receiving methylated xanthine causing nausea, vomiting, seizures. Plasma levels of carbamazepine [Tegretol] can also be elevated, leading to carbamazepine toxicity and nausea, vomiting, drowsiness and ataxia.

    Adverse Reactions: Adverse antibiotic responses were mild to moderate in clinical trials and included diarrhea (5%), nausea (3%), abdominal pain (3%). In rare cases (<1%) azithromycin may cause cardiovascular problems (palpitations, tachycardia, chest pain) and central nervous system (dizziness, headache, vertigo), allergic (rash, photosensitivity, angioderma), fatigue and other reactions (<1%). In pediatric patients >80% of the adverse responses were gastrointestinal. In children, doses above the suggested 10 mg/kg/day have been shown to produce hearing loss in some patients.

    Clarithromycin (aka Biaxin)

    Clarithromycin is a broad spectrum macrolide antibiotic with good absorption and serum half-life. This drug acts by binding to the 50S ribosomal subunit of susceptible organisms and interfering with protein synthesis. The drug is mostly bacterostatic but high concentrations can be bactericidal. Food decreases absorption rate, but absorption is unaffected by antacids containing magnesium, aluminum or other salts. Some drugs may interfere with absorption or depress immune systems (see above).

    For chronic illness patients the recommended dose is 500-750 mg/day (oral, 2-3X 250 mg capsules, 2 taken in morning) for 6 months of therapy, then 6-wk cycles. Clarithromycin should not be taken with meals (1 hr before or 1 hr after). Initially, clarithromycin may exacerbate some symptoms due to Herxheimer reactions and bacterial death but these are usually gone within wks. Patients usually start feeling better with alleviation of most major signs and symptoms within 1-2 wks, but in some patients major symptoms are not alleviated until after 12 wks or so. Clarithromycin has been used for patients that do not respond or cannot tolerate doxycycline. Herxheimer reactions usually pass within days to wks. Virtually all patients relapse (show the same major signs/symptoms) when therapy is stopped within 12 wks. Additional cycles of antibiotic result in milder relapses after drug is discontinued. For children, the recommended dose is 15 mg/kg/day X2; at this dose some children have gastrointestinal problems.

    Clarithromycin is effective against the following organisms: gram-negative bacteria (Neisseria gonorrhoeae, N. menigitidis, Moraxella catarrhalis, Campylobacter jejuni, Eikenella corrodens, Haemophilus ducreyi, Bordetella pertussis, Shigella species, Salmonella species, Haemophilus influenzae, Chlamydia species, Yersinia pestis, Brucella species, Vibrio cholera, Aeromonos species, E. coli, gram-positive bacteria (Streptococcus pyogenes, S. pneumeniae, anerobic Streptococci, Enterococcus faccalis, Staphlococcus aureus, S. epidermidis, Bacillus anthracis, Corynebacterium diptheriae, C. minutissimum, Listeria monocytogenes, Actinomyces israelii); mycoplasmas (Mycoplasma species, M. pneumoniae, Ureaplasma urealyticum); others (Clostridium species, Treponema pallidum [syphilis], Legionella pneumophilia, L. micdadei, Mycobacterium avium, M. chelonae, M. chelonae absessus, M. fortuitim, Rickettsia species and Borrelia species). Yeasts, fungi and viruses are resistant.

    Precautions: Clarithromycin is principally absorbed by the liver, and caution should be exercised with patients with impaired liver function. Antacids containing magnesium, aluminum or other salts should not be taken at the same of day as azithromycin. Other drugs may also interfere (see above). Macrolides plus terfenadine [Seldane] or astemizole [Hismaral] may dangerously elevate plasma antihistamine and cause arrhythmias and increase serum theophyline levels in some patients, particularly those receiving methylated xanthine causing nausea, vomiting, seizures. Plasma levels of carbamazepine [Tegretol] can also be elevated, leading to carbamazepine toxicity and nausea, vomiting, drowsiness and ataxia. Macrolides like clarithromycin should not be used with cyclosporin [Sandimmune].

    Adverse Reactions: Adverse antibiotic responses were mild to moderate in clinical trials and included diarrhea, nausea, and abdominal pain. In rare cases (<1%) azithromycin may cause cardiovascular problems (palpitations, tachycardia, chest pain) and central nervous system (dizziness, headache, vertigo), allergic (rash, photosensitivity, angioderma) and fatigue.

    Clindamycin (aka Cleocin, Dalacin, Lacin)

    Clindamycin is a semisynthetic antibiotic made from lincomycin and is effective against severe anaerobic infections. It is primarily bacteriostatic against a wide range of Gram-positive and anaerobic pathogens, including some protozoa. It has good absorption and tissue penetration; its half-life is ~3 hrs in adults and ~2 hrs in children. Since clindamycin use can result in severe colitis even weeks after cessation of the drug, it should not be used as primary therapy. Food does not adversely affect absorption rate, but absorption is affected by antacids containing magnesium, aluminum or other salts. Some drugs may interfere with absorption or depress immune systems (see above).

    The recommended dose is 600-1200 mg/day (oral, 4-8 X 150 mg capsules, in three divided doses) for 6-wk cycles of therapy. Herxheimer reactions may exacerbate signs/symptoms but these are usually gone within days-weeks. Patients usually start feeling better with alleviation of most major signs and symptoms within days-weeks, but in some patients major symptoms are not alleviated until after several weeks or so. For children, the recommended dose is 8-16 mg/kg/day divided into 3-4 doses.

    Precautions: Clindamycin should not be used for patients with nonbacterial (viral, fungal) infections. Its use is associated in some patients with colitis and severe, persistent diarrhea and abdominal cramps, and when this occurs the drug should be discontinued. It must not be used with opiates or diphenoxylate with atropine [Lomotil]. Cholestyramine or colestipol resins bind clindamycin and should not be administered simultaneously.

    Adverse Reactions: Adverse antibiotic responses were mainly diarrhea in 2-20% of cases, some severe and dangerous (colitis). Psuedomembranous colitis may develop during or several weeks after therapy. This can be serious if ignored. Other gastrointestinal effects of the drug have been reported (nausea, vomiting, esophagitis, abdominal pain or cramps), and hypersensitivity reactions, including skin rashes occur in up to 10% of patients. Mild cases of colitis should be managed promptly with fluid, electrolyte and protein supplementation as indicated. Other effects include transient leucopenia, polyarthritis and abnormal liver function (jaundice and hepatic damage rarely occur). Clindamycin should not be used with erythromycin. Clindamycin has been shown to have neuromuscular blocking properties that may enhance the action of other neuromuscular drugs. Clindamycin should only be used with caution in patients receiving such drugs.

    Ganciclovir (aka Cytovene)

    Ganciclovir is a synthetic antiviral made from a guanine derivative that is active against cytomegalovirus (CMV) and related herpes simplex viruses, such as HHV-6 viruses. Ganciclovir inhibits replication of herpes viruses by inhibiting viral DNA replication by its incorporation into viral DNA and by inhibition of viral DNA elongation.

    The recommended dosage of Ganciclovir[ i.v.] is an initial induction dose of 5 mg/Kg i.v. at a constant rate over 1 hr twice on the first day and then once /day for 3 wks. For oral use Ganciclovir 1000 mg X3/day with food for a 3 wk course. The drug reaches a maximum blood dose within 3 hrs after oral administration with food with a half-life of 4.6 hrs. Ganciclovir has been used mainly for treatment of CMV retinitis, CMV in organ transplant cases, and CMV in AIDS cases. Its use in chronic CMV and HHV-6 infections has not been fully investigated. An oral pro-drug form of Ganciclovir, Valganciclovir (Valcyte, 900 mg 2X/day for 3 wks), has been approved and can be substituted for Ganciclovir.

    Precautions: Ganciclovir should not be used in pregnancy, by nursing mothers or in patients with renal impairment or in patients with an absolute neutrophil count of <25,000 cells/microliter. In elderly patients particular attention must be paid to renal function before and during drug administration. Some patients should have serum creatinine or creatinine clearance values monitored to allow for possible dose adjustments in renally impaired patients. Ganciclovir can be used in children at the dose levels mentioned above with similar results. In addition, Ganciclovir should not be taken with drugs that have the potential to cause neutropenia and enimia. For example, and Ganciclovir and zidovudine both have the potential to decrease white blood cells and cause anemia.

    Ganciclovir can change serum clearance rates of didanosine and other drugs, and Ganciclovir used with drugs that inhibit rapidly growing cell populations may show added toxicity. Therefore, dapsone, pentamidine, flucytosine, vincristine, vinblastine, adriamycin, amphotericin B, among other drugs should not be used with Ganciclovir

    Adverse Reactions: Adverse drug responses were seen in patients that are hypersensitive to Ganciclovir or Acyclovir. .The most common side effects were reductions in white blood cells (6-29%), anemia (9-19%), impairment in fertility, chills (7%), sweating (11%), obdominal pain (15%), vomiting (13%), diarrhea (40%), paresthesias (8%) and retinal detachment (8-11%) as well as less frequently chest pain, headache, malaise, constipation, cough, anxiety, confusion, depression, dizziness, dry mouth, insomnia, tremor and edema. The values were obtained for patients with CMV retinitis, organ transplants and AIDS, and they may not reflect the actual incidence rates in chronic illness patients.

    Famciclovir (aka Famvir)

    Famciclovir is an orally administered pro-drug of the antiviral agent penciclovir. It is a synthetic acyclic guanine derivative of penciclovir that undergoes rapid biotransformation to the active antiviral compound penciclovir, which has inhibitory activity against herpes viruses. Famciclovir inhibits viral replication.

    For herpes virus infections Famciclovir 500 mg 3X/day for 7-14 days is the standard dose. Following oral adminis-tration of Famciclovir the drug is deacetylated and oxidized to form penciclovir. The half-life of penciclovir is 2-3 hrs. Famciclovir is used in patients with herpes zoster, herpes simplex, genital herpes, and herpes infections in AIDS patients and in sexually transmitted herpes infections.

    Precautions: Famciclovir should not be used in pregnancy, by nursing mothers or in patients with renal impairment. Famciclovir should not be used with drugs that are significantly eliminated by active renal tubular secretion. Use in children has not been established.

    Adverse Reactions: Adverse drug responses were seen in patients that are hypersensitive to Famciclovir. .The most common side effects were headache (22%), nausea (11%), diarrhea (4-7%), vomiting (1-3%), flatulence (<2%), rash (<1%), fatigue (4-6%), reductions in white blood cells (1-3%) and anemia (<1%).

    Final Comments/Suggestions

    Recovery will be gradual not rapid, and almost all patients with bacterial infections will experience initial Herxheimer reactions that can be quite severe and can last for weeks. You will have to be patient and not abandon therapy prematurely, because few patients who have been sick for years recover in less than one year of therapy. Do not take antibiotics or antivirals at the same time of day as vitamins, minerals, supplements, etc. Vitamins and minerals should be taken 3 hrs before or after antibiotics or antivirals to prevent interference with drug uptake. Stop antibiotics or antivirals if adverse reactions occur. You will experience cycles of relapse when severely physically or mentally stressed, and you should not be alarmed if some signs and symptoms occasionally return or worsen. This is not unusual. Eventually you will be off antibiotics or antivirals but you will need to continue various supplements to maintain your immune system and general nutritional status.

  17. victoria

    victoria New Member

    That's a lot of info to start with, it will take some time to work thru it all. . . I recognize a lot of these abx, my son has already tried many, almost all.

    It would be really handy to somehow set up a chart somewhere--

    if it's not already done (I keep hoping someone will tell me it has, lol!)

    Thanks again,

  18. cobie

    cobie New Member

    THANKYOU for the information on aBxs. cheers cobie
  19. PVLady

    PVLady New Member

    I believe they also call this a "Z Pack". I took it a couple of times last year for a cold, but it seemed to help my fibromyalgia.

  20. victoria

    victoria New Member


    all the best,

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