California US
An article at www.immunesupport.com/lib.../CFIDS_FM/
Dr. Gabe Mirkin repeats the exact article at his website below with the words CFS instead the of the rheumatoid or reactive arthritis, late onset asthma,
Crohn's disease fibromyalgia and other so-called "autoimmune diseases". Both state that he treats these patients with antibiotics. www.drmirkin.com/morehealth/G221.html
He talks about treating Chronic Fatigue Syndrome patients with doxycycline here www.shasta.com/cybermom/antibiot.htm . He seems to be relatively willing to give antibiotics a long term trial in at least some patients. Elsewhere there are hints that a year is the order of magnitude of a trial, not months. www.drmirkin.com/morehealth/G138.htm
Why I Prescribe Antibiotics
Gabe Mirkin, M.D.
I am often asked why I prescribe antibiotics to my patients with rheumatoid or reactive arthritis, late-onset asthma, Crohn's disease, fibromyalgia and other so-called "autoimmune diseases". Before I prescribe any medication, I ask myself whether it will help or hurt. All of the "auto-immune" diseases cause severe disability. Conventional medications neither cure these diseases nor stop the progressive destruction that they cause. Doctors prescribe immune suppressives that sometimes have deadly effects. Antibiotics are far safer than the drugs conventionally used to treat these diseases. So, if antibiotics can be shown to help control these diseases, they should be used long before a doctor thinks of using the conventional immune suppressives.
When a germ gets into your body, you are supposed to produce cells and proteins called antibodies that attach to and kill that germ. These diseases are felt by many doctors to be caused by your own immunity. Instead of doing its job of killing germs, your immunity attacks your own tissue. If it attacks your joints, it is called reactive arthritis; if it attacks your intestines, it's called Crohn's disease; your colon, it's called ulcerative colitis; and if it fills your lungs with mucous, it's called late-onset asthma. I do not believe that your immunity is that stupid. Accumulating data show that all of these conditions can be caused by infection. Many diseases that were thought to be autoimmune turn out to be infections: stomach ulcers are caused by bacterium, helicobacter pylori and others; multiple sclerosis may be caused by HHS-6 virus; rheumatic fever is caused by the bacterium, beta streptococcus, group A; Gillian-Barre syndrome may be caused by the bacterium, campylobacter; Crohn's disease and ulcerative colitis by E. Coli, Klebsiella, Bacteroides or Mycobacterium avium paratuberculosis; and so forth.
Shouldn't We Be Concerned About Resistant Bacteria?
The argument that giving antibiotics causes bacteria to be resistant to that antibiotic is reasonable, but it has no place in discouraging people with these diseases from taking them. First, these people have serious diseases that cause permanent damage and death. Second, the treatments that are available are toxic, shorten life, cause cancer, and have to be followed with frequent blood tests. On the other hand, I prescribe derivatives of tetracycline and erythromycin. These drugs are extraordinarily safe and do not require drawing frequent blood tests. If you were to become infected subsequently with bacteria that are resistant to these antibiotics, you would have lost nothing. No reasonable doctor would prescribe erythromycin or tetracycline for acute serious diseases, such as meningitis, pneumonia or an abscess, because tetracyclines and erythromycins do not kill germs, they only stop them from multiplying. Instead, doctors prescribe far more bacteriocidal antibiotics that kill bacteria.
Many doctors criticize my use of antibiotics, but antibiotics are far safer than conventional treatment, cost less, can be administered by a general practitioner, and often cure the condition, rather than just suppressing symptoms. I know that the most physicians who develop these conditions will treat themselves with antibiotics because they know that conventional treatments with prednisone, chloroquine, azathioprine and methotrexate are toxic and my treatments with erythromycins and tetracyclines are safe.
How you can help to prevent antibiotic-resistant bacteria:
Suffer through short-term illnesses. Don't ask your doctor for antibiotics when you have a cold, flu or other self-limiting illness. You may feel miserable, but antibiotics are useless against viruses.
Finish your prescription. If you stop taking a prescribed antibiotic as soon as you feel better, you encourage the development of resistant organisms.
Become a vegetarian. The bulk of antibiotics are given to animals raised for food. As long as humans demand huge amounts of meat, farmers will use whatever means they have to deliver their product economically.
Definitions:
Bacteriocidal Antibiotics, such as penicillins and cephalosporins, kill bacteria. They are used to combat most bacterial infections, particularly acute, serious diseases such as meningitis, pneumonia, a ruptured intestine or an abcess. However, most bacteriocidal antibiotics are not effective against chlamydia, mycoplasma or ureaplasma, bacteria that have no cell walls.
Bacteriostatic Antibiotics such as tetracyclines (including doxycycline and minocycline) and erythromycins (including Biaxin and Azithromycin) keep bacteria from multiplying. Your own immunity is then able to kill the bacteria and remove them from circulation.
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MINOCYCLINE, TETRACYCLINE AND DOXYCYCLINE
Gabe Mirkin, M.D.
Before a doctor prescribes a drug, he must decide whether the side effects can cause more harm than good. Many doctors have asked why I treat some of my patients with acne, arthritis, chronic fatigue syndrome and late-onset asthma with the antibiotic, doxycycline, when minocycline is probably more effective. Doxycycline is a fairly safe drug, although it can cause a sore throat, sunlight sensitivity, pigmentation and abnormal liver tests. It causes a sore throat and heartburn when it gets stuck in your esophagus, so take it with large amounts of water to wash it down to your stomach. To prevent sunburn, avoid excessive exposure to the sun. Minocycline is also fairly safe, but it can cause more serious serum sickness-like reaction, hypersensitivity syndrome reaction, and drug-induced lupus: characterized by fever, joint pain, a rash, a feeling of being sick, hives, itching and severe pain (1); Other reported side effects include dark colored eye balls (2), and liver damage (3).
One of my patients developed a disease called lupus while taking doxycycline, an antibiotic that I prescribe to treat arthritis. Lupus can cause terrible arthritis and even kidney damage. I reviewed the world's literature and could not find one case of lupus caused by doxycycline or tetracycline (although 33 cases were caused by a similar drug called minocycline, and then only after an average of two years.
Minocycline is more effective than doxycycline because it achieves much higher concentrations in the tissues where it does its work in reducing swelling, killing germs and stopping pain. Although minocycline and doxycycline are in the same class of antibiotics as tetracycline, we rarely use tetracycline because it does not achieve high tissue concentrations. Doxycycline achieves much higher tissue concentrations than tetracycline, while minocycline penetrates tissue far more effectively than doxycycline.
1) SR Knowles, L Shapiro, NH Shear. Serious adverse reactions induced by minocycline: Report of 13 patients and review of the literature. Archives of Dermatology 132: 8 (AUG 1996):934-939. serum sickness-like reaction, hypersensitivity syndrome reaction, and drug-induced lupus.
2) RA Sabroe, CB Archer, D Harlow, JW Bradfield, RDG Peachey.
Minocycline-induced discolouration of the sclerae. British Journal of Dermatology 135: 2 (AUG 1996):314-316.
3) A Malcolm, TR Heap, RP Eckstein, MR Lunzer. Minocycline-induced liver injury. American Journal of Gastroenterology 91: 8 (AUG 1996):1641-1643. intrahepatic cholestasis with bile duct depletion.
4) O Elkayam, M Yaron, D Caspi. Minocycline induced arthritis associated with fever, livedo reticularis, and pANCA. Annals of the Rheumatic Diseases 55: 10(OCT 1996):769-771. All three fever, arthritis/arthralgia and livedo reticularis.
4a) L Xenard, JL George, T Maalouf, T Malet, P Lesure. Adverse effects of tetracyclines. A report of two cases. Semaine Des Hopitaux 72:29-30 (NOV 7 1996):924-927. benign intracranial hypertension and palpebral photosensitization.
5) excellent review on safety. Joshi N, Miller DQ. Doxycycline revisited. Archives of Internal Medicine 1997 (July); 157:1421-1428.
6) MA Dodd, EJ Dole, WG Troutman, DA Bennahum.
Minocycline-associated tooth staining. Annals of Pharmacotherapy 32:
9 (SEP 1998):887-889.
7) SE Knights, MJ Leandro, MA Khamashta, GRV Hughes.
Minocycline-induced arthritis. Clinical and Experimental Rheumatology 16: 5(SEP-OCT 1998): 587-590. .
8) D Eisen, MD Hakim. Minocycline-induced pigmentation: Incidence, prevention and management. Drug Safety 18: 6 (JUN 1998):431-440.
Health Reports from The Dr. Gabe Mirkin Show and DrMirkin.com
Transcripts of segments of The Dr. Gabe Mirkin Show are provided as a service to listeners at no charge. Dr. Mirkin's opinions and the references cited are for information only, and are not intended to diagnose or prescribe. For your specific diagnosis and treatment, consult your doctor or health care provider.
He talks about treating Chronic Fatigue Syndrome patients with doxycycline here www.shasta.com/cybermom/antibiot.htm . He seems to be relatively willing to give antibiotics a long term trial in at least some patients. Elsewhere there are hints that a year is the order of magnitude of a trial, not months. www.drmirkin.com/morehealth/G138.htm
Why I Prescribe Antibiotics
Gabe Mirkin, M.D.
I am often asked why I prescribe antibiotics to my patients with rheumatoid or reactive arthritis, late-onset asthma, Crohn's disease, fibromyalgia and other so-called "autoimmune diseases". Before I prescribe any medication, I ask myself whether it will help or hurt. All of the "auto-immune" diseases cause severe disability. Conventional medications neither cure these diseases nor stop the progressive destruction that they cause. Doctors prescribe immune suppressives that sometimes have deadly effects. Antibiotics are far safer than the drugs conventionally used to treat these diseases. So, if antibiotics can be shown to help control these diseases, they should be used long before a doctor thinks of using the conventional immune suppressives.
When a germ gets into your body, you are supposed to produce cells and proteins called antibodies that attach to and kill that germ. These diseases are felt by many doctors to be caused by your own immunity. Instead of doing its job of killing germs, your immunity attacks your own tissue. If it attacks your joints, it is called reactive arthritis; if it attacks your intestines, it's called Crohn's disease; your colon, it's called ulcerative colitis; and if it fills your lungs with mucous, it's called late-onset asthma. I do not believe that your immunity is that stupid. Accumulating data show that all of these conditions can be caused by infection. Many diseases that were thought to be autoimmune turn out to be infections: stomach ulcers are caused by bacterium, helicobacter pylori and others; multiple sclerosis may be caused by HHS-6 virus; rheumatic fever is caused by the bacterium, beta streptococcus, group A; Gillian-Barre syndrome may be caused by the bacterium, campylobacter; Crohn's disease and ulcerative colitis by E. Coli, Klebsiella, Bacteroides or Mycobacterium avium paratuberculosis; and so forth.
Shouldn't We Be Concerned About Resistant Bacteria?
The argument that giving antibiotics causes bacteria to be resistant to that antibiotic is reasonable, but it has no place in discouraging people with these diseases from taking them. First, these people have serious diseases that cause permanent damage and death. Second, the treatments that are available are toxic, shorten life, cause cancer, and have to be followed with frequent blood tests. On the other hand, I prescribe derivatives of tetracycline and erythromycin. These drugs are extraordinarily safe and do not require drawing frequent blood tests. If you were to become infected subsequently with bacteria that are resistant to these antibiotics, you would have lost nothing. No reasonable doctor would prescribe erythromycin or tetracycline for acute serious diseases, such as meningitis, pneumonia or an abscess, because tetracyclines and erythromycins do not kill germs, they only stop them from multiplying. Instead, doctors prescribe far more bacteriocidal antibiotics that kill bacteria.
Many doctors criticize my use of antibiotics, but antibiotics are far safer than conventional treatment, cost less, can be administered by a general practitioner, and often cure the condition, rather than just suppressing symptoms. I know that the most physicians who develop these conditions will treat themselves with antibiotics because they know that conventional treatments with prednisone, chloroquine, azathioprine and methotrexate are toxic and my treatments with erythromycins and tetracyclines are safe.
How you can help to prevent antibiotic-resistant bacteria:
Suffer through short-term illnesses. Don't ask your doctor for antibiotics when you have a cold, flu or other self-limiting illness. You may feel miserable, but antibiotics are useless against viruses.
Finish your prescription. If you stop taking a prescribed antibiotic as soon as you feel better, you encourage the development of resistant organisms.
Become a vegetarian. The bulk of antibiotics are given to animals raised for food. As long as humans demand huge amounts of meat, farmers will use whatever means they have to deliver their product economically.
Definitions:
Bacteriocidal Antibiotics, such as penicillins and cephalosporins, kill bacteria. They are used to combat most bacterial infections, particularly acute, serious diseases such as meningitis, pneumonia, a ruptured intestine or an abcess. However, most bacteriocidal antibiotics are not effective against chlamydia, mycoplasma or ureaplasma, bacteria that have no cell walls.
Bacteriostatic Antibiotics such as tetracyclines (including doxycycline and minocycline) and erythromycins (including Biaxin and Azithromycin) keep bacteria from multiplying. Your own immunity is then able to kill the bacteria and remove them from circulation.
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
MINOCYCLINE, TETRACYCLINE AND DOXYCYCLINE
Gabe Mirkin, M.D.
Before a doctor prescribes a drug, he must decide whether the side effects can cause more harm than good. Many doctors have asked why I treat some of my patients with acne, arthritis, chronic fatigue syndrome and late-onset asthma with the antibiotic, doxycycline, when minocycline is probably more effective. Doxycycline is a fairly safe drug, although it can cause a sore throat, sunlight sensitivity, pigmentation and abnormal liver tests. It causes a sore throat and heartburn when it gets stuck in your esophagus, so take it with large amounts of water to wash it down to your stomach. To prevent sunburn, avoid excessive exposure to the sun. Minocycline is also fairly safe, but it can cause more serious serum sickness-like reaction, hypersensitivity syndrome reaction, and drug-induced lupus: characterized by fever, joint pain, a rash, a feeling of being sick, hives, itching and severe pain (1); Other reported side effects include dark colored eye balls (2), and liver damage (3).
One of my patients developed a disease called lupus while taking doxycycline, an antibiotic that I prescribe to treat arthritis. Lupus can cause terrible arthritis and even kidney damage. I reviewed the world's literature and could not find one case of lupus caused by doxycycline or tetracycline (although 33 cases were caused by a similar drug called minocycline, and then only after an average of two years.
Minocycline is more effective than doxycycline because it achieves much higher concentrations in the tissues where it does its work in reducing swelling, killing germs and stopping pain. Although minocycline and doxycycline are in the same class of antibiotics as tetracycline, we rarely use tetracycline because it does not achieve high tissue concentrations. Doxycycline achieves much higher tissue concentrations than tetracycline, while minocycline penetrates tissue far more effectively than doxycycline.
1) SR Knowles, L Shapiro, NH Shear. Serious adverse reactions induced by minocycline: Report of 13 patients and review of the literature. Archives of Dermatology 132: 8 (AUG 1996):934-939. serum sickness-like reaction, hypersensitivity syndrome reaction, and drug-induced lupus.
2) RA Sabroe, CB Archer, D Harlow, JW Bradfield, RDG Peachey.
Minocycline-induced discolouration of the sclerae. British Journal of Dermatology 135: 2 (AUG 1996):314-316.
3) A Malcolm, TR Heap, RP Eckstein, MR Lunzer. Minocycline-induced liver injury. American Journal of Gastroenterology 91: 8 (AUG 1996):1641-1643. intrahepatic cholestasis with bile duct depletion.
4) O Elkayam, M Yaron, D Caspi. Minocycline induced arthritis associated with fever, livedo reticularis, and pANCA. Annals of the Rheumatic Diseases 55: 10(OCT 1996):769-771. All three fever, arthritis/arthralgia and livedo reticularis.
4a) L Xenard, JL George, T Maalouf, T Malet, P Lesure. Adverse effects of tetracyclines. A report of two cases. Semaine Des Hopitaux 72:29-30 (NOV 7 1996):924-927. benign intracranial hypertension and palpebral photosensitization.
5) excellent review on safety. Joshi N, Miller DQ. Doxycycline revisited. Archives of Internal Medicine 1997 (July); 157:1421-1428.
6) MA Dodd, EJ Dole, WG Troutman, DA Bennahum.
Minocycline-associated tooth staining. Annals of Pharmacotherapy 32:
9 (SEP 1998):887-889.
7) SE Knights, MJ Leandro, MA Khamashta, GRV Hughes.
Minocycline-induced arthritis. Clinical and Experimental Rheumatology 16: 5(SEP-OCT 1998): 587-590. .
8) D Eisen, MD Hakim. Minocycline-induced pigmentation: Incidence, prevention and management. Drug Safety 18: 6 (JUN 1998):431-440.
Health Reports from The Dr. Gabe Mirkin Show and DrMirkin.com
Transcripts of segments of The Dr. Gabe Mirkin Show are provided as a service to listeners at no charge. Dr. Mirkin's opinions and the references cited are for information only, and are not intended to diagnose or prescribe. For your specific diagnosis and treatment, consult your doctor or health care provider.
USA
