This is my first post, but I’ve been a lurker for a while. I love this forum, but occasionally it can become a vehicle for bad advice. For example, this thread is way off the mark. The reason doxycycline is typically supposed to be taken on an empty stomach is because that’s the best way to get it absorbed. If you need doxycycline in your body, especially if you have a recent or acute Lyme infection, then you ABSOLUTELY want doxycycline to be absorbed as soon as possible. Unfortunately, many foods interfere with absorption. They’ve done numerous studies on taking doxycycline with food and concluded that absorption is often impeded significantly. In fact, one person with acute Lyme disease was able to successfully sue Rite Aid for telling her she could take doxycycline with dairy products. Her lawyers, as well as medical experts, proved that taking doxycycline with dairy products actually impedes absorption, and the same is true of many other foods. She won an award of $250,000, and the logic was basically that they had made her Lyme disease worse by impeding the doxycycline’s ability to get into her blood when she had a chance of actually eliminating the bacteria early.
The reason LLMDs often tell their patients to take doxycycline with food is NOT that doxycycline is somehow inherently intolerable in the human stomach. It’s for two simple reasons:
(1) Some people with chronic Lyme disease already have their own specific GI issues, and LLMDs don’t want to add to that. Taking doxycycline on an empty stomach is obviously a little harder on your stomach than taking it with food.
(2) As Girlie correctly stated, people with chronic Lyme will often have to take doxycycline, as well as other antibiotics, long-term. If you’re going to take the drug long-term, then it may be worth reducing absorption slightly to better protect your stomach. But again, this is a trade-off that has to be weighed based on how acute your infection is and how quickly you need that doxycycline to get into your body.
There’s a lot of misinformation in the posts above. People seem to take for granted that their particular experience of doxycycline applies to everyone. Do not take things for granted. Many people, including people with Lyme disease, can take doxycycline on an empty stomach and feel absolutely fine. I am one of those people. Also, keep in mind that some people visiting this forum may not have had Lyme disease for years and years. What if some poor hiker just got bitten by a tick and visits this forum, then reads that you shouldn’t take doxycycline on an empty stomach because it’s bad for you? That’s patently untrue. And let’s say this hiker takes doxycycline with food so that the absorption is impeded enough that the hiker is unable to sufficiently combat the infection early. Now this person will have a lifelong chronic disease because of bad medical advice spread in this forum.
The same applies to someone who may have only had Lyme disease for six months, or even a year. These people need to get the drugs into their body ASAP. It’s ultimately up to their doctors whether they can stomach, literally, the doxycycline, and that’s a conversation they need to have with their physician. But some of the things in this forum suggest that taking doxycycline on an empty stomach—ever—is not normal. That’s simply not true. JessicaMommy said she had never heard of that and even advised the OP to see if it was a mistake. That’s extremely strange, because virtually every reputable health institution, including the Mayo Clinic, very clearly spells out that doxycycline should be taken on an empty stomach under normal circumstances. You don’t have to do much Googling to discover that most doctors advise taking doxycycline on an empty stomach.
Chapelle then said that doctors “just generally tell everyone to take antibiotics on an empty stomach, mainly because they don't know which ones you need to and which ones you don't, so they play it safe.” This is completely factually inaccurate. Doctors do nothing of the sort. When a drug is invented, studies are done on that drug and recommendations are made about
absorption and consumption. There is nothing about
doxycycline specifically that makes it bad to take on an empty stomach. In fact, as you can clearly see all over the Internet, doxycycline is one of many antibiotics that is recommended to be taken on an empty stomach. That’s based on the science of the drug, absorption rates, etc.
As a matter of fact, Joseph Burrascano, one of the most famous Lyme doctors in the world, specifically states that doxycycline is most useful in treating Lyme disease when blood concentrations are higher. For this reason, he recommends taking higher doses of doxycycline fewer times a day, rather than taking lower doses of doxycycline more times per day. Getting your overall blood level of doxycycline to a sufficiently high point can make all the difference between a treatment failure and someone who effectively beats back their Lyme disease. Obviously if you’re taking doxycycline with food, and especially if you’re taking doxycycline with food while already taking it in very small doses, you could have a problem. Think of it this way: if you try to lift a heavy weight by pulling on it with insufficient force many times a day, you’re still not going to be able to lift the weight. To make any headway, you need a sufficient amount of force. The same is true with antibiotics and Lyme disease. It’s entirely possible that you can take doxycycline, as well as other antibiotics, for months or even years, without achieving the desired result, in part because those antibiotics are not getting into your bloodstream to a sufficient degree. This is something to people absolutely have to be mindful of.
Again, there may very well be good specific reasons in your particular Lyme disease situation to take doxycycline with food. But do not generalize advice based on vague hypotheses or conjecture. We should be steering people towards the best information, not spreading misinformation. As Lyme patients we already deal with plenty of that.
Post Edited (Medical Detectiveee) : 8/23/2019 12:27:14 PM (GMT-6)