Here we go:
1.) Aim for about
40g of fat per dose. In one study, atovaquone administered with 23g and 46g of fat led to 2.7- and 4-fold increases in AUC (blood concentration calculation) versus taking it without food, respectively.onlinelibrary.wiley.com/doi/10.1111/j.1365-2125.1994.tb04232.x/pdf
One tsp of almond butter has 3g of fat. Try to aim for more. 1 cup of whole milk has 8g, which is a good start if your diet allows for milk. Still though, the more fat you add, the less money you're peeing out.
2.) Yes, it's best to follow that up with a meal. There might be extra fat in your regular meal.
3.) Per the Mepron monograph, always store between 15-25 degrees C. Therefore, DO NOT refrigerate, NEVER freeze.ca.gsk.com/media/591391/mepron.pdf
4.) Adding Bactrim is a very, very good idea. Most prominent LLMD's add it to Mepron/Zithromax. In the last few years, some have added the newer drug Alinia instead. Alinia can also kill broader parasites like some nematodes, and is very safe, with no P450 interaction. Both Alinia and Bactrim DS are highly recommended.
5.) You could pulse it, since Mepron does have a lengthy half life, and Babesia is slow-growing. The only advantage to this however, is that it saves money. I've never heard of any clinical benefits of pulsing Mepron, and I've never heard anyone recommend it.
If it were me, I wouldn't pulse it, as it's important to avoid resistance at all costs, especially with a front-line medication. If you're going to spend the money to do Mepron, you may as well take a full, legit shot at it.
Adding Artemisinin is a great idea. I've found Zhang Artemisiae-2 to be much, much stronger than regular Artemisinin from Allergy Research Group.
In his Babesia book, Dr. S talks about
how regular Artemisinin is the weakest Artemesia derivative. His favourite appears to be Zhang's "Artemisiae", which contains artesunate. It's the most active and least toxic form of artemisinin. The "Artemisiae" formula is half the strength of Zhang's "Artemisiae-2" (a newer product that was released after the Dr. S book). "Artemisiae-2" contains straight dihydroartemisinin (the actual killer ingredient for Babesia, and what artemisinin and artesunate break down into).
It appears that these Zhang products do NOT need to be pulsed. While artemsinin decreases concentration in the body because of liver auto-induction, it's active metabolite, dihydroartemisinin, continues to increase regardless.
While Dr. S talks about
artemisinin's tendency to be pulsed, he doesn't say anything about
pulsing for any artemisinin derivatives. The only consideration to pulse these Zhang products seems to be to avoid toxicity over a long period like several months. Zhang himself recommends a 1 to 3 month treatment period. However, if doing it as an add-on with Mepron, you could very well pulse it.
Make sure the ferritin level in your blood is in the upper half of the range while on Artemisinin, as iron facilitates free-radical creation, which is what kills the parasites. If it's not up there, take Ferrous-heme (take ferrous heme with Vitamin C, and away from other minerals like calcium, zinc, etc., to facilitate absorption).
You should also be on anti-oxidants like NAC and others while on Artemisinin to minimize free-radical damage to other parts of your body, but try to take them away from the Artemisinin dose, so that they don't counter each other too much; you still want free-radicals smashing into the parasites.
Never take Milk Thistle, Rifampin, or Doxycycline at the same time as Mepron. They will all make Mepron concentrations plummet. I'm not sure about
minocycline, unfortunately. Further research would be needed for that.
Zithromax is the only macrolide that has been proven in the literature to work with Mepron to kill Babesia. Many LLMD's suspect other macrolides, like Biaxin, will work too, but again, this is hearsay and hasn't been proven to the same extent in the literature as zithromax.
Lastly, some anecdotal advice: start Beyond Balance BAB-2. I find it produces a VERY strong herx. My LLMD says there is absolutely no substituion for this product. Dr. C says she finds BAB-2 to be hepful in about
80% of her Protomyxzoa Rheumatica cases (similar to Babesia).
Think that's it for now!
Oh one more thing: when doing Mepron, do it for at least 5 months. The parasite can hid in the blood cell for 4 months, so the extra month gives you some overlap. It also takes a few weeks for blood concentrations to rise to a killing level.
You should be on 750mg/5mL of Mepron twice per day minimum. Dr. S is finding that even this dose does not offer a cure in most of his patients, and advocates higher doses (make sure you're checking liver function!).
Also keep an eye out for RBC death in your labs, as well as decreases in neutrophils and increases in eosinophils. Any of these findings after starting Mepron would make me very suspicious of a Babesia infection.
Post Edited (Mustard Seed) : 12/3/2016 8:28:06 AM (GMT-7)