"TRT/HRT/Nutrition/Cognition/Wellness/LT student of the game"

[Gman86]

She looks amazing for 82 and eating Carnivore for 65 years. Just WOW...

Even tho life must have been quite a bit harder for people thousands of years ago, part of me is jealous of how fckn amazing they must have felt mood and energy wise while they were alive. Assuming they had access to an abundant amount of ruminant heard animals. They also must have had 10/10 libidos, and zero issues erection wise. Just an optimally functioning body and brain, and most likely not having to deal with any chronic illnesses or day to day issues with their bodies. Other than physical injuries obv. Just imagine how great of a mood they must have been in, despite life being pretty difficult.

I know when I’ve felt my best mood wise, it didn’t matter what stressors I had going on. Everything rolled off my back and nothing could get me out of my great mood. But when I was on Clomid monotherapy, I was so depressed, and even if everything was going perfect in my life it wouldn’t have made a difference. I assume people thousands of years ago were the former day to day. Despite their life being dangerous and unpredictable, I have a feeling they felt amazing day to day. Which again, I’m pretty jealous of. But luckily by getting back to how our ancestors ate, we can at least get a lot closer to how they must have felt. But probably can’t get to their level, no matter what we do, due to all the things in our environment that effect us negatively that we can’t really control.

 

[Belekas]

Hey @sammmy how you doing man?

Very interested how you feeling post your HP treatment regiment. I'm composing a protocol myself but seems I can't get my hands on Rifabutin and will need to use "classic" antibiotics. Buying everything myself from pharmacies and hopefully that works out cuz my GP and the endos just fucking dissapeared once I talked and explained that 7 days won't cut it and at least 10 or 14 are required for better erradication %. Fucking taking a piss and labeled my situation as minor. A bunch of pricks, I hope they feel my pain one day so they know what time it is.

I'm thinking Amoxicillin 3.5g/day as this had the highest erradication % from what I've read. PPIs will do Rebeprazole 10mg/4xday as you did. Now the question is what would be better to add Metronidazole or also Tetracycline, as they have prescribed me all 3 together. In my 2 failed treatments I had metronidazole both times but just 800-1000mg/day FWIW. So I'm thinking what would be the best combination considering all the data from my last treatments.

All ideas appreciated.

Best regards,
Bel

 

[sammmy]

I'm doing better than before the treatment. I was trending towards anemia before, and now hemoglobin, RBC, and hematocrit are restored up to their usual values. I can eat fruits, fish, mayonnaise, eggs, yogurt, which were problematic before. Haven't tried denser meat yet.

I got oral thrush (tongue turned green-yellow-brown) after the antibiotics so now I am taking 150mg fluconazole/day for a month. Still taking probiotics and still no Clostridium Difficile.

I personally stayed away from Tetracycline - seemed to have more intense gastrointestinal side effects. You can start with Tetracycline and switch to Metronidazole if the side effects are too much.

 

[Belekas]

I'm doing better than before the treatment. I was trending towards anemia before, and now hemoglobin, RBC, and hematocrit are restored up to their usual values. I can eat fruits, fish, mayonnaise, eggs, yogurt, which were problematic before. Haven't tried denser meat yet.

I got oral thrush (tongue turned green-yellow-brown) after the antibiotics so now I am taking 150mg fluconazole/day for a month. Still taking probiotics and still no Clostridium Difficile.

I personally stayed away from Tetracycline - seemed to have more intense gastrointestinal side effects. You can start with Tetracycline and switch to Metronidazole if the side effects are too much.

Glad you doing better and hope it continues and you heal completely. Fucking antibiotics ain't no joke, some claim it takes years to recover from the damage it does...

I might just roll with Amoxicillin and Metronidazole bigger dose like you took and ignore Tetracycline at all. NHS GP wants me to take all 3 though but I won't. Will increase dose and do 14 days. Also I will hold Nexium for 2 months and only then slowly taper off. Got this piece of advice from my good mate whos been treated by a very smart female doc who said thats the way to go as only after 2 months of Nexium the stomach will get coated. And PPIs must be tapered off or too much acid might be spilled, if I understood him correctly on the explanation. Also she said that all stomach issues treated with for example Nexium must be at least 2 months and then tapered off. Thats how she cured him. Downside is that Nexium depletes magnesium badly so must keep at least 1000mg/day or even better do injectable.

 

[sammmy]

I have seen a Russian study, in which the ulcers by H. Pylori were not completely healed at the end of the 2 week antibiotics + bismuth + PPI eradication, so they kept the patients on Bismuth for additional 1 week after the eradication and the ulcers healed.

If you keep the PPI afterwards, you should take it in normal dose not 4 times daily. It will help the intestinal lining heal but the reduced stomach acid also invites microbial proliferation in the stomach and small intestine so the best is to stop the PPI when you feel you are healed enough.

 

[Belekas]

I have seen a Russian study, in which the ulcers by H. Pylori were not completely healed at the end of the 2 week antibiotics + bismuth + PPI eradication, so they kept the patients on Bismuth for additional 1 week after the eradication and the ulcers healed.

I'll keep it for longer as well. The thing is that with the amount of pain and discomfort I get, by my thinking, there has to be an ulcer somewhere. Although they never discovered it when they did biopsy back in January. The doc was surprised as well, because of how well everything looked. So thats a weird one, but maybe he missed something, somewhere. Not sure how precise these biopsies are. Hope nothing more serious as sometimes anxiety hits hard that maybe its not even that, you know.

If you keep the PPI afterwards, you should take it in normal dose not 4 times daily. It will help the intestinal lining heal but the reduced stomach acid also invites microbial proliferation in the stomach and small intestine so the best is to stop the PPI when you feel you are healed enough.

I have some Rebeprazole and it should be enough for 14 days cycle 10mg 4x/day. Maybe after its finished, switch to Nexium and do 40mg 2x/day till I heal, or keep same just do 10mg 2x/day?

 

[sammmy]

The side effects that you might experience (nausea, headaches, diarrhea) may be related not only to the antibiotics but also to the high dose and frequency of PPI. So after you are done, you should continue with normal doses of PPI, whatever those are.

Also, keep in mind that Metronidazole at high doses like 1500mg/day may color the urine brown like tea. If you don't have kidney pains and change in urination frequency, it is not kidney damage but some metabolite of metronidazole.

 

[Belekas]

The side effects that you might experience (nausea, headaches, diarrhea) may be related not only to the antibiotics but also to the high dose and frequency of PPI. So after you are done, you should continue with normal doses of PPI, whatever those are.

Also, keep in mind that Metronidazole at high doses like 1500mg/day may color the urine brown like tea. If you don't have kidney pains and change in urination frequency, it is not kidney damage but some metabolite of metronidazole.

So maybe go with a bit lower Metronidazole dose then as per usual protocol 400/500mg 2x/day? I also read that way higher resistance rates to Metronidazole then Clarithromycin but only in certain combinations.

 

[sammmy]

Metronidazole 500mg 2x/day seems reasonable.

Many medical articles claim that the H. Pylori resistance to Metronidazole is overcome when you take a PPI. In the Pylera study for example, about 33% of the patients were Metronidazole resistant, yet they achieved 94% eradication with no difference detected between patients that were resistant or not resistant to Metronidazole.

My dose of 1500mg Metronidazole total per day was selected because I had a resurgence of Clostridium Difficile before staring the H. Pylori eradication and this is the standard Metronidazole dose for suppressing Clostridium Difficile.

The Pylera protocol (Tetracycline, Metronidazole, Bismuth, PPI) also uses 1500mg total dose of Metronidazole per day.

On the other hand, the Japanese study with the PPI dosed 4 times per day used 250mg Metronidazole 2x/day and 500mg Amoxicillin 4x/day:

Efficacy of tailored Helicobacter pylori eradication treatment based on clarithromycin susceptibility and maintenance of acid secretion - PubMed

A tailored H. pylori eradication regimen based on CAM susceptibility and maintaining acid secretion (rabeprazole 10 mg q.i.d.) is useful because it can achieve an eradication rate exceeding 95%, irrespective of eradication history, thus overcoming differences among CYP2C19 genotypes.

pubmed.ncbi.nlm.nih.gov

 

[Belekas]

Metronidazole 500mg 2x/day seems reasonable.

Many medical articles claim that the H. Pylori resistance to Metronidazole is overcome when you take a PPI. In the Pylera study for example, about 33% of the patients were Metronidazole resistant, yet they achieved 94% eradication with no difference detected between patients that were resistant or not resistant to Metronidazole.

My dose of 1500mg Metronidazole total per day was selected because I had a resurgence of Clostridium Difficile before staring the H. Pylori eradication and this is the standard Metronidazole dose for suppressing Clostridium Difficile.

The Pylera protocol (Tetracycline, Metronidazole, Bismuth, PPI) also uses 1500mg total dose of Metronidazole per day.

On the other hand, the Japanese study with the PPI dosed 4 times per day used 250mg Metronidazole 2x/day and 500mg Amoxicillin 4x/day:

Efficacy of tailored Helicobacter pylori eradication treatment based on clarithromycin susceptibility and maintenance of acid secretion - PubMed

A tailored H. pylori eradication regimen based on CAM susceptibility and maintaining acid secretion (rabeprazole 10 mg q.i.d.) is useful because it can achieve an eradication rate exceeding 95%, irrespective of eradication history, thus overcoming differences among CYP2C19 genotypes.

pubmed.ncbi.nlm.nih.gov

So it seems that PPI 4x day is key here and then even a lower dose Antibiotics does the job. The Japanese study looks interesting, agree. So Metronidazole 500mg 2x/day, Amoxicillin 500mg 4x/day or even 6x/day, PPI Rebeprazole 10mg 4x/day and added Bismuth 120mg 4x/day sounds not too bad of a combination IMHO. I've read that Amoxicillin especially high dose 3-3.5g/day makes a huge difference, will attach paper if I find it.

 

[Belekas]

So it seems that PPI 4x day is key here and then even a lower dose Antibiotics does the job. The Japanese study looks interesting, agree. So Metronidazole 500mg 2x/day, Amoxicillin 500mg 4x/day or even 6x/day, PPI Rebeprazole 10mg 4x/day and added Bismuth 120mg 4x/day sounds not too bad of a combination IMHO. I've read that Amoxicillin especially high dose 3-3.5g/day makes a huge difference, will attach paper if I find it.

But on the flipside my previous failed #2 protocol I did in February was very similar - Rebeprazole 20mg 2x/day, Amoxicillin 1000mg 2x/day and Metronidazole 500mg 2x/day. Nearly identical only the doses were lower, no Bismuth and duration was 7 or 10 days don't remember. Not sure if worth doing the one I've mentioned just with bigger doses and longer duration but same meds?

 

[sammmy]

You can also add powdered probiotics if you can currently tolerate them - there are studies they increase the eradication rate, probably because they compete with H. Pylori in the stomach, and they decrease some of the side effects.

 

[Belekas]

You can also add powdered probiotics if you can currently tolerate them - there are studies they increase the eradication rate, probably because they compete with H. Pylori in the stomach, and they decrease some of the side effects.

Which one you have in mind?

Made another post above:

"TRT/HRT/Nutrition/Cognition/Wellness/LT student of the game"

She looks amazing for 82 and eating Carnivore for 65 years. Just WOW... Even tho life must have been quite a bit harder for people thousands of years ago, part of me is jealous of how fckn amazing they must have felt mood and energy wise while they were alive. Assuming they had access to an...

www.excelmale.com

Not sure if reasonable repeat same regiment just different dosing after a failed one?

 

[sammmy]

Then do 1500mg Metronidazole/day. I my case, I do not want to go through that protocol ever again, so I maxed out all parameters that matter - the eradication depends strongly on doses, duration, and frequency of PPI.

I think it takes a few days for the PPI to "turn on", that's why shorter protocols are basically running without PPI the first few days and they have lower eradication rates. I started feeling nausea on the 5th day, which I interpret as a sign that the PPI started messing with the stomach acid.

Don't know which probiotic. Just try some that you can currently tolerate with 10+ strains, at least 30 billion bacteria per capsule and open the capsule and mix the power with food.

 

[Belekas]

Then do 1500mg Metronidazole/day. I my case, I do not want to go through that protocol ever again, so I maxed out all parameters that matter - the eradication depends strongly on doses, duration, and frequency of PPI.

I think it takes a few days for the PPI to "turn on", that's why shorter protocols are basically running without PPI the first few days and they have lower eradication rates. I started feeling nausea on the 5th day, which I interpret as a sing that the PPI started messing with the stomach acid.

Yes, good point and fair enough. I never want to do it again as well and with such doses also bit scared, won't lie, but IIWII, no risk, no reward. Was contemplating 10 or 14 days so 14 days it is then. All maxed out, full tilt.

 

[sammmy]

The view in the Asian articles is that dosing the PPI and the antibiotics twice daily, gives H. Pylori time to multiply in between the doses. That's why dosing everything 4x/day is better and Amoxicillin 500mg 4x/day is better than 1000mg 2x/day, although the total daily dose is the same.

Adding the bismuth also increases the eradication rate. That's why Pylera doses everything 4x/day, uses bismuth, and the protocol is extended from 7 to 10 days. And it achieved eradication in patients that failed previous regimens with the same drugs.

 

[Belekas]

The view in the Asian articles is that dosing the PPI and the antibiotics twice daily, gives H. Pylori time to multiply in between the doses. That's why dosing everything 4x/day is better and Amoxicillin 500mg 4x/day is better than 1000mg 2x/day, although the total daily dose is the same.

Adding the bismuth also increases the eradication rate. That's why Pylera doses everything 4x/day, uses bismuth, and the protocol is extended from 7 to 10 days. And it achieved eradication in patients that failed previous regimens with the same drugs.

Agreed 100%. So pretty much all thought out and plan composed. Will update when I'll have (hopefully) all the meds and be ready to start. Thanks for your time and thoughts. Appreciate it.

 

[Belekas]

Been watching some Prof Bart Kays videos and enjoy how he rips these so called MDs, influencers and healers to little pieces LMAO

 

[sammmy]

We need more and more doctors like Bart Kays that challenge the contemporary medicine pseudo-science based on blatant abuse of statistics, observational studies that prove nothing, and "medical consensus" that is nothing more than a religious opinion, that frequently gets it wrong based on history.

I would love to see videos by him what he thinks are the way to reduce arteriosclerosis, based on actual well conducted studies, not opinions or medical consensus.

 

[sammmy]

That's another great one study buster by him: