I can now say definitively that disulfiram is indeed a breakthrough in the treatment of Lyme disease and babesiosis. Ninety of my patients are now on disulfiram, and, judging from the posts on Facebook, there are many more now taking this drug. Because of the increase in demand and the fact that Teva has stopped producing it, most U.
My patients now get it through Canadian pharmacies where it is sourced from other countries. Kenneth Liegner has had the longest experience treating tick-borne infections with disulfiram.
He is seeing sustained remissions of six months or more after completing treatment in many patients. He took disulfiram for four months and has now been off all treatment for almost two and a half years, feeling better than ever. Because we have large groups of patients on disulfiram reporting their experience on dedicated Facebook groups, we are getting a lot of feedback. The biggest issue is still Herxheimer reactions. To mitigate these reactions, I suggest starting with low doses, Patients who appear fragile, inflamed, or poor detoxifiers start as low as 15 mg every week, which is available at compounding pharmacies.
Doctors prescribing these doses should request that capsules be enteric-coated and time-release. Enteric coating allows the medications to get through the stomach without being broken down by the stomach acid. The medication is then released in the small intestine, which is best in this situation. Patients increase the dose every two weeks based on tolerance. The maintenance or target dose is based on weight but also tolerance : mg daily for patients over lbs. Patients continue the target dose for two to three months, and then stop.
Dihydromyricetin facilitates metabolism of both alcohol and acetaldehyde, 5 and some patients report that it also helps with the die-off symptoms.
Splitting the dose of disulfiram to two or three times daily and taking it with vitamin C and zinc also may mitigate Herxheimer reactions as well as neurotoxicity. If the Herxheimer reaction is severe or prolonged, then the dose of disulfiram should be decreased. I advise my patients to never advance the dosage if they are still Herxing, and to check in with me by email every two weeks.
Most of my patients are already on antimicrobials when they begin disulfiram. If they stay on these, the Herxheimer reactions are more severe. Therefore, I taper the antimicrobials as I increase the dose of disulfiram. If patients are having symptoms, it is necessary to determine if symptoms are related to Herxheimer reactions, drug side effects, or under-treatment due to tapering their antimicrobials too quickly.
For example, I advised a patient with Lyme disease and babesiosis to stop her Mepron when she reached a dose of Within a week, she complained of a recurrence of her Babesia symptoms, and I instructed her to go back on Mepron but at half dose. In a few days she was fine, and when she increased the dose of disufiram to mg daily, she stopped the Mepron without difficulty. Patients on disulfiram must avoid alcohol! Disulfiram—also known as Antabuse—has traditionally been prescribed for alcoholics to help them give up drinking.
When alcohol is ingested, disulfiram inhibits the breakdown of acetaldehyde and makes the person feel terrible.In this episode, you will learn about an exciting new therapeutic agent in Lyme disease called Disulfiram.
Find The Show. My guest for this episode is Dr. Dan Kinderlehrer. Daniel A. Kinderlehrer, MD is a nationally recognized physician with expertise in the fields of nutrition, allergy, environmental medicine, Lyme disease and the healing of mind-body-spirit as a unified whole.
He created and organized the Lyme Fundamentals course which is presented annually at the International Lyme and Associated Diseases conferences. He is the author of several review articles in medical journals and the Lyme Times. His integrated medical practice in Denver, CO focuses on the diagnosis and treatment of tick-borne disease.
They are not a full replacement for the discussion. Timestamps are provided to facilitate finding portions of the conversation. Errors and omissions may be present as the transcript is not created by someone familiar with the topics being discussed. Please Contact Me with any corrections.
Episode #111: Disulfiram with Dr. Dan Kinderlehrer, MD
And now, here's Scott, your Better Health Guy. Nothing in today's discussion is meant to serve as medical advice, or as information to facilitate self-treatment. As always, please discuss any potential health-related decisions with your own personal medical authority. Today's guest is Dr.
Dan Kinderlehrer, and the topic of the show is Disulfiram. Dan Kinderlehrer is a nationally recognized physician with expertise in the fields of nutrition, allergy, environmental medicine, Lyme disease, and the healing of mind, body, spirit as a unified whole. He created and organized the Lyme Fundamentals course, which is presented annually at the International Lyme and Associated Diseases conferences.
His integrative medical practice in Denver, Colorado focuses on the diagnosis and treatment of tick-borne diseases. And now, my interview with Dr. It is a hopeful time, and Disulfiram represents a very exciting new opportunity. But that does not mean that it's right for everyone, or that it's without potential side effects.
Dan Kinderlehrer has been practicing medicine for over four decades and is one of the early practitioners with a focus on helping those with Lyme disease.
Very honored to have him on the show to share his knowledge of Disulfiram with us today, thanks so much for being here today. Did you have your own personal health journey with Lyme disease that gave you the passion you have for the work you do today?
And have you had any personal experience with Disulfiram? Dan K. Basically, the sudden onset of high fever, shaking chills, night sweats, and that led to a diagnosis of Lyme within a few weeks we figured out it was Lyme. But we had no idea that I had Babesia, which was barely on the radar at that time.
So even though I was on prolonged antibiotics, I continued to be ill. And that led to my interest in Lyme disease when I finally got better from that, which was really quite prolonged. Because at one point, I was re-infected and had Bartonella as well. And I decided to dedicate my practice the treating people with tick-borne infections because it was clear that the internist, the infectious disease people had no idea what was happening.Anyone who reads the financial pages has heard of Steven Cohen, the multi-billionaire hedge fund manager and philanthropist.
Cohen lives in Connecticut where his wife, Alexandra, became ill with Lyme disease. The Cohens established the Cohen Lyme and Tick-borne Disease Initiative, a division within their philanthropic organization focused on supporting Lyme and tick-borne disease research. Those of us who actually treat Lyme disease know there is nothing precise about it. Treating chronic infection with Borrelia burgdorfericomplicated by any number of co-infections, is often hit or miss.
Nevertheless, we who practice where the rubber meets the road are grateful for whatever clues basic researchers provide that can help our patients. What is disulfiram? If you drink alcohol, your body converts it to acetaldehyde via the enzyme alcohol dehydrogenase.
Acetaldehyde is then broken down to acetic acid via the enzyme acetaldehyde dehydrogenase:. This is bad news if you drink alcohol, because acetaldehyde is responsible for the symptoms we know of as hangovers. This drug is prescribed to alcoholics as a deterrent to drinking alcohol, since having just one drink will result in a vicious headache. It turns out disulfiram has known activity as an antimicrobial. Studies have demonstrated its action against gram-positive bacteria such as Staphylococcus and Streptococcus species  as well as Plasmodium falciparum, a.
InVenkata Raveendra Pothineni and colleagues at Stanford reported on new drug candidates against Borrelia burgdorferi using a technique known as high-throughput screening.
In his talk at the Precision Medicine conference, Lewis showed a slide that looked like this:. This bar graph depicts the number of colonies remaining after treating Bb with the following four drugs: doxycycline, ceftriaxone, vancomycin, and disulfiram.
It is clear that vancomycin is a powerful drug to treat Lyme disease. But disulfiram completely sterilized the culture—there were no persisters! The mechanism of action of disulfiram as an antimicrobial is still unclear. The effectiveness of an antibiotic in the laboratory does not always translate to its effectiveness in people. Furthermore, there have been no animal or human studies researching the efficacy of disulfiram in the treatment of Lyme disease. But a patient of Dr. Kim Lewis on YouTube and asked to be treated with disulfiram.
This patient had been infected in Mayand diagnosed with Lyme disease and babesiosis. He was treated aggressively with oral antibiotics as well as intravenous gamma globulin IVIGsince his serum level of IgG antibodies was low. After nine years of treatment, the patient had improved substantially. However, any attempt to decrease or discontinue his antibiotics resulted in a relapse of his multi-systemic symptoms within two weeks.
Liegner explained to the patient that there were no studies investigating disulfiram in the treatment of Lyme disease. But he agreed to treat the patient with appropriate monitoring of his lab tests. The patient began disulfiram mg daily and simultaneously discontinued his previous antibiotic regimen. Interestingly, the patient had had a psychiatric hospitalization during treatment, which he related to significant situational stress.
Liegner was concerned because there have been rare reports of disulfiram causing psychiatric problems.The following is for your information only, and is not intended to replace your practitioners medical advice.
Please consult your health care practitioner before implementing any medical treatments. Disulfiram tetraethylthiuramalso known as Antabuse was first synthesized in and licensed by the FDA in as an enzyme inhibitor to treat alcoholism but recently in a Stanford study it was found to be highly effective against both active spirochetes and dormant antibiotic tolerant borrelia persister cells in culture and in mice.
The research team searched four chemical libraries containing 4, compounds to identify novel drug candidates that might be repurposed to effectively treat Lyme borreliosis. In multiple trials were started on disulfiram. A small human study on disulfiram has recently been approved. Kim Lewis had wondered if it inhibits an unidentified enzyme. It also chelates manganesethe trace metal borrelia uses instead of iron most bacteria use iron.
The antagonistic effects may be due to the compounds in disulfiram having antagonistic actions against glutathionewhich exists in abundance in the affected bacteria…. Disulfiram should not be administered to patients who take certain stimulant drugs and antidepressants.Does Disulfiram work to treat Lyme Disease and what is Azlocillin?
The metabolism of other drugs may be inhibited by disulfiram, increasing their potential for toxic effects. The PDR is one source, along with another excellent source provided:. Trazadone, Imipramine and desipramine levels may increase when taking disulfiram. Concurrent use of the imidazoles metronidazole and tinidazole is contraindicated.
High dopamine may lead to mania, low noepinephrine may lead to depression. This means it can take up to 14 days to reach steady-state plasma levels, and 14 days to be eliminated from the body. Blood counts may become abnormal, and frequent monitoring is medically necessary.
No one knows for certain the minimum or maximum length of treatment needed.
Neuropathy seems to develop the longer one is on treatment. No alcohol for at least 12 hours before beginning treatment and for 2 weeks after stopping treatment. Patients not responsive to long term combinations of antibiotics have responded to months of treatment with disulfiram mg a day. Sometimes a much lower dose is effective. Typical dosing suggestion: lbs or less mg; lbs. Here is one sample treatment planeach individual would have dose set for their own circumstances.
Don't increase if your herxes are unmanageable- work on detoxing. Do not increase dose if having:. Consult your health care practitioner frequently. Consider lab results every two weeks. Some may need to start even lower at 25mg tablet from a compounding pharmacy every other day or every third day.
Sometimes the body cannot handle the herx cannot detox and the reaction can persist for weeks. They may not reach their target dose, and may be on disulfiram for 6 months or longer if tolerated and if improving. There are many references and iPhone APPs that can help guide a low nickel diet.
A point system is generally assigned and one tries to stay at under 15 points. Be aware that region that plants are grown may matter a lot. NO foods high in nickel: cocoa, chocolate, soya beans, oatmeal, nuts, almonds and fresh and dried legumes. NO canned food. Nickel dissociates from the can and increases the total nickel content you ingest.Some people I spoke to said that the way Lyme disease changes the human immune system does two things: first, it suppresses the part of the immune system that tries to attack the Lyme bacteria; second, it provides its own protection by killing off various other infections in the host that grow faster than it does.
There were two other pieces of circumstantial evidence that corroborated their idea. This was evidence that the immune system was working again. The other started in for me when I had my first cold.
Whenever I have a Lyme flare, my lungs are clear, my upper respiratory system is also clear. But as soon as I get the Lyme into some kind of remission, I immediately get a cold. Inmy cough lasted for several months. It was at that point in time, that I started to deal with respiratory issues over and over. For the past several years, I get sick with colds and bronchitis chronically. So my fantasy is over. To make my life more complicated, right after I started disulfiram, my housemate came down with a severe respiratory infection.
My housemate only lives here part-time, and my coil machine is in the room where she sleeps. We are still working on getting her tested. After the first few doses of disulfiram and daily coiling for Babesia, the Babes infection calmed down. It seems like each dose of disulfiram works for about 40 hours on Babesia. I have an herbal combination called tri-biotics on hand in case the Babesia symptoms get worse than heart palpitations and fatigue. Lyme disease is a little more tricky.
It seems like I still need to do something, and for now that something is taking broccolinate sulforaphane glucosinolate twice a day, but skipping the dose when I take the disulfiram dose. I find it tolerable. My original plan was to start coiling for Bartonella as soon as I needed to, since disulfiram causes a Bartonella flare as the Lyme starts to calm down.
This is already starting to happen. In addition to some Bartonella symptoms, such as tingling in my feet first thing when I wake up in the morning, I have the cough I get as Lyme starts to go into remission. When I realized that the disulfiram seems to work for only 40 hours, I considered taking it daily or every 36 hours.
Herxing requires me to rest a lot.What does an anti-alcoholism drug have to do with Lyme disease? Nothing—until a study funded by Bay Area Lyme Foundation found a link. Why were they doing this? Borrelia burgdorferia spirochete, when cultured in a lab has roughly 3 different forms : a a culture with predominantly long or corkscrew forms, b a culture with predominantly round forms and some microcolonies, and c a culture with predominantly microcolonies 2.
Most laboratory studies regarding the effectiveness of antibiotics are conducted in cultures on long forms. In this long form, the spirochete is motile and can divide although very slowly and consequently, some antibiotics work much better on the long form. However, after exposure to antibiotics such as doxycycline, the spirochete curls up into a round form and some clump together with other spirochetes to form a few microcolonies.
These round-body and microcolony forms are understood to be a defensive posture for the bacteria. For patients who have the chronic form of Lyme disease, it is hypothesized for the purposes of finding better antibiotics that these patients have persister forms of the bacteria. And while Dr. In addition, it is widely known that inflammation is a big challenge for chronic Lyme patients which makes them feel poorly overall and have chronic pain symptoms.
Could we find drugs used for other purposes that kill Borrelia and reduce inflammation? But Dr. In Dr. Of the over drugs screened for activity against BbTetraethylthiuram disulfide was the top candidate. Tetraethylthiuram disulfide, also known as disulfiram and branded Antabuse, is an anti-alcoholism treatment that literally makes a patient have a massive hangover if he or she drinks any alcohol.
Disulfiram is known to also have antibiotic properties. After reading Dr. Kim Lewis became very curious about disulfiram and ran his own tests with some very interesting results. In October ofDr. During that speech, Dr. Lewis mentioned the work of Dr. A video recording of Dr.
Sometime after that, a patient of Dr. Ken Liegner, who had been following Dr. This individual, an engineer, was doing fairly well on intensive anti-microbial treatment for both Lyme disease and babesiosis but whenever treatment was suspended, he deteriorated with returning symptoms. Like many Lyme patients, the engineer combed the internet for improved methods of treatment that could keep him well. After finding the YouTube video and bringing it to Dr.
Liegner to start a treatment with disulfiram. The engineer has remained clinically well without need for further treatment for more than two years. Liegner, who read the publication by Drs. Pothineni and Rajadas which was the basis of Dr.
The problem is that Disulfiram works
Rajadas to learn more about his work. After treating several patients with disulfiram, Dr. Liegner published a case series in May which described his experiences with use of this drug. While not every patient has had as dramatically favorable an outcome as the engineer, Dr.
Liegner remains very impressed by the utility of disulfiram and has not seen such dramatic results with the application of any other agent during his 30 years of practice in treating individuals suffering from chronic Lyme disease and chronic babesiosis. Since then, other physicians have started prescribing disulfiram for patients, including Dr.It started when I increased my dose from mg nightly to I had a good day and then the herx hit me pretty hard.
It was the usual stuff, severe headache lasting 3 days, urgent loose bowel movements, fatigue, low appetite, problems regulating body temperature. It is what I expected. After the three day headache subsided, every part of my body hurt: muscles, bones, joints, intestines. My abdomen swelled up. Then things changed. The body pain level went down by half.
All I wanted to do was sleep. I was dizzy when I was awake. I would get up, eat, and lie down for a moment…and wake up three or four hours later. Then I would get up, eat and fall right back to sleep. When I was awake, I was sleepy and woozy. The world my eyes saw did not match my balance. I had a funny feeling in my head and a numbness around my neck and shoulders. I figured that this was then end of the herx, that I just had to get through this part. Some more symptoms have arrived: pain in my breasts, swelling in my feet, intermittent tingling in my arms and legs, sore soles on my feet when I get up from sleeping, urinary hesitation, difficulty starting bowel movements, episodes of blurry vision, and ringing in my right ear.
This is a Bartonella flare. In fact, many people are experiencing big flares in Bartonella symptoms after they get through the first die-off reaction on disulfiram. So I was reluctant to add any other treatments until I was sure. With the coil machine, however, I never let the Bartonella infection go completely untreated. It took me a long time to see it as part of a dysautonomia pattern, that for me, has usually been a clue to reactivated Bartonella.
I started big, 15 minutes on the back of my head, 10 minutes on my sacrum, and five minutes on the rest of my spine and my shoulder knobs. That was enough to clear my head to take the dogs for a walk in the neighborhood. This time it was the need to increase the disulfiram dose. Bartonella is tricky. It is the infection that causes me to put the breaks on, to wait things out, to not act, to feel paralyzed and that nothing will ever work.
No night sweats. No low blood pressure. As the herx has waned, so have many of the joint symptoms. I want to do many things that I do when I feel well, if I could only stay upright and awake. I had no confidence that the disulfiram would work. Now, I think it is doing many things, finally attacking the dormant forms of Lyme and Babesia.