Re: Visit with a cheif medical guy

I know your post is old now so I don't even know if you'll get to read this. But hopefully!

I'm just wondering why you would choose to take paromomycin *after* the other two anti-microbials, rather than simultaneously? Paromomycin kills the luminal cysts, while the others are systemic. Wouldn't it make sense to tackle both routes at the same time? To me, it seems like if there's a pause in treatment (i.e. the gap between taking a course of tinidazole, and a course of paromomycin), it could lead to trophozoites hatching and the paromomycin may not be able to cope with that. (Even though paromomycin has been used on its own successfully in some cases.)

Do we space out the treatments because their combined effect would be too harsh? I can't seem to find an answer to this question anywhere, even my doctor. If you do tinidazole + paro + a third Antibiotic (like nitazoxanide), it seems like the parasites would have no where to run.

My other question is... there is some debate about tinidazole concentration vs. frequency. For example, in your post you recommend using tinidazole TID instead of QD in order to keep blood levels constant. However, some research I've read suggests that 2g QD is a much stronger blast of medication at the parasites that they can't withstand, even though it will mean that there will be a gap where the drug wears off before the next dose. This is especially true if someone has already tried to treat their bugs with an azole class drug (like metronidazole) in the past.

In some studies, the TID approach seems to not work because the concentration does not get high enough. In other studies, TID seems to do the trick. I guess it depends on individual patients and their condition. I've had amebiasis for years and I'm doing triple therapy right now, and I'm concerned that the TID approach might not be strong enough.

If you're able to read this and could provide some information, I'd really love to hear back. I'm getting conflicting info from the research.

Re: avoiding foods with high gylcemic index. That's good advice, but you probably need some carbs as to avoid entering ketosis. I think ketosis while on these intense Antibiotics could be a bad scene for some people, especially if their condition has already resulted in major weight loss, as with mine.