Author Archive

Explaining DDDCT Protocol for Treating Bartonella, Parts 1-5

**UPDATE**

Just so you know you aren’t losing your mind, I posted this before back in March:  https://madisonarealymesupportgroup.com/2025/03/07/treating-bartonella-medical-detective-pts-1-5/

I hate to be proving the adage, “The mind is the first to go,” but here we are.

https://www.lymedisease.org/protocol-treating-bartonella

MEDICAL DETECTIVE: Explaining DDDCT protocol for treating Bartonella

This article was originally posted on Dr. Richard Horowitz’s Medical Detective Substack. It is Part 4 of a 5-part series. You can find more helpful content by subscribing here. 

By Dr. Richard Horowitz

Double Dose Dapsone Combination Therapy (DDDCT)

In Bartonella Parts 1, 2, and 3, you learned the basics of Bartonella testing, symptoms, and treatment options, with a detailed discussion of laboratory work needed before starting the protocol, and how/why the medication and support supplements are being used to increase the tolerability and safety of DDDCT and HDDCT.

Please review this information with your doctor before proceeding with the antibiotic protocol listed below. The full protocol can be found in:

Horowitz, R.I.; Fallon, J.; Freeman, P.R. Comparison of the Efficacy of Longer versus Shorter Pulsed High Dose Dapsone Combination Therapy in the Treatment of Chronic Lyme Disease/Post Treatment Lyme Disease Syndrome with Bartonellosis and Associated Coinfections. Microorganisms 2023, 11, 2301. https://doi.org/10.3390/microorganisms11092301

Here’s the detailed and simplified version of the protocol.

The first week protocol

Gradually add the medication one by one to ensure GI tolerance. For example, on a Monday, start with Plaquenil (hydroxychloroquine) 200 mg once per day after meals, with Nystatin 500,000 U tablets, 2 twice per day, cimetidine 400 mg twice per day, and minocycline 50 mg twice per day.

Lower dose minocycline or doxycycline (50 mg twice per day) can be started if you have a history of GI intolerance to tetracyclines or risk of sun exposure. If there is no issue with GI tolerance, add rifampin 300 mg twice a day on Wednesday, several days later.

Since rifampin can affect medication levels in the body, especially hormones (thyroid, adrenals), a drug interaction check should be done in advance to understand whether other medication you are on will need to be adjusted. For example, if you have low thyroid function, you may increase thyroid medication slightly on rifampin, and then check levels several weeks later to ensure they are in good range.

Then, assuming all the medication has been tolerated Monday through Wednesday, add pyrazinamide (PZA) on Thursday for those with evidence of active Bartonella.

Dosing is based on body weight

The dosing is based on body weight (40-55 kg: 1000 mg once per day x 2 months; 56-75 kg, 1500 mg once per day x 2 months; 76-90 kg: 2000 mg once a day). Pyrazinamide is a Mycobacterium/persister drug used to shorten the course of therapy of tuberculosis; adding it, along with a tetracycline, rifampin, and dapsone, has a stronger effect on flushing Bartonella out of its hiding place.

Rarely, pyrazinamide will cause a rash (in roughly 5% of patients), and if that occurs, it should be stopped immediately. The rash will resolve quickly within 1-2 days off the medication.  If there is any doubt about sensitivity to medication, speak to your health care provider about using an H1 and H2 blocker prior to using PZA, like cetirizine (Zyrtec) 10 mg once a day with famotidine (Pepcid) 10-20 mg once a day.

So before starting the official 8-week DDDCT protocol, after breakfast and dinner and with a full stomach, take minocycline or doxycycline twice a day, 2 Nystatin twice a day, Plaquenil once a day, cimetidine twice a day, rifampin twice a day, and pyrazinamide once a day, apart from all the support supplements discussed in Bartonella, Part 3. These include probiotics twice per day, biofilm agents twice per day, and inflammatory/detox support twice per day.

The first week protocol is designed in a way to ensure there is no diarrhea, by slowing increasing medication, and also so you know if you react to any specific medication (i.e., Herxheimer reactions) before adding dapsone and folic acid supplements.

The 8-week DDDCT protocol

The 8-week protocol starts when all antibiotics are on board and tolerated (which adds an extra week to the protocol). Take probiotics as soon as you get up in the morning and last thing at bedtime. Always take antibiotics after breakfast and dinner together at the same time.

Be sure to not take your minerals (like Min RX 2 twice a day [Xymogen] and magnesium malate [NutramediX] 2- 4 twice a day) within 1-2 hours of antibiotics; take them at lunchtime and bedtime instead. Minerals can impair the absorption of tetracyclines, which is why they are taken apart.

Week 1

Add Dapsone 25 mg per Day and Folic Acid Support

*Dapsone 25mg once per day will be added to the prior regimen along with folic acid support to help reduce dapsone induced anemia

*Leucovorin (folinic acid) 25 mg, two twice per day

*Xaquil XR (L-methyl folate, Xymogen) two twice per day.

*Take these antibiotics:

*Minocycline 50 mg 1 twice per day with meals (or mino/doxy 50-100 mg twice a day)

*Rifampin 300mg 1 twice per day

*Plaquenil (hydroxychloroquine) 200mg once per day

*Nystatin 500,000 units 2 twice per day

*Cimetidine 400 mg twice per day

*Pyrazinamide (PZA) 500 mg, 2-4 tablets once per day (dose is dependent on body weight, as above).

*Take the support supplements listed in Bartonella Part 3.

Week 2

Increase Dapsone to 50 mg per Day

*Continue the same Week 1 regimen.

*Increase dapsone to 25 mg twice per day (50mg daily). That is the only change, as dapsone is gradually increased over the next 4 weeks for tolerability. If there are any severe Herxheimer reactions, use the Herxheimer protocol in Substack Bartonella Part 3.

Week 3

Increase Dapsone to 75 mg per Day

*Continue the same Week 1 regimen.

*Increase dapsone 25 mg to 2 in the morning and 1 in the evening (75 mg daily).

Week 4

Increase Dapsone to 100 mg per Day, Begin Methylene Blue and High Dose Antioxidants

*Take Week 1 antibiotics.

*Take these supplements at these increased doses to reverse methemoglobin levels:

*1000 to 2000 mg of glutathione twice per day

*Vitamin C 1-2 g twice per day

*Vitamin E 300 IUs twice per day

*NADH 5 mg 1-2 times per day

*Dapsone 100mg 1 per day (or 25 mg, two twice per day)

*Start methylene blue 50 mg twice per day

Weeks 5-8

Double Dose Dapsone Combination Therapy for the Next 4 Weeks

Week 5

*Take Week 1 antibiotics and supplements at these increased doses to reverse methemoglobin levels

*Dapsone 100mg, 1 twice per day (total dapsone, 200 mg per day)

*Add azithromycin (Zithromax) 250 mg twice per day with a full stomach. Clarithromycin (Biaxin) can alternatively be used instead of Zithromax if insurance coverage requires a different medication.

*Check a QT interval on the EKG prior to using Zithromax, or clarithromycin as Plaquenil, Zithromax and/or use of Zofran (ondasentron) for nausea may increase the QT. A repeat EKG is advisable when using Zithromax to ensure stability.

*Increase Methylene Blue to 100 mg, 1 twice per day.

*Increase Leucovorin 25 mg tablets to 4, twice per day (100 mg twice per day).

*Increase Xaquil XR (L-methyl folate) to 4 twice per day (60 mg twice a day). Higher doses of folic acid support will help to reduce dapsone induced anemia while using higher doses of dapsone.

*Increase glutathione from 1000 mg twice per day, to 2000 mg twice per day, if methemoglobin levels rise above 5%.

Week 6

*Continue Week 5 regimen.

*Increase methylene blue to 150 mg twice per day.

Week 7

*Continue Week 5 regimen.

*Increase methylene blue to 200 mg twice per day.

Week 8

*Continue Week 5 regimen.

*Increase methylene blue to 250 mg twice per day.

Week 9

High Dose Dapsone Combination Therapy (HDDCT) for the Next Week

*Continue Week 8 regimen, except increase Rifampin to 600 mg twice per day.

* Increase dapsone to two, 100 mg tablets twice per day, for a total dose of 400 mg of dapsone.

*Increase methylene blue to 300 mg twice per day.

*This will be a 6-day pulse for Bartonella as long as the blood counts and methemoglobin levels are in acceptable range. In some cases, a 4-day HDDCT pulse may be needed if borderline blood counts are present, or if there is no clear evidence of active Bartonella. Blood tests with a CBC, CMP, and methemoglobin level are done on day 3 or 4 of the this last week of antibiotic therapy.

Month 3, After Week 9 and Finishing HDDCT

*Stop all antibiotics. Stop Plaquenil, cimetidine, minocycline or doxycycline, Rifampin, Zithromax (or clarithromycin), and PZA.

*Stop dapsone.

*Go for repeat laboratory work (CBC, CMP, methemoglobin level) once you are 2-3 weeks off all antibiotics.

*Stay on:

*Nystatin 2 twice per day (to eliminate any yeast overgrowth)

*Leucovorin 4 twice per day

*L-methylfolate (Xaquil), 4 twice per day,

*All probiotics, biofilm support, and nutritional support with NAC, ALA, glutathione (GSH), Curcuplex, Oncoplex, etc.

*Taper methylene blue. Decrease the dose to 200 mg twice per day for 2 days; 100 mg twice a day for 2 days; 50 mg twice a day for 1- 2 days, and then stop it. Do not keep taking high dose MB after dapsone is finished (use the above protocol), as this could lead to increased hemolysis with lower red cell counts and symptoms/signs of serotonin syndrome.

If you have blue hands/lips and any symptoms suggestive of elevated methemoglobin at the end of the protocol once you have tapered MB, the decision to remain on lower dose MB and/or other high dose antioxidants must be based on blood levels of methemoglobin, not pulse oximetry (which doesn’t work on MB) or symptoms. This is important.

*Continue folic acid support with Leucovorin and Xaquil at the above doses until the CBC returns, when you go for labs about 3 weeks off the protocol. At that point, any anemia should be improving nicely, and doses can be decreased. If not, Leucovorin and Xaquil should continue at 3 twice per day for 1-2 more weeks, going into Month 4 (one month off antibiotics); usually Leucovorin and Xaquil are taken at a dose of 2 twice per day until the anemia has sufficiently resolved.

*Women should take extra B12 support (Methyl protect, Xymogen, one per day) and extra iron if there heavy menses during the protocol.

When the protocol is finished

Month 3

Mitochondrial support has been shown to be helpful for many patients after the protocol has completed. Do this for one month during Month 3 post-antibiotic therapy along with Nystatin, Leucovorin, Xaquil, probiotics, biofilm support, and other support supplements:

*ATP 360, 3 capsules once a day (Researched Nutritionals)

*ENADA (NADH) 1-2 per day

*Carnitex (Xymogen) 2 twice per day (not for those with alpha gal allergy)

*CoQ Power 400 mg twice per day (Researched Nutritionals) with CardioRibose (Researched Nutritionals), one scoop twice per day

*Mitoprime (Xymogen) one per day

*MitoNR (Designs for Health) one per day.

This protocol has had excellent success in chronically ill patients who suffered with chronic Lyme disease and Bartonella. You can watch the 90-minute dapsone documentary I filmed on 18 patients who were chronically ill who have now recovered their health with DDDCT and HDDCT:

https://players.brightcove.net/6314452011001/PAMDt93Yi_default/index.html?videoId=6353288590112

In Part 5, you’ll read about how to use the 2-week antibiotic pulses using HDDCT for chronic Bartonella. I’ll also review how to manage potential side effects in more detail. Stay tuned!

Dr. Richard Horowitz has treated 13,000 Lyme and tick-borne disease patients over the last 40 years and is the best-selling author of  How Can I Get Better? and Why Can’t I Get Better? You can subscribe to read more of his work on Substack or join his Lyme-based newsletter for regular insights, tips, and advice.

Go here for Part 5.

Category:

Uncategorized

SOT Part 2

https://www.lymedisease.org/sot-for-lyme-part-two/

Targeting Lyme at the genetic level: SOT’s emerging role

This is Part Two of a series on Supportive Oligonucleotide Therapy (SOT),  a form of antisense oligonucleotide therapy. SOT is a personalized, gene-silencing treatment designed to disrupt pathogens like Lyme disease. Read Part One here.

10/8/25

By Maria Marian, ND, MSE

The idea of silencing genes to weaken pathogens may sound futuristic, but antisense oligonucleotide therapies have already proven themselves in medicine.

Cancer research: Multiple antisense drugs have been studied in oncology to block genes that promote tumor growth and survival (e.g., Bcl-2, EGFR). While not all succeeded in trials, these studies helped refine delivery methods and safety monitoring【PMID: 19164450】.

FDA approval for infection: In 1998, fomivirsen (Vitravene) became the first antisense drug approved for human use, targeting CMV retinitis in immunocompromised patients【PMID: 9815174】. This milestone showed that gene silencing could work safely against viruses in humans.

Emerging infectious disease applications:

  • Laboratory studies demonstrate antisense oligonucleotides can inhibit replication of HSV, EBV, hepatitis viruses, and influenza【PMID: 19920191】.
  • In Lyme disease, small clinical series using SOT have reported significant reductions in Borrelia burgdorferi DNA copy numbers in blood following one or two infusions, as measured by PCR. Viral infections like EBV and HSV may require more sessions to achieve measurable results.

Although the published data are limited, these results are encouraging for patients who have exhausted conventional treatment options.

The Patient Experience

From a patient’s perspective, SOT is different from antibiotics, antivirals, or even most integrative therapies.

  • One infusion, long effect: Instead of daily or weekly medication, SOT is given as a single intravenous infusion, yet its activity can last up to six months.
  • Gradual improvement: Because the therapy slowly reduces pathogen replication rather than rapidly killing organisms, many patients notice changes gradually over weeks to months.
  • Reported benefits: Improvements may include reduced fatigue, better cognitive clarity, less pain, and fewer flares of viral reactivation.
  • Side effects: Most reported side effects are mild—such as temporary fatigue, flu-like symptoms, or localized reactions during infusion. Serious side effects appear rare in current reports.

That said, responses vary. Some patients may need multiple SOT cycles for sustained benefit, and others may not notice dramatic changes. As with all therapies, individual outcomes depend on many factors, including immune status, co-infections, and overall health.

Benefits and Strengths of SOT

Patients and clinicians exploring SOT often highlight its unique advantages:

  • Precision: Targets one critical sequence of the pathogen’s genome with minimal off-target effects.
  • Immune-system independent: Works even when immunity is suppressed or exhausted.
  • Continuous action: Active day and night for months, unlike short-lived antibiotics or antivirals.
  • Compatibility: Can be combined with integrative approaches (herbal protocols, detoxification, nutritional support) for a systems-based strategy.

Limitations and Open Questions

Despite its promise, SOT is not a silver bullet. Important limitations remain:

  • Limited clinical research: Most studies so far are pilot projects or case series, not large randomized controlled trials.
  • Not FDA-approved for Lyme or herpes viruses: Currently, its approved infectious disease application (fomivirsen for CMV) is historical. Use for Lyme, EBV, or HSV is off-label/experimental.
  • Cost: Treatments are highly individualized and can be expensive, often not covered by insurance.
  • Unknowns in long-term outcomes: While short-term safety looks good, more research is needed to assess durability of remission and long-term effects.

For these reasons, patients considering SOT should do so under the guidance of a clinician familiar with both its potential and its uncertainties.

Where Does SOT Fit in Chronic Lyme Care?

SOT should be thought of as a potential adjunctive therapy—not a replacement for all other treatments. In chronic Lyme and co-infections, successful treatment usually requires a layered approach, addressing:

  • Microbial burden (Borrelia, Bartonella, Babesia, viruses, parasites)
  • Immune regulation
  • Detoxification and environmental exposures (mold, metals, chemicals)
  • Mitochondrial and hormonal health
  • Lifestyle and resilience factors

Within that framework, SOT may serve as a targeted tool to reduce microbial load when conventional antimicrobials or integrative protocols have plateaued.

The Future of Gene-Silencing Therapies

The broader field of RNA-based medicine is expanding at remarkable speed. In recent years, the FDA has approved multiple oligonucleotide drugs for rare genetic diseases, including:

  • Nusinersen (Spinraza): spinal muscular atrophy【PMID: 29191460】
  • Eteplirsen: Duchenne muscular dystrophy
  • Patisiran: hereditary transthyretin amyloidosis

These approvals show that oligonucleotide therapies can be safe, effective, and commercially viable. As technology advances, it is likely we will see more robust clinical trials for antisense therapies in infectious diseases, improved delivery systems that increase effectiveness and reduce costs, and expanded targets, not only for microbes but also for the inflammatory pathways they trigger.

For the Lyme community, this represents a hopeful horizon: a class of therapies designed with molecular precision to address infections that often resist conventional treatment.

Final Thoughts

Supportive Oligonucleotide Therapy is an exciting example of how genetic medicine is moving from the laboratory into clinical care. While not a cure-all, and not yet backed by large-scale Lyme disease trials, it offers a promising option for patients whose infections have proven stubborn to standard therapies.

As with all emerging treatments, the best approach is a balance of hope and caution: hope that this new tool may bring relief, and caution in recognizing the need for further research and informed decision-making.

For patients and families dealing with the daily challenges of chronic Lyme and viral co-infections, SOT reflects a broader truth in medicine today—sometimes the way forward is not more of the same, but something entirely new.

Click here for Part 1:  SOT therapy for Lyme is experimental, expensive—and full of potential

Maria Marian, ND, MSE, is a naturopathic physician at Jyzen Wellness in Mill Valley, California. In addition to her Doctorate of Naturopathic Medicine, she holds both a Bachelor and Master of Science in Chemical Engineering. She specializes in complex chronic illness, Lyme disease, and integrative approaches to immune dysfunction. Follow her on Instagram: @dr.marian.nd

References
  1. Perry CM, Balfour JA. Fomivirsen. Drugs. 1999;57(3):375–380. PMID: 10080450.
  2. Crooke ST. Antisense Drug Technology: Principles, Strategies, and Applications. CRC Press; 2008.
  3. Stein CA, Castanotto D. FDA-Approved Oligonucleotide Therapies in 2017. Mol Ther. 2017;25(5):1069–1075. PMID: 28457632.
  4. Kole R, Krainer AR, Altman S. RNA therapeutics: beyond RNA interference and antisense oligonucleotides. Nat Rev Drug Discov. 2012;11(2):125–140. PMID: 22262067.
  5. Khorkova O, Wahlestedt C. Oligonucleotide therapies for CNS disorders. Neurotherapeutics. 2017;14(4):827–840. PMID: 29191460.
  6. Stein CA, Hansen JB, Lai J, et al. Efficient gene silencing by delivery of locked nucleic acid antisense oligonucleotides. Nucleic Acids Res. 2010;38(1):e3. PMID: 19850725.

Category:

Lyme, Treatment

Inside the Vaccine Trials

http://  Approx. 1 hour 10 Min

Inside the Vaccine Trials

7/30/25

This film offers an intimate look into the lives of vaccine trial volunteers. These individuals came forward with hope and trust, only to encounter serious, lasting health complications.

www.vaccinetrialstories.com

Go to link for transcript

_______________

**Comment**

I don’t think the word ‘vaccine’ should be used in the title for this piece because it’s an experimental gene therapy injection in an ongoing clinical trial.  It is not a vaccine at all.  The only reason it can legally receive that title is because the CDC changed the definition of a vaccine so mRNA would fit.

Again, people receive different things.  Some one dose, some another dose, and some don’t get the mRNA at all but a placebo.  ‘The powers that be’ were and continue to be dishonest and have led people to believe everyone is getting an effective vaccine.

But the Covid injection is ineffective, doesn’t stop infection or transmission, but actually increases your risk of infection, myocarditis, blood clots, cancer, sets you up for prion disease, and causes more harm than good.

 It’s all a crock.
Buyer beware.

For more:

Category:

Activism, vaccines, Viruses

Covid Scientific Misconduct Rages On At World’s Top Medical Journals

https://pierrekorymedicalmusings.com/p/covid-scientific-misconduct-rages?

Covid Scientific Misconduct Rages On At The World’s Top Medical Journals

JAMA just published a study in order to bury a severely disturbing truth – that Covid vaccine policy victimized pregnant women by killing an untold number of their babies. There, I said it. Period.

Pierre Kory, MD, MPA
Oct 17, 2025

As my long-time readers know, my post-academic medical career has been driven by an unwavering commitment to exposing medical journal fraud in the world’s high-impact journals. This one has me so outraged I cannot contain myself (because they are targeting babies and pregnant women, my God).

This is a brief post, “inspired,” more accurately, “triggered” by yesterday’s absolute masterclass of a post from my colleague Jack Lyons-Weiler, entitled “How To Bias A Study On Covid-19 Vaccine Safety in Pregnancy” (Ed: you HAVE to subscribe to his Substack, one of the most erudite on Substack IMO).

What happened is that JAMA just published a study that purportedly compared the rates of fetal malformations in mothers who got the COVID jab versus the fortunate ones who did not. In the study, they purposely:

  1. Only looked at live births, not all pregnancies – misses 32% of them
  2. Only looked ’til one year old: misses another 10-40%
  3. Only looked at billing codes: misses another 20-40%

Doing the above (and propensity weighting the groups, which invites immense additional opportunity for chicanery), they happily arrived at the following conclusion:

In this cohort study of pregnancies exposed to mRNA COVID-19 vaccines in the first trimester, exposure was not associated with an increased risk of any major congenital malformations.

Problem: Thalidomide (yes, %$#$! thalidomide) and other major teratogens were not discovered to be toxic to babies… until they looked at all births, not just the live ones. Happened over and over, to the point that the WHO and EMA both emphasize the necessity of including prenatal losses in teratogenicity surveillance.

So, was it a simple oversight in the trial design phase (whoops!), or maybe they were amateurs who were untrained in designing a proper teratogenicity surveillance study?

Hmm, how can we answer that question? I am sure that it was a bunch of random residents and interns publishing their first paper, right? Wrong…..(See link for article)

_______________

**Comment**

Hopefully by now it’s clear as day there needs to be major reform in science and in science journals.  Sadly, researchers have become nothing but Big Pharma whores, who are completely bought and paid for.  They have gone from searching for unbiased truth to statistical wizards who purposely use numbers and methods to obtain a predetermined outcome.

A perfect example came out today: https://kirschsubstack.com/p/my-email-to-muge-cevik-do-you-want?  Within the link, Steve Kirsch refutes a poorly done study titled: COVID-19 vaccination: Evidence of Waning Immunity is Overstated, which concludes the following non-sensical statement:

“The risks of remaining unvaccinated are clear and far outweigh the unknown benefits of re-vaccinating the general population. Rapid scale-up of vaccination coverage globally remains the most urgent public health priority.”

Shame on these researchers who will push a narrative despite all evidence to the contrary.

For more:

Category:

Activism, research

‘AI Said I Had Lyme Disease Before a Doctor Did’

https://www.bbc.com/news/articles/crkjyrm5g1yo

‘AI said I had Lyme disease before a doctor did’

Oct. 13, 2025
 
Jamie Morris
South of England
BBC Oliver Moazzezi is sat looking at his computer screen. He has a beard, white glasses on his head and a black t-shirt.
BBC
 
“I felt like I was being a hypochondriac”

“I felt quite vindicated… if I hadn’t persisted, if I hadn’t put all of my symptoms into AI I would hate to think where I would have been left by healthcare professionals.”

It started with ringing in his ears but over a number of years Oliver Moazzezi also experienced high blood pressure, extreme fatigue and muscle spasms.

Unsatisfied with various explanations from doctors – including anxiety – he decided to ask Artificial Intelligence for answers.

After asking AI he had a test with a private doctor which come back positive for Lyme disease, so it seemed AI had given him the answer – but experts warn using these tools to self-diagnose comes with risks and should be treated with caution.

“I felt like I was being a hypochondriac, I felt like no-one actually wanted to understand or look at all the things I was trying to explain to people quite eloquently.”

Oliver used to go to the gym three times a week and swim regularly before he started developing symptoms – now he can’t.

He said it all started three years ago after he was bitten by a tick that was brought in by his cat from the woods near his home in Whiteley.

In those same woods he describes how at it’s worst, his tinnitus meant he couldn’t hear the rustling of the leaves or the sound of birds.

“All I had was this massive high-pitched scream… it was horrific and it was day and night for weeks and months,” he said.  (See link for article)

_______________

**Comment**

And this, my friends, is the state we are in…..you have to be diagnosed by machine learning because doctors purposely have their heads in the sand.  Oh – but these same deaf, blind, and dumb doctors warn that those concerned with their health speak to a trained clinician…..the very clinicians that miss the diagnosis in the first place!

 

Category:

Activism, Lyme, Uncategorized