Q re calcium, iron, & mag with mino

[Guest guest]

.. " One major reason that I've noticed for the tetracycline antibiotics

not to work for some people, is that they either aren't aware, or

haven't paid attention to the warning NOT to consume calcium, Iron,

magnesium or any other metal or mineral containing food, vitamin, or

supplement while taking it. No milk, cheese, butter, antacids or

other. It bonds with the tetracycline antibiotic and can make it

worthless. (doxy and mino are both of the tectracycline family)

Anyway, as I said, I'm just a newbie to all this and everything I

know is based on research and Mr Perfect. So, there may be lots that

I still don't understand yet. But I don't think anything I've

mentioned would hurt, and it might help.

Blessings "

------------------------------------------------------------

Hi! Please tell me more about this interaction! My first week on AP (when

I felt great and just before my herx started) I was careful to take the mino

1hr before or 2hrs after meals. However, this was miserable for me because

it gave me wretched heartburn and indigestion. My doc said I could just

take it with meals since I was on a high dose anyway (100mg morning and

evening). I also take azithromycin at lunch time.

When you say no dairy products, do you mean never or just not to take with

the meds? I've been prescribed a prenatal multivitamin to try to improve my

anemia, but I haven't been able to figure out when to take that! Ugh. Oh,

and I have osteopenia, and my doc wants me to supplement with calcium, but I

haven't figured that out either.

Any advice would be appreciated! Oh, and BTW, I'm past the herx now and

starting to improve at a slow but steady pace.

Blessings!

Terri

[Guest guest]

If you don't mind, I'm going to break your question down to smaller

parts, so that I don't get confused answering it.

I had to look up azithromycin

This is what I found:

Take azithromycin on an empty stomach 1 hour before or 2 hours after

meals. Do not take azithromycin at the same time as taking an antacid

that contains aluminum or magnesium. This includes Rolaids, Maalox,

Mylanta, Milk of Magnesia, Pepcid Complete, and others. These

antacids can make azithromycin less effective when taken at the same

time.

So it looks like this antibiotic does not interact with Iron or

calcium, only alumium and magnesium.

Since your doctor has you taking it specifically AT lunch time, my

guess is that your dose has been increased to allow for the reduced

absorbtion rate.

According to the Protocol, Minocin can be taken with meals, so I

haven't checked much on that. Only on the supplements. And just for

fun, I've found 1 source that says not 1 hour before or after,

another that uses 2 hours, and another that uses 3 hours between the

antibiotic and necessary supplements. So if you discuss it with your

pharmacist and your doctor and you really need the supplement. Follow

the one that lets you absorb the most of the supplement and the

antibiotic. Probably the 3 hours, or if you are taking the antibiotic

on alternate days ... can you alternate the supplement?

Also, I would like to thank you, because of your question I have

discovered something I overlooked. Both Doxy and Mino have a few

brands formulated to reduce, but not eliminate, the effect with

Diary, if one specifically asks their pharmacists for them.

These are the notes I took off the web about Minocin (minocycline):

Avoid: Reduced drug absorption/bioavailability—Avoid these

supplements when taking this medication since the supplement may

decrease the absorption and/or activity of the medication in the body.

Calcium

Iron

Magnesium

Zinc

Avoid: Adverse interaction—Avoid these supplements when taking this

medication because taking them together may cause undesirable or

dangerous results.

Vitamin A

Interactions with Foods and Other Compounds

Food

Food slightly reduces blood levels of minocycline, but the effect is

not significant. Unlike other tetracyclines, minocycline may be taken

with or without food.

Interactions with Dietary Supplements

Calcium, Iron, Magnesium, Zinc

Taking calcium, iron, magnesium, or zinc at the same time as

minocycline can decrease the absorption of both the drug and the

mineral. Therefore, calcium, iron, magnesium, or zinc supplements, if

used, should be taken an hour before or after the drug.

Vitamin C

Tooth discoloration is a side effect of minocycline observed

primarily in young children, but it may occur in adults as well.

Vitamin C supplementation may prevent staining in adults taking

minocycline.

Do not take iron supplements, multivitamins, calcium supplements,

antacids, or laxatives within 2 hours before or after taking

minocycline. These products can make minocycline less effective.

You may take this medication with or without food. Do not take the

medication with milk or other dairy products, unless your doctor has

told you to. Dairy products can make it harder for your body to

absorb the medicine. Certain brands of minocycline may not have

restrictions about taking them with dairy products. If your doctor

has instructed you to take minocycline with milk, tell your

pharmacist that you need a brand of minocycline that can be taken

with milk.

What other drugs will affect Minocin (minocycline)?

Before taking minocycline, tell your doctor if you are taking any of

the following drugs:

cholesterol-lowering medications such as cholestyramine (Prevalite,

Questran) or colestipol (Colestid);

isotretinoin (Accutane);

tretinoin (Renova, Retin-A, Vesanoid);

an antacid such as Tums, Rolaids, Milk of Magnesia, Maalox, and

others;

a product that contains bismuth subsalicylate such as Pepto-Bismol;

minerals such as iron, zinc, calcium, magnesium, and over-the-counter

vitamin and mineral supplements;

a blood thinner such as warfarin (Coumadin); or

a penicillin antibiotic such as amoxicillin (Amoxil, Trimox, others),

penicillin (BeePen-VK, Pen-Vee K, Veetids, others), dicloxacillin

(Dynapen), carbenicillin (Geocillin), oxacillin (Bactocill), and

others.

This list is not complete and there may be other drugs that can

interact with minocycline. Tell your doctor about all the

prescription and over-the-counter medications you use. This includes

vitamins, minerals, herbal products, and drugs prescribed by other

doctors. Do not start using a new medication without telling your

doctor.

Where can I get more information?

Your pharmacist can provide more information about minocycline.

If treatment with this medicine is continued for longer than 6

months, then your doctor should ask to see you regularly, usually

every three months, to monitor for possible side effects on the liver

or a condition called systemic lupus erythmatosus.

The following medicines may reduce the absorption of minocycline from

the gut, which may make it less effective. If you are taking

medicines containing any of the following ingredients they should be

taken at least three hours before or after your minocycline dose:

- antacids (for heartburn and indigestion) or vitamins that contain

aluminium, bismuth, calcium, magnesium or iron

- quinapril (brand name Accupro, because these capsules also contain

magnesium carbonate)

- iron tablets, eg ferrous sulphate (the absorption of iron tablets

from the gut is also reduced by the minocycline)

- zinc salts (the absorption of zinc salts from the gut is also

reduced by the minocycline)

- kaolin

- tripotassium dicitratobismuthate (TDB).

If minocycline is taken with acitretin, isotretinoin or tretinoin

there may be an increased risk of developing raised pressure within

the skull (benign intracranial hypertension), and minocycline should

be avoided in people taking these medicines.

Minocycline may increase the blood thinning effects of anticoagulants

such as warfarin.

There may be an increased risk of side effects on the kidneys if

minocycline is taken with diuretic medicines, particularly in people

with decreased kidney function.

Minocycline may decrease the effectiveness of penicillin antibiotics

in the treatment of serious infections such as meningitis. It is

recommended that minocycline should not be used with penicillins.

The following medicines may reduce the absorption of minocycline from

the gut, which may make it less effective. If you are taking

medicines containing any of the following ingredients they should be

taken at least three hours before or after your minocycline dose:

aluminium salts

antacids for heartburn and indigestion containing aluminium, bismuth,

calcium or magnesium

calcium supplements

iron preparations, eg ferrous sulphate (minocycline also reduces the

absorption of iron from the gut)

kaolin

magnesium salts

quinapril tablets that contain magnesium carbonate, eg Accupro brand

ranitidine bismuth citrate

strontium ranelate

sucralfate

tripotassium dicitrato-bismuthate

zinc salts (minocycline also reduces the absorption of zinc from the

gut).

Doxycycline:

Take doxycycline with a full glass of water (8 ounces).

You may take this medication with or without food. Do not take the

medication with milk or other dairy products, unless your doctor has

told you to. Dairy products can make it harder for your body to

absorb the medicine. Certain brands of doxycycline may not have

restrictions about taking them with dairy products. If your doctor

has instructed you to take doxycycline with milk, tell your

pharmacist that you need a brand of doxycycline that can be taken

with milk.

Do not take iron supplements, multivitamins, calcium supplements,

antacids, or laxatives within 2 hours before or after taking

doxycycline.

Do not lie down for 30 minutes after taking this medication.

What other drugs will affect doxycycline?

Before taking doxycycline, tell your doctor if you are taking any of

the following drugs:

cholesterol-lowering medications such as cholestyramine (Prevalite,

Questran) or colestipol (Colestid);

isotretinoin (Accutane);

tretinoin (Renova, Retin-A, Vesanoid);

an antacid such as Tums, Rolaids, Milk of Magnesia, Maalox, and

others;

a product that contains bismuth subsalicylate such as Pepto-Bismol;

minerals such as iron, zinc, calcium, magnesium, and over-the-counter

vitamin and mineral supplements;

a blood thinner such as warfarin (Coumadin); or

a penicillin antibiotic such as amoxicillin (Amoxil, Trimox, others),

penicillin (BeePen-VK, Pen-Vee K, Veetids, others), dicloxacillin

(Dynapen), carbenicillin (Geocillin), oxacillin (Bactocill), and

others.

This list is not complete and there may be other drugs that can

interact with doxycycline. Tell your doctor about all the

prescription and over-the-counter medications you use. This includes

vitamins, minerals, herbal products, and drugs prescribed by other

doctors. Do not start using a new medication without telling your

doctor.

Your pharmacist can provide more information about doxycycline.

>

Anyway, as I said, I'm just a newbie to all this and everything I

> know is based on research and Mr Perfect. So, there may be lots

that

> I still don't understand yet. But I don't think anything I've

> mentioned would hurt, and it might help.

>

> Blessings "

>

> ------------------------------------------------------------

>

>

>

> Hi! Please tell me more about this interaction! My first week on

AP (when

> I felt great and just before my herx started) I was careful to take

the mino

> 1hr before or 2hrs after meals. However, this was miserable for me

because

> it gave me wretched heartburn and indigestion. My doc said I could

just

> take it with meals since I was on a high dose anyway (100mg morning

and

> evening). I also take azithromycin at lunch time.

>

>

>

> When you say no dairy products, do you mean never or just not to

take with

> the meds? I've been prescribed a prenatal multivitamin to try to

improve my

> anemia, but I haven't been able to figure out when to take that!

Ugh. Oh,

> and I have osteopenia, and my doc wants me to supplement with

calcium, but I

> haven't figured that out either.

>

>

>

> Any advice would be appreciated! Oh, and BTW, I'm past the herx

now and

> starting to improve at a slow but steady pace.

>

>

>

> Blessings!

>

> Terri

>

>

>

>

[Guest guest]

I've been prescribed a prenatal multivitamin to try to improve my

> anemia, but I haven't been able to figure out when to take that!

Ugh.

>

> Any advice would be appreciated! Oh, and BTW, I'm past the herx

now and

> starting to improve at a slow but steady pace.

>

>

>

> Blessings!

>

> Terri

>

* * * * *

Congrats on getting past the herx and your improvement.

Regarding the Anemia.

I read somewhere that Dr McPherson Brown indicates that Anemia

is a typical symptom of RA and that supplements do not work.

So I went looking and found this as the best explanation, it's from

the Marshall Protocol

On Chronic disease anemia vs. Iron deficiency anemia, from the

Marshall Protocol

Iron feeds the bacteria, and makes the antibiotic less effective.

Do not take without the definitive testing to verify that you do NOT

have chronic disease anemia.

http://www.marshallprotocol.com/view_topic.php?

id=3479 & forum_id=32 & highlight=anemia

Apparently in most cases the anemia is caused by the bacteria, taking

the supplement is so very good for the bacteria and so very bad for

you. Can't hurt to get the tests recommended, before you actually

start the supplement, the website will give you a better

understanding of why, when and how.

Also, apparently most doctors don't bother to do the testing to

determine what is actually causing the anemia. So you have to ask for

it.

[Guest guest]

Oh,

> and I have osteopenia, and my doc wants me to supplement with

calcium, but I

> haven't figured that out either.

* * * * *

Some people who have osteopenia may not have bone loss; they may just

naturally have a lower bone density. Osteopenia may also be the

result of a wide variety of other conditions, disease processes, or

treatments. Women are far more likely to develop osteopenia and

osteoporosis than men. This is because women have a lower peak BMD

and because the loss of bone mass speeds up as hormonal changes take

place at the time of menopause. In both men and women, the following

factors can all contribute to osteopenia:

· Eating disorders or metabolism

problems that do not allow the body to take in and use enough

vitamins and minerals

· Chemotherapy, or medications such

as steroids used to treat a number of conditions, including asthma

· Exposure to radiation

Having a family history of osteoporosis, being thin, being white or

Asian, getting limited physical activity, smoking, regularly drinking

cola drinks, and drinking excessive amounts of alcohol also increase

the risk of osteopenia and, eventually, osteoporosis.

What are the symptoms of osteopenia?

Osteopenia has no symptoms. You notice no pain or change as the bone

becomes thinner, although the risk of breaking a bone increases as

the bone becomes less dense.

How is osteopenia diagnosed?

Osteopenia is diagnosed with a bone mineral density (BMD) test,

usually done to see whether you have osteoporosis. The most accurate

test of BMD is dual-energy X-ray absorptiometry (DEXA), although

there are other methods. DEXA is a form of X-ray that can detect as

little as 2% of bone loss per year

* * * * *

I notice that the info on osteopenia says it could be caused by

disease processes, or medication. It doesn't however say which ones,

and a brief look around doesn't provide any articles that do...sigh

Is there a possibility that your bacteria, and/or previous medication

might have caused, contributed to this condition?

Is the supplement simply precautionary or necessary?

If it's necessary then you just have to find a way to minimize the

conflict and get the most benefit from each without damaging the

other.

If it's precautionary, what are the risks if you wait for the

maintenance phase of the AP treatment before beginning the calcium

supplement?

Please note that taking extra calcium may reduce the absorbtion of

Iron, making the anemia worse, but starving the bacteria of it.

And reducing the absorbsion of magnesium which is also necessary for

bone health.

On Calcium, Magnesium and Zinc Interactions:

The Dietary Supplement Information Bureau recommends a daily dosage

of approximately 1200 mg of Calcium, 400 mg of Magnesium and 25 mg of

Zinc.

Caution: Calcium has possible interactions with the following:

Tetracycline

Tetracycline antibiotics bind to calcium in the stomach which

prevents the absorption of both the drug and Calcium into the body.

Check with your healthcare professional to determine if

supplementation with this nutrient and adjustment in the drug dosage

may be necessary.

These drugs include tetracycline, demeclocycline, doxycycline,

minocycline, oxytetracycline

Iron

Calcium can inhibit the absorption of iron. This interaction may

alter the effects of iron and possibly the dose needed for treatment

Salicylates

Aspirin and sodium salicylate are capable of reducing the amount of

calcium in the body. Check with your healthcare professional to

determine if supplementation with this nutrient is necessary. These

drugs include aspirin, choline salicylate, sodium salicylate,

magnesium salicylate, salsalate, diflunisal, sodium thiosalicylate

EDTA

EDTA binds to calcium which increases the elimination of calcium from

the body. Check with your healthcare professional to determine if

supplementation with this nutrient is necessary

Fluoroquinolone Antibiotics

Calcium can decrease the absorption of these drugs when taken by

mouth at the same time. Therefore, calcium supplements and milk/dairy

products should not be taken at the same time as this class of

antibiotics. Separate the doses by at least two hours. These drugs

include ciprofloxacin, norfloxacin, ofloxacin, levofloxacin,

moxifloxacin, gatifloxacin, lomefloxacin, sparfloxacin,

trovafloxacin, alatrofloxacin .

Levothyroxine

Calcium carbonate can decrease the absorption of levothyroxine, which

may alter the effects of these medications and possibly the dose

needed for treatment. Use with caution

Aminoglycosides

A study has shown that gentamicin reduces the amount of calcium in

the body. Check with your healthcare professional to determine if

supplementation with this nutrient is necessary. These drugs include

streptomycin, kanamycin, gentamicin, tobramycin, amakacin,

netilmicin, neomycin, paromomycin .

Anticonvulsants

Studies have shown that these drugs may decrease absorption of

calcium. Check with your healthcare professional to determine if

supplementation with this nutrient is necessary. These drugs include

phenytoin, carbamazepine, primidone, gabapentin, valproic acid,

felbamate, lamotrigine, mephenytoin, fosphenytoin, clonazepam,

ethosuximide, diazepam, clorazepate dipotassium, levatiracetam,

tiagabine, topiramate, methsuximide, phensuximide, trimethadione,

magnesium sulfate, acetazolamide, oxcarbazepine, zonisamide,

ethotoin .

Magnesium has possible interactions with the following:

Calcium

Magnesium absorption from the digestive tract may be decreased by

large doses of calcium. Supplementation with the affected nutrient

may be necessary.

Tetracryclines

These antibiotics have been reported to bind with magnesium, which

may decrease the absorption of both the drug and magnesium.

Supplementation with the affected nutrient and adjustment in the drug

dosage may be necessary.

These drugs include tetracycline, demeclocycline, doxycycline,

minocycline, oxytetracycline

Penicillamine

This medication has been reported to bind with magnesium, which may

decrease the absorption of both the drug and iron. Supplementation

with the affected nutrient and adjustment in the drug dosage may be

necessary

Amphotericin

This medication is reported to cause increased elimination of

magnesium in the urine. Supplementation with the affected nutrient

may be necessary.

Corticosteroid Medications

Long term use of these medications has shown a decrease in magnesium

blood levels. Supplementation with the affected nutrient may be

necessary. These drugs include prednisone, hydrocortisone,

methylprednisolone, prednisolone, betamethasone, budesonide,

triamcinolone, dexamethasone, cortisone, beclomethasone, flunisolide,

fluticasone, fludrocortisone, mometasone .

HRT

Hormone replacement therapy has been reported to decrease magnesium

levels in the body. Supplementation with the affected nutrient may be

necessary. These drugs include conjugated estrogens, estradiol,

estrone, esterified estrogens, estropipate, ethinyl estradiol,

progesterone, medroxyprogesterone, hydroxyprogesterone,

norethindrone .

Loop Diuretics

These medications are reported to cause increased elimination of

magnesium in the urine. Supplementation with the affected nutrient

may be necessary. These drugs include furosemide, bumetanide,

ethacrynic acid, torsemide

Oral Contraceptives

These medications may cause a loss of magnesium resulting in

decreased magnesium levels in the blood. Supplementation with the

affected nutrient may be necessary. These drugs include

norethindrone, ethynodiol diacetate, norgestrel, norgestimate,

ethinyl estradiol, drospirenone, desogestrel, levonorgestrel .

Thiazide Diuretics

These medications are reported to cause increased elimination of

magnesium in the urine. Supplementation with the affected nutrient

may be necessary. These drugs include hydrochlorothiazide,

chlorothiazide, indapamide, metolazone, chlorthalidone,

hydroflumethiazide, polythiazide, trichlormethiazide, benzthiazide,

methyclothiazide, bendroflumethiazide .

Zinc has possible interactions with the following

H-2 Receptor Antagonists

These medications decrease the amount of stomach acid which may

reduce the absorption of this nutrient. Supplementation with affected

nutrient may be necessary. These drugs include cimetidine,

famotidine, nizatidine, rantidine.

ACE Inhibitors

These medications may decrease the amount of zinc in the body due to

increased elimination in the urine. Supplementation with the affected

nutrient may be necessary. These drugs include benazepril, captopril,

enalapril, lisinopril, fosinopril,moexipril, quinapril, ramipril,

trandolapril, perindopril erbumine

Valproic Acid

This medication has been reported to cause a significant decrease in

zinc levels in the blood. Supplementation with the affected nutrient

may be necessary.

Copper

Zinc and copper are capable of decreasing the absorption of the other

from the digestive tract. Supplementation with affected nutrient(s)

may be necessary.

[Guest guest]

Wow, thank you for all of that hard work! Your fingers must be exhausted

from typing! I need to print out your emails to keep.

The only reason I took the azithromycin at lunch was just to spread out my

meds, but based on your research, I may move that to dinner with my second

mino and take my calcium supplements at lunch. I think you are right about

the RA induced anemia. So, I will probably not worry about that for now. I

don't think it was too bad anyway.

Thanks for all of your info! You have given me a lot to study!

Blessings!

Terri