Frequently Asked Questions

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Many of the non-prescription treatments are available at health food stores and some pharmacies. In Concord, the Prescription Center at 125 N. Main Street has a wellness center where they are familiar with many of the protocols that Dr. Durand uses. Also, you can access quality supplements and get a 25% discount if you use Dr. Durand’s account at FullScript  Fullscript no longer publicizes their quality program results but the following list of manufacturers did received the Gold or Silver quality certification by Emerson Ecologics, the prior owner of this distributor: 

Allergy Research Group
Ayush Herbs
Bio-Tech
BioClinic Naturals
DaVinci Labs
Designs for Health
Douglas Labs /Klean Athlete
EuroMedica, Inc
Gaia Herbs
Genestra
Herb Pharm
Immune Health Basics
Innate Response/MegaFood
Integrative Therapeutics/Nature's Way
Kirkman Labs
Klaire Labs/ProThera
Medinatura
Metagenics
New Chapter
Nordic Naturals
Nutritional Fundamentals for Health (NFH)
Perque
Pharmax
Protocol (PROT)/Now
Pure Encapsulations
Vital Nutrients
Vitanica LLC
Wise Woman Herbals

In addition to Fullscript, Dr Durand often recommends products from Researched Nutritionals. Use the code DRNMD.   From this website Dr. Durand often recommends: 

-Transfer Factors which can have antibacterial / antibiotic properties without actually being pharmaceutical antibiotics. Examples are Transfer factor Lyme Plus specifically for Lyme disease and Transfer Factor MultiImmune for across the board immune support.

-ATP 360 for energy support

-Histaquel for control of a dysregulated immune system and Mast Cell Activation Syndrome

  A Herxheimer reaction may occur after you start a new treatment or increase the dose of a treatment; due to “die off” you feel temporarily worse. Some of the bacteria have died and thus released the toxins in their cells now into your system. This can make you feel temporarily worse. The first treatment for this is to increase your “detoxification system.” You should: 

- Drink lots of water

- Consider taking several thousand mg of vitamin C

- Consider taking NAC to increase your glutathione levels; or taking glutathione itself

- Consider adding herbal milk thistle to try to help the liver to detoxify

- Take a hot bath (you can add Epsom salts for the magnesium) or hot tub or sauna to help you to sweat out the toxins

- Sometimes we need to lower the dose of the antibiotic or even put it on hold for a while or switch to a different antibiotic. Please talk to us if it seems like the Herxheimer reaction is too much to tolerate. 

Remember that a Herxheimer reaction should only last a few days to maybe 10 days. If you are worse it could also be that the antibiotic is not killing the bacteria and you are actually experiencing a flare up of the infection. Or, you could be experiencing a direct side effect of the antibiotic. Thus please be sure to let us know you are unable to control your Herxheimer reaction or if the exacerbation of symptoms is lasting longer than seems to be reasonable or tolerable. 

 You should always take your antibiotics with meals (the middle of the meal is best) to limit nausea. Doxycycline or Minocycline should, however, not be mixed with milk or yogurt due to the high levels of calcium in them. Please separate the milk/ yogurt from the antibiotic by at least an hour. 

You can take ginger to help the nausea. You can make a diluted ginger tea to sip. You can take “Nauzene” which is an antacid chewable tab that can be very helpful. Some people get benefit from aloe juice. Sometimes we need to use prescription Zofran (ondansetron) for nausea. 

  Probiotics are essential to try to limit the risks of the antibiotics. Therefore, having good quality probiotics is essential. The brand Visbiome has a large number of CFU per capsule (112.5). This is available at Sam’s Club for a  reasonable price. Basically I usually recommend a probiotic with at least 10 or more Billion CFUs (Colony Forming Unit). Some supplement companies are much better than some others in regards to performing quality control. Please see the list from question one above, about where to find supplements. This list of supplement producers there have passed the Emerson Ecologics quality control criteria. In particular I often use the probiotic line Ultraflora from Metagenics. I often add in a second probiotic that has a probiotic yeast called Sachromyces boulardii. All other probiotics should be taken at least an hour away from the antibiotic to keep the antibiotic from killing off the good bacteria in the probiotic. However, since Sachromyces boulardii is a yeast and not a bacteria, it can be taken with the antibiotic. I generally suggest the schedule of: 

Breakfast: antibiotic

Lunch: probiotic

Supper: antibiotic

Bedtime: probiotic

 The best way to contact us is through the patient portal.  You can also go straight to the URL: www.yourhealthfile.com. 

  Generally we should be eating whole foods in their “natural state” and avoiding highly processed foods and foods high in simple carbohydrates. In other words, focus on fresh fruits and vegetables and lean meats. Avoid processed foods, eg breads and packaged foods and foods with long lists of ingredients that look like chemical words. I know that some folks who treat Lyme disease say to avoid fruit due to its sugar content. My feeling is that the natural fructose in a fruit is much preferable to a processed sugar or carbohydrate and has many nutrients.The only vegetables that may be a bit in question here are white potatoes and corn. Those have a lot of simple carbohydrate. Many patients with Lyme disease have particular exacerbation of brain fog and fatigue with alcohol, especially beer. Beer has many simple carbs; carbs and the alcohol also feed yeast which can be an issue in this setting. 

  The killing off of the good bacteria does make us a set up for developing issues with yeast. Avoiding sugars and carbs helps to limit this. However, sometimes we need to use medicines for this. I usually first use Nystatin to kill off the yeast in the GI tract. Occasionally we use fluconazole which is a tablet to kill of yeast throughout the system. 

 If you miss a dose or two, just pick up where you left off and restart with the next dose. Please take note as to whether you have a flair up of symptoms when you are off or when you restart. This can help me to determine where you are at in the treatment process. 

Bacteria can go into a hibernated like state and thus not be killed by the antibiotics. The technique here is to stop the antibiotics and try to let the bacteria then “wake up” so that they are again susceptible to the antibiotics.  Sometimes these are very short pulses eg 4 days on and 3 days off antibiotics each week, and sometimes they are much longer pulses eg 1 week on and 3 weeks off antibiotics. We will work out the schedule during your office visit. It is very important that you take note of your symptoms during the pulsing. By that I mean note how long it takes when you are off until you develop symptoms again and how long it takes for the symptoms to get better when you restart the antibiotics. This will help us to determine the next step in the process.