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Comment by cududa | Hacker News Reader

Had to take doxycycline for 2 weeks after a tick bite. Man does that stuff destroy your digestive system. 7 years ago was on a date, just casually walking down the street. Coughed a couple times for no particular reason but my doxycycline lined stomach didn’t like that and boom projectile vomiting. Luckily he thought it was funny/ felt bad for me.

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I feel you man. I took it for acne for like 3 or so months, and every morning it was a daily battle not to puke my guts out.

It didn’t work btw, and I ended up needing accutane, which left my lips ravaged and bleeding for a year.

The sad part is your acne might have been completely fixed solely through dietary intervention.

Maybe. But severe/cystic acne and the like are rarely solved so simply by dietary intervention. If the acne was so bad as to warrant an Accutane prescription, then my guess is that diet would not have helped much. Accutane can take a large toll on the body but is often one of the most effective tools in eradicating acne long term for those so strongly impacted.

Cystic acne is often, but not always, caused by a reaction to a dietary ingredient. Fasting a full day between meals can also often resolve cases.

I will not reach for drugs until I have done everything I can in good faith with food and meal timing (24 hours between meals).

> I will not reach for drugs until I have done everything I can in good faith with food and meal timing

This is a great approach and I don't want to discourage it, but there's a spectrum of cystic acne. Honestly, I'm basing my comments more off personal experience (different people close to me have used Accutane), but I'm not sure how often diet is the cause of (non-simple) cystic acne, although, granted, I'm by default thinking of the more extreme cases. I had a single cyst under my cheek for a semester that dissolved on it's own - never considered Accutane for such a mild cyst. On the other hand, a close associate of mine developed severe cystic acne after being prescribed and using different birth control medicines. The symptoms not only continued, but got worse, well after ceasing these medications. No diet change was going to fix this - Accutane changed this persons life. After going to a few doctors seeking treatment, they were hesitant to prescribe Accutane to this person unless there were no other options. From what I've read online and stories I've heard from this person, this seems to be the norm - if you get prescribed Accutane (withholding doctors who jump straight to medication), you likely have a non-trivial case of acne that won't be reduced by say eating less chocolate. It's like treating depression - some people are able to solve other issues in their life that improve the depression tremendously, and other people have certain brain chemistry imbalances that make this process impossible _until_ they're treated with anti-depressants.

That sounds like what Steve Jobs said about his cancer.

As another anecdote - I got rid of my acne when I discovered benzoyl peroxide creams via an XKCD comic.

Mine cured up with: Glycerine soap 2x daily, benzoyl peroxide 2x daily, and sometimes erythromycin 300 mg daily, along with erythromycin alcohol wash, and sometime nitrogen facial sprays.

I didn't have severe cystic acne though. Diet has nothing to do with acne.

All very well, but my (moderate) acne was caused by… carbs. I would much rather have both acne and carbs, than neither. Accutane, of course, nuked it and it never came back.

Ah, no. It's typically a hormone-mediated process. Accutane works but it's also not without side-effects.

Ginger and delta 9 THC are antiemetics that work well.

Before any round of antibiotics, healthcare ought to collect a fecal sample for subsequent fecal transplantation. The carpet bombing of the GI with antibotics and reestablishment shouldn't be left to chance since something bad might develop or lack beneficial strains.

Interesting! Took doxy for months at a time, with a year being the longest ever taken it. The US military uses it as Malaria prophylaxis, so can end up taking it for a pretty significant amount of time. Never really had an side effects I can recall, but was in my early 20s at the time as well.

Do you recall the doseage?

Unfortunately I don’t - it was over a decade ago at this point. They were pretty large blue/turquoise gel capsules though.

it sucks. I've done the full courses a few times for tick bites. it is just very very hard to tolerate.

I guess that depends on the person susceptibility to side effect. I had 3 weeks of doxycycline for unidentifiable bug bite and I didn't notice any side effects.

I had treatment 100 mg 21 days BID for borreliosis and was careful to always take with a full glass of water, as directed. Only noticeable side effect was affect changes. 9/7 would take that drug again.

Can you elaborate on affect changes? I had a similar regimen and experienced a weird sense of mental clarity and sociability for a couple of weeks after. Never have figured out what the mechanism was.

Positive affect changes are a noted possible side effect. The mechanism is unknown. Some scientists believe it's the direct action of the drug on the brain, but others believe it has something to do with altering the natural intestinal flora and a vague "gut-brain connection". It's an area of research waiting to be tackled.

I wasn't going to complain about feeling better than normal, only a little disappointed after the scrip ran out.

> the scrip ran out.

Assuming that was written intentionally, I had no idea that this was a word, and that this was a usage. I’ve learned something.

It should be "script" I believe, short for "prescription".

Scrip is a word, but its meaning is different and it's close to archaic.

Interesting, why do you perceive that "scrip" cannot be short for "prescription" whereas "script" can be?

FWIW, Wiktionary lists both: https://en.wiktionary.org/wiki/scrip#Etymology_4

People in medicine use "scrip" to mean "prescription" when speaking to others in the field.

Interesting. Do you have a source for that?

I had hypothesized that the antibiotics were either giving my immune system a boost which was tamping down some underlying inflammation somewhere, or were helping fight some intestinal flora that normally cause some subtle mood effects that I wouldn’t normally notice until it was absent. But I was never able to find anything online to pin it down one way or the other.

Look into suramin, pax101 to be specific.

It's being used to treat autism symptoms (social).

Might be a similar mechanism

When I had Lyme disease, I needed to take it with a full meal, otherwise I was in for a half hour of horrible burning pain.

Interesting, when I took it I had zero side effects other than curing the infection.

That's awful. I did a two week course but had no adverse effects.

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