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Another "I started Anti-MAP" thread

I have been on Anti-MAP for a few days now and finally managed to convince myself to make a post about it. I've been taking notes which I'll put in chronological order below. I want to say thanks to IrishGal for giving me some advice on this over the last few days through PMs.

14 days before starting Anti-Map:
I have eventually been able to find a doctor who has the opinion that the Anti-Map theory is "unproven but worth exploring". I've been offered combination therapy of Azathioprine and Adalimumab, but really wanted to try Anti-MAP first.

He strongly advised that Anti-MAP is still very unproven and off label for this purpose, and that it should not be a replacement for Aza + Ada. He is happy for me to start Anti-Map now, and then review as we go. I've agreed to have the Aza + Ada if things don't work out on the Anti-MAP. I wouldn't recommend anyone to decline a thoroughly tested medication in place of an unproven one, but this is more of a "see how we go" approach first.

Anti-MAP along with the conventional therapy is a possibility for me in the future. We spoke about something that Dr. Borody has mentioned in the past, which is that combining anti-MAP with anti-TNF could be particularly effective. Since the anti-TNF induces apoptosis of macrophages where the MAP is hiding, so the macrophages then break open and release the MAP, which gives the antibiotics the chance to kill the bacteria more effectively.

I'll be getting regular blood tests but have also ordered some urinalysis strips, which check plenty of indicators in your urine, including for kidney and liver damage. I know these are far less accurate than a blood test, but it will give me extra peace of mind, since I can check more often and at my own convenience.

Day 1:
I tried a small dose of each antibiotic spaced two hours apart, I want to be very careful in case of any allergic reaction, a few members of my family are strongly allergic to certain antibiotics, but I have no known allergies yet.
I had 500mg of clarithromycin, 150mg rifampin and 250mg of levofloxacin.
I didn't notice any side effects apart from slightly discoloured urine due to the rifampin, which I was expecting from what I have read, the drug itself is a very strong orange dye.

Day 2:
I am taking 1000mg clarithro, 300mg of rifampin and 250mg levo per day now, spaced throughout the day. After half an hour of taking the rifampin I felt quite nauseous and had no appetite. Luckily I didn't end up vomiting. The nausea was really helped by having a cup of lemon and ginger tea.
My urine is now quite a dark sunset orange, very similar looking to the fizzy drink Irn Bru. I'm worried I won't be able to get an accurate reading from the urinalysis strips as they rely on a colour reading.
The dark coloured urine lasted most of the day but began to return to normal by the evening. I did a test with a urinalysis strip which was completely normal.
In one week I will be going up to a higher dose of the rifampin and levo, so my total per day will be 600mg of rifampin and 500mg of levo.

Day 3:
The rifampin associated nausea is less severe today. No other noticeable side effects other than the orange urine.

Day 4: Today I am having very runny stools which I am assuming is antibiotic associated diarrhoea. I don't think it is Crohn's diarrhoea because I have no stomach pain and don't feel run down like I do when I'm flaring badly.
This makes me more confident that the antibiotics are having some effect on my body. It is not a positive effect but I know they are doing something at least. I am hoping the diarrhoea should subside after a few days and then I will begin to feel better.
There is absolutely no smell to the diarrhoea whatsoever which I assume is due to the antibiotics. I also have no flatulence anymore after starting Anti-MAP.
Urinalysis strips all coming back normal, so no detectable levels of kidney or liver damage in my urine at least. I will have a blood test in a few days.
No weight gain or loss measurable by my scales as of yet.
Slightly elevated resting heart rate but I'm guessing this is a mild herxheimer-type reaction.

Did any others having Anti-MAP experience antibiotic associated diarrhoea?
Day 6: The D appears to be subsiding. It has moved one point towards the more solid end of the bristol stool scale. Still very loose but not as bad as it has been the past two days.

I had the same reaction when I was put on metronidazole + ceftriaxone + penicillin around two months ago when I had a flare along with tonsilitis. I seem to be quite sensitive to antibiotics giving me D.

I've lost about 1kg over the last week but I'm hoping I'll put that back on when the D subsides. I'm on the borderline of being underweight due to malabsorption over the last 9 months. I'll bring it up with my doctor if it doesn't resolve itself.

I slept for 9.5 hours last night and still felt tired when I got up.

I was prepared for it to be rough to begin with based on the other stories I've read.

I'll be having a blood test tomorrow to check my liver, kidneys, inflammation markers and full blood count.

IrishGal: did you lose any weight when you first started?

Deleted member 431298

Hi Kas8173
Thank you for updating us here on your progress. Did you take any MAP infection tests prior to starting? Something to then do after s period of time to see if infection numbers are down.
It will be interesting to follow how you respond. I hope for the best.
Yes - I lost weight initially. I could barely eat anything, but didn't vomit. Ginger helped. It took abiut 2 weeks before I started to feel “good” then I ate everything I could get my hands on and gained 10 pounds in 4 weeks. I was severely underweight to start with.

I also see you are on Levo. Be very careful with that one. The Levo made me “spacey” like I was out of it. Also, I think it contributed a lot to the nausea, though for me I think the main culprit was the clarithro. Worse, it gave me what I called “80 year old knees” where I could barely bend down to the floor, and then couldn't get up once I got there! I thought it was CD joint pain, but I went off the levo and it went away within a couple of days. Damage can be permanent, and it took 6 months for it to get bad enough for me to quit, but just be really careful of any joint pain stuff. You can always sub levo out for clofaz.
I didn't have any MAP test before I started as it's very likely I'm already infected. From what I've heard the MAP tests are expensive and take a while to come back, and only give a positive or negative rather than a quantitative result, which is not that interesting for me. If I could get a quantitative result and track it going down over time then I'd be more interested. Some of the more recent work (unpublished) from Professor Herman-Taylor with his new diagnostic test has shown 100% of Crohn's patients have MAP in their gut biopsies.

I am on Levo for now as it is apparently quite hard to get hold of Clofaz, due to it being an "Orphan drug".

Day 7: My bowel movements are firmer than yesterday but still loose. I had a short phone conversation with my Doctor who suggested we cut the Levo in half for now. Even though it seems to be getting better, he was still concerned about the D, of which Levo is the most likely culprit. I've also been having some palpitations which could be dehydration but could also be the Levo. Both Levo and Clarithromycin prolong the Q-T interval and should be taken at least 4 hours apart to minimise risk of compounding effects on the Q-T interval.

I was also scheduled to go up to the full dose of rifampin today but due to the concerns above we are keeping that at half for now.

Resting heart rate appears to be on it's way back down. We may have had a minor Jarisch–Herxheimer reaction here :) Die MAP die.
Day 9: The D has lasted 5 days now. It is definitely the antibiotics as my stools were not like this before I started. I am feeling quite run down.
I am not sure if I can reasonably go to a lower dose of the antibiotics without risking resistance. I'm only on a half dose of all of them.
I did read that someone pulsed a week on and week off of the antibiotics (I think that was irishgal), I think I will try a few days off for now.
I am not sure if my doctor will want me to start Aza soon if things continue this way.
Any advice anyone?
Anything I can do for the D?

I am taking probiotics but I'm not sure if they will be useless, since shouldn't the antibiotics just kill them all anyway?
I pulse one week on, one off, but only now - after establishing 3 years of great remission and healing. I don't think I'd do that on day 9. The D was the last thing to go away for me. It took months. Like 9 months! But it gradually became less and less over time. At day 9, that's really not enough time for much to happen. I'd suggest you talk to your doc and work with him/her, but I don't know if I'd give up so soon unless you really can't tolerate the meds or you have some other dangerous condition like CDiff. But i'm not a doc! so I'd talk to your doc before deciding what to do with the meds on your own. Wish you were feeling better!
I don't think I'd do that on day 9. The D was the last thing to go away for me. It took months. Like 9 months! But it gradually became less and less over time.
Ok, thanks for the advice. It is reassuring that you experienced the same thing. I was expecting the D to only last a few days.
I am going back on now. I must have only spent 24 hours off the antibiotics, probably less than that, but the D did noticeably improve in that time, which is also reassuring.
There has also been no blood in the D for about the last 5 days in a row, which is very good for me, I've had issues with spotting blood on and off for several months.
The following thought has been bugging me for several weeks now considering the long duration of Anti-MAP therapy.
Read this link for a background: https://academic.oup.com/femsle/article/217/2/133/501025

Consider the following points:
  • Butyrate is produced by friendly bacteria in the colon
  • Butyrate is essential for a healthy colon, due to it's anti-inflammatory properties and other benefits
  • Antibiotics probably kill most of the beneficial bacteria in the gut
  • This is probably what causes antibiotic associated diarrhoea
  • Friendly gut bacteria are needed not only for butyrate production but also a whole range of other benefits to the body

So it really confuses me how people even survive on extended courses of antibiotics, because of the totally disastrous effect it likely has on their friendly gut bacteria.

So that leads me to think that one or more of the following points must be true:
  1. Antibiotics don't actually kill ALL friendly gut bacteria (due to their targeted nature)
  2. The friendly gut bacteria are decimated by the antibiotics to begin with, but develop a resistance over time
  3. Friendly gut bacteria aren't actually that important

Personally I think a combination of 1 and 2 is probably true.
It would be interesting to hear the opinions of other members on this.
Totally agree with #1. And also, CD patients many times have dysbiosis, and their gut bacteria is so messed up it's doing more harm than good. I think ultimately, we are just scratching the surface of the gut biome research, and we really don't know exactly what's in there, how it interrelates, and what it does during disease states or the effect of antibiotics on it.

In the future, we may look back with this knowledge and wish we had done something differently, or have a better understanding of why something worked. But for now, I wasn't even going to live that long to see that research if I didn't do something about my CD, so I took the risk - with the full knowledge that AMAT was a bit of an unknown quantity. I minimize my risk as best I can by working closely with my doctor and getting regular blood work like liver function tests. Everyone needs to do this risk/reward assessment for themselves, and I'm hoping I will live long enough to see a cure, and that it will still be available for me after years of AMAT.
My resting heart rate over the last 4 months. The brown line is raw values, green is moving average.
Notice the spike when starting Anti-MAP. What happen here guys?


Day 15: Blood results have come back from a test I had last week.
Liver function is completely fine. So my doc has said I'm safe to go up to the full doses of the antibiotics. LETS KILL MAP :thumleft:

CRP was 14.9 which is slightly lower than usual for me, it has been 20-30 for many many months.

Vitamin B12 and D levels were both very good (well yeah but that is only because I supplement them massively. I supplement vitamin D right up to the tolerable upper intake level of 10,000 IU per day.)

Stools are the consistency of yoghurt, which is better than last week when they were basically water. The little pentasa granules like to show themselves as well :ylol:

There is occasional blood in the stools of about half a teaspoon once every few days, but it has been that way for months.

My weight is staying stable but not really very healthy at a BMI of 18.3 and body fat of 11%.

Stomach pain is about 1/10 so basically hardly noticeable.

Well at least I am not deteriorating.

Deleted member 431298

Karl, thanks for keeping us posted. Please keep us informed about how it goes!
Well I am nearly at four weeks now and starting to see an improvement.
My stools are about one point on the bristol stool scale away from being normal, and no blood in them for around a week.
Beginning to put on weight but only slowly.
My stomach pain has also gone.

I have just found out that my local hospital has approved me for infliximab and azathioprine (funded).
I am paying for the anti-MAP from a private doctor, so free to carry that on if I wish.
Dr. Borody has stated that in his opinion the ideal treatment is infliximab + anti-MAP at the same time.
Based on this, and several studies I have read I am inclined to have both, at least for some amount of time anyway. The treatments combined will hit the MAP harder than just anti-MAP alone.
Does anyone have any thoughts on this?

Deleted member 431298

Thanks for the update Karl. I am glad to hear you are getting better and do not experience adverse side effects.

These days I am reading up on the calprotectin (FC) marker - since it so well established as a precise indication of IBD. The reason I say this is that a very recent study I just read concludes that AZA-type drugs have been found to lower FC levels in patients.
Add to that a study by Michael Collins et. al. that found AZA inhibits MAP growth in-vitro, and the case for opening another front in the MAP war seems to be made, at least based on these sources.
FC has bacteriostatic and fungistatic properties, that arise from its ability to sequester manganese and zinc (this knowledge stems from in vitro studies). So all in all we can speculate that MAP causes FC levels to rise as the body tries to get rid of the infection. When MAP is attacked with effective drugs like AMAT, AZA, and MTX, FC levels go down.
When I presented these studies to my GI though, he shrugged and said it is not something they consider and that in vitro studies (outside the body) are not useful as a basis for practice. So see this as some interesting observations i'd like to share rather than treatment advice.


Well-known member
San Diego

These days I am reading up on the calprotectin (FC) marker - since it so well established as a precise indication of IBD.
FCP is not a precise indication of IBD so much as it is a good (but not perfect) indicator of inflammation in the gut. And there are other causes of inflammation in the gut beyond IBD - celiac disease and colon cancer for examples. FCP can also be elevated for these and other inflammatory conditions.
Well I have decided to go ahead with the infliximab and am having my first infusion tomorrow.

When I started this journey, I really wanted to have anti-MAP antibiotics by themselves, and no other treatment. Partly because I wanted to show to the world what my response would be, and do my part in giving some more evidence to the MAP theory. I wanted to be able to say "Hey look, I only had anti-MAP, and I got better".

I know that if I have anti-MAP antibiotics + infliximab then a lot of people could say "well you got better because of the infliximab" and just dismiss the MAP theory. I know this will be what a lot of doctors I see will say.

But I do believe based on my research that anti-MAP antibiotics + infliximab should be more effective than either treatment alone, and I have to do whatever I believe is best for my health, so I've chosen to have both.

My consultant wanted a baseline calprotectin test, before starting the infliximab, which I've sent off today, so at least I will know from that the effect of anti-MAP after a month and a half.

Deleted member 431298

Once again thank you for the update. I know of the urge to be rigorous and do one thing at a time, but with our disease sometimes you just gotta throw all you got at it to arrest it. I hope your health will improve on remicade+amat - thats what is most important.

FCP is not a precise indication of IBD so much as it is a good (but not perfect) indicator of inflammation in the gut. And there are other causes of inflammation in the gut beyond IBD - celiac disease and colon cancer for examples. FCP can also be elevated for these and other inflammatory conditions.
Scipio- I am aware that consensus is FC "just means inflammation", but I think it is worth noting that in practice high values over 500 to 600 μg/mg are extremely predictive of IBD - or food infections. On the contrary, one study from 2012 states (by refs) that "in several important gastrointestinal disorders, such as small bowel bacterial overgrowth, celiac disease, or food lactose intolerance, fecal calprotectin levels will be normal"

Hence the interesting correlation to the fact that FC exhibits bacteriostatic and fungistatic effects.
Well I had my first infliximab infusion 6 days ago now but before I speak about that I'll go back a bit before it.

I had a calprotectin test the day before the first infusion which I've just got the result of today: 1056 mg/kg. So still pretty high even after 6 weeks on anti-map antibiotics, but I don't know if that is due to antibiotic induced colitis inflammation or just general crohn's inflammation.

After having the infliximab infusion it took a few days to notice any difference but my bowel movements are now becoming more solid without a doubt. My energy levels are also improving and there is a nice big dip forming in the graph of my resting heart rate.

I had some bloods sent off today which includes CRP, very interested to know what the result of that will be.

I'd also be very interested to know what my calprotectin level is now, I am guessing it would be much lower. Unfortunately I don't think I could convince my doctor to give me another calprotectin test after only a week - I would love to measure it every week just from a research perspective. I've looked into getting it tested privately but the cheapest I've found is £99 per test.
I forgot about this post for a while but I am doing very well now.
Within a week of starting the infliximab all of my symptoms went completely away and I started putting weight back on. I was previously underweight.
My calprotectin went from being around 1100 to low 20s within 3 weeks.
I have now been in total remission for around 2.5 months and have put on around 5kg in weight.
This is quite significant considering that a few months ago, in the words of my consultant, I had severe pan-enteric crohn's disease with lesions in the stomach, duodenum, ileum, terminal ileum and right side of the colon.
I will never know whether I would have had such a good response without the anti-map but my consultant says that my response has been faster and better than you would usually see with infliximab alone.
My plan is to continue the infliximab maintenance indefinitely or until I lose response to it. I plan to continue the azathioprine at full dose, and if I reach 6 months of remission, go down to half the dose of azathioprine since there is some research which suggests full dose is no more effective than half dose after 6 months of remission in combination therapy.
I plan to continue the anti-map for 1-2 years depending on whether or not I stay in remission.
Kas8173, congratulations, that's great news. Which antibiotics are you currently using, what are their doses, and what is your experience with their side effects so far, could you share?

You said you are "doing very well now"; does that mean your energy is back to normal also? Can you eat foods that you couldn't tolerate before? How do you feel in general?
Kas8173, congratulations, that's great news. Which antibiotics are you currently using, what are their doses, and what is your experience with their side effects so far, could you share?

You said you are "doing very well now"; does that mean your energy is back to normal also? Can you eat foods that you couldn't tolerate before? How do you feel in general?
I swapped the clarithromycin around a month ago for azithromycin as it is cheaper, has a longer half life (and so maintains a more consistent level in the body throughout the day, and has been shown in some studies to be more effective against MAP)

I also removed the rifampin and started azathioprine around a month ago. Azathioprine helps to prevent forming antibodies against the infliximab and I was hesitant to take it along with rifampin as they can both be harmful to the liver. Azathioprine has also been shown to have some activity against MAP.

I am currently on 250mg of Azithromycin, 500mg levofloxacin and 50mg of azathioprine per day along with 250mg of infliximab every 8 weeks.

This is a lot of drugs to be taking, and if I reach 6 months of remission I plan to cut down on the anti-map or azathioprine. I plan to take infliximab indefinitely or at least until I have an adverse reaction or loss of response to it.

Yes my energy is great. I have been able to start weightlifting again and have been building a bit of muscle.

When I say I'm doing very well I mean no physical symptoms whatsoever. No abdominal pain and completely normal bowel movements.

I can eat whatever I want, but I would add that I have been vegeterian for 4 years now, which was a couple of years before my crohn's even began. I also cut out any form of dairy once I learned about the MAP theory and contamination of milk.
Are you getting the anti map separately from your nhs consultant? Mine has said no to antibiotics due to limited evidence base and is thinking about remicade but my preference would be to do both for the best chance of recovery
Yes they are separate, the anti-Map I am paying for privately so I can have that as long as I want and in combination with any nhs treatment I have.
The nhs doctors have the opinion that anti-map isn't effective so their position is basically "go ahead and add on the anti-map to what we're offering you if you want, as long as it's medically safe to do so, but because we think anti-map is ineffective, we're not going to stop offering you our treatment just because you're having anti-map as well". Which I can understand from their point of view.

Definitely ask them if they can do both, but they may decline due to funding. I would see if you can source the anti-map from alternative routes.

By the way I have changed my username :)
Why don't you use clofazimine? Due to unavailability without the help of the NHS? Though I think you can order it from some pharmacies around the world.

I personally would not use the fluoroquinolones because of the negative effects many people experience with it, some of which seems very serious and permanent (or hard to resolve). It can also cause tendonitis, so keep an eye on it if you haven't.

I think your treatment plan looks good. Are you seeing Dr. Sanders?

I hope your success continues.
Clofazimine is harder to get than most of the others and actually (according to the sources I've read) not that effective against MAP.
A good book I've been reading is the following: https://www.amazon.co.uk/Paratuberc...d=1547839941&sr=8-2&keywords=paratuberculosis I would highly recommend it.
It has a whole chapter on the susceptibility of MAP to different antibiotics.
According to one study, 77.8% of MAP strains tested were resistant to clofazimine compared to 39% resistant to the flouroquinolone ciprofloxacin.
Something else interesting to note is that no strains tested were resistant to azithromycin or clarithromycin.
I am watching out for tendonitis, and due to the risks you've mentioned I don't plan to continue these antibiotics for longer than a year or two assuming I stay in remission, and after that I will continue to maintain with infliximab and possibly azathioprine.
I am not seeing dr Sanderson but a colleague of his.
Hi All -

My son (10) started anti-map therapy a week ago. I would love to hear any other parents/folks experience. A little about my son. He was dx at 6 with UC then it changed to Crohns and now we sit at Indeterminate colitis. I sent his blood off to New Zealand to culture for MAP. It came back highly suggestive of MAP. My son previously failed, steriods, 6mp and remicade.

He has always been a bleeder and that has been one of our biggest issues. He doesn't have small intestine involvement (thank goodness) but does have joint pain, uclers and developed seizures which we had to medicate for. Please don't go into the neuro-toxicity of anti map or other meds because I am well aware of all of it.

I want to know how long it took to see bleeding stop on Antimap? My son has been super weepy which is not like him and I attribute that to the therapy as well. Anything you can offer would be greatly appreciated!

Thank you
Is your plan to stay on Anti-Map for 2 years?

Kas8173 said that after 3 weeks he stopped bleeding.
Exact quote: Well I am nearly at four weeks now and starting to see an improvement.
My stools are about one point on the bristol stool scale away from being normal, and no blood in them for around a week.
I plan to stay on it for at least 6 months but cost and side effects may be a prohibiting factor. If it starts to give me tendinopathy or other side effects and my Crohn's is still in remission then I may continue with just the infliximab and azathioprine.
I don't know for sure because the research in this area is not good enough but my assumption would be that due to the fact I've combined it with azathioprine and infliximab I may not require it for as long because the combination is probably more effective at killing the MAP.
If I was only taking Anti-MAP by itself then I would be more adamant about staying on it for at least two years because I think anything less than that would be risky.

My bleeding did reduce a lot after three weeks but I would still get some small spots of blood on the toilet paper every few days, which is nothing compared to what it was like before. It took about two months to stop completely. It reduced a lot when I started the infliximab as well.
Hi Kas8173 - Just wondering how things are going for you? Has the AntiMAP been successful one year on? Are you still taking any meds?
Hi there, I've been in total symptom free remission for almost a year now, which is amazing since I spent most of 2018 severely ill with Crohn's affecting my stomach, small and large intestine.

I stopped taking the antibiotics after 6 months due to cost and due to the uneasiness about taking so many drugs at once. Azathioprine can be harmful to the liver so I wasn't too comfortable taking it at the same time as antibiotics which can also be harmful to the liver.

I know that it's recommended to have the antibiotics for at least two years but I was also on Azathioprine and Infliximab as well so my thinking was that I didn't need so many drugs at once since I'd already been symptom free for 6 months at that point.

I still carried on with the Infliximab and Azathioprine and am on those to this day with no side effects.

We will see what the future holds, hopefully I have a long stretch of remission. I'm really grateful that I've been so healthy for so long now. Sometimes I go for several days without even thinking about Crohn's disease, I may forget that I even have Crohn's disease for periods of about a week or so, those are the best weeks.

I sometimes question whether or not I even have Crohn's because I'm so healthy at the moment, but then I remember how ill I was in 2018, and the many medical investigations I had. The results from those investigations are absolutely undeniable that I do have Crohn's.

I know from my research that even though I'm healthy at the moment, it would be extremely unlikely for me to never flare again for the rest of my life, and it scares me to know that some day it almost definitely will come back. I don't like to think about how ill I will get next time I relapse.

My hope is that by that time comes medical research will have improved and there are better treatments available.
Thanks for the update. It is encouraging to hear about successful progress stories. I hope that things continue in the right direction for you. All the best. :)


Well-known member
  1. Antibiotics don't actually kill ALL friendly gut bacteria (due to their targeted nature)

Anti-MAP antibiotics like clarithromycin, rifabutin and clofazimine are all broad spectrum antibiotics. They will cause large changes in the microbiome, which is why there is apprehension regarding antibiotics among gastros, rightfully so, we see dysbiosis in patients with inflammation.

Benzylpenicillin or phages are examples of narrow spectrum antibacterial agents.

My son (10) started anti-map therapy a week ago....He doesn't have small intestine involvement... I sent his blood off to New Zealand to culture for MAP. It came back highly suggestive of MAP. I want to know how long it took to see bleeding stop on Antimap?

MAP is ileal specific, it causes disease in the ileum, not the colon. Paratuberculosis is disease of the small intestine, the ileum to be specific, not the colon. If there's no ileal involvement, I don't see how MAP could possibly be involved.

Some information that I think is helpful for this thread

1) MAP causes paratuberculosis in ruminants.

2) MAP is specific to the small intestine, the ileum specifically, not the colon.

3) We have no idea if MAP has any zoonotic potential, we don't know if it causes disease in humans.

4) We can not accurately identify MAP through a blood test, IS900PCR is highly inaccurate.

5) We can culture MAP from tissue, but it takes a long time because MAP is a very slow dividing bacteria.

6) It is unlikely that MAP is a causative agent in children with intestinal inflammation. Incubation period of MAP can take years, and it is only when peyer's patches are highly active in animals that MAP manages to enter through M Cells. Peyer's patches in humans are only highly active during puberty.

7) Anti-MAP anbitioc therapy should not be taken lightly, it is highly experimental, the largest trial so far was done in 213 patients, using clarithromycin, rifabutin, and clofazimine for 2 years, there was no evidence of a sustained benefit in any of the patients. There was a short window of initial improvement (66% on antibiotics vs 50% placebo) , but a higher number of people on antibiotics later relapsed than on those on placebo (relapse in 59% of the antibiotic group and 50% in the placebo group). https://www.gastrojournal.org/article/S0016-5085(07)00555-0/fulltext?referrer=https://www.ncbi.nlm.nih.gov/

8) There are a number of straightforward questions that need to be answered by those convinced that MAP is behind crohn's disease.
-Why don't farmers have higher rates of crohn's disease when MAP is transmitted from ruminants.
-Why do people in urban areas have higher rates of crohn's disease and those in rural areas lower rates.
-Why do studies show consuming large amounts of milk reduces the chance of developing crohn's disease.
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Hi Kas8173 hope you are still doing well.

I am on AMAT and my 2 year NHS funding is just about to end. I am thinking of continuing for a little while longer until I get a new kidney (thats an unrelated long story).

How did you get a private perscription and how much did it cost?

On a side note I have been taking azathioprine for 20 years before I started AMAT so if you do ever relapse I have read that patients who go back on a low dose of AMAT can go.into remission again.