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On Flagyl (Metronidazole), Dientamoeba Killed (not)

I’m publishing this with the goal of perhaps helping someone else who runs into a similarly unsettling and baffling issue.

See Apparently Infection After All (Dientamoeba).

After a two week course of Metronidazole (brand name Flagyl), my gut is feeling like normal again, so I think that means the Dientameoba has been wiped out.

UPDATE It was so nice to feel normal again (for 11 days), but the damned Dientameobe seems to be back, all at once and all of a sudden.

Metronidazole was not an antibiotic I’d prefer to take again: no alchohol is just an annoyance, but overall, Metronidazole made me feel heavy and uncomfortable in general; nothing overt but something for sure.

“Burnt” toes

On Day 11.5 on Metronidazole, toes on both feet turned warm and itchy. Completely symmetric in reaction, so perfectly so that one might suspect a neurological side effect, above and beyond an allergic type reaction, since one of the rest of my body was affected. Very odd indeed.

By Day 12, my toes felt almost blistered (but no fluid): red and angry looking, and itchy. This persisted through Days 13 and 14, 14 being the last pill day and three days later, 72 hours after the last pill. My toes 3 days later (Day 17) were intensely itchy and irritated after my bike ride, so I called to set up an appointment with a dermatologist, but all were gone that Friday, so the date was set for Tuesday.

Since 72 hours is the recommended period before alcohol is to be consumed after taking Metronidazole, I did the only sensible thing: looked for a cure in a bottle. So I uncorked a bottle of red wine and over the course of evening to night, I drank and enjoyed while I worked.

Fancy that. The next morning, the itchiness was gone, all inflammation was gone, and the only remaining sign were some purply blotches where the skin had been particularly irritated. I’d say the red wine cured it, and heartily recommend my “red wine itchy toe cure” to anyone. Never in all my life has any medicine tasted so good and worked so well.


The whole 5-month discomforting experience (from infection to cure) reinforced this with me: be aggressive with your own medical issues. With doctors, it’s not so common to see keen insight or to have them push for action, or even perhaps to probe with precision. In my experience, many find it difficult to say “I don’t know”, which is part and parcel of the problem.

At least that’s the way it felt to me with both my primary care doctor and the gastroenterologist. I don’t recall having been asked a question of “how well do I do” (in whatever words it might be). But I see it as a “how can I raise my game” issue for them, or any profession.

I have some professional criticism for the gastroenterologist. My initial “are there any risks to Metronidazole” question was met point blank with “no”. No elaboration, no willingmess to engage, or so it felt to me. This seemed odd at the time, and I knew it to be suspect (all drugs have potential issues). Indeed, the very first person I met to whom I mentioned the antibiotic (a nurse in another context) immediately told me of all the issues her son had had with Flagyl. That same gastroenterologist took 30 hours to get back to me (via a nurse) on my concern about my toes. 30 hours and no doctor call with a nurse as an intermediary going both ways is not high quality care IMO. Can it be any wonder doctors get sued?

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