My child is on monthly rounds of Rifaximin and about to start the next round but is showing signs of developing a common cold. Should I start the round of Rifaximin as planned or wait?

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I generally counsel my parents to hold the next scheduled round of rifaximin for a few days until the child’s symptoms have resolved. If you are in the middle of giving a round of rifaximin or are using it continuously I recommend my patients do not interrupt the rifaximin even if another physician prescribes an antibiotic course for a middle ear or sinus infection.

My child is on monthly Rifaximin and having loose stools (diarrhea) at the end of each cycle, just before starting Rifaximin again. What does this mean?

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This most likely means that their intestinal bacteria overgrowth is relapsing before starting the next course of rifaximin. I often suggest starting the next round a few days early whenever diarrhea recurs in this fashion.

My child has gone from monthly rifaximin to continuous rifaximin over several months and we didn’t see much improvement. We added VNS 5 minutes per day and it wasn’t until we added a second 5 mins of VNS that we saw significant gains. Why is this?

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It’s difficult to always explain in particular why some children need more inflammation suppression than others. Each of these steps has an additive effect in reducing inflammation more. In this case, it finally took two doses of VNS per day to make a difference. Sometimes I’ve had to add inulin to twice daily rifaximin or change rifaximin to 3 times a day before significant recovery occurs.

My child is on monthly rifaximin but their behavior seems to worsen after finishing a course of rifaximin and then improves again after the starting the next course. What is happening?

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Your child may be relapsing well in advance of the next round. As such, it would be advisable to move on to continuous rifaximin to better prevent frequent relapses, which will allow neurological recovery to unfold.

Will Molluscum warts cause problems with the protocol?

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No, it will not. Follow your physician’s specific advice on treating this.

If a child is impacted by mold, does the Nemechek Protocol fix this? Or would it need to be treated separately (detoxify from mold)

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I do not believe toxicity from mold contributes at all to autism or developmental delay.

My child has Dysautonomia, and SIBO and likely PANS that is triggered by mold I’m trying to sort out if the protocol is all that’s needed or if mold work is needed as well.

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The protocol is very effective for children with a diagnosis of mold toxicity without needing any additional treatment for mold issues.n

Why is the modified protocol no longer recommended?

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I now recognize that in rare cases inulin can trigger an extreme response and that what was happening was something I now refer to as Inulin Intolerance. In the event of inulin intolerance it is best to just move on to Rifaximin.

I missed a day of the protocol for my child. Can I just give them double the amount the next day?

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I don’t think doubling the following dose is necessary. It is more important to examine why you missed the dose and if possible, make adjustments to limit it from happening again.

Is it ok to drink milk?

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Unless your child has a dairy allergy or intolerance it is perfectly fine to drink milk while on the protocol.