Four years on LDN

Four years today. How time flies, eh? The LDN for CFS/ME "scene" is quite different now than when I started. At the time I didn't know anyone else who was taking it and most CFS/ME patients had never heard of it. Now probably half of the people I know are taking it or at least have tried it, including dozens of Finns (I recently wrote this article, but after writing it there have been many new cases). My doctor is prescribing it for almost all of his CFS/ME patients now. I'll have to pressure him about writing a case series or at least a letter to a medical journal soon - trust me, I have tried that before and he always promises to do it some time.

I am now living in the Netherlands. I had some trouble finding a doctor to prescribe me more piracetam and LDN, but finally succeeded some time ago. Turns out the pharmacy even stocks LDN tablets! The downside is that they're very expensive - over 40 euros a month, which is more than twice the Finnish price. My insurance did not want to cover it (in Finland it was covered 42%, though of course not any longer, but it's still way cheaper). So it looks like I will still be getting my LDN from Finland, after all. Sigh.

After years on 4.5 mg LDN capsules, now that I had these 1.5 mg tablets I decided to try dosing them twice a day, as my doctor usually prescribes it these days, 1.5 mg in the morning and 3 mg in the evening. The first day I felt better than usual, but after that I have noticed no difference, so I'll be switching back to 4.5 mg at bedtime soon.

I am still struggling with hypopituitarism. In Finland I was written a referral to an endocrinologist, but never got to see one (because Finnish "health" "care" is wonderful like that). Here I got to see one, once, but she was clueless, so it was pretty much useless. My current hormonal supplements include taking hydrocortisone in four doses, 7-2-2-2 mg at about 8 AM, 3-4 PM, bedtime and 4-6 AM, and 75 mcg thyroxin (which has made very little difference, though I should probably be taking a little more) and 15 mg DHEA.

Anyway, I shouldn't be complaining, as the last year has been incredible. Besides my CFS/ME book being published in Finnish, I've signed three(!) book deals, one of which is a medical book for which I also got a grant and one is my first novel, also about chronic illness/disability, which will be out in a few weeks. I was a speaker at two LDN conferences, where I met some really wonderful people. I got married and moved to the country where I want to live. I am very grateful I can do this.

One interesting thing that happened lately is that my new doctor diagnosed me with whiplash (vertebrae C5 and C7, I think, were misaligned). I have never been in a car accident nor do I have any neck symptoms and only quite rarely headaches, which I have connected with my TMJ problems, but he said I may have had it since childhood. He realigned the vertebrae and I felt quite terrible for a week, but after that I have felt slightly better. No significant improvement though, but it was worth a try.

I am currently experimenting with some methylation boosting supplements, but it's difficult to judge the effects yet. So far it seems like 400 mcg megafolin makes me sleep too deep (had to discontinue it as couldn't afford that at the time), ~375 mg betaine/TMG makes me extremely sleepy during the day (-"-), 2 mg methyl-B12 makes me feel slightly better, but causes slight nausea and early morning sleeping problems.

2nd LDN anniversary

No worries, I'm not dead yet - just not much reason to blog, except for today. I've been on LDN for two years now and still no illness progression. Unfortunately I've developed quite a few new symptoms during the time, four fairly serious one since last June alone, but my functionality is still quite similar. The worst new symptom is overt adrenal insufficiency, which means I have to take hydrocortisone most of the time and easily get hypoglycemic. I've had a few adrenal crises too, but luckily nothing requiring hospitalization. Haven't had any infections in the last year, except for a bout of probable bronchitis, which went away on its own.

Currently I'm taking the following meds and supplements:

• LDN 4.5 mg
  
• piracetam 2x1,200 mg *
  
• baclofen 10-20 mg *
  
• melatonin 1.5 mg
  
• undenatured whey protein ~20 g
  
• creatine ~2 g **
  
• D-ribose ~10 g
  
• glutamine ~3-6 g **
  
• acetyl-L-carnitine ~750 mg
  
• Q10 100 mg
  
• R-lipoic acid 100 mg
  
• magnesium 350 mg
  
• vitamin D 50 mcg
  
• vitamin C 2x500 mg
  
• multivitamin
  
• probiotic
  
• Siberian ginseng (for cold prevention)
  
• ashwagandha (for sleep) **

* currently not taking this as I've run out, hoping to get more really soon
** may ditch this soon as it doesn't seem to do anything or is redundant

and as needed:

• hydrocortisone 2-10 mg
  
• celecoxib 200 mg
  
• bromelain & quercetin (for preventing post-exertional muscle pain)
  
• licorice & rhodiola tea

I no longer have to take the nimodipine (which restored most of my cognitive function) and I still retain its benefits - isn't that grand?

I haven't been able to play badminton since the last time two years ago, except for a short outdoor stint in the summer. Hopefully more this summer. I did go swimming a few weeks ago, for the first time in years. To my surprise, I was still able to swim. I had assumed I couldn't do it due to the residual muscle weakness I have, but I could. And because of taking a lot of bromelain, I didn't even have post-exertional myalgia. Just some fatigue, not bad.

I'm also happy to report that someone from my Finnish CFS/ME forum who started LDN recently has experienced great improvement. She has had fairly severe CFS/ME to the point that she hasn't been able to do much of anything at all. Now she can take long walks without much repercussions, the oversensivity of her senses has significantly reduced and she can watch TV for the first time in ages. Her asthma (or fairly severe breathing problems which have been diagnosed as asthma) is much better and she is also experiencing some relief in the food allergies that CFS/ME has caused, which previously prevented her from eating almost all foods. I guess it's needless to say she's very happy!

Living happily ever after

I'm sorry I have neglected this blog. I was supposed to write on my 1-year LDN anniversary, which was two months ago, but I simply haven't had the time. I was working on my CFS/ME/FM treatment book which is now finished, and after that I've worked on the website, the press campaign and other stuff. The book's website is located at http://www.brokenmarionettebook.com.

I've tried some new medications. Thyroxine didn't work and in fact caused loads of side effects. Maybe Armour would have worked better, or maybe I should have taken hydrocortisone at the same time (the morons refused to prescribe it, because "one thing at a time"). On the other hand, there has never been any evidence that I was hypothyroid. :-P

I've been taking undenatured whey since December in hopes that it will eradicate my active HHV-6A infection and any other chronic infections I may have. It seems to have slightly improved my overall condition. Also, it caused some "herx" like symptoms in the beginning and now, if I take licorice which is an antiviral and should work synergistically with the whey, I have the "herx" stuff again. So I'm hoping some microbes are actually being killed. Pentoxifylline didn't seem to do anything for my CFS/ME (probably because I'm already taking piracetam and LDN), but it did help the herx, because it downregulates inflammatory cytokines. But I'm afraid to take it any more, because it can actually worsen cytomegalovirus infections and I might have chronic CMV (and if it aids CMV it might aid HHV-6, too).

I also tried DL-phenylalanine, which is supposed to work as an adjunct to LDN, because it slows down the breakdown of endorphins. It also converts to dopamine to some extent. I didn't notice anything, but maybe I should have taken more than 500 mg a day. Luckily at least one thing I tried works very well for my cognitive dysfunction: nimodipine. It has almost eradicated my brainfog. If I could sleep 12 hours a day I would probably be 95% lucid. If I was religious I'd be singing "Hallelujah God and thanks for the new brain!" So far the medications I've chosen for myself have been great. My doctor was so impressed he prescribed nimodipine for a friend of mine, who seems to have benefited even more than I have.

My life is going incredibly well now, so well that I would have never thought it possible 1.5 years ago. At that time I was extremely disabled, could barely do anything, my brain didn't work and it looked like I would be in wheelchair soon. Now I have a good quality of life despite a variety of annoying symptoms. I moved together with my boyfriend of eight years in March. It wouldn't have happened if it wasn't for LDN, and I doubt my book would have been finished either.

Lately I've been thinking perhaps I might even get well some day, maybe not fully well but almost, considering I am closer to being well than being at my worst. On the other hand I am still getting new symptoms or old ones are showing new aspects, like my stomach problems, so it's not likely to happen any time soon. But even if I never get better than this, well, life can still be great. I just wish I would again find a job I could do.

P.S. I didn't get a single cold in the winter, even though my boyfriend had several "killer" ones. I haven't had any bacterial infections either, except for a possible throat infection lately (I don't know what it was, but it was a unilateral lump), which cleared up with oil of oregano and echinacea.

Nothing special to report (but doing it anyway)

Still doing alright, but also still looking for further improvement. As a result of my sleep study I got a prescription for melatonin. It did knock me out (the med, not the prescription), but kept me awake at night. I tried adding inositol to the regime, and surprisingly it did work just as I was hoping for, keeping me asleep. So now I've all but solved 18 years of poor sleep (I still have nocturia, nightmares and stuff) with a very inexpensive combo that has no side effects. Sadly, it did not make much of a difference in how I feel or my functionality.

I had a kind of a burnout about 1.5 months(?) ago, a mild adrenal crisis. So I do have adrenal fatigue, something I've tried to deny for a long time. I treated it with licorice and was expecting to get a Rx for low dose hydrocortisone from my doctor, but instead he wanted to try his circulatory hypothesis and prescribed me etilefrine, a med which works pretty much the opposite from tamsulosine which I tried in the summer. He theorizes my hypocortisolism may be secondary to poor circulation. Sadly I haven't noticed anything from the med. Save for some supine tachycardia episodes I could as well be taking sugar pills.

I'm going to the infection clinic soon, after not being there since August last year. No, I'm not going voluntarily! They're useless, but I have to hang around the clueless public sector folks if I want to ever get on disability, though maybe I'm just in denial, because unless I sue the public insurer it will most likely never happen. It's interesting to see what happens there, at least they'll probably frown upon my medication. The chap who leads the unit thinks LDN is "a hoax or something that makes CFS worse", based on having never heard of it prior to getting asked about it.

I _might_ be offered IVIG which I haven't been given before. I really don't know if I should take it. Just a year ago I would have jumped at the opportunity, but now the idea of an expensive IV treatment that would require me to spend me an entire day in the hospital every three weeks, carries small but life-thratening risks and may well offer no benefit since I'm already on LDN does not seem necessarily worth it, unlike when I was really really sick and the chance of getting any medical treatment seemed hopeless.

Now I'm not sure if I can even benefit from further treatment, with the exception for hydrocortisone and perhaps pyridostigmine. Perhaps there's nothing more that can be done unless I get treated for the chronic viral infection I most likely have, and that won't be happening since it would cost like 5,000 euros a month.

Six months and counting

Six months now (or little over a week ago, but anyway). Still no worsening in my condition. Normally I'd have deteriorated quite a bit in the span of six months. I've been sleeping quite poorly lately, but I'm trying to fix that. Had a sleep study a few days ago, slept a few hours at most. My doctor wants to send me for an even more complete sleep study to measure transcutaneous CO2, he has some theory related to that. It seems like the combination of taurine and valerian works well for my sleep, but I have to investigate it further. Could be just a coincidence.

I tried ranitidine (one of Goldstein's trusty meds) and it seemed to help a bit, but I've sworn off things that "may help a bit" unless they're extremely cheap, safe and stuff. And this stuff costs about 30 euros a month so it definitely isn't cheap. Still haven't got my nimodipine. I'm kind of hoping the public sector neuros would rewrite the Rx so that I'd get the med for free, but it's not very likely, as they don't want anyone to actually get better.

I've been gluten-free for a month now, since so many patients and doctors recommend it. Haven't noticed any changes, but I'll stick with it for two more weeks, as Sarah MyHill says it could take up to six weeks to notice a change. I had a UTI a few weeks ago, the first(?) infection I've had on LDN, which is quite impressive. Though since it's been three years since my last one, I strongly suspect it was somehow connected to the diet change (pH?).

I'm working on the English version of my book now and it's progressing at a decent rate. And I'm trying to get articles about LDN on some big illness-related websites (eg. ImmuneSupport and ButYouDon'tLookSick), but no replies yet.

Next trials:

* inositol
* pentoxifylline
* nimodipine?
* DMAE?
* pregnenolone?
* pyridostigmine?
* melatonin?

Speaking of trials, the HIV/AIDS trial is finally starting in Mali! This is the best news for HIV+ folks for like 20 years.

LDN saved my summer

So, I was in the Netherlands for 11 days (my third time there already). It's weird how well it went. In the winter I was sure I couldn't make it. I discussed the possibility of what it would be like to go in a wheelchair with my friend a while back, and it would have been otherwise possible, except that I don't think my SO would have agreed to. But luckily I was able to handle it on my feet, thanks entirely to LDN (well, maybe with some credit to the lipoic acid as well). I was most worried that it would be too hot there as the heat has been killing me this summer - but it was in fact cooler than in Finland. No problems sleeping due to the heat (though I did have unrelated sleeping problems).

I had to drop a whole bunch of supplements for the duration of the trip. Normally I carry a big jar with all kinds of supplements mixed in the same bottle, but you can't really do that when flying, unless you want to appear like a drug dealer. So I took just Q10, R-LA, B12, vitamin C, magnesium fizzies and my prescription meds with me. It might not sound like much, but I had to drop at least Siberian ginseng, multivitamin, glucosamine, ALCAR, MSM, NAC, probiotics and some herbs I take occasionally like valerian and rhodiola. Some of them I will have to drop permanently soon, anyway.

The probiotics would have come in handy though, as my stomach was quite upset at first. But I bought some kombucha tea which seemed to help a lot (I wish I could get a culture of my own). And I didn't have much joint pain at all, despite the lack of glucosamine. Maybe (hopefully) I don't need it any more. Oh, and I forgot to mention I managed to get rid of ginkgo after over three years! Thanks probably to the combination of LDN, piracetam and B12. I have tried to drop it before but have had to go back very quickly. No I didn't notice anything.

After a short rougher patch I've been doing quite decently (except that my stomach still hates me and my skin looks nasty). A few days this week I never really woke up, after that it's been ok. I think the tamsulosin (and perhaps the olive leaf extract I tried soon afterwards) fucked up my body for a while and it's now recovering.

Unfortunately my urinary frequency is still a lot higher than usual, and it's bad enough without any worsening. Having to go to the toilet 3-5 times a night is not much fun. Similar thing happened a few months ago after one tizanidine pill (it also works through the alpha receptors like tamsulosin), my urinary frequency worsened for 2-3 weeks. I guess my body is trying to tell me "don't fuck with the alpha receptors". :-P

My Finnish LDN site is now finished, see http://ldn.gehennom.org. If you can't understand Finnish you can't get much out of it, except that it has an extensive (yet far from conclusive) list of references about LDN and related research. Also, I uploaded an LDN documentary film I found on the LDN website on Google Video: http://video.google.com/videoplay?docid=8313092875696096715. Next week I'm finally going to send my book to the clinic of infectious diseases where I used to be treated, and ask that they consider using LDN and some other meds.

A woman with a myriad of different kinds of health problems (including cancer). I met on DA has improved a lot thanks to a combination of thyroid supplementation, allergen avoidance, LDN and large dose sublingual B12 (the latter two I suggested to her). I hope I can help many others to achieve such improvement.

Apparently Blogger isn't in the mood of letting me add a title today.

Better living through pharmacy

I've been doing fairly well lately despite some intense stress from another person's health problems. Normally I think that this amount of stress would have rendered me bedbound, but now I'm fairly functional. My cognition is actually fairly alright these days, even though still impaired. So I guess it took some time for the piracetam (and perhaps LDN) to achieve its full nootropic effects - or perhaps they still aren't at their highest. Other symptoms have been alright as well, except for sleep, stomach pain and muscle/joint pain. The sleep problems I can attribute to stress and overly warm weather, but I'm not sure what's flaring up the rest.

I saw my doctor last week and we couldn't decide whether should get tamsulosin (a selective alpha blocker, meant for prostate hypertrophy) or nimodipine (a calcium channel blocker with some other neuropharmacological effects), so he prescribed me both (and celecoxib for my aches, since ibuprofen gives me such stomach churning these days that I feel like I'm playing Russian roulette every time I take it).

I've been taking tamsulosin in 0.4 mg depot capsules every other day since Wednesday last week, and I haven't been too impressed. It was prescribed to improve overall vigilance and to decrease the urinary frequency, but so far neither has been improved at all. My orthostatic hypotension hasn't worsened as I feared, but the med gives me rhinitis, which is annoying and interferes with my sleep. I also woke up with a massive headache last night, which I believe is related. So if I don't start seeing some results soon I'll probably discontinue it.

So, I could try the nimodipine, but the problem is that the smallest pack (100 tablets) costs 130 euros, and it isn't covered in our public insurance which covers wonderfully arbitrary 42% of almost all prescription medications - the tamsulosin cost me 5 euros for 30 capsules. The nimodipine might help me a lot, but I might not be able to tolerate it. I'll have to talk with my dad since he's the one who pays for my meds as I don't have the money myself.

I've finally tried valerian for sleep and it seems to work alright without any side effects. However, at about 15 euros a month it is quite pricey for me. But maybe if I do manage to drop the ginkgo I can start taking it. I'll have to discontinue MSM, NAC, ALC and glucosamine soon due to money issues (the MSM is fairly cheap, but it hasn't done much of anything). At least I'll need to take much fewer pills.

My doctor suggested that I go to another city for a 24h cortisol and growth hormone testing in September. 24h bloodletting doesn't sound like much fun, but it would be free of cost for me, and advancing scientific research is a big priority for me. LDN may increase cortisol levels, but I believe I'm probably still low on it (adrenal fatigue) and I suspect my GH is low too. If the latter turns out to be true we'll probably try pyridostigmine, a very cheap cholinesterase inhibitor that can increase GH secretion.

My Finnish LDN website is close to completion. I'm very happy with it, especially with the bunch of studies I've collected.

Purple, and fine

Today hasn't been my best day. But I'm not let down because I know that tomorrow will most likely be better. And even today has been better than most days I had before LDN. The piracetam made me a bit lethargic and slightly irritable for the first days, but it's working quite well now. I'm hoping that in a few months my brain will be a bit more functional when the piracetam reaches its full efficacy.

I have something purple and wonderful cooking up on the stove (red cabbage stew, pretty much the same thing as the traditional Finnish cabbage casserole). It's one of my favorite foods, but I haven't been able to cook it for a few years now, because grating the cabbage was too exhausting. Now I can.

Even if I will never get better than this, I can deal with it. I'm still disabled, but my quality of life is way better - getting your health even 50% better can make a much bigger difference in quality of life. And life is very good now. Now I can make it better for other people, too. I'm determined to get my friend out of wheelchair, with LDN and/or something else. And another good friend of mine could use a prescription as well. I probably won't be posting much here any more, except for the LDN miracles I witness, and perhaps an update on myself every once in a while.

Piracetam

I got a prescription for piracetam yesterday. It's a medication that I've wanted for several years now due to my cognitive problems, which haven't been relieved by LDN as much as I'd have wished, and luckily my doctor thought it was alright even though he had no prior knowledge about the drug.

I've taken four 1200 mg tablets yesterday and today as an "attack dose" and after that I'll probably take 2-3 tablets a day. Hard to judge about brainfog, but the circulation in my limbs feels better already.

So I'm taking a hefty number of pills and such at the moment, even after I dropped carnosine and astragalus, both of which I had been taking twice a day. Each amount is for the single pill, eg. I take 3 1.5 mg pills of LDN at once for a total of 4.5 mg a day.

• piracetam 2-3x1 (1200 mg)
  
• LDN 1x3 (1.5mg)
  
• bromelain and quercetin 3x1 (125 mg/250 mg) (I will probably drop this as soon as it ends, it doesn't seem to work)
  
• glucosamine 3x1 (500 mg)
  
• sublingual B12 and folic acid 1x (1 mg/400 ug)
  
• acetyl-L-carnitine 2x1 (500 mg)
  
• R lipoic acid 1x (100 mg)
  
• ubiquinone (coenzyme Q10) 1x (100 mg)
  
• siberian ginseng 1x (1,000 mg)
  
• probiotics 1x
  
• gingko biloba 3x20 drops (hopefully the piracetam will let me drop this, I've been taking it for three years and it's the most inconvenient supplement, even though it works well)
  
• oil of oregano 2x2 drops
  
• magnesium citrate 1x (sometimes up to 3x1) (100 mg)
  
• vitamin C 1x (500 mg)
  
• a multi vitamin with essential minerals included 1x
  
• vitamin D about 30 ug a day (not every day, but it averages to that amount)

That works out to a total of 22 pills/capsules and a bunch of drops. But it has been similar in the past, eg. last autumn when I was taking many things I currently do and eg. prednisone, omeprazole, vitamin B complex, glutamine, astragalus and a total of five pills of beta carotene a day (the latter was a short trial recommended by some doctor in eMedicine, didn't work), then I averaged 22 as well. :-P