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.

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.

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.

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.

Orkut and writing

I've set up an LDN community on Orkut: http://www.orkut.com/Community.aspx?cmm=29921205. Note that the link doesn't work unless you're an Orkut member. And it's not worth it to join just for this. But in case anyone reading this is an Orkut member and interested in LDN... I've joined just about all Orkut communities for autoimmune illnesses, cancer and AIDS to spread the word.

On a sidenote, in the past 24 hours or so, I've written about four pages of a short story (the longest short story I've written since 1999 I think and the longest piece of fiction I've written since I finished my last novel in 2002 or 2003). It's strange to see it come out so easily.

I tried participating in "NaPoWriMo", a project where people try to write a poem a day for the whole of April. I failed miserably, I realized that I still have way too much cognitive dysfunction for that. And my brainfog doesn't really agree with writing articles or essays. But a certain kind of prose seems to be possible. It's thanks to LDN, but I also think due to the vitamin B12 lozenges. I haven't slept too well the past three nights, but the B12 seems to keep me more alert. Apparently it even helps many healthy people.

Now that my cognitive dysfunction is somewhat better it has helped me realize how bad it really was, and how bad it really is. I guess I've been somewhat in denial about it. I don't know how I got by at all, when my brainfog still seems to affect everyday living a lot.

My spleen or something nearby it seems to be slightly sore. I hope it's nothing of concern. My other lymph nodes are unusually un-sore, so I guess it's just a muscle cramp or something. Wildly theoretically it could be a broken rib, but I haven't done anything that could have broken a rib.

One-month conclusion

I've now been taking LDN quite exactly for a month, depends on how you count. I made a kind of summary of perceived improvements so far. I hope I haven't forgotten anything, though most likely I have.

Main symptoms

fatigue: improved quite a bit
brainfog: somewhat improved, still very bothersome
cognitive fatigability: improved quite a bit
muscle endurance: improved quite a bit
muscle weakness: improved quite a bit
chronic urticaria: 80-90% better
tiredness: pretty much unchanged
fever: temperature is a bit higher, but the feeling of feverishness is reduced
urinary frequency: unchanged at first, recently worsened (I don't think it's due to LDN, it gets worse at times)
muscle aches/soreness: somewhat improved
sleep: not much different in either quality and quantity, a bit better which could also be due to the reduced stress as a result of better functionality
IBS: better, though I have some bloating and constipation at night due to the LDN
infections: none so far, either bacterial or viral

Other symptoms

headaches: have got two in the last month, quite normal
migraines: none, though either of the headaches could have been a migraine, hard to say as there was no aura and ibuprofen always helps my migraines
seborrhea: 20-30% better (but now pretty much gone to a new shampoo I started about a week ago)
orthostatic hypotension: hard to say, I hadn't had much of it recently
nausea: haven't had much of it during the treatment, but in the beginning I did get nauseated
sensitivity to smells and such: seems to be still be there
non-allergic food sensitivity: I haven't tested yet
congestion/post-nasal drip: unchanged
lymph node swelling: seems to be better, hard to say because it varies a lot
hair loss: hard to say, hadn't had much of it recently (usually I have a lot of it all the time)
exercise-induced asthma (not anything to do with CFS): improved quite a bit

Other parameters

weight: unchanged, or perhaps a bit decreased due to more activity and exercise (I don't have anything to weigh myself with) - on the other hand I'm hoping I might have regained a tiny bit of muscle mass which would outset the possible weight loss
mood: unchanged (good)
libido: unchanged (normal)
appetite: unchanged (normal), though I sometimes get a bit more hungry in the evening than usual
skin in the face: a bit worse at first, now pretty much the same as before
hair and nails: pretty much the same, hair is perhaps a bit less greasy

Still alright

Yeah, the badminton went well. I felt incredibly hot but didn't really get fatigued. The 45 minutes went incredibly quickly. Not much fatigue today, but some of my muscles feel rather sore and have got worse during the day despite multiple stretching sessions. When I woke up I felt a bit icky and concluded I was still dehydrated and lacking salt, so I munched on some salted nuts and crackers. I have a feeling I took too much magnesium citrate (500 mg I think) yesterday, and the vasodilation caused the hotness and flushing face and got my sodium levels out of balance. But no big harm done and I will keep that in mind in the future.

We made Ethiopian lentil soup today. It was rather good. Sadly I'm still as oversensitive to onion fumes as I used to be, which makes cooking with onion rather tricky even if you keep the window open and someone does the actual chopping.

Making the most out of it

Life has been much more enjoyable when I can actually do things (like exercise and cooking)m don't have to worry about the repercussions and don't have to spend time just idling and having to stave off boredom. Well, today spent about two hours feeling like a zombie, as I decided to take a long, warm and relaxing bath which was apparently a bit too relaxing, as I could have easily fallen asleep then.

I've been eating more healthily than for ages, as now I can actually cook instead of eating frozen and canned stuff on most days and I don't put off eg. eating fruit and veg due to the energy needed to peel and slice it. I'm also getting into sprouting again, my broccoli sprouts should be just about ready.

One weird thing about the LDN is that I have a lot of strange dreams every night, but I just can't remember them. Normally I can almost always remember my dreams and some nights I could easily write half a page about them, but now it's different. Eg. last night I had a whole bunch of strange dreams and when I woke up in the middle of the night I tried to memorize it so that I'd still remember it in the morning. And in the morning I can only remember that one of my friends was in one of the dreams.

I'm leaving to play badminton soon. It's been years since I have even considered playing sports (except when I was on prednisone) and it's been a decade since I last played badminton. It might be excessive, but I'm confident that the most I'll get is a set of achy muscles. Let's see if I'm wrong.

Run, forest, run!

I got an email from my doctor saying that he had already prescribed LDN for another patient of his. Whoa! I really hope (s)he'll get good results, both for his/her own sake and the sake of encouraging future LDN prescriptions for others.

I've tried to stretch and walk as much as I can every day, even though the former feels a bit silly since there's "nothing to stretch" as my muscles aren't sore and crampy as usual. But I know it does good for circulation and joints at least. I try to rotate and stretch myself into every possible direction instead of just doing "classical" pre/post training stretches.

Yesterday I actually made several walks and during the last walk I tried to see if I can run short distances (like 100-200 m) as a form of interval training. To my surprise I could and I even enjoyed it. I would get out of breath in the end just like a normal person would, but it would dissipate in 5-10 minutes instead of taking an hour and it would not feel particularly awful. My muscles didn't complain at all. No bad after effects. I'll probably try to do more of that today.

Compare this to the day two weeks ago when I had my doctor's appointment. I ran like 50 m trying to catch a tram which was ahead of its schedule, I failed to catch it and I got some kind of an asthma attack (I have exercise-induced asthma, no meds) and I pretty much felt like dying, my muscles felt like shit for a long while afterwards and I could hardly walk from the tram stop to the doctor's office.

Some people think that I haven't exercised much because I'm lazy and unmotivated and don't like it, but that's total bullshit. I didn't like it much when I was still healthy, but I guess CFS learnt me a lesson (how lame). A few years ago I used to walk a lot, go dancing and do a well-planned combination of stretching and mild muscle workup up to 4x45 minutes a week. But then I got too sick to even stretch much and my ability to walk greatly diminished. I'd love to go bowling - if I could just lift the ball! - and if I suddenly got 100% healthy I'd probably get a gym card, at least if I could afford it. Off-topic rant ends now.

Whoa, huh

Yesterday was definitely a real test for LDN's efficacy. We were to first go to friends' engagement party (and even before that I worked on finishing my book and did a load of dishes from the previous night's baking session) and then to another (music) party right afterwards. I had some nasty stomach churning before the first party, but luckily it went away by the time we got there, as there was loads of good food and I ate a lot of it. My legs got quite sore as I spent most of the time either standing or walking around the house, so I was worried about the seocnd party. And usually socializing really wears me out.

It didn't help that we had to run to the bus when going from party A to party B, otherwise we would have had to wait for half an hour for the next bus. My legs felt awful. Then we had to queue for like 20 minutes at the door. But once inside I got to sit down and stretched my legs several times, which really helped. I had also grabbed a bunch of magnesium and some ALC while at my house between the parties and it could have helped too.

To my great surprise I realized that I could actually dance despite the severed legs, my legs didn't have the heavy as lead feeling that has been present for a long time and at times really hindered walking even the shortest distances. It wasn't wiggling this time, but real dancing, even if not as full-blown as some other people's. I could dance and it felt great, even if a bit sore. I think that if I hadn't exerted my legs before the party I could have danced for quite a long time. It was like a few years ago when I could still go partying at times despite the CFS. It was as if LDN had suddenly wiped off a few years of disease progression. And surprisingly I don't feel bad now. A bit tired because I didn't sleep enough, but not fatigued and my muscles don't hurt at all. I'm seriously impressed.

Doing well so far

Yesterday was a very good day overall. I did a lot of stuff, eg. planting and doing an interview of a friend with severe CFS. I couldn't get my dictaphone working properly as I had forgotten how it works, so I did the interview with pen and paper. Normally both of these things would have worn me out severely, as does everything where I have to use my hands a lot and "heavily". My muscles did get weak and sore but they seemed to regenerate fairly quickly and it the exertion didn't translate to overall fatigue. In fact I hardly had any fatigue during the day, only some tiredness. I did get some urticaria in the evening, but it was mild.

Also luckily the side effects (which weren't too awful to begin with) considerably lessened the second night. I fell asleep without much trouble, no tremors at all. I did get the hunger pangs when going to bed (despite having prepared with a large meal almost immediately before) but they weren't as bad as the night before. No bothersome dreams. I went to the toilet two times during the night (I think) which is a normal amount. I've had constipation and bloating which seems to have been caused by the LDN (at least exogenous opioids affect motility and transport time etc, so I guess endogenous ones do the same).

I woke up a bit earlier than I'd have normally and do feel a little tired, but not really fatigued. My muscles feel better than usual. I feel like my skin is a bit smoother than usual, but that could be just my imagination. I think that today I'm going to work on my book, write the interview article or most of it - and make pancakes! If this really is just placebo or something I should be able to find out. I think I'm going to stick with 3.0 mg for the rest of the week and then switch to 4.5.