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Gentle but important reminder…
adding progesterone and thereby optimizing their cycle, can and often does… make a woman MORE fertile. And so pls be sure to educate them about this (in case that was NOT one of their goals!)
Cynthia
Having said that about the cipro being helpful in tough infections ….
I really pretty never choose fluoroquinolones for children. In fact, I cannot ever ever remember writing for one.
The tendon injury/rupture risk is real, as are all the other “bad things” we have all seen with fluoroquinolones. And so personally for something non-life threatening like in this 4 y/o, I would 100% choose something else.
And I agree with you Clyde, Biocidin is one of my all-time very favorite supplements! It works great. Not expensive. Nothing risky.
Cynthia
Sorry…
re-read your clinical story…
eczema, allergies and asthma… so you DO already have indications for trouble with tight junctions…
…so absolutely I recommend larazotide.
Also, as you kill off any unwanted bacteria, it will be great to have tight junctions closed for less absorption of LPS and other toxins as you get any die-off.cynthia
Hello Lynn-
First off, you already took the time (and spent the money) to find out WHAT needs treating in this patient (with the GI Effects test). I know that when they tested for those bacteria they found in him/her (Citrobacter, Klebsiella, and Pseudomonas), that they also gave you both natural and Rx options to treat these with (that they would be sensitive to).
So, since you have such specific info about how to help him/her… there isn’t a need to do a more general “tune up” with something like Alinia (which I use more for when I haven’t tested).
About the dosing for Alinia in a child this age (if you were going to use it in someone else when you didn’t know what needed “weeding out”), there are doses for it in epocrates down to 1 y/o (for infectious diarrhea)… I would just use these standard doses. *
*For reference these read as 100mg BID for age 1-3, and 200mg BID for ages 4-11 for example.
As for larazotide… if there are signs of weakened tight-junctions in history, on exam, or in this case in the results… then I LOVE larazotide.
And for lactulose, “why not”? In general feeding happy bacteria in the gut isn’t a bad idea….. But, having said that, in this case, if you have results that shows a lot of overgrowth of some questionable bacteria, then I would wait to start something like a prebiotic of any kind until you have gotten control of the overgrowth (so that you do not risk “feeding” these as well). Just in case. This is a more nuanced timing kind of thing.
So in short to summarize again….
Alinia: I would use what you now know would be ideal for this patient since you did the testing.
Larazotide: worth the money IF signs, symptoms, results consistent with weak tight junctions
Lactulose: I would hold off starting this (or any pre-biotic type item) until you were in the restorative phase. But then, a good an inexpensive way to support someone’s wanted microbiome.
Hope this helps!
Warmly,
Cynthia
Hi Carrie 🙂
I just posted on this a few days ago
(This must be a timely question)
🙂
See here: https://ssrpinstitute.org/srrp-discussion-board/topic/bpc-157-dosing-in-2-year-old/#postid-2444
Warmly, Cynthia
Berna-
I worry about not knowing what is causing the worsening pain before deciding the appropriate next steps.
-If the pain got worse with treatment, the issue could be die off… so slow down, back off tx, and get better detox.
-If the pain is more muscular (in the tissue) then my money is on a recent mycotoxin exposure (inc MMP9, which leaches toxins into soft tissue causing muscle pain). Tx here is detox and binding.
-If the pain is more their own “this is my typical Lyme joint pain” just worse… then a) the current treatment is not the correct one, b) and I would consider adding LL-37 and TA1 trial *
-I would not do ozone until you are sure of what you are trying to do. You wouldn’t want to use it to kill more spirochetes, etc…if the worsening the patient was having was already about die off. Etc.
*Pls note as I have mentioned before, be careful about using TA1 in someone with TBD without including LL-37 at least in the beginning. Since maybe the inflammation is the only thing holding Lyme at least partially under control. You wouldn’t want to “modulate” the immune system and decrease the inflammation until you were also helping the body be better at killing directly. The body is smart and was likely doing the best it could with what it had to keep the spirochetes suppressed. Inflammation can do this to some degree. Sometimes 2-3 days of LL-37 before TA1 makes all the difference (someone with TBD getting better -vs- worse with TA1)
I love BPC for all kinds of things. But again, for me… I do not spend the patient money until I can speak clearly about what my goal/target is. And for this patient… if you are worried primarily about the pain, I think it is hard to know what to start until you know what the problem is (as mentioned above).
Lastly, I will say, that treating patients with TBD is tricky. And they are a hard bunch to do trial and error on (their systems are often not that forgiving and you can easily make them worse. And recovering from “worse” can be very long and hard for them). So if able/whenever possible I recommend finding someone to learn from if you plan to help more people with TBD in the future. Also, ILADS can be a very helpful resource when working with getting started in that field.
Hope that helps
Cynthia
Dosing larazotide… for a 2 year old I would usually do 1/2 capsule (of 500mcg) daily.
(When you look at the research of what they used on kids in the hospital with MIS-c .. the dosing was 10mcg/Kg QID for 21 days. So if the kid was lets say 20 pounds, that would be 90mcg X 4daily. So my 250mcg is fine.)
And most importantly, usually VERY effective and fast at that dose.
As for how long? It depends on if you have stopped the trigger.
If the trigger is over (food insult, viral GI insult, etc) then certainly a week to 2 weeks is usually fine in my kids.
But if the insult is ongoing, or you do not know what it is fully (like in this case where it is likely something that will need more “clean up” of the gut)…. then the larazotide would need to be longer. In cases like this… I just trial off, and the kid’s symptoms will tell you if they need it still.
As for BPC, as I have mentioned… since using larazotide in these cases, I haven’t also usually needed BPC. So, as far as how long to use it, I guess I would say that it doesn’t seem to work as fast in my experience so I would maybe try it for a month and then try off to see if they “missed it”.
As for the plane flight triggering…
Hummm, in my CIRS and chronic TBD patients flying is VERY hard on them due to the dropped air pressure. While this mild dip likely won’t bother anyone with good vascular flow in the smaller vessels, it absolutely does in these patients. (I suspect this is about Henry’s Law saying that you can get more gas into plasma under higher pressures. Therefore they get lots of fatigue and brain fog with flying due to relative dip in perfusion, etc ). But this wouldn’t explain things in your patient.
So I would “sleuth” a bit more. Do they give her a special treat for keeping her happy while flying? Did they give her something for discomfort that they do not usually give her? Eat processed food when they do not normally, etc. I suspect that they are missing the link and that it is something that the child puts in their mouth.
🙂
Jennifer-
shoot I typed up a nice long response and it didn’t save.
so I am typing up again (sorry not as long this time).
In short, my first top 3 choices for a kid with eczema due to food is larazotde! So if NuBioAge doesn’t ship to your state, I think Pure does.
I would absolutely start with that.
That dose of BPC, I’m totally comfortable with that.
please also do not forget to:
-remove any offending foods (at least while they heal). Most common are dairy, soy, nuts,eggs, shellfish/fish
-make SURE no constipation
-add lactulose (low dose) since it is cheap, tastes sweet, supports healthy microbiome
I hope that helps!
warmly,
cynthia
Stephen-
I have a few things to say on this topic, and while it sounds like maybe the physicians that are asking are actually interested in learning, since this is a question I get a lot in various forms… I mention my ways of handling these questions from all kinds of people.
1)-I decided a long time ago, that I have too much to teach my patients already, that I do not have time to try to “talk anyone into” believing me. If they want to fight me on things (this is different than an interested dialogue), I frankly just do not have the time.
2)-About other providers that also care for the same patients that I do… who might negatively see what I do (based out of fear and ignorance), I try to limit the contact I have with them (like not step in to help a patient until they have finished their work up’s, etc with those specialists).
3)-When I have an educated and open-minded specialist who shares care of a patient with me, I reach out to them with articles and information about that specific intervention, and we have conversations (this is unfortunately not the most common of these examples here for me unfortunately).
4)-If I have other open-minded people who ask me about learning about peptides in general (not about a shared patient)… I point them toward the SSRP website since I do not have time to do this education myself…and duh, I cannot do this as well as Dr Seeds can!
5)-I do not try to tackle the “where is all the data behind these ‘peptides’ ?” question as an umbrella question. I don’t think that you are really looking for articles saying why peptides as a whole are safe, effective, etc.
While people group this “new” focus on trying to use cellular medicine and the body’s own way to regulate itself … as “peptides”, truly….
it is more about asking in any situation………
a)What is going wrong with this person’s body?
b)What would the body do to correct this? Or what needs to be done to correct this?
c)How can I harness these naturally set-up processes to “push” (or nudge) the body into doing this healing that I want it to do?
And sometimes the best way to help someone do the above, is to use a certain peptide. And when it is…. I then would give education about THIS peptide.
And so, when people ask me “where is any data about the use of these peptides”?
I ask them “which one”? And if I do not already have the article on me (or if Betsy isn’t around… since she ALWAYS has these in her head 🙂 ), then I research (I like ‘google scholar’ usually) and give them specific articles ON that certain peptide. And for pretty much 100% of the ones you are likely using… this is a vast wealth of data on these. And while it is true, that sometimes I am using a peptide for something that it is not specifically peer-reviewed for yet, there is usually plenty of data to show why I would think to be using it in this way, and that it is safe to do so. At least this has been my experience.
So that was a long answer (since I get this question a lot in various forms) to your question.
In your specific situation, here is my short answer… I tell them, that there is lots of great data out there on most of the treatments we are using. And that it was reading about this data that I got good at safely using peptides, after learning about them from Dr Seeds and the SSRP. And if they have specific questions about a specific peptide’s use in a specific situation, I am happy to give them some articles to start with. And if instead, they wanted to learn how to start thinking about helping patients heal using peptides, then I recommend that they check out the SSRP’s website where there is a wealth of info (including some free modules!).
And again, if they were just being rude, I just don’t play with them.
Warmly,
Cynthia
I am sorry, I have never had to handle this issue in any of my patients since medical school.
Cynthia
Sorry it took me awhile to respond.
I have not had a patient with this directly… remember I do peds 🙂
But things I would think about:
-the same kinds of treatment protocols that Betsy has spoken about for pain syndromes at PWC 2021 and 2022 (or was it PWC 2021, and then the Peptide intensive?). It would be worth going back and watching one or both of these. She is excellent and giving clear and precise protocols when she lectures.
-cerebrolysin, ARA, and/or local vaginal estrogen would all be some of my thoughts.
-An excellent and savvy PT who specializes in this region.
-And of course, counseling (esp if there was trauma physical or emotional)
Betsy (@byurthgmail-com) do you have anything specific to add (in case Erich hasn’t heard you speak on this)?
-Cynthia
I am sorry, but I do not have one specifically for semaglutide. It likely wouldn’t be hard to add the short list of possible side effects/complications of semaglutide (constipation, retinal issues, etc) to one of the general forms. But I don’t have a specific one. Do the rest of you (Kris, Leonard above)?
Cynthia
Hello-
First off…
In my practice (and I have had a large Indian population over the years who traveled several times yearly to areas that needed Malaria prophylaxis) I have always used Rx prophylaxis when prophylaxis was indicated (like the seasons, areas, etc where recommended).
I say this… since Malaria is a nasty thing to have (both acutely and sometimes longer term), AND the prophylaxis options are not “nasty”.
Options like: chloroquine, hydroxychloroquine, doxy, Malarone, etc make great sense to me when the option is possible Malaria.
As for physical barrier options: I have tried to find an actually effective non-DEET mosquito repellant. Nope. And DEET, is a neuro-toxin (so not as safe an option in my book as the oral Rx above).
So, my short answer… is the above work, and are pretty benign, and Malaria SUCKS.
So, please just consider doing what we know works well.
This is my thinking and what my pediatric families have been doing for years.
I will be interested to see if Betsy, or Carl have different views.
-Cynthia
Hello-
I know that I was told that Dr Seeds would be discussing using Thymulin at the next Mastermind (Summit) in Jackson Hole next month….Like how he is using it, and what he has found.
I am looking forward to that as I have not “played” with it yet. I was waiting for the above.
This is one of the things I appreciate so much about getting to learn from Dr Seeds…. when we loose something like TA1 which has been so impactful in my patient population, I knew that he was “already on it” to find the best solution. And that then I could rest easy knowing that I did not have to “create the wheel” myself.
Hope this helps,
Cynthia
