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Funk's Regimen


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#301 aLurker

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Posted 27 July 2010 - 06:12 PM

I've seen you praising LDN previously, what made you remove LDN? Source?

#302 FunkOdyssey

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Posted 27 July 2010 - 06:16 PM

I've seen you praising LDN previously, what made you remove LDN? Source?


http://painsandiego....iple-sclerosis/

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#303 aLurker

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Posted 27 July 2010 - 06:31 PM

Ok thanks.

This seems to support the claim made about OGF and thus LDN being immunosuppressant:

Thus, at least exogenous OGF and perhaps endogenous OGF by paracrine/endocrine sources, can be an immunosuppressant. Modulation of the OGF-OGFr axis may be a novel paradigm for the treatment of autoimmune diseases.


This makes me wonder why so many praise it for viral deceases such as HIV, doesn't make sense to me. I guess I have to educate myself in the matter.


I often get colds/sore tonsils but I'd like to try LDN against depression, should I give it a shot?

Acetyl-L-Carnitine - blocks action of thyroid hormone

I guess you're basing that on the studies on L-Carnitine rather than ALCAR? I just want to know if you're playing it safe or if I've missed some study.

Edited by aLurker, 27 July 2010 - 06:33 PM.

  • Good Point x 1

#304 FunkOdyssey

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Posted 27 July 2010 - 06:35 PM

I often get colds/sore tonsils but I'd like to try LDN against depression, should I give it a shot?


I don't think most people would notice any immunosuppressive effects from it, anecdotally people tend to be robustly healthy while taking it. I'm erring on the cautious side. It has not been a great success for Lyme treatment: results are mixed. I think its more helpful in cases where autoimmunity has occurred secondary to Lyme.

I guess you're basing that on the studies on L-Carnitine rather than ALCAR? I just want to know if you're playing it safe or if I've missed some study.


Just playing it safe but supplementing ALCAR will raise L-Carnitine concentrations so most L-Carnitine research (including thyroid related research) should be relevant.

Edited by FunkOdyssey, 27 July 2010 - 06:37 PM.


#305 aLurker

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Posted 27 July 2010 - 06:50 PM

Ok, your decisions seem to make sense to me now, thank you for your prompt replies.

For others wondering about LDN and immunosuppression I found this on wiki helpful, although I do not deem myself qualified to attest to its validity and the only thing that's really clear after reading it is that more research is needed. There are so many things we don't know about our bodies yet.

Edited by aLurker, 27 July 2010 - 06:50 PM.


#306 FunkOdyssey

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Posted 27 July 2010 - 06:59 PM

Ok, your decisions seem to make sense to me now, thank you for your prompt replies.

For others wondering about LDN and immunosuppression I found this on wiki helpful, although I do not deem myself qualified to attest to its validity and the only thing that's really clear after reading it is that more research is needed. There are so many things we don't know about our bodies yet.


There is a section there that is 100% wrong and needs to be edited:

nor is there any evidence in the literature that low dose blockade with LDN results in a release of opioids at some later time, not just at a therapeutic dose but also not at any detectable dose at all.


There is solid evidence, not in vitro nor in animals, but in human clinical trials, that LDN produces elevated circulating beta-endorphin.

#307 nameless

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Posted 28 July 2010 - 06:08 PM

If pushing towards Th1, why not use grapeseed (or maybe a wine) extract?

Any particular reason for the switch from zinc picolinate to citrate?

#308 triplecrown

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Posted 28 July 2010 - 06:53 PM

Have you seen any decline in cognition since dropping ALCAR? I thought about dropping this from my regimen as well due to the whole thyroid issue.
Are there any other alternatives to ALCAR?

#309 FunkOdyssey

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Posted 28 July 2010 - 08:08 PM

Have you seen any decline in cognition since dropping ALCAR? I thought about dropping this from my regimen as well due to the whole thyroid issue.
Are there any other alternatives to ALCAR?


I haven't noticed any difference of any kind since I dropped it.

#310 FunkOdyssey

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Posted 28 July 2010 - 08:17 PM

If pushing towards Th1, why not use grapeseed (or maybe a wine) extract?


I've thought pycnogenol was basically similar but superior to grape seed in most respects. However, in preparing to answer your question, I am seeing these compounds have different effects on NO generation in response to IFN-gamma. I'm going to see how else they differ with respect to immune modulation and post my findings.

Any particular reason for the switch from zinc picolinate to citrate?

Nothing legitimately scientific, I just liked the idea that zinc citrate is the form of zinc provided in breast milk.

#311 FunkOdyssey

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Posted 28 July 2010 - 08:46 PM

Now these aren't looking at the same model (one is in rat glial cell cultures, the other macrophages) but the effects seem to be very different. Grape seed extract stimulated basal iNOS production of NO, and did not suppress IFN-gamma provoked NO production whereas Pycnogenol decreased IFN-gamma stimulated NO production by several mechanisms.

Nitric Oxide. 2001 Apr;5(2):137-49.
Protection of primary glial cells by grape seed proanthocyanidin extract against nitrosative/oxidative stress.

Roychowdhury S, Wolf G, Keilhoff G, Bagchi D, Horn T.

Otto-von-Guericke University, Institute for Medical Neurobiology, Leipziger Strasse 44, Magdeburg, D-39120, Germany.
Abstract

Previous studies showed that proanthocyanidins provide potent protection against oxidative stress. Here we investigate the effects of grape seed proanthocyanidin extract (GSPE) as a novel natural antioxidant on the generation and fate of nitric oxide (NO) in rat primary glial cell cultures. GSPE treatment (50 mg/L) increased NO production (measured by NO(2-) assay) by stimulation of the inducible isoform of NOS. However, GSPE failed to affect the LPS/IFN-gamma-induced NO production or iNOS expression. Similar responses were found in the murine macrophage cell line RAW264.7. GSPE did not show any effect on dihydrodichlorofluorescein fluorescence (ROS marker with high sensitivity toward peroxynitrite) either in control or in LPS/IFN-gamma-induced glial cultures even in the presence of a superoxide generator (PMA). GSPE treatment alone had no effect on the basal glutathione (GSH) status in glial cultures. Whereas the microglial GSH level declined sharply after LPS/IFN-gamma treatment, the endogenous GSH pool was protected when such cultures were treated additionally with GSPE, although NO levels did not change. Glial cultures pretreated with GSPE showed higher tolerance toward application of hydrogen peroxide (H(2)O(2)) and tert-butylhydroperoxide. Furthermore, GSPE-pretreated glial cultures showed improved viability after H(2)O(2)-induced oxidative stress demonstrated by reduction in lactate dehydrogenase release or propidium iodide staining. We showed that, in addition to its antioxidative property, GSPE enhances low-level production of intracellular NO in primary rat astroglial cultures. Furthermore, GSPE pretreatment protects the microglial GSH pool during high output NO production and results in an elevation of the H(2)O(2) tolerance in astroglial cells. Copyright 2001 Academic Press.

PMID: 11292363

Free Radic Biol Med. 1998 May;24(7-8):1120-9.
Procyanidins extracted from Pinus maritima (Pycnogenol): scavengers of free radical species and modulators of nitrogen monoxide metabolism in activated murine RAW 264.7 macrophages.

Virgili F, Kobuchi H, Packer L.

Department of Molecular and Cell Biology, University of California, Berkeley 94720-3200, USA.
Abstract

Nitrogen monoxide (NO) has diverse physiological roles and also contributes to the immune defense against viruses, bacteria, and other parasites. However, excess production of NO is associated with various diseases such arthritis, diabetes, stroke, septic shock, autoimmune, chronic inflammatory diseases, and atheriosclerosis. Cells respond to activating or depressing stimuli by enhancing or inhibiting the expression of the enzymatic machinery that produce NO. Thus, maintenance of a tight regulation of NO production is important for human health. Phytochemicals have been traditionally utilized in ways to treat a family of pathologies that have in common the disregulation of NO production. Here we report the scavenging activity of Pycnogenol (the polyphenols containing extract of the bark from Pinus maritima) against reactive oxygen and nitrogen species, and its effects on NO metabolism in the murine macrophages cell line RAW 264.7. Macrophages were activated by the bacterial wall components lipopolysaccharide (LPS) and interferon (IFN-gamma), which induces the expression of large amounts of the enzyme nitric oxide synthase (iNOS). Preincubation of cells with physiological concentrations of Pycnogenol significantly decreased NO generation. It was found that this effect was due to the combination of several different biological activities, i.e., its ROS and NO scavenging activity, inhibition of iNOS activity, and inhibition of iNOS-mRNA expression. These data begin to provide the basis for the conceptual understanding of the biological activity of Pycnogenol and possibly other polyphenolic compounds as therapeutic agents in various human disorders.

PMID: 9626566


Here's the study I assume you were referring to about GSE's pro Th1 properties:

Clin Diagn Lab Immunol. 2002 Mar;9(2):470-6.
Grape seed extract activates Th1 cells in vitro.

Nair N, Mahajan S, Chawda R, Kandaswami C, Shanahan TC, Schwartz SA.

Division of Allergy, Immunology, and Rheumatology, Department of Medicine, State University of New York at Buffalo and Kaleida Health, 14203, USA.
Abstract

Although flavonoids manifest a diverse range of biological activities, including antitumor and antiviral effects, the molecular mechanisms underlying these activities await elucidation. We hypothesize that the flavonoid constituents of a proprietary grape seed extract (GSE) that contains procyandins exert significant antiviral and antitumor effects, by inducing production of the Th1-derived cytokine gamma interferon (IFN-gamma) by peripheral blood mononuclear cells) from healthy donors. Our results show that GSE significantly induced the transcription of IFN-gamma mRNA as demonstrated by reverse transcription-PCR but had no effect on the Th2-derived cytokine interleukin-6. The enhancing effect of GSE on IFN-gamma expression was further supported by a concomitant increase in the number of cells with intracytoplasmic IFN-gamma as well as the synthesis and secretion of IFN-gamma. Our results demonstrate that the potentially beneficial immunostimulatory effects of GSE may be mediated through the induction of IFN-gamma.

PMID: 11874895


However in this study pycnogenol also demonstrates Th1-biased modulation via stimulation of IL-2 and suppression of IL-6 and IL-10:

Life Sci. 1996;58(5):PL 87-96.
Immunomodulation by pycnogenol in retrovirus-infected or ethanol-fed mice.

Cheshier JE, Ardestani-Kaboudanian S, Liang B, Araghiniknam M, Chung S, Lane L, Castro A, Watson RR.

Department of Family and Community Medicine, University of Arizona, Tucson 85724, USA.
Abstract

Pycnogenol is a commercial mixture of bioflavonoids that exhibits antioxidative activity. The effects of dietary pycnogenol on immune dysfunction in normal mice as well as those fed ethanol or infected with the LP-BM5 murine retrovirus were determined. The ethanol consumption and retrovirus infection caused abnormalities in the function and/or structure of a broad array of cells involved in humoral and cellular immunity. Pycnogenol enhanced in vitro IL-2 production by mitogen-stimulated splenocytes if its production was suppressed in ethanol-fed or retrovirus-infected mice. Mitogenesis of splenocytes did not show a significant change in mice treated with pycnogenol. It reduced the elevated levels of interleukin-6 produced in vitro by cells from retrovirus infected mice and IL-10 secreted by spleen cells from mice consuming ethanol. Natural killer cell cytotoxicity was increased with pycnogenol treatment.

PMID: 8594302


There are no studies showing how pycnogenol affects IFN-gamma production. Are there large enough differences between PYC and GSE that pycnogenol may affect this differently? I don't know.

#312 nameless

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Posted 28 July 2010 - 09:32 PM

There are no studies showing how pycnogenol affects IFN-gamma production. Are there large enough differences between PYC and GSE that pycnogenol may affect this differently? I don't know.


Yeah, that was the grapeseed/Th1 study I had looked at. As for the differences between pycnogenol/grapeseed there, not sure either.

But grapeseed is cheap enough that it doesn't necessarily have to be one or the other type of thing with pycnogenol. Just curious why you stopped taking grapeseed, unless you just figured pycnogenol would duplicate its effects anyway? Only downside with pycnogenol I've found (which I use too), is the price.

And are you still drinking green tea? Wouldn't green tea push Th2? I've seen that mentioned in some articles, but never looked for studies on it.

#313 FunkOdyssey

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Posted 28 July 2010 - 09:38 PM

There are no studies showing how pycnogenol affects IFN-gamma production. Are there large enough differences between PYC and GSE that pycnogenol may affect this differently? I don't know.


Yeah, that was the grapeseed/Th1 study I had looked at. As for the differences between pycnogenol/grapeseed there, not sure either.

But grapeseed is cheap enough that it doesn't necessarily have to be one or the other type of thing with pycnogenol. Just curious why you stopped taking grapeseed, unless you just figured pycnogenol would duplicate its effects anyway? Only downside with pycnogenol I've found (which I use too), is the price.

And are you still drinking green tea? Wouldn't green tea push Th2? I've seen that mentioned in some articles, but never looked for studies on it.


No more green tea. I figured pycnogenol and grape seed together would be redundant and possibly excessive, some people get spacey/foggy on higher doses of these compounds and I think I'm one of those people. Ideally I would determine which one is "better" for my circumstances and take only that.

Edited by FunkOdyssey, 28 July 2010 - 09:39 PM.


#314 Logan

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Posted 30 July 2010 - 06:07 AM

There are no studies showing how pycnogenol affects IFN-gamma production. Are there large enough differences between PYC and GSE that pycnogenol may affect this differently? I don't know.


Yeah, that was the grapeseed/Th1 study I had looked at. As for the differences between pycnogenol/grapeseed there, not sure either.

But grapeseed is cheap enough that it doesn't necessarily have to be one or the other type of thing with pycnogenol. Just curious why you stopped taking grapeseed, unless you just figured pycnogenol would duplicate its effects anyway? Only downside with pycnogenol I've found (which I use too), is the price.

And are you still drinking green tea? Wouldn't green tea push Th2? I've seen that mentioned in some articles, but never looked for studies on it.


No more green tea. I figured pycnogenol and grape seed together would be redundant and possibly excessive, some people get spacey/foggy on higher doses of these compounds and I think I'm one of those people. Ideally I would determine which one is "better" for my circumstances and take only that.


Why no more green tea? Is it a result of your focus on treating Lyme and it's symptoms through your regimen?

Edited by morganator, 30 July 2010 - 06:07 AM.


#315 PhDStudent

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Posted 30 July 2010 - 07:40 AM

Funk - what antibiotics have you been using? I only saw tetracycline and doxycycline. mostly parental or IM or just oral?

#316 FunkOdyssey

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Posted 30 July 2010 - 02:21 PM

Why no more green tea? Is it a result of your focus on treating Lyme and it's symptoms through your regimen?

The primary reason is because it seems to cause me anxiety independently of its caffeine content. Some other people have noticed the same thing on M&M. I'm also not a fan of caffeine in general anymore because its immunosuppressive and no longer does anything subjectively useful after several days at the same dose.

Funk - what antibiotics have you been using? I only saw tetracycline and doxycycline. mostly parental or IM or just oral?

Right now I'm on cefuroxime as indicated in the original post on the first page. I have used a wide variety of antibiotics including: tetracycline, doxycycline, minocycline, azithromycin, clarithromycin, roxithromycin, tinidazole, sulfamethoxazole/trimethoprim, atovaquone, amoxicillin, cefuroxime, and penicillin G benzathine IM (bicillin). I think I've responded best to tetracyclines and bicillin.

I wasn't able to take bicillin long-term because my ex who was administering the shots had some weird panic reaction to giving ME the shot. I might try it again though and see if I can do them myself.

#317 FunkOdyssey

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Posted 04 August 2010 - 08:59 PM

I decided to do this my own way again. I confirmed last month that I don't have babesia, which was the only thing I needed a doctor to treat (access to Mepron was the main concern).

This is what I'll be running for the next six months, a protocol of my own design with drugs supplied by my friends overseas:

A-
  • Amoxicillin 2g TID
  • Probenecid 500mg TID
  • Tinidazole 500mg TID
B-
  • Doxycycline 200-300mg BID
  • Rifampicin 600-900mg QD or Ciprofloxacin 250-500mg BID

Six weeks A. Six weeks B. Repeat. CBC/metabolic panel every two weeks.

I've made additional changes in recognition of my new understanding of what makes a human immune system effectively kill lyme. Ashwagandha, reishi, and high dose grape seed extract have been added.

Tianeptine totally backfired after the fourth day, and by the eighth day I'd had it. Switched to SJW and haven't looked back. This stuff is awesome -- mood and energy are much improved. No negative libido effects. Only side effect was some mild sleep onset insomnia which I think is fading each night.

Taking modafinil as needed for ADD. Only stimulant that improves immune function. Works well.

Added
  • Amoxicillin - high doses well tolerated, cheap, excellent bioavailbility and renally excreted, easy on gut flora.
  • Probenecid - increase Cmax, half-life and AUC of amoxicillin.
  • Tinidazole - well tolerated cyst killer.
  • Ashwagandha - stimulates Th1 immunity, improves sleep quality, libido, neuroprotective, etc.
  • Wood-grown, hot-water extracted Reishi - stimulates Th1 immunity.
  • Grape Seed Extract - stimulates Th1 immunity, neuroprotective.
  • St. John's Wort (WS 5570 / Perika) - antidepressant, neuroprotective
  • Modafinil - as needed for ADD, uniquely immune-boosting stimulant.

Removed
  • Tianeptine - made me feel like crap.
  • Pycnogenol - replaced with GSE.
  • Cefuroxime - too low a dose, too expensive, poor bioavailability, hard on gut flora.

I feel really good about this particular incarnation of the regimen.

#318 Animal

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Posted 05 August 2010 - 02:51 PM

Could you please elaborate on your experience with Tianeptine.

#319 FunkOdyssey

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Posted 05 August 2010 - 02:57 PM

Could you please elaborate on your experience with Tianeptine.


It acutely improved mood, for sure. And then, my mood remained elevated for the first few days. It also boosted libido the entire time I was on it. However on days 4-8 my mood and energy levels tanked. My mood was very flat, grumpy, and I had no energy to do anything, I could barely complete my tasks at work. I wanted to give it two weeks but it showed no signs of improvement by day 8 and I couldn't stand it anymore.

On M&M ex dubio has a pretty well developed and researched theory about how/why tianeptine reduces cortisol levels and its possible that this was involved. I'm getting the opposite effects, sustained improvement in mood and energy from SJW which increases cortisol levels. Its possible that tianeptine would have somehow turned around if I gave it more time but I didn't have the patience to find out.

Edited by FunkOdyssey, 05 August 2010 - 03:00 PM.


#320 KimberCT

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Posted 06 August 2010 - 05:00 PM

Funk, where are you getting your Thyroid-S? The pharmacies I frequent only carry Armour or Nature.

I think I remember you posting that it was just as good but much much cheaper.



#321 FunkOdyssey

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Posted 06 August 2010 - 05:24 PM

Funk, where are you getting your Thyroid-S? The pharmacies I frequent only carry Armour or Nature.

I think I remember you posting that it was just as good but much much cheaper.


That's because you're shopping in India I bet... gotta go further east my friend!

http://www.edrugnet.com/

Edited by FunkOdyssey, 06 August 2010 - 05:25 PM.


#322 Logan

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Posted 06 August 2010 - 05:51 PM

That's awesome you are experiencing success with Perika. So were the effects from Perika immediate? I know the effects of SJW can be immediate but I also know that full effects are not usually felt for a month or two. Are you just taking it one time in the morning or in the morning and evening?

#323 KimberCT

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Posted 06 August 2010 - 06:37 PM

Funk, where are you getting your Thyroid-S? The pharmacies I frequent only carry Armour or Nature.

I think I remember you posting that it was just as good but much much cheaper.


That's because you're shopping in India I bet... gotta go further east my friend!

http://www.edrugnet.com/

Thanks, great price! Looks like this place is right out of Bangkok.  You're right India followed by Hong Kong are the usual pharmacies I use.



#324 FunkOdyssey

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Posted 06 August 2010 - 07:19 PM

That's awesome you are experiencing success with Perika. So were the effects from Perika immediate? I know the effects of SJW can be immediate but I also know that full effects are not usually felt for a month or two. Are you just taking it one time in the morning or in the morning and evening?


Yes the effects were immediate. I noticed I've been in a REALLY great mood today, this is day 7 I beleieve. However, I am going to the black eyed peas concert tonight with a couple friends, and its also the second date with a very nice young woman I met last night (super freak) so I don't know if I can pin it all on the SJW. :~

Check out the timing in the original post, first page.

Edited by FunkOdyssey, 06 August 2010 - 07:19 PM.


#325 Logan

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Posted 06 August 2010 - 09:12 PM

That's awesome you are experiencing success with Perika. So were the effects from Perika immediate? I know the effects of SJW can be immediate but I also know that full effects are not usually felt for a month or two. Are you just taking it one time in the morning or in the morning and evening?


Yes the effects were immediate. I noticed I've been in a REALLY great mood today, this is day 7 I beleieve. However, I am going to the black eyed peas concert tonight with a couple friends, and its also the second date with a very nice young woman I met last night (super freak) so I don't know if I can pin it all on the SJW. :~

Check out the timing in the original post, first page.


Nice..have fun at the concert and the second date. I'm looking forward to seeing how you feel on Perika during the next few weeks. Maybe this it finally the fairly side effect free substance you have been looking for and can stay on for a long while.

Just curious, why did you choose Perika over Kira or New Chapter's Serofin?

Edited by morganator, 06 August 2010 - 09:22 PM.


#326 triplecrown

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Posted 07 August 2010 - 08:48 PM

[*]Modafinil - as needed for ADD, uniquely immune-boosting stimulant.

Could you supply evidence that Modafinil boost immune function? I have always been under the impression that stimulants tended to hamper immune function.

Edited by triplecrown, 07 August 2010 - 08:49 PM.


#327 triplecrown

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Posted 07 August 2010 - 08:53 PM

Taking modafinil as needed for ADD. Only stimulant that improves immune function. Works well.



Could you supply evidence that Modafinil boosts immune function? I have always been under the impression that stimulants tended to hampered immune function.

Edited by triplecrown, 07 August 2010 - 08:56 PM.


#328 FunkOdyssey

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Posted 08 August 2010 - 04:03 AM




Taking modafinil as needed for ADD. Only stimulant that improves immune function. Works well.



Could you supply evidence that Modafinil boosts immune function? I have always been under the impression that stimulants tended to hampered immune function.


Stimulants do tend to hamper immune function, in fact all of them do, except possibly modafinil. Lower infection rate than placebo:

J Clin Sleep Med. 2007 Oct 15;3(6):595-602.
Evaluation of the safety of modafinil for treatment of excessive sleepiness.

Roth T, Schwartz JR, Hirshkowitz M, Erman MK, Dayno JM, Arora S.

Henry Ford Sleep Disorders Center, Detroit, MI 48202, USA. TRoth1@hfhs.org
Abstract

STUDY OBJECTIVES: Modafinil is a wake-promoting agent shown to improve wakefulness in patients with excessive sleepiness (hypersomnolence) associated with shift work sleep disorder, obstructive sleep apnea, or narcolepsy. Safety and tolerability data from 6 randomized, double-blind, placebo-controlled studies were combined to evaluate modafinil across these different patient populations. METHODS: One thousand five hundred twenty-nine outpatients received modafinil 200, 300, or 400 mg or placebo once daily for up to 12 weeks. Assessments included recording of adverse events and effects of modafinil on blood pressure/heart rate, electrocardiogram intervals, polysomnography, and clinical laboratory parameters. RESULTS: Two hundred seventy-three patients with shift work sleep disorder, 292 with obstructive sleep apnea, and 369 with narcolepsy received modafinil; 567 received placebo. Modafinil was well tolerated versus placebo, with headache (34% vs 23%, respectively), nausea (11% vs 3%), and infection (10% vs 12%) the most common adverse events. Adverse events were similar across all patient groups. Twenty-seven serious adverse events were reported (modafinil, n = 18; placebo, n = 9). In modafinil-treated patients, clinically significant increases in diastolic or systolic blood pressure were infrequent (n = 9 and n = 1, respectively, < 1% of patients). In the studies, 1 patient in the modafinil group and 1 in the placebo group had a clinically significant increase in heart rate. New clinically meaningful electrocardiogram abnormalities were rare with modafinil (n = 2) and placebo (n = 4). Clinically significant abnormalities in mean laboratory parameters were observed in fewer than 1% of modafinil-treated patients at final visit. Modafinil did not affect sleep architecture in any patient population according to polysomnography. CONCLUSIONS: Modafinil is well tolerated in the treatment of excessive sleepiness associated with disorders of sleep and wakefulness and does not affect cardiovascular or sleep parameters.

PMID: 17993041


Reduces viral load in HIV:

J Clin Psychiatry. 2010 Jun;71(6):707-15. Epub 2010 May 4.
Modafinil treatment for fatigue in HIV/AIDS: a randomized placebo-controlled study.

Rabkin JG, McElhiney MC, Rabkin R, McGrath PJ.

Department of Psychiatry, College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York, NY 10032, USA. jgr1@columbia.edu
Abstract

OBJECTIVE: To evaluate the efficacy and safety of modafinil in the treatment of fatigue in patients with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and to assess effect on depressive symptoms. METHOD: Patients who were HIV+ and had clinically significant fatigue (according to the Fatigue Severity Scale [FSS]) were included in a 4-week randomized, placebo-controlled, double-blind trial. This was followed by an additional 8 weeks of open-label treatment for modafinil responders and 12 weeks for placebo nonresponders. The primary outcome measure for fatigue and depression was the Clinical Global Impressions-Improvement scale, supplemented by the FSS, Hamilton Depression Rating Scale, and Beck Depression Inventory. Safety was assessed with assays of CD4 cell count and HIV ribonucleic acid (RNA) viral load. Visits were weekly for 4 weeks, then biweekly, with a follow-up visit at 6 months. Maximum trial dose of modafinil was 200 mg/d. Data for this study were collected between December 2004 and December 2008. RESULTS: 115 patients were randomly assigned. In intention-to-treat analyses, fatigue response rate to modafinil was 73% and to placebo, 28%. Attrition was 9%. Modafinil did not have an effect on mood alone in the absence of improved energy. At week 4, CD4 cell counts did not change significantly; HIV RNA viral load showed a trend decline for patients taking modafinil but not for those taking placebo. At 6 months, those still taking modafinil had more energy and fewer depressive symptoms than patients who were not taking modafinil, and only those still taking modafinil showed a significant decline from baseline in their HIV RNA viral load. CONCLUSIONS: Modafinil appears to be effective and well tolerated in treating fatigue in HIV+ patients. Consideration of its use is warranted considering the high prevalence of fatigue in the HIV community, its minimal side effects, and overall patient acceptance. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00118378. 2010 Physicians Postgraduate Press, Inc.

PMID: 20492840


Edited by FunkOdyssey, 08 August 2010 - 04:04 AM.


#329 notlupus

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Posted 10 August 2010 - 12:58 AM

The problem I had with provigil is that it interacts with so many antibiotics that it makes me worse in the long run.

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#330 Thorsten3

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Posted 12 August 2010 - 08:28 PM

Interested by your success with Perika Funk. I ordered some about a month ago and I'm still waiting for it to arrive. Not sure if i'll get around to trying it in the near future but I'd like to trial it at some point. I have tried SJW before and I liked it (made me feel happy which I found kind of odd at the time - not in a superficial way that pharms tend to do - but like - really happy) but it also started making me quite sedated and irritable after a while. I lowered the dose but then lost interest for some reason (can't remember why, think I moved onto something else). I was making a bulk order at Vita.net and decided to get some Perika as well seeing as though it is seen as the grade A of SJW supplements (well along with Kira). So I'd like to trial it at some point.

The only thing that would worry me is the way everyone goes on about how it interacts with other stuff that you are taking. I know for sure I didn't enjoy mixing it with piracetam. I also take NAC, Reishi, Idebenone, ALA, Bacopa, Fish oil, LEF multivitamin and agomelatine.
If I did try it I would definitely need to drop piracetam, agomelatine and maybe bacopa (due to the sedation). So if I did try it it would need to be the 'main player' in my stack.
I have a whole stack of other stuff that it could also potentially interact with though. I suppose if I did eventually try it it would come down to trial and error.

I don't really know what enzymes SJW plays around with or whether it would interact with the stuff I currently take (above).

Did you have any reservations or issues with this? considering the things that you also take?

Oh actually i just had a thought... Do you find provigil fuses well with SJW? The actual sedation that I found unbearable could be completely offset by the wakefullness of modifinil. I remember you recommending that suggestion to me when I mentioned day time tiredness on agomelatine (which I still get from time to time by the way).
Modifinil does sound like such an interesting agent - problem being it's so damm expensive. I really can't justify its huge price at the moment.

Edited by Thorsten, 12 August 2010 - 08:35 PM.





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