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Retinitis Pigmentosa supplementation

retinitis pigmentosa retinitis retina supplementation

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#1 Xenthide

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Posted 09 August 2013 - 11:59 PM


I strongly suspect that in the next few days I will be diagnosed with Retinitis Pigmentosa, an apparently hereditary degenerative disease of the retina which in most cases eventually leads to blindness over a timescale which is seemingly widely variable and impossible to predict (the diagnosis is not quite confirmed, but the optician sounded like he knew what he was talking about and it seems to me the only thing left is to rule out some other highly unlikely possibilities - honestly what I have read about it since then seems to match my own experience a little too well to be much else - I have no family history but apparently 50% of such diagnoses happen without family history anyway). Obviously this situation is not ideal for a 25 year old male in otherwise fairly good health but such is life. :)

I am immediately going to start supplementing daily with:

15000 IU Vitamin A Palmitate
20mg Lutein
0.8mg Zeathanaxin
1000mg Omega 3 including 220mg DHA

There seems to be evidence that this will go some way towards delaying the progression of this condition as much as possible given current understanding of it, although again, exactly how much is difficult to predict. Knowing exactly the results I will get out of this are less important to me than knowing, given current available medical and scientific knowledge, I am doing as much as I reasonably can.


So my questions are ideally towards those with some kind of medical and scientific background, but please anyone feel free to respond if you feel you have something useful to add.


1) Besides the substances above, should I consider anything else?


2) Could the racetam nootropics have any effect on retinal degeneration?

I ask for 2 reasons (besides that I am probably going to take them sporadically anyway for nootropic benefits). Firstly, they are all widely considered to be neuroprotective, so I am wondering if this neuroprotection extends to retinal cells as well (are photoreceptor cells neurons?). People often report increased colour perception (an effect which various studies seem to confirm to be a measurable effect and not purely subjective), and Coluracetam specifically seems to potentially have some beneficial effects on retinal and optic nerve damage (although I have been unable to find any further information on this).


2) Have there been any studies done on the Russian drug Epithalamin ("Epitalon") in humans?

I ask this because the last study I could find that reported beneficial effects in rats with degenerative retinal diseases is from 2002, which doesn't seem to bode too well for this line of research. In any case this may be something of a moot question given that the only source I could locate is probably more expensive than I am willing to go for something that may be completely untested in humans and thus may have no real benefits at all.


I will add that I am obviously not expecting miracles. Thank you in advance for reading and for any responses.

#2 Adaptogen

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Posted 10 August 2013 - 12:23 AM

That is very unfortunate, I am sorry to hear of your declining vision. sadly i do not know much in regards to supplements for treating vision problems..

However, one of my favorite authors, Jim Knipfel, suffers from retinitis pigmentosa, and has written fairly extensively on his experiences in life and managing with the disease... I highly recommend his autobiography, "Slackjaw."
http://www.ebay.com/...=item43be1a821d

additionally, here is an online of his column when writing for the new york press: http://www.missioncr...kjaw/index.html

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#3 tham

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Posted 19 August 2013 - 11:31 AM

Start now :

Selegiline, 1 mg a day

1 drop = 1 mg.

http://www.antiaging...com/50-deprenyl


Minocycline, 100 mg a day.




I had alerted my friend to this study years ago, who has at least one brother
and sister with retinitis pigmentosa. They didn't seem to have taken much
interest in it though.


Etiology, pathogenesis, and experimental treatment of retinitis pigmentosa.


'' .... desmethyldeprenyl exerts antiapoptotic activities in a variety of neurodegenerative
disorders ..... involves the overexpression of the anti-apoptotic bcl-2 gene .....
underexpression of the pro-apoptotic bax gene. ''

'' Antiapoptotic effects can also be generated by the parent compound, deprenyl,
when this is used daily in low concentrations of 1-2 mg/100 kg body weight. ''

http://www.ncbi.nlm....pubmed/10859693



Both retinitis pigmentosa and macular degeneration, which are classed
under retinal dystrophies, appear to be the result of protein misfolding.


Contact Werner or Annette Baumgartner of the Ianus Foundation, who
has done the research and developed this protocol of selegiline and minocycline.


This just came out.

Rationale for an experimental treatment of retinitis pigmentosa:
140-Month test of hypothesis with one patient


'' Numerous mutations in over 100 rod genes are the well-established cause of
apoptotic death of these cells and development of night blindness in retinitis
pigmentosa (RP).Cone death is either concomitant or follows rod death with
resultant loss of criticalperipheral and central day vision. As cones are generally
not encumbered by genetic mutations, the causes of their death and its prevention
are the central problems of RPresearch. ''

'' It is proposed that cones, which are outnumbered 20:1 by rods, undergo
apoptosis as a consequence of neurotrophic factor deficiencies and oxidative
stresses accompanying massive rod death: increased retinal oxygen tension;
leakage oflipid-peroxidation catalysts from disrupted membranes; reactive
oxygen species from active/hyperactive microglia ingesting rod-apoptotic bodies. ''

'' Accordingly we developed and tested a treatment regimen with a range of
antioxidants in combination with the off-label use of deprenyl (1mg/day), a
safe antiapoptotic agent, which also upregulates eight neurotrophic factors.

Since deprenyl inhibits only one of four mitochondrial apoptotic pathways,
we added the antibiotic minocycline (100mg/day) to our protocol at month 76.

Minocycline complements deprenyl’s therapeutic properties: it inhibits
all four apoptotic pathways
; inhibits apoptosis-initiating proteins; as phenol
exerts powerful antioxidant properties; upregulates three antioxidant enzymes;
downregulates oxidative/inflammatory microglia activities. Its safe long-term
use
for acne and rheumatoid arthritis received FDA approval; it passes the
blood/brain and blood/retinal barriers readily
; and because of its rapid and
complete absorption causes no intestinal disturbances. The National Eye
Institute has initiated in 2010 and 2011 clinical trials with minocycline
(200mg/day) for diabetic macular edema and retinal branch vein occlusion. ''


http://www.medical-h...0360-5/abstract



L-deprenyl, blocking apoptosis and regulating gene expression in
cultured retinal neurons.


'' .... l-deprenyl blocks apoptosis induced by hypoxia as well as by growth factor
withdrawal and regulates the expression of apoptosis-related genes. ''

https://www.research...ation/223370078


Protective effects of selegiline and desmethylselegiline against
N-methyl-D-aspartate-induced rat retinal damage.


http://www.ncbi.nlm....pubmed/12498910



L-deprenyl protects injured retinal precursor cells in vitro.

'' L-deprenyl may be worthy of further investigation as a neuroprotective
agent to treat chronic open-angle glaucoma. ''

http://www.ncbi.nlm..../pubmed/9326730



(-)-Deprenyl increases the survival of rat retinal ganglion cells after optic nerve crush.

http://www.ncbi.nlm....pubmed/7768105/


This German study had negative findings though.

(-)-Deprenyl fails to promote axonal regeneration of retinal ganglion cells
in vitro and in vivo.


http://www.ncbi.nlm....pubmed/12037575


Chaperones.

Protein aggregation in retinal cells and approaches to cell protection.

'' ..... chaperones and selegiline may be considered promising candidates for the
protection of ocular cells from the accumulation of misfolded and aggregated proteins.

http://www.ncbi.nlm....pubmed/16392036



Unfolding retinal dystrophies: a role for molecular chaperones ?

http://www.ncbi.nlm....pubmed/1153033

Edited by tham, 19 August 2013 - 12:22 PM.

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#4 Xenthide

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Posted 19 August 2013 - 09:38 PM

Thank you both for your responses.

Adaptogen, I may well check out that book.

tham, thank you for such a detailed response - that was exactly the sort of information I was looking for.

#5 Xenthide

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Posted 20 August 2013 - 02:50 PM

Although that said, although Selegiline seems to be both cheap and safe, are there any possible complications with taking an antibiotic (Minocycline) long term?


Besides that unfortunately it's looking like Minocycline is also a little expensive, at least from the sources I have found so far, although I guess this is not a prohibitive issue given the potential benefits.

Edited by Xenthide, 20 August 2013 - 02:50 PM.


#6 tham

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Posted 20 August 2013 - 06:45 PM

http://www.unitedpha...ing=minocycline


It appears minocycline can cause autoimmune hepatitis and
intracranial hypertension, although they are relatively rare.
The tetracyclines are known to cause these adverse effects.



The headache of teenage acne

'' Although the incidence of IH with minocycline use is not known, it is
presumably low given the widespread use of the antibiotic. This suggests
that other risk factors and possibly a genetic predisposition may contribute
to the development of IH in susceptible people taking minocycline. ''

http://www.cmaj.ca/c...70/12/1788.long


You could go for periodic liver function tests to monitor elevation of
your liver enzmyes.


Minocycline-induced autoimmune hepatitis

http://www.ncbi.nlm....ubmed/23328022/


It can also cause lupus and vasculitis, but again rare.



You could cycle it, say one two weeks on, one week off.

Why don't you contact the above researchers, since their
info has already been given to you ?


A safer alternative is doxycycline, if you can tolerate its tendency
to cause gastritis.

Doxycycline was used to increase Gpx4 here.

Increased Expression of Glutathione Peroxidase 4 Strongly
Protects Retina from Oxidative Damage


'' These data suggest that gene therapy approaches to augment the
activity of Gpx4 in the retina and RPE should be considered in patients
with retinitis pigmentosa or age-related macular degeneration. ''

http://www.ncbi.nlm....les/PMC2787833/

#7 tham

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Posted 20 August 2013 - 11:58 PM

Natural therapies for ocular disorders, part one: diseases of the retina.

'' Retinitis pigmentosa resembles the retinal damage seen in taurine-deficient cats. While patients with retinitis pigmentosa do not appear to be deficient in taurine, they appear to have faulty cellular uptake of this important amino acid. ''

http://www.ncbi.nlm....ubmed/10559549/


Suppressive effect of astaxanthin on retinal injury induced by elevated intraocular pressure.

http://www.ncbi.nlm....ubmed/20457203/


Astaxanthin, a dietary carotenoid, protects retinal cells against oxidative stress in-vitro and in mice in-vivo.

http://www.ncbi.nlm....pubmed/18812030



Oxidative stress modulation using polyphenol-rich blueberries: application on a human retinal cell model

http://www.ncbi.nlm....pubmed/19107073



Prophylactic neuroprotection by blueberry-enriched diet in a rat model of light-induced retinopathy.

http://www.ncbi.nlm....pubmed/22832077


Blueberry anthocyanins: protection against ageing and light-induced damage in retinal pigment epithelial cells.

http://www.ncbi.nlm....pubmed/22018225



Bilberries potentially alleviate stress-related retinal gene expression induced by a high-fat diet in mice

http://www.ncbi.nlm....pubmed/22993483


Bilberry and its main constituents have neuroprotective effects against retinal neuronal damage in vitro and in vivo.

http://www.ncbi.nlm....ubmed/19415665/


Two-year randomized, placebo-controlled study of black currant anthocyanins on visual field in glaucoma.

http://www.ncbi.nlm....pubmed/22377796


Purple rice (Oryza sativa L.) extract and its constituents inhibit VEGF-induced angiogenesis.

http://www.ncbi.nlm....retina cyanidin


Purple rice extract and its constituents suppress endoplasmic reticulum stress-induced retinal damage in vitro and in vivo.


http://www.ncbi.nlm....retina cyanidin



Purple sweet potatoes, which are a very complex anthocyanin profile, in addition
to a high content of peonidin and cyanidin, would also have simialr benefits.

Purple Sweet Potato Color Ameliorates Cognition Deficits and Attenuates Oxidative
Damage and Inflammation in Aging Mouse Brain Induced by D-Galactose


http://www.hindawi.c...ri/2009/564737/

#8 niner

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Posted 21 August 2013 - 02:56 AM

This site talks about an ocular med that's already approved for Glaucoma. It's called Rescula, and is presumably available by prescription, although it's hard to find on the web. In a phase II study, the response of RP patients was quite impressive.

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#9 tham

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Posted 21 August 2013 - 01:21 PM

It's classed as a docasonoid, different from the PGF2 alpha analogs commonly
given for glaucoma - latanoprost, bimatoprost, travoprost.

Unoprostone does look impressive and looks like the first agent, topical
or otherwise, to have any significant effect on RP, moreover with a high
safety profile.

Improvement of central retinal sensitivity six months after topical
isopropyl unoprostone in patients with retinitis pigmentosa.


http://www.ijo.in/ar...9;aulast=Tawada



Unoprostone reduces oxidative stress- and light-induced retinal cell
death, and phagocytotic dysfunction, by activating BK channels.


'' It is well known that unoprostone’s mechanism of action involves activation
of BK channels. Previous studies have indicated that resveratrol directly
stimulated BK channel activity in vascular endothelial cells], and
significantly reduced oxidative stress-induced inhibition of phagocytosis in
human RPE cells, which was also linked to activation of BK channels. ''

http://www.molvis.org/molvis/v17/a382/


Resveratrol and large-conductance calcium-activated potassium
channels in the protection of human retinal pigment epithelial cells.


http://www.ncbi.nlm....pubmed/19049310



Very expensive. $ 129 for a small bottle.

http://www.planetdru...e-Drops/101883/



Rescula to the Rescue?
An old glaucoma medication stages a comeback in the United States.


http://www.revoptom..../true/?skinsrc=[l]skins/ro2009/pageprint&containersrc=[l]containers/ro2009/simple





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