Hormone Therapy - Preliminary Report

[mrsD]

That 85% comes up over and over! It is a mathematical % and
not a comparison %.

It has to due with area under the curve, in logarithmic numbers.

It does NOT mean 85% of the parent compound per dose.

It is on the FDA website.
http://www.fda.gov/Drugs/Development.../ucm079068.htm

The primary concern from the regulatory point of view is the protection of the patient against approval of products that are not bioequivalent. The current practice of carrying out two one-sided tests at the 0.05 level of significance ensures that there is no more than a 5% chance that a generic product that is not truly equivalent to the reference will be approved.

It is explained there, for those who understand math.

But this 85% (mostly in relation to opiates), is a misquote of a concept not well understood by laymen, or doctors.
Scroll down to "statistical criteria of bioequivalence"

[Dr. Smith]

Thanks, that'll do. Happen to have a couple of statistical mathematicians in the hizzy today...

Doc

[Dr. Smith]

Originally Posted by Dr. Smith

After reviewing Dr. Tennant's articles again, doing more homework online, and discussions with family & other patients, I've decided to add DHEA to my regimen. I began today. Again, I'm taking it slowly, titrating to find a good level, and will be taking regular breaks every week.

I've been off the pantothenic acid (B5) for a few weeks due to a foul-up in re-ordering. I've noticed a slight difference in how I feel in general (not as good as I did) and perhaps more significant, I've had a flare of cystic acne, which hasn't happened since I began the B5. If for nothing else, it's worth taking just for that.

I have now been taking DHEA (50 mg./day, divided into two 25 mg. doses, 4-5 contiguous days/week) since the middle of February. Earlier this week, my wife commented, for the first time since my chronic pain began, "I've got my old [Doc] back!" and that's what she plans to tell our doctor next time we see him. While I've noticed a vast (and I don't use that term cavalierly) improvement in how I feel, she has noticed a vast improvement in my demeanor, mood, and energy level.

I am NOT cured/healed. I am still in constant pain. But my perception of that pain is less, my ability to cope with it better, and I am doing more - I am able to do more - than I have in some considerable time - years.

I am back on the pantothenic acid (B5) as well - since mid-late February. acne flares are gone - even during times I should/would ordinarily get them (skin irritation, periods of high stress, dietary triggers), and I'm feeling more like I did before I stopped it - even better since I think it's doing what it's supposed to in fuelling the conversion of pregnenolone and DHEA into other badly deficient/needed/suppressed adrenal hormones. It has recently come to my attention (from a visitor post) that biotin may also be involved in this conversion process. Somehow I missed this in my previous research, but I checked my B-complex supplement, and it only supplies 1/3 of the RDA, so I will be looking into this further, and if warranted, may be adding biotin to my regimen.

My next round of blood tests is not for another two-plus months, but I am due to see our next week.

Doc

[Dr. Smith]

Started biotin (1000 mcg/day) two weeks ago, to aid in fuelling conversion of pregnenolone and DHEA as mentioned in previous post. Read that biotin and B5 can compete for absorption if taken together, so I'm taking the B5 morning & evening, and the biotin midday. No noticeable difference, so for the time being, I'm just assuming it's doing its thing in the background.

Saw our PCP today. He is delighted with my improvement - "Hey, I'm for whatever works," he says.

Got the lab order for blood tests coming up in June, and touched base on other issues.

Feeling pretty good, all things considered. Doing more, and in much better spirits.

Doc

[mrsD]

I've also read that biotin utilization may be blocked some (not 100%) by lipoic acid use.

So I am ordering it too, from Puritan's this go round. This is the longest I've used lipoic acid.... my previous attempts were brief, because it didn't work= the older version ALA.

Biotin is also blocked by uncooked egg whites, and sometimes my boiled eggs are a bit soft and runny... not good for biotin I guess?

[Dr. Smith]

Originally Posted by mrsD

I've also read that biotin utilization may be blocked some (not 100%) by lipoic acid use.

Thanks. I think I've got that covered, as I'm taking my RLA in the morning, and biotin around 2 pm (6 hrs apart)

Not a fan of runny eggs, so I don't see that as a problem either.

Doc

[mrsD]

Here is an article explaining this biotin issue:

http://www.geronova.com/content/lipoic-acid-biotin

It also mentions B5.

[Dr. Smith]

Originally Posted by mrsD

Here is an article explaining this biotin issue:

http://www.geronova.com/content/lipoic-acid-biotin

It also mentions B5.

I'm not sure what you're saying (or trying to say) here. From that link:

Regular users of lipoic acid products MIGHT benefit from supplemental d-biotin or d,l-biotin but it is probably wiser to consume biotin at a different time than lipoic acid to insure optimal absorption of both nutrients. It has been demonstrated by several groups of researchers (including Zempleni et al) in this and other studies that lipoic acid, biotin and pantothenic acid utilize at least one of the same transport systems and co-administration results in competition for uptake in various model systems.
http://www.geronova.com/content/lipoic-acid-biotin

This is exactly what I'm doing. If your concern is the B5 competing with RLA, I don't think there's a problem, as:
1. I only take RLA in the morning
2. I take B5 morning & evening (12 hr interval)
3. It's been 8 months (B5), and if the RLA were being interfered with, I would think it would have stopped working and the burning would have returned. It hasn't.

Doc

[mrsD]

What I am saying by providing the link, is that there is potential for interaction.

Data on supplements is often confusing and people with certain genetic failures, respond differently to them. Just like for drugs....genetic handling of drugs determine their toxicity and/or therapeutic effects or lack thereof. The transport of all 3 of these nutrients in this article may also explain your unique response to them. You may have a genetic need others don't possess.

It is not an easy to understand concept. Your bringing up the biotin, opened the door to the biotin controversy, and others who read here might appreciate the link I provided.

[Dr. Smith]

Originally Posted by mrsD

The transport of all 3 of these nutrients in this article may also explain your unique response to them. You may have a genetic need others don't possess.

The only unique response I'm aware of is how fast RLA (and only RLA) worked for me, and I don't know for sure that that's unique.

If I have some genetic need (and I don't know of any evidence or way to prove that) or if there's some other reason regarding the three supplements, many others have it too, and I thought others might appreciate what I've found, as well as what's working for others that doesn't affect me.

The majority - 28 out of 33 (~85%) - in the study reported improvement when taking B5 with RLA. I wish the study was larger and corroborated, but at the moment it's all we've got, and at least it's on people and not rats.

Many other people are reporting positive results with B5 for other conditions as well, from chronic acne to CFS to Lupus (SLE), and more.

One thing I've observed about claims about B5 is that they all involve large to mega doses. I don't know how I feel about that. Larger doses of other vitamins (B12, D3) are recommended here. They are better studied, and we can only hope that B5 will receive similar attention in the near future; IMO there's a little too much coincidence to dismiss it without a closer look.

There is insufficient evidence that B5 does anything for most of its claims, and I admit I'm skeptical about many/most of them myself, but that's not why I'm taking it anyway. It's coincidental that it seems to be helping some of those claims, and I'll take what I can get. Maybe there's something to them, or maybe I'm lucky, but I'm not alone. Also, like B12, C, and some other water solubles, there's no upper limit to dosage, and side effects are genrally negligible until one takes obscenely massive doses, so while it may do nothing, it can't hurt to try it and see.

B5 and biotin with adrenal hormones - I don't know if that's being done. I'm doing it myself based on what I've gleaned from looking into it. The adrenal hormones are Doctor Tennant's work, and many, many of his patients are benefitting from that - including at least two I've met here on NT. I think a LOT more chronic pain patients could benefit as well, particularly those that fit the profile - long periods of un(der) treated intractable pain and/or long-term opioid use. This therapy is new, like RLA for PN was at one time. All developments must start somewhere and build.

I wish I could say ALC worked for me as well, but it doesn't.