Monday, September 27, 2010

Low Dose Naltrexone for Hepatitis C September 2010 Lab Work

I got back my full September lab results the other day.  I have been on 3 mg. LDN since March of 2009 for my Hepatitis C - I also test positive for Sjogren's and RA, though with few symptoms.  I have/had an IGA partial deficiency and in these labs, it is normal for the first time.  My doctor ( Dr. Kashi Rai) believes that my limited but strict gluten/dairy free diet has been the reason for the result.

I am thrilled that my HCV viral load is still quite low as are my liver enzymes - and that most of my other tests are pretty darn good!  After the hellish time I've had of it these past few months, along with Panda's illness and death on October 4th (St. Francis Blessing of the Animals day), and enormous, unrelenting financial and emotional stress, I was prepared for the tests to be terrible.   Oh, the power of LDN and DIET!

My liver enzymes are still all within normal levels with ALT (6-40)  at 24 from a pre-LDN level of 174  - AST (10-35)  at 31 from pre-LDN of 99

HCV viral load went up a tad from the 11,600 it was on my last labs to it's current 14,679.  Still a far cry from the pre-LDN 1,280,000 level!

I was also pleased with the overall Lymphocytes - which have all increased.

October 2010 LAB RESULTS

 Tests                          09/10            01/09

C-Reactive Protein                   0.10              0.10

Platelet (140-400)                     171               163

Glucose (65-99)                         84                84

BUN (7-25)                               10                 5

Creatinine (.060-1.10)              0.73              0.70

Sodium (135-146)                    138                135

Potassium (3.5-5.3)                   4.3                4.6

Protein total (6.2-8.3)               7.9                 8.9

Albumin (3.6-5.1)                     4.9                 5.2

Globulin (2.2-3.9)                     3.0                 3.7

 Bilirubin Total                          1.1                 1.1

Alk. Phos (33-130)                   59                 72

AST (10-35)                             31                 99

ALT (6-40)                               24                174

Cytomegalovirus IGG              2.60                2.36

CMV - IGM                          0.79                0.67

DHEA Sulfate (15-170)          106                  92

Epstein-Barr IGG                  1:320                1.320

Estradiol                                  19                   31

Ferritin (10-232)                      53                  115

HCV RNA -                       14,679                 1,280,000

Herpesvirus 6 IGG                1:10                   1.80

HHV6 IGM                          1.20                    1:20

IGF I - ECL                          185

IGF -I                                                            139

Immunoglobulin A (81-463)    95                    72

Immunoglobulin G (694-1618) 1377              1932

Immunoglobulin M (48-271)     93                 135


CD3 (Mature T cells) ( 57-85)   78                   77

Absolute CD3+ Cells (840-3060)  1441        1008

%CD4 (Helper Cells) (30-61)       57                 52

Absolute CD4+ cells (490-1740) 1067             720

%CD8 (Suppressor T Cells) (12-42)  22            22

Absolute CD8+ cells (180-1170)    405             333

Helper/Suppressor ratio (0.86-5.00)  2.59           2.17

%CD16+CD56 (4-25)                        6               10
(Natural Killer Cells)

Absolute NK Cells (70-760)              102            128
(CD16+CD56 Cells)

%CD19 (B cells) (6-29)                      15             12

Absolute CD19+ Cells) (110-660)     277             189

Absolute Lymphocytes (850-3900)    1857          1577

Progesterone                                         0.5             0.5

Rheumatoid Factor (<14)                      18           31

Sjogren's Antibody(SS-A) (<1.0)          2.8         4.5

T3, FREE (230-420)                              330             337

T4, FREE (0.8-1.8)                                1.0             1.3

TSH, 3RD GENERATION (0.40-4.50)  2.67        1.97

Testosterone Total                                    60            63

Vitamin D, 25-OH Total                            83           62

Also, I wanted to mention that the new 2010 edition of the free LDN book 'Those Who Suffer Much, Know Much' is now available via PDF. My Hepatitis C story is included in this year's edition as well as Joyce's HBV positive daughter's. Also has much more info about using LDN in other disorders as well as more about LDN in general:

Wednesday, June 30, 2010

Please Help the Cats!

UPDATE - September 5th, 2013 After Magoo started drooling more and starting to spend more time up on the bed than with the other cats, I restarted him on .03mg of LDN.

The next morning, Magoo was out and about. Later in the day as I was coming back inside, Magoo pushed throught the screen door and out onto the porch. Then, underneath the house and up and down the driveway - we me in hot pursuit. After I caught him, it was dinner time. Magoo shocked me by jumping up on the counter to get a headstart on dinner - which he has never done. Usually, I am chasing him around the house trying to get him to eat. So this is a good sign. Will try the lower .03 dosage (he has lost weight too..) and go every other night and see what happens!

UPDATE - August 22, 2013 Miracle Man Magoo is still hanging tough. He has been able to eat more and the tumor isn't much different. Magoo is out and about and still very much enjoys life!
He is still on the Conium 200c twice daily - the vet also wanted to add the Thuja back as well. He gets one small syringe feeding at night but it's more to get various vitamins into him. Also added food grade hydrogen peroxide to the mix. His multi-daily mouth wash contains calendula, astragalus, and artemisa annua. And with the unavailability of any cannabis oil, I purchased the Dixie Botanicals Dew Drops - a hemp oil with CBD's - it seems to help with anxiety and appetite a lot.
So, keeping fingers crossed that something eventually will shrink or get rid of this tumor and disease - I am so very happy at this point that he is hanging so tough - he's such a good boy! UPDATE - August 3rd, 2013

A day after I sent out a glowing update on Magoo's progress, I pried open his mouth and found a raggedy growth underneath one side of his tongue. Freaked out - called both traditional and holistic vets.  Just assumed that it was tumor regrowth already. I must add that I had given him a night off from the LDN.
After I told my holistic vet that Magoo had resumed eating his beloved Indigo Moon kibble, she suggested that the dry food was irritating the surgery site.  So I pulled most of it up, much to the other cat's dismay.  At the same time, I upped his astragalus mix along with a co-q10 mixed with "Heart Terrain" a mix of supplments and herbs.  I also started him on Wormwood - Artemisia Absinthiam but later read that it is the Artemisa Annua Extract (Sweet Annie) that is what is needed

Someone wrote me about Cannabis Oil - I am looking into that - something I have meant to look into for awhile anyway, but there seems to be a lot of info on it being great for most disorders - and cancers!
If anyone knows more about this and can help, please contact me!
Meanwhile, Magoo's "tumor site" looks better, smaller and less raggedy

UPDATE - July 26, 2013 -

Magoo got his histopath report back on Tuesday - of course it is SCC - with "intermediate to high-grade features"  and "neoplastic cells extend to the margins."  The glimmer of hope is that "There is no evidence of any angiolymphatic invasion" - which means it has not spread to the lymph nodes.

The vet who did the surgery didn't even want to do a follow up - no checking of Magoo's mouth - no talk of chemo or other treatment.  I was a bit peeved - you'd think that a vet who did a biopsy and put 8 stitches in your cat's tongue might want to see if the poor creature was ok.  But never mind - the guy served his purpose - we now have a definitive diagnosis - and I wasn't going to subject Goo to that stuff anyway.

So, after a break from the LDN for a few days due to being on opioids, I started him on 0.32 of the liquid LDN the other night.  He is now back on Arnica 50M for pain care but he is eating a little better now -  I gave him some "junk food" Friskies and Whiskas canned just to whet his appetite - and he is scoffing that down.  And of course, rejecting his grain free stuff -  but I am happy that he is eating right now.

The main goal is to try to keep this thing from growing back!  The stats don't support this happening - but then again, the stats have never included LDN.  I am just hoping that even though the cancer extends past the surgical margins, the surgery might have retarded the growth enough, so that now, the LDN can do it's stuff - well that's the plan anyway.  My holistic vet (who actually cares about Magoo) wants me to give him the Thuja 50m as a dilution instead of just dumping the pellets down his throat, for one week.  And I guess by then, we will see how he is doing and how his mouth looks.  The few peeks that I took didn't show anything really scary - no infection or pus -  haven't wanted to push it with him though.

Will update again soon - Dr. Zagon research on Head and Neck Squamous Cell

Head and neck cancers (including oral cavity, pharynx, and larynx) account for 3% of new cases and 2% of cancer deaths annually in the United States,1 and 3% of all new cases worldwide.2,3 More than 90% of all head and neck cancers are of squamous cell origin (SCCHN) Low dosages of the opioid antagonist naltrexone are known to inhibit tumor (ie, human and murine neuroblastoma) growth,33,34 with the effects of opioid antagonists being stereospecific and dependent on the duration of opioid receptor blockade.35,36 In the case of low-dose naltrexone, production of OGF and OGFr is stimulated when the compound is present37,38 and, during the interval when naltrexone is no longer available and does not block opioid receptors, an enhanced interaction between OGF and OGFr ensues, resulting in reductions in cell proliferation. The present results confirm and extend the extensive literature documenting that daily administration of OGF, as well as low-dose naltrexone, can impede the appearance and growth of many tumor types. These previous studies were conducted so that OGF or low-dose naltrexone treatment began at the time of tumor cell inoculation, a model with parallels to the clinical situation wherein the cancers have been extirpated and tumor burden is diminished. However, the present investigation initiated OGF or low-dose naltrexone treatment at the time of established cancer (ie, the appearance of a tumor) and demonstrates that modulation of tumor progression by either agent can also be effective even at later stages of tumorigenesis. Moreover, in contrast with earlier reports using OGF and low-dose naltrexone in a daily regimen, we have discovered that administration of either agent administered just once a week has powerful antitumor activity.

UPDATE - July 17, 2013 -

Magoo had the mass under his tongue cut out yesterday - the vet said that he got "most" of it - anymore and he would have destroyed the tongue.  It is most probably SCC but will get back Path report in about a week.

Poor Magoo has many stitches under his tongue - he was very restless yesterday and upset that he could not eat his beloved kibble - the canned food juices were easier on him.  Hopefully, his tongue will heal soon and he will be back to his normal chow cat ways.

As he was given opioids, I did not resume the LDN dosage - and will wait and see how he is doing later.  He was sent home with buprenorphine that I was supposed to start today - however, I might try the arnica 200c instead.

From reading about oral SCC, it seems that whenever these tumors are cut out of the mouth, unless clear margins are achieved, then they do grow back.  Well, we shall see - I believe that yesterday's procedure has bought Magoo some time - time for Mom to try to help keep this from coming back.  Will keep you updated - meanwhile, please help me help him - if you can spare anything - please use the DONATE button on the sidebar.  Some very kind folks have donated Petco gift cards (next biggest expense is cat food!)  but unfortunately, Mom can't eat cat food...

UPDATE - July 15, 2013 - Magoo - Tumor in mouth - possible SCC -

A few weeks ago, a mass was found underneath Magoo's tongue - he is going in for biopsy tomorrow.  It appears to be oral squamous cell carcinoma but there is a chance that it is some kind of eosinophylic problem instead.  Please help Magoo - he will need follow up care after the surgery - and prayers that he does not have cancer.  Scroll over to the DONATE button for the "Magoo Cancer Fund" if you can help.  Also, this handsome guy has his own CafePress design here:  Mr. Magoo

Magoo CafePress


Panda crossed over at 12:45 AM this morning - up until this past weekend, she had done pretty well.  However, the Medicam, while buying her a couple more weeks of life, in the end, affected her liver and kidneys and she began to struggle on Saturday.

I had my own doctor's appointment yesterday but had made arrangements to bring Panda in to be put down that evening.  But when I got home from the doctor, she was close to being in a coma.  I got her onto the bed where she stretched out on her side - I supported her head with a pillow and also placed one near her paws.  Soon, she was kneading the pillows with her paws and breathing deeply, though with her customary purr.  I decided to let nature take it's course as she was not suffering.

I awoke at 12:44 to find Panda taking her final breaths - I pet her and kissed her and told her goodbye.  That it was okay to go and that I would see her again someday - at the Rainbow Bridge.

Just this side of heaven is a place called Rainbow Bridge.

When an animal dies that has been especially close to someone here, that pet goes to Rainbow Bridge.

There are meadows and hills for all of our special friends so they can run and play together.

There is plenty of food, water and sunshine, and our friends are warm and comfortable.

All the animals who had been ill and old are restored to health and vigor; those who were hurt or maimed are made whole and strong again, just as we remember them in our dreams of days and times gone by.

The animals are happy and content, except for one small thing; they each miss someone very special to them, who had to be left behind.

They all run and play together, but the day comes when one suddenly stops and looks into the distance. His bright eyes are intent; His eager body quivers. Suddenly he begins to run from the group, flying over the green grass, his legs carrying him faster and faster.

You have been spotted, and when you and your special friend finally meet, you cling together in joyous reunion, never to be parted again. The happy kisses rain upon your face; your hands again caress the beloved head, and you look once more into the trusting eyes of your pet, so long gone from your life but never absent from your heart.

Then you cross Rainbow Bridge together....

Author unknown...

Goodbye my love, my heart - you have left the biggest pawprint on my heart and I will never forget you my friend.  I love you.


After the last diagnosis of end-stage heart disease, Panda worsened and continued to try and hide.  She was struggling to breathe and panting. When I picked her up and put her on the bed, she plopped over onto her side.   I called the vet's office again and told them that I was bringing her in to be put down - she was suffering.   We got to the vet's office where Panda hobbled around the exam room and seemed to be breathing more normally.  Dr. Sagrera watched her and then examined the back of Panda's head - Panda flinched when the area behind her ears was pressed on.  Dr. Sagrera said that it was probably due to a tumor in her brain, which was causing her immense pain, which led to her walking about with her head close to the ground.   The vet said to try the Medicam, which is a pain killer and analgesic and to see what would happen.

I got Panda home and gave her a small dose of the Medicam - I had some left over from her ear surgery.  A couple of hours later, Panda was panting again and trying to push her head under the pillows on the bed.  I gave her more Medicam and she eventually went to sleep, breathing easier.  Later, after going to bed, I kept reaching over to touch Panda on the bed, to see if she was still breathing.  At around 4 AM, I reached over and she was not there - she was at the end of the bed and purring!  I got her down and brought her to her litter box, which she used, and took her back to her bed.  She demanded breakfast, which I happily gave to her.  The rest of the day was uneventful, with Panda dozing for most of it and looking much happier.

That was on the 15th and 16th, and blessedly, Panda has been the same since then!  It seems that as long as I can get the right dose of Medicam into her, she is doing okay.  And by okay, I mean, getting up and down from the bed on her own, finding her way to the litterbox and water dish. Not bad for a blind cat with a brain tumor and enlarged heart.  And not having any more panting or hiding her head episodes.  Which is amazing to me that the amount of pain that she must have been in, had led to her symptoms.  Whatever the reason, I am blessed that Panda is still with me and happy to be here.


After a hellish night, Panda seemed brighter at 6 a.m. and actually ate some food so I went back to sleep.  Upon waking, I couldn't find her and after a 15 minute search, found her wedged in on the side of the fridge.  I got her out and she seemed to be having problems walking - she did not want any more food or did not to use her litter box.  I called the vet who told me to let her sniff the Vick's vapor rub, which nullifies a homeopathic remedy.  I did and left her back on her bed.  I had to go out for a bit and when I came back, Panda wasn't on her bed but was in the closet.  I got her out and put her on the floor.  She seemed to stagger and opened her mouth, panting in a way I had never seen before.  So I frantically called the vet back and told the girl who answered the phone that it seemed like it was "time".

I rushed Panda out there where the vet immediately saw her. Panda, meanwhile, had perked up on the way over - she cried most of the trip over - as did I.  At Natural Pet Care, the vet has non-traditional exam rooms - just regular rooms with furniture - not the typical little cubicle with the stainless steel table.  Panda got up and wandered around the room, getting around much better than she had at home.  The vet listened to her chest and suggested a chest x-ray - I was able to check my email on my cell phone and saw that Steve E. had generously made a donation on the blog, so I told the vet to go ahead and do the test.  Shortly, the film was ready, and it showed a very enlarged heart - we had known that she had heart problems, but her heart was pushing on her lungs and diaphragm, making it difficult for Panda to breathe.  And fortunately, there was no sign of any cancer, at least on the x-ray.

So, for now, we know what we are dealing with!  I took Panda back home, where she immediately used her litter box, drank a little water and ate some food - things that she hadn't done in the last two days. She just had a small dinner of wet food and is napping now.  The vet also wants me to try and get Taurine and coQ-10 into her as well as the B vitamins and Omega that she is already getting.

Just goes to show you how strong homeopathy can be - those little pellets can pack a wallop!  The vet thinks that by tomorrow, any lingering effects of the remedy will be gone.  I hope that Panda will perk up even more so that she can enjoy what time she has left with the best quality of life.  Thank you Steve E. and to everyone who has donated toward's Panda's veterinary care!


Panda has taken a turn for the worse.  Last week, she began to get blocked again so she was taken to the vet.  The vet felt that Panda's colon was thickened and she also had an ugly ulcer in her mouth - no wonder she seemed so uncomfortable.  She has also been waking from her sleep and howling for food, which she would inhale once I'd give it to her.  I asked Dr. Sagrera if she thought that the cancer had possibly spread and she said that it was a good possibility - and would explain all of the things that have happened to Panda over the last year.  Her original squamous cell carcinoma diagnosis had come a few months following her saga during Hurricane Katrina, which resulted in the loss of her ear.

The vet gave her a homeopathic remedy (Silica 10M) and for the next few days, Panda seemed to spend much of the time sleeping.  She ate and used her litterbox regularly.  However, starting yesterday and today, she no longer wants to eat and is having problems getting around - not walking, but she will get to her litter box and then just crouch in it and stay in it for hours.  She does not seem to be in any pain but is in a fugue like state - she knows me and will purr if I pick her up and talk to her.

I can only hope that this is some kind of "healing crisis" that she will soon pull out of.  The vet did say that the Silica can aggravate a problem, or problems, for as long as a week.  Today is Monday and she was given the remedy last Thursday.

But I think that she is dying - she is hydrated and looks okay, but so lethargic and out of it that I just don't see how she will pull out of this.  I will have to wait until tomorrow to contact my vet as her office is closed on Mondays - but I will call her emergency page number later on tonight it need be - I hope not.  I still haven't figured out how to cover the post-dated check that I wrote on Thursday...

I took Panda off of the LDN last week - with the mouth ulcer and her symptoms, it did not seem that it was right to keep giving it to her.  She has had almost 5 years since her ear surgery - 4 good years though this last year has been fairly good, even though she lost her sight last October - she has not been in any pain until the impaction problems began and has been able to get around amazingly well.

She is currently on the bed for now, though she will get up every now and then and wander around - but she will run into something and then just sit there - so I am watching her constantly.

I hope that she pulls out of this but I wouldn't be surprised if she just went to sleep on the bed and just never wakes up.  If this is her time, then I hope that this is what will happen - I do not want her to suffer any kind of pain.  Thankfully, she doesn't seem to be in any - but if she has problems during the night, I will use my vet's emergency number and bring Panda to her - the hell with not having any money.  Panda has been my friend since 1996 - one of the longest relationships in my life.  We have been through everything together and I do not know what I will do without her.

I really don't want to bury her outside as I probably will be moving in the next year - and I don't want to leave her - though Brooks is out in the garden - I hated to have to bury him as well, but I could not afford to have him cremated, which is what I want for Panda.  Regardless, I am heartbroken and the tears are streaming as I type this post.

Please donate if you can.  Thank you


Panda is doing great - the extra fatty acids (omega fish oils) have helped her a great deal and she has not had any problems with impaction or constipation - knock on wood.  I want to thank everyone who donated towards her veterinary care (and bill)! 

But Mom is not doing too well - thankfully, the LDN along with a strict diet and supplements, have restored my health to the point that I can now function.  I pray that it stays that way.  However, I am struggling to survive here every day and I fear that the unrelenting stress will eventually take a toll.

Though the online book selling and sporadic cat sitting do bring in some income, it is just barely enough to pay the major bills (my credit cards went bye-bye months ago) - utilities, internet, cell phone.  The rest goes towards caring for the cats.

I am very small and do not require much food - I have been surviving on potatoes and baked vegetables - with an occassional bit of chicken thrown in.  I also still have my fruit smoothie most days though I have been out of the whey protein powder.

If anyone could possibly donate a bit towards the cat care, then I could eat a  little more than I have - I've lost 5 pounds in the last couple of weeks and 108 is much too low - I do better around 115 for my 5'4" frame.

Thanks again to all who helped the cats - and thereby helped me!

I haven't been posting too much on the blog lately as I have been struggling to survive here in New Orleans. The cost of living has never gone back to the pre-Katrina days and it's become a lot harder to get by. I just about have my rent money covered and I have paid my utility and car insurance bill.  Now, I just have to pay my internet bill - no net, no business as a book seller and no blog about LDN and Hep C - and now cats.

My concern is for my cats - the cats are probably the reason that I am here today - they helped bring me back to my childhood roots and my love for all animals - and away from the dark side of the streets.

It was a stray cat that led to my diagnosis of Hepatitis C back in 2002. I took in a stray cat "Oscar" early that year who had a multitude of health problems, including ringworm - and of course, I contracted it. It never would go completely away and I ended up at a doctor, who suggested blood work to "rule anything out". The "anything out" turned out to be Hepatitis C.

Oscar lost his life in early 2004 due to his health problems - but I will never forget him or be able to thank him enough. True, I would have been diagnosed eventually with the HCV, but finding out in 2002 might have saved my liver from additional stress.

Panda needs help - she is my oldest cat at around 15 - no one really knows how old she truly is. She was seen today at the vet and will require many vet visits to keep her comfortable for whatever time she has left. She is a cancer survivor who lost an ear to the disease - she recently went blind and, understandably, does not get around too much - hence, she becomes frequently becomes impacted and needs to see the vet for care.

I first met Panda in early 1996 when I moved into a new apartment following my separation. She was part of a large colony of cats that the former tenant had been feeding (and not spaying and neutering).

Unbeknownst to me, Panda had been adopted as a feral kitten, spayed and vaccinated by the tenant and then left behind when she moved. I kept wondering why Panda kept trying to get inside.

I ended up trapping all of the cats and having them spayed or neutered. In 1998, my landlord decided to sell the house and I was forced to move to another apartment about a mile away. I took Panda and Emerald with me.

Panda kept getting scared and disappearing - she kept going back to her old house, which now had a new owner who did not like cats. For a cat, a mile is not that far away, but she had to cross a major thoroughfare and railroad tracks to do so. I probably went back 5 different times to get her, until one day, she was not there. I went back for almost a month to look for her but never could find her and I feared the worst. However, one day, I got a call from the new owner - there was a black and white cat hanging around the house - could I come look at her. It was Panda! Skinny and scared but ok. I took her back and finally started bringing her inside and she never left again.

During those early years at the new apartment, I had a boyfriend, who had a Min Pin. She had a litter of pups that Panda enjoyed teasing and toying with.

As the years went on, my boyfriend moved away and I returned to cat rescue - and had a house full of cats, as well as caring for the multiple feral cats in the neighborhood. In 2002, I was devastated to learn that I had contracted Hepatitis C, and put me on a health roller coaster for the next several years. (I have detailed this story on my blog, Nola Hepper.

In August of 2005, I found myself with a broke down car, little money and 8 inside cats, along with many feral cats outside. Hurricane Katrina hit New Orleans and the cats and I were trapped inside my apartment with flood waters up to my neck. Emerald did not come in for the storm and was drowned under the floor boards. I was able to get rescued from my roof with 3 of the cats the next morning - Panda, Cayenne and Rosemary. The 5 others were placed up in high closets out of the water - it took me 2 weeks to get back to the house, via a boat, to rescue them - miraculously, they were all still alive!

I detailed our saga on my first post on this blog, here are a few links:

Photos from August 29th, 2005 Katrina

Photos from the LA Times

L.A. Times Sept. 12, 2005 story

Inside, they had a rather unflattering photo of my getting back up into the closet where the cats were - this was the closet that I was in after the water rose...

We spent 6 months in Alabama after Katrina. Panda had suffered an ordeal and ended up with squamous cell carcinoma, which led to surgery to remove her ear. The animal group IMOM (In Memory of Magic) and Best Friends both contributed towards Panda's surgery.

I moved back to New Orleans to a new apartment in early 2006 and became involved with the ongoing cat rescue. My old Lakeview neighborhood had been devastated and most of the feral cats had been killed - either drowned or killed by the ensuing dog packs that roamed the area for many months following Katrina. There were only 3 cats out of the 40 or so in my area that survived. I was able to do this for almost two years until my health took a turn for the worse. I developed shingles, severe IBD and fibromyalgia and at times, could barely get out of bed.

Fortunately, my Social Security appeal ruled in my favor and I soon was on Medicare and receiving a small disability check of $693.00 monthly. The Medicare enabled me to find a good integrative doctor, whose treatment helped me greatly - she also pointed me towards Dr. Berkson, who put me on the Low Dose Naltrexone (LDN). His protocol alone helped restore my liver health to almost normal.

Meanwhile, I lost Brooks, one of the Katrina survivors who had been left in the high closets, due to renal failure. His illness was costly and wiped out the remainder of my savings - though most of the money had gone towards my medical treatment and supplements that were not covered by Medicare.

Right before Brooks passed, Panda suddenly lost her sight! It was first thought that she had an infection but she did not respond to treatment. She was then taken to an eye specialist who thought that her cancer had returned and was causing her blindness. However, her blood work was normal and that diagnosis was later ruled out.

She managed go get around fairly well in the ensuing months, but lately has had a problem with impacted anal glands - which actually abscessed a couple of months back. I took her to the vet a few weeks ago to have them expelled and still owe my vet for that visit. Panda is having problems again and is close to another abscess. Today, my wonderful vet agreed to see Panda again, even though I cannot pay for the visit. I promised the vet's office that I would try and raise the money for payment.

If you can help pay for Panda's vet visit or donate towards the care of the other cats, please go to the "Donate" button which leads to our PayPal account. The DONATE button is on the right menu.

The Others

Cayenne came along in January 1999 - a neighbor found him and put a milk crate over him and called the SPCA. He was still there the next day, so I took him to the vet - and, of course, ended up keeping him.

After Katrina, with Sky:

Rosemary was found in the back alley with her brothers and sisters in 2001:


Woody was a relative of Rosemary's - found in the same alley - and very, very sick as a baby:

She came close to liver failure following her ordeal after Katrina and flirted with it again last summer.

Tortie Miss was an older feral kitten who was trapped across the street from us - she started following Cayenne home and ended up as an inside cat - lucky for her as all of her outside buddies perished after Katrina.

Mr. Magoo (Goober) showed up in 2002 with Oscar and never left:

Sky and her littermates appeared in the alley in 2004 - they were all trapped, tamed and adopted through PetsSmart. However, Sky got sick and was returned to me - by the time that she healed, she was too old for adoption:

sky kitten trap

After I moved back here in 2006 and was doing cat rescue, I trapped 4 kittens from my old neighborhood - the abandoned house where they were born was being demolished so I could not release them after they were spayed/neutered.  The two tamest kittens were taken to ARNO, who later shipped them out of state where they were both adopted.  I kept the other two - Velvet and Smoke.

Please help me continue to care for my cats as I have managed to do for many, many years. They saved my life and I am responsible for caring for them to the best of my ability - even with Hepatitis C, Celiac Disease and the multiple other viruses and conditions that I have.

If you are able to contribute to the cat's care, please go to the menu on the right - and either go to the Widget or to the DONATE button.  Or, you can help by purchasing a book from Amazon via my account at:


If you are in the New Orleans area, I offer a Cat Sitting or Cat Consultant service at:

Nola Catbox

Thank you so much for your help!

Saturday, June 5, 2010

Treating Hepatitis C with Low Dose Naltrexone (LDN)

3 mg. LDN next to Advil


Treating Hepatitis C with Low Dose Naltrexone (LDN)

UPDATE - JUNE 2014 -

The original post below was written back in 2010 but I have since edited it to reflect the newer research regarding using the lowest dose possible of LDN.

Please also see:   Why 3 mg Low Dose Naltrexone Might Be Best

After being on 3mg Low Dose Naltrexone for 5 years now, my HCV viral load still remains low and my liver enzymes are still normal.  And even though I imagine that in the next year or so, I will do the newest non-interferon treatment - minus the ribavirin, I still plan on taking Low Dose Naltrexone for the rest of my life - virus or no virus.  Meanwhile, now that a possible real cure for HCV has come along, most folks cannot afford it at this time.  So the best bet is to take Low Dose Naltrexone, use good quality supplements that help support one's liver and immune system and to eat as healthily as possible.  A paleo type diet and one that does not involve grains or any kind, particularly wheat.

I am successfully managing my Hepatitis C virus by using LDN - Low Dose Naltrexone, supplements, diet and exercise and have attempted to share my experiences on my blog, Nola Hepper. Now, I have tried to include all of this information in one place.

I was diagnosed in 2002 with Hepatitis C, genotype 1b. A biopsy revealed minor inflammation with Grade 0-1, Stage 0-1 and my lab work showed slightly elevated liver enzymes. Despite being urged to due interferon/ribavirin treatment back then, I chose to make healthy life style changes instead while waiting for "something else" to come along and learned as much as I could about the HCV virus. My health remained about the same for several years until 2005, when my Hurricane Katrina experience caused me to start having severe side effects. I developed fibromyalgia, shingles, severe chemical sensitivities and terrible IBD. My doctors told me that all of these problems were being caused by the Hep C and again urged me to do treatment.

I was able to get Social Security disability and Medicare and this allowed me to see a very good integrative doctor. She tested me for everything and suggested a course of action for me, which included several new supplements and diet changes. She also gave me a paper written by Dr. Burt Berkson, another integrative doctor who had done extensive work using ALA - Alpha-Lipoic-Acid. His work seemed very promising, so I began to do his protocol of ALA, Milk Thistle (although I had already been taking milk thistle for years), Selenium, and B Complex along with the other supplements that my doctor had recommended for me.

One of the diet changes that my doctor mentioned was to cut down or eliminate wheat - she said that most people cannot really digest it or are sensitive to it. I was a bit skeptical but after researching it, I decided to try it out. And the results were amazing! Within days it seemed that my IBD and bloating had greatly improved. Soon, I noticed that my fibromyalgia had gotten much better as had my chemical sensitivities - I didn't' seem to be quite so sensitive to smells anymore - and you must understand. It had been to the point where going to the grocery was an ordeal - I had to hold my breath going down the detergent or bug spray aisles. This also was much improved! Gluten (one of the proteins found in wheat) is a big problem to most folks with liver disease, particularly those who undergo interferon treatment, as it is a known trigger for celiac disease and can cause elevated liver enzymes.

After researching more about diet and nutrition, which included an appointment with a Certified Clinical Nutritionist, I took things a step further and ordered a food sensitivity/intolerance panel through a company called Alletess as they took my Medicare insurance. This test revealed that I had sensitivities to cow's milk, yeast and some shellfish. Upon eliminating these foods, my IBD really seemed to completely go away and my other health issues got much better as well.

However, my latest liver lab work (January 2009) was frustrating - my HCV viral load test was 1,400,000 - ALT was 174 and AST at 105 - other labs were pretty much in the normal range with a few blips here and there. I had exchange emails with a couple of folks who had seen Dr. Berkson and they said that they liked him and were seeing great improvements in their health - they also mentioned that he had put them both on Low Dose Naltrexone or LDN. So I decided to go out to New Mexico to see him myself.

I started on 3 mg. of LDN in mid-February 2009 while at Dr. Berkson's clinic but after I got back, I started having an upset stomach due to the lactose filler that the pharmacy in New Mexico used in their compounding mixture. I went off of the LDN for about 2 weeks until I got a new prescription mixed with acidophilus - probably March 1st, 2009. I had new labs done in late April 2009 and the results were remarkable. Viral load dropped from the 1,400,000 to 48,000! ALT from 174 to 22 and AST from 105 to 30!. My integrative doctor was amazed as I was but my traditional gastro actually yelled at me, saying that LDN was not "supposed" to treat Hepatitis C and that the labs had to be a mistake. I've never gone back to him.

This is about the time that I became an advocate for LDN and started posting more on my blog and on several LDN yahoo groups and various Hepatitis C, health sites, etc. How could I not with the results that I have had? Since that time, I have played around with the LDN dosage and have used my lab results as a kind of rough guide in doing so. Currently I am back on 3 mg. that I take most every night. My May 2010 lab work showed a viral load of 11,400 - ALT at 25; AST at 30.  (note - 2014 LDN dosage is 3mg taken every other night or every third night)

Ideally, it is best to work with a doctor who is familiar with the workings of LDN and who can prescribe it. And to get the LDN from a reputable compounding pharmacy such as Skip's Pharmacy. However, one can also order the 50 mg. tablets and make the solution themselves without a prescription.

If you already have a prescription for LDN, it is probably in a capsule form. If you want to start off at a different dose than whatever your prescription is for, it is better to mix the LDN with water than to simply take a third or half of the capsule alone. The reason being is that one can never be sure where the LDN is in the capsule and if you mix it with water, it is a more accurate dose. For example, I take my 3 mg. capsule and dump it into a dark colored vial (I got a 12 ml (cc) vial at Whole Foods for a couple of bucks). Use a 1 cc (ml) or 3 cc (mg.) syringe and measure in 3 ml. of distilled or bottled water - not tap water. Measure out the needed dose and store the rest in the fridge. For 4.5, simply increase to 4.5 cc's (ml's) of water.

There are slightly different instructions for the 50 mg. tablet but it is the same principal - 50 cc's (ml's) of water mixed with the tablet - obviously you would need a vial large enough for that amount - more detailed instructions are included in one of the links above or here: "How to Obtain Low Dose Naltrexone"

"Once you have a supply of 50 mg Naltrexone tablets, you can convert them as needed to LDN. To do so, fill a graduated cylinder with 50 ml of distilled water (unlike tap or spring water, distilled water contains no impurities that could potentially react with and thus reduce Naltrexone's effectiveness). Pour the water from the graduate into a 4 oz amber glass jar with a tight-fitting lid. Then add a 50 mg Naltrexone tablet. The tablet will mostly dissolve in about five to ten minutes. Since not all of the tablet is soluble in water, instead of yielding a clear solution, the result will be a cloudy suspension. It must be shaken each time before use to evenly disperse all the undissolved particles. One ml of the (shaken) suspension will contain one mg of Naltrexone. Use a graduated baby medicine dropper to measure out the dose you need."

Dosing is very individualized. I am finding that the biggest mistake that doctors are making with LDN is to prescribe the 4.5 dosage in the beginning, particularly to their patients with liver disease - some folks can tolerate this dosage, but in most it is a guarantee of initial side effects - sleep disorders being the most frequent. There are different theories on dosing, depending on what doctor or researcher you listen to. Dr. Berkson starts everyone off at 3 mg. but he prescribes sleep medications in the first month to counteract these sleep problems. Most savvy doctors and LDN veterans know to recommend that people start off at a very low dose such as 1 mg. Start at 1 mg. and stay on it for a week or so then move up to 1.5 or 2 for another week or so until you get to 3 mg. At this point, you can either work your way up to 4.5 or stay at the 3 mg. dosage until you get your first post LDN labs done. Again, dosing is very individual - up to that person's make up, medical problems, etc.  - some folks do well on 3 mg and have great results while others need more or less of the Low Dose Naltrexone - some folks take it every other night or less.  It really depends greatly on what disorder or multiple disorders the person has along with other factors.

Why LDN might not work -  According to several sites and personal accounts, yeast infections seem to be triggered or made worse when first starting LDN.  It is very important to have any candida, or other mold/yeast problems cleared up as having them can interfere with how well the LDN works.

The link below covers this as well as other side effects - note - the site was written by someone with MS, but it is still good info:

Side Effects & Dosing of Low Dose Naltrexone (LDN)

Dr. McCandless ( Children with Starving Brains )  has written about the dietary aspect when using LDN:

Dr McCandless, seldom is LDN stand-alone treatment

There is much more LDN info on other sites: site - Resouces page

I have covered supplements in another area of the blog -  Supplements 

a quick recap.  The most important supplements for the liver are those that help generate more glutathione,  - usually ALA - alpha-lipoic-acid, with  NAC - N-acetyl cysteine, SAMe, whey protein (gluten-free) and others.

Silymarin (Milk Thistle) is extremely important as is Vitamin D3.  Most folks are very deficient in Vitamin D3, particularly in those with HCV.   A multi vitamin without iron! (capsule form is best and more easily absorbed than tablet), vitamins C & E.

One of the most critical things is to keep one's ferritin levels below 100.  Ferritin is basically the iron storage in the liver - and it is the iron that does all of the damage!!!  Not the HCV virus as most docs and literature would have one believe.  See Iron Ferritin and the Liver for more.

Friday, May 7, 2010

May 2010 Hepatitis C Labwork with Low Dose Naltrexone (LDN)

In March, 2009, I started taking Low Dose Naltrexone, or LDN to treat my Hepatitis C. It was initially prescribed to me by Dr. Burt Berkson at his clinic in Las Cruces, New Mexico, in 3 mg. capsules. Since that time, my own doctor writes my LDN refill prescriptions.

Within months, it brought down my viral load and normalized my liver enzymes. And on my most recent lab work (5/2010), my viral load is even lower.

Viral load at 11,300! In December, it was 34,524. September: 18,729. Pre-LDN Jan. 09 - 1,280,000

ALT: 25  December: 34  Sept. 36   Pre-LDN Jan. 09 - 174 (range: 6-40)

AST: 30 December: 31 Sept. 37 Pre-LDN Jan. 09 - 99 (range: 10-35)

My doctor uses Quest lab:

HCV RNA, PCR test result of 11,300 with a log of 4.05. It was the COBAS (R) Ampliprep/COBAS, TagMan (R) RNA Test Kit (Roche)

Will update complete labs soon!  Vitamin D at 95 from 53 after taking 5,000-10,000 of NOW Vitamin D3.

Tuesday, April 6, 2010

Iron, Ferritin and the Liver

Most doctors only test serum iron levels, while they should always check serum ferritin levels, as this is a more accurate way to gauge iron that is stored in the liver. Elevated serum ferritin can cause oxidative stress, which leads to "fatty liver", fibrosis, elevated liver enzymes and worsening liver health.

Iron’s Role in Hepatitis C Infection

Hepatitis C inflicts most of its damage by latching onto molecules of iron, resulting in free-radical damage to liver cells. In turn, the liver becomes inflamed, which can lead to the formation of scar tissue (fibrosis). If left unchecked, this steady damage will result in cirrhosis or liver cancer.
About 30 percent of people with hepatitis C have very high iron levels. Reduction of serum iron has been shown to normalize liver enzyme levels, which are elevated during periods of active liver damage (Fong TL et al 1998). Iron depletion therapy has also been shown to improve the response to conventional medicines used to treat hepatitis (Fargion S et al 1997). The only effective way to decrease serum iron is to have an iron loss, as occurs when donating blood. Hepatitis C patients cannot donate blood for common use, but their blood can still be removed, although it must be discarded.

Serum ferritin is a measure of the amount of stored iron and is used to guide therapy. A serum ferritin value between 30 and 80 ng/dL is optimal. Many hepatitis C patients have serum ferritin values in excess of 300 ng/dL.

Despite substantial scientific evidence, however, few physicians implement iron-depletion therapy before beginning antiviral therapy. This partially accounts for the high failure rate of conventional drugs in eradicating the virus (Boucher E et al 1997; Martin-Vivaldi R et al 1997; Tsai NC et al 1997.

Hepatitis C Symptoms and Ferritin Levels Video

Other than phlebotomy that can help remove excess iron, I have found the IP-6(Inositol Hexaphosphate) helps lower ferritin levels and keep them down. My serum ferritin was at 176 and after using IP-6, it gradually came down. I switched over to the Jarrow brand of IP-6, which comes in capsules. I had been using a tablet form (Enzymatic Therapy) which was pretty expensive. The capsule form is much cheaper and apparently for me, works much better. My ferritin dropped from 80 to 38 from early September to late December and my lft's normalized.

IP6 Inositol Hexaphosphate

If you use this code: KOV896 you will receive $5.00 off your first order - and I eventually get a discount off of my own order.

Friday, February 19, 2010

Low Dose Naltrexone (LDN) and the Liver

note - this post title really should be "Naltrexone and the Liver" as the studies below all are based on full strength naltrexone and not LDN.

Low Dose Naltrexone, or LDN, is an FDA approved medication.
"Naltrexone itself was approved by the FDA in 1984 in a 50mg dose for the purpose of helping heroin or opium addicts, by blocking the effect of such drugs. By blocking opioid receptors, naltrexone also blocks the reception of the opioid hormones that our brain and adrenal glands produce: beta-endorphin and metenkephalin."

Although naltrexone itself is an FDA-approved drug, the varied uses of LDN still await application to the FDA after related scientific clinical trials. LDN (in the 3mg or 4.5mg dosage) has not yet been submitted for approval because the prospective clinical trials that are required for FDA approval need to be funded at the cost of many millions of dollars.

Naltrexone is a prescription drug, so your physician would have to give you a prescription after deciding that LDN appears appropriate for you.

Many doctors will not prescribe LDN, as they are not aware that it is FDA approved and that various clinical trials for various disorders have been done or are in progress. The other reason is because of the "Black Box Warning" for full strength Naltrexone due to adverse liver effects on obese patients using 300mg.

Full-dose naltrexone (50mg) carries a cautionary warning against its use in those with liver disease. This warning was placed because of adverse liver effects that were found in experiments involving 300mg daily. The 50mg dose does not apparently produce impairment of liver function nor, of course, do the much smaller 3mg and 4.5mg doses.

Further studies have shown that LDN is actually beneficial to the liver in low doses - however, most of the studies done used much higher doses of Low Dose Naltrexone.

Study of hepatotoxicity of naltrexone in the treatment of alcoholism.
Since a black box warning was issued by the Food and Drug Administration regarding the use of the opiate antagonist naltrexone (NTX), many clinicians have been concerned about current labeling of the potential hepatotoxicity risk of NTX in the treatment of opiate dependence and alcoholism. Despite many reports that demonstrated that the use of NTX did not cause elevation of liver enzymes, controversy concerning whether NTX is hepatotoxic continues. The current study monitored 74 alcoholic patients who received 25mg of NTX daily in the first week and then 50mg of NTX daily for the rest of the 12-week period. After the 12-week treatment, levels of the hepatic enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST) did not show any elevation, except in one subject, and the results strongly support that NTX did not induce abnormalities in liver function tests or elevate the liver enzymes. Instead, a statistical significance of decreasing levels of ALT and AST in the liver was shown throughout the study. These findings provide further support that NTX is not hepatotoxic at the recommended daily dose and may be beneficial for patients with elevated liver enzymes.
PMID: 16839858 [PubMed - indexed for MEDLINE]

Effects of long-term treatment with naltrexone on hepatic enzyme activity.Mean plasma levels of hepatic enzymes did not show significant modification in the course of treatment with naltrexone.

PMID: 1686854 [PubMed - indexed for MEDLINE]
Naltrexone: report of lack of hepatotoxicity in acute viral hepatitis, with a review of the literature.
Many clinicians appear to be concerned about the potential hepatotoxicity of the opiate antagonist naltrexone (NTX) and this may be one reason why it is not used more widely in treating both heroin and alcohol abusers. Some much-quoted early studies noted abnormalities in liver function tests (LFTs) in very obese patients taking high doses, although there was no evidence of clinically significant liver dysfunction.

We describe a heroin abuser in whom clinical and laboratory manifestations of acute hepatitis B and C appeared a few days after the insertion of a subcutaneous naltrexone implant. A decision was made not to remove the implant but the hepatitis resolved completely and uneventfully well within the normal time-scale. A review of the literature indicates that even when given at much higher doses than are needed for treating heroin or alcohol abusers, there is no evidence that NTX causes clinically significant liver disease or exacerbates, even at high doses, serious pre-existing liver disease.

PMID: 15203443 [PubMed - indexed for MEDLINE]

Naltrexone protects against lipopolysaccharide/D-galactosamine-induced hepatitis in mice.
Results demonstrated that post-treatment with naltrexone (20 mg/kg, i.p.) significantly attenuated the deleterious liver function in mice treated with LPS/D-gal. It was also found that naltrexone significantly inhibited the elevation of plasma tumor necrosis factor-alpha (TNF-alpha) caused by LPS/D-gal. The overproduction of nitric oxide (NO) and superoxide anions induced by LPS/D-gal were also significantly reduced by naltrexone. Moreover, infiltration of neutrophils into the liver of mice 12 h after treatment with LPS/D-gal was also decreased by naltrexone. In conclusion, the beneficial effects of naltrexone on LPS/D-gal-induced hepatitis result from its inhibition of pro-inflammatory factors and antioxidant effects. Thus, naltrexone is of therapeutic potential for treating liver injury.

PMID: 19023176 [PubMed - indexed for MEDLINE

Lack of hepatotoxicity with naltrexone treatment.
In summary, chronic administration of naltrexone in doses up to 300 mg/day for periods up to 36 months does not significantly change hepatic function, as measured by SGOT and SGPT levels.

PMID: 7983232 [PubMed - indexed for MEDLINE]

Opioid receptor blockade reduces Fas-induced hepatitis in mice.

PMID: 15389866 [PubMed - indexed for MEDLINE]

Naltrexone, an opioid receptor antagonist, attenuates liver fibrosis in bile duct ligated rats.

CONCLUSIONS: This is the first study to demonstrate that administration of an opioid antagonist prevents the development of hepatic fibrosis in cirrhosis. Opioids can influence liver fibrogenesis directly via the effect on HSCs and regulation of the redox sensitive mechanisms in the liver.

PMID: 16543289 [PubMed - indexed for MEDLINE]

Opioid system blockade decreases collagenase activity and improves liver injury in a rat model of cholestasis.
CONCLUSION: Opioid receptor blockade improved the degree of liver injury in cholestasis, as assessed by plasma enzyme and liver MMP-2 activities. The beneficial effect of naltrexone may be due to its ability to increase liver SAM level and restore the SAM : SAH ratio.

PMID: 17295775 [PubMed - indexed for MEDLINE]

Effect of oral naltrexone on pruritus in cholestatic patients.

CONCLUSION: Naltrexone can be used in the treatment of pruritus in cholestatic patients and is a safe drug showing few, mild and self-limited complications.

PMID: 16534857 [PubMed - indexed for MEDLINE]

Opioid peptides and primary biliary cirrhosis.
Patients with liver disease have increased plasma concentrations of the endogenous opioid peptides methionine enkephalin and leucine enkephalin. As an initial investigation to determine whether opioid peptides contribute to any of the clinical manifestations of hepatic disease nalmefene, a specific opioid antagonist devoid of agonist activity, was given to 11 patients with cirrhosis. They all experienced a severe opioid withdrawal reaction on starting the drug. In the nine patients with primary biliary cirrhosis pruritus was greatly alleviated, fatigue seemed to improve, and plasma bilirubin concentration, which had been rising, showed a modest fall in all except one patient. These results indicate that blocking opioid receptors has an effect on some of the metabolic abnormalities of liver disease.

PMID: 3147046 [PubMed - indexed for MEDLINE]
Pharmacokinetics of long-acting naltrexone in subjects with mild to moderate hepatic impairment.

Long-acting naltrexone is an extended-release formulation developed with the goal of continuous naltrexone exposure for 1 month for the treatment of alcohol dependence. The influence of mild and moderate hepatic impairment on naltrexone pharmacokinetics following long-acting naltrexone 190-mg administration was assessed. Subjects with mild (Child-Pugh grade A) and moderate (Child-Pugh grade B) hepatic impairment (n = 6 per group) and matched control subjects (n = 13) were enrolled. Naltrexone and 6beta-naltrexol concentrations were determined over a period of 63 days following a single intramuscular dose. Naltrexone and 6beta-naltrexol concentrations were detected in all subjects through 28 days. Total exposure (AUC(0-infinity)) of naltrexone and 6beta-naltrexol was similar across all groups. The long apparent half-lives of naltrexone and 6beta-naltrexol (5-8 days) were attributed to the slow release of naltrexone (long-acting naltrexone exhibits absorption rate-limited elimination or "flip-flop" kinetics); elimination was not altered in subjects with hepatic impairment. Based on pharmacokinetic considerations, the dose of long-acting naltrexone does not need to be adjusted in patients with mild or moderate hepatic impairment.

PMID: 16239359 [PubMed - indexed for MEDLINE]

High-dose naltrexone and liver function safety.

Studies have found naltrexone useful in the treatment of diseases other than opiate addiction in which endogenous opioids presumably play a role, such as alcoholism and eating disorders. Some of these studies involve high doses (100-200 mg bid). Because investigational studies with high doses (300 mg/day) reported clinically significant increases in liver enzyme levels, the authors measured a spectrum of liver function parameters in response to high doses of naltrexone in a double-blind, crossover trial (100 mg bid) followed by an open-label period (200 mg bid). They observed no adverse clinical or laboratory changes in liver function in association with high-dose naltrexone therapy in eating disorders.

PMID: 9097868 [PubMed - indexed for MEDLINE]

Effect of liver cirrhosis on the systemic availability of naltrexone in humans.

CONCLUSIONS: Our data suggest the occurrence of important changes in the systemic availability of naltrexone and 6 beta-naltrexol in liver cirrhosis; such alterations are consistent with lesser reduction of naltrexone to 6 beta-naltrexol and appear to be related to the severity of liver disease. This must be considered when administering naltrexone in conditions of liver insufficiency.
PMID: 9314128 [PubMed - indexed for MEDLINE]

Hepatic safety of once-monthly injectable extended-release naltrexone administered to actively drinking alcoholics.

RESULTS: There were no significant differences in alanine aminotransferase, aspartate aminotransferase, or bilirubin levels between the study groups at study initiation or at subsequent assessments. Gamma-glutamyltransferase in the XR-NTX 380 mg group was lower compared with placebo at weeks 4, 8, 12, and 20. Both high (>3 times the upper limit of normal) liver chemistry tests (LCTs) and hepatic-related adverse events were infrequent in all study groups. In patients who were drinking heavily throughout the study, obese subjects, or those taking nonsteroidal anti-inflammatory drugs, there was no increase in frequency of high LCTs or hepatic-related adverse events in patients receiving XR-NTX (either dose) compared with placebo. CONCLUSION: Extended-release formulation of naltrexone does not appear to be hepatotoxic when taken at the recommended clinical doses in actively drinking alcohol-dependent patients.

PMID: 18241321 [PubMed - indexed for MEDLINE]

Changes in transaminases over the course of a 12-week, double-blind nalmefene trial in a 38-year-old female subject.

A gradual return to normal in ALT and AST, while treatment with nalmefene continued, does not support the role of nalmefene as an hepatotoxin. Relapse to drinking was excluded because of normal values for the gamma-glutamyltransferase, and verification of sobriety by self-report, significant other, and breathalyzer. A virology panel ruled out the presence of viral hepatitis. Dietary intake before the elevation in LFTs contained elements that have established association with hepatocellular changes. The routine prescription of serial LFTs in alcoholism pharmacotherapy trials may be expected to reveal clinically nonsignificant elevations that could potentially be related to exogenous factors, such as dietary composition and should not be reflexively attributed to medication under investigation and/or drinking.

PMID: 7847604 [PubMed - indexed for MEDLINE]
Effects of long-term treatment with naltrexone on hepatic enzyme activity.

The influence of naltrexone on liver function in heroin addicts was studied, with respect to the metabolizing function by using the antipyrine clearance and to cellular damage by monitoring plasma levels of hepatic enzymes. The clearance of antipyrine was not affected by naltrexone treatment, and, during the study period, the use and withdrawal of benzodiazepines and alcohol did not change this parameter; moreover, there was no relationship between changes in plasma hepatic enzymes and antipyrine half-life. Mean plasma levels of hepatic enzymes did not show significant modification in the course of treatment with naltrexone.

PMID: 1686854 [PubMed - indexed for MEDLINE]

Effects of acute administration of naltrexone on cardiovascular function, body temperature, body weight and serum concentrations of liver enzymes in autistic children.

The effects of acute, orally administered naltrexone (0.5, 1.0, 1.5 and 2.0 mg/kg), a potent opiate receptor antagonist, on auscultated heart rate, systolic blood pressure and axillary body temperature were investigated before and about 1 h postdrug in 5 autistic children (4-12 years of age). In addition, an electrocardiogram was recorded on each child before and about 3 h after placebo or 2.0 mg/kg of naltrexone. Finally, the serum concentrations of the liver enzymes glutamic-oxaloacetic transaminase (SGOT) and glutamic-pyruvic transaminase (SGPT) were measured 24 h following placebo or naltrexone administration. Naltrexone had no statistically significant effects on any of these measures in comparison with baseline or placebo levels. Thus, these data provide preliminary evidence for the safety of acute administration of naltrexone in children.

PMID: 2721334 [PubMed - indexed for MEDLINE]

Naltrexone hydrochloride (Trexan): a review of serum transaminase elevations at high dosage.

In summary, evidence is presented associating typically asymptomatic and reversible elevations of serum transaminase values with high daily dosages of naltrexone. Statistical significance was found only between placebo and the 300 mg dosage. Subjects aged 40 years and over were significantly more likely to develop this finding than younger subjects. All subjects with significant elevations of transaminase values in these studies took daily naltrexone dosages higher than recommended for opioid addiction. The daily dosage of naltrexone recommended for opioid addiction did not cause abnormalities of serum transaminase values in these studies.

PMID: 3092099 [PubMed - indexed for MEDLINE]

Opioid receptor blockade improves mesenteric responsiveness in biliary cirrhosis.

The maximum pressure response to phenylephrine was decreased significantly in cirrhosis while chronic naltrexone treatment completely improved it (P <>

PMID: 18465246 [PubMed - indexed for MEDLINE]

[Antipruritic therapy with the oral opioid receptor antagonist naltrexone. Open, non-placebo controlled administration in 133 patients]

CONCLUSIONS: The oral opiate antagonists may well be an effective, well-tolerated therapy for intractable pruritus in many diseases.

PMID: 15517116 [PubMed - indexed for MEDLINE]
Endogenous opioids modulate hepatocyte apoptosis in a rat model of chronic cholestasis: the role of oxidative stress.

CONCLUSION: Our findings demonstrate that the administration of opioid antagonist is protective against hepatic damage in a rat model of chronic cholestasis. We suggest that increased levels of endogenous opioids contribute to hepatocytes apoptosis in cholestasis, possibly through downregulation of liver anti-oxidant defense.

PMID: 17403194 [PubMed - indexed for MEDLINE]

Involvement of endogenous opioid peptides and nitric oxide in the blunted chronotropic and inotropic responses to beta-adrenergic stimulation in cirrhotic rats.

Concurrent administration of naltrexone and L-NAME also restored to normal the basal abnormalities and the blunted responses to isoproterenol in cirrhotic rats, and did not show any antagonistic effect. Based on these findings, both the endogenous opioid peptides and NO may be involved in the attenuated chronotropic and inotropic responses to beta-adrenergic stimulation in cirrhosis. It seems that the iNOS activity results in NO-induced hyporesponsiveness to beta-adrenergic stimulation in cirrhosis.

PMID: 16968416 [PubMed - indexed for MEDLINE]

Tuesday, January 5, 2010

Low Dose Naltrexone January 2010 Lab Results for Hepatitis C

I started Low Dose Naltrexone (LDN) last March for Hepatitis C. I also test positive for Sjogren's Syndrome and Rheumatoid Arthritis (RA). These are my latest lab results.

I was a bit apprehensive as I didn't feel too well on the morning of my labwork - I had that "virusey" feeling and was also a bit stressed as they couldn't find the tests that they needed to run in the Quest Lab computer - so I sat for 45 minutes fuming. I had been feeling great except for that day (of course).

My HCV viral load crept up a bit from 18,729 in September to 34,524 - not too bad considering how I felt that day. Last January, pre-LDN, it was 1,280,000 and had dropped to 49,400 in June after being on LDN for 3 months. So I'm staying pretty stable - better than skyrocketing back up but not going down as I had hoped. For awhile, I was taking the 3 mg. LDN every other night, but for the last month or so, I went back to every night dosing. I will discuss with my doctor about possibly increasing the LDN dosage.

My ALT/AST were back to normal range though they weren't that high last time. In January last year, my ALT was 174, in May it dropped to 23, in Sept. it was 36 (range 6-40) and now is 34. My AST was 99 in January, 30 in May, 37 in Sept.(range 10-35) and 31 now.

Albumin (range 3.6 - 5.1) 4.8 - was 4.9 - it was 5.2 last January

Globulin (range 2.2 - 3.9) 2.9 from 3.0 - it was 3.7 last January

Bilirubin total (range 0.2 - 1.2) 0.7 from 1.1

Alkaline Phosphatase (range 33-130) 66 from 57

Total Protein - (range 6.2 - 8.3) 7.7 from 7.9 - it was 8.9 last January

Alpha Fetoprotein - 5.0 same as last time - was 6.1 which was high earlier last year.

My ferritin dropped from 80 to 38 which might be pushing it a bit - I'd been religiously taking the IP-6 along with a product called Chelaco (which my doc sells). My total iron is 136 (range 40-160) down from 165 and iron binding capacity is 373 from 352 (range 250-450)

Sjogren's level - 3.3 from 3.5 - it was 4.5 in January, pre-LDN

RA - 21 from 24 - it was 31 in January - pre-LDN

Vitamin D (range 20-100) - 59 from 49 but had been 62

Most of my other blood counts are the same - I need to talk to my doc before I try and interpret them - nothing really out of range but some of the ones that we were trying to change, via the methyl B vitamins are the same as they were in 2007. (MCV, MCH) red blood cell count, etc. I might talk to her about being tested for IF - Intrinsic Factor which can inhibit your body from absorbing B-12.

My red blood cell counts have always been on the low end - which was another argument on my part whenever a doc would try and push HCV treatment on me - ("how long before I'd be on Procrit? I'd ask them)

Slight decrease in platelets (range 140-400) 163 from 172 (186 last January)

Slight drop in red blood cell count (range 3.80-5.10) 3.84 from 3.95 (4.21 last January but 3.78 prior to that)

White blood cell count (range 3.8-10.8) 6.1 from 4.6 (6.0 from last Jan.)

Neutrophils - (range 1500-7800) 4111 from 2585 (3750 last jan.)

Eosinophils (range 15-500) 140 from 120 (102 last jan.)

Basophils (range 0-200) 24 from 14 (12 last Jan)

The LDN isn't really affecting my lymphocytes overall - some are better, some are worse.

CD3 (Mature T cells) (range - 57-85) 80 from 77

Absolute CD3+ Cells (range 840-3060) 1122 from 1008

%CD4 (Helper Cells) (range 30-61) 58 from 52

Absolute CD4+ cells (range 490-1740) 817 from 720

%CD8 (Suppressor T Cells) (range 12-42) 19 from 24

Absolute CD8+ cells (range 180-1170) 269 from 333

Helper/Suppressor ratio (range 0.86-5.00) 3.05 from 2.17

%CD16+CD56 (Natural Killer Cells) (range 4-25) 7 from 10

Absolute NK Cells (CD16+CD56 Cells) (range 70-760) 99 from 128

%CD19 (B cells) (range 6-29) 10 from 11

Absolute CD19+ Cells) (range 110-660) 139 from 134

Absolute Lymphocytes (range 850-3900) 1404 from 1308

Absolute CD3+ cells (range 840-3060) 1122 from 1008

Absolute CD4+ cells (range 490-1740) 817 from 720

Absolute CD8+ cells (range 180-1170) 269 from 333

Absolute NK Cells (CD16+CD56+ cells) (range 70-760) - 99 from 128

Absolute CD19+ cells - (range 110-660) 139 from 134

My doc also tests all of my adrenals (4 thyroid tests, progesterone, testosterone, etc.) Immunoglobulins, HHV 1-6 viruses, along with the standard CBC's, etc. All are pretty much the same as they were 2 years ago.

Overall, I'm pretty happy with the results especially as my viral load did not really increase as I had feared it might - and my LFT's have stabilized.