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Ketamine Update

zzz

Senior Member
Messages
675
Location
Oregon
@zzz Is there a magnesium test that is considered the most accurate? I'd love to learn more about it if you have any details. I take Magnesium supplements every night and sometimes test low but other times test normal.

There are basically three types of magnesium tests. The most common, cheapest, easiest to obtain, most heavily used, and least reliable is the blood serum test. Approximately 80% of Americans are magnesium deficient, and the percentage of people with ME who are magnesium deficient is at least that high. Yet only 30% of people with ME will get a "low" result on the blood serum test. These people definitely have magnesium deficiencies, but so do another 50% who score in the "normal" range. For example, I scored smack in the middle of the normal range, and yet I had a severe magnesium deficiency.

From Dr. Myhill:
Most doctors do not understand the difference between a serum magnesium and a red cell magnesium. Serum levels must be kept within a tight range, or the heart stops. Therefore serum levels are maintained at the expense of levels inside cells. Most labs just do serum levels and patients are told their magnesium is normal.

None of the CFS clinicians I have read about use this test.

The next better test is the intracellular red blood cell test. This is the one that Dr. Myhill does most often. This gives much better results; a magnesium deficiency will usually show up here. But as Dr. Myhill notes, taking adequate magnesium supplementation often does not bring this figure into normal range, so its accuracy is limited.

The best test is the sublingual magnesium test, where magnesium is measured in mucosal cells obtained from under the tongue. There are various companies that do this type of testing.

Some doctors recommend that the diagnosis of magnesium deficiency be made on the basis of symptoms. This can make a lot of sense when someone has a lot of metabolic abnormalities, as we do. There are many symptoms of magnesium insufficiency, including muscle cramps or twitches, insomnia, irritability, sensitivity to loud noises, anxiety, autism, ADHD, heart palpitations, angina, constipation, spasms in the muscles, headaches, migraines, fatigue, asthma and kidney stones

You probably noticed that many of these symptoms overlap those of ME. So you might want to try a magnesium injection (either IM or IV) in your doctor's office to see if it makes you feel better. The first injection should be done in the doctor's office in case you have a reaction to the magnesium, which is very rare.
@zzzz -I am on Natural Calm. Is that enough?

Although Natural Calm contains one of the better-absorbed forms of oral magnesium, for significant magnesium deficiencies, no oral form will provide enough; the gut simply won't absorb the amount that you need. This is especially true if your blood serum magnesium (the first test I mentioned) is low; this test shows low only when you are severely depleted in magnesium.
I am also low in Taurine.

If you do the magnesium injections as Dr. Cheney describes in my previous post, you can get your magnesium and taurine both in the same injection.
I have to see how much the lidocaine is...that can be super expensive and I am not rich. I am on SSD.

I don't know how much generic lidocaine would cost. But if you're on SSD, don't you have Medicare? They should cover the lidocaine if your doctor prescribes it.
 

Misfit Toy

Senior Member
Messages
4,178
Location
USA
@zzz -thank you for all of your comments. I know that anything mineral that is given via IV is paid out of pocket. I know lidocaine injections into muscle's is covered by medicare..yup, I am on medicare. But, I am not sure about an IV of lidocaine. I will have to ask.

Whenever I was given the IV of magnesium, I remember becoming flush and it's super hot..it made me feel really hot. Like I was on fire. Not sure why.

I didn't have a blood test. I had a urine test for magnesium from what I remember. With Dr.'s Data or something to check minerals. Magnesium was not even detected. Bizarre.

Anyway, it is something to look into. I would rather give it to myself because the drive to my doc's is way too long and I would need to go too often. He is an hour away when there is no traffic.

gosh, I can't thank you enough for all of this info. I so appreciate it.
 

zzz

Senior Member
Messages
675
Location
Oregon
@zzz -thank you for all of your comments. I know that anything mineral that is given via IV is paid out of pocket. I know lidocaine injections into muscle's is covered by medicare..yup, I am on medicare. But, I am not sure about an IV of lidocaine. I will have to ask.

I checked it out. Unfortunately, IV lidocaine for pain is classified as being in an "investigational" stage, which according to the rules means it is "not medically necessary".

The logic of that conclusion escapes me.

Apparently, some insurance companies used to pay for IV lidocaine for pain, but they then followed Medicare's lead and reclassified it as an "investigational" drug, so they no longer cover it. And without insurance, the cost of this is prohibitive.

Nevertheless, there are still many (affordable) options open for pain treatment.

It seems very likely that the pain is coming from the EBV or the Valtrex (or both). So what would be ideal would be if you could get rid of the active EBV infection quickly without having to use Valtrex.

This is not as unlikely as it may sound at first. In 1979, Dr. Goldstein discovered that he could cure acute mononucleosis infections in 90% of his patients in one to two days by using Tagamet. The theory behind this can be found on page 196 of Chronic Fatigue Syndrome Treatment: A Treatment Guide (well worth the $4 if you don't already have this book). You can also find this page online here. Tagamet is also helpful in reducing ME/CFS symptoms in general for 20% of the people who take it (sometimes by quite a bit); you may be more likely than most people to benefit from it since your CFS seems to be connected with your EBV.

Despite the fact that Dr. Goldstein published a paper on this, and the results were duplicated elsewhere, this still has not been adopted as a standard treatment for mononucleosis, so your doctor may not be familiar with it. However, it is quite effective; people with refractive mononucleosis used to travel long distances just to have Dr. Goldstein give them Tagamet. It was available only by prescription back then; now, you can get it over-the-counter at any drugstore, and cheap generic forms (cimetidine) are available. Tagamet is effective against all herpes viruses. From Life Extension Magazine:
While pharmaceutical companies promote expensive and only partially effective anti-viral drugs, there is evidence dating back more than 20 years that the drug cimetidine (sold over-the-counter as Tagamet) is highly effective in shortening the duration or preventing the outbreaks of herpes and shingles. The problem is that virtually no physicians are prescribing cimetidine to their herpes (or shingles) patients, despite persuasive findings in peer-reviewed scientific journals.

There's also a thread about Tagamet and ME/CFS right here on PR.

Zantac (ranitidine) works similarly to Tagamet; both are H(2) antagonists. Zantac has the advantage that it has fewer side effects than Tagamet. However, there is less evidence that Zantac works against EBV.

Because Tagamet may interact with and increase blood concentration of many drugs, it is important to check with your doctor before taking it. If he takes phone calls (or email), I would think that contacting him that way would be sufficient.
Whenever I was given the IV of magnesium, I remember becoming flush and it's super hot..it made me feel really hot. Like I was on fire. Not sure why.

This is a common effect of IV magnesium. It's nothing to worry about.
I didn't have a blood test. I had a urine test for magnesium from what I remember. With Dr.'s Data or something to check minerals. Magnesium was not even detected. Bizarre.

The urine test doesn't actually tell you about the body's magnesium levels; it just tells you how much magnesium is being excreted by the kidneys. Normally, you should be excreting about 75 to 150 mg of magnesium per day in your urine. The fact that you're apparently excreting none would seem to imply one of three things:
  • The EBV is causing problems in your kidneys, preventing them from excreting magnesium. This is rare.
  • Your body magnesium is so low that there's nothing left for your kidneys to excrete. This is unlikely.
  • The Valtrex is causing problems with your kidneys. This is a known side effect of Valtrex. If this is what's happening, you actually may have an excess of magnesium in your body, as the kidneys are one of the two routes through which magnesium is excreted. The other is through the liver, and as you mentioned at one point that you have liver problems, this could be causing additional magnesium retention. If the Valtrex is causing problems with the kidneys, the dose is supposed to be reduced.
In any case, this means that your magnesium may be either too high or too low, so you shouldn't try modifying its levels until you find out what's going on. I would think that under the circumstances, it would be good to have a full renal function panel. At the very least, you should have your creatinine and BUN tested. A magnesium test would also be good in your circumstances; please see my previous post for the various options.

If you're having kidney problems, it's likely that this would aggravate your MCS, as you can't detox properly; your liver problems are probably contributing to this as well. It would be good to resolve the kidney situation before starting the Tagamet, as otherwise the Tagamet side effects may be amplified. Fortunately, you would only have to take the Tagamet for a short time.
gosh, I can't thank you enough for all of this info. I so appreciate it.

My pleasure! It's nice to do something helpful even though I'm sick too.
@zzz I also wanted to thank you for all the information re: Magnesium and I am going to be asking my Dr's about it in the future. It was very helpful.

And you're welcome too, @Gingergrrl! Again, I'm glad to be able to help out.
 
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Gingergrrl

Senior Member
Messages
16,171
@zzz Wow, I had never heard of Tagamet being used to treat EBV, herpes viruses, or CFS and this was completely new for me!

I read all your links re: Dr. Jay Goldstein and was wondering if he is still around or retired? Sorry I did not google him yet! Why did his ideas not become more mainstream in the CFS community?

I also read the entire thread you linked which spans a three year period and wondering if any of those posters are still on PR or taking Tagament today?

Do you know if it only works for active shingles or cold sores? I have never had any outward signs of herpes but have positive IgM for VZV besides EBV.

Have you tried Tagament yourself and if so, how did it work? I am going to ask my Dr about this. Thanks again!!!
 

Sushi

Moderation Resource Albuquerque
Messages
19,935
Location
Albuquerque
@Gingergrrl I know of several ME/CFS doctors who recommend trying to block all 3 of the histamine receptors. Most of the later generation antihistamines are H1 antagonists. It is hard to find H3 antagonists but (I don't know of any drugs), but when researching it, there do seem to be some non-drug H3 antagonists.

I have heard of using Histamine antagonists for general ME/CFS symptoms (particularly inflammation), though I had not heard of antiviral properties.

Sushi
 

zzz

Senior Member
Messages
675
Location
Oregon
@zzz Wow, I had never heard of Tagamet being used to treat EBV, herpes viruses, or CFS and this was completely new for me!

Yes, it was new to me too until I read Dr. Goldstein's books. And most doctors have never heard of this, 35 years after Dr. Goldstein discovered it.
I also read the entire thread you linked which spans a three year period and wondering if any of those posters are still on PR or taking Tagament today?

I don't know. I haven't read the whole thread.
Do you know if it only works for active shingles or cold sores? I have never had any outward signs of herpes but have positive IgM for VZV besides EBV.

Yes, it works for all herpes viruses. It can also be used prohylactically to prevent outbreaks of shingles and cold sores if you know you have the underlying virus.
Have you tried Tagament yourself and if so, how did it work?

I started using Zantac (ranitidine) just a little while ago. Zantac is another H(2) antagonist which came out after Dr. Goldstein's initial discovery. Zantac has fewer side effects than Tagamet, and Dr. Goldstein started recommending it over Tagamet for this reason. I have not noticed any ME/CFS effects so far, with the possible exception of memory improvement which is theorized to be an effect of H(2) antagonists. I started taurine about the same time, and taurine is known to improve memory. My memory has definitely improved recently; I've been able to stop making lists of medications and whether I've taken them, as once again I can now just remember that. Word finding problems have decreased as well. This could all be from the taurine, though.
I am going to ask my Dr about this.

Be prepared for the likelihood that your doctor has never heard of this. As Dr. Goldstein says on page 313 of tuning the Brain:
As a probably predictable aside, I should mention no one evinced the slightest curiosity about how these results [the rapid termination of LSD effects using niacin] were accomplished, and this "antidote" remains little known thirty years later, much like my discovery in 1979 that cimetidine made acute infectious mononucleosis in teenagers or adults (and varicella, too) resolve in one or two days. I am getting tired of whining about it, but hardly anyone is aware of this treatment, even now [in 2004, 25 years after its discovery]. Although I reported a 90 percent cure rate in over 100 patients (rather high for a placebo response), the results were "anecdotal". Naturally, I was unable to get a grant to perform a double-blind, placebo-controlled experiment. "But Tagamet (and later Zantac) is for ulcers," the reviewers would write. The fact that the chairman of the department of infectious diseases at the local medical school was my coinvestigator on the grant proposal did not grease the wheel at all.

@Misfit Toy, I just discovered that Dr. Goldstein also used ketamine in the form of a nose spray. However, he found that ketamine drops in the mouth were much more effective. As that uses a different nerve pathway to the brain, perhaps that would work when the nose pathway doesn't. When used in the mouth, you swirl it around for a few seconds so that it gets all around the mouth tissue, and then you swallow it. The taste buds on the tongue are the most sensitive to ketamine, so be sure that it covers the tongue completely when you swish it around. Dr. Goldstein reports that just a couple of drops of a highly diluted ketamine solution can have a strong effect when taken this way.

@Gingergrrl, so that I don't hijack @Misfit Toy's thread, I'll answer your remaining questions about Dr. Goldstein in a new thread, and edit this post to point to it when I'm done. I have just started on Dr. Goldstein's CFS protocol, and I'm already getting positive results, so I have much to report.
 

Misfit Toy

Senior Member
Messages
4,178
Location
USA
@zzz , I don't mind you answering anything here as it is not offensive. I am learning so much. Where did you come from and where have you been? LOL....we need you here.

So, I have tried Tagement. I tried it with an asthma med. What is it called?? Singulair. I was knocked into outer space. My immuno thought it would be good because I was convinced I had a mast cell disorder which I ended up not having. I was so drugged and sick and having massive amounts of diarrhea. My doc had me stop it pronto. I am not sure if it was the Tagamet or the combo, but man, was I ever drugged. It took me days to recoup.

It couldn't have been the Valtrex regarding the Magnesium and it not being detected. I only took it 6 days. That magnesium test was done a year ago while on nothing.

Ketamine..I just started taking it here and there...but not the full dose of 3 sprays a day. It kicked my pain so well, I had to try it again. I am wondering if I could swish the nasal spray in my mouth? I would think if it was okay for my nose and it goes straight to the top, that it would be suitable for swallowing...In a sense, I do swallow it. It runs down the back of my throat.

My doc will prescribe anything I want. He knows I do so much research and the one good thing about him is he believes in me. I can't take narcotics, so he knows I am not a druggy. He is into outside of the box thinking, thank God.

He does Lidocaine injections, but medicare only pays for 4 of them a year. Crazy! I need one big injection...not trigger points. It stinks.

I can handle Zantac.

My doc just prescribed Red Marine Algae which is supposed to be good for EBV. I am not sure. All supplements sort of do nothing when it comes to a hardcore virus or bacterial infection.

Again, thank you so much for your information. You really do know so much and have all of these references which you must keep on file.

PS..I have a thought..I think with me what happens is, I have phase II liver problems bad. It's a genetic mishap that according to my doc, can't be undone. I think meds get stuck in me. They stick around because I can't detox them and they build up and I suddenly get super sick. The Ketamine was working good and then BOOM...not so much. Why? My liver. I can't clear it and I started mixing other meds with it and my body went nuts.

I think Heapsreal and Minkey are right that you sort of have to switch things up a bit. For me, because of my liver.

I drank green tea today with a tincture of Milk thistle in it to try and clear some things out. I am writing my doc about the magnesium...again, you are so kind to provide so much info.
 

Gingergrrl

Senior Member
Messages
16,171
@zzz Thank you so much for all the incredible information and I am going to read it all when I am more alert. I also do not want to side-track @Misfit Toy's thread so please put the info wherever it fits best and I will find it (or send you a private msg!)

I actually asked my CFS Dr today re: Tagamet (we had been e-mailing re: my new blood test results and an upcoming cardiac test he helped arrange, God bless him, so I threw in the Tagamet question.) He actually was familiar with it and said there was a lot of anecdotal evidence from the 80's re: Tagamet helping with T cells, herpes viruses and said that it is also a histamine blocker.

He felt it was an okay thing for me to try and told me not to take with Zantac or Pepcid (which I do not take) and some dosing suggestions. I asked him some follow-up questions b/c I always do best when starting at lower doses (and suspect my liver does not clear things properly similar to @Misfit Toy.) I do not have any Tagamet so it may take me a few days to get some as I have been really sick and unable to leave the house the last two days.

If I do end up getting Tagamet and giving it a try I will report on the board how it goes and I have never taken it before. Thanks again for the info.
 

Sushi

Moderation Resource Albuquerque
Messages
19,935
Location
Albuquerque
I started using Zantac (ranitidine) just a little while ago. Zantac is another H(2) antagonist which came out after Dr. Goldstein's initial discovery. Zantac has fewer side effects than Tagamet, and Dr. Goldstein started recommending it over Tagamet for this reason.
@Gingergrrl Note the quote above before opting for Tagamet.

Sushi
 

Soundthealarm21

Senior Member
Messages
420
Location
Dallas, TX
@zzz

I'm curious about the Tagamet. So obviously Tagamet and a PPI such as Nexium work in a much different way but both reduce stomach acid. What is it about Tagamet that gives it an antiviral property? Sounds like I have some reading to do.
 

Gingergrrl

Senior Member
Messages
16,171
@Sushi, thanks and I did not catch that quote re: Zantac. I actually have taken Zantac many, many years ago for stomach issues (pre-CFS) and never had any problem with it. I don't have either in the house now and will need to do some more research.

@Soundthealarm21 I wish I knew why it had anti-viral properties and my Dr said it was "anecdotal" stuff from the 80's but felt that it wouldn't hurt to try it. Please post anything that you find out.

@Misfit Toy, hope you feel better too.
 

SeaShell

Senior Member
Messages
122
There is some discussion here on Magnesium deficiency and sources. I have been getting my magnesium for the past few years via the following methods:

Oral: Magnesium Citrate - this is what I use Now Magnesium Citrate

Transdermal: Epsom Salts in bath. I get my Epsom salts in bulk (25 kg bag) from a good local supplier. A few years ago I used to take the baths twice a day. Morning and evening. I no longer need them that often but I still take them a few times a week. It is very relaxing. For those with muscle aches and pain, soaking in the bath with a few cups of salts helps to get magnesium into the body. It also relaxes the body, helps sleep and has a detox effect. Combined with sea salts it also helps eczema and skin issues.

Transdermal: Magnesium oil applied to skin. There are a number of brands available. This is what is use
Swanson Magnesium Oil

You can also get magnesium via green foods like chlorophyll.
 

zzz

Senior Member
Messages
675
Location
Oregon
@zzz , I don't mind you answering anything here as it is not offensive.

Thank you, @Misfit Toy, but it's not so much a question of being offensive as simply avoiding confusion by not having two different conversations mixed together. I will definitely post here when I have started the other thread, so you will be able to find it as soon as it's started. This may be a little while, as the time I am able to post here is limited.
Where did you come from and where have you been?

Where I came from is a deep ontological question, the answer to which I do not know. o_O But I think you're asking more about how I came to PR. :) PR has developed rather quickly, at least from the perspective of someone who has been watching the years fly by while mostly bedridden. I came across PR just a few months ago, when I was researching material to present to my doctor. I was very happily surprised to see a lot of information and a lot of leading-edge discussion about ME topics by a group of well-educated people. I have learned a lot from PR these last few months, and for that I am very grateful.

As for where I've been, I haven't been hanging out at any particular forums. I've just been doing research on my own for the 24 years that I've had ME. I subscribe to a number of newsletters, so I've kept fairly up to date that way.
So, I have tried Tagement. I tried it with an asthma med. What is it called?? Singulair. I was knocked into outer space. My immuno thought it would be good because I was convinced I had a mast cell disorder which I ended up not having. I was so drugged and sick and having massive amounts of diarrhea. My doc had me stop it pronto. I am not sure if it was the Tagamet or the combo, but man, was I ever drugged. It took me days to recoup.

Yes, Singulair is generally not a good medicine for those of us who are very sensitive to drugs. I took one dose of it and had a very bad reaction. That was the last dose I ever took. Singulair can cause diarrhea, as well as all sorts of CNS side effects. From the prescribing information:
Neuropsychiatric events have been reported in adult, adolescent, and pediatric patients taking
SINGULAIR. Post-marketing reports with SINGULAIR use include agitation, aggressive behavior or
hostility, anxiousness, depression, disorientation, disturbance in attention, dream abnormalities,
hallucinations, insomnia, irritability, memory impairment, restlessness, somnambulism, suicidal thinking
and behavior (including suicide), and tremor. The clinical details of some post-marketing reports involving
SINGULAIR appear consistent with a drug-induced effect.

And that's only the neuropsychiatric events.

If you ever have to take that type of drug again, I would recommend Symbicort, which is a much more benign drug, and which caused no problems for me.

Tagamet may cause diarrhea, but it does not produce the other side effects you mentioned; However, since it tends to delay the excretion of other drugs, it can make the side effects of other drugs worse. Tagamet is excreted in the urine, so it interferes with the excretion of other drugs that are excreted via the kidneys. This means that it increases the side effects of a different class of drugs than the ones that aren't metabolized properly by your liver. Nevertheless, you can certainly do without more side effects of any kind. So I think that Zantac definitely makes sense to try first here, especially for people with liver or kidney problems. The reason I didn't mention Zantac from the beginning is that there is less documentation on its effects against herpes viruses, and I found one study that claimed it was no better than a placebo when used as a treatment for mononucleosis. However, I have learned to take single studies with a grain of salt (remember XMRV?), and as Zantac is an H(2) antagonist just like Tagamet, and Dr. Goldstein recommends it over Tagamet, I would think that it would work equally well against EBV.
It couldn't have been the Valtrex regarding the Magnesium and it not being detected. I only took it 6 days. That magnesium test was done a year ago while on nothing.

Have you had your kidneys tested since that urine test? If not, I would highly recommend it.
Ketamine..I just started taking it here and there...but not the full dose of 3 sprays a day. It kicked my pain so well, I had to try it again. I am wondering if I could swish the nasal spray in my mouth? I would think if it was okay for my nose and it goes straight to the top, that it would be suitable for swallowing...In a sense, I do swallow it. It runs down the back of my throat.

I would also think that it would be OK for the reasons you mentioned, as long as the nasal spray doesn't have any other ingredients that would irritate your mouth. You might want to try a slightly smaller dose at first; since the reaction is pretty much immediate, you'll be able to tell if the dose is sufficient.
My doc will prescribe anything I want.

You are very lucky in that respect! I wish I had a doctor like that. :rolleyes:

Many years ago, a good friend of mine said, "A good doctor is one who will give you what you want." I've learned to appreciate the wisdom of those words, at least in the cases where the patient knows what he or she is doing.
My doc just prescribed Red Marine Algae which is supposed to be good for EBV. I am not sure. All supplements sort of do nothing when it comes to a hardcore virus or bacterial infection.

I took a quick look, and it appears that Red Marine Algae is an effective antiviral against herpes viruses. Interestingly, it's been used for over 2000 years in traditional Chinese medicine (TCM). As this is not a pharmaceutical product, there aren't any definitive clinical trials of it, although there are several studies, such as this one from 1974, that showed positive results for it. Apparently, there are a number of types of Red Marine Algae, and the effectiveness varies both by type of algae and by type of herpes virus. Some good versions of this algae are solid by iHerb. However, even the best forms of Red Marine Algae have not been reported to clear up herpes outbreaks as fast as Tagamet or Zantac.

I'd try the Zantac first, and if neither it nor the Tagamet could clear up your EBV, I'd give the Red Marine Algae a shot. The Red Marine Algae might also be useful to keep your EBV in check once the current outbreak has been stopped.
Again, thank you so much for your information. You really do know so much and have all of these references which you must keep on file.

Well, I do have a folder where I save useful information, but most of what I've posted in this thread I didn't know a month ago. It came either from Dr. Goldstein's books or from the Google Medical Library. :) All the material on magnesium I learned about six months ago, when I did research on it for myself.

PR is an excellent source of material, especially since people are very good about linking to references. Google is also very good; it just takes patience at times. The two most important things with Google are knowing which terms to use in a search, and which sources are most useful. Sources like WebMD are good only if you want a brief overview. Otherwise, sources designed for professionals are best. For drugs, the best single source of information for any prescription drug is the prescribing information, which is what goes into the PDR. If you just Google the drug name and "prescribing information", you should be able to find it quickly. Sometimes, there's some additional information about a drug (such as individual patient reports) that you can find by Googling just the drug's name.
PS..I have a thought..I think with me what happens is, I have phase II liver problems bad. It's a genetic mishap that according to my doc, can't be undone.

Oh, that's really nasty. That means you're a pathological detoxifier. Do you know which of your detoxification pathways aren't working? Although apparently your problem can't be fixed, there are various treatments that can lessen the impact of some of these defects. There's a thread here on PR about dealing with problems in the sulfation pathway.
I think meds get stuck in me. They stick around because I can't detox them and they build up and I suddenly get super sick.

This would be true for drugs that are metabolized and/or excreted by the liver. If you stick with drugs that don't depend on the liver to be metabolized and that are excreted mainly or solely through the kidneys, you should be able to avoid a lot of the drug side effects. That assumes that your kidneys are working properly, though, which you may need to check out.
The Ketamine was working good and then BOOM...not so much. Why? My liver. I can't clear it and I started mixing other meds with it and my body went nuts.

Ketamine and its metabolite norketamine are normally excreted almost entirely by the kidneys. The problem is that a healthy liver gradually metabolizes ketamine into norketamine, which is only about one third as active as ketamine. If your liver isn't doing this, then you have more of the stronger version of ketamine in your body than healthy people.

Since the excretion route of both ketamine and norketamine is through the kidneys, it seems that you could ameliorate this problem simply by taking a somewhat smaller dose of ketamine. But since the half life of ketamine is rather short (2.5 hours), you shouldn't have to reduce the dose by much. Overall, I think that the pharmacokinetics of ketamine are such that your liver problem shouldn't be causing you much trouble in this case.
I'm curious about the Tagamet. So obviously Tagamet and a PPI such as Nexium work in a much different way but both reduce stomach acid. What is it about Tagamet that gives it an antiviral property? Sounds like I have some reading to do.

Tagamet is an H(2) antagonist, which means that it blocks the histamine(2) receptors. Nexium is a proton pump inhibitor. Both reduce stomach acid, but the acid reduction has nothing to do with the antiviral action. Only the H(2) antagonists have antiviral properties. Please see the link from my original thread on this for further details.
 
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Little Bluestem

All Good Things Must Come to an End
Messages
4,930
I actually asked my CFS Dr today re: Tagamet (we had been e-mailing re: my new blood test results and an upcoming cardiac test he helped arrange, God bless him, so I threw in the Tagamet question.) He actually was familiar with it and said there was a lot of anecdotal evidence from the 80's re: Tagamet helping with T cells, herpes viruses and said that it is also a histamine blocker.

He felt it was an okay thing for me to try and told me not to take with Zantac or Pepcid (which I do not take) and some dosing suggestions.
@Gingergrrl , would you be willing to share his dosing suggestions?
 

Gingergrrl

Senior Member
Messages
16,171
@Gingergrrl , would you be willing to share his dosing suggestions?

@Little Bluestem I'm happy to share but want to give the disclaimer that this is not something he normally would suggest or prescribe. He felt it couldn't hurt based on the anecdotal evidence of the 80's but not part of his protocol. Having said that, I also am not sure if there are different kinds of Tagamet or only one. He initially told me 400 mg 3x/day but b/c I am extremely sensitive to meds & side effects he told me to only do it once per day.

I looked at CVS today and the Tagamet box says 200 mg 1-2x/day so it is a much lower dose! I went ahead and bought it but since I just started B-12 shots this week and about to start Methyl-Folate, I didn't want to throw anything else into the mix. I am keeping it for the future and if I try it, I will post about it here, but it won't be any time soon.
 

zzz

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@Gingergrrl, as you are extremely sensitive to drugs and side effects, I would recommend Zantac (ranitidine) instead of Tagamet. (This advice would also apply to you, @Little Bluestem.) Dr. Goldstein used Tagamet in his early studies only because Zantac had not been released at the time. But the actions of these two drugs are identical in terms of their function as H(2) antagonists, which is why they both continue to be marketed heavily and sell well. However, Zantac (ranitidine) has far fewer side effects, which is more important for us than for most people, and which is why Dr. Goldstein switched to it sometime before he wrote Betrayal of the Brain in 1996. There are very few medications I can take at this point, but I had no problem with OTC Zantac at the maximum dose.

The form of Zantac recommended by Dr. Goldstein is the 150 mg size, which is available OTC. It can be taken once or twice a day. It would seem to make sense to take it twice a day for herpes flare-ups, and once a day for maintenance. It could also be taken twice a day for general CFS symptoms, if it helps. For some people, it helps dramatically. For example, here is part of Dr. Goldstein's case report on someone who responded very well to Zantac (ranitidine):

A 50-year-old single Caucasian female probation officer... developed typical CFS/FMS symptoms and it was difficult for her to continue to work... She was begun on ranitidine 150 mg b.i.d. [twice daily] and felt much better in two days in all respects... Another physician referred her to a gastroenterologist for evaluation of heartburn. Her ranitidine was discontinued by the gastroenterologist and omeprazole [Prilosec, a proton pump inhibitor and not an H(2) antagonist] was prescribed with assurances that it would "work even better" than ranitidine for her CFS as well as for her reflux esophagitis. Three days after stopping ranitidine she began sleeping 14 hours a day and experienced severe malaise. After several days of this relapse, she restarted ranitidine and resumed good health in 48 hours.