Spironolactone for viruses - personal experience gathering

MartinK

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Hi there,
I would like to see more discussion about spironolactone for EBV (and maybe more viruses?) and especially personal experiences, if this drug someone helps?

STUDIES:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4822607/
https://onlinelibrary.wiley.com/doi/full/10.1111/imj.11_14849

@Hip summarizing thread: https://forums.phoenixrising.me/thr...emission-on-spironolactone-25-mg-daily.83701/

- How long to take it?
- Can help with more viruses?
- Who from PR forum currently trying this drug?

- Does anything increase the effect of this drug?

I'm interested to try it, because I found out my insurance company does not cover longterm Valcyte. Anything that has a potentially low risk, low cost and can affect the viral load should be thoroughly tested in ME/CFS! :)

I am adding someone (if they are still active here) who could give a useful summary: @pcmenten @Rrrr


Cheeers, Martin
 

raghav

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https://healthcare.utah.edu/publicaffairs/news/2016/02/herpesvirus-drug.php

In a search for new drugs to treat viral infections, scientists at the University of Utah School of Medicine found that a medicine routinely used to treat heart failure, spironolactone, has an unexpected ability to block infection by Epstein-Barr virus (EBV), a herpesvirus that causes mono and is associated with several human cancers. They find that the drug’s antiviral properties stem from its ability to block a key step in viral infection that is common to all herpesviruses. Spironolactone’s target is distinct from that of existing drugs, revealing that it could be developed into a new class of anti-herpesvirus drug.
 

raghav

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https://onlinelibrary.wiley.com/doi/full/10.1111/imj.11_14849

SPIRONOLACTONE AS TREATMENT FOR CHRONIC FATIGUE SYNDROME IN PATIENTS WITH POSITIVE EPSTEIN BAR VIRUS SEROLOGY
Background: Epstein Barr Virus (EBV) is a widely disseminated herpes virus (human herpes virus4). The majority of primary EBV infections in humans are thought to be originate in the oropharynx. Oropharyngeal epithelial cells are permissive for viral replication. EBV is the etiologic agent of infectious mononucleosis. The host cells of EBV are the B and T Lynphocytes. The EBV persist as a latent asymptomatic infection for life in adults and is associated to B cell Lymphoma, T cell lymphoma, Hodgkin lymphoma, Burkit-lymphoma and Naso-pharyngeal carcinoma. The EBV has been implicated in the pathogenesis of MS as high EBV titres have been reported in patients with MS. Patients with positive EBV serology and CFS could be considered as carriers of a chronic infection related to EBV. In patients with CFS positive levels of EBV antibody have been reported but there is no definitive evidence that chronic EBV infection is responsible for the symptoms. Spironolactone has an antivirus effect against EBV by inhibiting EBV SM protein function.

The present report is related to a group of patients with Chronic Fatigue Syndrome (CFS) and positive serology for EBV who voluntarily decided to try low dose Spironolactone for their condition.

Population and Method: 21 patients with positive serology for EBV infection and CFS were included All the patients were treated with multi-vitamins. Patients were invited and educated about potential benefit and adverse effects of Spironolactone; patients started Spironolactone at dose of 12.5 mg to 25 mg a day.

Results: 21 Patients seventeen Females age 54.2 +11, four Males 63.7+5. All the patients had multivitamins and Spironolactone. Five patients presented intolerance to Spironolactone. 16 tolerated the dose of 25 mg a day 5 of these patients had no more CFS and all the rest improve in fatigue and general symptoms.

But nothing is given of the duration for which spironolactone was given. Dr. Jacob Teitelbaum in his practice gives desmopressin low dose with spironolactone to compensate for the loss of fluids and electrolytes due to frequent urination and to avoid frequent visits to the toilet in the night which can cause fatigue on its own.
 

Hip

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They find that the drug’s antiviral properties stem from its ability to block a key step in viral infection that is common to all herpesviruses. Spironolactone’s target is distinct from that of existing drugs, revealing that it could be developed into a new class of anti-herpesvirus drug.
Spironolactone is antiviral for EBV when used at high concentrations in vitro, but a calculation I performed indicated that you would not be able to attain the same concentrations in vivo, so you will not get much antiviral effect when taking this drug.

This is why the study says spironolactone "could be developed into a new class of anti-herpesvirus drug". What they do is take a spironolactone as a lead molecule, and tweak it until they find a new similar molecule that does have potent in vivo antiviral effects.


Spironolactone nevertheless may have other benefits for ME/CFS, based on its anti-inflammatory or immunomodulator actions, which could explain why some ME/CFS patients benefit from it.

In this post I speculate that spironolactone's inhibition of Th17 might result in increased viral clearance of both EBV and coxsackievirus B.
 

MartinK

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@raghav
But nothing is given of the duration for which spironolactone was given.
Yes, this is main problem. :-/
Therefore, I urge everyone, if you know of someone who has tried it, to succeed, to join the discussion. Or know someone directly from that 2020 study?

@Hip
Spironolactone is antiviral for EBV when used at high concentrations in vitro, but a calculation I performed indicated that you would not be able to attain the same concentrations in vivo, so you will not get much antiviral effect when taking this drug.
Another main problem....but - I ask myself, didn't the scientists anticipate that in that study from 2020?
I'll probably try to address the scientists behind the study directly.
 

Hip

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Another main problem....but - I ask myself, didn't the scientists anticipate that in that study from 2020?
These sort of in vitro antiviral studies are usually not intended to identify compounds which can be directly used clinically to treat viral infection. Rather, they are designed to identify promising lead compounds that could be used as the inspiration for creating a new antiviral drug.

So in this case, drug companies or researchers may try to develop analogues of spironolactone, whose molecular details are optimized to make a much more powerful antiviral, and one which may be effective in vitro.
 
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MartinK

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@Hip yes, yes, but study from 2020 was on patients with CFS:

"The present report is related to a group of patients with Chronic Fatigue Syndrome (CFS) and positive serology for EBV who voluntarily decided to try low dose Spironolactone for their condition. "

This is why I consider reaching directly to the scientists behind the study (from Noosa hospital) to provide more info.
 

Hip

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@Hip yes, yes, but study from 2020 was on patients with CFS:
If spironolactone benefits ME/CFS as this study suggests, it could do so by a number of different mechanisms.

So the benefit for ME/CFS does not offer any proof that spironolactone is antiviral.

Note that there is a difference between fighting viruses by a direct antiviral action, and by an immunomodulatory action. So spironolactone could still fight viruses, in spite of a lack of antiviral effect.
 

MartinK

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I have some more important info about Spironolactone and patient conditions before treatment in study from Dr. do Campo:

"Dear Martin:
The patients treated with spironolactone are still taking it.Some of them for more than a year.
they also have Vit C 3 grs a day Vit B12 1mg intramuscular every 4 weeks, folate 5 mg a day and Vit B1 100 mg a day and Vit D 2000U a day.
Some of our patients are on low dose Naltrexone 3 mg a day (starting with 1.5 mg) targeting to increase the endorphin.

The spironolactone starting is 12.5 and later after 4 weeks and good tolerance they increase to 25 mg a day.
Monitor of blood pressure and maintain a good intake of fluids is very important, Spironolactone is a diuretic but we are no looking forward for the diuretic effect so oral intake of fluid should be maintain in no less than 2-3 litres a day.
The benefit of spironolactone takes weeks to come easy 4 weeks after dose is on 25mg a day.
The patients I have are no in bed but some are very limited in what they can do as physical activity.
Every patient is different we use the pedometer to know how many steps every one can tolerate.
we suggest to repeat the step as tolerated without trigger exhaustion post exercise,
This mean the pedometer tells you how many steps you can tolerate and then try to repeat them every day.

I think the neuroinflammation on neuroglia is a very attractive explanation for the effect of Spironolactone moderating the activity of macrophage.
The references in my abstract and poster are very good articles and explain this effect, no in chronic fatigue but yes in neuroinflamation."
 

godlovesatrier

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I've got a lytic ebv breakout currently on the back of some sort of bacterial infection which appears to now be gone. I haven't had a reactivation of ebv for about 4 months maybe it's been 6 I forget. I was always concerned doing Josh's protocol that this could happen so whilst it's angered and depressed me I guess I shouldn't be that surprised.

I intend to try 25mg a day and see how it effects my symptoms.

One thing I will say of this protocol (the one in my signature) it's giving me an excellent baseline for trying new treatments and drugs and I think a lot more to go on as I get all my new tests over the next 12 months.

But right now it seems that ebv is yet again the issue and coxsackie b4 might not be very far behind it for the unlucky ones who have it.
 

godlovesatrier

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Also it makes sense to me that spironolactone might help ME from a secondary mode of action unrelated to anti virals. Considering there's no way in hell ebv can just replicate like this without some sort of inflammatory/cytokine/th1/2 balance issue....or some other issue in the body, it makes sense that calming down the macrophage activity might explain what's going on.

As in my own experience even when taking tons of Lauricidin and various other things which have in my experience gradually reduced ebv, they don't tend to work. I might feel better for say an hour and then the issue comes straight back.
 

MartinK

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Hey @godlovesatrier great to read your successes with Joshuas protocol! I try this protocol now too, probably will write to you for some detail info ;-)
And tomorrow I will orded Spironolactone and definitely will try it!
There is nothing to lose... I think, its a very safe, well tolerated drug, also what write Dr. do Campo.

Have you positive some more infections/viruses in blood tests from Armin labs?
Or only Coxsackie A and EBV now?
 

godlovesatrier

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Hey,

Well the latest version is here: https://www.researchgate.net/public...for_Rapid_Testing_of_HASD_CFSME_Disease_Model although it's still quite hard to understand not going to lie. Also still very expensive must be £240 a month.

Well it's not meant to be very safe for men long term. Although some men report no ill effects from it. But there are VERY few ways to really control ebv. Valcyte might work but it is astronomically expensive. Valtrex didn't work for me. So worth a shot. Tagamet was another one but that's pretty toxic for men, as are almost all the h2 blockers.

No I got new ebv tests in sept 2020 that showed a recent ebv infection. I really need another test right now but I cannot afford to get one. I've got some mono lateral flow tests coming in the post, that might help me diagnose a flare up but probably won't. I need to fly to Berlin next year and get imd to take my blood so I can see what other infections I am dealing with. Praying I have no entereoviral infections as that would be bad news.

I lived in new zealand as a baby for 3 years, so distinctly possible I could have picked something up there and not become immune to it. Makes me wonder though if kiwi's have infections we don't have in the UK and there immune systems build natural defenses.