Monday, April 6, 2015

Oyxtocin and outside the box supportive therapies



This 40-year-old female has been under my care since the fall of 2014. She has an illness which dates back to 1998 which she contracted when while attending a university in Central Pennsylvania she had a typical Bull’s eye rash, diagnosed acutely and treated early with an appropriate course of antibiotics. She became part of the group of 10 to 20% of people who fail initial, standard IDSA sanctioned therapy. Another case of “post Lyme syndrome” of course - not.  Symptoms had been mild until 2011. She went down the usual road and was first diagnosed fibromyalgia. She was started on Lyrica, which was very helpful for pain management, but progressive weight gain of over 60 pounds due to this drug has made her very unhappy. In general, I have not found this drug to be helpful for my patients. When we met she was highly symptomatic but still able to work full-time, barely. Some prominent symptoms included night sweats with air hunger, severe joint pain, constant flulike symptoms, profound fatigue, poor sleep, easy fatigability, daily headaches, cognitive dysfunction, memory loss, anxiety, irritability, weakness and episodes of tearfulness. Depression has been a prominent issue for her. Chronic diffuse pain, diagnosed as fibromyalgia, has been a big problem for her. Readers, I am sure, are familiar with these symptoms and their attributions to Lyme and coinfections.  A previous treating prescribed aggressive antibiotic therapy, including months of intravenous therapy and a plethora of supplements including herbs and vitamins. She had been treated for with detoxifying regimens without much help. I can say her former treatments had been a hybrid approach of allopathic medicine and CAM (complementary and alternative medicine). This is the term allopathic doctors use for treatments not taught in medical school. Her case has been resistant to a wide array of therapies. She is gradually, slowly getting better with a tailored cocktail of variable antimicrobials.

It is important to address symptoms directly to improve her function and sense of well-being.
I have been treating her with a "modified allopathic" approach which has proved to be very helpful. I say modified allopathic because chosen therapies come from the allopathic armamentarium but are used out of turn. Supportive medication with a focus on symptoms can be invaluable; her case is illustrative of this principle.

First off, she has had tremendous success with oxytocin. Oxytocin is a hormone made by the hypothalamus and cycles through the hypothalamic, pituitary, endocrine cycle. Oxytocin is used by allopathic doctors to stimulate uterine contractions in the obstetrical setting. As of late, oxytocin has been called the “love drug” and been attributed with numerous therapeutic benefits. After one month of taking compounded oxytocin lozenges she noticed a significant change.

A problem for many Lyme patients is that they experience social isolation. They stop answering calls of friends who want to be helpful but do not understand. Patients who manage to work - barely - return home exhausted, unmotivated and unable to anything productive. They may become increasingly distant from erstwhile friends and acquaintances. Oxytocin improved her sense of well-being and a feeling of sociability and gave her the push to go out with friends even though it was tremendously difficult. Returning home, exhausted, she was glad she went out. 

Marinol is an overlooked drug. This THC derivative has been available since the 1980s. It can be a powerful analgesic. Despite its propensity for increasing appetite, my patient has been able to lose weight with the transition from Lyrica to Marinol. It has no addictive properties like opioids which may be less effective. Marinol is a safe and effective drug and may provide an array of therapeutic benifits - for some patients. 

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1 comment:

WLP Romania said...

babesia and possible bart coinfections?