May 21, 2024
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Yo, I see that a lot of diagnosis guidelines mention a kind of "dysphoria to have been present for at least two years" type thing and I only figured out that I was trans about a year ago..I always knew something was wrong and I spent about 6 years presenting hyper-femininely to hide myself (and being suicidal in the process) but does this mean that I have to live another year pre-anything because I had no idea I was dysphoric? thank you <3
Except in Wales, which is a bit inconsistent in this regard, there’s no specific amount of time you need to have been explicitly presenting with gender dysphoria in order to access medical transition resources. It’s quite common for people to not realise that what they’re experiencing is dysphoria about their gender for a long time, and when you see the gender clinic you’ll have plenty of opportunity to talk about how you realised you were trans, any difficulties you had prior to realising that can be understood as dysphoria in hindsight, things like that.
Practically, given waiting lists for gender clinics, unless you’re already nearing the top of a waiting list or going private it’s quite likely you’ll be waiting at least a year for things like hormones yet. If you’ve been concerned about whether you can be referred to a gender clinic at this stage, though - you definitely can seek referral, you don’t need to wait for any particular anniversary of coming out as trans or anything like that!
I hope this helps.
~ James
No science talk, this time
Melatonin for COVID-19: real-time analysis of all 44 studies
BY MARY BETH PFEIFFER | AUG. 8, 2020
“Becoming infected with COVID-19 -- even after exposure to it -- is not inevitable. The virus is a bear, yes. But, if masks and distancing fail, it may be vanquished using safe, over-the-counter supplements for which there are supporting studies. The substances, used everyday by thousands, may even heal.
The evidence for this is still speculative since no clinical trials have been done. We need those studies -- now. But there is a wealth of medical literature to suggest that we can take some control over our fate with a simple visit to a health food store.
I’m writing this article -- lest it read like an ad for Vitamins-R-Us -- for 10 selfish reasons: My two grown children, their spouses and five children, and their dad -- my husband. Ten people I love. Among the group are students, a teacher and a school administrator.
I fear school reopening. I want to protect my family.
So I contacted Dr. Richard Horowitz, a renowned Lyme disease physician who in April published the first study of two COVID patients treated with three natural supplements; they were also given the antimalaria drug hydroxychloroquine and an antibiotic. At 9 and 11 days into treatment, with both patients seeing gradual but incomplete improvement, a corner turned.
The breakthrough, as Horowitz calls it, came after he increased the dose of glutathione, an antioxidant in many foods that protects against inflammation, supports key cell functions, and, key to COVID care, is essential to a healthy respiratory system.
Within an hour, both patients were breathing better. “I definitely felt like the edge was taken off my symptoms,” said one of them, David Roth, 53. “I felt it fairly quickly.”
Natural supplements with exotic names like N-acetylcysteine (NAC) and glutathione were shown to have antiviral potential “years before COVID was on the scene,” Dr. Horowitz said. Having had success in using them and others to treat two dozen cases so far, he thinks they should be put toward preventing COVID.
“Although anecdotal,” he said, “I have heard from patients who were on NAC and glutathione when they were exposed to COVID-19, that they did not get sick or test positive for the virus, when others around them did.”
Calming the ‘storm’ What Horowitz did was apply to COVID the lessons of treating tick-borne pathogens, which also can cause harmful inflammation and over-stimulated immune systems.
“It’s not like this is a new treatment,” Dr. Horowitz said. “It’s moving it from one disease with cytokine storms to another disease, another infection, with cytokine storms.” Cytokines are made by the body to fight invaders; but when there are too many, when the immune system is on overdrive, the cytokines turn on the host itself. Glutathione and related supplements may well stop COVID’s “cytokine storm syndrome.”
Since those first two cases, Dr. Horowitz has seen the same pattern of recovery repeated in other COVID cases. He has put patients on glutathione, related supplements and a cheap, safe antiviral drug called ivermectin, and none has needed hospitalization. He dropped the controversial drug hydroxychloroquine because studies have been confusing and mixed. “I’m sitting on the fence on it personally,” he said. (See more below on how the supplements may work and Horowitz’s view of hydroxychloroquine. I plan a blog soon on my earlier HCQ reporting on this wrongly vilified and politicized drug.)
Horowitz, who has published influential studies on diagnosing and treating Lyme disease, is not one to think small. He and his long-time research collaborator Phyllis Freeman have published a plan to track, prevent and treat the virus. As part of it, he is urgently seeking sponsors for a clinical trial to test selected supplements against COVID.
“We need to start thinking outside the box,” he said. Look at what happened, he notes, at a weeklong summer camp in Georgia, where three-quarters of campers later turned COVID positive. Horowitz’s plan includes a screening tool that could have picked up on those infections earlier – by asking about cough, shortness of breath, loss of smell, fever and so on – and could be used in schools to ferret out cases.
At my request, Horowitz agreed to share his regimen to prevent infection and, further, prioritized the list for me because of the complexity and expense of supplements. He advises that “patients bring my articles to their doctor and speak to them” first.
Top tier: Glutathione, 250 to 500 mg twice a day N-acetylcysteine (NAC), 600 mg twice a day Second tier but makes above even better: Alpha lipoic acid, 600 mg once to twice a day Zinc, 40 to 50 mg a day Icing on the cake: Curcumin, 1000 mg twice a day Sulforaphane glucosinolate (broccoli seed extract), 100 mg twice a day 3, 6 Beta glucan, 500 mg to 1000 mg once a day
To treat the infection, Horowitz uses the same supplements as in the prevention protocol but in higher doses. He further adds high-dose Vitamin C and ivermectin, which shows promise for COVID and would have to be prescribed by a physician. (See treatment details below.)
Horowitz, Freeman and their spouses take the supplements. Richard and Lee Horowitz recently vacationed in Cape May, N.J., where, he said, “I didn’t have an iota of worry. And we are two people in our 60s.”
‘Helped me breathe’ Among Horowitz’s ardent new fans is Dr. Lou Rotkowitz, 43, a Queens, N.Y., emergency room physician who said he almost died from COVID, contracted five months ago when he intubated a patient. He spent 10 days in critical care, leaving the hospital debilitated, with only inhalers and oxygen, and “on my own to figure out” how to fully recover. He called Horowitz, whose glutathione success was featured in a New York Post article. Horowitz explained how supplements might repair the cellular damage of COVID.
“It was all starting to make sense to me,” he said. “It’s basic molecular physiology.” Rotkowitz took glutathione, NAC, alpha lipoic acid and ubiquinol QH, a form of CoQ10 that reduces stress on cells and supports the heart, among other things.
In looking back, Rotkowitz, who is also a New York City Fire Department physician, says three things saved him: A high-flow breathing machine called Vapotherm in the hospital; two rounds of hydroxychloroquine, and, finally, Horowitz's supplement regimen.
“It helped me to breathe better, helped my energy level to improve,” he said. “I had a really, really rough go of it. These things are really of value.”
Horowitz’s regimen isn’t the only option to protect against COVID.
Quercetin and Vitamin C, according to a review of the medical literature, prompt a “synergistic antiviral action” that may prevent infection and quell symptoms.
Elderberry has been shown to have antiviral qualities and to promote cytokine production (though it should be stopped at the first sign of COVID).
Zinc, Vitamins C and D3, and N-acetylcysteine can be effective against COVID, the Cleveland Clinic Journal of Medicine has reported.
The Cleveland Clinic article said there “is likely little risk” from taking the supplements, but called for additional research on dosages. Horowitz agreed that in the context of COVID, “We just don’t know the optimal doses.”
For Horowitz’s patient David Roth, relief was in a 2 gram oral dose of glutathione 11 days into the illness. “I felt some of the result,” he said, unlike the more subtle effects of perhaps 10 supplements, probiotics and drugs. “I have no idea if the hydroxychloroquine helped,” he said. “It could’ve been the passage of time.”
In brief, here’s what the scientific literature says on how the supplements work and their potential benefits:
Glutathione might be called the antiviral warrior in the COVID battle, playing a role, one article reported, in “antioxidant defense, nutrient metabolism, and regulation of cellular events." Of key importance, it’s essential to healthy lungs and respiration. One research article suggests its deficiency may increase COVID severity and drive up deaths.
N-acetylcysteine (NAC) has been found to neutralize harmful bodily stressors and promote production of glutathione in cells. It also "may help to reduce oxidative and inflammatory damage in pneumonia patients,” according to published research.
Alpha lipoic acid is an antioxidant that controls respiratory inflammation and, along with glutathione and NAC, quells cytokine storms; with glutathione, it detoxifies the body of heavy metals.
Zinc is “known to play a central role in the immune system,” making people low on it susceptible “to a variety of pathogens,” according to Horowitz’s paper.
Curcumin and sulforaphane glucosinolate (broccoli seed extract) decrease inflammatory cytokines and lower inflammation.
Beta glucan, from yeast, stimulates production of Natural killer (NK) and T cells, which defend against viruses.
Trial needed
As with many people, I’m grappling with the best course. For months, my family (except for the four-month-old) has been on elderberry and Vitamins C and D3, which has been shown to decrease the severity of COVID infection. Some of us have taken curcumin and, recently, quercetin along with C. I have started some of the supplements on Horowitz’s list after reading the considerable scientific literature.
How much, however, is too much?
Horowitz told me in response that he has not seen any toxicity from the supplements at recommended dosages. The exceptions, he said, may be alpha lipoic acid, which can cause hypoglycemia (low blood sugar) in a minority of patients; those with the condition should not take more than 300 mg twice a day. High-dose glutathione can cause a slight rash or wheezing that can be cleared with Benadryl.
For now, he wants to see his regimen put to a scientific test.
“If we were to do a randomized, clinical trial of the nutritional supplements now,” Horowitz told me, “we would have answers by the fall, regarding their antiviral and anti-inflammatory effects.”
And that would give people like me a great deal of reassurance.
Note from MBP: After 40 years in the mainstream media, I’ve decided to go it alone and self-publish. This is the first installment of my blog, “Question Authority.” That’s exactly what we need to do now. Institutions must earn our trust.
***
Horowitz’s regimen for active infection: Supplements listed above remain the same, except dosage changes. Glutathione, 2000 mg, 2 to 3 times per day NAC, 1200 mg twice a day Vitamin C, 2000 mg 3 times a day Ivermectin 0.2 mg/kg once a day for 10-14 days (Must be physician prescribed)
Dr. Horowitz’s comment on how the supplements work to treat and potentially prevent COVID:
“Although anecdotal, I have heard from patients who were on NAC and glutathione when they were exposed to COVID-19, that they did not get sick or test positive for the virus, when others around them did. This can potentially be explained by the antiviral effects of NAC and glutathione, which have been published in the peer-reviewed medical literature, years before COVID was on the scene. Supplements like NAC, alpha lipoic acid and glutathione also have anti-inflammatory effects. The way the viral machinery turns on is with oxidative stress, driving inflammation, and these supplements lower inflammation, by blocking a switch inside the nucleus called NF Kappa B. I have used this approach for over 2 decades, lowering cytokines and inflammation in Lyme disease patients. Some of the same cytokines seen in COVID-19 are exactly the same cytokines seen in Lyme patients, especially during Herxheimer reactions, which is how I knew to use this approach, which has been effective. I also used to treat Babesia patients with shortness of breath with IV glutathione and would see similar results, i.e., improvement of shortness of breath. So all of my years of treating tick-borne diseases has given me a perspective that other doctors or researchers may not have regarding the efficacy of this approach. I would suggest however, until a randomized, controlled trial is done, that patients bring my articles to their doctor and speak to them about taking NAC, alpha lipoic acid and glutathione. I believe it will help protect them against the inflammatory effects of the virus.”
Dr. Horowitz’s comment on the use of hydroxychloroquine:
“The hydroxychoroquine debate is a typical one in medicine. First a treatment is said to work, then it’s examined in greater detail in multiple studies, where there are conflicting results. Some older studies showed benefit. Others did not. One study resulted in a clinical benefit, if the patient was also taking zinc. Other studies showed no benefit and potential side effects (nausea, arrhythmias). Didier Raoult in France, who is the French researcher who initiated the trial of HCQ/macrolide trials, still believes that the regimen is effective. I'm waiting to see how it all plays out, especially because the Lancet had to retract negative comments about the combo. In the meantime, in part to avoid the debate, and because there were some good studies showing the efficacy of ivermectin for COVID-19 (a drug I had a lot of experience using), I decided to use it for the treatment of COVID-19 along with nutritional support like NAC, ALA glutathione, and zinc. We have seen success using ivermectin, where patients have reported improvements within hours of use. An in vitro study also showed efficacy of ivermectin in killing the virus in culture, with 2 clinical trials (one involved patients on respirators) showing some benefit. We still need better trials, but the basic science is there supporting its use, and as I said, I have seen patients respond positively within hours of taking it.””
Treating COVID, long-haul, and vaccine side-effects ASAP is key for best outcomes.
This article primarily covers treating COVID, long-haul COVID, and side-effects from COVID vaccines. We also talk about the Together trial results, why clinical trials fail, etc. We include COVID prophylaxis and early treatments that do not currently require a prescriptionbecause in many countries the prescription drugs may not be available.
Disclaimer: This info is for educational purposes only. Please consult with your doctor before taking any drugs.
If you have to get a vaccine, which one is the safest?
Pfizer, then Moderna, then J&J. See Vaccine risk benefit by age.
How to avoid vaccine side effects
Many people will try to get Sinovac-CoronaVac or Sinopharm. The vaccine doesn't work, but there are no side effects and you get your vaccine card which is the important thing. But it may not be "usable" in other countries.
If you are forced to get one of the US vaccines, using .2mg/kg of ivermectin the day before, the day of, and the day after will reduce your chance of side effects by 95% according to a prominent researcher in Brazil we know. Of course, the FDA and AMA are trying their best to block your access to ivermectin, a new low for medicine. The mainstream medical community are cheering them on.
Treating COVID
Got COVID? Treating it ASAP is key for best outcomes. Even if it seems mild at first, treat COVID like you'd treat a fire in your house: the sooner you put it out, the less the long term damage.
Remember: The only thing all the COVID patients in hospitals today have in common today is that they didn't treat their infection using a proven early treatment protocol (or they waited too long).
Step 1: Find a doc, get a prescription, and get the medications filled now so that they can be on hand for your immediate use. This is critical for new variants because every hour counts. In some cases, you may need to have another condition in order to get a prescription, e.g., if you have OCD, you can get fluvoxamine for that condition and the use for COVID is a nice fringe benefit. There are also some treatments that don't require a prescription.
Step 2: As soon as you think you might have COVID, start treatment. Don't wait for a positive test. If your test result ends up being negative, stop the treatment. Because the treatments are so safe, everyone, even kids, can and should be treated immediately upon suspected COVID. Early treatment reduces risk of hospitalization, death, and reduces the chance of getting long-haul COVID which can be very hard to treat. If you started treatment early, your symptoms should start reversing about 24 hours after you start treatment.
List of doctors
Your doctor is unlikely to know how to treat you correctly. Here is a list of telemedicine providers who know their stuff and will give you a prescription for you to fill now so that you will have ALL the drugs on hand if/when you get sick. This is important because you want to have all the drugs immediately available. Time is critical. List of doctors who will write early treatment COVID prescriptions
They generally will prescribe to you one of the following early treatment protocols or some modification that they personally like. Each physician ends up using his own judgement based on what they've personally seen work the best.
Modified Patterson protocol (shown below)
I-MASK+ protocol from flccc.net. See this Chris Martenson video.
Tyson-Fareed protocol: Has 99.76% risk reduction and no safety downsides.
Zelenko early treatment protocol: Another highly effective treatment.
Chetty protocol: Described in this paper, it has over 99% risk reduction.
Italy protocol: This is extremely effective. Reportedly, only 4 out of 66,000 people died in Italy. This is an HCQ-based protocol because ivermectin is prohibited in Italy.
Egyptian protocol: Very successful in Egypt
Dr. Urso protocol (the lack of units is a bit troubling):
Modified Patterson early treatment protocol for COVID
Based on recommendation of Dr. Bruce Patterson with a few minor improvements. Patterson who treats thousands of long-haul COVID and vaccine cases so he knowns more than anyone else the drugs that in combination are the most effective in countering the inflammation caused by COVID. Take all drugs (that you can access) IMMEDIATELY after you suspect a COVID infection (except as indicated). They are all safe and do not interact with each other.
Fluvoxamine (luvox) 50mg bid x 14day. If not available, use fluoxetine (prozac) 30mg qd x 14 days. If already on an antidepressant, consider talking to your doctor about switching. Avoid caffeine while on fluvoxamine (you'll be way too wired). This is the ticket for brain fog because it passes through the blood brain barrier. In rare cases, can cause hair loss. If you can't tolerate fluvoxamine, try Prozac instead. It works just as well (proven in multiple observational studies).
Ivermectin .6 mg/kg every day for a minimum of 10 days and continue until symptoms resolved. Take with a meal or right after a meal for best absorption. Ivermectin is one of the safest drugs ever invented. See the FLCCC website for more info.
Inhaled budesonide: 400 µg per actuation (two puffs to be taken twice per day; total dose per day 1600 µg) x 14 days (or until resolution of respiratory symptoms). You really want to throw the kitchen sink at this virus and the number one reason people got to the hospital is respiratory distress. The latest Together trial will be testing fluvoxamine and budesonide in combination. We recommend this even if you don't appear to have any respiratory symptoms because you want to play it safe and keep it that way.
NAC: 600mg/day for 14 days. This mitigates the damage caused by the spike protein. This is a super safe drug that was available over the counter for 60 years. After 60 years of safety, and incorporation in 1,500 products, it was made prescription only so people would not have access to it and would be forced to get vaccinated.
Vitamin D3: 15,000 IU/day for 14 days to lower inflammation.
Pravastatin: 20mg x 14 days. Other statins can be used but this is the best.
Early-treatment "add-ons"
Here are a few optional "add-ons" that you can safely add to any of the protocols that can make a difference (if not already in your protocol). You can even do quite well using these as your only defense. All are available without a prescription.
Aspirin: Reduces chance of death by around 50%. Either size works. Take once a day for 10 days after first symptoms.
Nigella sativa (no prescription needed) Black seeds 40mg/kg orally once per day for 14 days. $9 gets you a 70 day supply. Reduces hospitalization risk by 75%. Death by 95% .
Vitamin D3: 15,000 IU/day for 14 days to lower inflammation. Up to 80% reduced risk. Even better if you take it BEFORE you get infected. This is the single simplest intervention you can do.
Povidone-iodine (Betadine): 1% solution (no prescription needed; widely available at drug stores at low cost) The pro tip is to buy the 10% solution and then dilute it down to 1%. Otherwise you'll be sorry. So a bottle of the 10% solution (which will cost you around $15 or less for an 8oz container) is going to last you a LONG LONG time. Mouthwash/gargle and nasal drops (or rinse) 3 times a day starting on first symptoms. After 7 days you'll see a 99% drop in viral load and you'll lower your risk of death by nearly 90%. See Effect of 1% Povidone Iodine Mouthwash/Gargle, Nasal and Eye Drop in COVID-19 patients and Rapid initiation of nasal saline irrigation: hospitalizations in COVID-19 patients randomized to alkalinization or povidone-iodine compared to a national datasetwhich shows that early treatment can reduce your risk by 95% if you start early for just this one simple, easy, very safe intervention. You can get both solutions on Amazon or at www.immunemist.com. DO NOT USE THIS EVERYDAY as a prophylaxis. Instead, use within 12 hours of higher risk contact, or twice a day for 14 days if you get infected with COVID. It's basically a stronger solution than the hypertonic saline solution.
Colgate Total (no prescription needed) Total contains cetyl pyridinium chloride (CPC). Within 12 hours after possible contact, swish and gargle for 30 seconds and put a saturated Qtip up your nose (watch this instructional video). You can use other mouthwashes with CPC. This is a very simple and inexpensive solution to the problem ($5 per month) that protects you against other viruses as well.
Hypertonic saline solution nasal rinse (no prescription needed) Create a hypertonic solution by adding 1 tsp of salt (5g) to 8oz water. This will create a 2% solution. Do a nasal rinse with a squeeze bottle (I use the 8 oz NeilMed squeeze bottle) or a neti pot. If you do the rinses occasionally (because you are rarely exposed), the NeilMed bottle is fine. If you do more often, the neti pot is better since there is no pressure so less potential damage to sensitive nasal structures. Do this within 12 hours after a risky incident (e.g., before bed). For extra credit, with remaining hypertonic solution, gargle, swish and then spit after 20-30 seconds. However, most COVID infections are through the nose. A lot of doctors say you should use purified or distilled water. Others I highly respect say that's overkill and say tap water is fine. I've always used warm tap water (at same temperature as your body temperature) and never had a problem. Compliance is the most important factor.
NAC: 600mg/day for 14 days. This mitigates the damage caused by the spike protein. This is a super safe drug that was available over the counter for 60 years. After 60 years of safety, and incorporation in 1,500 products, it was made prescription only so people would not have access to it and would be forced to get vaccinated. I bought mine at Thorne. No prescription needed.
Glutamine: 10 g l-Glutamine available in powder forms were given 3 times a day with meals. In the control group, 38 out of 230 covid patients died. In the glutamine group, 0 out of 222 patients died:The effect of glutamine supplementation on serum levels of some inflammatory factors, oxidative stress, and appetite in COVID-19 patients: a case-control study - PubMed (nih.gov) Again, no mortality and no ICU admission in the glutamine group… Effect of oral l-Glutamine supplementation on Covid-19 treatment - PubMed (nih.gov)
Prophylaxis protocols (recommended)
Lactoferrin (no prescription needed) "“We found lactoferrin had remarkable efficacy for preventing infection, working better than anything else we observed," Sexton said. He adds that early data suggest this efficacy extends even to newer variants of SARS-CoV2, including the highly transmissible Delta variant.” This is safe.
However, it may be more convenient just to skip the prophylaxis, get COVID, and treat it early.
Prophylaxis protocols (not recommended)
FLCCC prophylaxis protocol This is an ivermectin-based protocol. However, in consultation with other docs (gut specialists), I do not recommend it because it will destroy the good bacteria in your gut. In general, do not take prescription drugs for prophylaxis.
Nasal irrigation (no prescription needed) Done twice a day has been remarkably effective in preventing COVID infections. See hypertonic above for details. Again, this is NOT recommended because you will upset the bacteria balance in your nose. If you do it, you only want to treat on an acute basis (i.e., when you are sick).
Other drugs that work against COVID-19
See C19 Early for a list of drugs and effect sizes.
Treating long haul COVID
Bruce Patterson’s long haul COVID treatment relies on four drugs. The dosing depends on what your bloodwork shows (based on the Cytokine 14 panel available at covidlonghaulers.com), so the dosages are averages.
Fluvoxamine: 50mg BID
Ivermectin: .2mg/kg every 3 days
Pravastatin: 20mg (substitute for fractal kinase inhibitor)
Maraviroc 300mg PO BID. This reduces CCR5 and takes about 5 days to work.
The other option is going to covidlonghaulers.com and getting tested. Then they'll prescribe drugs based on your test results.
Treating pre- and Post-Vaccine Inflammatory Syndrome (PVIS)
Ideally start this 3 days before you vaccinate. Less ideally, start this immediately after vaccination.
Continue for 14 days if using to minimize vaccine side effects.
The longer you wait, the more likelihood of permanent damage to heart, lungs, and brain. Once those tissues are scarred from inflammation, they will never heal. This is why many long-haulers never regain full function. It's exactly the same story with vaccine victims. Watch this 8 minute video featuring Dr. Charles Hoffe.
Fluvoxamine: 50mg BID (can substitute 30mg Prozac QD)
Ivermectin: .2mg/kg daily. You may see results in less than 24 hours. Note this is a lower dose than an active COVID infection.
Prednisone: 5mg/day for inflammation. Note: this is a low amount because if you give more you start to affect the immune system which is problematic because you want the macrophages to clear out the spike protein
Pravastatin: 20mg (substitute for fractal kinase inhibitor)
Maraviroc 300mg PO BID. This reduces CCR5 and takes about 5 days to work.
For best results, go to covidlonghaulers.com and getting tested with the 14 cytokine panel and they'll prescribe the appropriate drugs based on your test results (since the Maraviroc is pretty pricey). You also will want to get the Spike Protein test at incelldx.com (but it seems it isn't available as of Sept 7, 2021).
Or check out the FLCCC I-Recover protocol; it can be used for PVIS as well (as they note in the text).
Drugs that may be available in the future
These drugs will be difficult to impossible to obtain currently in the US but may be available in other countries:
enovid. This drug is made by SaNOtize . It probably won't be available in your area, but it appears to be effective.
Interferon Lambda: If you can get a single injection of Interferon Lambda (made by Eiger), that is the drug with the largest effect size and best safety profile. It is currently only available in clinical trials. It should be taken ASAP after infection for best results. It drastically reduces d-dimer which is an excellent indication that has a dramatic effect in lowering blood clotting (and likely inflammation). You basically will not get hospitalized if you get this drug. If you only can take one drug, this is the drug to take. If you can get access to this drug early, everything else is optional.
Camostat: 200mg taken orally, 4 times daily, for 7 days will absolutely reduce your chance of long haul COVID symptoms and reduce your risk of hospitalization. It isn't approved in the US, but is approved in other countries. It will not change your time to recover. It's about preventing you from developing long-haul COVID symptoms and severe disease. It's an antiviral so take ASAP.
Proxalutamide: Appears extremely impressive, near 100% efficacy. Now in Phase 3 trials in USA.
Currently, the five most effective drugs for COVID are:
Interferon lambda
Fluvoxamine or Fluoxetine (Prozac)
Ivermectin
Inhaled budesonide (see this tweet)
Camostat
That list was made on July 26, 2021. It will be 4 months before the rest of the world figures it out.
Note about Together trial results for fluvoxamine and ivermectin
Why did Ivermectin seem to fail and Fluvoxamine not do so well? Ivermectin was dosed for 3 days; fluvoxamine for 10 days.
We don't think the trial was gamed at all. I think this was a legit result.
We know the PI Edward Mills and believe he is totally honest and we have no reason not to believe the results he obtained. But we also believe other researchers as well.
So the question everyone has is how could these drugs do so well in other studies?
The answer: the variant was different. P1 is the variant in Brazil and makes Delta look like a walk in the park. If you do not treat P1, instantly upon symptoms, you will see big failures.
Had fluvoxamine been given on Day 0 instead of Day 4, there would have been a dramatically different result.
Had ivermectin been dosed at .6mg/day for 14 days starting on Day 0 (the first day of symptoms), there would have been a dramatically different result.
The more aggressive the variant, the earlier and harder you have to treat it.
Ivermectin likely failed for these five reasons:
Too little a dose
Started too late
Not taken with meal or shortly after
Not continued for long enough
Many patients may have already been taking ivermectin
The healthcare systems need to encourage people to have the meds in the cabinet for immediate use. Nobody does that. That's why we have a problem.
Also, you can't treat Delta and P1 in the hospital... it is much much tougher there. It's like a fire department arriving when the entire building is in flames.
Early aggressive treatment is key. There are near ZERO hospitalizations and DEATHs for anyone treated early. But the press never talks about that. The NIH or CDC never says that either. Why not?
You can't say vaccination works: at Mt Sinai in NY, 27% of the hospitalized cases are vaccinated, and 17% of ICU patients are vaccinated.
The sooner we stop following the NIH advice that early treatments don't work, the sooner we will start saving lives.
Ways a clinical trial can fail
Clinical trials on repurposed drugs should always be tested first on outpatients by physicians who prescribe on a shared decision making basis. Once a protocol is found to be reliable, then it can be "locked" into a clinical trial for "proof" of efficacy. Sadly, we do the opposite which wastes a lot of time and money. We form a hypothesis and then invest millions to test it out in a large scale trial rather than on an outpatient basis.
Here are some ways a clinical trial can fail.
Dose: standard dosing may need to be increased for new variants. The FLV dosing of 50mg BID was tested for alpha variant. In general, increase dose for aggressive variants or treatment that is started later after infection. In this trial they used 100mg BID. The downside is that this dose can lead to compliance problems where people have to discontinue the use of the drug.
Timing: Ivermectin is best taken with a fatty meal or right after, not on an empty stomach. The FDA however requires the drug to be taken on an empty stomach in trials due to worries about liver toxicity, even though this hasn't been a problem in any other trial. This seems very silly.
Treatment delay: Treatment in Together started on average 4 days after symptoms. Too long of a wait especially for fast replicating variants like Delta. The lesson is start treatment IMMEDIATELY after symptoms recognized or before, especially with aggressively replicating variants. This is the most important determinants of success; once the damage is done, it is hard to reverse. This is the most important thing to get right.
Compliance: Patient compliance in the Together trial was estimated to be somewhere around 80%. If compliance is low, it is going to limit your effect size. How can the study prove that everyone took all their meds as directed? We can only see this by looking at the source data of the study for clues. As the pandemic continues, we've found patient compliance to drop dramatically. Early in the pandemic, you could call participants and talk to you. Today, you call and they hang up on you.
Duration: Delta can hang around for 33 days. Treatment should be continued until 5 days after symptoms resolve. So shouldn't be a fixed duration (like it was in the trial). In the trial, the duration for ivermectin was only 3 days; was 10 days for fluvoxamine.
Deception: Participants were supposed to be early in COVID, but many could have given inaccurate information either willfully or mistakenly. There was no way to tell because this wasn't measured. This explains how so many ended up in the hospital so fast (e.g., within 1 day after treatment started). There wasn't baseline bloodwork taken to assess disease state of the participants. They could have determined disease stage from this and better assessed outcomes.
Lack of adaptability: Some doctors find that using D-dimer and CRP to guide the dose and duration can be very helpful. That is rarely done in a clinical trial.
Single drug: Using a multi-drug protocol will work better especially if the drugs are synergistic. For example, many people claim HCQ without zinc is a non-starter.
Tampering: Phase 3 trials don't have levels of controls to detect manipulation. It relies on everyone being trustable in doing their jobs. If the drugs are switched accidentally (placebo vs. real drug), no one will know. This is why it is important to look at the source data and the side effect reports. Even the best designed studies are susceptible to tampering. That tampering could be deliberate or accidental and it can be hard to detect.
Data manipulation: One ivermectin study showing a positive result was clearly manipulated. Data manipulation does happen. It can sometimes take months before this is exposed.
Controls may already be taking one of the study drugs: A major reason why ivermectin trials don't fare too well in S. America is that lots of controls may have taken ivermectin. For example, in the TOGETHER trial, it was NOT an exclusion criteria (and so the data should be segmented by that before coming to conclusions).
Dropouts. People can drop out of the trial causing you to lose statistical power.
Missing data. People can not report back what happened.
Low event rate. You may underpower the trial because people are healthier than you presumed or the virus mutates to a less dangerous strain.
Competitive sabotage. A competitor can pay enrollees to enroll in the trial and not take the drug.
These are issues that can come up with any trials, even well done trials. It's a shame these trials in general do not have more controls to detect these mistakes. They happen. This is a known limitation of every clinical trial; few if any have any robustness to errors.
One other very important point is that researchers are PROHIBITED by their IRB and other entities from testing ivermectin doses and durations that would be effective! One doctor in the US just told me that they wouldn't let him go higher than 200mg/kg for 3 days. That's crazy. Ivermectin is one of the safest drugs on the planet.
An idea for rapidly screening drugs against COVID
The biggest problem with COVID is the inflammation and clotting. The vaccines create the same rise in CRP and D-dimer as COVID and it's very reliable (happens post-vax in over 60% of cases).
Therefore, if we want to test a single drug against COVID, all we need is 5 volunteers who have been recently vaccinated. Treat immediately after vaccination with the drug. Measure CRP and D-dimer at 5 days. If both are normal in all 5 patients in 5 days, you have a candidate drug.
Once you have 3 candidate drugs and test the combo in a clinical trial.
For more information
Early treatment is key to better outcomes
Detailed advice on treatment
Ten things to know about treating COVID infections
Drugs and dosages
Summary of what we know about treating early (just read the introduction)
Short summary of the case for using fluvoxamine for COVID (slides only)
Video presentation of the slides: 15 minutes at start of Semmelweis effect seminar
Detailed summary of the evidence supporting the use of fluvoxamine for COVID The tl;dr is that every piece of evidence we have ever seen (observational studies, randomized trials, doctor experiences) is positive. There are no cases where fluvoxamine made things worse. If treated early enough with fluvoxamine, patients can recover and completely avoid long-haul COVID issues.
COVID-19 Early Treatment Fund (CETF) Introduction - YouTube
Fluvoxamine: Finding a possible early treatment for COVID-19 in a 40-year-old antidepressant - 60 Minutes - CBS News
BackgroundCOVID-19 is a global pandemic. Treatment with hydroxychloroquine (HCQ), zinc, and azithromycin (AZM), also known as the Zelenko protocol, and treatment with intravenous (IV) vitamin C (IVC) have shown encouraging results in a large number ...
Therapies to Prevent Progression of COVID-19, Including Hydroxychloroquine, Azithromycin, Zinc, and Vitamin D3 With or Without Intravenous Vitamin C: An International, Multicenter, Randomized Trial
Abstract
Background
COVID-19 is a global pandemic. Treatment with hydroxychloroquine (HCQ), zinc, and azithromycin (AZM), also known as the Zelenko protocol, and treatment with intravenous (IV) vitamin C (IVC) have shown encouraging results in a large number of trials worldwide. In addition, vitamin D levels are an important indicator of the severity of symptoms in patients with COVID-19.
Objectives
Our multicenter, randomized, open-label study aimed to assess the effectiveness of HCQ, AZM, and zinc with or without IVC in hospitalized patients with COVID-19 in reducing symptom severity and duration and preventing death.
Methods
Hospitalized patients with COVID-19 in seven participating hospitals in Turkey were screened for eligibility and randomly allocated to receive either HCQ, AZM, and zinc (group 1) or HCQ, AZM, zinc plus IV vitamin C treatment (group 2) for 14 days. The patients also received nontherapeutic levels of vitamin D3.
The trial is registered on the Australian and New Zealand Clinical Trial Registry ACTRN12620000557932 and has been approved by the Australian Therapeutic Goods Administration (TGA).
Results
A total of 237 hospitalized patients with COVID-19 aged 22-99 years (mean: 63.3 ± 15.7 years) were enrolled in the study. Almost all patients were vitamin D deficient (97%), 55% were severely vitamin D deficient (<25 nmol/L) and 42% were vitamin D deficient (<50 nmol/L); 3% had insufficient vitamin D levels (<75 nmol/L), and none had optimal vitamin D levels.
Of the patients, 73% had comorbidities, including diabetes (35%), heart disease (36%), and lung disease (34%).
All but one patient (99.6%; n = 236/237) treated with HCQ, AZM, and zinc with or without high-dose IV vitamin C (IVC) fully recovered. Additional IVC therapy contributed significantly to a quicker recovery (15 days versus 45 days until discharge; p = 0.0069).
Side effects such as diarrhea, nausea, and vomiting, reported by 15%-27% of the patients, were mild to moderate and transient. No cardiac side effects were observed.
Low vitamin D levels were significantly correlated with a higher probability of admission to the intensive care unit (ICU) and longer hospital stay.
Sadly, one 70-year-old female patient with heart and lung disease died after 17 days in ICU and 22 days in the hospital. Her vitamin D level was 6 nmol/L on admission (i.e., severely deficient).
Conclusions
Our study suggests that the treatment protocol of HCQ, AZM, and zinc with or without vitamin C is safe and effective in the treatment of COVID-19, with high dose IV vitamin C leading to a significantly quicker recovery.
Importantly, our study confirms vitamin D deficiency to be a high-risk factor of severe COVID-19 disease and hospitalization, with 97% of our study’s patient cohort being vitamin D deficient, 55% of these being severely vitamin D deficient, and none had optimal levels.
Future trials are warranted to evaluate the treatment with a combination of high-dose vitamin D3 in addition to HCQ, AZM, and zinc and high-dose intravenous vitamin C.