Can you give me guidance with my Dupuytrens treatment plan?

I need some guidance with my Dupuytrens treatment plan. I understand “tissue response guides dosage”, but I am (better package) taking multiple (6) oral products with multiple dosages. If I don’t see progress after 3 weeks, then which product dosages should I increase first? It doesn’t seem logical to increase all 6 at once, but increasing only one at a time would be a slow process. Can you give me some additional guidance on my next step if the starting dosages don’t do the trick?

I am also curious if you had insight as to the relative merits of adding additional products vs increasing the dose of the products I already have. While I am not rich, the cost is not my major concern… healing the condition is.

Greetings,

Thank you for some interesting questions about Dupuytrens treatment

Which particular therapies to increase first is dependent on what dosage you are currently taking.  For most people the dosage of vitamin E stops at 800-1200 IU daily; a few have taken higher dosages of vitamin E but it is not common.  So there is not much room to increase vitamin E dosage.  

As a general approach to increasing dosage after the initial round at the start of self-treatment: the systemic enzymes (Nattokinase 1500, Fibrozym, Bromelain and Neprinol) are increased earlier and to a greater level than the other support therapies (acetyl-L-carnitine, PABA, Fundamental Sulfur or MSM, Quercetin-Bromelain, Scar-X homeopathic remedy, Omega T).   More work and alteration of enzyme dosage is done than with the other therapies.   I tend to favor an increase of enzyme intake and an increase of one of the support therapies per 7-10 day period when no change is noted in the nodule or cord tissue.  If you follow this approach with your Dupuytrens treatment you will not make drastic or quick changes in your plan, but you will move it along nicely.

When the first change in the scar structure is noticed then no additional changes are made to the plan –until the tissue stops changing as it sometimes happens.

Your last question is most interesting, when you requestedinsight as to the relative merits of adding additional products vs. increasing the dose of the products…”     I find that people are far too eager and quick to add to their therapy plans – they make their plans too large too early, and only make it more complicated than it needs to be.  Many people make the mistake of increasing dosage once of a particular product and then assume they can go no higher.  It is far better to work deeply into the area of greater dosage and explore all the combinations of higher dosages that are possible before even thinking about adding another therapy item to your lineup.  

If you have a specific question about this subject of dosage in your Dupuytrens treatment plan I would be most happy to hear it and answer as best I can.  Most often these particular matters of higher dosage are so unique to the individual  and the particular dosages you are using, as well as the level of tissue change that you have noticed, that it is sometimes necessary to set up a telephone discussion so we can talk about your particular situation and get the best answer fore you.  Written generalities are often not as good as a one-on-one discussion about what is going on in your specific experience.   Please contact me if you feel you have to do so.     TRH

 

Comments

2 Responses to “Can you give me guidance with my Dupuytrens treatment plan?”
  1. Harold Bawlzangya says:

    I have a Dupuytren’s contracture question.  I read something about a medicine called Pentoxifylline as being helpful in treating Dupuytren’s contracture.  Do you know anything about this and would you agree it could be helpful or no?  I am horrified by some of the stories I have read about hand surgery and even more about the side effects of Xiaflex injections when they go bad.   Do you think Pentoxifylline might be more helpful for Dupuytren’s contracture than the natural treatment on your website?

  2. Dr.Herazy says:

    Greetings Harold,

    Rarely do I hear anything about using Pentoxifylline (Trental) for Dupuytren’s contracture from my readers, indicating it is not used very much to treat DC. This should tell you something.

    Most of what I report below to answer your question about Dupuytren’s contracture is related to Peyronie’s disease since Pentoxifylline is used more for PD, and these two conditions have some similarity, therefore similar conclusions can be drawn.

    Pentoxifylline is a drug that affects the body by changing the shape of red blood cells via a mechanism that is not completely understood.  This change allows for improved flow into small arteries and even capillaries. For this reason it is primarily used for treatment of circulation problems in the arms and legs. When it is taken the effects are like Pentoxifylline is a vasodilator, but it is not. It is a relatively recent drug that has only a few approved uses. These approved or designated uses are to “improve SYMPTOMS of blood flow problems,” as in certain types of breathing disorders, intermittent claudication and occlusive artery disease. I stress the point that this drug only changes symptoms and does nothing to treat, cure or eliminate any of the basic conditions for which it is prescribed or used; it only improves how a person feels while taking it. Otherwise Pentoxifylline is also prescribed for other uses that are not approved; when it is prescribed this way it is called an off-line use. Basically a doctor can experiment a bit with Pentoxifylline to see if the symptoms of condition X can be helped by improving the blood flow. Most information about Pentoxifylline I see indicate it is popular with only a small percentage of urologists who use it off-line for Peyronie’s disease. I think those who actually prescribe it for Peyronie’s disease do so because they are tired of dealing with the other drugs that do not help PD, and only try Pentoxifylline because they do not know what else to use. The same might also be true for Dupuytren’s contracture. Perhaps this is an overly skeptical and blunt opinion on my part, time will tell.

    The exact mechanism by which Pentoxifylline would help the Peyronie’s plaque, or the Dupuytren’s contracture nodule or cord, has not been at all researched because there is no known connection between alteration of blood cell shape and either problem. But then, its use for PD or Dupuytren’s contracture is off-label; its use is experimental and without scientific basis since the drug was not intended or designed to be used in this way.  Besides all that, Dupuytren’s contracture and Peyronie’s disease are not connected in any way to reduced blood flow.

    Common Pentoxifylline side effects include loss of appetite, nausea, constipation, headache, dizziness, anxiety or blurred vision. More significant are the other side effects of chest pain, mental confusion, gastric irritation, difficulty breathing, or severe rashes that should prompt immediate attention of the prescribing doctor. I have run across many men who tried Pentoxifylline for their PD to no effect, but experienced multiple side effects strong and bizarre enough that they had to stop usage. Also, Pentoxifylline can be difficult to reduce once you are on it since rapid reduction can worsen any of the above side effects.

    As I have mentioned, Pentoxifylline is one of those drugs that have multiple off-line uses as determined by any adventurous doctor who is forced to experiment with his/her patients. This is good and bad at the same time.  Pentoxifylline does so many things in the body that it can be used off-label for many conditions – this is good, I suppose, if you do not have side effects. By altering the shape of red blood cells throughout the body Pentoxifylline can cause widespread and surprising side effects and new health problems most anywhere – this is bad. It has been used off-line for a wide variety of inflammatory and fibrotic conditions, hence doctors try it for Dupuytren’s contracture because of occasional success reported by some for Peyronie’s disease. 

    This drug is so new that there have been very few – maybe only one – studies of Pentoxifylline for any use.  It has yet to be determined how much and how reliably Pentoxifylline reduces fibrous tissue formation in later term or well developed Dupuytren’s contracture or Peyronie’s disease.

    If you still want to experiment with your Dupuytren’s contracture and Pentoxifylline, let your doctor know if you have an ulcer of the stomach or duodenum, liver disease, any type of bleeding disorder or any type of surgery. Because Pentoxifylline increases the movement of blood into and out of all areas of the body, it increases how the body responds to some drugs. If you are taking another medication along with Pentoxifylline you might notice that the other drug will begin to affect you stronger or differently than before, therefore all drug dosages might have to be adjusted.

    Yes, Harold, Xiaflex reactions for Dupuytren’s contracture can be a nightmare. Actually, I have heard from a few sources that Xiaflex use for Dupuytren’s contracture is declining because of law suits.

    There is no way I can comment about your last question, if Pentoxifylline is more helpful for Dupuytren’s contracture than DCI natural treatment. However, I can offer you a few observations that might be helpful: 1. There are no side effects for Alt Med treatment. 2. Since 2002 I have received hundreds and hundreds of reports and testimonials from people who have eliminated or at least significantly reduced their Dupuytren’s contracture using our methods. 3. Better to try conservative Dupuytren’s contracture treatment first, then try more risky methods later if needed.

    I hope this information helps. Good luck to you and your Dupuytren’s contracture. TRH

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