Dupuytrens treatment plan

Can you give me guidance with my Dupuytren’s treatment plan 

Please, I need some guidance with my Dupuytrens treatment plan. I understand “tissue response guides dosage”, but I am using a medium (better) plan.  I am 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.


Dupuytrens treatment plan to be successful must follow the size, shape, density and degree of adhesion of hte Dupuytren's nodule and finger cord. natural treatment early is a good choice over hand surgery since there are no side effects. Thank you for some interesting questions about Dupuytrens treatment

Which therapies to increase first in a Dupuytrens treatment plan depends on what dosage you are currently taking.  For most people the dosage of vitamin E stops at just two capsules.  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.  That is not true for the other therapies in a DCI medium plan.  

>> Testimonials from Dupuytren Contracture Institute

As a general approach to increasing dosage after the initial round at the start of self-treatment.

  1. Increase the systemic enzymes (Inflamazym, Fibrozym, Neprinol, etc) earlier and to a greater level than other support therapies. As I tell customers, “All therapies are increased, but we tend to stress the enzymes a bit more than the support therapies.”
  2. Support therapies (PABA, MSM, L-arginine, Scar-X homeopathy, etc) are selectively worked with. Those support therapies found in a plan are usually all that are necessary.  Occasionally, we find someone who needs to add something else.   
  3. I tend to favor an increase of enzyme dosage and an increase of any one of the support therapies per each 7-10 day cycle.  If no change is noted in the Dupuytren’s nodule or cord tissue, do it again 7-10 days later.  Continue doing this every 7-10 days until the fibrous tissue changes a little.  If you follow this approach with your Dupuytrens treatment plan you will not make fast or drastic changes in your plan, but you will move it along nicely.
  4. Locate the DCI instruction sheet your received with your order, “Higher Treatment Dosage Levels and Safety.” It explains the general dosage level at which tissue changes occur in the palm lump and finger cord.  This instruction sheet is a general guide.  Keep in mind that everyone seems to have a different dosage pattern that must be determined.

Dupuytren’s treatment plan based on SSDD

Of course, you know to carefully determine the exact size, shape, density and degree of adhesion (SSDD) of the palm lump.  Frequently monitor SSDD to learn when to increase or stop increasing your dosages. Simple. After the first change in the palm lump or cord SSDD is noticed, then no additional changes are made to the plan.

Your last question is most interesting.  You asked for insight as to the relative merits of adding additional products vs. increasing the dose of the products…” People are far too eager to add to their therapy plans.  They make their plans too large too early.  This only makes their Dupuytrens treatment plan more complicated than it needs to be.  Some people make the mistake of increasing the dosage of a particular product once.  They then assume they can go no higher.  It is far better to work deeply into the area of greater dosage.  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 your Dupuytrens treatment plan I would be most happy to hear it.  I will answer as best I can.  Most often these particular questions about higher dosages are unique to the individual, and the level of tissue change noticed.  For these reasons, it is usually necessary to set up a telephone discussion to discuss your particular situation for the best answer.  Written generalities are often not as good as a one-on-one discussion.   Please contact me if you feel you have to do so.  TRH

4 thoughts on “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

  3. Dawn Egan says:

    Hi – This is not directly about Dupuytren’s contracture. I was diagnosed with Ledderhose Disease several years ago. This has not caused me many problems as yet other than a few nodules on one foot which are relatively painless. However, over the last year or two I have developed Garrod’s pads firstly on the PIP on my ring finger and another one now developing on my index finger PIP. These fingers are quite painful at times and the pad on the ring finger is about 0.5 cm diameter, round and often quite pinkish, although the size and appearance seems to vary throughout the day and from day to day (no pattern that I can work out). No signs of Dupuytren’s Contracure or nodes. I am wondering if there are any treatment options that you can suggest to decrease the size and hopefully the occurrence of more nodules.?

    Kind regards


  4. Dr.Herazy says:

    Greetings Dawn,

    Ledderhose disease is sometimes called Dupuytren’s contracture of the foot because it presents with similar signs and symptoms of fibrous nodule, cord, and pain development, Rarely does Ledderhose disease display the contracture or shortening of the involved digits as occurs in Dupuytren’s contracture.

    Garrod’s pads are slightly elevated patches or nodules of dark, rough, and thick skin usually located over knuckles at the PIP or MIP joints of the hand, causing slight to moderate pain. Recently I worked with a man whose Garrod’s pads, in addition to being located on all knuckles, were also on the front of back of his hands. Garrod’s pads occur in perhaps up to half of Dupuytren’s contracture cases.

    You are not the first to ask this question, Dawn, about possible natural Alt Med treatment of Garrod’s pads. Many of my Dupuytren’s contracture customers report that their Garrod’s pad have improved as their Dupuytren’s contracture has improved; often the Garrod’s pads will soften, become less painful and disappear easier and faster than the Dupuytren’s contracture responds, but not always. It seems these two problems have a similar abnormality of tissue physiology. Perhaps because of this the DCI Alt Med treatments (internal support with vitamin E, MSM, PABA, etc. and external support with DMSO, copper peptide, etc.) that benefit Dupuytren’s contracture can also benefit Garrod’s pads. I do not have nearly as much experience or feedback concerning Garrod’s pads as I do Dupuytren’s contracture, since this is not my primary area of interest, but enough people have reported back favorable responses that I suggest that anyone with Garrod’s pads should at least try a therapeutic trial of a few months to see how they respond. There is no medical treatment for Garrod’s pads, other than surgery which has abysmally bad results, so there is not much reason to not give it a try.

    If you are interested in trying this Alt Med approach for you Garrod’s pads please contact me and I will guide you through treatment selection. Who knows? It might even prevent you from developing Dupuytren’s contracture. Good luck. TRH

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