Negative reaction to valtrex due to IDO inhibition?

[Anonymoose]

Valtrex/acyclovir inhibits IDO
https://www.ncbi.nlm.nih.gov/m/pubmed/2 ... ull%20text

IDO inhibition exacerbates EAE
http://www.ncbi.nlm.nih.gov/m/pubmed/15206723/

Maybe that 1500mg/day is too much?

[Scott1]

Hi Anonymoose,

I'm not sure these two experimentals models are supporting each other. I'd agree 1500mg per day is too much if it is going to be for a prolonged period.

If you want to try Valtrex start with a very low dose and slowly increase it. See what happens. By the sound of it, there can be uncomfortable common negative reactions in some people.

I handled it very well so perhaps I didn't carry the same burden that others did.

More is not always better, especially for the wallet.

Regards

[Anonymoose]

Scott1,
Yep. It's a pretty weak way to build a case but that's all I've got for now. Cherry picking and rodents. One more rodent reference...

Inhibition of IDO leads to decreased tregs (immune suppression)
https://www.ncbi.nlm.nih.gov/m/pubmed/2 ... ull%20text

This explanation really does seem to make sense in light of the nature of my valtrex relapse. My relapses are always in feb/march and they last 8 weeks. The valtrex relapse was in late July and only lasted 2 weeks. It started after building valtrex to 1500mg/day and the intensity of the pain from said relapse diminished greatly after stopping valtrex. The neuro symptoms continued to spread like a normal relapse but they were half-hearted...very much less intense than usual.

It also makes sense that you would feel better on avonex and valtrex together. Avonex increases tregs so maybe it counteracted the inhibition by valtrex.

[Scott1]

Hi Anonymoose,

Just remember it's a step on a journey. Avonex is not for sissies.

I would take my Avonex on Thursday night, swallow two Panadol Rapid straight away and go to bed asap. On Friday I would take two Panadol every couple of hours up to a maximum of eight in a day. That way I got my weekends back. If you have young children there is nothing like acting normal when you ache all over whilst a child expects you play a rough game with them. It takes a while to get used to it.

Don't start both together or you won't know what is causing a particular reaction.

I'm not using either at the moment but I do keep Valtrex in reserve.

The other things I've mentioned elsewhere a working for me now.

Regards
Regards

[Anonymoose]

I said that "feel better" thing wrong, didn't I? I should have said maybe that is why you didn't relapse on 1000mg valtrex. Avonex sounds miserable. This sissy would rather have needles stuck in her spine.

I will still try the 500mg valtrex per day. Now that I know what I might need to look out for on it, I will feel safer trying it. The relapse didn't come out of the blue...I had warning signs (increased buzzing) and like a big dummy thought "oh, I must need another valtrex!" Somewhere in my head, probably a lesion, I was thinking ebv was kicking back when valtrex wore off. Error!

Glad the resveratrol seems to be working for you. Ever play with black seed oil?

[Scott1]

No I haven't. The first time I'd heard of it was in your post.

As I'm doing well, I probably will give it a miss. At the moment, I'll keep doing what seems to work for me till I learn otherwise.

Regards

[Anonymoose]

MRI shows three new small lesions. I think that almost proves the valtrex at 1500mg/day made me relapse since that was the only time in the year since last MRI I felt symptoms spread like a true relapse. I wonder if the size corresponds with the lack of relapse intensity and duration. I will have to compare to old lesions when I get the films.

Sooo, take it easy on the valtrex if you plan on trying it!

(Study of msers taking 3000mg/day showed continuance of relapses but fewer than before...how does that fit in?)

[Scott1]

Hi Anonymoose,

I don't think you can draw that conclusion. You are effectively saying Valtrex causes MS which I would find a strange conclusion. Nonetheless, I think you can say taking an antiviral whilst having an MS flare up (as measured by an MRI if that's a reasonable conclusion) can result in an adverse physical reaction. I doubt you can prove that rapid demylination can be induced by an antiviral as I don't think there is enough evidence to support that.
I agree you should start with a very small dose. Your reaction sounds more like a strong herximer response which will be due to your current state of health, the size of the Valtrex dose, a possible contrindication with other medication or a reaction to other viruses that are sensitive to the acyclovir.(or all of these factors)

Regards

[Anonymoose]

Hi scott1,
Whoa there cowboy! I am not saying valtrex causes ms. I am saying it is possible that it caused my immune response to go more inflammatory possibly triggering a relapse to start. The fact that I had just come off a three month stint of making my immune system go anti-inflammatory with fenofibrate likely plays a role too.

There is definitely oodles of room for doubt. As we all know, almost proved isnt proved. Lol. I am just throwing out another reason to be careful with the dose.

[Anonymoose]

Found a video on YouTube about ido and ms. It's framed around stem cells but the logic carries over to ido suppression in general. Since I don't buy into immune suppression being a good thing, I don't necessarily believe that suppressing ido is a bad thing. I do think ido inhibition should be done conservatively if it is to be done at all.



Scott1, did you notice gradual improvement and lessening reaction to valtrex over time? I wonder if the ido inhibition didn't help to slowly eat away at ebv (which uses ido to hide from immune system). During all of your years of taking valtrex and drinking carrot juice, have you ever had your ebv load measured? It would be nice to be able to see if your lack of ms symptoms might be connected to reduced ebv load.

[Scott1]

Hi Anonymoose,

I think we need to look very carefully at what other medications you are on.

I suspect the fenofibrate acted like an antipurine. As the Valtrex has a purine base you would be bound to have an adverse reaction. I had a similar problem when I took allopurinol for gout.

Look at the effect they generated here under results-


http://www.ncbi.nlm.nih.gov/pubmed/11669172

Regards

[Anonymoose]

Scott1,
I had slowly weaned off fenofibrate and stopped completely maybe 5 days before I started valtrex. I had already gone through the withdrawal symptoms and gotten back to no med baseline. With the valtrex, I was only taking standard supplements d3 mag zinc etc. So, I am not sure how much of an influence the uric acid component had there.

I was thinking the Feno part of the relapse was possibly due to it letting ebv play during my friendly immune system months. It gave my more aggressive valtrex immune response something to attack. My relapse free years started after I started drinking several cups of Ceylon cinnamon tea a day. I did nothing else with any regularity. Maybe it's antiviral qualities caused the long remission. Who knows?

As usual just guessing. Maybe I'll get lucky one of these days.

You are stubborn about this ido thing and you didn't answer my questions! Pllt!

[Scott1]

Hi Anonymoose,

Sorry I'm stubborn. I'm not trying to be. I really don't know enough about IDO to express an opinion. The man in the video said we could discuss the associations for months. So he may not be sure either.
He assumes the EAE mouse model is a model of MS in humans. Not everyone agrees with that but it is a valid assumption if you adopt the autoimmune approach. I'm not sure about it being valid.

I took Valtrex and quickly felt better. I didn't experience the problems (whatever they are I haven't seen described) that others have.
I don't think you measure EBV load. It's more IgG and IgM measures that tell you if you have an infection and whether it is active.

Regards,

[Anonymoose]

Hi Anonymoose,

Sorry I'm stubborn. I'm not trying to be. I really don't know enough about IDO to express an opinion. The man in the video said we could discuss the associations for months. So he may not be sure either.
He assumes the EAE mouse model is a model of MS in humans. Not everyone agrees with that but it is a valid assumption if you adopt the autoimmune approach. I'm not sure about it being valid.

I took Valtrex and quickly felt better. I didn't experience the problems (whatever they are I haven't seen described) that others have.
I don't think you measure EBV load. It's more IgG and IgM measures that tell you if you have an infection and whether it is active.

Regards,

Thanks for answering my questions. I thought valtrex did nothing for you on it's own and only rendered improvement when you took it with avonex. Maybe I am remembering wrong or your evaluation changed with hindsight?

Now, you can't just toss the valtrex ido thing out and tell me to look elsewhere just because you aren't familiar with ido (neither am I btw). It's against the rules, it is! And I think the ambiguity in the video was regarding why hsct renders improvement... not if ipo changes affect disease.

But now that I am distracted with your uric acid obsession, why would I have a relapse because I went from an anti purine to a purine med? Wouldn't the additional uric acid/superoxide eating make things better? Also, how long did it take between you starting valtrex and developing gout? Do you think by reducing ebv you reduced your use of uric acid leading to a reduced need for purines along with symptom reduction?

[Scott1]

Hi Anonymoose,

Yes, I did need to take both to stay well. The Avonex just left me with a bad flu effect each week and a slower decline. Adding the Valtrex lifted the cognitative fog and then I began my climb back. Of the two, I found the Valtrex to be of the most value over the long term because it was disrupting the RNA of the EBV whilst all the Avonex does is signal the immune system. I was so run down I needed both for a long time.
For me, this worked but I see it as an intermediate step. When I switched from thinking of MS as autoimmune to metabolic and began looking at endothelial dysfunction I added L-Arginine. Since then I have been able to drop the Avonex.
It was also very important to get the sodium potassium pump working as that wasn't working as it should. 450-600mg of coenzyeme Q10 before bed every night should fix that (be very careful if you are on blood thinners. Super dangerous combination).
When the pump is working you will find the uric acid will start to normalise. It can then scavenge the peroxynitrite for you. You need a constant plan to limit EBV.
I don't think the relapse is due to the contraindication of two treatments. If they contraindicate then you definitely won't feel well. Were you using any steroids to suppress symptoms around that time?
My approach has been to limit EBV and repair endothelial damage. The goal is to lower peroxynitrite. I assume my sodium potassium pump will require the assistance of Q10 for the rest of my life.
It took about 8 or 9 years to get gout.

Regards