Dr. Syed Haider Discusses COVID Management

all this is dr mobien say here from drewbean.com welcome to one more show so today we have another rock star and this is a special show for you on sunday so we have dr sayed heather with us he he is known for one of the doctors who started prescribing ivermectin for covet then i think he's one of the the first physicians or very early physicians who started using fluvoxamine in addition to ivormectin and with great success so let me just quickly introduce dr heather and then we would start talking with him so thank you very much you are a lot of people here already so dr heather was a national merit scholar and attended the university of florida on a full academic scholarship for two years studying computers and electrical engineering before enrolling at shifa college of medicine where he completed a five-year medical degree with honors in biochemistry he completed his residency in internal medicine at new york methodist hospital in brooklyn brooklyn and afterwards worked for 10 years as a hospitalist before transitioning into general telemedicine in early 2020 and he became focused on covet 19 delhi health since december of last year he was one of the first physicians to see success adding fluvoxamine to the avomatin protocol i also want to give a shout out to the redditor stereo match because it was a stereo match who reached out and said hey we want to talk with dr heather so here we are now dr heather and i have been talking off and on via the phone as well he is listed on flccc's site as well so here we have a rockstar with us dr heather welcome thank you it's really great to be here with you so tell us a little bit about your work and then we'll ask about the protocol that you're using for covert 19. sure so i started off with ivermectin in late december treating or early december actually after dr corey's video went viral in front of the senate so a lot of people started searching for iverbecten and initially i was seeing mostly people who just wanted to prevent covet 19. and in probably january february a lot more people started coming in looking for acute care and then in march april i started seeing a lot of long haulers coming in also and the acute patients rising becoming a larger part of the practice and so i think the the biggest takeaway i want to give people is that basically what steve kirsh has been talking about um in terms of my practice experience was that personally speaking on when i was using ivermectin and you know this is one patient's experience so you know take it with a grain of salt but this is what i saw that uh i was in the first 20 or so people i had just using the avermectin protocol and i think at the time i was also giving some people low-dose steroids dr bean's protocol and the second week towards the end of that batch of patients and some people were getting some colchicine but the the main drug that i thought was doing the work was the avermectin so in that first batch of about 20 people i had two hospitalizations and one near hospitalization i mean the patient should have been in the hospital for hypoxia and refused so he he requested me to arrange oxygen at home which i did um so so that was with ivermectin and you know looking back in it it was a bit unexpected i mean you expect the patients to do better and it was a very small you know sample and you know certainly just a lot of confounders and bias i mean some of them might have just happened to be very sick it's just one doctor's experience but after that you know i've treated probably close to 300 people afterwards after adding fluboxamine and with fluvoxamine added to ivermectin immediately there was a difference and so when you're in the thick of things you know treating patients um you're not always aware of what's happening unless you're really looking for the data and it didn't really occur to me how much of a difference there was until steve kirsch asked me you know what what have you seen after adding fuvoxamine and when i thought back on it i realized that there had been these you know 2 10 hospitalization rate you know quite shocking before uh fluvoxamine and afterwards it went down to went down to zero for the first 200 patients and also the other thing that i saw was no long haul you know patients coming back complaining at day 14 and the third week that they still had symptoms so we didn't see that happening either um if you started fluvoxamine ivermectin before day seven you know so day six or earlier um i didn't see any people having long haul or hospitalizations um and then finally uh somewhere in the second in the third hundred you know patients on fluboximenevermectin one patient ended up in the hospital but he had basically just started the protocol hours before and then went to the hospital so i would say that doesn't really count as a flubox main failure um but he was rapidly getting worse and you know he had some hypoxia so he was in the hospital for a few hours and also you know he wasn't able to tolerate flavoxamine so you know with ivermectin my experience has been that almost everyone can take acute treatment and the you know the preventative treatment of thyromectomy it's very rare for somebody to have any issues with ivermectin and it interacts with the only common drug is warfarin that we see in clinical practice in the us so nearly everyone can be on it and you know one i mean in my experience with preventative treatment of ivermectin um probably at least 1500 or more patients so far have started on that and out of that i can like probably on the fingers of one hand count the people who decided to stop one person had a rash on the face one person had a rash on the palms and feet and all of these are self-limited you know problems so they went away after they stopped the the medication one person elderly lady she was in her 90s um and you know really persistent you know give me the ivermectin you know we had to teach her how to use the computer to even get her you know on the protocol but um she when she started she felt dizzy and she felt too dizzy and you know and somebody was old and frail you don't want them to fall and she understood that she didn't want to continue taking it so there was the you know pretty you know concerning dizziness for her and for us as well and um and that's that's all i can think about my head you know three four people who weren't able to do the preventative protocol um i do want to just mention that i have had a lot of experience with higher dose ivermectin daily you know before the flccc recommended in some patients to go up to 0.4 megs per gig um so we were at that dose already for a lot of long haul patients and still most people tolerated great with no side effects but the side effects incidence goes up significantly at that um at the double double the dose so you're talking about somewhere less than ten percent still maybe five percent but uh people do have side effects people get you know the blurry vision that's been mentioned in some of the studies that's a pretty common one and initially i was you know kind of worried i'm pretty worried because you look at the prescribing information you see that ivermectin can cause all kinds of inflammation in different portions of the eyes so i had most of them go and get eye exams you know whoever agreed to and the eye doctors actually didn't see any problems so it was also a benign side effect that wore off and it was dose um related you know so a patient one long haul patient you know lowered his dose a bit and the side if it got better lowered a little bit more side effects gone um so people were able to titrate it like that the other thing i've seen is you know when you're treating just one illness [Music] you get to know it pretty well in terms of the side effects and the you know the effects um so with uh with fluvox i mean you know the the side effects are certainly more than with ivermectin and that's one of the reasons that i like to if we don't have lab data from in cell dx i'd like to start off long haulers with like weird change protocols start them with ivermectin because it's cheap it's super safe almost everyone responds and the people that don't we can go to drugs they have a slightly higher incidence of side effects less chance of success but you know we can try them later it's still cheap and then later on maybe ravrock if you need it because that for most people is very expensive it's not always covered by insurance and even when they have insurance it's not always covered so so anyway going to fluvoxamine you know the fluvoximine side effects that i've seen in my practice mostly nausea and rarely you know you'll see something that's listed on the side effects like so one patient had a bad headache she had bad body aches but it's mostly stomach upset like nausea and sometimes stomach pain and these side effects you can often um you know moderate them the insomnia is a big one you know so um not just normal insomnia but you feel really strange some people feel a little spacey they feel you know kind of strange and out of their normal sense of self and they just don't feel normal so those are concerning side effects for some people and that that's the reason that the patient who was admitted few hours after starting hypermic and phlebovox i mean actually said i can't take phobos and i just feel i feel very very weird and um so that was you know concerning because it you know it has to do with his sense of self and his experience of reality so but again very rare you know it doesn't happen very often and and so what i'm trying to get at is with fluvoxamine when you have a side effect usually usually you can moderate it with something like uh we're using fenergan now um myself and dr antonatos of text to md so we've been in touch you know a little bit through email and um here's the other doctor that steve kirsch convinced to try fluvoxamine in the beginning and uh so we've been trading some ideas so you know fenriken does have some interactions with some of the other drugs that we're treating with um but it's you know a lot of these interactions when you you know if you're not really familiar with um using these you know in hospitals and in patients in the clinic um they sound really concerning and you know they will put people off so you have to explain like for example with qt prolongation if you have qt prolongation to begin with and you've had some arrhythmias or something obviously i would probably avoid something that causes qt prolongation um like the you know mirtazapine sometimes we use to treat to help with the insomnia from fluvoxamine and fuloxamine murtazaming they can both you know theoretically along the qt interval um but very rarely you know like like dr mubin said i worked in hospitals for 10 years um it's very very rare for qt prolongation somebody who doesn't already have it to be an issue so frequently you know in the hospitals and in the clinic you know in my on my computer you know when i'm prescribing um you check the drug interactions you get these in the hospital you get these pop-ups from the emr you know warning warning and you know as you're going through residency you pay a lot of attention in the beginning to all these warnings that pop up with drug interactions and later on you realize that it just doesn't make much difference in clinical practice these these warnings are like case reports you know a handful of patients you know in 30 years had this you know they found that when they took these two drugs together um they developed a problem it's really something that individual physicians don't see and the individual patients are not likely to experience so prolongation um and this is similar to you know this just reminds me of this hysteria over hydroxychloroquine in the beginning right um uh with all the supposed you know dangerous side effects of that drug um i mean that's just people who are scaremongering you know and um i have to say shame on the doctors who you know participated in that in the media um because it's really a safe drug you know it's not it's not quite as safe as i've ever met in but still you know the things that they were talking about arrhythmias and things like that it's not something that you see you know and some of the side effects they were warning about were things you would see after years you know um instead of days uh you know during acute treatment makes sense and uh i also want to give a shout out to denise tg she's one of the cool beans and she has been she i think she's your patient as well she was talking about she connecting with you yesterday as well and talking about this denise thank you very much for the reference as well so yes she's here actually she was one of the early ones this morning let me actually see if i can find her messages she has her messages here i i'm gonna go blind now because i'm in the middle of the discussion as well so a quick thing on on my practice site so i had started with [Music] so it looks like we lost dr um dr heather so here he is all right he's back sorry nobody's so here is denise so denise has been talking about you for for a long time so she is your fan as well so uh so the my practice what i saw was in the beginning i started with hydroxychloroquine and so far in my patients i think about five or six hundred so far uh none of them have become long-hauler two of them became long-hauler but were healed or cured or it went away and and then the none thank god none of them have died so in the beginning i used to treat with hydroxy and zinc and then i transitioned toward ivormectin in april time frame when the kali study came out in australia that is when i started using ivermectin and i used to combine ivormectin with hydroxy and then something happened one of my family one family they all developed except mother and father all children who were taking hydroxy and adult children they all developed arrhythmias i have no idea why but one family they all would call me and they say my heart rate is 58 my blood pressure is going down and i would get worried because i do telemedicine as well and i would not be there to see what is exactly going on and i would say okay get ready to go to emergency and so that was a stressful time for me because that whole family three children and then they they they were okay so since then i then started shifting more towards ivermectin and since i've been using ivermectin i have never had anyone report any issues maybe at some point git disturbance or sometimes some dizziness but nothing else so it is very interesting to hear your experience dr heather if you give me a second people have been commenting that how do we reach out to the doctors how do we get ivermectin and i think that is an important outcome for today's discussion so if you if you're okay i'm gonna quickly share how to reach you so folks this is flccc's site so if you go to flccc.net.net.com they would redirect you to covet 19 criticalcare.com here under this red button it says how to get ivermectin so i'm going to make it big under this donate to support a mission how to get ivermectin if you click there you would see the list of doctors and in here you would see the so doctor sayeth heather is here as well so website is dr sayeth heather.com phone number is this and there are more doctors too and i have been in contact with dr sayeth heather he is here and also with text to md dr antonatos and by the way dr antonatos will be with us on 10th of this month so i just wanted to make sure that folks are aware and finally if you are in the u.s and if you're going to get ivermectin without insurance please you use goodrx you can have on cbs for example ivormectin for 226 dollars and then after using good art good rx it would come down to twenty dollars or twenty six dollars so just make sure that you use that okay so back to uh dr heather so i just wanted to mention a couple of things um you know i've been telling people about goodrx since the beginning and i've noticed you know a couple of one issue with goodrx is that a lot of elderly patients especially don't realize that they can change the quantity it's automatically set to 20 you have to click that and you can change it to any quantity and create a custom prescription for your custom coupon for yourself and uh just one other point i'm actually in 41 states now i haven't updated the website because we've been so overwhelmed with patients but if you go to my website and look at click the about button you'll see the list of 41 states that i'm in so let me very quickly actually go to your website as well i think the most important takeaway after your your protocol is to be able to reach you because that is the most common thing that folks ask me so cool means i'm going to go to dr sayeth heather.com so here we are and here dr heather what should people do once so once they're there i'd you know these people are coming for ivermectin and you know treatment for covet so the covet 19 button at the top right is the one that takes you to the sign up form for any covet 19 related issues so it's a bit of a more specific signup form so at this point it just asks you some questions and it's basically like filling out new patient paperwork got it so um so once again dr sayeth heather.com i'm gonna actually put this link here in the chat so if anybody is interested please copy this link i would tweet this link out afterwards as well uh doctor heather there was one more question from cool beans and that was do you have social media presence can they tweet at you or can they do you have presents i don't at this point and it was a conscious decision you know years ago that you know i never really got onto facebook or twitter and um i'm considering it now you know more of a business presence than a personal presence um but i haven't pulled the trigger yet absolutely excellent so i think as soon as you have your business presence we're gonna flood in and become your fans over there so with this now so i hope that by now there is a protocol that dr heather has used and with lots of success i wanted to ask you this question though so i'm assuming that your practice went something like practicing without knowing what to do yet so hydroxy was not known zinc was not known ivermectin was not known so practicing with symptomatic illness maybe then transitioning towards hydroxy if at all and then transitioning towards either and then trans transitioning towards avermectin plus fluvoxamine did you have this kind of a transition as well or so i in the beginning you know i'm talking about last january february i was still working in a hospital and um you know we saw a few this was a what was it called um one of those hospitals it's an ltc kind of situation where long-term acute care and you get patients who have been in the hospital and then they need continuing hospital care but they've gone beyond 30 days and they need long-term care so they go to another hospital that's a kind of a feeder hospital so it takes patients from the acute care hospitals and back in the beginning the pandemic you know nursing homes those kind of hospitals they weren't accepting people with covet 19 you know those people had to stay in the hospital and it was kind of a different thing you know they didn't want to take anyone who had coveted 19. so we didn't see a lot of patients in the beginning later on we started getting a couple of patients so i didn't really have a lot of hospital experience with covet 19 um maybe one or two patients and they had already improved they were like day 40 day 50 after the acute infection so um my experience back then was actually catching cobit you know so somebody there and gave me covet and you know it was i was sick you know it felt like a bad flu for the first couple of days and and then uh you know the bizarre loss of taste and smell that i'd never experienced in my life happened and um and then you know some trouble with uh sleeping you know and and it kind of lingered on for weeks and and then i felt um i thought i was over it and i didn't realize that i had transitioned into long covet i was having trouble sleeping i would wake up at like 4 a.m i would um you know and and so to answer your question i didn't know anything about treating coven 19 back then literally zero it was nothing at all i hadn't i don't think even heard of i had actually chloroquine at that point i must have heard about roxy foreign you know when president trump talked about it but um i yeah i didn't think of trying it you know for myself i'm not really a big medicine person so i don't often use medicine myself um rarely uh so the first thought was like maybe treat it with herbs but in the acute infection it just didn't seem like a big deal i thought i would get over it so i transitioned into having long coveted and i like i said i didn't realize it was long covered i thought i'd just develop insomnia you know i thought my heart was racing sometimes from anxiety maybe um so i was having these kind of symptoms and and they lingered on for months you know pretty pretty long time and then uh gradually kind of went away and then people started coming like i said with long coved in maybe january february the first people started trickling in and then you know the light bulb went off i was like oh that was long covered that i was suffering from um and so yeah i didn't treat myself i was patient zero or patient one you know for myself and i didn't treat myself um then uh then i was working for uh basically teledoc they're in their very large um telemedicine company general telemedicine company and i was seeing patients coming in with covid sometimes um not a lot you know because this is urgent care online telemedicine most of them were going to you know on the ground you know trying to get treatment in person but some people would come and at that point i don't remember exactly when but far before december you know months before december i had you know i ever met didn't come onto my radar i had heard about the flccc i'd heard about you know their protocol i didn't have much experience with it but i started telling people that hey you know this looks like it can work for prevention for treatment you know and usually i mean i would get this blank stare from people you know um trying to tell them that there's a medicine that can work and it's called iberomectin and it's like you've never heard this word before it's like a very strange weird alien-sounding word and so 99 of people would just be like looking at you as if like this can't be a thing you know what are you talking about you know where did you get that from you know your because they've never met me before you know this is just urgent care online and you're you've just met them for the first time um so you don't uh you know you don't have their trust and and so they have never heard of this anywhere else they they think you can see the wheels turning in their head that if this was a real thing if it really worked i would have heard it on cnn you know or nbc or fox or somewhere right or on social media you know somebody on facebook would have talked about it or something you know so um that wasn't happening at that time and the word hadn't gotten out so about one percent of the people i saw um were willing to try ivermectin and um you know kudos to teledoc they weren't you know interfering with doctors practice the way it seems a lot of um corporate uh corporations aren't fearing or interfering you know i get now i get a lot of patients who come to me with this bizarre experience that they've never had in their life of the doctor told me to call you they said i can't treat you but here's dr heather's phone number you know give him a call um you know just shocking that something like that would be happening in america you know i grew up here and it's something that we never imagined or thought could happen um and so sorry just a quick introduction and i actually feel this shocking as well that people in america are having to go find horse products or other products and and in desperation trying to use that because the doctors and the leading organizations are rejecting and actively saying don't use it undermining it it is it is a very sad thing i cannot even when the historians would write it down i cannot even imagine how embarrassing this will be i agree um so to continue the thread with the the experience of treating so so that was my first experience a very small percentage of people accepted ivermectin and went ahead and treated it i didn't have any follow-up at that point with teledoc so this was a drawback you know to being on that platform and then um and then you know dr corey's testimony went viral and more people started searching for it on a different you know my patient portal that i used they were coming through the portal as basically patients who didn't have a doctor assigned and just requesting ivermectin um so i started treating those people mostly with prevention regimens and you know a few acute patients and and then i just decided to set up my own practice and you know i realized that i could put my name up as a doctor who's prescribing overmechtin and actually end up helping a lot more people um who had already been convinced you know they'd already heard about it from somebody and then you get a lot of you know word of mouth and family members telling each other and you know it started showing up on social media so in the beginning i was basically using ivermectin and then at some point i spoke with dr daryl demello um in india and he told me about his experience with thousands you know tens of thousands of patients using colchicine that was his favorite um so i i put colchicine in there with ivermectin um in my experience you know again my personal experience and also maybe it's cultural maybe it's i don't know what but maybe it's just you know the types of patients that were drawn to me um my own experience with it was that it was pretty limited um especially for long covet i didn't see a lot of success with it um there was a lot of gi side effects um that would just turn people off on it um and and it didn't seem to make much difference with acute infection although it maybe it does i mean it's it should you know because of its mechanism action interleukin 1 and 6 suppression but um it didn't seem to be a big game changer for me and my own patients that i saw um and then at some point also i talked to dr mubeen on the phone and he mentioned his dexamethasone so i i started putting people on that in the second week in the beginning at some point uh i think those were the core you know drugs and and then i was about to be destined data you know i threw vanessa night in there and i was just filing things on the beginning i was like you know this could work that could work that could work and um the acute infection i think that that is a good approach you know um you're limited somewhat by interaction you know drug interactions if they occur and and you know something that people don't realize is they'll come to me and ask does you know ivor can interact with um ashwagandha or turmeric or you know something that i'm taking right and i don't know i mean i can try to figure it out but it's not something that we can very easily figure out and and the more drugs we're on like when you're casting for you need like a super computer to figure out how they might be interacting with you know theoretically interact so you get to the point where you can't predict and then you start running into problems with side effects that are unexpected and you know like a lot of the side effects could be also a proven effect right like diarrhea stomach pain headaches you know nausea you know a lot of these could be covered or they could be side effects right so you become a little confused you know is this working is it not working um should we push forward and try to treat the side effects and keep the drug and is it benefiting and what i have been doing is on this one what i have been doing is that i ask patients i'm sure that you ask them as well and i actually ask them to stop those things just not that i'm against them actually if somebody listens to my videos they know i'm very much pro herbs and other things but they ask them to stop just so that i don't have to deal with those side effects which i cannot understand and then i start this medicine and then i can slowly work back with their medications sorry so please yeah that's great i'm glad you told me i mean one of the reasons actually i wanted to come on here with you is basically to learn from your experience you know i feel like i should interview you instead of you interviewing me um you know you're the teacher i'm just a humble student you know i don't uh know that much and um i i don't consider myself a teacher so thank you for sharing your experience and please share thank you very much i actually think that your protocol of ivermectin with fluvoxamine is it is a it is something that should be more publicly used your experience has been great as well with this as well so i i'm loving it so thank you very much for being here now if you are ready there are some questions as well so we can do a quick hit with those questions okay sure so first of all i'm gonna look at so folks on the live side please if you have a question please put something question marks or the letter q q q so i can see that out of all the the the comments that are going on i'm gonna start with teddy teddy's saying dr heather do you prescribe ivormectin for prophylaxis as well yeah this is probably you know been 90 of my practice in the last four months is preventative treatment and you know the you know we can talk about a little bit um the flccc um on their site when you go there and always has been like this is we recommend ivermectin for prophylaxis for high risk patients so you know this is something when you have a group and you have like guidelines you know um of any kind of organization you have to err on the side of caution and you don't want to say okay everyone in the population should be on ivermectin although i believe and i think a lot of people have actually mentioned that if everyone was on hyperactin the pandemic would probably be over in a few weeks so um you know we don't know like who is high risk right like so we have a list of um you know age and we have diabetes and high blood pressure and heart disease and lung disease and you know it said we have a big list from the cdc of what constitutes a high risk medical problem or patient but on the other hand you know you have doctors who are in icus you know even if they're extremely healthy they're obviously high risk because just the pressure of you know the not the pressure like the job pressure but you know the the the amount of cobia that they're experiencing you know that they're exposed to is so much that they're very um likely to catch it if they don't take something and then you have people in overcrowded conditions you have people you know one of my patients was in a high-rise building with a lot of people with kovid and her neighbors you know if you're living with a lot of people if you're you know it depends on which country you're in it depends on your risky behaviors do you wear masks and distance and avoid people and don't go out or are you out everywhere all the time um is there a lot of covey in your community you know is there high are there high risk variants so all these things kind of roll together into deciding whether you're high risk and you know this is my perspective and one final thing that you know probably doesn't get a lot of play is that you know there's this such a large percentage of people get long covered and we don't really know that much about long covet you know is it going to last for months or years is it going to you know does it is going to cause permanent damage in some people so you know when people come to me i i don't make them convince me that they're high risk you know because ivermectin is such a safe drug and you know i'm giving them a three-month supply ask them to come back ask them all these questions make sure they're not having a problem with it and we can consider doing lab tests if we want um you know it's uh you look at the risk benefit ratio in medicine right what's the possibility of benefit and what's the what's the risk that you're going to take for that benefit and it's just like overwhelmingly in favor of using ivermectin if you're worried about kovid for any reason absolutely correct absolutely correct and um so the redditors who are watching i know that you have your questions you are the one who started this whole discussion as well so i'm going to go to those questions in a second kevin brasda he's a cool bean he's saying dr heather you're patient here you have said ivamectin is 95 effective at prevention yet dr bean has said it is 74 effective have you adjusted efficacy range with any new data so let me first explain my part here so my discussion of 74 comes from the studies that were done in egypt and india it is possible that there are more studies that dr heather may have seen or his own uh experience as well so doctor has it oh yeah i you know kevin hi um he's asked me the same question you know through my patient portal and i told them probably similar to what i'm going to tell them right now um so certainly in my practice what i tell people is that you know dog i can really only i can speak for my practice right and i can point to some studies where it was 100 effective you know other studies where it was you know much less effective and so each of these you know um you know studies in each of these situations are different there's different groups of patients right and they're they're in different countries they're in different situations there are different types of people you know there's people who are doctors being studied in some places there's a general population they have different living conditions they have different socioeconomic statuses so it really you know whether something is effective is going to depend on all these other variables it's not just the drug itself so you know you can if you're sitting in your house you're not going anywhere you don't need to take over you're not going to get cobia 19 right if you're sitting in your house and you're very rarely going out you know and you're on ivermectin every other week in my experience you know out of probably at this point sixteen seventeen hundred prescriptions of preventative vibromecton 99.9 like just a handful of them i told them okay take it weekly they wanted to take it weekly or i was like okay you're an icu nurse take it weekly um the vast majority of the i gave it to them every two weeks none of them came back with covet um and so so in my practice you know i'm looking at my patient population i'm saying okay these people are being careful you know for the most part and and they're not living in crowded conditions they're not you know in a place where there's a real massive outbreak of covet you know so i will tell people now that you know i sent a message you know yesterday probably about the you know just my thoughts on the flccc update should you take it weekly and you know if you decide to take it every two weeks because you're you know thinking you know we don't really know the long-term effects on being on ivermectin for months years you know every two weeks you know i'm a little worried about that you know some people approach it that way they're a little worried about that aspect and uh and so they say okay monthly definitely not super effective in the studies weekly very effective let's split the difference every two weeks seems to be good um get the best of both worlds um if you're in that you know group who want to take it every two weeks or even every month and you end up flying you know then take it weekly right or you end up being exposed to somebody take an extra dose right so um in some so to wrap up and just you know answer the question um i honestly like i told dr bean before the show started i have not had time in the last four months to really dive into all these studies so i'm not the person to ask about you know the science aspect of it i can tell you my experience and just my perspective which is that it's an extremely effective drug if you continue to be cautious and i think that you're spot on because the study that i refer is actually a study on healthcare workers so they were on daily basis exposed to covet and then they gave them those one and those three days later another dose one and that's it for the whole month so that is a very different dosing plus that is a very different environment right yes i i did mention this to kevin also in our discussion that you know the dosing protocols are all over the place you know like different all kinds of different dosing protocols so it's you know you have to take that into account when you're looking at this and my experience with the prophylaxis my protocol from the very beginning march april has been weekly prophylaxis i am yet not and the reason that the reason is the science behind this that i'm still not very much clear for how does the ivormectin stay in the tissues after first dose and third dose for the whole month it these studies show that it does that but because i'm not very much clear on it the half-life is 18 hours so i feel that one week is i i would even have made it more frequent so one week is a decent number so i'm gonna go to uh the uh reddit friend so here this is a so you you should have your twitter i'm saying this with humility not demanding it so stereo match from twitter us from reddit has put together this twitter subreddit subreddit where they have the questions for you and stereo match thank you very much for actually going to various areas on reddit curating the questions he actually got removed the post got removed in one of the places as well most of these questions here i felt that there were a lot but most of these questions here are about those interactions using it with food or not so i'm going to go quickly over them and please expand wherever you feel that you want to discuss more so first for metro team fluvoxamine seems fine with avermectin nsc etc question is for metadine plus fluvoxamine is there any issues and i'm going to open up the drug interaction for you here that i i have fluovoxamine and formating they say there is no drug interaction anything from your experience uh so i haven't actually used famotidine and i'd be interested in hearing people's experiences with it um but i just you know i know that you know obviously some patients actually come to me and say what about this what about that and um i got to the point where i wanted to you know pare it down and simplify it to something that works and and it seems like i've you know you don't have to keep adding things if you have something that works really great so there are you know dozens of drugs that you could add to the protocol at what point do you stop you know what are what is it bringing an additional benefit um and what could it be detract you know it could possibly be distracting you know if you add something you have to always consider side effects interactions um so if i have people on you know for a while actually i was adding a mantadine to see if we could you know make it even more effective um and and then you know you get the point where somebody has a side effect you're like which one is it right which one do i need to remove or which one is are they not is not working for them so at some point you have to say that in order to keep it really simple in order to know which is possibly causing a side effect how to tell the patient okay maybe stop this one and you know max out the dose on ivermectin for example you have to have a simplified protocol for most people and and then these secondary drugs i would consider them if for some reason somebody can't take the main protocol drugs but i haven't gotten to the point where i've actually even looked at the motivating data data so dr mubine do you know something about yes so femetrodine has been in studies shown very good results and reduces the symptoms and the viral load within 24 hours i think one of the reason could be and i had prepared in your honor i had prepared this uh long haul maybe you and i should do one more talk about the long haul separately and talk about what are the possible things here i had shared this with the cool beans as well in the long-haul state as well it is actually possible that sometimes excuse me sometimes uh antihistamines are actually useful and so metrodean may be playing a role there my own practice i have not used formating a lot so there are actually one one thing i haven't mentioned before is that you just recently you know one one approach was to try to add um amantadine to to get rid of the you know to increase the efficacy even more for the very small percentage of people who on ivermectin toolbox means still worsen um but the other approach that we've recently added is actually supraheptidine which is mentioned as one of the supplemental drugs by the flccc and i think you know that has some antihistamine effects that has you know anti-serotonin effects so so i think that is much you know stronger and much you know for people who are progressing their lungs are getting much worse um they're developing hypoxia um that is really as you know the salvage therapy that you would that's a beautiful point i'm gonna have dr free jalali i think tomorrow or day after and he is a cipro heptadine guy as well so thank you for bringing that up fluvoxamine so any insights in different dosing strategies for fluvoxamine 50 milligram twice per day for 14 days steve kirsch but has there been occasions for pulse dosing or low dosing or a different dosing so this is a great question because some patients are just you know for whatever reason genetic or physiologic whatever there's something going on in them and they're much more sensitive to a drug and so in that case if somebody says okay i just this is like overwhelming the side effects or whatever i just feel like this is too much um i i will go down if they're willing to you know go down to a lower dose maybe they just their body metabolizes it differently than most people's so i've had experience with this especially for long haul treatment where we'll we'll tell people um just use whatever dose works for you you know if i i have actually with long haul seen a couple of patients um who just felt like ivermectin was like super super strong especially the people who have like lyme or some kind of chronic lyme co-infection or you know they they feel like extremely sensitive to any medicine you know they get like a herxheimer reaction when they take something they feel like they're having some kind of die off or just some horrible reaction so some people they'll literally take like half a tablet like 1.5 milligrams of iberomectin and tell me that it was like too much it was too strong um so for some people you know they can tolerate you know you would expect them to be able to take for example one of my patients i'd expect her to be able to take 12 milligrams her dose 0.2 milligram per kilogram dose is 12 milligrams and she says that at 12 milligrams she feels like this chest depression she feels um and she has long haul and um at nine milligrams she feels great you know her symptoms are gone she doesn't feel bad and at six milligrams still some symptoms so i said you know nine milligrams works for you wonderful use nine milligrams so it's personalized you have to personalize everything um definitely a way to do it got it thank you thank you uh carolyn aaron says when a patient is already taking a different ssri would you lower the dose and give flux i mean along with it yeah so i've actually done this you know the official recommendation is not to do that if you're on an ssri just stop um so so i've done it i haven't done that with ssris what i did with ssris was told people to just stop their ssri and go on fluoxamine you know and i think that's a pretty easy switch to make when they're both doing you know the serotonin reuptake inhibition and fluvoxin is just doing the sigma one activation better so i have not had problems with that you know i wouldn't expect to you know why why would you it's basically taking the place of your drug and doing something else that you want for covet 19 and then you can go right back to your ssri right you know so um if you're taking a daily ssri after 24 hours after your last dose i would tell them to start the fluboxamine and then 12 hours after the last fluvox windows go back on their ssri no problem so far but not a lot of it i mean just a handful of people who i did that with um other people like on welbutrin for example um i think it's a norepinephrine serotonin reuptake inhibitor or something like that so it has a mixed mechanism of action um so for some of those drugs that aren't pure ssris i have told them to either lower it or just try it and see and very carefully see if they have any side effects you know they're not absolute contraindications i mean they are mixed sometimes so um again no problems with that either so far got it thank you very much and i want to quickly remind the uh cool means the listeners here that the so this is based on the questions i've been getting some of the psychiatrists psychologists have been saying that why are you giving anti-depression do you feel that the people are depressed and that's why you're trying to treat them as depressed people that's not the case there are actually studies that show that fluvoxamine molecule has benefit and we we realized that for depression this may be given for a couple of weeks and then the effects start coming in but this molecule for covet cases especially for the neurological symptoms starts acting right away so if you wanted to see it here is an important i've done this video sigma 1 agonism is actually started from the day one and that is an anti-inflammatory behavior it suppresses the cytokine production this is a very similar thing that on the on the systemic area not a logical side ivermectin is blocking or suppressing nuclear factor kappa b and in the neurological side the um fluvoxamine is helping with the sigma one agonism so they both can actually partner together and work holistically in the body so just to update it that the mechanism is not anti-depression that is working here it is the i mean that is a side effect meaning in a good way that if somebody needs it that is there too but it has an anti-inflammatory so this just reminded me that i should mention that you know if we were going to go down on the dosing of fluvoximine the reason it's twice a day you know for depression it's once a day but the reason we it's twice a day for kovit is because of its uh you know the serum half-life you know we think that you know it's dropping and we want to boost it back up again so if you were going to go down on the dose you would still want to keep it twice a day or more even you know so got it so frequency has to be twice a day or more but the dose can be low got it so a fluvoximent for long haulers dr bean and steve kirsch mentioned for us for use where our mechanism cannot go brain and neural areas and immunoprotected areas which may have low uh level viral presence persistence i just talked about it as well uh have you i think there is a so i think this this brings up a good um point that uh people who come in with brain symptoms think that they have a brain brain problem right so it's not always the case the the problem can be outside the brain but being manifested in the brain so you know we've known this forever that like you know people with metabolic disturbances or you know liver failure or something they're going to have brain dysfunction and when you're testing somebody in the hospital or in the icu for brain function you know the neurologist will come in and be like yeah first fix their kidneys and fix their liver and fix this and fix that and fix their sodium level and then you know i'll assess whether they have you know brain damage or whatever you know or whether they're um going to be able to come back from this whether they're in a coma or not right so it's the same thing goes here a lot of long haulers come in with brain symptoms and i tell them that you have inflammation in your body maybe it's in your lungs maybe it's your liver wherever it is you have inflammation and the inflammatory you know cytokines can go through the blood-brain barrier it doesn't mean you have virus in your brain necessarily you know possibly that's a possibility but you see a lot of people get better without a drug that passes through the blood-brain barrier a lot of people get better from brain symptoms taking ivermectin why because the problem's not in the brain the problem's outside but it's leaking into the brain and so it's not viral persistence in the brain for most people it's inflammation in the body causing brain symptoms and i want to add to this point this is such a beautiful point and i hope that this is understood more and more it is not the virus going into the brain so many people who send me studies that the virus is found in the brain these are on autopsy autopsies and i have done this discussion many times that a person who actually ended up dying with this disease their their blood vascular system is all messed up they're they are in a cytokine storm they are in an acute respiratory distress syndrome they're in a septic shock for their tissues to have virus in them is not unbelievable the virus would have crossed lots of barriers because those barriers would have torn down in a healthy person an outpatient patient it's not necessary that either the spike protein or the virus has crossed the blood-brain barrier it's a very good point great thank you for for bringing that up fluovoxamine for serious cases anecdotal cases and icu though some of this info is in the fluvoximin jammer but any interesting stories so have you seen fluoxen with the serious cases yeah i mean unfortunately i get a lot of people who are extremely sick um and they don't want to go to the hospital and it works you know that the protocol works you know um regardless of how sick you are it might take a little longer if you come in later so um this is something you know that i give you know i want to probably make a couple of points here first of all you know this just reminds me of the fact that it's really unfortunate that the only way 99.99 of people can get a drug that works in the hospital for covet 19 is to persistently complain of depression you know i first saw this in one of steve kirsch's papers you know he's recommending people you know one of his blog posts if you have cover 19 in hospital just say i have depression and get on a get on any ssri you know and then uh after that you know it's an easy you know um jump from any ssri to fluvoxamine specifically or even floccitine which probably has you know as good effects as fluvoxamine um so this is uh you know this unfortunately i do get a couple of you know people calling me you know family members distraught that my husband or my mother is in the icu or you know in the hospital on ventilated and everything can you help you know and i've tried even for like once for my own patient they were already my patient before and they ended up in the hospital and i called and spent like 30 minutes on the phone with the doctor you know the hospitalist and this was in the middle of nowhere in south carolina i mean he didn't have a lot of oversight he could have prescribed that you know it wasn't a big jump for him it wasn't a big deal but um you compare that to people who are in like you know mass general or they're in a giant hospital a thousand beds and they're in this you know corporate system where you know they're being watched like you know and um and if i try to call these people i mean they've never heard me you know of me before you know they don't know who i am i haven't published papers um so i'm not going to carry any weight with these people that's what i try to tell the people on the phone the only thing we've seen succeed is you get um you know the proper education yourself and then you advocate really really strongly for the patient in the hospital like forcefully extremely strong and so the only one i've seen who's had a lot of success with hospitalized patients convincing the doctors to use drugs is this critical care nurse in texas her name is laurie jean and i mean i don't know if she wants me to share but um if you're interested if you have one of these situations get in touch with me and i can give you she's basically doing this pro bono i mean she's not she's not accepting payment she's not doing anything but she's spending time on the phone calling the family member educating them enough you know giving them pointers how to talk to the doctor how to convince them to use fluvoxamine or ivormectin you know she's she's big on ivermectin um and uh and so i haven't um personally had this experience because i can't convince people to use it in the hospital it's impossible to call in and once the patient gets to the hospital that's another misconception people have oh you're licensed in texas my father's in the hospital in texas can you prescribe it for him no you can't prescribe it you know like uh the only person who can prescribe in the hospital is the patient are the physicians who are seeing the patient in the hospital and i think most people probably know this but a lot of people don't they call me and expect me to be able to just give them a prescription they can go to cvs and get the prescription and take it to the hospital and say hey the doctor prescribed this give it to him uh it doesn't work like that and um you know i know that a couple of people you know they didn't come out and say it but they basically tried to smuggle these things into the hospital right um because they just they're so convinced it works and the hospital refused um obviously i can't tell them to do that and the reason obviously there's a safety issue here i don't know everything is going on in the hospital that's the reason i can't prescribe in a hospital you know you have to be on the hospital staff you have to be seeing the patient you have to have the chart in front of you all the tests all the other drugs that they're giving you know what are the drug interactions you know fluvoxine does have serious interactions you know unlike ibramectin there are frequently a lot of interactions so wouldn't be something that i could prescribe so unfortunately i haven't um um you know just in my experience it does work for serious cases and unfortunately like i said in the beginning we do get some people who are really sick you know who are on oxygen or go on oxygen you know as outpatients because they refuse to go to hospital because they know that they're not going to get what they need you got it thank you very much for that answer kevin brazda says dr heather my friend has long coveted with heart issues recurrent heart palpitations recurrent fatigue do you think resolution of long covet can be related to age sex health state yeah i mean certainly it could be you know we just don't know enough about it yet and those symptoms are very common with encovid um they frequently get better and go away with treatment um you know what we're seeing a lot of which is strange you know this just reminds me it brings it up for me is that uh i don't get a lot of long covid in elderly patients who are at higher risk for acute covenant you know the the vast majority of severe long covert that comes to me or even moderate or mild are people you know 20 to 50 20 to you know 55 and they're generally very healthy so they're like the healthiest people are getting long covered and you know it's frequently triggered by exercise i tell all the acute patients don't exercise for 30 days i think this is what dr demillo told me he was like tell everyone not to exercise for 30 days don't drink alcohol don't you know drink eat junk food you know so literally people will come to you and you'll ask them oh was it triggered by actually or they'll tell you it was triggered by exercise i one lady all she did was like go for like a hike pushing a stroller up the hill you know for two hours and she developed long covet and a lot of these patients feel perfectly normal and then you know they do something you know like exercise or they have like a birthday cake and then they get long covered after that um so maybe they would have gotten it no matter what but uh you know that's certainly something that seems to be a trigger and and so you know covid does seem to affect you know different ethnicities differently um there is some you know data to suggest that it seems to suggest people you know affect people you know different ages differently affect people different health levels differently so it's it's a very strange disease and and so yes i think that the long-covered people um in terms of getting better and you know you might need to tell people who are gym rats like don't go to the gym until you get better you don't want to set back until you're better and it's it's probably very similar to chronic fatigue syndrome those patients that where exercise is actually like a net negative for them it's not a positive anymore it actually is creating biochemical you know damage in the body every time they exercise so this is also just you know i like it seems like i like to talk too much i just keep going on but um i want to look you know i'd like to learn more about the link between chronic fatigue and long covet you know are these the same thing are they just similar and could you know chronic fatigue be treated with things we're using for long covet i think you know dr patterson's work with the insult dx test i would love for him to do something like that with chronic fatigue and other inflammatory diseases you know can we get more targeted anti-inflammatories for like rheumatoid arthritis and lyme disease and all these other things got it and uh dr heather i think we should do another session if possible if you have time and we should go over uh the long covered work and the studies that i've collected so far and the possible reasons so it is it seems like long covert is not just one pathology it seems like it's a syndrome and then the pathologies could be mcas or it could be macrophage activation syndrome or it could be some virion of the virus sitting around or it could even be the virus hit and run where the the cells that are proliferating very fast after the viral attack those cells have opened up certain genes for cytokines and now they are stuck in that state and they're just replicating with those genes open and the virus is gone but they are just secreting and so giving steroids or giving ibm acting like things can kind of suppress them i'm going to continue on we have a lot of questions here so so once again thank you very much from all cool beans and from predators here and from me that you are here and adding so much value it is life-saving value high-dose ivormectin seems to work for taste and smell loss any similar observations for fluvoxamine uh yeah so a couple of people the taste and smell got better on fubox i mean so you know some people most people you know the vast major large majority who come with long covet they take ivermectin they get better um most of their symptoms go away or all their symptoms go away and and the people in my practice the people who don't have any improvement with ivormectin i tell them um add fluboxamine or starcluboxamine instead and see because when that works it's like flipping up for me what i've seen it's like flipping a switch i mean it's like a light bulb turning on it's just like very fast and just like symptom to no symptom within a day or two it's it's amazing usually um so yeah fluvoxamine helps with that in some patients and i think you know what i try to i think what this brings up is that it really depends on you know from dr patterson's point of view you know his research what it depends on is what is the problem you know you can have a clinical manifestation that's due to three different things you know in three different people and even though it's taser small loss it's not the same thing and that's the problem with trying to figure out which drug will work for long covid any of them could work it depends on what the inflammation what's causing the inflammation does the drug address that inflammation or not correct um just a quick anecdote again not a study not data anecdote that one of the long haulers cool bean reached out to me and i suggested that fluvoxamine has been working very well for neurological symptoms at least it it works very well otherwise too and he took it and he reported back that hey my tinnitus actually increased so then he withdrew fluoxamine maybe if he kept using it may have or changed the dose anyways he stopped fluoxamine and started antihistamines so leading on the point you're making there could be multiple pathologies all leading up to inflammation which has similar symptoms in all cases so he started antihistamines and he started improving very fast so just if fluvoxamine somehow exaggerates the symptoms then maybe antihistamines can be useful too a question from william dr heather i worry that ivermectin users are on the younger side 30 40s 50s swaying the statistics in age 65 plus the mortality is higher 15 ish what would you guess your mortality is for 65 plus very interesting questions so there's one patient that i have lost contact with right an elderly lady i think in her 80s and you know i'm worried that she may have passed away in the hospital she was one of the earlier you know one of those two patients who were hospitalized in the first twenty on ivermectin alone um so i have to you know reach out and find her family and figure out what happened um she may have made it you know people they get better and they don't call me again so that's also a possibility but um yeah there hasn't been so far any confirmed mortality in my patients so you know maybe four you know 350 or you know something like that that i've treated um and i actually have a lot of elderly patients you know that are using telemedicine they're using the computer for the first time it seems like you know sometimes so it's not just young patients coming to me it's mostly elderly patients mostly over 50. yeah got it thank you very much that's actually a very important data point ivermectin so thoughts on refresher doses of ivermectin weekly for a month post recovery as suggested by dr hector carvalho so dr carvalho says 100 of the long covered patients treated with a weekly dose of fibrometin were symptom-less after an average of 36 days treatment that's amazing i'm glad that you i didn't know i haven't seen that comment before um so i i i agree you know when people um you know i've been used using so far like a really aggressive you know aguero chang's protocol where it's like you know daily or twice a day or something for you know five days is the test and see if it works and then continue after that if it has an improvement um i have seen you know one patient who didn't have improvement with the guru chains like you know test you know version of let's try this out and you know he would have said stop it you know the protocol suggests okay don't use it because it didn't show any benefit in the first week um and the patient wanted to continue and i was like fine you're not having any side effects it's safe let's try it so he all of a sudden had complete resolution a day at week three you know after taking daily ivermectin it might have happened after taking weekly ivermectin too because certainly it's in the tissues you know that's what we see from the preventative studies um you see some people with lyme disease you know they're taking preventative dosing weekly or every other week even and their lyme disease clears up so you you may not need such high doses you know maybe you just need a weekly dose or every other week or even monthly dose you know might make a make a difference it's just people who come with long haul they're so desperate usually that they're reaching out to a doctor finally online they find you and you know they're they don't want to wait you know they don't a lot of them don't want to use the weekly dose or something so that's one point um after full recovery a lot of people will say okay i'll just do the weekly dose or the every other week dose um and you know occasionally people will their long haul will come back and it means it was never completely gone um and and then we'll do another you know round and you know some people are seeing that uh they don't ever have long haul symptoms again after the first you know two week you know push of treatment other people you know i had one patient i think he stopped after like two doses of vibramecten all completely cleared up this is like the first patient probably i use with long haul it was like amazing um and uh and then you know a couple weeks later he had like my my go-to example is the birthday cake he had some kind of cake or something some junk food and um and his long haul came back and then he did a couple more days of ivermectin and since then he hasn't reached out to me in like three months so um i think the main point to stress is that with long haul we don't know so much about it and it's like the patient has to be part of the experiment you know they have to be willing to try different things and figure out what works best for them because for some people you know i've seen you you take fluvox mean in the morning you feel terrible you take it at night every day and you feel great right and and your long haul disappears you know there's no hard and fast rules with this and probably with anything in medicine we don't we shouldn't have hard and fast rules because everyone is so different you know different things will work you know we the published guidelines are just guidelines really you know that you this is a starting point and then we have to create this n equals one experiment with this one patient and see what works best for them absolutely correct and um interestingly i think one takeaway which just it keeps amplifying in my head while a patient is ill with covet very early usage of fibromyalgia and fluvoxamine then in six seven days time frame usage of steroids these things have been helping patients not to become long haulers so i think correct treatment is also very important absolutely yeah this is another great point that you know a lot of people come to me and they want that medicine cabinet you know three four drugs to keep in the medicine cabinet in case they get covered and i warn all of them you know that uh it's i rarely see people take this on day one you know when they have it in their medicine cabinet they don't take it on day one so you have to decide for yourself you know do i get sick every month or do i get sick hardly ever you know if you're one of these people who never get sick then at the first sign of symptoms you have to assume it's covered otherwise you're way behind you're already behind at the day one because the virus has been replicated for days at that point um so just psychologically you have to prepare yourself if you're going to keep it in the medicine cabinet you're not going to go on preventative treatment you have to prepare yourself for day one treatment you know not don't wait until okay going you know a lot of people they get that first symptom and they'll come back to me these people who have the medicine cabinet prescriptions they come back to me on day five off usually you know saying that oh i got the test it is coven should i start treating now i'm like yes definitely yeah it's getting late yeah yeah you're absolutely correct and this is why i think the best way to manage this is prophylaxis first as you do and then early aggressive treatment second if the actual disease occurs and within that treatment the abramite and sluvoximin steroids they have a very important place as a prophylaxis during the treatment from the long coverage and then if still the long covert occurs and there is a management for that i'm going to continue here more questions so one more one more question about the flu voxamine dose so you have said anywhere from 9 milligram to 12 milligram have you used higher doses as well so i think they're asking about fuboxamine but for if we want to know about ivermectin yeah i mean ivermectin i'm using 0.2 milligrams per kilogram so some of these 300 pounds they're gonna get a huge dose um i mean i give like 10 pills to some people you know 30 milligrams um to somebody who's over 300 pounds so i'm just using weight-based dosing for ivermectin with fluvoxamine the dose that has been beneficial you know 50 milligrams twice a day is what we use um for most people and it's it's a great dose because most people don't have side effects it's very you know it's most people tolerate it well for long haul um often i'll start people on 50 once a day and tell them do it for a week if you're not having any benefit go up to twice a day and see if that helps got it so here is an interesting one i'm i'm in 50 i'm on 50 milligram per day and have been for two weeks might be helping with headaches but also might be increasing sterilization and brain fog yeah so i mean at this point i would lean towards trying something else if this was my patient you know um instead of doubling um i mean you could try going to twice a day but uh if you're having side effects already at once a day and you haven't seen benefit in two weeks i i wouldn't expect to see benefit by continuing longer with fluoxamine so this is an interesting question and not just for the fluvox i mean i would say this for ivamectin and steroids all this combination uh when you have been managing long covet do you see people becoming fully cured or do you feel that you take the medicines off and they bounce back or there is a mixture so there's obviously there's definitely a mixture some people seem to be completely cured and some people will stop the medicine and then a month later they sometimes come back and they come back to me and say okay let's restart you know ivermectin let's try some you know maybe add something else and and oftentimes nowadays you know after speaking with dr yo from bruce patterson's kind of collective um of physicians um the ncldx team basically you know i started really kind of pushing people let's try moravroc with ivermectin you know because uh they've seen a lot of success with that um i haven't had a lot of experience with it myself yet but they have and based on their experience i think that that's definitely worth a try and people who didn't get to you know 100 percent on ivermectin alone or they did and then it came back um maybe just give it a boost with the rav rock um but yes uh some people stay well and some people stay well for a time and then they get worse again and you have to repeat it and you know what what's happening in those people you know they're um it just means that they we didn't completely treat it and that's i think one of the reasons why um install dx exists is to help those people realize that they the pathology isn't gone yet even though your symptoms are gone maybe we should continue longer until the inflammation that we're seeing on the test is completely gone got it thank you very much i'm gonna look at a couple of so time we are over an hour and um can we ask a few more questions or should we do another session i'm okay i mean if you're okay i can continue i'm i'm totally okay so this is what i've been doing for a whole year so let's do this uh there is a question and for the for the cool beans we try not to provide specific answers for specific patients we can talk in terms of hypothetical because it's not an advice for anyone a question here can my mother 98 98 pound take hypomatin for systemic protection she has a pacemaker aliquous 2.5 milligram blood thinner metaprolol er 6850 milligram for afib through some eye 20 milligram for congestive heart failure all right so i get a lot of questions like this um and i mean obviously i can say in general for somebody you know if a patient of mine had similar issues you know what would i usually recommend um so i think some people have a misconception because iremectin and uh warfarin uh interact they think that ivormectin's is a blood thinner it's not a blood thinner you know it's and it really has doesn't say much about hybrimectin more it says about warfarin which is famous for interacting with almost everything so um the fact that i remember interacts with warfarin is not surprising a lot of things do and so it just increases blood levels of warfarin and increases the blood thinning spinning effect of warfarin but it is not a blood thinner itself and um if anything the fuvoxamine is a bit of a blood thinner you know it has some of these anti-platelet effects but uh ivermectin doesn't interact with eliquids it doesn't interact with anything that i saw in that patient um history um you know whether or not somebody should use it is a different story you know for you know like coming back to this uh side effect of dizziness you know if you're 90 years old and you've fallen down before and multiple falls you know ivermectin if it causes dizziness we don't want you to break a hip that's that's worse for you than um probably covet you know that's often the triggering factor that kills people in their late you know late ages uh is falling down breaking hip and getting hospitalized and catching pneumonia and you know maybe covered in the hospital so you want to do everything possible not to let not to have somebody elderly fall and if uh if there is dizziness on ivermectin that would probably be the greatest contraindication in the elderly got it thank you very much liza says long hauler brain fog feels like dementia even with ivamectin and steroids any ideas what will help so in general you know my approach to long-haul syndrome is this if you don't have the insult test results you know in cell dx test results we take a step-wise approach you know we try different things if you have found something you found online that hey this thing might work for me i'm open to it you know so so in general in my practice i start with ivermectin um if they can add marvrock we try them ravrock you know it depends on if you have a resolution or not you try one thing for a couple weeks if you've gotten some benefit you might keep it like hypermectin for example if you didn't get any benefit you might stop it and try something else so you might go to revrock ivermectin or you might go to adding fluvoxamine if phlebotomy doesn't work or it hurts you know it harms you you might try elavel or amitriptyline you know that's had some um some results in some people you might try colchicine you know maybe culture scene works for you i actually you know i'm glad that i remembered this one patient you know back in the beginning was long haul i was telling him you know colchicine aspirin this and that and he was like not working not working is you know it doesn't i feel worse and he just happened to take naproxen for some for some aches and pains for for like three doses like he took it for you know a day and a half basically and he came back and told me all my symptoms are gone it was like amazing wonderful thanks for sharing so so now i tell people you know a lot of times i'll tell people hey by the way this one guy just took naproxen you know that's what did it for him he has no symptoms anymore after three doses and just incredible so so you just have to keep trying things you have to be patient you know it's i think it's possible to heal from this you know eventually most people will probably their bodies will probably get rid of whatever viral remnants there are and hopefully you know some people come to me they said you know when as a teenager a recent patient said i had uh post uh viral fatigue for like two years it was horrible after i think it was ebv you know and then i got over it and so after that experience she um she's now experiencing long haul and she says you know i'm not you know i i believe that this can go away because i've had something like this happen before and it went away and i got over it so i think people just have to have hope that you can be cured and i think this is kind of like one of my one of my pet peeves is when people go to a doctor and they tell them that you're incurable they're your hopeless case you can't be you know fixed you know just forget about it you know and i mean i understand where they're coming from they kind of they don't want to give people false hope right but you know just the brain and just you know even the placebo effect is so powerful if you can give people hope and really convince them you know sometimes it's not even about the drug you know where does real healing come from it doesn't come from molecules you know it comes from the creator of molecules right so healing comes from above it's not uh it's not always about finding the right thing but you know some kind of grace happens and you're healed so people have to believe that any disease can be cured so this is my personal belief that any disease short of you know your death illness you know your deathbed illness can be cured whether or not it's cured or not you know not every patient can be cured certainly not everyone's willing to do everything they need to do not everyone will find that you know circuitous path towards wellness but there is one you know you can the body can heal from anything you just have to remove what's uh preventing the healing so the body naturally heals it's not like we're healing you we're just removing the impediment you know so with long haul you're stopping the inflammation that's preventing for example like my understanding of it at least one understanding one possibility is you're stopping the information so that your macrophages that have the viral remnants can digest them and get rid of them they can work properly they can stop creating you know the inflammation to begin with so it's this vicious cycle you interrupt it your body heals on its own and then you can stop the anti-inflammatories because you're not you don't have a problem anymore absolutely brilliantly said thank you very much for this and once again those healthcare professionals who feel that they may not be able to help and they just tell their patients that hey this is just you're you're depressed or there are solutions and so far what i've seen dr heather is that patients have been it takes some time some months but they become 100 once again i want to quickly uh just add something here which i have been very passionate for some long time about the long hauler and what i'm seeing is the following so first is the viral hit and run so let's say this is a macrophage or this is a dendritic cell or this may be some stem cells in the bone marrow that are making wbcs and as the viral load appears the infection appears and they are in a hurry to proliferate and make copies they open up various genes and those genes are then imprinted this is what what we say in the inner term side trained immunity and then the newer macrophages that are developing from the stem cells or that are present they just are with those genes open if this is the case if let's say so we do not know exactly what is the problem if this is a problem then steroids would help because what steroids would do is that they would provide a break to the immune system as he was just saying allow the macrophages to kind of clean themselves up and heal so they would provide a break to the immune system newer cells will be produced less older cells would have a chance to die off and then the the system would be reset so this is one possibility then it is also a possibility and dr paul marik the credit goes to him over a couple of days ago we were talking about long haul and he said that there is a study he sent me the study i would discuss it with the cool means in a few days he said that in some cases in some patients not the whole virus but there is a remnant of virus without messenger rna in it imagine the dead body of the virus the zombie virus is running around and it is just present and it actually makes sense that imagine if this was a b cell and that cell itself had the virus in it as well and now the virus was not fully baked yet it's in rna was not inserted in it yet it was being built and then b cell started proliferating to respond to the infection and it would just keep making copies of the virus with it and this presence of these spike proteins on the surface would continue to bother the immune system if this is the case then ivermectin would help a lot because met in binds with the spike protein so that means if steroid didn't work then ivermectin would end up working you know dr bean i have to jump in here so i don't forget it can you just talk about you know i i'm starting to see a couple of people who have vaccine side effects could there be something like this going on with people who have these side effects yes and could iber mech didn't possibly help them because absolutely absolutely so what is happening is so let me add one more mechanism here and then answer your question as well so the third possibility is that folks have gotten the so let's say immune system this was the b cell it got triggered by the by the covet and made antibodies these antibodies went on and got lodged on mast cells as well correct and in some people they don't even need the antibodies to be lost on the mast cell their mass cells are just generally very upset and they they are moody and they would degenerate very easily but now let's say we have primed the mast cell as well so if this is the case then these mass cells are going to start be granulating for every inflammatory cytokine produced and then managing this will be through antihistamines so that means your cocktail to test with is steroids ivermectin antihistamines culture sins fluvoxamine and finally the question about the covet and the vaccine so look at the end of the day what happens is when the vaccine so let's say this is a vaccine particle lipid nanoparticle has messenger rna in it the particle enters this cell so here is a cell it came in and gave off the messenger rna that messenger rna is going to help produce spike proteins and those spike proteins will be broken down by endosomes and finally presented here on the cell surface now this is the same spike protein pieces that the actual virus is also going to present and if the immune system does not like very well this thing and responds in some people negatively just like sometimes people have allergies then the vaccine is also helping produce a similar response in the immune system the only grace here is that vaccine would not be continuing to produce spike proteins for a long period of time so they would have these symptoms but then eventually they'll they will recover faster compared to a long hauler but the symptom set could be the same as a long color so so i thought that i would at least jump in and kind of what what about ivermectin document do you think they would have some uh roles to play in the vaccine side effects absolutely minimizing them yes so here is the reason the reason is that when so let me add a little more to this uh talk here and fortunately the cool beans have been having this talk for some time so let's say this was a question this was a cell some cell let's say it's a fibroblast or let's say it's a dendritic cell and it was presenting this let's use it fibroblast or a muscle cell and it is presenting an antigen now we know that it cytotoxic t cell is going to come in and dock here as well correct so it is standing there with that antigen and now naive t cell so naive t cell becomes activated here the t helper 2 becomes active or becomes t helper 2 or t helper 1 and the cyto can start start and the antibodies start but one part of that all is activation of the cytotoxic t cell cytotoxic t cell is going to do what it's going to destroy the cell that is their function so as soon as they're activated they're going to destroy the cell and when this cell is destroyed what would happen is the guts of the cell are going to spill out correct which contain small pieces of spike protein as well whole pieces these tiny pieces are going to be picked up by macrophages here and all of a sudden immune system would start responding so if ivormectin was present in the system ivermectin is going to bind here and it is going to prevent this immune system going mad that is one and secondly ivormatine is going to suppress the ns nfk beta pathway and that would also help with the inflammation so if people are getting covered side effects more than those general side effects and they are now lingering ivermectin actually would help a lot but it shouldn't interfere with the vaccine efficacy not at all so not at all so here is the good part of this and we have done this discussion so let's say here is a cell and the cell got the vaccine and now let's make another cell here which got infected so let's say this got the sarcoscope too and let's put ivermectin with both of them ivermectin here ivermectin here first thing the spike protein from the virus has to bind to the as2 and there is an in silico study and i have references for all of those studies anybody who wants it can ask me and i most of my videos about ivermectin have the list of those studies below so first is that ivermectin binds here so it would prevent or stall the entry of the virus to the cell now when a vaccine enters the cell it does not enters through using ac2 it is actually a lipid nanoparticle that just fuses with the cell membrane so ivermectin would do nothing it won't stop vaccines action while it would disrupt the virus then once the virus is inside the cell virus is going to make you know the the proteins with the ribosomes and it is going to make rdrp plus it's going to make three chemotrypsin-like protease both of those enzymes are necessary for viral replication and ivormectin disrupts them both now if you go back to the vaccine side vaccine does not need to make three chymotrypsin like protease or it does not need to make rdrp vaccine is just going to give off the messenger rna that is going to be fed into the ribosome and ribosome is going to make spike proteins there is nothing else needed so once again ivermectin would do nothing here then once the virus is now being built virus is sending its cargo in the cell this is the cali study and the cell is prevented by the virus cargo to produce a interferons right so now ivermectin prevents this because the viral cargo has to load onto important alpha and beta and then they go to the nucleus and ivermectin disrupts that so the cell can continue to produce interferon and stay strong the next cell stays strong as well vaccine does not do that vaccine has no business trying to disrupt interferons so ivormectin does not disrupt that function either and finally the final function is the nuclear factor kappa b so nuclear factor kappa b is a function which vaccine or the virus bo the virus can cause and the vaccine can cause and that is when the vaccine is taken there is the inflammatory pathway and that would cause in nuclear factor kappa b to be activated which would cause cytokines and ivermectin blocks this or stalls this this is the anti-inflammatory behavior this behavior is actually possible in the presence of vaccine because nuclear factor kappa b is just a function that means in the presence of vaccine when the avermectin is given vaccines function can continue training the immune system but inflammatory responses can be modulated downwards which is great yeah thank you thanks so much yeah you're very welcome so uh i wanted to put together that that menu of the things so continuing here we have you and we we're not gonna let you go until we it's my pleasure i'm enjoying it this is this is probably the most fun i've had in the last four months thank you thank you and and by the way so say dr sayeth some people came to me thinking that i was you actually you are me [Laughter] so uh i mentioned that dr said had their advices against using caffeine with fluvoxamine on his website so i i don't uh remember writing this on my website or mentioning this um i mean the only thing this reminds me of is oh right i think what they're talking about is long-haul covid um you might consider avoiding caffeine maybe i might have written something like that avoiding something like a stimulant in long-haul possibly um but what this reminds me of is dr patterson's group you know when i talk to dr yo who works with him um one of the patients came back to me and said that they gave me a list of foods and juices and things to avoid you know avoid these fruits and things when you're taking treatment and you know i looked it up it wasn't something that i was aware of but uh you know a lot of juices like grapefruit juice famously um inhibit some of the enzymes that um uh you know metabolize morevroc especially doesn't have as much of an effect i think on ivermectin but ravrock you could actually increase the levels probably by having juices so yeah but caffeine maybe for long haul patients if you're sensitive to oh oh right sorry caffeine and fuboxamine of course yeah so this this is also a famous interaction right caffeine um will stay in your system it won't be metabolized out when you're on flubox main so that's definitely very very important you know i have to stress that with everyone and when i send people you know my directions message um when i'm prescribing fluvoxamine it's like you know star star star no caffeine at the top at the bottom no caffeine yeah so definitely sorry i had like a little brain fog there for a second but definitely no it's not about no caffeine it's more about you know the caffeine is not going to go anywhere so if you drink a cup of coffee every day by day 10 on fubox i mean you're gonna have like something like nine cups of coffee in your body right wow it's uh i mean not exactly i'm just exaggerating but you know you're gonna have a lot of it's gonna stay it's gonna accumulate it's not gonna leave as quickly so you know you can experiment with it and you know it's just more going to be uncomfortable like you know if when i was in college i used to you know one night i tried you know the caffeine pills to stay up and study and i was so you know buzzed that i couldn't even think straight i mean most people aren't going to end up in the hospital with you know caffeine overdose but um you know in the elderly certainly that's something to worry about with palpitations and you know triggering an arrhythmia or something is possible but you just have to be careful basically with caffeine so maybe you know if you if you're addicted to it i mean i tell people just try decaf you know so i had a coffee shop owner come to me with long haul and she had to try to box me and she's like you know i i work in a coffee shop all day i won't lie to you i drink coffee all day you know and so um you know decaf has some caffeine but it's you know tiny amount so um it's not like an absolute contraindication it's more about you have to be careful got it thank you very much for that um so i'm gonna continue here some more questions but more of the questions here were in terms of um what not to take here where should we get these treatments if we live in the uk so this is a very common question that has been asked that fine for you as we have folks like you thank you very much for helping us but what do we do for uk and other places so yeah i think for the uk you have to just contact all the doctors who are prescribing ivermectin you know one by one and try to find somebody who's willing to um prescribe it for you or you know if you're if you're dying you know like you know a white lie you know for example um it depends you know i i'm not completely opposed to you know if somebody comes knocking on my door you know looking for you know that's a bad example but basically you know in some cases you might need to you might need to make something up you know so some patients for example will find a doctor who is willing to prescribe it to them and some patients will just say hey i live in jacksonville florida you know and um they tell you that i'm not checking i'm not looking up your you know internet address ip address you tell me you're in jacksonville florida that's where you are you know i'll send you a prescription in jacksonville florida so you know if somebody um has a you know family member in america who can ship them something from cvs using goodrx and they can find a doctor who's willing to prescribe it to them and the same thing with people who are in states that i'm not in i tell like somebody calls me from california i'm not licensed there yet hey drive to nevada okay call me on the phone establish your care with me i can send you a prescription nevada you can transfer to california when you drive back you know him um people have to get creative and you know when your life is on the line um i don't think a white lie is going to be held against you but you have to figure it out yourself basically got it and and one more addition to this many of the cool beans have been reporting from uh uk that they have been going on uh some websites that allow the martin to come in from india so that is one and secondly for my uh pleasure i was happy with this one that dr tina piers who is now managing long covered in uk she has started uh administering ivramecten as well in addition to antihistamines so it may be that reaching out to dr pierce would be useful and then hopefully her influence is going to start increasing and more and more doctors that know her are going to start giving the hypermectin as well so it may be useful to actually connect with dr pierce so thank you very much dr heather i'm going con continue to the next one so the redditor folks i thought we would not be able to go over all of them but thankfully dr heather has given us time so can you and one more clarification sorry dr bruce paterson somebody was asking what is ncx so dr bruce peterson has been on my shows as well please just search for his name or just google it dr bruce patterson he has a company called insult ex they have created a set of labs to figure out what may be happening with long covet and dr yod that dr hader was talking about it is funny dr heather it's a small world doctor yo is the class fellow of our medical director dr ahmed zafran my show here as well so he has been working with dr bruce paterson and they are working on figuring out labs and the management for long haul so you can just google them and you can tweet at them as well so here can you clarify what foods drinks to avoid while on ivermectin for long covert so coffee fruit fruit juices nuts coffees dairy yeah so i think um you know i don't have a lot of insight into this i mean i don't tell people to avoid anything other than maybe junk food or something that triggers their symptoms you know so some of these things might be you know people thinking about like inflammatory like fruit juice for example i think i mentioned to somebody maybe avoid try avoiding fruit juice um uh because it's just a lot of sugar you know maybe eat the whole fruit instead um so so what we're talking about is maybe having an anti-inflammatory diet because inflammation is the problem for most people glonkovid we're trying to give you the best chance of recovering but uh you know honestly the food is probably a little lower down the list when you're using medication like ivermectin um as long as you're not you know a lot of people come to me at long haul and they have gotten to the point where they just know they can't eat certain things because it'll give them terrible symptoms so some foods for example dairy have a lot of histamine in them and if histamine is part of your pathology you know it's not going to really help to be having you know uh food that already you know strawberries or dairy something that's high in histamine um so some of these things are particular to the patient you know one of my long haulers you know he had had some chronic inflammatory issue and he said that the only thing that worked for him was actually juicing fruit and and so i tried you know i told him like what about you know green juice and you know maybe try something else and you know he he said it doesn't really work as well so um he avoided the juice you know in the beginning and the beginning of the protocol and then later on you know we decided to try it you know so it's so everyone is different you know people should be a little bit flexible you know and with food i usually just outside of this particular you know scenario also i tell people that everything is really particular to you you know you can't say that everyone in the world you know coffee is bad for them or coffee is good for them you know i mean you can find studies that say anything is good for you it seems nowadays um it's just people are very very different and they have to be willing to examine their own reactions to foods and figure out what works for them what doesn't and hopefully avoid things that don't work for you for whatever reason you got it thank you very much so uh stereo match i'm gonna skip over the food related questions and go down here to um there was a question from an india redditor so krishna zim from new delhi had a question she got dengue in 2012 and since then she has had pain tingling in her extremities and body but always on one side next day it is on the alternate side never on the same side then in december 2020 she got covered 19 and her family too she was given a romantic hydroxy doxy and during that that disease her symptoms went away later they returned back to their daily cycle she occasionally gets a relief if she is distracted or goes out 35 year old female 5 tall 45 no diabetes so i'm gonna understand the question here the cyclical nature of it suggested to me a couple pendulum where the activation shift from one to the others seem to me perhaps be some kind of migraine maybe so is it possible that the of course the patient is saying that they are experiencing it is there some mechanism that shifts the symptoms from one side to the other and any solution for this yeah i mean this is a fascinating uh scenario and i've never actually heard of anything like this so i would return the question back to you dr mubi and what do you think about it yes so i have not heard of this cyclical change on daily basis from one side to the other almost seems like one side of the tissue is getting inflamed than the other but there are no such barriers in the brain so i am at a loss as well to figure out what this may be so uh why not we table this question for the time being uh stevia match we'll talk a little more and figure out what to talk about so here is a good news we have almost gone over all the questions on reddit so dr heather you got a trophy for that wonderful yeah so i'm gonna now just have one few last questions from the live and then we so here is kevin brazda dr bean let's host discussion with the doctor test laurie paul maddox topic human rights and ever absolutely [Music] yeah yeah this is a big issue um i mean what do we do um you know i think we need to honestly get lawyers involved maybe you know have some pro bono lawyers involved in this because if you have enough money you know you can go to the judge and get a court order you know you hear about this in the media here and there if you have enough money you can fly out to a different hospital that dr corey's working at that week you know but if you don't you know you're at a loss you know you just have to push for it yourself and absolutely it's really uh lately i have been actually thinking about it that we should have a number of lawyers now starting to sue fda cdc who number one and number two uh dr tess lori had said that we need a new who i actually think that we should try to figure out how to start a new just like nowadays there are open open music open movie open softwares i think there should be an open health system as well and we should figure out can we create our own who which then becomes so authentic and so influential at some point that it can actually be a parallel entity i think we'll need lots of resources for that but i think that time is now to do that so one more question cheryl says does ivermectin work with malaria my friend 71 year old female got malaria as a child and went untreated she still feels bad with malaria type feelings after all these decades so i'm not aware of any uh benefit in malaria i haven't treated anyone with malaria but i think that ivermectin has its profile has been raised and so people are starting to come who have other inflammatory conditions and they just want to try it so you know i've gotten mostly lyme patients with lyme disease um but you know other people who have just not specific inflammatory complaints you know aches and pains and arthritis type of things sometimes we'll take over method and get better um so if that's the case if you can be an ivermectin every week you know and your aches and pains go away that's fantastic you know it just means that we're you know we're addressing the root cause in some way right correct correct so i think the these are the there is one more question so one more question and then we um so gurav shah says post covert 19 i developed idiopathic articular it's nine months now still have the to take allegra at 120 milligram daily yeah so um this is sounds like long haul some you know version of long haul it's not the most uh common um uh symptom that i get uh i haven't actually seen that before but you know it's uh i'm glad that you can manage it and i hope there's not any side effects but it's certainly worth trying one of the other treatments to see if you can actually address the root cause stop the information completely and get off of medication um so it's just the the general approach to long-haul symptoms of any kind yeah it seems like the mast cells are active at this time so there may be something that is bothering the mast cells so dr heather this is it we are at the end of it thank you so much for your presence my pleasure absolutely yeah i'm so glad i could spend time with you and learn something from you and from the cool beans and actually the first part of this video where you have given your protocol i think that is the gold for for anyone in the world so thank you for doing that thank you for helping absolutely thanks so much for having me thank you very much so cool beans thank you very much uh so this was a special show today please like subscribe and share and i would see you tomorrow morning bye bye for now

Channel: Drbeen Medical Lectures

Views: 134,518

Keywords: drbeen, medicine, nursing, med school, microbiology, sars-cov-2, covid-19, coronavirus, usmle, mbbs, nclex, cytokines, Health (Industry), Medicine (Field of Study), Pathology (Medical Specialty), what is, nursing (field of study), Nursing school (organization), Dr. Syed Haider, Dr. Haider, long covid

Id: v8-J1ES86os

Length: 103min 39sec (6219 seconds)

Published: Sun May 02 2021