Greetings to all PDI Warriors,

Fall colors and cool mornings are starting to sneak up on us here in the Midwest. Welcome to this October 2011 PD Institute newsletter.

Again this month we use the familiar and popular format of presenting a simple exchange and blending of emails between one of your PD brothers and me. For those of you who are part of our DCI readership, please simply apply the ideas expressed here about treatment dosage to knowing everything you can about the size, shape, density, thickness, and degree of lateral movement of the palm nodules and cords, as well as the exact degree of finger extension when you try to open your hand.

Read this combined email like two people talking and one interrupts the other to make an important point. To understand the flow of the conversation, just keep in mind that the text in black is from TXXXXX and the text in red is from me.

Here we go:

Greetings TXXXX,

See below for comments…

Regards,

Theodore Herazy, DC, LAc
Peyronie’s Disease Institute

From: TXXXXX
Sent: Thursday, September 08, 2011 12:18 PM
To: Dr. T. Herazy
Subject: Enzymes

Hi Doc,

Thanks for the prompt reply to my last set of inquiries. Considering the difficulty in discussing this with people it’s great to feel that someone out there is listening and pulling for me.

I’m starting a new thread because I have a question about enzymes.

Specifically, how does one determine the potency of say, Fibrozym/Nattokinase vs. Neprinol?   Surprisingly, many manufacturers are reluctant to provide the specifics of their particular blend of enzymes and related co-enzymes and factors to which they attribute efficacy.  That is why you will so often read the common phraseology on a bottle of enzymes or supplements, “a proprietary blend of…” By using this method of listing the ingredients only as a group, without a specific percent, weight or functional measurement value of the various ingredients , a manufacturer can give only limited information on purpose. They do this to avoid giving away too much information about how they do things, thus protecting the formula so it cannot be copied. It is somewhat similar to a food ingredient label that says it has “a blend of various spices.” Only the basic ingredient information is given without revealing too much.  This is motivated by a desire to not allow others to copy their research information or benefit from their experience. For this reason it is difficult, if not impossible, for me or anyone else to answer this question about Neprinol or the next question you pose about matching dosage from one product to another one.  

It seems that there are several systems of measurement listed i.e…..FU, HUT, USP, GDU.  Yes that is true, but so long as you compare an FU unit to another FU unit you will have a fairly accurate and easy way to compare enzyme activity; but, you cannot compare one FU measurement with an HUT or GDU measurement. You have to compare apples and apples.

FU stands for Fibrinolytic Units. It is used to measure dosage needed to breakdown fibrin, a component of many types of scar tissue. For this reason in working with PD and DC, the FU unit is probably the most common and most important unit of enzyme activity you will find, although there are others.

SU stands for Sarett Glucose Oxidase Unit. It is used to measure glucose oxidase activity as determined by the amount of an enzyme needed to consume a specific amount of oxygen per minute. It is often used to measure digestive enzyme activity.

GDU stands for Gelatin Digesting Unit. It is used to measure as the dosage of bromelain needed to reduce pain and inflammation. We use bromelain in PD and DC treatment, but are only are interested in its ability to reduce fibrin, hence the DGU does not tell us much about what we are interested in.

HUT stands for Hemoglobin Units in a Tyrosine base. This is the unit of measurement for protease acitivity, a protein digesting enzyme.

USP stands for United States Pharmacopoeia and the measurement unit the USP uses is the primary legally recognized national drug and nutrient standard. In terms of vitamin and mineral supplements and various nutrients the USP number varies from one vitamin or enzyme to another. As long as you can find a company that uses USP to measure antifibrotic enzyme activity – not common – you can compare it to another company that does the same thing.

What is the proper way to measure enzyme activity/dosage?    For most of us involved in Peyronie’s treatment, the most common and appropriate measurement unit will be the FU, or Fibrinolytic Unit. As you see above in the last answer the different measurements (SU or DGU or FU) are measurements of different enzyme activity. There will be one way to measure a fat digesting enzyme, and another way to measure a protein digesting enzyme, and as we see still another way to measure a fibrin digesting enzyme.

I’d like to get as close to the level of enzyme activity as I was at before making the switch to Neprinol.  I appreciate you academic interest in this subject. I tried to do the same thing you wish when I was treating myself for Peyronie’s disease, and wasted a lot of time until I realized I was chasing clouds.  Since so much of this enzyme activity information is intentionally protected and obscured, it is difficult to make an accurate comparison from one company to the next. But, because I am a pragmatist by nature I have a different way of looking at this entire enzyme measurement question.  I counted pills. I swallowed a god-awful number of them during the year or more that I actively treated myself, while I looked for changes in the size, shape, density and surface features of my scars.  I simply focused on counting the number of pills I was taking and using different types of external therapies while monit oring for a structural shift in the scar.  I just used products from the best, oldest and largest companies I could find that had the highest dosages and highest FU ratings, and monitored my scars for change. That’s pragmatic.   When I took enough of this and that and began to see those physical aspects of the scars change, I stopped increasing the dosage.  When the changes stopped, I increased the dosage again until the positive changes started to occur once again.  I did this for a few cycles until I beat PD.  I thought FUs were interesting but irrelevant to a guy who was more interested in “How many pills, Kegels, Nei Gong exercises, Genesen treatments, massages, etc., is it going to take to get my body to reabsorb these damn scars?”  I finally found what numbers of what products worked for me to change the size, shape, density and surface features of my scars, and stayed with it until the scars disappeared and my distortion reversed itse lf. Very pragmatic and not very academic, but it worked.     

So how does that measure up?  I wish I had answer for you.  The Neprinol people say their product is 10-15 times more biologically active than Fibrozym and Nattokinase, and they are probably right.  When push comes to shove, you only need to know how many pills it will take to get your scar to move in the right direction, and I think the answer to that question is more complex than can be expressed in an FU number.  The best treatment tool and the very best measurement tool of all – the best – is to know the exact size, shape, density and surface characteristic of each of your scars during your treatment, and monitor them for palpable changes as you slowly increase dosage.   PLEASE keep good records of all changes you make in your plan because you will likely be tweaking those numbers in a variety of directions before you are done.  You do not want to make the mistake of duplicating a therapy combination that was previously unsuccessful. 

You know, we tend to discuss numbers of pills primarily, and that is unfortunate because DMSO, Scar-X, the PDI diet, Genesen pens, Kegel and Nei Gong are all extremely important and must also be used to treat your PD well.  The more broad and diverse your plan the better your results should be. You cannot treat your PD by just taking pills, no matter what they are. You must use all of these things available to you, in a wide and diverse plan mixed with internal and external therapies. Even though in this email I make it sound like successful treatment is determined by how many pills you take in a day, you must also use those other therapies that are not in pill form. Please keep in mind that good PD treatment involves a lot more than pills, OK?   You say on the website that Neprinol is much stronger than the others so I’m wondering how to get to a similar dose quickly so I can see if there’s any scar response. A lso, I realize everyone is different but what is considered a strong therapeutic dose and not merely a maintenance dose. It seems I’ve not really pushed things that high considering the dosages I read about for many of the supplements I’m taking. Now that I’m feeling more confident with ingesting all this stuff I really want to go for it and beat this damned thing. I simply must!   Consider this suggestion:  start taking 6/day of the Neprinol and slowly work up to 9/day and see what happens.  Remember any number is just an arbitrary point that could be too high or too low. The reaction of your PD scar to what you are doing within your personal therapy plan will tell you if your plan and your dosage is right for you – that should be your primary unit of dosage measurement that tells you what you need to know . Contact me if you have any questions, please.   TRH

Thanks again,

~TXXXXXX

So there you have it. This is a very instructive email exchange between TXXXXX and me. I really hope the message gets across that you simply have to keep your focus on how your scar is responding to your therapy. If you are approaching your treatment plan in any other way, you are playing the foolish game of hoping and guessing that something good will eventually happen to you. With this PDI treatment concept you will not have to hope, you will know and you will be in control of your treatment. You will feel confident and less stressed about your Peyronie’s disease – or Dupuytren contracture – for the first time in a long time. Wouldn’t that be nice for a change, eh?

See you next month. Stay in touch and send your treatment questions to me so I can give you some ideas to work with.

Regards,

Theodore R. Herazy, DC, LAc