Sharon’s Treatment Regimen for CBD (revised in 2012)

I know Sharon Comden from the CBD-related online support group.  She was diagnosed with corticobasal degeneration (CBD) in 2009.  She has a doctorate in public health from UCLA and, as you’ll see, she’s one smart cookie.

Sharon gave me her permission to circulate three recent posts in early 2012 about her treatment regimen (using supplements).  As CBD and PSP are similar disorders, her approach may be of interest to those with PSP (progressive supranuclear palsy).

One insignificant change I made to her posts is that I substituted “CBD” for “CBG.”  The old acronym for CBD was CBGD.

Sharon asks that you contact her via the CBD-related online support group (if you are a member there).  Let me know if you want to join; I’m a moderator of the group.

Robin

Editor’s Note: Sharon Comden died in late 2015. We at Brain Support Network were honored to help her make advance arrangements for her brain donation. She was a remarkable woman.

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(In this post, Sharon is responding to Elaine, whose mother is 91 and has a CBD diagnosis.)

Re: Treatment Options for PSP and CBD (Review)
Posted by: “Sharon Comden”
Date: Wed Feb 15, 2012 5:14 am ((PST))

Elaine, I have had CBD since 2009, when the first symptoms of hand apraxia (difficulty w/zippers, putting earrings on, and later deterioration of keyboard skills) showed up. In late 2010, I began having speech issues–slowing and intermittent difficulty pronouncing some words. It got progressively worse and my search of the “emerging therapies” literature paid off for me; I’ve seen significant improvements over the last eight months that I’ve been on my supplement regimen. My symptoms included: loss of sensation and fine motor coordination of my fingers (apraxia), slowed gait and upper limb movements, curling fingers of both hands when at rest (dystonia), speech slower and more hesitant than normal and difficulty pronouncing polysyllable words like “degenerative.”

Since there are no medical treatments currently available, I decided to look for promising therapies that had good preliminary results in animal studies, seeking low toxicity “emerging therapies” based on lab research results, if not clinical trials. I also contacted leading researchers with many years of experience working with drugs/supplements that act on neurodegenerative diseases. I have a doctorate in public health from UCLA and have research training (though not in neuroscience). I don’t pretend to understand everything–this is very technical research–but I am fairly confident in what I’m personally taking to delay progression of my CBD. It takes a multifactorial approach to combat CBD/PSP because there is no magic bullet that impacts all the elements of this disease, so a cocktail of different drugs/supplements is necessary, depending on what symptoms or part of the disease process we want to target.

Last May, I started taking 1000 mgs of bioavailable curcumin (Longvida, available in capsule and powder forms from phytosensia.com) w/ at least 500 mgs. vit. C and one 1200 mgs enteric coated DHA/omega 3 fish oil from Costco (Kirkland brand) on an empty stomach in the morning and at bedtime. Like your Mother, I also take 600 mgs. of CoQ10.

After four weeks on the curcumin/DHA/etc., I began to see improvements in my speech, at 4.5 weeks the curling fingers were gone, and my gait/limb movements returned to normal speed. Those benefits continue and most of the time, my speech is near normal. I subsequently lowered my dose of Longvida to 500 mgs. to twice a day after a few weeks, following what I call the initial induction phase when the curcumin levels are rising to therapeutic levels in the brain.

At the suggestion of my neurologist, I’ve added 25 grams of trehalose (NeuroCoatT, 1 tablespoon twice a day dissolved in a beverage or with food), a commercial sweetener shown to be safe and beneficial with Huntington’s Disease. It seems to be improving my articulation as well and compliments the action of the Longvida formulation curcumin. I understand there will be a clinical trial of the Longvida formulation, perhaps later this year. I also take a baby aspirin every other day.

Your Mother’s advanced age may or may not color her response to this regimen, all reputable over-the-counter supplements. Some caveats:

1. There is data available on the safety/efficacy of these supplements in animals and often humans too, but limited or no data on what happens when you take several concurrently. Many are common foodstuffs, e.g. curcumin (tumeric), trehalose (widely used commercial sweetener), but there is a risk that some combinations don’t work together or produce adverse reactions. Since I know what will happen if I do nothing, my personal decision is to accept that risk and keep good records of what I’m taking and how I respond. After eight plus months, I can report only benefits.

2. It takes three to six weeks to see changes after you start taking some supplements because it takes that long for them to build to therapeutic levels. Sometimes you feel a bit out of focus mentally before you feel better too. The “fuzziness” cleared up in a couple of weeks. I’ve been taking this combination for 8.5 months with no ill effects.

I hope your Mom does well with these supplements, if she decides to try them. This combination is based on hundreds of hours of reviewing scientific papers to find something that offers some hope for tauopathy sufferers (see First and Second Line of Defense maps on Yahoo CBD website). It’s the best we can do for ourselves right now, while researchers are looking for a cure.

Best regards,
Sharon Comden, Dr.PH

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(In this second post, Sharon is responding to Dawn, whose husband has a CBD (corticobasal degeneration) diagnosis and has not had the use of his left hand for over a year.  Dawn’s husband takes Aricept, Cipralex, and Crestor.)


Re: Treatment Options for PSP and CBD (Review)
Posted by: “Sharon Comden”
Date: Wed Feb 15, 2012 4:26 pm ((PST))

Dawn, this is a learning journey. My Mayo neurologist is cautiously watching what I’m doing–but he has also told colleagues about it and the results so far–so he is respectful of what appear to be symptom reversal for some things. I would normally refer you to your neurologist to help you assess potential contraindications, however, the likelihood of help there is about nil because outside of the research community, most neurologists are unfamiliar with supplements. I can share several scientific papers supporting the regimen, if you or your physician wants some reading.

As you note, I still enjoy a high level of function. Your husband may get some or no symptomatic relief at his stage; we just don’t know until the clinical trials are done with people at different disease stages. Here is reason to hope because at least one study of late curcumin intervention with mice, suggests that cognitive function can be improved by curcumin even in later stages of disease. We don’t have the luxury of waiting three to five years for human clinical trial results, unfortunately. Here is how I would proceed if it were my husband.

*    Crestor is a hybrid drug that can adversely affect muscles through its “statin” component. The evidence of the value of CoQ10 to treat myopathies caused by statin drugs is mixed, but some physicians advise their statin patients to take CoQ10 to reduce risks of side effects, so it would seem reasonable that the 600 mgs. in the anti-CBD regimen (300 mgs. morning and at bedtime) would not be contraindicated. To the contrary, there is evidence of benefit in neurodegenerative disease. Lahey Clinic has a clinical trial with PSP patients on very high doses of CoQ10.

*    The most powerful component of the anti-CBD regimen is the Longvida curcumin, originally developed in the lab of respected UCLA  researchers Drs. Sally Frautschy and Greg Cole and subsequently licensed by the University to an outside manufacturer. If your husband is  debilitated or sensitive to drugs in general, you might start with less Longvida and build up to the 1000 mgs. morning and at bedtime. One of curcumin’s actions is it stimulates autophagy, the cellular clean-up mechanism for the fragments of tau proteins created during abnormal hyperphosphorylation and destruction of normal neuron function. Not surprisingly, I did notice some cognitive effects after a week or so at a 1000 mgs. and my solitaire scores went down 500-1000 points. The fuzziness abated and the scores returned to normal after about three or four weeks. That is also when I began to see functional improvements.

*    I would start the regimen as described in the last post, but leave out the trehalose, so you can first establish his response to the curcumin.

Keep good notes of what he is taking and changes in his condition. You have to use your judgment if he reacts poorly to the supplements. Even with FDA approved drugs, sometime people will have adverse reactions.

TIPS: digestion of a meal will interfere with the absorption of the curcumin in the gut, so take it at least 45 minutes before or after meals. Liquids are ok and if swallowing capsules is a problem, it’s ok to mix the curcumin into yogurt, a smoothie; even hot liquids like a latte or cocoa are ok. The manufacturer, Phytosensia, sells it in powder form as well as capsules.

www.phytosensia.com/Longvida-Curcumin-Supplements.item

I have problems opening the capsules, so the powder is great. Rough measure if you elect to use the powder is one-quarter tsp = 500 mg and one-half tsp = 1000 mgs. It doesn’t taste bad either–cinnamon works well in hot cocoa to blend the flavors nicely and I like it in peach yogurt.

Let me know if you decide to proceed or if you want more information.

Sharon

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(In this post, Sharon is responding to me, when I’ve told her that her analysis is incredibly impressive.)


Re: Treatment Options for PSP and CBD (Review)
Posted by: “Sharon Comden”
Date: Wed Feb 15, 2012 4:49 pm ((PST))

Robin, thanks for the compliment. There is a strong possibility of a Longvida trial. The animal studies are very promising, as well as the results from my n=1 experiment. As you know, buying time until the cure is found is essential for tauopathy patients. I believe that I have bought time with this regimen. Coupled with regular exercise and cognitively challenging work–I feel good most all the time.

Caregiving tips from PSP caregiver

Online friend Jim posted these suggestions recently about caring for his wife.
He was responding to a family dealing with a new diagnosis and wanted to
offer suggestions on how to cope with changes.  Jim’s wife has
progressive supranuclear palsy (PSP).  These tips apply to all the disorders
in our group.

Posted by Jim
February 13, 2012
Posted to PSPinformation

 

It also took years for me to get a PSP diagnosis for my wife.
Unfortunately, it’s a good-news/bad-news situation. Good that you can stop
searching out new doctors to get a correct diagnosis, but bad news in that
there is no treatment for PSP. When a neuro finally said he knew what my
wife had, he looked very sad. He said, “She has PSP; I’m sorry”. It
was only later that I figured out why the ‘I’m sorry’.

 

My wife fell several times with her walker. We finally stopped that and
went to a wheelchair to keep her safe. She couldn’t use her arms, so her
travel is restricted to me pushing her around. I also have an inexpensive
shower/toilet chair which we use in a roll-in shower as my wife is no longer
strong enough to stand in the shower while being bathed.

 

A helpful tool to be used when moving your mother around as her mobility
declines is a ‘lazy Susan’ type disk which she can stand on and be used to
pivot her onto the commode; into a chair; even into the seat of an
automobile.
I smeared “shoe Goo” on the bottom of the bottom disk, to prevent it from
sliding on smooth surfaces.,

 

Having been on this List for quite some time, I have noticed the
pattern that the disease often takes a step downward following a traumatic
event such as surgery or a bad fall.

 

My wife can no longer speak as she has been unable to open her mouth
for some months now. I try and use a white board to draw picture symbols
for HUNGER, THIRST, PAIN, TOILET, etc. She can also sometimes blink
for ‘Yes’. [While your family member can still speak} establish some ground
rules.

While the wife and I long ago agreed that we could not

have a feeding tube inserted in the stomach, we HAVE been successful in
feeding her by squirting pureed food into her mouth in short spurts between
swallows. (I use 60 ml plastic syringes available at medical supply
stores/pharmacies).

 

[Members here] recommended we buy the Magic Bullet blender to puree food.
It is a lifesaver. Last night I used the syringe to feed a pureed meal of
pork chops, mashed potatoes and gravy (thinned with beef broth). We
bought the Magic Bullet at a reasonable price at Target Stores. It comes
with several jars, lids, and two grinding devices. It will puree almost
anything.

 

My wife’s daily feeding routine is BREAKFAST: Yoghurt and thickened
coffee. LUNCH: Chocolate, strawberry, or vanilla “boost” with ice cream
added. SUPPER: Various rich soups, stews, or mixed foods such as
chicken pot pie, roast beef and potatoes, pork chops, etc.

Best of luck,
Jim

One patient’s approach to living

An online friend, Aletta, who has multiple system atrophy (MSA), posted the following recently to an online support group. She
has lived for nearly two decades with MSA so maybe there is
something to her advice!

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Posted by Aletta
February 7, 2012
to the PSPinformation online support group

Personally I think much more needs to be done to help us live with the devastating symptoms, and to help slow down or even halt the progression of the disease to where we can have near normal lifespans.

So do a lot of reading and if you see something you want to try find a doctor who will let you try things and will monitor you thoroughly. If I had just sat back and taken this illness I would have been gone by now, and I really want to live to be eighty more than anything. I can’t be too unhappy with how it has gone until now, I am a few years past my expiry date, and still able to type and send you posts. I spent my weekend with my grand-kids already 8 and 6 years old, I almost did no live to see them at all. Find people who live longer than others, find out what they did and try doing that also. Never assume because a doctor read in his old textbook that you now have a lifespan of 2-8 years that this is gospel, it is not. Sadly believing something can result in the self fulfilling prophecy you might give up and dread the future, become depressed, and give up. If you have the will to fight and the desire to make every minute of what we have left count, just go on – enlist those who love you to help you out with it and decide on what you want to do and find a doctor who understands that, Ask lots of questions on groups like this one, find what works, what does not.

Look at the limitations you have and construct a different life reduce stresses, get lots of rest, learn to say no so you do not overdo it and find ways of filling that time at rest with laughter, books on tape, container gardening, art, crafts, music, whatever makes you happy and spend the time you have a with some energy being with those you love. Find some things that might help and are otherwise not dangerous (in my case cinnamon, flax seed, senna tea, video games, laughter, walnuts and blueberries) and have them often. Very importantly spell out what you need to those around you, they are not psychic.

Grief has to do with failure to accept change

This is a lovely New York Times (nytimes.com) article by a gentleman whose grandmother JoAnn was diagnosed with Alzheimer’s seven years ago.  I think the message applies to our approach in coping with any family member’s diagnosis — not just a diagnosis of dementia.

Here’s a key excerpt:

“But what I learned from my grandmother’s journey through Alzheimer’s was that my grief regarding her condition had largely to do with my failure to accept the change she was undergoing.  Regardless of how I felt about it, JoAnn’s change was the truth. What was gone in her was not missing. And the more fully I understood that, the more present I was able to be during her final years.”

Tying in one tidbit from a webinar I was on earlier today, it sounds as if the gentleman was stuck in the “denial” phase of grief and had to get to the “acceptance” stage before he could adjust his thinking “to be present” with his grandmother.

Here’s a link to the full article:

well.blogs.nytimes.com/2012/02/16/finding-joy-in-alzheimers/

Well Blog
Finding Joy in Alzheimer’s
By Robert Leleux
New York Times
February 16, 2012, 12:01 am

The author of the article, Robert Leleux, is the author of the book “The Living End: A Memoir of Forgetting and Forgiving.”

Happy reading!

Explaining fatigue – the “spoon theory”

The November 2011 newsletter for “Patients Like Me” refers to the “spoon theory” as a way to explain fatigue to those not dealing with chronic illness.  A woman with lupus, Christine Miserandino, developed the “spoon theory” when faced with her best friend who didn’t understand how Christine could be so fatigued when she looked so good (“you don’t look sick”).

Christine posted about this on the website, butyoudontlooksick.com.  Here’s a link to the post:

www.butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory-written-by-christine-miserandino/

The Spoon Theory
by Christine Miserandino
www.butyoudontlooksick.com

The post is also available in Spanish, French, and Hebrew.

Robin