Greetings from Seattle

Crohn's Disease Forum

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Joined
Mar 1, 2011
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7
Hello everyone,

I’m writing from Seattle, Washington, USA.

About me:

I am 55 years old and was diagnosed with CD in early 2005 in a rather round-about way.

My mother has an autoimmune disease: rheumatoid arthritis. And my uncle on the same side died of ulcerative colitis many years ago, before we had the treatments we have today.

I had been having mild symptoms of Crohn’s since my late teens, and had even been to the doctor more than once with complaints about same. My doctors (two different ones) did some very general tests and told me I was fine. One said I just had “a nervous stomach”.

The years go by.

I have restless legs syndrome which is a sleep disorder characterized by creepy-crawley sensations in the legs when they are not moving, and which are relieved by moving them. This is quiet distracting and often significantly disturbs sleep.

OK, so I go to sleep specialist and one of the things he does is measure my blood serum iron level; low serum iron can greatly aggravate restless legs. That same afternoon the physician himself calls me back to let me know my level was critically low and that I should see my primary care doctor as quickly as possible to get it checked out and to let me know that I should get a colonoscopy ASAP. I expect they were thinking I probably had colon cancer and that that was the source of the chronic bleeding which was making my iron low.

Off I go to my primary care physician and she makes arrangements for me to have a colonoscopy the following week.

Off to the colonoscopy. I am pretty worried about what they are going to find, but Crohn’s disease never crosses my mind.

There I am on the exam table, full of sedating medications and the gastroenterologists says to me “did you know you have Crohn’s ?” “No”, I reply, “but it sure explains a lot”.

I am started on Pentasa, which does not work for me. My gastroenterologist’s office turns out to be extremely disorganized, so I switched to another physician, who has been great. I am tried on several medications, including Remicaide, which worked pretty well, and when Humira becomes available, I switch to that with good to very good results. At that point I was only on Sulfasalazine and Humira and having pretty good control.

Then, one day, while perusing the internet, I find a site discussing low dose naltrexone as possible treatment for Crohn’s and, after more investigation, I decide I want to try it. That was almost two years ago.

I went to my GI doc and asked her about it. She said she had heard about it but was reluctant to try it given the small number of studies. I finally persuaded her that it was worth a try: there are very few side effects in most people, it is inexpensive, and the risks associated with long term use – like severe infection and increased risk of some cancers- are negligible as far as we know.

My symptoms are mild to moderate, so the risks of having a severe flare-up were fairly low. After a promise that I would be right back on the Humira if the Crohn’s increased in activity, she agreed and gave me a prescription.

Naltrexone has worked very well for me, despite my own initial skepticism. I am now on a small dose of sulfasalazine and 6mg of naltrexone every night as my only treatments.

Once in a while I have a day or two where I begin to have, what seem to be, mild gut symptoms. I take a dose of the probiotic Align (no other brand does the trick), and they subside within 24 hours.

I still have trouble with my serum iron level, but it appears to be an absorption problem rather than a bleeding problem.

I am excited to find my way here and look forward to learning from others.

Aisling
 
Hi Aisling
and welcome

Sounds like your meds are doing the trick, hope it continues for a long time to come!
We have a sub forum on LDN, check it out
Enjoy the forum, lots of friends here for you
lotsa luv
Joan xxx
 
Aisling - Welcome, fellow Seattlelite :) What part of the area are you from?

I'm glad you are able to control your symptoms so successfully with such a "minimally invasive" treatment regimen. I am curious about your RLS. I suffer from this too from time to time. It can be really annoying, to say the least. I wonder if you find the LDN worsens your RLS? I'm assuming you take the naltrexone just before bed. I've always wondered about this because mu agonist opioids (typical pain meds, like codeine, morphine, etc.) are sometimes used to treat RLS, and withdrawal from these drugs usually causes Restless Leg Syndrome. Since naltrexone in essence blocks these drugs, and presumably may interfere with the body's own endogenous equivalent, it seems like it could make the condition worse in people who suffer from it. Have you noticed any impact on your restless leg syndrome? Any other side effects from the LDN?

I'm sure you'll find this a forum to be a great, supportive place to discuss your IBD issues.

David
 
Hi Aisling, welcome to the forum, it's a great place for info and support and it's full of lovely people :)

I hope your meds continue to work for you, sounds like you've got a good handle on what your body needs.

By the way there is a great homeopathic remedy for restless legs, it's called rhus tox, if you fancy giving it a try.

Take care.

Paula
x
 
Hi Aisling and welcome!

We love to hear success stories here. It;s great to know you are doing so well on the LDN and Sulfa.

I suffer from RLS from time to time - it's always a dead giveaway that my iron levels have sunk to way below normal. Have you been able to keep your iron levels stable? If yes, how? Infusions or tablets?

Lots of good information and nice folks here on the forum. We hope you stick around!

- Amy
 
Hi David,

I live in Maple Leaf, not far from where the freeway exits onto Lake City Way.

Yes, the naltrexone - RLS issue is an interesting one.

For many years I took Mirapex, which, as I recall, is a dopamine agonist. Last year I started having much more trouble with my RLS, so I went back to the sleep specialist. Now, this was almost a year after I started taking naltrexone, so I don't think it was the culprit. Dr. K said that sometimes the dopamine agonists, after a long period of use, can actually make things worse. He called it "augmentation". So - he started me on 5mg of methadone every night (my RLS is really bad). He chose methadone because it has a very long half-life and few psychoactive properties. Works like a charm!

We had the discussion about the mu receptor blockade from the naltrexone and whether that would interfere with the methadone. There aren't any studies so it was a "try it and see" situation.

What I have found is that I have to take the methadone at least 2 hours before I take the naltrexone or the RLS is completely out of control. Apparently that is sufficient time for enough opioid receptors to be blocked to control the RLS regardless of the naltrexone coming along later. The dose of naltrexone is so small that it doesn't compete very effectively to unseat the methadone at the receptors once it is there.

As to whether the methadone makes the naltrexone less effective for CD. I have taken 6mg of naltrexone from very early on (that is what works best for me). Nothing changed when I started the methadone, so I assuming the interaction is minimal, if any.

Hope this is helpful,

Aisling
 
Hi Amy,

It is amazing isn't it what a profound effect serum iron level can have on RLS.

My doctor has resisted giving me infusions and has encouraged me to try different supplements until I find one that works. Problem is , something can be working fine when suddenly ... boom, the iron is out of whack. I assume it is because my CD is more active and I just don't have other symptoms.

I tried several and I now use Hema-plex by Nature's Plus. It has 85mg of elemental iron and some vitamin C. It works without making me nauseous, which is a big plus. It now comes in a gel cap and I'm hoping that will have even better absorption than the tablets

Have you had infusions? I have sometimes considered pestering my doctor into giving me one to tide me over until the iron level comes up from taking the oral supplements.

Aisling
 
Hi David,

I live in Maple Leaf, not far from where the freeway exits onto Lake City Way.

Aisling - That's amazing, I was JUST in that area. I drove down to Green Lake park (I'm in Edmonds) for a walk this afternoon. So pretty there.

I'm familiar with the use of anti Parkinson meds like Mirapex for RLS, and also with the phenomenon of "augmentation" (don't you love that term?). My RLS is milder than what many experience, and while I've had docs suggest I try one of the dopamine agonists, I've always declined, because of the rebound. Interesting that you are taking both methadone & naltrexone. Methadone does makes sense due to its long half life. What dose of methadone do you use with the naltrexone? Given the usual applications for these 2 drugs, I wouldn't be surprised if you had to go to a rehab clinic in Capital Hill for your refills! :lol:

I don't believe I have any iron issues, but I do find a number of drugs exacerbate my RLS, most notably, antihistamines, and "muscle relaxants", such as cyclobenzaprine (Flexeril), which can have H1 blocking effects.

You anticipated my question as to whether or not the methadone decreased the effectiveness of the LDN. Interesting that it does not.

Let's hope what you're doing continues to work for you!

David
 
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In answer to your question David,

I take 5mg of Methadone every night for my RLS. Most people take 2.5mg but I get a much better result from whole 5mg. Possible as a result of the naltrexone - very hard to know.

I've always taken 6mg of naltrexone, even before I started the methadone. The 6mg just works better for me.

No kidding about the Capitol Hill rehab clinic. At first I felt really weird about taking this combination of meds but my doctors and pharmacists don't seem too weirded out by it, the combination is working welll (XXX - fingers crossed), and heaven knows they are both inexpensive drugs, so I consider myself fortunate!

Aisling
 
Welcome to CF, Aisling!:) Such a pretty name!

Have fun browsing the forums. There is a lot of information. Hopefully, you will find what you're looking for and stay a while.:)
 

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