New Xiaflex Video

My wife and I are in the new Xiaflex public awareness video about Peyronie's.  I hope it raises awareness and men become pro-active in their treatment.  You have to wait for a 10 second countdown then click on the button; Watch Video.

I did not participate in the Xiaflex clinical trials, but was filmed to give support for Peyronie's patients.  They had a hard time finding men to go on camera.  It is an embarrassing problem for most guys.  I got over that a long time ago, when I went on youtube and talked about this.

What is the Big Deal with Serrapeptase?

Almost every site that talks about alternative treatment approaches to Peyronie's, recommend using Serrapeptase.  Many recommend using it alone or in combination with other enzymes and supplements.  If you are going to add this product to your treatment program, then definitely read this article.

One of the big problems with the Serrapeptase approach, is the lack of double blind placebo studies to support it's use.  Let's review some of the information available to us, and make an informed decision on whether it is worth while.

Serrapeptase has been studied for several different conditions with positive results.
Serrapeptase came out very favorably in this study to reduce buccal swelling after surgery.

Sixty five percent cases showed significant clinical improvement with Serrapeptase treatment for carpal tunnel. 

 There was a significant reduction in the extent of cheek swelling and pain intensity in the serrapeptase group in molar extraction.

  It is concluded that Serratia peptidase has anti-inflammatory, anti-oedemic and fibrinolytic activity and acts rapidly on localized inflammation.
193 subjects suffering from acute or chronic ear, nose or throat disorders, with treatment lasting 7-8 days. 

Regression of fibrinolysis in scalded rats by administration of serrapeptase. Biochem. Pharmacol. 31:2861-2866,1982

In Russia Serrapeptase has been used for treating ailments as diverse as Alzheimer's to Tuberculosis.  The studies on these area's are not readily available, so I could not include them. in this article.  

There are no specific studies using Serrapeptase in Peyronie's treatment, but the above studies, do show that it is effective for treating pain, inflammation, and fibrinolysis.  I have read a lot of testimonials, on its' effectiveness, but those are not verifiable through testing and sometimes, people just get better.  The human body is amazing, with its' healing abilities.

The Serrapeptase Theory: 
If you have read some of the articles at this blog, you will know that I took Serrapeptase and am one of those testimonials and success stories.  I can't reproduce my results though in a scientific study, since I'm just one guy that it seemed to work on.

The idea behind Serrapeptase is this;  The silkworm uses the Serrapeptase enzyme in its' saliva to dissolve the dead silk cocoon, at the time it is hatching out to become a moth.  Serrapeptase is a powerful proteolitic enzyme that scavenges dead tissue and reduces inflammation.  The idea of introducing it into the blood stream to scavenge fibrin (dead scar tissue) in the Peyronie's plaque is sound, it just isn't a proven science at this point.

Enteric Coating
When I took Serrapeptase, there was a lot of information about enteric coating that I was unaware of.   Serrapeptase should be taken on an empty stomach.  The reason for this is to avoid stomach acid that digests food, and would also digest the capsule before it can leave the stomach and enter the digestive tract.

Most Serrapeptase brands have enteric coating to help the capsule survive the stomach acid.  I recently did a study on what enteric coating consists of.  The most popular enteric coatings consist of HPMCP (hydroxypropyl methylcellulose phthalate), and CAP (cellulose acetate phthalate)  These enteric coatings are part of a family of chemicals that are plasticizers.  Phthalates are basically a thin plastic coating that protects the contents from dissolving in the stomach.

I am not happy that I ingested plastic, while trying to treat Peyronie's, and improve my health.  I definitely would not recommend products that include these chemicals in their enteric coating.  There are alternatives though.  

The other protective coatings I found are Acid Armor, which is an extra thick cellulose capsule that is phthalate free.  Arthur Andrew Medical uses this coating on their Serrapeptase capsule.  Robert Redfern's Serra Enzyme also uses a thickened delayed release capsule that is phthalate free.  I also found another enteric coating that is a food grade product.  MAAC (Methacrylic Acid Copolymer) which is considered food safe.  Serracor-NK uses this coating on their Serrapeptase/Natto blend product.

Advocates for Enteric coating test the enzyme capsules in extremely acid conditions, which do not reflect the "real life" conditions of an empty stomach.  The capsules by themselves, when taken on an empty stomach do not induce stomach acid production.  Acid production occurs when the stomach fills with food and the lining becomes stretched.  Taking Serrapeptase on an empty stomach will typically see the capsule enter the intestines in 30 minutes or less.  Once in the intestines, the capsule dissolves and the enzyme is absorbed into the body.

How is Serrapeptase Measured?
Serratiopeptidase units or SPU's are a measurement of activity per capsule.  Serrapeptase is not based on weight.  A capsule of Enterez brand contains 30 mg., while Dr's. Best contains 500 mg, but both brands contain 120,000 SPU's per capsule.  So you can see that weight alone does not indicate activity level.  When purchasing Serrapeptase look for the activity level.  A listing in mg.'s is not a relevant measurement.  

The most effective way to deliver Serrapeptase is in encapsulated powder capsules.  Hard tablets typically are heated during production and the heating decreases the activity of the enzyme.  Raw powder is hard to mix, it is inconvenient and most of it would be digested in the stomach.

Which Brand is the Best Buy?
Price comparison is based on the MSRP (manufacturer's suggested retail price).  I broke down the cost by the activity level of each brand.  Cost per 100,000 SPU's

Solaray came out to $1.09 per 100m SPU,  Dr.s Best was $.69 per 100m SPU on their 40 SPU capsule and $.48 per 100m SPU on their 120 SPU capsule.  Source Natural's price was $.62 per 100m SPU.  Vitamin Shoppe and Enerex were both $.55 per 100m SPU.  All of the brands just mentioned use traditional enteric coating.  Solary had the lowest price per bottle of capsules, but also the lowest activity level per capsule.  It ended up being the highest price, based on activity.
Drum Roll Please; the winners are:
Arthur Andrew Medical - Acid Armor
250 SPU capsule - 36 cents per 100,000 SPU

 Robert Redfern's Serra Enzyme delayed release
250 SPU capsule -  29 cents per 100,000 SPU

Based on this information, the best brands without phthalates and the the highest activity levels, are also the best buy.

Combination enzyme products are:
Serracor NK - MAAC enteric food safe phthalate free coating
Blockbuster All Clear - delayed release phthalate free coating
Neprinol - Acid Armor, phthalate free

Serranol - Couldn't find information on this brand capsule.

Enzyme combination products will be written about in a future article.  More research is needed for these products.

Stem Cell Research - Enrolling Patient's with Peyronie's Disease

Stem Cell treatment for Peyronie’s; Enrolling Patients
Cell Surgical Network has had success with treating a very similar connective tissue/fibrotic disease, Dupytrens contracture.  They are enrolling new patients for a study using stem cells for Peyronie’s Disease.  They manufacture stem cells from your own body.  The statement below is from Cell Surgical Network’s  website and tells how the stem cells work to fight the plaque in Peyronie’s.

Our Technology

The Cell Surgical Network uses adipose derived stem cells for deployment & clinical research. Early stem cell research has traditionally been associated with the controversial use of embryonic stem cells. The new focus is on non-embryonic adult mesenchymal stem cells which are found in a person’s own blood, bone marrow, and fat. Most stem cell treatment centers in the world are currently using stem cells derived from bone marrow.
These adult stem cells are known as “progenitor” cells. This means they remain dormant (do nothing) unless they witness some level of tissue injury. It’s the tissue injury that turns them on. So, when a person has a degenerative type problem, the stem cells tend to go to that area of need and stimulate the healing process. We’re still not sure if they simply change into the type of injured tissue needed for repair or if they send out signals that induces the repair by some other mechanism. Suffice it to say that there are multiple animal models and a plethora of human evidence that indicates these are significant reparative cells.
Click on the link at the top of this article to read more and apply.

Peyronie's disease, Erectile Dysfunction, and Sildenafil Citrate

Every man seems to have a different experience with Peyronie's disease.  Some experience pain, while other do not.  Severity of deformation varies widely, with a bend sideways or up or down or bell shaped deformation.  No two men are exactly alike.  Some men experience varying degrees of erectile dysfunction from mild to severe.  Erectile dysfunction is frequently associated with Peyronie's disease.

There is no consensus among patients or doctors on how to treat this.  There has been the belief that Viagra (Sildenafil Citrate) may contribute to PD.  There has not been a proven clinical connection though at this time.  Some doctors will not prescribe Sildenafil Citrate to patients with PD.  The fear is that the potential risk of further injury during intercourse from Sildenafil Citrate is greater than without it.  

Well, if a man has erectile dysfunction, he is probably not going to be performing sexually, without taking something like Sildenafil Citrate.    In some cases the plaque is large enough to block blood flow, resulting in vascular deficiency.  This causes erectile dysfunction beyond the plaque, which can cause hinging at the point of bend.  Hinging can cause penis fatigue, resulting in a fracture, much like fatigue in metal when it is repeatedly folded or bent.  Taking Sildenafil Citrate with this type of ED would increase the danger of further injury or fracture.

The manufacturers of PDE-5 inhibiters, Sildenafil, Vardenafil, Tadalafil (Viagra, Cialis, Levitra), have cautionary notes in  their package, regarding the use of this classification of drugs for men with Peyronie's disease.  The drug manufacturers did not include men with PD in their clinical trials.

73 men with curvatures less than 60 degrees were given sildenafil, as it was assumed that curvatures less than this would not be as susceptible to penetrative injury.  71% of these men were satisfied with their erections and no new pain or deformity increases were recorded in the group.

PDE-5 inhibitors in experimental use were shown to have a
potential anti-fribrotic effect.  When fibroblasts in human Peyronie's disease were exposed to daily low dose PDE-5 inhibitors it resulted in reduced collagen production.  In animal studies; animals were given sildenafil and vardenafil in their drinking water, shortly after they were injected with an agent that triggers  a Peyronie's type scar.  The PDE-5 inhibitors appeared to substantially reduce the development of fibrotic scar tissue in the animal studies. 

Elevated nitric-oxide levels appear to inhibit fibrosis, which forms the plaque.  Sildenafil elevates nitric-oxide levels in the blood and relax the muscles in the penis, which triggers erections when a man is sexually stimulated.

Another good way to boost nitric-oxide is with Arginine and Citruline supplements.  Beets are a rich source of nitric oxide.  A glass of beet juice every day could be the ticket to better cardio health and reduced scar tissue build up.  A good cardio workout will also boost your nitric oxide levels.

What is the Prevelance of Peyronie's Disease?

Statistics about how many men are affected by Peyronie's Disease vary widely.  The reason for that is, most men do not report it or go see their doctor for diagnosis. Recently Dr. Jon L. Pryor wrote that an autopsy study suggested Peyronie's may have a prevalence of 22 percent.   That's right! He said 22%.  That number indicates that Peyronie's is very under-reported.

He also stated that Peyronie's Disease is fairly common, yet most men and physicians don't know anything about it.  Some men develop Peyronie's in their 30's, but there is an age related increase as men age.

Alzheimer's Update:

My wife's mother has been living with us for the past 4 years.  We have watched her cognitive processes fade away for a long time now.  Mom is really good at hiding things, she has always been a classy lady, she was well read, well traveled
Mom in 1964 at the Pyramids
and sophisticated.  

Recently at a doctor's appointment the doctor asked her:  "What is the President's name?"  She didn't know.  "What is the year?"  She answered, "It's 7 or 11." Again, she had no idea.  Then the next question, "Do you know what town your are in."  Answer; "No idea."  We were shocked, we had no idea that her cognitive impairment was this far advanced.

Within a week, Mom began asking questions like. "Does a bus come by here?  I need to catch a bus to the airport, so that I can fly home to Seattle."  I heard her testing doors at 4:00 a.m.  She was trying to escape, to go somewhere in her past.  There was no home in Seattle for her. It had been sold long ago.  In her mind she had been on a long vacation, it was now time to go home.  Mom cannot prepare meals, drive a car, or take care of herself in the bathroom anymore.  In her state of mind, she believes that she needs to find a job.  She needs to become a productive part of society and contribute her part in working and finances.  She does not realize that reality is something far different than what she perceives.

It is really heartbreaking for us, her family, to watch her fade away and decline.  Three weeks ago, Mom made good on her escape attempts.  We ran to the grocery store and upon returning, she was gone.  The doors were all unlocked and open.  The dog didn't go with her, he stayed home.  Mom was gone.  We frantically searched the house and yard, shouting for her, then I recruited the neighbor to go one direction, while I went the other.  My wife called 911.  It was over 100 degrees out and Mom is 85 years old and very frail.  We knew she wouldn't last long out in the heat.  Within 5 minutes we received a phone call from a police officer.  He had picked Mom up 4 houses down from ours, but she could not tell him which one she lived in.  He took her to the local hospital emergency room and had just dropped her off there.

We jumped in the car and picked her up at the hospital.  The staff told us she looked great for a 114 year old.  They asked her when she was born.  She told them Jan. 1st, 1900.  It made it difficult to figure out who she was, with that birth date, it did not connect her name in the computer.

Now we knew that we were prisoners in our own house.  We couldn't leave Mom alone ever.  This was a 24 hours a day dilemma.  Within a week we found a Alzheimer's home, where she will receive 24 hour professional nursing care.  Mom has been there for two weeks now.  They have a bus stop in the side yard for the folks living there to make an escape when needed.  The difference is the bus stop is behind the fence and no bus ever comes.  The residents will go out and sit at the bus stop, then eventually they forget why they are there, or they get hungry. 

The really difficult part of this nightmare, is Mom doesn't really remember me anymore.  She doesn't recall me asking her for her daughter's hand in marriage, 20 years ago. (I never knew her husband, he had passed away years before.) She can't remember so many of the fun vacations we took together, and the great memories we have built over the last two decades.  She does remember our son, but does not recognize the young man that he has become.  She remembers him as a little boy.  She clings desperately to my wife, who represents the last fragments of her memory.  The things she imagines are just as real as the reality that surrounds her.  

One blessing that we have are the wonderful angels that care for these older folks as they cling to life, but lose their minds.  It is difficult to imagine living and working in an Alzheimer's care center, where there is no hope of recovery.  When a patient walks through that gate, it is a one way trip.  This is the last bus stop for them.  They are disembarking from their life as grandparents and parents, they were productive members of society.  We thank God everyday for the people that work to provide dignity and as much freedom as possible, in the twilight of  life.  

We know that Mom will not recover, this is a terminal condition.  She often says, "I'm going to get better."  But we know better.   

Update: Mom has left us and gone on to her eternal reward.  She left us a note, telling us not to rush through life and that she would see us again. She wrote this note, while she had Alzheimer's, which makes it even more meaningful.

We are so grateful to her care givers, and the Hospice people that helped her and us at the end. We will always miss her. Mom was such a vital part of our lives, and it is just not the same without her. 

Alzheimer's is an enemy to be fought and resisted.  Take care of your body, eat healthy food and avoid bad habits.  Smoking and excessive drinking are an open invitation to this terrible disease and condition.  Don't open the door and usher your enemy in. Take good care of yourself and your loved ones.