What would cause SUCH SLOW drug metabolism..?

Discussion in 'Fibromyalgia Main Forum' started by Wolverine, Nov 1, 2008.

  1. Wolverine

    Wolverine Member

    Hey all. I've had a long standing problem with drug intolerance etc. Even supps.

    Apart from being so sensitive, I have a strange problem that alot of drugs / supps are metabolized EXTREMELY slowly in my body. If the expected time to feel a drug effect is say, 1-3 hours in a normal person, it will take about 8-12 hours for me to feel it.

    I believe this is the major problem with my current cortisone therapy. Its taking so long to metabolize and process before i feel the effect, that it's literally nearly bedtime for the day before i feel it after taking it all day long. I lay around feeling soo sleepy, irritable, weak arms and legs, and generally ill. Finally.. somewhere between 6pm and 8pm, i start feeling like i can breathe a bit better, my mind wakes up some, and i have some feelings of stability, being able to get up and do a few things like eat and have a shower. Not every day, but more days now im getting this tiny window. However, I hate that it takes ALL DAY before i feel any effect.

    It's the same in the past for things like B complex.. generally if i took a strong b complex, i would get bad headaches and some nausea, generally not feel well, but about 5 hours later i would feel better in the body than usual.

    Difflucan is another one.. one dose, and I felt absolutely dreadful all day - extremely nauseous, heavy and weak, unable to eat, severe brain fog, just generally sick all over. That goes all day, however, the day after I felt wonderful, like it had really started killing that systemic low level fungal infection.

    Then theres other drugs, like Zyrtec (antihistamine), and zantac (stomach acid) which work just fine within 20 minutes just like everyone else.

    My only theory is that my liver doesn't detox well at all (which it doesnt, even though i take liver support tablets, and have done liver detox kits etc)..

    However, I would really love to hear any other opinions on why a body would process things SO slowly! Is there any specific weird conditions that causes this slow metabolism? My theory is if I could improve this drug metabolism, I would possibly need alot less cortisone and it would work much better for me all day long. However, it has been like this for about 7 years now and Im really not sure this type of thing can be improved so easily.

    Thanks.. ~Chris.
  2. richvank

    richvank New Member

    Hi, Chris.

    I'm wondering if your stomach empties into your gut very slowly (low gastric motility). If so, it might take longer for the drugs or supplements to be absorbed into your blood stream, because most of the absorption happens from the gut. It would make sense that Zantac would act faster, because it acts on the stomach.

  3. simonedb

    simonedb Member

    I have same issue.
    could it also be a p450 issue cytochrome, google that for awhile.
    but some people in their detox abilities can't break down certain drugs, supps because don't have the right stuff to do it, and then if you get mitochondrial damage from whatever its worse.
  4. Wolverine

    Wolverine Member

    Yes you're rather spot on there. I have had slow gastric emptying for a long time, since my first awful digestive issues in 2000. Also was diagnosed around '01 with gasto motility disorder.

    It's one thing i still struggle with - my food sits around too long after each meal making it hard to eat frequently (comfortably at least). So i guess even drugs must sit around a bit too long, possibly not mixing with digestive juices at the right time.

    I've tried a few drugs, but most don't agree with me. Interestingly, propulsid (cisapride) worked extremely well for the gastric emptying, and I actually got a load more energy from my food because of it. However, it made my heart jump all over the place, which it is well known for, causing rhythm disturbances. That was upsetting as it worked so well for the stomach. Nothing else i've tried works anything like it. I hope they make some advancements for this issue, as it could help alot of things for me I think.

    Yeah i definitely also have P450 problems. On a liver detox profile (from genova / ARL) it showed that i detox approximately 10x less well than normal people. Tylenol and coffee both make me feel like ive been poisoned by something deadly. If I have either, my body becomes very weak, heavy, toxic feeling, and it feels like my brain is being pulled in 10 different directions at once. Do you mean if the body can't break down certain drugs then that in itself can cause mitochondrial damage? I'm currently trying the herbal supp called Liv 52 - look it up, it's sposed to be the best worldwide. I havent got much results yet but from years of liver dysfunction i'd guess it woudln't happen too fast. I am hoping it will help though, and also hoping my new integrative prac might have some ideas for that. If I could get the liver processing drugs better things would work alot better in general im sure.

    Thanks guys. [This Message was Edited on 11/06/2008]
  5. getwellgirl

    getwellgirl New Member

    Hi Chris

    I wanted to reply on your other threat about h/c but I couldn’t find it so I will write it here.

    As you probably know it might well be that your problems lie with the HPA axis and not your adrenals, I think this is my problem too. Anyway the treatment is the same.
    What has worked for me is to take Prednisolone around 4-5 am every day and then top up with h/c when needed. Usually all I need is an extra 2.5mg h/c around lunchtime but if it’s a bad day then I might need to take 2.5 h/c around 10am but this is unusual. If it is a bad day then I might take a final dose around 5pm but again it doesn’t happen too often.

    I weight around 135 lbs so if you are heavier than this you would need more steroid, maybe 7.5mg Pred and a tiny bit extra h/c.

    I should say I have never had any side effects from the Pred whereas I didn’t do well on h/c, like you it would run out within 3 hours and I would literally feel nothing in my legs. This has never happened with Pred.

    Finally I also wanted to let you know that Diflucan blocks the steroids we take and I also have a lot of problems with it and it causes me to crash and have severe migraines. I have an unusual yeast in my gut which has shown up on a CDSA test so I am on a fairly strick diet but also take a very strong probiotic called VSL3 and when I took this before it really did help kill off the yeasts.

    I hope you will think about trying a similar regime to mine, Dr Myhill who is my CFS doctor thinks its an excellent idea to combine Pred and small amounts of h/c like I do. I am hoping that when I kill off the yeasts I might be able to cut down on the steroid but at the moment I have a horrible virus for which I need antibiotics cos I am feeling so sick and not getting better so this won’t help the yeast issue.

    Good Luck
  6. richvank

    richvank New Member

    Hi, wolverine.

    I think that slow stomach emptying can be caused by low stomach acid production. There is a simple test for this that you can do yourself: on an empty stomach, such as first thing in the morning, drink an 8-oz. glass of water into which you have mixed one-quarter teaspoon of baking soda (sodium bicarbonate). (I don't know if you use these measurement units, but hopefully you can translate them if necessary.) Time how long it takes you to burp after drinking this. You should burp within 2 minutes if your stomach is generating a reasonable amount of acid. If you haven't burped within 5 minutes, you can stop timing.

    I can't give individual treatment advice unless a physician is involved to review my suggestions for a particular case, but some people take betaine-HCl to augment their stomach acid. The dosage is determined by adding one more pill with each meal until a warm feeling is felt in the stomach, and then the dosage is backed off one pill and maintained there with each meal. You should consult with your doctor if you are considering trying this.

    Best regards,

  7. getwellgirl

    getwellgirl New Member

    Hi Rich and Chris

    I have this problem too, lack of stomach acid and have to take at least 1000mg betaine hcl with each meal, sometimes even 1500 mg with a bigger meal. I also use a good digestive enzyme and it does make a lot of difference to how I feel after a meal.

    Of course it is also so important because without good stomach acid we don't absorb the B vitamins and other essentials and also are far more likely to have problems with yeasts and parasites. I still have a yeast called Geotrichum species in my gut so I am also taking a strong probiotic called VSL3 in the hope that this will also kill off the yeasts.

    It would seem some of us have so many ongoing deficiencies.

  8. Wolverine

    Wolverine Member

    Hi Pam, it's great to read your story, and the success you've had with getting on the right replacement.

    Yes, I'm certain my probs are more to do with the HPA axis dysfunction than with the glands themselves. As you say though, treatment is the same in the end, once we aren't responding to stress properly.

    Very interesting to hear that you take Prednisolone, as it's something i've been looking into myself lately, as I am having terrible trouble still with the very regular HC dosing. I actually weigh less than you, at 125lb or so, and am 5'9" male! I'm very underweight. I've read though that prednisolone can cause growth supression more than hydrocortisone.. but I'm not sure if that means more in childeren, or in general. I really desparately want to gain some weight and muscle, and i know corticosteroids can cause muscle breakdown. i just wouldnt want to take anything that makes that worse. I honestly don't know if theres a big difference between pred and HC though when it comes to that.

    It's great you have no side effects too, and like me it ran out fast. It's good when ur not the only one. Most days I'm dosing too much HC because it runs out so quick. The evening doses last longer than the morning ones, as mentioned above im sure this is due to my slow drug clearance (metabolism improves somewhat at night).

    Thats awesome that you see Dr Myhill! Lucky, i would love to consult with her. I've just this week been reading alot of info on her website, on CFS and the 'stoneage' diet etc. She seems very good, so it's interesting that she thinks combining pred and HC is a good idea. I've been reading up on the 'stop the thyroid madness' forums, and alot of them over there have actually shifted from HC to Medrol (methylprednisolone) which alot of them say keeps them even most of the time. It's one of the longest acting which im sure is why.

    Have you seen the new info on the dual acting hydrocortisone, called Duocort? www.ducort.com - it's a once daily HC treatment, the first layer of the tablet is very rapid acting, about twice as fast as current HC tabs, and the 2nd part is sustained release, over the course of the rest of the day, claiming it follows the bodies diurnal rhythm better. I may try pred and so on, but I definitely will be trying that one when it comes out, as if possible I think it good to use what's closest to the bodies natural hormone.

    No good about your virus/infection! I too am on antibiotics at the moment for a severe toe infection ive had for 2 months or so. It's really reducing now after the ABX treatment, is much less sore and healing. With your current virus etc, have you had to increase your steroid? If so by how much? This is something dr's mention nothing about, i've had to read it via others experience. I read that we're sposed to double on infection, or even triple if it's like the flu. I think its silly that they dont mention these things.

    Wow! I just read up on this VSL#3 probiotic! It looks like nothing that's ever come out on the market. Its damn expensive.. and i guess worth it if it works. I've been through bottles of different brands of probiotics, and have never really felt a big difference. Its unbelieveable that every serving of this stuff has 450billion bacteria! That is beyond anything i've seen before, and im guessing it must work very well. Finances permitting, I'm going to order it as soon as i'm finished with ABX therapy, as my guts are really messed up from it and the cortisone together, so am really up for getting the ecology back in balance.

    Thanks and hope you get well soon too.
  9. Wolverine

    Wolverine Member

    True, that can be the case. Karen (Barrow) has given alot of info lately on betaine HCL, and i've read all over the place how good it is. However, I can't seem to take it all the time, especially since starting cortisone. This is because HC causes increased acidity.

    I've actually had to go back to taking zantac sometimes for quite bad acid reflux, which is upsetting. I like the idea of taking betaine all the time, but dont think i can for now. I do take prescription strength digestive enzymes which help meals alot. If I eat meat at meals I take one betaine HCL cap with it, long as Im not too acidy to start with, and it does seem to help. I think if i could get the emptying going better, i could tolerate more HCL because the food wouldnt sit around so long and cause the acid reflux.

    I'll def try that bicarb test, thats very interesting!

  10. getwellgirl

    getwellgirl New Member

    Hi Chris

    Thanks for the info re Duocort, I had never heard of it. I live in the UK so will probably be ages before it is licensed, we have an organisation called NICE which decides whether a drug can be used or not. Often it is just down to the cost so I won't hold my breath! I do like the sound of it though and would certainly give it a try cos as you say it is more natural.

    With this infection I have needed to take about an extra 2.5mg h/c once or twice a day, that's all. Even with these increases my bp tended to be about as high as it should go but things were complicated by me taking Echinacea, Astragalus and Cats Claw. I have found that the first 2 definitely hyperstimulate me causing a high pulse and increased thyroid activity. It gets so bad I cannot sleep at night, just when I need sleep to fight the infection. This has happened so many times before when I have taken these herbs but its only this time that I realised Echinacea was doing it to me but there again it is listed as a stimulant. I guess its cos I have got autoimmune thyroid disease too. The hyperstimulation effect also gives me nasty migraines and makes me feel truly terrible it felt like my head could explode, wish I had realised earlier and would have saved myself some money too. Just goes to show that so called natural isn't always better for us, I have proved that so many times where herbs are concerned.

    As I have stopped the herbs my pulse has been much better today and so has my energy been more normal and I was able to go out ok this morning and feel alright. What a relief. Hope that your infection is also now getting undercontrol and that your adrenals are recovering somewhat. Think I have only got another 2 days of Ceflexin.

    Its been very disappointing for me because I had started to see some good improvements from the antiyeast diet I was on, my energy was the best it had been for ages and so was my sleep. I began to think I had cracked it to a degree and then this bug hit last Sunday and devasted my IS. Will hopefully get started on the Immunocal shortly, been waiting 5 weeks for it to arrive from the US but a UK distributor keeps telling me it will be hear this week.

    Fingers crossed you are doing better on your h/c now and able to take a bit less. Do you remember to add about 1/4 or 1/2 teaspoon sea salt to your drinks cos that makes a BIG difference to my adrenal function?

  11. Wolverine

    Wolverine Member

    Hi gram. Yeah sometimes when i suddenly feel the cortisol has worn off too much, i chew the tablet a bit and leave it under the tongue for a while. It tastes terrible, very bitter chemical like, but i get past it. I dont really know if it absorbs any faster or works better this way as I've never done for all daily doses, only now and then. I've been trying it today and i think its actually working better than usual. I cant tell so much though because i only had 6 hours sleep last nite, but so far im not needing too much, and have been spacing the doses out in water and sublingual.

    I am ordering controlled release HC capsules from my compounding pharmacist, i got the script yesterday. I will combine 5mg of HC and a 10mg SR cap in the mornings, and see how long it lasts, am definitely curious to see how it goes.

    Pam, no worries. Yeah Duocort is really new. I only heard about it because i get the newsletter from the NADF (national adrenal disease foundation). They sent the info out about duocort quite a few months ago. It's got a major drug company designation now, so its only a matter of time before it's released. Hopefully wont take too long to come out for us in Australia and the UK aswell! I think it could be good, a more controlled daily dose.

    Thats good you don't have to take much extra HC with the infection. Alot of places i've read say you need to double the dose for systemic infections. Then again if you're on ABX it's probably killing it, therefore not needing much extra. Im also on Cephalexin too! I find it a bit hard on the liver, and it makes me generally less well. I can't wait till this stupid infection clears so I can get rid of the ABX and onto some strong probiotics to heal the gut! My gut is a mess since all these ABX. The toe is very stubborn and is still swollen and painful, so I dont know how long i'll have to be on these. I wish the stupid dr's in hospital didn't pre-maturely take me off IV abx, it was clearing up so fast at first on that!

    I also get hypersensitivity to herbs. If you're an allergic person like me, alot of herbals can have that effect. It's annoying because you read the wonderful benefits of all these herbs, but they make you feel really strange. I almost always feel better if i stop taking a bunch of herbs.

    What is your anti yeast diet? Is it no carb or just no sugar etc? I've read dr myhill's candida dysbiosis diet page and she doesnt suggest no carb unless nothing else works by the look of it. Personally im too weak at the moment to do no carb, i feel horrible without it, and need at least sweet potato and a bit of rice.

    As mentioned above, im going to try these compounded HC capsules, and see how that goes. If it doesn't work well or i'm still taking too much, next step is definitely trying the prednisolone, ive met quite a few people now who said it really evened out the highs and lows of HC.

    Yeap i drink celtic sea salt in water day and night, i feel it helps blood pressure etc.

    Hope ur bug clears up soon too. ~C.
  12. Wolverine

    Wolverine Member

    I haven't tried colloidal silver in years, since i got a bottle and it did nothing noticeable at all for me! Years ago this was, but the pain, fatigue, aches etc were no different after half a bottle, so I think i stopped. I can't remember really it was about 2003.

    Who knows now though, it could help. My mum is coming down in a week to help me out a bit, which will be a great relief rather than struggling through all this mostly alone. Shes a great help, is very caring, and cooks all the time! It will be a nice break. She apparently has started a high quality colloidal silver, so maybe i'll try some of hers.

    Heh, yeah well i've definitely had some better 'windows' lately. Things are hopefully working themselves out slowly. Ive def gotten more used to the cortisone, now its more a case of how much to dose at what times. The initial terrible side effects i was having from it have minimised quite a bit now which is good. Not so irritable and emotionally unstable. Also having some much better windows of feeling good at night especially. I may still try prednisolone as it's longer acting and many people with AI have said that switching over to it really smoothed things out. Im still extremely brain fogged from it though.. not sure why. Likely my liver metabolism, but have a few supps on the way to try help with that plus cognitive function.

    I think it's great that you got to really lower your dose of cort, and i definitely think things like gut dysbiosis and yeast overgrowth that so many of us have would make it neccessary to take higher doses of cort. Im sure thats why i need so much myself. Were your tests for thyroid low, or did you just trial armour?

    Take care.

  13. Hi Chris,

    I realize this was from 2008 but hopefully you still have an account. I have the EXACT same problem and I cannot tolerate any medication, no alcohol or caffeine either.

    Were you able to figure this out? Would you please let me know 1) if/how you resolved it, 2) which doctors you saw, 3) what the diagnosis (if any) was, 4) any advice you have for me.

    Thank you so much.
    Last edited: May 1, 2016