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Old 04-23-2015, 07:26 AM #21
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ALL medications carry risks of some sort! I can report that I have received IVIG starting monthly in 1997 to 2006 (9 years) and then again from 2013 to present...and I have NEVER got an infection from the IVIG. One of the worse reactions is aseptic meningitis (which is not an actual infection) and I did have that in 2006 and the reason I stopped for several years. But otherwise, I have not had a problem with IVIG...and never an infection. You are aware that IVIG cannot transmit HIV...even though it's a blood product? The process in which the IVIG is prepared actually keeps these types of blood infections from being passed.

I'd be interested in reading some of this information you say shows IVIG doesn't have the efficacy. As you have seen, there are numerous posts/threads on this subject and they include links to reputable articles supporting its use and that is does, in fact, have positive results. So, if you disagree, please include links so we can all read what about what you are saying, and therefore, make better objective decisions.
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Old 04-23-2015, 09:38 AM #22
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Seems to be risk with most everything!

SHORT bursts of steroids seems to be fairly low though except for people with diabetes. adrenals usually recover to baseline pretty quickly when prednisone is short term. We're not talking about people who take steroids to gain muscle. That is NOT a valid reason to take them, they aren't addressing a medical need and do cause damage over time in those circumstances. Long term for any reason can be a problem. Think instead of a Medrol dosepak given for everything from bad allergies to bronchitis to poison ivy. It does have a place for inflammatory problems in short rounds. In the world of potential medical misadventures stopping an oral medication due to side effects or concerns is not too bad a deal.

Unfortunately we sometimes have to take risks for the chance of getting better. When it gets to that point all one can do is get as much information as possible and follow your instincts about what YOUR body might improve with.
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Old 04-25-2015, 05:21 PM #23
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So if someone was lucky enough to get this approved for an autoimmune-based neuropathy, how often do you get it? And how long? For the rest of your life? I need to take charge and get some answers, which means I need to see a more knowledgeable neuro & rheumatologist!!!
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Idiopathic Sensorimotor Polyneuropathy
Atypical Migraine
Chiari 1 malformation 7 mm
PLIF L5-S1 Sept. 2013

Lumbar MRI March 2013: degenerative changes from L3 to S1. L3 and L4 have tiny annular tears with disc bulge. L5-S1 bilateral pars defects anterolisthesis (spondylosis/spondylithesis?) I have an annular tear here too, along with a conjoined left L5-S1 nerve root. Mild effacement of the thecal sac at the origins of the bilateral S1 nerve roots, left greater than right. Mild bilateral Neural foraminal stenosis.
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Old 04-25-2015, 06:35 PM #24
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The dose and time between IVIG may not be the same for everyone. 2gm per kg is a pretty standard dose for CIDP.
I started at 12 week intervals, then 6, then every 3 weeks (all 2gm per kg) I then did 1gm/kg every week for 12 weeks.
It depends on how long you stay stabile on your current plan, if not it may need to be altered.
I've also got other opinions, and found that each Dr, has their own ideas on how it works best as well.
As far as staying on it forever, that's not usually the plan , but it sometimes ends up that way for a lot of people. My doctor believed the only way to ever get off it , is to try to go without it for a while and see how you do.
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Old 04-27-2015, 08:39 PM #25
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I have autoimmune Addison's Disease, so i have taken corticosteroids everyday for about 6 years. Addison's means the part of my adrenal glands that make cortisol (as well as other things) is dead. The part that makes adrenaline still works (in spades haha). Autoimmune means my body made antibodies for this part of my adrenal glands, and killed it off. I would die without the daily steroids, taken 3 times a day. That being said, my dose is highly regulated to my body's needs. It is VERY small in the grand scheme of things. I take 20mg (separated into three smaller doses a day to mimic a normal cortisol curve) of hydrocortisone, which translates to less than 7mgs of prednisone a day...and really, it's just replacing the cortisol that my body can't make on its own anymore. Also, steroids used in autoimme illnesses and inflammation treatments are corticosteroids...the steroids used by body builders are different.

Symptoms of too high steroid use have been outlined above by other posters, but it would take very high doses and some length of time for those things to happen, and the damage isn't always permanent. I got very Ill a few years ago, and my steroid dose got increased more than it should have (when seriously ill, people naturally make more cortisol...so my docs were basically guessing at what my body would make for the illness I had, and they played it safe and gave me too much, because being unsafe would mean addisonian crisis and death). Needless to say, I had terribly high blood sugar, gained weight, face like moon, total mess. I was tapered off that dose slowly, and the side effects all went away. If on high enough doses or for long enough, certain damage caused by steroids can absolutely be permanent...and the threat of adrenal gland suppression is a real one, but again, a burst of steroids won't necessarily cause huge damage, and the steroids would need to be tapered very slowly. And there are no promises...bodies don't always react the same. That being said, steroids have saved lives, saved eyesight, and thrown people into remission when bad inflammation and sometimes out of control autoimmune diseases get a foothold.

IVIG shows incredible promise and has changed lives. I don't think it's fair to criticize its use in this regard. It's a powerful treatment, so yes, risks are real, as with steroids and any other powerful treatment...but I think it's efficacy has certainly been proven.

That's why idiopathic is so frustrating, because a lot of neuropathy treatments involve powerful mechanisms, and it's a guessing game when there is nothing specific to point to.

I don't notice any difference in my neuropathy (small fiber idiopathic, biopsy confirmed, non length dependent) due to my taking steroids...in fact, I developed it while on steroids. It's always possible I am on too much steroid each day, and maybe that tempers things for me, but I get blood work every three months to test my various levels, and I have zero indication of too much cortisol in my lab work and body.

IMO when faced with an idiopathic diagnosis, one really needs to weigh the pros and cons for themselves, and be informed as much as possible, and hopefully work with a very good neurologist (or team of doctors in necessary/available) to come to any treatment conclusions.
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Old 04-27-2015, 09:27 PM #26
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for the last 1 years, i have had many respiratory infections that go into long term chronic asthma. i have had to take steroids at relatively high doses at times for up to 3 weeks. I have never noticed the steroids helping my large fiber, axonal sensory motor peripheral neuropathy
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Old 04-27-2015, 09:43 PM #27
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Steroids typically do NOT help neuropathy unless it is inflammatory based. Steroids reduce inflammation, so they really only help in certain inflammatory situations (to include some autoimmune conditions).
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Old 04-28-2015, 07:57 AM #28
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Quote:
Originally Posted by JoannaP79 View Post
I worry about this exact thing. I have SFN confirmed by punch biopsy, significant loss of density, burning only started sept / Oct and its awful already. Spreading and I fearwwhatstate i may be in within a year. Its pretty obvious mine is autoimmune. Being deterred at every juncture from ivig. Cost and resource always the issue. I am still pushingto be considered but I know how ruthless they are when it cones to resource. I am not at deaths door so am not severe enough. Also, in NHS guidelines there is no mention of use for Sfn.
Same here with my acute onset in Sept.
No one will offer IVIG for me, yet both rheumatologists I've spoken to and a neurologist I have contacted have asked if I have had IVIG treatments and how I responded to it. It's very frustrating that there could be help, and not having that option.
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Old 04-29-2015, 02:45 PM #29
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which tests are the most common tests that look for autoimmune causes of SFN. I know I have had a few blood tests that I think were looking for autoimmune problems (ana, iga, igb, igg, igm) but I think that's it. Are there other tests for autoimmune causes that I should be asking for?
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Old 04-29-2015, 02:46 PM #30
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does ivig have the possibility of helping only SFN or does it help large fiber sensory and motor neuropathy too?
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