Ivermectin....Senate hearing today.

18,663 Views | 84 Replies | Last: 3 yr ago by garyt73
Aggie95
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AG


This has been discussed on here before but this doctor seems pretty convinced Ivermectin is the real deal


AggieRAGE
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Interesting!
bigtruckguy3500
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Interesting indeed. I'll have to look up the actual data and paper.

That being said, ivermectin is not a common drug. Drug companies would have to start pumping it out 24/7 for any meaningful supply to be available for use in this country.
robdobyns
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Dr Marek presents compelling evidence that shows ivermectin is very effective.
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CDub06
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Dr. Rev talked about Ivermectin a few days ago if y'all are interested:

https://www.facebook.com/permalink.php?story_fbid=2896318170651121&id=1998386763777604
AgResearch
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bigtruckguy3500 said:

Interesting indeed. I'll have to look up the actual data and paper.

That being said, ivermectin is not a common drug. Drug companies would have to start pumping it out 24/7 for any meaningful supply to be available for use in this country.


Just get a scrip from the local vet.
TexasAggie_02
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AgResearch said:

bigtruckguy3500 said:

Interesting indeed. I'll have to look up the actual data and paper.

That being said, ivermectin is not a common drug. Drug companies would have to start pumping it out 24/7 for any meaningful supply to be available for use in this country.


Just get a scrip from the local vet.
you don't need an Rx to get it from the feed store.
fightingfarmer09
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TexasAggie_02 said:

AgResearch said:

bigtruckguy3500 said:

Interesting indeed. I'll have to look up the actual data and paper.

That being said, ivermectin is not a common drug. Drug companies would have to start pumping it out 24/7 for any meaningful supply to be available for use in this country.


Just get a scrip from the local vet.
you don't need an Rx to get it from the feed store.


Just got some of the Pour On topical stuff on me today working cows.

Don't need a vaccine!
aggieduke
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Is it a 1 time dose?
Philippians 4:13
OldArmy71
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This is their protocol for prophylaxis and also for early outpatient treatment.
aggieduke
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Dr. Not Yet Dr. Ag
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robdobyns said:




Dr Marek presents compelling evidence that shows ivermectin is very effective.
Paul Marik's fall from grace is strange, but seemed inevitable. He made his name as a controversial skeptic of critical care dogma. He was never much of a researcher, and most of his contributions to medicine came from lectures and opinion pieces. He frequently criticized trials for poor science, and was famously quoted as stating "In the hierarchy of scientific evidence, before and after studies are just above wives' tales and anecdotes". His fall from grace then came in 2017 when he published his much maligned before and after study on vitamin therapy for severe sepsis where he absurdly claimed that he had found the cure for sepsis, and made ridiculous claims about how after he started his protocol, not a single patient of his died from sepsis (what he failed to mention is that they still died, but his claim was their deaths were due to multi-organ failure...which is how septic patients typically die).

Since 2017, there have been 3 major RCTs on his vitamin protocol demonstrating a lack of efficacy. Millions of taxpayer dollars have been wasted on a therapy that anyone with any understanding of sepsis care knew to be extremely unlikely to be beneficial. Despite this, he continues to promote his protocol and has now developed his COVID protocols, that equally have a lack of evidence base to support the protocol utilization. Nevertheless, a little lack of evidence has never stopped Marik. Unfortunately his critical care fame got the better of him and decided to jump off the deep end and turn into a full blown snake-oil salesman.

In that interview you can hear him ranting about how it is unethical to perform RCTs on COVID patients, when he used to support doing exactly that for numerous other conditions that have a significantly higher mortality rate compared to COVID. RCTs are only unethical when there is a clear and obvious benefit to the therapy that is considered being tested, like parachutes to prevent gravity related injuries, or fixing a perforated intestine.
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bigtruckguy3500
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Yeah, I last worked/trained under him in 2018. He'd look for any excuse to put someone on his vitamin C protocol. It was funny, the ICU there had pictures of oranges all over the walls, the nurses had shirts with oranges on them, etc.

I personally think he's fishing for a Nobel prize. Go big or go home. To be fair, medicine is full of people who were seen as crazy for their ideas at the time, and eventually the evidence came to support them.
Dr. Not Yet Dr. Ag
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bigtruckguy3500 said:

Yeah, I last worked/trained under him in 2018. He'd look for any excuse to put someone on his vitamin C protocol. It was funny, the ICU there had pictures of oranges all over the walls, the nurses had shirts with oranges on them, etc.

I personally think he's fishing for a Nobel prize. Go big or go home. To be fair, medicine is full of people who were seen as crazy for their ideas at the time, and eventually the evidence came to support them.
The issue isn't the vitamin protocol, it's the claims without evidence.
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robdobyns
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There are 4 RCTS and 3 observational studies showing statistically significant efficacy for Ivermectin in Covid.
Ivermectin is also in the outpatient treatment algorithm used at Baylor in Dallas. It's also at Memorial Hosiptal in Houston.
Are all these doctors quacks too? I think not.
What is the risk/benefit ratio of using ivermectin in Covid ?
That's the question to ask.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
jpb1999
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TexasAggie_02 said:

AgResearch said:

bigtruckguy3500 said:

Interesting indeed. I'll have to look up the actual data and paper.

That being said, ivermectin is not a common drug. Drug companies would have to start pumping it out 24/7 for any meaningful supply to be available for use in this country.


Just get a scrip from the local vet.
you don't need an Rx to get it from the feed store.
So asking for a friend...

I have only seen it as a topical. Does it also come in pill form? Would you just follow the dosage per weight on the bottle, even though it would be 100 to 200 lbs versus 1000 lbs? Would this only be taken IF you had it? If so, for how long?

Edit: So read the protocol linked above. So can you get it in this table form from the feed store or vet?
TexasAggie_02
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jpb1999 said:

TexasAggie_02 said:

AgResearch said:

bigtruckguy3500 said:

Interesting indeed. I'll have to look up the actual data and paper.

That being said, ivermectin is not a common drug. Drug companies would have to start pumping it out 24/7 for any meaningful supply to be available for use in this country.


Just get a scrip from the local vet.
you don't need an Rx to get it from the feed store.
So asking for a friend...

I have only seen it as a topical. Does it also come in pill form? Would you just follow the dosage per weight on the bottle, even though it would be 100 to 200 lbs versus 1000 lbs? Would this only be taken IF you had it? If so, for how long?

Edit: So read the protocol linked above. So can you get it in this table form from the feed store or vet?
I've seen pour on and injectable. I do not know if you can get it in a pill form. FYI the dosage for livestock is based upon weight, I do not know if that would translate to people.
Not a Bot
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robdobyns said:

There are 4 RCTS and 3 observational studies showing statistically significant efficacy for Ivermectin in Covid.
Ivermectin is also in the outpatient treatment algorithm used at Baylor in Dallas. It's also at Memorial Hosiptal in Houston.
Are all these doctors quacks too? I think not.
What is the risk/benefit ratio of using ivermectin in Covid ?
That's the question to ask.



The biggest question I'm asking is why hasn't this been publicized? Seems like there's a lot of suppression of the story. Is it because it's so widely available in feed stores that they don't want people doing what some already are, and buying livestock antimicrobials for human use?

On the other hand, it seems like a lot of doctors haven't gotten on board with this either.
Dr. Not Yet Dr. Ag
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Most doctors haven't gotten on board because the RCTs mentioned that are available for perusal are very small, demonstrate contradictory evidence, and are overall of low quality. That along with major institutions like NIH, CDC, WHO recommending against its use until convincing data is available explains why you will not find many doctors jumping on board the ivermectin bandwagon just yet.

It seems these doctors are really hammering the same talking points the HCQ proponents were early on: "there's no money in repurposed drugs" (ignoring that dexamethasone is standard of care now), "what's the harm in its use?", "it would be unethical to run a placebo controlled RCT in a pandemic".

There is certainly the possibility that it works, but we just don't have enough evidence to claim a "cure" quite just yet. I fully support any doc that reads the evidence, weighs the risks of initiating this therapy, and decides to start prescribing it; however, I am strongly against poor scientific literacy and over exaggerations of treatment efficacy based on low quality evidence.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
MousepadMarauder
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I know lots of folks out here in West Texas who are mixing the cattle pour on with lotion and rubbing it on their arms. I have a friend who was sick and ate the sheep paste and got better. Completely anecdotal. There does not appear to much downside as I know cattle ranchers who have been covered in it for years and I have not seen anyone claiming a connection to health conditions.
robdobyns
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Dr. Not Yet Dr. Ag said:

Most doctors haven't gotten on board because the RCTs mentioned that are available for perusal are very small, demonstrate contradictory evidence, and are overall of low quality. That along with major institutions like NIH, CDC, WHO recommending against its use until convincing data is available explains why you will not find many doctors jumping on board the ivermectin bandwagon just yet.

It seems these doctors are really hammering the same talking points the HCQ proponents were early on: "there's no money in repurposed drugs" (ignoring that dexamethasone is standard of care now), "what's the harm in its use?", "it would be unethical to run a placebo controlled RCT in a pandemic".

There is certainly the possibility that it works, but we just don't have enough evidence to claim a "cure" quite just yet. I fully support any doc that reads the evidence, weighs the risks of initiating this therapy, and decides to start prescribing it; however, I am strongly against poor scientific literacy and over exaggerations of treatment efficacy based on low quality evidence.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
robdobyns
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Where do you stand on the use of Remdesivir? And the "evidence" used by the FDA to grant an EUA?
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Dr. Not Yet Dr. Ag
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My stance is the original study was high quality, but the primary outcome was not patient centered, and demonstrated questionable clinical significance for the use of remdesivir.

Edit: And my current stance on its use based on the available evidence we have now is it probably should not be used given at best minimal efficacy, and it's high cost.
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Shooter McGavin
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I have some Soolantra prescribed for Rosacea. It is expensive stuff and contains ivermectin.

I guess I'll lather up with that stuff
bigtruckguy3500
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I agree. I don't think remdesivir is all it's hyped up to be.



I think ivermectin deserves a shot if someone thinks there's promise there, just like HCQ deserved a shot. It's not that hard to do a randomized prospective study to show efficacy. And it's not like the placebo arm is truly receiving a sugar pill, they're receiving standard of care. If ivermectin is as good as they say it is, it is not only possible, but ethical to end the study early (this happens all the time). When you start getting into double blinding and some of those other things, that's a bit more logistically difficult. But they've shown promise in observational studies. The next logical step is a randomized prospective study. If that shows promise then double blinded placebo controlled prospective.
wjs94
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So let me get this correct, you can take the horse paste and it's the same as the human pill? I've listen to and read several different articles that says it work. I tested positive yesterday and I'm thinking about trying it. According to my weight 260lbs 117.6 kg x .2 mg after the conversion I should take 23.6mg. Does this sound about right?
culdeus
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Talked to a ER doc about this stuff to see if it makes sense to get or not. Paraphrasing:

The only real in vitro studies don't translate to humans great, the in vitro stuff scaled up means you need to be taking a does somewhere 100x bigger than we would give an animal, or a HIV patient.

It seems to have the most value when treating side effects of dex, which may be the real benefit here. You can dose the **** out of some dex with this on board. That's how it's being evaluated. I didn't follow exactly the side effect, but more or less that the steroids promote what would be "parasite like" issues.

It's also really hard to get, and there have been periods where it's completely unavailable.
culdeus
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robdobyns said:

There are 4 RCTS and 3 observational studies showing statistically significant efficacy for Ivermectin in Covid.
Ivermectin is also in the outpatient treatment algorithm used at Baylor in Dallas. It's also at Memorial Hosiptal in Houston.
Are all these doctors quacks too? I think not.
What is the risk/benefit ratio of using ivermectin in Covid ?
That's the question to ask.


Where are these RCTs?
Reveille
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Dr. Not Yet Dr. Ag said:

Most doctors haven't gotten on board because the RCTs mentioned that are available for perusal are very small, demonstrate contradictory evidence, and are overall of low quality. That along with major institutions like NIH, CDC, WHO recommending against its use until convincing data is available explains why you will not find many doctors jumping on board the ivermectin bandwagon just yet.

It seems these doctors are really hammering the same talking points the HCQ proponents were early on: "there's no money in repurposed drugs" (ignoring that dexamethasone is standard of care now), "what's the harm in its use?", "it would be unethical to run a placebo controlled RCT in a pandemic".

There is certainly the possibility that it works, but we just don't have enough evidence to claim a "cure" quite just yet. I fully support any doc that reads the evidence, weighs the risks of initiating this therapy, and decides to start prescribing it; however, I am strongly against poor scientific literacy and over exaggerations of treatment efficacy based on low quality evidence.


I agree I don't think any doctor should be promoting anything as a "cure"! This type of statement by a physician is irresponsible. In fact I make it a point to tell patients that it's not FDA approved and there absolutely is no guarantee or promise of cure. Personally I am not even convinced we will have one thing that is a "cure". So I tell them these are the things we have found to have some potential in helping based on retrospective studies and it's all possible the results are only anctedol. As retrospective studies data can be manipulated. However, until we have more RCT completed this is the best information we have to go on.

I strongly believe in treating every patient the same way you would treat your mother, father, brother, sister or child. Knowing that if my mom caught Covid, I would do everything possible to improve her outcome I do the exact same for each and every patient I see. I tell them everything I know that might help and then make sure they have no condition that could cause issues with any of these things.

I believe every physician should do the same. If he reviews the studies and wouldn't give it to his family because he is convinced of no benefit then I 100% agree with that decision to not use it. He is doing what he thinks it's best for his patients.

I do have an issue with physicians who tell people not to take something. However, when someone in thier family is sick they give it to them. This goes for treatment of all diseases from Covid to diabetes. Every person deserves the best care you can possibly give.

We are all learning on the fly with Covid-19 and I will continue to review as much information as I can on a regular basis in order to help as many people as possible.

My opinion on treatments will most definately change as new studies are released as all ours should.

I also want to thank you and each physician on this site for helping all of us provide better care for every patient we see. Hopefully, we eventually find a treatment plan that will keep everyone out of the hospital and we don't have to say here for anymore Aggie loved ones.


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robdobyns
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AG

https://covid19criticalcare.com/wp-content/uploads/2020/12/FLCCC-PressConferencePresentation-Dec4-Houston.pdf

I agree with everything Dr Rev said above.
This link has some studies on the efficacy of Ivermectin.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
bigtruckguy3500
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I spent the past couple days perusing some of the data. I think ivermectin deserves a randomized placebo controlled trial. I don't think it should become standard of care just yet. I also don't think it a case controlled trial (or case matched, or whatever it's called) would be sufficient.

Hopefully Marik and his group try to generate more high quality evidence instead of just insisting that what they've done is enough for mass adoption.
robdobyns
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In normal times (no pandemic, no shutdowns etc) I agree.
These are not normal times. This is battlefield medicine.
In extreme emergencies like we have now, the question to ask is what is the risk/benefit ratio.
In my view there is minimal risk. And strong evidence that the benefit is robust. That's why I offer it to patients with informed consent.
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bigtruckguy3500
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How many patients take you up on it? What have your observations been? Or do you not really keep track?

I still think we more quality data before we put our weight behind something. What if we start retasking drug makers to start making it, only to find out in 6 months that large scale data shows minimal efficacy?
Reveille
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Almost all of them do. I don't keep exact numbers but I would estimate a little over 100 patients treated with it so far. I haven't seen a one yet have to go to the hospital. But I also have them take Quercetin, zinc, famotidine, baby aspirin, melatonin and NAC. So any of these could also be the cause or at least contributing to the benefit.

Personally for now I really don't care which drug is actually responsible for the benefit. I just want to keep my patients out of the hospital. I will let the researchers figure it out over time. I am more then willing to change to anything if it is proven to work better and is safe for my patients.
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robdobyns
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I'm having the same results as Dr Rev. much lower number of patients. Less than 10. So far. So good.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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