APPLICATION OF THE PROKARIN™ DISC

• The recommended site of application is on the trunk of the body. A preferred site is on the side of the abdomen/hip area just below the belt line. It can also be applied to the upper leg (thigh area) or the upper arm, but it may have a slower absorption rate (having a weaker effect) on the arms or legs as compared to the trunk of the body
• Make sure that the skin is clean and intact at the site of application. Do not put the disc over areas of the skin that are irritated, inflamed or have sores.
• Peel the disc off of the paper backing. Both sides of the disc are slightly sticky and it does not matter which side of the disc is against the skin.
• Apply a 2-3 inch long piece of paper tape (supplied by the pharmacy with the Prokarin™ prescription) over the disc to adhere it to the skin.
• Apply one disc daily in the morning upon awakening or after showering/bathing. Remove the disc at bedtime.

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POSSIBLE REACTIONS TO THE DISC

The majority of people using the Prokarin™ Disc have no site reaction. If you are sensitive to paper tape, notify the pharmacist who dispenses your ProkarinTM Disc as he/she can recommend a skin barrier to be applied to the skin prior to applying the paper tape. Note that if you use a skin barrier product, it must not be applied to the area of skin directly under the disc, as this would prevent the medication from being absorbed. Another alternative to the paper tape is to use a Tegaderm® patch to adhere the disc to the skin.
Some people can have a genetic intolerance to one of the components of the disc. If you experience nausea, diarrhea, sweating, fishy body odor, feeling faint, or hypotension (low blood pressure), remove the disc and call your pharmacist for an alternative form of transdermal delivery.

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DOSING

The Prokarin™ Disc contains the active ingredients histamine and caffeine. Generally most people see improvements in their symptoms wearing one disc (1.65 mg) worn from morning until bedtime. But the dosing is individualized.
If you see an overall worsening in your symptoms within the first three days of applying the disc then the dose is probably too high. Contact your pharmacist who dispensed the Prokarin™ disc as you may need to decrease your dose which can simply be accomplished by cutting your disc in half or quarters with a scissors and applying a lesser amount.
If you do not see any change in your symptoms (no better, no worse) after 2-3 weeks of using the Prokarin™ Disc, contact your pharmacy as you may need to have your dose increased by either applying more discs or portions of discs per application or having the concentration of the histamine phosphate increased per disc. Note, some patients who have a chronic underlying infection have required higher doses of the Prokarin™ Disc.

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STORAGE

The Prokarin™ Disc can be stored at room temperature, but for the longest shelf life and stability it is recommended that you store it in the refrigerator. When traveling it is not necessary to keep it in a cooler or refrigerator, but do protect it from extreme heat or cold. Do not leave it in the vehicle on warm or cold temperature days as this can deteriorate the disc and its potency.

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SUPPLEMENTS

Calcium supplementation is a must when using Prokarin™. Research studies show that histamine can lower the blood calcium level. Signs and symptoms of low blood calcium are muscle spasms, stiffness, and numbness and tingling in the hands,feet or face/mouth. The recommended calcium/magnesium supplement is included with each month?s supply of the Prokarin™ Disc from the dispensing pharmacy. Calcium is difficult to absorb, so it is important that calcium supplements are taken with meals to increase absorption. It is recommended that you take approximately 2,000 mg of calcium with breakfast every day. Calcium is very constipating but magnesium helps to counteract this. If you experience loose stools and/or increased spasms, stiffness, numbness and tingling in your feet, hands or face/mouth you may need to change to a calcium citrate supplement rather than the calcium carbonate supplement provided with the Prokarin™ Disc. Notify your pharmacist.
If you still experience increased stiffness despite taking the recommended calcium, then you may benefit from FOS (fructooligosaccharides) supplementation, 2,000-3,000 mg per day taken all at once with breakfast. Ask your pharmacist about this.
A good multivitamin and mineral supplement is important. Rule of thumb, a good vitamin and mineral will look the same on the inside as it does on the outside when the vitamin is cut in half. Talk to your pharmacist about a good brand of multivitamin and minerals. Vitamin B-12 is essential in the making of myelin components. Talk to your pharmacist about the type and dosage of Vitamin B-12 that would be best for you.
Generally those people taking only the minimum supplements of a multivitamin and mineral, the necessary calcium/magnesium and if needed the FOS do the best when using the Prokarin™ Disc.
Many herbs and roots will decrease the effects of Prokarin™, such as licorice root a nd tumeric (curcumin). Also Essential Fatty Acid (EFA) supplements will interfere with the effectiveness of Prokarin™. Do not take flaxseed oil, primrose oil, borage oil, or fish oil when using Prokarin™. Do not use soy products such as soy milk as these contain phytoestrogens that can decrease the effect of Prokarin™. Do not use tea tree oil products as these too increase estrogen levels and high estrogen can interfere with Prokarin™.
It is recommended to take no more than 200-300 i.u. of vitamin D3 daily as this is a fat soluble vitamin and it can accumulate and become toxic. Most multivitamin supplements contain adequate vitamin D concentrations.
Some patients using Prokarin™ have reported feeling anxious when taking a Co-enzyme Q10 supplement in conjunction with the Prokarin™.

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DIET

Histamine stimulates the production of melatonin, which is essential in fat metabolism. It is important that you get enough fats in your diet as the majority of the myelin is made up of fats called phospholipids. It is important that you have a balance of unsaturated and saturated fat in your diet. Unsaturated fats are liquid at room temperature like vegetable oil, flaxseed oil, primrose oil and fish oil. Saturated fats are solid at room temperature and are in most animal fats like butter, lard, red meat, cheese, etc. Research shows that diets high in unsaturated fats and low in saturated fats can result in lipid peroxidation. Lipid peroxidation is toxic to the myelin and nerve cell membranes. The trend has been to increase the unsaturated fats and decrease the saturated fats in the diet. I wonder if this trend is contributing to the prevalence of neurological disorders. I personally eat red meat 3-4 times a week, butter cheese, eggs, etc., as well as fish and my lipid peroxidation results were low which is desirable. This may vary from person to person. If you have been on the Swank diet with good results, yet don’t see any improvement when you try Prokarin™, consider adding some animal fat to your diet. Also, be sure to eat frequent small meals as Prokarin™ can lower your blood sugar.

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SWIMMING / SHOWERING

Do not get the disc wet. If the disc gets wet, remove the disc and apply a new disc. When showering, bathing or swimming remove the disc and wrap the paper tape around it, place it in a sealed baggie and cover it to protect it from light. Then after toweling yourself dry, reapply this same disc by removing it from the paper tape, and placing it on your skin in the appropriate site and cover with a new 2-3 inch long strip of paper tape.

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OTHER MEDICATIONS USED CONCOMITANTLY WITH THE PROKARIN™ DISC

Discuss this with your pharmacist and your doctor. Prokarin™ contains Histamine. In particular anything that blocks Histamine 2 receptors is going to interfere with the effectiveness of the Prokarin™. Histamine blockers include medication to decrease stomach acid, such as Zantac®, Pepcid®, and Tagamet®. It will say on the package if it is a Histamine blocking agent and this needs to be avoided. Also, anti-spasmodics such as Zanaflex® and Baclofen® at higher doses can also decrease the effectiveness of Prokarin™.
Avoid supplements that contain licorice root. Many Chinese herbs have licorice root in them. Licorice root may stimulate Histamine3 receptors, which can tell the body to turn down its Histamine production. This can decrease the effectiveness of Prokarin™.
If you have esophageal reflux (heart burn) you may take antacids such as Tums®. This won’t interfere with the action of Prokarin™. But as time goes on, you may find less reflux problems because as the Histamine is replaced in the body, it will stimulate gastric acid production. The increased acidity in the stomach increases the tone of the sphincter between the stomach and the esophagus, closing the sphincter tight so that food and acid don’t regurgitate back into the esophagus.
Occasional use of nasal allergy type of antihistamines does not seem to interfere with the effectiveness of Prokarin™ because antihistamines block the H1 receptors not the H2 receptors.

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SIGNS THAT INDICATE PROKARIN™ IS WORKING FOR ME:

• Heat Tolerance: Histamine is the heat stress regulator for the body. By supplementing Histamine to a body that is deficient in this neurotransmitter, you would expect to see the body tolerate heat again, such as a hot bath or shower. If you over expose yourself to heat you will use up Histamine. As your body temperature increases, your need for Histamine also increases. You need to adjust to heat gradually and watch for changes. Maybe you will now be able to tolerate a little warmer temperature in your bath or shower without getting wiped out or exacerbating your symptoms. If you live in an area that has hot seasonal temperatures, you may find that you will need a higher or more frequent dosing schedule during these hot temperatures. Talk to your doctor about this.
• Are you sleeping better? Are you dreaming again? Are you remembering your dreams? Histamine stimulates the production of melatonin. Low levels of melatonin interfere with the Rapid Eye Movement (REM) stage of sleep. This is a very important stage of sleep during which our body repairs itself. Melatonin levels fluctuate throughout the day and night and it is the swing from high to low levels that stimulate our body to go into the REM stage of sleep. If your melatonin levels are low, there is not enough of a swing from high to low to induce REM sleep. These increased levels of melatonin due to the supplementation of Histamine through Prokarin™ may make you feel drowsy for the first few days after starting Prokarin™. Your body just needs some time to adjust to the higher levels of melatonin.
• Decrease in Pain: if you have pain, has your pain decreased? Histamine is an analgesic for the body.
• Decrease in Fatigue: Do you notice a decrease in your fatigue? Maybe you can go shopping for a little bit longer, or stay up later with the family. Maybe you just don’t feel as wiped out. Histamine is a potent stimulator in our body to make cyclic AMP. Cyclic AMP is necessary to every cell in our body every second just as oxygen is. It is also vital to the myelin producing cells in the central nervous system. The primary avenue for our body to make the cyclic AMP is through Histamine, but if this system is defunct then our body has a backup system. The backup system is our body breaks down its energy molecule, ATP, to make the cyclic AMP. This depletes our body of its energy so a person may experience the overwhelming fatigue. By giving the body back Histamine, the body’s energy molecule is no longer being used up and the fatigue lessens.
• Stress Tolerance: Can you tolerate some stress a little better without it wreaking havoc on your symptoms like it did prior to being on ProkarinTM? Histamine is a major stress regulator for the body. The more stress you encounter, the more Histamine you need. Emotional, physical and environmental stress increases the body’s need for Histamine. Increased stress or prolonged stress may tap out your body’s supply of Histamine and the usual dose of Prokarin™ may no longer be adequate. Therefore you may notice increased symptoms during stressful periods. If you are a female, you may notice an increase in symptoms during, or just before your menses. If you are experiencing a prolonged period of stress, such as an emotional crisis etc, you may want to consult with your doctor to see if you should adjust your Prokarin™ dose to help accommodate your body’s increased need for Histamine during this time.
• Improvement in Motor Function or Sensory Function: Histamine is a major neurotransmitter for the body, as well as regulating many other neurotransmitters in our body. A neurotransmitter is a chemical that is necessary to send a message down a nerve pathway. Just like muscles, the nerve pathways atrophy (shrink) when we don’t use them. The only way to build these atrophied nerve pathways is by repetitively trying to send messages down them. This takes time and diligence. Please refer to the section on exercises for more information.
• Do Others Notice a Difference in You: Ask your family and friends if they notice any changes in you, such as a little more life behind your eyes, you engage in conversations more, or you all around look better? They will probably notice the subtle changes, which you may have overlooked. Remember, as your body moves toward normal it takes a conscious effort to notice it. So maybe changes are occurring, but you aren’t consciously aware of it. Here is an analogy: Our hands move several times a minute and we are not even aware of their movements. But if we have a hand that is tingling, or numb, we are aware of that hand every second because it is abnormal to the body. A lot of times a significant other or a friend will notice the difference before you will. Also, you may have your heart set on getting up and out of that wheelchair, so you might not notice the little changes that are occurring. Look for the little subtle changes. Please see the section on exercising nerve pathways if you haven’t been doing the exercises. Perhaps this is the variable that is missing.

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EXERCISES

The exercises to build back the nerve pathways consist of concentrating on sending a message from the brain to a part of your body that isn’t functional, trying to make it work. Repetitively trying to send these impulses down the nerve pathways is what causes dendrites to grow again. For example, if you can’t move your toes, think hard: I’m going to move my toes. Picture the impulse forcing its way down the nerve to the non-functional part, like a flame burning down a fuse. Even though you might not be able to move your toes, relax for 5-10 seconds and then concentrate hard again at trying to send the message to your toes. The key is repetition. Do these exercises 5-10 times per set, 3-4 sets per day every day. Apply this same type of exercise to different parts of your body, such as trying to rhythmically tap your feet on the floor, or touch your thumb to each of your fingers. Another exercise is to stand in front of your walker and tell yourself, I’m going to stand up straight, put my feet together and let go of the walker. Even if you can only let go of the walker for an instant, that is okay. Relax for 5-10 seconds and try again.

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FREQUENTLY ASKED QUESTIONS

Question:
I have been on Prokarin™ for one month and no changes, good or bad, have occurred in my symptoms

Answer:

• Ask yourself, are you sensitive to heat, does heat bother you? In other words, if you take a hot bath or shower, does it worsen your symptoms? If it does we need to find the missing piece of the puzzle. If you are heat sensitive this means that you may be deficient in Histamine because Histamine is a heat stress regulator for the body. So if heat worsens your symptoms, it may indicate that your body doesn’t have enough Histamine because as our body heats up, it needs more Histamine. Histamine is being supplemented in Prokarin™. If Histamine is supplemented to a body that is deficient in Histamine, the person may see an increase in heat tolerance.
• Are you taking the necessary 2,000 mg of calcium with breakfast? Are you taking EFA supplements or a supplement with licorice root as these can negate the effects of ProkarinTM ? Are you taking any H2 blockers such as Zantac, Tagamet, or Pepcid as these will interfere with Prokarin™?
  Are you on a low fat diet?
  If all of these variables seem to be under control and you are not seeing any changes in your symptoms, good or bad, then perhaps you should talk to your doctor and pharmacist, as it is possible that your dosage needs to be changed.

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Question:
When I first started using Prokarin™ I saw improvements for the first couple of weeks to a month, and then there was a gradual loss of these gains; the key word being gradual.

Answer:

• Are you taking the recommended supplements? See the section on Supplements. Prokarin™ can lower the blood calcium and it will feel like the Prokarin™ is no longer working.
• Are you on a low fat diet? A low fat diet can make you experience a weakness when using Prokarin™. It is important to eat a serving of meat a day and to eat red meat three times a week.

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Question:
I started and after about 3 days all my symptoms are getting worse including numbness, tingling, fatigue, etc.

Answer:

• The key word here would be abrupt. If you see an abrupt increase in symptoms or decline in your condition it may mean that the dose is too high for you and has triggered the body to decrease its own production of Histamine. Discuss this with your doctor and pharmacist, as you probably need a change in your dosage.
• Prokarin™ is supplementing something your body already produces (Histamine). Whenever you supplement something your body naturally makes, you want to give just enough to the body to keep it in its normal range. If you give too much back artificially and get the level too high in the body, it will trigger the body’s feedback mechanism, which tells the body that there is too much of this chemical. Because of this, the body won’t produce as much Histamine. When this happens, the body’s own production of the Histamine decreases and now you are trying to get by on the amount of Histamine that is in the disc. This may be why you see a sudden worsening of your symptoms because you are trying to get by on less Histamine than you were prior to being on the Prokarin™. Now, if you see improvement for the first 2-3 days and then the symptoms increase abruptly, perhaps your liver doesn’t metabolize quite as rapidly as most people, and you will start to get an accumulative effect. The first day you feel better, second day even better, and by the third day or fourth day, you hit a brick wall where all of your symptoms come crashing back. Perhaps your liver could not metabolize in 24 hours what you took in from the disc, so you got a carry over effect. By the third of fourth day the level was too high and you triggered your feedback mechanism to turn down your body’s production. You need to talk to your doctor and pharmacist about adjusting your dose and bringing it down, to the amount your liver can metabolize and then slowly titrating up.

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Question:
When should I talk to my doctor about increasing my dose?

Answer:

• We have a tendency to believe that if a little is good then more is better, but that is not generally the case when you are supplementing something that the body already makes. The body must keep all things within balance and we want to maintain that balance. Rule of thumb, as long as you are seeing slow, steady, subtle changes, remain on the lower dose.
  If you have been experiencing improvements and now your progress seems to have reached a plateau, are you doing the exercises? Are you on a low fat diet and/or taking the unsaturated fat supplements, such as flaxseed oil, primrose oil, salmon-omega, etc? All of these things can influence improvement. Please see the sections on Supplements, Diet and Exercises.
  Our body tries to maintain homeostasis. Change is stressful on the body even if it is good change. The body tries to level out change creating a plateau. So whether you are building muscle or trying to lose weight, your body does it in a stair-step fashion. For as you initiate a change, your body struggles to level out the change and you experience a plateau. The body would be happy just staying on this level stair, so you must take measures to force the body off the stair and continue to progress with change. For example, when you are dieting to lose weight, you limit your calories or change the type of foods you eat to initiate weight loss. You lose a few pounds very quickly, but then your weight loss plateaus because your body is working to adjust to this change and create homeostasis again. In order for you to start losing weight again, you need to increase your exercise or further limit your calorie intake, forcing your body to move off the level stair again to the next step.
  This same concept applies to any change initiated while using Prokarin™. If you feel you have reached a plateau, try doing more exercises, assessing your diet and balance of fat intake. If you continue to experience the plateau after trying to challenge your body with exercises, then perhaps consult with your doctor about increasing your dose of Prokarin™.

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Question:
Can I do bee sting therapy with Prokarin™?

Answer:

• Some people are using bee venom therapy and have reported needing fewer stings with Prokarin™. It may be wise to stop stings when starting Prokarin™; or if you choose to continue with bee stings, start with a low dose of Prokarin™ and increase gradually under the direction of your doctor.

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Question:
I have more energy, I’m sleeping better, and I can tolerate heat better, but I’m still not walking better. Why is that?

Answer:

• Histamine is an important neurotransmitter (chemical) in our bodies. Histamine is a heat stress regulator for the body. It also is the chemical that stimulates the pineal gland to make melatonin and cyclic AMP. Cyclic AMP is like oxygen to every living cell, in that every cell needs it every second. If your body doesn’t have enough Histamine to make cyclic AMP, your body has no other choice than to break down ATP (the energy molecule for the body) to make cyclic AMP. This results in the severe fatigue. By giving back the Histamine chemical, the body can quit robbing its energy molecule, so the fatigue may improve. Also the body can start making more melatonin so the deep sleep (REM state) can now occur. Restoring Histamine helps the body tolerate heat again because now it can sweat. Heat tolerance, fatigue, and sleep may all improve by just giving back Histamine to the body that is deficient in it. The motor function and sensory function improvements are dependent on rebuilding of nerve pathways. Research shows that the nerve pathways (dendrites) shrink with disuse, but by repetitively sending messages over these nerve pathways the dendrites grow. Please see section on Exercises.

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Question:
I am experiencing an increase in muscle spasms, stiffness, numbness and tingling since I started Prokarin™.

Answer:

• Research shows that Histamine can lower the blood level of calcium. Thus, calcium and magnesium supplements are necessary when using Prokarin™. Please see the section on Supplements.

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Question:
Caffeine bothers me.

Answer:

• Prokarin™ contains caffeine so if you don’t tolerate caffeine, talk to your doctor and pharmacist about this. The amount of caffeine in one disc is equivalent to drinking about a tablespoon of coffee.

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