Information about Prokarin™

The consistency (thickness) of Prokarin™ is very important. Thick Prokarin™ exerts a very weak effect; where as thin (runny) Prokarin™ can cause a very transient effect as well as rapid pulse, stomach pains, dizziness, and faint feelings. Prokarin™ should be fluffy in consistency like foam shaving cream. Holding the tip of the syringe right down on the patch at a 45-degree angle, the Prokarin™ should come out like a foam shaving cream. If it comes out in a column shape like toothpaste or a spaghetti noodle, it is too thick and will exert only a weak effect. Histamine is involved in the liver’s metabolism. If you are deficient in Histamine, your liver may not metabolize as efficiently as most people, thus thick Prokarin™ may act more potent in the beginning as it is not cleared from the system as quickly as it should be. As the liver becomes more efficient, this same thick Prokarin™ becomes too weak in potency to produce any improvements. Talk to your pharmacist regarding the need for a fluffy consistency of the Prokarin™. If your Prokarin™ is any other consistency than a foam shaving cream or stiff whipped cream, notify your pharmacy.
Note to the Pharmacist: The consistency of the Prokarin™ must be checked from the 1 ml syringe, not the 60 ml syringe.
If your Prokarin™ is moist but feels sandy and gritty when you rub it into your skin, then the caffeine may not be ground fine enough. This can result in symptoms of dizziness, orthostatic hypotension (decrease in blood pressure when you go from a sitting to standing position), rapid heart rate, and overall decreased effectiveness of Prokarin™. If you notice this sandy-gritty texture, please notify your pharmacist.

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Getting the patch sealed

It is very important that the patch is sealed from air. Air will crystallize the histamine very rapidly and it won’t go across the skin. You will know if you are having a problem with this if when you change the patch, the cream that is left is as smooth as lotion, but when you rub it in there is a white chalky residue on the skin. If this is happening follow these steps:

• The best place to apply the patch to seal it from air is on the front of the thighs. The reason being is that the front of the thigh has a very large muscle going in one direction. When you have different muscle groups in an area it is difficult to get the patch sealed. As the different muscle groups move they will wrinkle the patch.
• Use the middle section of the thigh, don’t get too close to the groin or knee as the muscle tapers.
• Apply the hydrocortisone to the area, at least 15 minutes before you apply the patch, especially if you are getting redness and irritation. Make sure when you apply the hydrocortisone cream that you use only about 1/16th of an inch so it just barely peeks out of the tube. That will cover about a 3-inch square area on your leg. If you use too much you might decrease the absorption of the Prokarin™ and also interfere with the patch sealing tight to the skin.
• It is very important that your knee is perfectly straight when applying the patch. Do it in a standing position with your knee straight, or if sitting down, elevate your leg on a chair to make the knee straight. You may have to put the foot on a pillow if you are lying in bed, to get the knee perfectly straight. If the knee is flexed (bent) at all, the thigh muscle is elongated. You need the muscle to be in its shortest position when you apply the patch.
  If you apply the patch with the thigh muscle in its longest position, it will wrinkle up the patch and wick air under it when you move your leg and shorten the muscle. This will quickly cause the medication to dry.
• While your leg is still straight, look to see if there is any rippling or dimpling on the edge of the patch. If there is, immediately peel up half of the patch (only half) and pull it back down with tension. (If you peel up the whole patch you will have difficulty getting it to stick). Apply tension on the other side of the patch as you do this. If you need to adjust the patch, you must do it immediately upon putting it on otherwise you won’t get it to stick, even 10 or 15 minutes later it won’t stick again.
• If you are still having difficulty sealing the patch, you may need to secure the patch with HyTape®. You can obtain this from your pharmacist in a 3” wide roll. Peel the tape back and cut it about 5 inches long so that it is about 2 inches longer than the patch. I secure my patch with this tape in the summer when I am moving around working in the yard, sweating, or if it’s humid. If you are a person whose skin repels adhesive tapes, try using the Skin Prep Barrier Wipe®. It comes in an individual foil packet like an alcohol wipe. You can get it from a pharmacy that sells ostomy supplies. When using the Skin Prep Barrier Wipe®, remember these steps:
  • Apply hydrocortisone cream as usual, 15 minutes before.
  • Then, just before you apply the patch, hold a quarter down where you plan to put the Prokarin™.
  • Take the Skin Prep Barrier Wipe® and wipe around the quarter. The quarter is used to ensure that the Skin Prep Barrier Wipe® doesn’t get applied where the Prokarin™ is going to be placed.
  • Wait about 10-15 seconds for the barrier wipe to dry.
  • Flip up the quarter on its edge and apply the Prokarin™ directly from the syringe onto the skin, where the quarter was.
  • Then take the quarter completely off and apply the patch, still making sure that your muscle is in its shortest position.

A good indicator that air is getting under the patch is that after about 4 hours of wearing your patch, it starts itching and you start to get some irritation at the patch site. This usually means that the patch has come loose slightly. If the patch moves at all on the skin, it becomes an irritant to the receptors in the skin and you will start to get a site reaction. If you experience this a few hours after applying your patch, check your patch and see if it has come loose at all. If it has, apply some HyTape® over the patch to secure it.
Often the patch adhesive leaves a residue on the skin, which is difficult to remove. The easiest way to remove it is with soap and water in the shower and then after your shower, while you are drying off, you can usually just rub it off with your hand.

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The majority of the people using Prokarin™ have a site reaction, a slight irritation or rash at the site. A little bit of a welt may be visible when you change the patch. You can minimize the site irritation by applying about a 1/16th of an inch of hydrocortisone to the site 15 minutes prior to applying the patch. Some peoples skin is not too sensitive, so they can get by with applying the hydrocortisone cream only 5 minutes before. But if you are getting a site reaction apply the hydrocortisone 15 minutes before the patch. The hardest part is remembering where you applied the hydrocortisone! You can mark the area with a pen or a little piece of tape.
If you continue to get a site reaction try another site. Some sites may be more sensitive than others. If a site gets irritated, avoid that site and a 3-inch diameter area around it until the irritation resolves. You can also use the outside of your thighs, although it is a little harder to get the patch sealed there because of other muscle groups in this area. Generally the skin is less sensitive on the outside of the thigh.
Site irritation may also be a result of the patch loosening. If the patch loosens the slightest bit, it will cause skin irritation. Check your patch and if you see a little bit of adhesive residue showing on the edge of the patch, it has probably loosened. Apply a 5” long piece of HyTape® tightly over the patch to seal it down tight again. This should decrease or stop the irritation.

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As a rule of thumb, if you are seeing changes in your symptoms while using the Prokarin™ then you are probably absorbing an adequate amount. Many people worry that when they change the patch they see a lot of cream left over and it is hard to judge how much has been absorbed. Generally the cream that is left is mostly the transdermal gel (cream) used to slowly release the active ingredients across the skin. Rub in this remaining cream as it may still have some active ingredients in it. When you remove the patch, the cream is usually stuck on the patch; wipe the cream off the patch and onto your skin. It usually takes 2-3 rubs with the palm of your hand to rub the cream into the skin and it should totally vanish. There should not be any cream left. If it takes a lot of rubbing to get the cream to rub in, then you are probably not absorbing very well. If you are not absorbing well, the Prokarin™ might be too thick. (See the Section on Consistency, page 1). If the Prokarin™ is of a foam shaving cream consistency, the patch is sealed tight from air, and you still are having very little absorption, try applying the patch in a different area. Some people may have better absorption from sites on their chest or arms. If after trying various sites, you still are not getting adequate absorption, talk to your pharmacist about a niacin cream that can be applied to the skin just prior to applying the Prokarin™ patch.

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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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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. I personally have been using Nutrilite® vitamins for several years. 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. Calcium and Magnesium are important to supplement 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 and feet. Calcium is difficult to absorb, so it is important
that calcium supplements are taken with meals to increase absorption. Calcium is very constipating, but magnesium helps to counteract this. Some forms of calcium are more absorbable than others, so talk to your pharmacist about brands and dosage recommendations.

Supplements commonly recommended by Dr. Gillson:

If you are not on a lot of supplements, don’t start all this at once! I suggest adding just one or two things at a time, and waiting a week to see if there is any adverse reaction (headache, nausea, worsening symptoms) before adding more things.

B Complex containing 100 mg of thiamine per capsule: one twice daily. (B Vitamins in general are beneficial for the nervous system and for energy generation) Niacin Three or four times daily, on an empty stomach. Start with one 100 mg tablet per dose and increase the dose until you develop a flush. It shouldn’t be unpleasant. If you don’t develop a flush with 1000 mg dose, don’t use niacin.

Niacinamide may be helpful for spasms in some individuals. Try 250-500 mg every 3-6 hours up to a maximum of 3000 mg/day. Niacinamide is a different chemical form of niacin and is much more active in the brain.

Sublingual B12: 1000 micrograms three times daily
Folic acid: 400 micrograms, twice daily.

Biotin 15-20 mg/day (Thorne makes something called Biotin-8, one twice daily would do it). Biotin has been shown to be beneficial for neuropathy in diabetics.

Chelated calcium 1200 –1500 mg/day

Chelated magnesium 750-1000 mg/day (sometimes causes diarrhea-if occurs, cut back). Magnesium is also a cofactor in the syntheses of histamine from histidine.
(Chelates include malate, citrate, succinate, taurinate)

Please note corrections to Supplements page 7 in soft-bound handout booklet. The booklet should read as follows:

Recommendations for individual supplementation of Vitamins E, D, and A have been removed. These are fat-soluble and can accumulate. Thus, these vitamins should not be supplemented separately, as they are generally found to be present in adequate amounts in a quality multivitamin and mineral supplement.

MSM (methylsulfonylmethane) 1000 mg, three times daily for liver and adrenal support and muscle spasms.

SAMe 200 mg once daily – some evidence that is supports myelin.

Anhydrous betaine (e.g. Thorne Research Methylguard) 600 mg twice daily. Boosts SAMe production.

Melatonin 1 mg sublingual tabs, 2 at bedtime. It is an important brain antioxidant.

Good quality multivitamin and multimineral without iron ($15-$20/month, not Centrum-type e.g. DaVinci Spectrum) Pancreatic enzymes with each meal. At the Tahoma Clinic, we typically aim for around 100,000 units each of Protease and Amylase, and around 25,000 units of Lipase per meal. Some examples are Lipanase by AMNI, Dipan-9 by Thorne, and BioZyme by PhytoPharmica. Viokase 16 is an enzyme complex available by prescription. These enzymes were never intended to pass through your stomach anyway, so I don’t think it matters whether you take them before, during or after meals. It makes the most sense to me to mix them in with your meal, so at least some of the dose makes it into the small intestine with your food. Betaine HCI with pepsin* 10 grain capsules (2 grains of pepsin), two with each meal, between the first few bites of food. Helps with digestion. Interestingly, histamine is one of the major triggers of acid release in the stomach. Amino acids 5 grams per day (amino acids as opposed to intact whey or soy protein). All patients should consider amino acid supplementation. Especially consider amino acids if you are underweight, have lost muscle mass or have pressure sores. (SeaCure hydrolyzed fish protein, 10 caps per day is an excellent choice as is Twenty Amino Blend or Twinlab. All are available at the Tahoma Clinic Dispensary.) Taurine in particular may help spasms. Take 500 mg, 1-2 three times daily on an empty stomach Injectable B12, folic acid, thiamine and liver extract In consultation with your doctor.

PADMA Basic: 2 tabs, three times daily (This is fairly expensive, $68/month at Tahoma Clinic Dispensary. It is a Tibetan blend of 19 different herbs which stimulate the circulation and immune system, and exert antioxidant effects.)
Chrysin (passion flower) 500 mg capsule three times daily may help spasms.
Kava Standardized extract, 70-100 mg, 2 or 3 times daily. May sedate. Don’t take with alcohol or prescription tranquilizers.

∗ Betaine has many liver supporting and neurologic functions over and above whatever effects it has on the stomach acid. I think Prokarin™ may stimulate gastric acidity on its own in some cases, so the betaine is recommended here more for liver and brain support. It may irritate the stomach initially. If so, use just one cap per meal for a few days before going to 2. Don’t try full strength betaine (5-7 capsules/meal) without the guidance of your doctor. It may be indicated in some cases.

Thymic proteins, especially live-cell extracts are another avenue which can be explored, although again, they are not a first-line intervention, and are expensive.

Some of these supplements are hard to find elsewhere, but are available from the Tahoma Clinic Dispensary 252-850-5661 or 888-893-6878. the on-line store may be accessed by going to www.tahoma-clinic.com and clicking on Dispensary.

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You must wear 2 patches a day in order for Prokarin™ to be effective (unless your liver metabolizes things very slowly and your pharmacist and doctor have determined that you can only tolerate 1 patch). It is important to apply the first patch as soon after rising in the morning as possible. Then 8 hours later remove that patch and put the next one on. The active ingredients in Prokarin™ are calculated to be released slowly over 8 hours and at the end of those 8 hours most of the active ingredients have been absorbed. For the most part, the only thing that remains is the transdermal cream. It is important that when you change the patches, try not to go more than 8 to 9 hours before you put the second patch on. If you go greater than 9 hours, you may have a decrease in your blood level of Histamine. You can leave the second patch on all night if it is not bothering your skin. It is important that you wear the Prokarin™ patches for the entire time that you are up, alert, and awake. You can take a nap while using Prokarin™. There is much more demand for Histamine during our alert, awake hours, and much less demand for it when we are sleeping. In order to get the most benefit from Histamine you need to apply the first patch in the morning and then after 8 hours, remove it and put another one on and wear it for the rest of your waking hours.

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Some people like to swim every day. There are certain things you can use to help waterproof the patch. It is important that you get the patch sealed from water. Remember the transdermal cream that is used in the Prokarin™ to carry the active ingredients across the skin will also carry all other things across the skin. If you get things like chlorine or soap under the patch, you can get an alkaline burn from them. The Tegaderm® dressing has been successful for some people in sealing the patch from water. You can get it in a 4 x 6 inch diameter, which you apply directly over the patch. The important thing is to apply the Tegaderm® at least one hour prior to going in the water, because it takes the heat of the skin to get it to form a good seal. Some people like to reinforce it with a waterproof tape such as Johnson and Johnson®. Another tape you can use is HyTape®, which you can obtain from the compounding pharmacist who supplies your Prokarin™. You can get this tape in a 3-inch wide roll, cut the tape about 2 inches longer than the patch. Cut 2 strips and apply them directly over the patch so that you have at least 1 inch of HyTape® all around the outside of the patch to help seal it from the water.

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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 these need 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 the Prokarin™ because antihistamines block the H1 receptors not the H2 receptors.

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• Prokarin™ is very temperature sensitive. The ideal storage temperature is 40-42 degrees F. It is best to store the Prokarin™ in the door of the refrigerator with a refrigerator thermometer on the same shelf of the door as the Prokarin™. If Prokarin™ comes in direct contact with ice or if it is exposed to temperatures below 36 degrees F, it may be ruined. If it becomes thin like milk or has a watery substance in the syringe, notify your pharmacy; your Prokarin™ has likely gotten too cold. Also if when you remove your patch, the Prokarin™ has a clear liquid like water droplets around a white gummy paste, then the Prokarin™ has separated, again probably due to excessively cold temperature. Again, notify your pharmacy if this occurs.
• When traveling with Prokarin™, take only as many doses as you will need (allowing a couple of extra doses just in case a dose is wasted accidentally). An insulated 6-pack carrier works well when traveling. Place a zip lock bag of ice in the bottom of the carrier. Then put the needed number of Prokarin™ syringes in an amber zip lock bag. (Ask your pharmacy for an extra amber zip lock bag.) Wrap the amber zip lock bag of Prokarin™ in a Styrofoam® wrap or bubble wrap so that there are at least 3 layers of Styrofoam® or bubble wrap around the amber bag. Secure the wrap around the Prokarin™ with a rubber band. Place the Prokarin™, which is now protected by Styrofoam® or bubble wrap, on top of the ice in the bottom of the carrier. Then place another zip lock bag of ice on top of the wrapped Prokarin™. It is wise to put a refrigerator thermometer in the carrier at the same level as the Prokarin™ to monitor the temperature.
• If you plan to put your Prokarin™ in a refrigerator in a motel room or at your final destination, be sure to check the refrigerator temperature with your thermometer for at least 1 hour before transferring your Prokarin™ from the insulated 6 pack carrier to the refrigerator. Many refrigerators may be set too cold.

Please call your pharmacist to provide you with a video that demonstrates the proper storage for traveling as well as how to apply the patch.

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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 night and day 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 a little 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 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 molecule so a person may experience the overwhelming fatigue. By giving the body back the 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 Prokarin™? 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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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 the 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 the toes, relax 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 other 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’s okay. Relax 5-10 seconds and try again.

Soon there will be a video available from your pharmacy that compounds Prokarin™, which demonstrates exercises that are used by professionals who teach kinesthetic exercises to rebuild nerve pathways.

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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: 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 a lessening in heat intolerance.
• Are you applying the patch in the morning as close to when you wake up as possible and 8 hours later are you removing that patch and applying the second patch? Please see the section on Patching Times.
• When you remove the patch, is the cream as moist as a lotion and does it rub into your skin and disappear, or does it leave a white chalky residue on the skin after you rub it in? Generally when you remove the patch, the cream that is left should simply rub into your skin with only 2-3 rubs of the palm of your hand and vanish like a lotion. If it leaves a white chalky residue, then air has gotten under the patch. If this is happening, please see the section on Getting the Patch Sealed.
• Are you storing the Prokarin™ properly? Prokarin™ needs to be stored in the refrigerator, preferably in the door with a thermometer right on the shelf with it. The temperature should be 40-42 Degrees Fahrenheit optimal. If the temperature is 36 Degrees Fahrenheit or less, the Prokarin™ will be ruined. If you are having problems with this or suspect this, please see the section on Storage for information.
• The consistency of Prokarin™ is of utmost importance in regards to its potency. Hold the syringe with the tip touching the patch at a 45 Degree angle and press on the plunger of the syringe. The Prokarin™ should come out of the syringe looking fluffy like a foam shaving cream or stiff whipped cream. If it comes out of the syringe in a column like a toothpaste or a spaghetti noodle, then the Prokarin™ is too thick and will exert a weak effect. The thicker the Prokarin™, the slower it releases the active ingredients, and if the ingredients are released too slowly they will not produce any therapeutic effect. It is very important that the Prokarin™ be of a foam shaving cream or stiff whipped cream consistency. If your Prokarin™ doesn’t have this consistency, notify your pharmacy.
• Shipping is also a variable. Prokarin™ is very temperature sensitive. There is a possibility that the Prokarin™ could have gotten too cold during shipping especially in cold weather. A good indication of this is when you push on the plunger of the syringe to dispense the Prokarin™, it may look watery, thin, or milky. When you take the patch off, you may notice a clear liquid separated from the white cream, which leaves a gummy or clumpy white residue. If this is the case, the Prokarin™ has probably frozen and you need to contact your pharmacy.
  It is harder to determine if the Prokarin™ got too warm in transport. 40-42 degrees F is the perfect temperature for Prokarin™. If it had gotten up to 50-54 degrees F during shipping, it probably will still remain effective, but may not last the whole 30 days. The shelf life of Prokarin™ shortens when exposed to higher temperatures. If at any time it was greater than 50 degrees F, contact your pharmacist about getting new Prokarin™.
  If you suspect that your Prokarin™ has been exposed to temperatures outside the ideal range, please see the section on storage.
• If you are applying Prokarin™, of the proper consistency which as been stored at the right temperature of 40-42 degrees F, two times a day for 8 hours each time, and you are getting the patch sealed from air so that the cream disappears like a lotion, then perhaps it could be your diet.
  
  Are you on a low fat diet?
  Do you take the recommended supplements?
  Please refer to the recommended Supplements and Diet section.
  
  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, 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:

Unfortunately Prokarin™ is a very fragile compound that can lose its shelf life very easily even under optimum conditions. If you saw improvements with your first batch and then not with your second batch look for a couple of things:
• Is the consistency of the Prokarin™ the same as the last batches? Is it fluffy like foam shaving cream or thicker like a column of toothpaste or a spaghetti noodle? See the section on Consistency.
• Are you on a low fat diet? See the section on Diet.
• Is the temperature of your refrigerator 40-42 degrees F? See the section on Storage.
  d) Is it near the end of your 30-day supply of Prokarin™? Prokarin™ has a shelf life of 60-70 days from the date it was compounded, under optimum 40-42 degrees F conditions. Many variables can influence the shelf life.
• Are you taking the recommended supplements? See the section on Supplements?

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Question:
I started Prokarin™ and after about 3 days all my symptoms got 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 Prokarin™ dose is too high for you and it 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 patch. 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 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 Prokarin™, so you got a carry over effect. By the third or 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 a 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 plateaued, 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™?

Some people are using bee venom therapy and Prokarin™ and have reported needing fewer stings with Prokarin™. It may be wise to stop stings when starting Prokarin™, then add stings; 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 body. 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 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 pharmacist and doctor about this. The amount of caffeine in one 8-hour dose is equivalent to about a half cup of regular strength coffee sipped over 8 hours.

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