ABPA

lilywing · Jan 12, 2009

Hi,
I was told that I have ABPA this past summer. My IgE is about 500. Is there any way to bring it down without prednisone? I really DON'T want to go down that road. Also, do you have to treat ABPA if the aspergillus count is low/zero?

lilywing · Jan 12, 2009

Hi,
I was told that I have ABPA this past summer. My IgE is about 500. Is there any way to bring it down without prednisone? I really DON'T want to go down that road. Also, do you have to treat ABPA if the aspergillus count is low/zero?

lilywing · Jan 12, 2009

Hi,
I was told that I have ABPA this past summer. My IgE is about 500. Is there any way to bring it down without prednisone? I really DON'T want to go down that road. Also, do you have to treat ABPA if the aspergillus count is low/zero?

lilywing · Jan 12, 2009

Hi,
I was told that I have ABPA this past summer. My IgE is about 500. Is there any way to bring it down without prednisone? I really DON'T want to go down that road. Also, do you have to treat ABPA if the aspergillus count is low/zero?

lilywing · Jan 12, 2009

Hi,
 I was told that I have ABPA this past summer. My IgE is about 500. Is there any way to bring it down without prednisone? I really DON'T want to go down that road. Also, do you have to treat ABPA if the aspergillus count is low/zero?

carmick · Jan 12, 2009

I don't know if it will help if you are colonized with aspergillus, but whenever I've grown it I've been prescribed Vfend (voriconazole). I've had a couple docs tell me it's the only antifungal that really works well on aspergillus. Unfortunately, it's expensive so check to see what your insurance will cover. One course has always knocked it out for me.

<a target=_blank class=ftalternatingbarlinklarge href="http://www.nlm.nih.gov/medlineplus/druginfo/meds/a605022.html">null</a>

carmick · Jan 12, 2009

I don't know if it will help if you are colonized with aspergillus, but whenever I've grown it I've been prescribed Vfend (voriconazole). I've had a couple docs tell me it's the only antifungal that really works well on aspergillus. Unfortunately, it's expensive so check to see what your insurance will cover. One course has always knocked it out for me.

<a target=_blank class=ftalternatingbarlinklarge href="http://www.nlm.nih.gov/medlineplus/druginfo/meds/a605022.html">null</a>

carmick · Jan 12, 2009

I don't know if it will help if you are colonized with aspergillus, but whenever I've grown it I've been prescribed Vfend (voriconazole). I've had a couple docs tell me it's the only antifungal that really works well on aspergillus. Unfortunately, it's expensive so check to see what your insurance will cover. One course has always knocked it out for me.

<a target=_blank class=ftalternatingbarlinklarge href="http://www.nlm.nih.gov/medlineplus/druginfo/meds/a605022.html">null</a>

carmick · Jan 12, 2009

I don't know if it will help if you are colonized with aspergillus, but whenever I've grown it I've been prescribed Vfend (voriconazole). I've had a couple docs tell me it's the only antifungal that really works well on aspergillus. Unfortunately, it's expensive so check to see what your insurance will cover. One course has always knocked it out for me.

<a target=_blank class=ftalternatingbarlinklarge href="http://www.nlm.nih.gov/medlineplus/druginfo/meds/a605022.html">null</a>

carmick · Jan 12, 2009

I don't know if it will help if you are colonized with aspergillus, but whenever I've grown it I've been prescribed Vfend (voriconazole). I've had a couple docs tell me it's the only antifungal that really works well on aspergillus. Unfortunately, it's expensive so check to see what your insurance will cover. One course has always knocked it out for me.
 
 <a target=_blank class=ftalternatingbarlinklarge href="http://www.nlm.nih.gov/medlineplus/druginfo/meds/a605022.html">null</a>

Havoc · Jan 13, 2009

Lilywing: Steroids have been traditionally the staple treatment of ABPA. There are other choices other than prednisone. Some people do better with Decadron, the only disadvantage to Decadron is its long half-life (and all of the side effects still apply). There is also the Xolair I mentioned earlier, but it's a relatively new approach to APBA treatment and your doc may not be familiar with it yet. If your IgE is 500 and you are not culturing aspergillus then likely there some other allergen that you are reacting to. One route to go would be to obtain an aspergillus specific IgE.

Carmick: Regarding itraconazole/voriconazole and ABPA. There is some debate whether it is always necessary to treat with an antifungal. Typically the aspergillus colonizes the mucus and doesn't invade the cells. Therefore an oral antifungal may not be of much use. Some docs treat with an antifungal simply to cover all the bases. All of the antifungals are fairly hard on your liver.

Havoc · Jan 13, 2009

Lilywing: Steroids have been traditionally the staple treatment of ABPA. There are other choices other than prednisone. Some people do better with Decadron, the only disadvantage to Decadron is its long half-life (and all of the side effects still apply). There is also the Xolair I mentioned earlier, but it's a relatively new approach to APBA treatment and your doc may not be familiar with it yet. If your IgE is 500 and you are not culturing aspergillus then likely there some other allergen that you are reacting to. One route to go would be to obtain an aspergillus specific IgE.

Carmick: Regarding itraconazole/voriconazole and ABPA. There is some debate whether it is always necessary to treat with an antifungal. Typically the aspergillus colonizes the mucus and doesn't invade the cells. Therefore an oral antifungal may not be of much use. Some docs treat with an antifungal simply to cover all the bases. All of the antifungals are fairly hard on your liver.

Havoc · Jan 13, 2009

Lilywing: Steroids have been traditionally the staple treatment of ABPA. There are other choices other than prednisone. Some people do better with Decadron, the only disadvantage to Decadron is its long half-life (and all of the side effects still apply). There is also the Xolair I mentioned earlier, but it's a relatively new approach to APBA treatment and your doc may not be familiar with it yet. If your IgE is 500 and you are not culturing aspergillus then likely there some other allergen that you are reacting to. One route to go would be to obtain an aspergillus specific IgE.

Carmick: Regarding itraconazole/voriconazole and ABPA. There is some debate whether it is always necessary to treat with an antifungal. Typically the aspergillus colonizes the mucus and doesn't invade the cells. Therefore an oral antifungal may not be of much use. Some docs treat with an antifungal simply to cover all the bases. All of the antifungals are fairly hard on your liver.

Havoc · Jan 13, 2009

Lilywing: Steroids have been traditionally the staple treatment of ABPA. There are other choices other than prednisone. Some people do better with Decadron, the only disadvantage to Decadron is its long half-life (and all of the side effects still apply). There is also the Xolair I mentioned earlier, but it's a relatively new approach to APBA treatment and your doc may not be familiar with it yet. If your IgE is 500 and you are not culturing aspergillus then likely there some other allergen that you are reacting to. One route to go would be to obtain an aspergillus specific IgE.

Carmick: Regarding itraconazole/voriconazole and ABPA. There is some debate whether it is always necessary to treat with an antifungal. Typically the aspergillus colonizes the mucus and doesn't invade the cells. Therefore an oral antifungal may not be of much use. Some docs treat with an antifungal simply to cover all the bases. All of the antifungals are fairly hard on your liver.

Havoc · Jan 13, 2009

Lilywing: Steroids have been traditionally the staple treatment of ABPA. There are other choices other than prednisone. Some people do better with Decadron, the only disadvantage to Decadron is its long half-life (and all of the side effects still apply). There is also the Xolair I mentioned earlier, but it's a relatively new approach to APBA treatment and your doc may not be familiar with it yet. If your IgE is 500 and you are not culturing aspergillus then likely there some other allergen that you are reacting to. One route to go would be to obtain an aspergillus specific IgE.
 
 Carmick: Regarding itraconazole/voriconazole and ABPA. There is some debate whether it is always necessary to treat with an antifungal. Typically the aspergillus colonizes the mucus and doesn't invade the cells. Therefore an oral antifungal may not be of much use. Some docs treat with an antifungal simply to cover all the bases. All of the antifungals are fairly hard on your liver.

mom2lillian · Jan 13, 2009

Ok I think I can be of some help here so...

1-once you have ABPA you have it so you can't prevent getting it in the future. ABPA is a difficult diagnosis to make so it is possible you could be told you have ABPA but then the high IGE was actually a one time thing and it was not ABPA but you cant have it and then get rid of it (though a 'remission stage' is possible more to follow).

2-If you are receiving itraconazole you most likely also cultured aspergillus and that in conjunction with a high IGE is pretty much a sure bet ABPA. HOwever you do not HAVE to culture aspergillus to have ABPA (I for one have never cultured it). Generally they will only treat with an anti-fungal if you have cultured or they suspect that you are culturing aspergillus. ABPA without a culture would normally be treated with steroids first. Some people will have high IGE with no apparent effects and some doctors will choose not to treat (though I am not a fan of this as you could always be doing better than you are).

3-although taking steroids is not something you want to do all the time its definately the lesser of the evils. It is best to get it under control asap and then try to prevent future flare-ups to avoid the steroids.

4-your ABPA may not flare up frequently. I was dx with ABPA ~6 years ago and have not had to do another long dose steroid treatment for it.

5-the typical treatment for ABPA is to treat with steroids until your IGE is reduced by at least half and then taper you off.

6-The best thing you can do for ABPA is to AVOID the situations that can expose you to mold. YOu can google 'household mold exposure' and other items and find a wealth of information on areas mold hides out that you might find surprising (wet paint for instance or the rubber seal in your fridge and freezer). Then of course there are pools rivers mop rooms (anywhere that is repeatedly wet or with standing water) leaves etc etc etc. Unfortunately the list is endless so figure out where you might be at increased risk and do what you can. I for one cant stand a musty bathroom so I wipe mine down including wall with dilute bleach and spray shower with bleach regularly. We have a damp basement that is unfinished so we purchased a dehumidifier and if it gets damp hubbys sprays bleach down there.

7-regarding xolair you can visit my blog (mom2lillian) and see my experience with it, it has been HUGE for me. it is not an approved abpa treatment and your cf doc will most likely not touch it unless they are very progressive or you are having massive problems for which steroids are not working. I went to an allergist as especially with having ABPA you want to get any and all allergies under control that you can, especially MOLD allergies that you almost certainly have. If you meet the criteria (any cf'er with elevated IGE would) then you should be eligible through their office as long as they are willing to step on a few toes of the cf doc, I had mine write a ltter letting them know and the lack of a response from CF doc was our go ahead.

8-Xolair is only effective if your ige is under 1000 so waiting until tehre is a problem (like I saw previously mentioned) is NOT a good idea, my number at dx was 1200 so it would not have been an option then. Also xolair is not something you can get started on quickly it requires bloodwork and a literal application to the company. Additionally xolair is not subcutaneous injection it is intramuscular and given in the arm. Its 1-2 shots 1-2 times a month not a huge deal in scheme of things, it stings a bit.

9-xolair is super expensive (though not moreso than say TOBI) it is given 2-4 week increments which is dependent upon weight and IGE level. Because my IGE resides at 3-400 range when in 'remission' I have to get larger dose and go every other week and it is just over 1000 each time. I believe range would be from 500-2000 a month as I dont think it gets higher than what I am taking and I believe 1/2 of what I am taking only once per month would be the minimum.

feel free to email me or PM me over on my blog
<a target=_blank class=ftalternatingbarlinklarge href="http://cftoo.blogspot.com/
">"><a target=_blank class=ftalternatingbarlinklarge href="http://cftoo.blogspot.com/
 http://cftoo.blogspot.com/
</a></a>

Nicole

mom2lillian · Jan 13, 2009

Ok I think I can be of some help here so...

1-once you have ABPA you have it so you can't prevent getting it in the future. ABPA is a difficult diagnosis to make so it is possible you could be told you have ABPA but then the high IGE was actually a one time thing and it was not ABPA but you cant have it and then get rid of it (though a 'remission stage' is possible more to follow).

2-If you are receiving itraconazole you most likely also cultured aspergillus and that in conjunction with a high IGE is pretty much a sure bet ABPA. HOwever you do not HAVE to culture aspergillus to have ABPA (I for one have never cultured it). Generally they will only treat with an anti-fungal if you have cultured or they suspect that you are culturing aspergillus. ABPA without a culture would normally be treated with steroids first. Some people will have high IGE with no apparent effects and some doctors will choose not to treat (though I am not a fan of this as you could always be doing better than you are).

3-although taking steroids is not something you want to do all the time its definately the lesser of the evils. It is best to get it under control asap and then try to prevent future flare-ups to avoid the steroids.

4-your ABPA may not flare up frequently. I was dx with ABPA ~6 years ago and have not had to do another long dose steroid treatment for it.

5-the typical treatment for ABPA is to treat with steroids until your IGE is reduced by at least half and then taper you off.

6-The best thing you can do for ABPA is to AVOID the situations that can expose you to mold. YOu can google 'household mold exposure' and other items and find a wealth of information on areas mold hides out that you might find surprising (wet paint for instance or the rubber seal in your fridge and freezer). Then of course there are pools rivers mop rooms (anywhere that is repeatedly wet or with standing water) leaves etc etc etc. Unfortunately the list is endless so figure out where you might be at increased risk and do what you can. I for one cant stand a musty bathroom so I wipe mine down including wall with dilute bleach and spray shower with bleach regularly. We have a damp basement that is unfinished so we purchased a dehumidifier and if it gets damp hubbys sprays bleach down there.

7-regarding xolair you can visit my blog (mom2lillian) and see my experience with it, it has been HUGE for me. it is not an approved abpa treatment and your cf doc will most likely not touch it unless they are very progressive or you are having massive problems for which steroids are not working. I went to an allergist as especially with having ABPA you want to get any and all allergies under control that you can, especially MOLD allergies that you almost certainly have. If you meet the criteria (any cf'er with elevated IGE would) then you should be eligible through their office as long as they are willing to step on a few toes of the cf doc, I had mine write a ltter letting them know and the lack of a response from CF doc was our go ahead.

8-Xolair is only effective if your ige is under 1000 so waiting until tehre is a problem (like I saw previously mentioned) is NOT a good idea, my number at dx was 1200 so it would not have been an option then. Also xolair is not something you can get started on quickly it requires bloodwork and a literal application to the company. Additionally xolair is not subcutaneous injection it is intramuscular and given in the arm. Its 1-2 shots 1-2 times a month not a huge deal in scheme of things, it stings a bit.

9-xolair is super expensive (though not moreso than say TOBI) it is given 2-4 week increments which is dependent upon weight and IGE level. Because my IGE resides at 3-400 range when in 'remission' I have to get larger dose and go every other week and it is just over 1000 each time. I believe range would be from 500-2000 a month as I dont think it gets higher than what I am taking and I believe 1/2 of what I am taking only once per month would be the minimum.

feel free to email me or PM me over on my blog
<a target=_blank class=ftalternatingbarlinklarge href="http://cftoo.blogspot.com/
">"><a target=_blank class=ftalternatingbarlinklarge href="http://cftoo.blogspot.com/
 http://cftoo.blogspot.com/
</a></a>

Nicole

mom2lillian · Jan 13, 2009

Ok I think I can be of some help here so...

1-once you have ABPA you have it so you can't prevent getting it in the future. ABPA is a difficult diagnosis to make so it is possible you could be told you have ABPA but then the high IGE was actually a one time thing and it was not ABPA but you cant have it and then get rid of it (though a 'remission stage' is possible more to follow).

2-If you are receiving itraconazole you most likely also cultured aspergillus and that in conjunction with a high IGE is pretty much a sure bet ABPA. HOwever you do not HAVE to culture aspergillus to have ABPA (I for one have never cultured it). Generally they will only treat with an anti-fungal if you have cultured or they suspect that you are culturing aspergillus. ABPA without a culture would normally be treated with steroids first. Some people will have high IGE with no apparent effects and some doctors will choose not to treat (though I am not a fan of this as you could always be doing better than you are).

3-although taking steroids is not something you want to do all the time its definately the lesser of the evils. It is best to get it under control asap and then try to prevent future flare-ups to avoid the steroids.

4-your ABPA may not flare up frequently. I was dx with ABPA ~6 years ago and have not had to do another long dose steroid treatment for it.

5-the typical treatment for ABPA is to treat with steroids until your IGE is reduced by at least half and then taper you off.

6-The best thing you can do for ABPA is to AVOID the situations that can expose you to mold. YOu can google 'household mold exposure' and other items and find a wealth of information on areas mold hides out that you might find surprising (wet paint for instance or the rubber seal in your fridge and freezer). Then of course there are pools rivers mop rooms (anywhere that is repeatedly wet or with standing water) leaves etc etc etc. Unfortunately the list is endless so figure out where you might be at increased risk and do what you can. I for one cant stand a musty bathroom so I wipe mine down including wall with dilute bleach and spray shower with bleach regularly. We have a damp basement that is unfinished so we purchased a dehumidifier and if it gets damp hubbys sprays bleach down there.

7-regarding xolair you can visit my blog (mom2lillian) and see my experience with it, it has been HUGE for me. it is not an approved abpa treatment and your cf doc will most likely not touch it unless they are very progressive or you are having massive problems for which steroids are not working. I went to an allergist as especially with having ABPA you want to get any and all allergies under control that you can, especially MOLD allergies that you almost certainly have. If you meet the criteria (any cf'er with elevated IGE would) then you should be eligible through their office as long as they are willing to step on a few toes of the cf doc, I had mine write a ltter letting them know and the lack of a response from CF doc was our go ahead.

8-Xolair is only effective if your ige is under 1000 so waiting until tehre is a problem (like I saw previously mentioned) is NOT a good idea, my number at dx was 1200 so it would not have been an option then. Also xolair is not something you can get started on quickly it requires bloodwork and a literal application to the company. Additionally xolair is not subcutaneous injection it is intramuscular and given in the arm. Its 1-2 shots 1-2 times a month not a huge deal in scheme of things, it stings a bit.

9-xolair is super expensive (though not moreso than say TOBI) it is given 2-4 week increments which is dependent upon weight and IGE level. Because my IGE resides at 3-400 range when in 'remission' I have to get larger dose and go every other week and it is just over 1000 each time. I believe range would be from 500-2000 a month as I dont think it gets higher than what I am taking and I believe 1/2 of what I am taking only once per month would be the minimum.

feel free to email me or PM me over on my blog
<a target=_blank class=ftalternatingbarlinklarge href="http://cftoo.blogspot.com/
">"><a target=_blank class=ftalternatingbarlinklarge href="http://cftoo.blogspot.com/
 http://cftoo.blogspot.com/
</a></a>

Nicole

mom2lillian · Jan 13, 2009

Ok I think I can be of some help here so...

1-once you have ABPA you have it so you can't prevent getting it in the future. ABPA is a difficult diagnosis to make so it is possible you could be told you have ABPA but then the high IGE was actually a one time thing and it was not ABPA but you cant have it and then get rid of it (though a 'remission stage' is possible more to follow).

2-If you are receiving itraconazole you most likely also cultured aspergillus and that in conjunction with a high IGE is pretty much a sure bet ABPA. HOwever you do not HAVE to culture aspergillus to have ABPA (I for one have never cultured it). Generally they will only treat with an anti-fungal if you have cultured or they suspect that you are culturing aspergillus. ABPA without a culture would normally be treated with steroids first. Some people will have high IGE with no apparent effects and some doctors will choose not to treat (though I am not a fan of this as you could always be doing better than you are).

3-although taking steroids is not something you want to do all the time its definately the lesser of the evils. It is best to get it under control asap and then try to prevent future flare-ups to avoid the steroids.

4-your ABPA may not flare up frequently. I was dx with ABPA ~6 years ago and have not had to do another long dose steroid treatment for it.

5-the typical treatment for ABPA is to treat with steroids until your IGE is reduced by at least half and then taper you off.

6-The best thing you can do for ABPA is to AVOID the situations that can expose you to mold. YOu can google 'household mold exposure' and other items and find a wealth of information on areas mold hides out that you might find surprising (wet paint for instance or the rubber seal in your fridge and freezer). Then of course there are pools rivers mop rooms (anywhere that is repeatedly wet or with standing water) leaves etc etc etc. Unfortunately the list is endless so figure out where you might be at increased risk and do what you can. I for one cant stand a musty bathroom so I wipe mine down including wall with dilute bleach and spray shower with bleach regularly. We have a damp basement that is unfinished so we purchased a dehumidifier and if it gets damp hubbys sprays bleach down there.

7-regarding xolair you can visit my blog (mom2lillian) and see my experience with it, it has been HUGE for me. it is not an approved abpa treatment and your cf doc will most likely not touch it unless they are very progressive or you are having massive problems for which steroids are not working. I went to an allergist as especially with having ABPA you want to get any and all allergies under control that you can, especially MOLD allergies that you almost certainly have. If you meet the criteria (any cf'er with elevated IGE would) then you should be eligible through their office as long as they are willing to step on a few toes of the cf doc, I had mine write a ltter letting them know and the lack of a response from CF doc was our go ahead.

8-Xolair is only effective if your ige is under 1000 so waiting until tehre is a problem (like I saw previously mentioned) is NOT a good idea, my number at dx was 1200 so it would not have been an option then. Also xolair is not something you can get started on quickly it requires bloodwork and a literal application to the company. Additionally xolair is not subcutaneous injection it is intramuscular and given in the arm. Its 1-2 shots 1-2 times a month not a huge deal in scheme of things, it stings a bit.

9-xolair is super expensive (though not moreso than say TOBI) it is given 2-4 week increments which is dependent upon weight and IGE level. Because my IGE resides at 3-400 range when in 'remission' I have to get larger dose and go every other week and it is just over 1000 each time. I believe range would be from 500-2000 a month as I dont think it gets higher than what I am taking and I believe 1/2 of what I am taking only once per month would be the minimum.

feel free to email me or PM me over on my blog
<a target=_blank class=ftalternatingbarlinklarge href="http://cftoo.blogspot.com/
">"><a target=_blank class=ftalternatingbarlinklarge href="http://cftoo.blogspot.com/
 http://cftoo.blogspot.com/
</a></a>

Nicole

mom2lillian · Jan 13, 2009

Ok I think I can be of some help here so...
 
 1-once you have ABPA you have it so you can't prevent getting it in the future. ABPA is a difficult diagnosis to make so it is possible you could be told you have ABPA but then the high IGE was actually a one time thing and it was not ABPA but you cant have it and then get rid of it (though a 'remission stage' is possible more to follow).
 
 2-If you are receiving itraconazole you most likely also cultured aspergillus and that in conjunction with a high IGE is pretty much a sure bet ABPA. HOwever you do not HAVE to culture aspergillus to have ABPA (I for one have never cultured it). Generally they will only treat with an anti-fungal if you have cultured or they suspect that you are culturing aspergillus. ABPA without a culture would normally be treated with steroids first. Some people will have high IGE with no apparent effects and some doctors will choose not to treat (though I am not a fan of this as you could always be doing better than you are).
 
 3-although taking steroids is not something you want to do all the time its definately the lesser of the evils. It is best to get it under control asap and then try to prevent future flare-ups to avoid the steroids.
 
 4-your ABPA may not flare up frequently. I was dx with ABPA ~6 years ago and have not had to do another long dose steroid treatment for it.
 
 5-the typical treatment for ABPA is to treat with steroids until your IGE is reduced by at least half and then taper you off.
 
 6-The best thing you can do for ABPA is to AVOID the situations that can expose you to mold. YOu can google 'household mold exposure' and other items and find a wealth of information on areas mold hides out that you might find surprising (wet paint for instance or the rubber seal in your fridge and freezer). Then of course there are pools rivers mop rooms (anywhere that is repeatedly wet or with standing water) leaves etc etc etc. Unfortunately the list is endless so figure out where you might be at increased risk and do what you can. I for one cant stand a musty bathroom so I wipe mine down including wall with dilute bleach and spray shower with bleach regularly. We have a damp basement that is unfinished so we purchased a dehumidifier and if it gets damp hubbys sprays bleach down there.
 
 7-regarding xolair you can visit my blog (mom2lillian) and see my experience with it, it has been HUGE for me. it is not an approved abpa treatment and your cf doc will most likely not touch it unless they are very progressive or you are having massive problems for which steroids are not working. I went to an allergist as especially with having ABPA you want to get any and all allergies under control that you can, especially MOLD allergies that you almost certainly have. If you meet the criteria (any cf'er with elevated IGE would) then you should be eligible through their office as long as they are willing to step on a few toes of the cf doc, I had mine write a ltter letting them know and the lack of a response from CF doc was our go ahead.
 
 8-Xolair is only effective if your ige is under 1000 so waiting until tehre is a problem (like I saw previously mentioned) is NOT a good idea, my number at dx was 1200 so it would not have been an option then. Also xolair is not something you can get started on quickly it requires bloodwork and a literal application to the company. Additionally xolair is not subcutaneous injection it is intramuscular and given in the arm. Its 1-2 shots 1-2 times a month not a huge deal in scheme of things, it stings a bit.
 
 9-xolair is super expensive (though not moreso than say TOBI) it is given 2-4 week increments which is dependent upon weight and IGE level. Because my IGE resides at 3-400 range when in 'remission' I have to get larger dose and go every other week and it is just over 1000 each time. I believe range would be from 500-2000 a month as I dont think it gets higher than what I am taking and I believe 1/2 of what I am taking only once per month would be the minimum.
 
 feel free to email me or PM me over on my blog
 <a target=_blank class=ftalternatingbarlinklarge href="http://cftoo.blogspot.com/
">"><a target=_blank class=ftalternatingbarlinklarge href="http://cftoo.blogspot.com/
 http://cftoo.blogspot.com/
</a> </a>
 
 
 Nicole

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