how can i convince my primary care dr to let me use vanco? My situation is that I clearly have PSC on MRI’s and I feel liver pain daily but my numbers are normal. I believe that starting early may help save me from a liver transplant.
Thanks for your advice
Tom
You should not be relying on a primary care physician for diagnosing and managing PSC. You need to go to a heptologist connected to a transplant hospital. The heptologist is best suited to diagnose PSC. For my son, the critical elements for the diagnosis were the elevated blood tests, the MRI showing bile duct inflamation and a colonoscopy, which showed Crohn’s. Depending on where you live, some people here can recommend potential heptologists who will prescribe Vanco. Also, on this site is plenty of research information. Put the homework together and present it to your doctor.
Update after 9 months on Vanco (one month on Lupin brand capsules):
ALP: 157 (normal range 35-144)
9 months ago my ALP was 492.
AST: 36 (normal range 10-35)
ALT: 62 (normal range 9-46)
GGT: 173 (normal range 3-95)
I was hoping to have LFTs normalized in 3-6 months, but I’m still cautiously optimistic that Vanco is working. At least general downward trend happened after Vanco started.
Based on the research literature, ALP needs to get lower than 1.5x normal range upper limit (those who achieve that had lower rate of a composite outcome (liver decompensation, liver transplantation, liver related deaths, cholangiocarcinoma) compared to those who did not).
Ulcerative colitis is better than ever (stool looks normal most of the time, never been like in at least in the last 20 years).
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Update after 10 months on Vanco (last 2 months taking Lupin brand):
ALP: 137 (within normal range, finally!)
AST: 37 (normal range 10-35)
ALT: 51 (normal range 9-46)
GGT: 148 (normal range 3-95)
Ulcerative colitis also under control. MRI looked very good.
I think Vancomycin is clearly working here, so I plan to continue with the current approach.
Ted, that’s wonderful news. I’m so glad to hear that your numbers have normalized. I have found with several problems I had in the last three years Now almost 9 years Post Transplant, that I am continuing on 250 mg of vancomycin four times a day to keep my bile ducts inflammation under control. It has made a big difference.
Mark