Friday, May 9, 2014

Bits and Pieces: Neurologists' Conference Edition (also: Tysabri,Tecfidera, Marijuana, Mold, Asinine Research, and other goodies)

(For those who receive Wheelchair Kamikaze via email, the following post contains videos which can be seen on the WK website – click here)

It’s time once again for Wheelchair Kamikaze’s semi regular compendium of MS news and notes.

Last week the American Academy of Neurology (AAN) held its annual meeting, this year held in Philadelphia. This weeklong event brings together some of the world’s best minds in neurology, and features presentations on all the latest and greatest research. I found it quite striking that this year’s multiple sclerosis presentations almost all had to do with information gleaned from drug trials, but since practically all mid to late stage medical research is conducted by the big pharmaceutical companies, I guess I shouldn’t be surprised. Most of the fault lies not with the drug companies themselves, but with the system within which they operate, which has handed these companies the reins of medical scientific investigation as governments and academia are increasingly less able to fund research due to the current political and economic climate. As a result, our medical research model is becoming more and more dysfunctional, with many potentially paradigm shifting basic research studies never making it out of the lab. Yippee!

I sometimes think about how strange life must be for neurologists who specialize in the most debilitating diseases of the nervous system, none of which have yet to be sufficiently remedied. Doctors practicing most other areas of medicine can look with satisfaction on the patients they’ve cured, but many neuros can spend their entire careers without ever having rid a patient of disease. I can’t help but imagine a group of specialist neurologists getting together at their annual meeting and quickly summarizing the major clinical advances of the past 12 months. “Let’s see, have we cured Parkinson’s disease?” “Nope…” “Okay, how about Huntington’s disease?” “Nope…” “Multiple sclerosis?” “Nope…” “Alzheimer’s?” “Nope…” “Muscular dystrophy?” “Nope…” “ALS?” “Nope…” “Right then, that sucks.... Anybody else really need a drink?…”

Okay, enough of my mental meanderings, here’s my latest collection of mostly MS related research and news, selected solely on the basis of what I deem to be important and/or interesting. Hey, it’s my blog and in this little corner of the Internet I rule with an iron fist. Actually, given my current state of physical decrepitude I’m not sure I could properly muster an iron fist, so I guess I’ll have to be satisfied ruling with a less than formidable half assed fist. Hey, we’ve gotta play the cards we’re dealt…

♦ First up, a sampling of the MS drug news that came out of the AAN meetings. Tysabri was shown to positively impact walking speed in some patients (click here). While at first glance this sounds impressive and could be an indicator that the drug has a positive impact on disease progression, digging down a little deeper leaves me less than knocked out. Slightly over 12% of patients on Tysabri demonstrated improved walking speeds over the course of two years of treatment, which really isn’t bad, but about 7% of patients treated with a placebo also managed a significant improvement in walking speed, which just goes to show you how variable is the nature of relapsing remitting MS. Tysabri did prove to be about 80% better than placebo in this regard, and since most patients would gladly settle for a state of stasis in their disease, any signs of improvement are a big plus. Researchers did find that this effect was more pronounced in patients with more advanced disability, with walking speed increased by as much as five times when compared to placebo in this patient group, which does make the research more compelling.

A small phase 2 trial of Tysabri on SPMS patients came up with encouraging outcomes (click here). In this study, 24 SPMS patients were treated with Tysabri for 60 months, and levels of osteopontin, a marker for inflammation, were tracked in their cerebrospinal fluid. Several other biomarkers were also tracked, and after 60 weeks of treatment statistically significant decreases in markers for inflammation, axonal damage, and demyelination were recorded. These are impressive findings, especially since there are currently no proven treatments for secondary progressive disease. Of course, these results will have to be replicated in larger trials, but this seems to be an encouraging start.

♦ In Tecfidera news, the oral MS drug was shown to be effective when used on patients with highly active disease, reducing annual relapse rates by 60% and the proportion of patients who relapsed by 63% when compared to placebo (click here). I know that many patients are concerned about Tecfidera’s uncomfortable side effects, and a study looking at gastrointestinal side effects in patients taking the drug found that “GI events were largely transient, occurred most frequently in the first month of therapy and were mostly reported as mild to moderate in severity. By the 10th week of treatment, less than 10 percent of patients reported GI AEs. The incidence of discontinuation due to GI-related AEs was low (7.3 percent).”

There has been much conjecture as to Tecfidera’s primary method of action (in other words, why it works), and a study out of Germany demonstrates that the drug keeps certain immune system cells out of the central nervous system (click here). It’s already been established that Tecfidera has immunosuppressive properties, and it is suspected that the compound also has anti-inflammatory and antioxidant properties as well. Based on the latter suspected properties, some have speculated that the efficacy of Tecfidera could be replicated using a combination of dietary supplements, but since immunosuppression seems to be the drug’s primary method of attack such an approach likely wouldn’t duplicate the effectiveness of the drug.

♦ Okay, let’s turn away from the world of pharmaceuticals and take a look at some recent research regarding more “natural” approaches at treating MS. Green tea has long been extolled as a powerful antioxidant, and a recent study demonstrated that green tea extract has a positive impact on cognitive function (click here). In this small study, healthy volunteers were given green tea extract and then asked to do memory tasks while undergoing functional MRI imaging. The imaging showed that the extract appeared to improve conductivity between certain areas of the brain, and these areas correlated with improved memory function. Happy to hear it, as I take green tea extract every day…

♦ The human gut is home to a wide variety of bacteria, which are known to help with the process of digestion. Doctors have noted for some time that there seems to be some correlation between the gut and so-called autoimmune diseases, and a recent study bears this out (click here-registration may be required, but it’s free and well worth it). Researchers compared the microorganisms contained in the guts of MS patients with those found in healthy subjects, and discovered that MS patients have higher levels of a bacteria that is known to stimulate the immune system, and lower levels of two other types of microorganisms that excrete anti-inflammatory substances. Fascinating findings, I think, which definitely hint at reasons for an immune system gone haywire. Just goes to show how many different elements come into play in the complicated MS disease puzzle, and how many different approaches might be taken to treat the illness.

♦ Here in the US, more and more states are legalizing medical marijuana and a few are even making it legal to use the stuff for recreational purposes. Ganja has been touted as an effective treatment for MS spasticity and muscle spasms, and a recent review done by the American Academy of Neurology gives such notions the official stamp of approval (click here). The AAN found that the demon weed does indeed reduce spasticity and muscle spasms, and the pain associated with these symptoms.

I’ve recently been plagued by an uptick in spasticity and muscle spasms, and the spasms in particular have been driving me crazy. So, though Mary Jane is still illegal in New York State even for medicinal purposes, based on the above study I decided to imbibe in a little reefer madness. Lo and behold, my spasms took a powder and my spasticity loosened its grip.

Truth be told, even as a teenager I was never much of a stoner, though wild and unsubstantiated rumors have it that I occasionally imbibed in some other illicit substances back in the quixotic days of my wayward youth. Hey, I was a teenager and young adult in the 70s and 80s, which were the “say yes to drugs” era. Anyway, as far as sparking up a little boo goes, based on the above study and my own anecdotal experience I see no reason not to give it a try, but if you do, don’t Bogart that joint, my friend…

BTW, despite what the video says, the song is by the band Fraternity of Man, not Country Joe and the Fish. My guess is the person who made the video was probably all goofed up on muggles when they put it together.

♦ Another recent article I came across touched close to home. Between 1993-1995 I worked in a “sick” building which eventually needed to be decontaminated by experts in hazmat suits. In a despicable attempt to save money, the bastards who comprised my company’s upper management withheld a report that said that our building was rife with all kinds of molds and bacteria. I’ve long suspected that my exposure to these nasties played a role in my developing much of the physical crap I’ve been dealing with over the last 15 years or so, and a recent article by an environmental hygienist might just validate my suspicions (click here). The article claims that toxic mold has been associated with MS and other autoimmune diseases, and a quick search around the Internet yielded a few other pieces making similar connections (click here). Granted, the article that originally caught my attention was written by somebody who profits from diagnosing sick buildings, but it isn’t hard to imagine that being exposed to all kinds of toxic muck for an extended period of time could lead to a wide variety of medical problems. And the kicker is that I hated that freaking job…

♦ The good folks at have put together a page full of infographics illustrating “Multiple Sclerosis by the Numbers: Facts, Statistics, and You” (click here). The page delves into statistics and information related to MS disease prevalence, risk factors, and the frequency of the different types of MS, along with symptoms and treatment options. It’s a great primer for all things MS, and highlights some interesting and beguiling facts about the disease. I think my favorite illustration is this one, which starkly demonstrates just how more prevalent MS is in northern regions than southern, using a map of the United States as an example.

The above Infographic shows that people living in the northern half of the US are just about twice as likely to develop MS as those living in the southern states. The Infographic doesn’t go into some other interesting elements regarding the regional effect on MS, such as the fact that people moving from north to south before the age of 15 take on the lower MS risk factors associated with the southern region, while those moving after the age of 15 retain the North’s higher risk of MS. Riddle me that, Batman…

♦ Okay, it’s time once again for one of my favorite topics (drumroll please), ASININE RESEARCH! Scientists from the University of Kansas heroically decided to tackle the following mindbending question: “Is there an increased risk of hip fracture in multiple sclerosis?” (click here). My God, of all of the mysteries associated with MS, finally – finally – paid researchers have valiantly taken on a question that folks with even the scantest knowledge of the disease could answer in about two seconds. Wait – before I divulge their findings, please take a fraction of a second and see if you can guess the answer to this most vexing of inquiries.

Okay, after spending a few microseconds contemplating whether or not multiple sclerosis – a disease that can weaken limbs and thus make walking a bit, um, treacherous – might lead to an increased risk of hip fractures, did you come up with the startlingly radical answer of “yes”? If so, kudos to you, you are now an official multiple sclerosis researcher. You can pick up your certificate at the nearest sandwich shop.

Indeed, after reviewing over one million (!) hospital records of hip fracture admissions spanning a period of 20 years, our stalwart investigators found that MS patients were over twice as likely to suffer hip fractures than the population at large!!! Shocking, no? I mean, who could have possibly surmised that a disease whose symptoms include muscle weakness, spasticity, paralysis, numbness, and balance issues could ever lead those afflicted with it to fall down and break their hips? I only wish the researchers had been able to quantify just how more likely MS patients were to suffer scraped knees and bruised elbows. Inquiring minds want to know!

While I wait on tenterhooks for those revelations, let me try to save future researchers a whole lot of time and effort by answering some other enigmatic questions: Do people with MS have an increased number of visits to neurologists? Yes! Do bladder frequency/urgency issues lead people with MS to spend a ridiculous amount of time in the bathroom? Wait a second, I'll tell you as soon as I get back from the loo... Do bears shit in the woods, is the Pope Catholic, do some researchers seem to have nothing better to do than waste time and money for no apparent reason other than my amusement? Why, yes, yes, and yes! Now which sandwich shop do I go to to pick up my Nobel Prize?…

♦ I leave you, dear readers, with the following music clip, by the British artist Paolo Nutini. I’ve been listening to a lot of the new “retro” Soul and R&B, the best of which captures the spirit of the great music that was made between the mid-60s and early 70s. Being 50 and an old fart gimp who is almost completely divorced from pop culture, this new music has come as something of a revelation, like mana from heaven. Before running across the song, I was completely unaware of Paolo Nutini, but since the video has almost two million hits I suppose I missed something somewhere along the way. From what I can gather, Mr. Nutini is much better known in the UK than in the US, but then again, he could be a household name among twentysomethings here in the states and I’d never know it. Anyway, I think it’s a great song that definitely has that indefinable element called “soul”. It also includes a spoken word piece that comes from a speech in the 1940 Charlie Chaplin film The Great Dictator, a monologue which is as relevant today as it was 74 years ago. The Chaplin clip is well worth googling if you’ve never seen/heard it. I hope you enjoy the music…


  1. Thank you very much for your blog! I really like it!! And I love your photos. so very much!! You see in a beautiful way!! Keep doing it:) Lots of love

    1. Wow, you're very welcome, and a big thank you to you for your extremely generous words. They are very much appreciated.

  2. Thanks for posting Paolo Nutini's song. I'm UK based but only recently have become aware of him. As someone who is in her early 50s following and getting excited about new musicians is something relatively low on my list of priorities. However, occasionally someone new explodes on the music scene who makes a huge impression. In the last few years Amy Winehouse, Adele and now Nutini. There is a hint of Marvin Gaye in Nutini's singing. Sadly, can't listen to Amy's songs anymore, too upset about how she died. Also, her songs take me back when MS wasn't very prominent in my life and as things have got worse her music is even more poignant for me. Nutini is only 27, hope he continues to compose and sing as well as he has done so far. Best wishes.

    1. Yes, it does seem to get harder to keep up with new music as the years pile on. Amazing to think that a few decades ago I knew just about every new band out there, especially those in the "underground". Every era has its share of good and bad music, but I honestly think most of today's popular music is pure crap.

      That said, the neo-soul and R&B movement really lights my jets. Of course, this music sounds old, so maybe that's why I like it so much. You're absolutely right, I definitely hear Marvin Gaye in Nutini's phrasing and tone. Marvin's voice was much smoother, but I like Nutini's throaty rasp. The Amy Winehouse story is incredibly tragic. And everybody could see it coming…

      Thanks for the comments…

  3. As usual, your blog is chock full of info, humor and restrained (ahem) cynicism. Always entertaining to read, and more fun to "get" your personality. I don't have to tell you how many remedies, sanctified by the drug companies as well as alternative, sometimes crazy methods George tried to alleviate his MS progression. MJ was something he used, and unfortunately, it just made him a bit buzzed but never stopped the spasticity or pain. I used to sit in the same room and inhale the stuff and I am a drug wimp! Glad it helped you cause that pain is more than miserable. Love you....Hilda

    1. Hilda, did you get my personality? If so, please return it. It somehow got out of its cage in the middle of the night and ever since then I've simply been too dull to bother to look for it.

      As you know, I'm well aware of George's attempts at finding some kind of respite from the disease, and although he sometimes acted out of desperation, nothing he did was crazy. In fact, I'm not sure anything anybody does to try to get rid of this beast is crazy. I'd crawl up the ass of a dyspeptic hippo if I thought it might help…

      Love you too…

    2. Yep, I found it and I have it in a pretty little box, saved for when you need it back. No wonder you and George were friends....two looney but clever tunes!

  4. Forgot to mention, your photos are really beautiful and touch my inner soul.

    1. Thank you. I'm working on a batch of photos that I took last summer, should be posting them sometime soon. Haven't been out shooting this year, yet, and I'm a little nervous that my increasingly weak and numb working hand won't be up to the task. I'll probably have to scale back my photo activities, just more adapting and adapting and adapting…

  5. Whoa...a WK Asinine Research rant AND good music I'd never heard of before. Loved that Chaplain quote too. Thanks!

    1. Glad I was able to provide some interesting stuff for your brainpan. The Chaplin clip is really exceptional, I probably should have posted it but I usually try to avoid politics on these pages and the speech could be inspiring to some and too much to take for others. It is remarkable how relevant his words still are after all these years. Maybe I shouldn't be such a wuss…

  6. Whew, this will be a long read. I'll start it in a few minutes. But wow there was a lot of scrolling. I can't wait to absorb all of your information.

  7. Interesting info about Tecfidera. I've taken it myself since around last August (estimate). At the start, I had strong skin flushing in my face/shoulders. It looked like sunburn from the outside, and I could feel my skin radiating warmth, much the way it feels when actually having a sunburn. This side effect would typically last for 30 minutes, (an hour or two after taking the medication), before going away completely. However, I haven't had any side effects at all this year. Regardless of how I take the medication.

    However, I was recently (March '14) diagnosed with Rheumatoid Arthritis, and this is a MAJOR pain in my ass. I wake up in agony almost daily. It's to the point where I feel like not taking Tecfidera any longer and focus on a stronger arthritis medication and a lesser MS one. I just don't know. The issue is that both medications I'm on affect the white blood cell counts, so I need to keep them in check. Fun times... And to think that I'm only 32 yet walking around as if I were 60-70.

    This has me wondering if taking the various medication that's been prescribed to me is actually causing more issues than not taking it.
    What are your thoughts? And has their ever been a study about what effects multiple "harmless" medications have on otherwise healthy people?

    1. Jonathan, so sorry to hear of the rheumatoid arthritis diagnosis on top of your MS. As far as whether or not these medications can cause more issues than they solve, I'm pretty sure that nobody really quite knows. A lot of these biologic drugs are so new that their long-term effects are a complete unknown. Keep in mind that most medical trials only last for two or three years, and patients will have to be on these medicines for an indefinite amount of time. In effect, we are all guinea pigs… Problem is, doing nothing is a pretty terrible option, also, especially for people with more aggressive disease. Quite the quandary…

      Make sure you keep on top of those white blood cell counts, as Tecfidera alone can sometimes drop them to dangerous levels. Wishing you the best…

    2. I wanted to give an early update. I've realized that the arthritis medication isn't making me feel any better. In fact, I went from irritating hand cramping to full body crippling pain once I began taking the 4 medications they prescribed for me. It was 2 at first, but if that didn't work, they stacked other things on while telling me to keep taking the earlier versions. As a result, I'm on 5mg Prednisone 2x daily to help with pain, then actual Arthritis medicines are Naproxen 2x daily. (this is a general joint swelling thing), Hydroxychloroquine 2x daily (Some type of arthritis medication), & finally, Sulfazine 6x daily (I'm not 100% sure what this does, but supposedly it helps). And I still have to pop 6 Tylenol & 6 Advil per day to help with the pain. All this shit must be destroying my liver.

      Well, I guess I should say "was" taking this stuff. I decided that the arthritis medication wasn't making my life any better. In fact, it seemed to make things drastically worse in a matter of weeks once I officially began taking it. As a result, I've decided to go cold turkey on almost all of it. It's been 2 days now, and I haven't noticed any differences from when I took it to when I'm not taking it. With one exception. I went out to dinner last night, and wasn't in pain at all while there. And typically, morning and night I regress down to an "ouch, leave me alone" state. For what it's worth, I'm still taking the prednisone, advil and tylenol, but the rest of the stuff is off my daily dosage. I plan on waiting it out a week or two and seeing how I feel once the medications are actually purged from my system. But as of right now, there's no difference. With that in mind, I don't see a reason to continue taking this stuff.

  8. I truly appreciate this site with your humour and challenges to the BIG PHARMA INDUSTRY. Thank you for introducing us to wonderful music and great photography. My husband Michael is a great Canadian artist who has had a 12 year battle with metastatic melanoma and he paints with his affected left arm (lymphadema). I was diagnosed with essentially SPMS three years later. My background is ICU, DIALYSIS and BURN UNIT and I consider the toxins I encountered. We live in beautiful LIONS BAY, BC on the SEA TO SKY
    HIGHWAY to Whistler. There is a forest full of moses and mildew. And there is RAIN and less vitamin D.
    Grew on family farm and both sides of family have MS with several cousins. Exposure to fertilizers, pesticides and other bacteria
    in lovely earth.
    I currently do not take any MS drugs...........but I ponder it. Do not trust the PHARMA STUDIES and STATISTICS.
    Good luck with your choices and please advise.

    1. So sorry to hear of you and your husband's medical problems. That's an awful lot to handle. Would love to see some of your husband's artwork, if it's available on the web.

      As you know, Canada has one of the highest rates of MS in the world. The fact that you have other family members with the disease certainly indicates that you carry genetic susceptibility, and certainly something you encountered set the MS disease process in motion. There probably isn't any one trigger, but a whole host of viruses, toxins, and other environmental elements that come into play.

      As for the MS drugs, if you were RRMS I would definitely recommend you start on one of the more effective therapies. More and more evidence suggests that early treatment is the key to keeping progression slowed down, if not in check entirely. Like you, I'm skeptical of many big Pharma funded studies and statistics, but unfortunately they are all we have to go on. Having been in contact with many, many MS patients, though, anecdotal evidence does point to drugs like Tysabri having a very positive effect on quality of life, at the very least, for many patients. Of course, there are risks involved with all of these drugs, so each patient must do a careful risk/reward assessment of their own.

      Since you have SPMS, the question is more tricky. There currently aren't any approved therapies for SPMS, but several are in trials now. As the above post notes, an early-stage trial of Tysabri in SPMS seems promising, and Gilenya is also being tested on progressive patients. Tecfidera might have neuroprotective and strong antioxidant properties, so that may be something to consider as well. My personal take, having very aggressive progressive disease, is that doing nothing is not an option. But that's just me, not sure there any right or wrong answers…

      My neurologist is a big proponent of intrathecal methotrexate for progressive MS patients (you can search for posts on this using the search box in the upper left corner of this blog page), and he's had success using this treatment. It's quite controversial, and many neuros are resistant to trying it, but it does seem to work for a large proportion of patients, at least those under my neurologist's care…

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  10. Hey Marc,

    Once again I'm a day late and a dollar short. Just wanted to say Hi and let you know I still adore you. Really enjoyed Nutini, I'm forwarding it others. Things have been quite good here the past few weeks, I'll have some exciting news the next time I email you. No, Cindy's not pregnant.


    1. Hi Charlie, I appreciate the adoration and you know I adore you right back. Not quite in the way a man adores a woman, but I think we understand each other. Not that there's anything wrong with same-sex adoration, I firmly believe that people should be able to adore who they want, when they want, where they want… It's also adorable.

      Glad you enjoyed the video, I'll post some more music in this vein in future posts.

      Send me that email, can't wait to hear your news…

  11. Hi Marc,
    As usual, great post. Thanks for making us aware of Nutini. Being and old rock musician, I'm a fan of the 'neo soul' movement - especially like Mayer Hawthorne.
    I don't see an mention of the Tisch MSC trial that's starting up - do you know where things stand with this?

    1. Glad you enjoyed the video. I also was in a band back in the day, was the lead singer of a post punk outfit in the mid-1980s. I do like Mayer Hawthorne. Also a big fan of Charles Bradley, Sharon Jones, and pretty much everything that's on the Daptone label. Listening to some Michael Kiwanuka right now, good stuff, slightly different vein…

      The Tisch Center MS trial successfully completed their fundraising efforts, and I believe the trial has enrolled all of its test subjects. I've been in touch with a few who are getting ready to get their first stem cell injections. I don't think any results will be released for at least six months, but I will post them as soon as I get them…

  12. Great Blog entry again Marc. I'm on Tysabri (49th infusion) - admin a FB page for Ty Support ( that has almost 2900 Ty users or those just getting ready to start. Many have chosen/Dr. forced to come off Ty due to High Titers and switched to another drug such as Tecfidera or Gilyenia and many have come back to Ty. I wonder how many are $$/Dr driven or truly a health precautionary driven action.

    1. It's terrible to think that some medical professionals make decisions based on financial concerns, but of course we know that this kind of stuff goes on. That's why it's so important that patients find doctors who they can really trust. For MS patients the doctor-patient relationship is a long-term one, so it's imperative to find a good fit.

      Although my thinking about Tysabri has evolved based on the data that continues to come in, I'd still be quite concerned about patients on Tysabri who have high antibody titers. Especially if they've previously been on any kind of immunosuppressive drugs. Still, proper monitoring should go a long way towards keeping them safe, but I personally don't think I'd be comfortable staying on the drug once my antibody titers reached high levels. Just hoping everyone stays safe…

  13. i have been enjoying a marijuana tincture for the past month or so. no smoke in my lungs, my house doesn't smell like a college dorm, and it doesn't mess with my head. it just chills out my body stiffness and puts me to sleep. i am convinced that marijuana - in the right form and type - is a wonder, helping kids with grand mal seizures, people with MD, etc. kudos to the AAN for getting on the bandwagon.

    1. Agreed, kudos to the AAN on their marijuana epiphany, and also, it's about time. Where do you get your marijuana tincture? Do you live in a state in which medical marijuana is legal?

      I just purchased a vaporizer, which heats the weed to less than combustible temperatures, but high enough that it still releases the active components of cannabis. So, no smoke, much easier on the lungs, and none of the telltale aroma. Definitely still gets the job done as far as spasms and spasticity go, and I think it might even enhance the strength of the stuff… Long story short, the vaporizer gets me pretty stoned, which I'm actually not all that thrilled about, but it's a sacrifice I'm willing to make for the spasticity/spasm relief :-)

  14. Marc,
    Always more learning from your blog!!
    Now for one more:
    H.P Acthar® Gel (repository corticotropin injection), USA cost $36,000
    For a five ml bottle. Have you had any experience with this? Questcor Pharmaceuticals main drug. Now Questcor Acquired By Mallinckrodt for $5.6 Billion -
    To early to say yes or no on my personal results.

    The other taboo subject:
    Marijuana... something all my drs agreed upon would help my spasticity. I am on maximum baclofen pills, Gabapentin, and a list of medicines. Never smoked. Culinary seems easy to decarb and change the chemical compounds, then use grain alcohol to absorb properly, stripping the usefull cannibinoids, leaving me a tincture

    Tinctures, figured if I made them, i would know what was in them, and not some crazy items that are scary to read on the internet of what some people use to strip the weed, and you never know what you get.
    The type of weed makes a diference, and the strength of the potion. The longer it sits, the better. Let natural evaporation, if wanting a concentrate. Do Not use heat to speed things up, as that % of alchohol is combustible. Lots of reading, and shortcuts that wont work.
    Small cost effective batchs that age with notes, like making a half dozen cookies, instead of six dozen the recipie call for.

    On the opposite side, vaporizing? Let me in on what you use, would consider, just lost on what equipment or pipe type to use.

    1. Joey, this past fall I wrote an entire post on Acthar gel, after I had a disastrous encounter with it. Here's the URL:

      I'm using a vaporizer called the Puffit, easy to find using Google. Pretty easy to use, looks just like an inhaler, like for asthma. Available online at a bunch of outfits. The type of marijuana used does make a difference, I've found, and my current batch isn't really ideal, but it still helps…