The IC Underground

C. Lowell Parsons, MD, one of the most prolific IC researchers, has presented a fascinating study at this years AUA 2007 which offers an explanation as to why the IC bladder is struggling to heal. He determined that the TAMM-HORSFALL protein, which helps to repel irritating cations from the bladder wall, has less Sialic Acid than normal patients. Sialic acid provides the electrical potential that provides repelling power. The less Sialic Acid, the less protection offered. This is a fascinating study which may lead to new diagnostic methods and potential treatments.

Source: AUA 2007 Abstract - SIALIC ACID CONTENT OF URINARY TAMM-HORSFALL PROTEIN IS REDUCED IN INTERSTITIAL CYSTITIS PATIENTS

C Lowell Parsons, MD, Mahadevan Rajasekaran, PhD, Marianne Chenoweth, RN, BSN, Paul Stein, PhD. University of California, San Diego, San Diego, CA; Veterans Medical Research Foundation, San Diego, CA

Cyclosporine Shows Promising Results for IC in Brazil study

Researcher Jamil Chade & colleagues (Brazil) shared their experience using Cyclosporine A as a treatment for IC. They enrolled 36 patients in their study, who received 1.5 mg/kg of cyclosporine A, twice a day, for 12 months. The patients were re-evaluated for the symptoms (ICSI) and by urodynamics at 6 and 12 months of treatment.

The results showed a decrease in IC symptoms, as well as an increase in bladder capacity. All the patients had biochemical analysis before and after the treatment, and no abnormalities were found for liver and renal function.

The authors concluded “Considering the treatment of IC, cyclosporine A represents a new alternative. The good tolerance, safety, and promising results recommend the use of cyclosporine A for the treatment of IC.”

————–

Source: AUA Abstract [121] EVALUATION OF SYMPTOMS IN PATIENTS WITH INTERSTITIAL CYSTITIS TREATED WITH CYCLOSPORINE A

Jamil Chade, MD, Antonio M Lucon, MD, Daher C Chade, MD, Miguel Srougi, MD, PhD. University of São Paulo, São Paulo, Brazil

Interstitial cystitis patients in Illinois have a new support resource. IC patient Tracie Klug is launching her group in the Dekalb Illinois region! For information on location, date and time, please contact Tracie!

Dekalb Area IC Support Group
Group Leader: Tracie Klug
Phone: (815) 761-4902
Email: traciek79@yahoo.com

A full list of USA and Canada IC support groups, by state and province, can be found at: http://www.ic-network.com/forum/showthread.php?p=331610#post331610

Jill Osborne

I just had a visit from one of my favorite young interstitial cystitis and irritable bowel syndrome patients who shared that her father has been struggling horribly with hemorrhoids. They are SO bad and have progressed so far that he actually has to pop them back inside of his rectum several times a day. He’s only in his 50’s but is barely leaving the house now.

The question is.. why hasn’t he had them treated?? The answer is that he’s fearful of having examinations “down there.” Can’t blame him. None of us doing like having tests, etc.. in the bowel region. On the otherhand, when your life is being limited so badly… it’s time to bite the bullet AND take action.

Hemorrhoids CAN be treated, often with something as simple as a cortisone suppository. That’s what I use when mine occasionally act up and they work like a dream. Also, fair warning, hemorrhoids often occur as a result of straining due to constipation, colitis, etc. Thus, making sure that your bowel movements are regular and “soft” … rather than hard… is important.

Because so many IC patients have IBS, we also have to remember that some of the traditional constipation remedies (i.e. metamucil, bran cereals, etc.) don’t work well for us because they are often too harsh, often contain insoluble (harsher & more irritating) fiber and stimulate an IBS attack. We have to use a soluble fiber, that’s more gentle… and works very well for both diarrhea and constipation. I strongly recommend the Heathers’ Tummy Care Acacia Fiber.. which I use twice a day. It’s available in the ICN Shop and, for me, has dramatically controlled my IBS and reduced most hemorrhoid irritation, etc.

You can find it at: http://icnshop.com/cgi-bin/ustorekee…_Products.html

So, please don’t let embarassment stop you from getting care!!!! If sitting is painful due to hemorrhoids, please talk with your doctor. They can be treated easily and effectively. You shouldn’t be popping anything back in side down there.. if that’s happening, it’s time to get care!

Useful Links -

Lecture on IBS by Heather Van Vorous:
http://www.2006icpatientconference.com/transcripts.html

Emedicine article on Hemorrhoids:
http://www.emedicine.com/MED/topic2821.htm

NIDDK Hemorrhoid Info:
http://digestive.niddk.nih.gov/ddise…oids/index.htm

Jill O.

Premarin, an estrogen product, remains popular in the USA despite harsh and overwhelming evidence that its production is cruel. Premarin creams are also notorious for causing burning on the vulva due, in part, to the large number of preservatives, chemicals and/or fillers found in the product. I think it’s very important that we all look for more humane and pure options. In any case, the United Animal Nations has a section on Premarin that is eye-opening and will, I hope, encourage you to ask for other therapy from your

About Premarin

For more than 40 years, Premarin was the most popular drug in the United States, with doctors writing an estimated nine million prescriptions to treat menopausal symptoms. Because Premarin is made with estrogens extracted from pregnant mares’ urine (PMU), thousands of mares suffer to produce this bitter pill, and their byproduct foals don’t fare much better.

What happens to PMU mares?

The mares are forced to stand in narrow stalls with urine collection devices strapped to them for months on end. The stalls are deliberately narrow to prevent pregnant mares from turning or lying down and detaching the collection cups. Their water intake may also be restricted to concentrate the estrogen in the urine, which can lead to swollen legs, sore hooves and other health problems. Many of these mares get little or no exercise for the six months they are forced to stand in the barns. And, when they are too tired, too old or too surly to stand on the “pee lines,” the reward for their years of service is often a trip to the slaughterhouse.

What about the foals who are born every year?

The manufacturers of PMU drugs would like us to believe that the foals born as a result of these pregnancies are sold as companion animals. But there just aren’t enough homes for an estimated 7,000 unwanted foals each year. The fillies sometimes grow up to replace their worn-out mothers. But the colts are weaned from their mothers too early, and frequently sold to slaughter, their meat shipped to Europe for human consumption.

Don’t PMU ranchers have to comply with humane standards of care?

Unfortunately, no official body regulates the PMU industry. The North American Equine Ranching Information Council (NAERIC) represents horse breeders and ranchers engaged in the collection of pregnant mares’ urine. NAERIC produces a Code of Practice that outlines care guidelines for PMU mares, but following these guidelines is voluntary. And, one glance at the guidelines shows that they are woefully inadequate. For example, the recommended minimum stall width is only five feet, and exercise is recommended only “as necessary.”

What about the health risks to women?

The Women’s Health Initiative recently completed a 15-year study that revealed taking PMU drugs like Premarin and Prempro may lead to serious health problems such as heart attack, stroke, dementia and breast cancer. Given these findings, millions of women have stopped taking PMU drugs. Yet many continue to rely on these drugs to alleviate menopausal symptoms and Wyeth, the manufacturer of Premarin, continues to market them aggressively.

Please read Premarin: The Bitter Truth for more details, including alternatives for treating menopausal symptoms.

http://www.uan.org/documents/Premarin_The_Bitter_Truth.pdf

What can women do?

1. Talk to your doctor about ways to alleviate menopausal system through lifestyle and diet changes, or discuss synthetic or plant-derived HRT alternatives such as:

Cenestin
Estrace
Estraderm
Ogen
OrthoEst
Estratab
Menest
Estinyl
Estrovirus
OrthoDienestrol
Tace

For every 150 women who stop taking Premarin, one mare is spared from the “pee line” and seven or eight byproduct foals will not be slaughtered for their meat.

2. Spread the word about the Premarin industry and the dangers these drugs pose to women.Our Premarin: The Bitter Truth brochure contains valuable information and is great to leave behind at your doctor’s office. Order copies today at the UAN Store, or download a PDF.

Jill

This new study will assess the effectiveness of physical therapy for the treatment of pelvic pain. Eligible participants will be randomly assigned to receive either myofascial tissue manipulation or global therapeutic massage. Those receiving myofascial tissue manipulation will have targeted internal and external connective tissue manipulation focusing on the muscles and connective tissues of the pelvic floor, hip girdle, and abdomen. Those receiving global therapeutic massage will have non-specific somatic treatment with full-body Western massage.

Ages Eligible for Study: 18 Years and above, Genders Eligible for Study: Both

Inclusion Criteria:

- female and male patients who have failed to respond to previous therapies for interstitial cystitis/painful bladder syndrome
- male patients who have failed to respond to previous therapies for chronic prostatitis/chronic pelvic pain syndrome

Exclusion Criteria:

- neurologic disorder affecting bladder
- bladder cancer, prostate cancer, or urethral cancer

Locations:

United States, California
Stanford University Medical Center, Stanford, California, 94305, United States; Recruiting
Debra Clay 650-724-1753 dclay@stanford.edu
Angie Morey, MS 650-498-4240 morey@stanford.edu
Christopher Payne, MD, Principal Investigator
Rodney Anderson, MD, Principal Investigator

United States, Illinois
Loyola University Medical Center, Maywood, Illinois, 60153, United States; Recruiting
Judith Senka 708-216-8495 jsenka@lumc.edu
Marypat Fitzgerald, MD, Principal Investigator

Northwestern University Feinberg School of Medicine, Chicago, Illinois, 60611, United States; Recruiting
Darlene Marko 312-695-3898 dmarko@northwestern.edu
Quentin Clemens, MD, Principal Investigator

United States, Michigan
William Beaumont Hospital, Royal Oak, Michigan, 48073, United States; Recruiting
Eleanor Anton, RN 248-551-0885 eanton@beamont.edu
Kenneth Peters, MD, Principal Investigator

United States, Ohio
Cleveland Clinic Foundation, Cleveland, Ohio, 44195, United States; Recruiting
Donel Murphy 216-445-7505 murphyd1@ccf.org
Jeannette Potts, MD, Principal Investigator

Study chairs or principal investigators

John Kusek, PhD, Study Director, National Institute of Diabetes & Digestive & Kidney Diseases/National Institutes of Health
Leroy Nyberg, PhD, MD, Study Director, National Institute of Diabetes & Digestive & Kidney Diseases/National Institutes of Health

We’re always excited when we’ve finished another new issue of the Interstitial Cystitis Optimist. It reflects our approach to IC. We’re positive, encouraging, informative and, always, try to focus on support.

In this issue:

(1) New, Emerging Therapies for IC: An Interview With Dr. Robert Moldwin - This exceptionally long, eight page interview is with one of the most important IC clinicians and shares his thoughts on IC diagnosis and treatment. He shares his insight into new therapies currently emerging and also provides commentary on older therapies, such as DMSO, that are now falling out of favor. He also discusses the treatment of Hunner’s Ulcers. The author of the IC Survival Guide, Dr. Moldwin’s generosity and compassion towards the IC patient is legendary and this article provides superb information.

(2) About Eosinophilic Cystitis by Stacey Shannon - Eosinophilic Cystitis is a very rare form of cystitis that is often confused with IC. Patients struggling with EC find diagnosis easy but treatment far more challenging.

(3) IC Research News - Two important studies have been released this spring. Patients considering pregnancy will find a study by Dr. Deborah Erickson especially helpful as they consider the safety of medication use during their pregnancy. Still another study shares a rare complication to hydrodistention, bladder necrosis, that may be related to the use of silver nitrate during the procedure.

(4) Clinical Trial Announcements - Three studies of interest to ICer’s including a pain study, CellCept and the MaGIC study.

(5) FDA Warnings and Recalls - Two medications often used by IC patient (Detrol & Zelnorm)

(6) Fresh Tastes by Bev: Sometimes I Feel Like A Nut - Bev Laumann shares yet another superb article on the IC diet, this one discussing the pros and cons of nuts and their allergic and/or irritation potential to the bladder. She also provides two great new recipes!

(7) ‘I Need Help With This Pain’ by Frannie Rose - In yet another uplifting and encouraging feature, Frannie offers support for patients struggling with pain and ideas on how they can better manage that pain. Frannie is the author of ‘Fixing Frannie’ and one of our favorite columnists.

(8) Bathroom Giggles: The Ladies Room - A hysterical yet so common experience. You can all relate to this one and get a great laugh too!

24 pages
Published by the Interstitial Cystitis Network

Price: $10.00 in print
$8.00 by email

ICN Silver Subscriptions - $20 a year by email
ICN Gold Subscription - $40 a year by email, includes any special reports released that year
ICN Angel Subscription - $60 a year by mail or email, includes a 15% discount on purchases in the ICN Shop
ICN Professional Subscription - $80 a year by mail!

More info and to purchase your subscription or copy today, please visit: The ICN Shop

Urologic Diseases Cost Americans $11 Billion a Year

Bladder, prostate and other urinary tract diseases cost Americans nearly $11 billion a year, according to a new report from the National Institutes of Health. Medicare’s share exceeded $5.4 billion.

The five most expensive urologic problems — accounting for $9.1 billion — are, in descending order, urinary tract infections, kidney stones, prostate and bladder cancers and benign prostate enlargement, according to the authors of Urologic Diseases in America. The report was published online this spring and will be available in print and on CD in early May.

“This research sharply illustrates the immense burden of urologic diseases and the importance of studies to preempt disease processes and develop targeted treatments,” said Elias A. Zerhouni, M.D., NIH Director.

Five years in the making, Urologic Diseases in America stitches together a patchwork of reliable data, both new and previously published, revealing numbers of people affected, treatment patterns and economic cost.

TOP 10 DISEASES BY COST TOTAL
Infection (Women & Men) - $3.5 Billion

Kidney Stones - $2.1 Billion

Prostate Cancer - $1.3 Billion

Bladder Cancer - $1.1 Billion

BPH/Prostate Enlargement - $1.1 Billion

Urinary Incontinence - $463.1 Million

Kidney Cancer - $401.4 Million

Erectile Dysfunction - $327.6 Million

Prostatitis - $84.4 Million

Interstitial Cystitis/PBS - $65.9 Million

“The data have broad implications for quality of care and access to care and helps to inform discussions about health care and research needs,” said UDA coeditor Mark S. Litwin, M.D., M.P.H, a urologist at the David Geffen School of Medicine and School of Public Health at the University of California, Los Angeles.

Urologic Diseases in America describes more than a dozen diseases of children and adults, among them congenital abnormalities, erectile dysfunction, chronic prostatitis, interstitial cystitis, urinary incontinence and a chapter on sexually transmitted diseases, contributed by the Centers for Disease Control and Prevention. Findings include:

Medical care for nearly 12.8 million urinary tract infections in women alone costs nearly $2.5 billion annually. Adding the cost for men raises the total to $3.5 billion; Medicare’s share was $1.4 billion. Another $96.4 million was spent on 3.3 million prescriptions. More than half of all women will have an infection during their lifetimes. Reporting a trend toward using newer, and more expensive, fluoroquinolones raises concerns about increasing antibiotic resistance said UDA authors. And while only 20 percent of infections are in men, they are more often hospitalized and out of work about twice as long as women.

While hospitalizations, length of stay and the need for open surgery are declining for kidney stones, medical care still costs $2.1 billion annually, with another $4 million to $14 million spent on prescription drugs. Men are two to three times more likely than women to develop a stone, but more people of all ages and races are getting them: an estimated 5 percent of adults between 1988 and 1994, up from nearly 4 percent between 1976 and 1980. Compared to whites, African Americans and Mexican Americans have a 70 percent and 35 percent lower risk, respectively, of developing a stone.

Although data for childhood urologic diseases are scarce, urinary problems in children cost at least $75 million dollars a year. Vesicoureteral reflux, the abnormal flow of urine from the bladder up toward the kidneys, affects about 10 percent of all children and makes them prone to urinary tract infections and kidney damage. The cost of hospitalizations for reflux alone rose from $10 million in 1997 to $47 million in 2000; Southern states, defined using U.S. Census Bureau regions, saw the highest rise — 56 percent — attributable to a doubling in the number of cases.

“Our biggest challenge was finding reliable data in children,” said Christopher Saigal, M.D., M.P.H., Litwin’s coeditor at UCLA and RAND Health. “More research is needed in children.”

Urologic Diseases in America was funded by NIH’s National Institute of Diabetes and Digestive and Kidney Diseases and developed by a team of epidemiologists, health economists, statisticians, programmers and urologists.

Learn more about urologic diseases at http://kidney.niddk.nih.gov; click on statistics to find Urologic Diseases in America. UDA books and CDs may be ordered from the National Kidney and Urologic Diseases Information Clearinghouse at 1–800–891–5390, nkudic@info.niddk.nih.gov and at www.catalog.niddk.nih.gov.

The NIDDK, a component of the NIH, conducts and supports research in diabetes and other endocrine and metabolic diseases; digestive diseases, nutrition, and obesity; and kidney, urologic and hematologic diseases. For more information about NIDDK and its programs, see www.niddk.nih.gov.

The National Institutes of Health (NIH) — The Nation’s Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

The FDA warning below proves that patients must stay on alert when cruising the web for on-line pharmacies or suppliers. In this case, a group of 24 related websites appear to be distributing not only fake medications (i.e. pills made from just starch) but are also distributing different medications than what the prescription requires. This is incredibly dangerous.

You run serious risk if you use any pharmacy or online source that: (1) doesn’t have a phone available for contact, (2) appears to be run from outside the USA and (3) has pricing so far below the market that it’s clearly suspicious.

I’m going to throw in what I believe is another equally disturbing instance that is occuring to some interstitial cystitis patients.. buying an unlabelled herb, chinese herb or supplement from any provider, even those in the USA. If your doctor handed you a pill and refused to tell you what it was, I’m sure you would be cautious. Yet, when it comes to alternatives, many patients seem to throw their logic out the door. You should NEVER taken an unlabelled product AND you should atleast be informed of exactly what it contains. A statement of “herbs” is just not good enough. What herbs are included in that pill??

Jill O.

—-
The Food and Drug Administration (FDA) is cautioning U.S. consumers about dangers associated with buying prescription drugs over the Internet. This alert is being issued based on information the agency received showing that 24 apparently related Web sites may be involved in the distribution of counterfeit prescription drugs.

On three occasions during recent months, FDA received information that counterfeit versions of Xenical 120 mg capsules, a drug manufactured by Hoffmann-La Roche Inc. (Roche), were obtained by three consumers from two different Web sites. Xenical is an FDA-approved drug used to help obese individuals who meet certain weight and height requirements lose weight and maintain weight loss.

None of the capsules ordered off the Web sites contained orlistat, the active ingredient in authentic Xenical. In fact, laboratory analysis conducted by Roche and submitted to the FDA confirmed that one capsule contained sibutramine, which is the active ingredient in Meridia, an FDA-approved prescription drug manufactured by Abbott Laboratories.

While this product is also used to help people lose weight and maintain that loss, it should not be used in certain patient populations and therefore is not a substitute for other weight loss products. In addition the drug interactions profile is different between Xenical and sibutramine, as is the dosing frequency; sibutramine is administered once daily while Xenical is dosed three times a day.

Other samples of drug product obtained from two of the Internet orders were composed of only talc and starch. According to Roche, these two samples displayed a valid Roche lot number of B2306 and were labeled with an expiration date of April 2007. The correct expiration date for this lot number is actually March 2005. Pictures of the counterfeit Xenical capsules provided by Roche can be viewed at http://www.fda.gov/bbs/topics/news/photos/xenical.html.

Roche identified the two Web sites involved in this incident as brandpills.com and pillspharm.com. Further investigation by FDA disclosed that these Web sites are two of 24 Web sites that appear on the pharmacycall365.com home page under the “Our Websites” heading. Four of these Web sites previously have been identified by FDA’s Office of Criminal Investigations as being associated with the distribution of counterfeit Tamiflu and counterfeit Cialis.

At this point, it appears that these Web sites are operated from outside of the United States. Consumers should be wary, if there is no way to contact the Web site pharmacy by phone, if prices are dramatically lower than the competition, or if no prescription from your doctor is required. As a result, FDA strongly cautions consumers about purchasing drugs from any of these Web sites which may be involved in the distribution of counterfeit drugs and reiterates previous public warnings about buying prescription drugs online. Consumers are urged to review the FDA Web page at www.fda.gov/buyonline/ for additional information prior to making purchases of prescription drugs over the Internet.

The 24 Web sites appear on pharmacycall365.com.

AllPills.net
Pharmacy-4U.net
DirectMedsMall.com
Brandpills.com
Emediline.com
RX-ed.com
RXePharm.com
Pharmacea.org
PillsPharm.com
MensHealthDrugs.net
BigXplus.net
MediClub.md
InterTab.de
Pillenpharm.com
Bigger-X.com
PillsLand.com
EZMEDZ.com
UnitedMedicals.com
Best-Medz.com
USAPillsrx.net
USAMedz.com
BluePills-Rx.com
Genericpharmacy.us
I-Kusuri.jp

More info, please visit: http://www.fda.gov/bbs/topics/NEWS/2007/NEW01623.html

Alaven Pharmaceutical LLC (Marietta, GA) and Algonot, LLC announced that Alaven has acquired an exclusive license to manufacture and sell CystoProtek throughout the United States, its territories and possessions.

CystoProtek®, a patent protected, natural oral dietary supplement in softgel capsule form, has been clinically demonstrated to relieve symptoms associated with Interstitial Cystitis. The anti-inflammatory properties of the chondroitin sulfate, quercetin and rutin in CystoProtek®’s1 unique natural formula reduce bladder damage and pain, while its glucosamine sulfate, chondroitin sulfate and hyaluronate sodium help replenish the damaged glycosaminoglycan (GAG) protective layer in the bladder2,3. CystoProtek®’s beneficial effects in Interstitial Cystitis are believed to be due to this dual action4.

CystoProtek® is the result of years of research into Interstitial Cystitis by Theoharis Theoharides, PhD. Dr. Theoharides is a professor of Pharmacology, Internal Medicine and Biochemistry and Director of the Molecular Immunopharmacology and Drug Discovery Laboratory at Tufts University in Boston, MA (www.mastcellmaster.com). In two open label studies, CystoProtek® was well tolerated by patients ingesting 4-6 softgel capsules per day for 4-6 months and reported to be effective in reducing the pain and improving overall symptoms in many patients with Interstitial Cystitis 2,3.

About Interstitial Cystitis and Cystitis:
According to the National Institutes of Health, Interstitial cystitis (IC), also called Painful Bladder Syndrome, is a condition that results in recurring discomfort or pain in the bladder and the surrounding pelvic region. The symptoms vary from case to case and even in the same individual. People may experience mild discomfort, pressure, tenderness, or intense pain in the bladder and pelvic area. Symptoms may include an urgent need to urinate (urgency), a frequent need to urinate (frequency), or a combination of these symptoms. Pain may change in intensity as the bladder fills with urine or as it empties. Women’s symptoms often get worse during menstruation. They may sometimes experience pain with vaginal intercourse. IC often occurs together with other conditions, such as endometriosis, and is far more common in women than in men. Of the estimated 1 million Americans with IC, up to 90 percent are women.

Cystitis is inflammation of the urinary bladder. The condition more often affects women, but can affect either sex or all age groups.

Patients Using Cystoprotek:
Cystoprotek is available for purchase through the ICN Shop at: http://www.icnshop.com

References:
Issued patents include 6,689,748, 6,984,667, and 6,635,625. Other applications are pending.

Publications:
Theoharides TC, Vakali S, Kempuraj D, Sant R. A retrospective open label study of CYSTOPROTEK® in painful bladder syndrome/interstitial cystitis (PBS/IC). Proceedings NIDDK International Symposium: Frontiers in Painful Bladder Syndrome and Interstitital Cystitis (October 24-27, 2006; Bethesda, MD).

Theoharides TC. Treatment approaches for painflul bladder syndrome/interstitial cystitis. Drugs vol. 67:215-235, 2007.

Theoharides, TC, O’Leary M. Nutraceuticals in painful bladder syndrome/interstitial cystitis. Seminars in Preventive Alternative Medicine vol. 2:6-14, 2006

Theoharides TC, Sant GR. Immunomodulators for the treatment of interstitial cystitis. Urology vol. 65:633-638, 2005

Theoharides TC, Sant GR A pilot open label study of CystoProtek in interstitial cystitis. International Journal of Immunopathology and Pharmacology vol. 18: 183-188, 2005.

Results of the two studies indicate that CystoProtek® can be given to patients who have failed other therapies and can also be given with patients on other oral or intravesical therapies. There was stomach upset in less than 1% of subjects, especially those with concurrent irritable bowel syndrome (IBS). CystoProtek® does not offer substantial relief of pain and other symptoms before 90-120 days of use at 4-6 softgel capsules per day. CystoProtek® should best be taken with a meal and only in the suggested dosages. Patients allergic to eggs, soy, shellfish or olive oil should consult their doctor about CystoProtek®. CystoProtek® should be kept in a cool place or refrigerator away from children.

This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any diseases.