Great piece Joomi! I admire people's abilities to translate science in a more approachable manner. I feel like my writings kind of get bogged down too deep into the jargon without deeply analyzing a lot of the nuance. There's a lot of appreciation to drawing comparisons between studies.
It's strange the type of battlefield that has arisen around Ivermectin. I will never state that people should use it because that's not my place (and something something medical advice) but the idea that practicing physicians are being blocked from practicing medicine is absolutely ludicrous. It's also quite frustrating that so many people who claim to understand a lot of the science around ivermectin shouting things such as "horse dewormer". I've pointed out multiple times in my posts that Ivermectin is a common ingredient in cat and dog dewormers, so why isn't it called a dog dewormer? How many people own cats and dogs vs those who own horses? There's a reason that label stuck because it makes the whole concept appear ludicrous to people who don't do their own analysis outside of anything within the mainstream media.
I should also remind the readers here that Ryan Grim made the claim that myocarditis is recoverable and it's a sign that the vaccines are working because inflammation is a sign that the immune system is responding! Yes, he legit said myocarditis is a sign that the immune system is working!
A few more things to point out.
I never understand the "worm" hypothesis. Quite frankly, it just feels like some sort of uneven comparison. How is it that Africa fares better because no worms means they are better at fighting off COVID, while we are told it doesn't work in the US because we don't have any worms here. Wouldn't that mean that "no worms" would be the baseline, and that Africans are "returning to baseline" by removing worms? How would you still explain why they are faring better? And if we get into talks about comorbidities then the issue would have been comorbidities aside from worm status!
I have written a bit about PAXLOVID and Ivermectin, here's one pertinent post to add to your argument about dosing:
One thing to point out is that PAXLOVID is using a P450 inhibitor called Ritonavir which prevents the protease inhibitor from being metabolized. However, Ritonavir targets the same P450 isozyme that metabolizes Ivermectin. If blood concentrations and half-life are an issue why not try Ivermectin with Ritonavir? Certainly we would at least have comparable data to PAXLOVID if we do so! Also, I posted Dr. Chris Martensen's video about Ivermectin's toxicity as well to highlight that point.
Overall, great post! I hope more people view it and at least attempt to dig a bit deep into the data rather than listen to whatever the media tells them.
I've been both fascinated and appalled at what seems to be a campaign against repurposed generics being used as COVID therapeutics.
Do you remember that campaign pharma launched warning people about the dangers of acetaminophen and how it's responsible for 50,000 ER visits each year?
Or that other one warning about the over use of antibiotics and how it promotes antibiotic resistant bacteria?
Yeah, me neither. Maybe they were too busy handing out opiods like Halloween candy. It's hard to believe this level of push back is simply because they think they don't work.
Thanks for an outstanding article summarizing the issue.
Thanks for sharing many fascinating things about IVM that I had not been previously aware of. I did kinda laugh out loud when I read about the adipose tissue (so men store their fat on the inside where it isn't seen and women store it on the outside). Honestly, it's a shame that people cherry-pick a tiny bit of information and use it to unequivocally disprove something. There's a lot going on in a human body and these in vitro studies just don't capture that. Anecdotally it does appear to be helpful for COVID and it really isn't harmful (which can't necessarily be said for the vaccines and newly approved COVID drugs) ... so why not?
TLDR, but I promise to take a crack at it later (I'm a former science/pharm writer/editor) but I'm currently working on a big article about CLIMATE (another area of massing DUPING by our EXPERTS). Reason being, Money Mike survived Covid and all variants with nary a thought of getting vaxxed, or even worrying about it that much because of my strong heart and lungs and everything else... but I would have tried ivermectin if I ever got really sick, which, I never did. Keep digging!
When I got Omicron, I took both Ivermectin 18mg b.i.d and hydroxychloroquine 200mg b.i.d (among other things) and I was pretty sick with fever and cough for ~5 days before getting better. I started on Day -3 (that is, when my wife tested positive, but three days before I became symptomatic). I was kind of disappointed in the fact that I got that ill at all, though I am grateful that as a 59yo man with a BMI of ~25 it was not worse. I sure do wish we had more, better studies to find the correct dose based on a large number of patient criteria. But alas, we will never know.
Joni are you aware of the active6 study? It’s looking at the effectiveness of IVM. I am actually enrolled. Came down with CoVID two weeks ago. Obviously I don’t know whether I am test or placebo, but my concern is by the time I got the meds most of my symptoms had resolved. I am also curious about the dosage. As it seems double what the FLCC recommends, and taken over a week could show some mild adverse effects that coupled with start of treatment, >5 days, would make IVM look less effective.
the efficacy of IVM is __very clear__ and beyond any reasonable doubt. Period.
The matter is settled after the following papers got published and after thousands of patients got treated with it.
Not mentioning any of the studies by world experts such as Tess Lawrie, Prof. Fenton, Flavio Cadegiani, etc. (but mentioning Alexandros Marinos, who's not an expert, just a techie) is beyond reprehensible:
Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines
From 21,232 subjects, ICU admission was significantly lower in the ivermectin group compared to controls among participants ≥40 year-old (1.2 vs. 2.0%, odds ratio 0.608; p = 0.024). Similarly, mortality was lower in the ivermectin group in the full group analysis:
One of the odd things about both hydroxychloroquine and ivermectin is that the proponents seem so awfully sure that they know the "right" dosing, timing, and combination with other drugs---even though there's no clinical evidence for any of that. Even worse, this certainty only emerges whenever (as is often the case) an RCT shows that the drug in question doesn't work. When it comes to low-quality observational studies showing a correlation between hydroxychloroquine/ivermectin and Covid rates, suddenly the dosage, timing, and combination don't matter at all--the only thing that matters is that a Japanese official said something positive about ivermectin, and then later Covid rates went down, or some such nonsense.
Another outstanding piece. Thank you!! Glad to be a paying subscriber of your work.
If someone else hasn't asked this, would you mind providing in the piece some references for Andrew Hill's conflicts of interest related?
Great piece Joomi! I admire people's abilities to translate science in a more approachable manner. I feel like my writings kind of get bogged down too deep into the jargon without deeply analyzing a lot of the nuance. There's a lot of appreciation to drawing comparisons between studies.
It's strange the type of battlefield that has arisen around Ivermectin. I will never state that people should use it because that's not my place (and something something medical advice) but the idea that practicing physicians are being blocked from practicing medicine is absolutely ludicrous. It's also quite frustrating that so many people who claim to understand a lot of the science around ivermectin shouting things such as "horse dewormer". I've pointed out multiple times in my posts that Ivermectin is a common ingredient in cat and dog dewormers, so why isn't it called a dog dewormer? How many people own cats and dogs vs those who own horses? There's a reason that label stuck because it makes the whole concept appear ludicrous to people who don't do their own analysis outside of anything within the mainstream media.
I should also remind the readers here that Ryan Grim made the claim that myocarditis is recoverable and it's a sign that the vaccines are working because inflammation is a sign that the immune system is responding! Yes, he legit said myocarditis is a sign that the immune system is working!
A few more things to point out.
I never understand the "worm" hypothesis. Quite frankly, it just feels like some sort of uneven comparison. How is it that Africa fares better because no worms means they are better at fighting off COVID, while we are told it doesn't work in the US because we don't have any worms here. Wouldn't that mean that "no worms" would be the baseline, and that Africans are "returning to baseline" by removing worms? How would you still explain why they are faring better? And if we get into talks about comorbidities then the issue would have been comorbidities aside from worm status!
I have written a bit about PAXLOVID and Ivermectin, here's one pertinent post to add to your argument about dosing:
https://moderndiscontent.substack.com/p/pfizer-releases-an-interim-report?s=w
One thing to point out is that PAXLOVID is using a P450 inhibitor called Ritonavir which prevents the protease inhibitor from being metabolized. However, Ritonavir targets the same P450 isozyme that metabolizes Ivermectin. If blood concentrations and half-life are an issue why not try Ivermectin with Ritonavir? Certainly we would at least have comparable data to PAXLOVID if we do so! Also, I posted Dr. Chris Martensen's video about Ivermectin's toxicity as well to highlight that point.
Overall, great post! I hope more people view it and at least attempt to dig a bit deep into the data rather than listen to whatever the media tells them.
I've been both fascinated and appalled at what seems to be a campaign against repurposed generics being used as COVID therapeutics.
Do you remember that campaign pharma launched warning people about the dangers of acetaminophen and how it's responsible for 50,000 ER visits each year?
Or that other one warning about the over use of antibiotics and how it promotes antibiotic resistant bacteria?
Yeah, me neither. Maybe they were too busy handing out opiods like Halloween candy. It's hard to believe this level of push back is simply because they think they don't work.
Thanks for an outstanding article summarizing the issue.
Thanks for sharing many fascinating things about IVM that I had not been previously aware of. I did kinda laugh out loud when I read about the adipose tissue (so men store their fat on the inside where it isn't seen and women store it on the outside). Honestly, it's a shame that people cherry-pick a tiny bit of information and use it to unequivocally disprove something. There's a lot going on in a human body and these in vitro studies just don't capture that. Anecdotally it does appear to be helpful for COVID and it really isn't harmful (which can't necessarily be said for the vaccines and newly approved COVID drugs) ... so why not?
TLDR, but I promise to take a crack at it later (I'm a former science/pharm writer/editor) but I'm currently working on a big article about CLIMATE (another area of massing DUPING by our EXPERTS). Reason being, Money Mike survived Covid and all variants with nary a thought of getting vaxxed, or even worrying about it that much because of my strong heart and lungs and everything else... but I would have tried ivermectin if I ever got really sick, which, I never did. Keep digging!
Also, you might be interested in this article from 2020. You probably have better sources, but Reuters reported this... and it all died. Never seen anything since. https://news.yahoo.com/maybe-too-soon-rule-hydroxychloroquine-062705897.html
amazing work!!
When I got Omicron, I took both Ivermectin 18mg b.i.d and hydroxychloroquine 200mg b.i.d (among other things) and I was pretty sick with fever and cough for ~5 days before getting better. I started on Day -3 (that is, when my wife tested positive, but three days before I became symptomatic). I was kind of disappointed in the fact that I got that ill at all, though I am grateful that as a 59yo man with a BMI of ~25 it was not worse. I sure do wish we had more, better studies to find the correct dose based on a large number of patient criteria. But alas, we will never know.
Joni are you aware of the active6 study? It’s looking at the effectiveness of IVM. I am actually enrolled. Came down with CoVID two weeks ago. Obviously I don’t know whether I am test or placebo, but my concern is by the time I got the meds most of my symptoms had resolved. I am also curious about the dosage. As it seems double what the FLCC recommends, and taken over a week could show some mild adverse effects that coupled with start of treatment, >5 days, would make IVM look less effective.
Joomi,
the efficacy of IVM is __very clear__ and beyond any reasonable doubt. Period.
The matter is settled after the following papers got published and after thousands of patients got treated with it.
Not mentioning any of the studies by world experts such as Tess Lawrie, Prof. Fenton, Flavio Cadegiani, etc. (but mentioning Alexandros Marinos, who's not an expert, just a techie) is beyond reprehensible:
Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines
https://journals.lww.com/americantherapeutics/fulltext/2021/08000/ivermectin_for_prevention_and_treatment_of.7.aspx
Bayesian Meta Analysis of Ivermectin Effectiveness in Treating Covid-19 (with sensitivity analysis to account for possibly flawed studies)
https://www.researchgate.net/publication/353794395_Bayesian_Meta_Analysis_of_Ivermectin_Effectiveness_in_Treating_Covid-19_with_sensitivity_analysis_to_account_for_possibly_flawed_studies
https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8415515/
Ivermectin Prophylaxis Used for COVID-19: A Citywide, Prospective, Observational Study of 223,128 Subjects Using Propensity Score Matching
https://www.cureus.com/articles/82162-ivermectin-prophylaxis-used-for-covid-19-a-citywide-prospective-observational-study-of-223128-subjects-using-propensity-score-matching
From 21,232 subjects, ICU admission was significantly lower in the ivermectin group compared to controls among participants ≥40 year-old (1.2 vs. 2.0%, odds ratio 0.608; p = 0.024). Similarly, mortality was lower in the ivermectin group in the full group analysis:
https://www.frontiersin.org/articles/10.3389/fpubh.2022.813378/full
One of the odd things about both hydroxychloroquine and ivermectin is that the proponents seem so awfully sure that they know the "right" dosing, timing, and combination with other drugs---even though there's no clinical evidence for any of that. Even worse, this certainty only emerges whenever (as is often the case) an RCT shows that the drug in question doesn't work. When it comes to low-quality observational studies showing a correlation between hydroxychloroquine/ivermectin and Covid rates, suddenly the dosage, timing, and combination don't matter at all--the only thing that matters is that a Japanese official said something positive about ivermectin, and then later Covid rates went down, or some such nonsense.