I just started Benicar. Why do I feel worse? What should I do?
About 25% of folks experience immediate symptomatic relief when they begin the Benicar blockade. About 25% feel no different. The other 50% will experience some adjustment symptoms.
Benicar has two actions, a palliative action by blocking the Nuclear Factor-kappaB cytokine pathway, and an action whereby it activates the VDR and gets the innate immune system working again.
The initial palliative action of Benicar is can be profound, but it will fade with time.
Th1 inflammation gradually increases the level of 1,25-D and your body, in order to maintain homeostasis, has begun somewhat accustomed to this abnormally high level. The Benicar blockade dramatically lowers 1,25-D quickly (by as much as half in just 2 weeks). 1,25-D is a powerful, secosteroid paracrine mediator that affects just about every cell in your body and interacts with many hormones.
Dr. Marshall has created a diagram summarizing some of the key relationships between the body's hormones and 1,25-D.
You can access it at http://autoimmunityresearch.org/hormones-bw.pdf
When the Benicar blockade is in place, many hormones must adjust their levels according to the new lower level of 1,25-D. This often causes temporary neurological-type symptoms such as (but not limited to) fatigue, dizziness, headache, photosensitivity, irritability, sleep disturbances, brain fog, etc. As your body adjusts to this hormonal shift these symptoms will dissipate and usually subside in a week or two. You've embarked on a serious treatment plan and need to respect the profound changes that are happening in your body.
Avoid lights during this hormonal adjustment period
You'll want to be extra careful to avoid sunlight/ bright lights during this time as it will increase the level of 1,25-D at a time when your body is trying hard to readjust to a more normal level. This would make you feel even worse. If you work you may need to take a couple of weeks off work until your symptoms stabilize. See Why does exposure to natural light increase symptoms?
Sunglasses
Do not start taking Benicar until you have your NoIR sunglasses. If you have started Benicar without adequate eye protection, you will need to stay indoors during daylight hours in a low lux environment. Regular sunglasses may provide some relief indoors if you eyes are symptomatic.
Immunopathology with Benicar alone
It's possible that the Benicar blockade alone is sufficient to allow your immune system to begin functioning effectively against the intracellular bacteria. In that case, you may also experience immune system reactions. See My immune system seems to be responding to Benicar alone. Why?
If symptoms are approaching intolerable, assess your natural light exposure, assess your symptoms and use your personal tool kit to be sure symptoms are not due to other factors besides immunopathology (sun exposure, lack of rest, exercise, diet, etc) that can be modified to reduce symptoms asap.
The recommended first step when symptoms have gone past tolerable is to increase Benicar.
Do not wait. Take an extra oral 40mg immediately. A hot drink (sugar-free chocolate or weak tea) will help the pill reach the stomach quickly.
Chewing the tablet and placing it under the tongue will promote faster absorption and quicker symptom relief. See How to make Benicar act faster.
If an extra oral or sublingual dose of Benicar does not work, do not assume that increasing Benicar to every 3-4 hours will not work.
If intolerable symptom/s persist, increase oral 40mg Benicar to every three or fours hours around the clock (set an alarm and use a dosette to avoid error). Continue until symptoms are tolerable.
During a 'crisis' situation, an extra 20mg of Benicar may be taken sublingually with each every three or four hour oral Benicar dose.
If increase Benicar isn't enough, you may be able to lessen your symptoms by beginning minocyline. The dose may need to be adjusted to maintain tolerable symptoms. See What to do when immunopathology (immune system reaction) is too strong.
When your Doctor orders Benicar, we recommend asking him/her to prescribe minocycline at the same time, to have in hand for use if needed.
As always, if our information does not provide the answer for you (be sure to click on all the links), please ask before you take action that is unfamiliar to you.
Discontinuing Benicar
If you are unable to tolerate the symptoms that occur with adjustment to the Benicar blockade, despite compliance with avoiding sun/lights, altering your Benicar schedule and adding minocycline, you and your doctor may decide to discontinue Benicar/minocycline and try again at a later date.
Note: It is okay to stop Benicar and minocycline suddenly but some folks will continue to experience immunopathology symptoms. Ask you doctor to help you palliate symptoms with standard medication.
In the meantime, continue to reduce your 25-D by avoiding all sources of ingested Vitamin D and diligently avoid sun/lights to reduce your level of 1,25-D. This may make it easier to tolerate the hormonal adjustment when you try the Benicar blockade the next time.
See also:
Benicar-Basic Information
Light Sensitivity-basic information
Pain Control
Last edited on Mon Nov 3rd, 2008 18:23 by Foundation Staff
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