Re: csm and extended release meds

[Guest guest]

When I took CSM 4x a day I always took it an hr. before eating and other

meds (per Dr. Shoemaker's instructions) and NEVER had any problems.

Pharmacists say differently but I always followed his directions.

>>>

extended release meds sit in small intestines, right? so taking csm even

2-4 hours after taking time released meds could be a problem...?

speaking specifically about toprol xxl (extended release) and this is

serious..

Robin

[Guest guest]

Re: CSM Protocol

per Dr. Shoemaker

1. On an empty stomach, take one scoop of CSM (9 grams), mix with

water, or juice, 4-6 oz

2. Stir well and swallow. Add more liquid, repeat 1 above until done.

3. Drink an extra 4-6 oz of liquid

4. After 30 minutes, you may eat or take meds (wait at least 2 hours

before taking thyroxine, digitalis, theophylline, coumadin and

others, ask your doctor for information)

5. Take CSM 4 times a day!

6. If you eat first, wait at least 60 minutes before taking your next

CSM

7. Reflux, constipation, bloating and bowel distress are to be

expected

8. Use acid blocking medications as needed

9. Use sorbitol, 70% solutions, 1 TBSP 3-4 times a day to relieve

constipation

[Guest guest]

I don't think anything 'sits' in your gi tract. It's constantly moving but

extended release, the ingredients are designed to release a little at a time,

have different coatings on them that allow some to release immediately and some

later and some later, etc. Yes, though, you should take far away from CSM. The

exact number I don't know. I think the most I have heard is six hours away from

certain types of drugs.

>

> extended release meds sit in small intestines, right? so taking csm even 2-4

hours after taking time released meds could be a problem...?

>

> speaking specifically about toprol xxl (extended release) and this is

serious..

>

> Robin

>

[Guest guest]

Does it them cross into the blood stream intact with the time release material?

Othewise, it is held longer in the small intestines .. doent not break down and

absorb as fast.

I cant find (1) does extended release pass into blood stream intact with time

release material or (2) how long does it remain in small intestines slow

releasing until it is moved out?

Ive had extreme tachy since taking csm and am wondering if this is an issue. I

separated by 2 hours either way. Now I have gone not onlye to hospital twice but

from 12.5 mg of toprol xl (metoptolol ER) to a recommended 50 mg in am and 25 in

pm. Thats a bit extreme and worrisome. I stopped csm now for a week?

I am barely comfortable.. pulse in 90s at 25 mg of extended release twice a

day.. this is how messed up my systrem got.

I dont know if related to csm or something else.

Robin

> >

> > extended release meds sit in small intestines, right? so taking csm even 2-4

hours after taking time released meds could be a problem...?

> >

> > speaking specifically about toprol xxl (extended release) and this is

serious..

> >

> > Robin

> >

>

[Guest guest]

were you taking any extended release meds that would have an effect on your BP?

I will check with several pharmacists. Extended meds act diff and I feel pretty

certain they remain in small intestines longer.. slow released, where as other

meds are most likely absorbed within 30 mintues.

Two hours may be sufficient.. I dont know. Im doubting one hour is, which is why

some instructions space out up to 4-6 hours from taking csm.

Robin

>

> When I took CSM 4x a day I always took it an hr. before eating and other

> meds (per Dr. Shoemaker's instructions) and NEVER had any problems.

> Pharmacists say differently but I always followed his directions.

>

> >>>

> extended release meds sit in small intestines, right? so taking csm even

> 2-4 hours after taking time released meds could be a problem...?

>

> speaking specifically about toprol xxl (extended release) and this is

> serious..

>

> Robin

>

>

>

>

>

[Guest guest]

everything is absorbed from the stomach because it's the first stop unless the

drug is enteric coated or delayed release. enteric coated tablets as well as

some delayed release products dissolve in the small intestine. some extended

release tablets or pellets release drug continually over 8-12 hrs.

***********************************

So... then what to do about the Toprol deleayed release and the csm...

Robin

[Guest guest]

Toprol-XL is selective, meaning it 'prefers'

beta 1 receptors. The drug comes in 4 strengths : 25,

50, 100, and 200 mg. The 100mg tablet is made of

hundreds of individually coated metoprolol pellets,

each of which is actually a separate delivery system.

Fluid penetrates the membrane of each pellet and

dissolves the drug.

The drug is released at a constant rate over

a 20 hour period, giving consistent blood levels over

the once a day dosing period.

???

>

> everything is absorbed from the stomach because it's the first stop unless the

drug is enteric coated or delayed release. enteric coated tablets as well as

some delayed release products dissolve in the small intestine. some extended

release tablets or pellets release drug continually over 8-12 hrs.

>

> ***********************************

>

> So... then what to do about the Toprol deleayed release and the csm...

>

> Robin

>

[Guest guest]

No, things are broken down in stomach so they can pass into the small intestine.

The small intestine is largest part of your digestive system and it is where

everything is absorbed. It takes a very long time for things to travel through

the small intestine bec it is very long. In the large intestine water may be

absorbed if you are dehydrated and may make you constipated but the large

intestine is not able to absorb nutrients and neither does the stomach. In the

stomach, stomach acids break down the food into a form that can go into small

intesting. That is all it does.

Search finds that Wikipedia at link below says 'most' things absorbed in small

intestine but I don't see any references to stomach doing anything but breaking

food down. It says small intestine is av 16 ft long. I think *ideally, a time

released capsule would by pass the stomach acid and start to dissolve at the

beginning of the small intestine and finish releasing it's medicine by the end,

whereas other medicine may be absorbed all at once at the beginning of small

intestine. I think if you ate a meal between when you took your time released

medicine and took your CSM and also given the couple hours, they should not meet

up with each other...but of course you should check w a pharmacist or doctor if

the medicine is critical. Perhaps csm is not even advised.

http://en.wikipedia.org/wiki/Small_intestine

>

> everything is absorbed from the stomach because it's the first stop unless the

drug is enteric coated or delayed release. enteric coated tablets as well as

some delayed release products dissolve in the small intestine. some extended

release tablets or pellets release drug continually over 8-12 hrs.

>

> ***********************************

>

> So... then what to do about the Toprol deleayed release and the csm...

>

> Robin

>

[Guest guest]

so csm is sweeping down the small intestines and is picking up bile the whole

time or just at beginning and do we know how long it takes to go through the

small intestines? Some delayed release like metoprolol take 20 hours to

complete.

I have a MD appt tomorrow.. maybe she will know.

I cant imagine people who take beta blockers cant take csm..

RObin

>

> No, things are broken down in stomach so they can pass into the small

intestine. The small intestine is largest part of your digestive system and it

is where everything is absorbed. It takes a very long time for things to travel

through the small intestine bec it is very long. In the large intestine water

may be absorbed if you are dehydrated and may make you constipated but the large

intestine is not able to absorb nutrients and neither does the stomach. In the

stomach, stomach acids break down the food into a form that can go into small

intesting. That is all it does.

>

> Search finds that Wikipedia at link below says 'most' things absorbed in small

intestine but I don't see any references to stomach doing anything but breaking

food down. It says small intestine is av 16 ft long. I think *ideally, a time

released capsule would by pass the stomach acid and start to dissolve at the

beginning of the small intestine and finish releasing it's medicine by the end,

whereas other medicine may be absorbed all at once at the beginning of small

intestine. I think if you ate a meal between when you took your time released

medicine and took your CSM and also given the couple hours, they should not meet

up with each other...but of course you should check w a pharmacist or doctor if

the medicine is critical. Perhaps csm is not even advised.

>

> http://en.wikipedia.org/wiki/Small_intestine

>

[Guest guest]

Maybe someone else knows or your doctor or maybe there is info on the net. I

really don't understand how CSM works down to the details like this but wish I

did. I think when food passes by the liver, the liver secretes bile into it if

there is fat present, as the bile is to digest fats (I think) so how the CSM

figures in here I don't know. I know it has worked/helped me. I FORGET

sometimes to eat something fatty half hour later. To me, it would seem logical

to eat something fatty WITH the CSM, not afterwards. If bile is secreted to

digest the fatty food, it seems the CSM would already have passed by!! I think

I'm pretty logical person but I have never been able to understand that and

wonder if it wouldn't be more effective if taken with fatty food but???

Interesting question but I don't know the answer to it. I like to understand

how things work like you do but I haven't been able to figure this one out

either. I just know it happens in the small intesting.

>

> so csm is sweeping down the small intestines and is picking up bile the whole

time or just at beginning and do we know how long it takes to go through the

small intestines? Some delayed release like metoprolol take 20 hours to

complete.

>

> I have a MD appt tomorrow.. maybe she will know.

>

> I cant imagine people who take beta blockers cant take csm..

>

> RObin

[Guest guest]

The most important thing is to follow Dr. Shoemaker's protocol. He knows

how it works & his directions are different than regular Drs/ pharmacies.

They don't understand that it is being used for something different than what

it was meant for. I'd follow his instructions only. Read Mold Warriors or

the new book that is coming out. May be that will help explain it better.

May be after taking the CSM for a while the BP medication won't even be

needed!

>>>

Maybe someone else knows or your doctor or maybe there is info on the net.

I really don't understand how CSM works down to the details like this but

wish I did. I think when food passes by the liver, the liver secretes bile

into it if there is fat present, as the bile is to digest fats (I think) so

how the CSM figures in here I don't know. I know it has worked/helped me.

I FORGET sometimes to eat something fatty half hour later. To me, it would

seem logical to eat something fatty WITH the