Group,

I try not to respond to often on this board, but I felt like I needed
to again, due to the questions I have seen on the board this past week
on ivomec.

There have been questions in regards to taking Eqvalan and Heartgard
orally or topically, and I want to explain why this might not be the
best or safest way to take ivermectin into the body.

I have had many private emails in regards to the issue of taking
ivomec, and want to clear the air again, as to what is acceptable and
advisable.

Also the most common question has by far been, where can a person
obtain ivermectin for human use at a reasonable price, and how can the
dosage be figured.

I will reclarify though, here intitially, for anyone that is
new..........I am not a physician, I am a veterinarian.

The reason that I always hesitate in posting anything in regards to
using any drug in the extra label use, is because the liablility of my
medical license, and also because I would hate to advicate something
that caused harm to any person.

We all want better treatments to help us deal with this disease and
that means we have to push the limits in finding things out for
ourselves, yet at the same time use common sense and good reasoning
skills in disregarding snake oil treatments.

So with that being said, I will answer the first question:

Eqvalan is a paste dewormer which comes in a 1.87% concentration.
This is equal to 18.7 mg/gram of ivermectin. The syringe usually
contains 6 grams of paste. To get 12 grams of ivermection a person
would need to ingest roughly 1/2 a gram of paste. This drug also goes
under the name Zimectrin.

Heartgard is a chewable ivermectin product for dogs and cats and
contains anywhere from 68 to 272 micrograms of ivermection per chew.
Micrograms is converted to milligrams by moving the decimal 3 places
to the left. Hence 68 micrograms is .068 milligrams. You can now see
why you would need alot of Heartgard to give any beneficial effects.

But the main reason I would not ingest these products is because they
are oral animal grade products.

Ivermection can be adsorbed through the skin but has to be in the
right carrier to get effective and consistant blood levels.
Revolution is an example of a topical canine and feline -mectin
product. But I will add, has fallen into disfavor in the medical
community due to is irregular absorbtion patterns.

If....I....were a person that was considering ingesting
ivermectin....I....would go to the feed store (for cows and horses)
and buy the injectable form of ivermectin called Ivomec which comes in
a 1% solution, this is a concentration of 10mg/ml.

If 12 mg was to be taken once weekly for 4 weeks then a person would
draw out 1.2 ml with a STERILE syringe, from this STERILE bottle, and
consume it with a meal once weekly for 4 weeks.

I want to reiteriate that this treatment will only possibly benefit a
small number of individuals who's symptoms are due to an overgrowth of
demodex.......BUT............due to this drugs absolute proven safety
in humans I would say that it would be worth a try. Also if anyone
had any roundworms, hookworms, or tapeworms it would be beneficial.
Especially if any of you have pets, or farm animals, or have traveled
outside any modern country to any lower sanitized environment. The
prevalence of these parasites are ubiquitous in our environments, and
no matter how clean you think you are, you could harbor these in your
body. I was just reading yesterday that ophthamologist are now seeing
an increase in ocular roundworm infections in the anterier chamber of
childrens eyes, due to their poor sanitation around pets. I council
all my parents of pets to worm periodically and routinely to keep the
probability of transmission to a minimum.

Anyway I still agree that demodex is a secondary problem due to a
underlying primary neurovascular disease process, but regardless, if a
person had the ability to put a stop to the exacerbation of their
symptoms then it would be worth the try.

ALSO.........the number one reason I see demodex flare in older dogs
is because of a physiological STRESS to the body. Whether that be
due to a new disease that the dog develops or to iatrogenic steriod
use. Anything that will lower the local dermal immunity will allow
for the overgrowth of demodex in the follicles. Cortisol is the
bodies natural stress hormone (steriod) produced by the adrenal
glands, yet when the body is externally stressed by physical or
psycological reasons then this excess cortisol lowers the bodies
natural defenses by lowering the ability of the immune cells to fight
of foriegn invaders i.e. prions, viruses, bacteria, fungus, yeast,
micoplasma, ehrlichia, parasites, or cancer cells. Prednisone is the
other unnaturally induced steriod which we all have to be leery of.
All of your immunomodulator drugs could possibly do this also, i.e.
Elidel.

Well, hopefully this helps, I also want to say a thank you to those
who emailed me with questions and appreciation.

Again these are only my opinions so please except them is just that.

Sincerely,

Dr. Young